Cardiac Resynchronization Therapy for Pacing-Related Dysfunction Post Cardiac Surgery in Neonates.

An infant with DiGeorge syndrome, multiple comorbidities, and truncus arteriosus type II underwent repair complicated by heart block necessitating placement of a dual-chamber bipolar pacing system with right ventricular leads and subsequent resynchronization with placement of left ventricular apical pacing leads. Resynchronization therapy improved QRS duration from 180 ms to 100 ms and ejection fraction from 25% to 54% over the course of 4 weeks with gradual return to normal function and eventual discharge.

Cardiac crises: Cardiac arrhythmias and cardiomyopathy during TANGO2 deficiency related metabolic crises.

Background: TANGO2 deficiency disorder (TDD) is an autosomal recessive disease associated with metabolic crisis, lethal cardiac arrhythmias, and cardiomyopathy. Data regarding treatment, management, and outcomes of cardiac manifestations of TDD are lacking.

Objective: The purpose of this study was to describe TDD-related cardiac crises.

Implantable Cardioverter-defibrillators in Adult Congenital Heart Disease.

With improved surgical techniques and medical therapies, many patients who are born with complex congenital heart defects are now living well into adulthood. As these patients age, an increasingly common cause of mortality is sudden cardiac death (SCD) from ventricular tachyarrhythmias. The implantable cardioverter-defibrillator (ICD) is a therapy with the ability to prevent some of these deaths; however, there are many diagnostic and technical challenges that remain in the congenital heart disease (CHD) population.

P- and R-wave Amplitude Sensed by Reveal LINQ™ Loop Recorder in Pediatric Patients.

Implantable loop recorders are commonly used to sense arrhythmias. The purpose of this study is to assess the P- and R-wave amplitudes at implantation (I) and follow-up (F) following insertion of the Reveal LINQ™ Insertable Cardiac Monitor (Medtronic, Minneapolis, MN) in an institutional review board-approved, multicenter study performed on pediatric patients younger than 18 years old. Collected data included demographics, presence of congenital heart disease (CHD), P- and R-wave-sensed amplitude at I and F, and the method of implant (i.

Catheter Ablation to Treat Supraventricular Arrhythmia in Children and Adults With Congenital Heart Disease: What We Know and Where We Are Going.

Background: Catheter ablation has been used to manage supraventricular arrhythmia in children since 1990. This article reviews the history of catheter ablation used to treat arrhythmia in children and discusses new frontiers in the field. We also address ablation in adult patients with a history of congenital heart disease (CHD) that was diagnosed and initially treated in childhood.

Arrhythmias in children with ventricular assist devices.

Background: Children with decompensated heart failure are at high risk for arrhythmias, and ventricular assist device placement is becoming a more common treatment strategy. The impact of ventricular assist devices on arrhythmias and how arrhythmias affect the clinical course of this population are not well described.

Methods And Results: A single-centre retrospective analysis of children receiving a ventricular assist device between 1998 and 2011 was performed.

Limited utility of exercise stress tests in the evaluation of children with chest pain.

Objectives: The objective of this study was to assess the utility of the exercise stress test (EST) in pediatric patients without previously diagnosed heart disease who present with chest pain and to correlate EST results with echocardiographic findings.

Design: Retrospective chart review over a 14-month period.

Setting: Cardiology clinic at an academic children's hospital.

Magnetic versus manual catheter navigation for ablation of free wall accessory pathways in children.

Background: Transcatheter ablation of accessory pathway (AP)-mediated tachycardia is routinely performed in children. Little data exist regarding the use of magnetic navigation (MN) and its potential benefits for ablation of AP-mediated tachycardia in this population.

Methods And Results: We performed a retrospective review of prospectively gathered data in children undergoing radiofrequency ablation at our institution since the installation of MN (Stereotaxis Inc, St.

Acute heart failure syndromes in the pediatric emergency department.

Objective: The objectives of this study were to (1) describe the clinical presentation of acute heart failure syndromes (AHFS) in the pediatric emergency department (ED) and (2) determine the physician treatment regimens and outcomes in the same population.

Methods: This was a cross-sectional study of patients who presented with AHFS to the ED at our institution from January 2003 to October 2006. We defined AHFS as "the gradual or rapid deterioration in heart failure signs and symptoms resulting in a need for urgent therapy.