CHD Electrophysiology Featured Articles of March 2016

1. Electrocardiographic repolarization abnormalities and increased risk of life-threatening arrhythmias in children with dilated cardiomyopathy.

Chen S, Motonaga KS, Hollander SA, Almond CS, Rosenthal DN, Kaufman BD, May LJ, Avasarala K, Dao DT, Dubin AM, Ceresnak SR.

Heart Rhythm. 2016 Mar 2. pii: S1547-5271(16)00184-3. doi: 10.1016/j.hrthm.2016.02.014. [Epub ahead of print]

PMID: 26945851

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Take Home Points:

  • Repolarization abnormalities, specifically JTc prolongation and ST segment shifts may be associated with increased risk for LTEs in pediatric cardiomyopathy patients.
  • These findings should be repeated in a larger pediatric population, as the present findings could not be adjusted for other covariates due to the small number of outcomes.
  • Risk stratification for sudden cardiac death in pediatric dilated cardiomyopathy patients remains ill-defined.

J MooreCommentary from Dr. Jeremy Moore (Los Angeles, CA), section editor of Congenital Heart Electrophysiology Journal Watch:  This is a single-center retrospective review of 178 pediatric patients with dilated cardiomyopathy (defined in this study as LVEF <55% and LVEDD z score ≥2) from Stanford University. Given the known risk of electrocardiographic depolarization abnormalities in this population, the authors were interested in examining the independent contribution related to repolarization abnormalities. In order to exclude influence from co-existing QRS prolongation, the corrected JT interval (JTc) was manually calculated (predominantly from lead II) by 3 cardiologists at the study site.

From this cohort of dilated cardiomyopathy patients, the upper 90th percentile for the corrected QT interval (QTc) was 510 ms and for the JTc was 390 ms. A total of 15 life-threatening events (LTE – defined as an episode of ventricular fibrillation or ventricular tachycardia that resulted in syncope or hypotension) occurred during a median follow-up duration of 12 months. The JTc was significantly longer in patients with LTEs versus unaffected dilated cardiomyopathy patients (371 ± 77 ms vs 342 ± 44 ms, p=0.01). Other variables associated with LTE in a Cox proportional hazards model included QRS duration >120 ms, JTc >390 ms, QTc >510 ms, JT dispersion ≥100 ms, QT dispersion >100 ms, T wave inversion, and ST segment depression. No adjustment for multiple comparisons was performed, and multivariable regression was limited to 2 covariates in this small sample population with few clinical outcomes.

 

 

2. Mechanism and outcomes of catheter ablation for ventricular tachycardia in adults with repaired congenital heart disease.

van Zyl M, Kapa S, Padmanabhan D, Chen FC, Mulpuru SK, Packer DL, Munger TM, Asirvatham SJ, McLeod CJ.

Heart Rhythm. 2016 Mar 4. pii: S1547-5271(16)30003-0. doi: 10.1016/j.hrthm.2016.03.002. [Epub ahead of print]

PMID: 26961296

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Select item 26944361

Take Home Points:

  • Catheter ablation of isthmus-dependent VT with subsequent verification of conduction block across the targeted isthmus appears to be highly effective for prevention of recurrent VT in patients with CHD.
  • As many as one-third of patients may have focal VT rather than an isthmus-dependent substrate.
  • A more exhaustive approach to determine the VT mechanism (rather than a substrate-based approach) may be useful to improve procedural outcomes.

Commentary from Dr. Jeremy Moore (Los Angeles, CA), section editor of Congenital Heart Electrophysiology Journal Watch:  This was a retrospective study of 21 patients with repaired congenital heart disease undergoing catheter ablation for clinically-documented ventricular tachycardia (VT) at the Mayo Clinic over a 10-year period spanning 2004 and 2015. The electrophysiologic approach was based on a combination of substrate mapping and entrainment at the site of the suspected critical isthmus, in order to determine the optimal site for catheter ablation. Whenever possible, conduction block was confirmed after lesion placement.

Congenital diagnoses included tetralogy of Fallot in 10, transposition of the great arteries after atrial switch operation in 4, isolated ventricular septal defect in 2, Ebstein anomaly in 2, and 1 each with pulmonary atresia, truncus arteriosus, and congenital aortic valve stenosis. Seven patients (33%) were found to have a focal VT, and 14 (67%) were found to have a conduction isthmus believed to be responsible for the clinical VT. Conduction block was achieved in 8/14 isthmuses (57%). Complete procedural success was achieved in 17 patients (81%). Over a mean follow up of 33 ± 7 months, 18/21 patients were free from VT recurrence. No patient with confirmed conduction block at the targeted isthmus experienced a recurrence.

