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Electrical storm (ES) is a life-threatening arrhythmia complication affecting patients treated with an implantable cardioverter defibrillator (ICD). Despite its increasing importance, existing data on prognosis and management of ICD patients affected by ES are limited and conflicting.We prospectively studied 169 consecutive patients receiving an ICD. Thirty-two patients presented with at least one...
The reentry circuit of idiopathic left ventricular tachycardia (ILVT) has been demonstrated to be confined to the left posterior Purkinje network. We hypothesized that mapping and linear ablation of the left posterior fascicle (LPF) during sinus rhythm guided by non-contact mapping can effectively modify the arrhythmogenic substrate in patients with ILVT and abolish the tachycardia.Six patients with...
Increased ECG QRS duration (QRSd) in patients with dilated cardiomyopathy (DCM) or heart failure (HF) is a well-known phenomenon. The QRSd is not a static ECG measurement but shows fluctuations, and its recent inclusion among the parameters used in referring patients for implantable cardioverter/defibrillators (ICDs) or cardiac resynchronization therapy (CRT) has led to renewed interest in its natural...
This study is a single centre long-term experience on a consecutive cohort of patients with paroxysmal or persistent atrial fibrillation (AF) undergoing electrical disconnection of pulmonary veins (PVs) by means of catheter ablation. Long-term outcome was analyzed in relation to acute procedure success and to the clinical presentation.Two hundred and thirty-four patients (182 males, mean age 55.9±10...
The purpose of this prospective randomized study was to investigate the efficacy of atrial overdrive pacing (AOP) and bradycardia prevention pacing (BPP) in the prophylaxis of atrial fibrillation (AF) after coronary artery bypass surgery (CABG).One hundred and twenty-four on-pump CABG patients were randomized into three groups: AOP, BPP, and NP (no pacing). AOP patients were paced via epicardial wires...
The hypothesis was that there is more undetected dysfunction of implanted pacemaker systems than that detected and corrected. This prompted a research project (sponsored by the German Research Foundation) to detect pacemaker abnormalities and evaluate their complications for patients, thus, proving or disproving the hypothesis.Four hundred and fifteen pacemakers of deceased patients were analyzed...
In more than 95% of patients with atrioventricular nodal reentrant tachycardia (AVNRT), curative treatment can be achieved with selective ablation of the slow pathway in the right-sided septum. We report a patient with typical AVNRT who had failed attempts to perform conventional right septal ablation of the slow as well as of the fast pathway and finally underwent successful ablation of the fast...
Surgical treatment of atrial fibrillation recently gained new popularity since the introduction of different energy sources for ablative therapy as an alternative to the original “cut-and-sew” techniques. However, most of the cases have been performed together with other cardiac surgical procedures and mainly through a standard median sternotomy approach. We report here the first European case of...
Patients with heart failure and sinus rhythm undergoing cardiac resynchronization therapy (CRT) require the proper detection of atrial signals and reliable atrial pacing for AV-synchronous ventricular pacing. The study aim was to compare atrial pacing and sensing characteristics in patients with transvenous CRT and patients with standard pacing indications.The study group consisted of 31 heart failure...
To study the prevalence, characteristics and natural course of inappropriate sinus tachycardia (IST).The prevalence and characteristics of IST were evaluated in a random sample of 604 middle-aged subjects. Seven of the subjects (1.16%) fulfilled the contemporary diagnostic criteria of IST. The systolic (147±11mmHg vs. 130±13mmHg, P<0.001) and diastolic ambulatory blood pressures (92±7mmHg vs. 81±8mmHg,...
Two cases are reported of inappropriate implantable cardioverter–defibrillator shocks due to external alternating current leak. Electromagnetic interference (EMI) can mimic cardiac signals and cause inappropriate implantable cardioverter–defibrillator (ICD) shocks. EMI can arise from the normal functioning of electrical appliances or from alternating current leak. The two cases had inappropriate ICD...
Onset and termination of atrial fibrillation are often associated with abrupt changes in heart rate. Presence and time-course of delayed adaptation of the QT/QTc interval are unknown, but a temporary “mismatch” between rate and the QT interval may enhance the risk of proarrhythmia.In a prospective two-part study, time-course of adaptation of ventricular repolarization after abrupt changes in heart...
Cardiac conduction disease (CCD) is a serious disorder of the heart. The pathophysiological mechanisms underlying CCD are diverse. In the last decade the genes responsible for several inherited cardiac diseases associated with CCD have been identified. If CCD is of an inherited nature (ICCD), its underlying mechanism can be either structural, functional or there can be overlap between these two mechanisms...
A case of a young woman with multiple exercise induced syncopal episodes due to arrhythmogenic right ventricular dysplasia is described. The report emphasizes the importance of exercise induced syncope and the management is described.
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