A Review of Temporary Permanent Pacemakers and a Comparison with Conventional Temporary Pacemakers.

Temporary cardiac pacing is commonly used in patients with life-threatening bradycardia and serves as a bridge to implantation of a permanent pacemaker (PPM). For years, passive fixation leads have been used for this purpose, offering the advantage of that they can be placed at bedside. The downside, however, is that patients must remain on telemetry and bed rest until lead removal due to the risk of displacement and failure to capture.

Retrograde venography and three-dimensional mapping of a great cardiac vein with separate drainage into the high right atrium in a patient with Wolf-Parkinson-White syndrome.

A 13-year-old boy presenting with palpitations was diagnosed with Wolf-Parkinson-White syndrome. We elected to bring him to the electrophysiology lab for evaluation of the accessory pathway and potential ablation. Structural assessment of the coronary sinus with electro-anatomical mapping and retrograde venography led to the discovery of a great cardiac vein having a separate insertion from the coronary sinus into the high right atrium.

Cardiac resynchronization therapy resulting from atrial pacing: An unusual case of intraventricular conduction delay.

Cardiac resynchronization therapy device implantation is complicated by a significant rate of failure to place a left ventricular lead via the coronary sinus. The present case describes one such failure ironically leading to resynchronization. The patient's QRS narrowing subsequent to postimplant atrial pacing alone suggests that bradycardia-dependent phase 4 block was the indirect but exclusive cause of the patient's intraventricular conduction delay.

Psychotropic Pharmacotherapy Associated With QT Prolongation Among Veterans With Posttraumatic Stress Disorder.

Background: In 2012, the Food and Drug Administration issued Drug Safety Communications on several drugs associated with QT prolongation and fatal ventricular arrhythmias. Among these was citalopram, a selective serotonin reuptake inhibitor (SSRI) approved for depression and commonly used for posttraumatic stress disorder (PTSD). Evaluation of the risk for QT prolongation among other psychotropic drugs for individuals with PTSD remains limited.

Emerging role of digital technology and remote monitoring in the care of cardiac patients.

Current available mobile health technologies make possible earlier diagnosis and long-term monitoring of patients with cardiovascular diseases. Remote monitoring of patients with implantable devices and chronic diseases has resulted in better outcomes reducing health care costs and hospital admissions. New care models, which shift point of care to the outpatient setting and the patient's home, necessitate innovations in technology.

Tricuspid valve incompetence following implantation of ventricular leads.

Most cardiovascular implantable electronic devices (CIEDs) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an understudied clinical complication of right ventricular lead implantation and its clinical significance is unknown. We review the incidence, predictors, and current management of TR as a complication of ventricular lead implantation.

Surface 12 lead electrocardiogram recordings using smart phone technology.

Importance: AliveCor ECG is an FDA approved ambulatory cardiac rhythm monitor that records a single channel (lead I) ECG rhythm strip using an iPhone. In the past few years, the use of smartphones and tablets with health related applications has significantly proliferated.

Objective: In this initial feasibility trial, we attempted to reproduce the 12 lead ECG using the bipolar arrangement of the AliveCor monitor coupled to smart phone technology.

Clinical significance of increased tricuspid valve incompetence following implantation of ventricular leads.

Purpose: Cardiac rhythm management devices (CRMD) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an under-recognized clinical complication of lead implantation and its clinical significance is unknown. We studied the incidence of hospitalizations for congestive heart failure (CHF) exacerbation among patients with worsening TR after ventricular lead implantation.

Clinical efficacy of dofetilide for the treatment of atrial tachyarrhythmias in adults with congenital heart disease.

Background: Atrial tachyarrhythmias (AT) including atrial fibrillation (AF), atrial flutter (AFL), and atrial tachycardia represent a clinical challenge in the adult with congenital heart disease (CHD). Dofetilide (D) is a rapidly activating delayed rectifier potassium channel (IKr) blocker effective in pharmacological conversion and maintenance of normal sinus rhythm in patients with AF and AFL. There is limited knowledge regarding the role of D in adults with CHD.

Isolated left ventricular noncompaction causing stroke in a 30-year-old woman: case report and literature review.

Isolated left ventricular noncompaction is a rare form of cardiomyopathy characterized by prominent left ventricular trabeculations and intertrabecular recesses. The typical clinical manifestations are severe systolic and diastolic dysfunction, conduction abnormalities, and cardiac embolic events theorized to result from thrombus formation within the intertrabecular recesses. Evidence-based recommendations for preventing thromboembolic events in isolated left ventricular noncompaction have not been established.

Safety and efficacy of dronedarone in the treatment of atrial fibrillation/flutter.

Dronedarone is an amiodarone analog but differs structurally from amiodarone in that the iodine moiety was removed and a methane-sulfonyl group was added. These modifications reduced thyroid and other end-organ adverse effects and makes dronedarone less lipophilic, shortening its half-life. Dronedarone has been shown to prevent atrial fibrillation/flutter (AF/AFl) recurrences in several multi-center trials.

Dofetilide reduces the frequency of ventricular arrhythmias and implantable cardioverter defibrillator therapies.

Background: Patients with an implanted cardioverter defibrillator (ICD) and ventricular arrhythmias leading to ICD therapies have poor clinical outcomes and quality of life. Antiarrhythmic agents and catheter ablation are needed to control these arrhythmias. Dofetilide has only been approved for the treatment of atrial fibrillation.