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Koneru Jayanthi N JN Division of Cardiology, Department of Medicine, Medical College of Virginia / VCU School of Medicine, Richmond, - - 2014
A 65-year-old man with recurrent palpitations and documented supraventricular tachycardia was referred for electrophysiology study and catheter ablation. His baseline ECG is shown in Figure 1 suggesting a parahisian accessory pathway. This article is protected by copyright. All rights reserved.
Kaneko Yoshiaki Y Department of Medicine and Biological Sciences, Gunma University Graduate School of Medicine, Maebashi, Gunma, - - 2014
A 64-year-old woman with a history of a healed anteroseptal myocardial infarction underwent radiofrequency (RF) catheter ablation of paroxysmal supraventricular tachycardia refractory to drug therapy. Transthoracic echocardiography revealed the presence of a 16% left ventricular (LV) ejection fraction. This article is protected by copyright. All rights reserved.
Ip James E JE Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, NY, - - 2014
A 63-year-old man presented with frequent episodes of paroxysmal supraventricular tachycardia (SVT) at a rate of 150/min. He underwent an invasive electrophysiology study during which SVT was induced with single atrial extrastimuli during isoproterenol infusion. This article is protected by copyright. All rights reserved.
Michael Kevin A KA Heart Rhythm Service, Queen's University and Kingston General Hospital, Kingston, ON K7L 2V7, - - 2014
Atrial fibrillation/tachycardia (AF/AT) may result in inappropriate therapies in implantable cardioverter-defibrillators (ICDs). The post-pacing interval (PPI) and tachycardia cycle length difference (PPI - TCL) has been previously demonstrated to indicate the proximity of the pacing site to a tachycardia origin. We postulated that the PPI and PPI - TCL would ...
Page Stephen P SP Department of Electrophysiology, St Bartholomew's Hospital, London, United - - 2014
This report describes a patient presenting with a narrow complex tachycardia in the context of prior myocardial infarction and impaired ventricular function. Electrophysiological studies confirmed ventricular tachycardia and activation and entrainment mapping demonstrated a critical isthmus within an area of scar involving the His-Purkinje system accounting for the narrow QRS ...
Han Seongwook S Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, - - 2014
A contralateral bundle branch block (BBB) aberration during tachycardia with a preexisting BBB strongly suggests the presence of ventricular tachycardia. We report on a middle-aged, female patient presented with wide QRS tachycardia. The patient had orthodromic atrioventricular tachycardia with a left BBB aberration in the presence of a preexisting right ...
Cheung Jim W JW Department of Medicine, Division of Cardiology, Weill Cornell Medical College, New York, NY - - 2014
A hallmark of idiopathic right ventricular outflow tract (RVOT) tachycardia is its sensitivity to adenosine (ADO), which is consistent with a triggered mechanism. We have identified a novel group of patients with ADO-insensitive, non-reentrant RVOT tachycardia. To identify the clinical and electrophysiologic characteristics of ADO-insensitive RVOT tachycardia. The response of ...
Yaegashi Takanori - - 2014
Right ventricular septal pacing is thought to be better than right ventricular apical pacing for shortening the QRS duration and for preserving left ventricular function. However, right ventricular septal pacing may not be effective in all cases. In this case report, we present a rare case in which right ventricular ...
Ip James E JE Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, - - 2014
-Based on current understanding of cardiac conduction system development and the observation that arrhythmogenic foci can originate in areas near the atrioventricular annuli, we hypothesized that focal annular tachycardias, whether atrial or ventricular, share a common mechanism. We therefore prospectively evaluated this hypothesis in patients with sustained atrial and ventricular ...
Zarbock Alexander A Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Munster, - - 2014
This review summarizes the approach to and recent developments in the treatment of acute right ventricular dysfunction and failure in the perioperative setting. Right ventricular failure, defined as the inability to deliver sufficient blood flow through the pulmonary circulation at normal central venous pressure, is a common problem in the ...
