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Erratum regarding missing Ethical statements in previously published articles 关于以前发表的文章中缺少伦理声明的更正。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.08.001
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引用次数: 0
Left conduction system pacing – An Ocean of opportunity 左传导系统起搏--充满机遇的海洋。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.09.008
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引用次数: 0
Antiarrhythmic therapy for narrow QRS supraventricular tachyarrhythmias in newborns and infants in the first year of life: Potent tools to be handled with care 新生儿和出生后第一年婴儿窄 QRS 室上性快速性心律失常的抗心律失常治疗:需谨慎使用的有效工具。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.07.005
Supraventricular tachyarrhythmias pose a significant challenge in neonates and infants, particularly within the first year of life, where prompt and effective management is crucial. By synthesizing available evidence and clinical experience, this review aims to provide a comprehensive overview of antiarrhythmic therapy in this vulnerable population, with a focus on narrow QRS supraventricular tachyarrhythmias. This review examines the current understanding of supraventricular tachyarrhythmia management and discusses the challenges associated with antiarrhythmic therapy in newborns and infants during the critical first year of life, evaluating the efficacy and safety of various antiarrhythmic agents commonly utilized in this population, including dosing considerations, adverse effects, and strategies for acute management and prophylactic long-term antiarrhythmic treatment.
室上性快速性心律失常是新生儿和婴儿面临的重大挑战,尤其是在出生后的第一年内,及时有效的治疗至关重要。通过综合现有证据和临床经验,本综述旨在全面概述针对这一易患人群的抗心律失常治疗,重点关注窄 QRS 室上性心动过速。本综述探讨了目前对室上性快速性心律失常治疗的理解,并讨论了新生儿和婴儿在生命关键的第一年中与抗心律失常治疗相关的挑战,评估了这一人群中常用的各种抗心律失常药物的疗效和安全性,包括剂量注意事项、不良反应以及急性治疗和预防性长期抗心律失常治疗的策略。
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引用次数: 0
Arrhythmogenic or dilated or desmoplakin cardiomyopathy? A challenging case managed by our multidisciplinary cardiogenetic team 致心律失常型心肌病、扩张型心肌病还是脱髓鞘型心肌病?我们的多学科心脏遗传学团队处理的一个具有挑战性的病例。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.07.002
Arrhythmogenic cardiomyopathy (ACM), characterized by fibro or fibrofatty infiltration of the myocardium with a predominant arrhythmic presentation, is a genetically mediated cause of sudden cardiac death in the young and athletic individuals. We report a case of a severe form of biventricular ACM in a middle-aged man with a family history of cardiomyopathy-related young death. The proband was identified to harbor two novel mutations in the DES and DOLK genes and was managed comprehensively with a multidisciplinary team approach. This report reinforces the need for a dedicated cardiovascular genetics program as well as a population-specific genetic database in developing countries.
心律失常性心肌病(ACM)以心肌纤维或纤维脂肪浸润为特征,以心律失常为主要表现形式,是导致年轻人和运动员心脏性猝死的遗传因素之一。我们报告了一例严重的双心室 ACM 病例,患者是一名中年男子,有心肌病相关的年轻死亡家族史。经鉴定,该原发性患者携带 DES 和 DOLK 基因的两个新型突变,并通过多学科团队的方法进行了综合治疗。该报告进一步说明,发展中国家需要专门的心血管遗传学项目以及特定人群的遗传学数据库。
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引用次数: 0
Feasibility of using chest strap and dry electrode system for longer term cardiac arrhythmia monitoring: Results from a pilot observational study 使用胸带和干电极系统进行长期心律失常监测的可行性:试点观察研究的结果。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.ipej.2024.08.003

Background and aim

Cardiac arrhythmia diagnostic yield improves with increased duration of monitoring. We investigated patient comfort, diagnostic quality of ECG, and arrhythmia diagnostic yield using a single lead longer term external cardiac monitor (ECM).

Methods

The observational ECM feasibility study enrolled patients with increased risk of cardiac arrhythmia. The ECM investigational prototype was designed using a chest strap with dry electrodes connected to module capable of triggered loop recording of ECG, and automatic detection of arrhythmia. In group-A of study (24-h inpatient), patients wore ECM and Holter that recorded ECG from the ECM and adhesive electrodes. In group-B of study (12-weeks ambulatory), at monthly follow-ups patients filled out a comfort survey and device stored arrhythmia episodes were reviewed.

