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Heart Rhythm 2021 Apr 19. Epub 2021 Apr 19.

From the University of Calgary, Calgary, Canada (RSS, LYL, SRR, DR); Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy (MS, GC); University of Alberta, Edmonton, Canada and Smidt Heart Institute, Cedars-Sinai Hospital, USA (RKS).

Background: Syncope may be caused by intermittent complete heart block in patients with bundle branch block. Electrophysiologic studies (EPS) testing for infraHisian heart block is recommended by the ESC syncope guidelines, based on decades-old estimates of their negative predictive values (NPV) for complete heart block.

Objective: The aim was to determine the NPV of EPS for complete heart block in syncope patients with bundle branch block. Read More

Case Rep Cardiol 2021 2;2021:6637720. Epub 2021 Apr 2.

Division of Internal Medicine, Health Co-op, Watari Hospital, Fukushima, Japan.

This case report presents a patient with Takotsubo cardiomyopathy (TCM) and complete atrioventricular (AV) block who was treated with permanent pacemaker implantation. A 78-year-old woman with a history of hypertension presented with a 6-month history of palpitations. On initial evaluation, her heart rate was 40 beats/minute. Read More

Pediatrics 2021 Apr 13. Epub 2021 Apr 13.

Department of Pediatrics, Rush Medical College, Rush University Medical Center, Chicago, Illinois.

A male individual aged 18 years with no significant past medical history presented with fever, headache, dry cough, and chest pain. On clinical examination, he had tachycardia and hypotension needing intravenous fluid resuscitation and inotropic support. A chest radiograph revealed streaky lung opacities, and he was treated with antibiotics for suspected community-acquired pneumonia complicated by septic shock. Read More

Circ Res 2021 Apr 14. Epub 2021 Apr 14.

Cardiovascular Sciences, University of Manchester, UNITED KINGDOM.

Athletes present with atrioventricular node (AV node) dysfunction manifesting as AV block. This can necessitate electronic pacemaker implantation, known to be more frequent in athletes with a long training history. AV block in athletes is attributed to high vagal tone. Read More

Surg Today 2021 Apr 13. Epub 2021 Apr 13.

Shanghai Municipal Institute for Cardiovascular Diseases, 1609 Xietu Road, Shanghai, 200032, China.

Purposes: A previous study reported that the ventricular septum is more fragile in geriatric patients, and thus myectomy may expose geriatric patients to a higher risk of serious complications. This single-center study evaluates the impacts of the advanced age on the results following myectomy for symptomatic hypertrophic obstructive cardiomyopathy (HOCM).

Methods: All eligible patients were divided into an elderly group (septuagenarians, n = 35) and a control group (patients under 70 years, n = 197). Read More

J Cardiovasc Electrophysiol 2021 Apr 12. Epub 2021 Apr 12.

Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA.

Background: Catheter ablation is considered the first-line treatment of symptomatic atrioventricular nodal reentrant tachycardia (AVNRT). It has been associated with a risk of heart block (HB) requiring a pacemaker. This study aims to determine potential clinical predictors of complete heart block as a result AVNRT ablation. Read More

J Cardiol Cases 2021 Apr 21;23(4):158-162. Epub 2020 Nov 21.

Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Japan.

Pacing-induced cardiomyopathy (PICM), defined as left ventricular dysfunction, occurs in the setting of chronic, high burden right ventricular pacing. We describe an unusual case of PICM. A 64-year-old man underwent a medical check-up and was diagnosed with complete atrioventricular block (AVB) with regular and slow ventricular contractions at 38 beats/min (bpm). Read More

Kyobu Geka 2021 Mar;74(3):217-219

Department of Cardiovascular Surgery, Mito Saiseikai General Hospital, Mito, Japan.

A 45-year-old man was diagnosed with active aortic valve endocarditis accompanied by massive aortic regurgitation, complete atrioventricular block, para-annular abscess and a mobile large vegetation. He underwent emergency resection of the aortic valve, direct closure of the abscess with an autologous pericardium patch and mechanical valve replacement. Acquired communication between the left ventricle and the right atrium was closed simultaneously. Read More

J Interv Cardiol 2021 18;2021:6634667. Epub 2021 Mar 18.

