Indian Pacing and Electrophysiology Journal最新文献_第2页

Retrievable dual-chamber leadless pacemaker implant (Aveir DR) in an adult patient with congenital heart disease. 为一名患有先天性心脏病的成年患者植入双腔无导线起搏器 (Aveir DR)。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-04 DOI: 10.1016/j.ipej.2024.09.001

Howard How-Peng Liu, Daniel Cortez

{"title":"Retrievable dual-chamber leadless pacemaker implant (Aveir DR) in an adult patient with congenital heart disease.","authors":"Howard How-Peng Liu, Daniel Cortez","doi":"10.1016/j.ipej.2024.09.001","DOIUrl":"10.1016/j.ipej.2024.09.001","url":null,"abstract":"<p><p>Leadless pacemakers have demonstrated potential as a transvenous pacing option in Adult Congenital Heart Disease patients. Aveir™ single-chamber (VR) leadless pacemakers have demonstrated safety in patients without congenital heart disease in a dual chamber approach. We present a case of dual-chamber pacing using the Aveir dual-chamber (DR) leadless pacemaker in a patient with repaired dextro-transposition of the great arteries with ventricular septal defect (VSD) surgical closure. A 26-year-old male patient with a history of transposition of the great arteries status post arterial switch and VSD repair neonatally had complicated second degree atrioventricular block and sinus node dysfunction necessitating pacemaker placement. Epicardial single-chamber ventricular pacemaker was placed neonatally, which was switched to dual-chamber pacemaker at age 17 due to malfunction. Recent fracture of pacemaker leads led to implantation of new dual chamber leadless pacemaker. Removal of previous pacemaker leads via mechanical extraction occurred and implantation of Aveir DR leadless pacemaker was performed under anesthesia via right femoral vein access without complication. Follow-up demonstrated Aveir VR threshold of 1.0V@0.2 ms, R-wave of 8.9mV, impedance of 490Ω, and the Aveir AR threshold of 0.75V@0.2 ms, P-wave of 3.7mV, and impedance of 400Ω. This case demonstrates safety and efficacy of dual chamber leadless pacemaker implantation in an ACHD patient.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146467","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}

引用次数: 0

A case report of a combined implantation technique of a cardioverter-defibrillator in an infant with long QT syndrome type 8 (Timothy's syndrome). 长 QT 8 型综合征（蒂莫西综合征）婴儿心律转复除颤器联合植入技术病例报告。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-04 DOI: 10.1016/j.ipej.2024.09.002

Sergei Viktorovich Nemtsov, Roman Borisovich Tatarskiy, Sergei Arturovich Termosesov, Dmitriy Sergeevich Lebedev

引用次数: 0

Left bundle fascicular versus left bundle trunk pacing: A comparison of their electrical synchrony parameters 左束筋膜起搏与左束主干起搏：两者电气同步参数的比较。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.07.006