Fernández-Armenta Juan - - 2014
Percutaneous pericardial access for epicardial mapping and ablation of ventricular arrhythmias has expanded considerably in recent years. After its description in patients with Chagas disease, the technique has provided relevant information on the arrhythmia substrate in other cardiomyopathies and has improved the results of ablation procedures in various clinical settings. ...
Barake Walid W Walid Barake is a senior internal medicine resident at Queen's University, Kingston, Ontario, Canada. Adrian Baranchuk is an associate professor of medicine in the Division of Cardiology at Queen's University. Arnold Pinter is an assistant professor in the Division of Cardiology at St Michael's Hospital, University of Toronto, Toronto, Ontario, - - 2014
Artifacts can simulate arrhythmias such as atrial flutter, atrial fibrillation, and ventricular tachycardia. A case of pseudo-ventricular tachycardia is outlined in a patient with newly diagnosed atrial fibrillation, which made the diagnosis a special challenge. Characteristic signs of pseudo-ventricular tachycardia are described. This case reinforces the importance of recognizing artifacts ...
Dabiri Abkenari L L Clinical Electrophysiology, Department of Cardiology, Erasmus MC, Rotterdam, the - - 2014
Contact force (CF) is one of the major determinants for sufficient lesion formation. CF-guided procedures are associated with enhanced lesion formation and procedural success. We report our initial experience in epicardial ventricular tachycardia (VT) ablation with a force-sensing catheter using a new approach with an angioplasty balloon. Two patients with ...
Singh David K DK Queens Medical Center, Division of Cardiology. Electronic address: - - 2014
Because the His bundle is intrinsic to the circuit in ORT and remote from that of AVNRT, pacing the His bundle during supraventricular tachycardia (SVT) may be useful to distinguish these arrhythmias OBJECTIVE: We tested the hypothesis that His Overdrive Pacing (HOP) would affect SVT immediately for ORT and in ...
Vaidya Vaibhav R VR Department of Internal Medicine, Mayo Clinic, Rochester, - - 2014
Hemodynamic instability hinders activation and entrainment mapping during ventricular tachycardia (VT) ablation. The Impella 2.5 microaxial flow device (MFD) (Abiomed Inc., Danvers, MA, USA) is used to prevent hemodynamic instability during electrophysiologic study. However, electromagnetic interference (EMI) generated by this device can preclude accurate electroanatomic mapping. Impella was placed in ...
Shenthar Jayaprakash J Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore, 560069, Karnataka, - - 2014
Wide QRS tachycardia can pose a diagnostic dilemma, and a number of electrocardiographic criteria have been proposed to differentiate ventricular tachycardia from supraventricular tachycardia with aberrancy. This article is protected by copyright. All rights reserved.
Yamabe Hiroshige H Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. Electronic address: - - 2014
The mechanism and tachycardia circuit of verapamil-sensitive atrial tachycardia originating from the atrioventricular annulus (AVA-AT) other than the atrioventricular node vicinity are not well clarified. In 23 patients, we examined the mechanism and anatomic tachycardia circuit of AVA-AT. While recording the atrial electrogram at the earliest atrial activation site (EAAS) ...
Willems Stephan S Department of Electrophysiology, University Heart Center, University Hospital Eppendorf, Martinistr. 52, 20246, Hamburg, Germany, - - 2014
The involvement of the Purkinje system in a subset of patients with idiopathic ventricular fibrillation or polymorphic VT/VF related to structural heart disease was first demonstrated in the pioneering work of Michel Haissaguerre and co-workers (Circulation 106:962-967, 2002 and Lancet 359:677-678, 2002). It is very important to identify these patients ...
Xue Feng - - 2014
Although cardiac troponin I gives excellent accuracy in the identification of myocardial necrosis, it can also be elevated in a series of diseases other than acute coronary syndromes. We present two cases of Chinese patients with a high serum troponin I level after an acute episode of paroxysmal supraventricular tachycardia ...
Krishnamoorthy Jaishankar J Department of Cardiology, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, - - 2014
A 21-year-old man presented with recurrent palpitations and giddiness. Clinical examination, echocardiography, and magnetic resonance imaging revealed a structurally normal heart. Electrocardiography showed broad-complex tachycardia with 250 beats per minute, which required cardioversion. An electrophysiological study could not induce tachycardia by programmed electrical stimulation. On isoprenaline infusion, frequent ventricular ectopics, ...
