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Left bundle branch block

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https://www.readbyqxmd.com/read/29452255/radiofrequency-ablation-of-premature-ventricular-contractions-originating-from-uncommon-sites-of-right-ventricle
#1
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Arun Gopalakrishnan, Ajitkumar Valaparambil
Premature Ventricular Contraction (PVC)/ventricular tachycardia (VT) with left bundle branch block (LBBB) morphology and inferior axis has been described classically to originate from the right ventricular outflow tract (RVOT). Some uncommon sites of idiopathic ventricular arrhythmia (VA) origins have been revealed including tricuspid annulus (TA) and right ventricular (RV) inflow free wall region. We present a series of two cases who have undergone electrophysiological study and successful radiofrequency ablation of frequent monomorphic PVCs with LBBB pattern originating from relatively uncommon sites of RV - TA and RV inflow free wall region...
February 13, 2018: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29442383/atrial-overdrive-pacing-during-lbbb-tachycardia-what-is-the-mechanism
#2
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Hiren Kevadiya, Ajitkumar Valaparambil
A 35-year old lady was referred for evaluation of recurrent palpitation. During one of the episodes of palpitation a wide QRS tachycardia with left bundle branch block (LBBB) morphology was recorded and it was terminated with intravenous adenosine. The surface electrocardiogram during sinus rhythm did not show any pre-excitation. Echocardiogram was normal. Patient underwent an electrophysiology study after informed consent. During catheter placement a wide QRS tachycardia with LBBB morphology and left axis deviation (LAD) similar to the clinical tachycardia got induced (Fig:1)...
February 14, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29440008/novel-%C3%AE-actin-gene-mutation-p-ala21val-causing-familial-hypertrophic-cardiomyopathy-myocardial-noncompaction-and-transmural-crypts-clinical-pathologic-correlation
#3
Andrea Frustaci, Alessandro De Luca, Valentina Guida, Tommaso Biagini, Tommaso Mazza, Carlo Gaudio, Claudio Letizia, Matteo Antonio Russo, Nicola Galea, Cristina Chimenti
BACKGROUND: Mutations of α-actin gene (ACTC1) have been phenotypically related to various cardiac anomalies, including hypertrophic cardiomyopathy and dilated cardiomyopathy and left ventricular (LV) myocardial noncompaction. A novel ACTC mutation is reported as cosegregating for familial hypertrophic cardiomyopathy and LV myocardial noncompaction with transmural crypts. METHODS AND RESULTS: In an Italian family of 7 subjects, 4 aged 10 (II-1), 14 (II-2), 43 (I-4) and 46 years (I-5), presenting abnormal ECG changes, dyspnea and palpitation (II-2, I-4, and I-5), and recurrent cerebral ischemic attack (I-5), underwent 2-dimensional echo, cardiac magnetic resonance, Holter monitoring, and next-generation sequencing gene analysis...
February 10, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29432133/programming-cardiac-resynchronization-therapy-for-electrical-synchrony-reaching-beyond-left-bundle-branch-block-and-left-ventricular-activation-delay
#4
Niraj Varma, David O'Donnell, Mohammed Bassiouny, Philippe Ritter, Carlo Pappone, Jan Mangual, Daniel Cantillon, Nima Badie, Bernard Thibault, Brian Wisnoskey
BACKGROUND: QRS narrowing following cardiac resynchronization therapy with biventricular (BiV) or left ventricular (LV) pacing is likely affected by patient-specific conduction characteristics (PR, qLV, LV-paced propagation interval), making a universal programming strategy likely ineffective. We tested these factors using a novel, device-based algorithm (SyncAV) that automatically adjusts paced atrioventricular delay (default or programmable offset) according to intrinsic atrioventricular conduction...
