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Pacing and Clinical Electrophysiology: PACE

Min Soo Cho, Jun Kim, Jung-Bok Lee, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim
Introduction The incidence and predictors of tricuspid regurgitation (TR) after permanent pacemaker (PM) implantations have not been well evaluated. We attempted to determine TR's natural course and predictors, especially focusing on the influence of atrial fibrillation (AF). Methods Data from 530 patients with dual-chamber PMs were evaluated. The main study outcomes were moderate to severe TR and isolated TR (moderate to severe TR without other structural heart diseases [SHD]) in follow-up echocardiography...
November 11, 2018: Pacing and Clinical Electrophysiology: PACE
Muhammad R Afzal, Sarah Horner, Nancy B Matre, Patricia Blake, Kari Dunham, Daniel Pinkhas, Toshimasa Okabe, Jaret Tyler, Mahmoud Houmsse, Steven J Kalbfleisch, Raul Weiss, John D Hummel, Emile G Daoud, Ralph S Augostini
BACKGROUND: Lead dislodgement (LD) is a well-recognized complication during implantation of cardiac implantable electronic devices (CIED). An intra-procedural protocol, referred as reduction of lead dislodgement (RLD) protocol, was developed to reduce the risk of LD. METHODS: The protocol involved i) inserting a straight stylet down the right atrial (RA) lead and applying forward pressure while monitoring for fluoroscopic stability, ii) visualizing all leads during deep inspiration to determine if there is adequate lead redundancy and iii) having the patient take a deep breath and cough while pacing just at capture threshold to assess for loss of capture in each lead...
November 10, 2018: Pacing and Clinical Electrophysiology: PACE
Krittapoom Akrawinthawong, Takumi Yamada
No abstract text is available yet for this article.
November 9, 2018: Pacing and Clinical Electrophysiology: PACE
Frank Pelosi
Lead Dislodgment is an important complication of CIED implant procedure. Creating a standardized protocol that can be adopted by providers is an important component of any quality improvement measure This article is protected by copyright. All rights reserved.
November 9, 2018: Pacing and Clinical Electrophysiology: PACE
Justin Gould, Magdalena Klis, Bradley Porter, Baldeep S Sidhu, Benjamin J Sieniewicz, Steven E Williams, Thomas Teall, Jessica Webb, Anoop Shetty, Jaswinder Gill, Christopher A Rinaldi
BACKGROUND: Transvenous lead extraction (TLE) may be necessary due to infective and non-infective indications. We aim to identify predictors of 30-day mortality and risk factors between infective versus non-infective groups and systemic versus local infection subgroups. METHODS: 925 TLEs between October 2000 and December 2016 were prospectively collected and dichotomized (infective group n = 505 vs. non-infective group n = 420 and systemic infection n = 164 vs...
November 9, 2018: Pacing and Clinical Electrophysiology: PACE
Vinit Sawhney, Alexander Breitenstein, Troy Watts, Jason Garcia, Malcolm Finlay, Martin Lowe, Ross Hunter, Mark J Earley, Richard J Schilling, Simon Sporton, Mehul Dhinoja
BACKGROUND: Transseptal puncture (TSP) is commonly performed under fluoroscopic guidance in left atrial ablation procedures. This exposes patients and healthcare professionals to deleterious ionizing radiation. We describe a novel technique for performing TSP non-fluoroscopically using a 3D mapping system only. The safety and efficacy of this technique is compared to traditional fluoroscopy guided TSP. METHODS: Retrospective, single-centre study of patients undergoing TSP for left atrial ablation...
November 5, 2018: Pacing and Clinical Electrophysiology: PACE
Antonio Madaffari, Anett Große, Elisabetta Conci, J Christoph Geller
Left atrial appendage (LAA) may be the source for initiation and maintenance of atrial fibrillation (AF). This report shows restoration of sinus rhythm in the atria during radiofrequency wide-area LAA electrical isolation, whereas AF persists in the LAA. This article is protected by copyright. All rights reserved.
