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Brugada phenocopy: A new electrocardiogram phenomenon

World Journal of Cardiology 2014年第3期6卷 81-86页

作者： Daniel D Anselm Jennifer M Evans Adrian Baranchuk division of Cardiology Electrophysiology and PacingQueen's UniversityKingston General Hospital

Brugada phenocopies(BrP) are clinical entities that are etiologically distinct from true congenital Brugada syndrome. BrP are characterized by type 1 or type 2 Brugada electrocardiogram(ECG) patterns in precordial leads V1-V3. However, BrP are elicited by various un-derlying clinical conditions such as myocardial ischemia, pulmonary embolism, electrolyte abnormalities, or poor ECG filters. Upon resolution of the inciting underlying pathological condition, the BrP ECG subsequently nor-malizes. To date, reports have documented BrP in the context of singular clinical events. More recently, recur-rent BrP has been demonstrated in the context of re-current hypokalemia. This demonstrates clinical repro-ducibility, thereby advancing the concept of this new ECG phenomenon. The key to further understanding the pathophysiological mechanisms behind BrP requires experimental model validation in which these phenom-ena are reproduced under strictly controlled environ-mental conditions. The development of these validation models will help us determine whether BrP are tran-sient alterations of sodium channels that are not repro-ducible with a sodium channel provocative test or al-ternatively, a malfunction of other ion channels. In this editorial, we discuss the conceptual emergence of BrP as a new ECG phenomenon, review the progress made to date and identify opportunities for further investiga-tion. In addition, we also encourage investigators that are currently reporting on these cases to use the term BrP in order to facilitate literature searches and to help establish this emerging concept.

关键词： Brugada phenocopy Brugada syndrome Electrolytes Myocardial ischemia Pulmonary embo-lism Cardiomyopathy Electrocardiogram filters

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Leadless pacemakers： a contemporary review

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Journal of Geriatric Cardiology 2018年第4期15卷 249-253页

作者： Neal Bhatia Mikhael El-Chami Department of Medicine Division of Cardiology Section of Electrophysiology Emory University School of Medicine Atlanta USA

1 Introduction Over one million cardiac pacemakers are implanted every year worldwide,[11 of which approximately 200,000 are implanted in the United States alone.121 Combined with an aging population and increasing pacing indications, these numbers are expected to grow. Since the first pacemaker implantation in 1950s, cardiac pacemaker technology has rapidly advanced. Reduction in generator size, increased battery longevity, quality of pacemaker leads, algorithmic and rate responsive programming-all have revolutionized and transformed the implantation and management of transvenous cardiac pacemaker （TV-PPM）.

关键词： Leadless pacemakers Micra Nanostim Perforation

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Improvement in MR and in the dyssynchrony between the mid segments predict super responders in patients undergoing CRT

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World Journal of Cardiovascular Diseases 2012年第4期2卷 295-301页

作者： Miry Blich Shemy Carasso Mahmoud Suleiman Ibrahim Marai Tawfig Zeidan Shwiri Lior Gepstein Monther Boulos division of Echocardiography Department of Cardiology Rambam Health Care Campus and Rappaport Faculty of Medicine division of pacing and electrophysiology Technion Haifa Israel

Background: Twenty to thirty percent of patients with left heart failure in randomized trials do not respond clinically to cardiac resynchronization therapy (CRT). The objectives of our work were to estimate the effec-tiveness of CRT in our routine practice, and to find predictors of favorable response to CRT. Methods: Retrospective analysis of consecutive patients who underwent CRT from 2003-2007. Results: Fifty six consecutive patients (73.2% men, age 66.3 ± 10.2 years) with left heart failure (LHF) (ischemic cardiomyopathy 60.7%) received CRT and were followed for a mean of 27 months. After the implantation: Mean NYHA improved by one class (p < 0.001), LHF admissions were reduced by 79% (p < 0.0001) and mean ejection fruction improved by 31% (19.5% vs 25.6%, p < 0.002). Significant improvement in severity of mitral regurgitation (MR) was an important predictor of high responsiveness (p = 0.004). Improvement of MR was associated with complete left bundle branch block (CLBBB) (p = 0.04) and lower total mortality (p = 0.005). Improvement in synchronization between the mid lateral and mid septal segments, as was calculated with longitudinal strain using echocardiography (105 ± 38 vs 20 ± 23 msec, p = 0.008) was predictor of super responsiveness and reduction in MR among patients with moderate to severe MR prior to implantation. Worsening the delay between the mid posterior and mid anterior septal segments (21 ± 27 vs 120 ± 0 msec, p = 0.006) was associated with absence of response and lack of improvement in MR. Conclusions: Patients who improve mid segments dyssynchrony in four chamber view, have more chance to improve MR and to become super responders.

