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https://www.readbyqxmd.com/read/28543771/right-ventricular-pacemaker-lead-position-is-associated-with-differences-in-long-term-outcomes-and-complications
#1
Chance M Witt, Charles J Lenz, Henry H Shih, Elisa Ebrille, Andrew N Rosenbaum, Martin van Zyl, Htin Aung, Kevin K Manocha, Abhishek J Deshmukh, David O Hodge, Siva K Mulpuru, Yong-Mei Cha, Raul E Espinosa, Samuel J Asirvatham, Christopher J McLeod
INTRODUCTION: Cardiac pacing from the right ventricular apex is associated with detrimental long-term effects and non-apical pacing locations may be associated with improved outcomes. There is little data regarding complications with non-apical lead positions. The aim of this study was to assess long-term outcomes and lead-related complications associated with differing ventricular lead tip position. METHODS AND RESULTS: All adult patients who underwent dual-chamber pacemaker implantation from 2004-2014 were included if they had post-procedure chest radiographs amenable to lead position determination...
May 24, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28543265/stricter-criteria-for-left-bundle-branch-block-diagnosis-do-not-improve-response-to-crt
#2
Emanuele Bertaglia, Federico Migliore, Anna Baritussio, Antonio De Simone, Albino Reggiani, Domenico Pecora, Antonio D'Onofrio, Antonio Rapacciuolo, Gianluca Savarese, Attilio Pierantozzi, Biondino Marenna, Franco Ruffa, Monica Campari, Maurizio Malacrida, Giuseppe Stabile
BACKGROUND: Cardiac resynchronization therapy (CRT) has proved to be effective in patients with heart failure and left bundle branch block (LBBB). Recently, new ECG criteria have been proposed for the diagnosis of LBBB. These criteria are stricter than the current American Heart Association (AHA) criteria. We assessed the rate of echocardiographic response to CRT in patients with traditional LBBB versus patients who met the new criteria (strict LBBB). METHODS: Consecutive patients undergoing CRT were enrolled in the CRT MORE registry...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28542844/the-inward-rectifier-current-inhibitor-pa-6-terminates-atrial-fibrillation-and-does-not-cause-ventricular-arrhythmias-in-dedicated-goat-and-dog-models
#3
Yuan Ji, Rosanne Varkevisser, Dragan Opacic, Alexandre Bossu, Marion Kuiper, Jet D M Beekman, Sihyung Yang, Azinwi Phina Khan, Dobromir Dobrev, Niels Voigt, Michael Zhuo Wang, Sander Verheule, Marc A Vos, Marcel A G Van der Heyden
BACKGROUND AND PURPOSE: Inward rectifier current (IK1 ) density increases in atrial fibrillation (AF), shortening effective refractory period and thus promotes atrial reentry. Pentamidine-Analogue 6 (PA-6) is a selective and potent IK1 inhibitor. We tested PA-6 for anti-AF efficacy and potential proarrhythmia, in established large animal models. EXPERIMENTAL APPROACH: PA-6 was applied i.v. in anaesthetized goats with rapid pacing induced AF and anaesthetized chronic AV block dogs...
