Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Aug 2006
Randomized Controlled TrialClinical experience with tiered atrial therapies and atrial arrhythmia prevention algorithms in a dual chamber cardioverter defibrillator.
The acceptance of atrial arrhythmia features in implantable cardioverter defibrillators (ICDs) will depend on their ability to appropriately discriminate atrial tachyarrhythmias/atrial fibrillation (AT/AF). This study tested the effectiveness of an atrial/ventricular ICD with advanced atrial detection and new algorithms designed to prevent atrial arrhythmias. ⋯ Enhanced atrial detection and discrimination features combined with tiered atrial therapies did not adversely impact the ability of the ICD (Model 1900) to appropriately detect and treat ventricular tachyarrhythmias.
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J. Cardiovasc. Electrophysiol. · Jul 2006
Case ReportsCardiac pacing in a patient with diaphragm pacing for congenital central hypoventilation syndrome (Ondine's curse).
Mechanical ventilation support and diaphragm pacing has improved the prognosis of patients with idiopathic congenital central hypoventilation syndrome (CCHS; Ondine's curse). However, severe bradyarrhythmias may occur. This report is about a patient who was supplied with a bilateral diaphragm pacing system at early childhood. At the age of 17 years, he experienced multiple syncopes due to sinus nodal arrest, which was successfully treated by the implantation of a dual chamber pacemaker.
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J. Cardiovasc. Electrophysiol. · Jun 2006
Comparative StudyThe full stomach test as a novel diagnostic technique for identifying patients at risk of Brugada syndrome.
Autonomic modulation, particularly high vagal tone, plays an important role in the occurrence of ventricular tachyarrhythmias in the Brugada syndrome. Food intake modulates vagal activity. We assessed the usefulness of a novel diagnostic technique, the "full stomach test," for identifying a high-risk group in patients with a Brugada-type electrocardiogram (ECG). ⋯ Characteristic ECG changes diagnostic of Brugada syndrome are augmented by a large meal. These data are associated with a history of life-threatening events in Brugada syndrome.
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J. Cardiovasc. Electrophysiol. · Jun 2006
Case ReportsPersistent inappropriate sinus tachycardia after radiofrequency ablation of left lateral accessory pathway.
A patient with palpitations and narrow QRS tachycardia was evaluated. In the EP study an atrioventricular reentrant tachycardia mediated by a left lateral accessory pathway was identified and catheter ablation was performed with success. ⋯ After unsuccessful clinical treatment with beta-blockers, diltiazem and digoxin she underwent sinus node modification using radiofrequency catheter ablation with success. We postulated that RF application to ablate the lateral accessory pathway damaged the parasympathetic innervation in the left atrioventricular groove, causing inappropriate sinus tachycardia.
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J. Cardiovasc. Electrophysiol. · Jun 2006
Serial cardioversion by class IC Drugs during 4 months of persistent atrial fibrillation in the goat.
The success rate of pharmacological cardioversion of atrial fibrillation (AF) in patients depends on the duration of AF. It is unknown to what extent AF-induced structural atrial remodeling contributes to this loss of efficacy. ⋯ The progressive loss of efficacy of Class IC drugs to cardiovert AF of longer duration is not due to a decrease in the sensitivity of remodeled atrial myocardium for Class IC drugs. Failure of cardioversion was due to an increase in the critical AF cycle length required for pharmacological cardioversion.