Federico Landra, Andrea Peirone, Camilla Marconetto, Emanuela Racca, Erika Taravelli
{"title":"Cardioneuroablation for the treatment of acute iatrogenic atrioventricular block during slow pathway ablation procedure.","authors":"Federico Landra, Andrea Peirone, Camilla Marconetto, Emanuela Racca, Erika Taravelli","doi":"10.1016/j.ipej.2026.04.003","DOIUrl":"https://doi.org/10.1016/j.ipej.2026.04.003","url":null,"abstract":"<p><p>Atrioventricular nodal reentrant tachycardia (AVNRT) is a common paroxysmal supraventricular tachycardia, often treated with slow pathway (SP) ablation. Rarely, iatrogenic AV block occurs. In the present case, a 50-year-old male underwent SP ablation for recurrent symptomatic AVNRT. The procedure was complicated by long-lasting 2:1 nodal atrioventricular (AV) block. Cardioneuroablation (CNA) targeting the inferior paraseptal ganglionated plexus was attempted during the same procedure. Bi-atrial ablation suddenly restored a sustained 1:1 AV conduction. Follow-up at two months showed normal AV conduction without arrhythmia documentation. This case demonstrates, for the first time, the use of CNA to treat acute iatrogenic nodal AV block during index SP ablation. It highlights CNA's potential to restore nodal function and avoid pacemaker implantation, potentially expanding its clinical indications beyond functional bradyarrhythmias.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deva Nirthanakumaran, Belinda Gray, Bianca Coelho, Hari Raju
{"title":"Tachycardia with a shock - what is the underlying mechanism?","authors":"Deva Nirthanakumaran, Belinda Gray, Bianca Coelho, Hari Raju","doi":"10.1016/j.ipej.2026.04.002","DOIUrl":"10.1016/j.ipej.2026.04.002","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rare use of epicardial pacing wire in severe aortic stenosis with Wolf-Parkinson-White syndrome: Who goes first?","authors":"Sudipta Mondal, Nadeem Afroz Muslim","doi":"10.1016/j.ipej.2026.04.001","DOIUrl":"10.1016/j.ipej.2026.04.001","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tachycardia with left bundle branch block morphology in a patient with right bundle branch block.","authors":"Ayelet Shauer, Bernard Belhassen","doi":"10.1016/j.ipej.2026.02.014","DOIUrl":"10.1016/j.ipej.2026.02.014","url":null,"abstract":"<p><p>A 35-year-old woman with a history of surgical mitral valve repair at age 16 years, underwent Holter monitoring because of frequent episodes of palpitations. Her baseline ECG showed sinus rhythm with right bundle branch block (RBBB) and a PR interval of 120 ms, with no suspicion of ventricular preexcitation.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lesion characteristics created by bipolar radiofrequency ablation; right-vs. left-side of septum and epicardium vs. endocardium in the free wall.","authors":"Osamu Saitoh, Takumi Kasai, Ryosuke Inomata, Hiroshi Furushima, Masaomi Chinushi","doi":"10.1016/j.ipej.2026.03.014","DOIUrl":"10.1016/j.ipej.2026.03.014","url":null,"abstract":"<p><strong>Background: </strong>Circumstances around ablation catheters placed in the ventricular cavity and pericardial space are not identical, and therefore bipolar (BIP) ablation targeting the interventricular septum (IVS) or left ventricular free wall (LVFW) may induce lesions with different characteristics on either side of the wall.</p><p><strong>Methods: </strong>Porcine hearts prepared for IVS or LVFW were placed between two inner containers which were set in an outer experimental container. For IVS ablation, each inner container was filled with Tyrode's solution circulated by a pump to mimic the right- and left-ventricular cavities. For LVFW ablation, a plastic board was inserted into one of the inner containers to mimic the pericardial space, thereby minimizing the circulating solution. Thereafter, BIP ablation (30W, 120-s) was attempted 30 applications each in IVS and LVFW.</p><p><strong>Results: </strong>All 60 applications were successfully accomplished without steam-pop. Total impedance decline (TID) and %-TID were larger in LVFW than IVS ablation (-19.4 ± 5.3 vs. -15.8 ± 4.6 Ω, and -16.2 ± 4.0 vs. -13.2 ± 3.6%), and total lesion depth was deeper in LVFW than in IVS (14.4 ± 2.6 vs. 12.7 ± 3.3 mm) due to deeper lesions in the epicardial wall. Surface lesions were also larger in epicardial than in endocardial wall in LVFW ablation, whereas there were no differences between right- and left-side septal wall. Transmural lesion was created in 13/30 in LVFW and 9/30 in IVS ablation.</p><p><strong>Conclusions: </strong>As compared to IVS, BIP ablation targeting LVFW demonstrated larger TID and induced deeper lesions in the epicardial wall in this study, probably due to less current leakage into the small space.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giovanni Domenico Ciriello, Diego Colonna, Carmela Morelli, Fiorella Fratta, Fortuna Del Gaizo, Laura Di Pietto, Antonia Giudicepietro, Ludovica Spinelli Barrile, Beniamino Tormettino, Berardo Sarubbi, Maria Giovanna Russo
