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https://www.readbyqxmd.com/read/29442383/atrial-overdrive-pacing-during-lbbb-tachycardia-what-is-the-mechanism
#1
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
https://www.readbyqxmd.com/read/29428145/his-bundle-pacing-is-it-ready-for-prime-time
#2
REVIEW
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
https://www.readbyqxmd.com/read/29419690/association-between-paced-qrs-duration-and-atrial-fibrillation-after-permanent-pacemaker-implantation-a-retrospective-observational-cohort-study
#3
FuWei Xing, JingZhou Jiang, XiaoLiang Hu, Chong Feng, JianGui He, YuGang Dong, YueDong Ma, AnLi Tang
Right ventricular pacing often results in prolonged QRS duration (QRSd) as the result of right ventricular stimulation, and atrial fibrillation (AF) may result. The association of pacing-induced prolonged QRSd and AF in patients with permanent pacemakers is unknown.We selected 180 consecutive patients who underwent pacemaker implantation for complete/advanced atrioventricular block. All of the patients were paced from the right ventricular septum. Electrocardiography recordings were obtained at the beginning and the end of pacemaker implantation...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29416210/assesment-of-rhythm-disorders-in-classical-and-nonclassical-mitral-valve-prolapse
#4
Enisa Hodzic
Introduction: Mitral Valve Prolapse (MVP) is the most common cardiac valve pathology of to day. Aim of article was to identify the types and frequency of potentially malignant arrhythmia and atrial brillation in patients with MVP, to determine the differences in these arrhythmias between classical and non-classical MVP, to evaluate the correlation of potentially malignant arrhythmia and atrial fibrillation with MVP with possible clinical complications of arrhythmogenic sudden cardiac death and potential risk of thromboembolic vascular incident...
February 2018: Medical Archives
https://www.readbyqxmd.com/read/29399750/implantable-loop-recorders-in-patients-with-unexplained-syncope-clinical-predictors-of-pacemaker-implantation
#5
Martin Huemer, Ann-Kristin Becker, Alexander Wutzler, Philipp Attanasio, Abdul S Parwani, Philipp Lacour, Leif-Hendrik Boldt, Burkert Pieske, Wilhelm Haverkamp, Florian Blaschke
BACKGROUND: Implantable loop recorders (ILR) are a valuable tool for the investigation of unexplained syncopal episodes. The aim of this retrospective single center study was to identify predictive factors for pacemaker implantation in patients with unexplained syncope who underwent ILR insertion. METHODS: 106 patients were retrospectively analyzed (mean age 59.1 years; 47.2% male) with unexplained syncope and negative conventional testing who underwent ILR implantation...
February 5, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29391388/a-patient-with-left-bundle-branch-block-and-persistent-atrial-fibrillation-treated-with-cardiac-catheter-ablation-and-pharmacologic-cardiac-resynchronization-therapy-without-the-use-of-an-implantable-cardiac-device
#6
Hideyuki Hasebe
BACKGROUND Left bundle branch block (LBBB) is associated with atrial fibrillation (AF) and systolic heart failure, which can be treated with cardiac resynchronization therapy (CRT) that includes an implantable cardiac device (ICD). However, in some patients, LBBB may vary with heart rate, and during episodes of AF in LBBB, aberrant ventricular conduction, or wide QRS complex tachycardia (Ashman beats) can occur. This report is a case of LBBB treated with pharmacologic CRT, without the use of an ICD. CASE REPORT A 68-year-old man presented with persistent AF and systolic heart failure...
February 2, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29387326/performance-of-electrophysiologic-study-in-an-asymptomatic-patient-with-type-2-intermittent-brugada-syndrome-to-do-or-not-to-do
#7
Kaveh Hosseini, Mansour Jahangiri, Ali Vasheghani Farahani
Background: Brugada syndrome (BrS) is an inherited channelopathy, which is associated with sudden cardiac death due to rapid polymorphic VT or VF. There is no definite consensus regarding the management of asymptomatic patients. Some experts advocate close follow-up; others propose the programmed stimulation for risk stratification. We aimed to evaluate the benefit of complete atrial and ventricular stimulation in patients with BrS and palpitation. Case Presentation: A 30-year-old man was admitted to our hospital because of a family history of sudden cardiac death (SCD) at age less than 45 years...
2018: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/29367535/management-of-arrhythmias-in-heart-failure
#8
REVIEW
Daniele Masarone, Giuseppe Limongelli, Marta Rubino, Fabio Valente, Rossella Vastarella, Ernesto Ammendola, Rita Gravino, Marina Verrengia, Gemma Salerno, Giuseppe Pacileo
Heart failure patients are predisposed to develop arrhythmias. Supraventricular arrhythmias can exacerbate the heart failure symptoms by decreasing the effective cardiac output and their control require pharmacological, electrical, or catheter-based intervention. In the setting of atrial flutter or atrial fibrillation, anticoagulation becomes paramount to prevent systemic or cerebral embolism. Patients with heart failure are also prone to develop ventricular arrhythmias that can present a challenge to the managing clinician...
