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Journal of Arrhythmia

Michael Spartalis, Eleni Tzatzaki Md PhD, Nikolaos I Nikiteas Md MSc PhD, Eleftherios Spartalis Md MSc PhD
No abstract text is available yet for this article.
December 2017: Journal of Arrhythmia
Mohammad Alasti, Karthikeyan Rangasamy, Stewart Healy, David Adam, Emily Kotschet
Here, we discuss the case of a man with a history of ischemic cardiomyopathy and cardiac resynchronization therapy defibrillator implantation, who presented to emergency department with decompensated heart failure due to the loss of resynchronization therapy. The reason for the malfunction was left ventricle upper rate interval lock-in due to inappropriate programming of the device.
December 2017: Journal of Arrhythmia
Hisaaki Aoki, Misugi Emi, Noboru Inamura, Shigemitsu Iwai, Futoshi Kayatani
Cardiac resychronization therapy (CRT) was performed via transvenous approach in a 2-year-old boy with a tetralogy of Fallot and postoperative severe heart failure, and complete atrioventricular block treated with a dual-chamber pacemaker. Epicardial leads were unavailable because of mediastinitis and the presence of severe bilateral pleural effusions requiring continuous drainage. There were no procedural complications. Biventricular pacing was significantly effective and both mediastinitis and pleural effusions recurred...
December 2017: Journal of Arrhythmia
Hiroki Konishi, Shumpei Mori, Tatsuya Nishii, Yu Izawa, Naoki Tamada, Hidekazu Tanaka, Kunihiko Kiuchi, Koji Fukuzawa, Ken-Ichi Hirata
Extracardiac structures can cause distortion of cardiac anatomy particularly in patients presenting with a significantly dilated heart, and/or thoracic deformities. We present the case of a 69-year-old woman with dilated cardiomyopathy who underwent cardiac resynchronization therapy. Preoperative electrocardiography-gated contrast-enhanced computed tomography revealed the inferolateral wall of her significantly dilated and leftward-rotated heart was close to the descending aorta, and the descending aorta compressed the sandwiched inferolateral branch of the coronary vein...
December 2017: Journal of Arrhythmia
Megumi Kisanuki, Kazumasa Fujita, Shohei Moriyama, Kei Irie, Chiharu Yosida, Mitsuhiro Fukata, Takeshi Arita, Taku Yokoyama, Keita Odashiro, Toru Maruyama, Koichi Akashi
A 53-year-old woman reported burning pain, muscle weakness, and dysesthesia of the left arm 2 months after permanent pacemaker insertion in the ipsilateral side for the treatment of sick sinus syndrome. Complex regional pain syndrome (CRPS) induced by pacemaker implantation was diagnosed. In 2017, her pulse generator became exhausted and was exchanged carefully to avoid exacerbation of CRPS, under the application of local anesthesia and premedication. Six months later, the patient's grip strength in her left hand remained lower relative to that in her right hand...
December 2017: Journal of Arrhythmia
Kunihiko Kiuchi, Koji Fukuzawa, Shumpei Mori, Tatsuya Nishii, Kensuke Matsumoto, Hirotoshi Ichibori, Takashi Yamada
Transvenous lead extraction (TLE) is performed to prevent deaths in patients with device infections. Intracardiac masses detected by echocardiography, i.e., "ghosts," are reported in 8% of patients after a TLE in retrospective studies and in 14% in prospective studies. We herein describe a case with unusual ghosts after a TLE. Three-dimensional computed tomography (3DCT) is useful for revealing all the details of unusual ghosts. In this case, the residual silicone insulation and "cast," including the fibrous sheath and severe calcifications could be visualized and differentiated by 3DCT...
December 2017: Journal of Arrhythmia
Jun Kishihara, Shinichi Niwano, Hidehira Fukaya, Ryo Nishinarita, Ai Horiguchi, Hironori Nakamura, Tazuru Igarashi, Naruya Ishizue, Tamami Fujiishi, Tomoharu Yoshizawa, Jun Oikawa, Akira Satoh, Masami Murakami, Junya Ako
Ventricular capture management is an automatic pacing threshold adjustment algorithm that automatically measures pacing threshold through detection of the evoked response after a pacing stimulus. Although it is principally designed to save device battery under the maintenance of the patient׳s safety, we experienced a rare case with serious pacing failure due to a weakness of this algorithm. This pacing failure might be explained by a large variation in the ventricular pacing threshold depending on the atrioventricular interval and daily variation of pacing threshold and concomitant steroid use in this patient...