{"title":"Prenatal echocardiographic diagnosis and outcomes of fetal sustained supraventricular tachycardia: a ten-year single-center experience.","authors":"Giovanni Domenico Ciriello, Diego Colonna, Carmela Morelli, Fiorella Fratta, Fortuna Del Gaizo, Laura Di Pietto, Antonia Giudicepietro, Ludovica Spinelli Barrile, Beniamino Tormettino, Berardo Sarubbi, Maria Giovanna Russo","doi":"10.1016/j.ipej.2026.03.015","DOIUrl":"10.1016/j.ipej.2026.03.015","url":null,"abstract":"<p><p>Fetal echocardiography plays a pivotal role in the diagnosis and management of fetal arrhythmias, allowing evaluation of the electrophysiological mechanism and guiding appropriate medical therapy. Herein, we describe our ten-year experience as a tertiary referral center in Southern Italy in the diagnosis and management of fetal sustained supraventricular tachycardia. Thirty-two consecutive fetuses were included: 16 fetuses with atrioventricular reentrant tachycardia, 7 fetuses with ectopic atrial tachycardia, 8 fetuses with atrial flutter, and 1 fetus with permanent junctional reciprocating tachycardia. Transplacental therapy guided by echocardiographic diagnosis was highly effective in achieving complete rhythm control (74%) or partial rhythm control (24%), even in presence of heart failure or hydrops fetalis. Postnatal antiarrhythmic therapy was not required in over one third of cases due to spontaneous resolution. Earlier gestational age at diagnosis was associated with arrhythmia resolution at birth. The presence of fetal heart failure or hydrops did not predict postnatal persistence of arrhythmia.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Can Menemencioglu, Ugur Canpolat, Alper Bulut, Ahmet Hakan Ates, Ahmet Kivrak, Kudret Aytemir
{"title":"Permanent pacing via coronary sinus after tricuspid valve replacement: Keep bipolar coronary sinus leads on hand!","authors":"Can Menemencioglu, Ugur Canpolat, Alper Bulut, Ahmet Hakan Ates, Ahmet Kivrak, Kudret Aytemir","doi":"10.1016/j.ipej.2026.03.012","DOIUrl":"10.1016/j.ipej.2026.03.012","url":null,"abstract":"<p><strong>Background: </strong>Conduction disturbances requiring permanent pacemaker (PPM) implantation are common after tricuspid valve replacement (TVR). Conventional transvalvular right ventricular pacing carries a risk of prosthetic valve dysfunction, whereas epicardial pacing is limited by surgical complexity, high pacing thresholds, and reduced lead durability. Coronary sinus (CS) pacing represents a potential alternative; however, data following TVR remain limited.</p><p><strong>Methods: </strong>We retrospectively analyzed eight patients who underwent PPM implantation via the CS after TVR at our center. Demographic characteristics, procedural details, and pacing parameters were collected. Electrical performance (pacing threshold, lead impedance, and pacing percentage) was assessed during follow-up.</p><p><strong>Results: </strong>PPM implantation via the CS was successfully performed in all patients (median age: 61 years; 87.5% female). Seven patients underwent bioprosthetic TVR and one underwent mechanical TVR. The median interval between surgery and PPM implantation was 7 days. Mean procedure and fluoroscopy times were 66.5 ± 25.2 min and 13.3 ± 6.8 min, respectively. No acute or periprocedural complications occurred. During a median follow-up of 20.5 months, pacing thresholds and lead impedance remained stable (median threshold: 1.5 V, IQR: 1.0-2.25; median impedance: 846 Ω, IQR: 470-979), with a median ventricular pacing percentage of 82%. No lead-related complications were observed.</p><p><strong>Conclusion: </strong>CS pacing is a feasible and safe strategy for patients requiring PPM implantation after TVR, providing stable electrical performance while avoiding the risks associated with transvalvular and epicardial leads. This approach may be particularly valuable in patients with mechanical prostheses and should also be considered in selected bioprosthetic valve recipients. Larger studies are required to confirm long-term outcomes.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spontaneous template beats: A physiological clue for effective left bundle area pacing.","authors":"Sampath Kumar Madapati, Krishna Prasad Akkineni, Mohan Prasad Akkineni, Shunmuga Sundaram Ponnusamy","doi":"10.1016/j.ipej.2026.03.013","DOIUrl":"https://doi.org/10.1016/j.ipej.2026.03.013","url":null,"abstract":"<p><p>Recent evidence suggests that left bundle area pacing (LBAP) is non-inferior to conventional cardiac resynchronization therapy (CRT) using biventricular pacing (BVP). In addition, LBAP directly recruits the native conduction system, thereby addressing several procedural limitations inherent to BVP. Despite these advantages, electrocardiographic (ECG) analysis rarely provides specific clues to identify patients who may benefit most from LBAP. We report a case in which a spontaneous \"template beat\" or \"left bundle capture beat\" was observed on the baseline ECG and propose this finding as a potential novel marker for identifying patients likely to respond favourably to this therapy.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Audible alarm from an implantable cardioverter defibrillator- unravelling the cause.","authors":"Ashwin Kodliwadmath, Papani Sridhar, Kumar Narayanan","doi":"10.1016/j.ipej.2026.03.011","DOIUrl":"https://doi.org/10.1016/j.ipej.2026.03.011","url":null,"abstract":"<p><p>An audible alarm from an implantable cardioverter defibrillator (ICD) can provoke considerable anxiety in the patient. An alarm may result from several causes, some of which require urgent attention. A knowledge of the different types of audible alerts as well as methodical device interrogation is needed to unravel the cause of ICD alarms. The present case instructively illustrates the systematic approach to a patient presenting with an audible alarm from an ICD, discusses appropriate management and details of the relevant device algorithms involved.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}