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Bundle branch blocks

Ali Vasheghani-Farahani, Masih Tajdini, Seyed Abolfazl Mohsenizadeh, Seyed Mohammad Reza Hosseini
BACKGROUND: Cardiac resynchronization therapy (CRT) is a medical device to help cardiac synchronized contractility by electrical impulses. Improvement of symptoms and left ventricular systolic function, reducing hospital admissions and mortality in patients with moderate to severe heart failure are the main benefits of administration of cardiac resynchronization therapy. CASE REPORT: In this article, we describe a case of heart failure and left bundle branch block (LBBB) who was candidate for cardiac resynchronization therapy; but after managing hyperkalemia, left bundle branch block resolved, ejection fraction increased and cardiac resynchronization therapy implantation was canceled...
May 2016: ARYA Atherosclerosis
Tiffany Healey, Clifford Buckley, Matthew Mollman
BACKGROUND: Brugada syndrome is a genetic disorder that increases an individual's risk for sudden cardiac death and ventricular dysrhythmias that was first described by the Brugada brothers in 1992. Brugada syndrome is characterized by an atypical electrocardiogram pattern that includes a bundle branch block and ST-segment elevation in the precordial leads. CASE REPORT: A 74-year-old man had a cardiac arrest at the time of a low-speed motor vehicle collision. When emergency medical services arrived, the patient was in torsades de pointes...
October 14, 2016: Journal of Emergency Medicine
Mukund A Prabhu, B V Srinivas Prasad, Anees Thajudeen, Narayanan Namboodiri
INTRODUCTION: Bundle branch reentry as a mechanism of ventricular tachycardia (VT) in endomyocardial fibrosis (EMF) is not described. CASE REPORT: A 52-year-old woman with left ventricular (LV) EMF had VT needing cardioversion. She had mitral regurgitation and left bundle branch block, but no LV dilation or heart failure. During electrophysiological study, clinical VT could be easily induced, and it was confirmed to be bundle branch reentrant VT (BBRVT). She was treated with ablation of the right bundle branch...
September 2016: Indian Heart Journal
Pranil Bhalchandra Gangurde, Abhay Tidake, Hetan Shah, Ajay Mahajan, Yash Lokhandwala, Pratap Nathani
A 14-year-old male with a history of symptomatic tachycardia was referred for ablation. Sinus rhythm electrocardiogram was not showing any pre-excitation. Tachycardia episode was showing antidromic tachycardia with left bundle branch block morphology. Echocardiographic examination was showing Ebstein's anomaly with septal tricuspid leaflet displaced 24mm apically. The right bundle branch block (RBBB) was concealed during sinus rhythm. The RBBB was revealed with ablation of right posterior atriofascicular accessory pathway...
September 2016: Indian Heart Journal
Ru-Xing Wang, Hon-Chi Lee, Jia-Ping Li, David O Hodge, Yong-Mei Cha, Paul A Friedman, Thomas M Munger, Komandoor Srivathsan, Behzad B Pavri, Win-Kuang Shen
BACKGROUND: Although sudden death (SD) is a rare complication after atrioventricular junction (AVJ) ablation and permanent pacemaker implantation, the risk factors leading to this SD remain unknown. The purpose of this study was to investigate SD and its risk factors after ablate-and-pace strategy for rate control in atrial fibrillation (AF) patients during long-term follow-up. HYPOTHESIS: METHODS: From January 2005 to December 2009, we enrolled into this study 517 AF patients with AVJ ablation and right ventricular pacemaker implantation...
October 17, 2016: Clinical Cardiology
Agnieszka Wsol, Wioletta Wydra, Marek Chmielewski, Andrzej Swiatowiec, Marek Kuch
BACKGROUND: A retrospective study was designed to investigate P-wave duration changes in exercise stress (EST) test for the prediction of angiographically documented substantial coronary artery disease (CAD). METHODS: We analyzed 265 cases of patients, who underwent EST and subsequently coronary angiography. Analysis of P-wave duration was performed in leads II, V5 at rest, and in the recovery period. RESULTS: The sensitivity and specificity for the isolated ST-segment depression were only 31% and 76%, respectively...
October 17, 2016: Cardiology Journal
Akm Monwarul Islam, Md Toufiqur Rahman, Abu Hana Chowdhury
Naxos disease is a rare autosomal recessive form of arrhythmogenic right ventricular cardiomyopathy (ARVC) with woolly hair and palmoplantar keratoderma. The cardiomyopathy presents by adolescence with syncope, ventricular tachycardia (VT) of left bundle branch block (LBBB) morphology, and/or ventricular fibrillation. The diagnosis and management of ARVC are at present in evolution; the recently published modified Task Force Criteria for diagnosis and International Task Force consensus statement for treatment of ARVC will hopefully bring about uniformity in recognition and management of Naxos disease as well...
