Determining the optimal length of artificial chordae tendineae and then effectively securing them is a major challenge in mitral valve repair. Our technique for measuring and stabilizing neochordae involves tying a polypropylene suture loop onto the annuloplasty ring. We used this method in 4 patients who had moderate-to-severe mitral regurgitation from degenerative posterior leaflet (P2) prolapse and flail chordae. Results of intraoperative saline tests and postoperative transesophageal echocardiography revealed only mild insufficiency. One month postoperatively, echocardiograms showed trivial regurgitation in all 4 patients. We think that this simple, precise method for adjusting and stabilizing artificial chordae will be advantageous in mitral valve repair.
{"title":"Optimizing P2 Neochordal Length and Stability in Mitral Valve Repair With Use of a Polypropylene Loop.","authors":"Anil Ozen, Ertekin Utku Unal, Hamdi Mehmet Ozbek, Gorkem Yigit, Hakki Zafer Iscan","doi":"10.14503/THIJ-18-6913","DOIUrl":"https://doi.org/10.14503/THIJ-18-6913","url":null,"abstract":"<p><p>Determining the optimal length of artificial chordae tendineae and then effectively securing them is a major challenge in mitral valve repair. Our technique for measuring and stabilizing neochordae involves tying a polypropylene suture loop onto the annuloplasty ring. We used this method in 4 patients who had moderate-to-severe mitral regurgitation from degenerative posterior leaflet (P2) prolapse and flail chordae. Results of intraoperative saline tests and postoperative transesophageal echocardiography revealed only mild insufficiency. One month postoperatively, echocardiograms showed trivial regurgitation in all 4 patients. We think that this simple, precise method for adjusting and stabilizing artificial chordae will be advantageous in mitral valve repair.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529069/pdf/i1526-6702-47-3-207.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kalyan Chakravarthy Potu, Jay N Patel, Majd Ibrahim, Sujitha Sree Ketineni, Sudhir Mungee
A 52-year-old woman presented with chest pain from spontaneous coronary artery dissection of the distal segment of the first diagonal branch of the left anterior descending coronary artery. We performed left ventriculography, injecting 20 mL of contrast medium at 10 mL/s through a 5F, 100-cm Performa® Ultimate 1 diagnostic cardiac catheter with bumper tip and wire-braid design (Merit Medical Systems, Inc.). The opacified left ventricle (LV) showed mild anterolateral hypokinesis (estimated LV ejection fraction, 0.50). The catheter moved during the procedure, inadvertently cannulating a Thebesian vein with contrast injection (Fig. 1). The dye cleared in 30 seconds. The patient was discharged from the hospital the next day, in stable condition.
{"title":"Incidental Cannulation of Left Ventricular Thebesian Vein.","authors":"Kalyan Chakravarthy Potu, Jay N Patel, Majd Ibrahim, Sujitha Sree Ketineni, Sudhir Mungee","doi":"10.14503/THIJ-17-6254","DOIUrl":"https://doi.org/10.14503/THIJ-17-6254","url":null,"abstract":"A 52-year-old woman presented with chest pain from spontaneous coronary artery dissection of the distal segment of the first diagonal branch of the left anterior descending coronary artery. We performed left ventriculography, injecting 20 mL of contrast medium at 10 mL/s through a 5F, 100-cm Performa® Ultimate 1 diagnostic cardiac catheter with bumper tip and wire-braid design (Merit Medical Systems, Inc.). The opacified left ventricle (LV) showed mild anterolateral hypokinesis (estimated LV ejection fraction, 0.50). The catheter moved during the procedure, inadvertently cannulating a Thebesian vein with contrast injection (Fig. 1). The dye cleared in 30 seconds. The patient was discharged from the hospital the next day, in stable condition.","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529075/pdf/i1526-6702-47-3-238.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan Senior, Marina Roelas Guillamo, Angie Ghattas, Luke Tapp
Advances in stent design and technology have made stent loss during percutaneous coronary intervention rare. When stent loss occurs, the risk of life-threatening procedural complications is high. We describe the use of an endovascular snare system to retrieve a dislodged stent from the proximal right coronary artery of a 54-year-old man during percutaneous coronary intervention after other conventional retrieval techniques had failed.