Graduate School, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.

Background: With the rapid development of transcatheter techniques and instruments, transcatheter occlusion for patients with perimembranous ventricular septal defect (pVSD) and aortic valve prolapse (AVP) was constantly being tried, while the efficacy and safety of pVSD with AVP remain controversial.

Objective: The aim of this study was to evaluate long-term efficacy and safety of transcatheter occlusion of pVSD with AVP.

Methods: We retrospectively analyzed 164 children with pVSD and AVP who underwent transcatheter occlusion between January 2013 and November 2014. Read More

Animals (Basel) 2021 Mar 9;11(3). Epub 2021 Mar 9.

Equine Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Palackého tř. 1946/1, 612 42 Brno, Czech Republic.

A five-month-old African jenny was presented with a history of exercise intolerance and syncopal episodes. Severe bradycardic arrhythmia due to a high-grade second-degree atrioventricular (AV) block with progression to complete AV block was diagnosed. The jenny underwent a transvenous single-chamber pacemaker implantation. Read More

J Card Surg 2021 Apr 2. Epub 2021 Apr 2.

Department of Global Health, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Background: Pulmonary artery banding (PAB) remains a crucial technique in modern cardiac surgery. Left lateral thoracotomy, median sternotomy, and left anterior thoracotomy are well-known approaches. With significant scarce reports addressing the application of the upper mini sternotomy approach for PAB, this study aims to share experience and report outcomes of patients operated upon using this approach and its impact on facilitating the redo surgery. Read More

SAGE Open Med Case Rep 2021 15;9:2050313X21996113. Epub 2021 Mar 15.

Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Inferior wall myocardial infarction occurs in approximately 50% of all myocardial infarctions. The most common conduction disorder of this disease is complete atrioventricular block. Immediate attention must be given to the myocardial infarction patients with conduction block due to the increased mortality rate in these patients. Read More

Pan Afr Med J 2020 31;37:391. Epub 2020 Dec 31.

Cardiology Department, Hedi Chaker University Hospital, Sfax, Tunisia.

Acute myocarditis represents a challenging diagnosis as there is no pathognomonic clinical presentation. It is rare to see heart block as the first-and-only presentation of infectious myocarditis. We report the case of a young healthy patient who presented with syncope secondary to a complete heart block. Read More

Circulation 2021 Apr 1. Epub 2021 Apr 1.

Department of Cardiology, Boston Children's Hospital, Boston, MA; Harvard Stem Cell Institute, Cambridge, MA.

Mutations in tafazzin (), a gene required for biogenesis of cardiolipin, the signature phospholipid of the inner mitochondrial membrane, causes Barth syndrome (BTHS). Cardiomyopathy and risk of sudden cardiac death are prominent features of BTHS, but the mechanisms by which impaired cardiolipin biogenesis causes cardiac muscle weakness and arrhythmia are poorly understood. We performed in vivo electrophysiology to define arrhythmia vulnerability in cardiac specific knockout mice. Read More

Biomech Model Mechanobiol 2021 Mar 28. Epub 2021 Mar 28.

Department of Bioengineering, Imperial College London, London, UK.

Left atrial ligation (LAL) of the chick embryonic heart at HH21 is a model of the hypoplastic left heart syndrome (HLHS) disease, demonstrating morphological and hemodynamic features similar to human HLHS cases. Since it relies on mechanical intervention without genetic or pharmacological manipulations, it is a good model for understanding the biomechanics origins of such HLHS malformations. To date, however, the fluid mechanical environment of this model is poorly understood. Read More

J Electrocardiol 2021 Mar 3;66:54-61. Epub 2021 Mar 3.

