scholarly journals Premature ventricular contraction–induced polymorphic ventricular tachycardia after leadless pacemaker implantation: A unique adverse effect of leadless pacing

2018 ◽  
Vol 4 (5) ◽  
pp. 180-183 ◽  
Author(s):  
Anish K. Amin ◽  
Sreedhar R. Billakanty ◽  
Nagesh Chopra ◽  
Eugene Y. Fu ◽  
Allan J. Nichols ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Ventricular Tachycardia ◽  
Pacemaker Implantation ◽  
Premature Ventricular Contraction ◽  
Polymorphic Ventricular Tachycardia ◽  
Ventricular Contraction ◽  
Leadless Pacemaker ◽  
Leadless Pacing

Premature ventricular contraction-induced cardiomyopathy in children

2015 ◽  
Vol 26 (4) ◽  
pp. 711-717 ◽  
Author(s):  
Zebulon Z. Spector ◽  
Stephen P. Seslar
Keyword(s):  
Ventricular Tachycardia ◽  
Radiofrequency Ablation ◽  
Premature Ventricular Contraction ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Ventricular Contraction ◽  
Premature Ventricular Contractions ◽  
Multi Centre Study ◽  
History Of

AbstractBackgroundAdults with high premature ventricular contraction burden can develop left ventricular dilation, dysfunction, and strain, consistent with a cardiomyopathy, which is reversible with radiofrequency ablation of the premature ventricular contractions. Evidence in children with similar ectopy burden is limited. We performed a single-centre retrospective review to examine the prevalence of premature ventricular contraction-induced cardiomyopathy, natural history of ventricular ectopy, and progression to ventricular tachycardia in children with frequent premature ventricular contractions.MethodsChildren aged between 6 months and 18 years, with premature ventricular contractions comprising at least 20% of rhythm on 24-hour Holter monitor, were included in our study. Those with significant structural heart disease, ventricular tachycardia greater than 1% of rhythm at the time of premature ventricular contraction diagnosis, or family history of cardiomyopathy – except tachycardia-induced – were excluded. Cardiomyopathy was defined by echocardiographic assessment.ResultsA total of 36 children met the study criteria; seven patients (19.4%, 95% CI 6.2–32.6%) met the criteria for cardiomyopathy, mostly at initial presentation. Ectopy decreased to <10% of beats without intervention in 16.7% (95% CI 4.3–29.1%) of the patients. No patient progressed to having ventricular tachycardia as more than 1% of beats on follow-up Holter. Radiofrequency ablation was performed in three patients without cardiomyopathy.ConclusionsOur study demonstrates a higher prevalence of cardiomyopathy among children with high premature ventricular contraction burden than that previously shown. Ectopy tended to persist throughout follow-up. These trends suggest the need for a multi-centre study on frequent premature ventricular contractions in children. In the interim, regular follow-up with imaging to evaluate for cardiomyopathy is warranted.

Pediatric Micra leadless pacemaker implantation via internal jugular and femoral vein: a single center, US experience

2021 ◽  
Author(s):  
Hani Siddeek ◽  
Erick Jimenez ◽  
Matthew Ambrose ◽  
Elizabeth Braunlin ◽  
Julia Steinberger ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Jugular Vein ◽  
Pediatric Population ◽  
Femoral Vein ◽  
Pacemaker Implantation ◽  
University Of Minnesota ◽  
Leadless Pacemaker ◽  
Growth Activity ◽  
Leadless Pacing ◽  
The University

Background: In the pediatric population, conventional transvenous and epicardial pacemaker systems carry complications such as lead distortion due to growth/activity, in addition to other lead/pocket complications. Materials & methods: A retrospective review of pediatric leadless pacing at the University of Minnesota Masonic Children’s Hospital from 2018 to 2020 was performed. Rationale for pacing, demographics of patients, thresholds and longevity of devices were recorded. Results: Seven leadless pacemaker insertions and one removal were performed successfully, in patients weighing between 19 kg and 58 kg. Three patients had Micra implantation via internal jugular vein. One pericardial effusion occurred perioperatively in a 19 kg patient with baseline thrombocytopenia, sideroblastic anemia and Pearson Marrow Pancreas syndrome. Conclusion: Leadless pacemaker implantation/early retrieval is feasible in pediatric patients.

scholarly journals Premature Ventricular Contraction-induced Cardiomyopathy

2017 ◽  
Vol 6 (4) ◽  
pp. 153 ◽  
Author(s):  
David J Callans ◽  
Keyword(s):  
Ventricular Dysfunction ◽  
Differential Susceptibility ◽  
Premature Ventricular Contraction ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Polymorphic Ventricular Tachycardia ◽  
Proper Treatment ◽  
Ventricular Contraction ◽  
Premature Ventricular Contractions ◽  
Antiarrhythmic Medications