{"title":"Dislodged Coronary Artery Stent Retrieved With an Endovascular Snare.","authors":"Jonathan Senior, Marina Roelas Guillamo, Angie Ghattas, Luke Tapp","doi":"10.14503/THIJ-17-6587","DOIUrl":"https://doi.org/10.14503/THIJ-17-6587","url":null,"abstract":"<p><p>Advances in stent design and technology have made stent loss during percutaneous coronary intervention rare. When stent loss occurs, the risk of life-threatening procedural complications is high. We describe the use of an endovascular snare system to retrieve a dislodged stent from the proximal right coronary artery of a 54-year-old man during percutaneous coronary intervention after other conventional retrieval techniques had failed.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529073/pdf/i1526-6702-47-3-213.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Influenza causes cardiac and pulmonary complications that can lead to death. Its effect on the conduction system, first described a century ago, has long been thought to be fairly benign. We report 2 cases of high-grade atrioventricular block associated with acute influenza infection. Both patients-a 50-year-old woman with no history of cardiac disease or conduction abnormalities and a 20-year-old man with a history of complex congenital heart disease and conduction abnormalities-received a permanent pacemaker. In the first case, pacemaker interrogation at 4 months revealed persistent atrioventricular block. In the second case, pacemaker interrogation at 3 months suggested resolution. Whether such influenza-associated changes are transient or permanent remains unknown. We recommend keeping a careful watch on influenza patients with cardiac rhythm abnormalities and monitoring them closely to see if the problem resolves.
{"title":"High-Grade Atrioventricular Block Associated With Acute Influenza.","authors":"Kevin Ergle, Janelle Y Gooden, Mustafa M Ahmed","doi":"10.14503/THIJ-18-6658","DOIUrl":"https://doi.org/10.14503/THIJ-18-6658","url":null,"abstract":"<p><p>Influenza causes cardiac and pulmonary complications that can lead to death. Its effect on the conduction system, first described a century ago, has long been thought to be fairly benign. We report 2 cases of high-grade atrioventricular block associated with acute influenza infection. Both patients-a 50-year-old woman with no history of cardiac disease or conduction abnormalities and a 20-year-old man with a history of complex congenital heart disease and conduction abnormalities-received a permanent pacemaker. In the first case, pacemaker interrogation at 4 months revealed persistent atrioventricular block. In the second case, pacemaker interrogation at 3 months suggested resolution. Whether such influenza-associated changes are transient or permanent remains unknown. We recommend keeping a careful watch on influenza patients with cardiac rhythm abnormalities and monitoring them closely to see if the problem resolves.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529078/pdf/i1526-6702-47-3-220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balloon pulmonary valvuloplasty is a safe and effective treatment for isolated pulmonary valve stenosis. Several balloon catheters are available for this procedure in neonates and infants. However, obtaining additional vascular access for the double-balloon technique in this population is troublesome, and tricuspid valve injury is a concern. We used a TMP PED balloon catheter to perform valvuloplasty in 2 infants with isolated pulmonary valve stenosis. This thin-walled, relatively large 12-mm balloon catheter can be delivered through a small-diameter sheath. In both cases, the transpulmonary pressure gradient was reduced without causing any valvular or vascular injuries. Neither patient had recurrent pulmonary valve stenosis. Together, these cases highlight the suitability and feasibility of using the 12-mm TMP PED balloon catheter for treating young infants with valvular stenosis.