November 5, 2018: Pacing and Clinical Electrophysiology: PACE
Hannah Garside, Francisco Leyva, Lucy Hudsmith, Howard Marshall, Joseph de Bono
BACKGROUND: Patients with adult congenital heart disease (ACHD) have an increased risk of arrhythmic, sudden cardiac death. The subcutaneous implantable cardioverter defibrillator (S-ICD) provides a potentially safer alternative to transvenous ICDs in ACHD. Suitability for S-ICD depends on the surface ECG which is often abnormal in ACHD patients. This study investigates the proportion of ACHD patients who meet the screening criteria for S-ICD METHODS: A standard screening ECG was performed in 102 patients with complex ACHD (Tetralogy of Fallot, Fontan Circulation, Transposition of the Great Arteries)...
November 5, 2018: Pacing and Clinical Electrophysiology: PACE
Muhammad R Afzal, Lauren Lastinger, Raul Weiss
No abstract text is available yet for this article.
November 5, 2018: Pacing and Clinical Electrophysiology: PACE
Selçuk Kanat, Hakan Çakır, Ahmet Tütüncü, Erhan Tenekecioğlu
We herein report a successful cryoablation of paroxysmal atrial fibrilation via right jugular vein in patient with interrupted inferior vena cava. We preferred cryoablation instead of radiofrequency ablation in the treatment of our patient. For stronger support in aiming the Brockenbrough needle toward to the septum, we manuallly curved the needle with a 120⁰ angle about 6 cm proximal to the tip. After successful septostomy, we performed balloon dilatation in the septal puncture zone to facilitate passage...
November 5, 2018: Pacing and Clinical Electrophysiology: PACE
Sunil K Sinha, Daniel Carlson, Jonathan Chrispin, Andreas S Barth, John Jack Rickard, David D Spragg, Ronald Berger, Charles Love, Hugh Calkins, Gordon F Tomaselli, Joseph E Marine
BACKGROUND: Pacemaker patients experience battery depletion and activate their alert for replacement notification. Automatic reprogramming at replacement notification can result in loss of rate response and atrio-ventricular (AV) synchrony. OBJECTIVE: Determine if relevant symptoms or clinical events may be associated with automatic reprogramming at replacement notification. METHODS: Electronic medical record review was undertaken for 298 patients referred for pacemaker generator replacement...
October 30, 2018: Pacing and Clinical Electrophysiology: PACE
Adam Lee, Joshua D Moss
No abstract text is available yet for this article.
October 28, 2018: Pacing and Clinical Electrophysiology: PACE
Ossama K Abou Hassan, Marwan M Refaat
No abstract text is available yet for this article.
October 26, 2018: Pacing and Clinical Electrophysiology: PACE
Mohammed Osman, Azza Ahmed, Hussam Alzubi, Babikir Kheiri, Khansa Osman, Mahmoud Barbarawi, Carlos F Ríos-Bedoya, Ghassan Bachuwa, Mustafa Hassan
BACKGROUND: Ventricular arrhythmias (VAs) are independently related to mortality risk in patients with heart failure (HF). The wide availability of implantable cardioverter defibrillators and cardiac resynchronization therapy devices now offer an opportunity to clinically correlate the two disease processes. We hypothesized that there is an association between changes in the intrathoracic impedance and episodes of VA. METHODS: Non-concurrent prospective study of adults (age > 20) with known HF with reduced ejection fraction (EF < 35%)...
October 25, 2018: Pacing and Clinical Electrophysiology: PACE
Deepak Padmanabhan, Krishna Kancharla, Majd A El-Harasis, Ameesh Isath, Nayani Makkar, Peter A Noseworthy, Paul A Friedman, Yong-Mei Cha, Suraj Kapa
BACKGROUND: Implantable loop recorders (ILRs) are effective in achieving symptom-rhythm correlation, However, diagnostic yield in routine clinical practice is not as well established. METHODS: Patients undergoing ILR implantation between April 2010 and May 2015 were included. All devices were enrolled in remote monitoring with automatic arrhythmia detection and P sense algorithms switched 'ON'. Symptom-rhythm correlation was assessed and changes in management were recorded...
