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Left bundle branch block

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https://www.readbyqxmd.com/read/28820653/fibrous-skeleton-of-the-heart-anatomic-overview-and-evaluation-of-pathologic-conditions-with-ct-and-mr-imaging
#1
Farhood Saremi, Damián Sánchez-Quintana, Shumpei Mori, Horia Muresian, Diane E Spicer, Cameron Hassani, Robert H Anderson
The fibrous skeleton is concentrated at the base of the ventricular mass. It provides electrical insulation at the atrioventricular level and fibrous continuity for the leaflets of the mitral, aortic, and tricuspid valves. Its components include the fibrous trigones, the fibrous area of aortic-mitral continuity, the subvalvar collar of the mitral valve, the membranous septum, the interleaflet triangles, the tendon of Todaro, and likely the conus ligament. The majority of the mitral annulus is fibrous, but the only true fibrous part of the tricuspid annulus is where the valvar leaflets are attached to the central fibrous body...
August 18, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28794085/idiopathic-ventricular-arrhythmias-originating-from-the-parietal-band-electrocardiographic-and-electrophysiological-characteristics-and-outcome-of-catheter-ablation
#2
Takumi Yamada, Naoki Yoshida, Taihei Itoh, Silvio H Litovsky, Harish Doppalapudi, H Thomas McElderry, G Neal Kay
BACKGROUNDS: The parietal band is one of the muscle bands in the right ventricle. This study investigated the electrocardiographic and electrophysiological characteristics and ablation outcome of idiopathic ventricular arrhythmias (VAs) originating from the parietal band. METHODS AND RESULTS: We studied 14 patients with idiopathic VA origins in the parietal band among 294 consecutive patients with VA origins in the right ventricle. The QRS morphologies of the parietal band VAs were characterized by a left bundle branch block and left inferior (n=12) or superior (n=2) axis pattern with the presence of a notch in the middle of the QRS in all cases, precordial transition at ≤lead V3 in 7 patients, and a slow QRS onset in 4 patients...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28791747/ecg-morphology-of-premature-ventricular-contractions-predicts-presence-of-myocardial-fibrotic-substrate-on-cardiac-magnetic-resonance-imaging-in-patients-undergoing-ablation
#3
Sabrina Oebel, Borislav Dinov, Arash Arya, Sebastian Hilbert, Philipp Sommer, Andreas Bollmann, Gerhard Hindricks, Ingo Paetsch, Cosima Jahnke
BACKGROUND: The most likely origin of PVCs may be deduced from surface ECG analysis while planning an electrophysiological study (EPS). Apart from purely benign forms of increased ventricular ectopy, myocardial substrate (e.g., regional fibrosis) may be present in certain cases, which will significantly impact the ablation approach. CMR imaging can reliably identify fibrotic target lesions and, hence, may assist in adequate patient selection and procedural planning. METHODS AND RESULTS: We analyzed 101 patients (59% male, mean age 57...
