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Pranil Bhalchandra Gangurde, Abhay Tidake, Hetan Shah, Ajay Mahajan, Yash Lokhandwala, Pratap Nathani
A 14-year-old male with a history of symptomatic tachycardia was referred for ablation. Sinus rhythm electrocardiogram was not showing any pre-excitation. Tachycardia episode was showing antidromic tachycardia with left bundle branch block morphology. Echocardiographic examination was showing Ebstein's anomaly with septal tricuspid leaflet displaced 24mm apically. The right bundle branch block (RBBB) was concealed during sinus rhythm. The RBBB was revealed with ablation of right posterior atriofascicular accessory pathway...
September 2016: Indian Heart Journal
Santhosh R Devarapally, Sameer Arora, Ali Ahmad, Mike Sood, Amaar El Sergany, Terrence Sacchi, Barry Saul, Rahul Gaglani, John Heitner
BACKGROUND: Right ventricular (RV) failure has proven to be independently associated with adverse outcomes. Electrocardiographic parameters assessing RV function are largely unknown, making echocardiography the first line for RV function assessment. It is however, limited by geometrical assumptions and is inferior to cardiac magnetic resonance imaging (CMRI) which is widely regarded as the most accurate tool for assessing RV function. METHODS: We seek to determine the correlation of ECG parameters of right bundle branch block (RBBB) with RV ejection fraction (EF) and RV dimensions using the CMRI...
October 2016: Cardiovascular Diagnosis and Therapy
C Moini, B Sidia, D Poindron, L Fiorina, A Farge, W Amara, M El Issa
Transcatheter aortic valve implantation (TAVI) is nowadays a worldwide technique in the field of treating aortic stenosis. One of the main side effects linked to the technique are mostly attached to rhythm disturbances, such as atrioventricular (AV) and intraventricular blocks. Consequently, a pacemaker implantation is often required. That implantation rate is estimated between 8 and 30%, depending on the valve chosen. Thanks to main meta analysis on the subject, it has been managed to isolate the following risks factors for AV block development: preoperative right bundle branch block (RBBB: the most powerful element), complete AV block during the procedure, male gender, a so-called porcelain aorta, the absence of previous valvular surgery, the aortic annulus size (i...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Parikshit S Sharma, Faiz A Subzposh, Kenneth A Ellenbogen, Pugazhendhi Vijayaraman
BACKGROUND: Conduction disease is not uncommon after prosthetic valve (PV) surgery. The feasibility of His bundle pacing (HBP) in this patient (pt) population is not well studied. OBJECTIVE: We report our experience with permanent HBP in pts undergoing pacemaker (PM) implantation following PV surgery. METHODS: Permanent HBP was attempted in pts with AV conduction disease post PV surgery referred for PM implantation. Conduction disease was characterized as AV nodal vs infra-nodal...
September 20, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Sonia Ferretto, Elvin Tafciu, Immacolata Giuliani, Giuseppe Feltrin, Tomaso Bottio, Antonio Gambino, Angela Fraiese, Sabino Iliceto, Gino Gerosa, Loira Leoni
BACKGROUND: Causes and significance of interventricular conduction disorders (IVCDs) after orthotopic heart transplantation (OHT) are still unknown. METHODS: We retrospectively researched the presence of IVCDs in 240 patients who underwent bicaval OHT in three time periods: at day 1, after 1 year, and after 3 years from OHT. To evaluate the impact of the surgical technique, a control population treated with biatrial anastomosis was used. RESULTS: The most common IVCD was right bundle branch block (RBBB)...
September 9, 2016: Annals of Noninvasive Electrocardiology
Johannes Grand, Jakob Hartvig Thomsen, Jesper Kjaergaard, Niklas Nielsen, David Erlinge, Sebastian Wiberg, Michael Wanscher, John Bro-Jeppesen, Christian Hassager
This study reports the prevalence and prognostic impact of right bundle branch block (RBBB) and left bundle branch block (LBBB) in the admission electrocardiogram (ECG) of comatose survivors of out-of-hospital cardiac arrest (OHCA). The present study is part of the predefined electrocardiographic substudy of the prospective randomized target temperature management trial, which found no benefit of targeting 33°C over 36°C in terms of outcome. Six-hundred eighty-two patients were included in the substudy. An admission ECG, which defined the present study population, was available in 602 patients (88%)...
