Journal of Innovations in Cardiac Rhythm Management最新文献

{"title":"Taming the Tiger: Partial Input Block Results in a Stable, Organized Coronary Sinus Activation During Atrial Fibrillation.","authors":"Emir Baskovski, Timucin Altin, Omer Akyurek","doi":"10.19102/icrm.2024.15045","DOIUrl":"10.19102/icrm.2024.15045","url":null,"abstract":"<p><p>In this manuscript, we present a case where coronary sinus activation was organized and stable despite the rhythm being atrial fibrillation. We discuss the possible mechanisms of this rare occurrence.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 4","pages":"5819-5821"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877553","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":"Letter from the Editor in Chief.","authors":"Moussa Mansour","doi":"10.19102/icrm.2024.15046","DOIUrl":"10.19102/icrm.2024.15046","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 4","pages":"A7"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877551","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":"Erector Spinae Plane Block Decreases Narcotic Requirements in Patients Undergoing Subcutaneous Implantable Cardioverter-defibrillator Placement Under Sedation.","authors":"Himani V Bhatt, Jane Gui, Samit Ghia, Asad Mohammad, Hung-Mo Lin, Yuxia Ouyang, Dane Doctor, Bharat K Kantharia, Davendra Mehta, Ali Shariat","doi":"10.19102/icrm.2024.15043","DOIUrl":"10.19102/icrm.2024.15043","url":null,"abstract":"<p><p>Providing adequate analgesia perioperatively during subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation can be a challenge. The objective of our study was to assess the efficacy and safety of the erector spinae plane (ESP) block technique in providing analgesia and minimizing the risk of opioid use in high-risk patient populations. We enrolled consecutive patients >18 years of age undergoing S-ICD implantation from February 2020 to February 2022 at our center prospectively. Patients were randomly assigned to receive the ESP block or traditional wound infiltration. A total of 24 patients were enrolled, including 13 patients randomized to ESP block and 11 patients as controls who received only wound infiltration. The primary outcome assessed was the overall use of perioperative analgesic medications in the ESP block group versus the surgical wound infiltration group. A significant reduction in intraoperative fentanyl use was observed [median ([interquartile range]) in the ESP block group (0 [0-50] μg) compared to the wound infiltration block group (75 [50-100] μg) (<i>P</i> = .001). The overall postoperative day (POD) 0 fentanyl use was also significantly decreased (75 [50-100] μg) in the ESP block group compared to the surgical wound infiltration group (100 [87.5-150] μg) (<i>P</i> = .049). There was also a trend of decreased POD 0 oxycodone-acetaminophen use. Finally, the number of days to discharge was less in the ESP block group. These results indicate that ESP block is an innovative, safe, and effective technique that decreases intraoperative and postoperative opioid consumption and may be a useful adjunct pain-management technique in these high-risk patients. Larger studies are needed to further validate its use.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 4","pages":"5839-5845"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877550","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":"Use of High-density Mapping to Ablate a Wide Accessory Pathway and Mahaim Fiber in a Patient with Ebstein's Anomaly.","authors":"Eric Rosenthal, Timothey Un, Julian Bostock","doi":"10.19102/icrm.2024.15041","DOIUrl":"10.19102/icrm.2024.15041","url":null,"abstract":"<p><p>Ablation of accessory pathways in patients with Ebstein's anomaly can be challenging. Despite increasing experience and advances in mapping technology, success is limited and recurrence rates can be high. To date, high-density electroanatomic mapping has not been studied in this anatomical substrate. We present a pediatric case of Ebstein's anomaly in which high-density mapping in Ebstein's anomaly was a useful additional tool to improve the outcome of catheter ablation.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 4","pages":"5823-5827"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11073423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877554","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":"Surviving the Shocks: A Contemporary of Short-coupled Ventricular Fibrillation.","authors":"Deepti Ranganathan, Eduardo Sanhueza Gonzalez, Maria Terricabras, Christopher C Cheung","doi":"10.19102/icrm.2024.15033","DOIUrl":"https://doi.org/10.19102/icrm.2024.15033","url":null,"abstract":"<p><p>A young man presented following successful cardiac resuscitation after an out-of-hospital cardiac arrest. During his admission, he had multiple runs of short-coupled ventricular fibrillation with a similar morphology premature ventricular complex (PVC) trigger. He was brought to the electrophysiology laboratory, and, with a high dose of isoprenaline, the PVC was localised to the moderator band. Ablation induced short runs of ventricular tachycardia before elimination of the PVC. He subsequently underwent subcutaneous implantable cardiac defibrillator implantation before his discharge.