February 28, 2017: Journal of Cardiovascular Development and Disease
https://www.readbyqxmd.com/read/29341176/different-responses-of-supraventricular-tachycardia-with-2-1-av-block-to-consecutive-premature-ventricular-contractions
#9
Svetoslav Kurtev, Cristina Valduva, László Sághy, Robert Pap
A 52-year old female was admitted with complaints of palpitations for two years. The transthoracic echocardiography and electrocardiogram were both normal at the time of admission. We performed an electrophysiology study where the baseline intervals were in normal range. During burst atrial pacing we observed HV prolongation (HV = 80 ms) and infra-Hisian block. This article is protected by copyright. All rights reserved.
January 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29325364/-the-efficacy-and-safety-of-coil-embolization-of-septal-branch-in-the-treatment-of-patients-with-obstructive-hypertrophic-cardiomyopathy
#10
H Liu, Q Wu, H W Tan, J Pang
Objective: To observe the clinical efficacy and safety of coil embolization of septal branch in the treatment of obstructive hypertrophic cardiomyopathy (HOCM). Methods: Eighteen patients with HOCM hospitalized in our department from September 2014 to October 2016 were enrolled in this study. There were 12 males and 6 females in this cohort and the age of patients ranged from 22 to 64 years old. Left ventricular outflow tract gradient (LVOTG) was derived from echocardiographic apical five-chamber view at pre-operation and at 48 hours and 6 months post operation...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29311401/hepatic-cyst-compressing-the-right-atrial-and-ventricular-inflow-tract-an-uncommon-cardiac-complication
#11
Maulik Panchal, Ahmed Alansari, Marc Wallack, Ferdinand Visco, Susan Williams, Alexander M Sy
Commonly reported complications of hepatic cysts are spontaneous hemorrhage, rupture into the peritoneal cavity, infection and compression of the biliary tree however cardiac complications are not commonly reported. We are presenting a case of a large liver cyst presenting with right atrial and ventricular inflow tract impingement resulting in cardiac symptoms. A 68 year-old Hispanic female presented with one month of fatigue and shortness of breath after household work and walking less than one block, right upper quadrant pain and weight loss...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29310559/arrhythmias-in-children-in-early-postoperative-period-after-cardiac-surgery
#12
Manoj Kumar Sahu, Anupam Das, Bharat Siddharth, Sachin Talwar, Sarvesh Pal Singh, Atul Abraham, Arin Choudhury
BACKGROUND: Postoperative arrhythmias are a known complication after cardiac surgical repairs for congenital heart disease. METHODS: Data were reviewed pertaining to incidence, diagnosis, potential risk factors, and management of postoperative arrhythmias in 369 consecutive patients under 18 years of age, undergoing elective open heart surgery. All children were admitted to the intensive care unit and continuous electrocardiographic monitoring was performed. Patient factors such as Aristotle Basic Complexity Score, total surgical duration, hypotension, tachycardia, serum lactate level, and inotropic score were analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29296060/short-term-outcomes-of-transcatheter-closure-of-secundum-atrial-septal-defect-in-children-and-adolescents-an-experience-of-two-centers-in-upper-egypt
#13
Safaa H Ali, Amal El Sisi, Duaa M Raafat, Salah-Eldin Amry, Sharaf E D Mahamoud
Background: The aim of this study was to evaluate the acute and short-term outcomes of transcatheter closure of secundum atrial septal defect (ASD) in children and adolescents in the first 4-year experience in two institutional centers in Upper Egypt. Methods: This was a retrospective cohort study including 135 children and adolescents who underwent ASD closure between April 2012 and May 2016. A review of the acute and short-term outcomes and adverse events was performed...
January 2018: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/29286395/benefits-of-cardiac-resynchronization-therapy-in-an-asynchronous-heart-failure-model-induced-by-left-bundle-branch-ablation-and-rapid-pacing
#14
Jingfeng Wang, Zhenning Nie, Haiyan Chen, Xianhong Shu, Zhaohua Yang, Ruiming Yao, Yangang Su, Junbo Ge
It is now well recognized that heart failure (HF) patients with left bundle branch block (LBBB) derive substantial clinical benefits from cardiac resynchronization therapy (CRT), and LBBB has become one of the important predictors for CRT response. The conventional tachypacing-induced HF model has several major limitations, including absence of stable LBBB and rapid reversal of left ventricular (LV) dysfunction after cessation of pacing. Hence, it is essential to establish an optimal model of chronic HF with isolated LBBB for studying CRT benefits...
