herarducci G

Incessant Nonreentrant Atrioventricular Nodal Tachycardia Due to Multiple Nodal Pathways Treated by Radiofrequency Ablation of the Slow Pathways

Incessant Nonreentrant AVNT by Multiple Pathways. In patients with dual AV nodal physiology, simultaneous anterograde fast and slow pathway conduction resulting in an unusual form of nonreentrant A V nodal tachycardia has been observed. We describe the case of a young patient with an incessant form of complex supraventricular tachycardia who underwent electrophysiologic evaluation, which showed simultaneous conduction via multiple AV nodal pathways that caused a unique form of incessant nonreentrant AV nodal tachycardia. Radiofreqeuncy ablation of the spatially closed intermediate and slow pathways effectively treated the tachycardia. The electrophysiologic determinants of simultaneous conduction through the multiple nodal pathways and the apparently different behavior of the fast pathway before and after ablation are discussed.

P‐Wave Signal‐Averaged Electrocardiogram Predicts Atrial Fibrillation After Coronary Artery Bypass Grafting

Background: AF is one of the most common complications after CABG. The aim of the study was to identify the risk factors for postoperative AF.

Percutaneous Extraction of Infected Pacemaker/ICD Leads: What Are the Current Technological Advances and Results?

Transvenous removal of permanent pacing and implantable cardioverter-defibrillator (ICD) leads is today an effective and relatively safe technique; its use will probably spread in the future because of the increasing number of pacemaker- or ICD-related complications. Abandonment of functionless pacing leads is becoming relatively common because the performance of the leads decreases with the implant duration [1,2]. Infection is another complication of implanted devices; it is reported to occur in from 0% up to 19% of the patients [3,4]. Endocardial ICD leads seem to give rise to the same complications as pacing leads; in ICD patients lead malfunction may result in dangerously inappropriate therapy or none. Infections occurring after implantation of an ICD are reported at an incidence of 2%-7%. All these complications can be treated by percutaneous lead removal. The indications for the procedure have been codified [5, 6] and today’s techniques are effective. The success rate of transvenous removal in most reports is now more than 90%, with a low rate of serious, life-threatening complications. Despite these excellent results, however, efforts are still being made to improve both the techniques and the outcome of the procedures, in order to achieve better success rates and a lower incidence of complications.