The Role of High-output His-bundle Pacing During Atrioventricular Node Ablation.

Atrioventricular (AV) junction ablation (AVJA) is an acceptable strategy to control the heart rate in atrial fibrillation (AF) with a high procedural success rate. However, a small subset of patients pose a technical challenge with the standard right-sided approach. High-output His-bundle pacing has been shown to help localize the His bundle in a difficult-to-ablate AV junction.

Outcomes of hospitalizations with acute respiratory distress syndrome with and without atrial fibrillation - Analyses from the National Inpatient Sample (2004-2014).

Background: Acute respiratory distress syndrome (ARDS) is associated with high mortality. Atrial fibrillation (AF) is a common arrhythmia seen in critically ill patients. The impact of AF on the outcomes in patients with ARDS is less understood.

Inappropriate sinus tachycardia: a review.

Inappropriate sinus tachycardia (IST) has been defined as a resting heart rate of >100 beats per minute and an average 24-hour heart rate >90 bpm with distressing symptoms resulting from the persistent tachycardia. IST is prevalent in 1% of the middle-aged population, mostly females. Rarely can elderly patients also present with IST.

Left-sided Macro-reentry or Right-sided Focal Tachycardia in Patients with Prior Pulmonary Vein Isolation: A Tale of Two Atria.

We report on three patients with prior pulmonary vein isolation who presented with atrial tachycardia/atrial flutter. During electrophysiology study, the whole tachycardia cycle length was mapped to the left atrium. Multiple ablation attempts failed to terminate the tachycardia and, subsequently, right atrial mapping revealed a focal early site of origin near the superior vena cava-right atrial junction in two patients and outside the coronary sinus ostium in one patient.

Focally Appearing Activation Map of a Reentrant Tachycardia Using a New Coherent Mapping Tool.

Here, we discuss mapping of an atrioventricular reciprocating tachycardia (AVRT) using color-coding and a coherence module of the CARTO mapping system (Biosense Webster, Diamond Bar, CA, USA). AVRT is a reentry tachycardia and, when the atrial exit site of the arrhythmia circuit was mapped in this case, it appeared to have a focal centrifugal activation pattern as depicted by coherent mapping.

A Case of Biatrial-dependent Tachycardia.

We present an interesting case of atrial flutter in a patient with previous pulmonary vein isolation. The entirety of the atrial flutter cycle length was mapped to the left atrium; however, an atrial flutter could not be terminated from the left side. Subsequently, the right atrium was mapped and an area of earliest activation was noted in the junction between the superior vena cava and right atrium.

How to Achieve Near Zero Fluoroscopy During Radiofrequency Ablation of Atrial Fibrillation: A Strategy Used at Two Centers.

Radiofrequency ablation for atrial fibrillation is currently the most effective rhythm control strategy. These procedures, although safe, pose a risk for potential exposure to radiation and can be time consuming. Radiation exposure during ablation can increase the risk of serious complications in both patients as well as physicians.

A Case of Intermittent Preexcitation and Palpitations: More than Meets the Eye.

We discuss the case of a 22-year-old female who presented to the clinic experiencing recurrent palpitations. She was also found to have intermittent preexcitation on her electrocardiogram (ECG). Her palpitations were attributed to stress.