Left cardiac sympathetic denervation in children with Jervell Lange-Nielsen syndrome and drug refractory torsades - A case series.

Introduction: Long QT syndrome is an inherited malignant channelopathy which leads to life-threatening arrhythmia, with multiple genotypes. Jervell and Lange-Nielsen syndrome (JLNS) is an autosomal recessive subtype of this disease, characterized by congenital sensorineural deafness and a high incidence of sudden cardiac death (SCD).

Methodology: We prospectively followed up six children who underwent left cardiac sympathetic denervation (LCSD) for JLNS in view of high-risk features despite being on maximally tolerated doses of oral propranolol.

Clinical profile and outcomes of semi-permanent pacing in a tertiary care institute in southern India.

Background: Semi-permanent pacing (SPP) includes the placement of a permanent lead through the internal jugular vein and connection to a pulse generator on the skin outside the venous access site.

Aim: To evaluate the clinical profile and outcomes of semi-permanent pacing in a tertiary care institute in Southern India.

Methods: This is a retrospective observational study.

A Team-Based Approach Toward Risk Factors of Atrial Fibrillation.

Atrial fibrillation (AF), being the most common arrhythmia, the service of primary care physicians and internists in preventing, identifying, and treating AF is of paramount importance. There are nonmodifiable, modifiable, and reversible risk factors for AF. The modifiable risk factors include hypertension, obesity, coronary artery disease, heart failure, diabetes mellitus etc.

Cardiac resynchronization with His-CRT-D in a patient with severe heart failure and Scimitar syndrome.

Cardiac resynchronization therapy with His-bundle pacing is evolving rapidly as a viable cardiac device strategy for the treatment of severe chronic heart failure. The success of this technique in patients with congenital heart disease is facilitated by advanced integrated imaging modalities. We report a case of cardiac resynchronization therapy with His-bundle pacing with defibrillator for the management of a patient with heart failure with severely reduced ejection fraction, left bundle branch block, and congenital heart disease characterized by Scimitar syndrome with cardiac dextroposition.

Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism?

33 year old gentleman has undergone an electrophysiology study for recurrent paroxysmal palpitation. During one of the episodes of palpitation a regular narrow QRS tachycardia was documented which has terminated with intravenous adenosine. Baseline electrocardiogram did not show any pre-excitation.

Classical response of antidromic atriofascicular tachycardia to premature atrial extrastimulus delivered during septal refractoriness.

A 23-year-old gentleman presented with a history of palpitations. The 12-lead electrocardiogram showed no manifest ventricular pre-excitation. Echocardiogram was within normal limits.

An unusual cause of heart failure in a young man.

A 21year old gentleman was admitted with shortness of breath and heart failure. He was noted to have incessant supraventricular tachycardia which was refractory to pharmacological and electrical cardioversion. Electrophysiology study revealed focal atrial tachycardia from an unusual location which was successfully ablated.

RBBB tachycardia with north-west axis. What is the mechanism?

RBBB tachycardia with NW axis is considered to be VT unless proved otherwise. However underlying conduction system disease can produce electrocardiographic patterns suggestive of bundle branch block with extreme left axis which can cause difficulty in differentiating VT from SVT as in this case.