Journal of Innovations in Cardiac Rhythm Management最新文献_第4页

Digoxin Dilemma: Diagnosing Toxicity Amidst Dementia. 地高辛困境：诊断痴呆中的毒性。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI: 10.19102/icrm.2025.16041

Parth Sushil Bajoria, Vinod Nookala

{"title":"Digoxin Dilemma: Diagnosing Toxicity Amidst Dementia.","authors":"Parth Sushil Bajoria, Vinod Nookala","doi":"10.19102/icrm.2025.16041","DOIUrl":"https://doi.org/10.19102/icrm.2025.16041","url":null,"abstract":"Digoxin, a cardiac glycoside and sodium-potassium adenosine triphosphatase inhibitor, has a narrow therapeutic index and is primarily prescribed for conditions such as systolic heart failure and atrial fibrillation. This narrow window increases the risk of toxicity, especially among susceptible populations. Although digoxin use has declined in recent decades and cases of toxicity have become less frequent, clinicians must remain vigilant, particularly with geriatric patients, who are more susceptible due to polypharmacy and reduced renal function. Here, we present a case of a 77-year-old woman with dementia who exhibited elevated digoxin levels and was successfully treated with digoxin immune Fab. While the use of immune Fab in chronic toxicity cases remains uncertain, our retrospective review of similar cases, managed both with and without immune Fab, provides insights into its role and limitations. We further underscore the importance of regular digoxin monitoring rather than checking the levels only during toxic episodes, as consistent monitoring can prevent fatal cases and reduce overall mortality.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 4","pages":"6235-6238"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053378","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

Left Septal Fascicular Block Following Left Bundle Branch Area Pacing. 左束支区起搏后左间隔束束阻滞。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI: 10.19102/icrm.2025.16044

Ahmet Lutfu Sertdemir, Ahmet Taha Sahin, Andrés Ricardo Pérez-Riera, Enes Elvin Gul, Adrian Baranchuk

引用次数: 0

The Rhythms of the Moon: Can the Moon Affect Cardiac Arrhythmias? 月亮的节奏：月亮会影响心律失常吗？

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16034

Athanasios Ziakos, Armin Sause, Melchior Seyfarth

{"title":"The Rhythms of the Moon: Can the Moon Affect Cardiac Arrhythmias?","authors":"Athanasios Ziakos, Armin Sause, Melchior Seyfarth","doi":"10.19102/icrm.2025.16034","DOIUrl":"10.19102/icrm.2025.16034","url":null,"abstract":"Diagnosing paroxysmal cardiac arrhythmias early poses a challenge, yet it holds paramount significance. Certain patients hold strong beliefs regarding the moon's impact on cardiac arrhythmias. This study aims to examine the potential correlation. In our emergency room, each patient presentation is assigned an \"admission diagnosis.\" An analysis was conducted on admission diagnoses from 2012-2020 (before the coronavirus disease 2019 pandemic). The frequency of rhythmological diagnoses was investigated, both collectively and separately, as well as categorized by the underlying pathomechanism, in relation to the lunar phase and the moon's proximity to the Earth at the time of admission. Moreover, the impacts of sex, age, and weight were evaluated. A total of 58,230 patient presentations were recorded, with 16.9% coded with rhythmological diagnoses. No significant differences were found in the distribution of cardiac arrhythmias concerning lunar phases or the moon-Earth distance. Sex, age, and weight did not influence this distribution, except in a small group of underweight patients (<55 kg), where a statistically significant difference was observed with greater moon distance. To verify this result, we investigated all existing Holter records of underweight patients presenting to the emergency room between 2017 and 2020. In 195 24-h Holter recordings, a uniform burden of supraventricular extrasystoles and atrial fibrillation/flutter irrespective of the moon's distance from the Earth was observed. Contrary to patients' beliefs, the moon does not seem to affect the presentations with rhythmological complaints and diagnoses in our single-center analysis, irrespective of age, sex, or the arrhythmia type. The moon cannot aid in diagnosing paroxysmal arrhythmias.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 3","pages":"6220-6222"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693813","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

Letter from the Editor in Chief. 总编辑的来信。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16038

Devi Nair

引用次数: 0

"Optimizing" the Anesthetic for Cardiac Contractility Modulation Devices. “优化”心脏收缩调节装置的麻醉剂。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16032

Samit Ghia, Ashanay Allen, Ranjit Suri, Himani Bhatt

{"title":"\"Optimizing\" the Anesthetic for Cardiac Contractility Modulation Devices.","authors":"Samit Ghia, Ashanay Allen, Ranjit Suri, Himani Bhatt","doi":"10.19102/icrm.2025.16032","DOIUrl":"10.19102/icrm.2025.16032","url":null,"abstract":"We present a case report of a patient undergoing implantation of a cardiac contractility modulation (CCM) device. The Optimizer® Smart Implantable Pulse Generator (Impulse Dynamics, Orangeburg, NY, USA) provides electrical energy to the right ventricular septum to modulate cardiac contractility and improve cardiac function in heart failure patients. The non-excitatory electrical signals are delivered by transvenous leads during the refractory period. Anesthetic administration during implantation can affect appropriate lead positioning. Propofol at high doses can attenuate diaphragmatic contraction and discomfort from inappropriate lead positioning, resulting in diaphragm stimulation. Therefore, local or conscious sedation is preferred during CCM device implantation. In patients undergoing procedures with this CCM device in situ, the Optimizer® activity causes upward deflections of the RS segment on the electrocardiogram. Also, strong electromagnetic fields can disrupt device function. This case report reviews the novel CCM device and its major anesthetic considerations.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 3","pages":"6223-6228"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693818","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

