Long QT syndrome (LQTS) is a life-threatening channelopathy, characterized by permanent or transient QT interval prolongation on the 12-lead electrocardiogram and syncope associated with malignant ventricular rhythm disturbances, particularly polymorphic ventricular tachycardia also known as torsade de pointes. Corrected QT (QTc) interval measurement remains the initial source of LQTS diagnosis in any patient, but the borderline QTc interval prolongation should induce further investigation. Genetic testing has the greatest value to provide definitive diagnosis in such situations, but it cant be applied to each patient routinely, putting aside that it can often be incomprehensive, costly or unavailable. The present review discusses the most promising non-invasive electrophysiological markers associated with Long QT syndrome, particularly in absence of visible QT interval prolongation and clinical manifestations.
{"title":"Non-Invasive Electrophysiological Markers Associated With Long QT Syndrome","authors":"A. Ardashev, V. A. Snezhitskiy, L. V. Kalatsei","doi":"10.17816/cardar100224","DOIUrl":"https://doi.org/10.17816/cardar100224","url":null,"abstract":"Long QT syndrome (LQTS) is a life-threatening channelopathy, characterized by permanent or transient QT interval prolongation on the 12-lead electrocardiogram and syncope associated with malignant ventricular rhythm disturbances, particularly polymorphic ventricular tachycardia also known as torsade de pointes. Corrected QT (QTc) interval measurement remains the initial source of LQTS diagnosis in any patient, but the borderline QTc interval prolongation should induce further investigation. Genetic testing has the greatest value to provide definitive diagnosis in such situations, but it cant be applied to each patient routinely, putting aside that it can often be incomprehensive, costly or unavailable. The present review discusses the most promising non-invasive electrophysiological markers associated with Long QT syndrome, particularly in absence of visible QT interval prolongation and clinical manifestations.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73879911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Davi Sales Pereira Gondim, Maria Eduarda Quidute Arrais Rocha, Camila Pinto Cavalcante Miná, Eduardo Augusto Quidute Arrais Rocha, Francisca Tatiana Pereira Gondim, I. P. Costa
{"title":"Brief History of Cardiac Arrhythmias in Facts and Photos","authors":"Davi Sales Pereira Gondim, Maria Eduarda Quidute Arrais Rocha, Camila Pinto Cavalcante Miná, Eduardo Augusto Quidute Arrais Rocha, Francisca Tatiana Pereira Gondim, I. P. Costa","doi":"10.24207/jca.v35i1.3467","DOIUrl":"https://doi.org/10.24207/jca.v35i1.3467","url":null,"abstract":"","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42699989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum to \"Late Electrode Sepsis: Clinical Features, Diagnostics and Management. Clinical Cases\"","authors":"Sergey A. Saiganov","doi":"10.17816/cardar101328","DOIUrl":"https://doi.org/10.17816/cardar101328","url":null,"abstract":"","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"139 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78013493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Valério, Rafael Thiesen Magliari, Alfredo Augusto Eyer Rodrigues, C. Dietrich
Atrial fibrillation is the most prevalent arrhythmia in clinical practice and has different strategies for its control. Of these strategies, the percutaneous ablation of the pulmonary veins stands out, with robust results in relation to drug treatment. It is an invasive procedure and, therefore, not free from complications, which must be properly diagnosed and treated. Among the possible complications, there is stiff atrium syndrome, characterized by reduced atrial compliance caused by post-ablation fibrosis, which, in turn, leads to atrial filling dysfunction and the consequent increase in atrial and venous capillary pulmonary pressures. The case report demonstrates this infrequent but important complication, which presents good results for clinical treatment, in addition to the contribution of cardiac magnetic resonance in its diagnosis and in the assessment of arrhythmia recurrence rates.