Aras Dursun D Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, - - 2014
We report a case of a 69-year-old male with non-ischemic cardiomyopathy, having drug- and antitachycardia pacing-refractory ventricular tachycardia resulted in multiple ICD shocks. The sustained and intractable ventricular arrhythmia was mapped and ablated with the aid of the three-dimensional electroanatomic mapping system, initially performed but unsuccessful from the endocardial site ...
Jiménez-Candil Javier J Cardiology Department, IBSAL-University Hospital, Salamanca, - - 2014
We have read with great interest the letter by Reif et al. It is incontroversial that distinguishing supraventricular tachycardia from ventricular tachycardia remains a major challenge for ICDs. This article is protected by copyright. All rights reserved.
Aziz Sally S University of - - 2014
The recently commercially available Subcutaneous Implantable Cardioverter-Defibrillator (S-ICD) utilizes a completely subcutaneous electrode configuration to treat potentially lethal ventricular tachyarrhythmia. Clinical trials have proven its effectiveness in detecting and treating ventricular fibrillation and tachycardia. The S-ICD offers the advantage of eliminating the need for intravenous and intracardiac leads and their ...
Duan Xu X Department of Cardiology, The First People's Hospital of Hangzhou, Hangzhou, China; Second Department of Internal Medicine, People's Hospital of Aksu County, Aksu, China. Electronic address: - - 2014
A case of electrocardiographic artifact due to mobile a phone mimicking ventricular tachycardia was presented. The artifact was discriminated by close scrutiny of ECG and was attributed to a mobile phone because it was simultaneous with mobile phone game.
Kaneko Yoshiaki Y Department of Medicine and Biological Science, Gunma University Graduate School of - - 2014
An 81-year-old man with long RP narrow QRS tachycardia underwent catheter ablation. Ventricular pacing reset the atrial cycle over a retrograde slow pathway, followed by termination of the tachycardia without atrial capture, confirming the diagnosis of fast-slow atrioventricular nodal reentrant tachycardia (AVNRT). The earliest atrial activation during tachycardia was found ...
Alonso-Martin Concepción C Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Institut de Recerca HSCSP-IIB Sant Pau, Barcelona, - - 2014
A 61-year-old male patient with a history of valvular and ischemic cardiomyopathy and low left ventricular ejection fraction (33%) was referred to our institution for palpitation episodes over the last 3 months. This article is protected by copyright. All rights reserved.
VAN Heuverswyn Frederic F Ghent University Hospital, Ghent, - - 2014
A 61-year-old woman with Leriche's syndrome and ischemic cardiomyopathy (left ventricular ejection fraction 24% after inferior myocardial infarction) and a single-chamber implantable cardioverter-defibrillator (ICD) presented to the hospital with palpitations. The electrocardiogram (Fig.1, left panel) revealed a relatively narrow QRS complex tachycardia (NCT, QRS width 104ms), slightly irregular at 154 ...
Manfredi Joseph A JA AnMed Health Arrhythmia Specialists, Anderson, - - 2014
A 53-year-old man with a dual-chamber implantable cardioverter-defibrillator (ICD) presented to the electrophysiology (EP) lab for an EP study in evaluation of supra-ventricular tachycardia despite medical therapy. Fluoroscopic imaging during placement of diagnostic catheters demonstrated insulation failure with an externalized conductor on the right ventricular defibrillator lead just distal to ...
Monigatti-Tenkorang Joanna J Department of Cardiology, Lausanne University Hospital, Lausanne, - - 2014
Paroxysmal atrial fibrillation (AF) may be triggered by intermittent atrial tachycardia, and ultimately lead to persistent AF. However, the mechanisms by which intermittent atrial tachycardia promotes sustained AF are not well understood. Eight sheep were chronically implanted with two pacemakers for the recording of broadband right atrial unipolar electrograms, and ...
