Search Our Scientific Publications & Authors

Res Rep Urol 2020 17;12:193-197. Epub 2020 Jun 17.

Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia.

Sacral neuromodulation has gained widespread use for bladder overactivity, frequency, urgency, fecal incontinence, and nonobstructive urinary retention; hence, implantations of this device in patients with comorbid cardiac conduction diseases have increased. Theoretically, there are some concerns regarding the use of sacral neuromodulation implants in patients with Wolf-Parkinson-White syndrome and cardiac conduction diseases because of the risk of interference with electrical impulses. This study aimed to describe the safety of using sacral neuromodulation to treat nonobstructive urinary retention in patients with a cardiac conduction disease. Read More

Clin Cardiol 2020 Jun 27. Epub 2020 Jun 27.

Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust, St. George's University of London, London, UK.

Accessory pathways are present in 1 in 300 young individuals. They are often asymptomatic and potentially lethal arrhythmias may be the first presentation. During long-term follow-up, up to 20% of asymptomatic individuals with pre-excitation go on to develop an arrhythmia and the absence of traditional clinical and electrophysiological high-risk markers does not guarantee the "safe" nature of an accessory pathway. Read More

Front Pediatr 2020 10;8:280. Epub 2020 Jun 10.

Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang, China.

To explore the correlation between different phenotypes of arrhythmia and the prognosis in children with EFE/LVNC/DCM. A total of 167 children with cardiomyopathy diagnosed and treated in Shengjing Hospital between January 2010 and May 2019 were evaluated. After patient screening, 31 patients with endomyocardial fibroelastosis (EFE), left ventricular non-compaction, or dilated cardiomyopathy with significant arrhythmias were selected. Read More

Clin Imaging 2020 Jun 17;68:108-110. Epub 2020 Jun 17.

University of Pennsylvania Health Systems (UPHS), 3400 Spruce Street, Philadelphia, PA 19104, USA.

Diagnosis of intracranial arterial dissections can be challenging due to the wide spectrum of imaging presentations. High-resolution vessel wall MR imaging can be a useful adjunct to conventional lumen-based imaging techniques for diagnosing arterial dissections. We present a case of a 37-year-old male with a history of a Wolff-Parkinson-White syndrome presenting with acute onset of nausea, vertigo, and left body hemisensory loss of pain and temperature. Read More

Pacing Clin Electrophysiol 2020 Jun 16. Epub 2020 Jun 16.

Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Department of Pediatric Cardiology/Electrophysiology, University of Health Sciences, Istanbul, Turkey.

Radiofrequency catheter ablation (RFCA) procedure is performed for many tachyarrhythmias. We performed successful RFCA in a 5-year-old child for supraventricular tachyarrhythmia and Wolff-Parkinson-White Syndrome. Acute circumflex artery (CxA) occlusion occurred due to RFCA. Read More

J Emerg Med 2020 Jun 11. Epub 2020 Jun 11.

Department of Emergency Medicine, Beaumont Health, Royal Oak, Michigan.

Background: Flecainide is a class Ic antidysrhythmic agent used to prevent and treat both ventricular and supraventricular tachycardias, including atrial fibrillation, atrioventricular nodal re-entrant tachycardia, and Wolff-Parkinson-White syndrome. Flecainide can cause serious side effects, including cardiac arrest, dysrhythmias, and heart failure. Despite its growing use, the presenting signs and symptoms of flecainide toxicity are not familiar to most clinicians. Read More

J Cardiol 2020 Jun 9. Epub 2020 Jun 9.

Division of Cardiology, Policlinico Casilino, Roma, Italy.

Background: Catheter ablation is the established treatment for patients with symptomatic Wolff-Parkinson-White syndrome (WPW). However, some patients undergo a challenging ablation or have recurrences during the early post-ablation phase. The aim of this study was to evaluate the clinical factors associated with an unsuccessful ablation outcome or repeated sessions. Read More

Pediatr Cardiol 2020 Jun 11. Epub 2020 Jun 11.

Pediatric Cardiology, Cohen Children's Medical Center-Northwell Health, New Hyde Park, NY, USA.

Surrogates for the shortest pre-excited R-R interval in atrial fibrillation (SPERRI) such as the accessory pathway effective refractory period (APERP) and shortest pre-excited paced cycle length (SPPCL) are flawed assessments of accessory pathway function in patients with WPW. Multi-extrastimulus pacing may have the theoretical advantage of more accurately mimicking the clinical reality of atrial fibrillation and thus may serve to better assess accessory pathway function. This cross-sectional study included 25 consecutive patients, aged ≤ 18 years, undergoing electrophysiology study for WPW. Read More

Heart Rhythm 2020 Jun 1. Epub 2020 Jun 1.

