Left ventricular pacing induced polymorphic ventricular tachycardia via the adaptive left ventricle pacing algorithm
Providers should be aware of the possibility of cardiac resynchronization therapy ‐related proarrhythmia which could be life‐threatening. His‐bundle pacing may serve as an alternative, more physiological, option in the management as it preserves the normal sequence of depolarization from the septum to the lateral wall, and from endocardium to epicardium. AbstractProviders should be aware of the possibility of cardiac resynchronization therapy ‐related proarrhythmia which could be life‐threatening. His‐bundle pacing may serve as an alternative, more physiological, option in the management as it preserves the normal sequence of depolarization from the septum to the lateral wall, and from endocardium to epicardium.
CONCLUSIONS: The mortality rate was 6/80 (7.5%), in the twenty-two-year follow-up. The rate of AT vs. IT was almost equal and remained steady in the long observation period. Severe TR might be a serious clinical problem in some patients. Entirely subcutaneous system (S-ICD) for SCD prevention is a feasible and safe therapy in young recipients. PMID: 32631024 [PubMed - as supplied by publisher]
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This study aims to explore the predictive values of both systolic LVMD and diastolic LVMD for CRT in DCM patients.MethodsEighty-four consecutive CRT patients with both DCM and complete left bundle branch block (CLBBB) who received gated resting SPECT MPI at baseline were included in the present study. The phase analysis technique was applied on resting gated short-axis SPECT MPI images to measure systolic LVMD and diastolic LVMD, characterized by phase standard deviation (PSD) and phase histogram bandwidth (PBW). CRT response was defined as ≥ 5% improvement of LVEF at 6-month follow-up. Variables withP
Conclusion: Patients with implantable cardioverter defibrillator/cardiac resynchronization therapy-defibrillator undergoing VT ablation with ICE use had significantly lower likelihood of VT-related readmission. PMID: 32134325 [PubMed - as supplied by publisher]
AbstractIntroductionBy providing real ‐time monitoring of catheter‐tissue interface and for complications, intracardiac echocardiography (ICE) during catheter ablation for ventricular tachycardia (VT) may improve outcomes. To test this hypothesis, we compared 12‐month readmission rates (all‐cause, cardiovascular [CV]‐related, VT‐related), repeat ablation and complications among VT patients with structural heart disease undergoing ablation with versus without ICE.Methods and ResultsUsing the 2008 ‐2017 IBM MarketScan® Commercial and Medicare Supplemental databases, patients with a history of implantable ca...
Why VTs have wide QRS complex? Brief answer: VT usually presents with wide QRS tachycardia because it originates in ventricular myocardium, travels muscle to muscle instead of the normal conduction system. However, VTs need not be wide always, if it captures the conduction system early and more proximally it can be as narrow as SVT. Further reading: Only for cardiology fellows Two empirical statements are made here. (The scientific chances of both being reasonably correct are fair) 80 % of wide QRS tachycardia by default is VT. That means 20 % of wide QRS is not VT. We all accept that. 80 % of narrow QRS tachy...
This article provides a review of the aforementioned mechanisms of arrhythmogenesi s in heart failure; the role and impact of HF therapy such as cardiac resynchronization therapy (CRT), including the role, if any, of CRT-P and CRT-D in preventing VAs; the utility of both non-invasive parameters as well as multiple implant-based parameters for telemonitoring in HF; and the effect o f left ventricular assist device implantation on VAs.
Conclusions: The clinical course of patients with ICM and DCM treated with CRT-D differs significantly during long-term follow-up, with increased mortality and incidence of ICD therapies in ICM patients. PMID: 31360179 [PubMed]
AbstractPurposeTargets for substrate-based catheter ablation of scar-related ventricular tachycardia (VT) include sites with fractionated and late potentials (LPs). We hypothesized that in patients with cardiac resynchronization therapy (CRT), the pacing mode may influence the timing of abnormal electrograms (EGMs) relative to the surface QRS complex.MethodsWe assessed bipolar EGM characteristics in left ventricular low bipolar voltage areas (
Investigations in dilated cardiomyopathy Chest X-ray PA view will assess the cardiac size in dilated cardiomyopathy and show evidence of pulmonary congestion. Sick persons may present with features of frank pulmonary edema in the form of hilar haze or bat wing pattern of pulmonary edema. Significant left ventricular dysfunction can exist without much of cardiomegaly on chest X-ray as well. ECG may show sinus tachycardia, left atrial overload and sometimes left ventricular hypertrophy. A wide QRS complex with left bundle branch block pattern may indicate potential benefit from cardiac resynchronization therapy (CRT). ECG ...