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https://www.readbyqxmd.com/read/28341304/the-normal-variants-in-the-left-bundle-branch-system
#1
REVIEW
M V Elizari
This article reviewed the main anatomic and physiopathological aspects of the left bundle branch from its origin in the His bundle and its intraventricular distribution on the left endocardial surface. The results are based on the relevant literature and on personal observations executed on 206 hearts distributed as follows: 67 dogs, 60 humans, 45 sheep, 22 pigs, 10 cows, 2 monkeys, 1 guanaco, and 1 sea lion. The main anatomical features of the His-Purkinje conducting system may be summarized as follows: The bundle of His is composed by two segments: the penetrating and branching portions...
March 14, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28340894/wenckebach-pattern-in-right-bundle-branch-block-benign-or-not
#2
Weiting Huang, Paul Chun Yih Lim, Chi-Keong Ching
A Mobitz type I block (Wenckebach phenomenon) with narrow QRS complex is almost always due to a lesion in the AV node. In a type I block with wide QRS complex (>0.12sec), the block can be in the His-Purkinje system in 60-70% of the cases. Even though the progressive PR prolongation with every conducted beat suggests Wenckebach phenomenon, one needs to pay attention to the accompanying QRS complex. In the setting of persistent right bundle branch block, axis change of subsequent conducted beat before an unconducted p suggests alternating fascicular block, giving clue to unreliable infra-Hisian conduction; and in the setting of symptoms, a pacemaker should be implanted...
March 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28340603/blunt-cardiac-injury-due-to-trauma-associated-with-snowboarding-a-case-report
#3
Fuminori Yamaji, Hideshi Okada, Yasuhiro Nakajima, Kodai Suzuki, Takahiro Yoshida, Yosuke Mizuno, Haruka Okamoto, Yuichiro Kitagawa, Taku Tanaka, Shiho Nakano, Sho Nachi, Tomoaki Doi, Keisuke Kumada, Shozo Yoshida, Narihiro Ishida, Katsuya Shimabukuro, Hiroaki Ushikoshi, Izumi Toyoda, Kiyoshi Doi, Shinji Ogura
BACKGROUND: Cardiac trauma is associated with a much higher mortality rate than injuries to other organ systems, even though cardiac trauma is identified in less than 10% of all trauma admissions. Here we report blunt trauma of the left atrium due to snowboarding trauma. CASE PRESENTATION: A 45-year-old Asian man collided with a tree while he was snowboarding and drinking. He lost consciousness temporarily. An air ambulance was requested and he was transported to an advanced critical care center...
March 25, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28318819/slow-pathway-radiofrequency-ablation-using-magnetic-navigation-a-description-of-technique-and-retrospective-case-analysis
#4
Abhishek Bhaskaran, Maha Albarri, Neil Ross, Sara Al Raisi, Rahul Samantha, Leonette Roode, Fazlur Nadri, Jeanette Ng, Stuart Thomas, Aravinda Thiagalingam, Pramesh Kovoor
BACKGROUND: The Magnetic Navigation System (MNS) catheter was shown to be stable in the presence of significant cardiac wall motion and delivered more effective lesions compared to manual control. This stability could potentially make AV junctional reentrant tachycardia (AVNRT) ablation safer. The aim of this study is to describe the method of mapping and ablation of AVNRT with MNS and 3-D electro-anatomical mapping system (CARTO, Biosense Webster, Diamond bar, CA, USA) anatomical mapping, with a view to improve the safety of ablation...
February 21, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28298182/electrocardiogram-his-bundle-potentials-can-be-recorded-noninvasively-beat-by-beat-on-surface-electrocardiogram
#5
Gaopin Wang, Renguang Liu, Qinghua Chang, Zhaolong Xu, Yingjie Zhang, Dianzhu Pan
BACKGROUND: The micro waveform of His bundle potential can't be recorded beat-to-beat on surface electrocardiogram yet. We have found that the micro-wavelets before QRS complex may be related to atrioventricular conduction system potentials. This study is to explore the possibility of His bundle potential can be noninvasively recorded on surface electrocardiogram. METHODS: We randomized 65 patients undergoing radiofrequency catheter ablation of paroxysmal superventricular tachycardia (exclude overt Wolff-Parkinson-White syndrome) to receive "conventional electrocardiogram" and "new electrocardiogram" before the procedure...
