Adults with Congenital Heart Disease: At Long Last, Guidelines for Arrhythmia Management

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108633/1/pace12456.pd

Optimizing resynchronization pacing in the failing systemic right ventricle

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147807/1/pace13560.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147807/2/pace13560_am.pd

Testing Efficacy in Determination of Recurrent Supraventricular Tachycardia among Subjectively Symptomatic Children Following “Successful” Ablation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108265/1/pace12373.pd

Electrocardiographic early repolarization characteristics and clinical presentations in the young: a benign finding or worrisome marker for arrhythmias

BackgroundThe early ECG repolarization QRS pattern (ERp), with J‐point elevation of 0.1 mV in two contiguous inferior and/or lateral leads, can be associated with ventricular arrhythmias among adults. The significance of an ERp in the young is unknown.ObjectiveThe purpose of this study was to assess the prevalence of ERp among young patients (pts), describe and correlate the characteristics with clinical presentations and any arrhythmias.MethodsThis was a 1 y retrospective review of ECGs obtained from patients referred specifically for documented arrhythmias, possible arrhythmia‐related symptoms or sports clearance. ECGs were analyzed for ERp (J‐point, ascending/horizontal patterns, location) and correlated with presenting complaints.ResultsOf 301 patient ECGs, an ERp was found in 177 (59%), (pts age 11.7 ± 4.3 y); 54% male; 23% Caucasian. Of these, 6 pts had a family history of sudden cardiac death. Arrhythmias (72% atrial) occurred in 22 pts. Only 3 pts had ventricular arrhythmias (1 successfully ablated). The ascending ST segment and elevated J‐point occurred in 77% and 51% of pts with and without arrhythmias respectively. In 73% of all pts, the ERp location was in inferior/lateral leads. Neither gender, ethnicity, large J‐point, lead location, nor the combination of a horizontal ST segment with large J‐point correlated with any arrhythmias.ConclusionsERp, especially the diffuse ascending pattern, is common among the young, in those of European ethnicity, found equally in both genders, and with no apparent correlation with atrial nor ventricular arrhythmias.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136329/1/chd12410.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136329/2/chd12410_am.pd

Arrhythmias and Sudden Death among Older Children and Young Adults Following Tetralogy of F allot Repair in the Current Era: Are Previously Reported Risk Factors Still Applicable?

Background Young adult patients (pts) with repaired tetralogy of F allot ( TOF ) remain at risk for arrhythmias ( A r) and sudden cardiac death ( SCD ). Based on past studies with earlier pt subsets, A r/ SCD events were associated with right ventricular ( RV ) systolic pressures >60 mm Hg, outflow tract gradients >20 mm Hg, and QRS duration >180 ms. However, there are limited recent studies to evaluate these risk factors in the current patient generation. Methods Patients with TOF followed over the past 50 years were grouped by presence of any arrhythmias (group 1), absence of arrhythmias (group 2), and presence of SCD or significant ventricular arrhythmias (group 3) and correlated with current pt age, gender, age at repair, repair types, echocardiogram, cardiac magnetic resonance imaging, electrocardiogram/ H olter, hemodynamics, and electrophysiology findings. Results Of 109 pts, 52 were male aged 17–58 years. Of these, 59 (54%) had A r, two of whom had SCD . These 59 pts were chronologically older at the time of analysis, with repair at an older age and wider QRS duration (78–240, mean 158 ms) when compared with those without A r. However, there was no correlation with surgical era, surgical repair, gender, RV pressure >60 mm Hg, right ventricular outflow tract gradient >20 mm Hg, or RV end‐diastolic volume on CMRI . Conclusions A r/ SCD risk continues to correlate with repair age and advancing pt age. QRS duration is longer in these patients but at a shorter interval (mean 158 ms) and less RV pressure (mean 43 mm Hg) than previously reported. In the current TOF patient generation, neither surgical era, type of repair, RV outflow gradient nor RV volume correlate with A r/ SCD . Electrophysiologic testing to verify and identify arrhythmias remains clinically effective.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108615/1/chd12153.pd

Radiofrequency and Cryoablation Therapies for Supraventricular Arrhythmias in the Young: Five‐Year Review of Efficacies

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91333/1/j.1540-8159.2012.03372.x.pd

Comparative Chronic Valve and Venous Effects of Lumenless versus Stylet‐Delivered Pacing Leads in Patients with and Without Congenital Heart

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/115920/1/pace12728.pd

Reversible Symptomatic Dilated Cardiomyopathy in Older Children and Young Adolescents Due to Primary Non-Sinus Supraventricular Tachyarrhythmias

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42390/1/30240274.pd

Developed in collaboration with and endorsed by the Heart Rhythm Society (HRS), the American College of Cardiology (ACC), the American Heart Association (AHA), and the Association for European Paediatric and Congenital Cardiology (AEPC). Endorsed by the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS).

AbstractIn view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients