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AV Node

Bharath Yarlagadda, Mohit K Turagam, Tawseef Dar, Pragna Jangam, Vaishnavi Veerapaneni, Donita Atkins, Sudharani Bommana, Paul Friedman, Abhishek J Deshmukh, Rahul Doshi, Vivek Y Reddy, Srinivas R Dukkipati, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: Atrioventricular node (AV) ablation and permanent pacing is an established strategy for rate control in the management of symptomatic atrial fibrillation (AF). Leadless pacemakers (LP) can overcome some of the short-term and long-term limitations of conventional transvenous pacemakers (CTP). OBJECTIVES: Compare the feasibility and safety of LP vs single chamber CTP in AF patients undergoing AVN ablation. METHODS: We conducted a multicenter, observational study of patients undergoing AVN ablation and pacemaker implantation (LP vs...
February 26, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Suneet Mittal, Dan L Musat, Michael H Hoskins, Julie B Prillinger, Gregory J Roberts, Yelena Nabutovsky, Faisal M Merchant
PURPOSE: The purpose of the current study is to characterize and quantify the impact of complete atrioventricular block (cAVB) on heart failure hospitalization (HFH) and healthcare utilization in pacemaker (PM) patients. METHODS: Patients ≥ 18 years implanted with a dual-chamber PM from April 2008 to March 2014 were selected from the MarketScan® Commercial and Medicare Supplemental claims databases. Patients with ≤ 1-year continuous MarketScan enrollment prior to and post-implant, and those with prior HF diagnosis were excluded...
February 28, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Matthew B Ambrose, Jennifer N Avari Silva, Michael Rudokas, Tammy M Bowman, Joshua Murphy, George F Van Hare
PURPOSE: The anatomic basis of atrioventricular node reentrant tachycardia (AVNRT) remains incompletely characterized in children. Differences in coronary sinus (CS) size and morphology have been observed in adults with AVNRT but have not been well characterized in children. METHODS: Children (< 18 years) brought to the EP lab with supraventricular tachycardia for ablation underwent CS venography. A blinded pediatric interventional cardiologist performed CS measurements, which were indexed to body surface area...
February 3, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Antonio Berruezo, Markus Linhart, Angelo Auricchio, José Luis Zamorano, Pilar Santamaria, Roger Borràs, Felip Burgos, Josep Brugada
PURPOSE: Dual-chamber (DDD) pacing has been used for treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM). Due to inconclusive results in prior trials, current guidelines assign DDD pacing a class IIb indication in selected patients. Prior observations indicate that lack of clinical improvement may result from suboptimal effect of DDD pacing with non-physiological AV intervals due to fusion of intrinsic and paced QRS complex. METHODS: The Triple Chamber Pacing in Hypertrophic Obstructive Cardiomyopathy Patients (TRICHAMPION) trial is a prospective, randomized, single-blinded, multicenter study to investigate the benefit of atrial synchronous biventricular pacing (CRT-P) in highly symptomatic HOCM patients with severe left ventricular outflow tract (LVOT) obstruction who are not candidates for ablative therapies...
February 3, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Yingxin Li, Xiaoxiao Zhang, Chen Zhang, Xiaoying Zhang, Ying Li, Zhao Qi, Christopher Szeto, Mingxin Tang, Yizhi Peng, Jeffery D Molkentin, Steven R Houser, Mingxing Xie, Xiongwen Chen
OBJECTIVE: Cav3.1 (α1G ) T-type Ca2+ channel (TTCC) is expressed in mouse sinoatrial node cells (SANCs) and atrioventricular nodal (AVN) cells and contributes to heart rate genesis and AV conduction. However, its role in heart rate (HR) regulation and AV conduction acceleration by the β-adrenergic system (SAS) is unclear, which is the topic of this study. METHODS AND RESULTS: L- (ICa-L ) and T-type (ICa-T ) Ca2+ currents were recorded in SANCs from Cav3.1 transgenic (TG) and knockout (KO), and control mice...
December 23, 2017: Journal of Physiology
Esseim Sharma, Antony F Chu
PURPOSE: Transcatheter aortic valve replacement (TAVR) is an increasingly prevalent therapy in patients with severe symptomatic aortic stenosis. Conduction disturbances requiring permanent pacemaker (PPM) implantation are a known complication of TAVR. This study investigated the progression of cardiac conduction disease in the post-TAVR pacemaker population and identified predictors of post-TAVR right ventricular (RV) pacing dependence. METHODS: Prospectively collected echocardiographic, ECG, and PPM interrogation data of 262 consecutive patients who underwent TAVR with placement of a balloon-expandable valve at one institution from March 2012 to October 2016 were analyzed...