August 9, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28781300/successful-catheter-ablation-as-a-substitute-for-cardiac-resynchronization-therapy-in-patient-with-an-accessory-pathway-induced-cardiomyopathy
#4
Keisuke Nakabayashi, Ryo Sugiura, Yusuke Mizuno, Hiroko Kato, Naomi Nakazawa, Toshiaki Suzuki, Hideki Saito, Naomi Kawakatsu, Masayuki Goto, Daichi Isomura, Hisayuki Okada, Toshiaki Oka
A 50-year-old man presented with exertional dyspnea and orthopnea. An electrocardiogram showed a delta wave and a wide QRS complex, similar to left bundle branch block. Cardiac echocardiography revealed diffuse severe hypokinesis and dyssynchrony. The patient was diagnosed with congestive heart failure. We considered that the patient's condition was caused by an accessory pathway-induced cardiomyopathy after heart failure compensation with guideline-oriented medical therapy. We therefore performed catheter ablation for right-sided pre-excitation syndrome as cardiac resynchronization therapy...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28772031/local-microrna-133a-downregulation-is-associated-with-hypertrophy-in-the-dyssynchronous-heart
#5
Lars B van Middendorp, Marion Kuiper, Chantal Munts, Philippe Wouters, Jos G Maessen, Frans A van Nieuwenhoven, Frits W Prinzen
AIMS: Left bundle branch block (LBBB) creates considerable regional differences in mechanical load within the left ventricle (LV). We investigated expression of selected microRNAs (miRs) in relation to regional hypertrophy and fibrosis in LBBB hearts and their reversibility upon cardiac resynchronization therapy (CRT). METHODS AND RESULTS: Eighteen dogs were followed for 4 months after induction of LBBB, 10 of which received CRT after 2 months. Five additional dogs served as control...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28765745/rapid-and-potent-antiarrhythmic-effect-of-cardiac-resynchronization-therapy-in-a-patient-with-advanced-dilated-cardiomyopathy-and-a-large-ventricular-arrhythmia-burden
#6
Dong Sub Jeon, Jong Sung Park
We report a case demonstrating a rapid and potent antiarrhythmic effect of biventricular pacing. A 67-year-old male patient with dilated cardiomyopathy was admitted for heart failure. The initial surface electrocardiogram revealed a left bundle branch block with a QRS complex duration of 200 ms. Echocardiographic examination revealed a left ventricular ejection fraction of 16%, a left ventricular end-diastolic dimension of 91 mm, and marked interventricular dyssynchrony. Continuous rhythm monitoring revealed frequently-recurring non-sustained monomorphic ventricular tachycardia (VT)...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28762918/-noninvasive-electrophysiological-mapping-in-patients-with-complete-left-bundle-branch-block-and-different-modes-of-biventricular-pacing
#7
S V Zubarev, M P Chmelevsky, M A Budanova, M A Trukshina, T A Lyubimtseva, V K Lebedeva, D S Lebedev
OBJECTIVE: to investigate possibilities of noninvasive electrophysiological mapping (NEM) during biventricular (BiV) pacing and to compare the results with data of 12 lead ECG and tissue Doppler echocardiography (TDI). MATERIAL AND METHODS: The study included 25 patients with complete left bundle branch block (LBBB) and implanted cardiac resynchronization therapy (CRT) system. Twenty-two patients were CRT responders, three other patients did not demonstrate a clear effect...
May 2017: Kardiologiia
https://www.readbyqxmd.com/read/28759818/histological-topography-of-the-atrioventricular-node-and-its-extensions-in-relation-to-the-cardiothoracic-surgical-landmarks-in-normal-human-hearts
#8
Arpandeep Randhawa, Tulika Gupta, Anjali Aggarwal, Daisy Sahni, Rana Sandip Singh
BACKGROUND: Atrioventricular (AV) nodal injury which results in cardiac conduction disorders is one of the potential complications of heart valve surgeries and radiofrequency catheter ablations. Understanding the topography of the AV conduction system in relation to the tricuspid and mitral valves will help in reducing these complications. METHODS: A tissue block of 3cmx4cm, which contain the AV node, bundle of His and the AV nodal extensions, was excised at the AV septal junction in 20 apparently normal human hearts...
June 30, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28756427/thrombolysis-a-useful-tool-in-the-primary-pci-cupboard
#9
Konstantin Schwarz, Deepak Goyal, Helen Routledge
A 44-year-old woman presented to the emergency department with central crushing chest pain and dynamic anterior ST elevation on a background of a known left bundle-branch block on her electrocardiogram. Past medical history included insulin-dependent diabetes, asthma, fibromyalgia, and a gradually failing kidney transplant. This case demonstrates the rarely utilized niche role for intracoronary thrombolysis in STEMI treatment in the modern angioplasty era.
