Abstract:
INTRODUCTION:Cardiac resynchronization therapy (CRT) or biventricular pacing (BVP) is becoming an important treatment option in patients with severe congestive heart failure (CHF) and electrical dyssynchrony. When combined with implantable cardioverter-defibrillator (ICD) therapy, cardiac resynchronization therapy with a defibrillator (CRT-D) has been shown to improve quality of life, functional class, and, most recently, survival. However, left ventricular (LV) stimulation in the form of BVP in patients at high risk of developing ventricular tachyarrhythmias has raised concerns that BVP may be proarrhythmic. We describe the incidence, clinical characteristics, and management in a series of patients who developed ventricular tachycardia storm (VTS) after initiation of BVP. METHODS AND RESULTS:Clinical data on all patients undergoing CRT-D were collected prospectively. VTS occurred in eight of 191 (4%) patients and was characterized by recurrent sustained monomorphic ventricular tachycardia (MMVT) with a single morphology. All patients with VTS were men (seven with ischemic heart disease, one with nonischemic cardiomyopathy) with a remote (5 +/- 2 years) history of MMVT. VTS developed a mean of 16 +/- 12.5 days after initiation of BVP. All patients presented with palpitations and/or decompensated CHF. VTS was refractory to intravenous antiarrhythmic medication and was managed by turning off LV pacing and/or radiofrequency catheter ablation and long-term oral antiarrhythmic therapy. Despite elimination of VT, presenting with VTS carried a poor prognosis in that all eight patients subsequently developed refractory CHF. CONCLUSIONS:VTS with recurrent MMVT can occur after initiation of BVP. Patients present with decompensated CHF and are best managed by either turning off LV pacing or radiofrequency catheter ablation (RFA) in combination with long-term antiarrhythmic medication. Despite eliminating MMVT, most patients have poor outcomes.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Nayak HM,Verdino RJ,Russo AM,Gerstenfeld EP,Hsia HH,Lin D,Dixit S,Cooper JM,Callans DJ,Marchlinski FEdoi
10.1111/j.1540-8167.2008.01122.xsubject
Has Abstractpub_date
2008-07-01 00:00:00pages
708-15issue
7eissn
1045-3873issn
1540-8167pii
JCE1122journal_volume
19pub_type
杂志文章abstract:INTRODUCTION:Sinus node dysfunction (SND) commonly manifests with atrial arrhythmias alternating with sinus pauses and sinus bradycardia. The underlying process is thought to be because of atrial fibrosis. We assessed the value of atrial fibrosis, quantified using late gadolinium enhanced-MRI (LGE-MRI), in predicting s...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02140.x
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Recent work has suggested a role for organized sources in sustaining ventricular fibrillation (VF). We assessed whether ablation of rotor substrate could modulate VF inducibility in canines, and used this proof-of-concept as a foundation to suppress antiarrhythmic drug-refractory clinical VF in a patient w...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12753
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Symptom recurrence following sinus node modification (SNM) for inappropriate sinus tachycardia (IST) remains significant despite achieving acute procedural success. The impact of non-IST tachyarrhythmias on symptom recurrence remains poorly characterized. OBJECTIVES:The objective was to determine the preval...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2012.02297.x
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Warning symptoms may provide an opportunity to diagnose genetic disorders leading to preventative therapy. We explored the symptom history of patients with apparently unexplained cardiac arrest to determine the frequency of sentinel symptoms. METHODS:Patients with apparently unexplained cardiac arrest and n...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1540-8167.2011.02185.x
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:To determine if collagenase-dispersed epicardial myocytes overlying myocardial infarction reproduce the same altered electrophysiology observed in intact epicardium, multicellular tissue preparations and enzymatically-dispersed myocytes from ischemically-injured canine subepicardium were examined 1 and 4 d...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1993.tb01208.x
更新日期:1993-02-01 00:00:00
abstract:INTRODUCTION:Longer observational time and adenosine challenge have proven to be able to detect pulmonary vein (PV) reconnections. The aim of this study was to assess incidence of spontaneous and adenosine-induced PV reconnection after ablation with second-generation cryoballoon (CB-Adv). METHODS AND RESULTS:Fifty con...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12421
