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https://www.readbyqxmd.com/read/29338549/sedation-in-cardiac-arrhythmias-management
#1
Federico Guerra, Giulia Stronati, Alessandro Capucci
Procedural sedation is of paramount importance for a plethora of electrophysiological procedures. From electrical cardioversion to electrophysiology studies, device implantations, and catheter ablations, intraprocedural sedation and anesthesia have a pivotal role in allowing procedural success while ensuring patient safety and avoiding discomfort. Areas covered: The present review will discuss the current state-of-the-art in sedation and anesthesia during electrical cardioversion, cardiac implantable electronic device implantation, catheter ablation and electrophysiology studies...
January 17, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29333794/ablation-induced-change-in-the-course-of-fascicular-tachycardia
#2
Avishag Laish-Farkash, Avi Sabbag, Michael Glikson, Aharon Glick, Vladimir Khalameizer, Amos Katz, Yoav Michowitz
BACKGROUND: Multiform fascicular tachycardia (FT) was recently described as a ventricular tachycardia (VT) that has a reentrant mechanism using multiple fascicular branches and produces alternate fascicular VT forms. Ablating the respective fascicle may cause a change in the reentrant circuit resulting in a change in morphology. Ablation of the septal fascicle is crucial for successful treatment. OBJECTIVES: To describe four cases of FT in which ablation induced a change in QRS morphologies and aggravated clinical course...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29330130/perioperative-electrophysiology-study-in-tetralogy-of-fallot-patients-undergoing-pulmonary-valve-replacement-will-identify-those-at-high-risk-for-subsequent-ventricular-tachycardia
#3
Amneet Sandhu, Emily Ruckdeschel, William H Sauer, Kathryn K Collins, Joseph Kay, Amber Khanna, James Jaggers, David Campbell, Max Mitchell, Duy T Nguyen
BACKGROUND: Ventricular tachyarrhythmias (VAs) are the most common cause of death in patients with repaired Tetralogy of Fallot (TOF), but predicting those at risk remains a challenge. Electrophysiological study (EPS) has been proposed to risk stratify TOF patients. OBJECTIVE: We sought to evaluate a perioperative EPS-guided approach to risk stratify TOF patients undergoing PVR and guide concomitant cryoablation. METHODS: A prospective cohort study of TOF patients undergoing EPS at time of PVR from 2006-present was conducted at 2 centers...
January 9, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29316261/arrhythmia-after-cone-repair-for-ebstein-anomaly-the-mayo-clinic-experience-in-143-young-patients
#4
Philip Wackel, Bryan Cannon, Joseph Dearani, Kristen Sessions, Kimberly Holst, Jonathan Johnson, Frank Cetta
BACKGROUND: The increased incidence of preoperative and postoperative arrhythmia in Ebstein anomaly (EA) prompted some clinicians to perform an electrophysiology study (EPS) in all patients prior to surgery for EA. The cone repair (CR) is the current surgical option of choice for most young patients with EA but the effect of the CR on arrhythmia is not well established. OBJECTIVES: To assess the burden of arrhythmia in young patients after CR and to assess the utility of selective preoperative EPS...
January 8, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29309556/statistics-on-the-use-of-cardiac-electronic-devices-and-interventional-electrophysiological-procedures-in-africa-from-2011-to-2016-report-of-the-pan-african-society-of-cardiology-pascar-cardiac-arrhythmias-and-pacing-task-forces
#5
Aimé Bonny, Marcus Ngantcha, Mohamed Jeilan, Emmy Okello, Bundhoo Kaviraj, Mohammed A Talle, George Nel, Eloi Marijon, Mahmoud U San, Zaheer Yousef, Kamilu M Karaye, Ibrahim A Touré, Mohamed A Awad, George Millogo, Jonas Kologo, Adama Kane, Romain Houndolo, Anastase Dzudié, Amam Mbakwem, Bongani M Mayosi, Ashley Chin
Aims: To provide comprehensive information on the access and use of cardiac implantable electronic devices (CIED) and catheter ablation procedures in Africa. Methods and results: The Pan-African Society of Cardiology (PASCAR) collected data on invasive management of cardiac arrhythmias from 2011 to 2016 from 31 African countries. A specific template was completed by physicians, and additional information obtained from industry. Information on health care systems, demographics, economics, procedure rates, and specific training programs was collected...