March 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28292752/fascicular-ventricular-tachycardia-originating-from-papillary-muscles-purkinje-network-involvement-in-the-reentrant-circuit
#6
Yuki Komatsu, Akihiko Nogami, Kenji Kurosaki, Itsuro Morishima, Keita Masuda, Tomoya Ozawa, Takashi Kaneshiro, Yuichi Hanaki, Yasutoshi Shinoda, Ahmed Karim Talib, Shinya Kowase, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: Verapamil-sensitive fascicular ventricular tachycardia (FVT) has been demonstrated to be a reentrant mechanism using the Purkinje network as a part of its reentrant circuit. Although the papillary muscles (PMs) are implicated in arrhythmogenic structure, reentrant FVT originating from the PMs has not been well defined. METHODS AND RESULTS: We studied 13 patients in whom FVT was successfully eliminated by ablation at the posterior PMs (n=8; PPM-FVT) and anterior PMs (n=5; APM-FVT)...
March 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28275856/-window-sliding-analysis-combined-with-high-density-and-rapid-electroanatomical-mapping-its-efficacy-and-the-outcome-of-catheter-ablation-of-atrial-tachycardia
#7
Kosuke Nakasuka, Koji Miyamoto, Takashi Noda, Tsukasa Kamakura, Mitsuru Wada, Ikutaro Nakajima, Kohei Ishibashi, Yuko Inoue, Hideo Okamura, Satoshi Nagase, Takeshi Aiba, Shiro Kamakura, Wataru Shimizu, Teruo Noguchi, Toshihisa Anzai, Satoshi Yasuda, Nobuyuki Ohte, Kengo Kusano
Atrial tachycardia (AT) is a clinically challenging arrhythmia that can occur based on atrial substrates. Nowadays, a rapid construction of three-dimensional electroanatomical maps, which has an analysis function for complex arrhythmias, named 'Window Sliding' (WS) is available. However, little data has revealed the efficacy of this mapping strategy. The aim of this study was to investigate the efficacy of the WS analysis for AT treatments. All patients underwent electrophysiological studies during ATs and the characteristics of the ATs were analyzed using rapid high-density mapping followed by the WS analysis...
March 8, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28265215/nonfluoroscopic-imaging-as-guidance-for-radiofrequency-ablation-of-atrioventricular-nodal-reentrant-tachycardia-after-mustard-repair
#8
Jan Hluchy, Dinh Q Nguyen, Henrik Sobczak, Bodo Brandts
Most tachycardias in the pulmonary venous atrium are inaccessible by direct means and require either a retrograde approach or a transseptal approach for ablation. We present a case in which successful radiofrequency ablation of common atrioventricular nodal reentrant tachycardia was accomplished via a retrograde transaortic approach guided by nonfluoroscopic mapping with use of the NavX(™) mapping system. The patient was a 49-year-old woman who at the age of 4 years had undergone Mustard repair for complete dextrotransposition of the great arteries...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28259696/comparison-of-strategies-for-catheter-ablation-of-focal-atrial-tachycardia-originating-near-the-his-bundle-region
#9
Evgeny Lyan, Mauro Toniolo, Alexey Tsyganov, Luca Rebellato, Alessandro Proclemer, Massimiliano Manfrin, Anatoly Nechepurenko, Alexandr Morozov, Ayan Abdrahmanov, Grigory Gromyko, Vitaly Lyashenko, Marina Yakovleva
BACKGROUND: Recent studies have suggested that para-Hisian atrial tachycardia (AT) can be successfully ablated from the right atrium (RA), left atrium (LA) or non-coronary cusp (NCC) in the aorta; however, the best approach remains unclear. OBJECTIVE: This study aimed to compare different approaches to radiofrequency catheter ablation (RFCA) of para-Hisian AT. METHODS: We retrospectively analyzed 68 consecutive patients (72% females, aged 61±13 years) treated with RFCA for this type of AT...
