- Cystic tumour of the atrioventricular node: treatment dilemma. [Journal Article]
- BCBMJ Case Rep 2017 Apr 24; 2017
- An asymptomatic 18-year-old black woman was found to have an incidental finding of third-degree atrioventricular (AV) block on a routine ECG. 2-Dimensional transthoracic echocardiography showed a het...
An asymptomatic 18-year-old black woman was found to have an incidental finding of third-degree atrioventricular (AV) block on a routine ECG. 2-Dimensional transthoracic echocardiography showed a heterogeneous mass in the region of the peri-membranous septum in the AV node area. A cardiac MRI showed a well-defined cystic mass arising from the right side of the interatrial septal wall. An MRI compatible permanent pacemaker was implanted with plans to monitor the tumour with non-invasive imaging. Cystic tumour of the AV node is a rare primary cardiac tumour. It is known as the smallest and most common primary cardiac tumour that can cause sudden death. All previous six cases of living patients with cystic tumour of the AV node reported in the literature were females and symptomatic. We present a rare case of a patient with cystic tumour of the AV node, and we highlight the treatment dilemmas for this condition.
- Vagal third-degree atrioventricular block in a highly trained endurance athlete. [Journal Article]
- EEuropace 2017 Apr 18
- Delayed pacemaker lead perforations: Why unusual presentations should prompt an early multidisciplinary team approach. [Journal Article]
- IJInt J Crit Illn Inj Sci 2017 Jan-Mar; 7(1):65-68
- Our first case is an 84-year-old female diagnosed with sick sinus syndrome. She underwent implantation of dual chamber permanent pacemaker without complications. On the 8(th) day status-postimplantat...
Our first case is an 84-year-old female diagnosed with sick sinus syndrome. She underwent implantation of dual chamber permanent pacemaker without complications. On the 8(th) day status-postimplantation, she returned to the emergency department (ED) with moderately severe left anterior chest pain and significant ecchymosis. She was given an initial diagnosis of shingles and discharged. Two days later, she returned to the ED with increasing chest pain, dyspnea, nausea, and vomiting. Lead migration and cardiac perforation was confirmed by chest X-ray and computed tomography (CT), respectively. She was taken to the operating room (OR) for lead repositioning, and she was discharged the next day. Our second case is a 64-year-old female with a diagnosis of 2:1 high-grade third-degree atrioventricular block. A dual chamber permanent pacemaker system was implanted without initial complication. Five days after implantation, she presented to the ED following an episode of syncope due to hypotension (67/46), shortness of breath, left flank pain, and fatigue. The initial diagnosis was sepsis. A chest CT was obtained, noting lead perforation and hemothorax. The patient was taken to the OR for lead repositioning.
- Third-Degree Atrioventricular Block and Collapse Associated with Eosinophilic Myocarditis in a Horse. [Case Reports]
- JVJ Vet Intern Med 2017 Mar 14
- Third-degree atrioventricular block (AVB) and primary inflammatory myocarditis are uncommon findings in horses. The horse of this report presented for collapse at rest and was found to have multiple ...
Third-degree atrioventricular block (AVB) and primary inflammatory myocarditis are uncommon findings in horses. The horse of this report presented for collapse at rest and was found to have multiple cardiac arrhythmias, most notably 3rd-degree AVB. The horse was subsequently diagnosed with eosinophilic myocarditis on necropsy, a rare form of myocarditis not previously reported in horses. Despite extensive testing, an etiologic agent could not be identified, illustrating the difficulty in identifying a specific cause of myocarditis in horses.
- Is there a prognostic relevance of electrophysiological studies in bundle branch block patients? [Journal Article]
- CCClin Cardiol 2017 Mar 15
- CONCLUSIONS: Our present study suggests that an indication for pacemaker implantation based solely on a diagnostic EP study with prolongation of the HV interval is not justified.
- [The Pacemaker and Implantable Cardioverter-Defibrillator Registry of the Italian Association of Arrhythmology and Cardiac Pacing - Annual report 2015]. [Journal Article]
- GIG Ital Cardiol (Rome) 2017; 18(1):67-79
- CONCLUSIONS: The PM and ICD Registry appears fundamental for monitoring PM and ICD utilization on a large national scale with rigorous examination of demographics and clinical indications. The PM Registry showed stable electrocardiographic and symptom indications, with an important prevalence of dual-chamber pacing. The use of CRT-PM regards a very limited number of patients. The ICD Registry documented a large use of prophylactic and biventricular ICD, reflecting a favorable adherence to trials and guidelines in clinical practice.
