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https://www.readbyqxmd.com/read/28641861/permanent-his-bundle-pacing-in-intra-hisian-conduction-block-mechanistic-insights
#1
Bengt Herweg, Paul Z Gerczuk, Aamir Sofi, Pugazhendhi Vijayaraman, S Serge Barold
We are reporting a patient with discrete intra-His conduction block and describe a refined technique of permanent His bundle pacing assuring reliable ventricular capture. Meticulous mapping of the site of block with lead placement distal to the site of block and non-selective His bundle pacing with local myocardial capture as an additional safety back up appears to be the technique of choice.
June 9, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28639747/the-effect-of-activation-rate-on-left-atrial-bipolar-voltage-in-patients-with-paroxysmal-atrial-fibrillation
#2
Steven E Williams, Nick Linton, Louisa O'Neill, James Harrison, John Whitaker, Rahul Mukherjee, Christopher A Rinaldi, Jaswinder Gill, Steven Niederer, Matthew Wright, Mark O'Neill
INTRODUCTION: Bipolar voltage is used during electroanatomic mapping to define abnormal myocardium, but the effect of activation rate on bipolar voltage is not known. We hypothesized that bipolar voltage may change in response to activation rate. By examining corresponding unipole signals we sought to determine the mechanisms of such changes. METHODS AND RESULTS: LA extrastimulus mapping was performed during CS pacing in 10 patients undergoing 1(st) time paroxysmal atrial fibrillation ablation...
June 22, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28630174/experimental-pathologic-and-clinical-findings-of-radiofrequency-catheter-ablation-of-para-hisian-region-from-the-right-ventricle-in-dogs-and-humans
#3
Yumei Xue, Xianzhang Zhan, Shulin Wu, Hongyue Wang, Yang Liu, Zili Liao, Hai Deng, Xuejing Duan, Shaoying Zeng, Dongpo Liang, Arif Elvan, Xianhong Fang, Hongtao Liao, Anand R Ramdat Misier, Jaap Jan J Smit, Andreas Metzner, Christian-Hendrik Heeger, Fangzhou Liu, Feng Wang, Zhiwei Zhang, Karl-Heinz Kuck, Siew Yen Ho, Feifan Ouyang
BACKGROUND: Ablation of para-Hisian accessory pathway (AP) poses high risks of atrioventricular block. We developed a pacing technique to differentiate the near-field (NF) from far-field His activations to avoid the complication. METHODS AND RESULTS: Three-dimensional mapping of the right ventricle was performed in 15 mongrel dogs and 23 patients with para-Hisian AP. Using different pacing outputs, the NF- and far-field His activation was identified on the ventricular aspect...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28626939/technical-note-a-3-d-rendering-algorithm-for-electromechanical-wave-imaging-of-a-beating-heart
#4
Pierre Nauleau, Lea Melki, Elaine Wan, Elisa Konofagou
PURPOSE: Arrhythmias can be treated by ablating the heart tissue in the regions of abnormal contraction. The current clinical standard provides electroanatomic 3- D maps to visualize the elec-trical activation and locate the arrhythmogenic sources. However, the procedure is time-consuming and invasive. Electromechanical Wave Imaging is an ultrasound- based non-invasive technique that can provide 2-D maps of the electromechanical activation of the heart. In order to fully visualize the complex 3-D pattern of activation, several 2-D views are acquired and processed separately They are then manually registered with a 3-D rendering software to generate a pseudo-3-D map However, this last step is operator-dependent and time-consuming...
June 19, 2017: Medical Physics
https://www.readbyqxmd.com/read/28625927/entrainment-and-high-density-three-dimensional-mapping-in-right-atrial-macro-reentry-provide-critical-complementary-information-entrainment-may-unmask-visual-reentry-as-passive
#5
Bhupesh Pathik, Geoffrey Lee, Chrishan Nalliah, Stephen Joseph, Joseph B Morton, Paul B Sparks, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
BACKGROUND: With the recent advent of high-density(HD) 3D mapping, the utility of entrainment is uncertain. On the other hand, the limitations of visual representation and interpretation of these high-resolution 3D maps are unclear. OBJECTIVES: Using both HD 3D mapping and entrainment mapping in right atrial(RA) macro-reentry, we sought to determine their strengths and limitations. METHODS: 15 patients were studied. The number and type of circuits accounting for ≥90% of the tachycardia cycle length(TCL) using HD 3D mapping were verified using systematic entrainment mapping...
