A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices.

Aims: We aimed to identify all syncope units (SUs) in the Netherlands and assess the extent to which these SUs fulfil the essential requirements outlined by the consensus statements of the European Heart Rhythm Association and the European Society of Cardiology syncope guidelines. For this, we developed the SU-19 score, a novel guideline based validation tool for best practice.

Methods And Results: All outpatient clinics of cardiology, neurology, and internal medicine in the Netherlands were screened for presence of any form of structured specialized syncope care.

MR feature tracking in patients with MRI-conditional pacing systems: The impact of pacing.

Purpose: To develop feature tracking (FT) software to perform strain analysis on conventional (nontagged) cardiac magnetic resonance imaging (MRI) function images. With the advent of MRI-conditional pacemaker systems, effects of cardiac pacing on myocardial strain can be studied using MR. In this study the impact of pacing on left ventricular (LV) strain was investigated using MR-FT in patients with an MRI-conditional cardiac implantable electronic device (CIED).

New-generation atrial antitachycardia pacing (Reactive ATP) is associated with reduced risk of persistent or permanent atrial fibrillation in patients with bradycardia: Results from the MINERVA randomized multicenter international trial.

Background: Atrial fibrillation (AF) is a frequent comorbidity in patients with pacemaker and is a recognized cause of mortality, morbidity, and quality-of-life impairment. The international MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduce permanent AF occurrence in comparison with standard dual-chamber pacing (DDDR).

Objective: We aimed to determine the role of new-generation atrial antitachycardia pacing (Reactive ATP) in preventing AF disease progression.

Mid-term follow up of thromboembolic complications in left ventricular endocardial cardiac resynchronization therapy.

Background: Endocardial left ventricular (LV) pacing for cardiac resynchronization therapy (CRT) has been proposed as an alternative to traditional LV transvenous epicardial pacing with equal or superior cardiac performance. The risks of cerebral thromboembolism and possible interference with mitral valve function moderate its clinical application.

Objective: The purpose of this study was to investigate cerebral thromboembolic complications after LV endocardial lead placement.

Increase of ventricular output inducing ventricular afterpotential sensing and ventricular safety pacing in a biventricular implanted cardioverter defibrillator.

Programming maximum right ventricular output in a patient with a biventricular implanted cardioverter defibrillator resulted in ventricular oversensing and ventricular safety pacing in the same cardiac cycle.

Toward understanding response to cardiac resynchronization therapy: left ventricular dyssynchrony is only one of multiple mechanisms.

Aim: To date, most published echocardiographic methods have assessed left ventricular (LV) dyssynchrony (DYS) alone as a predictor for response to cardiac resynchronization therapy (CRT). We hypothesized that the response is instead dictated by multiple correctable factors.

Methods And Results: A total of 161 patients (66 +/- 10 years, EF 24 +/- 6%, QRS > 120 ms) were investigated pre- and post-CRT (median of 6 months).

Right ventricular outflow and apical pacing comparably worsen the echocardiographic normal left ventricle.

Aims: A depressed left ventricular function (LVF) is sometimes observed during right ventricular apical (RVA) pacing, but any prediction of this adverse effect cannot be done. Right ventricular outflow tract (RVOT) pacing is thought to deteriorate LVF less frequently because of a more normal LV activation pattern. This study aims to assess the acute effects of RVA and RVOT pacing on LVF in order to determine the contribution of echocardiography for the selection of the optimum pacing site during pacemaker (PM) implantation.

Transseptal endocardial left ventricular pacing: an alternative technique for coronary sinus lead placement in cardiac resynchronization therapy.

Background: Coronary sinus (CS) lead placement for transvenous left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) has a failure rate at implant and short-term follow-up between 10% and 15%.

Objective: The purpose of this study was to assess the feasibility of transseptal endocardial LV pacing in patients in whom transvenous CS lead placement had failed.

Methods: An atrial transseptal LV lead placement was attempted in 10 patients (six females, age 69.

A technique of lead insertion for low atrial septal pacing.

Background: Pacing in the low right atrial septum (LAS) appears superior to right atrial appendage or free wall stimulation for the prevention of paroxysmal atrial fibrillation. However, insertion of active fixation lead in the low right atrial septal position is difficult and time consuming, inhibiting application of this pacing method in daily practice.

Methods: The technique of handling and positioning of a new "over the wire" lead system is presented with emphasis on electrocardiographic P wave pattern and fluoroscopic landmarks.

Electrocardiographic characteristics in low atrial septum pacing.

Aim: The aim of the study was to compare P-wave morphology and duration in pacing from the low right atrial septal wall and the high right atrial appendage (RAA).

Methods: The electrocardiogram (ECG) of 50 patients with low atrial septum (LAS) pacing and that of 50 patients with RAA pacing were compared with their electrocardiogram during sinus rhythm.

Results: In the frontal plane, patients with LAS pacing showed a superior P-wave axis between -60 degrees and -90 degrees .

Electrical characteristics of low atrial septum pacing compared with right atrial appendage pacing.

Aim: The study was designed to compare the electrical characteristics of atrial leads placed in the low atrial septum (LAS) with those placed in the right atrial appendage (RAA) associated with dual chamber pacing.

Methods: In 86 patients an active-fixation (St. Jude Medical's Tendril DX model 1388T) atrial lead was positioned in RAA and in 86 patients the same model atrial lead was placed in the LAS.