 

3. Gene-Specific Therapy With Mexiletine Reduces Arrhythmic Events in Patients With Long QT Syndrome Type 3.

Mazzanti A, Maragna R, Faragli A, Monteforte N, Bloise R, Memmi M, Novelli V, Baiardi P, Bagnardi V, Etheridge SP, Napolitano C, Priori SG.

J Am Coll Cardiol. 2016 Mar 8;67(9):1053-8. doi: 10.1016/j.jacc.2015.12.033.

PMID: 26940925 Free PMC Article

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Select item 26950378

Take Home Points:

  • Mexilitine may be an effective therapeutic agent for reduction of cardiac events in LQT3.
  • The clinical efficacy of Mexilitine response may be best gauged by a resultant QTc< 500 ms after initiation of therapy.
  • Further prospective evaluation is warranted.

Commentary from Dr. Jeremy Moore (Los Angeles, CA), section editor of Congenital Heart Electrophysiology Journal Watch:  This is a retrospective study from Italy evaluating the clinical efficacy of Mexilitine in the treatment of long QT syndrome (LQTS) type 3. Although LQTS type 3 is the least prevalent of the major forms of LQTS, clinical events in these patients tend to be the most malignant.

The authors report a total of 34 patients (38% symptomatic and 7/34 with ≥1 cardiac arrest) that were given Mexilitine at an average dose of 8 mg/kg/day. The QTc shortened by a mean of 63 ± 6 ms; and for patients with a QTc >500 ms at baseline, 73% decreased to below this threshold after initiation of therapy. Three infants continued to have significantly prolonged QTc values after initiation of Mexilitine (see figure below) and continued to have clinical cardiac events.

QTc response to Mexilitine therapy. *Patients with ongoing clinical events.

Risk exposure assessment based on the comparison of periods of equal duration (median 35 months) before and after Mexilitine administration was performed in order for the patients to serve as their own controls. There was a significant reduction in the percentage of patients with arrhythmic events (22% to 3%) and mean number of events per patient (0.43 to 0.03) using this methodology.

The authors concluded that not only does Mexilitine shorten the QTc as shown previously, but also results in a clinically meaningful reduction in cardiac events. The only “nonresponders” were those with QTc values that were persistently >500 ms on therapy.

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CHD EP Articles of March 2016

  1. Demographics and Epidemiology of Sudden Deaths in Young Competitive Athletes: From the U.S. National Registry.

Maron BJ, Haas TS, Ahluwalia A, Murphy CJ, Garberich RF.

Am J Med. 2016 Mar 31. pii: S0002-9343(16)30288-1. doi: 10.1016/j.amjmed.2016.02.031. [Epub ahead of print]

PMID: 27039955

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  1. Improved Ventricular Function after TEE-guided Cardioversion of Atrial Arrhythmias in Patients after the Fontan Operation.

Poterucha JT, Egbe AC, Johnson JN, Niaz T, Wackel PL, Cannon BC, Eidem BW, Cetta F.

Congenit Heart Dis. 2016 Mar 31. doi: 10.1111/chd.12339. [Epub ahead of print]

PMID: 27030521

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  1. Transmural Placement of Endocardial Pacing Leads in Patients With Congenital Heart Disease.

Sandrio S, Purbojo A, Toka O, Dittrich S, Cesnjevar R, Rüffer A.

Ann Thorac Surg. 2016 Mar 30. pii: S0003-4975(15)02019-6. doi: 10.1016/j.athoracsur.2015.12.028. [Epub ahead of print]

PMID: 27038918

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  1. Atrial Tachyarrhythmias after Atrial Switch Operation for Transposition of the Great Arteries: Treating Old Surgery with New Catheters.

Houck CA, Teuwen CP, Bogers AJ, de Groot NM.

Heart Rhythm. 2016 Mar 24. pii: S1547-5271(16)30147-3. doi: 10.1016/j.hrthm.2016.03.046. [Epub ahead of print]

PMID: 27018378

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  1. Ratchet syndrome in complex congenital heart disease.

Shoda M, Takeuchi D, Manaka T.

Europace. 2016 Mar 21. pii: euw051. [Epub ahead of print] No abstract available.

