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Right bundle branch block

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https://www.readbyqxmd.com/read/28800177/exercise-stress-test-reveals-ineligibility-for-subcutaneous-implantable-cardioverter-defibrillator-in-patients-with-brugada-syndrome
#1
Motomi Tachibana, Nobuhiro Nishii, Hiroshi Morita, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Ito
BACKGROUND: The eligibility of patients with Brugada syndrome (BrS) for implantation of a subcutaneous implantable cardioverter defibrillator (S-ICD) is not well known. This study aimed to clarify the eligibility of BrS patients for S-ICD using electrocardiography (ECG) at rest and during exercise testing. We also analyzed factors associated with ineligibility for S-ICD from standard 12-lead ECG at rest. METHODS: We enrolled 110 consecutive BrS patients who visited Okayama university hospital from December 2015 to December 2016...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28794532/local-anaesthetic-systemic-toxicity-following-oral-ingestion-in-a-child-revisiting-dibucaine
#2
Raylene Dias, Nandini Dave, Milind S Tullu, Chandrahas T Deshmukh
Dibucaine, a potent and toxic local anaesthetic, although currently withdrawn by the United States Food and Drug Administration for use as a spinal anaesthetic, continues to remain available in many over-the-counter topical formulations. Systemic toxicity following oral ingestion of local anaesthetics is rare. We report a case of accidental ingestion of dibucaine (ear drops) in a 7-year-old child who developed diplopia, giddiness, ventricular premature contractions and a right bundle branch block. We also present a brief discussion on the pharmacologic and toxicity profile of dibucaine, the Naranjo algorithm for assessing causality in case of adverse drug reactions and a review of current guidelines on the management of local anaesthetic systemic toxicity...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28794367/earlier-right-ventricular-pacing-in-cardiac-resynchronization-therapy-for-a-patient-with-right-axis-deviation
#3
Yusuke Hattori, Kohei Ishibashi, Takashi Noda, Hideo Okamura, Hideaki Kanzaki, Toshihisa Anzai, Satoshi Yasuda, Kengo Kusano
We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28794085/idiopathic-ventricular-arrhythmias-originating-from-the-parietal-band-electrocardiographic-and-electrophysiological-characteristics-and-outcome-of-catheter-ablation
#4
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
#5
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
#6
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/28759818/histological-topography-of-the-atrioventricular-node-and-its-extensions-in-relation-to-the-cardiothoracic-surgical-landmarks-in-normal-human-hearts
#7
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/28757765/pulseless-electrical-activity-in-acute-massive-pulmonary-embolism-during-thrombolytic-therapy
#8
Han-Hua Yu, Jing-Ren Jeng
We report a case of acute pulmonary embolism with hemodynamic instability diagnosed by a computed tomography pulmonary angiogram. The patient developed pulseless electrical activity during systemic thrombolytic therapy with recombinant tissue plasminogen activator. Successful return of spontaneous circulation was achieved after immediate cardiopulmonary resuscitation with chest compressions for 6 min. His electrocardiogram (ECG) on arrival in the emergency department displayed sinus tachycardia, an S wave in lead I, a Q wave in lead III, incomplete right bundle branch block (RBBB), T-wave inversion (TWI) in leads V1-V3, ST elevation in leads aVR and V1, and ST depression in leads I, II, III, aVF, and V4-V6...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28736019/endomyocardial-biopsy-via-the-femoral-vein-using-a-long-curved-sheath
#9
N Naderi, S Taghavi, A Amin, G Houshmand, K Mozaffari, M Maleki
BACKGROUND: Endomyocardial biopsy (EMB) has been defined as the gold standard method for surveillance of rejection after heart transplantation, and it has also been used in the diagnosis of myocarditis and the unknown causes of cardiomyopathies. The procedure, however, is not free from complications. Access through the jugular vein or the femoral vein is the standard approach. In this study, we performed biopsies by using a long, curved sheath and evaluated the rate of complications with this technique...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28734886/pre-transcatheter-aortic-valve-replacement-right-bundle-branch-block-a-bundle-of-trouble
#10
EDITORIAL
Ron Waksman, Arie Steinvil
No abstract text is available yet for this article.
July 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28734885/clinical-impact-of-baseline-right-bundle-branch-block-in-patients-undergoing-transcatheter-aortic-valve-replacement
#11
Vincent Auffret, John G Webb, Hélène Eltchaninoff, Antonio J Muñoz-García, Dominique Himbert, Corrado Tamburino, Luis Nombela-Franco, Fabian Nietlispach, César Morís, Marc Ruel, Antonio E Dager, Vicenç Serra, Asim N Cheema, Ignacio J Amat-Santos, Fábio Sandoli de Brito, Pedro Alves Lemos, Alexandre Abizaid, Rogério Sarmento-Leite, Eric Dumont, Marco Barbanti, Eric Durand, Juan H Alonso Briales, Alec Vahanian, Claire Bouleti, Sebastiano Immè, Francesco Maisano, Raquel Del Valle, Luis Miguel Benitez, Bruno García Del Blanco, Rishi Puri, François Philippon, Marina Urena, Josep Rodés-Cabau
OBJECTIVES: This study sought to assess the influence of baseline right bundle branch block (RBBB) on all-cause and cardiovascular mortality as well as sudden cardiac death (SCD) among patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Few data exist regarding the late clinical impact of pre-existing RBBB in TAVR recipients. METHODS: A total of 3,527 patients (mean age 82 ± 8 years, 50.1% men) were evaluated according to the presence of RBBB on baseline electrocardiography...
