1,313 results match your criteria Junctional Rhythm


Postnatal recurrence and transesophageal inducibility of prenatally treated fetal supraventricular tachycardia.

Heart Rhythm 2022 Apr 21. Epub 2022 Apr 21.

Labatt Family Heart Centre, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Background: Antiarrhythmic treatment of fetal supraventricular tachycardia (SVT) is used to prevent morbidity and mortality. The postnatal management of survivors is often arbitrary and varied.

Objective: The purpose of this study was to examine the utility of a risk-based postnatal management strategy. Read More

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Slow-Pathway Visualization by Using Panoramic View: A Novel Ablation Technique for Ablation of Atrioventricular Nodal Reentrant Tachycardia.

J Cardiovasc Dev Dis 2022 Mar 22;9(4). Epub 2022 Mar 22.

Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.

(1) Background: The panoramic view of a novel wide-band dielectric mapping system could show the individual anatomy. We aimed to compare the feasibility, efficacy and safety of the panoramic view guided approach for ablation of AVNRT with the conventional approach. (2) Methods: Ablation distributions in eight patients were retrospectively analyzed using the panoramic view. Read More

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Total atrioventricular block in pregnancy -Case report.

Ann Med Surg (Lond) 2022 Mar 4;75:103441. Epub 2022 Mar 4.

Department of Cardiology, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.

Introduction And Importance: Bradycardia in pregnancy due to total atrioventricular block (TAVB) is a rare occurrence, often asymptomatic and may arise from a congenital disorder. Pacemaker is often required. Cases are few and management is not yet standardised. Read More

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Accelerated junctional rhythm (AJR) revealing light-chain cardiac amyloidosis: A case report with literature review.

Ann Med Surg (Lond) 2022 Mar 3;75:103410. Epub 2022 Mar 3.

Mohammed V University, Rabat, Morocco.

Introduction And Importance: Cardiac amyloidosis (CA) is a rare condition, characterized by fibrillary proteins infiltration in the extracellular space of the heart. Even though many types of cardiac amyloidosis exist, light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR) remain the most described forms. The diagnosis of amyloidosis represents a real challenge for clinicians, requiring both invasive and non-invasive investigations. Read More

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Hypersensitivity Myocarditis after COVID-19 mRNA Vaccination.

J Clin Med 2022 Mar 16;11(6). Epub 2022 Mar 16.

Department of Clinical, Internal, Anesthesiologist and Cardiovascular Sciences, La Sapienza University, 00161 Rome, Italy.

Background: Myocarditis, even in a severe and lethal form, may occur after COVID-19 mRNA (BNT162b2) vaccination. However, its pathway, morphomolecular characterization and treatment are still unknown.

Methods: Routine hematochemical screening, ECG, Holter monitoring, 2D echocardiogram cardiac magnetic resonance (CMR) and invasive cardiac studies (cardiac catheterization, selective coronary angiography, left ventriculography and left ventricular endomyocardial biopsy) are reported from three patients (39F-pt1, 78M-pt2, 52M-pt3) with severe compromise of conduction tissue (junctional rhythm and syncope, pt1) or cardiac function compromise (LVEF ≤ 35%, pt2 and pt3) after COVID-19 mRNA (BNT162b2). Read More

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Severe bradycardia from severe hyperkalemia: Patient characteristics, outcomes and factors associated with hemodynamic support.

Am J Emerg Med 2022 05 10;55:117-125. Epub 2022 Mar 10.

Department of Emergency Medicine, Einstein Healthcare Network, Einstein Medical Center Philadelphia, 5501 Old York Rd, Philadelphia, PA, 19141. Electronic address:

Objective: Bradycardia is an under-studied manifestation of hyperkalemia potentially associated with adverse outcomes. We sought to systematically describe emergency department (ED) patients that present with severe bradycardia (heart rate < 50) associated with severe hyperkalemia (potassium ≥6.0 mEQ/L) and identify factors associated with the receipt of hemodynamic support. Read More

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A unique case report of relapsing eosinophilic myocarditis causing atrial myopathy and persistent sinus arrest.

Eur Heart J Case Rep 2022 Feb 7;6(2):ytac047. Epub 2022 Feb 7.

Department of Cardiology, Concord Repatriation General Hospital, 1 Hospital Rd, Concord West, Sydney, New South Wales 2139, Australia.

Background: Eosinophilic myocarditis (EM) is a rare and devastating condition. The underlying cause of EM is unknown, and the natural history is not well understood.