The Children's Hospital at Montefiore Medical Center, Bronx, NY.

Background: Abrupt loss of ventricular pre-excitation on non-invasive evaluation, or non-persistent pre-excitation, in Wolff-Parkinson-White syndrome (WPW) is thought to indicate a low risk of life-threatening events.

Objective: To compare accessory pathway (AP) characteristics and occurrences of sudden cardiac arrest (SCA) and rapidly conducted pre-excited atrial fibrillation (RC-AF) in patients with non-persistent and persistent pre-excitation.

Methods: Patients ≤21 years with WPW and invasive electrophysiology study (EPS) data, SCA, or RC-AF were identified from multicenter databases. Read More

J Innov Card Rhythm Manag 2019 Nov 15;10(11):3892-3895. Epub 2019 Nov 15.

Martinsburg VA Medical Center, Marinsburg, WV, USA.

We discuss the case of a 22-year-old female who presented to the clinic experiencing recurrent palpitations. She was also found to have intermittent preexcitation on her electrocardiogram (ECG). Her palpitations were attributed to stress. Read More

HeartRhythm Case Rep 2020 May 8;6(5):272-274. Epub 2020 Feb 8.

Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.

Cureus 2020 Apr 21;12(4):e7766. Epub 2020 Apr 21.

Cardiac Electrophysiology, UC Davis Medical Center, Sacramento, USA.

Hypertrophic cardiomyopathy (HCM) and Wolff-Parkinson-White syndrome have been associated with sudden cardiac death. A subcutaneous implantable cardioverter-defibrillator (S-ICD) is an effective device used to reduce the risk of sudden cardiac death in these patients. The most common cause of inappropriate shocks with S-ICD is T-wave oversensing. Read More

Kardiol Pol 2020 Jun 20;78(6):567-573. Epub 2020 May 20.

Background: Several electrocardiographic (ECG) algorithms have been developed for predicting accessory pathway (AP) location in Wolff-Parkinson-White syndrome. However, their accuracy may be related to the manifested degree of preexcitation on ECG.

Aims: Our goal was to assess the effect of the degree of preexcitation on the accuracy of 4 traditional AP localization algorithms and to compare them with the algorithm specifically designed for ECGs with maximal preexcitation (Pambrun) Methods: The study included 300 patients who underwent successful ablation of an overt atrioventricular AP. Read More

Medicine (Baltimore) 2020 May;99(19):e19992

Department of Cardiology, Nagoya City University Graduate School of Medical Sciences.

The high-sensitivity cardiac troponin I (hs-cTnI) in serum can increase due to an increase in left ventricular (LV) overload in individuals with hypertension. Since LV voltage on an electrocardiogram (ECG) reflects LV load, it is possible that LV voltage is closely associated with hs-cTnI in individuals without hypertension. This study investigated the association between LV voltage indices and serum hs-cTnI levels in normotensive Japanese individuals. Read More

BMC Cardiovasc Disord 2020 May 6;20(1):210. Epub 2020 May 6.

Cardiovascular Surgery Department, University Medical Centre Ljubljana, Zaloška 7, 1000, Ljubljana, Slovenia.

Background: Right free wall accessory pathways (AP) are difficult to treat with catheter ablation as ablation catheter (AC) instability at the tricuspid annulus often precludes successful procedure. The aim of our study was to test a novel intra-cardiac echocardiography (ICE) guided technique for AC placement. Feasibility and success rates were observed. Read More

J Cardiovasc Electrophysiol 2020 Jun 22;31(6):1413-1419. Epub 2020 Apr 22.

Heart Institute (Incor), University of Sao Paulo Medical School, Sao Paulo, Brazil.

Introduction: Catheter ablation of the parahisian accessory pathways (PHAP) has been established as the definitive therapy for this type of arrhythmia. However, the PHAP proximity to the normal atrioventricular conduction system makes the procedure technically challenging. Here, we have reported a case series of 20 patients with PHAP who underwent aortic access ablation to evaluate the safety and efficacy of this approach in the PHAP ablation. Read More

Trials 2020 Apr 9;21(1):321. Epub 2020 Apr 9.

Thoraxcenter, Department of Clinical Electrophysiology, Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000, CA, Rotterdam, The Netherlands.

Background: Multiple studies have demonstrated the importance of adequate catheter-tissue contact in the creation of effective lesions during radiofrequency catheter ablation. The development of contact force (CF)-sensing catheters has contributed significantly to improve clinical outcomes in atrial fibrillation. However, CF-sensing technology is not used in the ablation of paroxysmal supraventricular tachycardia (PSVT). Read More

Am J Med Genet A 2020 06 31;182(6):1387-1399. Epub 2020 Mar 31.

Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.

Background: Wolff-Parkinson-White (WPW) syndrome is a relatively common arrhythmia affecting ~1-3/1,000 individuals. Mutations in PRKAG2 have been described in rare patients in association with cardiomyopathy. However, the genetic basis of WPW in individuals with a structurally normal heart remains poorly understood. Read More

Kardiol Pol 2020 03 25;78(3):177-178. Epub 2020 Mar 25.

Electrophysiology Unit, Department of Internal Medicine, Santa Maria Nuova Hospital,Florence, Italy.

Sci Transl Med 2020 Mar;12(536)

Division of Cardiology, Department of Medicine and Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.

Cardiac arrhythmias are a major cause of morbidity and mortality worldwide. The 12-lead electrocardiogram (ECG) is the current noninvasive clinical tool used to diagnose and localize cardiac arrhythmias. However, it has limited accuracy and is subject to operator bias. Read More

N Engl J Med 2020 Mar;382(13):e22

University of Texas Southwestern Medical Center, Dallas, TX

Cardiol J 2020 Mar 24. Epub 2020 Mar 24.

Department of Paediatric Cardiology and General Paediatrics, Medical University of Warsaw.

Background: In contrast to adults, in whom cardiac rhythm disorders are mainly conditioned by coronary artery disease, in children, arrhythmias are most often associated with inherited heart disorders. Catheter ablation (CA) has an important role in the management of cardiac arrhythmias, in adults and children. The aim of the study was to assess and compare the efficacy and safety of CA in children and adults with preexcitation syndrome. Read More

Eur J Immunol 2020 Mar 17. Epub 2020 Mar 17.

Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.

AMPK (adenosine monophosphate-activated protein kinase) is phosphorylated (AMPK-P) in response to low energy through allosteric activation by Adenosine mono- or diphosphate (AMP/ADP). Folliculin (FLCN) and the FLCN-interacting proteins 1 and 2 (FNIP1, 2) modulate AMPK. FNIP1 deficiency patients have a AMPK-P gain of function phenotype with hypertrophic cardiomyopathy, Wolff-Parkinson-White pre-excitation syndrome, myopathy of skeletal muscles and combined immunodeficiency. Read More

J Anat 2020 Jul 2;237(1):155-165. Epub 2020 Mar 2.

Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.

Cardiac arrhythmias, notably Wolff-Parkinson-White syndrome, are known to represent a major issue in patients with Ebstein's malformation of the tricuspid valve. Abnormal conducting circuits, however, can also be produced by pathways extending either from the atrioventricular node or the ventricular components of the atrioventricular conduction axis, direct to the crest of the muscular ventricular septum. We hoped to provide further information on the potential presence of such pathways by investigations of six autopsied examples of Ebstein's malformation. Read More

JA Clin Rep 2019 Feb 28;5(1):13. Epub 2019 Feb 28.

Department of Anesthesiology and Reanimatology, Faculty of Medicine Sciences, University of Fukui, 23-3 Eiheijicho, Yoshidagun, Fukui, 910-1193, Japan.

Background: Wolff-Parkinson-White (WPW) syndrome has the risk of sudden cardiac death. Without appropriate treatment, coronary vasospasm is also a potentially fatal condition due to ischemia-induced ventricular fibrillation. A rare case of cardiac arrest due to coronary vasospasm during general anesthesia in a patient with pre-existing WPW syndrome is presented. Read More

Europace 2020 Apr;22(4):632-642

Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.

Aims: Idiopathic left ventricular hypertrophy (LVH) is defined as LVH in the absence of myocyte disarray or secondary causes. It is unclear whether idiopathic LVH represents the phenotypic spectrum of hypertrophic cardiomyopathy (HCM) or whether it is a unique disease entity. We aimed to ascertain the prevalence of HCM in first-degree relatives of decedents from sudden death with idiopathic LVH at autopsy. Read More

Heart Rhythm 2020 Jan 22. Epub 2020 Jan 22.

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address:

Background: Catheter ablation of accessory pathways (APs) in patients with Ebstein anomaly (EA) has a higher recurrence rate than in subjects with normal hearts. Anatomic features could account for suboptimal ablation outcomes.

Objective: The purpose of this study was to examine the right atrioventricular (AV) groove in autopsy hearts with EA, correlate with clinical data, and identify features relevant for catheter ablation. Read More

Pediatr Cardiol 2020 Apr 23;41(4):709-715. Epub 2020 Jan 23.

Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 21, Chicago, IL, 60611, USA.