March 1, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28247926/non-invasive-determination-of-hv-interval-using-magnetocardiography
#10
Sengottuvel Senthilnathan, Raja J Selvaraj, Rajesh Patel, Santhosh Satheesh, Gireesan Katholil, Madhukar P Janawadkar, Thimmakudy S Radhakrishnan
BACKGROUND: The HV interval is an important index of atrio-ventricular conduction, but at present can be reliably measured only during an invasive electrophysiology (EP) study. Magnetocardiography (MCG) is a non-invasive measurement of weak magnetic fields generated by the heart. We compared HV interval non-invasively assessed using MCG with the corresponding values measured directly in an EP study. METHODS: MCG was measured using a 37 channel system inside a magnetically shielded room in patients who had previously undergone an EP study...
March 1, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28237734/respective-role-of-surface-electrocardiogram-and-his-bundle-recordings-to-assess-the-risk-of-atrioventricular-block-after-transcatheter-aortic-valve-replacement
#11
N Badenco, C Chong-Nguyen, C Maupain, C Himbert, G Duthoit, X Waintraub, T Chastre, E Gandjbakhch, F Hidden-Lucet, P Le Prince, J-P Collet, R Frank
BACKGROUND: Atrioventricular block (AVB) is common after transcatheter aortic valve replacement (TAVR) and permanent pacemaker (PPM) implantation is needed in up to 30% of patients. Main predictors of long term AVB are electrocardiographic. The purpose of this study is to assess the prognostic value of serial HV intervals measured before and after TAVR to shorten the timing of PPM implantation. METHODS: His bundle recordings were performed before (HV1), immediately after TAVR (HV2) and at day 2 for Edwards Sapien (ES) and 5 for Medtronic CoreValve (CV) (HV3)...
February 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28230913/an-unexpected-finding-in-sudep-involving-a-child-focal-myocardial-infarct-adjacent-to-bundle-of-his
#12
Jadee L Neff, Peter T Lin
Sudden unexpected death in epilepsy (SUDEP) is a nontraumatic, nondrowning death of an individual with epilepsy in which an autopsy with appropriate ancillary studies does not identify a cause of death. The mechanism of death in SUDEP is unknown, but is thought to involve cardiac and/or respiratory mechanisms. Research in SUDEP is hindered by a lack of consensus regarding required components of a death investigation before a cause of death may be certified as SUDEP. Histopathologic examination of the cardiac conduction system is not routinely performed in SUDEP death investigations...
February 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28188930/microrna-135a-regulates-sodium-calcium-exchanger-gene-expression-and-cardiac-electrical-activity
#13
Eric Duong, Jiening Xiao, Xiao Yan Qi, Stanley Nattel
BACKGROUND: Complete atrioventricular block (CAVB) causes arrhythmogenic remodeling and increases the risk of Torsades de Pointes (TdP) arrhythmias. MicroRNAs (miRNAs) are key regulators of gene-expression that contribute to cardiac remodeling. OBJECTIVE: To assess miRNA changes after complete atrioventricular block (CAVB) and identify novel candidates potentially involved in arrhythmogenic cardiac remodeling. METHODS: CAVB was induced in mice via His bundle ablation...
