Initial Experience with Fractionation Mapping in the Identification of Vagal Ganglionated Plexus During Cardioneuroablation

2021 ◽  
Vol 34 (3) ◽  
pp. 105-112
Author(s):  
Fabricio Vassallo ◽  
Edevaldo da Silva ◽  
Lucas Luis Meigre ◽  
Christiano Cunha ◽  
Eduardo Serpa ◽  
...  
Keyword(s):  
Sinus Bradycardia ◽  
Stress Test ◽  
Pacemaker Implantation ◽  
Holter Monitoring ◽  
Initial Experience ◽  
Short Term ◽  
Mapping Software ◽  
Anatomical Basis ◽  
Ganglionated Plexus ◽  
Treadmill Stress Test

This is a series case report of five symptomatic patients presented with diagnosis of sinus bradycardia, first and second degrees atrioventricular (AV) blocks, that were referred to pacemaker implantation. During the screening, a functional cause for the bradycardia and AV blocks were documented by treadmill stress test, 24-hour Holter monitoring and atropine test. After the confirmation of the diagnosis, patients were submitted to cardioneuroablation on an anatomical basis supported by a tridimensional electroanatomical fractionation mapping software. The technique and the acute and short-term results of the cardioneuroablation are described.

High-Resolution Electrocardiography in Twins Affected by Situs Viscerum Specularis: Short Case Report

1987 ◽  
Vol 36 (4) ◽  
pp. 563-564
Author(s):  
S. Villatico Campbell ◽  
F. Di Maio ◽  
M.E. Silvotti ◽  
A. Sciacca ◽  
G. Brenci ◽  
...  
Keyword(s):  
High Resolution ◽  
Cardiovascular System ◽  
Stress Test ◽  
Holter Monitoring ◽  
Electrode Position ◽  
Electrical Field ◽  
Mz Twins ◽  
Treadmill Stress Test ◽  
Cold Pressure ◽  
Cold Pressure Test

We previously studied a pair of MZ twins with situs viscerum inversus of the heart, liver and stomach, concordant with regard to all other factors normally utilized to diagnose zygosity [3]. We have now reexamined them after three years to evaluate the development of their cardiovascular system.Our male MZ twins, now 17 years old, have been examined with high-resolution electrocardiography (HRE), treadmill stress test with Bruce protocol, tests stressing the cardiovascular system (cold pressure test, handgript test, arithmetic mental test), and single and two-dimensional dynamic echocardiography after holter monitoring.Atriogram analysis is made possible by HRE, that shows individual morphological reproducibility. Such reproducibility is present in both twins. In the dextrocardiac twin it is also present with the electrode position inverted. The similarity of morphology in the cotwins is further confirmed, even if such similarity is only apparent, in view of the fact that the vectors are spatially of opposite orientation, thereby causing an inversion of the electrical field [1-4]. The H-V interval is normal, although in the dextrocardiac twin it is longer (30 ms) than in his cotwin (25 ms). As regards the echocardiographic and dynamic ECG examination, normal data were obtained for both twins which were pratically superposable to those obtained three years before.

Pacemaker use for the treatment of reflex-mediated syncope: 40-year experience at a single paediatric institution

2021 ◽  
pp. 1-6
Author(s):  
Thomas Huang ◽  
Edward O’Leary ◽  
Mark E. Alexander ◽  
Laura Bevilacqua ◽  
Francis Fynn-Thompson ◽  
...  
Keyword(s):  
Young Adults ◽  
Atrioventricular Block ◽  
Sinus Bradycardia ◽  
Pacemaker Implantation ◽  
Complication Rates ◽  
Single Centre Experience ◽  
Procedural Complications ◽  
Children And Young Adults ◽  
Dual Chamber Pacemakers

Abstract Introduction: Reflex-mediated syncope occurs in 15% of children and young adults. In rare instances, pacemakers are required to treat syncopal episodes associated with transient sinus pauses or atrioventricular block. This study describes a single centre experience in the use of permanent pacemakers to treat syncope in children and young adults. Materials and methods: Patients with significant pre-syncope or syncope and pacemaker implantation from 1978 to 2018 were reviewed. Data collected included the age of presentation, method of diagnosis, underlying rhythm disturbance, age at implant, type of pacemaker implanted, procedural complications and subsequent symptoms. Results: Fifty patients were identified. Median age at time of the first syncopal episode was 10.2 (range 0.3–20.4) years, with a median implant age of 14.9 (0.9–34.3) years. Significant sinus bradycardia/pauses were the predominant reason for pacemaker implant (54%), followed by high-grade atrioventricular block (30%). Four (8%) patients had both sinus pauses and atrioventricular block documented. The majority of patients had dual-chamber pacemakers implanted (58%), followed by ventricular pacemakers (38%). Median follow-up was 6.7 (0.4–33.0) years. Post-implant, 4 (8%) patients continued to have syncope, 7 (14%) had complete resolution of their symptoms, and the remaining reported a decrease in their pre-syncopal episodes and no further syncope. Twelve (24%) patients had complications, including two infections and eight lead malfunctions. Conclusions: Paediatric patients with reflex-mediated syncope can be treated with pacing. Complication rates are high (24%); as such, permanent pacemakers should be reserved only for those in whom asystole from sinus pauses or atrioventricular block has been well documented.

