Antonio Sorgente

Nodo- and fasciculoventricular pathways: Electrophysiological features and a proposed diagnostic algorithm for preexcitation variants

Introduction Fasciculoventricular and nodoventricular pathways (FVP and NVP) are uncommon preexcitation variants that can be misleading during electrophysiology studies (EPSs), and differentiating them could be challenging. In this article, we describe 2 representative cases and then we present various electrophysiological features and phenomenon encountered in patients with these particular accessory pathways (APs).

Asystole Detected by Implantable Loop Recorders: True or False?

We report a case of a false asystole detected by an implantable loop recorder a few days after its implantation. In the discussion section we try to give some hints to help cardiac electrophysiologists in distinguish true from false asystoles, in order to avoid unuseful and potentially dangerous implantations of pacemakers.

An Uncommon Block of a Common Circuit

No abstract available Keywords: atrial flutter; cardiac surgery; catheter ablation; electrical anatomic mapping.

Junctional Beats and Short HV Interval: What More Do You Need?

A 14-year-old woman without any structural cardiac disease was referred to our center because of recurrent episodes of regular palpitations, with a sudden onset and offset and an episode of syncope. An electrophysiological study was planned. Baseline ECG showed sinus rhythm with a short PR interval interrupted by 2 occasional junctional beats (black arrows in Fig. 1). Baseline atrio-His and His-ventricular intervals were 70 and 25 ms. A short HV interval is usually associated with a preexcitation or, theoretically, with an atrio-Hisian bypass or

Discordant Junctional Beats and Preexcitation What Is the Mechanism

An 18-year-old woman with Down syndrome and ventricular preexcitation was referred to our center for electrophysiological evaluation. She had no structural heart disease, and her 12-lead ECG showed minimal preexcitation. After obtaining an informed consent, an electrophysiology study was performed under conscious sedation. Via bilateral femoral veins, multipolar diagnostic catheters were introduced and positioned at the His bundle region and coronary sinus. A roving quadripolar catheter was positioned alternatively in the right ventricle, the right atrium appendage, and successively was used for mapping. At the beginning of the procedure, nonpreexcited junctional beats were recorded, a phenomenon compatible with a typical atrioventricular accessory pathway (AP). However, a comprehensive electrophysiology study confirmed the presence of an innocent fasciculoventricular pathway (FVP), showing minimal and fixed preexcitation (ie, the His–ventricular interval) during multisite atrial pacing and at different pacing rates. The effective refractory period …

Every cloud has a silver lining: a case of simultaneously appropriate and inappropriate implantable cardioverter defibrillator shock

We report a case of oversensed atrial flutter with a cycle length of 213–225 ms (panel A ), terminated by an implantable cardioverter defibrillator (ICD) shock in a patient with ischaemic cardiomyopathy and complete atrio-ventricular block. The intracardiac tracings, in panel A represent, respectively, from the top to the bottom, the atrial electrograms, the ventricular electrograms, the leadless electrocariogram, and the ICD markers. Due …

Electrocardiogram from a Young Trained Athlete

Ann Noninvasive Electrocardiol 2012;17(1):57

The Eternal Dilemma Between Supraventricular and Ventricular Tachycardias in a Patient With Brugada Syndrome

![Figure][1] The image shows the result of an ajmaline test in a 42-year-old patient with a diagnosis of Brugada syndrome. A shows the transition from sinus rhythm to a right bundle branch block tachycardia with a heart rate of 140 beats/min, with a wide QRS complex (220 ms) and a right axis