October 25, 2018: Pacing and Clinical Electrophysiology: PACE
Wei Zhou, Long Wang, Bo Zhou, LiRong Wu
BACKGROUND: This study aimed to evaluate the effect of substrate modification in paroxysmal atrial fibrillation (AF) patients prior to circumferential pulmonary vein isolation (CPVI). METHODS: Patients without left atrial low-voltage and/or scar areas were defined as Group A. Patients with left atrial low-voltage and/or scar areas underwent regular CPVI (Group B) or substrate modification after CPVI (Group C). The procedural success rate and differences in the left atrial diameter (LAD) among groups were compared at 1 year postoperatively...
October 24, 2018: Pacing and Clinical Electrophysiology: PACE
Masato Shimizu, Hiroyuki Fujii, Makoto Suzuki, Noriyoshi Yamawake, Mitsuhiro Nishizaki
BACKGROUND: PR segment deviation (PRD: defined as PR elevation in aVR and PR depression in lead II/III) on electrocardiography is observed frequently in patients with acute pericarditis, however there have been few studies which explore the occurrence of PRD in patients with Takotsubo syndrome (TTS). The clinical significance of PRD in TTS is not clearly elucidated. METHODS AND RESULTS: A total of 52 consecutive patients with TTS in sinus rhythm (73.9 ± 13.8 years, 9 males) were enrolled in the study...
October 23, 2018: Pacing and Clinical Electrophysiology: PACE
Aman Gupta, Adetola Ladejobi, Mohammad Bilal Munir, Deepak Kumar Pasupula, Aditya Bhonsale, Krishna Kancharla, Norman C Wang, Sandeep Jain, Samir Saba
BACKGROUND: There is insufficient information about the long-term prognosis of sudden cardiac arrest (SCA) survivors. We therefore derived a clinical score (Sudden Cardiac Arrest - mortality score, SCA-MS) that predicts long-term mortality in patients surviving to hospital discharge and validated it in an independent cohort of SCA survivors. METHODS: Data was collected on 1,433 SCA survivors, discharged from the hospitals of the University of Pittsburgh Medical Center between 2002 and 2012...
October 21, 2018: Pacing and Clinical Electrophysiology: PACE
Amneet Sandhu, Joseph L Schuller, Wendy S Tzou, Alexis Z Tumolo, William H Sauer, Duy T Nguyen
A 62-year-old man was referred to our institution for high-density, symptomatic PVCs with resultant decrease in LV function having failed prior ablation attempts. Successful, durable ablation of the patient's mid-myocardial PVC arising from the LV summit region was achieved through the proximal great cardiac vein with ablation depth augmented by use of half-normal saline irrigant. Though standard ablation of ventricular arrhythmias using normal saline irrigation from the coronary venous system has been well-reported, this may be of limited value in addressing mid-myocardial sites of origin...
October 20, 2018: Pacing and Clinical Electrophysiology: PACE
Alexander R Mattson, Jorge D Zhingre Sanchez, Paul A Iaizzo
BACKGROUND: Today there is no manufacturer-supplied retrieval tool for the Micra™ pacemaker (Medtronic, Minneapolis, MN USA), therefore off-the-shelf catheters have been employed for retrievals. The proximal retrieval feature of the Micra™ can be snared and the device is then retracted from the myocardium, pulling the device through the tricuspid valve. This study characterizes the potential risks of Micra™ nitinol tine engagement with the tricuspid sub-valvular apparatus. METHODS: Fresh human hearts nonviable for transplant (n = 10) were obtained from our regional organ procurement agency (LifeSource, Minneapolis, MN USA)...
October 20, 2018: Pacing and Clinical Electrophysiology: PACE
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