Full Text Journal Articles in
Journal Card Electrophysiol Clin

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Pacing of Specialized Conduction System.

Santosh K Padala, Kenneth A Ellenbogen,

Right ventricular pacing for bradycardia remains the mainstay of pacing therapy. Chronic right ventricular pacing may lead to pacing-induced cardiomyopathy. We focus on the anatomy of the conduction system and the clinical feasibility of pacing the His bundle and/or left bundle conduction system. We review the hemodynamics of conduction system ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):755-784]

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Iatrogenic Atrioventricular Block.

Christopher C Cheung, Shumpei Mori, Edward P Gerstenfeld,

Iatrogenic atrioventricular (AV) block can occur in the context of cardiac surgery, percutaneous transcatheter, or electrophysiologic procedures. In cardiac surgery, patients undergoing aortic and/or mitral valve surgery are at the highest risk for developing perioperative AV block requiring permanent pacemaker implantation. Similarly, patients undergoing transcatheter aortic valve replacement are also ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):711-720]

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Electrocardiography of Atrioventricular Block.

Bradley A Clark, Eric N Prystowsky,

Delayed atrioventricular (AV) conduction most commonly occurs in the AV node, resulting from AH prolongation on an intracardiac electrocardiogram and PR prolongation on a surface electrocardiogram. AV conduction may be blocked in a 2:1 manner, with a normal PR interval and wide QRS suggesting infranodal disease, whereas a prolonged PR ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):599-605]

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Epidemiology and Outcomes Associated with PR Prolongation.

Larry R Jackson, Francis Ugowe,

PR prolongation is defined primarily as delayed conduction through the AV node, but can also signify delayed electrical impulse propagation through any part of the conduction system. The prevalence of PR prolongation ranges from 1% to 5% in patients younger than 50 years, with increasing prevalence, after the sixth decade ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):661-669]

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Atrioventricular Conduction: Physiology and Autonomic Influences.

Eric N Prystowsky, Jasen L Gilge,

Atrioventricular (AV) nodal conduction is decremental and very prone to alterations in autonomic tone. Conduction through the His-Purkinje system (HPS) is via fast channel tissue and typically not that dependent on autonomic perturbations. Applying these principles, when the sinus rate is stable and then heart block suddenly occurs preceded by ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):585-598]

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Genetic Abnormalities of the Sinoatrial Node and Atrioventricular Conduction.

Andreu Porta-Sánchez, Silvia Giuliana Priori,

The peculiar electrophysiological properties of the sinoatrial node and the cardiac conduction system are key components of the normal physiology of cardiac impulse generation and propagation. Multiple genes and transcription factors and metabolic proteins are involved in their development and regulation. In this review, we have summarized the genetic underlying ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):625-639]

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Physiologic Variants of Cardiac Conduction (Aberration, Gap, Supernormal Conduction).

William M Miles, Philip George,

Wide QRS complexes during supraventricular rhythms can be caused by fixed bundle branch block, functional (intermittent) bundle branch block, preexcitation, or toxic/metabolic causes. Functional bundle branch block can be caused by long-short aberrancy (usually physiologic), or acceleration/deceleration dependent aberrancy (usually pathologic). Electrocardiogram criteria have been proposed to differentiate aberration from ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):607-624]

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Pacing-Induced Cardiomyopathy.

Shaan Khurshid, David S Frankel,

Right ventricular (RV) pacing-induced cardiomyopathy (PICM) is typically defined as left ventricular systolic dysfunction resulting from electrical and mechanical dyssynchrony caused by RV pacing. RV PICM is common, occurring in 10-20% of individuals exposed to frequent RV pacing. Multiple risk factors for PICM have been identified, including male sex, wider ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):741-753]

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Bilateral Bundle Branch Block.

Jasen L Gilge, Benzy J Padanilam,

Left bundle branch block (LBBB) and right bundle branch block (RBBB) are classic manifestations of bundle branch conduction disorders. However, a third form that is uncommon and underrecognized may exist that has features and pathophysiology of both: bilateral bundle branch block (BBBB). This unusual form of bundle branch block exhibits ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):685-689]

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Sinus Node Dysfunction.

Neeraj Sathnur, Emanuel Ebin, David G Benditt,

Sinus node dysfunction (SND) is a multifaceted disorder most prevalent in older individuals, but may also occur at an earlier age. In most cases, the SND diagnosis is ultimately established by documenting its ECG manifestations. EPS has limited utility. The treatment strategy is largely dictated by symptoms and ECG manifestations. ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):641-659]

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Reversible Causes of Atrioventricular Block.

Chiara Pavone, Gemma Pelargonio,

Atrioventricular blocks may be caused by a variety of potentially reversible conditions, such as ischemic heart disease, electrolyte imbalances, medications, and infectious diseases. Such causes must be always ruled out to avoid unnecessary pacemaker implantation. Patient management and reversibility rates depend on the underlying cause. Careful patient history taking, monitoring ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(4):703-710]

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Data Management and Integration with Electronic Health Record Systems.

Gerald A Serwer,

Movement of information from a cardiac implantable electronic device to an electronic health record (EHR) can be a complex and multistep process. It requires unambiguous patient identification, device identification, standardized semantic and syntactic data nomenclature, common secure data transfer methodology, and structured reporting within the EHR. Common workflow using a ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):473-481]

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Device-Based Arrhythmia Monitoring.

