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Pacing and Clinical Electrophysiology: PACE

S Serge Barold, Andreas Kucher
BACKGROUND: Analog blanking periods (BP) that hold down the display of electrograms (EGM) in cardiac rhythm devices have received much less attention than the well-known digital blanking periods which do not influence the EGM display. In Biotronik devices, when a paced event initiates an analog BP in one chamber [right atrium (RA), right ventricle (RV) or left ventricle (LV)], an identical cross-chamber analog BP starts in the other 2 chambers. METHODOLOGY: All clinical observations were recorded from patients with Biotronik devices...
November 28, 2016: Pacing and Clinical Electrophysiology: PACE
Ajay Yadlapati, Susan S Kim, Bradley P Knight
No abstract text is available yet for this article.
November 21, 2016: Pacing and Clinical Electrophysiology: PACE
Yasser Rodriguez, Andrew D Althouse, Evan C Adelstein, Sandeep K Jain, G Stuart Mendenhall, Samir Saba, Alaa A Shalaby, Andrew H Voigt, Norman C Wang
BACKGROUND: Characteristics and outcomes of concurrently diagnosed new rapid atrial fibrillation (AF) or flutter (AFL) and new heart failure with reduced left ventricular ejection fraction (LVEF) are not well described. METHODS: A retrospective cohort study of subjects referred for expedited transesophageal echocardiography (TEE)-guided rhythm-control strategies for concurrent new AF/AFL and new LVEF ≤40% diagnosed during the same admission was analyzed. RESULTS: Twenty-five subjects (median age 57 years; 96% male; 100% Caucasian; median CHA2 DS2 -VASc = 2) presented with new AF (n = 18) or AFL (n = 7) with rapid ventricular rate (median 135 beats per minute) and new reduced LVEF (median 27%; range, 10%-37...
November 21, 2016: Pacing and Clinical Electrophysiology: PACE
Julia Collin, Varnavas Varnavas, Wilko WEIßENBERGER, Raimund Erbel, Nico Reinsch
BACKGROUND: The Reveal LINQ™ implantable cardiac monitor (ICM) is obviously smaller than its precursor (the Reveal XT™, but little is known about its long-term safety. Here we investigated the long-term R-wave sensing reliability of the Reveal LINQ™ ICM. METHODS: We analyzed the sensing quality of the Reveal LIN Q™ ICM over time between March 2014 and January 2015. RESULTS: A total of 30 patients underwent Reveal LINQ™ implantation...
November 11, 2016: Pacing and Clinical Electrophysiology: PACE
Enes E Gul, Usama Boles, Sohaib Haseeb, Benedict Glover, Chris Simpson, Adrian Baranchuk, Kevin Michael
Twiddler's syndrome is caused by patient manipulation of the cardiac implantable device (CID) around its central axis within the pocket resulting in retraction and dislocation of the electrodes. There are however some reports that Twiddler's syndrome may occur spontaneously without the patient`s manipulation (ref). This remains contentious as it may be argued that patients may not want to admit to manipulating the CID or may have been unaware of their actions. Recently, we have observed three very similar cases with a "spontaneous" Twiddler's syndrome resulting in lead displacement...
November 11, 2016: Pacing and Clinical Electrophysiology: PACE
Luigi Padeletti, Antonio Curnis, Claudio Tondo, Maurizio Lunati, Stefano Porcellini, Roberto Verlato, Luigi Sciarra, Gaetano Senatore, Domenico Catanzariti, Loira Leoni, Maurizio Landolina, Pietro Delise, Saverio Iacopino, Paolo Pieragnoli, Giuseppe Arena
BACKGROUND: Catheter ablation (CA) is recommended for patients with drug refractory symptomatic atrial fibrillation (AF). "One Shot" catheters have been introduced to simplify CA and cryoballoon-ablation (CBA) is spreading rapidly. Few real-world data are available on standard clinical practice, mainly from single center experience. We aimed to evaluate clinical settings, demographics and acute procedural outcomes in a large cohort of patients treated with CBA. METHODS: 903 patients (73% male, mean age 59±11) underwent pulmonary veins CBA...