PMID: 27001036

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  1. Sinus Node Dysfunction After Extracardiac Conduit and Lateral Tunnel Fontan Operation: The Importance of the Type of Prior Superior Cavopulmonary Anastomosis.

Rajanbabu BB, Gangopadhyay D.

World J Pediatr Congenit Heart Surg. 2016 Mar;7(2):210-5. doi: 10.1177/2150135115616370.

PMID: 26957405

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  1. ECGs in the ED.

Tanel RE.

Pediatr Emerg Care. 2016 Mar;32(3):202-3. doi: 10.1097/PEC.0000000000000769. No abstract available.

PMID: 26928105

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  1. Catheter Ablation of Pediatric Focal Atrial Tachycardia: Ten-Year Experience Using Modern Mapping Systems.

Dieks JK, Müller MJ, Schneider HE, Krause U, Steinmetz M, Paul T, Kriebel T.

Pediatr Cardiol. 2016 Mar;37(3):459-64. doi: 10.1007/s00246-015-1299-x. Epub 2015 Nov 4.

PMID: 26538211

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  1. Is non-sustained ventricular tachycardia a predictor of sudden death in adults with congenital heart disease?

Lim E, Wong T.

Int J Cardiol. 2016 Mar 15;207:264-5. doi: 10.1016/j.ijcard.2016.01.161. Epub 2016 Jan 9. No abstract available.

PMID: 26808989

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  1. Sudden Cardiac Death in the Young.

Ackerman M, Atkins DL, Triedman JK.

Circulation. 2016 Mar 8;133(10):1006-26. doi: 10.1161/CIRCULATIONAHA.115.020254.

PMID: 26951821

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  1. Mechanism and outcomes of catheter ablation for ventricular tachycardia in adults with repaired congenital heart disease.

van Zyl M, Kapa S, Padmanabhan D, Chen FC, Mulpuru SK, Packer DL, Munger TM, Asirvatham SJ, McLeod CJ.

Heart Rhythm. 2016 Mar 4. pii: S1547-5271(16)30003-0. doi: 10.1016/j.hrthm.2016.03.002. [Epub ahead of print]

PMID: 26961296

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  1. Twin Atrioventricular Nodal Reentrant Tachycardia Associated with Heterotaxy Syndrome with Malaligned Atrioventricular Canal Defect and Atrioventricular Discordance.

Patel A, Tanel R.

Card Electrophysiol Clin. 2016 Mar;8(1):211-6. doi: 10.1016/j.ccep.2015.12.001. Review.

PMID: 26920197

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  1. Ventricular Tachycardia in Congenital Pulmonary Stenosis.

Ruckdeschel ES, Schuller J, Nguyen DT.

Card Electrophysiol Clin. 2016 Mar;8(1):205-9. doi: 10.1016/j.ccep.2015.10.030. Epub 2016 Jan 16. Review.

PMID: 26920196

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14, Ventricular Tachycardia Following Surgical Repair of Complex Congenital Heart Disease.

Baysa SJ, Kanter RJ.

Card Electrophysiol Clin. 2016 Mar;8(1):201-4. doi: 10.1016/j.ccep.2015.10.029. Epub 2016 Jan 19. Review.

PMID: 26920195

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  1. Slow Pathway Modification in a Patient with D-Transposition of the Great Arteries and Atrial Switch Procedure.

Ruckdeschel ES, Kay J, Varosy P, Nguyen DT.

Card Electrophysiol Clin. 2016 Mar;8(1):191-6. doi: 10.1016/j.ccep.2015.10.027. Epub 2016 Jan 13. Review.

PMID: 26920193

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  1. An Approach to Endovascular Ventricular Pacing in a Patient with Ebstein Anomaly and a Mechanical Tricuspid Valve.

Zipse MM, Groves DW, Khanna AD, Nguyen DT.

Card Electrophysiol Clin. 2016 Mar;8(1):169-71. doi: 10.1016/j.ccep.2015.10.020. Epub 2016 Jan 13. Review.

PMID: 26920188

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  1. Evaluation of cardiac electrophysiological properties in an experimental model of right ventricular hypertrophy and failure.

Schultz JG, Andersen S, Andersen A, Erik Nielsen-Kudsk J, Nielsen JM.

Cardiol Young. 2016 Mar;26(3):451-8. doi: 10.1017/S1047951115000402. Epub 2015 Apr 14.

PMID: 25872028

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  1. Can we rely on machines? Device-detected atrial high rates correspond well with atrial arrhythmias in cardiac resynchronization recipients†.

