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https://www.readbyqxmd.com/read/29476814/the-right-axillary-incision-a-potential-new-standard-of-care-for-selected-congenital-heart-surgery
#1
Timothy Lee, Aaron J Weiss, Elbert E Williams, Fuad Kiblawi, Joanna Dong, Khanh H Nguyen
OBJECTIVES: Although the median sternotomy has been the traditional approach for congenital heart surgery, young patients and their families often find the midline scar to be cosmetically unappealing. At our center, a right transverse axillary incision has become the standard approach for many congenital cardiac lesions due to its safety, versatility, and unsurpassed aesthetic result. We present our experience with the axillary approach for a diverse array of congenital defects. METHODS: A retrospective review of patients receiving a right transverse axillary incision for congenital cardiac surgery between 2005-2016 was conducted...
February 21, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29409618/outcome-of-tricuspid-valve-surgery-in-the-presence-of-permanent-pacemaker
#2
Nishant Saran, Sameh M Said, Hartzell V Schaff, Simon Maltais, John M Stulak, Kevin L Greason, Richard C Daly, Alberto Pochettino, Katherine S King, Joseph A Dearani
OBJECTIVES: Given the paucity of available literature, we sought to evaluate the mechanisms of tricuspid regurgitation and the outcomes of tricuspid valve surgery in the presence of permanent pacemakers. METHODS: We retrospectively reviewed the records of 622 adult patients who underwent tricuspid valve surgery in the presence of permanent pacemakers between January 1993 and December 2013. Those with prosthetic tricuspid valve or tricuspid valve endocarditis and those undergoing concomitant heart transplant were excluded (n = 23)...
April 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29300890/lateral-thoracotomy-for-epicardial-pacemaker-placement-in-patients-with-congenital-heart-disease
#3
Paulina J Haight, Robert E Stewart, Elizabeth V Saarel, Gosta B Pettersson, Hani K Najm, Peter F Aziz
OBJECTIVES: Our institution adopted a lateral thoracotomy approach to epicaridal pacemaker implantation with the objective of avoiding epicardial scar tissue and to achieve adequate lead pacing and sensing. We sought to assess the short-term outcomes of this approach. METHODS: A single-centre review was conducted in paediatric patients and adults with congenital heart disease or inherited arrhythmia syndromes who underwent a lateral thoracotomy for epicardial pacemaker placement from August 2010 to January 2016...
January 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29098486/implantable-loop-recorders-in-the-real-world-a-study-of-two-canadian-centers
#4
Omar A Ibrahim, Doran Drew, Christopher J Hayes, William McIntyre, Colette M Seifer, Wilma Hopman, Benedict Glover, Adrian M Baranchuk
PURPOSE: Implantable loop recorders (ILRs) are increasingly being used for ambulatory electrocardiography. We sought to evaluate ILR indications, diagnostic yield, ILR-guided interventions, and complications in two Canadian centers. METHODS: This was a retrospective study using electronic medical records to identify ILR implants at Queen's University and the University of Manitoba. Information was collected on patient characteristics, medications, indication for implant, results of prior investigations, diagnostic outcome, and subsequent management...
November 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29066100/the-selvester-qrs-score-as-a-predictor-of-cardiac-events-in-nonischemic-dilated-cardiomyopathy
#5
Hiroaki Hiraiwa, Takahiro Okumura, Akinori Sawamura, Yuki Sugiura, Toru Kondo, Naoki Watanabe, Soichiro Aoki, Takeo Ichii, Katsuhide Kitagawa, Naoaki Kano, Kenji Fukaya, Kenji Furusawa, Ryota Morimoto, Kyosuke Takeshita, Yasuko K Bando, Toyoaki Murohara
BACKGROUND: Myocardial fibrosis is associated with poor prognosis in nonischemic dilated cardiomyopathy (NIDCM) patients. The Selvester QRS score on 12-lead electrocardiogram is associated with both the amount of myocardial scar and poor prognosis in myocardial infarction patients. However, its use in NIDCM patients is limited. We investigated the prognostic value of the QRS score and its association with collagen volume fraction (CVF) in NIDCM patients. METHODS: We enrolled 91 consecutive NIDCM patients (66 men, 53±13 years) without permanent pacemakers or cardiac resynchronization therapy devices...
