Far-Field Atrial Sensing by the Left Ventricular Channel of a Biventricular Device

2014 ◽  
Vol 37 (12) ◽  
pp. 1624-1629 ◽  
Author(s):  
S. SERGE BAROLD ◽  
ANDREAS KUCHER
Keyword(s):  
Left Ventricular ◽  
Far Field ◽  
Atrial Sensing

Unusual Cause of Far-Field Atrial Sensing by the Ventricular Lead of a Dual Chamber Defibrillator. What is the Mechanism?

2012 ◽  
Vol 36 (4) ◽  
pp. 501-504
Author(s):  
S. SERGE BAROLD ◽  
ANDREAS KUCHER ◽  
FREDERIC VAN HEUVERSWYN ◽  
LIESBETH TIMMERS ◽  
ROLAND X. STROOBANDT
Keyword(s):  
Far Field ◽  
Dual Chamber ◽  
Ventricular Lead ◽  
Dual Chamber Defibrillator ◽  
Atrial Sensing

Is Atrial Sensing of Ventricular Far-Field Signals Important in Single-Lead VDD Pacing?

1998 ◽  
Vol 21 (11) ◽  
pp. 2236-2239 ◽  
Author(s):  
BERND NOWAK ◽  
BERTHOLD KRAMM ◽  
HEIKE SCHWAIER ◽  
AILAITI MAIMAITIMING ◽  
STEPHANIE GEIL ◽  
...  
Keyword(s):  
Far Field ◽  
Atrial Sensing

scholarly journals Heart rhythm model for the simulation of electric fields in transesophageal atrial pacing and cardiac resynchronization therapy

2018 ◽  
Vol 4 (1) ◽  
pp. 443-445
Author(s):  
Kerem Göküs ◽  
Matthias Heinke ◽  
Johannes Hörth
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Heart Rhythm ◽  
Left Ventricular ◽  
Right Atrial ◽  
Cardiac Resynchronization ◽  
Electrode Position ◽  
Atrial Pacing ◽  
Far Field ◽  
Resynchronization Therapy ◽  
Rv Pacing

AbstractElectric field of biventricular (BV) pacing, left ventricular (LV) electrode position and electrical interventricular desynchronization are important parameters for successful cardiac resynchronization therapy (CRT) in patients with heart failure, sinus rhythm and reduced LV ejection fraction. The aim of the study was to evaluate electric pacing field of transesophageal left atrial (LA) pacing and BV pacing with 3D heart rhythm simulation. Bipolar right atrial (RA), right ventricular (RV), LV electrodes and multipolar hemispherical esophageal LA electrodes were modeled with CST (Computer Simulation Technology, Darmstadt). Electric pacing field were simulated with bipolar RA and RV pacing with Solid S (Biotronik) electrode, bipolar LV pacing with Attain 4194 (Medtronic) electrode and bipolar LA pacing with TO8 (Osypka) esophageal electrode. 3D heart rhythm model with esophagus allowed electric pacing field simulation of 4-chamber pacing with bipolar intracardiac RA, RV, LV pacing and bipolar transesophageal LA pacing. The pacing amplitudes were 3V RA pacing amplitude, 50V LA pacing amplitude, 1.5V RV pacing amplitude and 3V LV pacing amplitude with 0.5ms pacing pulse duration. The atrioventricular delay between RA pacing and BV pacing was 140ms atrioventricular pacing delay and simultaneous RV and LV pacing. Electric pacing fields were simulated during the different pacing modes AAI, VVI, DDD and DDD0V. The intracardiac far-field pacing potentials were evaluated with intracardiac electrodes and a distance of 1mm from the electrodes with RA electrode 1.104V, RV electrode 0.703V and LV electrode 1.32V. The transesophageal far-field pacing potential was evaluated with transesophageal electrode and a distance of 10mm from the elelctrode with LA electrode 6.076V. Heart rhythm model simulation with esophagus allows evaluation of electric pacing fields in AAI, VVI, DDD, DDD0V and DDD0D pacing modes. Electric pacing field of RA, RV and LV pacing in combination with LA pacing may additional useful pacing mode in CRT non-responders.

