Pacing and clinical electrophysiology : PACE最新文献

{"title":"Idiopathic brachial plexopathy after pacemaker implant.","authors":"Devesh Kumar,&nbsp;Aayush K Singal,&nbsp;Raghav Bansal,&nbsp;Animesh Das,&nbsp;Krithika Rangarajan,&nbsp;Atin Kumar","doi":"10.1111/pace.14421","DOIUrl":"https://doi.org/10.1111/pace.14421","url":null,"abstract":"<p><p>A middle-aged woman presented with symptomatic complete heart block and underwent an uneventful dual chamber pacemaker implantation. Three weeks post procedure, she developed left arm pain and weakness, with neurological localization to the lower trunk of left brachial plexus. Possibilities of traumatic compression by the device/leads or postoperative idiopathic brachial plexopathy were considered. After ruling out traumatic causes, she was started on oral steroids, to which she responded remarkably. This case highlights the importance of recognizing this rare cause of brachial plexopathy following pacemaker implantation, because not only does an expedited diagnosis and medical treatment lead to prompt recovery with minimal neurological deficits, but it also circumvents an unnecessary surgical re-exploration.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"574-577"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39793745","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":"Impact of lockdown during COVID-19 pandemic on physical activity and arrhythmia burden in heart failure patients.","authors":"Jörn Schmitt,&nbsp;Beate Wenzel,&nbsp;Bernd Brüsehaber,&nbsp;Ignasi Anguera,&nbsp;Joao de Sousa,&nbsp;Georg Nölker,&nbsp;Alan Bulava,&nbsp;Pedro Marques,&nbsp;Robert Hatala,&nbsp;Gregory Golovchiner,&nbsp;Jürgen Meyhöfer,&nbsp;Michael Ilan","doi":"10.1111/pace.14443","DOIUrl":"https://doi.org/10.1111/pace.14443","url":null,"abstract":"<p><strong>Background: </strong>Restricted outdoor activity during COVID-19 related lockdown may accelerate heart failure (HF) progression and thereby increase cardiac arrhythmias. We analyzed the impact of March/April 2020 lockdown on physical activity and arrhythmia burden in HF patients treated with cardiac resynchronization therapy (CRT) devices with daily, automatic remote monitoring (RM) function.</p><p><strong>Methods: </strong>The study cohort included 405 HF patients enrolled in Observation of Clinical Routine Care for Heart Failure Patients Implanted with BIOTRONIK CRT Devices (BIO|STREAM.HF) registry in 16 countries, who had left ventricular ejection fraction (LVEF) ≤40% (mean 28.2 ± 6.6%) and NYHA class II/III/IV (47.9%/49.6%/2.5%) before CRT pacemaker/defibrillator implantation. The analyzed RM data comprised physical activity detected by accelerometer, mean heart rate and nocturnal rate, PP variability, percentage of biventricular pacing, atrial high rate episode (AHRE) burden, ventricular extrasystoles and tachyarrhythmias, defibrillator shocks, and number of implant interrogations (i.e., follow-ups). Intraindividual differences in RM parameters before (4-week period) versus during (4-week period) lockdown were tested for statistical significance and independent predictors were identified.</p><p><strong>Results: </strong>There was a significant relative change in activity (mean -6.5%, p < .001), AHRE burden (+17%, p = .013), and follow-up rate (-75%, p < .001) during lockdown, with no significant changes in other RM parameters. Activity decreased by ≥8 min/day in 46.5% of patients; predictors were higher LVEF, lower NYHA class, no defibrillator indication, and more activity before lockdown. AHRE burden increased by ≥17 min/day in 4.7% of patients; predictors were history of atrial fibrillation, higher LVEF, higher body mass index, and activity decrease during lockdown.</p><p><strong>Conclusion: </strong>Unfavorable changes in physical activity, AHRE burden, and follow-up rate were observed during lockdown, but not in ventricular arrhythmia.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"471-480"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39795654","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":"Leadless pacemaker implant guided by intracardiac echocardiography in a patient after Mustard repair.","authors":"Josef Kautzner,&nbsp;Hanka Wunschova,&nbsp;Jana Haskova","doi":"10.1111/pace.14417","DOIUrl":"https://doi.org/10.1111/pace.14417","url":null,"abstract":"<p><p>This case report describes a successful leadless pacemaker implant (Micra VR Medtronic, Inc, Minneapolis, MN) in a 48-year-old patient with a history of Mustard repair. Twenty-one years after dual-chamber pacemaker implant, both conventional leads became dysfunctional. Lead extraction was refused by the patient and the subclavian vein was obstructed. A leadless pacemaker was selected as an alternative. Intracardiac echocardiography allowed the safe introduction of the delivery system into the nonsystemic left ventricle. Four months after implant, the pacing parameters are stable and the patient is without new complaints. A leadless pacemaker could be considered in patients with complex grown-up congenital heart disease (GUCH).