February 6, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29428145/his-bundle-pacing-is-it-ready-for-prime-time
#5
REVIEW
Fatima M Ezzeddine, Gopi Dandamudi
Long-term right ventricular apical pacing has been associated with detrimental effects, including an increased risk for heart failure, atrial fibrillation, and death. Most of these adverse effects result from ventricular dyssynchrony related to perturbed ventricular depolarization. In addition, biventricular pacing has limited benefits in patients with non-left bundle branch block and severely reduced ejection fraction. Consequently, alternative pacing strategies that mimic natural physiology are desired. Recently, permanent His bundle pacing has emerged as a true physiologic form of ventricular pacing that has been shown to be safe and feasible in clinical practice...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29423906/relationships-between-electrical-and-mechanical-dyssynchrony-in-patients-with-left-bundle-branch-block-and-healthy-controls
#6
Saara Sillanmäki, Jukka A Lipponen, Mika P Tarvainen, Tiina Laitinen, Marja Hedman, Antti Hedman, Antti Kivelä, Hanna Hämäläinen, Tomi Laitinen
BACKGROUND: Abnormal electrical activation may cause dyssynchronous left ventricular (LV) contraction. In this study, we characterized and analyzed electrical and mechanical dyssynchrony in patient with left bundle branch block (LBBB) and healthy controls. METHODS: Myocardial perfusion imaging (MPI) data from 994 patients were analyzed. Forty-three patient fulfilled criteria for LBBB and 24 for controls. Electrical activation was characterized with vector electrocardiography (VECG) and LV function including mechanical dyssynchrony with ECG-gated MPI phase analysis...
February 8, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29413245/left-bundle-branch-block-and-new-permanent-pacemaker-implantation-after-transcatheter-aortic-valve-replacement-are-they-benign
#7
EDITORIAL
John G Webb, Janarthanan Sathananthan
No abstract text is available yet for this article.
February 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29408870/mid-term-outcomes-of-biventricular-obstruction-and-left-ventricular-outflow-tract-obstruction-after-surgery-correction-in-child-and-adolescent-patients-with-hypertrophic-cardiomyopathy
#8
Shanshan Zhai, Haitao Xu, Chaomei Fan, Yinjian Yang, Fei Hang, Xiying Guo, Hongyue Wang, Fujian Duan, Jun Yan
BACKGROUND: Data on the outcomes of hypertrophic cardiomyopathy (HCM) with biventricular obstruction are limited. OBJECTIVE: Our aim is to compare mid-term outcomes of biventricular outflow tract obstruction (BVOTO) HCM, left ventricular outflow tract obstruction (LVOTO) HCM and nonobstructive hypertrophic cardiomyopathy (NO-HCM) in children and adolescents who were treated with standard medication or surgical resection. METHODS: This retrospective study identified 21 BVOTO patients and recruited 27 LVOTO and 24 NO-HCM patients younger than 18 years presenting at our institution...
2018: PloS One
https://www.readbyqxmd.com/read/29407483/persistent-ventricular-preexcitation-despite-right-bundle-branch-block
#9
Taihei Itoh, Takumi Yamada
A 44-year-old man with a history of ventricular preexcitation and supraventricular tachycardia was evaluated. The baseline electrocardiogram exhibited ventricular preexcitation with a normal PR interval and a minimally negative delta wave in lead V1 and positive delta waves in the inferior leads. The administration of adenosine resulted in a progressive prolongation of the PR interval with a fixed preexcitation degree, suggesting the presence of antegrade conduction over the fasciculo-ventricular pathway. When complete right bundle branch block occurred, the degree of preexcitation never changed...