{"title":"Stiff Left Atrium Syndrome After Atrial Fibrillation Ablation – A Diagnosis Not To Forget","authors":"R. Valério, Rafael Thiesen Magliari, Alfredo Augusto Eyer Rodrigues, C. Dietrich","doi":"10.24207/jca.v34i3.3457","DOIUrl":"https://doi.org/10.24207/jca.v34i3.3457","url":null,"abstract":"Atrial fibrillation is the most prevalent arrhythmia in clinical practice and has different strategies for its control. Of these strategies, the percutaneous ablation of the pulmonary veins stands out, with robust results in relation to drug treatment. It is an invasive procedure and, therefore, not free from complications, which must be properly diagnosed and treated. Among the possible complications, there is stiff atrium syndrome, characterized by reduced atrial compliance caused by post-ablation fibrosis, which, in turn, leads to atrial filling dysfunction and the consequent increase in atrial and venous capillary pulmonary pressures. The case report demonstrates this infrequent but important complication, which presents good results for clinical treatment, in addition to the contribution of cardiac magnetic resonance in its diagnosis and in the assessment of arrhythmia recurrence rates.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45146824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karila Scarduelli Luciano, Victoria Souza Bogo, Milena Luisa Schulze, R. Ronsoni
Bidirectional ventricular tachycardia (BDVT) is defined by beat-to-beat alternation of the QRS axis on the electrocardiogram. Its diagnosis is uncommon, and the most characteristic etiology is digitalis intoxication (DI). We report the case of a patient with heart failure of valve origin admitted for sepsis that progressed to BDVT and death, associated with DI.
{"title":"Bidirectional Ventricular Tachycardia Due to Digitalis Intoxication","authors":"Karila Scarduelli Luciano, Victoria Souza Bogo, Milena Luisa Schulze, R. Ronsoni","doi":"10.24207/jca.v34i3.3447","DOIUrl":"https://doi.org/10.24207/jca.v34i3.3447","url":null,"abstract":"Bidirectional ventricular tachycardia (BDVT) is defined by beat-to-beat alternation of the QRS axis on the electrocardiogram. Its diagnosis is uncommon, and the most characteristic etiology is digitalis intoxication (DI). We report the case of a patient with heart failure of valve origin admitted for sepsis that progressed to BDVT and death, associated with DI.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41388496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Barbara Adelmann de Lima, A. C. B. da Silva, M. A. L. Saffi, Clóvis Fröemming Junior, Gabriela Castilhos, M. Kruse, G. D. de Lima, T. Leiria
Introduction: Tetralogy of Fallot (TOF) is a cyanotic congenital heart disease that has an incidence of sudden cardiac death of 0.2% per year, being arrhythmias the main cause of its occurrence. Objective: To compare characteristics of TOF patients referred for electrophysiological study (EPS) against those that were not (No-EPS). Method: Retrospective cohort with 215 patients (57.2% men; age = 29 ± 4) with corrected TOF (median of three years, ranging from 0.33 to 51) that underwent EPS between 2009-2020. The primary outcome was composed of death, implantable cardiac defibrillator (ICD) requirement and hospitalization. Results: Pre-syncope (EPS = 4.7%, No-EPS = 0%; p = 0.004), syncope (EPS = 7.1%, No-EPS = 1.7%; p = 0.056) and palpitations (EPS = 31%, No-EPS = 5.8%; p < 0.001) were symptoms that justified electrophysiological investigation. ICD was implanted in 24% of EPS and 0.6% of No-EPS (p=0.001). Twenty-six percent of the EPS group presented non-sustained ventricular tachycardia, while 0% in No-EPS (p = 0.012). The EPS group had more atrial fibrillation or atrial Flutter (35.7% vs. 6.9%; p < 0.001). The EPS patients had a wider QRS duration than the no-EPS group (171.12 ± 29.52 ms vs. 147 ± 29.77 ms; p < 0.001). Also, 26.2% of EPS performed ablation to correct macroreentrant atrial tachycardias. The incidence of primary outcome (death + ICD requirement + hospitalization) was higher in patients in the EPS group compared to the No-EPS group (p = 0.001). However, the total of seven deaths occurred during the clinical follow-up, but without differences between the groups (EPS = 4.7% vs. No-EPS = 2.8%; p = 0.480). Conclusion: EPS group had a profile of greater risk, more complex heart disease, and a greater occurrence of the primary outcome when compared to the No-EPS group.
