Publications by authors named "Laurent Lewkowiez"
Objective: The purpose of this study is to review a series of patients with complex congenital heart disease in whom preprocedural imaging was used to assist placement of cardiac resynchronization therapy (CRT) leads.
Background: CRT may be beneficial in patients with a failing systemic ventricle and transposition of the great arteries (TGA). However, complex coronary venous anatomy can be challenging for placement of CRT leads.
Endocardial electrogram characteristics of epicardial ventricular arrhythmias.
J Cardiovasc Electrophysiol
June 2013
Article Synopsis
- Most ventricular arrhythmias can be treated with endocardial approaches, but some require epicardial mapping and ablation, which can be challenging to identify accurately from surface electrocardiograms.
- A study analyzed electrogram data from patients who had successful endo and epi mapping for ventricular arrhythmias, identifying key indicators that suggest a need for epicardial intervention.
- The findings highlight three main characteristics: a large area of diffusely early activation, a specific sequence of EGM components, and the inability to capture a far-field EGM, all pointing towards the necessity of epicardial ablation for effective treatment.
Article Synopsis
- Ventricular fibrillation (VF) can be treated by identifying and ablating its triggering sources, often found in the Purkinje network or right ventricular outflow tract (RVOT), without needing to induce VF or premature ventricular complexes (PVC).
- A study involving 11 patients with frequent VF episodes used stored electrograms from implantable cardioverter defibrillators (ICDs) to locate and successfully ablate VF triggers, targeting areas like the left posterior and anterior fascicles and the RVOT.
- All procedures were successful, with no complications, leading to 10 out of 11 patients being free of VF after about 288 days of follow-up, indicating effective short-term outcomes of this ablation strategy.
Article Synopsis
- * During pacemaker implantation, it was discovered that there was actually sinus rhythm in the donor’s atrium, indicating a more complex situation than originally thought.
- * The case highlights a rare instance of sinus arrest that mimicked complete heart block two years post-transplant, demonstrating the complexity of cardiac conduction in transplant patients.
Article Synopsis
- - The study investigates the effects of pacing on the AV node to uncover concealed accessory pathways (APs) that standard pacing methods might miss, specifically when an atrial extrastimulus is delivered.
- - Researchers developed a technique called dual-chamber sequential extrastimulation, which involves a series of controlled pacing sequences to identify the presence of APs in patients undergoing tests for supraventricular tachycardia.
- - Results showed that all patients with an identifiable AP exhibited exclusive VA conduction without fusion during the new pacing method, while those without an AP had significantly longer retrograde AV nodal effective refractory periods, highlighting the technique's effectiveness in revealing hidden APs.
The Brugada syndrome is an important cause of sudden cardiac death primarily among males without structural heart disease. Although not widely known, it may be unmasked by an acute febrile illness. An association between mastitis and Brugada syndrome has not been previously reported.
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- Methadone is a well-known treatment for opioid dependency and chronic pain, but concerns were raised after a related drug, levacetylmethadol, was linked to torsade de pointes, a type of heart arrhythmia.
- A study analyzed 17 patients who were treated with high doses of methadone and experienced torsade de pointes, observing their health records for risk factors and heart activity.
- Results indicated that these patients had significantly high doses of methadone and prolonged QT intervals, highlighting potential risks associated with high-dose methadone and suggesting a need for further research, especially as methadone use expands in primary care.