Bosak Adam R AR Department of Medical Toxicology, Banner Good Samaritan Medical Center, 925 East McDowell Road, Phoenix, AZ, 85006, USA, - - 2014
A patient with chronic lithium toxicity developed a life-threatening ventricular arrhythmia that resolved during removal of lithium by hemodialysis. Chronic lithium toxicity commonly results from diminished elimination and can produce neurotoxicity. Cardiovascular complications have been reported and generally affect the sinoatrial node and produce bradyarrhythmias. The majority of these arrhythmias ...
Koza Yavuzer Y Department of Cardiology, Atatürk University Faculty of Medicine, Erzurum, Turkey. - - 2014
An early repolarization (ER) pattern, characterized by J-point elevation, slurring of the terminal part of the QRS and ST-segment elevation, is a common finding on the 12-lead electrocardiogram. It has been suggested that J-point elevation, which was considered benign for many years, may play a critical role in the pathogenesis ...
Matoshvili Z Z Central University Clinic after N. Kipshidze, Tbilisi; Tbilisi State Medical University, Department of Internal Medicine №1, - - 2014
Early repolarization pattern (ERP) is a common ECG variant, characterized by J point elevation manifested either as terminal QRS slurring (the transition from the QRS segment to the ST segment) or notching (a positive deflection inscribed on terminal QRS complex) associated with concave upward ST-segment elevation and prominent T waves ...
Jastrzębski Marek M I Klinika Kardiologii i Elektrokardiologii Interwencyjnej oraz Nadciśnienia Tętniczego, Szpital Uniwersytecki, Kraków. - - 2014
We describe 5 cases of a rare and often lethal arrhythmia: short-coupled variant of torsade de pointes. In the light of quitecharacteristic electrocardiograms and clinical picture of this arrhythmia, we consider the name 'short-coupled variant torsade de pointes' as more appropriate than, the more commonly applied term for such cases ...
Ying Zhi-Qiang ZQ Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, - - 2014
Isolated left ventricular noncompaction (IVNC) is a rare congenital form of cardiomyopathy. Verapamil-sensitive fascicular ventricular tachycardia is a rare arrhythmogenic condition characterized by a right bundle-branch block pattern and left-axis deviation with a relatively narrow QRS complex. We herein present the case of a patient with IVNC who presented with ...
Choudhary Dinesh D Fellow in Cardiac Electrophysiology, Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Thiruvananthapuram 695 011, India. Electronic address: - - 2014
'Masquerading' bundle branch block (right bundle branch block in the precordial leads with left bundle branch block in frontal leads and left axis deviation) is seen most commonly with coronary artery disease and hypertension. No definite explanation is available so far for these changes. We are presenting a case of ...
Chan Wah Hak Yee-Sen - - 2013
We report a case of pectus excavatum associated with ventricular tachycardia provoked by exercise in a 19-year-old man. Although this chest deformity has been associated with supraventricular dysrhythmias, documented ventricular tachycardia has only been reported once. Our patient's ventricular dysrhythmia was treated by surgical correction of his pectus excavatum only, ...
Osmonov D - - 2013
Isolated left ventricular non-compaction is a rare genetic disorder manifesting mainly with heart failure, ventricular arrhythmias and systemic embolism. Isolated ventricular tachycardia originating from the right ventricular outflow tract is an arrhythmia that can be treated medically and/or by radiofrequency catheter ablation. Here, we report a case of an asymptomatic ...
Ozcan Emin Evren EE Heart Center, Semmelweis University Budapest - - 2013
Early recognition of ventricular tachycardias (VTs) with epicardial circuits is crucial. Surface electrocardiogram (ECG) suggesting an epicardial origin could guide ablation procedures and increase success rates. A 35-year-old female patient with VT treated by combined epicardial and endocardial ablation approach is presented in this report, and the role of surface ...
Tekur Venkatesh V Department of Cardiology, Apollo Hospitals, Bangalore 560076, - - 2013
Many types of cardiac arrhythmias have been noted following acute myocardial infarction. Polymorphic ventricular arrhythmias (polymorphic ventricular tachycardia and ventricular fibrillation) related to an acute myocardial infarction generally strike during the hyperacute phase, are clearly related to ischaemia and are not associated with a long QT interval time. Pause-dependent Torsade ...
