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https://www.readbyqxmd.com/read/28534206/-3-d%C3%A2-mapping-and-ablation-of-recurrent-ventricular-tachycardia-in-patients-with-ischemic-cardiomyopathy
#1
REVIEW
Kristina Wasmer, Lars Eckardt
Catheter ablation of ventricular tachycardia (VT) is an established therapy for patients with ischemic cardiomyopathy to reduce implantable cardioverter-defibrillator (ICD) interventions and is a class I recommendation in international guidelines. Numerous publications confirm its value. Use of three-dimensional mapping systems with or without image integration is standard for ablation of complex arrhythmias. In patients with history of myocardial infarction they help to understand activation of reentrant circuits and are prerequisite for substrate mapping...
May 22, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28534205/outflow-tract-ventricular-arrhythmias-electrocardiographic-features-in-relation-to-mapping-and-ablation
#2
REVIEW
Deepak Padmanabhan, Alan Sugrue, Prakriti Gaba, Samuel J Asirvatham
Ventricular arrhythmia arising from the outflow tracts can manifest itself as frequent premature ventricular complexes (PVCs), salvos of ventricular tachycardia (VT), and/or sustained VT. It is amenable to management with medication and catheter ablation without need for an intracardiac defibrillator. The electrocardiogram (ECG) is a crucial tool in the management of these patients as it is can help localize the site of origin, thereby helping guide the electrophysiologist. An appreciation of the unique anatomy of the outflow tracts as well as their relationships with the surrounding structures is essential in interpreting the ECG...
May 22, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28534204/-ventricular-arrhythmias-in-ion-channel-diseases
#3
REVIEW
Christian Wolpert, Mara Vogel, Christian Nagel, Claudia Herrera-Siklody, Norman Rüb
In patients with ion channel disease the predominant arrhythmias are polymorphic ventricular tachycardias (VT), torsade de pointes tachycardia and ventricular fibrillation (VF). In only extremely rare cases is very rapid monomorphic ventricular tachycardia observed. This is why implantable cardioverter-defibrillators (ICDs) should always be programmed for treatment of VF only with high detection rates to avoid inappropriate discharges. In idiopathic VF and catecholaminergic polymorphic ventricular tachycardia (CPVT), no baseline electrocardiographic abnormalities can be detected, whereas in Brugada syndrome, long QT syndrome, early repolarisation syndrome and Anderson-Tawil syndrome alterations of the baseline ECG are very important to identify patients at risk...
May 22, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28533740/correlation-of-ventricular-arrhythmogenesis-with-neuronal-remodeling-of-cardiac-postganglionic-parasympathetic-neurons-in-the-late-stage-of-heart-failure-after-myocardial-infarction
#4
Dongze Zhang, Huiyin Tu, Chaojun Wang, Liang Cao, Robert L Muelleman, Michael C Wadman, Yu-Long Li
Introduction: Ventricular arrhythmia is a major cause of sudden cardiac death in patients with chronic heart failure (CHF). Our recent study demonstrates that N-type Ca(2+) currents in intracardiac ganglionic neurons are reduced in the late stage of CHF rats. Rat intracardiac ganglia are divided into the atrioventricular ganglion (AVG) and sinoatrial ganglion. Only AVG nerve terminals innervate the ventricular myocardium. In this study, we tested the correlation of electrical remodeling in AVG neurons with ventricular arrhythmogenesis in CHF rats...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28532781/usefulness-of-left-atrial-emptying-fraction-to-predict-ventricular-arrhythmias-in-patients-with-implantable-cardioverter-defibrillators
#5
Mischa T Rijnierse, Mehran Kamali Sadeghian, Sophie Schuurmans Stekhoven, P Stefan Biesbroek, Anne-Lotte C van der Lingen, Peter M van de Ven, Albert C van Rossum, Robin Nijveldt, Cornelis P Allaart
Impaired left atrial emptying fraction (LAEF) is an important predictor of mortality in patients with heart failure. As it may reflect increased LV wall stress, it might predict ventricular arrhythmia (VA) specifically. This study evaluated the predictive value of LAEF assessed with cardiovascular magnetic resonance (CMR) imaging with respect to appropriate device therapy (ADT) for VA and compared its role with CMR assessed scar size and other risk factors. In total, 229 patients (68% male, 63 ± 10 years, 61% ischemic cardiomyopathy) with LV ejection fraction ≤35% who underwent CMR and implantable cardioverter defibrillator (ICD) implantation for primary prevention in 2005 to 2012 were included...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28532779/meta-analysis-of-risk-of-ventricular-arrhythmias-after-improvement-in-left-ventricular-ejection-fraction-during-follow-up-in-patients-with-primary-prevention-implantable-cardioverter-defibrillators
