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J Electrocardiol 2018 Dec 18;53:28-30. Epub 2018 Dec 18.

Department of Medicine, Section of Cardiology at Baylor College of Medicine and Texas Heart Institute, Baylor St. Luke's Medical Center, Houston, Texas, United States of America. Electronic address:

A 67 year old female with diabetes mellitus type 2, chronic kidney disease, ischemic cardiomyopathy, status post biventricular implantable cardioverter-defibrillator presented to the Heart Failure clinic for routine follow up with a tachycardia with alternating pacemaker spikes. Read More

Elife 2018 12 31;7. Epub 2018 Dec 31.

Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, United States.

Neuronal networks generating hindlimb locomotion are located in the spinal cord. The mechanisms underlying spinal rhythmogenesis are unknown but network activity and interconnectivity of excitatory interneurons likely play prominent roles. Here, we investigate interconnectivity within the Shox2 interneuron population, a subset of which has been suggested to be involved in locomotor rhythm generation, using paired recordings in isolated spinal cords or slices from transgenic mice. Read More

Transplant Proc 2018 Dec 7;50(10):3988-3994. Epub 2018 Sep 7.

Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address:

Background: Combined liver and kidney transplant is a very complex surgery. To date, there has been no report on the intraoperative management of patients with impaired cardiac function undergoing simultaneous ABO-compatible liver and ABO-incompatible kidney transplant from 2 living donors.

Case Report: A 60-year-old man underwent simultaneous ABO-compatible liver and ABO-incompatible kidney transplant from 2 living donors because of IgA nephropathy and alcoholic liver cirrhosis. Read More

Crit Ultrasound J 2018 Nov 12;10(1):30. Epub 2018 Nov 12.

Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan.

Systolic anterior motion (SAM) after mitral valve repair (MVR) can adversely affect hemodynamics due to exacerbation of left ventricular outflow tract obstruction and mitral regurgitation. Intraoperative transient SAM after MVR can usually be managed with hemodynamic maneuvers under continuous monitoring by transesophageal echocardiography (TEE). However, during postoperative intensive care management, transient SAM is seldom diagnosed and the start of treatment may be delayed. Read More

Congenit Heart Dis 2018 Oct 23. Epub 2018 Oct 23.

Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia.

Introduction: In the pediatric Appropriate Use Criteria (AUC), abnormal electrocardiogram (ECG) in an asymptomatic patient has been rated as an "Appropriate" indication for transthoracic echocardiogram (TTE). We hypothesized that the yield of abnormal findings on TTE for this indication will be low.

Methods: All asymptomatic patients (≤ 18 years) from January 1, 2015 to December 31, 2017 who underwent initial outpatient evaluation at our center and had a TTE ordered for an abnormal ECG, were included. Read More

Front Physiol 2018 8;9:1227. Epub 2018 Oct 8.

Heart Research Center Göttingen, Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.

Recently, abundant axial tubule (AT) membrane structures were identified deep inside atrial myocytes (AMs). Upon excitation, ATs rapidly activate intracellular Ca release and sarcomeric contraction through extensive AT junctions, a cell-specific atrial mechanism. While AT junctions with the sarcoplasmic reticulum contain unusually large clusters of ryanodine receptor 2 (RyR2) Ca release channels in mouse AMs, it remains unclear if similar protein networks and membrane structures exist across species, particularly those relevant for atrial disease modeling. Read More

J Am Soc Echocardiogr 2019 Jan 16;32(1):145-156. Epub 2018 Oct 16.

Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada. Electronic address:

Background: Accurate fetal arrhythmia (FA) diagnosis is key for effective management. Currently, FA assessment relies on standard echocardiography-based techniques (M mode and spectral Doppler), which require adequate fetal position and cursor alignment to define temporal relationships of mechanical events. Few data exist on the application of color Doppler tissue imaging (c-DTI) in FA assessment. Read More

Acute Med Surg 2018 Oct 25;5(4):380-383. Epub 2018 Jun 25.

Department of Emergency and Critical Care Medicine Tokai University School of Medicine Isehara Kanagawa Japan.

Case: A 45-year-old man presented to our emergency department with disturbance of consciousness; he had mentioned to his family earlier about a drug overdose. When first responders arrived, he suffered cardiac arrest. Cardiac arrest due to drug overdose was diagnosed. Read More

J Arrhythm 2018 Oct 13;34(5):565-571. Epub 2018 Aug 13.