October 15, 2016: American Journal of Cardiology
Marwa A Sabe, Sharif A Sabe, Kenya Kusunose, Scott D Flamm, Brian P Griffin, Deborah H Kwon
BACKGROUND: Decreased right ventricular (RV) ejection fraction (RVEF) portends poor prognosis in patients with ischemic cardiomyopathy, and previous studies have suggested an association between mitral regurgitation (MR) and RVEF. We sought to evaluate this association and whether mitral valve repair or replacement affects the relationship between RV function and mortality. METHODS: We included 588 patients (mean age, 63±11 years; 75% male) with ischemic cardiomyopathy who underwent cardiac magnetic resonance imaging between 2002 and 2008...
August 30, 2016: Circulation
Pugazhendhi Vijayaraman, Gopi Dandamudi, Kenneth A Ellenbogen
BACKGROUND: Permanent His bundle pacing (HBP) is a physiological alternative to right ventricular pacing (RVP). Catheter manipulation during HBP can cause trauma to the His bundle during implantation. We sought to determine acute and long-term incidence of His bundle (HB) injury with HBP. METHODS: Patients undergoing permanent HBP at Geisinger Wyoming Valley Medical Center from 2006 to 2014 formed the study group. Patients with pre-existing His-Purkinje disease (HPD) were excluded from the study...
September 2016: Journal of Electrocardiology
Bram B Bessem, Matthijs M C de Bruijn, Wybe W Nieuwland
OBJECTIVES: Gender-related differences are frequently used in medicine. Electrocardiograms are also subject to such differences. This study evaluated gender differences in ECG parameters of young athletes, discussing the possible implications of these differences for ECG criteria used in the cardiovascular screening of young athletes. DESIGN: Observational cross-sectional study. METHODS: In 2013 and 2014 all the ECGs from the cardiovascular screenings performed at University Sports Medical Centre in Groningen of the student athletes who wanted to participate in a college sports program were collected...
July 6, 2016: Journal of Science and Medicine in Sport
Michael A Valentino, Andrew Panakos, Loheetha Ragupathi, Janna Williams, Behzad B Pavri
In the setting of flecainide toxicity, supraventricular tachycardia can manifest as a bizarre right or left bundle branch block, sometimes with a northwest axis, and can easily be mistaken for ventricular tachycardia leading to inappropriate therapy. We conducted a comprehensive literature review for cases of flecainide toxicity. We found 21 articles of flecainide toxicity in adult patients in which 22 ECG tracings were published. In patients with flecainide toxicity and QRS duration ≤ 200 ms, the ECGs were more likely to show RBBB, visible P waves (p = 0...
July 19, 2016: Cardiovascular Toxicology
Gianni Pastore, Massimiliano Maines, Lina Marcantoni, Francesco Zanon, Franco Noventa, Giorgio Corbucci, Enrico Baracca, Silvio Aggio, Claudio Picariello, Daniela Lanza, Gianluca Rigatelli, Mauro Carraro, Loris Roncon, S Serge Barold
BACKGROUND: Estimating left ventricular electrical delay (Q-LV) from a 12-lead ECG may be important in evaluating cardiac resynchronization therapy (CRT). OBJECTIVE: To assess the impact of the Q-LV interval on ECG configuration. METHODS: One hundred ninety-two consecutive patients undergoing CRT implantation were divided electrocardiographically into 3 groups: left bundle branch block (LBBB), right BBB (RBBB), and non-specific intraventricular conduction delay (IVCD)...
July 13, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Hideki Hayashi, Qi Wu, Minoru Horie
BACKGROUND: Prolonged QRS duration on electrocardiogram (ECG) has been known as a poor prognostic marker. However, little is known about association between progressive intraventricular conduction disturbance and cardiovascular prognosis. METHODS: From among a database containing 359,737 12-lead ECG recordings, patients whose QRS duration progressively increased from <120 msec to ≥120 msec were selected using software. The prognosis of patients was searched by medical record...
2016: PloS One
Thomas A Dewland, Elsayed Z Soliman, Barry R Davis, Jared W Magnani, Jose-Miguel Yamal, Linda B Piller, L Julian Haywood, Alvaro Alonso, Christine M Albert, Gregory M Marcus
IMPORTANCE: Cardiac conduction abnormalities are associated with an increased risk for morbidity and mortality, and understanding factors that accelerate or delay conduction system disease could help to identify preventive and therapeutic strategies. Antifibrotic and anti-inflammatory properties of angiotensin-converting enzyme inhibitors and treatment for hyperlipidemia may reduce the risk for incident conduction system disease. OBJECTIVE: To identify the effect of pharmacologic therapy randomization and clinical risk factors on the incidence of conduction system disease...