{"title":"Left bundle fascicular versus left bundle trunk pacing: A comparison of their electrical synchrony parameters","authors":"","doi":"10.1016/j.ipej.2024.07.006","DOIUrl":"10.1016/j.ipej.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Variation in human left bundle branch (LBB) anatomy has a significant effect on the sequence of left ventricular depolarization. However, little is known regarding the electrophysiological characteristics of pacing different LBB fascicles.</div></div><div><h3>Objective</h3><div>We aimed to analyse the different electrocardiographic characteristics of LBB pacing (LBBP) attending to the site of pacing at the LBB system.</div></div><div><h3>Methods</h3><div>In 200 consecutive patients with confirmed LBBP, we distinguished left bundle trunk capture (LBTP) from any LB fascicular pacing (LBFP) based on the presence of LB potentials and paced QRS morphologies. We compared them regarding procedure, LBBP criteria and electrical synchrony parameters.</div></div><div><h3>Results</h3><div>One hundred and seventy-three patients with LBFP were compared to 25 patients with LBTP. Left septal and posterior fascicles were significantly more prevalent than left anterior in LBFP (46.8 %, 41.0 % and 12.2 % respectively). QRS transition criteria (80.0 % vs 61.8 %; p = 0.077), selective LBBP (40.0 vs 21.5 %; p = 0.101), paced QRS width (110.3 ± 16.8 ms vs 115.4 ± 14.9 ms; p = 0.117), V6-RWPT (79.2 ± 10.7 ms vs 75.3 ± 9.7 ms; p = 0.068) and interpeak interval (42.5 ± 19.1 ms vs 45.7 ± 12.9 ms; p = 0.282) were not significantly different between LBTP and LBFP. All short-term complications occurred in LBFP, mainly driven by septal perforations (n = 23), without any difference in the pacing parameters. Among the LBFP subgroups, only aVL-RWPT was longer when the posterior fascicle was paced.</div></div><div><h3>Conclusions</h3><div>LBFP is much more prevalent than LBTP in unselected consecutive patients with LBBP. LBFP seems more feasible, and as good as LBTP in terms of electrical synchrony and pacing safety.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of ST segment depression in supraventricular tachycardia and its relationship with underlying mechanism 室上性心动过速 ST 段压低及其与潜在机制的关系分析

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.06.007

{"title":"Analysis of ST segment depression in supraventricular tachycardia and its relationship with underlying mechanism","authors":"","doi":"10.1016/j.ipej.2024.06.007","DOIUrl":"10.1016/j.ipej.2024.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Electrocardiographic diagnosis of causes of supraventricular tachycardia (SVT) is sometimes difficult and application of routine algorithms can lead to misdiagnosis in as many as 37 % of patients. ST segment depression may be useful in diagnosing the nature of SVT.</div></div><div><h3>Methods</h3><div>We reviewed surface electrocardiogram (ECG) characteristics of 300 patients having SVT with 1:1 AV relationship and correlated findings with electrophysiology study (EPS) findings. Final diagnosis of AVNRT (Atrioventricular nodal reentrant tachycardia), Orthodromic AVRT (atrioventricular reentrant tachycardia) and atrial tachycardia (AT) was correlated with ECG parameters like heart rate, ST segment depressions and QRS morphology.</div></div><div><h3>Results</h3><div>Out of 300 patients, majority patients included in study, were having AVNRT or AVRT. ST depression predicted AVRT if the ST depression was ≥ 2 mm (overall sensitivity of 38.3 % and specificity of 93.8 % to predict AVRT) and was downsloping in morphology (sensitivity of 36.9 % and specificity of 94.7 % to predict AVRT). At heart rates ≥214 beats per minute (bpm) as measured by 7 small squares of ECG at 25 mm/s, downsloping ST depression ≥2 mm had a sensitivity 37.9 % of and specificity of 89.2 % to predict AVRT. At heart rate <214 bpm, downsloping ST depression ≥2 mm had sensitivity of 37.2 % and specificity of 96.5 % to predict AVRT. Downsloping ST depression of ≥2 mm helps to differentiate AVNRT from AVRT.</div></div><div><h3>Conclusion</h3><div>A downsloping ST segment depression ≥2 mm predicted SVT being an AVRT and can be used as a useful criteria in diagnosing the tachycardia.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of 3D electroanatomic mapping systems allows us to see the past and predict the future of SVT ablation 三维电解剖绘图系统的使用使我们能够看到 SVT 消融的过去并预测其未来。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.09.007

引用次数: 0

Long- and short-term outcomes after transvenous lead extraction in a large single-centre patient cohort using the clinical frailty scale as a risk assessment tool 使用临床虚弱程度量表作为风险评估工具，在大型单中心患者队列中评估经静脉引线拔除术后的长期和短期疗效。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.07.001

