Heart rhythm : the official journal of the Heart Rhythm Society
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Patients treated by atrial redirection surgery (Senning or Mustard procedure) for transposition of the great arteries (TGA) have an important risk for heart failure caused by dysfunction of the systemic right ventricle. Conventional nonsystemic ventricular pacing (non-systVP) may even further increase this risk. ⋯ In a population of patients with SenningMustardTGA, acute hemodynamic effects of endocardial systVP and BiVP were significantly and equally better than those of non-systVP. In some patients, systVP and BiVP might even be better than ventricular activation by the intrinsic conduction system.
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Randomized Controlled Trial Multicenter Study
Randomized trial of pacemaker and lead system for safe scanning at 1.5 Tesla.
Magnetic resonance imaging (MRI) of pacemakers is a relative contraindication because of the risks to the patient from potentially hazardous interactions between the MRI and the pacemaker system. Chest scans (ie, cardiac magnetic resonance scans) are of particular importance and higher risk. The previously Food and Drug Administration-approved magnetic resonance conditional system includes positioning restrictions, limiting the powerful utility of MRI. ⋯ This randomized trial demonstrates that the Advisa MRI pulse generator and CapSureFix MRI 5086MRI lead system is safe and effective in the 1.5 T MRI environment without positioning restrictions for MRI scans or limitations of body parts scanned.
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Idiopathic left ventricular tachycardia (ILVT) is a common form of ventricular tachycardia (VT) in structurally normal heart. Different methods have been proposed for radiofrequency ablation (RFA) of ILVT that have good short-term results but recurrence is higher. Termination of tachycardia during RFA and/or noninduciblity has been the procedural end point. ⋯ Distal posterior fascicle and Purkinje-myocardial junction is an effective target site for ILVT ablation. The demonstration of myocardial to fascicle conduction block serves as an important electrophysiological marker of successful ablation and improved long-term success.