Utility of preoperative Holter monitoring in children undergoing extracardiac conduit Fontan operation.

Background: In patients undergoing extracardiac conduit Fontan (ECF) who require postoperative pacing, epicardial leads are usually required because of anatomical constraints. If indicated, these could be conveniently placed at the time of ECF. We have routinely performed ambulatory 24-hour Holter monitoring before ECF to determine the presence or absence of preoperative sinus node dysfunction, in an attempt to avoid repeat sternotomy at a later time.

Arrhythmias Following the Mustard and Senning Operations for Dextro-Transposition of the Great Arteries: Clinical Aspects and Catheter Ablation.

The atrial switch operations, the Mustard and Senning procedures, performed for dextro-transposition of the great arteries, have largely been supplanted by the arterial switch operation. As such, affected patients will only exist for approximately 30 more years. The main arrhythmias in these patients include sinoatrial node dysfunction, intraatrial reentry tachycardia, and sudden death.

Defibrillation Testing Strategies of Pediatric and Adult Congenital Electrophysiologists during ICD Implantation.

Background: Recently, there has been an increasing number of internal medicine-trained electrophysiologists who choose not to test for acute defibrillation efficacy during implantable cardioverter defibrillator (ICD) implantation. It is not known whether this same trend is seen in pediatric electrophysiologists, who care primarily for patients with congenital heart disease or primary electrical problems.

Methods: Through a 14-question survey created on Survey Monkey, we asked the members of the Pediatric and Adult Congenital Electrophysiology Society (PACES) for their approach to ICD implantation.

Ventricular Tachycardia Following Surgical Repair of Complex Congenital Heart Disease.

A nine year old boy with complex congenital heart disease requiring right ventricular outflow tract surgery and palpitations had inducible monomorphic ventricular tachycardia at 300 bpm by programmed ventricular stimulation. He was treated with enteral phenytoin. With a therapeutic plasma level, repeat electrophysiological study was negative for inducible ventricular tachycardia using an aggressive pacing protocol.

Development and gene expression profiling of a metastatic variant of the human breast cancer MDA-MB-435 cells.

We have developed a model system of late stage metastatic progression by isolating a highly malignant variant of human breast cancer cells from the parental MDA-MB-435 cell line. These cells, isolated from early lung metastasis, displayed increased anchorage independent growth in vitro and when transplanted ortho-topically into nude mice showed accelerated tumor growth rate and early lung spontaneous metastasis when compared to its parental counterpart. These cells, designated as MDA-MB-435-F-L, also showed intense wide spread early skeletal metastasis in vertebrae, mandible, femur, tibia and skull as detected by fluorescence imaging in an experimental bone metastasis model.