Premature ventricular contractions (PVCs) are very common and usually do not require treatment. However, in the clinical setting of troublesome symptoms, or when PVCs trigger polymorphic ventricular tachycardia or cause cardiomyopathy, proper treatment is critical. In this review, the clinical syndrome of PVC-induced cardiomyopathy, including risk factors for development and treatment, is discussed. Although PVC-induced cardiomyopathy is typically associated with frequent PVCs there are also patients with this burden that do not develop cardiomyopathy, suggesting a differential susceptibility. Treatment often consists of catheter ablation, although antiarrhythmic medications may also provide both reduction in PVC frequency and resolution of left ventricular dysfunction.

scholarly journals Left femoral venous access for leadless pacemaker implantation: patient characteristics and outcomes

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
J Jelisejevas ◽  
A Breitenstein ◽  
D Hofer ◽  
S Winnik ◽  
J Steffel ◽  
...  
Keyword(s):  
Pacemaker Implantation ◽  
Patient Characteristics ◽  
Venous Access ◽  
Femoral Access ◽  
Funding Sources ◽  
Leadless Pacemaker ◽  
Leadless Pacing ◽  
Procedural Success ◽  
The Right ◽  
Transfemoral Tavi

Abstract Funding Acknowledgements Type of funding sources: None. Background Leadless pacing has become an alternative approach for patients requiring a single-chamber pacemaker. Conventionally, Leadless Micra Transcatheter Pacing System (TPS) pacemakers are implanted via a right femoral venous access. However, due to various reasons, a left sided femoral venous approach may benecessary. We hypothesized that a left sided femoral venous approach is as safe and effective as compared to a right sided approach. Objective We assessed indications, procedural characteristics, safety and mid-term outcomes of Micra TPS implantation via a left femoral venous approach as compared to the conventional right sided approach. Methods and Results: In this retrospective single-center analysis, 143 consecutive patients undergoing Micra TPS implantation were included. 87% (125/143) underwent Micra TPS implantation via a right, and 13% (18/143) via a left femoral venous access. The mean age at implantation was 79.8 ± 7.5 years. Acute procedural success, mean procedure and fluoroscopy times as well as device parameters at implantation and follow-up (mean 15 ± 11.5 months) were similar between the two groups. Five major complications (3.5%) were encountered, all using a right-sided approach. After a transfemoral TAVI procedure, left femoral venous access was used in 42% of cases as compared to 8% in the remaining population (p = 0.003). Final leadless pacemaker position within the right ventricle was mid-septal in 82% (102/125) for right femoral access vs 72% (13/18) for left femoral access (p = 0.16).  In the remaining cases (28 %, 5/18), the device was placed infero-septal following a left femoral venous access, as compared to 14% (18/125) for a right sided approach (p = 0.19). No repositioning was needed in 68% (85/125) using a right femoral access vs 72% (13/ 18) patients with a left femoral access (p = 0.84). Conclusions A left femoral venous access for Micra TPS implantation is safe and effective with an excellent implantation success rate similar to a conventional right femoral venous access without longer implantation and fluoroscopy times. The most frequent reason for choosing left- vs. right femoral venous access was a previous transfemoral TAVI procedure.

scholarly journals 629 CPVT and complete atrio-ventricular block: two faces of the same coin?

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Mattia Petrungaro ◽  
Martina Nesti ◽  
Elena Cavaretta ◽  
Zefferino Palamà ◽  
Antonio Scarà ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Mri ◽  
Genetic Test ◽  
Genetic Disorder ◽  
Stress Test ◽  
Pacemaker Implantation ◽  
Clinical Manifestations ◽  
Case Series ◽  
Polymorphic Ventricular Tachycardia ◽  
Av Block

Abstract Aims Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an electrical genetic disease characterized by induction of malignant ventricular arrhythmias during adrenergic stress in structurally normal hearts. CPVT is correlated to syncope or sudden cardiac death (SCD). Usually, it is caused by an autosomal dominant mutation in the cardiac ryanodine receptor (RyR2), an essential gene for Ca2+ homeostasis. Methods and results Our case series refers to: a man (59 years) who came to our attention for a clinical check-up 4 years after implanting bicameral pacemaker at the age of 55 years for complete AV block; and his three sons (E. female 27 years; D. male 25 years; and B. female 17 years) who had evidence of polymorphic non-sustained ventricular tachycardia (NSVT) with increasing effort during stress test. The three sons performed cardiac MRI and underwent genetic test. All three were found to be carriers of the same microdeletion of the RYR 2 gene (1q43- extended for about 49 kb) at the genetic test. They also have non-compacted myocardium at cardiac MRI. The father was also found to be a carrier of the same genetic microdeletion, while the mother was negative to the genetic test. The man was diagnosed to be a carrier of the mutation 4 years after pacemaker implantation. Conclusions Mutation of the RyR2 may have different phenotypic expressions and can be correlated to various clinical manifestations. CPVT is the most common one, and its prompt identification is crucial to prevent subjects from sport-related risks and to plan an efficient therapy. Our case series provides evidence for a careful consideration of such a genetic disorder even in presence of a major AV conduction disease in a relatively young subject. In the present case series, no major adverse events occurred. However, we can, in the aftermath, speculate that if a genetic disorder had been suspected when AV block occurred, a timely diagnosis could have been made earlier also for the sons.

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