December 2017: Journal of Arrhythmia
Yasushi Wakabayashi, Takekuni Hayashi, Yoshitaka Sugawara, Takeshi Mitsuhashi, Hideo Fujita, Shin-Ichi Momomura
A 74-year-old woman who developed atrial tachycardia following the Cox-Maze IV procedure underwent catheter ablation. The reentrant circuit included the coronary sinus (CS), Marshall bundle (MB), distal MB-left atrial (LA) connection, and anterolateral mitral annulus. The distal MB-LA connection was the last barrier in the conduction pathway between the CS and the left atrium.
December 2017: Journal of Arrhythmia
Shota Tohoku, Kenichi Hiroshima, Shoichi Kuramitsu, Michio Nagashima, Masato Fukunaga, Yoshimori An, Kenji Ando
We describe a case of radiofrequency ablation of ventricular premature contraction (VPC) originating from the left ventricular outflow tract after transcatheter aortic valve replacement. The VPC origin was the native aortic valve annulus between the left and right coronary cusps. Radiofrequency ablation was successfully performed by manipulating the ablation catheter from the gap between the sinotubular junction and implanted valve.
December 2017: Journal of Arrhythmia
Sit-Yee Kwok, Andreas Pflaumer, Sarah-Jane Pantaleo, Erin Date, Mangesh Jadhav, Andrew Mark Davis
Background: Due to its availability, atenolol is the primary beta-blocker used in Australia for children with long QT syndrome. There is limited data on long-term follow-up of its use. Methods: A single-tertiary-center, retrospective, observational study investigating all children and adolescents who had genetically proven long QT syndrome type 1 (LQT1) and type 2 (LQT2) was conducted. Their pretreatment exercise tests were evaluated for QTc intervals into the recovery phase of exercise...
December 2017: Journal of Arrhythmia
Tasuku Kuwayama, Hiroyuki Osanai, Masayoshi Ajioka, Kotaro Tokuda, Hirofumi Ohashi, Akihiro Tobe, Tatsuya Yoshida, Tomohiro Masutomi, Takahiro Kambara, Yosuke Inoue, Yoshihito Nakashima, Hiroshi Asano, Kazuyoshi Sakai
Background: Dabigatran is a direct thrombin inhibitor used to decrease the risk of ischemic stroke in patients with non-valvular atrial fibrillation (NVAF). Its prodrug, dabigatran etexilate (DE) is often co-administrated with a proton pump inhibitor (PPI) because of its adverse effects on the gastrointestinal tract. Drug-drug interactions between DE and PPIs in daily clinical practice have not been fully elucidated. Methods: Changes in blood dabigatran concentration (DC) were investigated using the dilute thrombin time test in a randomized, open-label, two-period crossover study including 34 Japanese patients with NVAF receiving dabigatran therapy with or without PPI...
December 2017: Journal of Arrhythmia
Kyoko Inao, Tadakazu Hirai, Keiko Nakagawa, Satoshi Numa, Kazumasa Ohara, Nobuyuki Fukuda, Koichiro Kinugawa, Hiroshi Inoue
Background: Smoking is a risk factor for cardiovascular diseases, but it is unclear whether smoking status, including environmental tobacco smoke, increases stroke risk in patients with atrial fibrillation (AF). Abnormalities of the left atrium (LA) and aortic atherosclerosis, as detected by transesophageal echocardiography (TEE), are risk factors for stroke and thromboembolism in AF patients. We investigated the impact of smoking status on thromboembolic risk by TEE in patients with nonvalvular AF...
December 2017: Journal of Arrhythmia
Naoko Yamaguchi, Yasuo Okumura, Ichiro Watanabe, Koichi Nagashima, Keiko Takahashi, Kazuki Iso, Ryuta Watanabe, Masaru Arai, Sayaka Kurokawa, Kimie Ohkubo, Toshiko Nakai, Atsushi Hirayama
Background: The association between circulating adiponectin levels and atrial fibrillation (AF) is uncertain. We, therefore, investigated whether an increased serum adiponectin level is implicated in the long-term recurrence of AF after ablation therapy. Methods: Our study included 100 consecutive patients (88 men; median age, 57.9±10.9 years) who underwent catheter ablation for AF at our hospital between 2011 and 2013. The adiponectin and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured before ablation and compared between those in whom AF recurred and those in whom AF did not recur...