October 20, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28967698/right-ventricular-involvement-and-the-extent-of-left-ventricular-enhancement-with-magnetic-resonance-predict-adverse-outcome-in-pulmonary-sarcoidosis
#6
Jan-Peter Smedema, Robert-Jan van Geuns, Joris Ector, Hein Heidbuchel, Gillian Ainslie, Harry J G M Crijns
AIMS: Cardiac involvement is the main determinant of poor outcomes in sarcoidosis. Right ventricular (RV) dysfunction and left ventricular (LV) late gadolinium enhancement (LGE) have been reported to be predictive of adverse outcome in non-ischaemic cardiomyopathies. The aim of our study was to determine whether delayed RV LGE with cardiovascular magnetic resonance would be predictive of adverse events in addition to LV LGE during the long-term follow-up of pulmonary sarcoidosis patients...
October 2, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28780194/scar-characterization-to-predict-life-threatening-arrhythmic-events-and%C3%A2-sudden-cardiac-death-in-patients-with-cardiac-resynchronization-therapy-the-gaudi-crt-study
#7
Juan Acosta, Juan Fernández-Armenta, Roger Borràs, Ignasi Anguera, Felipe Bisbal, Julio Martí-Almor, Jose M Tolosana, Diego Penela, David Andreu, David Soto-Iglesias, Reinder Evertz, María Matiello, Concepción Alonso, Roger Villuendas, Teresa M de Caralt, Rosario J Perea, Jose T Ortiz, Xavier Bosch, Luis Serra, Xavier Planes, Andreas Greiser, Okan Ekinci, Luis Lasalvia, Lluis Mont, Antonio Berruezo
OBJECTIVES: The aim of this study was to analyze whether scar characterization could improve the risk stratification for life-threatening ventricular arrhythmias and sudden cardiac death (SCD). BACKGROUND: Among patients with a cardiac resynchronization therapy (CRT) indication, appropriate defibrillator (CRT-D) therapy rates are low. METHODS: Primary prevention patients with a class I indication for CRT were prospectively enrolled and assigned to CRT-D or CRT pacemaker according to physician's criteria...
July 28, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28728694/alcohol-septal-ablation-for-obstructive-hypertrophic-cardiomyopathy-a-word-of%C3%A2-endorsement
#8
REVIEW
Max Liebregts, Pieter A Vriesendorp, Jurrien M Ten Berg
Twenty years after the introduction of alcohol septal ablation (ASA) for the treatment of obstructive hypertrophic cardiomyopathy, the arrhythmogenicity of the ablation scar appears to be overemphasized. When systematically reviewing all studies comparing ASA with myectomy with long-term follow-up, (aborted) sudden cardiac death and mortality rates were found to be similarly low. The focus should instead shift toward lowering the rate of reinterventions and pacemaker implantations following ASA because, in this area, ASA still seems inferior to myectomy...
July 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28382083/prognostic-implication-of-the-qrs-axis-and-its-association-with-myocardial-scarring-in-patients-with-left-bundle-branch-block
#9
Chan Soon Park, Myung-Jin Cha, Eue-Keun Choi, Seil Oh
BACKGROUND AND OBJECTIVES: Left bundle branch block (LBBB) with left axis deviation (LAD) has a worse prognosis than LBBB with a normal axis, and myocardial dysfunction has been suggested as a cause of left axis deviation. This study investigated the prognostic significance of the QRS axis in patients with LBBB and analyzed its relationship with the amount of myocardial scarring. SUBJECTS AND METHODS: A total of 829 patients were diagnosed with LBBB at Seoul National University Hospital from October 2004 to June 2014...
March 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28224227/-exceptional-pacemaker-complication-in-still-s-disease
#10
Salma Haj Kheder, Thomas Hummel, Heike Majewski, Rafael Jimènez, Alexander Wutzler
CASE REPORT: A 49-year-old man with Still's disease presented with a rash above his pacemaker scar. In 2012, there was a replacement of the generator in which the position was changed from subpectoral to subcutaneous. A revision operation was performed after the local finding became worse, turning from a granuloma to a macula. THERAPY: During surgery, a superficial position of the leads was revealed. Both leads and generator were removed with great effort from the granulation tissue...
