Methodist Journal

IN THIS ISSUE

Lipids and Lipoproteins

Vol 15, Issue 1 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

Lipids and Cardiovascular Disease: Putting it All Together

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RECOGNITIONS

Guest Editors Henry Pownall and Antonio Gotto Offer Insight and Expertise on the topic of Lipids and Cardiovascular Disease

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REVIEW ARTICLES See More

Cholesterol: Can’t Live With It, Can’t Live Without It

How Much Do Lipid Guidelines Help the Clinician? Reading Between the (Guide)lines

Statins: Then and Now

Poststatin Lipid Therapeutics: A Review

HDL and Reverse Cholesterol Transport Biomarkers

Revisiting Reverse Cholesterol Transport in the Context of High-Density Lipoprotein Free Cholesterol Bioavailability

High-Density Lipoprotein Subspecies in Health and Human Disease: Focus on Type 2 Diabetes

Gene Delivery in Lipid Research and Therapies

CASE REPORTS See More

Device-Related Thrombus: A Reason for Concern?

Retained Coronary Balloon Requiring Emergent Open Surgical Retrieval: An Uncommon Complication Requiring Individualized Management Strategies

Loperamide Mimicking Brugada Pattern

Reversed Pulsus Paradoxus in Right Ventricular Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Transcatheter Embolization of a Persistent Vertical Vein: A Rare Cause of Left-to-Right Shunt and Right-Sided Heart Failure

CLINICAL PERSPECTIVES See More

EXCERPTA

Talking Statins with Antonio Gotto

POINTS TO REMEMBER

Lipids and Renal Disease

EXCERPTA

Addressing the Feedback Loop Between Depression, Diabetes, and Cardiovascular Disease

POINTS TO REMEMBER

The Kidney as an Endocrine Organ

EDITORIALS

Addressing the Underrepresentation of Women in Cardiology through Tangible Opportunities for Mentorship and Leadership

Vol 14, Issue 4 (2019)

Article Full Text

EDITORIALS

Letter to the Editor in response to “Role of Subcutaneous Leadless Implantable Cardioverter Defibrillator in Young Patients

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Article Citation:

Khalid N, Sareen P, Ahmad SA, Chhabra L. Letter to the Editor in response to “Role of Subcutaneous Leadless Implantable Cardioverter Defibrillator in Young Patients.” Methodist DeBakey Cardiovasc J. 2019;14(4):e4.



Keywords
leadless , subcutaneous , implantable cardioverter defibrillator , venous stenosis , venous thrombosis , young patients

December 8, 2018

To the Editor:

We enjoyed reading the article by Gwozdz et al. in the recent issue of the Methodist DeBakey Cardiovascular Journal.1 The authors have described therapeutic endovascular modalities of the upper and lower extremity central venous thrombosis in contemporary practice in the published special edition on venous interventions.

In the present article, the authors state that a 34-year-old woman received a permanent pacemaker for Brugada syndrome (BrS).1 The pacemaker should be correctly identified as a single-chamber implantable converter defibrillator (ICD) as it is the correct form of intervention for patients with BrS to prevent sudden cardiac death. BrS is a genetic channelopathy most commonly involving the SCN5A gene, which encodes the cardiac sodium channel function, and leads to increased incidence of ventricular arrhythmias. The illustrated venogram also appears to demonstrate a single lead, which appears to represent an ICD lead. Also relevant to the case, the rate of venous thrombosis and stenosis is usually directly proportional to the increasing diameter and the increasing number of leads. An ICD lead usually has a larger diameter than a pacemaker lead, thus being more prone to stenosis.

The current practice guidelines recommend the placement of an ICD for primary or secondary prevention of sudden cardiac death in symptomatic BrS patients.2,3 Leadless or subcutaneous ICDs have recently begun gaining favor, especially in younger patients (such as those with channelopathy), to prevent the associated complications of the transvenous cardiac device leads.4,5 The extrathoracic placement and elimination of transvenous endocardial leads makes these miniaturized devices particularly attractive options in the younger population since these patients often require multiple device exchanges in their lifetime, which increases the risks of other complications such as device infection.4,5

Nauman Khalid, M.D.a; Pooja Sareen, M.D.b; Sarah Aftab Ahmad, M.D.c; Lovely Chhabra, M.D.d

aMedStar Washington Hospital Center, Washington, DC
bHarrisburg Medical Center, Harrisburg, Illinois
cSaint Francis Medical Center, Monroe, Louisiana
dHeartland Regional Medical Center, Marion, Illinois

 

References

  1. Gwozdz AM, Silickas J, Smith A, Saha P, Black SA. Endovascular Therapy for Central Venous Thrombosis. Methodist Debakey Cardiovasc J. 2018 Jul-Sep;14(3):214-8.
  2. Khalid N, Chhabra L, Kluger J. PYREXIA-INDUCED BRUGADA PHENOCOPY. J Ayub Med Coll Abbottabad. 2015;27:228-31.
  3. Chhabra L, Spodick DH. Brugada pattern masquerading as ST-segment elevation myocardial infarction in flecainide toxicity. Indian Heart J. 2012 Jul;64(4):404-7.
  4. Abu-El-Haija B, Bhave PD, Campbell DN, et al. Venous Stenosis After Transvenous Lead Placement: A Study of Outcomes and Risk Factors in 212 Consecutive Patients. J Am Heart Assoc. 2015 Aug;4(8):e001878.
  5. Müller MJ, Dieks JK, Backhoff D, et al. Efficacy and safety of non-transvenous cardioverter defibrillators in infants and young children. J Interv Card Electrophysiol. 2018 Sep 25. doi: 10.1007/s10840-018-0451-y. [Epub ahead of print]

 

Response from the author:

We are grateful to the authors for identifying the error in our original manuscript and for elaborating on the role and function of pacemakers in Brugada Syndrome.

Stephen A. Black, M.D.
Guy’s and St Thomas’ NHS Trust
London, England

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