June 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28617864/pitch-contour-impairment-in-congenital-amusia-new-insights-from-the-self-paced-audio-visual-contour-task-sact
#6
Xuejing Lu, Yanan Sun, Hao Tam Ho, William Forde Thompson
Individuals with congenital amusia usually exhibit impairments in melodic contour processing when asked to compare pairs of melodies that may or may not be identical to one another. However, it is unclear whether the impairment observed in contour processing is caused by an impairment of pitch discrimination, or is a consequence of poor pitch memory. To help resolve this ambiguity, we designed a novel Self-paced Audio-visual Contour Task (SACT) that evaluates sensitivity to contour while placing minimal burden on memory...
2017: PloS One
https://www.readbyqxmd.com/read/28601532/genetics-of-atrial-fibrillation-state-of-the-art-in-2017
#7
REVIEW
Diane Fatkin, Celine F Santiago, Inken G Huttner, Steven A Lubitz, Patrick T Ellinor
Genetic variation is an important determinant of atrial fibrillation (AF) susceptibility. Numerous rare variants in protein-coding sequences of genes have been associated with AF in families and in early-onset cases, and chromosomal loci harbouring common risk variants have been mapped in AF cohorts. Many of these loci are in non-coding regions of the human genome and are thought to contain regulatory sequences that modulate gene expression. Disease genes implicated to date have predominantly encoded cardiac ion channels, with predicted mutation effects on the atrial action potential duration...
May 11, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28590351/a-novel-approach-to-optimal-placement-of-new-trauma-centers-within-an-existing-trauma-system-using-geospatial-mapping
#8
Michael A Horst, Frederick B Rogers, Brian W Gross, Alan D Cook, Turner M Osler, Eric H Bradburn
BACKGROUND: Trauma system expansion is a complex process often governed by financial and health care system imperatives. We sought to propose a new, informed approach to trauma system expansion through the use of geospatial mapping. We hypothesized that geospatial mapping set to specific parameters could effectively identify optimal placement of new trauma centers (TC) within an existing trauma system. METHODS: We used Pennsylvania Trauma Systems Foundation (PTSF) registry data of adult (age ≥ 15) trauma for calendar years 2003-2015 (n=408,432), hospital demographics, road networks, and US Census data files...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28579601/efficacy-of-intensive-radiofrequency-energy-delivery-to-the-localized-dense-scar-area-in-post-infarction-ventricular-tachycardia-ablation%C3%A3-a-comparative-study-with-standard-strategy-targeting-the-infarcted-border-zone
#9
Kenji Kuroki, Akihiko Nogami, Kentaro Yoshida, Masahiko Goya, Masato Fukunaga, Kazuaki Kaitani, Naoaki Onishi, Takanao Mine, Takashi Koyama, Masayuki Igawa, Takeshi Machino, Hiro Yamasaki, Dongzhu Xu, Miyako Igarashi, Nobuyuki Murakoshi, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: Several reports have demonstrated the importance of severely low voltage areas as arrhythmogenic substrates of ventricular tachycardia (VT). However, a comparative study of dense scar-targeted and infarcted border zone-targeted strategies has not been reported.Methods and Results:We divided 109 consecutive patients with VT post-infarction from 6 centers into 2 groups according to the ablation strategy used: dense scar-targeted ablation (DS ablation, 48%) or border zone-targeted ablation (BZ ablation, 52%)...