June 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28204917/-ecg-score-to-predict-icd-therapies-in-patients-with-nonischemic-cardiomyopathy-and-primary-prophylactic-crt-d
#11
Martin Grett, Martin Christ, Jan-Peter Röing Gen Nölke, Hans-Joachim Trappe
BACKGROUND AND PROBLEM: Recently published results of the DANISH study raise concerns, if primary prophylactic ICD implantations in patients with nonischemic cardiomyopathy (NICM) and severe reduced left ventricular ejection fraction (LVEF) should be performed without further risk stratification. There was no significant difference in the overall mortality of patients with or without ICD and CRT defibrillator (CRT-D) or CRT pacemaker (CRT-P), respectively. Clinical risk scores to identify patients with ischemic cardiomyopathy (ICM) who benefit most from an ICD have been recommended...
March 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28131806/-effects-of-prolonged-endocardial-stimulation-on-left-ventricular-mechanical-synchrony-a-pilot-study-applying-gated-spect-phase-analysis-endocardial-stimulation-and-dyssynchrony
#12
Federico Ferrando-Castagnetto, Roberto Ricca-Mallada, Alejandro Vidal, Rodolfo Ferrando
OBJETIVE: To evaluate left ventricular mechanical dyssynchrony (LVMD) associated with prolonged right ventricular pacing through an innovative imaging technique as a pilot study in Uruguay. METHODS: A 99mTc-MIBI gated-SPECT and phase analysis was performed in 12 patients with pace-makers implanted at least one year before scintigraphy, due to advanced atrioventricular block. Clinical data, QRS duration, rate, mode and site of pacing in right ventricle, chamber diameters, presence and extension of myocardial scar and ischaemia, as well as LVEF at rest, were recorded...
October 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/27780367/the-role-of-multi-modality-imaging-in-selecting-patients-and-guiding-lead-placement-for-the-delivery-of-cardiac-resynchronization-therapy
#13
REVIEW
Jonathan M Behar, Simon Claridge, Tom Jackson, Ben Sieniewicz, Bradley Porter, Jessica Webb, Ronak Rajani, Stamatis Kapetanakis, Gerald Carr-White, Christopher A Rinaldi
Cardiac resynchronization therapy (CRT) is an effective pacemaker delivered treatment for selected patients with heart failure with the target of restoring electro-mechanical synchrony. Imaging techniques using echocardiography have as yet failed to find a metric of dyssynchrony to predict CRT response. Current guidelines are thus unchanged in recommending prolonged QRS duration, severe systolic function and refractory heart failure symptoms as criteria for CRT implantation. Evolving strain imaging techniques in 3D echocardiography, cardiac MRI and CT may however, overcome limitations of older methods and yield more powerful CRT response predictors...
February 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27751664/the-utilization-of-an-insertable-cardiac-monitor-in-a-child-with-pallid-breath-holding-spells
#14
Shai Tejman-Yarden, Bruria Ben-Zeev, Yuval Goldshmit, Georgia Sarquella-Brugada, Assi Cicurel, Uriel Katz, David Mishali, Michael Glikson
BACKGROUND: Pacing can be a successful treatment for pallid breath-holding spells, primarily in individuals with severe bradycardia. PATIENT DESCRIPTION: We describe an 18-month-old girl experiencing severe pallid breath-holding spells in whom repeated electrocardiographic, Holter, and electroencephalographic monitoring tests were all normal. RESULTS: Using a subcutaneous insertable cardiac monitor, severe bradycardia was detected during one of this girl's episodes...
November 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27723623/-left-ventricular-dyssynchrony-in-prolonged-septal-stimulation
#15
Federico Ferrando-Castagnetto, Roberto Ricca-Mallada, Alejandro Vidal, Fabián Martínez, Rodolfo Ferrando
Pacemaker stimulation is associated with unpredictable severe cardiac events. We evaluated left ventricular mechanical dyssynchrony (LVMD) during prolonged septal right ventricular pacing. We performed 99mTc-MIBI gated-SPECT and phase analysis in 6 patients with pacemakers implanted at least one year before scintigraphy due to advanced atrioventricular block. Using V-Sync of Emory Cardiac Toolbox we obtained phase bandwidth (PBW) and standard deviation (PSD) from rest phase histogram. Clinical variables, QRS duration, rate and mode of pacing in septal right ventricle wall, chamber diameters, presence and extension of myocardial scar and ischemia and rest LVEF were recorded...