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28724945/effect-of-septal-flash-on-right-ventricular-systolic-function-in-left-bundle-branch-block-patients-with-preserved-left-ventricular-ejection-fraction
#10
Guang-Yuan Li, Yong-Huai Wang, Zheng-Yu Guan, Xuan-Yi Jin, Yang Li, Shuang Liu, Chun-Yan Ma, Jun Yang
A leftward motion of the ventricular septum prior to ejection, known as the septal flash (SF), is frequently observed in patients with left bundle-branch block (LBBB). We investigated whether the abnormal motion of the ventricular septum affects right ventricle (RV) contractile performance in LBBB patients with preserved left ventricular ejection fraction (LVEF). Forty-four patients with complete LBBB were selected using standard 12-lead electrocardiograms (ECGs), with 30 healthy individuals serving as controls...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28711360/false-positive-stemi-activations-in-a-regional-network-comprehensive-analysis-and-clinical-impact-results-from-the-catalonian-codi-infart-network
#11
Ander Regueiro, Diego Fernández-Rodríguez, Xavier Freixa, Xavier Bosch, Victoria Martín-Yuste, Salvatore Brugaletta, Mercè Roqué, Manel Sabaté, Mónica Masotti
INTRODUCTION AND OBJECTIVES: ST-segment elevation myocardial infarction (STEMI) network activation by a noncardiologist reduces delay times but may increase the rate of false-positive STEMI diagnoses. We aimed to determine the prevalence, predictors, and clinical impact of false-positive activations within the Catalonian STEMI network (Codi Infart). METHODS: From January 2010 through December 2011, all consecutive patients treated within the Codi Infart network were included...
July 12, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28708290/rationale-and-design-of-the-adaptresponse-trial-a-prospective-randomized-study-of-cardiac-resynchronization-therapy-with-preferential-adaptive-left-ventricular-only-pacing
#12
Gerasimos Filippatos, David Birnie, Michael R Gold, Bart Gerritse, Ahmad Hersi, Sandra Jacobs, Kengo Kusano, Christophe Leclercq, Wilfried Mullens, Bruce L Wilkoff
The AdaptResponse trial is designed to test the hypothesis that preferential adaptive left ventricular-only pacing with the AdaptivCRT(®) algorithm reduces the incidence of the combined endpoint of all-cause mortality and intervention for heart failure (HF) decompensation, compared with conventional cardiac resynchronization therapy (CRT), among patients with a CRT indication, left bundle branch block (LBBB) and normal atrioventricular (AV) conduction. The AdaptResponse study is a prospective, randomized, controlled, single-blinded, multicentre, clinical trial (ClinicalTrials...
July 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28706597/an-infrequent-cause-of-apical-ventricular-aneurysm-in-the-united-states
#13
Mohammed M Taleb
Chronic Chagas cardiomyopathy (CCC) is a late complication of Chagas disease with various manifestations including arrhythmia, heart failure, thromboembolism, and stroke. In a patient with symptoms of heart failure and left ventricular apical aneurysm unexplained by structural heart or coronary vascular abnormalities, CCC should be strongly considered and inquiry made about exposure status. Typical electrocardiographic findings of bundle branch block, complete heart blocks, and ventricular arrhythmia are helpful clues...
April 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28701682/prognostic-impact-of-segmental-wall-motion-abnormality-in-patients-with-idiopathic-dilated-cardiomyopathy
#14
Yuichiro Iida, Takayuki Inomata, Toyoji Kaida, Teppei Fujita, Yuki Ikeda, Takeru Nabeta, Shunsuke Ishii, Toshimi Koitabashi, Ichiro Takeuchi, Junya Ako
The clinical impact of left ventricular (LV) segmental wall motion abnormalities (SWMA) in patients with idiopathic dilated cardiomyopathy (IDCM) has not been well elucidated.Among 100 consecutive IDCM patients with follow-up visits, we enrolled 85 after excluding those with left bundle branch block and/or ventricular pacemaker implantation. LV wall motion was assessed using left ventriculography scored for 7 segments according to the American Heart Association classification as follows: 0, normokinesis; 1, hypokinesis; 2, akinesis; and 3, dyskinesis...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28701672/the-shortest-qrs-duration-of-an-electrocardiogram-might-be-an-optimal-electrocardiographic-predictor-for-response-to-cardiac-resynchronization-therapy
#15
Jan-Yow Chen, Kuo-Hung Lin, Kuan-Cheng Chang, Che-Yi Chou