December 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29304037/influence-of-advancing-age-on-clinical-presentation-treatment-efficacy-and-safety-and-long-term-outcome-of-inducible-paroxysmal-supraventricular-tachycardia-without-pre-excitation-syndromes-a-cohort-study-of-1960-patients-included-over-25-years
#6
Béatrice Brembilla-Perrot, Jean Marc Sellal, Arnaud Olivier, Thibaut Villemin, Daniel Beurrier, Julie Vincent, Vladimir Manenti, Christian de Chillou, Erwan Bozec, Nicolas Girerd
AIM: To investigate the influence of increasing age on clinical presentation, treatment and long-term outcome in patients with inducible paroxysmal supraventricular tachycardia (SVT) without pre-excitation syndromes. METHODS: Clinical and electrophysiological study (EPS) data, as well as long-term clinical outcome (mean follow-up 2.4±4.0 years) were collected in patients referred for regular tachycardia with inducible SVT during EPS without pre-excitation. RESULTS: Among 1960 referred patients, 301 patients (15...
2018: PloS One
https://www.readbyqxmd.com/read/29302263/radiofrequency-catheter-ablation-of-atrioventricular-nodal-reentry-tachycardia-in-children-and-adolescents-a-single-center-experience
#7
Myung Chul Hyun
Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center...
December 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29287718/noninvasive-clues-for-diagnosing-ventricular-tachycardia-mechanism
#8
REVIEW
Andres Enriquez, Michael Riley, Francis Marchlinski
The electrophysiologic mechanisms responsible for the initiation and maintenance of ventricular tachycardia (VT) include enhanced automaticity, triggered activity and reentry. Differentiating between these three mechanisms can be challenging for the clinician and usually requires an invasive electrophysiology study. Establishing the underlying VT mechanism in a particular patient is helpful to define the optimal therapeutic approach, including the selection of pharmacologic agents or delineation of an ablation strategy...
November 21, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29282324/biphasic-functions-for-the-gdnf-ret-signaling-pathway-in-chemosensory-neuron-development-and-diversification
#9
Christopher R Donnelly, Amol A Shah, Charlotte M Mistretta, Robert M Bradley, Brian A Pierchala
The development of the taste system relies on the coordinated regulation of cues that direct the simultaneous development of both peripheral taste organs and innervating sensory ganglia, but the underlying mechanisms remain poorly understood. In this study, we describe a novel, biphasic function for glial cell line-derived neurotrophic factor (GDNF) in the development and subsequent diversification of chemosensory neurons within the geniculate ganglion (GG). GDNF, acting through the receptor tyrosine kinase Ret, regulates the expression of the chemosensory fate determinant Phox2b early in GG development...
December 27, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29250292/comparison-of-the-efficacy-of-pvac%C3%A2-and-nmarq%C3%A2-for-paroxysmal-atrial-fibrillation
#10
REVIEW
Avishag Laish-Farkash, Mahmoud Suleiman
Pulmonary vein isolation (PVI) has become the mainstay of therapy for atrial fibrillation (AF) and one of the most frequently performed procedures in the cardiac electrophysiology laboratory. PVI by a single-tip radiofrequency (RF) ablation catheter remains a complex and time-consuming procedure, especially in centers with limited experience. In order to simplify the PVI procedure, to shorten it and reduce the complication rate, circular multi-electrode catheters were introduced for simultaneous mapping and ablation...
