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Tachy-Brady Syndrome

William N Evans, Ruben J Acherman, Humberto Restrepo
We hypothesized that normal sinus rhythm-sinus bradycardia is common in young children following extracardiac Fontan. After excluding patients with sinus pauses, junctional rhythm, tachy-brady syndrome, frequent ectopics, or ectopic atrial rhythm, we found an ambulatory 24-h Holter monitor average heart rate of 78 ± 12 beats per minute (bpm) in 33 post-extracardiac Fontan children with a median age of 6 years (5-10). A 24-h average heart rate of 78 ± 12 bpm is statistically significantly lower than a 24-h average heart rate value of 90 ± 10 bpm derived from a similarly aged control population (p < 0...
October 2016: Pediatric Cardiology
Narayanan Namboodiri, Shomu Bohora, Valaparambil K Ajitkumar, Jaganmohan A Tharakan
A young male presented with incessant narrow QRS tachycardia and left ventricular dysfunction. 24-Holter monitoring revealed multiple episodes of sustained and nonsustained episodes of tachycardia with prolonged sinus pauses at termination. The analysis of the electrocardiogram, followed by an invasive electrophysiological study, suggested an unusual mechanism for this tachy-brady syndrome.
September 2015: Indian Pacing and Electrophysiology Journal
Tamas Ruttkay, Julia Götte, Ulrike Walle, Nicolas Doll
We describe a minimally invasive heart surgery application of the EinsteinVision 2.0 3D high-definition endoscopic system (Aesculap AG, Tuttlingen, Germany) in an 81-year-old man with severe tricuspid valve insufficiency. Fourteen years ago, he underwent a Ross procedure followed by a DDD pacemaker implantation 4 years later for tachy-brady-syndrome. His biventricular function was normal. We recommended minimally invasive tricuspid valve repair. The application of the aformentioned endoscopic system was simple, and the impressive 3D depth view offered an easy and precise manipulation through a minimal thoracotomy incision, avoiding the need for a rib spreading retractor...
November 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Panagiotis Korantzopoulos, Konstantinos Kyrlas, Tong Liu, Guangping Li, John A Goudevenos
BACKGROUND: Sick sinus syndrome (SSS) is associated with atrial fibrillation (AF). Red blood cell distribution width (RDW) is a marker of anisocytosis of erythrocytes and is related to inflammatory stress. Recently, RDW has been associated with AF. The aim of the present study was to evaluate the potential association of RDW with AF history in patients with SSS. METHODS: Consecutive patients with symptomatic SSS undergoing dual-chamber pacemaker implantation were screened...
June 2016: Journal of Cardiology
Angelo G Torrente, Rui Zhang, Audrey Zaini, Jorge F Giani, Jeanney Kang, Scott T Lamp, Kenneth D Philipson, Joshua I Goldhaber
In sinoatrial node (SAN) cells, electrogenic sodium-calcium exchange (NCX) is the dominant calcium (Ca) efflux mechanism. However, the role of NCX in the generation of SAN automaticity is controversial. To investigate the contribution of NCX to pacemaking in the SAN, we performed optical voltage mapping and high-speed 2D laser scanning confocal microscopy (LSCM) of Ca dynamics in an ex vivo intact SAN/atrial tissue preparation from atrial-specific NCX knockout (KO) mice. These mice lack P waves on electrocardiograms, and isolated NCX KO SAN cells are quiescent...
August 4, 2015: Proceedings of the National Academy of Sciences of the United States of America
H J Schrickx, J H Ruiter, R Antenbrink, A Maarsse, M I Sedney
OBJECTIVE: To evaluate the efficiency of adaptive rate dual-chamber pacing to control the recurrence of atrial arrhythmias in patients with the brady-tachy variant of the sick sinus syndrome (SSS) with or without associated AV block. METHOD: A total of 23 patients were included in this double-blind, randomised, crossover study. In each patient a CPI 1230 dual pacemaker was implanted. The pacemaker was programmed blind to the investigator in a randomised order to four different pacing modalities for a period of four weeks each: DDD, lower rate 60 PPM; DDD, lower rate 80 PPM; DDD-R, lower rate 60 PPM; and DDD-R, lower rate 80 PPM...
January 2002: Netherlands Heart Journal
Frederick K Korley, Steven P Schulman, Lori J Sokoll, Andrew P DeFilippis, Andrew I Stolbach, Jamil D Bayram, Mustapha O Saheed, Rodney Omron, Christopher Fernandez, Albert Lwin, Stephen S Cai, Wendy S Post, Allan S Jaffe
OBJECTIVES: With clinical use of high-sensitivity troponin I (hsTnI), more frequent troponin elevations will occur. However, the burden and implications of these elevations are not well understood. The authors quantified the prevalence of elevated hsTnI in patients presenting with possible acute coronary syndrome (ACS) who do not have elevated troponin with a current generation assay (cardiac troponin I [cTnI]) and determined the association of these newly detected elevations with a composite of all-cause mortality and subsequent cardiac hospitalization...
