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Cardiac pacing

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https://www.readbyqxmd.com/read/28550171/%C3%AE-adrenergic-receptor-stimulation-inhibits-proarrhythmic-alternans-in-post-infarction-border-zone-cardiomyocytes-a-computational-analysis
#1
Jakub Tomek, Blanca Rodriguez, Gil Bub, Jordi Heijman
The border zone (BZ) of viable myocardium adjacent to an infarct undergoes extensive autonomic and electrical remodelling and is prone to repolarisation alternans-induced cardiac arrhythmias. BZ remodelling processes may promote or inhibit calcium and/or repolarisation alternans and may differentially affect ventricular arrhythmogenesis. Here, we employed a detailed computational model of the canine ventricular cardiomyocyte to study the determinants of alternans in the BZ and their regulation by β-adrenergic receptor (βAR) stimulation...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28543771/right-ventricular-pacemaker-lead-position-is-associated-with-differences-in-long-term-outcomes-and-complications
#2
Chance M Witt, Charles J Lenz, Henry H Shih, Elisa Ebrille, Andrew N Rosenbaum, Martin van Zyl, Htin Aung, Kevin K Manocha, Abhishek J Deshmukh, David O Hodge, Siva K Mulpuru, Yong-Mei Cha, Raul E Espinosa, Samuel J Asirvatham, Christopher J McLeod
INTRODUCTION: Cardiac pacing from the right ventricular apex is associated with detrimental long-term effects and non-apical pacing locations may be associated with improved outcomes. There is little data regarding complications with non-apical lead positions. The aim of this study was to assess long-term outcomes and lead-related complications associated with differing ventricular lead tip position. METHODS AND RESULTS: All adult patients who underwent dual-chamber pacemaker implantation from 2004-2014 were included if they had post-procedure chest radiographs amenable to lead position determination...
May 24, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28543265/stricter-criteria-for-left-bundle-branch-block-diagnosis-do-not-improve-response-to-crt
#3
Emanuele Bertaglia, Federico Migliore, Anna Baritussio, Antonio De Simone, Albino Reggiani, Domenico Pecora, Antonio D'Onofrio, Antonio Rapacciuolo, Gianluca Savarese, Attilio Pierantozzi, Biondino Marenna, Franco Ruffa, Monica Campari, Maurizio Malacrida, Giuseppe Stabile
BACKGROUND: Cardiac resynchronization therapy (CRT) has proved to be effective in patients with heart failure and left bundle branch block (LBBB). Recently, new ECG criteria have been proposed for the diagnosis of LBBB. These criteria are stricter than the current American Heart Association (AHA) criteria. We assessed the rate of echocardiographic response to CRT in patients with traditional LBBB versus patients who met the new criteria (strict LBBB). METHODS: Consecutive patients undergoing CRT were enrolled in the CRT MORE registry...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543106/the-concept-of-triple-wavefront-fusion-during-biventricular-pacing-using-the-egm-to-produce-the-best-acute-hemodynamic-improvement-in-crt
#4
Iris A H Ter Horst, Margot D Bogaard, Anton E Tuinenburg, Thomas P Mast, Teun P de Boer, Pieter A Doevendans, Mathias Meine
BACKGROUND: Previous reports suggest that Biventricular pacing (BiVp) fused with intrinsic conduction (BiVp-fusion, triple wavefront fusion) is associated with improved resynchronization compared to pure-BiVp in cardiac resynchronization therapy (CRT). This study aimed to assess the association between acute hemodynamic benefit of CRT and signs of BiVp-fusion by using a novel EGM-based method. METHODS: In 17 patients undergoing CRT implantation, 28 combinations of atrioventricular (AV) and interventricular (VV) delays were applied while invasively measuring acute hemodynamic response based on maximum rate of LV pressure rise (LV dP/dtmax ) to assess optimal BiVp settings...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28542844/the-inward-rectifier-current-inhibitor-pa-6-terminates-atrial-fibrillation-and-does-not-cause-ventricular-arrhythmias-in-dedicated-goat-and-dog-models
#5
Yuan Ji, Rosanne Varkevisser, Dragan Opacic, Alexandre Bossu, Marion Kuiper, Jet D M Beekman, Sihyung Yang, Azinwi Phina Khan, Dobromir Dobrev, Niels Voigt, Michael Zhuo Wang, Sander Verheule, Marc A Vos, Marcel A G Van der Heyden
BACKGROUND AND PURPOSE: Inward rectifier current (IK1 ) density increases in atrial fibrillation (AF), shortening effective refractory period and thus promotes atrial reentry. Pentamidine-Analogue 6 (PA-6) is a selective and potent IK1 inhibitor. We tested PA-6 for anti-AF efficacy and potential proarrhythmia, in established large animal models. EXPERIMENTAL APPROACH: PA-6 was applied i.v. in anaesthetized goats with rapid pacing induced AF and anaesthetized chronic AV block dogs...
