Question An 85 year old male presents to the emergency room with presyncopal episode associated with nausea and diaphoresis that lasted for 10 minutes. He has past medical history of hypertension and paroxysmal atrial fibrillation on anticoagulation. He also had complete AV block that necessitated the implantation of a dual chamber pacemaker (Medtronic… (More)
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that causes stroke affecting more than 2.3 million people in the US. Catheter ablation to terminate AF is successful for paroxysmal AF but suffers limitations with persistent AF patients as current mapping methods cannot identify AF active substrates outside of pulmonary vein region.… (More)
We present a case of incessant wide-complex tachycardia in a patient with left-ventricular assist device, and discuss the differential diagnosis with an in-depth analysis of the intracardiac tracings during the invasive electrophysiologic study, including interpretation of the relative timing of the fascicular signals during tachycardia and in sinus rhythm,… (More)
Catheter ablation is associated with limited success rates in patients with persistent atrial fibrillation (AF), which is mostly maintained by rotors that are located outside of pulmonary veins (PV) region. None of the currently available commercial mapping systems can accurately predict the rotor location outside of PV in patients with persistent AF.
A 72 year old male with past medical history of hypertension and dyslipidemia presented with a 10 year history of palpitations associated with dizziness. His physical exam was within normal limits. His LV function was 62% and left atrial size was within normal limits. He was euthyroid and a recent stress test was negative for inducible ischemia. During the… (More)
We thank Dr Bhargava for careful reading of our article . As highlighted by Dr Bhargava, Non Competitive Atrial Pacing (NCAP) algorithm is designed to prevent atrial arrhythmias by preventing atrial pacing within 300msec after a sensed atrial event in the post ventricular atrial refractory period (PVARP). The varying AV delays and fixed interval of… (More)
A 56 year old male with a past medical history of hypertension and dyslipidemia presented with recurrent dizziness. Routine EKG was performed, which suggested frequent junctional extra systoles with compensatory pauses. During telemetry periods of 2:1 block with effective ventricular rate of 34 bpm was observed. His bundle study suggested frequent His extra… (More)