关键词： Mitral Regurgitation Cardiac Resynchronization Therapy

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Establishment of a predictive model for inpatient sudden cardiac death in a Chinese cardiac department population:a retrospective study

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Chinese Medical Journal 2019年第1期132卷 17-24页

作者： Lu-Xiang Shang Xian-Hui Zhou Jiang-Hua Zhang Wen-Hui Zhang ZuKe-La TuEr-Hong Yang Zhao Wen-Kui Lyu Yao-Dong Li Bao-Peng Tang Department of pacing and electrophysiology First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiang 830054China

Background:Little is known about the risk factors for sudden cardiac death (SCD) in the overall hospitalized cardiac department *** study was conducted to investigate the risk factors and develop a predictive model for SCD in a hospitalized cardiac department ***:We conducted a retrospective study of patients admitted to the cardiac department of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to February *** collected the clinical data from medical *** stepwise logistic regression analysis was carried out to confirm the risk factors for SCD and develop a predictive risk *** risk score was assessed by the area under receiver operating characteristic (AUROC) curve and the Hosmer-Lemeshow goodness-of-fit ***:A total of 262 patients with SCD and 4485 controls were enrolled in our *** regression modeling identified eight significant risk factors for in-hospital SCD:age,main admitting diagnosis,diabetes,corrected QT interval,QRS duration,ventricular premature beat burden,left ventricular ejection fraction,and estimated glomerular filtration rate.A predictive risk score including these variables showed an AUROC curve of 0.774 (95% confidence interval:0.744–0.805).The Hosmer-Lemeshow goodness-of-fit test showed the chi-square value was 2.527 (P= 0.640).The incidence of in-hospital SCD was 1.3%,4.1%,and 18.6% for scores of 0 to 2,3 to 5 and ≥6,respectively (P<0.001).Conclusions:Age,main admitting diagnosis,diabetes,QTc interval,QRS duration,ventricular premature beat burden,left ventricular ejection fraction,and estimated glomerular filtration rate are factors related to in-hospital SCD in a hospitalized cardiac department *** developed a predictive risk score including these factors that could identify patients who are predisposed to in-hospital SCD.

关键词： Sudden cardiac death inpatient risk factors predictive risk score

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The subcutaneous implantable cardioverter defibrillator—— review of the recent data

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Journal of Geriatric Cardiology 2018年第3期15卷 222-228页

作者： Stacy B Westerman Mikhael El-Chami Emory University School of Medicine Atlanta USA division of Cardiology Section of Electrophysiology Emory University School of Medicine Atlanta USA

The subcutaneous implantable cardioverter defibrillators （SICD） is an altemative to the transvenous ICD for the prevention of sudden cardiac death （SCD）. Multiple studies have shown that the SICD is safe and effective in treating ventricular arrhythmias. While earlier stud- ies mainly enrolled younger patients with channelopathies, more recent reports included patients with ＂typical＂ indications for ICD therapy for the prevention of SCD. In this review we summarize the data available to date on the SICD while highlighting its pros and cons.

关键词： Inappropriate shocks Subcutaneous ICD Sudden Cardiac death Transvenous ICD

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Ventricular tachycardia as the initial symptom of cardiac hydatidosis

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Chinese Medical Journal 2019年第22期132卷 2765-2766页

作者： Yan-Mei Lu Ling Zhang Qiang Xing Xian-Hui Zhou Yao-Dong Li Jiang-Hua Zhang Tuerhong Zukela Bao-Peng Tang Department of pacing electrophysiology The First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiang 830054China

To the Editor:A 44-year-old female presented at the local hospital for repeated episodes of having palp Nations,accompanied with cold sweats,amaurosis,vomiting,and limb weakness in the previous 2 *** electrocardiogram indicated "ventricular tachycardia" when she was not feeling *** symptoms alleviated significantly after injections of"amiodarone"(dose unknown),after which the patient was discharged.A local physician recommended ablation,so the patient was transferred to our *** patient was generally healthy and had lived in a region with *** to the patient5 self-report,she had been diagnosed as having liver hydatidosis 30 years ago,but had recovered after surgical treatment at the local ***,the patient claimed to have no other medical history.

关键词： tachycardia transferred claimed

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INTRA-HISIAN BLOCK ASSOCIATED WITH UNUSUAL ETIOLOGIES

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中华医学杂志(英文版) 1987年第3期100卷 167-172页

作者：孙瑞龙王方正胡绳俊田瑞国 Cardiac pacing and electrophysiology Laboratory Institute of Cardiovascular Diseases and Fuwai Hospital Chinese Academy of Medical Sciences Beijing

Four cases with documented intra-Hisian block associated with unusual etiologies are reported. They occurred in rheumatoid arthritis, cysticercosis cellulosae, Behcet’s disease and aorto-arteritis.

