Pub Date : 2025-11-01DOI: 10.1016/j.ipej.2025.12.006
Y.J. Kulkarni , Y. Sangeetha , M. Thomas , J.R. Jacob , A. Manickavasagam , S.C. Srinath , A. Sivadasan , Danda
{"title":"Electrocardiographic abnormalities in Duchenne muscular dystrophy patients and its relation to LV function and other factors","authors":"Y.J. Kulkarni , Y. Sangeetha , M. Thomas , J.R. Jacob , A. Manickavasagam , S.C. Srinath , A. Sivadasan , Danda","doi":"10.1016/j.ipej.2025.12.006","DOIUrl":"10.1016/j.ipej.2025.12.006","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Page 471"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802040","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}
Pub Date : 2025-11-01DOI: 10.1016/j.ipej.2025.09.009
Shivani Lawa , Ghania Aizad , Charles Bingham , Daniel Cortez
Introduction
Sinus node dysfunction (SND) is a disorder defined by abnormal initiation and conduction of electrical signals from the sinoatrial node. The preferred first-line treatment for a patient with symptomatic SND is a permanent pacemaker implant. We describe the implantation of an Aveir dual-chamber leadless pacemaker through the right internal jugular vein in a 65-year-old female patient with inaccessible femoral veins and a chemotherapy port in the left internal jugular vein.
Methods
A retrospective review was performed at the University of California at Davis of the dual-chamber leadless pacemaker (Aveir DR) procedure.
Results
A 65-year-old female with a history of chronic dialysis use and chemotherapy, with persistence of left internal jugular vein port, presented with symptomatic bradycardia. After a failed attempt at an outside institution, she presented for a dual-chamber leadless pacemaker implant at our institution. Via the right internal jugular vein, the Aveir VR was deployed with stable thresholds, impedance, and sensing into the ventricular septum, with a subsequent atrial device being deployed with stable thresholds, impedance, and sensing into the right atrial appendage. Follow-up at 8 days demonstrated a ventricular threshold of 0.75V at 0.2 ms, impedance of 440 Ohms, and sensing of 9.9 mV. Follow-up atrial threshold of 0.75V at 0.2 ms, impedance of 400 Ohms, and P wave sensing of 0.8 mV.
Conclusion
Placement of the Aveir dual chamber leadless pacemaker is safe in an adult patient without any complications.
{"title":"Dual-chamber leadless pacemaker implant via the RIJ after failed femoral vein implant in a 65-year-old patient with symptomatic bradycardia, with left IJ port and right-sided AV fistula","authors":"Shivani Lawa , Ghania Aizad , Charles Bingham , Daniel Cortez","doi":"10.1016/j.ipej.2025.09.009","DOIUrl":"10.1016/j.ipej.2025.09.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Sinus node dysfunction (SND) is a disorder defined by abnormal initiation and conduction of electrical signals from the sinoatrial node. The preferred first-line treatment for a patient with symptomatic SND is a permanent pacemaker implant. We describe the implantation of an Aveir dual-chamber leadless pacemaker through the right internal jugular vein in a 65-year-old female patient with inaccessible femoral veins and a chemotherapy port in the left internal jugular vein.</div></div><div><h3>Methods</h3><div>A retrospective review was performed at the University of California at Davis of the dual-chamber leadless pacemaker (Aveir DR) procedure.</div></div><div><h3>Results</h3><div>A 65-year-old female with a history of chronic dialysis use and chemotherapy, with persistence of left internal jugular vein port, presented with symptomatic bradycardia. After a failed attempt at an outside institution, she presented for a dual-chamber leadless pacemaker implant at our institution. Via the right internal jugular vein, the Aveir VR was deployed with stable thresholds, impedance, and sensing into the ventricular septum, with a subsequent atrial device being deployed with stable thresholds, impedance, and sensing into the right atrial appendage. Follow-up at 8 days demonstrated a ventricular threshold of 0.75V at 0.2 ms, impedance of 440 Ohms, and sensing of 9.9 mV. Follow-up atrial threshold of 0.75V at 0.2 ms, impedance of 400 Ohms, and P wave sensing of 0.8 mV.</div></div><div><h3>Conclusion</h3><div>Placement of the Aveir dual chamber leadless pacemaker is safe in an adult patient without any complications.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 433-437"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226153","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}
While the safety and efficacy of cryoablation procedures have been well-established in Western populations, data regarding these outcomes in the subcontinent remain limited.