Case Summary: A 20-year-old male presented in cardiogenic shock with preceding 24-h history of pleuritic chest pain associated with nausea and vomiting. Read More

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February 2022

Early postoperative arrhythmias after pediatric congenital heart disease surgery: a 5-year audit from a lower- to middle-income country.

Acute Crit Care 2022 Feb 3. Epub 2022 Feb 3.

Department of Pediatrics, Liaquat National Hospital, Karachi, Pakistan.

Background: Postoperative arrhythmias are a known complication after surgical repair for congenital heart disease (CHD). This study aimed to identify and discuss the prevalence, diagnosis, and management of common rhythm disturbances seen in the immediate postoperative period after surgery for CHD in the pediatric population at a tertiary care hospital in Pakistan.

Methods: A retrospective study was conducted at a tertiary care hospital in Pakistan between January 2014 and December 2018. Read More

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February 2022

A long RP tachycardia: Where is the culprit?

Heart Rhythm 2022 02;19(2):334-335

Cardiology Division, Department of Medicine, University of California San Francisco, San Francisco, California. Electronic address:

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February 2022

Prenatal diagnosis and management of fetal supraventricular tachyarrhythmia and postnatal outcomes.

J Gynecol Obstet Hum Reprod 2022 Mar 19;51(3):102323. Epub 2022 Jan 19.

Department of Perinatology, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Objective: We aimed to describe a single institutional experience managing tachyarrhythmic fetuses, to investigate the underlying pathological findings and to evaluate the postnatal follow-up results.

Method: This retrospective study included 24 fetuses, treated and followed up with the diagnosis of supraventricular tachyarrhythmia between January 2014 and July 2020. Fetal tachyarrhythmia was evaluated by M mode and Doppler ultrasound. Read More

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Severe Oleander Poisoning Presenting with Hyperkalaemia and Unusual Electrocardiographic Changes.

Eur J Case Rep Intern Med 2021 14;8(12):003044. Epub 2021 Dec 14.

All India Insititute of Medica Sciences, Bhubaneswar, Odisha, India.

Background: Hyperkalaemia in oleander (Nerium oleander) poisoning has been associated with a poor prognosis. Different electrocardiographic (ECG) presentations are possible because of vagotonia and hyperkalaemia.

Methods/results: We report a series of three cases of oleander poisoning in which ECG showed unusual hyperkalaemia features, such as bradyarrhythmia, sinoatrial block, atrioventricular block and junctional rhythm. Read More

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December 2021

BRASH Syndrome: A Case Report.

Am J Case Rep 2022 Jan 21;23:e934600. Epub 2022 Jan 21.

Department of Emergency, Heart Institute (InCor), University of São Paulo Faculty of Medicine Clinics Hospital, São Paulo, SP, Brazil.

BACKGROUND BRASH syndrome is a newly recognized clinical entity characterized by bradycardia, renal failure, atrioventricular blockade, shock, and hyperkalemia. Patients with BRASH syndrome often have severe bradycardia that is refractory to antidotes and chronotropic medications. In these situations, transvenous pacemaker and renal replacement therapy may be necessary. Read More

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January 2022

Acute myocarditis presenting as accelerated junctional rhythm in Graves' disease: A case report.

World J Clin Cases 2021 Dec;9(35):11085-11094

Department of Emergency Medicine, Qingdao Central Hospital, Affiliated Qingdao Central Hospital, Qingdao University, Qingdao 266042, Shandong Province, China.

Background: Acute myocarditis is an acute myocardium injury that manifests as arrhythmia, dyspnea, and elevated cardiac enzymes. Acute myocarditis is usually caused by a viral infection but can sometimes be caused by autoimmunity. Graves' disease is an autoimmune disease that is a rare etiology of acute myocarditis. Read More

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December 2021

Junctional AV ablation in patients with atrial fibrillation undergoing cardiac resynchronization therapy (JAVA-CRT): results of a multicenter randomized clinical trial pilot program.

J Interv Card Electrophysiol 2022 Jan 18. Epub 2022 Jan 18.

Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, NY, USA.

Introduction: Cardiac resynchronization therapy (CRT) improves outcomes in sinus rhythm, but the data in atrial fibrillation (AF) is limited. Atrio-ventricular junctional ablation (AVJA) has been proposed as a remedy. The objective was to test if AVJA results in LV end-systolic volume (ESV) reduction ≥ 15% from baseline to 6 months. Read More

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January 2022

Pleomorphic wide complex tachycardia.

Heart Rhythm 2022 01;19(1):167-168

Division of Electrophysiology, University of California San Francisco, San Francisco, California. Electronic address:

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January 2022

Prevention of trigeminocardiac reflex-induced severe bradycardia during cerebral aneurysm clipping surgery by topical anesthesia of the dura surface and atropine administration: a case report.