{"title":"Use of Large Balloon Catheter to Treat Infants With Pulmonary Valve Stenosis.","authors":"Yuji Ohnishi, Seigo Okada, Takashi Furuta, Yasuo Suzuki, Yuki Iwaya, Shunji Hasegawa, Jun Muneuchi","doi":"10.14503/THIJ-18-6599","DOIUrl":"https://doi.org/10.14503/THIJ-18-6599","url":null,"abstract":"<p><p>Balloon pulmonary valvuloplasty is a safe and effective treatment for isolated pulmonary valve stenosis. Several balloon catheters are available for this procedure in neonates and infants. However, obtaining additional vascular access for the double-balloon technique in this population is troublesome, and tricuspid valve injury is a concern. We used a TMP PED balloon catheter to perform valvuloplasty in 2 infants with isolated pulmonary valve stenosis. This thin-walled, relatively large 12-mm balloon catheter can be delivered through a small-diameter sheath. In both cases, the transpulmonary pressure gradient was reduced without causing any valvular or vascular injuries. Neither patient had recurrent pulmonary valve stenosis. Together, these cases highlight the suitability and feasibility of using the 12-mm TMP PED balloon catheter for treating young infants with valvular stenosis.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529066/pdf/i1526-6702-47-3-216.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omar Ray Kahaly, Dilesh Patel, Ralph S Augostini, Gregory D Rushing, Mahmoud M Houmsse
A 76-year-old man presented for electrophysiologic evaluation of a temporary pacemaker wire detected in his aorta. His medical history included coronary artery disease, 2-vessel coronary artery bypass grafting (CABG) 16 years previously, congestive heart failure (left ventricular ejection fraction, 0.35–0.40), hyperlipidemia, hypertension, frequent premature ventricular contractions, and singlechamber implantable cardioverter-defibrillator placement. His primary care physician had ordered chest computed tomograms to evaluate shortness of breath, chest pain, and hemoptysis. The images revealed mild infiltrative disease in the right upper lung lobe and a temporary pacemaker wire in the aortic arch. The proximal end of the wire terminated in the right ventricular wall, and the distal end was floating in the descending aorta (Fig. 1). Transesophageal echocardiograms (TEE) showed the wire in the lumen of the descending aorta (Fig. 2). At the time of CABG, the patient’s epicardial pacemaker wires had been clipped at skin level and left in place. From that time to the current presentation, he had experienced no stroke symptoms, nor had he undergone TEE or dedicated aortic scanning procedures until the current presentation. We concluded that the imaging findings were incidental. We then consulted our cardiac surgery colleagues regarding the high risks of percutaneous lead extraction, and they surmised that the epicardial lead had Images in Cardiovascular Medicine
{"title":"Intra-Aortic Migration of a Clipped Epicardial Pacing Wire.","authors":"Omar Ray Kahaly, Dilesh Patel, Ralph S Augostini, Gregory D Rushing, Mahmoud M Houmsse","doi":"10.14503/THIJ-17-6507","DOIUrl":"https://doi.org/10.14503/THIJ-17-6507","url":null,"abstract":"A 76-year-old man presented for electrophysiologic evaluation of a temporary pacemaker wire detected in his aorta. His medical history included coronary artery disease, 2-vessel coronary artery bypass grafting (CABG) 16 years previously, congestive heart failure (left ventricular ejection fraction, 0.35–0.40), hyperlipidemia, hypertension, frequent premature ventricular contractions, and singlechamber implantable cardioverter-defibrillator placement. His primary care physician had ordered chest computed tomograms to evaluate shortness of breath, chest pain, and hemoptysis. The images revealed mild infiltrative disease in the right upper lung lobe and a temporary pacemaker wire in the aortic arch. The proximal end of the wire terminated in the right ventricular wall, and the distal end was floating in the descending aorta (Fig. 1). Transesophageal echocardiograms (TEE) showed the wire in the lumen of the descending aorta (Fig. 2). At the time of CABG, the patient’s epicardial pacemaker wires had been clipped at skin level and left in place. From that time to the current presentation, he had experienced no stroke symptoms, nor had he undergone TEE or dedicated aortic scanning procedures until the current presentation. We concluded that the imaging findings were incidental. We then consulted our cardiac surgery colleagues regarding the high risks of percutaneous lead extraction, and they surmised that the epicardial lead had Images in Cardiovascular Medicine","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529080/pdf/i1526-6702-47-3-239.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kainat Khalid, Nadeen Faza, Nasser M Lakkis, Rashed Tabbaa
Malignant metastases are among the most common cardiac masses. We report a rare case of cardiac involvement by Burkitt lymphoma in a 49-year-old man who presented with a 2-month history of dyspnea and palpitations. A transthoracic echocardiogram revealed 2 intracardiac masses in the right atrium (one of which partially encased the tricuspid valve), myocardial infiltration, and pericardial disease. Results of pleural fluid cytology and flow cytometry confirmed involvement by Burkitt lymphoma. Subsequent chemotherapy markedly reduced the intracardiac tumor burden and resolved the patient's presenting symptoms. Our case highlights the importance of cardiac imaging in diagnosing systemic illness, initiating early and appropriate treatment, and monitoring disease progression in patients with intracardiac Burkitt lymphoma.
