- Risk stratification and clinical outcomes after surgical pulmonary valve replacement. [Journal Article]
- AHAm Heart J 2018 Sep 29; 206:105-112
- CONCLUSIONS: Patients undergoing PVR at larger RV volumes had similar survival but more overall CAE. A larger study population with a longer follow-up will be required to determine if early PVR provides survival benefit in the long-term.
- Safety and efficacy of in-hospital cardiac rehabilitation following antiarrhythmic therapy for patients with electrical storm. [Journal Article]
- JCJ Cardiol 2018 Oct 17
- CONCLUSIONS: The incidence of electrical storm relapse is substantial following antiarrhythmic therapy, but it is not increased by in-hospital rehabilitation. Although caution is urged for early mobilization, sustaining mobility to resume activity is recommended because ADL levels tend to deteriorate as a result of prolonged bed rest.
- Study of Rhythm Disturbances in Acute Myocardial Infarction. [Journal Article]
- JAJ Assoc Physicians India 2018; 66(1):54-58
- CONCLUSIONS: Compared to studies elsewhere it was observed that sinus tachycardia and bradycardia were commonest arrhythmias in AMI. That atrial fibrillation as observed in most studies elsewhere was not a common arrhythmia in this study. Mortality was statistically significant in tachyarrhythmias in both AWMI(55.71%) and IWMI(17.14%) as compared to bradyarrhythmias with p < 0.0001.
- The Incremental Benefit of Color Tissue Doppler in Fetal Arrhythmia Assessment. [Journal Article]
- JAJ Am Soc Echocardiogr 2018 Oct 16
- CONCLUSIONS: c-DTI with offline analysis permits rapid and accurate definition of FA mechanism, providing new information in nearly one-third of affected pregnancies.
- Hyperglycemia and risk of ventricular tachycardia among patients hospitalized with acute myocardial infarction. [Journal Article]
- CDCardiovasc Diabetol 2018 Oct 19; 17(1):136
- CONCLUSIONS: Efforts should be made to closely monitor and treat patients who develop hyperglycemia, especially early after hospital admission, to reduce their risk of VT.
- Information Theory to Tachycardia Therapy: Electrogram Entropy Predicts Diastolic Microstructure of Reentrant Ventricular Tachycardia. [Journal Article]
- AJAm J Physiol Heart Circ Physiol 2018 Oct 19
- There is no known strategy to differentiate which multicomponent electrograms in sinus rhythm maintain reentrant ventricular tachycardia(VT). Low entropy in the voltage breakdown of a multicomponent ...
There is no known strategy to differentiate which multicomponent electrograms in sinus rhythm maintain reentrant ventricular tachycardia(VT). Low entropy in the voltage breakdown of a multicomponent electrogram can localize conditions suitable for reentry, but has not been validated against the classic VT activation mapping. We examined whether low entropy in a late and diversely activated ventricular scar region characterizes and differentiates the diastolic path of VT and represents protected tissue channels devoid of side branches. Intraoperative bipolar electrogram(BiEGM) activation and entropy maps were obtained during sinus rhythm in 17 patients with ischemic cardiomyopathy and compared with diastolic activation paths of VT(total 39 VTs). Mathematical modelling of a zigzag main channel with side branches was also used to further validate structural representation of low entropy in the ventricular scar. A median of one region per patient(range 1-2) was identified in sinus rhythm, where BiEGMwith latest mean activation time and adjacent minimumentropy were assembled together in a high activation dispersion region. These regions accurately recognized diastolic paths of 34VTs, often to multiple inducible VTs within a single individual arrhythmogenic region. In mathematical modeling, side branching from the main channel had a strong influence on the BiEGMcomposition along the main channel. The BiEGM obtained from a long unbranched channel had the lowest entropy compared to those with multiple side branches. In conclusion,amongst a population of multicomponentsinus electrograms, those that demonstrate low entropy and are delayed co-localize to critical long-protected channels of VT. This information is pertinent for planning VT ablation in sinus rhythm.
- Ventricular arrhythmias in patients with obstructive sleep apnea. [Journal Article]
- CCCurr Cardiol Rev 2018 Oct 12
- Obstrutive sleep apnea (OSA) is a prevalent condition thought to increase in the future. Being mostly undiagnosed, the most serious complications are cardiovascular diseases, among which arrhythmias....
Obstrutive sleep apnea (OSA) is a prevalent condition thought to increase in the future. Being mostly undiagnosed, the most serious complications are cardiovascular diseases, among which arrhythmias. Controversy remains as to whether OSA is a primary etiologic factor for ventricular arrhythmias, because of the high incidence of cardiovascular comorbidities in OSA patients. However, there is mostly a strong evidence of a relation between OSA and ventricular arrhythmias. A few mechanisms have been proposed to be responsible for this association and some electrocardiographic changes have also been demonstrated to be more frequent in OSA patients. Treatment of OSA with continuous positive airway pressure (CPAP) has the potential to reduce arrhythmias and confer a mortality benefit.
- Noninvasive Identification of Ventricular Tachycardia-Related Anatomical Isthmuses in Repaired Tetralogy of Fallot: What Is the Role of the 12-Lead Ventricular Tachycardia Electrocardiogram. [Journal Article]
- JCJACC Clin Electrophysiol 2018; 4(10):1308-1318
- CONCLUSIONS: In rTOF with only AI1 and AI3, RBBB VTs are due to clockwise and LBBB VTs to counterclockwise activation of AI3. Involvement of both AIs in the VT circuit limits the role of the 12-lead VT ECG and PM. AI3 can always be targeted irrespective of the 12-lead VT ECG.
- Catheter Ablation of Ventricular Arrhythmia for Ebstein's Anomaly in Unoperated and Post-Surgical Patients. [Journal Article]
- JCJACC Clin Electrophysiol 2018; 4(10):1300-1307
- CONCLUSIONS: VA in EA may be either focal or macro-re-entrant. In the absence of surgery, substrates chiefly involve the ARV. After surgery, focal VA involves injured myocardium or Purkinje tissue and re-entrant ventricular tachycardia is related to post-surgical scar. Catheter ablation is a reasonable therapeutic approach for these patients.
New Search Next
- Ebstein's Anomaly of the Tricuspid Valve: A Natural Laboratory for Re-Entrant Tachycardias. [Review]
- JCJACC Clin Electrophysiol 2018; 4(10):1271-1288
- Ebstein's anomaly of the tricuspid valve is a relatively rare form of congenital heart disease that has long been a challenge to electrophysiologists and cardiac surgeons. In addition to the hemodyna...
Ebstein's anomaly of the tricuspid valve is a relatively rare form of congenital heart disease that has long been a challenge to electrophysiologists and cardiac surgeons. In addition to the hemodynamic burden of the actual valve defect, Ebstein's patients must also contend with an extraordinarily high incidence of tachyarrhythmias, most of which can be attributed to accessory atrioventricular pathways (APs) located along the posterior and septal border of the tricuspid valve where the valve leaflets are most abnormal. It is the only congenital heart defect with such a dramatic predisposition toward APs. Although it is logical to postulate a link between the anatomic deformity and the conduction abnormality, the exact nature of this link is still not fully understood and remains a fertile area for investigation that might shed light on abnormal conduction pathways in many other forms of heart disease. Furthermore, for reasons that are only now being fully appreciated, successful catheter ablation of APs in this setting is frequently more challenging than would be expected in a structurally normal heart. This review will explore the gross and microscopic anatomy of Ebstein's anomaly with attention to features that could be important to both arrhythmogenesis and ablation therapy in this unique population.