2016: Medicina
https://www.readbyqxmd.com/read/26942019/bortezomib-induced-complete-heart-block-and-myocardial-scar-the-potential-role-of-cardiac-biomarkers-in-monitoring-cardiotoxicity
#16
Sachin Diwadkar, Aarti A Patel, Michael G Fradley
Bortezomib is a proteasome inhibitor used to treat multiple myeloma and mantle cell lymphoma. Traditionally, bortezomib was thought to have little cardiovascular toxicity; however, there is increasing evidence that bortezomib can lead to cardiac complications including left ventricular dysfunction and atrioventricular block. We present the case of a 66-year-old man with multiple myeloma and persistent asymptomatic elevations of cardiac biomarkers who developed complete heart block and evidence of myocardial scar after his eighth cycle of bortezomib, requiring permanent pacemaker placement...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/26458791/leadless-pacemakers-a-new-era-in-cardiac-pacing
#17
REVIEW
Haseeb Munaf Seriwala, Muhammad Shahzeb Khan, Muhammad Bilal Munir, Irbaz Bin Riaz, Haris Riaz, Samir Saba, Andrew H Voigt
Cardiac pacemakers are a critical management option for patients with rhythm disorders. Current efforts to develop leadless pacemakers have two primary goals: to reduce lead-associated post-procedural morbidity and to avoid the surgical scar associated with placement. After extensive studies on animal models and technological advancements, these devices are currently under investigation for human use. Herein, we review the evidence from animal studies and the technological advancements that have ushered in the era of use in humans...
January 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/26427291/-future-of-implantable-electrical-cardiac-devices
#18
REVIEW
Jean-Claude Daubert, Albin Behaghel, Christophe Leclercq, Philippe Mabo
Major improvements in implantable electrical cardiac devices have been made during the last two decades, notably with the advent of automatic internal defibrillation (ICD) to prevent sudden arrhythmic death, and cardiac resynchronisation (CRT) to treat the discoordinated failing heart. They now constitute a major therapeutic option and may eventually supersede drug therapy. The coming era will be marked by a technological revolution, with improvements in treatment delivery, safety and efficacy, and an expansion of clinical indications...
March 2014: Bulletin de L'Académie Nationale de Médecine
https://www.readbyqxmd.com/read/26161513/enhanced-electrical-integration-of-engineered-human-myocardium-via-intramyocardial-versus-epicardial-delivery-in-infarcted-rat-hearts
#19
Kaytlyn A Gerbin, Xiulan Yang, Charles E Murry, Kareen L K Coulombe
Cardiac tissue engineering is a promising approach to provide large-scale tissues for transplantation to regenerate the heart after ischemic injury, however, integration with the host myocardium will be required to achieve electromechanical benefits. To test the ability of engineered heart tissues to electrically integrate with the host, 10 million human embryonic stem cell (hESC)-derived cardiomyocytes were used to form either scaffold-free tissue patches implanted on the epicardium or micro-tissue particles (~1000 cells/particle) delivered by intramyocardial injection into the left ventricular wall of the ischemia/reperfusion injured athymic rat heart...
2015: PloS One
https://www.readbyqxmd.com/read/26142378/paced-qrs-duration-and-myocardial-scar-amount-predictors-of-long-term-outcome-of-right-ventricular-apical-pacing
#20
Seung-Ah Lee, Myung-Jin Cha, Youngjin Cho, Il-Young Oh, Eue-Keun Choi, Seil Oh
Long-term right ventricular apical pacing (RVAP) is reportedly associated with heart failure (HF) development. However, the predictors of pacing-induced HF (PHF) remained unclear. We retrospectively enrolled 234 patients without structural heart disease who underwent a permanent pacemaker implantation with RVAP between 1982 and 2004. RVAP-induced HF was defined as left ventricular ejection fraction decrease >5 % with HF symptom without other HF development etiology. The QRS duration of a paced beat (pQRSd) and myocardial scar score were analyzed from each patient's 12-lead ECG...
July 2016: Heart and Vessels
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