Indian Pacing and Electrophysiology Journal最新文献

{"title":"Heart failure and atrial fibrillation: To freeze or to burn, that's the question!","authors":"Nayani Makkar MD, DM, Narayanan Namboodiri MD, DM","doi":"10.1016/j.ipej.2024.05.002","DOIUrl":"10.1016/j.ipej.2024.05.002","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909357","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}

{"title":"Epicardial ablation of ventricular tachycardia in ischemic cardiomyopathy: A review and local experience","authors":"Henri Roukoz ,&nbsp;Venkatakrishna Tholakanahalli","doi":"10.1016/j.ipej.2024.02.002","DOIUrl":"10.1016/j.ipej.2024.02.002","url":null,"abstract":"<div><p>Myocardial scar in ischemic cardiomyopathy is predominantly endocardial, however, between 5% and 15% of these patients have an arrhythmogenic epicardial substrate. Percutaneous epicardial ablation should be considered in patients with ICM and VT especially if they failed an endocardial ablation. Simultaneous epicardial and endocardial ablation of VT in ICM may reduce short- and medium-term VT recurrence compared with an endocardial only approach. Cardiac imaging could be used to help guide patient selection for a combined epi-endo approach. Complications related to epicardial access can happen in up to 7% of patients. Epicardial ablation in these patients should be referred to experienced tertiary centers. We review the literature and share interesting cases.</p></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S097262922400024X/pdfft?md5=0666b66e3b8957515291789b36010a55&pid=1-s2.0-S097262922400024X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716484","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}

{"title":"A cluster of inappropriate shocks in a pediatric S-ICD patient - how to troubleshoot?","authors":"Christina Menexi ,&nbsp;Mohamed ElRefai ,&nbsp;David Farwell ,&nbsp;Neil Srinivasan","doi":"10.1016/j.ipej.2023.12.006","DOIUrl":"10.1016/j.ipej.2023.12.006","url":null,"abstract":"<div><p>We present the case of a 16-year-old male pediatric patient diagnosed with hypertrophic cardiomyopathy (HCM, identified as having a high risk of sudden cardiac death (SCD), who underwent a successful subcutaneous implantable cardiac defibrillator (S-ICD) implantation as a primary prevention measure in 2018.</p><p>His past medical history included ADHD, Autism, and panic attacks. The patient experienced appropriate shocks that successfully terminated VF episodes. However, he also experienced multiple inappropriate shocks from the S-ICD, triggered by anxiety-induced tachycardia during panic episodes. Meticulous assessment of S-ICD tracings and electrocardiograms (ECGs) revealed the erroneous classification of sinus tachycardia as sustained ventricular tachycardia, leading to unwarranted therapeutic interventions.</p><p>Clinical intervention involved reprogramming of the S-ICD, emphasizing the pivotal role of personalized device configuration in pediatric cases where fine margins matter. While literature on S-ICD use in pediatric populations remains limited, emerging registries underscore the efficacy and safety of S-ICDs in preventing sudden cardiac death while reducing complications associated with intravascular leads. This case underscores the critical nature of customized device programming in pediatric patients, underscoring S-ICDs as a practical defibrillation alternative that addresses distinct concerns within this cohort of patients.</p></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972629223001328/pdfft?md5=dfe42eb737d733bb52c5ae434547f866&pid=1-s2.0-S0972629223001328-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075268","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}

{"title":"Symmetrical recovery time course between impedance and intramyocardial temperature after bipolar radiofrequency ablation; Role of impedance monitoring to estimate temperature rise","authors":"Takumi Kasai,&nbsp;Osamu Saitoh,&nbsp;Kyogo Fuse,&nbsp;Ayaka Oikawa,&nbsp;Hiroshi Furushima,&nbsp;Masaomi Chinushi","doi":"10.1016/j.ipej.2023.12.001","DOIUrl":"10.1016/j.ipej.2023.12.001","url":null,"abstract":"<div><h3>Introduction</h3><p>During radiofrequency (RF) ablation, impedance monitoring has been used to avoid steam-pop caused by excessive intramyocardial temperature (IMT) rise. However, it is uncertain why the impedance decline is related to steam-pop and whether the impedance decline is correlated to IMT.</p></div><div><h3>Methods</h3><p>Twenty-one bipolar ablations (40 W, 30-g contact, 120 s) were attempted for seven perfused porcine myocardium. Immediately after ablation, a temperature electrode was inserted into the mid-myocardial portion, and the recovery process of impedance and its correlation to IMT were assessed.</p></div><div><h3>Results</h3><p>Transmural lesion was created in all 21 applications but steam-pop occurred in 5/21 applications with large impedance decline. In the 16 applications without steam-pop, impedance and IMT soon after ablation were 97.2 ± 4.0 Ω and 66.1 ± 4.8 °C, respectively. Reasonably high linear correlation was demonstrated between the maximum IMT after ablation and impedance differences before and after ablation. Recovery processes of the decreased impedance and the elevated IMT fit well to each equation of the single exponential decay function and showed symmetric shapes with no statistical difference of time constant (100.1 ± 34.5 s in impedance vs. 108.7 ± 27.3 s in IMT) and half-time of recovery (144.5 ± 49.8 s in impedance vs. 156.9 ± 39.4 s in IMT). Recovered impedance after ablation (104.8 ± 3.9 Ω) was 5.1 ± 2.0 Ω smaller than that before ablation (109.9 ± 2.7 Ω), suggesting several factors other than IMT rise participate in impedance decline in RF ablation.</p></div><div><h3>Conclusions</h3><p>Recovery of impedance and IMT after ablation well correlated, which supports the usefulness of impedance monitoring for safe RF ablation.</p></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972629223001274/pdfft?md5=a4a4e482549ddb0e2294da66183588e5&pid=1-s2.0-S0972629223001274-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138804870","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}

