Heart rhythm : the official journal of the Heart Rhythm Society
-
The best protocol for cardiovascular preparticipation screening (PPS) in young athletes is uncertain. ⋯ ECG adds value to PPS through increased detection of arrhythmogenic and structural cardiovascular conditions associated with sudden cardiac death. Use of modern ECG interpretation standards allows a low false-positive rate. Routine echo may detect other clinically important cardiac abnormalities, but its role in PPS remains uncertain.
-
Acute atrial fibrillation (AF) is often treated with the administration of intravenous flecainide; however, this treatment may not always be successful and is potentially hazardous. Previous studies suggest that electro-echocardiographic tissue velocity imaging (TVI) of the atrial wall may reflect atrial remodeling. ⋯ Electro-echocardiographic atrial TVI measurement is a promising noninvasive tool for predicting outcome of pharmacological cardioversion. A short AFCL-TVI and a low AFV-TVI are related to failure of cardioversion of AF using flecainide.
-
Late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) of ventricular scar has been shown to be accurate for detection and characterization of arrhythmia substrates. However, the majority of patients referred for ventricular tachycardia (VT) ablation have an implantable cardioverter-defibrillator (ICD), which obscures image integrity and the clinical utility of MRI. ⋯ Wideband LGE MRI improves the ability to visualize myocardium for clinical interpretation, which correlated well with EAM findings during VT ablation.
-
Comparative Study
Short- and long-term electrical performance of the 5086MRI pacing lead.
Owing to potential patient harm, magnetic resonance imaging (MRI) in patients with cardiac implantable electronic devices has traditionally been contraindicated. Following the EnRhythm MRI SureScan Study, an MR conditional pacemaker with modified leads was approved by the Food and Drug Administration. Electrical and handling characteristics of MR conditional pacing leads compared with those of traditional leads have not been established. ⋯ The 5086MRI lead demonstrates clinically acceptable electrical characteristics while providing safe access to MR-guided diagnostics. However, compared with the 5076 lead, the 5086MRI lead exhibits lower ventricular sensing, slightly higher ventricular capture thresholds, and higher acute lead dislodgement rate.
-
Quantitative measures of the ventricular fibrillation waveform at the outset of resuscitation are associated with survival. However, little is known about the course of these measures during resuscitation and how this course is related to outcome. ⋯ Given their prognostic and dynamic qualities, quantitative waveform measures may provide an effective real-time strategy to guide individual treatment and improve survival.