Surface ECG criteria can discriminate post-septal pacing cardiac memory from ischemic T wave inversions.

Unlabelled: Cardiac memory (CM) refers to transient T wave changes that appear after cessation of a period of abnormal ventricular activation, such as right ventricular (RV) pacing. ECG criteria for differentiating post-pacing CM from ischemia-induced T wave changes were previously published only for apical, but not for septal RV pacing.

Aim: To find ECG criteria for discriminating post-septal pacing CM from ischemic T wave inversions.

Regional Mechanical Changes Assessed by 2D Speckle-Tracking Longitudinal Strain do not Parallel Electrical Post-Pacing Cardiac Memory.

Background: Cardiac memory (CM) refers to persistent T-wave changes that appear after cessation of a period of abnormal ventricular activation, such as ventricular pacing. Prior animal studies using tagged magnetic resonance imaging have suggested that CM is associated with prolonged action potential duration and increased strain of late-activated myocardial segments.

Objective: The aim of the present study is to determine whether CM induced by ventricular pacing in human subjects is accompanied by regional mechanical changes in late-activated myocardial segments, assessed by left ventricular (LV) longitudinal strain (peak LS) and time-to-peak longitudinal strain (TTP-LS), using 2D-speckle tracking echocardiography (2DSE).

Do left atrial strain and strain rate reflect intrinsic atrial function, or are they determined by left ventricular function?

Background: Left atrial (LA) strain (S) and strain rate (SR) are reported as measures of intrinsic function.

Aim: Since the LA and left ventricle (LV) are connected through the mitral annulus, we investigated: (1) if deformation indices in the LA are mostly predicted by deformation of the LV; (2) if timings of S and SR events are similar in both the LA and LV; and (3) if alteration of S and SR in patients with primarily LV dysfunction would be similar in the LA and LV.

Methods: We retrospectively assessed 50 asymptomatic women (Group 1) and 20 patients with recent (< 96 h) acute pulmonary oedema (10 women) (Group 2).

Left ventricular strain analysis reveals better synchrony and diastolic function for septal versus apical right ventricular permanent pacing.

Objectives: Left ventricular function and synchrony may be altered by right ventricular (RV) apical pacing. Septal pacing might be a better alternative. We compared effects on cardiac synchrony and function, between the 2 pacing sites, in chronically implanted patients.

Right ventricular electrical and mechanical synchronization by properly timed septal pacing in a patient with right bundle branch block and first degree AV block--a case report.

We present a case of near-normalization of the QRS by septal pacing in a patient with dual-chamber pacemaker and underlying complete right bundle branch block and first degree atrioventricular block. The right ventricular mechanical synchronization suggested by the ECG was validated as such by strain echo. To the best of our knowledge, this is the first time it has been shown that the narrowing of the QRS corresponds to mechanical synchronization in a case of this seldom-recognized phenomenon.

Inaccuracy of radiological and ECG criteria for right ventricular outflow tract implantation of pacemaker leads.

We present three cases of active fixation pacemaker lead implantation, where the leads were believed to be inserted in the right ventricular outflow tract (RVOT) septal position, using established radiological criteria. However, when the exact location of the leads was documented by three-dimensional echocardiography, true septal RVOT position was achieved in only one patient. In the other two patients, the leads were, in fact, implanted into the RVOT anterior free wall.

Successful slow pathway ablation in a patient with persistent left superior vena cava.

Persistent left superior vena cava (PLSVC) is a rare vascular variant which can add difficulties to slow pathway (SP) ablation procedures because of the disturbed anatomy of the triangle of Koch. We describe a case of a successful SP ablation using an anatomical approach in a patient with PLSVC.