{"title":"Long- and short-term outcomes after transvenous lead extraction in a large single-centre patient cohort using the clinical frailty scale as a risk assessment tool","authors":"","doi":"10.1016/j.ipej.2024.07.001","DOIUrl":"10.1016/j.ipej.2024.07.001","url":null,"abstract":"<div><h3>Background and aims</h3><div>The rate of cardiac implantable electronic device (CIED) implantations and the need for transvenous lead extraction (TLE) are growing worldwide. This study examined a large Swedish cohort with the aim of identifying possible predictors of post-TLE mortality with special focus on systemic infection patients and frailty.</div></div><div><h3>Methods</h3><div>This was a single centre study. Records of patients undergoing TLE between 2010 and 2018 were analysed. Statistical analyses were conducted to compare baseline characteristics of patients with different indications and identify risk factors of 30-day and 1-year mortality.</div></div><div><h3>Results</h3><div>A total of 893 patients were identified. Local infection was the dominant indication and pacemaker was the most common CIED. The mean age was 65 ± 16 years, 73 % were male and median follow-up was 3.9 years. Heart failure was the most common comorbidity. Patients with systemic infection were significantly older, frailer and had significantly higher levels of comorbidities. 30-day mortality and 1-year mortality rates were 2.5 % and 9.9 %, respectively. Systemic infection and chronic kidney disease (CKD) were independently associated with 30-day and 1-year mortality. Clinical frailty scale (CFS) 5–7 correlated independently with 1-year mortality in the entire cohort and specifically in systemic infection patients. CKD, cardiac resynchronization therapy and CFS 5–7 were significant risk factors for long-term mortality (death >1 year after TLE) in multivariable analysis.</div></div><div><h3>Conclusions</h3><div>Systemic infection, kidney failure in addition to the novel parameter of frailty were associated with post-TLE all-cause mortality. These risk factors should be considered during pre-procedure risk stratification to improve post-TLE outcomes.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Speech induced atrial tachycardia – Case report and review of literature 演讲诱发的房性心动过速--病例报告和文献综述。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.06.009

引用次数: 0

Real-time Ripple technique: A case report on Ripple map for real-time identification of conduction gaps without first-pass pulmonary vein isolation 实时波纹技术：无需第一道肺静脉隔离即可实时识别传导间隙的波纹图病例报告。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.06.008

{"title":"Real-time Ripple technique: A case report on Ripple map for real-time identification of conduction gaps without first-pass pulmonary vein isolation","authors":"","doi":"10.1016/j.ipej.2024.06.008","DOIUrl":"10.1016/j.ipej.2024.06.008","url":null,"abstract":"<div><div>This paper presents a novel approach to gap mapping in pulmonary vein isolation (PVI) for atrial fibrillation (AF) treatment, utilizing the real-time Ripple (RR) technique. Radiofrequency (RF) catheter ablation, particularly encircling PVI, is a common intervention for AF. Identifying left atrium–pulmonary vein conduction gaps is crucial for achieving PVI with minimal additional ablation if first-pass PVI is unsuccessful. However, identifying conduction gaps can be relatively challenging, often necessitating manual electrocardiogram reannotation due to the limitations of local activation time (LAT) maps. In the case of a 63-year-old patient with drug-resistant symptomatic persistent AF, the RR technique was utilized to identify conduction gaps during RF ablation. The technique involved pausing fast anatomical mapping (FAM), activating Ripple map (RM) feature on the CARTO 3 system and acquiring points with an ultrahigh-resolution mapping catheter. This approach revealed that the actual site of earliest activation differs from the LAT map indication, enabling successful PVI.</div><div>The RM feature's capability to reflect actual excitation propagation without reliance on map annotations was crucial for precise conduction gap identification, overcoming inter-operator variability and inaccuracies of conventional methods. The RR technique not only facilitated real-time analysis during gap mapping but also significantly reduced the procedure time, minimizing potential complications.</div><div>This case report highlights the efficacy of the RR technique in real-time gap mapping, demonstrating its value in cases where first-pass PVI is unsuccessful. The integration of this technique into PVI procedures can enhance both the accuracy and efficiency of catheter ablation for AF.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Longitudinal reduction in fluoroscopy with continued use of 3-dimensional electroanatomic mapping systems in catheter ablation of supraventricular tachycardia – then and now 在室上性心动过速导管消融术中持续使用三维电解剖图系统，纵向减少了透视 - 当时和现在。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.06.010