{"title":"Is left bundle branch pacing (LBBP) associated with better depolarization and repolarization kinetics than right ventricular mid septal pacing (RVSP)? - Comparison of frontal QRS -T angle in patients with LBBP, RVSP and normal ventricular conduction","authors":"Vadivelu Ramalingam ,&nbsp;Shunmugasundaram Ponnusamy ,&nbsp;Rizwan Suliankatchi Abdulkader ,&nbsp;Senthil Murugan ,&nbsp;Selvaganesh Mariyappan ,&nbsp;Jeyashree Kathiresan ,&nbsp;Mahesh Kumar ,&nbsp;Vijesh Anand","doi":"10.1016/j.ipej.2023.12.004","DOIUrl":"10.1016/j.ipej.2023.12.004","url":null,"abstract":"<div><h3>Aims</h3><p>To assess the frontal QRS- T angle (f QRS- T angle) in patients with left bundle branch pacing (LBBP) as compared to right ventricular mid septal pacing (RVSP) implanted for symptomatic high degree atrioventricular (AV) block and to compare with control subjects with normal ventricular conduction (CSNVC)</p></div><div><h3>Methods</h3><p>A total of one-fifty subjects were chosen (50 patients with LBBP, 50 patients with RVSP and 50 CSNVC). The indication for pacemaker implantation was symptomatic high degree AV block. Baseline clinical and electrocardiogram (ECG) parameters like QRS duration (QRSD), QRS axis and f QRS-T angle and Ejection Fraction (EF) were assessed. f QRS-T angle was measured as the difference between the computerised mean frontal QRS and T wave axes in the limb leads. If the difference between the QRS axis and T-wave axis exceeds 180°, then the resultant QRS-T angle would be calculated as 360° minus the absolute angle to obtain a value between 0° and 180°. Baseline, immediate post procedural and 6 month follow up (f/u) ECGs and EF were chosen for the analysis.</p></div><div><h3>Results</h3><p>Patients who underwent LBBP had significantly shorter paced QRSD than patients who had undergone RVSP (112 ± 12 ms vs 146 ± 13 ms; 95 % confidence interval (CI): 43, −31; <strong>p&lt;0.001</strong>). There was no significant difference in the QRSD before and after LBBP. The QRSD before and after pacing in RVSP was 111 ± 27 ms and 146 ± 13 ms; 95 % CI: 43, −28; <strong>p &lt; 0.001</strong>. The QRSD in control patients with NVC was 82.94 ± 9.59 ms.</p><p>RVSP was associated with wider f QRS-T angle when compared with LBBP (103 ± 53° vs 82 ± 43°; 95 % CI: 39, −1.0; <strong>p = 0.037</strong>). The baseline and immediate post procedure f QRS-T angle in LBBP was 70 ± 48° and 82 ± 43°; 95 % CI: 31, 5.3; p = 0.2. At 6 months f/u, the f QRS-T angle was 61 ± 43°; 95 % CI: 8.5, 35; <strong>p=0.002</strong>. The baseline and immediate post procedure f QRS-T angle in RVSP was 67 ± 51° and 103 ± 53°; 95 % CI: 54, −17; <strong>p &lt; 0.001</strong>. At 6 months f/u, the f QRS-T angle in RVSP group was 87 ± 58°; 95 % CI: 2.6, 29; <strong>p = 0.020</strong>. The f QRS T angle in control patients with NVC was 24 ± 16°. When subgroup analysis was done the difference in the f QRS-T angle was significant between RVSP and LBBP groups only in patients who had wide QRS escape.</p><p>The mean LVEF at 6-month follow-up in LBBP vs RVSP was 61 ± 3.7 % vs 57.1 ± 7.8 %; 95 % CI:1.48, 6.32, <strong><em>p = 0.002</em></strong>. In the RVSP group, three patients developed pacing induced cardiomyopathy (PIC) whereas no patients in the LBBP group developed PIC at 6-month follow-up; <strong>p=0.021</strong>. One patient with PIC had deterioration of functional status with new onset HF symptoms. The patient symptoms improved with medical therapy and needed no hospitalisation. The patient declined further interventions including upgradation to CRT or LBB","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972629223001304/pdfft?md5=b86d5cc13c3cf15a9a879426d380532b&pid=1-s2.0-S0972629223001304-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049455","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}

