The Experts below are selected from a list of 51 Experts worldwide ranked by ideXlab platform

Robert Coelho - One of the best experts on this subject based on the ideXlab platform.

  • Case Report Novel Technique of Dual Chamber Pacing Through Mini- thoracotomy and Transatrial Endocardial Active Fixation Lead Insertion for Epicardial Pacing Lead Malfunction
    2016
    Co-Authors: Am Sivakumar, Robert Coelho
    Abstract:

    Epicardial pacing lead fixation is employed in patients with cavopulmonary anastamosis (Glenn shunts) when they need permanent pacing. Epicardial pacing in these patients may malfunction due to high pacing thresholds or diaphragmatic pacing. A novel technique of transatrial insertion of two endocardial screw-in pacing leads through right anterolateral minithoracotomy could achieve synchronous atrioventricular pacing in a patient with Ebsteins Anomaly with symptomatic sinoatrial and atrioventricular nodal disease. Case Report A 23-year-old female with Ebstein's Anomaly of tricuspid valve underwent one and half ventricular repair with tricuspid valve annuloplasty, atrial septal defect closure and cavopulmonary anastamosis of right superior venacava to the right pulmonary artery. She also needed dual chamber pacing for symptomatic bradycardia secondary to sinus nodal and atrioventricular nodal disease. There was no pre-excitation or tachyarrhythmias. Left atrial and left ventricular epicardial leads were connected to a pulse generator that was implanted in epigastric subcutaneous pocket. There was synchronous atrioventricular pacing wit

Philip J Kilner - One of the best experts on this subject based on the ideXlab platform.

  • cardiac index left ventricular longitudinal systolic function and atrialised right ventricle size affect exercise capacity in adults with Ebsteins Anomaly
    European Heart Journal, 2013
    Co-Authors: Yumi Shiina, Philip J Kilner, Beatriz Bouzas, Riikka Rydman, A Kempny, Theodoros Karonis, Oktay Tutarel, Michael A Gatzoulis, Sonya V Babunarayan
    Abstract:

    Background: Small and squashed left ventricular (LV) compressed by markedly enlarged atrialised RV may have some influence on exercise capacity; however, there is no detailed study of the LV in a large cohort of adults with Ebstein's Anomaly. Left heart haemodynamic changes including cardiac output and longitudinal LV function may be sensitive in detecting early myocardial damage or ventricular interaction in adults with Ebstein's Anomaly. Methods: We enrolled 71 consecutive adults (age 37.0±13.6 years, range 18 – 82 years, 36 males) with Ebstein's Anomaly who underwent cardiac magnetic resonance (CMR) between Jan 2004 and Dec 2011. All of them did not undergo any surgery. Bi-atrial and -ventricular size and longitudinal function, and cardiac output were analysed using CMR and two dimensional echocardiogram. We also assessed brain natriuretic peptide (BNP) and exercise capacity using cardiopulmonary exercise test (CPET). Results: Thirteen patients (18.3%) fulfilled the criteria of LV non-compaction. Mean cardiac index (CI) was 2.82±0.70 L/min/m2; mean LV end-diastolic volume index (EDVi) of 79.8±21.8 ml/m2; mean LV end-systolic volume index (ESVi) of 37.2±14.3 ml/m2; mean LV ejection fraction (EF) of 54.7±6.6%; mean LV global longitudinal strain of 15.1±3.5%. The median of mean peak oxygen uptake (peak VO2) of the predicted value in CPET was 64%. We defined peak VO2 of the predicted value<64% as significantly reduced exercise capacity (32 patients, 45.1%). On univariate logistic regression analysis, CI (Odds ratio 0.41 per 1L/min/m2, P=0.045), maximum atrialised right ventricular (RV) volume index in 4 chamber view (Odds ratio per 1cm2/m2, P=0.046), LV global longitudinal strain (Odds ratio 1.25 per 1%unit, P=0.01) were related to exercise capacity. On multivariate analysis, CI and LV global longitudinal strain were significantly related to exercise intolerance. Furthermore, there was significant correlation with LVEF and RVEF (P<0.0001, R=0.60), suggesting ventricular interaction. Conclusions: Cardiac index and LV longitudinal dysfunction are associated with exercise intolerance as well as atrialised RV volumes in adults with Ebstein's Anomaly. Furthermore, there is obvious ventricular interaction which has great influence on exercise capacity. Considering the potential prognostic value of LV dysfunction and exercise intolerance in Ebstein's Anomaly, left sided meticulous assessments should be regarded as a useful adjunct to potential outcome information in this challenging population.

  • impact of abnormal septal geometry on cardiac output in Ebsteins Anomaly with tricuspid regurgitation compared to repaired tetralogy of fallot
    Journal of Cardiovascular Magnetic Resonance, 2011
    Co-Authors: Sylvia S M Chen, Hideki Uemura, Philip J Kilner
    Abstract:

    We previously found reduction of cardiac index (CI) in patients with tricuspid regurgitation (TR) due to Ebstein Anomaly, but not in patients with comparable right ventricular (RV) volume loading due to pulmonary regurgitation (PR) in patients with repaired tetralogy of Fallot (rTOF). We postulated that the difference may be attributable to impaired left ventricular (LV) filling caused by leftward bulging of the atrialized portion of the RV in Ebstein patients.

Coelho Robert - One of the best experts on this subject based on the ideXlab platform.

Am Sivakumar - One of the best experts on this subject based on the ideXlab platform.

  • Case Report Novel Technique of Dual Chamber Pacing Through Mini- thoracotomy and Transatrial Endocardial Active Fixation Lead Insertion for Epicardial Pacing Lead Malfunction
    2016
    Co-Authors: Am Sivakumar, Robert Coelho
    Abstract:

    Epicardial pacing lead fixation is employed in patients with cavopulmonary anastamosis (Glenn shunts) when they need permanent pacing. Epicardial pacing in these patients may malfunction due to high pacing thresholds or diaphragmatic pacing. A novel technique of transatrial insertion of two endocardial screw-in pacing leads through right anterolateral minithoracotomy could achieve synchronous atrioventricular pacing in a patient with Ebsteins Anomaly with symptomatic sinoatrial and atrioventricular nodal disease. Case Report A 23-year-old female with Ebstein's Anomaly of tricuspid valve underwent one and half ventricular repair with tricuspid valve annuloplasty, atrial septal defect closure and cavopulmonary anastamosis of right superior venacava to the right pulmonary artery. She also needed dual chamber pacing for symptomatic bradycardia secondary to sinus nodal and atrioventricular nodal disease. There was no pre-excitation or tachyarrhythmias. Left atrial and left ventricular epicardial leads were connected to a pulse generator that was implanted in epigastric subcutaneous pocket. There was synchronous atrioventricular pacing wit

Sivakumar Kothandam - One of the best experts on this subject based on the ideXlab platform.