Methodist Journal

IN THIS ISSUE

Adult Congenital Heart Update

Vol 15, Issue 2 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

The Growing Number of Adults Surviving with Congenital Heart Disease

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RECOGNITIONS

Drs. MacGillivray and Lin Take the Lead in Adult Congenital Heart Disease

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REVIEW ARTICLES See More

Advanced Cardiac Imaging for Complex Adult Congenital Heart Diseases

149 Fontan Conversions

Anomalous Aortic Origin of a Coronary Artery

Pulmonary Valve Replacement for Tetralogy of Fallot

Management of the Adult with Arterial Switch

Ebstein’s Anomaly

Heart Transplantation in Adults with Congenital Heart Disease

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

CASE REPORTS See More

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

Device-Related Thrombus: A Reason for Concern?

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

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do I Look Fat in This? Multimodality Imaging Findings of a Cardiac Lipoma

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

The Kidney in Congenital Cyanotic Heart Disease

EXCERPTA

Talking Statins with Antonio Gotto

POINTS TO REMEMBER

Lipids and Renal Disease

EXCERPTA

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

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

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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