October 2016: Cardiovascular Diagnosis and Therapy
Santhosh R Devarapally, Sameer Arora, Ali Ahmad, Mike Sood, Amaar El Sergany, Terrence Sacchi, Barry Saul, Rahul Gaglani, John Heitner
BACKGROUND: Right ventricular (RV) failure has proven to be independently associated with adverse outcomes. Electrocardiographic parameters assessing RV function are largely unknown, making echocardiography the first line for RV function assessment. It is however, limited by geometrical assumptions and is inferior to cardiac magnetic resonance imaging (CMRI) which is widely regarded as the most accurate tool for assessing RV function. METHODS: We seek to determine the correlation of ECG parameters of right bundle branch block (RBBB) with RV ejection fraction (EF) and RV dimensions using the CMRI...
October 2016: Cardiovascular Diagnosis and Therapy
Martin Grett, Martin Christ, Hans-Joachim Trappe
BACKGROUND: Little is known about the incidence and risk factors for progression to pacemaker dependency or the need for cardiac resynchronization in typical patients with an implanted defibrillator with regard to an alternative implantation of a subcutaneous ICD (S-ICD). STUDY DESIGN AND METHODS: After retrospective analysis of 291 patients with first implantation of a transvenous single chamber ICD (VVI-ICD) from 2010-2016 and excluding those with an indication for pacemaker or lack of follow-up data, 121 patients were included and investigated with regard to the following endpoints: need for pacemaker stimulation, upgrade for cardiac resynchronization (CRT), and secondary occurrence and effectiveness of antitachycardia pacing (ATP)...
October 13, 2016: Herzschrittmachertherapie & Elektrophysiologie
Claudia Schaarschmidt, Christof Kolb
The subcutaneous implantable defibrillator (S-ICD) has become an established tool for the prevention of sudden cardiac death. Based on its detection properties, the S‑ICD is essentially dependent on correct morphology discrimination of the QRS complex and avoidance of potential T‑wave sensing. We report on a patient who experienced multiple inappropriate S‑ICD shocks due to T‑wave oversensing in the setting of new onset of right bundle branch block. Strategies for the optimisation of the device programming are discussed...
October 13, 2016: Herzschrittmachertherapie & Elektrophysiologie
Bingbo Hou, Lihui Zheng, Guodong Niu, Lingmin Wu, Yu Qiao, Wei Sun, Ligang Ding, Gang Chen, Shu Zhang, Reginald Liew, Yan Yao
AIMS: This study was aimed to report the characteristics and treatment of ventricular tachycardia (VT) following surgical treatment of pulmonary stenosis with intact ventricular septum. METHODS AND RESULTS: Five patients underwent radiofrequency catheter ablation for sustained monomorphic left bundle branch block (LBBB) type VT who previously underwent surgical treatment of pulmonary stenosis. Except stimulation, voltage and activation mapping was performed using three-dimensional (3D) electro-anatomic mapping and ablation was applied accordingly...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Takumi Yamada, Harish Doppalapudi, Silvio H Litovsky, H Thomas McElderry, G Neal Kay
BACKGROUND: Radiofrequency catheter ablation (RFCA) of idiopathic ventricular arrhythmias (VAs) originating from the basal portion of the left ventricular (LV) summit, which is divided from the apical LV (A-LV) summit by the great cardiac vein (GCV), is challenging. This study investigated the efficacy of RFCA and electrocardiographic and electrophysiological characteristics of these VAs. METHODS AND RESULTS: Forty-five consecutive patients with symptomatic idiopathic LV summit VAs were studied...
October 2016: Circulation. Arrhythmia and Electrophysiology
Ahmed Karim Talib, Akihiko Nogami, Itsuro Morishima, Yasushi Oginosawa, Kenji Kurosaki, Shinya Kowase, Yuki Komatsu, Kenji Kuroki, Miyako Igarashi, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: The most common form of idiopathic Purkinje-related ventricular tachycardia (VT) is the reentrant type. We describe the clinical and electrophysiological characteristics of focal non-reentrant fascicular tachycardia. METHODS AND RESULTS: Among 530 idiopathic VT patients who were referred for ablation, we identified 15 (2.8%) with non-reentrant fascicular tachycardia (11 men, 45±21 years). Sinus rhythm ECG showed normal conduction intervals with a His-ventricular interval of 41±4 ms...
October 2016: Circulation. Arrhythmia and Electrophysiology
Hui Yang, Fabio Leonelli
QRS morphology is commonly used in the electrocardiographic diagnosis of ventricular depolarization such as left bundle branch block (LBBB) and ventricular septal infarction. We investigated whether pattern matching of QRS loops in the 3-dimensional vectorcardiogram (VCG) will improve the grouping of patients whose space-time electrical activity akin to each other, thereby assisting in clinical decision making. First, pattern dissimilarity of VCG QRS loops is qualitatively measured and characterized among patients, resulting in a 93×93 distance matrix of patient-to-patient dissimilarity...