February 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28128912/robotic-assisted-radical-cystoprostatectomy-and-intracorporeal-ileal-conduit-urinary-diversion-for-a-kidney-transplant-recipient
#14
Peter A Caputo, Daniel Ramirez, Matthew Maurice, Ryan Nelson, Onder Kara, Ercan Malkoc, David Goldfarb, Jihad Kaouk
INTRODUCTION AND OBJECTIVES: Robotic assisted radical cystectomy (RARC) is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. MATERIALS AND METHODS: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#15
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28089344/heparan-sulfate-storage-in-the-cardiac-conduction-system-triggers-atrioventricular-block
#16
Rie Kato, Hiroaki Miyahara, Tatsuya Kawano, Atsuko Matsuzuka, Kimiko Noda, Tatsuro Izumi
OBJECTIVE: To elucidate the novel biological functions of heparan sulfate (HS) by clinic-pathologically studying a patient with paroxysmal atrioventricular (AV) block. PATIENT: A long-surviving male patient with Sanfilippo syndrome type A presented with paroxysmal AV block at age 33years. He then survived another 2.5years after the onset of paroxysmal AV block and pacemaker implantation. METHODS AND RESULTS: His cardiac histopathological examination at autopsy showed HS storage in the cardiac conduction system (CCS), especially in the atrioventricular node (AVN)-His bundle branches...
January 12, 2017: Brain & Development
https://www.readbyqxmd.com/read/28041584/hemodynamics-of-his-bundle-pacing
#17
REVIEW
Luca Alberti, Paolo Pieragnoli, Giuseppe Ricciardi, Luigi Padeletti
This review will focus on the feasibility of long term His bundle pacing and its effects on left ventricle (LV) hemodynamics. Compared with right ventricular pacing, His bundle pacing results in a more physiological electro-mechanical activation that contributes to preserve LV function. Moreover some studies showed a similar effect to biventricular pacing in patients with heart failure and left bundle branch block. Recent observations indicate that His bundle pacing should be considered as an optimal site to pace right ventricle in patients who are candidates for cardiac resynchronization therapy...
January 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28032941/permanent-his-bundle-pacing-the-past-present-and-future
#18
REVIEW
Parikshit S Sharma, Kenneth A Ellenbogen, Richard G Trohman
Long-term right ventricular (RV) apical pacing has been associated with an increased risk of death, heart failure, and atrial fibrillation (AF). Alternative sites for RV pacing have not proven to be superior to RV apical pacing. Cardiac resynchronization therapy (CRT) using a biventricular (BiV) lead system is indicated for patients with a low left ventricular ejection fraction and QRS prolongation, but there remains about a 25-30% nonresponse rate. CRT has been less effective for nonleft bundle branch block conduction delay and with normal/low normal left ventricular function...
December 29, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28000309/utilization-of-permanent-his-bundle-pacing-for-management-of-pro-arrhythmia-related-to-bi-ventricular-pacing
#19
Aamir Sofi, Pugazhendhi Vijayaraman, S Serge Barold, Bengt Herweg
Biventricular pacing has occasionally been associated with ventricular pro-arrhythmia which at times can be refractory to conventional antiarrhythmic drug therapy and ablative intervention. Recently, permanent His bundle pacing has emerged as a reasonable alternative to right ventricular and biventricular pacing. In addition, by maintaining the physiologic pattern of ventricular electrical activation it is less likely to be arrhythmogenic. We here report the use of permanent His-bundle pacing to manage ventricular pro-arrhythmia that developed after initiation of biventricular pacing and was unresponsive to antiarrhythmic and ablative therapy...
December 20, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27989087/the-double-orifice-valve-technique-to-treat-tricuspid-valve-incompetence
#20
Roland Hetzer, Mariano Javier, Eva Maria Delmo Walter
BACKGROUND: A straightforward tricuspid valve (TV) repair technique was used to treat either moderate or severe functional (normal valve with dilated annulus) or for primary/organic (Ebstein's anomaly, leaflet retraction/tethering and chordal malposition/tethering, with annular dilatation) TV incompetence, and its long-term outcome assessed. METHODS: A double-orifice valve technique was employed in 91 patients (mean age 52.6 ± 23.2 years; median age 56 years; range: 0...
January 2016: Journal of Heart Valve Disease
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