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https://www.readbyqxmd.com/read/28109316/adenosine-induced-ventricular-fibrillation-in-a-structurally-normal-heart-a-case-report
#1
Christopher A Rajkumar, Norman Qureshi, Fu Siong Ng, Vasileios F Panoulas, Phang Boon Lim
BACKGROUND: Adenosine is the first-line pharmacotherapy for termination of supraventricular tachycardia through its action on the atrioventricular node. However, pro-arrhythmic effects of adenosine are also recognised, most notably in the presence of pre-excited atrial fibrillation. In this case report, we describe the induction of ventricular fibrillation in a patient with no demonstrable accessory pathway, nor any other structural heart disease. This rare, idiosyncratic reaction has never previously been reported and is of relevance given the widespread and routine use of adenosine in clinical practice...
January 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28108548/the-effect-of-left-ventricular-pacing-on-transmural-activation-delay-in-myopathic-human-hearts
#2
Andreu Porta-Sánchez, Paul Angaran, Stéphane Massé, Krishnakumar Nair, Talha Farid, Karthikeyan Umapathy, John Asta, Sigfus Gizurarson, Kumaraswamy Nanthakumar
AIMS: Left ventricular (LV) epicardial pacing (LVEpiP) in human myopathic hearts does not decrease global epicardial activation delay compared with right ventricular (RV) endocardial pacing (RVEndoP); however, the effect on transmural activation delay has not been evaluated. To characterize the transmural electrical activation delay in human myopathic hearts during RVEndoP and LVEpiP compared with global epicardial activation delay. METHODS AND RESULTS: Explanted hearts from seven patients (5 male, 46 ± 10 years) undergoing cardiac transplantation were Langendorff-perfused and mapped using an epicardial sock electrode array (112 electrodes) and 25 transmural plunge needles (four electrodes, 2 mm spacing), for a total of 100 unipolar transmural electrodes...
January 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28106965/transapical-approach-to-optimize-left-ventricular-resynchronization-in-patients-with-dilated-cardiomyopathy
#3
Imre Kassai, Alberto Pozzoli, Orsolya Friedrich, Zsuzsanna Kis, Tamas SziliTorok, Elisabetta Lapenna, Stefano Benussi, Ottavio Alfieri
An alternative to coronary sinus implantation for a left ventricular pacing lead is frequently needed for cardiac resynchronization therapy. We have developed a transapical approach to implant an endocardial pacing lead that will reach the most delayed segment of the left ventricle. This method is easily combined with other transapical heart surgeries. After some technological improvement our technique should offer easier access and better results than other currently available implantation methods.
January 16, 2017: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28105997/first-successful-transcatheter-double-valve-replacement-from-a-transapical-access-and-nine-month-follow-up
#4
Robert Bauernschmitt, Stefan Bauer, Christian Liewald, Ramiz Emini, Wolfgang Oechsner, Meinrad Beer, Ralf Sodian, Andreas Liebold
AIMS: While TAVI is the treatment of choice in patients with aortic stenosis considered inoperable or at high risk, interventional replacement of the mitral valve is still in the preclinical or early clinical phase. Our aim was to report on the first transcatheter double valve replacement into native valves from a transapical access. METHODS AND RESULTS: A 67-year-old, highly symptomatic female patient considered inoperable due to severe calcification of the mitral annulus and comorbidities was scheduled for transcatheter double valve replacement by the local Heart Team...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28103423/adipose-derived-perivascular-mesenchymal-stromal-stem-cells-promote-functional-vascular-tissue-engineering-for-cardiac-regenerative-purposes
#5
Justin Morrissette-McAlmon, Adriana Blazeski, Sarah Somers, Geran Kostecki, Leslie Tung, Warren L Grayson
Cardiac tissue engineering approaches have the potential to regenerate functional myocardium with intrinsic vascular networks. In this study, we compared the relative effects of human adipose-derived stem/stromal cells (hASCs) and human dermal fibroblasts (hDFs) in co-cultures with neonatal rat ventricular cardiomyocytes (NRVCMs) and human umbilical vein endothelial cells (HUVECs). We found that at the same ratios of NRVCM:hASC and NRVCM:hDF, the hASC co-cultures displayed shorter action potentials and maintained capture at faster pacing rates...
January 19, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28090637/diltiazem-prevents-stress-induced-contractile-deficits-in-cardiomyocytes-but-does-not-reverse-the-cardiomyopathy-phenotype-in-mybpc3-knock-in-mice
#6
Frederik Flenner, Birgit Geertz, Silke Reischmann-Düsener, Florian Weinberger, Thomas Eschenhagen, Lucie Carrier, Felix W Friedrich
Left ventricular hypertrophy, diastolic dysfunction and fibrosis are main features of hypertrophic cardiomyopathy (HCM). Guidelines recommend β-adrenoceptor or Ca(2+) channel antagonists as pharmacological treatment. The Ca(2+) channel blocker diltiazem recently showed promising beneficial effects in pre-clinical HCM, particularly in patients carrying MYBPC3 mutations. In the present study we evaluated whether diltiazem could ameliorate or reverse the disease phenotype in cells and in vivo in Mybpc3-targeted knock-in (KI) mouse model of HCM...