Children with ventricular pre-excitation are at risk for sudden death. This retrospective pediatric study identified patients > 8 years of age who had undergone electrophysiology study (EPS). Our primary objective was to determine the performance characteristics of non-invasive risk stratification. Read More

BMJ 2020 Jan 23;368:l6877. Epub 2020 Jan 23.

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

Ann Noninvasive Electrocardiol 2020 Jan 20:e12740. Epub 2020 Jan 20.

Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Background: Inserting an electrophysiological (EP) catheter into the coronary sinus (CS) via the femoral vein can be difficult and time-consuming in patients with variants of the CS orifice or lumen curve. Our experience with such patients inspired us to develop two new techniques: the Asclepius and Yellow Ribbon techniques.

Methods: Data from a 4-year period were retrieved from records of patients undergoing radiofrequency ablation for paroxysmal supraventricular tachycardia (PSVT) or Wolff-Parkinson-White (WPW) syndrome. Read More

BMC Cardiovasc Disord 2020 Jan 17;20(1):18. Epub 2020 Jan 17.

Department of Cardiology, Northern Jiangsu People's Hospital, No. 98, Nantong West Road, Yangzhou, 225001, Jiangsu, China.

Background: Radiofrequency catheter ablation is an established procedure with a high success rate for treating Wolff-Parkinson-White (WPW) syndrome. Rare complications post-ablation may nonetheless occur particularly associated with coronary sinus. Identifying and avoiding these complications remains a challenge. Read More

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:6192-6195

Arrhythmia localization prior to catheter ablation is critical for clinical decision making and treatment planning. The current standard lies in 12-lead electrocardiogram (ECG) interpretation, but this method is non-specific and anatomically limited. Accurate localization requires intracardiac catheter mapping prior to ablation. Read More

Indian Pacing Electrophysiol J 2020 Jan - Feb;20(1):3-7. Epub 2020 Jan 13.

U N Mehta Institute of Cardiology and Research Centre, Asarwa, Ahmedabad, India. Electronic address:

Aims And Objectives: Atrial fibrillation (AF) with preexcitation can be life threatening. Our study evaluated the incidence, clinical features, electrophysiologic characteristics and outcomes of patients presenting with AF and fast ventricular rates associated with an antegrade conducting accessory pathway.

Methods: Hospital data of patients who had undergone electrophysiology study and radiofrequency ablation for AF and Wolff-Parkinson-White (WPW) syndrome was retrospectively evaluated over 10 years and prospective data was further collected over 1 year. Read More

HeartRhythm Case Rep 2019 Sep 15;5(9):476-479. Epub 2019 Jul 15.

ELMedica EP-Network, Kielce, Poland.

J Clin Rheumatol 2019 Dec 24. Epub 2019 Dec 24.

Pediatric Cardiology, Dr. Ali Kemal Belviranli Maternity and Children's Hospital, Konya, Turkey.

Case Rep Cardiol 2019 4;2019:1061065. Epub 2019 Dec 4.

Department of Medicine, College of Medical Sciences, University of Maiduguri, Nigeria.

Syncope is a common manifestation of both hypertrophic cardiomyopathy (HCM) and Wolff-Parkinson-White (WPW) syndrome. The most common arrhythmia in HCM is ventricular tachycardia (VT) and atrial fibrillation (AF). While preexcitation provides the substrate for reentry and supraventricular tachycardia (SVT), AF is more common in patients with preexcitation than the general population. Read More

Ann Noninvasive Electrocardiol 2019 Dec 19:e12735. Epub 2019 Dec 19.

Department of Internal Medicine, Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, MI, USA.

Wolff-Parkinson-White (WPW) syndrome is a conduction disturbance in which atrial impulses are transmitted to the ventricles by an accessory pathway instead of the normal atrioventricular conduction. The WPW syndrome may either simulate myocardial infarction or mask the electrocardiographic abnormalities of an acute MI. However, concealed WPW revealed after an acute coronary syndrome is rare with few cases reported in the literature. Read More

J Interv Card Electrophysiol 2019 Dec 13. Epub 2019 Dec 13.

Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital at Montefiore Medical Center, Albert Einstein College of Medicine, 3415 Bainbridge Ave, Bronx, NY, 10467, USA.

