Urgent left bundle branch pacing for heart block and cardiogenic shock, facilitating percutaneous mechanical circulatory support removal (original) (raw)
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2021
Aortic stenosis is the most prevalent valve disease in developed countries and has high morbidity and mortality after the onset of symptoms. The prevalence of severe aortic stenosis in elderly patients (>75 years) is approximately 3.4%. The transcatheter aortic valve replacement has been employed for approximately 20 years and had robust outcomes published. However, it is a challenging procedure when performed on a patient in cardiogenic shock, caused by severe deterioration of left ventricular function, a condition aggravated in cases of electromechanical dyssynchrony due to left bundle branch block. There is evidence that reestablishing the electrical conduction with a pacemaker implanted directly in the conduction system, in patients with left ventricular dysfunction and dyssynchrony, can significantly improve the systolic function. In this context, the objective of the present study was to present and discuss the particularities and evidence available for treating this comple...
Complete Left Bundle Branch Block and Blunt Cardiac Injury: A Lesson Learned
2020
definitions, endpoints, research trial design, and data collection requirements for clinical scientific studies and registries: endorsed by APHRS/HRS/ LAHRS. Europace 2018;20:1217. https://10.1093/ europace/euy050. 6. Shetty AK, Walker F, Cullen S, Lambiase PD.Extraction of pacing leads jailed by a stent in a mustard circulation. Pacing Clin Electrophysiol 2010;33:e65-7. https://10.1111/j.1540-8159.2010.02710.x. 7. Okamura H, Van Arnam JS, Aubry MC, Friedman PA, Cha YM. Successful pacemaker lead extraction involving an ossified thrombus: A case report. J Arrhythm 2017;33:150-1. https://10.1016/j. joa.2016.06.007.
An Unconventional Route of Left Ventricular Pacing
Cardiology Research, 2015
We present a case of a rare complication of transvenous right ventricular pacing by temporary pacing wire causing iatrogenic interventricular septal perforation and left ventricular pacing in a 69-year-old man who was referred for recurrent syncope with sinus arrest.
State of the Art in Cardiac Intervention: A Case Report
International Journal of Clinical Medicine, 2012
The first acute myocardial infarction (MI) of an elderly male was determined through angiography to be due to an infarct of the circumflex artery. The angiogram also revealed chronic occlusion and diffuse disease of the left anterior descending artery (LAD). This had been compensated for by collateral circulation from the right coronary artery. Since the patient had no prior history of coronary artery disease, the chronic and collateralized disease of the LAD was presumed to be stable and this artery was not treated. Due to a history of aspirin intolerance a bare metal stent was implanted in the circumflex artery. Within hours after stenting the patient had a second acute MI. Despite no change in the angiogram, the EKG suggested that the LAD was the source of the second MI. Indeed, a drug-eluting stent implanted in the LAD resolved the patient's signs and symptoms and he was discharged with a favorable outcome. The surprising second MI and the inconsistent stenting illustrate that when the unexpected occurs, there is no substitute for the judgment of a skilled clinician.