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Effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony

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Chinese Medical Journal 2004年第4期117卷 516-520页

作者：支力大华伟张澍史蓉芳王方正陈新 division of Clinical electrophysiology Department of Nuclear Medicine

Background Right ventricular apical pacing has been reported to reduce cardiac performance. But there are few reports on the effects of dual chamber (DDD) pacing on cardiac function compared to sinus rhythm. In this study, we evaluated the effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony using equilibrium radionuclide angiography. Methods Ten patients implanted with a right atrial and ventricular DDD pacemaker underwent equilibrium radionuclide angiography. The scintigraphic data were obtained during sinus rhythm and pacing rhythm. Cardiac function parameters were obtained semimanually. Phase analysis was used to study the ventricular activation sequence and ventricular synchrony. Results The left ventricular 1/3 ejection fraction decreased significantly during pacing compared with that during sinus rhythm[ (23.4 +/- 6.1)% vs (27.7 +/- 4.5) %, P = 0.01]. Regional ejection fraction also decreased during pacing, although the difference was not statistically significant. Phase analysis showed that the right ventricle was activated earlier than the left ventricle during pacing, and that the phase shift was significantly greater during pacing than that during sinus rhythm[ 64.13degrees +/- 16.80degrees vs 52.88degrees +/- 9.26degrees, P = 0. 007 ]. The activation of both ventricles occurred simultaneously during sinus rhythm, with the activation sequence from proximal septum or base of left ventricle to apex. The earliest activation during pacing occurred at the right ventricular apex, and subsequently spread to the base and left ventricle. Conclusion Right atrial and ventricular DDD pacing impairs left ventricular systolic function and ventricular synchrony.

关键词： equilibrium radionuclide angiography · phase analysis · cardiac pacing · cardiac function

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Predisposing factors for atrial fibrillation in the elderly

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Journal of Geriatric Cardiology 2017年第3期14卷 179-184页

作者： Kristina Wasmer Lars Eckardt Gunter Breithardt division of electrophysiology Department of Cardiovascular Medicine University Hospital Miinster Germany

Atrial fibrillation （AF） in the elderly occurs as a consequence of cardiovascular aging and an age related increase of comorbidity. Several predisposing factors for AF have been identified for the overall AF population. Most of them, cardiovascular disease in particular, play a role in younger and older patients. The longer time period during which these risk factors can cause structural changes that ultimately lead to AF may, at least in part, explain the association between age and AF. In addition, less well defined age-related changes in cellular electrophysi- ologic properties and structure predispose to AF in the elderly.

关键词： Atrial fibrillation Atrial fibrosis Mechanisms Risk factors Stroke The elderly

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Real-time cardiovascular magnetic resonance-guided radiofrequency ablation:A comprehensive review

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World Journal of Cardiology 2023年第9期15卷 415-426页

作者： Konstantinos Tampakis Sokratis Pastromas Alexandros Sykiotis Stamatina Kampanarou Georgios Kourgiannidis Chrysa Pyrpiri Maria Bousoula Dimitrios Rozakis George Andrikopoulos Department of pacing&electrophysiology Henry Dunant Hospital CenterAthens 11526Greece Department of Radiology Henry Dunant Hospital CenterAthens 11526Greece Department of Anesthesiology Henry Dunant Hospital CenterAthens 11526Greece

Cardiac magnetic resonance(CMR)imaging could enable major advantages when guiding in real-time cardiac electrophysiology procedures offering high-resolu-tion anatomy,arrhythmia substrate,and ablation lesion visualization in the absence of ionizing *** the last decade,technologies and platforms for performing electrophysiology procedures in a CMR environment have been ***,performing procedures outside the conventional fluoro-scopic laboratory posed technical,practical and safety *** development of magnetic resonance imaging compatible ablation systems,the recording of high-quality electrograms despite significant electromagnetic interference and reliable methods for catheter visualization and lesion assessment are the main limiting *** first human reports,in order to establish a procedural workflow,have rationally focused on the relatively simple typical atrial flutter ablation and have shown that CMR-guided cavotricuspid isthmus ablation represents a valid alternative to conventional *** expansion to other more complex arrhythmias,especially ventricular tachycardia and atrial fibrillation,would be of essential impact,taking into consideration the widespread use of substrate-based ***,all limitations need to be solved before application of CMR-guided ablation in a broad clinical setting.

关键词： Interventional cardiac magnetic resonance Image-guided ablation Substrate ablation Cavotricuspid isthmus Catheter ablation Tracking

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