May 24, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28540981/comparison-of-de-novo-versus-upgrade-cardiac-resynchronization-therapy-focused-on-the-upgrade-for-pacing-induced-cardiomyopathy
#6
Hye Bin Gwag, Kwang Jin Chun, Jin Kyung Hwang, Kyoung Min Park, Young Keun On, June Soo Kim, Seung Jung Park
PURPOSE: This study aimed to determine whether upgrade cardiac resynchronization therapy (CRT) shows better outcomes than de novo CRT. To do so, we compared the efficacy of CRT between de novo and upgrade groups, focusing particularly on the effect of upgrade CRT on patients with pacing-induced cardiomyopathy (PiCM). MATERIALS AND METHODS: PiCM was defined as new-onset dilated cardiomyopathy following pacemaker implantation in patients with baseline normal ejection fraction ≥50%...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28536893/neurologic-recovery-after-cardiac-arrest-a-multifaceted-puzzle-requiring-comprehensive-coordinated-care
#7
REVIEW
Carolina B Maciel, Mary M Barden, David M Greer
Surviving cardiac arrest (CA) requires a longitudinal approach with multiple levels of responsibility, including fostering a culture of action by increasing public awareness and training, optimization of resuscitation measures including frequent updates of guidelines and their timely implementation into practice, and optimization of post-CA care. This clearly goes beyond resuscitation and targeted temperature management. Brain-directed physiologic goals should dictate the post-CA management, as accumulating evidence suggests that the degree of hypoxic brain injury is the main determinant of survival, regardless of the etiology of arrest...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28529181/leadless-cardiac-pacemakers-current-status-of-a-modern-approach-in-pacing
#8
REVIEW
Skevos Sideris, Stefanos Archontakis, Polychronis Dilaveris, Konstantinos A Gatzoulis, Konstantinos Trachanas, Ilias Sotiropoulos, Petros Arsenos, Dimitrios Tousoulis, Ioannis Kallikazaros
Since the first transvenous pacemaker implantation, that took place 50 years ago, important progress has been achieved in pacing technology. Consequently, today, more than 700,000 pacemakers are implanted annually worldwide. However, conventional pacemakers' implantation carries a non-negligible risk of periprocedural and long-term complications associated with the transvenous leads and pacemaker pocket. Recently, Leadless Pacing Systems have emerged as a therapeutic alternative to conventional pacing systems providing therapy for patients with bradyarrhythmias, while eliminating potential transvenous leads and pacemaker pocket related complications...
May 18, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28526597/slow-ventricular-tachycardia-in-a-91-year-old-man-with-implantable-cardioverter-defibrillator-and-acute-respiratory-failure
#9
Nicola Vargas, Loredana Tibullo, Cesare A E Landi, Giovanni Carifi, Emanuela Landi, Elisa Salsano, Francesco Di Grezia, Fiore Candelmo
Slow ventricular tachycardia (VT) in patients with devices such as an implantable cardioverter - defibrillator (ICD) is more common than in the rest of the population. The incidence in elderly patients with an ICD remains largely unknown. In younger patients, slow VT is generally asymptomatic or associated with limited clinical relevance. It may be efficiently and safely terminated by anti-tachycardia pacing. We present a case of slow VT in a 91-year-old man with ICD with type 1 acute respiratory failure and drowsiness...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28525921/a-new-electrogram-based-diagnostic-algorithm-to-improve-the-left-ventricular-effective-pacing-detection-corrected-a-non-response-to-cardiac-resynchronization-therapy-pacing
#10
Roberto Matía, Antonio Hernández-Madrid, Ruth Nicholson Klepfer, Subham Ghosh, Gonzalo Sánchez-Huete, Javier Moreno
No abstract text is available yet for this article.
May 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28521596/overcoming-the-current-issues-surrounding-device-leads-reducing-the-complications-during-extraction
#11
Maria Grazia Bongiorni, Luca Segreti, Andrea Di Cori, Giulio Zucchelli, Luca Paperini, Stefano Viani, Ezio Soldati
The implantation rate of of Cardiac implantable Elecrtonical Devices has consistently increased in the last 20 years, so as related complication rates. According, devices infections and malfunctions required the development of appropriate strategies. The most relevant issue is the removal of pacing and ICD leads, which, few months after implantation, tend to develop intravascular fibrosis, often making extraction a challenging and risky procedure. Areas Covered: TLE scenario is constantly evolving. Transvenous lead extraction (TLE) is a key procedure in lead management strategies...