Jiménez-Díaz Javier - - 2013
A 74-year-old man underwent an electrophysiological study due to Mobitz type II second-degree AV block with narrow QRS and frequent junctional extrasystoles. During the study, there were very frequent single His bundle depolarizations with multiple coupling intervals that reproduces the ECG findings. In this case, some His bundle extrasystoles result ...
Cheng Ho-Shun - - 2013
A female patient was admitted to our hospital for catheter ablation arising from paroxysmal supraventricular tachycardia (PSVT). In the laboratory, PSVT (the earliest retrograde atrial activation at the coronary sinus ostium) with intermittent atrioventricular (AV) block could be induced repeatedly. The tachycardia could be terminated during ventricular pacing without retrograde ...
Wang Qunshan - - 2013
Ventricular tachycardia arising in the His-Purkinje system is an important cause of narrow complex tachycardia that is often amenable to catheter ablation. Ventricular arrhythmias may require targeted mapping and ablation of endocavitary structures, such as papillary muscles or false tendons to eliminate symptomatic arrhythmia. We describe a patient with narrow ...
Bradfield Jason S JS UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, - - 2013
We describe a scar-related reentrant ventricular tachycardia circuit with a proximal segment in an endocardial basal septal scar and an exit in a region of slow conduction in a non-overlapping region of epicardial basal lateral scar. The 12-lead EKG demonstrates criteria for a basal lateral epicardial VT, however the same ...
Yokoshiki Hisashi - - 2013
A 56-year-old man in hypertrophic cardiomyopathy had an electrical storm caused by ventricular fibrillation (VF). Mapping during the initiation of the VF triggered by a premature ventricular contraction (PVC1), with right bundle branch block (RBBB)-like morphology and superior axis, demonstrated a prominent Purkinje-muscle junction (PMJ) delay at the distal portion ...
Takaishi K - - 2013
J waves appear on an electrocardiogram as an elevation of the J point in the terminal portion of the QRS complex. J waves are often benign, but may be associated with malignant ventricular arrhythmias. In some cases, such problems appear to have been precipitated by propofol infusions. We observed a ...
Akgun Taylan T Kartal Kosuyolu Heart and Research Hospital. Electronic address: - - 2014
YouTube has become a useful resource for knowledge and is widely used by medical students as an e-learning source. The purpose of this study was to assess the videos relating electrocardiogram (ECG) on YouTube. YouTube was searched on May 28, 2013 for the search terms "AF ecg" for atrial fibrillation, ...
Kaneko Yoshiaki - - 2013
After entrainment pacing, the postpacing interval of a diastolic potential may be misinterpreted if the distal tip of the ablation catheter captures a remote bystander pathway adjacent to the critical isthmus of a complex reentrant circuit in a structurally diseased heart. We discuss this possible pitfall of entrainment mapping of ...
Ozyilmaz Isa - - 2013
Curative therapy of idiopathic ventricular tachycardia remains a challenge in interventional electrophysiology. The aim of this study was to demonstrate the utility of an EnSite NavX system in the catheter ablation of idiopathic ventricular tachycardia in children. Patients and methods In all, 17 children with idiopathic ventricular tachycardia underwent electrophysiological ...
Efremidis Michalis - - 2013
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is an inherited cardiomyopathy characterized by progressive fibro-fatty replacement of the right ventricular myocardium. We report a case where mapping of endocardial potentials during sinus rhythm identified the re-entry circuit of a recurrent ventricular tachycardia in a patient with ARVC. The tachycardia was subsequently ablated ...
Errahmouni Abdelkarim - - 2013
We present the case of a 72-year-old male who underwent a permanent transvenous DDD pacemaker implantation for symptomatic complete heart block. The postoperative surface electrocardiogram (ECG) revealed a right bundle branch block (RBBB) pacing pattern with transition in lead V3 and left bundle branch block (LBBB) in D1, suggesting a ...
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