Vagal response during radiofrequency catheter ablation initiated from right superior pulmonary vein: Incidence, risk factors, and clinical outcomes.

Background: The vagal response (VR) is unavoidable during pulmonary vein isolation (PVI) for atrial fibrillation (AF). In this study, we aimed to investigate the incidence, risk factors, and clinical outcomes of VR during PVI initiated from the right superior pulmonary vein (RSPV).

Methods: Patients with AF were consecutively enrolled.

Bradyarrhythmias in patients with embolic stroke of undetermined source: a tight relationship with atrial cardiomyopathy.

Background: Implantable loop recorders (ILRs) have been shown to significantly improve the detection of atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS). The incidence and characterization of bradyarrhythmias in this subset of patients is still unknown.

Methods: All consecutive patients who received ILRs, after an ESUS, between March 2015 and December 2022 in our Center were retrospectively enrolled and analyzed.

The Association Between Chronic Kidney Disease and Third-Degree Atrioventricular Block: A Danish Nationwide Study.

Background: Chronic kidney disease (CKD) is frequently complicated by arrhythmias, plausibly leading to the increased risk of sudden cardiac death in this population. However, little is known about the association between CKD and third-degree atrioventricular block (3AVB) and need for permanent pacing.

Objectives: This study aimed to investigate the association between CKD and 3AVB.

Cardiac Implantable Electronic Devices in Cardiac Transplant Patients: A Comprehensive Review.

A fraction of patients (approximately 10%) undergoing heart transplantation require permanent pacemaker (PPM) implantation due to sinus node dysfunction or atrioventricular block, occurring either shortly after surgery or later. The incidence of PPM implantation has declined to less than 5% with the introduction of bicaval anastomosis transplantation surgery. Pacing dependency during follow-up varies among recipients.

Contribution of Continuous Intravenous Lidocaine in Managing Congenital Long QT Syndrome with 2:1 Atrioventricular Block.

Congenital long QT syndrome (LQTS) is a rare hereditary cardiac disorder characterized by prolongation of the QT interval on electrocardiogram (ECG), predisposing affected individuals to life-threatening arrhythmias. We present a case of a newborn with congenital LQTS and 2:1 atrioventricular (AV) block who presented with bradycardia and QT prolongation. Continuous intravenous lidocaine infusion was initiated, because of hypoglycemia with beta-blockers, resulting in stabilization of AV conduction and prevention of malignant arrhythmias.

Atypical Wenckebach AV Block in the Infra-Hisian Region: Clinical Implications and Management.

BACKGROUND Second-degree atrioventricular (AV) block is a frequently encountered conduction abnormality on surface electrocardiogram (ECG). However, it does not always imply a block at the AV nodal level. In rare cases, this block can occur below the bundle of His, within the infra-Hisian region of the His-Purkinje system.

The Mechanism and Management of Pneumopericardium Caused by Right Ventricular Lead Perforation.

An 83-year-old man underwent dual-chamber pacemaker placement for complete atrioventricular block at another hospital. The active-fixation ventricular lead was positioned on the free wall of the anterior right ventricle. Ventricular pacing failure occurred on the day after pacemaker implantation, and fluoroscopy revealed right ventricular (RV) lead perforation.

A case report of pre-implantation feasibility test for combining leadless pacemaker and subcutaneous implantable cardioverter-defibrillator in adult congenital heart disease.

Unlabelled: New cardiac implantable electronic devices (CIEDs), such as leadless pacemakers and subcutaneous implantable cardioverter defibrillators (S-ICDs), are being used in patients with adult congenital heart disease. The selection of CIEDs often requires careful consideration due to technical challenges posed by a unique heart structure. A 27-year-old man following a surgical tetralogy of Fallot (TOF) repair developed non-sustained ventricular tachycardia, sick sinus syndrome, and complete atrioventricular block.

A Novel Focal Lattice Tip Catheter Toggling Between Pulsed Field Energy and Radiofrequency for Atrial Arrhythmia Ablation: Results from a Real-World, Multicenter Registry.

Introduction: A novel focal lattice tip catheter allowing the delivery of either pulsed field (PF) or radiofrequency (RF) energy has recently received regulatory approval. The technology features a proprietary 3D electroanatomical mapping system.

Objective: to describe the first real-world and multicentre experience.

Short RP Interval and Long PR Interval: What Is the Cardiac Rhythm?

Marked first-degree atrioventricular block with a PR interval ≥500 ms is rare, leading to unusual P-wave placement. In this case, the P waves immediately after the QRS waves complicated rhythm interpretation. Close attention to P-wave morphology and fused premature ventricular complexes can be important for a proper diagnosis.

A Novel Wave-speed Mapping Method for Visualizing Accessory Pathways in Wolff-Parkinson-White Syndrome.

Introduction: Catheter ablation (CA) is the first-line treatment with a high success rate for patients with symptomatic Wolff-Parkinson-White syndrome, while three-dimensional (3D) mapping systems enable the identification of accessory pathways (APs). We aimed to develop a novel mapping method using wave-speed mapping (WSM) to determine AP locations and CA outcomes.

Methods And Results: This study included 19 patients diagnosed with atrioventricular (AV) reciprocating tachycardia.

End-stage heart failure and heart transplant in cardiac sarcoidosis: a case series.

Background: Diagnosing cardiac sarcoidosis (CS) is challenging. Immunosuppressive therapies are less effective in end-stage disease, and often heart transplant (HT) is the only available option. We present a series of advanced CS cases, requiring HT, along with a review of the literature evidence in this field.