Results

The study enrolled 34 patients (38 % females, average age 57.5 years, 65 % had palpitations, 12 % had syncope). Diagnostic quality ECG was recorded on 76.5 % of the monitoring duration in 12 of 20 patients with reviewable data in group-A, with motion artifacts causing loss in ECG signal for 18.7 % of the time. In 14 patients in group-B, 94.9 % of the survey responses indicated that ECM was comfortable to wear. Cardiac arrhythmia was observed in 4 of 17 patients (24 %) in group-A and 9 of 14 patients (64 %) in group-B in device recorded episodes. All ECM detected pause and tachycardia were inappropriate detections due to motion artifacts and temporary device removal.

Conclusion

The chest strap-based ECM device was mostly comfortable to wear and recorded diagnostic quality ECG in three-fourth of monitoring period. Cardiac arrhythmia was observed in 64 % of patients over 3-month monitoring along with large number of motion artifact induced inappropriate detections.
背景和目的:心律失常诊断率随着监护时间的延长而提高。我们研究了使用单导联长期体外心脏监护仪(ECM)的患者舒适度、心电图诊断质量和心律失常诊断率:观察性 ECM 可行性研究招募了心律失常风险较高的患者。ECM 的研究原型设计使用胸带,胸带上的干电极与模块相连,能够触发循环记录心电图并自动检测心律失常。在研究的 A 组(24 小时住院患者)中,患者佩戴 ECM 和 Holter,通过 ECM 和粘性电极记录心电图。在研究 B 组(12 周非卧床)中,患者在每月随访时填写舒适度调查表,并对设备存储的心律失常事件进行复查:研究共招募了 34 名患者(38% 为女性,平均年龄 57.5 岁,65% 有心悸症状,12% 有晕厥症状)。在 20 名患者中,A 组有 12 人在 76.5%的监测时间内记录到了高质量的心电图,其中 18.7%的时间因运动伪影导致心电图信号丢失。在 B 组的 14 名患者中,94.9% 的受访者表示 ECM 佩戴舒适。在设备记录的事件中,A 组 17 名患者中有 4 人(24%)观察到心律失常,B 组 14 名患者中有 9 人(64%)观察到心律失常。所有 ECM 检测到的暂停和心动过速都是由于运动伪影和临时移除设备造成的不恰当检测:结论:胸带式 ECM 设备佩戴舒适,在四分之三的监测时间内记录到诊断质量的心电图。临床试验注册:临床试验注册号:CTRI/2020/02/023576。
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引用次数: 0
The Janus Heads of ventricular Tachycardia: Single-circuit with dual exits. 室性心动过速的杰纳斯头:单回路双出口。
Q3 Medicine Pub Date : 2024-08-31 DOI: 10.1016/j.ipej.2024.08.005
Devendra S Bisht, Kamal Kishor

In the setting of ischemic heart disease (IHD), ventricular tachycardia (VT) commonly originates from areas of incomplete scar tissue. High-density electroanatomic mapping has enhanced our understanding of VT circuits, predominantly characterised by dense scar and surviving myocyte bundles. We present a case of a 58-year-old male with IHD and sustained monomorphic VT, successfully treated with radiofrequency ablation following high-density mapping and entrainment techniques. Two inducible VT phenotypes were identified, with ablation at one site effectively terminating both VT morphologies. This case illustrates the importance of precise circuit localisation and targeted ablation in managing post-infarction VT, leading to a satisfactory patient outcome.

在缺血性心脏病(IHD)的情况下,室性心动过速(VT)通常起源于瘢痕组织不完整的区域。高密度电解剖图增强了我们对室性心动过速回路的了解,其主要特征是致密的瘢痕和存活的心肌细胞束。我们介绍了一例患有心肌缺血和持续性单形室性心动过速的 58 岁男性病例,该病例在采用高密度绘图和夹带技术后,成功地接受了射频消融治疗。确定了两种可诱发的 VT 表型,在一个部位进行消融可有效终止两种 VT 形态。该病例说明了精确电路定位和定向消融在治疗梗死后 VT 方面的重要性,从而为患者带来了令人满意的结果。
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引用次数: 0
Conflicting responses with simultaneous atrioventricular pacing. What is the mechanism? 房室同步起搏时的冲突反应。其机制是什么?
Q3 Medicine Pub Date : 2024-08-22 DOI: 10.1016/j.ipej.2024.08.004
Suresh Kumar Sukumaran, Anish Bhargav, Sridhar Balaguru, Raja J Selvaraj

A 60-year-old woman presented with recurrent episodes of palpitations, documented short RP, narrow QRS tachycardia and absence of preexcitation in the electrocardiogram during sinus rhythm. During an electrophysiology study, programmed stimulation induced a narrow QRS tachycardia with cycle length of 380 ms, VA interval of 164 ms and earliest atrial activation in the His region. Ventricular overdrive pacing failed to entrain the atrium even with isoprenaline infusion and atrial burst pacing repeatedly terminated the tachycardia. Difference in AH interval with pacing and SVT was 27 msec. Simultaneous atrial and ventricular pacing was done with atrial pacing from the high right atrium and showed a His signal as the first return electrogram suggestive of atrioventricular nodal reentrant tachycardia (AVNRT). The manoeuvre was repeated with atrial pacing from the proximal coronary sinus and showed an atrial signal as the first return electrogram suggestive of atrial tachycardia (AT). What is the explanation for the conflicting results of the two pacing maneuvers?