Cardiology Department The Royal Children's Hospital Melbourne Victoria Australia.

Background: Supraventricular tachycardia is a group of rhythm disturbances that affect 1 in 300-1200 Australian children annually. The differentiation of supraventricular tachycardia (SVT) symptoms and age of onset according to their subtype is not well understood in the pediatric population. Most studies rely on ECG criteria only to characterize the subtype of the SVT, which is not applicable to all subtypes. Read More

Arh Hig Rada Toksikol 2018 Sep;69(3):275-277

Department of Internal Medicine, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

A 37-year-old male was referred to us about one hour after deliberate ingestion of two 3-gram aluminium phosphide (ALP) tablets. Three hours after admission, his blood pressure dropped to 85/55 mmHg, his heart rate increased to 120 bpm, O2 saturation dropped to 82 %, and the electrocardiogram showed junctional rhythm. We started whole blood exchange, and gross haematuria and jaundice ensued. Read More

J Cardiol Cases 2018 Sep 18;18(3):99-102. Epub 2018 Jun 18.

Department of Cardiovascular Surgery, New Tokyo Hospital, Chiba, Japan.

Although surgical left atrial (LA) volume reduction combined with mitral valve surgery and/or surgical ablation for atrial fibrillation has been reported to be effective, its long-term outcomes in the absence of mitral procedure are not well established. A 74-year-old man with two previous sternotomies-the first for pericardiectomy due to constrictive pericarditis and the second for mitral valve replacement with mechanical valve and tricuspid annuloplasty-presented with heart failure and thrombus in his giant left atrium (1291 mL), complicated by cerebral infarction. His electrocardiogram showed rate-controlled persistent atrial fibrillation. Read More

J Cardiol Cases 2018 May 9;17(5):178-181. Epub 2018 Feb 9.

Division of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Komatsu, Japan.

The long-term effects of enzyme replacement therapy (ERT) on cardiac function and the conduction system in Fabry disease are not clearly understood. We report a case of a 48-year-old man with non-classical Fabry disease treated with ERT for 11 years. He was diagnosed with Fabry disease at age 27 years based on the presence of decreased alpha-galactosidase A activity in the peripheral leukocytes and of the causal alpha-galactosidase A mutation (Val339Gln). Read More

BMJ Case Rep 2018 Oct 2;2018. Epub 2018 Oct 2.

Cardiovascular Medicine, University of Missouri, Columbia, Missouri, USA.

A 69-year-old severely obese diabetic woman developed nausea, vomiting and diarrhoea which caused multiple metabolic alterations leading to hypotension and bradycardia due to slow atrioventricular junctional rhythm. Transcutaneous pacing (TCP) was initiated and maintained until the underlying heart rate and blood pressure normalised. TCP gel pads were kept in place prophylactically after pacing was terminated. Read More

PLoS One 2018 12;13(9):e0203828. Epub 2018 Sep 12.

Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.

Objective: We sought to investigate determinants and prognosis of sinus node dysfunction (SND) after surgical ablation of atrial fibrillation (AF) with concomitant mitral valve (MV) surgery. A total of 202 patients who underwent surgical AF ablation with concomitant MV surgery were studied.

Study Design And Setting: SND was defined as electrocardiographic manifestations, such as junctional bradycardia, symptomatic sick sinus syndrome, or symptomatic sinus bradycardia, 7 days after surgery. Read More

J Electrocardiol 2018 Nov - Dec;51(6S):S83-S87. Epub 2018 Aug 23.

Department of Physiological Nursing, University of California, San Francisco, CA, USA; Institute for Computational Health Sciences, University of California, San Francisco, CA, USA; Department of Neurological Surgery, University of California, San Francisco, CA, USA; Department of Neurosurgery, University of California, Los Angeles, CA, USA.

Background: Accurate and timely detection of atrial fibrillation (AF) episodes is important in primarily and secondary prevention of ischemic stroke and heart-related problems. In this work, heart rate regularity of ECG inter-beat intervals was investigated in episodes of AF and other rhythms using a wavelet leader based multifractal analysis. Our aim was to improve the detectability of AF episodes. Read More

J Card Surg 2018 Sep 22;33(9):565-569. Epub 2018 Aug 22.

University Hospital Nantes, Medico-Surgical Federation of Congenital and Pediatric Cardiology, Nantes, France.