</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"571-573"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39793748","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":"The long-term outcomes of cardiac implantable electronic devices implanted via the femoral route.","authors":"Samuel Griffiths,&nbsp;Jonathan M Behar,&nbsp;Daniel B Kramer,&nbsp;Mike T Debney,&nbsp;Christopher Monkhouse,&nbsp;Alicia Y Lefas,&nbsp;Martin Lowe,&nbsp;Fouad Amin,&nbsp;Emily Cantor,&nbsp;Vennela Boyalla,&nbsp;Nabeela Karim,&nbsp;Jan Till,&nbsp;Vias Markides,&nbsp;Jonathan R Clague,&nbsp;Tom Wong","doi":"10.1111/pace.14449","DOIUrl":"https://doi.org/10.1111/pace.14449","url":null,"abstract":"Conventional superior access for cardiac implantable electronic devices (CIEDs) is not always possible and femoral CIEDs (F‐CIED) are an alternative option when leadless systems are not suitable. The long‐term outcomes and extraction experiences with F‐CIEDs, in particular complex F‐CIED (ICD/CRT devices), remain poorly understood.","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"481-490"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/c6/PACE-45-481.PMC9305836.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39832712","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":"Clinical impact of left bundle branch area pacing in heart failure with preserved ejection fraction and mid-range ejection fraction.","authors":"Yousaku Okubo,&nbsp;Shogo Miyamoto,&nbsp;Yukimi Uotani,&nbsp;Yoshihiro Ikeuchi,&nbsp;Shunsuke Miyauchi,&nbsp;Sho Okamura,&nbsp;Takehito Tokuyama,&nbsp;Yukiko Nakano","doi":"10.1111/pace.14470","DOIUrl":"https://doi.org/10.1111/pace.14470","url":null,"abstract":"<p><strong>Background: </strong>Recently, conduction system pacing, including His bundle and left bundle branch area pacing (LBBAP), has emerged as an alternative pacing procedure for right ventricular (RV) pacing. The current study aimed to compare the clinical outcomes of LBBAP and conventional RV midseptal pacing (RVMSP) in patients with heart failure (HF) with preserved ejection fraction (HFpEF) and HF with midrange ejection (HFmrEF) requiring frequency RV pacing due to atrioventricular block (AVB).</p><p><strong>Methods: </strong>A total of 89 patients with HFpEF and HFmrEF requiring RV pacing due to symptomatic AVB were enrolled between September 2018 and April 2021, among whom 43 and 46 underwent LBBAP and RVMSP, respectively.</p><p><strong>Results: </strong>No significant differences in baseline characteristics were observed between the two groups. The LBBAP group had a significantly shorter paced-QRS duration and paced left ventricular activation time (LVAT) compared to the RVMSP group (123.4 ± 10.4 ms vs. 152.3 ± 12.3 ms, p < .001 and 68.3 ± 10.0 ms vs. 95.2 ± 12.3 ms, p < .001, respectively). The LBBAP group had significantly lower N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels at the 6-month follow-up compared to the RVMSP group [459.6 pg/ml (240.4-678.7) vs. 972.7 pg/ml (629.5-1315.9), p = .01]. More patients in the LBBAP group exhibited a significant improvement in NT-proBNP, defined as a > 50% decreased from baseline levels.</p><p><strong>Conclusion: </strong>LBBAP maintains physiological ventricular activation and contributes to greater improvement in NT-proBNP value 6 months after implantation in patients with HFpEF and HFmrEF compared to RVMSP.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"499-508"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39933993","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":"An intriguing case of supraventricular tachycardia and a \"deadly\" cure.","authors":"João Santos,&nbsp;Vanda Neto,&nbsp;Joana Correia,&nbsp;Luís Santos,&nbsp;Gonçalo Ferreira,&nbsp;Emanuel Correia","doi":"10.1111/pace.14472","DOIUrl":"https://doi.org/10.1111/pace.14472","url":null,"abstract":"A 62-year-old man was admitted to the emergency department due to sudden onset palpitations and chest discomfort. He denied syncope, dyspnea, and other relevant symptoms. Past medical history was relevant for excessive alcohol