A 78-year-old man came for a scheduled check up one month after the implantation of a permanent dualchamber pacemaker for symptomatic transient atrioventricular conduction disturbances (intermittent Mobitz II atrioventricular block). The patient's ECG indicated a loss of atrial capture by the atrial electrode with 1:1 atrioventricular conduction. A subsequent X-ray examination showed that both electrodes were well placed and in their correct sites.
View Article and Find Full Text PDFMyocardial perforation is a rare complication of permanent pacemaker insertion and is usually detected during the first month after implantation. Pericardial effusion often occurs at the same time, and as a consequence may generate difficulties in the diagnostic workup due to the various aetiologies of its origin. Computed tomography has been used for the documentation of lead perforation, but its diagnostic accuracy in comparison to echocardiographic examination has not been validated.
View Article and Find Full Text PDFImplantable Cardioverter Defibrillator (ICD) implantation is the only established therapy for primary or secondary prevention of sudden cardiac death in patients with Hypertrophic Cardiomyopathy (HCM). Ineffectiveness of shock therapy for the termination of potentially fatal ventricular arrhythmias in ICD recipients is rare in the presence of appropriate arrhythmia detection by the device. We report the case of a 48-year-old woman with HCM and a single chamber ICD, who received five inefficient high-energy (35 Joules) shocks for the termination of an appropriately detected episode of Ventricular Tachycardia (VT).
View Article and Find Full Text PDFRadiofrequency ablation is the interventional therapy of choice for the definitive cure of patients with tachycardias facilitated by accessory pathways. Ablation of an accessory pathway at sites close to the His bundle is inevitably associated with an increased risk of causing complete atrioventricular block. Here we describe the case of a patient with pre-excitation syndrome and episodes of supraventricular tachycardia, in whom an electrophysiological study identified an accessory pathway so close to the His bundle that discrete sites between the pathway and the His bundle were extremely difficult to find.
View Article and Find Full Text PDFHellenic J Cardiol
December 2006
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a primary cardiomyopathy, characterized mainly by anatomic and functional defects of the right ventricle. In many cases its diagnosis is quite difficult in spite of the existence of defined diagnostic criteria for the disease. We describe an interesting case of a patient with sustained ventricular tachycardia derived from the right ventricular outflow tract, in whom the diagnosis of ARVC was made with the contribution of electrophysiologic study and electroanatomical mapping, as the use of all other diagnostic tests and laboratory methods had left many unanswered questions.
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