Background And Aims: Surgical repair of right partial pulmonary anomalous connection to the superior vena cava (SVC) with the Warden procedure can be complicated by SVC obstruction, pulmonary veins obstruction, and sinus node dysfunction. We review our 20 years of experience with Warden procedures for the repair of right partial pulmonary venous connection to the SVC.

Methods: This was a single-center retrospective study of all patients (pediatric and adult) with right partial pulmonary abnormal venous connections who underwent a complete repair with the Warden procedure between 1997 and 2016. Read More

Heart Rhythm 2018 Aug 10. Epub 2018 Aug 10.

Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:

Background: Narrow QRS tachycardia or premature beat with bystander atrial activation or ventricular-atrial dissociation is an unusual arrhythmia that can present diagnostic and therapeutic challenges. When ventricular-atrial conduction is robust, these arrhythmias can be difficult to distinguish from atrioventricular nodal reentry.

Objective: The purpose of this study was to describe the electrophysiology characteristics, diagnostic maneuvers, and treatment of these types of arrhythmias in a series of 7 cases. Read More

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618788110. Epub 2018 Jul 16.

University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

Permanent pacemaker implantation is a class I indication for all symptomatic patients with complete heart block either congenital or acquired. However, certain portions of patients with congenital complete heart block are asymptomatic. Those patients are often very young, and implanting a permanent pacemaker is not always an easy decision. Read More

Heart Rhythm 2019 Jan 17;16(1):98-105. Epub 2018 Aug 17.

Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, Amsterdam, The Netherlands. Electronic address:

Background: Rare genetic variants in TNNI3K encoding troponin-I interacting kinase have been linked to a distinct syndrome consisting primarily of supraventricular tachycardias and variably expressed conduction disturbance and dilated cardiomyopathy in 2 families.

Objective: The purpose of this study was to identify new genetic variants associated with inherited supraventricular tachycardias, cardiac conduction disease, and cardiomyopathy.

Methods: We conducted next generation sequencing in 3 independent multigenerational families with atrial/junctional tachycardia with or without conduction disturbance, dilated cardiomyopathy, and sudden death. Read More

Ann Thorac Surg 2018 Nov 5;106(5):1561-1569. Epub 2018 Jun 5.

Bluhm Cardiovascular Institute, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Background: There is concern that the right atrial lesions of the maze procedure lead to more permanent pacemakers postoperatively and that they provide little therapeutic advantage over left atrial lesions alone.

Methods: A discussion of the pertinent anatomy related to atrial fibrillation and the performance of the maze procedure, the potential ways that the specialized conduction system could theoretically be damaged by the procedure, non-procedure-related causes for increased postoperative pacemaker requirements, and the basis for the efficacy of the right atrial lesions of the maze procedure are presented. Several factors that can lead to a dysfunctional sinoatrial node preoperatively in patients with atrial fibrillation are also discussed. Read More

Pacing Clin Electrophysiol 2018 10 27;41(10):1372-1377. Epub 2018 Jun 27.

Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Center Hospital, Saglik Bilimleri University, Istanbul, Turkey.

Junctional ectopic tachycardia (JET) is a rare form of arrhythmia that is most commonly seen during infancy. JET is continuous and incessant, characterized by persistently high heart rates that may result in impaired cardiac function and tachycardia-induced cardiomyopathy. Despite the availability of multiple antiarrhythmic treatments, including flecainide and amiodarone, management of JET is generally very difficult. Read More

Heart Rhythm 2018 May 23. Epub 2018 May 23.

State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. Electronic address:

Background: Catheter ablation of ventricular arrhythmias (VAs) originating from the para-Hisian region could be challenging because of a potential damage to atrioventricular conduction system.

Objective: The purpose of this study was to evaluate the safety and efficacy of catheter ablation of VAs originating from the para-Hisian region via a systematic direct approach from aortic sinus cusps (ASCs).

Methods: Twenty-one consecutive patients with VAs with para-Hisian origin were included. Read More

Card Electrophysiol Clin 2018 06;10(2):397-412

Paediatric Cardiology and Cardiac Arrhythmias Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Piazza Sant'Onofrio 4, Rome 00165, Italy.

Arrhythmias have acquired a specific identity in pediatric cardiology, but for pediatric cardiologists it has always been difficult to recognize and treat them. Changes in anatomy and physiology result in electrocardiogram features that differ from the normal adult pattern and vary according to the age of the child. Sinus arrhythmia, ectopic atrial rhythm, "wandering pacemaker," and junctional rhythm can be normal characteristics in children (15%-25% of healthy children can have these rhythms on the electrocardiogram). Read More

J Thorac Cardiovasc Surg 2018 Aug 18;156(2):763-770.e1. Epub 2018 Apr 18.

