Ultrasound-guided vs. fluoro-guided axillary venous access for cardiac implantable electronic devices: a patient-based meta-analysis.

Aims: The use of ultrasound (US)-guided venous puncture for cardiac pacing/defibrillation lead placement may minimize the risk of periprocedural complications and radiation exposure. However, none of the published studies have been sufficiently powered to recommend this approach as the standard of care. We compare the safety and efficacy of ultrasound-guided axillary venous puncture (US-AVP) vs.

Usefulness of risk scores and predictors of atrial fibrillation recurrence after elective electrical cardioversion.

Introduction: Electrical cardioversion (ECV) is a frequently used procedure for restoring sinus rhythm in atrial fibrillation (AF); however, the rate of recurrence is high. The identification of patients at high risk of recurrence could influence the decision-making process. The present study evaluates the predictive value of risk scores in atrial fibrillation recurrence after elective electrical cardioversion.

Medium-long-term mortality and change in functional status in elderly patients with pacemaker.

Background: Nowadays, 49% of patients with pacemakers are older than 80 years old. Nevertheless, mortality and change in functional status after pacemaker implantation are not well documented in elderly patients.

Objective: We designed a prospective study to analyze the cardiovascular mortality and change in functional status of elderly patients, medium-long term after pacemaker implantation.

Personalized monitoring of electrical remodelling during atrial fibrillation progression via remote transmissions from implantable devices.

Aims: Atrial electrical remodelling (AER) is a transitional period associated with the progression and long-term maintenance of atrial fibrillation (AF). We aimed to study the progression of AER in individual patients with implantable devices and AF episodes.

Methods And Results: Observational multicentre study (51 centres) including 4618 patients with implantable cardioverter-defibrillator +/-resynchronization therapy (ICD/CRT-D) and 352 patients (2 centres) with pacemakers (median follow-up: 3.

Medium-long term mortality and change in functional status in elderly patients with pacemaker.

Background: Nowadays, 49% of patients with pacemakers are older than 80 years old. Nevertheless, mortality and change in functional status after pacemaker implantation are not well documented in elderly patients.

Objective: We designed a prospective study to analyze cardiovascular mortality and change in functional status of elderly patients, medium-long term after pacemaker implantation.

Fluoroscopy-guided axillary vein access vs cephalic vein access in pacemaker and defibrillator implantation: Randomized clinical trial of efficacy and safety.

Introduction: The most widespread venous sites of access for implantation intravenous implantable cardiac electronic device (CIED) are the cephalic and subclavian vein. Fluoroscopy-guided axillary venous access is an alternative, but efficacy and safety have not been studied under equal conditions. The aim of the present study is to compare the efficacy and safety of fluoroscopy-guided axillary vs cephalic vein access in CIED implant.

Hybrid Approach for the Treatment of Superior Vena Cava Syndrome Induced by Pacemaker.

Pacemaker-induced superior vena cava syndrome (SVCS) is a rare but incapacitating adverse event that can occur years after implantation. Inasmuch as it is a rare disease, there is no consensus about its treatment. The most widely used option is balloon angioplasty and venous stent implantation, with preservation of the lead or previous extraction and subsequent reimplantation after the procedure, which is associated with new episodes of thrombosis.

Long RP interval tachycardia. What is the mechanism?

A 41-year-old man with a history of tachycardia refractory to multiple antiarrhythmic drugs was sent to our institution. His 12-lead electrocardiogram demonstrated incessant narrow QRS complex tachycardia with negative waves in the inferior leads and long RP interval. Occasionally, the tachycardia terminated after a wave and then was restarted after a sinusal beat.

[Aortopulmonary window].

The aortopulmonary window is a rare cause of heart failure in the neonate. It must be ruled out if there are signs of pulmonary edema without the most frequent left-right shunts. We report the echocardiographic images of a newborn who was admitted with symptoms of heart failure at our institution.

Mobitz type II second-degree atrioventricular block with narrow QRS and junctional extrasystoles: what is the mechanism?

A 74-year-old man underwent an electrophysiological study because of Mobitz type II second-degree atrioventricular (AV) block with narrow QRS and frequent junctional extrasystoles. During the study, there were very frequent single His bundle depolarizations with multiple coupling intervals that reproduce the ECG findings. In this case, some His bundle extrasystoles result in retrograde concealed conduction and prolonged local refractoriness in the AV node that manifest as block of the next atrial impulse.

[Does the Tako-Tsubo syndrome need a certain coronary anatomy in the apical ventricular region as predisposing factor?].

The Tako-Tsubo transient left ventricular apical ballooning was born as a clinical profile in the year 2001. This syndrome occurs mainly in women older than 60 years and it is frequently preceded by a physical or emotional stress. Its presentation simulates a myocardial infarction, although with some differences: the pain is not always typical, and its intensity is moderate.