- Concealed Accessory Pathways with a Single Ventricular and Two Discrete Atrial Insertion Sites. [Journal Article]
- PCPacing Clin Electrophysiol 2017 Jan 18
- CONCLUSIONS: Concealed retrograde accessory pathways with discrete atrial insertion sites may have a common ventricular insertion site. Identification and ablation of the ventricular insertion site, or the separate discrete atrial insertion sites results in successful treatment. This article is protected by copyright. All rights reserved.
- Junctional Ectopic Tachycardia Localization and Procedural Approach using Cryoablation. [Journal Article]
- PCPacing Clin Electrophysiol 2017 Jan 18
- CONCLUSIONS: In the majority of patients JET can be safely ablated with the use of cryotherapy. Foci not identified in the lower 2/3 of the TOK are associated with longer procedures, more lesions, and decreased chance for long term success. This article is protected by copyright. All rights reserved.
- Increased mitochondrial nanotunneling activity, induced by calcium imbalance, affects intermitochondrial matrix exchanges. [Journal Article]
- PNProc Natl Acad Sci U S A 2017 Jan 17
- Exchanges of matrix contents are essential to the maintenance of mitochondria. Cardiac mitochondrial exchange matrix content in two ways: by direct contact with neighboring mitochondria and over long...
Exchanges of matrix contents are essential to the maintenance of mitochondria. Cardiac mitochondrial exchange matrix content in two ways: by direct contact with neighboring mitochondria and over longer distances. The latter mode is supported by thin tubular protrusions, called nanotunnels, that contact other mitochondria at relatively long distances. Here, we report that cardiac myocytes of heterozygous mice carrying a catecholaminergic polymorphic ventricular tachycardia-linked RyR2 mutation (A4860G) show a unique and unusual mitochondrial response: a significantly increased frequency of nanotunnel extensions. The mutation induces Ca(2+) imbalance by depressing RyR2 channel activity during excitation-contraction coupling, resulting in random bursts of Ca(2+) release probably due to Ca(2+) overload in the sarcoplasmic reticulum. We took advantage of the increased nanotunnel frequency in RyR2(A4860G+/-) cardiomyocytes to investigate and accurately define the ultrastructure of these mitochondrial extensions and to reconstruct the overall 3D distribution of nanotunnels using electron tomography. Additionally, to define the effects of communication via nanotunnels, we evaluated the intermitochondrial exchanges of matrix-targeted soluble fluorescent proteins, mtDsRed and photoactivable mtPA-GFP, in isolated cardiomyocytes by confocal microscopy. A direct comparison between exchanges occurring at short and long distances directly demonstrates that communication via nanotunnels is slower.
- Avoiding Untimely Implantable Cardioverter/Defibrillator Implantation by Intensified Heart Failure Therapy Optimization Supported by the Wearable Cardioverter/Defibrillator-The PROLONG Study. [Journal Article]
- JAJ Am Heart Assoc 2017 Jan 17; 6(1)
- CONCLUSIONS: A relevant proportion of patients with newly diagnosed heart failure shows recovery of LVEF >35% beyond 3 months after initiation of heart failure therapy. To avoid untimely ICD implantation, prolongation of WCD period should be considered in these patients to prevent sudden cardiac death while allowing left ventricular reverse remodeling during intensified drug therapy.
- Utility and safety of the SafeSept™ transseptal guidewire for electrophysiology studies with catheter ablation in pediatric and congenital heart disease. [Journal Article]
- JIJ Interv Card Electrophysiol 2017 Jan 14
- CONCLUSIONS: SSTG is effective for use in atrial transseptal and surgical trans-baffle access in pediatric and congenital heart disease patients. Placement of the SSTG into the pulmonary vein is necessary to avoid major complications, and if not achieved requires additional methods to determine appropriate left atrial placement.
- Prognostic Relevance of Nonsustained Ventricular Tachycardia in Patients with Pulmonary Hypertension. [Journal Article]
- BRBiomed Res Int 2016; 2016:1327265
- Background. Increased pulmonary vascular resistance in patients with pulmonary hypertension (PH) leads to an increased afterload of right heart and cardiac remodeling which could provide the substrat...