intake and a previous diagnosis of hypertension. The patient wasmedicatedwith 20mg of lisinopril daily. Physical examination at admission revealed blood pressure of 170/99 mmHg, heart rate of 140 bpm with no signs of hypoperfusion nor peripheral congestion. Cardiac auscultation revealed tachycardia without murmurs and pulmonary auscultation was normal. A 12-lead electrocardiogram was taken at admission, revealing a regular narrow-QRS tachycardia (Figure 1). The emergency physician decided to administer an intravenous drug, which almost immediately caused a decrease in the cycle-length (CL) of the tachycardia, culminating in very rapid heart rate (290 bpm) and hemodynamic collapse of the patient, with loss of consciousness. A rhythm strip was taken during drug administration (Figure 2). The patient was immediately submitted to emergent synchronized electrical cardioversion, which restored sinus rhythm.","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"532-534"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39937972","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":"Surgical left atrial appendage occlusion in patients with left ventricular assist device.","authors":"Jakrin Kewcharoen,&nbsp;Kuldeep Shah,&nbsp;Rahul Bhardwaj,&nbsp;Tahmeed Contractor,&nbsp;Mohit K Turagam,&nbsp;Ravi Mandapati,&nbsp;Dhanunjaya Lakkireddy,&nbsp;Jalaj Garg","doi":"10.1111/pace.14471","DOIUrl":"https://doi.org/10.1111/pace.14471","url":null,"abstract":"<p><strong>Background: </strong>Thromboembolic (TE) events are among the most common and devastating adverse events in patients with continuous-flow left ventricular assist device (cf-LVAD). Given the high burden of AF among cf-LVAD patients, we sought to evaluate the effect of concomitant surgical LAAO in patients receiving cf-LVAD.</p><p><strong>Methods: </strong>A systematic search using electronic databases was performed using the keywords: \"left atrial appendage occlusion\" and \"left ventricular assist device.\" Statistical analysis was performed using metapackage for R version 4.0 and Rstudio version 1.2. Mantel-Haenszel risk ratio (RR) random-effects model was used to summarize data between two groups. The primary outcomes included: (a) stroke; (b) LVAD pump thrombosis; (c) all-cause mortality RESULTS: Three studies with a total of 305 patients (LAAO = 68 and No-LAAO = 237) were included in the analysis. HeartMate II (39%) and Heartware (27.5%) were the two most common cf-LVADs utilized, while only 5% received HeartMate III. At a mean follow up of 1.47 years, LAAO group had a lower risk of stroke (8.8% vs. 15.2%, RR 0.64; 95% CI 0.28-1.49), LVAD pump thrombosis (1.5% vs. 3.8%, RR 0.28; 95% CI 0.05-1.55) and all-cause mortality (5.9% vs. 20.2%, RR 0.69; 95% CI 0.19-2.52) when compared with no-LAAO group, but the difference did not reach statistical significance.</p><p><strong>Conclusion: </strong>Concomitant surgical LAAO at the time of cf-LVAD implantation demonstrated a trend toward positive outcomes and was not associated with adverse outcomes during the follow-up period, though the results were not statistically significant.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"567-570"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39660749","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":"2019 Chinese expert consensus statement on left atrial appendage closure in patients with atrial fibrillation.","authors":"He Ben,&nbsp;Ma Changsheng,&nbsp;Wu Shulin","doi":"10.1111/pace.14448","DOIUrl":"https://doi.org/10.1111/pace.14448","url":null,"abstract":"<p><p>The left atrial appendage closure (LAAC), the efficacy and safety of which has been proved by a number of randomized controlled trials and registries, is recommended by several guidelines to prevent stroke in high-risk patients with non-valvular atrial fibrillation. However, current guidelines only discuss the indications and contraindications of LAAC, as an emerging technology, there still lacks comprehensive recommendations involved with LAAC, including devices, image assessment modality, identification and treatment of complications, perioperative medication, and postoperative management. Therefore, the Chinese Society of Cardiology (CSC) of Chinese Medical Association (CMA) and the Editorial Board of Chinese Journal of Cardiology jointly issued the expert consensus statement on LAAC in the prevention of stroke in patients with atrial fibrillation after comprehensive discussion by experts with different backgrounds. This consensus provided three levels of recommendations to guide and standardize the clinical application of LAAC based on existing evidence and clinical practice experience, including appropriate (more potential benefits or fewer harms), uncertain (somehow reasonable but need more evidence), and inappropriate (unlikely to benefit, or have more complications).