QRS duration has been associated with the response to cardiac resynchronization therapy (CRT). However, the methods for defining QRS duration to predict the outcome of CRT have discrepancies in previous reports. The aim of this study was to determine an optimal measurement of QRS duration to predict the response to CRT.Sixty-one patients who received CRT were analyzed. All patients had class III-IV heart failure, left ventricular ejection fraction not more than 35%, and complete left bundle branch block. The shortest, longest, and average QRS durations from the 12 leads of each electrocardiogram (ECG) were measured...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28691201/combined-myocardial-deformation-to-predict-cardiac-resynchronization-therapy-response-in-non-ischemic-cardiomyopathy
#16
Ning Yang, Zhao-Guang Liang, Zhao-Jun Wang, Hui Liu, Chao Chi, Yan-Feng Tian, Shu-Han Qi, Bi-Yu Wang, Wei Han
BACKGROUND: 20-30% of patients do not benefit from CRT when the established selection criteria were applied. We hypothesized that a combined assessment of mechanical dyssynchrony, myocardial deformation and diastolic function would identify patients who would benefit most from CRT. METHOD: In 36 CRT patients, clinical evaluation and echocardiography were performed before and after CRT. Patients were classified into 3 subgroups according to their amount of response: echocardiographic responders, clinical responders, and nonresponders...
July 10, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28688704/long-term-survival-of-patients-with-left-bundle-branch-block-who-are-hypo-responders-to-cardiac-resynchronization-therapy
#17
Himabindu Vidula, Valentina Kutyifa, Scott McNitt, Ilan Goldenberg, Scott D Solomon, Arthur J Moss, Wojciech Zareba
Guidelines support cardiac resynchronization therapy with a defibrillator (CRT-D) in mild heart failure (HF) patients with left bundle branch block (LBBB). However, not all patients demonstrate echocardiographic or clinical response to CRT-D. We aimed to evaluate the long-term outcomes of echocardiographic hypo-responders and clinical hypo-responders to CRT-D with LBBB in the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy. Five-hundred thirty-four patients with LBBB in the CRT-D arm were followed for 5...
June 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28680626/years-of-palpitations-and-a-heart-rate-of-213-beats-per-minute
#18
Kevin Lee, Joseph Banta, Matthew D'Ambrosio, Apostolos Voudouris, Antonios Tsompanidis
Belhassen tachycardia is the most common idiopathic ventricular tachycardia arising from the left ventricle, classically characterized by a right bundle branch block and left axis deviation. Vigilance for Belhassen tachycardia is essential as intravenous verapamil has proven to be highly efficacious for treating symptomatic patients with this underlying arrhythmia.
July 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28670186/unusual-dipyridamole-induced-aberrant-conduction-in-the-absence-of-myocardial-ischemia
#19
Roberto Ricca-Mallada, Federico Ferrando-Castagnetto, Rodolfo Ferrando, Fernando Mut
We report two patients referred to 2 day stress-rest single photon emission computed tomography for diagnosis of ischemia who elicited a transient left bundle branch block during dipyridamole intravenous infusion. The conduction disturbance disappeared after aminophyline infusion and became permanent during follow-up. Possible mechanisms underlying this unusual phenomenon in the absence of myocardial ischemia are discussed.
July 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28667170/isolated-cardiac-sarcoidosis-masquerading-as-right-ventricular-outflow-tract-ventricular-tachycardia
#20
Auras R Atreya, Mitkumar Patel, Senthil K Sivalingam, Mathias L Stoenescu
A 67-year-old man with coronary artery disease (CAD) and left anterior descending artery (LAD) stent presented with symptomatic monomorphic ventricular tachycardia (VT) at a rate of 190 bpm requiring cardioversion. ECG showed left bundle branch block pattern and inferior axis, suggestive of a right ventricular outflow tract (RVOT) focus rather than left ventricular scar due to LAD territory myocardial infarction (MI). Echocardiography showed normal wall motion. Angiography revealed a patent mid-LAD stent. Cardiac MRI with delayed postcontrast sequence revealed several regions of hyperenhancement abnormality within the basal portion of the interventricular septum...
June 30, 2017: BMJ Case Reports
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