May 24, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28522677/synergistic-effect-of-dofetilide-and-mexiletine-on-prevention-of-atrial-fibrillation
#4
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/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#5
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515003/reverse-atrial-electrical-remodeling-induced-by-cardiac-resynchronization-therapy
#6
Bryce Alexander, Fariha Sadiq, Kousha Azimi, Benedict Glover, Pavel Antiperovitch, Wilma M Hopman, Zardasht Jaff, Adrian Baranchuk
PURPOSE: Cardiac resynchronization therapy (CRT) has been shown to improve left atrial function; however the effect on reverse electrical remodeling has been poorly evaluated. We hypothesized that CRT might induce reverse atrial electrical remodeling manifesting in the surface ECG as a shortening in P-wave duration. METHODS: Patients with CRT and more than 92% biventricular pacing at minimum follow-up of 1 year were included in the analysis. Those with prior history of atrial fibrillation (AF) were excluded...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28506917/atrial-antitachycardia-pacing-and-atrial-remodeling-a-substudy-of-the-international-randomized-minerva-trial
#7
Giuseppe Boriani, Raymond Tukkie, Mauro Biffi, Lluis Mont, Renato Ricci, Helmut Pürerfellner, Giovanni Luca Botto, Antonis S Manolis, Maurizio Landolina, Michele Gulizia, J Harrison Hudnall, Lorenza Mangoni, Andrea Grammatico, Luigi Padeletti
BACKGROUND: Atrial tachycardia (AT) and atrial fibrillation (AF) are common in pacemaker patients and are associated with bad prognosis. OBJECTIVE: To evaluate atrial antitachycardia pacing impact on AT/AF induced atrial remodeling, measured by early recurrence of AT/AF (ERAF) and by change in left atrium diameter (LAD). To evaluate impact of AT/AF duration on ERAF incidence. METHODS: Pacemaker patients were randomized to dual-chamber pacing (Control DDDR-385 patients), managed ventricular pacing (MVP-398 patients) or atrial antitachycardia pacing plus MVP (DDDRP+MVP-383 patients)...
May 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28502873/synchronization-as-a-mechanism-for-low-energy-anti-fibrillation-pacing-leap
#8
Yanyan Claire Ji, Ilija Uzelac, Niels Otani, Stefan Luther, Robert F Gilmour, Elizabeth M Cherry, Flavio H Fenton
BACKGROUND: Low-energy anti-fibrillation pacing (LEAP) has been suggested as an alternative treatment to symptomatic fibrillation patients. It significantly lowers the energy required compared with standard one-shock defibrillation. OBJECTIVE: In this study, we investigated the mechanism of arrhythmia termination by LEAP and systematically analyzed the influence of shock period and timing on the success rate of LEAP. METHODS: We induced atrial and ventricular fibrillation in isolated canine hearts and applied LEAP and standard one-shock defibrillation to terminate the arrhythmia...
May 11, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28497860/intermittent-preexcitation-indicates-a-low-risk-accessory-pathway-time-for-a-paradigm-shift
#9
Marek Jastrzębski, Piotr Kukla, Maciej Pitak, Andrzej Rudziński, Adrian Baranchuk, Danuta Czarnecka
We report three patients with intermittent loss of the preexcitation pattern in the ECG that had undergone an electrophysiological study. Despite apparently poorly conducting accessory pathway (AP), in each case a fast anterograde conduction, either during spontaneous atrial fibrillation or during incremental atrial pacing (on isoproterenol) was documented; shortest preexcited RR intervals of 200-240 ms were observed. We review the literature and conclude that intermittent preexcitation observed on resting 12-lead ECG lacks sufficient specificity for the diagnosis of an AP with long refractory period and cannot be considered a substitute for electrophysiological study in patients with this electrocardiographical phenomenon...
May 12, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28496929/management-of-patients-with-atrial-fibrillation-focus-on-treatment-options
#10
REVIEW
Pawel Matusik, Jacek Lelakowski, Barbara Malecka, Jacek Bednarek, Remigiusz Noworolski
Atrial fibrillation (AF) is leading cardiac arrhythmia with important clinical implications. Its diagnosis is usually made on the basis on 12-lead ECG or 24-hour Holter monitoring. More and more clinical evidence supports diagnostic use of cardiac event recorders and cardiovascular implantable electronic devices (CIED). Treatment options in patients with atrial fibrillation are extensive and are based on chosen rhythm and/or rate control strategy. The use and selected contraindications to AF related pharmacotherapy, including anticoagulants are shown...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28475580/neural-substrate-of-posterior-left-atrium-a-novel-modulation-for-inducibility-and-remodeling-of-atrial-fibrillation-in-canine
#11
Mu Qin, Li Li, Xu Liu, Tao Liu, Shao Bo Shi
BACKGROUND: The neural mechanism of posterior left atrium (PLA) for genesis of atrial fibrillation has not been completely elucidated. We sought to assess the contribution of PLA denervation on atrial fibrillation (AF) inducibility and atrial remodeling. METHODS AND RESULTS: After left thoracotomy in anesthetized dogs (n = 32), electrode catheters were attached to the PLA, left atrial roof, left pulmonary vein and left atrial appendage. Experiment 1 (n = 16): Vagal stimulation (VS group, n = 8) led to more pronounced ERP shortening in PLA than in other sites (CTL:71±7 ms vs VS: 52±6 ms, P<0...