#6
Aiman Smer, Alok Saurav, Muhammad Soubhi Azzouz, Mohsin Salih, Mohamed Ayan, Ahmed Abuzaid, Abhilash Akinapelli, Arun Kanmanthareddy, Lynda E Rosenfeld, Faisal M Merchant, Hussam Abuissa
Implantable cardioverter defibrillators (ICDs) reduce the risk of sudden cardiac death in patients with impaired left ventricular ejection fraction (LVEF). However, there are limited data on the long-term benefit of ICD therapy in patients whose LVEF subsequently improves. We conducted a meta-analysis to evaluate the effect of LVEF improvement on ICD therapy during follow-up. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated using random-effects modeling. Sixteen studies with 3,959 patients were included in our analysis...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28532774/genotype-positive-long-qt-syndrome-in-patients-with-coexisting-congenital-heart-disease
#7
Mohammed A Ebrahim, Matthew R Williams, Suzanne Shepard, James C Perry
Congenital long QT syndrome (LQTS) is characterized by QT prolongation with predisposition to life-threatening arrhythmia. There have been sporadic reports of LQTS coexisting with more common forms of congenital heart disease (CHD). However, the diagnosis of LQTS when CHD is present may be confounded by several common variables including postoperative electromechanical factors predisposing to ventricular arrhythmia, intrinsic, and postoperative QRS abnormalities. This report documents a single-center experience with patients who have both genetically confirmed LQTS and CHD to examine their modes of presentation and factors associated with making the diagnosis of LQTS in this patient population, as well as potential confounding variables that may mask or delay both LQTS diagnosis and initiation of therapy...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28527921/drug-induced-fatal-arrhythmias-acquired-long-qt-and-brugada-syndromes
#8
REVIEW
Isik Turker, Tomohiko Ai, Hideki Itoh, Minoru Horie
Since the early 1990s, the concept of primary "inherited" arrhythmia syndromes or ion channelopathies has evolved rapidly as a result of revolutionary progresses made in molecular genetics. Alterations in genes coding for membrane proteins such as ion channels or their associated proteins responsible for the generation of cardiac action potentials (AP) have been shown to cause specific malfunctions which eventually lead to cardiac arrhythmias. These arrhythmic disorders include congenital long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, short QT syndrome, progressive cardiac conduction disease, etc...
May 17, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28527890/mechano-electric-coupling-heterogeneity-in-repolarization-and-the-electrocardiographic-t-wave
#9
REVIEW
V M F Meijborg, C N W Belterman Va, J M T de Bakker, R Coronel, C E Conrath
Stretch influences repolarization by mechano-electric coupling (MEC) and contributes to arrhythmogenesis. Although there is an abundance of research on electrophysiological effects of MEC, it is still unclear how MEC translates to the ECG. We aim to provide an overview of the MEC research focused on the ECG and the underlying changes in electrophysiology. In addition, we present new data on the effect of left ventricular pressure on the electrocardiographic T-wave. We show that an increase in left ventricular pressure leads to prolonged QT-intervals with increased amplitudes of the STT-segment...
May 17, 2017: Progress in Biophysics and Molecular Biology
https://www.readbyqxmd.com/read/28525920/torsade-de-pointes-arrhythmias-arise-at-the-site-of-maximal-heterogeneity-of-repolarization-in-the-chronic-complete-atrioventricular-block-dog
#10
Albert Dunnink, Thom R G Stams, Alexandre Bossu, Veronique M F Meijborg, Jet D M Beekman, Sofieke C Wijers, Jacques M T De Bakker, Marc A Vos
Aims: The chronic complete atrioventricular block (CAVB) dog is highly sensitive for drug-induced torsade de pointes (TdP) arrhythmias. Focal mechanisms have been suggested as trigger for TdP onset; however, its exact mechanism remains unclear. In this study, detailed mapping of the ventricles was performed to assess intraventricular heterogeneity of repolarization in relation to the initiation of TdP. Methods and results: In 8 CAVB animals, 56 needles, each containing 4 electrodes, were inserted in the ventricles...
