- Phenotypic Spectrum ofHCN4Mutations: A Clinical Case. [Journal Article]
- CGCirc Genom Precis Med 2018; 11(2):e002033
- Ozone therapy induced sinus arrest in a hypertensive patient with chronic kidney disease: A case report. [Case Reports]
- MMedicine (Baltimore) 2017; 96(50):e9265
- CONCLUSIONS: Although ozone therapy is widely used in the treatment of several diseases, adverse reactions should be given attention in clinical practice, especially in patients with chronic kidney disease.
- HCN4 pacemaker channels attenuate the parasympathetic response and stabilize the spontaneous firing of the sinoatrial node. [Journal Article]
- JPJ Physiol 2018 Jan 09
- CONCLUSIONS: The contribution of HCN4 pacemaker channels in the autonomic regulation of the sino-atrial node (SAN) has been a matter of debate. The transgenic overexpression of HCN4 did not induce tachycardia, but reduced heart rate variability, while the conditional knockdown of HCN4 gave rise to sinus arrhythmia. The response of the SAN to β-adrenergic stimulation was not affected by overexpression or knockdown of HCN4 channels. When HCN4 channels were knocked down, the parasympathetic response examined by cervical vagus nerve stimulation (CVNS) was enhanced; the CVNS induced complete sinus pause. The overexpression of HCN4 attenuated bradycardia induced by CVNS only during β-adrenergic stimulation. We concluded that HCN4 pacemaker channels stabilize the spontaneous firing by attenuating the parasympathetic response of the SAN.
- Twitching of the Pacemaker Pocket Induced by Radiofrequency Energy Delivery to the Cavotricuspid Isthmus. [Journal Article]
- IMIntern Med 2017 Dec 21
- An 82-year-old man with a permanent pacemaker (PM) implanted for sick sinus syndrome complained of palpitation due to paroxysmal atrial fibrillation and flutter. During extensive pulmonary vein isola...
An 82-year-old man with a permanent pacemaker (PM) implanted for sick sinus syndrome complained of palpitation due to paroxysmal atrial fibrillation and flutter. During extensive pulmonary vein isolation, the atrial lead was dislodged to the level of the tricuspid annulus. Radiofrequency energy delivery to the cavotricuspid isthmus reproducibly caused twitching of the PM pocket. The atrial lead was repositioned to the right atrial appendage, PM check revealed no functional change in the PM or lead performance. This is the first reported case of twitching of the PM pocket due to electromagnetic interference.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Sick sinus syndrome, also known as sinus node dysfunction (SND), is a disorder of the sinoatrial (SA) node caused by impaired pacemaker function and impulse transmission producing a constellation of ...
Sick sinus syndrome, also known as sinus node dysfunction (SND), is a disorder of the sinoatrial (SA) node caused by impaired pacemaker function and impulse transmission producing a constellation of abnormal rhythms. These include atrial bradyarrhythmias, atrial tachyarrhythmias and, sometimes, bradycardia alternating with tachycardia often referred to as “tachy-brady syndrome.” These arrhythmias may result in palpitations and tissue under-perfusion leading to fatigue, lightheadedness, pre-syncope, and syncope.
- Complex regional pain syndrome induced by pacemaker implantation for sick sinus syndrome. [Journal Article]
- JAJ Arrhythm 2017; 33(6):643-645
- A 53-year-old woman reported burning pain, muscle weakness, and dysesthesia of the left arm 2 months after permanent pacemaker insertion in the ipsilateral side for the treatment of sick sinus syndro...
A 53-year-old woman reported burning pain, muscle weakness, and dysesthesia of the left arm 2 months after permanent pacemaker insertion in the ipsilateral side for the treatment of sick sinus syndrome. Complex regional pain syndrome (CRPS) induced by pacemaker implantation was diagnosed. In 2017, her pulse generator became exhausted and was exchanged carefully to avoid exacerbation of CRPS, under the application of local anesthesia and premedication. Six months later, the patient's grip strength in her left hand remained lower relative to that in her right hand. Although rare, the presence of CRPS following device implantation should be remembered.
- Dilated cardiomyopathy with severe arrhythmias in Emery-Dreifuss muscular dystrophy: from ablation to heart transplantation. [Journal Article]
- JAJ Atr Fibrillation 2016; 9(4):1468
- CONCLUSIONS: heart failure in Emery-Dreifuss muscular dystrophy can progress quickly unless the previously stable condition. The use of correct regimens of immunosuppression therapy provides good long-term results of the heart transplantation.
- Atrial Fibrillation is Associated with Increased Pacemaker Implantation Rates in the Placement of AoRTic Transcatheter Valve (PARTNER) Trial. [Journal Article]
- JAJ Atr Fibrillation 2017 Jun-Jul; 10(1):1494
- Atrial fibrillation (AF) is associated with worse outcomes in many cardiovascular diseases. There are few data examining pacemaker implantation rates and indications in patients with AF who undergo t...
Atrial fibrillation (AF) is associated with worse outcomes in many cardiovascular diseases. There are few data examining pacemaker implantation rates and indications in patients with AF who undergo transcatheter aortic valve replacement (TAVR). To examine the impact of AF on the incidence of and indications for pacemakers in patients undergoing TAVR, we evaluated data of 1723 patients without pre-existing pacemakers who underwent TAVR in the Placement of AoRTic TraNscathetER Valve (PARTNER) trial. Permanent pacemaker implantation rates and indications were compared in groups based on baseline and discharge heart rhythm: sinus rhythm (SR) vs. AF. 1211 patients manifested SR at baseline/SR at discharge (SR/SR), 105 SR baseline/AF discharge (SR/AF), and 407 AF baseline/AF discharge (AF/AF). Patients who developed and were discharged with AF (SR/AF) had the highest rates of pacemaker implantation at 30 days (13.7% SR/AF vs. 5.4% SR/SR, p=0.0008 and 5.9% AF/AF, p=0.008) and 1 year (17.7% SR/AF vs. 7.1% SR/SR, p=0.0002 and 8.1% AF/AF, p=0.0034). Conversion from SR to AF by discharge was an independent predictor of increased pacemaker implantation at 30 days (HR 2.19 vs. SR/SR, 95% CI 1.23-3.93, p=0.008) and 1 year (HR 1.91 vs. SR/SR, 95% CI 1.33-3.80). Pacemaker indications differed between groups, with relatively more implanted in the AF groups for sick sinus syndrome (SSS) versus AV block. In conclusion, conversion to AF is an independent predictor of permanent pacemaker implantation in TAVR patients. Indications differ depending on heart rhythm, with patients in AF manifesting clinically significant tachy-brady syndrome versus AV block.
- Predictors of the need for pacemaker implantation after the Cox maze IV procedure for atrial fibrillation. [Journal Article]
- STSurg Today 2017 Dec 16
- CONCLUSIONS: A low amplitude of the fibrillatory wave was identified as a risk factor of PMI necessity, whereas the internal use of ACEIs/ARBs diminished the need for PMI. These factors should be considered before CMIV is performed.
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- The proportion of asymptomatic recurrence after catheter ablation of atrial fibrillation in patients with a pacemaker for sick sinus syndrome. [Journal Article]
- IPIndian Pacing Electrophysiol J 2017 Sep - Oct; 17(5):125-131
- CONCLUSIONS: One-third of PAF patients with SSS and pacemakers recurred after multiple CA sessions. However, 65% of them were asymptomatic and difficult to be identified with conventional follow-up. Pacemaker interrogation significantly increased the detection rate of AF-recurrence.