June 3, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28570440/successful-reinnervation-of-the-diaphragm-after-intercostal-to-phrenic-nerve-neurotization-in-patients-with-high-spinal-cord-injury
#10
Kulvir S Nandra, Martin Harari, Thea P Price, Patrick J Greaney, Michael S Weinstein
OBJECTIVE: Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. INTRODUCTION: Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a means to reduce or eliminate the need for mechanical ventilation. However, this technique relies on intact phrenic nerve function. Recently, phrenic nerve reconstruction with intercostal nerve grafting has expanded the indications for diaphragmatic pacing...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28569191/the-strategic-framework-of-tuberculosis-control-and-prevention-in-the-elderly-a-scoping-review-towards-end-tb-targets
#11
REVIEW
Jun Li, Pui-Hong Chung, Cyrus L K Leung, Nobuyuki Nishikiori, Emily Y Y Chan, Eng-Kiong Yeoh
With the rapid pace of population ageing, tuberculosis (TB) in the elderly increasingly becomes a public health challenge. Despite the increasing burden and high risks for TB in the elderly, targeted strategy has not been well understood and evaluated. We undertook a scoping review to identify current TB strategies, research and policy gaps in the elderly and summarized the results within a strategic framework towards End TB targets. Databases of Embase, MEDLINE, Global health and EBM reviews were searched for original studies, review articles, and policy papers published in English between January 1990 and December 2015...
June 1, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28558154/theta-paced-flickering-between-place-cell-maps-in-the-hippocampus-a-model-based-on-short-term-synaptic-plasticity
#12
Shirley Mark, Sandro Romani, Karel Jezek, Misha Tsodyks
Hippocampal place cells represent different environments with distinct neural activity patterns. Following an abrupt switch between two familiar configurations of visual cues defining two environments, the hippocampal neural activity pattern switches almost immediately to the corresponding representation. Surprisingly, during a transient period following the switch to the new environment, occasional fast transitions of activity patterns between the representations (flickering) were observed (Jezek et al. 2011)...
May 30, 2017: Hippocampus
https://www.readbyqxmd.com/read/28552884/ranolazine-facilitates-termination-of-ventricular-tachyarrhythmia-associated-with-acute-myocardial-ischemia-through-suppression-of-late-ina-mediated-focal-activity
#13
Takashi Ogawa, Haruo Honjo, Masatoshi Yamazaki, Yasunori Kushiyama, Ichiro Sakuma, Itsuo Kodama, Kaichiro Kamiya
BACKGROUND: Ventricular tachycardia/fibrillation (VT/VF) associated with acute myocardial ischemia is the most common cause of sudden cardiac death, but its underlying mechanisms are incompletely understood. It is hypothesized that late Na(+)current (INa) contributes to arrhythmogenic activity in ischemic myocardium.Methods and Results:Langendorff-perfused rabbit hearts with regional ischemia in ventricles were optically mapped. Perfusion with ranolazine (10 μmol/L), a selective inhibitor of lateINa, significantly reduced excitation frequency and facilitated termination of VT/VF induced after occlusion of the left main coronary trunk...
May 26, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28543788/automated-verification-of-pulmonary-vein-isolation-in-radiofrequency-and-cryoballoon-guided-ablation
#14
Jan De Pooter, Thomas Phlips, Milad El Haddad, Frederic van Heuverswyn, Liesbeth Timmers, René Tavernier, Sebastien Knecht, Yves Vandekerckhove, Mattias Duytschaever
BACKGROUND: Verification of pulmonary vein isolation (PVI) can be challenging due to the coexistence of pulmonary vein potentials (PVP) and far field potentials. This study aimed to prospectively validate a novel algorithm for automated verification of PVI in radiofrequency-guided (RF) and cryoballoon-guided (CB) ablation strategies. METHODS: A dataset of 620 (RF: 516 EGMs and CB: 104 EGMs) bipolar electrograms (EGM), recorded by circular mapping catheter (CMC) placed at the left atrium-pulmonary vein (PV) junction, were prospectively analyzed by a two-step algorithm...
