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44 results on '"Stevenson, Irene"'

7. Sinus Node Dysfunction

Author

Stevenson, Irene H., Sparks, Paul B., Kalman, Jonathan M., Kusumoto, Fred M., editor, and Goldschlager, Nora F., editor

Published
2008
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9. His bundle combined with deep septal left bundle branch area pacing for atrial fibrillation prior to atrioventricular node ablation.

Author

Nam, Michael C. Y., O'Sullivan, Patricia, Tonchev, Ivaylo, Moore, Benjamin M., Watts, Troy, Wynn, Gareth, Lee, Geoff, Joshi, Subodh, and Stevenson, Irene

Subjects
ATRIAL fibrillation treatment, ATRIOVENTRICULAR node, SCIENTIFIC observation, RETROSPECTIVE studies, DESCRIPTIVE statistics, DATA analysis software, HIS bundle
Abstract

Background: To mitigate the risk of dyssynchrony‐induced cardiomyopathy, international guidelines advocate His bundle pacing (HBP) with a ventricular backup lead prior to atrioventricular node ablation in treatment‐refractory atrial fibrillation and normal left ventricular ejection fraction. As a result of concerns with long‐term pacing parameters associated with HBP, this case series reports an adopted strategy of HBP combined with deep septal left bundle branch area pacing (dsLBBAP) in this patient cohort, enabling intrapatient comparison of the two pacing methods. Methods and Results: Eight patients aged 72 ± 10 years (left ventricular ejection fraction 53 ± 4%) underwent successful combined HBP and dsLBBAP implant prior to AV node ablation. Intrinsic QRS duration was 118 ± 46 ms. When compared to dsLBBAP, HBP had lower sensed ventricular amplitude (2.4 ± 1.1 vs. 15 ± 5.3 V, p =.001) and lower lead impedance (522 ± 57 vs. 814 ± 171ohms, p =.02), but shorter paced QRS duration (101 ± 20 vs. 119 ± 17 ms, p =.02). HBP pacing threshold was 1.0 ± 0.6 V at 1 ms pulse width, and dsLBBAP pacing threshold was 0.5 ± 0.2 V at 0.4 ms pulse width. Five patients underwent cardiac CT showing adequate dsLBBAP ventricular septal penetration (8.6 ± 1.3 mm depth, 2.4 ± 0.5 mm distance from left ventricular septal wall). No complications occurred during a mean follow‐up duration of 121 ± 92 days. Conclusions: Combined HBP and dsLBBAP pacing is a feasible approach as a pace and ablate strategy for atrial fibrillation refractory to medical therapy. [ABSTRACT FROM AUTHOR]

Published
2023
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23. A Grave Case of Bradycardia

Author

LEE, GEOFFREY, MCGAVIGAN, ANDREW D., HILLOCK, RICHARD J., ROBERTS-THOMSON, KURT C., STEVENSON, IRENE H., and MOND, HARRY G.

Published
2006

29. Third pillar volunteers prepare students to go back-to-school

Author

Stevenson, Irene

Subjects
Police departments -- Rites, ceremonies and celebrations, International relations
Abstract

On Aug. 18, a hot, muggy Friday, Third Pillar held its 4th Annual Back-to-School Celebration at the Benning Terrace Community Center in Washington, DC's Ward 7. Prior to the start [...]

Published
2017

40. Sinus Node Dysfunction.

Author

Kusumoto, Fred M., Goldschlager, Nora F., Stevenson, Irene H., Sparks, Paul B., and Kalman, Jonathan M.

Abstract

Sinus node dysfunction was initially described in the early 1900s, and is the primary indication for pacemaker implantation in industrialized countries. The only effective treatment for symptomatic sinus node dysfunction is cardiac pacing. However, despite the widespread use of pacing therapy for this group of patients, the optimal pacing mode, pacing system and site of ventricular stimulation for sinus node dysfunction remains controversial. The available data for the diagnosis and treatment of sinus node dysfunction are reviewed in this chapter. [ABSTRACT FROM AUTHOR]

Published
2008
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41. Focal Atrial Tachycardia From the Ostium of the Coronary Sinus Electrocardiographic and Electrophysiological Characterization and Radiofrequency Ablation

Author

Kistler, Peter M., Fynn, Simon P., Haqqani, Haris, Stevenson, Irene H., Vohra, Jitendra K., Morton, Joseph B., Sparks, Paul B., and Kalman, Jonathan M.

Abstract

ObjectivesThe goal of this study was to characterize the electrocardiographic and electrophysiologic features and frequency of focal atrial tachycardia (AT) originating from the coronary sinus ostium (CS).BackgroundThe ostium of the coronary sinus has been described as a site of origin of AT, but detailed characterization of these tachycardias is limited.MethodsThirteen patients (6.7%) of 193 undergoing radiofrequency ablation (RFA) for focal AT are reported. Endocardial activation maps (EAM) were recorded from catheters at the CS (10 pole), crista terminalis (20 pole), and His positions. The P waves were classified negative, positive, isoelectric, or biphasic.ResultsThe mean age was 41 ± 6 years, seven female patients, with symptoms for 8 ± 3 years. Tachycardia was induced by programmed extra-stimuli in eight patients, was spontaneous in three patients, and in response to isoproterenol in two patients. These foci had a characteristic P-wave morphology. At the CS ostium, the P-wave was deeply negative in all inferior leads, negative or isoelectric becoming positive in lead V1, then progressively negative across the precordium. Lead aVL was positive in all patients. Earliest EAM activity occurred at the proximal CS at 20 ± 3 ms ahead of P-wave. Mean activation time at the successful RFA site = −36 ± 8 ms; RFA was acutely successful in 11 of 13 patients. Long-term success was achieved in 11 of 11 over a median follow-up of 25 ± 4 months.ConclusionsThe CS ostium is an uncommon site of origin for focal AT (6.7%). It can be suspected as a potential anatomic site of AT origin from the characteristic P-wave and activation timing. Long-term success was achieved with focal ablation in the majority of patients.

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