Methods
This retrospective observational study included patients with paroxysmal atrial fibrillation (PAF) or persistent atrial fibrillation (PsAF) treated with cryoballoon catheter ablation according to standard clinical practice. The primary efficacy endpoints (mean follow-up of 15.3 months) were freedom from AF/atrial flutter (AFL)/atrial tachycardia (AT) lasting ≥30 s. The primary safety endpoint was the occurrence of serious procedure-related adverse events within 30 days of the procedure.
Results
The study population included 66 consecutive patients with recurrent symptomatic atrial fibrillation despite medications and underwent the cryoablation procedure for rhythm control. The cohort had a mean age of 55 ± 14 years, was 77 % male, had a CHA2DS2-VASc score of 1.63 ± 1.53, and had been diagnosed with AF for a mean of 2.93 ± 3.25 years before cryoablation. Patients with PAF comprised 75.8 % of the total cohort. The PsAF subgroup had a significantly larger mean left atrial (LA) diameter (42 mm vs. 36 mm; p < 0.01), lower LVEF (57 % vs 63 %; p = 0.016), fewer presyncope episodes (6 % vs. 30 %; p = 0.048), and higher amiodarone use within last one year (69 % vs. 22 %; p < 0.01). Two serious procedure-related events (3.03 %) occurred (phrenic nerve injury), both of which resolved within 3 months’ follow-up. Freedom from recurrence of atrial arrhythmia at 12 months was 71 % (95 % CI 55–81 %), with a significant difference between PAF 84 % (95 % CI 68–92 %) and PsAF 34 % (95 % CI 10–60 %) groups. Presence of atrial arrhythmia at the beginning of the study (87 % vs 51 %) and failure to terminate it after completion of ablative procedure, requiring electrical cardioversion, impose a higher risk (83 % vs 28 %) of recurrence. No difference was found between the PVI and PVI + groups.
Conclusions
Cryoballoon ablation demonstrated efficiency, safety, and effectiveness in treating patients with paroxysmal and persistent AF. 12-month atrial arrhythmia-free survival rates were significantly higher in patients with PAF compared to those with PsAF. Pre-procedural atrial arrhythmias and post-procedural atrial arrhythmias requiring cardioversion are associated with a higher risk of recurrence. Major procedural adverse effects were comparable to those reported in global standards.
背景：虽然冷冻消融手术的安全性和有效性在西方人群中已经得到证实，但在次大陆地区，关于这些结果的数据仍然有限。方法：本回顾性观察研究纳入阵发性心房颤动（PAF）或持续性心房颤动（PsAF）患者，根据标准临床实践采用冷冻球囊导管消融治疗。主要疗效终点（平均随访15.3个月）是房颤/心房扑动(AFL)/房性心动过速（AT）持续≥30秒。主要安全终点是手术后30天内发生的严重手术相关不良事件。结果：研究人群包括66例连续的复发性症状性心房颤动患者，尽管接受了药物治疗，并接受了冷冻消融手术以控制心律。该队列的平均年龄为55±14岁，男性占77%，CHA2DS2-VASc评分为1.63±1.53，在冷冻消融前诊断为房颤的平均时间为2.93±3.25年。PAF患者占总队列的75.8%。PsAF亚组平均左房直径明显增大（42mm对36mm， p < 0.01）， LVEF明显降低（57%对63%，p = 0.016），晕厥前发作较少（6%对30%，p = 0.048），近一年内胺碘酮的使用率较高（69%对22%，p < 0.01）。发生2例严重手术相关事件（膈神经损伤）（3.03%），均在随访3个月内消退。12个月房性心律失常复发率为71% (95% CI 55-81%), PAF 84% （95% CI 68-92%）和PsAF 34% （95% CI 10-60%）组之间存在显著差异。在研究开始时存在心房心律失常（87%对51%），并且在消融手术完成后未能终止心房心律失常，需要电复律，会增加复发的风险（83%对28%）。PVI组与PVI+组间无差异。结论：低温球囊消融治疗阵发性和持续性房颤的有效性、安全性和有效性。与PsAF患者相比，PAF患者12个月无房性心律失常生存率显著高于PsAF患者。术前心房心律失常和术后需要复律的心房心律失常与较高的复发风险相关。主要程序性不良反应与全球标准报告的不良反应相当。
{"title":"Indian experience with cryoablation for paroxysmal and persistent atrial fibrillation","authors":"Sudipta Mondal , Nayani Makkar , Usnish Adhikari , Kakarla Saikiran , Jyothi Vijay , Sreevilasam P. Abhilash , Sabari Saravanan , Narayanan Namboodiri","doi":"10.1016/j.ipej.2025.11.016","DOIUrl":"10.1016/j.ipej.2025.11.016","url":null,"abstract":"<div><h3>Background</h3><div>While the safety and efficacy of cryoablation procedures have been well-established in <em>Western populations</em>, data regarding these outcomes in the subcontinent remain limited.</div></div><div><h3>Methods</h3><div>This retrospective observational study included patients with paroxysmal atrial fibrillation (PAF) or persistent atrial fibrillation (PsAF) treated with cryoballoon catheter ablation according to standard clinical practice. The primary efficacy endpoints (mean follow-up of 15.3 months) were freedom from AF/atrial flutter (AFL)/atrial tachycardia (AT) lasting ≥30 s. The primary safety endpoint was the occurrence of serious procedure-related adverse events within 30 days of the procedure.