January 30, 2018: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29407007/new-insights-into-the-use-of-the-12-lead-electrocardiogram-for-diagnosing-acute-myocardial-infarction-in-the-emergency-department
#10
REVIEW
David F Miranda, Angie S Lobo, Brooks Walsh, Yader Sandoval, Stephen W Smith
The 12-lead electrocardiogram (ECG) remains the most immediately accessible and widely used initial diagnostic tool for guiding management in patients with suspected myocardial infarction (MI). Although the development of high-sensitivity cardiac troponin assays has improved the rule-in and rule-out and risk stratification of acute MI without ST elevation, the immediate management of the subset of acute MI with acute coronary occlusion depends on integrating clinical presentation and ECG findings. Careful interpretation of the ECG might yield subtle features suggestive of ischemia that might facilitate more rapid triage of patients with subtle acute coronary occlusion or, conversely, in identification of ST-elevation MI mimics (pseudo ST-elevation MI patterns)...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29405655/a-case-of-cardiac-sarcoidosis-mimicking-cardiac-amyloidosis-on-cardiovascular-magnetic-resonance
#11
Kazunori Takemura, Ryuta Nakamura, Kazuhito Shimazu, Youichiro Sugimoto, Tetsuro Takase, Minamimoto Ryogo, Michiaki Hiroe
A 52-year-old male visited our hospital with abnormal electrocardiogram and exertional fatigue. The electrocardiogram showed first-degree atrioventricular block, complete right bundle branch block, and inverted T waves in Leads II, III, aVF, V3, and V4. Echocardiography showed biventricular wall thickening involving granular sparkling of the interventricular septum. Late gadolinium enhancement on cardiovascular magnetic resonance (CMR) was found at the circumferential right ventricular wall and patchy regions of the left ventricle...
February 5, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29401235/arrhythmogenic-response-to-isoproterenol-testing-vs-exercise-testing-in-arrhythmogenic-right-ventricular-cardiomyopathy-patients
#12
A Denis, F Sacher, N Derval, R Martin, H S Lim, T Pambrun, G Massoullie, J Duchateau, H Cochet, X Pillois, G Cheniti, A Frontera, M Takigawa, K Vlachos, C Martin, T Kitamura, M Hocini, H Douard, P Jaïs, M Haïssaguerre
Aims: To compare the arrhythmic response to isoproterenol and exercise testing in newly diagnosed arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. Methods and results: We studied isoproterenol [continuous infusion (45 µg/min) for 3 min] and exercise testing (workload increased by 30 W every 3 min) performed in consecutive newly diagnosed ARVC patients. Both tests were evaluated with regard to the incidence of (i) polymorphic premature ventricular contractions (PVCs) and couplet(s) or (ii) sustained or non-sustained ventricular tachycardia (VT) with left bundle branch block [excluding right ventricular outflow tract VT]; and compared to a control group referred for the evaluation of PVCs without structural heart disease...
February 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29396657/twenty-year-experience-with-the-konno-operation-konno-incision-does-not-impair-lv-function
#13
Yuichi Matsuzaki, Takeshi Hiramatsu, Takahiko Sakamoto, Mitsugi Nagashima, Hiroshi Niinami, Kenji Yamazaki
BACKGROUND: There has been no report observing the LV function of Konno incision. We examined the outcomes of the Konno operations over 20 years. METHODS: We investigated 63 Konno operations with mechanical valves performed from 1984. This study aimed to evaluate the effects of Konno incision including LV function changes and the long-term outcomes of patient survival and reoperation rate (RVOT and LVOT complications). RESULTS: The postoperative follow-up period was 20...
February 2, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29395105/new-formula-for-defining-normal-and-prolonged-qt-in-patients-with-bundle-branch-block
#14
Lior Yankelson, Aviram Hochstadt, Ben Sadeh, Benley Pick, Ariel Finkelstein, Raphael Rosso, Sami Viskin
OBJECTIVES: To predict the QT interval in the presence of normal QRS for patients with left bundle branch block (LBBB). BACKGROUND: There is no acceptable method for simple and reliable QT correction for patients with bundle branch block (BBB). METHODS: We measured the QT interval in patients with new onset LBBB who had a recent electrocardiogram with narrow QRS for comparison. 48 patients who developed in-hospital LBBB were studied. Patients who had similar heart rate before and after LBBB were included...
January 30, 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29391388/a-patient-with-left-bundle-branch-block-and-persistent-atrial-fibrillation-treated-with-cardiac-catheter-ablation-and-pharmacologic-cardiac-resynchronization-therapy-without-the-use-of-an-implantable-cardiac-device
#15
Hideyuki Hasebe
BACKGROUND Left bundle branch block (LBBB) is associated with atrial fibrillation (AF) and systolic heart failure, which can be treated with cardiac resynchronization therapy (CRT) that includes an implantable cardiac device (ICD). However, in some patients, LBBB may vary with heart rate, and during episodes of AF in LBBB, aberrant ventricular conduction, or wide QRS complex tachycardia (Ashman beats) can occur. This report is a case of LBBB treated with pharmacologic CRT, without the use of an ICD. CASE REPORT A 68-year-old man presented with persistent AF and systolic heart failure...