July 13, 2017: JACC. Cardiovascular Interventions
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
#12
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/28691201/combined-myocardial-deformation-to-predict-cardiac-resynchronization-therapy-response-in-non-ischemic-cardiomyopathy
#13
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/28680626/years-of-palpitations-and-a-heart-rate-of-213-beats-per-minute
#14
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/28677917/recovery-of-atrioventricular-conduction-in-patients-with-heart-block-after-transcatheter-aortic-valve-replacement
#15
Colin A Raelson, James Gabriels, Jonathan Ruan, James E Ip, George Thomas, Christopher F Liu, Jim W Cheung, Bruce B Lerman, Apoor Patel, Steven M Markowitz
INTRODUCTION: Recovery of conduction has been demonstrated in >50% of patients who receive pacemakers (PPMs) for high-degree atrioventricular block (HD-AVB) after transcatheter aortic valve replacement (TAVR). Little information is available about the time course of conduction recovery in these patients and if any features predict early recovery of conduction. METHODS: A retrospective review was performed of patients who underwent TAVR with balloon and self-expanding valves who required PPMs for HD-AVB...
July 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28667170/isolated-cardiac-sarcoidosis-masquerading-as-right-ventricular-outflow-tract-ventricular-tachycardia
#16
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
https://www.readbyqxmd.com/read/28666538/the-relevance-of-looking-for-right-bundle-branch-block-in-catheter-ablation-of-ebstein-s-anomaly
#17
Laila Gonzalez-Melchor, Santiago Nava, Pedro Iturralde, Manlio F Marquez
INTRODUCTION: Ebstein's anomaly is the most commonly occurring congenital defect associated with the Wolff-Parkinson-White syndrome. In patients with Ebstein's anomaly and supraventricular tachycardia, the absence of right bundle branch block (RBBB) in sinus rhythm is a highly sensitive and specific indicator of the presence of an ipsilateral accessory AP. CASE: We present an electrophysiology case of a patient with Ebstein's anomaly and 3 ipsilateral accessory pathways...
June 17, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28666487/mahaim-tachycardia-induced-cardiomyopathy
#18
Ibrahim Gul, Qamaruddin Roziman, Aamir Hameed Khan
We present the case report of a 22-year man, with incessant palpitations, chest pain, shortness of breath, and pulsations in his neck for the past 7 months. He was referred to the cardiology unit for workup of wide complex tachycardia (WCT). His echocardiography, 6 months earlier, had demonstrated severe left ventricular (LV) systolic dysfunction, severe global hypokinesia, mild tricuspid regurgitation (TR), and mild mitral regurgitation (MR) which resolved with medical therapy including beta-blockers. He underwent electrophysiological study, which revealed a decremental right sided atriofascicular pathway causing a WCT with left bundle branch block (LBBB) morphology and left axis deviation (LAD, Mahaim tachycardia)...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28652528/electrophysiological-characteristics-and-radiofrequency-catheter-ablation-treatment-of-idiopathic-ventricular-arrhythmias-successfully-ablated-from-the-ostium-of-the-coronary-sinus
#19
Yoshiaki Yui, Yukio Sekiguchi, Akihiko Nogami, Hiro Yamasaki, Takeshi Machino, Kenji Kuroki, Miyako Igarashi, Kazutaka Aonuma
BACKGROUND: Idiopathic ventricular arrhythmias (VAs) rarely arise from the epicardium at the crux of the heart. However, the electrophysiological characteristics of VAs successfully ablated from the ostium of the coronary sinus (CSO) have not yet been documented.Methods and Results:Electrocardiographic and electrophysiological data were analyzed in patients with idiopathic VAs successfully ablated from the CSO.Among 309 patients with idiopathic VAs treated with radiofrequency catheter ablation (RFCA), 6 (1...
June 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28648429/ddd-pacemaker-for-severe-heart-failure-alternate-to-crt
#20
N C Krishnamani
Patients with severe systolic Heart Failure continue to have poor quality of life and increased mortality in spite of optimal medical management. Cardiac Resynchronization Therapy [CRT] is promising modality in patients with systolic heart failure and electrocardiographic [ECG] evidence of left bundle branch block [LBBB]. Cost issues continue to elude many deserving cases of this therapy in our society. Relatively cost effective Dual chamber pacing [DDD] with right atrial and isolated left ventricular pacing [RA-LV] can be a good alternative...
May 2017: Indian Heart Journal
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