Jędrzejczyk-Patej E, Lenarczyk R, Mazurek M, Liberska A, Przybylska-Siedlecka K, Podolecki T, Kowalczyk J, Sokal A, Leopold-Jadczyk A, Kowalski O, Kalarus Z.

Europace. 2016 Mar;18(3):436-44. doi: 10.1093/europace/euv095. Epub 2015 May 27.

PMID: 26017467

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  1. Arrhythmia diagnosis and management throughout life in congenital heart disease.

Clark BC, Berul CI.

Expert Rev Cardiovasc Ther. 2016 Mar;14(3):301-20. doi: 10.1586/14779072.2016.1128826. Epub 2016 Jan 9.

PMID: 26642231

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  1. Non-sustained ventricular tachycardia in patients with congenital heart disease: An important sign?

Teuwen CP, Ramdjan TT, Götte M, Brundel BJ, Evertz R, Vriend JW, Molhoek SG, Reinhart Dorman HG, van Opstal JM, Konings TC, van der Voort P, Delacretaz E, Wolfhagen NJ, van Gastel V, de Klerk P, Theuns DA, Witsenburg M, Roos-Hesselink JW, Triedman JK, Bogers AJ, de Groot NM.

Int J Cardiol. 2016 Mar 1;206:158-63. doi: 10.1016/j.ijcard.2016.01.042. Epub 2016 Jan 6.

PMID: 26805391

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  1. Remote Magnetic Navigation for Catheter Ablation in Patients With Congenital Heart Disease: A Review.

Roy K, Gomez-Pulido F, Ernst S.

J Cardiovasc Electrophysiol. 2016 Mar;27 Suppl 1:S45-56. doi: 10.1111/jce.12903.

PMID: 26969223

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  1. Sudden infant death due to Lactococcal infective endocarditis.

Taniguchi K, Nakayama M, Nakahira K, Nakura Y, Kanagawa N, Yanagihara I, Miyaishi S.

Leg Med (Tokyo). 2016 Mar;19:107-11. doi: 10.1016/j.legalmed.2015.07.013. Epub 2015 Jul 26.

PMID: 26277368

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  1. Tachyarrhythmia in patients with congenital heart disease: inevitable destiny?

Teuwen CP, Taverne YJ, Houck C, Götte M, Brundel BJ, Evertz R, Witsenburg M, Roos-Hesselink JW, Bogers AJ, de Groot NM; DANARA Study Investigators.

Neth Heart J. 2016 Mar;24(3):161-70. doi: 10.1007/s12471-015-0797-z. Erratum in: Neth Heart J. 2016 Apr;24(4):301-2.

PMID: 26728051 Free PMC Article

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  1. Left and Right Parasternal Sensing for the S-ICD in Adult Congenital Heart Disease Patients and Normal Controls.

Wilson DG, Zeb M, Veldtman G, Dimitrov BD, Morgan JM.

Pacing Clin Electrophysiol. 2016 Mar;39(3):282-90. doi: 10.1111/pace.12802. Epub 2016 Jan 21.

PMID: 26694691

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  1. Neonatal ventricular fibrillation and an elusive ALCAPA: things are not always as they seem.

Walker TC, Renno MS, Parra DA, Guthrie SO.

BMJ Case Rep. 2016 Mar 31;2016. pii: bcr2015214239. doi: 10.1136/bcr-2015-214239.

PMID: 27033289

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  1. Variation in Antiarrhythmic Management of Infants Hospitalized with Supraventricular Tachycardia: A Multi-Institutional Analysis.

Guerrier K, Shamszad P, Czosek RJ, Spar DS, Knilans TK, Anderson JB.

Pediatr Cardiol. 2016 Mar 31. [Epub ahead of print]

PMID: 27033244

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  1. High Incidence of Dilated Cardiomyopathy After Right Ventricular Inlet Pacing in Patients With Congenital Complete Atrioventricular Block.

Tsujii N, Miyazaki A, Sakaguchi H, Kagisaki K, Yamamoto T, Matsuoka M, Shima Y, Ichikawa H, Ohuchi H.

Circ J. 2016 Mar 24. [Epub ahead of print]

PMID: 27008922 Free Article

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  1. Late-onset periodic bradycardia during vagus nerve stimulation in a pediatric patient. A new case and review of the literature.

Cantarín-Extremera V, Ruíz-Falcó-Rojas ML, Tamaríz-Martel-Moreno A, García-Fernández M, Duat-Rodriguez A, Rivero-Martín B.

