Two-year Outcomes of Ventricular-demand Leadless Pacemaker Therapy for Heart Block After Transcatheter Aortic Valve Replacement.

Ventricular-demand leadless pacemakers (VVI-LPMs) have often been used as an alternative to atrioventricular (AV) synchronous transvenous pacemakers (DDD-TPMs) in patients with high-grade AV block following transcatheter aortic valve replacement (TAVR). However, the clinical outcomes of this unusual usage are not elucidated. Patients who received permanent pacemakers (PPMs) owing to new-onset high-grade AV block after TAVR from September 2017 to August 2020 at a high-volume center in Japan were included in the analysis, and the clinical courses of VVI-LPM and DDD-TPM implants through 2 years of follow-up were compared retrospectively.

Clinical Outcomes of Non-Atrial Fibrillation Bradyarrhythmias Treated With a Ventricular Demand Leadless Pacemaker Compared With an Atrioventricular Synchronous Transvenous Pacemaker - A Propensity Score-Matched Analysis.

Background: Implanting a ventricular demand leadless pacemaker (VVI-LPM) for patients with non-atrial fibrillation (AF) bradyarrhythmias such as sick sinus syndrome (SSS) or high-grade (i.e., second- or third-degree) atrioventricular (AV) block is not recommended unless they have limited vascular access or a high infection risk; nevertheless, an unexpectedly high number of VVI-LPM implantations have been performed.

Spontaneous Resolution of Residual Shunting in 2 Compromised Patients after Amplatzer Occlusion of Postinfarction Ventricular Septal Defects.

Ventricular septal defect (VSD) is a rare, potentially fatal complication of acute myocardial infarction. When surgical closure is contraindicated, transcatheter closure may be an alternative. Residual shunting after transcatheter closure of postinfarction VSDs has been reported; however, we found few cases of this in patients who also had severe heart failure or hemolysis.

Percutaneous coronary intervention without use of guiding catheters for extreme downsizing: the Emperor's new clothes technique.

A 72-year-old male with effort angina pectoris and old myocardial infarction underwent percutaneous coronary intervention (PCI). A 4 Fr sheath was inserted in the radial artery. After diagnostic angiography, a guidewire was inserted from the diagnostic catheter.