Failure of communication and capture: The perils of temporary unipolar pacing system
We present a case of a patient with pacemaker dependence secondary to complete heart block who developed loss of capture of her temporary pacemaker. Patient developed torsades de pointes then ventricular fibrillation, requiring CPR and external cardioversion. After patient was stabilized, it was noticed that loss of capture of pacemaker corresponded with nursing care, when the pulse generator was lifted off patient׳s chest wall, and that patient׳s temporary pacing system had been programmed to unipolar mode without knowledge of attending cardiologist. This case highlights the importance of communication ensuring all care...
Source: Journal of Arrhythmia - December 17, 2014 Category: Cardiology Source Type: research
Usefulness of entrainment mapping using the activation sequence of the last captured excitation in complex dual-loop atrial tachycardia
Conclusions The PPI is obtained from the pacing site only, but the last captured beat could be obtained from all electrodes. It is advantageous to use the information from all available electrode recordings to determine the dynamic relation between complex dual-loop reentrant circuits. (Source: Journal of Arrhythmia)
Source: Journal of Arrhythmia - December 17, 2014 Category: Cardiology Source Type: research
Frequent neurally mediated reflex syncope in a young patient with dextrocardia: Efficacy of catheter ablation of the superior vena cava–aorta ganglionated plexus
We report a case of successful catheter ablation in a 17-year-old male with neurally mediated syncope (NMS) of the cardioinhibitory type. The patient had dextrocardia situs inversus totalis with a mirror-image reversal of the thoracic and abdominal organs. Because he experienced multiple syncope episodes despite pharmacological intervention, we performed endocardial ablation of the superior vena cava–aorta ganglionated plexus. Shortly afterwards, his heart rate increased from 40 to 76 beats per minutes. He has not experienced syncope during the 1-year follow-up. (Source: Journal of Arrhythmia)
Source: Journal of Arrhythmia - December 17, 2014 Category: Cardiology Source Type: research
Demonstration of a hidden interaction between the aortomitral continuity and the conduction system in a case of idiopathic left ventricular outflow tract ventricular tachycardia
We describe a case of idiopathic left ventricular outflow ventricular tachycardia. Monomorphic ventricular arrhythmia (VA) with a right bundle branch block morphology and an inferior axis was induced through exercise or isoproterenol infusion. During VA bigeminy, a spiked presystolic potential (PP) preceding the VA with a qrS pattern in the unipolar electrogram was recorded at the aortomitral continuity (AMC). Radiofrequency catheter ablation eliminated the VA despite the persistence of sinus-PP bigeminy. Furthermore, these PP rates were dependent on the preceding sinus rhythm rates. The present case suggests a hidden inte...
Source: Journal of Arrhythmia - December 17, 2014 Category: Cardiology Source Type: research
Visualization of the radiofrequency lesion after pulmonary vein isolation using delayed enhancement magnetic resonance imaging fused with magnetic resonance angiography
Conclusions DE-MRI fused with MRA was superior to DE-MRI for visualization of the RF lesion owing to the precise information on LA and PV anatomy provided by DE-MRI. (Source: Journal of Arrhythmia)
Source: Journal of Arrhythmia - December 17, 2014 Category: Cardiology Source Type: research