Eur J Paediatr Neurol. 2016 Mar 16. pii: S1090-3798(16)00049-0. doi: 10.1016/j.ejpn.2016.02.014. [Epub ahead of print] Review.

PMID: 27056279

 

Select item 26994646

 

  1. Spectrum and Prevalence of CALM1-, CALM2-, and CALM3-Encoded Calmodulin (CaM) Variants in Long QT Syndrome (LQTS) and Functional Characterization of a Novel LQTS-Associated CaM Missense Variant, E141G.

Boczek NJ, Gomez-Hurtado N, Ye D, Calvert ML, Tester DJ, Kryshtal D, Hwang HS, Johnson CN, Chazin WJ, Loporcaro CG, Shah M, Papez AL, Lau YR, Kanter R, Knollmann BC, Ackerman MJ.

Circ Cardiovasc Genet. 2016 Mar 11. pii: CIRCGENETICS.115.001323. [Epub ahead of print]

PMID: 26969752

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  1. Increased PR Interval in Fetuses of Patients with Intrahepatic Cholestasis of Pregnancy.

Rodríguez M, Moreno J, Márquez R, Eltit R, Martinez F, Sepúlveda-Martínez A, Parra-Cordero M.

Fetal Diagn Ther. 2016 Mar 10. [Epub ahead of print]

PMID: 26959834

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  1. Radiofrequency Catheter Ablation of Accessory Atrioventricular Pathways in Infants and Toddlers ≤ 15 kg.

Backhoff D, Klehs S, Müller MJ, Schneider H, Kriebel T, Paul T, Krause U.

Pediatr Cardiol. 2016 Mar 9. [Epub ahead of print]

PMID: 26961570

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  1. Gene-Specific Therapy for Congenital Long QT Syndrome: Are We There Yet?

Arbelo E, Sarquella-Brugada G, Brugada J.

J Am Coll Cardiol. 2016 Mar 8;67(9):1059-61. doi: 10.1016/j.jacc.2015.12.030. No abstract available.

PMID: 26940926

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Select item 26940925

 

  1. Gene-Specific Therapy With Mexiletine Reduces Arrhythmic Events in Patients With Long QT Syndrome Type 3.

Mazzanti A, Maragna R, Faragli A, Monteforte N, Bloise R, Memmi M, Novelli V, Baiardi P, Bagnardi V, Etheridge SP, Napolitano C, Priori SG.

J Am Coll Cardiol. 2016 Mar 8;67(9):1053-8. doi: 10.1016/j.jacc.2015.12.033.

PMID: 26940925 Free PMC Article

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Select item 26950378

 

  1. Electrocardiographic repolarization abnormalities and increased risk of life-threatening arrhythmias in children with dilated cardiomyopathy.

Chen S, Motonaga KS, Hollander SA, Almond CS, Rosenthal DN, Kaufman BD, May LJ, Avasarala K, Dao DT, Dubin AM, Ceresnak SR.

Heart Rhythm. 2016 Mar 2. pii: S1547-5271(16)00184-3. doi: 10.1016/j.hrthm.2016.02.014. [Epub ahead of print]

PMID: 26945851

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Select item 26970963

 

  1. Junctional Bradycardia as Early Sign of Digoxin Toxicity in a Premature Infant with Congestive Heart Failure due to a Left to Right Shunt.

Dasgupta S, Aly AM, Jain SK.

AJP Rep. 2016 Mar;6(1):e96-8. doi: 10.1055/s-0035-1567858. Epub 2015 Nov 20.

PMID: 26929880 Free PMC Article

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  1. Unusual Outflow Tract Ventricular Tachycardia.

Motonaga KS, Ceresnak SR, Hsia HH.

Card Electrophysiol Clin. 2016 Mar;8(1):79-88. doi: 10.1016/j.ccep.2015.10.032. Review.

PMID: 26920175

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  1. Sinus bradycardia, junctional rhythm, and low-rate atrial fibrillation in Short QT syndrome during 20 years of follow-up: three faces of the same genetic problem.

Righi D, Silvetti MS, Drago F.

Cardiol Young. 2016 Mar;26(3):589-92. doi: 10.1017/S1047951115001432. Epub 2015 Aug 17.

PMID: 26279191

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  1. Effects of surgical en bloc rotation of the arterial trunk on the conduction system in children with transposition of the great arteries, ventricular septal defect and pulmonary stenosis.