February 2, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29387538/overcoming-left-bundle-branch-block-by-permanent-his-bundle-pacing-evidence-of-longitudinal-dissociation-in-the-his-via-recordings-from-a-permanent-pacing-lead
#16
Parikshit S Sharma, Kristin Ellison, Hena N Patel, Richard G Trohman
No abstract text is available yet for this article.
November 2017: HeartRhythm Case Reports
https://www.readbyqxmd.com/read/29386188/patient-specific-computer-simulation-to-elucidate-the-role-of-contact-pressure-in-the-development-of-new-conduction-abnormalities-after-catheter-based-implantation-of-a-self-expanding-aortic-valve
#17
Giorgia Rocatello, Nahid El Faquir, Gianluca De Santis, Francesco Iannaccone, Johan Bosmans, Ole De Backer, Lars Sondergaard, Patrick Segers, Matthieu De Beule, Peter de Jaegere, Peter Mortier
BACKGROUND: The extent to which pressure generated by the valve on the aortic root plays a role in the genesis of conduction abnormalities after transcatheter aortic valve replacement (TAVR) is unknown. This study elucidates the role of contact pressure and contact pressure area in the development of conduction abnormalities after TAVR using patient-specific computer simulations. METHODS AND RESULTS: Finite-element computer simulations were performed to simulate TAVR of 112 patients who had undergone TAVR with the self-expanding CoreValve/Evolut R valve...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29382690/man-in-his-50s-with-chest-pain-and-dyspnoea
#18
Yuki Obayashi, Chisato Izumi, Yoshihisa Nakagawa
CLINICAL INTRODUCTION: A man in his 50s with sudden-onset chest pain and dyspnoea was transferred to the emergency room. He had a history of aortic valve replacement due to aortic regurgitation with a mechanical valve 6 years previously. Heart rate was 90 bpm, and blood pressure was too low to measure. In the emergency room, he presented with severe dyspnoea and a chest X-ray showed severe lung congestion (figure 1A). ECG showed complete left bundle branch block. His respiratory status rapidly worsened, and he went into cardiopulmonary arrest...
January 30, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29369050/endocardial-center-motion-for-quantification-of-left-ventricular-discoordination-in-heart-failure-using-cine-mri
#19
Salvatore Saporito, Patrick Houthuizen, Jean-Paul M M Aben, Jos J M Westenberg, Harrie C M van Den Bosch, Hans C van Assen, Massimo Mischi
To compare a novel cardiovascular magnetic resonance technique for the assessment of left ventricular (LV) mechanical discoordination by characterizing the endocardial center motion (ECM) in short-axis cine MRI in healthy volunteers and heart failure patients with left bundle branch block (HF-LBBB), Materials and Methods: To evaluate ECM analysis as mechanical discoordination measure, we retrospectively compared spatial and temporal features of the ECM between a group of healthy volunteers (n=14) and conduction defect patients (HF-LBBB, n=31)...
January 25, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29361486/afterload-hypersensitivity-in-patients-with%C3%A2-left-bundle-branch-block
#20
John Aalen, Petter Storsten, Espen W Remme, Per A Sirnes, Ola Gjesdal, Camilla K Larsen, Erik Kongsgaard, Espen Boe, Helge Skulstad, Jonny Hisdal, Otto A Smiseth
OBJECTIVES: This study sought to investigate the hypothesis that patients with left bundle branch block (LBBB) are hypersensitive to elevated afterload. BACKGROUND: Epidemiological data suggest that LBBB can provoke heart failure in patients with hypertension. METHODS: In 11 asymptomatic patients with isolated LBBB and 11 age-matched control subjects, left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) were measured by echocardiography...
January 12, 2018: JACC. Cardiovascular Imaging
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