May 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28525585/the-effects-of-gender-on-electrical-therapies-for-the-heart-physiology-epidemiology-and-access-to-therapies-a-report-from-the-xii-congress-of-the-italian-association-on-arrhythmology-and-cardiostimulation-aiac
#11
Giuseppe Boriani, Stefano Lorenzetti, Elisabetta Cerbai, Giuseppe Oreto, Gabriele Bronzetti, Vincenzo Livio Malavasi, Alessandro Biffi, Luigi Padeletti, Gianluca Botto, Igor Diemberger
The difference between men and women is clear even just by looking at an electrocardiogram: females present higher resting heart rate, a shorter QRS complex length and greater corrected QT interval. The development of these differences from pubertal age onward suggests that sexual hormones play a key role, although their effect is far from being completely understood. Different incidences between sexes have been reported for many arrhythmias, both ventricular and supraventricular, and also for sudden cardiac death...
May 19, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28523857/arrhythmia-burden-and-related-outcomes-in-eisenmenger-syndrome
#12
Shankar Baskar, Philippa Horne, Samantha Fitzsimmons, Philip R Khoury, Joseph Vettukattill, Koichiro Niwa, Teiji Agaki, Mark Spence, Hisanori Sakazaki, Gruschen Veldtman
BACKGROUND: Patients with Eisenmenger syndrome have a shorter lifespan than the general population. A significant proportion develop arrhythmia and some, sudden death. OBJECTIVE: The aims of this study were to characterize the frequency, type and effects of arrhythmias in adult patients with Eisenmenger's syndrome and to identify risk factors for arrhythmias. METHODS: This retrospective study included patients aged ≥ 18 years of age with Eisenmenger's syndrome from three institutions...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28522783/splenic-abcesses-as-infectious-complication-following-127-implantation-of-left-ventricular-asssist-device-case-report
#13
Sławomir Gajda, Anna M Szczepanik, Grzegorz Religa, Andrzej Misiak, Andrzej B Szczepanik
Left ventricular assist device (LVAD) is one of the modern management therapies in patients with advanced heart failure, and it serves as a bridge to heart transplantation or even as destination therapy. However, it is burdened with a high risk of thromboembolic, hemorrhagic, and infectious complications despite prophylactic management. Splenic abscesses, as septic complications following implantation of mechanical ventricular support, have not yet been described in the literature. We report of a patient with severe left ventricular insufficiency (NYHA II/III), pulmonary hypertension, and arrhythmia who underwent implantation of the Heart Ware® pump for left ventricular support with simultaneous tricuspidvalvoplasty, as a bridge therapy to heart transplantation...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28522677/synergistic-effect-of-dofetilide-and-mexiletine-on-prevention-of-atrial-fibrillation
#14
Guizhi Liu, Xiaolin Xue, Chuanyu Gao, Jiaqi Huang, Datun Qi, Yanzhou Zhang, Jian-Zeng Dong, Chang-Sheng Ma, Gan-Xin Yan
BACKGROUND: Although atrial fibrillation (AF) is the most common abnormal heart rhythm and its prevalence continues to rise, there is a marked paucity of effective and safe antiarrhythmic drugs for AF. This study was done to test whether combined use of dofetilide and mexiletine exhibits not only a synergistic effect on AF suppression but also a safer profile in drug-induced ventricular proarrhythmias. METHODS AND RESULTS: The effects of dofetilide plus mexiletine on atrial effective refractory period (ERP), AF inducibility, QT, and QT-related ventricular arrhythmias were studied using the isolated arterially perfused rabbit atrial and ventricular wedge preparations...
