Intraoperative pectoral nerve blocks during cardiac implantable electronic device procedures.

Background: Cardiac implantable electronic device (CIED) procedures can cause significant postoperative pain. Opioid use for postoperative pain is associated with risk of persistent use. The benefits of pectoral nerve (PECs) blocks have been established for other chest wall surgeries, but adoption in electrophysiology has been limited.

Predictors of nonpulmonary vein triggers for atrial fibrillation: A clinical risk score.

Background: Targeting non-pulmonary vein triggers (NPVTs) after pulmonary vein isolation may reduce atrial fibrillation (AF) recurrence. Isoproterenol infusion and cardioversion of spontaneous or induced AF can provoke NPVTs but typically require vasopressor support and increased procedural time.

Objective: The purpose of this study was to identify risk factors for the presence of NPVTs and create a risk score to identify higher-risk subgroups.

Identifying Origin of Nonpulmonary Vein Triggers Using 2 Stationary Linear Decapolar Catheters: A Novel Algorithm.

Background: Targeting nonpulmonary vein triggers (NPVTs) of atrial fibrillation (AF) after pulmonary vein isolation can be challenging. NPVTs are often single ectopic beats with a surface P-wave obscured by a QRS or T-wave.

Objectives: The goal of this study was to construct an algorithm to regionalize the site of origin of NPVTs using only intracardiac bipolar electrograms from 2 linear decapolar catheters positioned in the posterolateral right atrium (along the crista terminalis with the distal bipole pair in the superior vena cava) and in the proximal coronary sinus (CS).

Atrial Transseptal Catheterisation: Challenging Scenarios and Techniques to Overcome Them.

Atrial transseptal catheterisation is a fundamental skill of any interventional electrophysiologist. In this review, various scenarios that pose unique challenges to atrial transseptal catheterisation are discussed. These scenarios include post-surgical or congenital malformations of the interatrial septum, presence of interatrial septal closure devices, absent or obstructed inferior vena cava and complex congenital heart disease after palliative surgery.

Patent Foramen Ovale With Platypnea - Orthodeoxia Syndrome: A Case Report.

Platypnea-orthodeoxia syndrome (POS) is an extraordinary medical condition characterized by positional dyspnea (platypnea) and arterial desaturation or hypoxemia (orthodeoxia) in the setting of an upright position. The difficulty breathing is alleviated upon lying down. It is the opposite of orthopnea and is manifested by a decrease in oxygen saturation when changing from supine to an orthostatic position.

Hypothyroidism Causing Pericardial Effusion: A Case Report.

Hypothyroidism is an endocrine disorder with worldwide prevalence that can affect multiple organ systems. It can be asymptomatic and subclinical or overtly symptomatic with a potential to get complicated by fatal pathologies. It is an established cause of pericardial effusion, which in turn can be complicated by cardiac tamponade and severe hemodynamic instability.

Peripartum cardiomyopathy: A systematic review of the literature.

Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure. It is defined as cardiomyopathy that develops in the last month of pregnancy or within 5 months of the postpartum period without an identifiable cause. We conducted a systematic review of literature of prospective studies with a focus on echocardiographic and long-term clinical outcomes in PPCM.