Japanese Journal of Electrocardiology
Online ISSN : 1884-2437
Print ISSN : 0285-1660
ISSN-L : 0285-1660
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Volume 31, Issue 5
Displaying 1-11 of 11 articles from this issue
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  • Comparison of the Clinical Efficacy of Cardiac Resynchronization Therapy in Patients with Sinus Rhythm and Atrial Fibrillation
    Yoshihiro Sobue, Eiichi Watanabe, Mayumi Yamamoto, Kan Sano, Hiroto Ha ...
    2011 Volume 31 Issue 5 Pages 459-466
    Published: 2011
    Released on J-STAGE: June 10, 2015
    DOIhttps://doi.org/10.5105/jse.31.459
    JOURNAL FREE ACCESS
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    Cardiac resynchronization therapy (CRT) using biventricular pacemakers offers additive mortality and morbidity benefits beyond medication in patients with severe heart failure. There is a paucity of data regarding the impact of CRT in patients with atrial fibrillation. We therefore determined the differential impact of CRT for patients with atrial fibrillation and sinus rhythm. We analyzed 38 consecutive patients (age 61±11 years, male 58%) who had received CRT between January 2003 and January 2009. Biventricular pacing rate in both sinus rhythm and atrial fibrillation was more than 95%. During a follow-up period of 25 months, 17 (44%) patients died from cardiac causes or were hospitalized for heart failure. There was no significant difference in the endpoint between the patients with sinus rhythm and those with atrial fibrillation (p = 0.87). The echocardiogram revealed that the left ventricular end-systolic volume was significantly reduced 6 months after the CRT and the magnitude of its decrease was significantly correlated with the rate of biventricular pacing (r =−0.42, p<0.01, n = 38). We concluded that there was no significant differential impact of CRT between the patients with atrial fibrillation and those with sinus rhythm.
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  • A Case of an Inappropriate Implantable Cardioverter Defibrillator Shock Delivery Coincident with a Decline in the Biventricular Pacing Rate due to T-wave Oversensing
    Kengo Sasaki, Shumpei Mori, Hakudou Kanno, Tomohiro Suzuki, Takeshi Ch ...
    2011 Volume 31 Issue 5 Pages 467-475
    Published: 2011
    Released on J-STAGE: June 10, 2015
    DOIhttps://doi.org/10.5105/jse.31.467
    JOURNAL FREE ACCESS
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    T-wave oversensing results in over-counting ventricular sensed events, thus satisfying the rate criterion and sometimes leading to inappropriate shocks in patients with implantable cardioverter defibrillator (ICD). ICD shocks are associated with worse mental health, impaired quality of life, and increased risk of mortality.
    In patients with cardiac resynchronization therapy device with defibrillator (CRT-D), T-wave oversensing can also lead to a decline in the biventricular pacing rate.
    Here, we present a case of a 70-year-old male who underwent CRT-D implantation and experienced an inappropriate shock three months after the operation. At this time, the biventricular pacing rate recorded in the pacing summary decreased from 99% to 75%. Intracardiac electrocardiogram revealed T-wave oversensing in the right ventricular lead as the cause of both unfavorable events. Although we could not avoid T-wave oversensing by adjusting the threshold of ventricular sensitivity, customizing frequency filter characteristics successfully resolved it. Inappropriate shock has never recurred and the biventricular pacing rate has been kept above 98% for the subsequent 22 months.
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  • A Case of Brugada Syndrome Associated with Inferolateral Early Repolarization Presenting Idiopathic Ventricular Fibrillation
    Shioto Yasuda, Yousuke Kokawa, Hisataka Nakamura, Mitsuhiro Fukata, Ke ...
    2011 Volume 31 Issue 5 Pages 476-484
    Published: 2011
    Released on J-STAGE: June 10, 2015
    DOIhttps://doi.org/10.5105/jse.31.476
    JOURNAL FREE ACCESS
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    The relationship between Brugada syndrome and early repolarization syndrome remains controversial. Here, we report a case of a 34-year-old male who had visited the hospital due to nocturnal atrial fibrillation (AF). Sinus rhythm was restored after the administration of pilsicainide at the first episode of AF, but AF was converted to ventricular fibrillation (VF) after the same treatment during the second episode. Immediately prior to the onset of VF, ST elevation in inferior leads and J waves in lateral leads were observed. No organic heart diseases were suspected. Diagnosis of Brugada syndrome associated with inferolateral early repolarization was made based on the positive pilsicainide infusion test (1 mg/kg). VF was not detected after the implantation of implantable cardioverter-defibrillator and coadministration of cilostazol (200 mg) and bepridil (100 mg). This case provides additional information on the complicated relationship between Brugada syndrome and early repolarization syndrome.
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