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'Junctional Rhythm' (1142)


Dec
2017

Atrial premature contractions (APCs) are commonly encountered in clinical practice. The APCs may influence heart conduction system and induce other arrhythmia. The disorder of atrioventricular conduction is related to electrophysiological phenomena, difficult to understand and diagnose.

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Jan
2018

Using calcium salts in management of amlodipine overdose is challenging. A 25-year-old male with known history of adult polycystic kidney disease presented with hypotension, tachycardia, and intact neurological status after ingestion of 450 mg of amlodipine. Immediately, normal saline infusion and norepinephrine were initiated.

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Dec
2017

Peripheral chemoreflex mediated increases in both parasympathetic and sympathetic drive under chronic hypoxia may evoke brady-arrhythmias during apneic periods. We determined if: a) voluntary apnea unmasks arrhythmia at sea level and altitude (5050m), b) if high altitude natives (Nepalese Sherpa) exhibit similar cardiovagal responses at altitude; and c) if brady-arrhythmias at altitude are partially chemoreflex mediated. Participants were grouped as Lowlanders (n=14; age=27{plus minus}6yrs) and Nepalese Sherpa (n=8; age=32{plus minus}11yrs).

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Mar
2018

Transient anoxic seizure upon application of pressure on a giant pseudomeningocele has never been reported in the literature; such abrupt changes in intracranial pressure due to large volume of cerebrospinal fluid (CSF) translocation, if left untreated may lead to permanent cerebral hypoxic injury and death. Here we describe a case of a 26-year-old woman who had undergone lumbar disc surgery in another unit few months ago and developed a large lump around her back. Any pressure on the lump resulted in headaches and at times episodes of seizures.

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Feb
2018

Ablation is an effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). The occurrence of junctional ectopic rhythm (JER), including junctional ectopic tachycardia, following AVNRT ablation has been described as an extremely rare phenomenon, but may be underestimated. We aimed to determine the incidence of JER following AVNRT ablation within our institution, as well as that reported in the literature via an extensive review.

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Dec
2017

Heart transplantation is the gold standard for treatment of end stage heart failure. Atrial parasystole (AP), defined as the presence of an additional dissociated atrial pacemaker on a surface electrocardiogram, has been described to be seen after heart transplantation using biatrial surgical technique. AP may pose a challenge in diagnosing underlying rhythm disturbances in these patients.

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Nov
2017

Neonatal arrhythmias: diagnosis, treatment, and clinical outcome.

Korean J Pediatr 2017 Nov 27;60(11):344-352. Epub 2017 Nov 27.
Ji-Eun Ban
Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy.

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Nov
2017

More mature or older women are more likely to undergo in vitro fertilization and embryo implant. These women have a greater chance of receiving ergonovine therapy because of a suspected abortion. We present this case report to call attention to a latent lethal adverse effect in everyday obstetric practice using ergonovine.

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Aug
2017

The electrocardiogram (ECG) is often used to identify which hyperkalemic patients are at risk for adverse events. However, there is a paucity of evidence to support this practice. This study analyzes the association between specific hyperkalemic ECG abnormalities and the development of short-term adverse events in patients with severe hyperkalemia.

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Aug
2017

We report a case of junctional rhythm that occurred both preoperatively and later during a portion of general anesthesia. A 19-year-old woman was scheduled to undergo bilateral sagittal split ramus osteotomy after being diagnosed with a jaw deformity. Preoperative electrocardiography (ECG) revealed a junctional rhythm with a slow heart rate (HR).

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Nov
2017

Paroxysmal atrioventricular (A-V) block is relatively rare, and due to its transient nature, it is often under recognized. It is often triggered by atrial, junctional, or ventricular premature beats, and occurs in the presence of a diseased His-Purkinje system (HPS). Here, we present a 45-year-old white male who was admitted for observation due to recurrent syncope and near-syncope, who had paroxysmal A-V block.

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Jun
2017

We present here a 45-year-old male with no past medical problem who presented with palpitations. He was found to have supraventricular tachycardia intractable to medical therapy. Later his rhythm converted to junctional tachycardia.

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Sep
2017

The atrioventricular junction has a central role in electrophysiology, responsible for reentrant and automatic forms of supraventricular tachycardia. During atrioventricular nodal reentry tachycardia, the circuit involves 2 electrophysiologically separate pathways located in the vicinity of the atrioventricular node. Atrioventricular reentry tachycardia is caused by the presence of an accessory pathway located almost anywhere along the atrioventricular groove; the macroreentrant circuit involves the atrioventricular node, the accessory pathway and necessarily portions of atria and ventricles.