August 1, 2016: JAMA Internal Medicine
Xiaoping Li, Rong Luo, Wei Fang, Xiaolei Xu, Guodong Niu, Yixian Xu, Michael Fu, Wei Hua, Xiushan Wu
BACKGROUND: Ventricular conduction blocks (VCBs) are associated with poor outcomes in patients with known cardiac diseases. However, the prognostic implications of VCB patterns in dilated cardiomyopathy (DCM) patients need to be evaluated. The purpose of this study was to determine all-cause mortality in patients with DCM and VCB. METHODS: This cohort study included 1119 DCM patients with a median follow-up of 34.3 (19.5-60.8) months, patients were then divided into left bundle branch block (LBBB), right bundle branch block (RBBB), intraventricular conduction delays (IVCD) and narrow QRS groups...
2016: BMC Cardiovascular Disorders
Weihua Zhou, Zhixin Jiang, Ji Chen, Ernest V Garcia, Dianfu Li
OBJECTIVES: The purpose of this study is to develop a right-ventricular (RV) phase analysis tool which when coupled with our left ventricular (LV) phase analysis tool can provide measurement of the interventricular mechanical dyssynchrony from gated SPECT myocardial perfusion imaging (MPI), and validate the tool by electrocardiography (ECG). METHODS: For each patient, short-axis LV and RV SPECT MPI images were input into an automatic sampling algorithm to generate the 3D maximal count circumferential profiles for both LV and RV in each cardiac frame...
May 25, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Jane A Cannon, Li Shen, Pardeep S Jhund, Inder S Anand, Michel Komajda, Robert S McKelvie, Michael R Zile, Peter E Carson, John J V McMurray
BACKGROUND: The aims of this study were to describe the prevalence of QRS prolongation and abnormal QRS morphology in patients with heart failure and preserved ejection fraction (HF-PEF) and to examine the relationship between these QRS abnormalities and clinical outcomes. METHODS AND RESULTS: We categorized patients in the Irbesartan in Heart Failure with Preserved Ejection Fraction trial (I-PRESERVE) according to QRS duration <120 vs. ≥120 ms and QRS morphology: normal, left bundle branch block (LBBB), and right bundle branch block (RBBB) or other non-specific intra-ventricular conduction defect (IVCD)...
August 2016: European Journal of Heart Failure
Ali Ahmadi, Koorosh Etemad, Arsalan Khaledifar
OBJECTIVES: Risk factors for heart failure (HF) have not yet been studied in myocardial infarction (MI) patients in Iran. This study was conducted to determine these risk factors. METHODS: In this nationwide, hospital-based, case-control study, the participants were all new MI patients hospitalized from April 2012 to March 2013 in Iran. The data on 1,691 new cases with HF (enrolled by census sampling) were compared with the data of 6,764 patients without HF as controls...
2016: Epidemiology and Health
Ramón Rodríguez-Olivares, Lennart van Gils, Nahid El Faquir, Zouhair Rahhab, Luigi F M Di Martino, Sander van Weenen, John de Vries, Tjebbe W Galema, Marcel L Geleijnse, Ricardo P J Budde, Eric Boersma, Peter P de Jaegere, Nicolas M Van Mieghem
BACKGROUND: The interaction of left ventricular outflow tract (LVOT) and transcatheter heart valve (THV) is complex and may be device design specific. We sought to study LVOT characteristics and its relation with permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR). METHODS: We studied 302 patients with a median age of 81years [75-84]. Computed tomography was used to assess LVOT in terms of amount of calcium, perimeter and device size relative to LVOT...
August 1, 2016: International Journal of Cardiology
Karsten Keller, Johannes Beule, Jörn Oliver Balzer, Wolfgang Dippold
INTRODUCTION: Risk stratification in acute pulmonary embolism (PE) is crucial for identification of patients with poor prognosis. We aimed to investigate the ECG alterations of right bundle branch block (RBBB) and SIQIII-type patterns for risk stratification in acute PE. MATERIALS AND METHODS: Retrospective analysis of PE patients, treated in the Internal Medicine Department, was performed. Patients with RBBB and/or SIQIII-type were compared with those without both patterns...
July 2016: Journal of Electrocardiology
Cheng Zheng, Jin Li, Jia-Xuan Lin, Lu-Ping Wang, Jia-Feng Lin
BACKGROUND: In recent years, radiofrequency catheter ablation(RFCA) has been established as an effective therapy for idiopathic premature ventricular contractions (PVCs), however, its effect on the narrow PVCs (QRS duration < 130 msec) with qR pattern in inferior leads, may not been fully concluded. METHODS: Characteristics of 12-lead electrocardiogram (ECG) and electrophysiologic recordings were analyzed in 40 patients with symptomatic PVCs manifesting narrow QRS complex with qR pattern in inferior leads...
2016: BMC Cardiovascular Disorders
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