Pacing and Clinical Electrophysiology : PACE

BACKGROUND: J waves may be augmented by coronary angiography (CAG) or intracoronary drug administration but the underlying mechanism is unknown. PURPOSE: The effect of intracoronary normal saline (NS) on J waves were investigated. PATIENTS AND METHODS: After the standard CAG using iopamidol (IopamiroR Inj), NS was injected into the right coronary artery in 10 patients with and eight patients without J waves at the baseline. The 12-lead ECG was monitored, stored on a computer and retrieved later for measurement of the J wave amplitude before or during the coronary interventions...

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No abstract text is available yet for this article.

BACKGROUND: The existing literature regarding the treatment strategy for high-power short-duration (HPSD) ablation in patients diagnosed with atrial fibrillation (AF) is currently insufficient. The objective of this study is to perform a comparative analysis evaluating the effectiveness, safety, and procedural efficiency of HPSD versus cryoballoon ablation (CBA) for AF. METHODS: A comprehensive search was conducted in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and ClinicalTrials...

INTRODUCTION: Closed Loop Stimulation (CLS) is a rate-responsive algorithm that adjusts heart rate (HR) based on changes in intracardiac impedance measured from the right ventricle lead. However, the use of CLS in conduction system pacing has not been investigated. In this retrospective study, we aimed to assess whether CLS with left bundle branch area pacing (LBBAP) can generate an appropriate distribution of HR in daily life. METHODS AND RESULTS: Our study included 24 patients with CLS pacing and chronotropic incompetence, comparing them with 19 patients receiving DDD pacing, all with LBBAP...

BACKGROUND: Electromagnetic interference (EMI) encompasses electromagnetic field signals that can be detected by a device's circuitry, potentially resulting in adverse effects such as inaccurate sensing, pacing, device mode switching, and defibrillation. EMI may impact the functioning of Cardiac Implantable Electronic Devices (CIEDs) and lead to inappropriate therapy. METHOD: An experimental measuring device, a loop antenna mimicking the implantable cardioverted defibrillator (ICD) antenna, was developed, and validated at the US Food and Drug Administration (FDA) and sent to Wright State University for testing...

BACKGROUND: Several studies have evaluated the role of QRS duration (QRSd) or QRS narrowing as a predictor of response to cardiac resynchronization therapy (CRT) to reduce nonresponders. AIM: Our study aimed to determine the correlation between the relative change in QRS index (QI) compared to clinical outcome and prognosis in patients who underwent CRT implantation. METHODS: A three-centers study involving 398 patients with a CRT device was conducted...

While Brugada syndrome (BrS) is well described in adults and older children, presentation of BrS within the first 12 months of life is rare and therefore poorly characterized. We report a 7-year-old male with a malignant BrS phenotype with onset at 8 months of age, leading to multiple ventricular tachycardia (VT) and ventricular fibrillation (VF) related cardiac arrests and ultimately his death. The report is supplemented by a comprehensive review of existing literature on infantile-onset BrS and unique features in this population are discussed...

We report a case of a 44-year-old male who underwent an electrophysiological study for symptomatic supraventricular tachycardia (SVT) with wide QRS complex. The SVT was diagnosed as an antidromic atrioventricular reentrant tachycardia (AVRT) via antegrade conduction of left-sided accessory pathway (AP). However, the QRS morphology changed during the SVT, and then the SVT was terminated spontaneously. The mapping of AP was performed during sinus rhythm, and the radiofrequency application successfully eliminated the AP, which rendered tachycardias non-inducible...

OBJECTIVE: This study evaluates the feasibility and efficacy of implanting a leadless pacemaker at the right atrial appendage (RAA) in a preclinical minipig model, aiming to address the limitations of atrial pacing with current leadless devices like the Medtronic Micra, which is typically used for right ventricular implantation. METHODS: Four minipigs, each with a median body weight of 45.8 ± 10.0 kg, underwent placement of the Micra transcatheter pacing system (TPS) via the right femoral vein into the RAA apex...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

The pacing threshold is important for leadless pacemakers, as the pacing output has a significant impact on battery longevity. Acute pacing rate-dependent threshold increases have also been reported with leadless pacemakers. In the present case, we experienced a case in which the threshold, which had been raised in the acute phase, once showed a tendency to improve, but then worsened again. And, as in previous reports, thresholds improved completely in the chronic phase. Repeated retrieval and reimplantation of leadless pacemakers increases the likelihood of fatal complications, so being aware of such phenomenon may prevent unnecessary procedure and complications...

BACKGROUND: The disease related to the heart is serious and can lead to death. Precise heart disease prediction is imperative for the effective treatment of cardiac patients. This can be attained by machine learning (ML) techniques using healthcare data. Several models on the basis of ML predict and identify disease in the heart, but this model cannot manage a huge database because of the deficiency of the smart model. This paper provides an optimized SpinalNet with a MapReduce model to categorize heart disease...

BACKGROUND: T-wave memory (TWM) is a rare cause of T-wave inversion (TWI). Alterations in ventricular activation due to abnormal depolarization may cause repolarization abnormalities on the ECG, even if myocardial conduction returns to normal. These repolarization changes are defined as TWM. In our study, we aimed to determine the frequency of TWM development and the predictors affecting it in the pediatric population who underwent accessory pathway (AP) ablation due to Wolff-Parkinson-White (WPW) syndrome...

BACKGROUND: Lesion durability and transmurality are crucial for successful radiofrequency (RF) ablation. This study provides a model of real-time RF lesion visualization and insights into the role of underlying parameters, as local impedance (LI). METHODS: A force-sensing, LI-sensing catheter was used for lesion creation in an ex vivo model involving cross-sections of porcine cardiac preparations. During 60 s of RF application, one measurement per second was performed regarding lesion size and available ablation parameters...

The rapid growth in computational power, sensor technology, and wearable devices has provided a solid foundation for all aspects of cardiac arrhythmia care. Artificial intelligence (AI) has been instrumental in bringing about significant changes in the prevention, risk assessment, diagnosis, and treatment of arrhythmia. This review examines the current state of AI in the diagnosis and treatment of atrial fibrillation, supraventricular arrhythmia, ventricular arrhythmia, hereditary channelopathies, and cardiac pacing...

A larger left bundle branch (LBB) potential or LBB current of injury (COI) indicates a low LBB capture threshold in LBB pacing. During LBB pacing in an 85-year-old woman, achieving a low LBB capture threshold did not initially present with a larger LBB potential or LBB COI, but rather with a new initial negative deflection in a ventricular electrogram. LBB COI gradually developed over 7 min thereafter, which suggested that the lead tip had reached the left ventricular subendocardium. Therefore, this negative deflection may be the first sign to avoid further lead rotation...

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, significantly impacting patients' quality of life and increasing the risk of death, stroke, heart failure, and dementia. Over the past two decades, there have been significant breakthroughs in AF risk prediction and screening, stroke prevention, rhythm control, catheter ablation, and integrated management. During this period, the scale, quality, and experience of AF management in China have greatly improved, providing a solid foundation for the development of the guidelines for the diagnosis and management of AF...

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