Heart rhythm : the official journal of the Heart Rhythm Society
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Comparative Study
Class I recall of defibrillator leads: a comparison of the Sprint Fidelis and Riata families.
In recent years, 2 popular implantable cardioverter-defibrillator (ICD) leads have undergone a class I recall by the Food and Drug Administration (FDA): the Sprint Fidelis and the Riata leads. ⋯ In this study, a comparative analysis of the failure-free survival of 2 recalled leads demonstrates discrepancies in the timing of the recall despite comparable failure-free survival patterns leading to the recall. The causes of these discrepancies are unclear and raise questions regarding the consistency of postmarketing surveillance and manufacturers' reporting of malfunctions of medical devices.
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Pacemaker-dependent patients with device infection require temporary pacing while the infection is treated. External transthoracic pacing is painful and variably effective, while temporary pacing leads are susceptible to superinfection. ⋯ The right-sided delivery of K(AAA) + H2 to the AV junctional region provided physiologically relevant biological pacing over a 14-day period. Our approach may provide temporary, bridge-to-device pacing for the effective clearance of infection prior to the reimplantation of a definitive electronic pacemaker.
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Case Reports
Refractory inappropriate sinus tachycardia successfully treated with radiofrequency ablation at the arcuate ridge.
Supraventricular tachycardias similar to sinus rhythm are difficult to evaluate and treat with catheter ablation. In addition to inappropriate sinus tachycardia (IST), curative ablation of atrial tachycardia arising from the crista terminalis is well described. We report the case of a 48-year-old woman with multiple failed ablation attempts for IST successfully ablated on the arcuate ridge. Ultrasound and fluoroscopy-guided mapping and ablation of this specific endocavitary anatomic site may be helpful in certain patients with the diagnosis of IST.
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An early repolarization (ER) pattern is common in ECGs from patients with ventricular fibrillation (VF). These patients with ER have shorter QT intervals. Morphological variants of the ER pattern also have been associated with idiopathic VF, but their prevalence in healthy subjects is unclear. ⋯ ER and all of its variants are common in healthy young males with slower heart rates and slightly shorter QTc intervals. A short QT interval (QTcF <350 ms) is rare.
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For years early repolarization (ER) has been considered as a benign electrocardiographic finding. However, recent reports show that ER is associated with a higher incidence of ventricular fibrillation (VF) and sudden cardiac death in patients without structural heart disease. Sporadic case studies have pointed out that ER might be related to an adverse outcome in patients with stable coronary artery disease. ⋯ Early repolarization pattern seems to be associated with ventricular tachyarrhythmias in the setting of acute myocardial infarction.