{"title":"The leadless pacemaker in ACHD – Cautiously optimistic","authors":"Jayant Kakarla,&nbsp;Krishnakumar Nair","doi":"10.1016/j.ipej.2024.03.002","DOIUrl":"10.1016/j.ipej.2024.03.002","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972629224000275/pdfft?md5=39e07ad69a103dfbb08795d182e0e80f&pid=1-s2.0-S0972629224000275-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159234","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}

{"title":"Open window mapping for redo accessory pathway ablation in Ebstein anomaly","authors":"Anindya Ghosh ,&nbsp;Akram KA. Mohamed ,&nbsp;Sabari Saravanan ,&nbsp;Ulhas M. Pandurangi","doi":"10.1016/j.ipej.2023.12.007","DOIUrl":"10.1016/j.ipej.2023.12.007","url":null,"abstract":"<div><p>Accessory pathway ablation in Ebstein anomaly can be significantly more challenging than in structurally normal hearts. An alternative to the conventional approach to mapping APs is to detect points with a high-density mapping catheter based on an automated detection algorithm using open window mapping. It detects the sharpest signal at each point with high-density mapping rather than relying on the origin of the local electrogram to localize the pathway and determine a site for successful ablation. We herein report the first case in literature of a redo-accessory pathway ablation in Ebstein anomaly using this technique.</p></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S097262922300133X/pdfft?md5=0e4ac2ce74638813aeba8083d8eff62d&pid=1-s2.0-S097262922300133X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098850","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}

{"title":"Retrievable leadless pacemakers (Aveir VR) may be beneficial in adult patients with congenital heart disease","authors":"Zainab Syyeda Rahmat ,&nbsp;Daniel Cortez","doi":"10.1016/j.ipej.2024.01.008","DOIUrl":"10.1016/j.ipej.2024.01.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Congenital heart disease may present in up to 1.6 % of newborns. Given high burden of pacing need in adult patients with repaired congenital heart disease and availability of different pacing options, more information on outcomes of newer pacemaker types are needed. Retrievable leadless pacemaker implants in adult congenital patients have not been described.</p></div><div><h3>Methods</h3><p>Retrospective review of three Aveir (Abbott) retrievable leadless pacemaker implants were reviewed at the UC Davis Medical Center. All patients underwent implant via femoral access.</p></div><div><h3>Results</h3><p>All patients had one deployment only, after mapping prior. No complications occurred. Implant thresholds were 0.5 V (V) @0.2msilliseconds (ms) for patients 1 and 2 and 1 V @0.4 ms for patient 3. With impedances between 500 and 1290 Ω. Sensing was 5.5–8 mV (mV). Follow-up occurred up to one year (for two patients) with similar values overall. The predicted longevities of each device were between 22.6 and &gt;25 years.</p></div><div><h3>Conclusion</h3><p>Safety and short-mid-term parameters of retrievable leadless pacemaker implantation is reported in three patients with adult congenital heart disease.</p></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972629224000081/pdfft?md5=0a9cc4994b75c2f452a2747ee0f2676f&pid=1-s2.0-S0972629224000081-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565077","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}

{"title":"An unusual ECG lead reversal","authors":"Suresh Kumar Sukumaran,&nbsp;Raja J. Selvaraj","doi":"10.1016/j.ipej.2023.11.007","DOIUrl":"10.1016/j.ipej.2023.11.007","url":null,"abstract":"<div><p>Lead reversals are a common cause of electrocardiographic abnormality, which can lead to a false diagnosis like chamber enlargement, myocardial ischemia or infarction. Isolated limb lead reversals and chest lead reversals are common in clinical practice. This article reports a rare case where multiple limb and chest leads were reversed due to the reversal of cables leading to a false diagnosis of myocardial ischemia.</p></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972629224000251/pdfft?md5=b59802e6c93cce16313404fc601c774a&pid=1-s2.0-S0972629224000251-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736303","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}

{"title":"Subcutaneous cardioverter-defibrillator implantation in an adult with congenital heart disease and left infra-mammary pacemaker","authors":"Soham Dasgupta ,&nbsp;Kevin Thomas ,&nbsp;Christopher Johnsrude","doi":"10.1016/j.ipej.2023.12.008","DOIUrl":"10.1016/j.ipej.2023.12.008","url":null,"abstract":"<div><p>The approach/type of an implantable cardioverter defibrillator (ICD) is determined by the underlying cardiac anatomy, venous access, and pre-existing cardiac implantable electronic devices. We describe a case of subcutaneous ICD implantation in an adult with congenital heart disease (CHD) with a pre-existing inframammary transvenous pacemaker. This was preferred over adding a defibrillator coil to existing pacing leads, extraction/replacement of pacing system, or a sternotomy/epicardial ICD placement. The procedure was accomplished uneventfully with successful defibrillation threshold testing. Innovative approaches are required to manage arrhythmias in adults with CHD, with shared decision making playing a critical role.</p></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0972629223001341/pdfft?md5=fabf2c1c7b363b65a7cb03a4ccc5fc1d&pid=1-s2.0-S0972629223001341-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139088877","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}