{"title":"Clinical Characteristics of Patients with Tetralogy of Fallot who Underwent an Invasive Procedure for Arrhythmias","authors":"Barbara Adelmann de Lima, A. C. B. da Silva, M. A. L. Saffi, Clóvis Fröemming Junior, Gabriela Castilhos, M. Kruse, G. D. de Lima, T. Leiria","doi":"10.24207/jca.v34i3.3452","DOIUrl":"https://doi.org/10.24207/jca.v34i3.3452","url":null,"abstract":"Introduction: Tetralogy of Fallot (TOF) is a cyanotic congenital heart disease that has an incidence of sudden cardiac death of 0.2% per year, being arrhythmias the main cause of its occurrence. Objective: To compare characteristics of TOF patients referred for electrophysiological study (EPS) against those that were not (No-EPS). Method: Retrospective cohort with 215 patients (57.2% men; age = 29 ± 4) with corrected TOF (median of three years, ranging from 0.33 to 51) that underwent EPS between 2009-2020. The primary outcome was composed of death, implantable cardiac defibrillator (ICD) requirement and hospitalization. Results: Pre-syncope (EPS = 4.7%, No-EPS = 0%; p = 0.004), syncope (EPS = 7.1%, No-EPS = 1.7%; p = 0.056) and palpitations (EPS = 31%, No-EPS = 5.8%; p < 0.001) were symptoms that justified electrophysiological investigation. ICD was implanted in 24% of EPS and 0.6% of No-EPS (p=0.001). Twenty-six percent of the EPS group presented non-sustained ventricular tachycardia, while 0% in No-EPS (p = 0.012). The EPS group had more atrial fibrillation or atrial Flutter (35.7% vs. 6.9%; p < 0.001). The EPS patients had a wider QRS duration than the no-EPS group (171.12 ± 29.52 ms vs. 147 ± 29.77 ms; p < 0.001). Also, 26.2% of EPS performed ablation to correct macroreentrant atrial tachycardias. The incidence of primary outcome (death + ICD requirement + hospitalization) was higher in patients in the EPS group compared to the No-EPS group (p = 0.001). However, the total of seven deaths occurred during the clinical follow-up, but without differences between the groups (EPS = 4.7% vs. No-EPS = 2.8%; p = 0.480). Conclusion: EPS group had a profile of greater risk, more complex heart disease, and a greater occurrence of the primary outcome when compared to the No-EPS group.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45389745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Vassallo, Luciano Santos, Betina Reseck Walker, R. França, Christina Madeira, V. Mauro, F. Cesar, Lucas Corcino, R. Serpa
Percutaneous procedures through femoral access in patients with inferior vena cava (IVC) filter may be at risk of complications. We evaluated the feasibility and safety of left atrial appendage closure (LAAC) through femoral access in patients previously implanted with IVC filter. We described the WatchmanTM device implantation in two patients with formal contraindication for oral anticoagulation. First patient had a GreenfieldTM filter and the second one an OpteaseTM filter, and in this patient an attempt to withdrawal the filter immediately before the LAAC procedure failed. A femoral approach was performed in both patients using a 14 Fr sheath. Before crossing IVC filters, venographies did not detect any thrombus. All steps of IVC filter crossing were performed under fluoroscopic guidance. No immediate or intrahospital complications related to the procedure occurred. Herein, we presented two cases of successful LAAC closure with Watchman device in patients with two different kinds of IVC filters.
{"title":"Successful Left Atrial Appendage Closure with Watchman Device Implantation in Two Patients with Inferior Vena Cava Filters","authors":"F. Vassallo, Luciano Santos, Betina Reseck Walker, R. França, Christina Madeira, V. Mauro, F. Cesar, Lucas Corcino, R. Serpa","doi":"10.24207/jca.v34i3.3454","DOIUrl":"https://doi.org/10.24207/jca.v34i3.3454","url":null,"abstract":"Percutaneous procedures through femoral access in patients with inferior vena cava (IVC) filter may be at risk of complications. We evaluated the feasibility and safety of left atrial appendage closure (LAAC) through femoral access in patients previously implanted with IVC filter. We described the WatchmanTM device implantation in two patients with formal contraindication for oral anticoagulation. First patient had a GreenfieldTM filter and the second one an OpteaseTM filter, and in this patient an attempt to withdrawal the filter immediately before the LAAC procedure failed. A femoral approach was performed in both patients using a 14 Fr sheath. Before crossing IVC filters, venographies did not detect any thrombus. All steps of IVC filter crossing were performed under fluoroscopic guidance. No immediate or intrahospital complications related to the procedure occurred. Herein, we presented two cases of successful LAAC closure with Watchman device in patients with two different kinds of IVC filters.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41573960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Vassallo, Edevaldo da Silva, Lucas Luis Meigre, C. Cunha, Eduardo Serpa, Aloyr Simões Jr, Hermes Carloni, C. Volponi
This is a series case report of five symptomatic patients presented with diagnosis of sinus bradycardia, first and second degrees atrioventricular (AV) blocks, that were referred to pacemaker implantation. During the screening, a functional cause for the bradycardia and AV blocks were documented by treadmill stress test, 24-hour Holter monitoring and atropine test. After the confirmation of the diagnosis, patients were submitted to cardioneuroablation on an anatomical basis supported by a tridimensional electroanatomical fractionation mapping software. The technique and the acute and short-term results of the cardioneuroablation are described.
