Bilateral cardiac sympathetic denervation for refractory arrhythmia in an individual with catecholaminergic polymorphic ventricular tachycardia associated with T-cell-mediated ganglionitis.

The individual in our case was troubled with difficult to control arrhythmia in the context of RYR2-mutation positive catecholaminergic polymorphic ventricular tachycardia (CPVT) despite medication. Recurrent implantable cardioverter defibrillator (ICD) shocks occurred for ventricular tachycardia (VT) and ventricular fibrillation (VF) as well as inappropriate shocks as a result of rapidly conducted atrial fibrillation (AF). Catheter ablation was effective in controlling these episodes of AF.

Late unexpected complete fracture of a right ventricular lead still capturing the myocardium.

A 72-year-old man presented for routine dual chamber pacemaker interrogation 13 years following insertion for sick sinus syndrome. Increased noise, impedance and threshold of the right ventricular (RV) lead were identified. RV capture was maintained with an overall RV pacing burden of 47%.

Importance of thorough investigation in a patient presenting with recurrent collapse and ST elevation.

There is increasing literature to suggest numerous subgroups of Brugada syndrome (BrS), including those with ST elevation in the lateral or inferior leads. We present a case of a patient presenting with recurrent collapse and inferior ST elevation degenerating to ventricular fibrillation and ultimately leading to a diagnosis of BrS.

Quantitative evaluation and comparison of coronary artery characteristics by 3D coronary volume reconstruction.

Non-atherosclerotic abnormalities of vessel calibre, aneurysm and ectasia, are challenging to quantify and are often overlooked in qualitative reporting. Utilising a novel 3-dimensional (3D) quantitative coronary angiography (QCA) application, we have evaluated the characteristics of normal, diabetic and aneurysmal or ectatic coronary arteries. We selected 131 individuals under 50 years-of-age, who had undergone coronary angiography for suspected myocardial ischaemia between 1st January 2011 and 31st December 2015, at the Bristol Heart Institute, Bristol, UK.

Safety and mid-term outcome of catheter ablation of ventricular tachycardia in octogenarians.

Aims: Radiofrequency (RF) catheter ablation (CA) is superior to standard medical therapy in controlling recurrent ventricular tachycardia (VT). The majority of procedures have been performed in a middle-aged population. The outcome of VT ablation in the elderly has not been described.

Using the Valeo dilatable stent in coarctation stenting for small children: expanding the inclusion criteria for coarctation stenting?

The application of coarctation stenting has grown in paediatric and adult practice in recent years. Stent and delivery sheath technology has improved; however, we remain technically limited when implanting small calibre stents through small sheaths in small children, which then have the potential to be dilated to adult size as time passes. We describe the first reported use of the Valeo Biliary Pre-mounted Re-dilatable Stent (Edwards Life Sciences, California, USA) in aortic coarctation with 1 year follow-up including cross-sectional imaging.

Staged interventional and surgical management for complex low birthweight tetralogy of Fallot: another imperfect but legitimate strategy.

Management of spelling low weight infants with complex tetralogy of Fallot is often fraught. We present a 2.8-kg infant with DiGeorge syndrome and spelling tetralogy with non-confluent pulmonary arteries, the left pulmonary artery being supplied by an aberrant ductus arteriosus from the left common carotid artery.