Background. Increased pulmonary vascular resistance in patients with pulmonary hypertension (PH) leads to an increased afterload of right heart and cardiac remodeling which could provide the substrate or trigger for arrhythmias. Supraventricular arrhythmias were associated with clinical deterioration but were not associated with sudden cardiac death (SCD). SCD has been reported to account for approximately 30% of deaths in patients with pulmonary arterial hypertension (PAH). Objective. The role of nonsustained ventricular tachycardia (nsVT) and its prognostic relevance in patients with PH remains unclear. This study evaluated the prognostic relevance of nsVT in patients with PAH and chronic thromboembolic pulmonary hypertension (CTEPH). Methods. Retrospectively, patients with PAH and CTEPH who underwent Holter ECG monitoring and available data of survival were investigated. Results. Seventy-eight (PAH: 55, CTEPH: 23) patients were evaluated. Holter ECG revealed nsVT in 12 patients. Twenty-one patients died during follow-up. In patients with nsVT, tricuspid annular plane systolic excursion was lower (p = 0.001), and systolic pulmonary arterial pressure was higher (p = 0.163). Mean survival of patients without/with nsVT was 155.2 ± 8.5/146.4 ± 21.4 months (p = 0.690). The association between arrhythmias and survival was not confounded by age (p = 0.681), gender (p = 0.752), 6-MW distance (p = 0.196), or arterial hypertension (p = 0.238). Conclusions. In patients with PH, nsVT occurs more often than previously reported, and patients with PH group 1 seem to be more at risk.
- Magnetic resonance imaging conditional devices. Luxury or real clinical need? [Review]
- HJHellenic J Cardiol 2017 Jan 09
- Although the risk of MRI scanning on patients with conventional devices is rather lower than initially thought, the patient's safety can only be assured by using MRI-conditional devices. The most imp...
Although the risk of MRI scanning on patients with conventional devices is rather lower than initially thought, the patient's safety can only be assured by using MRI-conditional devices. The most important modifications in MRI-conditional devices include: a) Reduction in ferromagnetic components to reduce magnetic attraction and susceptibility artefacts b) Replacement of reed switch by Hall sensor in order to avoid unpredictable reed switch behaviour c) Lead coil design to minimize lead heating and electrical current induction d) Filter circuitry to prevent damage to internal power supply e) Dedicated pacemaker programming to prevent inappropriate pacemaker inhibition and competing rhythms. Although many companies claim to have MRI-conditional devices, adoption in clinical practice is limited because: a) Not all companies have MRI conditional devices approved for both 1.5 and 3T, b) Not all companies offer the option of unlimited MRI scanning (without exclusion zone in thorax), c) Some companies allow only a 30 min MRI scanning and only in afebrile patients, d) Despite having MRI-conditional pacemakers, some companies do not have MRI-conditional defibrillators and CRT systems. It is clear that this new technology opens the door for MRI to a growing number of patients; however, the widespread adoption of MRI-conditional devices will depend on real life issues such as cost, clinical indications for such a device and permanent education of health care professionals.
- Fascicular Ventricular Arrhythmias: Pathophysiologic Mechanisms, Anatomical Constructs, and Advances in Approaches to Management. [Journal Article]
- CACirc Arrhythm Electrophysiol 2017; 10(1)
- Endoepicardial Ventricular Tachycardia Ablation With a New High-density Non-fluoroscopic Navigation System. [Journal Article]
- RERev Esp Cardiol (Engl Ed) 2017 Jan 10
New Search Next
- Implantable cardioverter-defibrillator implantation for primary and secondary prevention: indications and outcomes. [Journal Article]
- CYCardiol Young 2017; 27(S1):S126-S131
- Implantable cardioverter-defibrillators effectively reduce the rate of sudden cardiac death in children. Significant efforts have been made to better characterise the indications for their placement,...
Implantable cardioverter-defibrillators effectively reduce the rate of sudden cardiac death in children. Significant efforts have been made to better characterise the indications for their placement, and over the past two decades there has been a shift in their use from secondary to primary prevention. Primary prevention includes placement in patients thought to be at high risk of sudden cardiac death before the patient experiences any event. Secondary prevention includes placement after a high-risk event including sustained ventricular tachycardia or resuscitated cardiac arrest. Although liberal device implantation may be appealing even in patients having marginal indications, studies have shown high rates of adverse effects including inappropriate device discharges and the need for re-intervention because of hardware malfunction. The indications for placement of an implantable cardioverter-defibrillator, whether for primary or secondary prevention of sudden cardiac death, vary based on cardiac pathology. This review will assist the provider in understanding the risks and benefits of device implantation in order to enhance the shared decision-making capacity of patients, families, and providers.