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Successful anticoagulation is critical for stroke prevention in adults with atrial fibrillation (AF). Anticoagulation satisfaction is a key indicator of treatment success. While physical, cognitive, and psychosocial limitations are common in elderly AF patients, their associations with anticoagulation satisf...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.14176
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Patients with left bundle branch block (LBBB) undergoing right heart catheterization can develop complete heart block (CHB) or right bundle branch block (RBBB) in response to right bundle branch (RBB) trauma. We hypothesized that LBBB patients with an initial r wave (>or=1 mm) in lead V1 have intact left to ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01714.x
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:The incidence and characteristics of dissociated arrhythmia confined to the pulmonary vein (PV) following disconnection have not been described in a large number of patients with paroxysmal atrial fibrillation. METHODS AND RESULTS:This was a prospective study of 152 patients (29 female, mean age 51 +/- 11...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2003.02583.x
更新日期:2003-11-01 00:00:00
abstract:INTRODUCTION:We conducted this study to examine the effect of the ICD on the outcomes of patients with prior coronary revascularization enrolled in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) and to assess the association of time from coronary revascularization to enrollment with death and sudden cardiac...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01191.x
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:The aims of this study were to investigate: (1) the effect of supplementing the culture medium on preservation of L-type calcium channel current (1Ca,L) in adult rabbit ventricular myocytes cultured for 4 days; and (2) preservation of the ICa,L response in cultured myocytes to the beta-adrenergic agonist i...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb00626.x
更新日期:1997-09-01 00:00:00
abstract:INTRODUCTION:Catheter ablation for paroxysmal AF (PAF) is limited by an unacceptable recurrence rate, mainly due to pulmonary vein (PV) reconnection. Strategies to minimize reconnection include adenosine infusion and also a waiting period of 30 minutes after PV isolation. The aim of the present study was to assess whet...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01564.x
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION:A neural network classifier has been designed, which is able to distinguish atrial fibrillation (AF) from other supraventricular arrhythmias in ambulatory (Holter) ECGs. METHOD AND RESULTS:The classification algorithm uses a rhythm analysis that considers the ECG to be a time series of RR interval duratio...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01301.x
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Current transcatheter ablation of ventricular tachycardia (VT) techniques is limited in part by its invasive nature and superficial depth of ablation lesions. OBJECTIVES:This study was aimed at evaluating the feasibility of targeted ablation of cardiac tissues using high-intensity focused ultrasound (HIFU) ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13459
更新日期:2018-05-01 00:00:00
abstract::The case of an 8-year-old girl with incessant nonsustained left bundle branch block-like tachycardia refractory to antiarrhythmic drug therapy is reported. Electrophysiologic study revealed the presence of a right-sided accessory atriofascicular pathway. Episodes of nonsustained tachycardia were found to be based upon...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.04036.x
更新日期:2004-10-01 00:00:00
abstract:INTRODUCTION:Functional tricuspid regurgitation (TR) remains a challenging clinical problem with poor outcomes and few effective treatments. Atrial fibrillation (AF) has been associated with functional TR. We sought to determine whether restoring sinus rhythm through catheter ablation of AF can decrease the degree of T...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14707
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:Atrial fibrillation and atrial flutter often coexist. The long-term occurrence of atrial fibrillation in patients presenting with atrial flutter alone is unknown. We report the long-term follow-up in patients who underwent cavotricuspid isthmus ablation for treatment of lone atrial flutter. METHODS AND RE...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2007.00885.x
更新日期:2007-08-01 00:00:00
abstract:INTRODUCTION:Ventricular pacing may add additional risk for right ventricular (RV) dysfunction in patients with transposition of the great arteries (TGA) and atrial redirection. The aim of our study was to evaluate the effects of long-term nonsystemic ventricular pacing on cardiac function, dyssynchrony, and clinical p...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02271.x