{"title":"Initial Experience with Fractionation Mapping in the Identification of Vagal Ganglionated Plexus During Cardioneuroablation","authors":"F. Vassallo, Edevaldo da Silva, Lucas Luis Meigre, C. Cunha, Eduardo Serpa, Aloyr Simões Jr, Hermes Carloni, C. Volponi","doi":"10.24207/jca.v34i3.3461","DOIUrl":"https://doi.org/10.24207/jca.v34i3.3461","url":null,"abstract":"This is a series case report of five symptomatic patients presented with diagnosis of sinus bradycardia, first and second degrees atrioventricular (AV) blocks, that were referred to pacemaker implantation. During the screening, a functional cause for the bradycardia and AV blocks were documented by treadmill stress test, 24-hour Holter monitoring and atropine test. After the confirmation of the diagnosis, patients were submitted to cardioneuroablation on an anatomical basis supported by a tridimensional electroanatomical fractionation mapping software. The technique and the acute and short-term results of the cardioneuroablation are described.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49161015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thiago Sampaio Marengo, Vitor Martins, Guilherme Viana Barbosa, Fernando Mello Porto, Halim Cury Filho, Adão Bento de Lucena Neto, José Marco Nogueira Lima
Case report of a 49-year-old patient with Wolff-Parkinson-White syndrome, very symptomatic, with apparent parahisian pathway who, during an electrophysiological study, presented orthodromic atrioventricular tachycardia, featuring two accessory pathways, retrogradely, the parahisian pathway and a hidden left posterolateral pathway, during the same tachycardia, alternating the retrograde pathway of tachycardia without interruption.
{"title":"Orthodromic Atrioventricular Tachycardia in Wolff-Parkinson-White Syndrome with Two Accessory Pathways Participation during the Same AVT","authors":"Thiago Sampaio Marengo, Vitor Martins, Guilherme Viana Barbosa, Fernando Mello Porto, Halim Cury Filho, Adão Bento de Lucena Neto, José Marco Nogueira Lima","doi":"10.24207/jca.v34i3.3463","DOIUrl":"https://doi.org/10.24207/jca.v34i3.3463","url":null,"abstract":"Case report of a 49-year-old patient with Wolff-Parkinson-White syndrome, very symptomatic, with apparent parahisian pathway who, during an electrophysiological study, presented orthodromic atrioventricular tachycardia, featuring two accessory pathways, retrogradely, the parahisian pathway and a hidden left posterolateral pathway, during the same tachycardia, alternating the retrograde pathway of tachycardia without interruption.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48550985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Nechepurenko, N. Ilov, S. S. Durmanov, P. Shugaev, Andrey V. Ivanchenko, I. Suchkov, Khosni A. Bsharat, Andrey M. Lukin, Lyudmila G. Medyanсeva, V. Povarov
Pocket hematoma (PH) is a common complication of pacemaker implantations which prolongs hospitalization and may demand surgical revision in some cases. According to the data from different researchers PH rate varies from 2 to 7%. It depends on number of factors including a need for anticoagulation therapy. We present a review of design of multicenter clinical trial evaluating safety and efficacy of application of hemostatic agent Haemoblock for pocket hematoma reduction in patients taking oral anticoagulants.
{"title":"Application of Hemostatic Agent “Haemoblock” for Pocket Hematoma Reduction. Design of the PEGAS study: a Multicenter Clinical Trial","authors":"A. Nechepurenko, N. Ilov, S. S. Durmanov, P. Shugaev, Andrey V. Ivanchenko, I. Suchkov, Khosni A. Bsharat, Andrey M. Lukin, Lyudmila G. Medyanсeva, V. Povarov","doi":"10.17816/cardar70497","DOIUrl":"https://doi.org/10.17816/cardar70497","url":null,"abstract":"Pocket hematoma (PH) is a common complication of pacemaker implantations which prolongs hospitalization and may demand surgical revision in some cases. According to the data from different researchers PH rate varies from 2 to 7%. It depends on number of factors including a need for anticoagulation therapy. We present a review of design of multicenter clinical trial evaluating safety and efficacy of application of hemostatic agent Haemoblock for pocket hematoma reduction in patients taking oral anticoagulants.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"107 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89742795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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