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To manage the complex comorbidities, we opted for dual-chamber pacemaker implantation. Meanwhile, a dual-chamber pacemaker can treat HCM by changing the sequence of myocardial contraction. Typically, patients with HCM experience sinus tachycardia and sinus arrest relatively infrequently.
UC San Diego Health is the first in San Diego to successfully implant the world’s first dual chamber and leadless pacemaker system to help treat people with abnormal heart rhythms. Holding the device and pictured above is Ulrika Birgersdotter-Green, MD, cardiologist and director of pacemaker and ICD services at UC San Diego Health.
Atrioventricular nodal (AVN) ablation with permanent pacemaker implantation – ‘pace and ablate’ – may be considered for patients with symptomatic atrial fibrillation (AF) for whom rhythm control has been unsuccessful. This creates concerns about inducing pacemaker dependence and potential pacemaker-induced cardiomyopathy (PICM).
ABSTRACT Introduction Atrial fibrillation (AF) is the most common arrhythmia, and atrioventricular (AV) node ablation with pacemaker implantation is a therapeutic option for refractory cases. However, AV node ablation in patients with bioprosthetic tricuspid valves poses technical challenges.
Atrioventricular junction (AVJ) ablation is reserved for patients with refractory uncontrolled atrial fibrillation despite antiarrhythmic drug use or ablation. Atrial lead implant is uncommon during pacemaker implant at the time of AVJ ablation.
Cardio-neural ablation (CNA) may offer favorable outcomes without the need for a pacemaker (PM). However, long-term autonomic implications post-ablation are still unknown. Swallow [or deglutition] syncope, a rare form of neurally-mediated situational syncope, has limited treatment options.
Pacemaker implantation combined with atrioventricular node ablation (AVNA) is a well-established strategy for non-controlled atrial arrhythmias. Limited amount of data is available regarding His Bundle Pacing (HBP), or Left Bundle Branch Area Pacing (LBBAP) in this setting.
Due to atrial and ventricular pacing dependence, a comprehensive congenital care team concluded the need for lead extraction and replacement of pacemaker via leadless peacemaking device. Laser-lead extraction and temporary atrial pacemaker placement was performed.
Abstract Introduction Catheter ablation of atrial fibrillation (AF) has emerged as the most effective therapy. However, rare anatomical abnormalities such as situs inversus totalis, dextrocardia, or interrupted inferior vena cava can make ablation challenging.
Cardioneuroablation could be a reasonable alternative to pacemaker implantation in symptomatic carotid sinus syndrome. Abstract Introduction Carotid sinus syndrome (CSS), characterized by exaggerated vagal responses leading to asystolic pauses with carotid sinus massage (CSM), often necessitates pacemaker implantation.
AFHCUs included clinical actions such as ablation, cardioversion, initiation/intensification of rate or rhythm control medication, or progression to a pacemaker or implantable cardioverter-defibrillator. i Centers for Disease Control and Prevention. 2024, May 15). About Atrial Fibrillation.
Cox-Maze IV AF ablation. No differences observed in freedom from stroke (p = 0.80) or permanent pacemaker (p = 0.33) between the groups. Therefore, surgical risk should not be reason to deny benefits of concomitant AF-ablation. They were subdivided into two groups: 1. No-Surgical AF treatment.
The primary outcome was clinically actionable event that was a composite of the newly detected atrial fibrillation (AF), pacemaker or implantable cardioverter defibrillator (ICD) implantation, catheter ablation, and anticoagulation initiation. vs. 15.8%; p =0.001), pacemaker implantation (11.2% The mean age was 64.3
She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. Seeing as the patient has a single chamber ICD/pacemaker, pacing the ventricle will also lead to AV dyssynchrony that will compromise ventricular filling, further impairing hemodynamics. small squares in width (260ms).
Abstract Background Cardioneuroablation (CNA) is a novel therapeutic approach for functional bradyarrhythmias, specifically neurocardiogenic syncope or atrial fibrillation, achieved through endocardial radiofrequency catheter ablation of vagal innervation, obviating the need for pacemaker implantation.
Conclusions This study is expected to provide valuable findings regarding arrhythmia in HFnon-rEF patients, and elucidate a potential new therapeutic approach for HFnon-rEF.
Cardioneuroablation (CNA) is a catheter-based intervention, used to identify and ablate the epicardial ganglionated plexi (GP), which results in disruption of the vagal-mediated parasympathetic input to the sinus and atrioventricular node. Post-CNA, the median longest pause was 1.3 s s (range 0.8–2.2) with 0 documented pauses.
A patient in the ICU with significant underlying cardiac disease [HFrEF 30%, non-ischemic cardiomyopathy, LBBB s/p CRT-D (biventricular pacer), AVNRT s/p ablation a few yrs ago, hx sinus tachycardia while on max tolerated BB therapy] went into a regular wide-complex tachycardia after intubation for severe COPD exacerbation. What to do?
Discussing further, Catheterization Laboratory, also called Cath Lab, is a medical examination room where angiogram, angioplasty, ablation, and implantation of pacemaker are carried out. Building Smart Cath Labs is highly related to it.
The consensus statement suggests moving to a two-year requirement (previously annual) for in-clinic interrogations for pacemaker and ICD patients without any events or comorbidities who are compliant with remote monitoring.
If there had been — a temporary atrial pacemaker could have been considered as a way of increasing the heart rate to suppress a bradycardia-dependent arrhythmia ("overdrive pacing"). Some residual ischemia in the infarct border might still be present. QUESTION: How will you handle this arrhythmia given the clinical scenario?
ABSTRACT Background Catheter ablation (CA) for atrial fibrillation (AF) in the elderly poses a growing challenge. Methods Octogenarians with AF or consecutive atrial tachycardia undergoing index or re-ablation (pulmonary vein isolation [PVI] and ablation beyond PVI with different energy sources) in a single center, were analyzed.
Methods Recent publications on the following topics were reviewed; understanding of vasovagal syncope pathophysiology, tilt-testing methodology and interpretation, drug, ablation and pacemaker therapy.
The accessory pathway was not further stratified due to evidence of intermittent conduction with a sinus node heart rate of 60bpm, and a bicameral pacemaker was implanted.
In 3 cases (14%) the ablation was performed only on the GPs of the right atrium, while in the remaining 86% of cases we performed biatrial lesions. All patients underwent CNA under conscious sedation targeting the superior and/or inferior paraseptal ganglionated plexus (GPs).ResultsNine
A permanent pacemaker was placed and the patient was atrial paced at 60bpm. After pacemaker placement — a ß-blocker was initiated. When these measures did not work — the patient underwent PVC ablation, which did achieve a good clinical result. Figure-7: I've labeled Figure-6.
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