Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Sep 2007
Clinical TrialAn approach to ablate and pace:AV junction ablation and pacemaker implantation performed concurrently from the same venous access site.
Atrioventricular junction (AVJ) ablation combined with permanent pacemaker implantation (the "ablate and pace" approach) remains an acceptable alternative treatment strategy for symptomatic, drug-refractory atrial fibrillation (AF) with rapid ventricular response. This case series describes the feasibility and safety of catheter ablation of the AVJ via a superior vena caval approach performed during concurrent dual-chamber pacemaker implantation. ⋯ Catheter ablation of the AVJ can be performed successfully and safely via a superior vena caval approach in patients undergoing concurrent dual-chamber pacemaker implantation.
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Pacing Clin Electrophysiol · Aug 2007
Case ReportsBrugada syndrome in the presence of coronary artery disease and parasympathomimetic drug therapy.
Brugada pattern ECG changes have been described in various disease states and drug therapies, including electrolyte abnormalities, myocardial pathology, medications, and mechanical abnormalities. Therefore, the diagnosis of Brugada syndrome cannot be made in the presence of confounding variables according to prevailing guidelines. We present a case report which illustrates two important principles regarding Brugada syndrome, the dynamic ECG manifestations and the elimination of confounding variables (in this case significant coronary artery disease and cholinergic pharmacotherapy) prior to definitive diagnosis.
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Pacing Clin Electrophysiol · Aug 2007
Predictors of a positive response to biventricular pacing in patients with severe heart failure and ventricular conduction delay.
Cardiac resynchronization therapy (CRT) is recommended in patients with ejection fraction <35%, QRS width> 120 ms, and New York Heart Association (NYHA) functional class III or IV despite optimal medical therapy. We aimed to define demographic, clinical, and electrocardiographic predictors of positive clinical response to CRT. ⋯ An idiopathic origin of the cardiomyopathy, a wider QRS before implantation, and a narrowing of the QRS width after implantation were identified as independent predictors of clinical positive response to CRT.
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Pacing Clin Electrophysiol · Jul 2007
Case ReportsResolution of T-wave oversensing with implantable cardioverter defibrillator generator replacement in an adolescent.
Inappropriate delivery of therapy due to T-wave oversensing is a frequent complication of intracardiac cardioverter defibrillators (ICD). A 16-year-old adolescent with congenital long QT syndrome type 3 underwent single-chamber implantable cardioverter defibrillator (ICD) (EnTrust VR, Medtronic Inc., Minneapolis, MN, USA) implantation. ⋯ Following the replacement of ICD with a different brand generator (Vitality 2 VR, Boston Scientific Inc., Natick, MA, USA), no more T-wave oversensing is noted. Proper filtering is imperative in ICDs in order to prevent T-wave oversensing-related inappropriate delivery of therapy.