Abstract 12974: Successful VT Ablation Utilising Intracoronary Gelatin Sponge Injection

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Eugene M Gan ◽  
Paul C Lim ◽  
Kelvin C Chua ◽  
Eric T Lim ◽  
Daniel T Chong ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Left Ventricular ◽  
Gelatin Sponge ◽  
Far Field ◽  
Exit Site ◽  
Circumflex Artery ◽  
Ventricular Assist ◽  
Left Circumflex Artery ◽  
Vt Ablation ◽  
Epicardial Access

Introduction: We report two cases of recurrent ventricular tachycardia (VT) successfully treated by intra-coronary Gelatin sponge embolization where initial endocardial ablation was unsuccessful and epicardial approaches were unfavourable. Case Histories: (1) A 75-year-old male with Inferior STEMI who underwent PCI to oRPDA developed VT storm that required DCCV 11 times. The VT was hemodynamically unstable, hence only substrate modification was performed. He still had recurrent episodes of VT and a second ablation attempt localised VT circuit breakout to the infero-apical septum, but ablation was unsuccessful due to a deep intramural circuit. Epicardial ablation was not attempted due to a 1cm pericardial effusion after the first procedure. Unipolar signals from selective wiring of the distal rPDA with a percutaneous coronary intervention guidewire and microcatheter showed early local electrograms. 5ml of Gelatin sponge injection was injected after a 5x2mm coil failed to occlude the distal rPDA. Post occlusion, VT was not inducible with double ventricular extra-stimuli. He has been VT free for 5 months (2) A 41-year-old female with dilated cardiomyopathy, previous left ventricular assist device and revision was admitted for VT storm. The VT map identified earliest activation with far-field pre-systolic potentials at the baso-lateral LV segment. Pre-systolic far field ventricular EGMs were also seen in the adjacent coronary sinus, consistent with a likely epicardial exit site of the VT. Endocardial ablation failed, and epicardial access was not feasible due to adhesions. Coronary angiography revealed a small calibre non dominant left circumflex artery supplying the VT exit site. Cold saline injection down the mLCX terminated the VT and the vessel was occluded with 5 ml of Gelatin sponge. VT was subsequently not inducible. Discussion & Conclusion: Critical portions of VT circuits may course epicardially or intramurally 3 , limiting successful endocardial catheter ablation. Epicardial access was risky. Coronary vessel embolization using coils 4 and ethanol 5 have been performed. Use of absorbable Gelatin sponge has been described in managing coronary perforation 6 , but to the best of our knowledge these are the first cases of its use in VT ablation.

Mitochondria in Cardiomyopathy: Alterations in Size, Number and Internal Structures

1968 ◽  
Vol 26 ◽  
pp. 126-127
Author(s):  
George Hug ◽  
William K. Schubert
Keyword(s):  
Heart Failure ◽  
Biochemical Analysis ◽  
Left Ventricular ◽  
Size Number ◽  
Internal Structures ◽  
Left Ventricular Outflow ◽  
Chest X Ray ◽  
Myocardial Fibers ◽  
Muscle Biopsies ◽  
Needle Liver Biopsy

A white boy six months of age was hospitalized with respiratory distress and congestive heart failure. Control of the heart failure was achieved but marked cardiomegaly, moderate hepatomegaly, and minimal muscular weakness persisted.At birth a chest x-ray had been taken because of rapid breathing and jaundice and showed the heart to be of normal size. Clinical studies included: EKG which showed biventricular hypertrophy, needle liver biopsy which showed toxic hepatitis, and cardiac catheterization which showed no obstruction to left ventricular outflow. Liver and muscle biopsies revealed no biochemical or histological evidence of type II glycogexiosis (Pompe's disease). At thoracotomy, 14 milligrams of left ventricular muscle were removed. Total phosphorylase activity in the biopsy specimen was normal by biochemical analysis as was the degree of phosphorylase activation. By light microscopy, vacuoles and fine granules were seen in practically all myocardial fibers. The fibers were not hypertrophic. The endocardium was not thickened excluding endocardial fibroelastosis. Based on these findings, the diagnosis of idiopathic non-obstructive cardiomyopathy was made.

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