Division of Cardiology, Children's National Health System, Washington, DC. Electronic address:

Objectives: Postoperative arrhythmias are common in children undergoing congenital heart surgery. We evaluated whether intraoperative administration of magnesium was associated with a reduced occurrence of specific postoperative arrhythmias, as has been described previously, or had a broader effect on multiple arrhythmia types, and whether there existed a dose-effect of intraoperative magnesium.

Methods: We used a historical prospective observational cohort study. Read More

JACC Clin Electrophysiol 2017 Dec 6;3(13):1547-1556. Epub 2017 Nov 6.

Department of Medicine, University of Utah Health Sciences Center, Division of Cardiovascular Medicine, Salt Lake City, Utah.

Objectives: This study sought to describe the clinical features and sites of successful ablation for incessant nodofascicular (NF) and nodoventricular (NV) tachycardias.

Background: Incessant supraventricular tachycardias have been associated with tachycardia-induced cardiomyopathies and have been previously attributed to permanent junctional reciprocating tachycardias, atrial tachycardias, and atrioventricular nodal re-entrant tachycardias. Incessant concealed NF and NV tachycardias have not been described previously. Read More

Heart Rhythm 2018 Sep 28;15(9):1356-1362. Epub 2018 Apr 28.

Cardiology Clinical Academic Group, St. George's University of London, London, United Kingdom. Electronic address:

Background: Idiopathic ventricular ectopy (VE) shows predilection to sites within the left ventricular (LV) base such as the outflow tract/aortic sinuses, LV summit, and areas adjacent to the aortomitral continuity. We characterize VE arising from the inferior septum of the LV base that was successfully managed by LV endocardial ablation from the inferoseptal recess of the LV.

Objective: The purpose of this study was to determine the incidence, electrocardiographic (ECG) findings, electrophysiological findings, and anatomical features associated with VE arising from the basal inferoseptal process of the LV (ISP-LV) ablated using an LV endocardial approach via the inferoseptal recess of the LV. Read More

Pediatr Crit Care Med 2018 Aug;19(8):713-717

All authors: Departments of Cardiovascular Surgery, Pediatric Cardiology, and Medical English Communications Center, University of Tsukuba, Tsukuba, Japan.

Objectives: Junctional ectopic tachycardia is a supraventricular tachyarrhythmia with atrioventricular dissociation that causes life-threatening postsurgical conditions in pediatric heart patients. This study evaluates the efficacy of landiolol hydrochloride for managing junctional ectopic tachycardia.

Design: A single-center retrospective study. Read More

Interact Cardiovasc Thorac Surg 2018 Oct;27(4):536-542

Department of Cardiac Surgery, Trent Cardiac Centre, Nottingham University Hospitals, Nottingham, UK.

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether there was a difference in postoperative outcomes [namely permanent pacemaker (PPM) insertion, rhythm disturbance, reoperation for bleeding, hospital stay and in-hospital mortality] between trans-septal or superior (extended) trans-septal (STS) approaches in comparison with the conventional left atriotomy (LA) used in mitral valve surgery. Using the reported search strategy, 353 papers were found of which 11 represented the best evidence to answer the clinical question. Read More

Nat Commun 2018 03 14;9(1):1062. Epub 2018 Mar 14.

RIKEN Brain Science Institute (BSI), Wako, 351-0198, Japan.

Mammalian circadian clocks have a hierarchical organization, governed by the suprachiasmatic nucleus (SCN) in the hypothalamus. The brain itself contains multiple loci that maintain autonomous circadian rhythmicity, but the contribution of the non-SCN clocks to this hierarchy remains unclear. We examine circadian oscillations of clock gene expression in various brain loci and discovered that in mouse, robust, higher amplitude, relatively faster oscillations occur in the choroid plexus (CP) compared to the SCN. Read More

Medicine (Baltimore) 2017 Dec;96(50):e6997

Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China.

Introduction: Atrial premature contractions (APCs) are commonly encountered in clinical practice. The APCs may influence heart conduction system and induce other arrhythmia. The disorder of atrioventricular conduction is related to electrophysiological phenomena, difficult to understand and diagnose. Read More

Cardiovasc Toxicol 2018 06;18(3):290-293

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Koodakyar Ave., Daneshju Blvd., Velenjak, Tehran, 1985717443, Iran.

