Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Sep 2007
Comparative StudySpontaneous pulmonary vein firing in man: relationship to tachycardia-pause early afterdepolarizations and triggered arrhythmia in canine pulmonary veins in vitro.
Rapid firing originating within pulmonary veins (PVs) initiates atrial fibrillation (AF). The following studies were performed to evaluate spontaneous PV firing in patients with AF to distinguish focal versus reentrant mechanisms. ⋯ The studies demonstrate (1) tachycardia-pause initiation of rapid, short-coupled PV firing in AF patients and (2) tachycardia-pause facilitation of isometric force, EAD formation, and autonomic-dependent triggered firing within canine PVs, suggestive of a common arrhythmia mechanism.
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J. Cardiovasc. Electrophysiol. · Sep 2007
Comparative StudyClose relationship between the bronchi and pulmonary veins: implications for the prevention of atriobronchial fistula after atrial fibrillation ablation.
Atrio-bronchial fistula (ABF) can be a rare but potentially lethal complication following the catheter ablation of atrial fibrillation (AF). Understanding the extent of the contact between the bronchial tree and pulmonary veins (PVs) is critical to avoid this complication. We investigated the anatomic relationship between the four PVs and bronchial tree using multi-detector computed tomography (MDCT) images. ⋯ Isolation of the superior PVs may carry the potential risk of bronchial damage. The clinical or anatomic characteristics associated with the proximal contact between the bronchi and superior PVs can provide useful information to prevent this complication.
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Sudden death claims 250,000 lives annually in the U. S. The vast majority of such events are due to ventricular fibrillation and ventricular tachycardia. ⋯ Society has embraced these data and legislation has been passed that supports the implementation of PAD programs into communities and protects lay rescuers and organizations implementing these programs from liability. Concerns about cost versus benefit still serve as barriers to widespread implementation of PAD programs, but with the declining cost of AEDs and increased public awareness, many communities have initiated PAD programs. We encourage widespread implementation of PAD programs and enhanced public awareness about basic life support, with the expectation that such efforts will enhance survival of out of hospital cardiac arrest.
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J. Cardiovasc. Electrophysiol. · Aug 2007
Case ReportsTaser-induced rapid ventricular myocardial capture demonstrated by pacemaker intracardiac electrograms.
A Taser weapon is designed to incapacitate violent individuals by causing temporary neuromuscular paralysis due to current application. We report the first case of a Taser application in a person with a dual-chamber pacemaker demonstrating evidence of Taser-induced myocardial capture. ⋯ This report describes the first human case of ventricular myocardial capture at a rapid rate resulting from a Taser application. This raises the issue as to whether conducted energy devices can cause primary myocardial capture or capture only in association with cardiac devices providing a preferential pathway of conduction to the myocardium.