一名 60 岁的女性反复发作心悸,记录有短 RP、窄 QRS 心动过速,窦性心律时心电图无预激。在电生理学检查中,程序性刺激诱发了窄 QRS 心动过速,周期长度为 380 毫秒,VA 间期为 164 毫秒,最早的心房激活位于 His 区。即使输注异丙肾上腺素,心室超速起搏也不能控制心房,而心房猝发起搏多次终止了心动过速。起搏与 SVT 的 AH 间期相差 27 毫秒。同时进行心房和心室起搏,并从右心房高点进行心房起搏,结果显示第一个回波电图为 His 信号,提示房室结复律性心动过速(AVNRT)(图 1)。从冠状窦近端进行心房起搏后重复该操作,显示心房信号为第一个回流电图,提示房性心动过速(AT)(图 2)。两种起搏操作的结果相互矛盾,原因何在?
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引用次数: 0
Paradoxical under-sensing of atrial lead at high sensitivity setting in dual chamber pacemaker during atrial flutter - What is the mechanism? 心房扑动时,双腔起搏器在高灵敏度设置下对心房导联的反常感应不足--其机制是什么?
Q3 Medicine Pub Date : 2024-08-22 DOI: 10.1016/j.ipej.2024.08.002
Than Htike, Saroj Choudhury, Debabrata Bera

Introduction: The causes of atrial undersensing in a dual chamber pacemaker include true undersensing (low amplitude electrogram), functional undersensing (related to the effect of special timing cycles in the presence of an adequate signal) and paradoxical undersensing. This case report describes paradoxical atrial undersensing at a higher programmed atrial sensitivity and with the return of normal atrial sensing at a lower programmed sensitivity.

导言:导致双腔起搏器心房传感不足的原因包括真正的传感不足(低振幅电图)、功能性传感不足(在信号充足的情况下与特殊定时周期的影响有关)和矛盾性传感不足。本病例报告描述了在较高的编程心房灵敏度下出现的矛盾性心房感应不足,以及在较低的编程灵敏度下恢复正常的心房感应。
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引用次数: 0
Atrial placement of Aveir-VR leadless pacemaker in a patient with complex cardiac anatomy 为一名心脏解剖结构复杂的患者在心房置入 Aveir-VR 无导联起搏器。
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ipej.2024.04.009

Leadless pacemakers have provided new treatment modalities that can be especially useful in patients with complex cardiac anatomy and contraindications toward other pacemaker approaches. The Aveir™ single-chamber (VR) leadless pacemaker (LP) (Abbott Laboratories, Chicago, IL) is a recently approved device that can be placed in the right ventricle for patients with bradycardia. In this case, we present a novel use for the device through placement in the atrium to control atrial flutter in a patient with a hypoplastic right ventricle.

无导联起搏器提供了新的治疗模式,尤其适用于心脏解剖结构复杂且有其他起搏器禁忌症的患者。Aveir™ 单腔(VR)无引线起搏器(LP)(雅培实验室,芝加哥,伊利诺斯州)是最近获得批准的一种设备,可以放置在右心室,用于治疗心动过缓患者。在本病例中,我们介绍了该装置的一种新用途,即通过在心房放置该装置来控制右心室发育不良患者的心房扑动。
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引用次数: 0
A case report of right ventricular defibrillator and left bundle branch area leads placement and atrioventricular node ablation with chronic right ventricular thrombus 右心室除颤器和左束支区导联置入术及房室结消融术合并慢性右心室血栓的病例报告。
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.1016/j.ipej.2024.06.001

Despite lack of concrete evidence, right ventricular thrombus is generally considered to be a contraindication for intracardiac lead placement. We present a case of successful placement of a right ventricular defibrillator lead and left bundle branch pacing lead and atrioventricular node ablation in a patient with chronic right ventricle thrombus.

尽管缺乏具体证据,但右室血栓通常被认为是心内导联置入的禁忌症。我们介绍了一例在慢性右室血栓患者中成功置入右室除颤导联和左束支起搏导联以及房室结消融术的病例。
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引用次数: 0
期刊
Indian Pacing and Electrophysiology Journal
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