July 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jörg Mittag, Kai Sonne, Helmut U Klein
Recent prospective trials of pacing in atrial fibrillation are inconclusive. A substantial suppression of atrial tachyarrhythmias has been observed in patients with brady-tachy-syndrome and high rate of paced vs. intrinsic beats. An improvement in prognosis, incidence of thromboembolism, rehospitalization and improvement in heart failure have been controversally described in different trials. The quality of life improves in most studies in physiologic pacing. This paper presents a short overview on published and ongoing trials in pacing of atrial fibrillation...
March 2002: Herzschrittmachertherapie & Elektrophysiologie
D Pfeiffer, Aida Salameh, Norbert Klein, Maika Mende, Andreas Hagendorff
Recent prospective trials of pacing in atrial fibrillation are inconclusive. A substantial suppression of atrial tachyarrhythmias has been observed in patients with brady-tachy-syndrome and high rate of paced vs. intrinsic beats. An improvement in prognosis, incidence of thromboembolism, rehospitalization and improvement in heart failure have been controversally described in different trials. The quality of life improves in most studies in physiologic pacing. This paper presents a short overview on published and ongoing trials in pacing of atrial fibrillation...
March 2002: Herzschrittmachertherapie & Elektrophysiologie
Giacomo Caio, Umberto Volta, Enrico Cerrato, Paolo Clavenzani, Nicolò Montali, Rosanna Cogliandro, Vincenzo Stanghellini, Pier Giorgio Golzio, Fiorenzo Gaita, Gianrico Farrugia, Roberto De Giorgio
A 26-year-old patient was diagnosed as having chronic intestinal pseudo-obstruction with manometric and histopathologic features suggestive of an intestinal myopathy. Histology was characterized by smooth muscle degeneration without inflammatory or immune cells. The severe gut dysfunction required full parenteral nutritional support. After a few months, the patient developed symptomatic tachy-brady arrhythmia episodes with syncopes. A thorough diagnostic work-up led to a diagnosis of sick sinus syndrome, which was managed by pacemaker implantation and administration of β-blockers...
November 2013: European Journal of Gastroenterology & Hepatology
Michael Semelka, Jerome Gera, Saif Usman
Sick sinus syndrome refers to a collection of disorders marked by the heart's inability to perform its pacemaking function. Predominantly affecting older adults, sick sinus syndrome comprises various arrhythmias, including bradyarrhythmias with or without accompanying tachyarrhythmias. At least 50 percent of patients with sick sinus syndrome develop alternating bradycardia and tachycardia, also known as tachy-brady syndrome. Sick sinus syndrome results from intrinsic causes, or may be exacerbated or mimicked by extrinsic factors...
May 15, 2013: American Family Physician
Fulvio Fiorini, Antonio Granata, Annalisa Noce, Olga Durante, Monica Insalaco, Nicola Di Daniele
In the area of renal diagnosis, B-mode ultrasound allows for the study of renal morphology, while power color Doppler is of strategic importance not only for the qualitative and quantitative information it provides on renal vasculature, but also because it allows for the measurement of 'Index Resistance'. This is the ratio between the peak systolic speed [VPS] minus the telediastolic speed [VTD] and the VPS: [VPS-VTD/VTD]), now one of the most sensitive parameters in the study of renal pathologies through the quantification of changes in renal plasma flow...
March 2013: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Federica Censi, Giovanni Calcagnini, Eugenio Mattei, Alessio Gargaro, Gianluca Biancalana, Alessandro Capucci
INTRODUCTION: The current external monitoring strategies used to detect atrial fibrillation (AF) and atrial tachycardia (AT) episodes are based either on transient periods of shortterm ECG recordings or on infrequent period of long-term continuous monitoring. The aim of this study was to investigate the ability of short-term daily ECG monitoring strategies for the detection of AF events. METHODS AND MATERIALS: The investigation was based on simulations performed on data extracted from Burden II study (patients implanted with pacemaker for brady-tachy syndrome), reporting date, time and duration of each episodes...
2013: Annali Dell'Istituto Superiore di Sanità
Robert M A van der Boon, Nicolas M Van Mieghem, Dominic A Theuns, Rutger-Jan Nuis, Sjoerd T Nauta, Patrick W Serruys, Luc Jordaens, Ron T van Domburg, Peter P T de Jaegere
BACKGROUND/OBJECTIVES: To determine pacemaker (PM) dependency at follow-up visit in patients who underwent new permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI). METHODS: Single center prospective observational study including 167 patients without previous PM implantation who underwent TAVI with the self-expanding Medtronic CoreValve System (MCS) between November 2005 and February 2011. PM dependency was defined by the presence of a high degree atrioventricular block (HDAVB; second [AV2] and third degree [AV3B]), or a slow (<30 bpm) or absent ventricular escape rhythm during follow-up PM interrogation...
