Cardiology Commons^™

Use Of Triple-Site Ventricular Pacing In A Patient With Severe Congestive Heart Failure And Atrial Fibrillation., Faizel Osman, Jeilan Mohamed, G. Andre' Ng

Internal Medicine, East Africa

Cardiac resynchronization therapy (CRT) has become an accepted treatment for selected patients with drug-resistant heart failure. Data for patients in atrial fibrillation (AF) remains limited but suggests benefit in these patients too. We report the case of an 82-year-old patient with heart failure, VVIR permanent pacemaker, and permanent AF who had an upgrade to triple-site CRT implantation with good clinical response. Triple-site ventricular pacing may enhance the chance of response and LV reverse remodeling and should be considered in AF patients undergoing CRT implantation.

Pulmonary Vein Isolation Using A High Density Mesh Ablator Catheter: Incorporation Of Three-Dimensional Navigation And Mappin, Jiun Tuan, Jeilan Mohamed, Faizel Osman, Suman Kundu, Rajkumar Mantravadi, Peter J. Stafford, G. André Ng

Internal Medicine, East Africa

Background: We evaluated the use of a novel High Density Mesh Ablator (HDMA) catheter in combination with three-dimensional navigation for the treatment of paroxysmal atrial fibrillation.

Methods: The HDMA catheter was used to carry out pulmonary vein isolation in a consecutive series of patients. Three-dimensional geometry of the left atrial-pulmonary vein (LA-PV) junctions were first created with the HDMA catheter. Ostial, proximal and distal sites within the pulmonary veins were tagged with catheter shadows on the created geometry to allow for re-interrogation of these exact sites after ablation.

Results: The HDMA catheter was successfully used to create three dimensional geometry …

Letter By Jeilan Et Al Regarding Article, "Longitudinal Strain Delay Index By Speckle Tracking Imaging: A New Marker Of Response To Cardiac Resynchronization Therapy"., Jeilan Mohamed, Jiun H. Tuan, G. Andre' Ng

Internal Medicine, East Africa

We read with interest the recent article by Lim et al.1 This article demonstrated a strong correlation between a novel longitudinal strain delay index and left ventricular end-systolic volume reduction in both ischemic and nonischemic patients.

The principle outlined by the authors is that an increased longitudinal strain delay index requires both dyssynchrony (defined in their article as a discrepancy between the time of end-systolic contraction and the time to peak strain) and residual contractility. Their concept elegantly considers the problem of cardiac resynchronization therapy (CRT) nonresponse in heart failure patients who have myocardial segments with delayed contraction due …