Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Oct 2018
Case ReportsIvabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia-induced cardiomyopathy during infancy: Case studies.
Junctional ectopic tachycardia (JET) is a rare form of arrhythmia that is most commonly seen during infancy. JET is continuous and incessant, characterized by persistently high heart rates that may result in impaired cardiac function and tachycardia-induced cardiomyopathy. Despite the availability of multiple antiarrhythmic treatments, including flecainide and amiodarone, management of JET is generally very difficult. ⋯ No cardiac or other side effects were observed during ivabradine treatment, and left ventricular functions and rhythms improved within 24 hours. These three cases therefore provide hope that ivabradine may be a suitable standard initial treatment for congenital JET. However, additional research is needed to confirm the validity of these results in other circumstances.
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Pacing Clin Electrophysiol · Sep 2018
Coexistence of atrioventricular accessory pathways and drug-induced type 1 Brugada pattern.
Atrial arrhythmias, particularly atrioventricular nodal reentrant tachycardia, can coexist with drug-induced type 1 Brugada electrocardiogram (ECG) pattern (DI-Type1-BrP). The present study was designed to determine the prevalence of DI-Type1-BrP in patients with atrioventricular accessory pathways (AV-APs) and to investigate the clinical, electrocardiographic, electrophysiologic, and genetic characteristics of these patients. ⋯ DI-Type1-BrP is relatively common in patients with AV-APs. We identify 12-lead ECG characteristics during preexcitation and orthodromic AVRT that point to an underlying type1-BrP, portending an increased probability for development of malignant arrhythmias.
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Pacing Clin Electrophysiol · Sep 2018
QT correction across the heart rate spectrum, in atrial fibrillation and ventricular conduction defects.
Incorporation of QTc in clinical decision support systems requires accurate QT-interval correction, also during common electrocardiogram abnormalities as ventricular conduction defects (VCD). We compared the performance and predictive value of QT correction formulas to design a patient-specific QT correction algorithm (QTcA). ⋯ A patient-specific QT correction algorithm would combine accurate heart rate correction, improved predictive value of mortality, and a reduction of patients considered to be at risk.
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Pacing Clin Electrophysiol · Jan 2018
Pulmonary vein isolation with real-time pulmonary vein potential recording using second-generation cryoballoon: Procedural and biophysical predictors of acute pulmonary vein reconnection.
The study sought to evaluate the procedural and biophysical factors related to acute pulmonary vein isolation (PVI) guided by real-time pulmonary vein (PV) potential recordings. ⋯ The ablation using CB2 is effective in achieving acute PVI. Real-time assessment of PVI could be achieved during CB application in 86% of PVs. The incidence of spontaneous PV reconnection is very low, observed in just 3% of isolated PVs. TTI ≤ 65 seconds and TCI ≤ 119 seconds predicted absence of acute PV reconnection. Although they may identify effective cryoapplications in the acute phase, their performance still needs to be verified in the long term.
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Pacing Clin Electrophysiol · Jan 2018
Automated QT analysis on Holter monitors in pediatric patients can differentiate long QT syndrome from controls.
Borderline QTc is a common referral to the pediatric cardiology clinic. Evaluation is challenging due to significant overlap of normal and abnormal QTc ranges. We hypothesized that automated QT analysis on Holter could differentiate between patients with long QT syndrome (LQTS) and healthy controls. ⋯ Holter monitor testing with automated QT analysis may be a useful tool to differentiate LQTS and control patients.