- A Case of Congenitally Corrected Transposition of Great Arteries: An Infrequent Happenstance. [Journal Article]
- CRCase Rep Med 2017; 2017:7565870
- Congenitally corrected transposition of the great arteries (CCTGA) is rare form of congenital heart diseases. It may be present with or without associated anomalies. Patients with CCTGA are usually d...
Congenitally corrected transposition of the great arteries (CCTGA) is rare form of congenital heart diseases. It may be present with or without associated anomalies. Patients with CCTGA are usually diagnosed at early stages of life due to associated anomalies, but they may even remain asymptomatic till later decades of their life. We report a case of a 42-year-old man who presented at neurosurgery department with dizziness, seizures, and loss of consciousness, in whom isolated CCTGA was discovered incidentally. Further investigation depicted right ventricular hypertrophy, mild valvular regurgitation, mildly dilated pulmonary artery, low heart rate with AV dissociation, and third-degree heart block. These indicated for implantation of permanent pacemaker into the patient. The implantation of VVI mode pacemaker was uneventful and the patient is being followed up in the past eight months in favorable condition.
- Incidence, Predictors, and Outcomes of High-Grade Atrioventricular Block in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (from the HORIZONS-AMI Trial). [Journal Article]
- AJAm J Cardiol 2017 May 01; 119(9):1295-1301
- High-grade atrioventricular block (HAVB) is historically considered a marker of worse outcomes in patients with ST-segment elevation myocardial infarction (STEMI). However, the predictors and prognos...
High-grade atrioventricular block (HAVB) is historically considered a marker of worse outcomes in patients with ST-segment elevation myocardial infarction (STEMI). However, the predictors and prognostic impact of HAVB in the primary percutaneous coronary intervention (PCI) era remain poorly understood. We sought to describe the characteristics and predictors of HAVB in patients undergoing primary PCI in STEMI and to assess the prognostic significance of HAVB in the contemporary reperfusion era. The present analysis includes 3,115 patients presenting with STEMI from the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trial who underwent primary PCI. Outcomes were examined according to the presence of HAVB on a presenting electrocardiogram, as interpreted by an independent electrocardiography core laboratory. HAVB (second-degree Mobitz II or third-degree atrioventricular block) was present at baseline in 46 patients (1.5%). Independent predictors of HAVB included increased age, diabetes mellitus, right coronary artery occlusion, sum of ST-segment deviation, and baseline Thrombolysis In Myocardial Infarction flow 0/1. Thrombolysis In Myocardial Infarction flow 3 was restored in 83.7% and 91.5% of patients with versus without baseline HAVB respectively (p = 0.06). Mortality rate was significantly higher in patients with versus without HAVB at 30-day, 1-, and 3-year follow-ups (unadjusted hazard ratio [HR] 3.83, 95% CI 1.40 to 10.48; unadjusted HR 4.37, 95% CI 2.09 to 9.38 and unadjusted HR 2.78, 95% CI 1.31 to 5.91, respectively). After covariate adjustment, mortality rate was significantly higher in patients with HAVB at 1 year (adjusted HR 2.45, 95% CI 1.09 to 5.50, p = 0.03) but not at 30 days (adjusted HR 1.70, 95% CI 0.58 to 5.01, p = 0.33) or 3 years (adjusted HR 0.71 to 3.41, p = 0.27). In conclusion, HAVB is a rare complication of STEMI but remains associated with increased mortality, even after primary PCI.
- Cardiovascular Disease Update: Bradyarrhythmias. [Journal Article]
- FEFP Essent 2017; 454:18-23
- Bradyarrhythmia (bradycardia) is a heart rate lower than 60 beats/min. It can be due to sinus, atrial, or junctional bradycardia or to a problem with the conduction system (eg, an atrioventricular bl...
Bradyarrhythmia (bradycardia) is a heart rate lower than 60 beats/min. It can be due to sinus, atrial, or junctional bradycardia or to a problem with the conduction system (eg, an atrioventricular block). Asymptomatic bradycardia is common, especially among trained athletes or during sleep. Bradycardia symptoms can include syncope, dizziness, chest pain, dyspnea, or fatigue. It is important to determine during the evaluation if bradycardia is the cause of the patient's symptoms. In the acute setting, symptomatic patients should be treated with atropine. Percutaneous pacing can be used as a bridge to definitive treatment. The only therapy for persistent bradycardia is placement of a permanent pacemaker. Symptomatic patients with sick sinus syndrome and high second- or third-degree atrioventricular blocks require placement of permanent pacemakers.
New Search Next
- Third-degree atrioventricular block: tip of the iceberg of a systemic disease. [Journal Article]
- EHEur Heart J 2017 Feb 14