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Cardiac Electrophysiology Clinics

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https://www.readbyqxmd.com/read/27837902/pathophysiology-of-the-human-his-purkinje-system
#1
EDITORIAL
Masood Akhtar
No abstract text is available yet for this article.
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837901/foreword
#2
EDITORIAL
Ranjan K Thakur, Andrea Natale
No abstract text is available yet for this article.
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837900/changes-in-the-reentrant-pathway-in-verapamil-sensitive-fascicular-reentrant-ventricular-tachycardia-during-ablation
#3
REVIEW
Patrick Tchou, Khaldoun Tarakji, Mohamed Kanj
The sequence of changes in the QRS morphology and the accompanying cycle lengths of the tachycardia confirm that the reentrant circuit involves the left ventricular myocardium as well as the His Purkinje system as part of the reentrant circuit. The reentrant propagation likely goes from local left ventricular myocardium into a slowly conducting, verapamil-sensitive tissue, which then connects into the inferior fascicle. This case demonstrates that fascicular reentrant tachycardias can generate different QRS morphologies depending on the path of breakout into the myocardium...
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837899/retrograde-concealed-conduction-in-the-his-purkinje-system
#4
REVIEW
Masood Akhtar
An 83-year-old man was seen due to recurrent syncopal episodes. Only the His bundle recording was able to be obtained, which showed the His-Purkinje System as the site of a conduction delay. A permanent dual-chamber pacemaker was implanted with no further syncopal episodes.
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837898/wenckebach-phenomenon-in-left-bundle-branch-block
#5
REVIEW
Masood Akhtar
A 60-year-old patient had recurrent wide QRS complex tachycardia with a left bundle branch and normal axis pattern. The underlying mechanism was atrioventricular nodal reentry tachycardia. Besides the palpitation, there were no other symptoms. The cardiovascular examination was normal.
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837897/wenckebach-phenomenon-in-the-his-purkinje-system
#6
REVIEW
Masood Akhtar
The author discusses Wenckebach phenomenon (WP) in the His-Purkinje system (HPS). Subtle PR changes may be interpreted as no change, often seen in the HPS-WP. Changes in the QRS axis help to localize the site of delay and block along fascicles of the left bundle branch. Marked PR changes may occur during HPS-WP. All the QRS complexes that are conducted depict right bundle branch and left anterior superior fascicular block, so the visible changes in the HV interval suggest WP mostly occurring in the left posterior inferior fascicle...
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837896/recording-the-accessory-his-bundle-potential-from-a-right-atriofascicular-accessory-pathway
#7
REVIEW
Warren M Jackman
The author discusses the case of a 42-year-old man with a long history of episodes of rapid palpitations. Recordings from the proximal end of a right atriofascicular accessory pathway at the lateral tricuspid annulus are discussed. There was successful catheter ablation of the right atriofascicular accessory pathway, without recurrence of tachycardia.
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837895/bidirectional-ventricular-tachycardia-due-to-a-mixture-of-focal-fascicular-firing-and-reentry
#8
REVIEW
Sarfraz A Durrani, Raphael Sung, Melvin Scheinman
Bidirectional ventricular tachycardia (BDVT) is a well-known phenomenon since it was first described in 1922. Various mechanisms have been proposed for BDVT, including digitalis toxicity, hypokalemia, Anderson-Tawil syndrome, acute myocarditis, and catecholaminergic polymorphic ventricular tachycardia. It is characterized by rapid, wide complex electrocardiogram pattern with alternating QRS morphology and axis. The alternation of the QRS is usually right bundle branch block with 180° swings in the frontal plane axis or, less commonly, alternation of right bundle branch and left bundle branch forms...
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837894/review-of-his-purkinje-system-abnormality-with-case-studies
#9
REVIEW
Venkatakrishna N Tholakanahalli, Ilknur Can, Samuel J Asirvatham
A single beat arising as extra systole within the His-Purkinje system or from ventricle or even atrium based on conduction timing can invoke delayed conduction or block within intra-Hisian or infra-Hisian sites. This may be either manifested in the form of premature atrial or ventricular complexes or concealed as with His extra systoles. It appears commonly there is disease within the His-Purkinje system.
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837893/rare-cause-of-infranodal-block
#10
REVIEW
Anwer A Dhala, Anoop K Singh
The patient exhibits multiple features suggestive of Timothy syndrome, which is a multisystem autosomal-dominant condition with findings that include prolonged QT interval, hand and foot abnormalities, dysmorphic facial features, and mental retardation. A 2:1 infranodal atrioventricular block may occasionally be seen in the setting of severely prolonged QT interval. Functional nature of atrioventricular block is demonstrated by resumption of 1:1 conduction with changes in heart rate.
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837892/human-his-purkinje-system-abnormalities-of-conduction-rhythm-disorders-and-case-studies
#11
REVIEW
Masood Akhtar
This review covers many of the arrhythmias and conduction abnormalities related to His-Purkinje System. These include junctional premature complexes, junctional and fascicular tachycardias, bundle branch reentry (BBR), and the role of apparent conduction in various forms of supraventricular tachycardias (SVT) with or without involvement of accessory pathways (AP).