December 11, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29258620/refractory-ventricular-fibrillations-after-surgical-repair-of-atrial-septal-defects-in-a-patient-with-cacna1c-gene-mutation-case-report
#15
Ai Kojima, Fumiaki Shikata, Toru Okamura, Takashi Higaki, Seiko Ohno, Minoru Horie, Shunji Uchita, Yujiro Kawanishi, Kenji Namiguchi, Takumi Yasugi, Hironori Izutani
BACKGROUND: Congenital long QT syndrome (LQTS) can cause ventricular arrhythmic events with syncope and sudden death resulting from malignant torsades de pointes (TdP) followed by ventricular fibrillations (VFs). However, the syndrome is often overlooked prior to the development of arrhythmic events in patients with congenital heart diseases demonstrating right bundle branch block on electrocardiogram (ECG). We present a case of an adult patient with congenital heart disease who developed VFs postoperatively, potentially due to his mutation in a LQTS related gene, which was not identified on preoperative assessment due to incomplete evaluation of his family history...
December 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29240293/transvenous-pacemaker-implantation-after-the-bidirectional-glenn-operation-for-patients-with-complex-congenital-disease
#16
Danielle E Harake, Kevin M Shannon, Jamil A Aboulhosn, Jeremy P Moore
INTRODUCTION: The bidirectional Glenn operation for congenital heart disease produces anatomical constraints to conventional transvenous pacemaker implantation. An iliac approach, although not previously described in this population, is potentially a preferable alternative to a thoracotomy for epicardial pacing. METHODS AND RESULTS: A single-center retrospective review was performed for all patients that underwent transvenous pacemaker implantation following the bidirectional Glenn operation with partial biventricular repair...
December 14, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29223306/diagnostic-accuracy-of-multi-lead-ecgs-obtained-using-a-pocket-sized-bipolar-handheld-event-recorder
#17
Ani Nigolian, Nicolas Dayal, Haïg Nigolian, Carine Stettler, Haran Burri
BACKGROUND: Handheld ECG event recorders are useful for rhythm monitoring but only record a single lead, which may limit interpretation. We sought to investigate if a multi-lead ECG may be reconstituted using this device, and aimed to evaluate diagnostic accuracy. METHODS: A commercially-available handheld bipolar ECG event recorder was used to reconstruct a 9-lead ECG (leads I, II and III, V1-6). Tracings were analyzed independently by a cardiologist and a fellow...
November 21, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29222864/effects-of-cardiac-resynchronization-therapy-after-inferior-myocardial-infarction-on-secondary-mitral-regurgitation-and-mitral-valve-geometry
#18
Christos G Mihos, Evin Yucel, Romain Capoulade, Mary P Orencole, Gaurav A Upadhyay, Orlando Santana, Jagmeet P Singh, Michael H Picard
BACKGROUND: The effects of cardiac resynchronization therapy (CRT) on secondary mitral regurgitation (MR), and mitral valve (MV) and left ventricular (LV) geometry, in patients with prior inferior myocardial infarction is not clearly defined. We assessed these outcomes utilizing 2-dimensional echocardiography, and analyzed echocardiographic geometric variables that may correlate with follow-up MR severity. METHODS: Between 2009 and 2012, 229 CRT were implanted. Twenty-two had prior inferior myocardial infarction, ≥ mild MR at baseline, and serial echocardiography...
December 9, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29218016/synergistic-anti-arrhythmic-effects-in-human-atria-with-combined-use-of-sodium-blockers-and-acacetin
#19
Haibo Ni, Dominic G Whittaker, Wei Wang, Wayne R Giles, Sanjiv M Narayan, Henggui Zhang
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Developing effective and safe anti-AF drugs remains an unmet challenge. Simultaneous block of both atrial-specific ultra-rapid delayed rectifier potassium (K+) current (IKur) and the Na+ current (INa) has been hypothesized to be anti-AF, without inducing significant QT prolongation and ventricular side effects. However, the antiarrhythmic advantage of simultaneously blocking these two channels vs. individual block in the setting of AF-induced electrical remodeling remains to be documented...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29202647/swallow-presyncope-in-an-athletic-patient-caused-by-third-degree-atrioventricular-block
#20
Axel Van Damme, Tine De Backer, Philippe Vanderheeren
Introduction Swallow syncope is a neurally mediated syncope. Multiple causes have been described in literature. A rare cause is arrhythmias. Only a limited amount of cases present the association of swallow syncope and third degree AV-block. Case presentation A 39-year-old man presented with episodes of presyncope while eating. Further medical history, physical examination, resting 12-lead ECG, cyclo-ergometry, transthoracic echocardiography and MRI of the heart were normal. 24 h Holter monitoring demonstrated high-grade third-degree atrioventricular (AV) block...
December 5, 2017: Acta Clinica Belgica
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