Division of Cardiology, Department of Internal Medicine, School of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam 31116, Republic of Korea. Electronic address:

Background: Right ventricular (RV) apical pacing is associated with systolic dysfunction and heart failure. Paced QRS duration has been suggested as a predictor of heart failure and left ventricular (LV) systolic dysfunction. However, the effect of paced QRS duration on LV diastolic function is not well known. Read More

Turk Gogus Kalp Damar Cerrahisi Derg 2021 Jan 13;29(1):27-35. Epub 2021 Jan 13.

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

Background: This study aims to evaluate early postoperative arrhythmias in children undergoing congenital cardiac surgery.

Methods: A total of 670 pediatric patients (355 males, 315 females; median age: 4 months; range, 1 day to 18 years) who underwent cardiac surgery due to congenital heart defects between December 2018 and November 2019 were included. The rate of postoperative arrhythmias, diagnosis, potential risk factors, and management strategies were evaluated. Read More

Cardiol Young 2021 Mar 22:1-3. Epub 2021 Mar 22.

Department of Pediatric Critical Care Medicine, INOVA Fairfax Children's Hospital, 3300 Gallows Road, Falls Church, VA22042, USA.

SARS-CoV-2, which causes the disease COVID-19, generally has a mild disease course in children. However, a severe post-infectious inflammatory process known as multisystem inflammatory syndrome in children has been observed in association with COVID-19. This inflammatory process is a result of an abnormal immune response with similar clinical features to Kawasaki disease. Read More

J Cardiothorac Surg 2021 Mar 21;16(1):41. Epub 2021 Mar 21.

Department of Cardiac Surgery, Faculty of Medicine, Damascus University, Damascus, Syria.

Background: Primary cardiac tumours are extremely rare. Most of them are benign. Sarcomas account for 95% of the malignant tumours. Read More

Pediatr Crit Care Med 2021 Mar 17. Epub 2021 Mar 17.

Department of Anesthesiology and Intensive Care medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden. Department of Internal Medicine, Diakonhjemmet Hospital and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway. Department of Pediatric Cardiology, Children's Hospital, Helsinki University Hospital, Helsinki University, Helsinki, Finland. Department of Anesthesia and Intensive Care, Children's Hospital, Helsinki University Hospital, Helsinki University, Helsinki, Finland. Statistical Consultation Group, Gothenburg, Sweden. Department of Pediatric Thoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. Department of Pediatric Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Objectives: We compared the effect of two inodilators, levosimendan and milrinone, on the plasma levels of myocardial injury biomarkers, that is, high-sensitivity troponin T and heart-type fatty acid binding protein, and on N-terminal prohormone of brain natriuretic peptide as a biomarker of ventricular function. We hypothesized that levosimendan could attenuate the degree of myocardial injury when compared with milrinone.

Design: A post hoc, nonprespecified exploratory secondary analysis of the Milrinone versus Levosimendan-1 trial (ClinicalTrials. Read More

J Card Surg 2021 Mar 19. Epub 2021 Mar 19.

Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy.

An 82-year-old woman with precordial pain at rest was admitted to the Emergency Department for possible cardiac heart disease; electrocardiogram excluded ischemia and high-sensitive troponin was normal. Echocardiogram revealed a hyperechoic mass adjacent to the mitral annulus. Electrocardiography-gated computed tomography (CT) angiography exam confirmed the presence of the mass protruding into the atrioventricular groove, adjacent to the posterior mitral. Read More

Eur Heart J Case Rep 2021 Feb 12;5(2):ytaa558. Epub 2021 Jan 12.

Department of Cardiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan.

Background: The high F-fluorodeoxyglucose (FDG) uptake in sarcoidosis lesions reflects infiltration of inflammatory cells such as macrophages. An increased incidence of cancer in patients with sarcoidosis has been suggested, and some combination of the following mechanisms has been proposed: chronic inflammation, immune dysfunction, shared aetiologic agents, and genetic susceptibility to both cancer and autoimmune diseases.

Case Summary: A 73-year-old man was admitted to our hospital due to effort dyspnoea. Read More

Int Heart J 2021 Mar 17;62(2):329-336. Epub 2021 Mar 17.

