{"title":"Transient 2:1 Atrioventricular Block with Peri-Conduction System Pacing After Leadless Pacemaker Implantation","authors":"Salim N. Najjar, Michael A. Bruno, Wilson W. Lam","doi":"10.14503/thij-23-8268","DOIUrl":"https://doi.org/10.14503/thij-23-8268","url":null,"abstract":"<p>This report discusses a case of transient 2:1 atrioventricular block with conduction system pacing 4 hours after leadless right ventricular pacemaker implantation in a 19-year-old patient with a history of cardioinhibitory syncope and asystole cardiac arrest but without preexisting atrioventricular block. The atrioventricular block was resolved spontaneously. Pacing morphology was suggestive of right bundle branch pacing. Neither 2:1 atrioventricular block nor conduction system pacing has previously been a reported outcome of right ventricular leadless pacemaker implantation. The report demonstrates that conduction system pacing with leadless devices is achievable. Further study of techniques, limitations, and complications related to intentional right ventricular leadless conduction system pacing is warranted.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Remembering Paolo Angelini, MD","authors":"Roberto Lufschanowski, E. Hernandez-Vila","doi":"10.14503/thij-23-8367","DOIUrl":"https://doi.org/10.14503/thij-23-8367","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138596680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Transition From Temporary to Durable Mechanical Circulatory Support: Surgical Considerations.","authors":"Syed B Peer, Harveen K Lamba, Alexis E Shafii","doi":"10.14503/THIJ-23-8227","DOIUrl":"10.14503/THIJ-23-8227","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical Considerations for Left Ventricular Assist Device Implantation.","authors":"Syed B Peer, Gabriel Loor","doi":"10.14503/THIJ-23-8226","DOIUrl":"10.14503/THIJ-23-8226","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10121092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mitigating Diagnostic Errors With Point-of-Care Ultrasonography: A New Framework.","authors":"Jayne Chirdo Taylor","doi":"10.14503/THIJ-23-8234","DOIUrl":"10.14503/THIJ-23-8234","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10493029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimization of Left Ventricular Assist Device Support.","authors":"Arantxa G Suero, Lola X Xie","doi":"10.14503/THIJ-23-8231","DOIUrl":"10.14503/THIJ-23-8231","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10455584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harveen K Lamba, Lucy D Hart, Qianzi Zhang, Jackquelin M Loera, Andrew B Civitello, Ajith P Nair, Mourad H Senussi, Gabriel Loor, Kenneth K Liao, Alexis E Shafii, Subhasis Chatterjee
{"title":"Clinical Predictors and Outcomes After Left Ventricular Assist Device Implantation and Tracheostomy.","authors":"Harveen K Lamba, Lucy D Hart, Qianzi Zhang, Jackquelin M Loera, Andrew B Civitello, Ajith P Nair, Mourad H Senussi, Gabriel Loor, Kenneth K Liao, Alexis E Shafii, Subhasis Chatterjee","doi":"10.14503/THIJ-23-8100","DOIUrl":"10.14503/THIJ-23-8100","url":null,"abstract":"<p><strong>Background: </strong>Postoperative respiratory failure is a major complication that affects up to 10% of patients who undergo cardiac surgery and has a high in-hospital mortality rate. Few studies have investigated whether patients who require tracheostomy for postoperative respiratory failure after continuous-flow left ventricular assist device (CF-LVAD) implantation have worse survival outcomes than patients who do not.</p><p><strong>Objective: </strong>To identify risk factors for respiratory failure necessitating tracheostomy in CF-LVAD recipients and to compare survival outcomes between those who did and did not require tracheostomy.</p><p><strong>Methods: </strong>Consecutive patients who underwent primary CF-LVAD placement at a single institution between August 1, 2002, and December 31, 2019, were retrospectively reviewed. Propensity score matching accounted for baseline differences between the tracheostomy and nontracheostomy groups. Multivariate logistic regression was used to identify tracheostomy risk factors and 90-day survival; Kaplan-Meier analysis was used to assess midterm survival.</p><p><strong>Results: </strong>During the study period, 664 patients received a CF-LVAD; 106 (16.0%) underwent tracheostomy for respiratory failure. Propensity score matching produced 103 matched tracheostomy-nontracheostomy pairs. Patients who underwent tracheostomy were older (mean [SD] age, 57.9 [12.3] vs 54.6 [13.9] years; P = .02) and more likely to need preoperative mechanical circulatory support (61.3% vs 47.8%; P = .01) and preoperative intubation (27.4% vs 8.8%; P < .001); serum creatinine was higher in the tracheostomy group (mean [SD], 1.7 [1.0] vs 1.4 [0.6] mg/dL; P < .001), correlating with tracheostomy need (odds ratio, 1.76; 95% CI, 1.21-2.56; P = .003). Both before and after propensity matching, 30-day, 60-day, 90-day, and 1-year survival were worse in patients who underwent tracheostomy. Median follow-up was 0.8 years (range, 0.0-11.2 years). Three-year Kaplan-Meier survival was significantly worse for the tracheostomy group before (22.0% vs 61.0%; P < .001) and after (22.4% vs 48.3%; P < .001) matching.</p><p><strong>Conclusion: </strong>Given the substantially increased probability of death in patients who develop respiratory failure and need tracheostomy, those at high risk for respiratory failure should be carefully considered for CF-LVAD implantation. Comprehensive management to decrease respiratory failure before and after surgery is critical.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10084104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of COVID-19 on the Autonomic Cardiovascular System: Heart Rate Variability and Turbulence in Recovered Patients.","authors":"Sedat Taş, Ümmü Taş","doi":"10.14503/THIJ-22-7952","DOIUrl":"10.14503/THIJ-22-7952","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 may be a risk factor for developing cardiovascular autonomic dysfunction. Data are limited, however, on the association between heart rate variability, heart rate turbulence, and COVID-19. The aims of this study were to evaluate the effect of COVID-19 on the cardiovascular autonomic system in patients with persistent symptoms after recovering from COVID-19 and to determine whether these patients showed changes in ambulatory electrocardiography monitoring.</p><p><strong>Methods: </strong>Fifty-one adults who had confirmed SARS-CoV-2 infection and presented with persistent symptoms to the cardiology outpatient clinic after clinical recovery between April and June 2021 were included. Patients were prospectively followed for 6 months. The patients were evaluated at the time of first application to the cardiology outpatient clinic and at 6 months after presentation. Ambulatory electrocardiography monitoring and echocardiographic findings were compared with a control group of 95 patients.</p><p><strong>Results: </strong>Patients in the post-COVID-19 group had significantly higher mean (SD) turbulence onset (0.39% [1.82%] vs -1.37% [2.93%]; P < .001) and lower heart rate variability than those in the control group at both initial and 6-month evaluations. The post-COVID-19 group had no significant differences in echocardiographic findings compared with the control group at 6 months, except for right ventricle late diastolic mitral annular velocity (P = .034). Furthermore, turbulence onset was significantly correlated with turbulence slope (r = -0.232; P = .004), heart rate variability, and the parameters of left (r = -0.194; P=.049) and right (r = 0.225; P = .02) ventricular diastolic function.</p><p><strong>Conclusions: </strong>COVID-19 may cause cardiovascular autonomic dysfunction. Heart rate variability and turbulence parameters can be used to recognize cardiovascular autonomic dysfunction in patients who have recovered from COVID-19 but have persistent symptoms.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10421178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perioperative Hemotherapy Management in Left Ventricular Assist Device Surgery.","authors":"Arthur W Bracey","doi":"10.14503/THIJ-23-8216","DOIUrl":"10.14503/THIJ-23-8216","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10477474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}