JA Clin Rep 2022 Jan 7;8(1). Epub 2022 Jan 7.

Department of Anesthesiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.

Background: Trigeminocardiac reflex (TCR) by stimulation of the sensory branch of the trigeminal nerve induces transient bradycardia and hypotension. We report a case in which light mechanical stimulation to the dura mater during brain surgery induced severe bradycardia.

Case Presentation: A 77-year-old woman with bradycardia-tachycardia syndrome was scheduled for clipping of an unruptured left middle cerebral artery aneurysm. Read More

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January 2022

Extreme Hypoxia Causing Brady-Arrythmias During Apnea in Elite Breath-Hold Divers.

Front Physiol 2021 3;12:712573. Epub 2021 Dec 3.

Department of Clinical Medicine, Faculty of Medicine, University of Copenhagen, Copenhagen, Denmark.

The cardiac electrical conduction system is very sensitive to hypoglycemia and hypoxia, and the consequence may be brady-arrythmias. Weddell seals endure brady-arrythmias during their dives when desaturating to 3.2 kPa and elite breath-hold-divers (BHD), who share metabolic and cardiovascular adaptions including bradycardia with diving mammals, endure similar desaturation during maximum apnea. Read More

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December 2021

Accelerated Idioventricular Rhythm Following Intraoral Local Anesthetic Injection During General Anesthesia.

Anesth Prog 2021 12;68(4):230-234

Okamura Dental Clinic, Morioka, Iwate, Japan.

Some anesthetic agents or adjunct medications administered during general anesthesia can cause an accelerated idioventricular rhythm (AIVR), which is associated with higher vagal tone and lower sympathetic activity. We encountered AIVR induced by vagal response to injection-related pain following local anesthetic infiltration into the oral mucosa during general anesthesia. A 48-year-old woman underwent extraction of a residual tooth root from the left maxillary sinus under general anesthesia. Read More

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December 2021

Sotalol vs amiodarone for postoperative junctional ectopic tachycardia: Citius, Altius, Fortius?

Heart Rhythm 2022 03 2;19(3):457-458. Epub 2021 Dec 2.

Thomas P. Graham Jr. Division of Pediatric Cardiology and the Center for Pediatric Precision Medicine, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address:

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Esophageal Rupture Presenting with ST Segment Elevation and Junctional Rhythm Mimicking Acute Myocardial Infarction.

Case Rep Crit Care 2021 18;2021:8843477. Epub 2021 Nov 18.

Division of Cardiology, Medical College of Georgia at Augusta University, Augusta, GA, USA.

Esophageal rupture is a rare but potentially fatal cause of chest pain. The presentation is variable and can mimic other conditions such as aortic dissection, pulmonary embolism, and myocardial infarction (MI). A 71-year-old male with a history of coronary artery disease presented to the ED with complaints of acute chest pain and respiratory distress. Read More

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November 2021

Sotalol versus amiodarone for postoperative junctional tachycardia after congenital heart surgery.

Heart Rhythm 2022 03 18;19(3):450-456. Epub 2021 Nov 18.

Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.

Background: Junctional ectopic tachycardia (JET) is a common arrhythmia after congenital heart disease surgery. There is variability in the choice of antiarrhythmic therapy, with amiodarone used commonly. Intravenous (IV) sotalol is a newly available agent that may be useful for JET. Read More

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Comparative characteristics of a pacemaker implantation after biatrial or left atrial ablation of atrial fibrillation in combination with coronary artery bypass grafting in patients with ischemic heart disease and long-standing persistent atrial fibrillation.

Kardiologiia 2021 Oct 30;61(10):46-52. Epub 2021 Oct 30.

National medical research center named after academician E.N. Meshalkin, Novosibirsk.

Aim      To compare the incidence of a permanent pacemaker (PP) implantation based on the chosen treatment technology (biatrial ablation, BA, or left atrial ablation (LAA) for long-standing persistent atrial fibrillation (AF) with simultaneous coronary bypass (CB).Material and methods  The study included 116 patients with long-standing persistent AF and indications for CB. Patients were randomized to two equal groups (58 patients in each). Read More

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October 2021

Electrocardiography of Atrioventricular Block.

Card Electrophysiol Clin 2021 12 25;13(4):599-605. Epub 2021 Sep 25.

Cardiac Arrhythmia Service, St. Vincent Hospital, 8333 Naab Road, Indianapolis, IN 46260, USA; Duke University Medical Center, Durham, NC, USA.