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 3","pages":"5805-5809"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869042","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":"Atrial Tachycardias After \"Multiple\" Previous Ablations for Tachyarrhythmias: Treatment by Anti-arrhythmic Drugs or Additional Ablation?","authors":"Bharat K Kantharia, Zaw Win Tun, Arti N Shah","doi":"10.19102/icrm.2024.15037","DOIUrl":"https://doi.org/10.19102/icrm.2024.15037","url":null,"abstract":"<p><p>Pulmonary vein (PV) isolation (PVI) ablation as the first-line therapy for atrial fibrillation (AF) and repeat PVIs for patients who had symptomatic improvement with the index PVI but who develop AF recurrence are directed by practice guidelines. How many catheter ablation (CA) procedures constitute the definition of \"multiple\" ablations is not known. Whether atrial tachyarrhythmias (AF, atrial tachycardia [AT], atrial flutter [AFL]) that occur post-ablation are due entirely to the proarrhythmic effects of CA or a continuum of the arrhythmia spectrum from the underlying atriopathy is debatable. Herein, we describe a case of a 65-year-old man with a CHA₂DS₂-VASc score of 5 points who suffered from atrial tachyarrhythmias for which seven CA procedures were performed. Because of symptomatic and drug-refractory AT/AFL that failed cardioversions, he requested another ablation procedure. During the eighth procedure, high-density three-dimensional electroanatomic mapping, including Coherent and Ripple mapping (CARTO^® 3; Biosense Webster, Diamond Bar, CA, USA), of AT/AFL was performed. Small discrete areas of relatively viable tissue within an extensively scarred left atrium and a macro-re-entrant circuit with early-meets-late activation between the left atrial anterior wall and the right superior PV were found. Radiofrequency ablation performed at this site resulted in the termination of the tachycardia, and bidirectional conduction block across the line was achieved. On clinical follow-ups and rhythm monitoring by an implantable loop recorder, the patient remained in sinus rhythm with significant clinical improvement. Our case suggests that, in patients with prior multiple CAs, additional clinically indicated ablation should be performed using high-density mapping to accurately identify arrhythmia mechanisms, elucidate the disease substrate, and restore the sinus rhythm successfully.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 3","pages":"5795-5802"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852077","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":"Letter from the Program Directors.","authors":"Wendy Tzou, William Sauer","doi":"10.19102/icrm.2024.15038","DOIUrl":"https://doi.org/10.19102/icrm.2024.15038","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 3","pages":"5803-5804"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852689","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":"Letter from the Editor in Chief.","authors":"Moussa Mansour","doi":"10.19102/icrm.2024.15036","DOIUrl":"10.19102/icrm.2024.15036","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 3","pages":"A7-A8"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865885","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":"High-density \"APLE\" Mapping-Activation, Propagation, Low Voltage, and Electrogram Evaluation with the HD Grid for Atrioventricular Nodal Re-entry Tachycardia Ablation.","authors":"Nitin Somasundaram, Nicholas H Von Bergen","doi":"10.19102/icrm.2024.15034","DOIUrl":"https://doi.org/10.19102/icrm.2024.15034","url":null,"abstract":"<p><p>This is the first case series to evaluate high-density mapping of the triangle of Koch (TOK) using the HD Grid to guide slow-pathway ablation integrating activation, propagation (with wave collision), low-voltage signals, and atrial electrogram appearance. We will describe our technique and the results in this case series. Using three-dimensional mapping and the HD Grid, patients underwent high-density voltage mapping of the TOK. Ablation site selection was based on properties during sinus rhythm with late activation, at or above the propagation wave collision, over low voltage, and with appropriate electrogram appearance. Five patients underwent mapping of the slow pathway using the HD Grid. Their median age was 14 years, their median weight was 54.1 kg, and their median height was 161.5 cm. The TOK was mapped with the HD Grid for a median of 3 min. The procedure was successful in all patients using this technique. The median lesion number to the site of success was 3, with a median total number of cryotherapy lesions of 11. No radiation was used. There were no recurrences. Using activation, propagation wave, low voltage, and electrogram appearance when mapping for slow-pathway localization and ablation with the HD Grid can be successful, results in high-density maps, and is relatively faster.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 3","pages":"5787-5793"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865977","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":"Refractory Inappropriate Sinus Tachycardia Treated with Pulsed-field Ablation of the Sinus Node: A Breath of Fresh Air.","authors":"Robert N Kerley, Noel Fitzpatrick, Joseph Galvin","doi":"10.19102/icrm.2024.15032","DOIUrl":"https://doi.org/10.19102/icrm.2024.15032","url":null,"abstract":"<p><p>The pathogenesis of inappropriate sinus tachycardia is not well understood, and the symptoms of inappropriate sinus tachycardia can be difficult to manage. Here, we present a case of inappropriate sinus tachycardia refractory to medical therapy and discuss our approach to sinus node modification by catheter ablation.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 3","pages":"5813-5818"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868327","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}