Purpose: Success rates for catheter ablation of supraventricular tachycardia (SVT) in the young exceed 90%. While studies have described reasons for initial ablation failure, less is known about outcomes of repeat ablation attempts. The purpose of this study was to report acute and mid-term success rates for second ablation attempts in young patients, as well as to analyze factors that may affect these outcomes. Read More

ARYA Atheroscler 2019 Jul;15(4):201-204

PhD Candidate, Department of Medical Genetics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Despite recent advances in diagnostic techniques in cardiology, electrocardiography (ECG) has yet remained the first and corner stone of detecting emergency cardiac events including myocardial infarction (MI). There are some ECG findings which are considered as equivalents to MI. De Winter ST-T wave pattern is one of the important ECG findings which is thought to be related to left anterior descending artery occlusion. Read More

J Perinat Med 2019 Dec;48(1):74-81

Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Background The main objective of this retrospective analysis in a large tertiary center was the clinical outcome of prenatally diagnosed cardiac rhabdomyomas as well as the identification of factors influencing fetal prognosis. Methods A total of 45 cases of fetuses with prenatally suspected rhabdomyoma and their clinical outcome were analyzed retrospectively. A review of the literature was also performed. Read More

J Cardiol Cases 2019 Dec 2;20(6):191-196. Epub 2019 Oct 2.

Division of Cardiology, Ako City Hospital, Ako, Hyogo, Japan.

The electrocardiogram of a 14-year-old boy with recurrent palpitation showed a wide QRS regular tachycardia with a right bundle branch block and right-axis deviation of 226 beats per minute. Verapamil infusion terminated the tachycardia after a few minutes. Electrophysiological study revealed that this tachycardia was considered as a reentrant tachycardia associated with the anterograde left posterior accessory pathway (AP) and retrograde right septal AP. Read More

Tunis Med 2019 Apr;97(4):599-603

Complete atrioventricular block (AV block) associated with an accessory pathway is a rare phenomenon. We report the case of a third degree AV block paired with a Wolff Parkinson White (WPW) syndrome in a 91-year-old patient. The electrocardiogram (ECG) on admission showed a Mobitz type II AV block alternating with a third degree block on a wide-QRS ventricular rhythm beating at 35 cycles per minute. Read More

J Interv Card Electrophysiol 2019 Nov 15. Epub 2019 Nov 15.

Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.

Purpose: The classification using QRS morphology of V1 lead is a useful simple predictor of accessory pathway location (type A, R or Rs pattern; type B, rS pattern; type C, QS or Qr pattern), but often leads to misdiagnosis of accessory pathway location, especially in types B and C. The synthesized 18-lead electrocardiography (ECG) derived from standard 12-lead ECG can provide virtual waveforms of right-sided chest leads. This study aimed to evaluate the usefulness of the right-sided chest lead ECG for prediction of accessory pathway location. Read More

Pediatr Cardiol 2020 Apr 12;41(4):843-845. Epub 2019 Nov 12.

Department of Pediatric Cardiology, Royal Hospital for Children, 1345 Govan Rd, Glasgow, G51 4TF, UK.

We describe the case of a novel PRKAG2 mutation that manifested with a ventricular fibrillation cardiac arrest in a child. The previously healthy 13-year old boy, was subsequently diagnosed with Wolff-White-Parkinson syndrome, mild left ventricular hypertrophy and atrial fibrillation. His father had also been diagnosed in the past with Wolff-White-Parkinson syndrome and developed left ventricular hypertrophy. Read More

Clin Genet 2020 Apr 9;97(4):628-633. Epub 2020 Jan 9.

Service de Néphrologie Transplantation Dialyse et Aphérèses, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.

Kidney is a highly adenosine triphosphate dependent organ in human body. Healthy and functional mitochondria are essential for normal kidney function. Clinical and genetic variability are the hallmarks of mitochondrial disorders. Read More

Neuropathol Appl Neurobiol 2020 Jun 25;46(4):303-322. Epub 2019 Nov 25.

Neuromuscular Department, IRCCS San Camillo Hospital, Venice, Italy.

Danon disease is a severe multisystem disorder clinically characterized by hypertrophic cardiomyopathy, skeletal myopathy and mental retardation in male patients, and by a milder phenotype (predominantly involving cardiac muscle) in female patients. The disease is inherited as an X-linked dominant trait. The primary deficiency of lysosome-associated membrane protein-2 (LAMP-2) causes disruption of autophagy, leading to an impaired fusion of lysosomes to autophagosomes and biogenesis of lysosomes. Read More

Acta Cardiol Sin 2019 Sep;35(5):493-500

Division of Cardiology, Department of Pediatrics, Taipei Veterans General Hospital.

Background: The location of the accessory pathway (AP) can be precisely identified on surface electrocardiography (ECG) in adults with Wolff-Parkinson-White (WPW) syndrome. However, current algorithms to locate the AP in pediatric patients with WPW syndrome are limited.

Objective: To propose an optimal algorithm that localizes the AP in pediatric patients with WPW syndrome. Read More