</div></div><div><h3>Results</h3><div>The study population included 66 consecutive patients with recurrent symptomatic atrial fibrillation despite medications and underwent the cryoablation procedure for rhythm control. The cohort had a mean age of 55 ± 14 years, was 77 % male, had a CHA2DS2-VASc score of 1.63 ± 1.53, and had been diagnosed with AF for a mean of 2.93 ± 3.25 years before cryoablation. Patients with PAF comprised 75.8 % of the total cohort. The PsAF subgroup had a significantly larger mean left atrial (LA) diameter (42 mm vs. 36 mm; <em>p</em> < 0.01), lower LVEF (57 % vs 63 %; <em>p</em> = 0.016), fewer presyncope episodes (6 % vs. 30 %; <em>p</em> = 0.048), and higher amiodarone use within last one year (69 % vs. 22 %; <em>p</em> < 0.01). Two serious procedure-related events (3.03 %) occurred (phrenic nerve injury), both of which resolved within 3 months’ follow-up. Freedom from recurrence of atrial arrhythmia at 12 months was 71 % (95 % CI 55–81 %), with a significant difference between PAF 84 % (95 % CI 68–92 %) and PsAF 34 % (95 % CI 10–60 %) groups. Presence of atrial arrhythmia at the beginning of the study (87 % vs 51 %) and failure to terminate it after completion of ablative procedure, requiring electrical cardioversion, impose a higher risk (83 % vs 28 %) of recurrence<strong>.</strong> No difference was found between the PVI and PVI + groups<strong>.</strong></div></div><div><h3>Conclusions</h3><div>Cryoballoon ablation demonstrated efficiency, safety, and effectiveness in treating patients with paroxysmal and persistent AF. 12-month atrial arrhythmia-free survival rates were significantly higher in patients with PAF compared to those with PsAF. Pre-procedural atrial arrhythmias and post-procedural atrial arrhythmias requiring cardioversion are associated with a higher risk of recurrence. Major procedural adverse effects were comparable to those reported in global standards.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 397-403"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696491","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}
Pub Date : 2025-11-01DOI: 10.1016/j.ipej.2025.11.002
Anubhav Das , Anup Khetan , Debabrata Bera , Kingshuk Bag
{"title":"ICD-associated R-wave double counting in ARVC: A mechanistic approach to troubleshooting inappropriate shocks","authors":"Anubhav Das , Anup Khetan , Debabrata Bera , Kingshuk Bag","doi":"10.1016/j.ipej.2025.11.002","DOIUrl":"10.1016/j.ipej.2025.11.002","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 458-462"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597814","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}
Pub Date : 2025-11-01DOI: 10.1016/j.ipej.2025.12.001
Boris Schmidt MD, FHRS, K.R. Julian Chun MD
{"title":"The power of the flower – how to facilitate pentaspline navigation to the right inferior pulmonary vein","authors":"Boris Schmidt MD, FHRS, K.R. Julian Chun MD","doi":"10.1016/j.ipej.2025.12.001","DOIUrl":"10.1016/j.ipej.2025.12.001","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Page 413"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670176","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}
Pub Date : 2025-11-01DOI: 10.1016/j.ipej.2025.11.005
Deepthi Rajan , Tobias Skjelbred , Thomas Hadberg Lynge , Jacob Tfelt-Hansen
