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Anatomy for right ventricular lead implantation
AbstractTo understand the position of a  pacing lead in the right ventricle and to correctly interpret fluoroscopy and intracardiac signals, good anatomical knowledge is required. The right ventricle can be separated into an inlet, an outlet, and an apical compartment. The inlet and outlet are separated by the septomarginal trabeculae, w hile the apex is situated below the moderator band. A lead position in the right ventricular apex is less desirable, last but not least due to the thin myocardial wall. Many leads supposed to be implanted in the apex are in fact fixed rather within the trabeculae in the inlet, which are ...
Source: Herzschrittmachertherapie und Elektrophysiologie - June 28, 2022 Category: Cardiology Source Type: research

Reversible high-grade atrioventricular block with septal myocardial edema in Lyme carditis
AbstractA  34-year-old road builder was admitted to the authors’ emergency department due to progressive dyspnoea that had been present for 6 days. The patient had a history of excessive smoking (60 cigarettes/day). The medical history was otherwise unremarkable. A transient rash had occurred during wo rk 2 weeks previously. The patient could not remember a bite. The electrocardiogram showed 2:1 atrioventricular (AV) block with narrow QRS complexes. D‑dimer and C‑reactive protein were slightly elevated; all other laboratory findings were within normal range. Echocardiography revealed normal findings. ELISA and...
Source: Herzschrittmachertherapie und Elektrophysiologie - June 23, 2022 Category: Cardiology Source Type: research

Erratum zu: EKG-Diagnostik mit Hilfe k ünstlicher Intelligenz: aktueller Stand und zukünftige Perspektiven – Teil 2
(Source: Herzschrittmachertherapie und Elektrophysiologie)
Source: Herzschrittmachertherapie und Elektrophysiologie - June 2, 2022 Category: Cardiology Source Type: research

EKG-Diagnostik mithilfe k ünstlicher Intelligenz: aktueller Stand und zukünftige Perspektiven – Teil 1
ZusammenfassungAuch wenn die Elektrokardiographie mittlerweile ein über 100 Jahre altes diagnostisches Verfahren ist, kann die Medizin auf sie nicht verzichten. Ganz im Gegenteil, das Interesse am Elektrokardiogramm (EKG) und seine klinische Bedeutung nehmen derzeit sogar wieder zu. Dies hat nicht nur mit einer Fülle von neuen Erkenntnissen zu der elektrokardiog raphischen Manifestation alter und neuer kardiovaskulärer Pathologien zu tun, sondern auch damit, dass das EKG vermehrt Gegenstand von Analysen ist, die sich künstlicher Intelligenz (KI) bedienen. Die Schwächen, die der klassischen computerassistierten EKG-Au...
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research

Anatomy for atrial lead implantation
AbstractPositioning and fixation of pacemaker leads in the right atrium depends on advanced anatomic knowledge in order to correctly interpret information from fluoroscopy and electrograms. Particularly the inability to reach a  certain position or to achieve lead stability requires familiarity with right atrial structures such as the Eustachian ridge or areas of trabeculated versus smooth myocardium. Only a good understanding of right atrial anatomy makes it possible to replace electrophysiologically suboptimal atrial p acing sites such as right atrial appendage or high lateral wall by electrophysiologically better sept...
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research

Anatomy of the coronary sinus with regard to cardiac resynchronization therapy implantation
AbstractKnowledge of the coronary sinus (CS) anatomy is crucial for implantation of cardiac resynchronization therapy (CRT). Obstacles to CS entry, such as the Eustachian ridge and Thebesian valve, as well as within the CS, such as Vieussen ’s valve and the vein of Marshall, are important to understand and differentiate during implantation or to identify earlier by imaging. Anatomic knowledge is mandatory to select the most suitable side branch for lead implantation. Modern tools and techniques almost always enable other anatomic pro blems, such as tortuous, small, short, or overly straight side branches, to also be over...
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research

Anatomy for ablation of atrioventricular nodal reentry tachycardia and accessory pathways
AbstractThe atrioventricular (AV) valve plane and the central septum are of particular importance for electrophysiological diagnosis and interventional therapy of supraventricular tachycardias because accessory electrical connections of various types may be present in addition to the specific conduction system. Although modern 3D electroanatomic reconstruction systems including high-density mapping can be of great assistance, detailed knowledge of the anatomic structures involved, their complex three-dimensional arrangement, and their electrical properties in conjunction with electrophysiological features of supraventricul...
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research

How to: Basics der Schrittmacherprogrammierung
ZusammenfassungDie Programmierung von Schrittmachersystemen, insbesondere von Zweikammerschrittmachersystemen kann die untersuchenden Ärzte vor große Herausforderungen stellen. Eine genaue Kenntnis der zu programmierenden Parameter sowie der herstellerspezifischen Algorithmen ist essentiell. Bei der Programmierung sollte darauf geachtet werden, die Programmierung den individuellen Bedürfnissen der Patient:innen anzupassen und „ Out-of-the-box“-Programmierungen zu vermeiden. Ein weiteres wichtiges Ziel der Programmierung ist es, unnötige Stimulation im rechten Ventrikel zu vermeiden und dem Patienten eine gute Belas...
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research

Neuigkeiten aus der Young EP
(Source: Herzschrittmachertherapie und Elektrophysiologie)
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research

What can anatomy teach the electrophysiologist for diagnostic procedures?
AbstractEven for a  basic study, the electrophysiologist needs to have a clear mental picture of cardiac anatomy when positioning the diagnostic catheters. This review highlights some of the features of the four cardiac chambers relevant for translating anatomic knowledge into an understanding of fluoroscopy images and electrograms. Integration of images from real cardiac anatomy into three-dimensional mapping based on electrograms and “virtual” anatomy is crucial for the success and safety of diagnostic and therapeutic electrophysiological procedures. (Source: Herzschrittmachertherapie und Elektrophysiologie)
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research

Mitteilungen aus der Arbeitsgruppe Elektrophysiologie und Rhythmologie (AGEP)
(Source: Herzschrittmachertherapie und Elektrophysiologie)
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research

Was passiert in der kardialen Anatomie?
(Source: Herzschrittmachertherapie und Elektrophysiologie)
Source: Herzschrittmachertherapie und Elektrophysiologie - June 1, 2022 Category: Cardiology Source Type: research