2017: PloS One
https://www.readbyqxmd.com/read/28467972/mitral-isthmus-ablation-using-a-circular-mapping-catheter-positioned-in-the-left-atrial-appendage-as-a-reference-for-conduction-block
#12
Takahiko Nishiyama, Takehiro Kimura, Taishi Fujisawa, Kazuaki Nakajima, Akira Kunitomi, Shin Kashimura, Yoshinori Katsumata, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Keiichi Fukuda, Seiji Takatsuki
BACKGROUND: For perimitral atrial flutter (PMFL) developing after catheter ablation of atrial fibrillation (AF), to create a complete conduction block at the mitral isthmus (MI) is mandatory to terminate it, however, it is still challenging. METHODS: This study consisted of 80 patients (74 male, 61 ± 8.1 years) undergoing MI ablation. After a circular mapping catheter was positioned at the neck of the left atrial appendage (LAA), the MI ablation was performed on the MI line just below the LAA neck targeting the earliest activation recording site of the LAA catheter during pacing from the coronary sinus (CS)...
April 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28461795/prolonged-sinus-pauses-upon-termination-of-paroxysmal-atrial-fibrillation-abnormal-right-atrial-electrophysiologic-and-electroanatomic-findings
#13
Zhengyu Bao, Hongwu Chen, Bing Yang, Michael Shehata, Weizhu Ju, Fengxiang Zhang, Gang Yang, Kai Gu, Mingfang Li, Kejiang Cao, Xunzhang Wang, Minglong Chen
The efficacy of pulmonary vein antral isolation for patients with prolonged sinus pauses (PSP) on termination of atrial fibrillation has been reported. We studied the right atrial (RA) electrophysiologic and electroanatomic characteristics in such patients. Forty patients underwent electroanatomic mapping of the RA: 13 had PSP (group A), 13 had no PSP (group B), and 14 had paroxysmal supraventricular tachycardia (control group C). Group A had longer P-wave durations in lead II than did groups B and C (115.5 ± 15...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28457700/human-connexin40-mutations-slow-conduction-and-increase-propensity-for-atrial-fibrillation
#14
Ajita Kanthan, Peter Fahmy, Renuka Rao, Jim Pouliopoulos, Ian E Alexander, Stuart P Thomas, Eddy Kizana
BACKGROUND: Patch clamping studies using non-cardiomyocytes revealed that the human connexin40 mutations P88S, G38D, and A96S are associated with reduced gap junction conductances compared to wild type connexin40 (wtCx40). Their effects within myocytes however are unclear. We aimed to characterise P88S, G38D, and A96S after expression in rat hearts and primary cardiomyocyte cultures. METHODS: Adult Sprague-Dawley rat atria were transduced with a lentivector containing a transgene encoding wtCx40, P88S, G38D, A96S, or eGFP (n=6 per transgene)...