September 28, 2016: Computers in Biology and Medicine
Ismail Bouhout, Amine Mazine, Lena Rivard, Aly Ghoneim, Ismail El-Hamamsy, Yoan Lamarche, Michel Carrier, Philippe Demers, Denis Bouchard
BACKGROUND: Sutureless self-expandable aortic bioprostheses rely on radial forces for stabilization, raising concern that these devices may increase the risk of postoperative conduction disease. The purpose of this study was to determine the incidence of conduction disorders after sutureless aortic valve replacement (AVR) with the Perceval S (Sorin Group, Saluggia, Italy) bioprosthesis. METHODS: Between June 2011 and March 2013, 108 consecutive patients underwent sutureless AVR with the Perceval S prosthesis...
October 4, 2016: Annals of Thoracic Surgery
Y-X Kang, Y-J Wang, Q Zhang, X-H Pang, W Gu
Kearns-Sayre syndrome (KSS) is a disorder caused by mutations in mitochondrial DNA. Here, we report an unusual case of Kearns-Sayre syndrome accompanied by hypopituitarism (deficiencies in reproductive and growth hormones). A 20-year-old male presented with growth retardation for the last 8 years, as well as the following findings: short stature, delayed puberty, myasthenia, an extraocular movement deficit, drooping eyelids, pectus carinatum and scoliosis. Cerebral enhanced magnetic resonance imaging revealed dysplasias of the pituitary, white matter and cerebellum...
October 6, 2016: Andrologia
A Zweerink, L Wu, G J de Roest, R Nijveldt, C C de Cock, A C van Rossum, C P Allaart
AIMS: This study evaluates the relative importance of two components of QRS prolongation, myocardial conduction velocity and travel distance of the electrical wave front (i.e. path length), for the prediction of acute response to cardiac resynchronization therapy (CRT) in left bundle branch block (LBBB) patients. METHODS: Thirty-two CRT candidates (ejection fraction <35%, LBBB) underwent cardiac magnetic resonance (CMR) imaging to provide detailed information on left ventricular (LV) dimensions...
October 5, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
C Moini, B Sidia, D Poindron, L Fiorina, A Farge, W Amara, M El Issa
Transcatheter aortic valve implantation (TAVI) is nowadays a worldwide technique in the field of treating aortic stenosis. One of the main side effects linked to the technique are mostly attached to rhythm disturbances, such as atrioventricular (AV) and intraventricular blocks. Consequently, a pacemaker implantation is often required. That implantation rate is estimated between 8 and 30%, depending on the valve chosen. Thanks to main meta analysis on the subject, it has been managed to isolate the following risks factors for AV block development: preoperative right bundle branch block (RBBB: the most powerful element), complete AV block during the procedure, male gender, a so-called porcelain aorta, the absence of previous valvular surgery, the aortic annulus size (i...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Jani Pirinen, Jukka Putaala, Karoliina Aarnio, Aapo L Aro, Juha Sinisalo, Markku Kaste, Elena Haapaniemi, Turgut Tatlisumak, Mika Lehto
INTRODUCTION: Ischemic stroke (IS) in a young patient is a disaster and recurrent cardiovascular events could add further impairment. Identifying patients with high risk of such events is therefore important. The prognostic relevance of ECG for this population is unknown. MATERIALS AND METHODS: A total of 690 IS patients aged 15-49 years were included. A 12-lead ECG was obtained 1-14 d after the onset of stroke. We adjusted for demographic factors, comorbidities, and stroke characteristics, Cox regression models were used to identify independent ECG parameters associated with long-term risks of (1) any cardiovascular event, (2) cardiac events, and (3) recurrent stroke...
September 29, 2016: Annals of Medicine
Julian Ck Tay, Liou Wei Lun, Zhong Liang, Terrance Sj Chua, Swee Han Lim, Aaron Sl Wong, Marcus Eh Ong, Kay Woon Ho
INTRODUCTION: Door-to-balloon (DTB) time is critical to ST elevation myocardial infarction (STEMI) patients' survival. Although DTB time is reduced with direct cardiovascular laboratory (CVL) activation by emergency physicians, concerns regarding false-positive activation remain. We evaluate false-positive rates before and after direct CVL activation and factors associated with false-positive activations. MATERIALS AND METHODS: This is a retrospective single centre study of all emergency CVL activation 3 years before and after introduction of direct activation in July 2007...
August 2016: Annals of the Academy of Medicine, Singapore
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