December 2017: Journal of Arrhythmia
Mohammad Iqbal, Anupam Jena, Hee-Soon Park, Yong-Soo Baek, Kwang-No Lee, Seung-Young Roh, Jae-Min Shim, Jong-Il Choi, Young-Hoon Kim
Background: Recent studies investigating the implications of additional ablation guided by dormant pulmonary vein (PV) conduction testing using adenosine showed conflicting results, and the data about atrial fibrillation (AF) recurrence after trigger site elimination in adenosine-induced AF are still lacking. Methods: Of 846 patients with paroxysmal AF (PAF) who underwent PV isolation (PVI), adenosine test after PVI was performed in 148 patients. Results: PVI was successfully achieved in 846 patients...
December 2017: Journal of Arrhythmia
Eiichi Watanabe, Haruhiko Abe, Shigeyuki Watanabe
Implantable cardioverter-defibrillators (ICDs) improve the survival in patients at risk of sudden cardiac death. However, these patients have an ongoing risk of sudden incapacitation that may cause harm to individuals and others when driving. Considerable disagreement exists about whether and when these patients should be allowed to resume driving after ICD therapies. This information is critical for the management decisions to avoid future potentially lethal incidents and unnecessary restrictions for ICD patients...
December 2017: Journal of Arrhythmia
Masataka Sumiyoshi
Reflex syncope is the most common form of syncope that occurs while driving. The 2014 revision of Japanese Road Traffic Laws placed stricter driving restrictions, along with some associated legal penalties, on individuals with recurrent syncope. "Recurrent syncope" is defined as the occurrence of more than two episodes of syncope over a period of 5 years. No restrictions are recommended for private drivers unless they experience syncope without a reliable prodrome while driving or sitting. For commercial drivers, a driving restriction is recommended unless the efficacy of treatment can be confirmed...
December 2017: Journal of Arrhythmia
Ritsuko Kohno, Haruhiko Abe, David G Benditt
Capturing electrocardiograms (ECGs) during spontaneous events is the most powerful available tool to identify or exclude an arrhythmic cause of symptoms, and often can elucidate the definite diagnosis for different conditions, such as transient loss of consciousness (T-LOC), lightheadedness, or palpitations. Current ambulatory ECG monitoring technologies include 24-hour Holter, wearable event recorder, external loop recorder (ELR), and insertable cardiac monitoring (ICM). Of them, Holter ECG is most frequently used in daily practice in Japan, while ELR and ICM are less frequently used...
December 2017: Journal of Arrhythmia
Kaoru Tanno
The gold standard for diagnosing syncope is to elucidate the symptom-electrocardiogram (ECG) correlation. The ECG recordings during syncope allow physicians to either confirm or exclude an arrhythmia as the mechanism of syncope. Many studies have investigated the use of internal loop recorder (ILR), while few studies have used external loop recorder (ELR) for patients with unexplained syncope. The aim of this review is to clarify the clinical usefulness of ILR and ELR in the diagnosis and management of patients with unexplained syncope...
December 2017: Journal of Arrhythmia
Yukiko Nakano, Shimizu Wataru
Syncope, a common symptom of cerebral ischemia often shows a multifactorial etiopathogenesis. Although inherited arrhythmias causing syncope is uncommon, such an occurrence could be a warning sign preceding cardiac arrest. Long QT syndrome (LQTS) is a typical inherited arrhythmia causing syncope in children. Early diagnosis and treatment of LQTS using beta-blockers prevents recurrent syncope in LQTS. Brugada syndrome, another typical inherited arrhythmia causes syncope or sudden cardiac arrest in young individuals...
December 2017: Journal of Arrhythmia
Toshiyuki Furukawa
The tilt table test (TTT) is a useful method for the management of reflex syncope. However, the TTT is incomplete and has several problems. The indications for this test are established using guidelines. The TTT is not suitable for all syncopal patients. It is currently unclear (1) When should the TTT be used, (2) for which types of patients TTT should be performed, and (3) does the TTT provide useful information to guide indication for pacing therapy for reflex syncope. The answers to these questions appear in recent reports from two guidelines published by the European Society of Cardiology and the Japan Circulation Society...
December 2017: Journal of Arrhythmia
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