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Journal of Arrhythmia

Serkan Cay, Firat Ozcan, Ozcan Ozeke, Serkan Topaloglu, Dursun Aras
No abstract text is available yet for this article.
June 2018: Journal of Arrhythmia
Federico Migliore, Giacomo Cavalli, Tomaso Bottio, Martina Testolina, Manuel De Lazzari, Emanuele Bertaglia, Sabino Iliceto, Gino Gerosa
We report a case of a 63-year-old man referred for lead extraction with the bidirectional rotational Evolution ® RL mechanical sheath because of systemic infection. As it was judged a "high-risk" procedure, we opted for a "hybrid," minimally invasive approach consisting in a minithoracotomic access. This technique is a feasible approach, and it might be a potential safer alternative in the most challenging transvenous lead extraction procedures.
June 2018: Journal of Arrhythmia
Ikuko Togashi, Toshiaki Sato, Kyoko Hoshida, Kyoko Soejima
A subclinical cardiac perforation by a device cup of the Micra™ transcatheter pacing system was suspected in a 78-year-old woman. During the procedure, the device cup was placed on the septum. The contrast media was injected before device deployment and remained outside of the myocardium. Later, a cardiac computed tomography scan visualized a protruded diverticular structure on the right ventricle. The contrast material remained in a pouch within the pericardium. To ensure the device is oriented away from the border between the right ventricular septum and the free wall, right anterior oblique view should be carefully reviewed before deployment...
June 2018: Journal of Arrhythmia
Debabrata Bera, Tejas Dharia, Aniruddh Trivedi, Anand Rao, Prashant Dilip Pawar, Neeta Bachani, Vihang Shah, Gopi Panicker, Yash Lokhandwala
Iatrogenic arteriovenous fistula is a unique complication during pacemaker implantation. A 55-year-old man was posted for pacemaker implantation for recurrent unexplained syncope with trifascicular AV block. After axillary/subclavian venous puncture and introduction of RV lead, arterial spurting was immediately noticed as the the sheath was peeled away. After dissecting the overlying pectoralis muscle, deep sutures and manual compression achieved hemostasis. However, Subclavian arteriogram revealed an arteriovenous fistula from a lateral thoracic artery branch to the innominate vein...
June 2018: Journal of Arrhythmia
Masatsugu Nozoe, Kazuo Sakamoto, Daisuke Nagatomo, Nobuhiro Suematsu, Toru Kubota, Masanori Okabe, Yusuke Yamamoto
Cardiac perforation by a transvenous lead is an uncommon but serious complication. We herein present a case of very late perforation of a Riata implantable cardioverter-defibrillator lead, which occurred 8 years after implantation. The patient was successfully treated with percutaneous lead extraction using an excimer laser. Lead perforation should be considered, even after years from implantation.
June 2018: Journal of Arrhythmia
Hiroaki Kise, Seiko Ohno, Yosuke Kono, Masashi Yoshizawa, Daisuke Harama, Asami Okafuji, Takako Toda, Keiichi Koizumi, Minako Hoshiai, Kanji Sugita, Minoru Horie
A 10-month-old infant experienced cardiac arrest caused by ventricular fibrillation (VF). His electrocardiogram (ECG) at rest was within the normal range. Amiodarone was indispensable due to its refractoriness to defibrillation. After implantable cardioverter defibrillator (ICD) implantation, ICD shock was delivered. ICD recordings documented VF and ventricular tachycardia (VT) triggered by premature ventricular contractions with an extremely short coupling interval (240 ms), which were controlled by verapamil...
June 2018: Journal of Arrhythmia
Adam Lee, James Lindemann, Oscar Davison, Daniel Wright, Russell Denman
Concealed accessory pathways (APs) are considered benign as they can only sustain orthodromic atrioventricular re-entrant tachycardia (ORT). We describe a unique case of a concealed posteroseptal AP where longitudinal surveillance following repeated failed ablation attempts due to abnormal coronary sinus (CS) anatomy revealed spontaneous development of manifest pre-excitation. The pathway was ultimately ablated via the percutaneous epicardial approach. The potential for development of Wolff-Parkinson-White (WPW) syndrome in patients with concealed APs has implications for ongoing surveillance in these patients...