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27837891/human-his-purkinje-system-normal-electrophysiologic-behavior
#12
REVIEW
Masood Akhtar
The His-Purkinje system (HPS) plays a significant role in human pathophysiology, but knowledge is scattered. This article highlights some of the relevant concepts, phenomena, and mechanisms; clarifies, expands, confirms, or modifies commonly encountered clinical events; and adds new information, which is often available but obscure. Also included are the essentials of HPS anatomy and physiology. It is important to abandon inaccurate concepts that are still taught and occasionally appear in text books.
December 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27521098/ventricular-arrhythmias-in-apparently-normal-hearts
#13
EDITORIAL
Frank M Bogun, Thomas C Crawford, Rakesh Latchamsetty
No abstract text is available yet for this article.
September 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27521097/a-matter-of-definition
#14
EDITORIAL
Ranjan K Thakur, Andrea Natale
No abstract text is available yet for this article.
September 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27521096/sustained-ventricular-tachycardia-in-apparently-normal-hearts-medical-therapy-should-be-the-first-step-in%C3%A2-management
#15
REVIEW
Ali Kazemi Saeid, George J Klein, Peter Leong-Sit
Sustained monomorphic ventricular tachycardia or repetitive premature ventricular complexes can be seen in patients with structurally normal hearts. Among these types of patients, the prognosis is predominantly benign and the treatment mostly focused on elimination of symptoms rather than improving survival or reduction of mortality. This article focuses on the pharmacologic options for management and compares them with invasive options. Based on the current literature, we demonstrate that medical therapies should be used as first-line management and favored over invasive therapies...
September 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27521095/sustained-ventricular-tachycardia-in-apparently-normal-hearts-ablation-should-be-the-first-step-in-management
#16
REVIEW
Joshua D Moss, Roderick Tung
Patients without structural heart disease tend to have fewer morphologies of ventricular tachycardia, with automaticity and triggered activity a more common mechanism than re-entry associated with extremely low risk of sudden death. Ablation can be curative in patients with a single morphology of ventricular tachycardia that is focal in origin, particularly in patients without overt structural heart disease. There are limited data in secondary prevention implantable cardioverter defibrillator literature to support the routine implementation of implantable cardioverter defibrillator in normal hearts...
September 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27521094/ventricular-arrhythmias-in-apparently-normal-hearts-who-needs-an-implantable-cardiac-defibrillator
#17
REVIEW
Alex Y Tan, Kenneth Ellenbogen
Idiopathic ventricular tachycardia is often considered a benign form of ventricular arrhythmia in patients without apparent structural heart disease. However, a subset of patients may develop malignant ventricular arrhythmias and present with syncope and sudden cardiac arrest. Survivors of cardiac arrest are candidates for implantable cardiac defibrillators (ICDs). The indications for ICDs in patients with less than a full-blown cardiac arrest presentation but with electrocardiographically high-risk ectopy features remain uncertain...
September 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27521093/dynamics-and-molecular-mechanisms-of-ventricular-fibrillation-in-structurally-normal-hearts
#18
REVIEW
José Jalife
Ventricular fibrillation (VF) is the most severe cardiac rhythm disturbance and one of the most important immediate causes of sudden cardiac death. In the structurally normal heart, a small number of stable reentrant sources, perhaps 1 or 2, underlie the mechanism of VF, and the stabilization of the sources, their frequency, and the complexity of the turbulent waves they generate depend on the expression, spatial distribution, and intermolecular interactions of the 2 most important ion channels that control cardiac excitability: the inward rectifier potassium channel, Kir2...
September 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27521092/exercise-induced-ventricular-tachycardia-ventricular-fibrillation-in-the-normal-heart-risk-stratification-and-management
#19
REVIEW
Yoav Michowitz, Sami Viskin, Raphael Rosso
Exercise-induced ventricular tachycardia (VT) rarely occurs in the absence of organic heart disease. Idiopathic monomorphic VT has an excellent prognosis. The main aspect of the risk stratification process is recognizing subtle forms of organic heart disease, particularly arrhythmogenic right ventricular cardiomyopathy. Exercise-induced polymorphic VT is potentially malignant. Exercise-induced polymorphic VT has also been seen in mitral valve prolapse. Some patients with stable coronary disease, and even healthy athletes, sometimes have short bursts of polymorphic VT during exercise tests but these arrhythmias are usually not reproducible during repeated testing and have unknown long-term clinical significance...
September 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27521091/polymorphic-ventricular-tachycardia-ventricular-fibrillation-and-sudden-cardiac-death-in-the-normal-heart
#20
REVIEW
Ashok J Shah, Meleze Hocini, Arnaud Denis, Nicolas Derval, Frederic Sacher, Pierre Jais, Michel Haissaguerre
Primary electrical diseases manifest with polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF) and along with idiopathic VF contribute to about 10% of sudden cardiac deaths (SCDs) overall. These disorders include long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, short QT syndrome, and early repolarization syndrome. This article reviews the clinical electrophysiological management of PMVT/VF in a structurally normal heart affected with these disorders...
September 2016: Cardiac Electrophysiology Clinics
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