December 19, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Jian-Du Yang, Gong-Bu Zhou, Qi Sun, Xiao-Gang Guo, Xu Liu, Bin Luo, Hui-Qiang Wei, Jackson J Liang, Shuanglun Xie, Fei-Fan Ouyang, Jian Ma
Aims: We aimed to examine the electrocardiographic and electrophysiologic characteristics of anterograde-conducting decremental accessory pathways (DAP) and to identify surrogate criteria to distinguish short atrioventricular (SAV) DAP from atriofascicular (AF) AP and long atrioventricular (LAV) DAP. Methods and results: We identified all patients with DAPs and analysed electrocardiographic and electrophysiologic characteristics. Distal insertion sites were examined using existing criteria, including V-H interval, ventricular activation at the right ventricular apex, and around tricuspid annulus during antidromic atrioventricular re-entrant tachycardia (A-AVRT) or complete pre-excitation and evaluated the AV node-like properties according to the response to adenosine and radiofrequency ablation...
December 13, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Danielle E Harake, Kevin M Shannon, Jamil A Aboulhosn, Jeremy P Moore
INTRODUCTION: The bidirectional Glenn operation for congenital heart disease produces anatomical constraints to conventional transvenous pacemaker implantation. An iliac approach, although not previously described in this population, is potentially a preferable alternative to a thoracotomy for epicardial pacing. METHODS AND RESULTS: A single-center retrospective review was performed for all patients that underwent transvenous pacemaker implantation following the bidirectional Glenn operation with partial biventricular repair...
December 14, 2017: Journal of Cardiovascular Electrophysiology
Francis Bessière, François-Pierre Mongeon, Judith Therrien, Paul Khairy
Twin AV nodal reentrant tachycardia most commonly occurs in patients with complex congenital heart disease who have two distinct AV nodes, His bundles, and non-preexcited QRS morphologies. Catheter ablation of the weaker AV node may be hindered by anatomical complexities. In such cases, remote magnetic guidance offers a potentially effective solution.
December 2017: Clinical Case Reports
Jessica G Y Luc, Kevin Phan, Vakhtang Tchantchaleishvili
Primary cardiac tumors are uncommon clinical entities with an incidence of 0.0017% to 0.03% of all autopsies. Cystic tumor of the atrioventricular (AV) node, also known as mesothelioma of the AV node, is a benign congenital tumor that is located in the triangle of Koch in the AV nodal region of the atrial septum of the heart. It comprises of 2.7% of cardiac tumors and is the most common primary cardiac tumor causing sudden death. We herein review the etiology, presentation, differential diagnosis, diagnosis, management, surgical approaches and outcomes of this rare tumor...
September 2017: Journal of Thoracic Disease
J Tian, X-J An, M-Y Fu
Progressive cardiac conduction disease (PCCD) is a common pediatric heart conduction disorder. It is an autosomal inheritance of rare mutations, which leads to familial cases of PCCD. In these cases, the His-Purkinje system's conductive capacity is progressively deranged, involving either right or left bundle branch block. Also, QRS complexes display widening is an important characteristic that culminates in complete AV block, syncope, and sudden death. Mutations in TRPM4 gene that encodes for transient receptor potential melastatin 4 have recently been reported to cause familial cases of PCCD and heart block...
October 2017: European Review for Medical and Pharmacological Sciences
Vratika Agarwal, Neeraj Shah, Kathan Mehta, Anand Agarwal, Jonathan Willner, James Lafferty
PURPOSE: Paroxysmal supraventricular tachycardia (PSVT) ablation can result in injury to the atrioventricular (AV) node causing complete heart block requiring permanent pacemaker (PPM) implantation. Few studies have examined the impact of hospital PSVT ablation volume and PPM implantation rates post ablation. METHODS: We included adult patients from the Nationwide Inpatient Sample (NIS) database, from 1998 to 2011, using ICD-9 diagnoses codes 427.0 and 427.89 for PSVT and ICD-9 procedure code 37...
November 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Marwan M Refaat, Jad A Ballout, Patrick Zakka, Mostafa Hotait, Karine A Al Feghali, Ibrahim Abu Gheida, Charbel Saade, Mukbil Hourani, Fady Geara, Malek Tabbal, Pierre Sfeir, Wassim Jalbout, Wael Al-Jaroudi, Abdo Jurjus, Bassem Youssef
BACKGROUND: Linear accelerator-based stereotactic radiosurgery delivered to cardiac arrhythmogenic foci could be a promising catheter-free ablation modality. We tested the feasibility of in vivo atrioventricular (AV) node ablation in swine using stereotactic radiosurgery. METHODS AND RESULTS: Five Large White breed swine (weight 40-75 kg; 4 females) were studied. Single-chamber St Jude pacemakers were implanted in each pig. The pigs were placed under general anesthesia, and coronary/cardiac computed tomography simulation scans were performed to localize the AV node...
