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His bundle

Mohamed Abdelrahman, Faiz A Subzposh, Dominik Beer, Brendan Durr, Angela Naperkowski, Haiyan Sun, Jess W Oren, Gopi Dandamudi, Pugazhendhi Vijayaraman
BACKGROUND: Right ventricular pacing (RVP) is associated with heart failure and increased mortality. His bundle pacing (HBP) is a physiological alternative to RVP. OBJECTIVE: The aim of the study is to evaluate clinical outcomes of HBP compared to RVP. METHODS: All patients requiring initial pacemaker implantation between Oct 1st , 2013 and December 31st , 2016 were included in the study. Permanent HBP was attempted in consecutive patients at one hospital and RVP at a sister hospital...
March 5, 2018: Journal of the American College of Cardiology
Konstantin V Borisov
BACKGROUND: In patients with hypertrophic obstructive cardiomyopathy myocardial fibrosis is an independent predictor of adverse outcome. A new technique of HOCM surgical correction in patients with severe hypertrophy and septal myocardial fibrosis has been proposed. METHODS: The excision of the asymmetrical hypertrophied area of the interventricular septum causing obstruction was performed from the conal part of the right ventricle corresponding to the zone of obstruction of the left ventricle (LV)...
March 10, 2018: Annals of Thoracic Surgery
Krzysztof Boczar, Agnieszka Sławuta, Andrzej Ząbek, Maciej Dębski, Jacek Gajek, Jacek Lelakowski, Barbara Małecka
CRT is a therapeutic option for patients with heart failure, sinus rhythm, prolonged QRS complex duration and reduced ejection fraction. We present a case of 71-year-old woman with dilated cardiomyopathy, NYHA functional class III and AF. We implanted CRT combined with direct His-bundle pacing. The indication for such a therapy was a left bundle branch block with a QRS complex of 178ms and a left ventricular EF of 15%, left ventricular end-diastolic diameter (LVEDD) of 75mm. After 8months of follow-up the LVEDD was 60mm with EF 35-40%...
March 2, 2018: Journal of Electrocardiology
Pugazhendhi Vijayaraman, Kenneth A Ellenbogen
No abstract text is available yet for this article.
March 7, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Neal A Chatterjee, E Kevin Heist
Cardiac resynchronization therapy (CRT) is an important therapeutic tool in the management of patients with heart failure and electrical dyssynchrony. In appropriately selected patients, landmark randomized controlled trials have demonstrated morbidity and mortality benefit beyond standard goal-directed medical therapy. Current guidelines emphasize the greatest clinical efficacy of CRT in patients with symptomatic heart failure, left bundle branch block, and wide QRS duration (> 150 ms). Other relevant considerations include the presence of atrial fibrillation, the presence of AV block, the etiology of cardiomyopathy, the presence of masked left-sided conduction delay, and the impact of comorbidities that might predict poor clinical response...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
William A Huang, Maereg A Wassie, Olujimi A Ajijola
His bundle pacing (HBP) has been shown to be a feasible, beneficial, and safe way to achieve cardiac resynchronization therapy (CRT) with recruitment of the heart's physiological conduction system. HBP should be considered for those with unfavorable coronary sinus (CS) anatomy, and nonresponders to biventricular (BiV) pacing. HBP CRT may also help patients with the nonleft bundle branch block form of conduction delay and heart failure (HF). HBP CRT should be considered strongly in preventing right ventricular (RV) pacing-induced cardiomyopathy, especially after atrioventricular nodal ablation given the discrete nature of the block and the low likelihood of distal block...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
Diego Castejón, Guiomar Rotllant, Enric Ribes, Mercè Durfort, Guillermo Guerao
The esophagus of the eucrustaceans is known as a short tube that connects the mouth with the stomach but has generally received little attention by the carcinologists, especially during the larval stages. By this reason, the present study is focused on the morphology and ultrastructure of the esophagus in the brachyuran Maja brachydactyla during the larval development and adult stage. The esophagus shows internally four longitudinal folds. The simple columnar epithelium is covered by a thick cuticle. The epithelial cells of the adults are intensively interdigitated and show abundant apical mitochondria and bundles of filamentous structures...
March 1, 2018: Journal of Morphology
Angelo Auricchio, Ward A Heggermont
Cardiac resynchronization therapy (CRT) is a well-established treatment for symptomatic heart failure patients with reduced left ventricular ejection fraction, prolonged QRS duration, and abnormal QRS morphology. The ultimate goals of modern CRT are to improve the proportion of patients responding to CRT and to maximize the response to CRT in patients who do respond. While the rate of CRT nonresponders has moderately but progressively decreased over the last 20 years, mostly in patients with left bundle branch block, in patients without left bundle branch block the response rate is almost unchanged...
February 14, 2018: Revista Española de Cardiología
Rajesh Patel, S Sengottuvel, K Gireesan, M P Janawadkar, T S Radhakrishnan
Measurement of the late potentials and His-bundle activity is crucial for many clinical studies using the noncontact and noninvasive magnetocardiography (MCG) technique; these weak signals are extracted by averaging many cardiac cycles aligned using the R-peak of the cardiac cycle identified using an electrocardiography (ECG) lead. ECG is measured simultaneously with MCG using a conventional dual-supply ECG amplifier, which requires either two separate batteries or a single battery with a switching voltage inverter circuit for its proper operation...