Prandstetter C, Tulzer A, Mair R, Sames-Dolzer E, Tulzer G.

Cardiol Young. 2016 Mar;26(3):516-20. doi: 10.1017/S1047951115000578. Epub 2015 Jul 14.

PMID: 26168956

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Select item 26095337

 

  1. Current approaches to the clinical assessment of syncope in pediatric population.

Bayram AK, Pamukcu O, Per H.

Childs Nerv Syst. 2016 Mar;32(3):427-36. doi: 10.1007/s00381-015-2988-8. Epub 2016 Jan 5.

PMID: 26732063

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  1. The blue child – amiodarone-induced blue-gray skin syndrome and pulmonary mass in a child.

Paech C, Wagner F, Suchowerskyj P, Weidenbach M.

Clin Case Rep. 2016 Feb 8;4(3):276-8. doi: 10.1002/ccr3.483. eCollection 2016 Mar.

PMID: 27014451 Free PMC Article

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  1. SCN4A variants and Brugada syndrome: phenotypic and genotypic overlap between cardiac and skeletal muscle sodium channelopathies.

Bissay V, Van Malderen SCh, Keymolen K, Lissens W, Peeters U, Daneels D, Jansen AC, Pappaert G, Brugada P, De Keyser J, Van Dooren S.

Eur J Hum Genet. 2016 Mar;24(3):400-7. doi: 10.1038/ejhg.2015.125. Epub 2015 Jun 3.

PMID: 26036855

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  1. Genetic testing and genetic counseling in patients with sudden death risk due to heritable arrhythmias.

Spoonamore KG, Ware SM.

Heart Rhythm. 2016 Mar;13(3):789-97. doi: 10.1016/j.hrthm.2015.11.013. Epub 2015 Nov 12.

PMID: 26582592

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Select item 25430418

 

  1. Phrenic nerve protection via packing of gauze into the pericardial space during ablation of cristal atrial tachycardia in a child.

Takahashi K, Fuchigami T, Nabeshima T, Sashinami A, Nakayashiro M.

Heart Vessels. 2016 Mar;31(3):438-9. doi: 10.1007/s00380-014-0603-7. Epub 2014 Nov 28.

PMID: 25430418

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Select item 26901450

 

  1. Genetic investigation of sudden unexpected death in epilepsy cohort by panel target resequencing.

Coll M, Allegue C, Partemi S, Mates J, Del Olmo B, Campuzano O, Pascali V, Iglesias A, Striano P, Oliva A, Brugada R.

Int J Legal Med. 2016 Mar;130(2):331-9. doi: 10.1007/s00414-015-1269-0. Epub 2015 Sep 30.

PMID: 26423924

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  1. Professor André Jouve (1909-2001): A French cardiologist who was a pioneer of clinical vector-electrocardiography and cardiovascular epidemiology.

Puddu PE.

J Electrocardiol. 2016 Mar-Apr;49(2):243-7. doi: 10.1016/j.jelectrocard.2016.01.003. Epub 2016 Jan 14.

PMID: 26846422

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Select item 25492300

 

  1. The Benefit of a General, Systematic Use of Mapping Systems During Electrophysiological Procedures in Children and Teenagers: The Experience of an Adult EP Laboratory.

Marini M, Del Greco M, Ravanelli D, Cima A, Coser A, Porcedda G, Guarracini F, Valentini A, Bonmassari R.

Pediatr Cardiol. 2016 Mar 1. [Epub ahead of print]

PMID: 26932365

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Select item 26932364

 

  1. Arrhythmias Following Comprehensive Stage II Surgical Palliation in Single Ventricle Patients.

Wilhelm CM, Paulus D, Cua CL, Kertesz NJ, Cheatham JP, Galantowicz M, Fernandez RP.

Pediatr Cardiol. 2016 Mar;37(3):552-7. doi: 10.1007/s00246-015-1314-2. Epub 2015 Dec 14.

PMID: 26667962

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Select item 26667961

 

  1. Arrhythmia Detection in Pediatric Patients: ECG Quality and Diagnostic Yield of a Patient-Triggered Einthoven Lead-I Event Recorder (Zenicor EKG-2™).

Usadel L, Haverkämper G, Herrmann S, Löber R, Weiss K, Opgen-Rhein B, Berger F, Will JC.

Pediatr Cardiol. 2016 Mar;37(3):491-6. doi: 10.1007/s00246-015-1304-4. Epub 2015 Nov 14.

PMID: 26573815

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