Using calcium salts in management of amlodipine overdose is challenging. A 25-year-old male with known history of adult polycystic kidney disease presented with hypotension, tachycardia, and intact neurological status after ingestion of 450 mg of amlodipine. Immediately, normal saline infusion and norepinephrine were initiated. Read More

J Appl Physiol (1985) 2018 Apr 21;124(4):930-937. Epub 2017 Dec 21.

Neurovascular Health Laboratory, Faculty of Physical Education and Recreation, University of Alberta , Edmonton, Alberta , Canada.

Peripheral chemoreflex mediated increases in both parasympathetic and sympathetic drive under chronic hypoxia may evoke bradyarrhythmias during apneic periods. We determined whether 1) voluntary apnea unmasks arrhythmia at low (344 m) and high (5,050 m) altitude, 2) high-altitude natives (Nepalese Sherpa) exhibit similar cardiovagal responses at altitude, and 3) bradyarrhythmias at altitude are partially chemoreflex mediated. Participants were grouped as Lowlanders ( n = 14; age = 27 ± 6 yr) and Nepalese Sherpa ( n = 8; age = 32 ± 11 yr). Read More

Acta Neurochir (Wien) 2018 Mar 3;160(3):479-485. Epub 2018 Jan 3.

Department of Spinal Surgery, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

Transient anoxic seizure upon application of pressure on a giant pseudomeningocele has never been reported in the literature; such abrupt changes in intracranial pressure due to large volume of cerebrospinal fluid (CSF) translocation, if left untreated may lead to permanent cerebral hypoxic injury and death. Here we describe a case of a 26-year-old woman who had undergone lumbar disc surgery in another unit few months ago and developed a large lump around her back. Any pressure on the lump resulted in headaches and at times episodes of seizures. Read More

Pacing Clin Electrophysiol 2018 02 16;41(2):182-193. Epub 2018 Jan 16.

Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky and Lexington VAMC, Lexington, KY, USA.

Background: Ablation is an effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). The occurrence of junctional ectopic rhythm (JER), including junctional ectopic tachycardia, following AVNRT ablation has been described as an extremely rare phenomenon, but may be underestimated. We aimed to determine the incidence of JER following AVNRT ablation within our institution, as well as that reported in the literature via an extensive review. Read More

J Electrocardiol 2018 May - Jun;51(3):555-558. Epub 2017 Dec 7.

Division of Pediatric Cardiology, Department of Pediatrics, Jackson Memorial Hospital, University of Miami/Miller School of Medicine, Miami, Florida, United States. Electronic address:

Heart transplantation is the gold standard for treatment of end stage heart failure. Atrial parasystole (AP), defined as the presence of an additional dissociated atrial pacemaker on a surface electrocardiogram, has been described to be seen after heart transplantation using biatrial surgical technique. AP may pose a challenge in diagnosing underlying rhythm disturbances in these patients. Read More

Korean J Pediatr 2017 Nov 27;60(11):344-352. Epub 2017 Nov 27.

Division of Cardiology, Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.

Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Read More

Medicine (Baltimore) 2017 Nov;96(44):e8559

aEmergency Department bDivision of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Rationale: More mature or older women are more likely to undergo in vitro fertilization and embryo implant. These women have a greater chance of receiving ergonovine therapy because of a suspected abortion. We present this case report to call attention to a latent lethal adverse effect in everyday obstetric practice using ergonovine. Read More

Arch Cardiol Mex 2017 Oct - Dec;87(4):349-351. Epub 2017 Sep 12.

Servicio de Cardiología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España; Unidad de Cardiología, Hospital Ruber Internacional, Madrid, España; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, España.

West J Emerg Med 2017 Aug 10;18(5):963-971. Epub 2017 Jul 10.

Kent Hospital, Department of Emergency Medicine, Warwick, Rhode Island.

Introduction: The electrocardiogram (ECG) is often used to identify which hyperkalemic patients are at risk for adverse events. However, there is a paucity of evidence to support this practice. This study analyzes the association between specific hyperkalemic ECG abnormalities and the development of short-term adverse events in patients with severe hyperkalemia. Read More

Anesth Prog Fall 2017;64(3):165-167

Department of Anesthesiology, Osaka Dental University, Osaka, Japan.