Delayed atrioventricular (AV) conduction most commonly occurs in the AV node, resulting from AH prolongation on an intracardiac electrocardiogram and PR prolongation on a surface electrocardiogram. AV conduction may be blocked in a 2:1 manner, with a normal PR interval and wide QRS suggesting infranodal disease, whereas a prolonged PR interval and narrow QRS are more suggestive of AV nodal disease. Block within the His is suspected when there is 2:1 AV block with normal PR and QRS intervals. Read More

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December 2021

Hemodynamic Impact of Atrial Pacing in Patients with Fontan Physiology and Junctional Rhythm: A Cardiac Catheterization Study.

Pediatr Cardiol 2022 Mar 18;43(3):508-514. Epub 2021 Oct 18.

Division of Cardiology, Department of Pediatrics, Oregon Health & Science University, 700 SW Campus Dr, Portland, OR, 97239, USA.

Sinus node dysfunction is a common problem and adversely impacts patients who have undergone the Fontan operation. In Fontan patients with an adequate junctional escape rhythm, the benefit of atrial pacing to restore atrioventricular synchrony remains unclear. Data were collected retrospectively on all Fontan patients with junctional rhythm who underwent atrial pacing during cardiac catheterization. Read More

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Atrioventricular Conduction Abnormalities in Multisystem Inflammatory Syndrome in Children.

Case Rep Pediatr 2021 1;2021:6124898. Epub 2021 Oct 1.

Advent Health Director Pediatric and Adult Congenital Electrophysiology, Orlando, FL, USA.

Cardiac manifestations in multisystem inflammatory syndrome in children (MIS-C) can include coronary artery aneurysms, left ventricular systolic dysfunction, and electrocardiographic disturbances. We report the clinical course of three children with MIS-C while focusing on the unique considerations for managing atrioventricular conduction abnormalities. All initially had normal electrocardiograms but developed bradycardia followed by either PR prolongation or QTc elongation. Read More

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October 2021

Exercise Stress Test-Induced Atrioventricular Dissociation With Syncope.

Ochsner J 2021 ;21(3):319-324

The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY.

The exercise stress test is widely used as a diagnostic test for evaluating coronary artery disease in symptomatic patients or those with underlying cardiovascular disorders. Although exercise stress test risk is minimal with a <1% chance of causing heart block, physician awareness of potential complications is paramount for prompt recognition and treatment. A 65-year-old-female with angina-like chest pain underwent an exercise stress test for ischemic heart disease evaluation. Read More

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January 2021

Six-Year Follow-Up Outcomes of Catheter Ablation of Para-Hisian Accessory Pathways.

Front Cardiovasc Med 2021 7;8:692945. Epub 2021 Sep 7.

Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.

Ablation of para-hisian accessory pathways (APs) remains challenging due to anatomic characteristics, and a few studies have focused on the causes for recurrence of radiofrequency ablation of para-hisian APs. This retrospective single center study aimed to explore the risk factors for recurrence of para-hisian APs. One hundred thirteen patients who had para-hisian AP with an acute success were enrolled in the study. Read More

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September 2021

Looking Deep Into the Palpitation - Pheochromocytoma Presenting as Sinus Node Dysfunction.

Cureus 2021 Aug 13;13(8):e17151. Epub 2021 Aug 13.

Cardiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, IND.

A 23-year-old male came to the outpatient department with a history of intermittent palpitations and headaches for the past six to eight months. He was diagnosed with hypertension and had a junctional rhythm on an electrocardiogram (ECG). On further workup for his hypertension, he was found to have elevated levels of serum metanephrines and computed tomography (CT) and positron emission tomography (PET) scan revealed pheochromocytoma. Read More

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An unusual incessant long RP tachycardia-What is the mechanism?

Heart Rhythm 2021 12 19;18(12):2215-2218. Epub 2021 Aug 19.

Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

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December 2021

Slow pathway elimination using antegrade conduction improvement with fast atrial pacing during AVNRT radiofrequency ablation: a proof-of-concept study.

Acta Cardiol 2021 Aug 20:1-8. Epub 2021 Aug 20.

Pasteur University Hospital Centre, Nice, France.

Background: Radiofrequency (RF) ablation of slow pathway (SP) is usually performed in sinus rhythm while monitoring the occurrence of a slow junctional rhythm (JR). JR although sensitive, is not specific for elimination of SP conduction. Our objective was to prospectively evaluate feasibility and safety of SP elimination using fast atrial rate pacing (FAP) during RF delivery. Read More

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