Persistence of ICD indication at the time of replacement in patients with initial implant for primary prevention indication: Effect on subsequent ICD therapies.

Background: Indication to implantable cardioverter defibrillator (ICD) for primary prevention of sudden death relies on left ventricular ejection fraction (LVEF). We measured the proportion of patients in whom indication to ICD persisted at the time of generator replacement (GR) and searched for predictors of appropriate therapies after GR.

Methods: We identified all consecutive patients who had received an ICD at our hospital, for LVEF ≤35% and no previous arrhythmias or unexplained syncope.

Right ventricular septal pacing: Safety and efficacy in a long term follow up.

Aim: To evaluate the safety and efficacy of the permanent high interventricular septal pacing in a long term follow up, as alternative to right ventricular apical pacing.

Methods: We retrospectively evaluated: (1) 244 patients (74 ± 8 years; 169 men, 75 women) implanted with a single (132 pts) or dual chamber (112 pts) pacemaker (PM) with ventricular screw-in lead placed at the right ventricular high septal parahisian site (SEPTAL pacing); (2) 22 patients with permanent pacemaker and low percentage of pacing (< 20%) (NO pacing); (3) 33 patients with high percentage (> 80%) right ventricular apical pacing (RVA). All patients had a narrow spontaneous QRS (101 ± 14 ms).

Left ventricular torsion in paced patients.

Background: In healthy people the left ventricle presents a counter-clockwise apical rotation and a clockwise basal rotation ending in late systole. In early systole (during isovolumic contraction) there is a fast and inverse rotation (counter-clockwise at the base and clockwise at the apex). This opposite rotation between apex and base produces the systolic torsion of the left ventricle.

Cardiac dyssynchrony quantitated by time-to-peak or temporal uniformity of strain at longitudinal, circumferential, and radial level: implications for resynchronization therapy.

Background: The standard deviation of time to peak strain (TPS-SD) has been proposed as an index of left ventricular (LV) dyssynchrony in patients to be resynchronized. However, TPS-SD is sensitive to noise, and the influence of outliers on TPS-SD is also relevant. Alternatively, dyssynchrony can be indexed by temporal uniformity of strain (TUS), whereby a time plot of regional strains, arranged for LV location, is subjected to Fourier analysis.

[Electrical storms in patients with implantable cardioverter-defibrillator: incidence and clinical management].

Background: Electrical storm in implantable cardioverter-defibrillator (ICD) recipients is a dramatic experience for the patient and a hard emergency for the cardiology team. The aim of our study was to evaluate the incidence and the clinical significance of electrical storm in a standard population of ICD patients.

Methods: We considered retrospectively 262 consecutive ICD patients (86% males, mean age 65+/-10.