{"title":"Cardiac Involvement by Burkitt Lymphoma in a 49-Year-Old Man.","authors":"Kainat Khalid, Nadeen Faza, Nasser M Lakkis, Rashed Tabbaa","doi":"10.14503/THIJ-17-6448","DOIUrl":"https://doi.org/10.14503/THIJ-17-6448","url":null,"abstract":"<p><p>Malignant metastases are among the most common cardiac masses. We report a rare case of cardiac involvement by Burkitt lymphoma in a 49-year-old man who presented with a 2-month history of dyspnea and palpitations. A transthoracic echocardiogram revealed 2 intracardiac masses in the right atrium (one of which partially encased the tricuspid valve), myocardial infiltration, and pericardial disease. Results of pleural fluid cytology and flow cytometry confirmed involvement by Burkitt lymphoma. Subsequent chemotherapy markedly reduced the intracardiac tumor burden and resolved the patient's presenting symptoms. Our case highlights the importance of cardiac imaging in diagnosing systemic illness, initiating early and appropriate treatment, and monitoring disease progression in patients with intracardiac Burkitt lymphoma.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529070/pdf/i1526-6702-47-3-210.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rajiv A Kabadi, Mital Shah, Gregary D Marhefka, Gautam George, Bharat Awsare, Mizue Terai, Takami Sato
Locoregional cytokine treatment, or immunoembolization, is an experimental targeted therapy for uveal melanoma metastatic to the liver. Unlike systemic cytokine treatments that have been associated with substantial toxicity, this method of drug delivery appears to be better tolerated. Because this newer therapy is being prescribed more widely, oncologists, interventional radiologists, cardiologists, pulmonologists, critical care specialists, and other providers should become familiar with potential adverse reactions. We describe the case of a 67-year-old man who had metastatic uveal melanoma. Before he underwent liver-directed immunoembolization, he had elevated markers of endothelial dysfunction. He died after the rapid onset of acute right ventricular failure from severe pulmonary hypertension with possible superimposed isolated right ventricular takotsubo cardiomyopathy. In discussing this rare case, we focus on the differential diagnosis.