Permanent pacemaker implantation: our initial experience with Two cases reported

2019 ◽  
Vol 22 (1) ◽  
pp. 38
Author(s):  
IsmailMohammed Inuwa ◽  
Jameel Ahmad ◽  
Ibrahim Aliyu ◽  
Tunde Oyebanji ◽  
NasirAhmad Ishaq ◽  
...  
Keyword(s):  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Initial Experience ◽  
Permanent Pacemaker Implantation

scholarly journals Computerized Cardiotocography Analysis: Comparison among Several Parental Ethnic Origins

2016 ◽  
Vol 38 (12) ◽  
pp. 589-592 ◽  
Author(s):  
Mariarosaria Di Tommaso ◽  
Giulia Martello ◽  
Tomi Kanninen ◽  
Federica Perelli ◽  
Laura Iannuzzi ◽  
...  
Keyword(s):  
Racial Disparity ◽  
Stress Test ◽  
Categorical Variables ◽  
Fetal Life ◽  
Signal Loss ◽  
Short Term ◽  
Chi Square ◽  
Black Patients ◽  
Fetal Movements ◽  
Chi Square Test

Objective We speculate that genetic racial disparity exists in fetal life and can be detected by modern computerized cardiotocography (cCTG). Methods This is a retrospective study comparing the results of the cCTG of pregnant patients at 37–42 weeks according to the parental ethnicity (black versus white). A cCTG was performed to analyze the variables of fetal heart rate (FHR). The cCTG variables analyzed were: percentage of signal loss; number of contractions; basal FHR; number of accelerations; number of decelerations; length of high variation episodes; short-term variability (STV); total trace duration time; and number of fetal active movements. Non-stress test (NST) parameters in the two groups were compared using the Mann-Whitney test for continuous data, and the Chi-square test for categorical variables. Results We found a significantly lower number of active fetal movements (p = 0.007) and longer periods of low variation (p = 0.047) in the cCTG of black patients when compared with white patients. Conclusions In conclusion, identifying the factors responsible for the variance in the objective analysis of CTG results is important to improve the outcomes of patients. Our study lends further evidence as to the importance of ethnicity in clinical cCTG interpretation.

1265The results of whole exome sequencing in patients with bradyarrhythmias

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Polyakova ◽  
N Shcherbakova
Keyword(s):  
Family History ◽  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Heart Diseases ◽  
Stress Test ◽  
Family Members ◽  
Pacemaker Implantation ◽  
Structural Heart Disease ◽  
Clinical Prognosis ◽  
Whole Exome

Abstract Introduction. Sick sinus syndrome (SSS) and atrioventricular block (AVB) are life-threatening cardiac arrhythmias, that sometimes can manifest itself with syncope and needs a pacemaker implantation even in children. Sometimes, SSS and AVB are accompanied by structural heart diseases such as septal defects, cardiomyopathies, but often the heart is structurally normal. Some genes associated with bradyarrhythmias are well known. At the same time, the etiology of the SSS is unidentified and may be genetic caused in 50% of patients with SSS. There are no studies on the prevalence of with bradyarrhythmia-associated mutations in children. The purpose of our work is to identify and study the types of mutations associated with SSS and AVB in children. Methods. We included in the study 15 patients (27% boys) with severe SSS and AVB, from the database of the Russian Pediatric Arrhythmia Center. 11 were the probands and 4 - family members.  Personal and family history, physical examination, including ECG, stress test, Holter monitoring, ECHO and other tests, and whole exome sequencing were made. The average age was 14.1 ± 4.5 (from 2 to 17). Results.  In 30% (5 pts) there was the combination of with bradyarrhythmias and structural heart disease. 7 pts (47%) had syncope, 4 pacemakers were implanted. 10 children (67%) had the genetic variants of genes associated with SSS and AVB: SCN5A, TNNI3K, KCNA5, TRPM4, ANK2 and others. Family history of cardiac diseases was positive in 5 probands; 2 probands had family members with implanted pacemakers. In 3 pts were likely pathogenic variants and in 7 pts - variants of unknown significance found. Conclusion.  We found the genetic cause of bradyarrhythmias in 67% of children. Further research and larger patient samples are required to study the prevalence of genetic types of and show the correlation of the genotype with the clinical prognosis. In addition, our work will enable practitioners to identify children from families with family forms of SSS, AVB and sudden cardiac death. Further research can help us determine the criteria for selecting children for genetic testing.

Use of the multivariate approach to enhance the diagnostic accuracy of the treadmill stress test

1980 ◽  
Vol 13 (3) ◽  
pp. 227-236 ◽  
Author(s):  
Paul S. Greenberg ◽  
Barbara Cangiano ◽  
L. Leamy ◽  
M.H. Ellestad
Keyword(s):  
Diagnostic Accuracy ◽  
Stress Test ◽  
Multivariate Approach ◽  
Treadmill Stress Test ◽  
Treadmill Stress
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