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Jan
2018

Symptomatic second-degree atrioventricular (AV) block is typically treated by implantation of a pacemaker. An otherwise healthy AV conduction system can nevertheless develop AV block due to interference from junctional extrasystoles. When present with a high burden, these can produce debilitating symptoms from AV block despite an underlying normal AV node and His-Purkinje system properties.

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Nov
2017

Cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is associated with higher recurrence rates than radiofrequency ablation (RFA). Junctional tachycardia marks procedural success with RFA, but no such indicator exists for cryoablation.
The purpose of this study as to determine the impact of voltage mapping plus longer ablation lesions on midterm success of cryoablation for children with AVNRT.

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Jun
2017

The significance and incidences of intraoperative arrhythmias occurring in the operating room (OR) in children with congenital heart disease (CHD) are unknown. Aims of this study were to determine incidences of intraoperative arrhythmias in children with CHD and to examine whether they are associated with persistent arrhythmias during follow-up.
Continuous ECG recordings obtained from 134 consecutive paediatric CHD patients were manually examined from the moment the aortic cross-clamp (ACC) was removed [use of ACC and cardiopulmonary bypass (CPB)], when CPB was stopped (use of only CPB) or when the sternum was closed (no use of ACC and CPB) until departure from the OR.

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Jun
2017

Coronary artery spasm (CAS) could cause serious lethal ventricular arrhythmias. While implantable cardioverter defibrillators (ICDs) have been recommend for secondary prevention of sudden cardiac death related to lethal ventricular arrhythmias. However, in resuscitated sudden cardiac death caused by CAS, the effect of ICD is still not well clear.

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Nov
2017

A 58-year-old man with a long R-P' narrow QRS tachycardia underwent an electrophysiological study. The tachycardia was diagnosed as a permanent form of junctional reciprocating tachycardia (PJRT), and the earliest atrial activation site during tachycardia was coronary sinus (CS) ostium. Radiofrequency ablation at the site was initially not successful because the tip impedance and temperature were unstable.

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Nov
2017

Lithium is a commonly used drug in psychiatric practice. It is used in the treatment of depression and bipolar disorder. It has a narrow therapeutic index with documented adverse effects even near therapeutic levels.

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Nov
2017

Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control.
Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified.

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Apr
2017

A 66-year-old woman with palpitations was referred to our center for catheter ablation due to drug-refractory, common type atrioventricular nodal tachycardia (AVNRT). A selective slow pathway ablation was attempted. A fast junctional rhythm with transient ventriculoatrial block followed by transient prolongation of the A-H interval occurred immediately after the radiofrequency (RF) application at the coronary sinus ostium (CSOS) level.

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May
2017

Our approach to the ablation of atrioventricular nodal reciprocating tachycardia (AVNRT), the most common supraventricular tachycardia, is as follows: We first attempt ablation in the right atrial posteroseptum anterior to the coronary sinus ostium with a 4-mm non-irrigated tip catheter. If ablation within the triangle of Koch is unsuccessful with radiofrequency (RF), we switch to cryoablation and target a more superior (mid septal) region. We also utilize cryoablation if RF ablation produces transient VA block (absence of retrograde conduction during junctional rhythm) or a fast junctional rhythm (<350 msec).

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Sep
2017

The cardiac sodium channel SCN5A regulates atrioventricular and ventricular depolarization as well as cardiac conduction. Patients with cardiac electrical abnormalities have an increased risk of sudden cardiac death (SCD) and cardio-embolic stroke. Optimal management of cardiac disease includes the understanding of association between the causative mutations and the clinical phenotype.

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Sep
2017

A 70-year-old man, who previously received a dual chamber pacemaker for paroxysmal AV block (Sorin Symphony DR 2550), was noted on telemetry to have multiple episodes of rapid ventricular pacing at approximately 120bpm. Evaluation of the telemetry strips revealed that all of the rapid ventricular pacing episodes were initiated by brief runs of escape junctional rhythm. Programmed bradycardia parameters were AAI SafeR with lower rate limit of 50bpm.