September 30, 2013: International Journal of Cardiology
Qing Lou, Alexey V Glukhov, Brian Hansen, Lori Hage, Pedro Vargas-Pinto, George E Billman, Cynthia A Carnes, Vadim V Fedorov
BACKGROUND: In patients with sinoatrial nodal (SAN) dysfunction, atrial pauses lasting several seconds may follow rapid atrial pacing or paroxysmal tachycardia (tachy-brady arrhythmias). Clinical studies suggest that adenosine may play an important role in SAN dysfunction, but the mechanism remains unclear. OBJECTIVE: To define the mechanism of SAN dysfunction induced by the combination of adenosine and tachycardia. METHODS: We studied the mechanism of SAN dysfunction produced by a combination of adenosine and rapid atrial pacing in isolated coronary-perfused canine atrial preparations by using high-resolution optical mapping (n = 9)...
January 2013: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Jean Luc Rey, Serge Quenum, Marc Hero
AIMS: The aim of this study was to validate the ambulatory automatic atrial threshold monitoring algorithm by comparing the measurements assessed by the automatic system and those evaluated manually by the physician at discharge, 2- and 8-month follow-up sessions. METHODS AND RESULTS: This is an observational multicentric prospective study of 352 patients implanted with EnPulse(®) DR pacemakers. Mean age was 76.3 ± 9.4 years. Indications of pacing were atrio-ventricular block (AVB) (64%) and sinus dysfunction (SD) or brady-tachy syndrome (36%)...
November 2012: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Justyna Piekarz, Jacek Lelakowski, Anna Rydlewska, Jacek Majewski
INTRODUCTION: Heart perforation is a rare complication of pacemaker (PM)/implantable cardioverter-defibrillator (ICD) implantation. MATERIAL AND METHODS: In our clinic in 2005-2010, 6 patients with heart perforation were hospitalized (3 women, 3 men), mean age 58.6 ±20.8 years (17 to 73 years). The indication to PM/ICD implantation was tachy-brady syndrome in 3 cases, second-degree atrioventricular block, advanced with losses of consciousness, vaso-vagal syndrome type II B with asystole lasting 12 s and recurrent non-sustained ventricular tachycardia in 1 patient...
February 29, 2012: Archives of Medical Science: AMS
Alessandro Capucci, Giovanni Calcagnini, Eugenio Mattei, Michele Triventi, Pietro Bartolini, Gianluca Biancalana, Alessio Gargaro, Andrea Puglisi, Federica Censi
AIMS: Disorders such as paroxysmal atrial fibrillation (AF) and atrial tachyarrhythmias (AT) are difficult to investigate because of their intermittent, and sometimes asymptomatic, nature. The aim of this study was to investigate the daily temporal distribution of AT/AF episodes--onset and occurrence--by analysing data from 250 pacemaker-implanted, brady-tachy syndrome patients who have been enrolled in the Burden II Study. METHODS AND RESULTS: Data were analysed accounting for the mode switch list which includes date, time, and duration of each mode switch episode...
August 2012: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Henri Benkemoun, Jean Sacrez, Philippe Lagrange, Alain Amiel, Atul Prakash, Ewald Himmrich, Ezio Aimè, Georges H Mairesse, Christine Guénon, Pascal Sbragia
BACKGROUND: This study aimed to describe the influence on dual-chamber devices' expected longevity of devices' settings. METHODS: Data from patients implanted with dual chamber devices (Symphony™, SORIN CRM SAS, Clamart, France) from 2003 to 2006 were collected in registries. Programmer files were retrieved: device-estimated longevity, assessed through algorithm prediction, was analyzed according to device settings. RESULTS: One thousand sixty-eight recipients of dual chamber pacemaker in sinus rhythm (75...
April 2012: Pacing and Clinical Electrophysiology: PACE
Shamai A Grossman, Nathan I Shapiro, J Lawrence Mottley, Leon Sanchez, Edward Ullman, Richard E Wolfe
Since the development of coronary care units (CCUs), telemetry has rapidly become the standard of care in evaluating patients with suspected acute coronary syndromes, regardless of the probability for ischemia. However, there is no data to support this practice. Our objective was to evaluate the utility of routine cardiac monitoring in a chest pain observation unit. We prospectively studied the utility of routine cardiac monitoring in 249 consecutive patients admitted to an observation unit in an academic Emergency Department over a 6-month period...
December 2011: Internal and Emergency Medicine
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