March 21, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28451774/relationship-between-left-atrium-catheter-contact-force-and-pacing-threshold
#15
Teresa Barrio-López, Mercedes Ortiz, Eduardo Castellanos, Carla Lázaro, Jefferson Salas, Sergio Madero, Jesús Almendral
PURPOSE: The purpose of this study is to analyze the relationship between contact force (CF) and pacing threshold in left atrium (LA). METHODS: Six to ten LA sites were studied in 28 consecutive patients with atrial fibrillation undergoing pulmonary vein isolation. Median CF, bipolar and unipolar electrogram voltage, impedance, and bipolar and unipolar thresholds for consistent constant capture and for consistent intermittent capture were measured at each site. RESULTS: Pacing threshold measurements were performed at 188 LA sites...
April 27, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28449531/ablation-of-atrial-fibrillation-single-shot-techniques-poised-to-dominate-rhythm-control-strategies-the-future-is-here
#16
EDITORIAL
Antonis S Manolis
Over the recent years, the advent of single-shot techniques, such as circular catheter and cryoballoon ablation, has ushered in a new era in the catheter ablation approach and rhythm control strategies of patients with atrial fibrillation (AF). These techniques make it easier to navigate the heart and have the potential to decrease the threshold for, expand the access to, and increase patient and physician acceptance of rhythm-control therapies, that may lead to reduction of the AF disease burden and its socioeconomic impact...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28441850/-clinical-application-of-one-stage-operation-of-epicardial-permanent-pacemaker-implantation-and-cardiac-surgery
#17
C L Ren, S L Jiang, C S Xiao, R Wang, C Q Gao
Objective: To summarize the results and clinical application experience of one-stage operation of epicardial permanent pacemaker implantation and cardiac surgery. Methods: From November 2014 to July 2016, 15 patients (9 males and 6 females) with ages ranging from 50 to 73 (63.5±6.2) years requiring cardiac surgery with bradycardia underwent one-stage operation of epicardial permanent pacemaker implantation and cardiac surgery. All operations were performed under general anesthesia with chest median incision approach...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28434449/electrical-superior-vena-cava-isolation-using-a-novel-pace-and-ablate-technique-under-diaphragmatic-electromyography-monitoring
#18
Shinsuke Miyazaki, Shigeki Kusa, Hitoshi Hachiya, Hiroshi Taniguchi, Takayuki Niida, Sadamitsu Ichijo, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Diaphragmatic compound motor action potential (CMAP) amplitude monitoring is a standard technique to anticipate phrenic nerve injury during cryoballoon ablation. OBJECTIVE: The purpose of this study was to evaluate the feasibility of a novel superior vena cava isolation (SVCI) technique using simultaneous pacing and ablation through the tip of a single mapping/ablation catheter. METHODS: Fifty-four patients with atrial fibrillation were included...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28430960/triple-site-pacing-for-cardiac-resynchronization-in-permanent-atrial-fibrillation-follow-up-results-from-a-prospective-observational-study
#19
Pedro Marques, Miguel Nobre Menezes, Gustavo Lima da Silva, Tatiana Guimarães, Ana Bernardes, Nuno Cortez-Dias, Luis Carpinteiro, João de Sousa, Fausto J Pinto
Aims: Cardiac Resynchronization Therapy (CRT) is associated with a particularly high non-response rate in patients with atrial fibrillation (AF). We aimed to assess the effectiveness of triple-site (Tri-V) pacing CRT in this population. Methods and results: Prospective observational study of patients with permanent AF who underwent CRT implantation with an additional right ventricle lead in the outflow tract septal wall. After implantation, programming mode (Tri-V or biventricular pacing) was selected based on cardiac output determination...
April 19, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28427082/perioperative-outcomes-and-safety-of-atrial-fibrillation-catheter-ablation-in-octogenarians-a-retrospective-study-and-review-of-the-benefits-of-rhythm-control
#20
Stephanie Hakimian, Juan C Camacho, Edwin Grajeda Silvestri, Farid AbdelMalak, Elie Donath, Robert Chait
OBJECTIVES: Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control. METHODS: Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified. The primary outcome was normal sinus rhythm (NSR) on electrocardiogram at discharge...
April 21, 2017: Cardiology
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