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His bundle

John D Fisher
In the words of the legendary late John Messenger, pacemakers have evolved from the equivalent of a pirate's peg leg that simply prevents you from falling down, to a fully articulated prosthesis. Each "ultimate" step has been succeeded by ever more sophisticated devices. Very early attempts at providing atrioventricular synchrony included metal wire connections between atrium and ventricle, and His bundle pacing with large screw-in electrodes. These efforts failed, largely because of poor conductivity, excessive fibrosis and loss of capture...
October 24, 2016: Pacing and Clinical Electrophysiology: PACE
James P Daubert
Stimulation of the His bundle was reported first in canines and then in humans nearly half-century ago and was characterized by a QRS morphology identical to both the native QRS and to that produced by atrial pacing. (1 2 3,4) The isoelectric interval between the His bundle pacing stimulus and the QRS equaled the native HV interval. This article is protected by copyright. All rights reserved.
October 24, 2016: Pacing and Clinical Electrophysiology: PACE
Marek Sramko, Dan Wichterle, Josef Kautzner
This study evaluated hemodynamic feasibility and reproducibility of a new method for in vivo simulation of human atrial fibrillation (AF). The method was tested during sinus rhythm in 10 patients undergoing catheter ablation for AF. A simple electronic device was assembled that allowed triggering a cardiac stimulator by predefined series of RR intervals. Irregular RR interval sequences with a mean heart rate of 90/min and 130/min were obtained from ECG recordings of another patients with AF. Simultaneous atrioventricular pacing was delivered by catheters placed inside the coronary sinus and at the His bundle region...
2016: PloS One
Jun Hyuk Son, Joon Hyuk Choi, Su-Ho Lim
PURPOSE: To present a rare case of a conjunctival hypertrophic scar presenting as eyelid mass after surgical treatment of a chalazion. CASE PRESENTATION: A 74-year-old man visited our clinic with severe ocular discomfort and excessive lacrimation since several months in his left eye accompanied by itching of the upper eyelid. Examination of the anterior segment revealed a 6 mm (horizontal) × 8 mm (vertical) round, immobile, hard, mushroom-shaped protruding mass on the tarsal conjunctiva of his left eye...
2016: SpringerPlus
Farhood Saremi, Cameron Hassani, Damián Sánchez-Quintana
The septal atrioventricular junction is a centrally located region of the heart where the septal components of the atria and ventricles meet the aortic, mitral, and tricuspid valves. Important structures in this region include the membranous septum, the central fibrous body, the Koch triangle, the inferior pyramidal space, and the base of the interventricular septum. This small area is the home of the atrioventricular node and the atrioventricular conduction axis and has enormous importance to electrophysiologists owing to its prime role in the conduction system of the heart...
October 14, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Ahmed Karim Talib, Akihiko Nogami, Itsuro Morishima, Yasushi Oginosawa, Kenji Kurosaki, Shinya Kowase, Yuki Komatsu, Kenji Kuroki, Miyako Igarashi, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: The most common form of idiopathic Purkinje-related ventricular tachycardia (VT) is the reentrant type. We describe the clinical and electrophysiological characteristics of focal non-reentrant fascicular tachycardia. METHODS AND RESULTS: Among 530 idiopathic VT patients who were referred for ablation, we identified 15 (2.8%) with non-reentrant fascicular tachycardia (11 men, 45±21 years). Sinus rhythm ECG showed normal conduction intervals with a His-ventricular interval of 41±4 ms...
October 2016: Circulation. Arrhythmia and Electrophysiology
Olujimi A Ajijola, Jorge Romero, Gabriel Vorobiof, William M Suh, Kalyanam Shivkumar, Roderick Tung
No abstract text is available yet for this article.
November 2015: HeartRhythm Case Reports
Gopi Dandamudi, Pugazhendhi Vijayaraman
Chronic right ventricular (RV) pacing has been shown over the years to exert detrimental physiological changes including increased risk for heart failure and atrial fibrillation. His bundle pacing offers the promise of physiological activation of the ventricular tissue, with the potential for reducing the detrimental effects of RV pacing. We describe His bundle pacing in a historical context and briefly highlight several clinical trials that have helped shape the landscape of permanent His bundle pacing.
September 24, 2016: Journal of Electrocardiology
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
A Ebert, K-H Frosch
Background: Anatomical reconstruction of the anterior cruciate ligament (ACL) using the double-bundle (DB) technique is becoming increasingly popular. Despite its proved biomechanical and anatomical superiority, clinical studies have found little advantage for the DB technique. The aim of this study was therefore to evaluate whether an experienced surgeon is able to obtain his usual good results with ACL reconstruction with the single-bundle (SB) technique directly after changing to the DB technique. Patients/Material and Methods: In a prospective, non-randomised and controlled interventional study, we compared the first 19 patients in our clinic who had an anterior cruciate ligament reconstruction using the DB technique with 31 patients who underwent a SB ACL reconstruction performed by the same surgeon during the same period of investigation...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Hans-Joachim Trappe
Consciousness disorders may have many causes, mainly cardiac arrhythmias. The incidence of bradyarrhythmias (BA) in patients with acute coronary syndrome (ACS) is 0.3-18 % and caused by sinus node dysfunction (SND), high degree atrioventricular (AV) block or bundle branch blocks. SND are sinus bradycardia or sinus arrest. 1st degree AV-block occurs in 4-13 % of patients with ACS caused by rhythm disturbances in atrium, AV node, bundle of His or the Tawara system. 1st or 2nd degree AV block is seen very frequently within 24 hours after beginning of ACS and these arrhythmias are frequently transient and no more present after 72 hours...
