Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
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Identification of atypical atrial flutter (AFL) (non-cavo-tricuspid isthmus-dependent) prior to the electrophysiology laboratory is potentially useful because it allows appropriate procedural planning and enables discussion of the likely success rates and risks of the procedure with the patient. Typical counterclockwise AFL has a stereotypic appearance, the electrocardiogram (ECG) is predictive of the diagnosis in the majority of cases, and ablation procedures are associated with a high degree of safety and success. ⋯ Targeting these complex and often multiple re-entrant circuits is aided by expertise and use of electroanatomic mapping systems. This review will address whether there are clues from the 12-lead ECG which assist in the localization of AFL circuits.
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Comparative Study
Atrial vs. dual-chamber cardiac pacing in sinus node disease: a register-based cohort study.
In patients with sinus node disease, dual-chamber pacing (DDD) possibly results in adverse effects on the ventricular function. We have compared the incidence of cardiovascular morbidity and mortality in patients with sinus node disease and with atrioventricular (AV) synchronous pacemakers, DDD vs. atrial pacing (AAI). ⋯ Our results support AAI as the preferred mode of pacing in patients with sinus node disease, and a normal AV node function.
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Case Reports
Fatal left internal mammary artery graft to subclavian vein fistula complicating dual-chamber pacemaker implantation.
We describe the case of a 75-year-old woman with an iatrogenic fistula between a left internal mammary artery graft to the left anterior descending coronary artery and the left subclavian vein that developed after implantation of a dual-chamber pacemaker.
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The aim of this study is to evaluate the long-term prognosis in infants affected by paroxysmal reciprocating supraventricular tachycardia (SVT), to identify predictors of SVT disappearance, and to assess the efficacy of electrophysiologically guided drug therapy in preventing recurrences. ⋯ Supraventricular tachycardia disappeared in approximately 50% of the patients during the first year of life and in another 20% thereafter. The necessity for A treatment is the only predictor of persistence of the re-entry circuit during the first year of life. Transesophageal atrial pacing is useful in guiding the medical treatment.
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Follow-up of implantable cardioverter defibrillator (ICD) patients, with regular in-office visits every 3-6 months, puts a significant burden on specialized electrophysiology clinics. New technology allows for remote monitoring of device function. We wanted to investigate its potential reliability and to which extent its use can reduce in-office visits. ⋯ ICD remote monitoring can potentially diagnose >99.5% of arrhythmia- or device-related problems if combined with clinical follow-up by the local general practitioner and/or referring cardiologist. It may provide a way to significantly reduce in-office follow-up visits that are a burden for both hospitals and patients.