April 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29250240/towards-a-mechanistic-understanding-and-treatment-of-a-progressive-disease-atrial-fibrillation
#11
REVIEW
Felix Yang, Joseph Tiano, Suneet Mittal, Mintu Turakhia, Israel Jacobowitz, Yisachar Greenberg
Atrial fibrosis appears to be a key factor in the genesis and/or perpetuation of atrial fibrillation (AF). The pathological distribution of atrial fibrosis is geographically consistent with the attachments between the posterior left atrium and the pericardium along the reflections where wall stiffness is increased and structural changes are found. While there is a wide range of complex etiological factors and electrophysiological mechanisms in AF, there is evidence for a common pathophysiological pathway that could account for deliberate substrate formation and progression of AF...
October 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29244066/electrocardiographic-and-electrophysiologic-differentiation-between-atriofascicular-long-atrioventricular-and-short-atrioventricular-decrementally-conducting-accessory-pathways
#12
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
https://www.readbyqxmd.com/read/29236642/noninvasive-cardiac-radiation-for-ablation-of-ventricular-tachycardia
#13
Phillip S Cuculich, Matthew R Schill, Rojano Kashani, Sasa Mutic, Adam Lang, Daniel Cooper, Mitchell Faddis, Marye Gleva, Amit Noheria, Timothy W Smith, Dennis Hallahan, Yoram Rudy, Clifford G Robinson
BACKGROUND: Recent advances have enabled noninvasive mapping of cardiac arrhythmias with electrocardiographic imaging and noninvasive delivery of precise ablative radiation with stereotactic body radiation therapy (SBRT). We combined these techniques to perform catheter-free, electrophysiology-guided, noninvasive cardiac radioablation for ventricular tachycardia. METHODS: We targeted arrhythmogenic scar regions by combining anatomical imaging with noninvasive electrocardiographic imaging during ventricular tachycardia that was induced by means of an implantable cardioverter-defibrillator (ICD)...
December 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29231821/familial-atrioventricular-nodal-re-entrant-tachycardia-a-case-seriers-and-a-systematic-review
#14
Muthiah Subramanian, M S Harikrishnan, Mukund A Prabhu, Praveen G Pai, Saritha S Shekhar, Kumaraswamy Natarajan
Multiple reports of familial clustering suggest that genetic factors may contribute in the pathogenesis of atrioventricular nodal re-entrant tachycardia (AVNRT). We report three cases of AVNRT in a father and his two sons along with a review of literature of other similar cases. Electrophysiological studies induced typical AVNRT, which was successfully eliminated by radiofrequency ablation in all of them. Of the 22 reported cases, 96% had typical (slow-fast) variant of AVNRT. The predominant pattern of inheritance appears to be autosomal dominant, though other patterns may exist...
November 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29226896/recovery-of-cardiomyopathy-induced-by-ventricular-premature-beats-of-parahisian-origin-after-successful-radiofrequency-catheter-ablation
#15
Gökhan Aksan, Ali Elitok, Mehmet Tezcan, Ahmet Kaya Bilge, Kamil Adalet
A 51-year-old male patient presented with frequent and symptomatic premature ventricular complexes (PVCs) that had induced cardiomyopathy. Radiofrequency (RF) catheter ablation of the origin of the PVCs was planned and the patient underwent electrophysiological study. During activation mapping, the earliest ventricular activation was identified at the His bundle region. Small His bundle electrogram recording by the distal ablation electrode during sinus rhythm revealed that the earliest ventricular activation during PVC preceded the QRS onset by 58 milliseconds...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29215547/hypnosis-as-an-effective-and-inexpensive-option-to-control-pain-in-transcatheter-ablation-of-cardiac-arrhythmias
#16
Umberto Barbero, Federico Ferraris, Milena Muro, Carlo Budano, Matteo Anselmino, Fiorenzo Gaita
: Supportive care for pain relief and back discomfort during electrophysiology interventions is usually needed in the electrophysiology lab, especially in long-lasting procedures like atrial fibrillation ablation. Although this is usually achieved with conventional pharmacologic anesthesia, hypnosis has recently aroused interest as a reliable tool to complement and possibly enhance conscious sedation. We collected five case of percutaneous arrhythmia ablation in which, after informed consent, hypnosis was performed by nurse anesthetists in the cath lab...
