Two cases of inappropriate sinus tachycardia refractory to combined pharmacotherapy (beta-blocker, ivabradine) are described. Both were female patients (28 and 45 years-old) and underwent sinus node modification/ablation using non-contact mapping (EnSite Array). Since ablation had to be performed in both cases very close to the phrenic nerve (captured during 10V pacing at ablation spots) its function was monitored during ablation with constant phrenic nerve pacing from the superior vena cava. One case was successful after single and straightforward ablation session, the other case despite several attempts and initially good result had recurrences; first recurrence two days after cryoablation, and second three weeks after radiofrequency ablation with irrigated tip catheter.
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J Cardiol Cases
January 2025
Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
Unlabelled: There are some reports of atrial screw-in lead perforation, but the entire lead body is rarely exposed outside the right atrium at an early stage of the procedure. A man in his 80s had undergone catheter ablation for atrial fibrillation (AF) and had recurrent AF and tachycardia-bradycardia syndrome with 8.8 s of sinus arrest, which caused presyncope.
View Article and Find Full Text PDFJ Clin Monit Comput
January 2025
Department of Electrical Engineering, Eindhoven University of Technology, Groene Loper 3, 5612 AZ, Eindhoven, the Netherlands.
Unobtrusive pulse rate monitoring by continuous video recording, based on remote photoplethysmography (rPPG), might enable early detection of perioperative arrhythmias in general ward patients. However, the accuracy of an rPPG-based machine learning model to monitor the pulse rate during sinus rhythm and arrhythmias is unknown. We conducted a prospective, observational diagnostic study in a cohort with a high prevalence of arrhythmias (patients undergoing elective electrical cardioversion).
View Article and Find Full Text PDFJACC Clin Electrophysiol
January 2025
Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA. Electronic address:
Background: In patients with structurally normal hearts, algorithms using surface electrocardiographic P-wave morphology are helpful to predict focal atrial tachycardia (FAT) location. However, these algorithms have not been formally assessed in patients with adult congenital heart disease (ACHD).
Objectives: This study sought to assess the efficacy of FAT-location prediction algorithms in an adult population of patients with ACHD.
Arrhythm Electrophysiol Rev
December 2024
Heart Rhythm Research Group, Division of Biomedical Sciences, Warwick Medical School, Clinical Sciences Research Laboratory Coventry, UK.
Functional substrate mapping has emerged as an essential tool for electrophysiologists, overcoming many limitations of conventional mapping techniques and demonstrating favourable long-term outcomes in clinical studies. However, a consensus on the definition of 'functional substrate' mapping remains elusive, hindering a structured approach to research in the field. In this review, we highlight the differences between 'functional mapping' techniques (which assess tissue response to the 'electrophysiological stress' using short coupled extrastimuli) and those highlighting regions of slow conduction during sinus rhythm.
View Article and Find Full Text PDFCureus
January 2025
Emergency Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA.
Anticholinergic toxicity typically presents with symptoms of cutaneous vasodilation, delirium, mydriasis, urinary retention, hyperthermia, anhidrosis, and tachycardia. This case report presents a 68-year-old female patient who exhibited some of these signs and symptoms after ingesting an unknown quantity of dicyclomine. However, she displayed one notable exception to the classic toxidrome.
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