Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · May 2012
Case ReportsTwelve hours of sustained ventricular fibrillation supported by a continuous-flow left ventricular assist device.
Left ventricular assist device (LVAD) therapy improves survival and quality of life by mechanically unloading the left ventricle and maintaining hemodynamics in patients with end-stage heart failure. LVADs can also be lifesaving by maintaining hemodynamics during ventricular arrhythmia. ⋯ As presented here, a continuous-flow LVAD successfully provided hemodynamic support to a patient in sustained ventricular fibrillation for over 12 hours when the internal defibrillator was unable to terminate the arrhythmia. This case demonstrates that continuous-flow LVADs can be lifesaving in the setting of otherwise certain hemodynamic collapse from sustained ventricular fibrillation.
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Pacing Clin Electrophysiol · Apr 2012
Randomized Controlled TrialNear elimination of ventricular pacing in SafeR mode compared to DDD modes: a randomized study of 422 patients.
SafeR performance versus DDD/automatic mode conversion (DDD/AMC) and DDD with a 250-ms atrioventricular (AV) delay (DDD/LD) modes was assessed toward ventricular pacing (Vp) reduction. ⋯ In this selected patient population, SafeR markedly suppressed unnecessary Vp compared with DDD modes.
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Pacing Clin Electrophysiol · Apr 2012
Case ReportsFetal and neonatal presentation of long QT syndrome.
This report describes a fetus presenting with intrauterine tachycardia and hydrops fetalis. Soon after birth the neonate was noted to be in torsades de pointes that responded dramatically to medical management. ⋯ The prognosis is poor when LQTS presents in utero or during the first week of life. However, our infant did well with medical management and has remained free of arrhythmias at follow-up.
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Pacing Clin Electrophysiol · Mar 2012
Case ReportsA case of severe gastroparesis: indigestion and weight loss after catheter ablation of atrial fibrillation.
We describe a patient with gastroparesis after radiofrequency catheter ablation (RFCA) as a result of vagus nerve injury. A 42-year-old man underwent redo-RFCA due to recurrent drug-resistant symptomatic atrial fibrillation. ⋯ He underwent endoscopy during which food material was noticed. In the upper gastrointestinal series, most contrast material still remained in the stomach on the 2-hour delayed images, suggesting delayed gastric emptying time.
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Pacing Clin Electrophysiol · Mar 2012
Pulmonary vein isolation guided by real-time three-dimensional transesophageal echocardiography.
The present case illustrates pulmonary vein isolation guided by real-time three-dimensional transesophageal echocardiography. This imaging modality allowed to navigate in a point-by-point fashion around pulmonary veins to assess both catheter location in relation to pulmonary vein ostia and stability of catheter tip. Also, it offered high-resolution visualization of a thickened, prominent tissue that surrounded the left upper pulmonary vein (the ligament of Marshall). The ability to visualize this anatomical structure along with intracardiac recording of electrical signals allowed to safely modulate in loco radiofrequency energy delivery, thus achieving electrical isolation of the pulmonary vein.