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:We sought to systematically investigate the role of the ligament of Marshall (LOM) and inferior left ganglionated plexi (ILGP) in modulating electrophysiological functions. METHODS:The following structures were exposed in 36 dogs: (1) LOM, (2) superior left GP (SLGP) near the junction of left superior pulmo...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01315.x
更新日期:2009-03-01 00:00:00
abstract::Application of radiofrequency energy to arrhythmogenic substrates after careful cardiac mapping could ensure a high success rate in eliminating certain types of tachyarrhythmias. Future studies of catheter ablation will focus on how to improve ablation efficacy and achieve a better result in various types of tachyarrh...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.1995.tb00360.x
更新日期:1995-10-01 00:00:00
abstract::A 64-year-old man with atrial tachycardia (AT) 3 years after a superior vena cava (SVC) isolation for atrial fibrillation underwent electrophysiologic testing. SVC mapping with a basket catheter revealed a more frequent activation in the SVC than in either of the atria during the AT and consequently the recovered cond...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00570.x
更新日期:2006-11-01 00:00:00
abstract:INTRODUCTION:Outflow tract ventricular arrhythmias (OT VAs) are common and catheter ablation is an effective treatment option. We sought to investigate the relationship between age-related anatomic aortic root changes and QRS morphology during left ventricular outflow tract (LVOT) pace-mapping using cardiac magnetic re...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12712
更新日期:2015-09-01 00:00:00
abstract:INTRODUCTION:Following conversion of atrial fibrillation (AF), QT interval transiently and variably prolongs and can trigger torsades de pointes (TdP). However, quantitative analysis of risk in this setting is difficult because cycle length variability during AF makes rate-corrected QT impossible to calculate. In this ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2007.00817.x
更新日期:2007-06-01 00:00:00
abstract:UNLABELLED:Atrial Defibrillator. INTRODUCTION:The atrial defibrillator empowers patients to cardiovert themselves from atrial arrhythmias at a time that is socially and physically acceptable, thereby preventing hospitalization. The long-term psychosocial effects of repeated use of the patient-activated atrial defibril...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2003.03108.x
更新日期:2003-08-01 00:00:00
abstract:INTRODUCTION:An early afterdepolarization (EAD)-induced triggered beat is thought to precipitate torsade de pointes (TdP) in the long QT syndrome (LQTS). Previous studies demonstrated the development of EAD activity and dispersion of repolarization under LQT2 (reduced I(Kr)) and LQT3 (augmented late I(Na)), but not LQT...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00342.x
更新日期:2000-04-01 00:00:00
abstract:INTRODUCTION:While atrial fibrillation (AF) initiation in the pulmonary veins has been well-studied, simultaneous biatrial and three-dimensional noncontact mapping (NCM) has not been performed. We hypothesized that these two techniques would provide novel information on triggers, initiation, and evolution of spontaneou...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.40531.x
更新日期:2005-05-01 00:00:00
abstract::Patients with congenital heart disease have unique pacing challenges and often require epicardial systems. High pacing threshold is one of the major factors that decrease these systems' durability. Sometimes surgical reintervention or lead replacement is difficult or prohibitive in these patients due to repeated surge...
journal_title:Journal of cardiovascular electrophysiology
pub_type:
doi:10.1111/jce.14603
更新日期:2020-08-01 00:00:00
abstract::We describe the case of 2-year-old baby with compound heterozygosity for paternal and maternal alleles mutation of α-subunit of the cardiac sodium channel (SCN5A), sinus node dysfunction, atrial flutter recurrences, and drug induced long-QT syndrome. In this setting, we chose at first to perform linear ablation of cav...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12570
更新日期:2015-03-01 00:00:00
abstract:INTRODUCTION:Following radiofrequency catheter ablation of AV nodal reentrant tachycardia (AVNRT), inappropriate sinus tachycardia may occur, possibly due to damage to autonomic cardiac nerve fibers. Furthermore, inducibility of AVNRT is often critically dependent on the autonomic balance. We investigated whether succe...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00936.x
更新日期:1998-06-01 00:00:00
abstract:INTRODUCTION:In patients with sinus node disease (SND), the dual-chamber pacemaker (PM) is programmed in DDDR mode with an algorithm to avoid unnecessary right ventricular (RV) pacing. This pacing mode may prolong PR interval with consequently atrioventricular (AV) asynchrony which is associated with a higher risk of a...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14810
更新日期:2020-11-11 00:00:00