Sudden cardiac death (SCD) is accountable for 10–20 % of deaths in Europe. While inherited and acquired structural heart disease underlie a considerable proportion, many SCDs remain unexplained after conventional autopsy. Lack of structural cardiac abnormalities in sudden death points towards the possibility of inherited heart disease, yet to manifest in observable changes. In fact, 70 % of SCDs in the young are potentially inherited, and causes may be familial hypercholesterolemia, cardiomyopathies, and primary arrhythmias syndromes. Early diagnosis of occult hereditary conditions and initiation of tailored prevention is key in risk reduction of SCD in relatives of deceased individuals. Postmortem genetic testing is recommended in potential inherited causes of SCD, with novel data showing the technique enables detection of concealed cardiomyopathies and channelopathies. Yet widespread implementation is impeded by a number of challenges, including lack of awareness among clinicians of the value of postmortem genetics. Current guidelines from the European Society of Cardiology (ESC) and the American Heart Association (AHA) advise both post-mortem genetic testing of the SCD victim with a potential inherited cause of death and testing of first-degree relatives to prevent future SCDs. Furthermore, it is recommended that specialists interpret findings, and that family evaluation takes place in multidisciplinary collaboration between cardiologists, pathologists, geneticists, and counsellors. This review provides a summary of contemporary knowledge on SCD, outlines guidelines for general forensic management and use of post-mortem genetic testing – including its interpretation, advantages, and challenges - and finally describes standard procedures for investigations of relatives to the deceased individual.
{"title":"Sudden cardiac death and the role of postmortem genetic testing in unexplained cases","authors":"Deepthi Rajan , Tobias Skjelbred , Thomas Hadberg Lynge , Jacob Tfelt-Hansen","doi":"10.1016/j.ipej.2025.11.005","DOIUrl":"10.1016/j.ipej.2025.11.005","url":null,"abstract":"<div><div>Sudden cardiac death (SCD) is accountable for 10–20 % of deaths in Europe. While inherited and acquired structural heart disease underlie a considerable proportion, many SCDs remain unexplained after conventional autopsy. Lack of structural cardiac abnormalities in sudden death points towards the possibility of inherited heart disease, yet to manifest in observable changes. In fact, 70 % of SCDs in the young are potentially inherited, and causes may be familial hypercholesterolemia, cardiomyopathies, and primary arrhythmias syndromes. Early diagnosis of occult hereditary conditions and initiation of tailored prevention is key in risk reduction of SCD in relatives of deceased individuals. Postmortem genetic testing is recommended in potential inherited causes of SCD, with novel data showing the technique enables detection of concealed cardiomyopathies and channelopathies. Yet widespread implementation is impeded by a number of challenges, including lack of awareness among clinicians of the value of postmortem genetics. Current guidelines from the European Society of Cardiology (ESC) and the American Heart Association (AHA) advise both post-mortem genetic testing of the SCD victim with a potential inherited cause of death and testing of first-degree relatives to prevent future SCDs. Furthermore, it is recommended that specialists interpret findings, and that family evaluation takes place in multidisciplinary collaboration between cardiologists, pathologists, geneticists, and counsellors. This review provides a summary of contemporary knowledge on SCD, outlines guidelines for general forensic management and use of post-mortem genetic testing – including its interpretation, advantages, and challenges - and finally describes standard procedures for investigations of relatives to the deceased individual.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 441-448"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589242","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}
Pub Date : 2025-11-01DOI: 10.1016/j.ipej.2025.12.007
S. Sharma , S. Bohora , Raghav Bansal
{"title":"Spontaneous Pacemaker Lead Screw Retraction: A Single-Center Case Series and Clinical Analysis","authors":"S. Sharma , S. Bohora , Raghav Bansal","doi":"10.1016/j.ipej.2025.12.007","DOIUrl":"10.1016/j.ipej.2025.12.007","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Page 471"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802041","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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