{"title":"Longitudinal reduction in fluoroscopy with continued use of 3-dimensional electroanatomic mapping systems in catheter ablation of supraventricular tachycardia – then and now","authors":"","doi":"10.1016/j.ipej.2024.06.010","DOIUrl":"10.1016/j.ipej.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Catheter ablation is a first-line treatment for symptomatic, recurrent supraventricular tachycardia (SVT). This study aims to demonstrate if 3D-electroanatomic mapping (EAM) during SVT ablation reduces fluoroscopy time (FT) and determine if further reductions in FT are observed longitudinally.</div></div><div><h3>Methods</h3><div>All cases of SVT ablation between May 2011–May 2022 at a single tertiary centre were prospectively recruited. FT between the cohorts with and without EAM were compared. Within the EAM subset, the trend of FT across the years was analysed.</div></div><div><h3>Results</h3><div>There were 1758 cases included, 563 without EAM, 1195 with EAM. EAM was associated with a longer procedure time (mean + 8.8 min, p = 0.001), but with mean reductions in FT and dose area product (DAP) by 19.6 min and 18 621 mGy*cm2 respectively (p < 0.001). There was comparable efficacy without any increase in complication rates. Over time (2011–2022), further reduction in FT of 0.9 min year on year was observed (p = 0.001). Between 2011 and 2017, there was a significant reduction in FT of 1.1 min year on year (p = 0.019), which was not observed from 2017 onwards (p = 0.061). The greatest reduction in FT was after the first year of adoption.</div></div><div><h3>Conclusion</h3><div>EAM in SVT ablation reduces fluoroscopy use. FT was initially observed to reduce further over time before plateauing, likely due to increased operator experience. While there is increased interest in zero fluoroscopy SVT ablation, complementary use of fluoroscopy may still be necessary in complex cases.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of intracardiac electrocardiogram during ill-sustained tachycardia – Door to a successful troubleshooting of ‘unnecessary’ defibrillator discharge 分析病态持续性心动过速时的心电图--成功排除 "不必要的 "除颤器放电故障之门。

Indian Pacing and Electrophysiology Journal Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.07.004

{"title":"Analysis of intracardiac electrocardiogram during ill-sustained tachycardia – Door to a successful troubleshooting of ‘unnecessary’ defibrillator discharge","authors":"","doi":"10.1016/j.ipej.2024.07.004","DOIUrl":"10.1016/j.ipej.2024.07.004","url":null,"abstract":"<div><div>A 50-year-old gentleman with old anterior wall myocardial infarction with implantable cardioverter defibrillator (ICD, Abbott Medical, Fortify ST VR 1235-40) presented with recurrent appropriate ICD shock. The ICD stored EGM indicated a possibility of supraventricular tachycardia (SVT) rather than ventricular tachycardia (VT) when the morphology match was found high. Bundle brunch re-entry (BBR) VT was another differential. An EP study conducted on antiarrhythmic drugs (AAD) induced reproducible but only ill-sustained tachycardia too short to perform any SVT maneuvers during tachycardia. However, critical analysis of the tachycardia electrograms suggested atypical AVNRT as the most likely mechanism. The other differentials were atrial tachycardia (AT) and BBR VT. Manoeuvres during sinus rhythm and ventricular pacing excluded other diagnosis. A single point radiofrequency ablation (RFA) near the SP region cured the arrhythmia. The reason for misclassification of SVT as VT was also sought for. It was found that the shocks were received due to fulfilment of 2/3 criteria (sudden onset and regular tachycardia). Hence, he received therapy despite an appropriate morphology match favouring SVT. This is one of the known limitations of ICDs where regular SVTs (AVNRT/AVRT or AT) may receive inappropriate ICD therapies. After slow pathway modification there was no further recurrence of either SVT or VT; hence, a substrate modification was deferred.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0