Immune Checkpoint Inhibitor-induced Myocarditis: A Case Report of Complete Heart Block and Challenges in a Patient on Pembrolizumab. 免疫检查点抑制剂诱导的心肌炎：1例使用派姆单抗的患者完全性心脏传导阻滞和挑战

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16033

Viraj Panchal, Elina Momin, Shubhika Jain, Anaiya Singh, Guntas Ghuman, Vijaywant Brar

{"title":"Immune Checkpoint Inhibitor-induced Myocarditis: A Case Report of Complete Heart Block and Challenges in a Patient on Pembrolizumab.","authors":"Viraj Panchal, Elina Momin, Shubhika Jain, Anaiya Singh, Guntas Ghuman, Vijaywant Brar","doi":"10.19102/icrm.2025.16033","DOIUrl":"10.19102/icrm.2025.16033","url":null,"abstract":"Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by modulating immune responses, leading to enhanced anti-tumor activity. ICIs, including agents targeting cytotoxic T-lymphocyte antigen 4, programmed cell death 1, and programmed cell death ligand, are now widely used in various malignancies, either as monotherapy or in combination with chemotherapy, radiotherapy, or targeted therapies. However, ICIs are associated with immune-related adverse events, affecting multiple organ systems, with myocarditis emerging as a rare but potentially fatal complication. We present a 67-year-old man with a history of prostate and renal cell carcinoma treated with pembrolizumab and lenvatinib, who developed myocarditis secondary to ICI therapy. The patient initially presented with generalized fatigue and bradycardia, later progressing to more severe symptoms, including sinus bradycardia and elevated troponin levels. An electrocardiogram revealed a sinus rhythm with first-degree atrioventricular block, non-specific intraventricular conduction delay, and elevated high-sensitivity troponin levels progressively increasing to 50,000 pg/mL. A comprehensive diagnostic workup ruled out ischemic causes, leading to the diagnosis of ICI-induced myocarditis. The patient was treated with high-dose corticosteroids, intravenous immunoglobulin, and temporary pacemaker insertion, resulting in clinical improvement. This case highlights the need for vigilance and prompt intervention in patients receiving ICI therapy, as early recognition and treatment of myocarditis are crucial to optimizing patient outcomes in this high-risk population.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 3","pages":"6215-6219"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693787","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

Non-invasive Vagus Nerve Stimulation as an Adjunct Treatment for Inappropriate Sinus Tachycardia. 非侵入性迷走神经刺激作为不适当窦性心动过速的辅助治疗。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16037

Ashley Houff, Bernard Gros, Svetlana Blitshteyn, Rebecca Guido, David Fries

{"title":"Non-invasive Vagus Nerve Stimulation as an Adjunct Treatment for Inappropriate Sinus Tachycardia.","authors":"Ashley Houff, Bernard Gros, Svetlana Blitshteyn, Rebecca Guido, David Fries","doi":"10.19102/icrm.2025.16037","DOIUrl":"10.19102/icrm.2025.16037","url":null,"abstract":"Inappropriate sinus tachycardia (IST) is a type of cardiovascular autonomic dysfunction (CVAD) that mainly affects young women and has a prevalence of 1%-2%. IST is characterized by a sinus heart rate of >100 bpm at rest with a mean 24-h heart rate of >90 bpm associated with distressing symptoms such as palpitations, dizziness, and syncope. Here, we discuss a case of a 30-year-old woman who presented with complaints of tachycardia and associated symptoms, including dizziness, diaphoresis, and sudden loss of consciousness. The 24-h Holter monitoring was consistent with the diagnosis of IST. The patient had minimal improvement on β-blocker therapy. Due to persistent symptoms consistent with IST, she was started on non-invasive vagal nerve stimulation (n-VNS) therapy. Following 2 months of n-VNS applied twice daily over the carotid artery, the patient noted near-complete relief of her tachycardia and other debilitating symptoms. While n-VNS has recently been reported as a possible treatment for postural orthostatic tachycardia syndrome, another type of CVAD, to the best of our knowledge, this is the first report of low-level n-VNS as a treatment for IST. Our case study highlights the need for further clinical studies on the benefits of n-VNS in treating IST.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 3","pages":"6231-6234"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693796","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

Checking Ablation Lines-Is Bidirectional Block Sufficient? 检查消融线——双向阻断是否足够？

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16031

Sebastian Weyand, Stephanie Löbig, Peter Seizer

引用次数: 0

2024 EP Fellows Summit: Letter from the Program Directors. 2024 EP研究员峰会：项目主管的信。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16036

William Sauer, Wendy Tzou

引用次数: 0

Brugada Phenocopy due to Hyponatremia: A Case Report and Review of the Literature. 低钠血症所致Brugada表型：1例报告及文献复习。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-02-15 eCollection Date: 2025-02-01 DOI: 10.19102/icrm.2025.16026

Christos S Konstantinou, Dimitrios Sfairopoulos, Konstantinos Zekios, Konstantinos P Letsas, Panagiotis Korantzopoulos

引用次数: 0