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Feb
2017

To determine the reliability of the interpretation of electrocardiograms (ECG) by general practitioners and those in training by making a comparison with the interpretation made by the cardiologist.
An observational study was conducted that included general practitioners working in the Toledo Health Area, physicians during their training in Family and Community Medicine, and cardiologists in their first 3 years of specialist training (R1-R3). A questionnaire was used that included 13 ECGs with no clinical details of the patient.

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Feb
2017

A 53-year-old woman presented to our hospital with dizziness and low-grade fever. She underwent percutaneous coronary intervention to the obtuse marginal artery with a drug-eluting stent 20 months prior to this presentation. Physical examination was remarkable for bradycardia.

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Feb
2017

Junctional ectopic tachycardia(JET) is a rare childhood arrhythmia originating from the area adjacent to the atrioventricular(AV) node. It often occurs after surgical procedures like repair of Tetralogy of Fallot, atrioventricular septal defect and ventricular septal defect, which are all performed in that area. While AV block (AVB) can occur after JET, it is very rare for late JET occurring after early postoperative AVB to be followed by normal sinus rhythm (NSR).

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Apr
2017

The goal of the study was to compare the early postoperative course after fenestrated lateral atrial tunnel (LT) and non-fenestrated extracardiac conduit (EC) Fontan operation (FO) in a single center where both techniques were parallelly used. Between 2004 and 2012, 56(32.7%) children underwent LT and 113(66.

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Jul
2017

Accelerated junctional rhythm has been reported in children in the setting of acute rheumatic fever; however, we describe a hitherto unreported case of isolated junctional tachycardia in a child with streptococcal pharyngitis, not meeting revised Jones criteria for rheumatic fever. A previously healthy, 9-year-old girl presented to the emergency department with complaints of sore throat, low-grade fever, and intermittent chest pain. She was found to have a positive rapid streptococcal antigen test.

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Dec
2017

We sought to investigate focal atrial tachycardias (ATs) in patients with congenitally corrected transposition of the great arteries (ccTGA).
We identified three cases of focal ATs with ccTGA from 2007 to 2015. The clinical findings, electrocardiography, electrophysiological features, and ablation were reported.

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Dec
2015

Cardiac Resynchronization in Patients with Atrial Fibrillation.

J Atr Fibrillation 2015 Dec 31;8(4):1383. Epub 2015 Dec 31.
S Serge Barold, Bengt Herweg
Atrial fibrillation (AF) occurs in one of four patients undergoing cardiac resynchronization therapy (CRT).-Without special therapy, the prognosis of AF patients with CRT has been generally worse than those in sinus rhythm. The importance of a high percentage of biventricular pacing (BIV%) was confirmed in a large study where the mortality was inversely associated with BIV% both in the presence of normal sinus and atrial paced rhythm and with AF.

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Oct
2016

Congenital heart block (CHB) is rare disorder that has a higher mortality when associated with structural congenital heart defects. Very few cases have been reported in Sub-Saharan Africa (SSA). We present a case of complete CHB associated with a complex congenital heart defect in a neonate in Cameroon.

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Oct
2016

Atrial fibrillation (AF) increases the risk of stroke by a factor of 4-5 and is the most common abnormal heart rhythm. The progression of AF with age, from short self-terminating episodes to persistence, varies between individuals and is poorly understood. An inability to understand and predict variation in AF progression has resulted in less patient-specific therapy.

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Dec
2016

This review covers many of the arrhythmias and conduction abnormalities related to His-Purkinje System. These include junctional premature complexes, junctional and fascicular tachycardias, bundle branch reentry (BBR), and the role of apparent conduction in various forms of supraventricular tachycardias (SVT) with or without involvement of accessory pathways (AP).

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Mar
2017

Complete heart block (CHB) is a major complication that occurs after congenital heart surgery. We hypothesized that genetic and clinical factors are associated with the development of postoperative CHB and recovery of atrioventricular (AV) conduction.
The purpose of this study was to identify predictors of CHB and recovery after congenital heart surgery.

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Dec
2016

Pathogenesis and management of Brugada syndrome.

Nat Rev Cardiol 2016 Dec 15;13(12):744-756. Epub 2016 Sep 15.
Juan Sieira, Gregory Dendramis, Pedro Brugada
Brugada syndrome is an inherited disease characterized by an increased risk of sudden cardiac death owing to ventricular arrhythmias in the absence of structural heart disease. Since the first description of the syndrome >20 years ago, considerable advances have been made in our understanding of the underlying mechanisms involved and the strategies to stratify at-risk patients. The development of repolarization-depolarization abnormalities in patients with Brugada syndrome can involve genetic alterations, abnormal neural crest cell migration, improper gap junctional communication, or connexome abnormalities.