Shanghai Municipal Institute for Cardiovascular Diseases.

The reasons of residual left ventricular outflow tract (LVOT) obstruction following alcohol septal ablation (ASA) remain unclear, and outcomes of myectomy following failed ASA remain underreported.Thirteen symptomatic patients (10 women, a median age of 60.0 years) who underwent septal myectomy following failed ASA were reviewed. Read More

J Cardiothorac Surg 2021 Mar 17;16(1):25. Epub 2021 Mar 17.

Shanghai Municipal Institute for Cardiovascular Diseases, 1609 Xietu Road, Shanghai, 200032, China.

Background: Although septal myectomy is a standard strategy for managing patients with hypertrophic obstructive cardiomyopathy (HOCM) and drug-refractory symptoms, so far, only a few experienced myectomy centers exist globally. Mainly, this can be explained by the many technical challenges presented by myectomy. From our clinical experience, applying the mini-invasive surgical instruments during myectomy potentially reduces the technical difficulty. Read More

Cureus 2021 Feb 11;13(2):e13276. Epub 2021 Feb 11.

Cardiology, University of Miami at Holy Cross Hospital, Fort Lauderdale, USA.

The appearance of first-degree atrioventricular block and mitral annulus calcification in an end-stage renal failure patient with elevated parathyroid hormone levels should raise the suspicion of metastatic cardiac calcification. Measures should be taken to normalize the parathyroid hormone, calcium, and phosphorus levels to limit the progression of atrioventricular block. Exploration or removal of parathyroid glands should be considered if heart block worsens. Read More

J Thorac Dis 2021 Feb;13(2):1055-1065

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

Background: Although surgical treatment of residual obstruction after alcohol septal ablation (ASA) is often challenging in patients with obstructive hypertrophic cardiomyopathy (OHCM) there are very few relevant clinical reports. Thus, outcomes of surgical septal myectomy (SSM) in this subgroup of patients remain to be determined. Therefore, this study aimed to determine the surgical and follow-up outcomes in patients with OHCM exhibiting residual obstruction after ASA. Read More

Rev Port Cardiol 2021 Mar 11;40(3):245.e1-245.e5. Epub 2021 Mar 11.

Hospital Garcia de Orta, Almada, Portugal.

Clinical Case: A 64-year-old male, with cardiovascular risk factors and previous history of bilateral carpal tunnel syndrome, presented with exertional retrosternal pain. The resting echocardiogram was unremarkable. A stress echocardiogram with dobutamine revealed hypokinesis of the inferior wall, associated with angina, followed by ventricular tachycardia. Read More

Europace 2021 Mar 10. Epub 2021 Mar 10.

Department of Neurology & Clinical Neurophysiology, Leiden University Medical Centre, Leiden, The Netherlands.

Aims: We describe five patients with syncope caused by a complete atrioventricular block (AVB) while they were bending forward, not rising after bending, and aim to describe the occurrence and the association between bending forward and AVB.

Methods And Results: In two patients, bending forward was the exclusive trigger for syncope, while in the remaining three, other postural changes (sitting down, standing up, and exertion) could also provoke syncope. Complete AVB as the cause of syncope was documented using ECG monitoring in two cases and an implantable loop recorder in the other three. Read More

Circ Rep 2020 Feb 20;2(3):207-208. Epub 2020 Feb 20.

Department of Cardiovascular Medicine, Tokushima University Hospital Tokushima Japan.

BMJ Case Rep 2021 Mar 9;14(3). Epub 2021 Mar 9.

Cardiovascular Disease, VCU Health, Richmond, Virginia, USA

A 53-year-old man was admitted for recurrent syncope and found to have complete heart block (CHB). Cardiac magnetic resonance imaging MRI) showed extensive patchy late gadolinium enhancement in the apical and lateral walls, consistent with cardiac sarcoidosis (CS) but no scar in the septum. A fluorodeoxyglucose (FDG)-positron emission tomography showed FDG uptake in the septum and basal lateral walls. Read More