February 1, 2018: SLAS Technology
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Hiren Kevadiya, Ajitkumar Valaparambil
A 35-year old lady was referred for evaluation of recurrent palpitation. During one of the episodes of palpitation a wide QRS tachycardia with left bundle branch block (LBBB) morphology was recorded and it was terminated with intravenous adenosine. The surface electrocardiogram during sinus rhythm did not show any pre-excitation. Echocardiogram was normal. Patient underwent an electrophysiology study after informed consent. During catheter placement a wide QRS tachycardia with LBBB morphology and left axis deviation (LAD) similar to the clinical tachycardia got induced (Fig:1)...
February 14, 2018: Pacing and Clinical Electrophysiology: PACE
Fatima M Ezzeddine, Gopi Dandamudi
Long-term right ventricular apical pacing has been associated with detrimental effects, including an increased risk for heart failure, atrial fibrillation, and death. Most of these adverse effects result from ventricular dyssynchrony related to perturbed ventricular depolarization. In addition, biventricular pacing has limited benefits in patients with non-left bundle branch block and severely reduced ejection fraction. Consequently, alternative pacing strategies that mimic natural physiology are desired. Recently, permanent His bundle pacing has emerged as a true physiologic form of ventricular pacing that has been shown to be safe and feasible in clinical practice...
March 2018: Cardiac Electrophysiology Clinics
Jose M Marcial, Seth J Worley
Subclavian obstruction is common after lead implantation and the need to add or replace a lead is increasing. Subclavian venoplasty (SV) is a safe and effective option for venous occlusion. Peripheral venography overestimates the severity of the obstruction. A wire can usually be advanced into the central circulation for SV. Compared with dilators, SV improves the quality of venous access, providing unrestricted catheter manipulation for His bundle pacing and left ventricular lead implantation. SV preserves venous access and reduces lead burden...
March 2018: Cardiac Electrophysiology Clinics
Taihei Itoh, Takumi Yamada
A 44-year-old man with a history of ventricular preexcitation and supraventricular tachycardia was evaluated. The baseline electrocardiogram exhibited ventricular preexcitation with a normal PR interval and a minimally negative delta wave in lead V1 and positive delta waves in the inferior leads. The administration of adenosine resulted in a progressive prolongation of the PR interval with a fixed preexcitation degree, suggesting the presence of antegrade conduction over the fasciculo-ventricular pathway. When complete right bundle branch block occurred, the degree of preexcitation never changed...
January 30, 2018: Indian Pacing and Electrophysiology Journal
Arneh Babakhani, Robert N Clapp, William B Warner
A 25-year-old man, who was an active duty US Navy sailor, went to his ship's medical department complaining of a mild cough that he'd had for 2 days. He denied having any fevers, chills, night sweats, angina, or dyspnea. He said he hadn't experienced any exertional fatigue or difficulty completing the rigorous physical tasks of his occupation as an engineman on the ship. The patient had no medical or surgical history of significance, and he wasn't taking any medications or supplements. On exam, he was not in acute distress and his vital signs were within normal limits...
February 2018: Journal of Family Practice
Mazen M Kawji, D Luke Glancy
In a woman with syncope, junctional premature complexes and what appeared to be intermittent atrioventricular block suggested concealed conduction of His bundle extrasystoles.
March 15, 2018: American Journal of Cardiology
Santosh K Padala, Kenneth A Ellenbogen, Jayanthi N Koneru
No abstract text is available yet for this article.
November 2017: HeartRhythm Case Reports
Advay G Bhatt, Dan L Musat, Mark W Preminger, Tina Sichrovsky, Suneet Mittal
No abstract text is available yet for this article.
November 2017: HeartRhythm Case Reports
Parikshit S Sharma, Kristin Ellison, Hena N Patel, Richard G Trohman
No abstract text is available yet for this article.
November 2017: HeartRhythm Case Reports
Yuki Obayashi, Chisato Izumi, Yoshihisa Nakagawa
CLINICAL INTRODUCTION: A man in his 50s with sudden-onset chest pain and dyspnoea was transferred to the emergency room. He had a history of aortic valve replacement due to aortic regurgitation with a mechanical valve 6 years previously. Heart rate was 90 bpm, and blood pressure was too low to measure. In the emergency room, he presented with severe dyspnoea and a chest X-ray showed severe lung congestion (figure 1A). ECG showed complete left bundle branch block. His respiratory status rapidly worsened, and he went into cardiopulmonary arrest...
January 30, 2018: Heart: Official Journal of the British Cardiac Society
Xing Liu, Jianmei Zheng, Zhongcai Fan, Li Rao
RATIONALE: Brugada syndrome (BrS) is a cardiac ion channel disease that is caused by an autosomal dominant genetic abnormality. A ventricular septal defect is a common congenital heart disease, in which genetic defects play a significant role. PATIENT CONCERNS: We report an extremely rare case of a 42-year-old male with congenital heart disease, who suffered recurrent syncope and gastrointestinal bleeding. His electrocardiogram showed an unusual right bundle branch block-like pattern and ST-segment elevation in leads V1-V3...
November 2017: Medicine (Baltimore)
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