June 2018: Journal of Arrhythmia
Takumi Yamada, George Neal Kay
A 64-year-old man with a history of congestive heart failure secondary to nonischemic cardiomyopathy, mitral and aortic valve replacements, and biventricular cardioverter-defibrillator placement, developed a tachycardia. The tachycardia exhibited a biventricular paced rhythm with a short R-P interval and concentric atrial activation sequence within the coronary sinus, suggesting that the tachycardia might be a pacemaker-mediated tachycardia (PMT). However, the tachycardia was diagnosed as counterclockwise cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL), and linear ablation of the CTI eliminated the tachycardia...
June 2018: Journal of Arrhythmia
Ryota Aoki, Masao Takemoto, Kazuta Nakasuga, Honsa Kang, Atsushi Tanaka, Takahiro Mito, Yoshibumi Antoku, Atsutoshi Matsuo, Satoru Hida, Teiji Okazaki, Kiyonobu Yoshitake, Kei-Ichiro Tayama, Ken-Ichi Kosuga
A 72-year-old woman with symptomatic and drug-refractory paroxysmal atrial fibrillation (AF) underwent radiofrequency catheter ablation (RFCA). She had a history of a total right lung excision. Her chest X-ray and computed tomography (CT) revealed a severely sight-sided dislocation of the heart. Thus, the procedure was carefully performed under guidance of a CT, intracardiac echogram, atriography, and 3D mapping system. Finally, the AF was successfully treated by RFCA without any complications.
June 2018: Journal of Arrhythmia
Toyokazu Otsubo, Takeshi Tsuchiya, Takanori Yamaguchi, Naohiko Takahashi
We here report a case of a 32-year-old man with genetically diagnosed myotonic dystrophy and persistent atrial fibrillation (AF) who underwent a low-voltage zone (LVZ) ablation. His cardiac function was normal except for a prophylactic pacemaker implantation for a high risk of complete atrioventricular block. An LVZ was found in the anteroseptal left atrium during sinus rhythm and was ablated during induced AF after a pulmonary vein antrum isolation, which terminated the AF and rendered it noninducible by rapid pacing and/or isoproterenol...
June 2018: Journal of Arrhythmia
Rintaro Hojo, Seiji Fukamizu, Satoshi Miyazawa, Iwanari Kawamura
A 73-year-old woman was admitted for atrial tachycardia (AT) ablation. The activation map and pacing study indicated that the AT propagated around the left pulmonary vein and that the Marshall bundle (MB) bypassed the scar area of the left pulmonary vein ridge and mitral isthmus. The Rhythmia Mapping System revealed double potentials propagated along the assumed position of the MB. The mapping system includes a confidence mask that can be used to visually identify low-confidence areas of the map based upon extremely low-voltage signals...
June 2018: Journal of Arrhythmia
Yasuharu Matsunaga-Lee, Sen Matsumoto, Nobutaka Masunaga, Yuzuru Takano
A 42-year-old woman without a history of catheter ablation or cardiac surgery was referred to our institution for a paroxysmal atrial tachycardia (AT). Programed stimulation could not induce any AT. The AT spontaneously initiated during a continuous isoproterenol infusion. The earliest activation during the AT was recorded at the cavo-tricuspid isthmus, and local abnormal atrial activity (LAATA) was recorded during sinus rhythm at that same site. When rapid atrial activity was recorded at the cavo-tricuspid isthmus where the LAATA was recorded, an AT was induced...
June 2018: Journal of Arrhythmia
Aki Saito, Seiko Ohno, Norihito Nuruki, Yuichi Nomura, Minoru Horie, Masao Yoshinaga
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is one of the leading causes of sudden arrhythmic death in the young. The QT interval in CPVT patients is typically within the normal range. However, those with prolonged QT interval have often been diagnosed with mutation-negative long QT syndrome (LQTS). We report three CPVT patients with prolonged QT interval. Case 1 and 2 were diagnosed as LQTS at first. Genetic test using next-generation sequencing (NGS) revealed RyR2 mutations. We should consider genetic test using NGS to identify the genes responsible for CPVT in mutation-negative LQTS...
June 2018: Journal of Arrhythmia
Azam Amirian, Zahra Zafari, Mohammad Dalili, Siamak Saber, Morteza Karimipoor, Samira Dabbagh Bagheri, Amir Farjam Fazelifar, Sirous Zeinali
Jervell-Lange Nielsen syndrome (JLNS) with autosomal recessive inheritance is a congenital cardiovascular disorder characterized by prolongation of QT interval on the ECG and deafness. We have performed molecular investigation by haplotype analysis and DNA Sanger sequencing in 2 unrelated Iranian families with a history of syncope. Mutational screening of KCNQ1 gene revealed the novel homozygous frameshift mutation c.733-734delGG (p.G245Rfs*39) in 2 obviously unrelated cases of JLNS which is probably a founder mutation in Iran...