May 25, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28537786/designing-a-community-based-population-health-model
#15
Christopher J Durovich, Peter W Roberts
The pace of change from volume-based to value-based payment in health care varies dramatically among markets. Regardless of the ultimate disposition of the Affordable Care Act, employers and public-private payers will continue to increase pressure on health care providers to assume financial risk for populations in the form of shared savings, bundled payments, downside risk, or even capitation. This article outlines a suggested road map and practical considerations for health systems that are building or planning to build population health capabilities to meet the needs of their local markets...
May 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#16
Margaret E Balfour, Kathleen Tanner, Paul J Jurica, Dawn Llewellyn, Robert G Williamson, Chris A Carson
BACKGROUND: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. METHODS: A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28525920/torsade-de-pointes-arrhythmias-arise-at-the-site-of-maximal-heterogeneity-of-repolarization-in-the-chronic-complete-atrioventricular-block-dog
#17
Albert Dunnink, Thom R G Stams, Alexandre Bossu, Veronique M F Meijborg, Jet D M Beekman, Sofieke C Wijers, Jacques M T De Bakker, Marc A Vos
Aims: The chronic complete atrioventricular block (CAVB) dog is highly sensitive for drug-induced torsade de pointes (TdP) arrhythmias. Focal mechanisms have been suggested as trigger for TdP onset; however, its exact mechanism remains unclear. In this study, detailed mapping of the ventricles was performed to assess intraventricular heterogeneity of repolarization in relation to the initiation of TdP. Methods and results: In 8 CAVB animals, 56 needles, each containing 4 electrodes, were inserted in the ventricles...
May 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28522367/qrs-t-wave-and-calcium-alternans-in-a-type-i-diabetic-mouse-model-for-spontaneous-postmyocardial-infarction-ventricular-tachycardia-a-mechanism-for-the-antiarrhythmic-effect-of-statins
#18
Hongwei Jin, Charles M Welzig, Mark Aronovitz, Farzad Noubary, Robert Blanton, Bo Wang, Mohammad Rajab, Alfred Albano, Mark S Link, Sami F Noujaim, Ho-Jin Park, Jonas B Galper
BACKGROUND: The incidence of sudden arrhythmic death is markedly increased in diabetics. OBJECTIVE: The purpose of this study was to develop a mouse model for postmyocardial infarction (post-MI) ventricular tachycardia (VT) in the diabetic heart and determine the mechanism of an antiarrhythmic effect of statins. METHODS: ECG transmitters were implanted in wild-type (WT), placebo, and pravastatin-treated type I diabetic Akita mice. MIs were induced by coronary ligation, and Ca(2+) transients were studied by optical mapping, and Ca(2+) transients and sparks in left ventricular myocytes (VM) by the Ionoptix system and confocal microscopy...
May 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28515824/cardiogenic-shock-acute-severe-mitral-regurgitation-and-complete-heart-block-after-cavo-tricuspid-isthmus-atrial-flutter-ablation
#19
Thein Tun Aung, Edward Samuel Roberto, Kevin D Kravitz
Radiofrequency (RF) ablation is the first-line management of cavo-tricuspid isthmus dependent atrial flutter. It has been performed with 95% success rate. Adverse events are very rare. We report the first case of acute severe mitral regurgitation (MR) and complete heart block developed after successful atrial flutter ablation. A 62-year-old female with mild MR presented with palpitations. Surface electrocardiogram was suggestive of isthmus dependent atrial flutter. A duodecapolar mapping catheter showed an atrial flutter with cycle length of 280 ms...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28484842/conventional-mapping-and-ablation-of-focal-ventricular-tachycardias-in-the-healthy-heart
#20
REVIEW
Sonia Busch, Johannes Brachmann, Ahmed Saleh, Mathias Forkmann
Ventricular tachycardias (VT) in the healthy heart, also known as idiopathic VTs, often have a focal origin. Triggered activity due to delayed after-depolarization is the most likely mechanism of focal VTs. Localization of the site of origin of focal VTs is based on activation mapping with or without combination with pace mapping. The characteristic anatomic site of origin of idiopathic VTs is the right and left outflow tract. Other sites include the tricuspid and mitral annulus, the papillary muscles, and Purkinje fibers...
May 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
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