January 15, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28088306/ventricular-fibrillation-occurring-after-atrioventricular-node-ablation-despite-minimal-difference-between-pre-and-post-ablation-heart-rates
#7
F Squara, G Theodore, D Scarlatti, E Ferrari
We report the case of an 82-year-old man presenting with ventricular fibrillation (VF) occurring acutely after atrioventricular node (AVN) ablation. This patient had severe valvular cardiomyopathy, chronic atrial fibrillation (AF), and underwent prior to the AVN ablation a biventricular implantable cardiac defibrillator positioning. The VF was successfully cardioverted with one external electrical shock. What makes this presentation original is that the pre-ablation spontaneous heart rate in AF was slow (84 bpm), and that VF occurred after ablation despite a minimal heart rate drop of only 14 bpm...
January 11, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28086779/the-effect-of-electrical-conductivity-of-myocardium-on-cardiac-pumping-efficacy-a-computational-study
#8
Ana Rahma Yuniarti, Ki Moo Lim
BACKGROUND AND AIMS: The existence of non-excitable cells in the myocardium leads to the increasing conduction non-uniformity and decreasing myocardial electrical conductivity. Slowed myocardial conduction velocity (MCV) believed to enhance the probability of cardiac arryhthmia and alter the cardiac mechanical pumping efficacy, even in sinus rhythm. Though several studies on the correlation between MCV and cardiac electrical instabilities exist, there has been no study concerning correlation or causality between MCV and cardiac mechanical pumping efficacy, due to the limitation in clinical methods to document and evaluate cardiac mechanical responses directly...
January 10, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28079553/end-of-life-decisions-in-heart-failure-to-turn-off-the-intracardiac-device-or-not
#9
Bilal Ayach, Amrit Malik, Colette Seifer, Shelley Zieroth
PURPOSE OF REVIEW: Heart failure is a significant public health concern around the world. Implantable cardioverter defibrillators with or without cardiac resynchronization therapy (CRT-D) have proven survival benefit. As patients progress to end-stage disease, management shifts to palliative care, and cardiologists are often confronted with how to best manage these devices. RECENT FINDINGS: Studies suggest that up to one-third of patients with an implantable cardioverter defibrillator receive painful shocks in the last 24 h of life...
January 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28074823/pharmacological-update-new-drugs-in-cardiac-practice-a-critical-appraisal
#10
REVIEW
Rohan Magoon, Arindam Choudhury, Vishwas Malik, Ridhima Sharma, Poonam Malhotra Kapoor
Cardiac practice involves the application of a range of pharmacological therapies. An anesthesiologist needs to keep pace with the rampant drug developments in the field of cardiovascular medicine for appropriate management in both perioperative and intensive care set-up, to strengthen his/her role as a perioperative physician in practice. The article reviews the changing trends and the future perspectives in major classes of cardiovascular medicine.
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073886/endocardial-left-ventricular-pacing-for-cardiac-resynchronization-systematic-review-and-meta-analysis
#11
James Hugo Phillimore Gamble, Neil Herring, Matthew Ginks, Kim Rajappan, Yaver Bashir, Timothy Rider Betts
AIMS: Endocardial left ventricular (LV) pacing for Cardiac Resynchronization Therapy has been proposed as an alternative to conventional LV lead placement via the coronary sinus. In order to assess the relative benefits and risks of this technique, we have performed a meta-analysis of published reports. METHODS AND RESULTS: A systemic search was performed using online databases to identify studies of lead-based endocardial pacing. A random-effects meta-analysis was performed, to assess the rate of complications and clinical response (defined as ≥1 decrease in NYHA class)...
January 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28073434/two-to-one-crtd-pacing-when-the-t-wave-and-the-p-wave-interact
#12
Hilmi Alnsasra, Moti Haim, Aref Alnsasra, Yuval Konstantino
We presented a unique phenomenon of 2:1 cardiac resynchronization therapy pacing due to T wave oversensing. Ultimately, by utilizing a unique feature of integrated bipolar sensing, we succeeded to eliminate the T wave oversensing signals, and restore 1:1 CRTD pacing. Importantly, this feature enabled us to overcome the T wave oversensing issue, without the need to decrease the ventricular sensitivity, which could potentially interfere with ventricular arrhythmia detection and appropriate shock delivery when required...
December 29, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28070867/analytical-modeling-for-computing-lead-stress-in-a-novel-epicardial-micropacemaker
#13
Li Zhou, Yaniv Bar-Cohen, Raymond A Peck, Giorgio V Chirikian, Brett Harwin, Ramen H Chmait, Jay D Pruetz, Michael J Silka, Gerald E Loeb
Implantation and maintenance of a permanent cardiac pacing system in children remains challenging due to small patient size, congenital heart defects and somatic growth. We are developing a novel epicardial micropacemaker for children that can be implanted on the epicardium within the pericardial space via a minimally-invasive technique. The key design configurations include a novel open-coiled lead in which living tissue replaces the usual polymeric support for the coiled conductor. To better understand and be able to predict the behavior of the implanted lead, we performed a radiographic image-based modeling study on a chronic animal test...