</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"535-555"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/09/PACE-45-535.PMC9314806.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39822677","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":"Should add-hoc cardiac biopsy be routine in patients with cardiomyopathy of unknown etiology undergoing electrical storm ablation?","authors":"Emin Evren Ozcan,&nbsp;Resit Yigit Yilancioglu,&nbsp;Umut Dursun Inevi,&nbsp;Duygu Gurel,&nbsp;Mustafa Dogdus","doi":"10.1111/pace.14432","DOIUrl":"https://doi.org/10.1111/pace.14432","url":null,"abstract":"Sarcoidosis is a multisystem disorder of unknown etiology characterized by non-necrotizing and non-caseating granuloma formation in pulmonary tissue and extrapulmonary organs, such as the skin, lymph nodes, and the heart.1 Myocardial involvement is characterized by the development of atrioventricular block, congestive heart failure, ventricular tachycardia (VT), and sudden cardiac death. In autopsy studies, 20% to 70% of patients with recognized extracardiac sarcoid have subclinical cardiac involvement.2 Sustained monomorphic VT in cardiac sarcoidosis (CS) is a significant predictor of mortality.3 The management of VT in patients with CS is challenging, owing to the complexity of the underlying substrate and the progressive nature of the inflammatory process. Besides, the management of VT is much more difficult, especially if the aetiology is unclear. Endomyocardial biopsy (EMB) is useful in establishing a histopathologic diagnosis for infiltrative and other cardiomyopathies for which a histopathologic diagnosis can influence therapy.4 Herein, we report a patient with cardiomyopathyof unknownetiologyundergoingelectrical stormablation and performing fluoroscopy-guided EMB.","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"578-580"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39883621","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":"Repolarization abnormalities unmasked with a 252-lead BSM system in patients with ARVC and healthy gene carriers.","authors":"Varvara Kommata,&nbsp;Elena Sciaraffia,&nbsp;Carina Blomström-Lundqvist","doi":"10.1111/pace.14456","DOIUrl":"https://doi.org/10.1111/pace.14456","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing arrhythmogenic right ventricular cardiomyopathy (ARVC) at an early stage can be challenging even after ECG recording and a combination of several imaging techniques. The purpose of this study was to explore if a body surface mapping (BSM) system with 252-leads could identify repolarization abnormalities and thereby diagnose early stages of ARVC.</p><p><strong>Methods: </strong>ARVC patients, gene carriers without signs of ARVC and controls underwent a 12-lead resting ECG, signal-averaged ECG, echocardiography, 24-hours Holter monitoring, and BSM with electrocardiographic imaging (ECGI). All 252-leads, divided into four quadrants of the vest, were analyzed regarding concordances between T wave polarity and QRS main vector.</p><p><strong>Results: </strong>Of 40 patients included there were 12 ARVC patients, 20 gene carriers, and 8 controls. The ARVC patients had two different repolarization patterns, one with more pronounced negative T waves at the lower left panel and another with mixed changes that clearly differed from the controls, all of whom had a normal 12 lead ECGs and consistent repolarization patterns on their BSM recordings. The patterns observed in ARVC patients were also present in 5/20 (25%) gene carriers, three of whom had normal resting ECG. A novel repolarization index successfully detected all ARVC patients and 88% of gene carriers with pathologic repolarization pattern.</p><p><strong>Conclusions: </strong>The finding that abnormal repolarization patterns could be unmasked by BSM in 25% of healthy gene carriers, suggests that it may potentially be a useful tool for identifying early manifestations of ARVC. Further and larger studies are warranted to assess its diagnostic accuracy.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"509-518"},"PeriodicalIF":1.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/84/PACE-45-509.PMC9314798.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39948183","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}