We report a case of junctional rhythm that occurred both preoperatively and later during a portion of general anesthesia. A 19-year-old woman was scheduled to undergo bilateral sagittal split ramus osteotomy after being diagnosed with a jaw deformity. Preoperative electrocardiography (ECG) revealed a junctional rhythm with a slow heart rate (HR). Read More

Pacing Clin Electrophysiol 2017 Nov 20;40(11):1234-1241. Epub 2017 Sep 20.

Department of Pharmacology, Columbia University College of Physicians and Surgeons, New York, New York, USA.

Background: Paroxysmal atrioventricular (A-V) block is relatively rare, and due to its transient nature, it is often under recognized. It is often triggered by atrial, junctional, or ventricular premature beats, and occurs in the presence of a diseased His-Purkinje system (HPS). Here, we present a 45-year-old white male who was admitted for observation due to recurrent syncope and near-syncope, who had paroxysmal A-V block. Read More

Clin Pract 2017 Jun 3;7(3):979. Epub 2017 Aug 3.

Department of Cardiology, Abington Jefferson Health, Abington, PA, USA.

We present here a 45-year-old male with no past medical problem who presented with palpitations. He was found to have supraventricular tachycardia intractable to medical therapy. Later his rhythm converted to junctional tachycardia. Read More

Card Electrophysiol Clin 2017 09;9(3):435-452

Heart and Vessels Department, University of Florence, Largo Brambilla 3, 50134, Firenze (FI), Italy; Cardiovascular Department IRCCS Multimedica, Sesto San Giovanni, Italy, Via Gaudenzio Fantoli, 16/15, 20138 Milano (MI), Italia.

The atrioventricular junction has a central role in electrophysiology, responsible for reentrant and automatic forms of supraventricular tachycardia. During atrioventricular nodal reentry tachycardia, the circuit involves 2 electrophysiologically separate pathways located in the vicinity of the atrioventricular node. Atrioventricular reentry tachycardia is caused by the presence of an accessory pathway located almost anywhere along the atrioventricular groove; the macroreentrant circuit involves the atrioventricular node, the accessory pathway and necessarily portions of atria and ventricles. Read More

Heart Rhythm 2018 01 18;15(1):90-96. Epub 2017 Aug 18.

Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:

Background: Symptomatic second-degree atrioventricular (AV) block is typically treated by implantation of a pacemaker. An otherwise healthy AV conduction system can nevertheless develop AV block due to interference from junctional extrasystoles. When present with a high burden, these can produce debilitating symptoms from AV block despite an underlying normal AV node and His-Purkinje system properties. Read More

Heart Rhythm 2017 11 14;14(11):1649-1654. Epub 2017 Jul 14.

Division of Pediatric Cardiology, Stanford University, Palo Alto, California.

Background: Cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is associated with higher recurrence rates than radiofrequency ablation (RFA). Junctional tachycardia marks procedural success with RFA, but no such indicator exists for cryoablation.

Objective: The purpose of this study as to determine the impact of voltage mapping plus longer ablation lesions on midterm success of cryoablation for children with AVNRT. Read More

Europace 2018 07;20(7):e115-e123

Department of Cardiology, Erasmus University Medical Center, Ba-579, 's Gravendijkwal 230, Rotterdam, The Netherlands.

Aims: The significance and incidences of intraoperative arrhythmias occurring in the operating room (OR) in children with congenital heart disease (CHD) are unknown. Aims of this study were to determine incidences of intraoperative arrhythmias in children with CHD and to examine whether they are associated with persistent arrhythmias during follow-up.

Methods And Results: Continuous ECG recordings obtained from 134 consecutive paediatric CHD patients were manually examined from the moment the aortic cross-clamp (ACC) was removed [use of ACC and cardiopulmonary bypass (CPB)], when CPB was stopped (use of only CPB) or when the sternum was closed (no use of ACC and CPB) until departure from the OR. Read More

Medicine (Baltimore) 2017 Jun;96(26):e7251

Department of Cardiology, Zhongshan Hospital of Sun Yat-sen University, Guangdong, China.

Rationale: Coronary artery spasm (CAS) could cause serious lethal ventricular arrhythmias. While implantable cardioverter defibrillators (ICDs) have been recommend for secondary prevention of sudden cardiac death related to lethal ventricular arrhythmias. However, in resuscitated sudden cardiac death caused by CAS, the effect of ICD is still not well clear. Read More