May 18, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28520951/non-selective-his-bundle-pacing-with-a-biphasic-waveform-enhancing-septal-resynchronization
#12
Daniel F Ortega, Luis D Barja, Emilio Logarzo, Nicolas Mangani, Analia Paolucci, Maria P Bonomini
Aims: His bundle pacing has shown to prevent detrimental effects from right ventricular apical pacing (RVA) and proved to resynchronize many conduction disturbances cases. However, the extent of His bundle pacing resynchronization is limited. An optimized stimulation waveform could expand this limit when implemented in His bundle pacing sets. In this work, we temporarily implemented RVA and Non-selective His bundle pacing with a biphasic anodal-first waveform (AF-nHB) and compared their effects against sinus rhythm (SR)...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28517367/rationale-and-design-of-a-randomized-trial-to-assess-the-safety-and-efficacy-of-multipoint-pacing-mpp-in-cardiac-resynchronization-therapy-the-mpp-trial
#13
Gery Tomassoni, James Baker, Raffaele Corbisiero, Charles Love, David Martin, Robert Sheppard, Seth J Worley, Kwangdeok Lee, Imran Niazi
BACKGROUND: Although the majority of Class III congestive heart failure (HF) patients treated with cardiac resynchronization therapy (CRT) show a clinical benefit, up to 40% of patients do not respond to CRT. This paper reports the design of the MultiPoint Pacing (MPP) trial, a prospective, randomized, double-blind, controlled study to evaluate the safety and efficacy of CRT using MPP compared to standard biventricular (Bi-V) pacing. METHODS: A maximum of 506 patients with a standard CRT-D indication will be enrolled at up to 50 US centers...
May 18, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#14
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515003/reverse-atrial-electrical-remodeling-induced-by-cardiac-resynchronization-therapy
#15
Bryce Alexander, Fariha Sadiq, Kousha Azimi, Benedict Glover, Pavel Antiperovitch, Wilma M Hopman, Zardasht Jaff, Adrian Baranchuk
PURPOSE: Cardiac resynchronization therapy (CRT) has been shown to improve left atrial function; however the effect on reverse electrical remodeling has been poorly evaluated. We hypothesized that CRT might induce reverse atrial electrical remodeling manifesting in the surface ECG as a shortening in P-wave duration. METHODS: Patients with CRT and more than 92% biventricular pacing at minimum follow-up of 1 year were included in the analysis. Those with prior history of atrial fibrillation (AF) were excluded...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28507234/modelling-far-field-pacing-for-terminating-spiral-waves-pinned-to-ischaemic-heterogeneities-in-cardiac-tissue
#16
E Boccia, S Luther, U Parlitz
In cardiac tissue, electrical spiral waves pinned to a heterogeneity can be unpinned (and eventually terminated) using electric far field pulses and recruiting the heterogeneity as a virtual electrode. While for isotropic media the process of unpinning is much better understood, the case of an anisotropic substrate with different conductivities in different directions still needs intensive investigation. To study the impact of anisotropy on the unpinning process, we present numerical simulations based on the bidomain formulation of the phase I of the Luo and Rudy action potential model modified due to the occurrence of acute myocardial ischaemia...
June 28, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28506918/cardiac-resynchronization-therapy-utilizing-permanent-his-bundle-pacing-are-we-there-yet
#17
EDITORIAL
Pugazhendhi Vijayaraman
No abstract text is available yet for this article.
May 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28506648/antegrade-versus-continuous-retrograde-del-nido-cardioplegia-in-the-david-i-operation
#18
Xuan Jiang, Tianxiang Gu, Enyi Shi, Chun Wang, Zongyi Xiu, Guangwei Zhang
BACKGROUND: The efficacy of continuous retrograde del Nido cardioplegia for myocardial protection is still controversial. We hypothesised that antegrade and retrograde cardioplegia offer equivalent safety for myocardial protection in the David I procedure. METHODS: We retrospectively reviewed 33 patients undergoing the David I operation with antegrade or retrograde del Nido solution from June 2014 to January 2016. The outcomes were compared. The follow-up was 1 month to 15 months...
April 26, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506439/clinical-review-loperamide-toxicity
#19
REVIEW
Peter E Wu, David N Juurlink
Loperamide is a nonprescription opioid widely used for the treatment of diarrhea. Although it is relatively safe at therapeutic doses, increasing reports describe its misuse and abuse at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal. Life-threatening loperamide toxicity can result from the relatively new clinical syndrome of loperamide-induced cardiac toxicity. These patients are often young and may present in cardiac arrest or with unheralded, recurrent syncope in conjunction with ECG abnormalities, including marked QT-interval prolongation, QRS-interval widening, and ventricular dysrhythmias...
May 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28502871/a-leadless-pacemaker-in-the-real-world-setting-the-micra-transcatheter-pacing-system-post-approval-registry
#20
Paul R Roberts, Nicolas Clementy, Faisal Al Samadi, Christophe Garweg, Jose Luis Martinez-Sande, Saverio Iacopino, Jens Brock Johansen, Xavier Vinolas Prat, Robert Kowal, Didier Klug, Lluis Mont, Jan Steffel, Shelby Li, Dirk Van Osch, Mikhael F El-Chami
BACKGROUND: First-in-man studies of leadless pacemakers have demonstrated high implant success rates, and safety and efficacy objectives were achieved. Outside of the investigational setting, there are particular concerns over cardiac effusion/perforation, device dislodgement, infection, telemetry, and battery issues. OBJECTIVE: The acute performance of the Micra transcatheter pacemaker from a worldwide post-approval registry is reported. METHODS: The registry is an ongoing prospective single-arm observational study designed to assess the safety and effectiveness of Micra in the post-approval setting...
May 11, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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