Heart Conduction, System

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Letter to the Editor

Prolonged PR Interval and Outcome in Cardiac Resynchronization Therapy

Jakrin Kewcharoen et al. Chanavuth Kanitsoraphan

Dear Editor

We read the article “Baseline Prolonged PR Interval and Outcome of Cardiac Resynchronization Therapy: A Systematic Review and Meta-analysis” by Rattanawong et al. with great interest. The authors investigated the effect of prolonged PR interval on composite outcome among patients who received cardio resynchronized therapy. The authors conclude that prolonged PR is associated with worse outcome in this population.

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Case Report

Atrioventricular block pathology in cardiomyopathy by desmin deposition

Luiz Alberto Benvenuti et al. Vera Dermarchi Aiello Breno Alencar Araripe Falcão Silvia Gelás Lage

Generally, restrictive cardiomyopathy due to desmin deposition is characterized by restriction to ventricular diastolic filling and different degrees of atrioventricular block (AVB). In this report, we describe the pathological changes of the cardiac conduction system related to AVB. The sinus node, the compact node, and the penetrating bundle (bundle of His) had no abnormalities, however, there was extensive fibrosis of the terminal portions of the branching bundle and the beginning of the left and right bundles at the top of the ventricular septum. The pathogenesis of this fibrous replacement is probably the same that leads to extensive fibrosis of the working ventricular myocardium, and remains to be elucidated.

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Artigo Original

Cardiac electrophysiological assessment in patients with sarcoidosis

Jefferson Curimbaba et al. Silvia Carla Souza Rodrigues José Marcos Moreira Lenine Ângelo Alves Silva … Carlos Alberto de Castro Pereira João Pimenta

BACKGROUND: Sarcoidosis is a multisystem granulomatous disease of unknown origin that can cause sudden death. OBJECTIVE: Electrophysiological evaluation of patients with suspected sarcoidosis with cardiac involvement. METHODS: We studied 22 patients with mean age of 55.32 ± 13.13 years, diagnosed with sarcoidosis and suspected cardiac involvement. These patients underwent clinical evaluation, laboratory tests, electrocardiogram, echocardiogram, 24-hour Holter, technetium or gallium scintigraphy and electrophysiological study. In selected cases, we performed positron emission tomography or magnetic resonance imaging. Patients were followed up in the outpatient care service with quarterly visits. RESULTS: Cardiac involvement was confirmed in four (18.2%) patients. Ventricular extrasystoles with density > 100/24h were documented in 24-Holter monitoring in 12 (54.5%) patients. Electrophysiological studies revealed an increased HV interval in seven patients (31.8%) and increased Wenckebach point in four (18.2%) patients. There was induction of atrial fibrillation in seven patients (31.8%) and sustained ventricular tachycardia in one patient (4.5%). Four patients with confirmed cardiac sarcoidosis had documented ventricular extrasystoles with density > 100/24h. Out of these, two had prolonged HV interval and atrial fibrillation was induced in two of them. Sustained ventricular tachycardia was not induced in any of these patients. After mean follow-up period of 20.9 ± 15.7 months, one patient with cardiac sarcoidosis had sudden death. CONCLUSION: Patients with sarcoidosis and suspected cardiac involvement have a high prevalence of ventricular extrasystoles (VEs) and conduction system disorders.

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Prolonged PR Interval and Outcome in Cardiac Resynchronization Therapy

Atrioventricular block pathology in cardiomyopathy by desmin deposition

Cardiac electrophysiological assessment in patients with sarcoidosis

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