May 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28521022/management-of-untreatable-ventricular-arrhythmias-during-pharmacologic-challenges-with-sodium-channel-blockers-for-suspected-brugada-syndrome
#15
Stefano Poli, Mauro Toniolo, Massimo Maiani, Davide Zanuttini, Luca Rebellato, Igor Vendramin, Ermanno Dametto, Guglielmo Bernardi, Flavio Bassi, Carlo Napolitano, Ugolino Livi, Alessandro Proclemer
Pharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Current consensus guidelines suggest to adopt cautious protocols interrupting the sodium channel blockers as soon as any ECG alteration appears...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28520537/anomalous-origin-of-right-coronary-artery-from-left-coronary-sinus-13-cases-treated-with-the-reimplantation-technique
#16
Alain Cubero, Alejandro Crespo, Gadah Hamzeh, Andrés Cortes, Daniel Rivas, José Ignacio Aramendi
OBJECTIVES: Anomalous aortic origin of a coronary artery is uncommon but potentially clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe our experience with surgical reimplantation and results at midterm follow-up. METHODS: Between February 2003 and July 2016, a total of 13 patients with anomalous origin of the right coronary artery (RCA) from the left sinus underwent surgical reimplantation...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28518124/direct-re-implantation-of-left-coronary-artery-into-the-aorta-in-adults-with-anomalous-origin-of-left-coronary-artery-from-the-pulmonary-artery-alcapa
#17
Reza Tavakoli, Peiman Jamshidi, Nassrin Yamani, Max Gassmann
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ischemia and infarction in children. If left untreated, it results in a 90% mortality rate in the first year of life. In patients who survive to the adulthood, the coronary steal phenomenon and retrograde left-sided coronary flow provide a substrate for chronic subendocardial ischemia, which may lead to left ventricular dysfunction, ischemic mitral regurgitation, malignant ventricular arrhythmias, and sudden cardiac death...
April 24, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28517022/impact-and-management-of-left-ventricular-function-on-the-prognosis-of-takotsubo-syndrome
#18
Ibrahim El-Battrawy, Uzair Ansari, Siegfried Lang, Michael Behnes, Katja Schramm, Christian Fastner, Xiaobo Zhou, Jürgen Kuschyk, Erol Tülümen, Susanne Röger, Martin Borggrefe, Ibrahim Akin
AIMS: Early research has proposed that patients with Takotsubo syndrome (TTS) could have a higher mortality rate than the general population. Our study was conducted to determine the short- and long-term outcome of TTS patients associated with a significantly compromised left ventricular function on hospital admission. METHODS AND RESULTS: Our institutional database constituted a collective of 112 patients diagnosed with TTS between 2003 and 2015. The patients were classified into two groups based on the left ventricular ejection fraction (LVEF), with those presenting with a LVEF >35% on admission categorized into one group (n=65, 58%) and those presenting with LVEF ≤35% (n=47, 42%) categorized into another group...
May 18, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28516454/a-multiscale-computational-modelling-approach-predicts-mechanisms-of-female-sex-risk-in-the-setting-of-arousal-induced-arrhythmias
#19
Pei-Chi Yang, Laura L Perissinotti, Fernando López-Redondo, Yibo Wang, Kevin R DeMarco, Mao-Tsuen Jeng, Igor Vorobyov, Robert D Harvey, Junko Kurokawa, Sergei Y Noskov, Colleen E Clancy
Female sex is a risk factor for inherited and acquired Long-QT associated Torsade de Pointes (TdP) arrhythmias, and sympathetic discharge is a major factor in triggering TdP in female Long-QT syndrome patients. We used a combined experimental and computational approach to predict 'the perfect storm' of hormone concentration, IKr block, and sympathetic stimulation that induces arrhythmia in females with inherited and acquired Long-QT. More specifically, we developed mathematical models of acquired and inherited Long-QT syndrome in male and female ventricular human myocytes by combining effects of a hormone and a hERG blocker dofetilide or hERG mutations...
May 18, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28512586/cryoablation-for-ventricular-tachycardia-originating-from-anterior-papillary-muscle-of-left-ventricle-guided-by-intracardiac-echocardiography
#20
Ibrahim Marai, Nizar Andria, Osnat Gurevitz
Papillary muscles (PMs) were reported to be origin of ventricular arrhythmia (VA). Radiofrequency (RF) ablation was reported to be acutely effective in eliminating VA. However, the recurrence rate is high. Recently, cryoablation guided by intracardiac echocardiography, 3-dimensional mapping system, and image integration was introduced as alternative strategy for this challenging ablation. We present a case of ventricular tachycardia originating from anterior PM of left ventricle treated by cryoablation guided only by intracardiac echocardiography...
2017: Case Reports in Cardiology
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