June 2018: Journal of Arrhythmia
Surabhi Yadav, Salman Akhtar, Surendra K Agarwal, Gauranga Majumdar, Suman Vimal, Mala Sharma
Background: There is an accumulating body of evidence indicating a strong association between inflammation and the pathogenesis of atrial fibrillation (AF) in different ethnicities across the globe. AF increases the risk of stroke and heart failure. Despite various researches on IL-10 response, there is limited clinical evidence present, which demonstrate a role of these immunity regulators in AF. Therefore, this study was designed to decipher the role of IL-10(-592A/C) polymorphism in the development of postoperative AF (post-OP AF)...
June 2018: Journal of Arrhythmia
Liam Toner, Darragh Flannery, Hariharan Sugumar, Michelle Ord, Tina Lin, David O'Donnell
Background: Cardiac resynchronization therapy (CRT) improves morbidity and mortality in patients with heart failure. Although structural remodelling correlates with improved long-term outcomes, the role of electrical remodelling is poorly understood. This study aimed to evaluate electrical remodelling following CRT using a quadripolar left ventricular (LV) lead and to correlate this with structural remodelling. Methods: Consecutive patients undergoing initial CRT implantation using a quadripolar LV lead were enrolled...
June 2018: Journal of Arrhythmia
Fani Zagkli, Stefanos Despotopoulos, Christos Spiliotopoulos, John Chiladakis
Background: The study was designed to investigate the effect of heart rate and pacing mode on QRS fragmentation (f-QRS). Moreover, the usefulness of f-QRS in distinguishing patients with impaired left ventricular ejection function (EF) and ventricular tachycardia (VT) from patients with normal EF was assessed. Methods: Three hundred and six recipients, with dual-chamber device, with intrinsic narrow or wide QRS complex and preserved atrioventricular conduction were grouped into normal-EF or impaired-EF VT...
June 2018: Journal of Arrhythmia
Shizuka Tada, Masayoshi Shibata, Seiko Ohno, Yasunobu Haruki, Hironori Murakami, Daisuke Hotta, Masanori Nojima, Gregory W Ruhnke
Background: The optimal implantation site of a new implantable cardiac monitor (ICM) named Reveal LINQ® may be limited based on a sufficient amplitude of R wave potential (AEP) acquisition because it is the same anatomic area used for transthoracic echocardiography (TTE). Methods: Among 18 healthy volunteers, we assessed AEPs in 3 combinations through parasternal placement of 2 electrodes, (i) in the 4th intercostal space (ICS; site A/setting a; A/a), (ii) the same setting in the 5th ICS (site B/setting a; B/a), and (iii) in a sagittal plane relative to the left sternal border at the 4th ICS (site A/setting b; A/b), and further measured AFPs in several body positions in all site-setting combinations: supine, left and right lateral decubitus, sitting, and standing...
June 2018: Journal of Arrhythmia
Takahiro Kamihara, Fumihiko Yasuma, Toyoaki Murohara
Background: Nonsustained ventricular tachycardia (NSVT) is sometimes observed in patients with neuromuscular diseases (NMDs). The aim of this study was to assess the role of NSVT in the survival prognosis of NMD patients. Methods: We retrospectively analyzed the patients with NMDs who had undergone Holter ECG recordings at a single center between February and August 2012. Sixty-eight patients were enrolled in this study. The 5 year follow-up was assessed according to the cumulative event-free rate...
June 2018: Journal of Arrhythmia
Osamu Inaba, Yasutoshi Nagata, Masahiro Sekigawa, Naoyuki Miwa, Junji Yamaguchi, Takamichi Miyamoto, Masahiko Goya, Kenzo Hirao
Background: The clinical impact of a decrease in impedance during radiofrequency catheter ablation (RFCA) has not been fully clarified. The aim of the study was to analyze the impact of impedance decrease and to determine its optimal cutoff value during RFCA. Methods: We evaluated 34 consecutive patients (total 3264 lesions, mean age 66 ± 8.7 years, 10 females) who underwent their first ablation for atrial fibrillation (AF). The impedance decrease, average contact force (CF), application time, force-time integral (FTI), product of impedance decrease and application time (PIT), and the product of impedance decrease and FTI (PIFT) were measured for all lesions...
June 2018: Journal of Arrhythmia
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