October 27, 2017: Journal of the American Heart Association
Maneesh K Rai, Mukund A Prabhu, Abhishek Sharma, Ritesh Vekariya, Padmanabh Kamath, Narasimha Pai, Ramanath L Kamath
BACKGROUND: Cardiac Resynchronization therapy (CRT) remains largely under-used in developing countries owing to the high cost of therapy. In this pilot study, we explore 'optimized' Left Ventricle Only Pacing (LVOP) as a cost effective alternative to cardiac resynchronization therapy in selected patients with heart failure. HYPOTHESIS: In economically poorer patients with heart failure, left bundle branch block (LBBB) and intact AV node conduction, synchronization can be obtained using a dual chamber pacemaker (leads in right atrium and Left ventricle) with the help of 2D strain imaging...
May 2017: Indian Pacing and Electrophysiology Journal
İbrahim Faruk Aktürk, Mustafa Kemal Erol
With the dramatic increase in the number of elderly people in most parts of the world and in our country there will be an accompanying increase in patients with sinus node dysfunction (SND) and atrioventricular (AV) block. For this reason, it will be essential for health care personnel to have a basic knowledge of bradyarrhythmias and the special considerations required for managing these rhythms in elderly patients. Because of frailty of this patient group indivualised approach and consideration for management of these patients must be done carefully...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Joseph Gascho
No abstract text is available yet for this article.
November 2017: Pacing and Clinical Electrophysiology: PACE
Marco A Mercader, Dingchao He, Aditya C Sharma, Mark C Marchitto, Gregory Trachiotis, Gene A Bornzin, Richard Jonas, Jeffrey P Moak
Junctional ectopic tachycardia (JET) and atrial fibrillation (AF) occur in patients recovering from open-heart surgery (OHS). Pharmacologic treatment is used for the control of post-operative atrial arrhythmias (POAA), but is associated with side effects. There is a need for a reversible, modulated solution to rate control. We propose a non-pharmacologic technique that can modulate AV nodal conduction in a selective fashion. Ten mongrel dogs underwent OHS. Stimulation of the anterior right (AR) and inferior right (IR) fat pad (FP) was done using a 7-pole electrode...
2017: PloS One
Damián Longo, Adrian Baranchuk
In patients with manifest anterograde ventricular preexcitation, the electrocardiographic manifestation of the anomalous conduction through the simultaneous conduction over the atrioventricular (AV) node and the accessory pathway ("delta wave"); depends on several factors, the most representative being the conduction velocity over one or another connection. Occasionally, ventricular ectopic beats may present with retrograde penetration over one or both conduction pathways (AV node and/or accessory pathway), impacting on the morphology of the next immediate anterogradely conducted QRS...
August 24, 2017: Annals of Noninvasive Electrocardiology
Corinne Marzahn, Cornel Koban, Martin Seifert, Akihiro Isotani, Michael Neuß, Frank Hölschermann, Christian Butter
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established treatment option for patients with severe aortic stenosis and high surgical risk. Currently, various prosthesis types are available. Atrioventricular block (AVB) requiring pacemaker (PM) implantation is a typical complication after TAVI. This study investigated the recovery of AV node conduction and mid-term outcome of patients with or without PM implantation after TAVI according to prosthesis type. METHODS: From July 2008 to May 2015, 856 transcatheter heart valves were implanted at our center (age: 80...
January 2018: Journal of Cardiology
S Vivekanandan, D B Landau, N Counsell, D R Warren, A Khwanda, S D Rosen, E Parsons, Y Ngai, L Farrelly, L Hughes, M A Hawkins, J D Fenwick
PURPOSE: The heart receives high radiation doses during radiation therapy of advanced-stage lung cancer. We have explored associations between overall survival, cardiac radiation doses, and electrocardiographic (ECG) changes in patients treated in IDEAL-CRT, a trial of isotoxically escalated concurrent chemoradiation delivering tumor doses of 63 to 73 Gy. METHODS AND MATERIALS: Dosimetric and survival data were analyzed for 78 patients. The whole heart, pericardium, AV node, and walls of left and right atria (LA/RA-Wall) and ventricles (LV/RV-Wall) were outlined on radiation therapy planning scans, and differential dose-volume histograms (dDVHs) were calculated...
September 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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