Long-term, real world experience of ventricular tachycardia and granulomatous cardiomyopathy.

Background: Granulomatous cardiomyopathy (GCM) is relatively uncommon in patients presenting with ventricular tachycardia (VT). Sarcoidosis and tuberculosis are the most common causes of GCM with VT. The aim of study was to evaluate their clinical characteristics and the long-term outcomes.

A case report: metastatic complete heart block.

Background: Though primary malignant tumours of the heart are rare, secondary metastatic affection of the heart is quite common. Common presentations include pericardial effusion, obstruction of inflow and outflow tracts and arrhythmias, most notably tachyarrhythmias, and very rarely complete heart blocks (CHBs).

Case Summary: A 28-year-old man suffering from carcinoma of the tongue underwent a surgery in the form of radical hemimandibulectomy.

Professor of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh.

Atrial fibrillation (AF) is the most common supraventricular tachycardia and its incidence increases with age. The pathophysiology of AF has been studied extensively and is a subject of continuing research. The primary pathologic change seen in AF is progressive fibrosis of the atria and hence structural remodeling, is the mainstay in many forms of AF.

Percutaneous tricuspid valvotomy for pacemaker lead-induced tricuspid stenosis.

Permanent pacemaker lead-induced tricuspid regurgitation is extremely uncommon. We report a patient with severe tricuspid stenosis detected 10 years after permanent single chamber pacemaker implantation in surgically corrected congenital heart disease. The loop at the level of the tricuspid valve may have caused endothelial injury and eventually led to stenosis.

A survey of cardiac implantable electronic device implantation in India: By Indian Society of Electrocardiology and Indian Heart Rhythm Society.

Background: There is limited data regarding the demographics and type of cardiac implantable electronic device (CIED) in India.

Aim: The aim of this survey was to define trends in CIED implants, which included permanent pacemakers (PM), intracardiac defibrillators (ICD), and cardiac resynchronization therapy pacemakers and defibrillators (CRT-P/D) devices in India.

Methods: The survey was the initiative of the Indian Society of Electrocardiology and the Indian Heart Rhythm Society.

Classical Cardiovascular Manifestations of Marfan Syndrome.

Presence of multiple cardiovascular manifestations of the Marfan syndrome in the same patient is not commonly encountered. We present a 49 year-old lady with this syndrome who presented with decompensated heart failure. Evaluation revealed presence of extensive Stanford type A aortic dissection alongwith severe aortic and mitral incompetence.

Subvalvular apparatus and adverse outcome of balloon valvotomy in rheumatic mitral stenosis.

Background: Balloon mitral valvotomy (BMV) is a well-established therapeutic modality for rheumatic mitral stenosis (RMS). However, there are chances of procedural failure and the more ominous post-procedural severe mitral regurgitation. There are only a few prospective studies, which have evaluated the pathogenic mechanisms for these major complications of BMV, especially in relation to the subvalvular apparatus (SVA) pathology.

Can carbonated lime drink intake prior to myocardial perfusion imaging with Tc-99m MIBI reduce the extracardiac activity that degrades the image quality and leads to fallacies in interpretation?

Background: During myocardial perfusion imaging with Tc-99m sestamibi, intestinal and hepatic radiotracer activity commonly interfere with visualization of the inferior wall of the myocardium leading to difficulties in interpretation. This study was undertaken to assess if carbonated lime drink ingestion prior to imaging prevents the said interference and improves the quality of images.

Materials And Methods: The study group comprised 33 consecutive patients including 26 males (age range: 30-80 years) and 7 females (42-62 years) who were referred for myocardial perfusion imaging.

Ablation of atrial flutter: block (isthmus conduction) or not a block, that is the question?

It is important to identify residual slow conduction and minimize the chance of resumption of conduction after right atrial isthmus ablation to reduce the chance of recurrence of atrial flutter (AFL). The aim of this article is to discuss the best possible way of confirming a bi-directional isthmus conduction (BIC) block after ablation of an isthmus-dependent AFL. A combination of activation and double potential mapping seems to be the most practical way of acutely confirming the BIC block.

Temporal patterns of electrical remodeling in canine ventricular hypertrophy: focus on IKs downregulation and blunted beta-adrenergic activation.

Objectives: Electrical remodeling in cardiac hypertrophy often involves the downregulation of K+ currents, including beta-adrenergic (beta-A)-sensitive IKs. Temporal patterns of ion-channel downregulation are poorly resolved. In dogs with complete atrioventricular block (AVB), we examined (1) the time course of molecular alterations underlying IKs downregulation from acute to chronic hypertrophy; and (2) concomitant changing responses of repolarization to beta-adrenergic receptor (beta-AR) stimulation.

Variable patterns of septal activation in patients with left bundle branch block and heart failure.

Introduction: Little is known about the septal activation pattern in patients with heart failure and left bundle branch block (LBBB-HF).

Methods And Results: The right ventricular (RV) and left ventricular (LV) activation patterns of 12 patients (mean age 67 +/- 11 years) with LBBB-HF and 5 patients (mean age 45 +/- 14) with normal hearts were studied during sinus rhythm using a three-dimensional mapping system. The etiology of HF was myocardial infarction (n = 4) or idiopathic dilated cardiomyopathy (n = 8).

Echocardiographic predictors of survival in patients undergoing radiofrequency ablation of postinfarct clinical ventricular tachycardia.

Introduction: The aim of this study was to determine the predictive value of echocardiographic parameters of systolic left ventricular (LV) dysfunction for survival in a group of patients with "mappable" ventricular tachycardia (VT) after myocardial infarction who underwent radiofrequency ablation (RFA) of their clinical VT(s).

Methods And Results: RFA of at least one inducible, "mappable," and clinical VT was attempted in 61 patients. In total, 63 (79%) of 80 target clinical VTs were ablated successfully, such that clinical VT(s) were noninducible in 49 (80%) of 61 patients.