Circulation. Arrhythmia and electrophysiology
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Circ Arrhythm Electrophysiol · Aug 2012
Use of primary prevention implantable cardioverter-defibrillators in a population-based cohort is associated with a significant survival benefit.
Underuse of implantable defibrillators has been previously noted in patients at risk for sudden cardiac death, as well as for survivors of sudden cardiac death. We sought to determine the utilization rates in a primary prevention implantable cardioverter-defibrillator (ICD)-eligible population and mortality in this group compared with a group that had undergone implantation of this therapy. ⋯ A significant mortality benefit was observed for patients who underwent primary prevention ICD implantation compared with those who did not. Vigilance is required to ensure that patients eligible for primary prevention ICDs are appropriately referred and assessed to allow such patients to benefit from this life-saving therapy.
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Circ Arrhythm Electrophysiol · Aug 2012
Association of early repolarization and sudden cardiac death during an acute coronary event.
Electrocardiographic early repolarization (ER) pattern has been previously associated with arrhythmic mortality and with an increased risk of ventricular fibrillation. We hypothesized that there is an association between ER and sudden cardiac death (SCD) during an acute coronary event. ⋯ Higher prevalence of ER in a standard 12-lead ECG in victims of SCD than in survivors of an acute coronary event suggests that the presence of ER increases the vulnerability to fatal arrhythmia during acute myocardial ischemia and provides a plausible mechanistic link between this ECG pattern and higher arrhythmic mortality of middle-aged/elderly subjects.
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Circ Arrhythm Electrophysiol · Aug 2012
Effect of bipolar electrode spacing on phrenic nerve stimulation and left ventricular pacing thresholds: an acute canine study.
Phrenic nerve stimulation (PNS) is a common complication of cardiac resynchronization therapy when left ventricular (LV) pacing occurs via a coronary vein. The purpose of this study was to evaluate the effects of bipolar electrode spacing on PNS and LV pacing thresholds. ⋯ This study suggests that reducing LV bipolar electrode spacing from the standard 20 mm to 1 or 2 mm may significantly increase the PNS threshold without compromising LV pacing thresholds.
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Circ Arrhythm Electrophysiol · Aug 2012
Randomized Controlled Trial Multicenter StudyRelevance of electrical remodeling in human atrial fibrillation: results of the Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial mechanisms of atrial fibrillation study.
In animal models of atrial fibrillation (AF), changes in atrial electrophysiological properties are associated with the development of AF. Their relevance to human AF is unclear. ⋯ Prolonged P-wave duration, but not differences in atrial effective refractory periods, was associated with the development of atrial tachyarrhythmias in pacemaker patients.