November 10, 2016: Pacing and Clinical Electrophysiology: PACE
Bing Hu, Yanxiang Sun, Sha Li, Jie Sun, Tong Liu, Zidi Wu, L I Feng
BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia and an independent increased risk of stroke and death. Although the exact mechanisms of AF are not completely elucidated, a large number of evidences demonstrate that autoimmunity may play an important role in the initiation, the progression and the maintenance of AF. In this study, we aimed to compare Anti-β1-Adrenergic Receptor Autoantibody (anti-β1 -R) and Anti- M2-Muscarinic Receptor Autoantibody(anti-M2 -R) levels between non-valvular AF patients and healthy control subjects...
November 10, 2016: Pacing and Clinical Electrophysiology: PACE
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Syamkumar Divakaramenon, Bharatraj Banavalikar, Abhilash S P, Anees Thajudeen, Ajitkumar Valaparambil
No abstract text is available yet for this article.
November 10, 2016: Pacing and Clinical Electrophysiology: PACE
James Gabriels, Michael Wu, Lisa Rosen, Apoor Patel, Bruce Goldner
BACKGROUND: Permanent pacemaker electrograms record a variety of arrhythmias, including nonsustained ventricular tachycardia (NSVT). Little has been reported regarding incidence and clinical significance of NSVT in pacemaker patients after long-term monitoring. METHODS: Records from all patients implanted with Medtronic pacemakers (Medtronic, Minneapolis, MN, USA) at a single institution from January 1, 2009 to February 27, 2012 were reviewed. Demographic characteristics, imaging studies, pacemaker interrogations, and the Social Security Death Index were examined in patients older than 18 years of age who had ≥ 2 follow-up device interrogations...
November 3, 2016: Pacing and Clinical Electrophysiology: PACE
Usama Daimee, Yitschak Biton, Mehmet K Aktas, Faiez Zannad, Helmut Klein, Barbara Szepietowska, Scott McNitt, Bronislava Polonsky, Paul J Wang, Wojciech Zareba, Arthur J Moss, Valentina Kutyifa
BACKGROUND: Weight loss has been associated with adverse outcomes among heart failure (HF) patients, including those receiving cardiac resynchronization therapy with defibrillator (CRT-D). The effect of significant weight change on inappropriate implantable cardioverter-defibrillator (ICD) therapy among CRT-D patients is not well understood. METHODS: We evaluated the impact of significant weight change at 1 year on subsequent inappropriate ICD therapy during follow-up among 993 CRT-D patients enrolled in MADIT-CRT...
November 3, 2016: Pacing and Clinical Electrophysiology: PACE
Meryna Manandhar, Dmitry Nemirovsky, David Y Feigenblum, Grant R Simons
BACKGROUND: Medtronic implantable cardioverter defibrillators (ICDs; Medtronic Inc., Mounds View, MN, USA) are equipped with Patient Alert™, a feature in which the ICD generator emits a series of audible tones to notify patients of possible system malfunction. A prior study of this issue revealed that only 50% of patients with older Medtronic devices were able to hear alerts. More recently, Medtronic has incorporated modifications to the alert. Therefore, we studied how frequently alert tones emitted by the current generation of Medtronic ICDs are audible by patients...
November 3, 2016: Pacing and Clinical Electrophysiology: PACE
Vincenzo Russo, Andrea Antonio Papa, Anna Rago, Gerardo Nigro
No abstract text is available yet for this article.
November 3, 2016: Pacing and Clinical Electrophysiology: PACE
Abhishek Maan, Neal W Jorgensen, Moussa Mansour, Samuel Dudley, Nancy S Jenny, Christopher Defilippi, Moyses Szklo, Alvaro Alonso, Marwan M Refaat, Jeremy Ruskin, Susan R Heckbert, E Kevin Heist
BACKGROUND: During atrial fibrillation (AF), a high rate of myocyte activation causes cellular stress and initiates the process of atrial remodeling, which further promotes persistence of AF. Although heat shock proteins (HSPs) have been shown to prevent atrial remodeling and suppress the occurrence of AF in cellular and animal experimental models, increased levels of HSP-60 have been observed in patients with postoperative AF, likely reflecting a response to cellular stress. To better understand the role of HSP-60 in relation to AF, we examined the association of HSP-60 levels in relation to the future development of AF in the Multi-Ethnic Study of Atherosclerosis (MESA)...
