Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Oct 2012
Transseptal left ventricular lead placement using snare technique.
Coronary sinus (CS) lead placement for cardiac resynchronization therapy has a failure rate of ∼5-10%. Here we describe a way of implanting an endocardial left ventricular (LV) lead via a transseptal puncture (TSP), using a GooseNeck snare and active fixation lead. ⋯ The use of a GooseNeck snare via a deflectable transseptal sheath represents a reliable alternative method for endocardial LV lead placement in patients with failed CS LV lead implantation.
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Pacing Clin Electrophysiol · Aug 2012
Review Case ReportsIsolated tramadol overdose associated with Brugada ECG pattern.
Tramadol is a commonly prescribed synthetic opioid analgesic. In humans, electrocardiogram (ECG) changes consistent with sodium-channel blockade have not been described in overdoses with tramadol. ⋯ However, in vitro blockade of sodium-channels has been demonstrated with high concentrations of tramadol. Tramadol overdose should be recognized as a cause for the manifestation of a Brugada ECG pattern in the setting of suicidal intoxication.
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Pacing Clin Electrophysiol · Aug 2012
Case ReportsMarked QT prolongation and ventricular tachycardia of a transient nature in young children with cardiomyopathy.
Significant prolongation of the QT interval in pediatric patients with cardiomyopathy is rare. We report two cases of dilated myopathy with transient and dramatic QT prolongation. Both had associated ventricular arrhythmias, with one having torsade de pointes, and the other nonsustained ventricular tachycardia. Normalization of their QTc occurred as their ventricular function improved.
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Pacing Clin Electrophysiol · Aug 2012
Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are prolonged in patients with moderate and severe obstructive sleep apnea.
Prolongation of the peak and the end of T wave (Tp-e) has been reported to be associated with ventricular arrhythmias. Tp-e/QT ratio and Tp-e/QTc ratio are used as an index of ventricular arrhythmogenesis. An increased incidence of ventricular arrhythmias has been reported in patients with obstructive sleep apnea (OSA). The aim of this study was to assess ventricular repolarization in patients with OSA by using Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. ⋯ Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are prolonged in patients with moderate and severe OSA patients. There is a positive correlation between the presence of OSA and Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.
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Pacing Clin Electrophysiol · Jul 2012
Case ReportsImprovised transvenous cardiac pacing during Operation Enduring Freedom.
We report a case of combat cardiology at a military medical facility in Afghanistan. The patient had a high-degree heart block following inferior ST-elevation myocardial infarction requiring cardiac pacing. ⋯ An available transvenous pacing wire was soldered to leads from transcutaneous pacing pads allowing effective in-flight cardiac pacing until definitive therapy was available. This case demonstrates use of available resources under austere conditions, has the potential to inform physicians in similar circumstance, and addresses an area of need at military medical facilities.