January 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29194653/electrophysiological-markers-predicting-impeding-av-block-during-ablation-of-atrioventricular-nodal-re-entry-tachycardia
#17
Nikolaos Fragakis, Lydia Krexi, Panagiota Kyriakou, Melani Sotiriadou, Charalambos Lazaridis, Athanasios Karamanolis, Panagiotis Dalampyras, Stelios Tsakiroglou, Vassilios Skeberis, Dimitrios Tsalikakis, Vassilios Vassilikos
BACKGROUND: Radiofrequency (RF) ablation of the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT) is occasionally complicated with atrioventricular block (AVB) often predicted by junctional beats (JB) with loss of ventriculo-atrial (VA) conduction. METHODS: We analysed retrospectively 153 patients undergoing ablation of SP for typical AVNRT. Patients were divided into two age groups: 127 ≤70 years and 26 > 70 years. We analysed the interval between the atrial electrogram in the His-bundle position and the distal ablation catheter [A(H)-A(RFd)] and the proximal coronary sinus catheter [A(RFd)-A(CS)] before RF applications with and without JB...
November 30, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29186419/management-of-ventricular-tachycardia-in-the-ablation-era-results-of-the-european-heart-rhythm-association-survey
#18
Roland Richard Tilz, Radoslaw Lenarczyk, Daniel Scherr, Kristina Herman Haugaa, Konstantinos Iliodromitis, Helmut Pürerfellner, Marek Kiliszek, Nikolaos Dagres
Patients with sustained ventricular tachycardia (VT) are at risk of sudden death. Treatment options for VT include antiarrhythmic drug therapy, insertion of an implantable cardioverter-defibrillator, and catheter ablation. Evidence on indications for VT ablation, timing, ablation strategies, and periprocedural management is sparse. The aim of this European Heart Rhythm Association (EHRA) survey was to evaluate clinical practice regarding management of VT among the European countries. An electronic questionnaire was sent to members of the EHRA Electrophysiology Research Network...
November 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29177981/long-term-incidence-of-inappropriate-shocks-in-patients-with-implantable-cardioverter-defibrillators-in-clinical-practice-an-underestimated-complication
#19
Daniel Hofer, Jan Steffel, David Hürlimann, Laurent Haegeli, Thomas F Lüscher, Firat Duru, Urs Eriksson, Nazmi Krasniqi
BACKGROUND: Implantable cardioverter defibrillators (ICD) are life-saving device therapy, and patients often carry devices for decades with interim pulse generator exchanges. Inappropriate shocks are associated with impaired quality of life and increased mortality, but available data on their incidence and etiology outside of clinical trials is limited and usually restricted to the lifespan of a singular device. We hypothesized that the incidence in clinical practice is underestimated and aimed this study to retrospectively assess the long-term incidence and etiology of inappropriate shocks in a real-world cohort of patients with multiple ICDs over a long follow-up period...
November 25, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29167624/unique-ventricular-tachycardia-originating-from-the-right-bundle-branch
#20
Hongliang Yang, Daoyuan Si, Yaliang Tong, Zhe An, Ping Yang, Yuquan He
Ventricular tachycardia (VT), a common arrhythmia, frequently originates from in the right ventricular outflow tract, left ventricular outflow tract, aortic sinus, and left ventricular papillary muscle but infrequently from the His-Purkinje system, whereas the VT stemming from the right bundle branch has rarely been reported. Here we reported a case with of VT originating from the right bundle branch which was subsequently successfully treated with radiofrequency ablation and demonstrated the electrocardiac features of VT using an electrophysiological examination...
November 2017: Acta Cardiologica Sinica
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