Is conduction system pacing more effective than right ventricular pacing in reducing atrial high-rate episodes in patients with heart failure and preserved ejection fraction?

Background: The relationship between conduction system pacing (CSP) and the incidence of atrial fibrillation (AF) in patients with heart failure and preserved ejection fraction (HFpEF) remains uncertain. This study aims to investigate the occurrence of atrial high-rate episodes (AHREs) following CSP in patients with HFpEF, in comparison to right ventricular pacing (RVP).

Methods: Patients with HFpEF who received dual-chamber pacemakers for atrioventricular block were retrospectively enrolled from January 2018 to January 2023.

Prognostic Value of Ultra-Short Heart Rate Variability Measures Obtained from Electrocardiogram Recordings of Hospitalized Patients Diagnosed with Non-ST-Elevation Myocardial Infarction.

Myocardial infarction (MI) is a common emergency with high rates of morbidity and mortality. Current risk stratification scores for non-ST-elevation MI (NSTEMI) use subjective or delayed information. Heart rate variability was shown to correlate with prognosis following MI.

Periannular extension of infective endocarditis with atrioventricular block successfully treated with antibiotic therapy after transcatheter aortic valve implantation: a case report.

Background: Although transcatheter aortic valve implantation (TAVI) is performed for very elderly patients in whom surgical aortic valve replacement (SAVR) poses unacceptably high operative risk, some of these patients are ultimately forced to undergo open surgery when TAVI is complicated by infective endocarditis (IE). To our knowledge, there have been no reports of cases with periannular extension of IE and atrioventricular block successfully treated by antibiotics without valve replacement.

Case Summary: An 80-year-old Japanese man who had undergone TAVI developed IE with loss of consciousness on Day 39 after the procedure.

Amyloidosis and the Syncopal Enigma.

Background: Syncope is a common presenting complaint in the outpatient setting and requires a thoughtful and meticulous approach to history-taking skills. This is crucial in discerning cardiac versus non-cardiac etiologies, underscoring the pivotal role of healthcare professionals in the diagnostic process.

Case Report: This is a case of a 76-year-old male who presented to the primary care clinic following an episode of syncope with abrupt loss of consciousness.

Uncommon Cardiac Perforation and Lead Displacement After Pacemaker Implantation: A Case Study and Diagnostic Insights.

BACKGROUND Pacemaker implantation serves as a prevalent therapeutic approach for bradycardia or atrioventricular blocks associated with syncope. While generally regarded as safe, this procedure is not devoid of rare yet severe complications. Examples include lead-induced cardiac perforation resulting in pneumothorax or pericardial effusion, which pose life-threatening risks.

Effect of excitation sequence of myocardial contraction on the mechanical response of the left ventricle.

In the past two decades there has been rapid development in the field of computational cardiac models. These have included either (i) mechanical models that assumed simultaneous myocardial activation, or (ii) electromechanical models that assumed time-varying myocardial activation. The influence of these modelling assumptions of myocardial activation on clinically relevant metrics, like myocardial strain, commonly used for validation of cardiac models has yet to be systematically examined, leading to uncertainty over their influence on the predictions of these models.

Prophylactic Permanent Pacemaker Implantation for Baseline Right Bundle Branch Block in Patients Undergoing Transcatheter Aortic Valve Replacement: Clinical Efficacy, Safety, and Long-Term Pacing Requirement.

Background: Baseline right bundle branch block (RBBB) is an established predictor of permanent pacemaker (PPM) requirement after transcatheter aortic valve replacement (TAVR). There are limited data to support prophylactic PPM implantation in advance of TAVR. We aimed to evaluate the efficacy and safety of prophylactic PPM implantation in patients with RBBB prior to TAVR, and to identify the predictors of pacing dependence after TAVR.

Clinical outcomes during and after wearable cardioverter defibrillator use in Japanese patients with heart failure: A single-center experience.

Background: A wearable cardioverter defibrillator (WCD) is indicated for a limited period in patients at high risk of sudden cardiac death (SCD). Nonischemic heart failure (HF) is common among Japanese patients with HF. The aim of this study was to evaluate the incidence of fatal arrhythmias during WCD use and the clinical outcomes after WCD withdrawal in Japanese patients with HF.

A spontaneous or pacing-induced transition from slow-fast atrioventricular nodal reentrant tachycardia to fast-slow type using a superior slow pathway.

Wenckebach-periodic VA prolongation and abrupt shortening of HH interval during tachycardia indicate (i) a retrograde block at the upper common pathway that manifested a retrograde atrial activation via the superior slow pathway, and (ii) an antegrade return of a retrograde atrial activation to His bundle via the fast pathway.

An abrupt loss of capture during permanent His-bundle pacing: Assessment of mechanism underlying late capture threshold rise.

A His-bundle (HB) capture threshold rise is still a significant concern in permanent His-bundle pacing (HBP). We present a case where an abrupt increase in HB threshold and loss of capture occurred even after 3.5 years of stable permanent HBP for an atrioventricular block.

Implications of Primary Bradycardia in Patients with Hypertrophic Cardiomyopathy.

Background: Hypertrophic cardiomyopathy (HCM) with tachyarrhythmias has been extensively studied in recent years. The characteristics of primary bradycardia in HCM remain largely unknown.

Objective: This study aimed to comprehensively investigate the prevalence, clinical features, and prognosis of primary bradycardia in patients with HCM in a large cohort.