We present a case of surgical implantation of biventricular epicardial pacing leads and a defibrillating patch via lower half mini sternotomy. Although median sternotomy is routinely used for this purpose, lower half mini sternotomy could provide the surgeon with the same surgical field exposure and a faster post operative recovery.

A 72 year old male with permanent AF was referred for a pulmonary vein isolation procedure. He had associated ischaemic heart disease, with prior myocardial infarctions in 1980 and 1981 and coronary artery bypass grafting in 1988. PAF developed in 2000, with a possible TIA. LV function was impaired with an ejection fraction of 40%. He was started on amiodarone and warfarin and after a second ca...

We report an unusual congenital cardiac anomaly consisting of a downward displacement of all leaflets of both atrio-ventricular valves. In addition to these changes, an atrial septal defect of the secundum type was noted. In light of the extreme rarity of this interesting anomaly complex, we reviewed the literature and compare the morphologic features of the present case with classic Ebstein's ...

We present a case of dengue myocarditis related Mobitz type I atrio-ventricular (A-V) block. To our knowledge, this is the first report of such a patient requiring pacing. An early response to methylprednisolone suggests the possibility of a therapeutic role for steroids in these patients.

We report atrio-ventricular cross talk in a patient with a dual chamber ICD leading to ventricular pacing inhibition. This was observed in an ICD without the ventricular safety pace option, which normally is a sufficient protection against this phenomenon. Cross talk could be prevented effectively by reprogramming ventricular sensitivity to a less sensitive setting.

In this review we present evidence from many experimental studies which challenge the concept of predestination of His bundle fibers. Using both intra- and extracellular His bundle pacing in the context of atrio-ventricular block and the development of bundle branch blocks these experimental studies provide the underlying mechanisms for the recent clinical findings showing the benefits of perma...

A 58 year old gentleman with complaints of palpitations and documented tachycardia was found to have a dilated right atrium, right ventricle and coronary sinus, which were due to partial unroofed coronary sinus without a left superior vena cava. He had upper septal ventricular tachycardia and atrio-ventricular nodal reentrant tachycardia, which was successfully treated by radiofrequency ablation.

A 67-year-old male patient with heart failure and permanent atrial fibrillation underwent atrio-ventricular nodal ablation and a biventricular device implantation. Instead of a standard cardiac resynchronization therapy device, a DDD pacemaker was implanted with the left ventricular lead in the atrial channel. After the implant, a pacemaker-mediated tachycardia caused by T wave oversensing by t...