Enhanced detection of atrial tachyarrhythmias with pacing devices by using more accurate atrial sensing.

Purpose: Cardiac pacing devices can detect and monitor atrial tachyarrhythmias (ATA) which increase the risk of thromboembolic complications. The aim of this study was to compare (1) two different atrial leads and (2) standard and optimized settings to detect ATA and reject far-field R-wave signal (FFRW).

Methods: This was a prospective, randomized multi-center trial comparing St.

Coronary artery disease in congenital single coronary artery in adults: A Dutch case series.

Aim: To assess the current diagnostic and therapeutic management and the clinical implications of congenital single coronary artery (SCA) in adults.

Methods: We identified 15 patients with a SCA detected from four Dutch angiography centers in the period between 2010 and 2013. Symptomatic patients who underwent routine diagnostic coronary angiography (CAG) for suspected coronary artery disease and who incidentally were found to have isolated SCA were analyzed.

Cardiac involvement in Dutch patients with sarcoglycanopathy: a cross-sectional cohort and follow-up study.

Introduction: The aim of this study is to describe the frequency, nature, severity, and progression of cardiac abnormalities in a cohort of Dutch sarcoglycanopathy patients.

Methods: In this cross-sectional cohort study, patients were interviewed using a standardized questionnaire and assigned a functional score. Electrocardiography (ECG), echocardiography, and 24-h ECG were performed.

Clinical results of far-field R-wave reduction with a short tip-ring electrode.

Background: Far-field R-wave (FFRW) sensing of the atrial lead of AAI or DDD pacemakers causes incorrect mode switches and remains a problem in patients with atrial arrhythmias in whom low voltage sensing is essential. We studied a pacing electrode with a short tip-ring distance (1.1 mm).

Routine follow-up after pacemaker implantation: frequency, pacemaker programming and professionals in charge.

Aims: To describe current evidence of the frequency, contents, and involved professionals of the routine follow-up visits in patients who have received a pacemaker (PM).

Methods And Results: The multicentre FOLLOWPACE study prospectively collected data during implantation and follow-up of 1526 patients who received a PM for the first time. A total of 4914 follow-up visits were studied.

Surgical treatment of bilateral aneurysmal coronary to pulmonary artery fistulas associated with severe atherosclerosis.

A 39-year-old diabetic patient with an old inferior wall infarction presented with disabling angina pectoris, despite medical treatment. Coronary angiography showed severe triple-vessel coronary artery disease, and bilateral coronary to pulmonary fistulas originating from the right coronary artery and the left anterior descending coronary artery. Both coronary artery saphenous vein bypass grafting and ligation of the fistulas was performed.

Cardiac and pulmonary investigations in Bethlem myopathy.

Background: Bethlem myopathy is considered a relatively mild neuromuscular disorder without significant cardiac and respiratory involvement.

Objective: To investigate cardiac and respiratory involvement in Bethlem myopathy.

Design: Cross-sectional study.

Verification of pacemaker automatic mode switching for the detection of atrial fibrillation and atrial tachycardia with Holter recording.

Aims: Verification of the accuracy of onset, offset, and duration of automatic mode switching (AMS) of pacemakers compared with onset and end of atrial fibrillation (AF) or atrial tachycardia (AT). Correct pacemaker diagnosis of atrial tachyarrhythmias (AA) is indispensable for reliable automatic prevention and intervention algorithms of AA.

Methods And Results: Comparison was made of the AMS registration of the pacemaker-stored electrograms (EGMs) and the number and cumulative duration of these episodes with continuous 7-day Holter monitoring.

Occlusion of the coronary sinus: a complication of resynchronisation therapy for severe heart failure.

The finding of complete obstruction of the proximal coronary sinus after left ventricular (LV) lead extraction during LV lead replacement is uncommon. In our case, we used a large collateral branch of the middle cardiac vein as an alternative route to the postero-lateral region. We have termed this the 'collateral approach'.

A technique of lead insertion for low atrial septal pacing.

Background: Pacing in the low right atrial septum (LAS) appears superior to right atrial appendage or free wall stimulation for the prevention of paroxysmal atrial fibrillation. However, insertion of active fixation lead in the low right atrial septal position is difficult and time consuming, inhibiting application of this pacing method in daily practice.

Methods: The technique of handling and positioning of a new "over the wire" lead system is presented with emphasis on electrocardiographic P wave pattern and fluoroscopic landmarks.

Electrocardiographic characteristics in low atrial septum pacing.

Aim: The aim of the study was to compare P-wave morphology and duration in pacing from the low right atrial septal wall and the high right atrial appendage (RAA).

Methods: The electrocardiogram (ECG) of 50 patients with low atrial septum (LAS) pacing and that of 50 patients with RAA pacing were compared with their electrocardiogram during sinus rhythm.

Results: In the frontal plane, patients with LAS pacing showed a superior P-wave axis between -60 degrees and -90 degrees .

Electrical characteristics of low atrial septum pacing compared with right atrial appendage pacing.

Aim: The study was designed to compare the electrical characteristics of atrial leads placed in the low atrial septum (LAS) with those placed in the right atrial appendage (RAA) associated with dual chamber pacing.

Methods: In 86 patients an active-fixation (St. Jude Medical's Tendril DX model 1388T) atrial lead was positioned in RAA and in 86 patients the same model atrial lead was placed in the LAS.

Meta-analysis of clinical characteristics of 299 carriers of LMNA gene mutations: do lamin A/C mutations portend a high risk of sudden death?

This study evaluated common clinical characteristics of patients with lamin A/C gene mutations that cause either isolated dilated cardiomyopathy or dilated cardiomyopathy in association with skeletal muscular dystrophy. We pooled clinical data of all published carriers of lamin A/C gene mutations as cause of skeletal and/or cardiac muscle disease and reviewed ECG findings. Cardiac dysrhythmias were reported in 92% of patients after the age of 30 years; heart failure was reported in 64% after the age of 50.

Understanding capture detection.

Automatic capture detection systems are currently available in several cardiac pacing devices. All current systems use low-polarization electrodes and no beat to beat detection system is available for all types of electrodes. In addition the success ratio for currently available systems is not always 100%.