September 2016: Deutsche Medizinische Wochenschrift
Krzysztof Wilczek, Rafał Reguła, Kamil Bujak, Piotr Chodór, Michał Długaszek, Mariusz Gąsior
Transcatheter aortic valve implantation (TAVI) has become a safe and efficient alternative to cardiac surgery in patients with severe aortic stenosis. In many countries the number of performed TAVI procedures equals the number of surgical implantations. Indications for TAVI are becoming more liberal, allowing a wider spectrum of patients to benefit from the advantages of transcatheter therapy. Due to its invasive nature, TAVI is associated with some complications such as conduction disturbances. Although these disturbances are usually not lethal, they have a great influence on patients' state and long term-survival...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Takumi Yamada, Harish Doppalapudi, William R Maddox, H Thomas McElderry, Vance J Plumb, G Neal Kay
BACKGROUNDS: Idiopathic ventricular arrhythmias (VAs) originating from the left ventricular outflow tract (LVOT) sometimes require catheter ablation from both the endocardial and epicardial sides for their elimination, suggesting the presence of intramural VA foci. This study investigated the prevalence and electrocardiographic and electrophysiological characteristics of these idiopathic intramural LVOT VAs when compared with the idiopathic endocardial and epicardial LVOT VAs. METHODS AND RESULTS: We studied 82 consecutive VAs with origins in the aortomitral continuity (n=30), LV summit (n=34), and intramural site (n=18)...
September 2016: Circulation. Arrhythmia and Electrophysiology
Giulia Ottaviani, L Maximilian Buja
Sudden cardiac death (SCD) is defined as the unexpected death without an obvious noncardiac cause that occurs within 1 h of witnessed symptom onset (established SCD) or within 24 h of unwitnessed symptom onset (probable SCD). In the United States, its incidence is 69/100,000 per year. Dysfunctions of the cardiac conduction and autonomic nervous systems are known to contribute to SCD pathogenesis, even if most clinicians and cardiovascular pathologists lack experience with detailed examination of the cardiac conduction system and fail to recognize lesions that are crucial to explain the SCD itself...
August 28, 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Takumi Yamada, Yung R Lau, G Neal Kay
No abstract text is available yet for this article.
September 12, 2016: Journal of Cardiovascular Electrophysiology
Jae Wook Lee, Sung-Moon Lee, Dong Gyu Lee
Pudendal nerve entrapment syndrome is an unusual cause of chronic pelvic pain. We experienced a case of pudendal neuralgia associated with a ganglion cyst. A 60-year-old male patient with a tingling sensation and burning pain in the right buttock and perineal area visited our outpatient rehabilitation center. Pelvis magnetic resonance imaging showed the presence of multiple ganglion cysts around the right ischial spine and sacrospinous ligament, and the pudendal nerve and vessel bundle were located between the ischial spine and ganglion cyst at the entrance of Alcock's canal...
August 2016: Annals of Rehabilitation Medicine
Rafael L O'Halloran, Alexander G Chartrain, Jonathan J Rasouli, Ritesh A Ramdhani, Brian Harris Kopell
BACKGROUND: The caudal zona incerta (cZI) is an increasingly popular deep brain stimulation (DBS) target for the treatment of tremor-predominant disease. The dentatorubrothalamic tract (DRTT) is a white matter fiber bundle that traverses the cZI and can be identified using diffusion-weighted magnetic resonance imaging fiber tractography to ascertain its precise course. In this report, we compare 2 patient cases of cZI DBS, a responder and a nonresponder. CASE DESCRIPTION: Patient 1 (responder) is a 65-year-old man with medically refractory Parkinson disease who underwent bilateral DBS lead placement in the cZI...
September 1, 2016: World Neurosurgery
Amrish Deshmukh, Pramod Deshmukh
Direct His bundle pacing provides the most physiologic means of artificial pacing of the ventricles with a preserved His-Purkinje system and may play a role in patients with a diseased intrinsic conduction system. We describe our initial motivations and experience with permanent direct His bundle pacing and important lessons learned since that time.
September 2016: Journal of Electrocardiology
C C Moser, M M Sheehan, N M Ennist, G Kodali, C Bialas, M T Englander, B M Discher, P L Dutton
Relatively simple principles can be used to plan and construct de novo proteins that bind redox cofactors and participate in a range of electron-transfer reactions analogous to those seen in natural oxidoreductase proteins. These designed redox proteins are called maquettes. Hydrophobic/hydrophilic binary patterning of heptad repeats of amino acids linked together in a single-chain self-assemble into 4-alpha-helix bundles. These bundles form a robust and adaptable frame for uncovering the default properties of protein embedded cofactors independent of the complexities introduced by generations of natural selection and allow us to better understand what factors can be exploited by man or nature to manipulate the physical chemical properties of these cofactors...
2016: Methods in Enzymology
Rajeev K Pathak, Brian P Betensky, Pasquale Santangeli, Sanjay Dixit
Most premature ventricular contractions (PVCs) arise from the right or left ventricular outflow tract. Some VPCs originate near the His-bundle region. However, there remains a paucity of information on PVCs originating directly from the cardiac conduction system. We describe two cases with idiopathic frequent PVCs that were mapped directly to the left bundle branch itself. We also provide an anatomic-based mapping and ablation approach for management of these uncommon and challenging arrhythmias. In both cases we were able to either eliminate or significantly suppress the ectopic source by applying radiofrequency at this location without causing any significant impairment of the atrioventricular conduction...
August 28, 2016: Journal of Cardiovascular Electrophysiology
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