Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Jul 2009
ReviewThe long QT syndrome and catecholaminergic polymorphic ventricular tachycardia.
Thanks to the contribution of molecular genetics, the genetic bases, the pathogenesis and genotype-phenotype correlation of diseases such as the long QT syndrome and catecholaminergic polymorphic ventricular tachycardia have been progressively unveiled and show an extremely high degree of genetic heterogeneity. Data from clinical registries are summarized together with the recommendations provided in clinical practice guidelines for management of patients with these diseases. Furthermore the evidence supporting the importance of genetic analysis for risk stratification and therapy selections is reviewed.
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Pacing Clin Electrophysiol · Jul 2009
Clinical TrialLeft ventricular ejection fraction as criterion for implantation of an implantable cardioverter-defibrillator in heart failure patients undergoing surgical left ventricular reconstruction.
Besides implantation of an implantable cardioverter-defibrillator (ICD), a proportion of patients with left ventricular (LV) dysfunction due to ischemic cardiomyopathy are potential candidates for surgical LV reconstruction (Dor procedure), which changes LV ejection fraction (LVEF) considerably. In these patients, LVEF as selection criterium for ICD implantation may be difficult. This study aimed to determine the value of LVEF as criterium for ICD implantation in heart failure patients undergoing surgical LV reconstruction. ⋯ LVEF before and after surgical LV reconstruction is of limited use as criterium for ICD implantation in patients with end-stage heart failure.
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Pacing Clin Electrophysiol · Jul 2009
Case ReportsMonomorphic ventricular tachycardia caused by electrocautery during pacemaker generator change in a patient with normal left ventricular function.
Pacemaker generator replacement is a simple procedure that is mostly done on outpatient basis. Electrocautery is almost universally used for bleeding control and tissue dissection. Ventricular fibrillation (VF) caused by electrocautery in these procedures is a very uncommon occurrence and an underappreciated possibility with modern day devices. We report a case of monomorphic ventricular tachycardia induced by electrocautery in a patient with normal left ventricular ejection fraction during elective pacemaker generator change.
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Pacing Clin Electrophysiol · Apr 2009
Clinical TrialSafety and imaging quality of MRI in pediatric and adult congenital heart disease patients with pacemakers.
Magnetic resonance imaging (MRI) is a standard of care in evaluating many disease processes. Given concerns about device damage or movement, programming changes, lead heating, inappropriate pacing, and image artifact, MRI is contraindicated in pacemaker patients. Despite this, studies have demonstrated safety and efficacy of MRI in adults with acquired heart disease and endocardial pacing leads. We sought to evaluate MRI use in congenital heart disease (CHD) patients with predominantly epicardial pacing leads. ⋯ Diagnostic quality MRI can be performed safely in nonpacemaker-dependent CHD patients with predominantly epicardial leads. Further studies will define safe practice measures in this population, as well as in CHD patients with pacemaker dependency.
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Pacing Clin Electrophysiol · Mar 2009
Controlled Clinical TrialSleep-disordered breathing in recipients of implantable defibrillators.
To examine the prevalence and clinical significance of sleep-disordered breathing in patients with implantable cardioverter defibrillators (ICD). ⋯ Previously undiagnosed CSA is common in ICD recipients. Severely disordered breathing during sleep was more prevalent among patients with CSA than patients with OSA. This prospective, observational study will examine the long-term clinical significance of sleep-disordered breathing in ICD recipients.