Ranjan K Thakur, Andrea Natale,

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):xiii]

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Organizational Models for Cardiac Implantable Electronic Device Remote Monitoring: Current and Future Directions.

Carly Daley, Tammy Toscos, Tina Allmandinger, Ryan Ahmed, Shauna Wagner, Michael Mirro,

This review provides an overview of the literature on the organization, staffing, and structure of remote monitoring (RM) clinics, primarily from countries in Western Europe and United States, as well as the challenges, considerations, and future directions for RM clinic models of care. Using a current case example of an ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):483-497]

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Device-Based Arrhythmia Monitoring.

Suneet Mittal, David J Slotwiner,

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):xv-xvi]

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Current Guidelines and Clinical Practice.

Charles J Love,

Guidelines exist for monitoring to diagnose and manage patients with several different conditions. Although there have been recent updates to the guidelines, the constantly evolving and advancing nature of the technologies creates a gap at times between the newest monitors, the indications for their use, and the reimbursement by the ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):459-471]

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Atrial Fibrillation Population Screening.

Henri Gruwez, Tine Proesmans, Stijn Evens, Frederik H Verbrugge, Sébastien Deferm, Jeroen Dauw, Rik Willems, Pieter Vandervoort, Peter Haemers, Laurent Pison,

Atrial fibrillation (AF) is associated with adverse outcomes. Screening may lead to earlier recognition and treatment of asymptomatic AF. However, most evidence regarding AF applies to clinical AF, with symptoms or electrocardiographic diagnosis. Whether this evidence can be translated toward subclinical AF, without symptoms and detected by novel, more continuous ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):531-542]

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Ambulatory External Electrocardiography Monitoring: Holter, Extended Holter, Mobile Cardiac Telemetry Monitoring.

Arjun N Sharma, Adrian Baranchuk,

Ambulatory external electrocardiography (AECG) monitoring is effective as an evidence-based diagnostic tool when suspicion for cardiac arrhythmia is high. Multiple modalities of AECG monitoring exist, with unique advantages and limitations that predict effectiveness in a variety of clinical settings. Knowledge of these characteristics allows appropriate use of AECG, maximizing patient ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):427-438]

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Use of Smartphones and Wearables for Arrhythmia Monitoring.

David J Sanders, Jeremiah Wasserlauf, Rod S Passman,

Smartphones and other wearable electronic devices increasingly are used for ambulatory cardiac rhythm assessment. These consumer technologies have been evaluated in several studies for diagnosis and management of atrial fibrillation. Diverse mobile health applications, including management of other arrhythmias and medical conditions, are expanding alongside advances in technology. Electronic devices ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):509-522]

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Remote Monitoring of Permanent Pacemakers and Implantable Cardioverter Defibrillators.

Bryan Wilner, John Rickard,

Remote monitoring of permanent pacemakers and implantable cardiac defibrillators has undergone considerable advances over the past several decades. Advancement of technology has created the ability for remote monitoring of implantable cardiac devices; a device can monitor its own function, record arrhythmias, and transmit data to health care providers without frequent ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):449-457]

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The Role of Artificial Intelligence in Arrhythmia Monitoring.

Konstantinos C Siontis, Paul A Friedman,

Arrhythmia management has been revolutionized by the ability to monitor the cardiac rhythm in a patient's home environment in real-time using high-fidelity prescription-grade and commercially available wearable electrodes. The vast amount of digitally acquired electrophysiological signals has generated the need for scalable and efficient data processing with actionable output that ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):543-554]

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Cybersecurity of Cardiovascular Implantable Electronic Devices and Remote Programming.

David J Slotwiner, Kenneth P Hoyme, Sudar Shields,

The ability to remotely reprogram a cardiac implantable electronic device (CIED) and the ability to remotely install software or firmware updates would reduce the need for in-office visits and could provide a mechanism to rapidly deploy important software or firmware updates. The challenges of implementing remote reprogramming of cardiac implantable ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):499-508]

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Implantable Loop Recorders-Syncope, Cryptogenic Stroke, Atrial Fibrillation.

Suneet Mittal,

The implantable loop recorder (ILR) is a subcutaneous, single-lead, electrocardiographic (ECG) monitoring device used for diagnosis in patients with recurrent, unexplained episodes of palpitations or syncope, for long-term monitoring in patients at risk for atrial fibrillation (AF), and to guide clinical management in patients with known AF. These devices are ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):439-447]

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Remote Monitoring of the QT Interval and Emerging Indications for Arrhythmia Prevention.

Silvia Castelletti, Bo Gregers Winkel, Peter J Schwartz,

QT interval prolongation is a marker of increased risk for life-threatening arrhythmias, and needs to be promptly recognized. Many effective drugs, however, prolong QTc (QT interval corrected for heart rate) in genetically predisposed subjects. The possibility of remote monitoring and QTc measurement for up to 2 weeks, continuously providing physicians ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):523-530]

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Returning Cardiac Rhythm Data to Patients: Opportunities and Challenges.

Ruth Masterson Creber, Meghan Reading Turchioe,

Spurred by federal legislation, professional organizations, and patients themselves, patient access to data from electronic cardiac devices is increasingly transparent. Patients can collect data through consumer devices and access data traditionally shared only with health care providers. These data may improve screening, self-management, and shared decision-making for cardiac arrhythmias, but ... Read more >>

Card Electrophysiol Clin (Cardiac electrophysiology clinics)
[2021, 13(3):555-567]

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