November 3, 2016: Pacing and Clinical Electrophysiology: PACE
Chao-Feng Chen, Petras P Dzeja, Yong-Mei Cha, Wei Hua, Bin Chen, Xiao-Fei Gao, Yi-Zhou Xu
BACKGROUND: Heart failure (HF) is associated with changes in cardiac substrate utilization and energy metabolism, including a decline in high-energy phosphate content, mitochondrial dysfunction, and phosphotransfer enzyme deficiency. METHODS AND RESULTS: A shift toward glucose metabolism was noted in the end stage of HF in animals, although HF in humans may not be associated with a shift toward predominant glucose utilization. Deficiencies of micronutrients are well-established causes of cardiomyopathy...
November 3, 2016: Pacing and Clinical Electrophysiology: PACE
Ethan Bunting, Litsa Lambrakos, Paul Kemper, William Whang, Hasan Garan, Elisa Konofagou
BACKGROUND: Current electrocardiographic and echocardiographic measurements in heart failure (HF) do not take into account the complex interplay between electrical activation and local wall motion. The utilization of novel technologies to better characterize cardiac electromechanical behavior may lead to improved response rates with cardiac resynchronization therapy (CRT). Electromechanical wave imaging (EWI) is a noninvasive ultrasound-based technique that uses the transient deformations of the myocardium to track the intrinsic EW that precedes myocardial contraction...
October 27, 2016: Pacing and Clinical Electrophysiology: PACE
Nicole E Worden, Musab Alqasrawi, Alexander Mazur
BACKGROUND: Available atrial electrograms in implantable cardioverter defibrillators (ICDs) improve arrhythmia diagnosis, allow monitoring for atrial fibrillation, and may reduce the risk of inappropriate therapies. A recently introduced ICD system using a single-lead with floating atrial electrodes provides diagnostic capability of a dual-chamber system without placing an additional lead. Data on long-term clinical performance of this system are limited. METHODS: We retrospectively analyzed data from 35 consecutive patients implanted with Biotronik VR-T DX devices and Linox(Smart) DX leads...
October 24, 2016: Pacing and Clinical Electrophysiology: PACE
John D Fisher
In the words of the legendary late John Messenger, pacemakers have evolved from the equivalent of a pirate's peg leg that simply prevents you from falling down, to a fully articulated prosthesis. Each "ultimate" step has been succeeded by ever more sophisticated devices. Very early attempts at providing atrioventricular synchrony included metal wire connections between atrium and ventricle, and His bundle pacing with large screw-in electrodes. These efforts failed, largely because of poor conductivity, excessive fibrosis and loss of capture...
October 24, 2016: Pacing and Clinical Electrophysiology: PACE
James P Daubert
No abstract text is available yet for this article.
October 24, 2016: Pacing and Clinical Electrophysiology: PACE
Onur Kaypakli, Mevlüt Koç, Gökhan Gözübüyük, Durmuş Yildiray Şahin
BACKGROUND: Cardiac resynchronization therapy (CRT) was shown to improve heart failure (HF) prognosis. But many patients do not benefit from CRT. Optimization of left ventricular (LV) lead position to the latest activated LV area is important to increase CRT response. We aimed to detect the relationship between LV lead sensing delay and echocardiographic and electrocardiographic response to CRT treatment. METHODS: We prospectively included 156 consecutive patients with HF diagnosis, QRS ≥ 120 ms, left bundle branch block, New York Heart Association II-IV, LV ejection fraction (LVEF) < 35%, and scheduled for CRT (100 male, 56 female; mean age 65...
October 18, 2016: Pacing and Clinical Electrophysiology: PACE
Kaylin T Nguyen, Rachel A Gladstone, Jonathan W Dukes, Babak Nazer, Eric Vittinghoff, Nitish Badhwar, Vasanth Vedantham, Edward P Gerstenfeld, Byron K Lee, Randall J Lee, Zian H Tseng, Jeffrey E Olgin, Melvin M Scheinman, Gregory M Marcus
BACKGROUND: Atrial refractoriness may be an important determinant of atrial fibrillation (AF) risk, but its measurement is not clinically accessible. Because the QT interval predicts incident AF and the atrium and ventricle share repolarizing ion currents, we investigated the association between an individual's QT interval and atrial effective refractory period (AERP). METHODS: In paroxysmal AF patients presenting for catheter ablation, the QT interval was measured from the surface 12-lead electrocardiogram...
October 18, 2016: Pacing and Clinical Electrophysiology: PACE
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