{"title":"Rapid, Fatal Acute Right Ventricular Failure After Locoregional Cytokine Therapy for Uveal Melanoma Liver Metastases.","authors":"Rajiv A Kabadi, Mital Shah, Gregary D Marhefka, Gautam George, Bharat Awsare, Mizue Terai, Takami Sato","doi":"10.14503/THIJ-18-6762","DOIUrl":"https://doi.org/10.14503/THIJ-18-6762","url":null,"abstract":"<p><p>Locoregional cytokine treatment, or immunoembolization, is an experimental targeted therapy for uveal melanoma metastatic to the liver. Unlike systemic cytokine treatments that have been associated with substantial toxicity, this method of drug delivery appears to be better tolerated. Because this newer therapy is being prescribed more widely, oncologists, interventional radiologists, cardiologists, pulmonologists, critical care specialists, and other providers should become familiar with potential adverse reactions. We describe the case of a 67-year-old man who had metastatic uveal melanoma. Before he underwent liver-directed immunoembolization, he had elevated markers of endothelial dysfunction. He died after the rapid onset of acute right ventricular failure from severe pulmonary hypertension with possible superimposed isolated right ventricular takotsubo cardiomyopathy. In discussing this rare case, we focus on the differential diagnosis.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529077/pdf/i1526-6702-47-3-224.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Effusive-constrictive pericarditis is typically caused by tuberculosis or other severe inflammatory conditions that affect the pericardium. We report a case of effusive-constrictive pericarditis consequent to a motor vehicle accident. A 32-year-old man with gastroesophageal reflux disease presented with severe substernal chest pain of a month's duration and dyspnea on exertion for one week. Echocardiograms revealed a moderate pericardial effusion, and the diagnosis was subacute effusive-constrictive pericarditis. After thorough tests revealed nothing definitive, we learned that the patient had been in a motor vehicle accident weeks before symptom onset, which made blunt trauma the most likely cause of pericardial injury and effusion. Medical management resolved the effusion and improved his symptoms. To our knowledge, this is the first report of effusion from posttraumatic constrictive pericarditis associated with a motor vehicle accident. We encourage providers to consider recent trauma as a possible cause of otherwise idiopathic pericarditis.
{"title":"Posttraumatic Subacute Effusive-Constrictive Pericarditis After a Motor Vehicle Accident.","authors":"Melroy S D'Souza, Kaitlin Shinn, Anup D Patel","doi":"10.14503/THIJ-19-7002","DOIUrl":"https://doi.org/10.14503/THIJ-19-7002","url":null,"abstract":"<p><p>Effusive-constrictive pericarditis is typically caused by tuberculosis or other severe inflammatory conditions that affect the pericardium. We report a case of effusive-constrictive pericarditis consequent to a motor vehicle accident. A 32-year-old man with gastroesophageal reflux disease presented with severe substernal chest pain of a month's duration and dyspnea on exertion for one week. Echocardiograms revealed a moderate pericardial effusion, and the diagnosis was subacute effusive-constrictive pericarditis. After thorough tests revealed nothing definitive, we learned that the patient had been in a motor vehicle accident weeks before symptom onset, which made blunt trauma the most likely cause of pericardial injury and effusion. Medical management resolved the effusion and improved his symptoms. To our knowledge, this is the first report of effusion from posttraumatic constrictive pericarditis associated with a motor vehicle accident. We encourage providers to consider recent trauma as a possible cause of otherwise idiopathic pericarditis.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529076/pdf/i1526-6702-47-3-233.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38437796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 73-year-old man with a medical history of ischemic cardiomyopathy (left ventricular ejection fraction, 0.20–0.24), coronary artery disease with percutaneous coronary intervention to the left anterior descending coronary artery, end-stage renal disease, hypertension, and diabetes mellitus presented at a routine clinical visit. We interrogated his biventricular implantable cardioverter-defibrillator (ICD) (Medtronic Claria MRI CRT-D SureScan), which was programmed in DDDR mode (dual-chamber, sensed, rate-adaptive). The patient’s electrocardiogram (ECG) raised concerns about improper pacing (Fig. 1).
{"title":"Improper Atrial Pacing: Differential Diagnosis.","authors":"Sanket Borgaonkar, Mark Pollet, Yochai Birnbaum","doi":"10.14503/THIJ-19-7006","DOIUrl":"https://doi.org/10.14503/THIJ-19-7006","url":null,"abstract":"A 73-year-old man with a medical history of ischemic cardiomyopathy (left ventricular ejection fraction, 0.20–0.24), coronary artery disease with percutaneous coronary intervention to the left anterior descending coronary artery, end-stage renal disease, hypertension, and diabetes mellitus presented at a routine clinical visit. We interrogated his biventricular implantable cardioverter-defibrillator (ICD) (Medtronic Claria MRI CRT-D SureScan), which was programmed in DDDR mode (dual-chamber, sensed, rate-adaptive). The patient’s electrocardiogram (ECG) raised concerns about improper pacing (Fig. 1).","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529074/pdf/i1526-6702-47-3-236.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38534954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}