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Dec
2016

Atrial fibrillation is the most common sustained heart arrhythmia. Premature beats arising from foci other than pulmonary veins have been related to its pathogenesis.
A 64-year-old female underwent superior vena cava (SVC) isolation after triggers were identified originating from the SVC following pulmonary vein isolation; immediately after SVC isolation, she developed junctional rhythm with symptomatic hypotension requiring emergent management.

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Oct
2016

Atrial fibrillation (AF) increases the risk of stroke by a factor of 4-5 and is the most common abnormal heart rhythm. The progression of AF with age, from short self-terminating episodes to persistence, varies between individuals and is poorly understood. An inability to understand and predict variation in AF progression has resulted in less patient-specific therapy.

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Sep
2016

Regular cannon wave.

Indian Heart J 2016 Sep 14;68 Suppl 2:S291-S293. Epub 2016 Jan 14.
Mangalachulli Pottammal Ranjith, Kayakkal Shajudeen, Sankaran Prasanth
A 52-year-old male with history of dilated cardiomyopathy was admitted with progressive dizziness and worsening dyspnea. His blood pressure was 100/60 with a regular pulse of 70 per minute. Jugular vein wave showed a prominent pulse like regular cannon waves.

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Sep
2016

Atrioventricular (AV) block and pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) are rare complications of infective endocarditis (IE). A 72-year-old man with severe aortic stenosis was hospitalized due to IE. After admission, intermittent AV block and P-MAIVF were noted.

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Sep
2016

We report the case of a 38-year-old woman with history of syncope and polymorphic ventricular tachycardia; tachycardia was inducible at exercise stress test, not at electrophysiologic study. Phases of QT prolongation were found at ambulatory electrocardiogram monitoring. The woman came to our attention for periodic control of implantable loop recorder.

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Oct
2016

Many patients with atrial fibrillation (AF) or atrial flutter (Aflutter) have concomitant sinus node dysfunction (SND). Ablation may result in injury to the sinus node complex or its blood supply resulting in sinus arrest and need for temporary pacing. We sought to characterize patients who develop acute SND (ASND) during/immediately after AF/Aflutter ablation.

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Dec
1969


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Jul
2016

This study aimed to determine the risk of thromboembolic events in patients with junctional bradycardia(JB).
We retrospectively reviewed electrocardiograms(ECGs) for 380,682 patients. Those with JB on an ECG at least twice over a ≥3-month interval were included for analysis.

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Dec
1969

Postoperative arrhythmias such as junctional ectopic tachycardia and atrioventricular block are serious postoperative complications for children with congenital heart disease. We hypothesize that ischemia-reperfusion (I/R) related changes exacerbate these postoperative arrhythmias in the neonate heart and administration of postoperative inotropes is contributory.
The purpose of this study was to study the effects of I/R and postischemic dopamine application on automaticity and rhythmicity in immature and mature pacemaker cells and whole heart preparations.

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Sep
2016

Deer hunting includes various stimuli resulting in augmented sympathetic activity, increased heart rate (HR) response, and rhythm changes. Collectively, these superimposed stresses may increase an individual's risk for cardiovascular events. We undertook this study to evaluate HR and rhythm responses in multiple phases of deer hunting in men and women with and without cardiovascular disease (CVD).

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Oct
2016

We hypothesized that normal sinus rhythm-sinus bradycardia is common in young children following extracardiac Fontan. After excluding patients with sinus pauses, junctional rhythm, tachy-brady syndrome, frequent ectopics, or ectopic atrial rhythm, we found an ambulatory 24-h Holter monitor average heart rate of 78 ± 12 beats per minute (bpm) in 33 post-extracardiac Fontan children with a median age of 6 years (5-10). A 24-h average heart rate of 78 ± 12 bpm is statistically significantly lower than a 24-h average heart rate value of 90 ± 10 bpm derived from a similarly aged control population (p < 0.

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Dec
1969

Treatment of congenital junctional ectopic tachycardia (JET) is often challenging. In the majority of patients affected, a combination of ≥2 antiarrhythmic drugs is required for JET control.
The purpose of this study was to assess the efficacy and safety of adjunctive ivabradine therapy for pediatric congenital JET.

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