January 9, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28069274/extended-bipolar-left-ventricular-pacing-as-a-possible-therapy-for-late-electrical-storm-induced-by-cardiac-resynchronization-therapy
#14
Dimitrios Asvestas, Richard Balasubramaniam, Mark Sopher, John Paisey, Girish G Babu
Although cardiac resynchronization therapy (CRT) has become a well-established treatment option for patients with drug-refractory severe systolic heart failure, there has been some evidence of adverse proarrhythmic events. We report a case of a patient with ischemic cardiomyopathy who underwent CRT with a defibrillator for primary prevention of sudden cardiac death. Two years after the implantation, the patient presented with electrical storm, which was completely terminated by modifying the left ventricular (LV) pacing configuration from true to extended bipolar LV pacing...
December 30, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28067978/imaging-left-ventricular-mechanical-activation-in-heart-failure-patients-using-cine-dense-mri-validation-and-implications-for-cardiac-resynchronization-therapy
#15
Daniel A Auger, Kenneth C Bilchick, Jorge A Gonzalez, Sophia X Cui, Jeffrey W Holmes, Christopher M Kramer, Michael Salerno, Frederick H Epstein
PURPOSE: To image late mechanical activation and identify effective left-ventricular (LV) pacing sites for cardiac resynchronization therapy (CRT). There is variability in defining mechanical activation time, with some studies using the time to peak strain (TPS) and some using the time to the onset of circumferential shortening (TOS). We developed improved methods for imaging mechanical activation and evaluated them in heart failure (HF) patients undergoing CRT. MATERIALS AND METHODS: We applied active contours to cine displacement encoding with stimulated echoes (DENSE) strain images to detect TOS...
January 9, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28066827/optimized-left-ventricular-endocardial-stimulation%C3%A2-is-superior-to-optimized-epicardial%C3%A2-stimulation-in-ischemic-patients-with%C3%A2-poor-response-to-cardiac-resynchronization%C3%A2-therapy-a%C3%A2-combined-magnetic-resonance-imaging-electroanatomic%C3%A2-contact-mapping-and-hemodynamic
#16
Jonathan M Behar, Tom Jackson, Eoin Hyde, Simon Claridge, Jaswinder Gill, Julian Bostock, Manav Sohal, Bradley Porter, Mark O'Neill, Reza Razavi, Steve Niederer, Christopher Aldo Rinaldi
OBJECTIVES: The purpose of this study was to identify the optimal pacing site for the left ventricular (LV) lead in ischemic patients with poor response to cardiac resynchronization therapy (CRT). BACKGROUND: LV endocardial pacing may offer benefit over conventional CRT in ischemic patients. METHODS: We performed cardiac magnetic resonance, invasive electroanatomic mapping (EAM), and measured the acute hemodynamic response (AHR) in patients with existing CRT systems...
December 2016: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28054365/mapping-for-acute-transvenous-phrenic-nerve-stimulation-study-maps-study
#17
Lukas R C Dekker, Bart Gerritse, Avram Scheiner, Lilian Kornet
AIMS: Central Sleep Apnea Syndrome, correlated with the occurrence of heart failure, is characterized by periods of insufficient ventilation during sleep. This acute study in 15 patients aims to map the venous system and determine, if diaphragmatic movement can be achieved by phrenic nerve stimulation at various locations within the venous system. METHODS: Subjects underwent a scheduled catheter ablation procedure. During the procedural waiting time, one multi-electrode EP catheter was subsequently placed at the the superior and inferior vena cava and the junctions of the left jugular and left brachiocephalic vein and right jugular and right brachiocephalic vein, for phrenic nerve stimulation (1-2 seconds ON / 2-3 seconds OFF, 40 Hz, pulse width 210 μs)...
January 5, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28043451/transapical-cannulation-through-a-transcatheter-aortic-valve-implantation-valve-a-novel-approach-for-cardiogenic-collapse
#18
Louis Philippe Tremblay, Claudia Cote, Marc P Pelletier
We report a case of rescue bypass cannulation of the ventricular apex during a transapical transcatheter aortic valve implantation procedure in a patient with peripheral vascular disease not amenable to peripheral cannulation. Following rapid pacing and deployment of the transcatheter valve, cardiac function did not recover. The arterial cannula was inserted through the left ventricular apex, at the site of the transapical sheath, and advanced across the prosthetic valve, allowing for rapid initiation of cardiopulmonary bypass...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28041584/hemodynamics-of-his-bundle-pacing
#19
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
#20
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 (HF) and atrial fibrillation (AF). Alternative sites for RV pacing have not proven to be superior to right ventricular apical pacing. Cardiac resynchronization therapy (CRT) using a biventricular (BiV) lead system is indicated for patients with a low left ventricular ejection fractions (LVEF) and QRS prolongation, but there remains about a 25-30% non-response rate. CRT has been less effective for non-LBBB conduction delay and with normal/low normal left ventricular (LV) function...
December 29, 2016: Journal of Cardiovascular Electrophysiology
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