Coronary Sinus: A short vein that collects about two thirds of the venous blood from the MYOCARDIUM and drains into the RIGHT ATRIUM. Coronary sinus, normally located between the LEFT ATRIUM and LEFT VENTRICLE on the posterior surface of the heart, can serve as an anatomical reference for cardiac procedures.Coronary Vessels: The veins and arteries of the HEART.Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium.Coronary Circulation: The circulation of blood through the CORONARY VESSELS of the HEART.Coronary Artery Disease: Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.Steroid 16-alpha-Hydroxylase: A liver microsomal cytochrome P450 enzyme that catalyzes the 16-alpha-hydroxylation of a broad spectrum of steroids, fatty acids, and xenobiotics in the presence of molecular oxygen and NADPH-FERRIHEMOPROTEIN REDUCTASE. This enzyme is encoded by a number of genes from several CYP2 subfamilies.Angioplasty, Balloon, Coronary: Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.Coronary Stenosis: Narrowing or constriction of a coronary artery.Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.Cranial Sinuses: Large endothelium-lined venous channels situated between the two layers of DURA MATER, the endosteal and the meningeal layers. They are devoid of valves and are parts of the venous system of dura mater. Major cranial sinuses include a postero-superior group (such as superior sagittal, inferior sagittal, straight, transverse, and occipital) and an antero-inferior group (such as cavernous, petrosal, and basilar plexus).Maxillary Sinus: The air space located in the body of the MAXILLARY BONE near each cheek. Each maxillary sinus communicates with the middle passage (meatus) of the NASAL CAVITY on the same side.Coronary Disease: An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.MedlinePlus: NATIONAL LIBRARY OF MEDICINE service for health professionals and consumers. It links extensive information from the National Institutes of Health and other reviewed sources of information on specific diseases and conditions.Cardiac Pacing, Artificial: Regulation of the rate of contraction of the heart muscles by an artificial pacemaker.Cavernous Sinus: An irregularly shaped venous space in the dura mater at either side of the sphenoid bone.Coronary Vessel Anomalies: Malformations of CORONARY VESSELS, either arteries or veins. Included are anomalous origins of coronary arteries; ARTERIOVENOUS FISTULA; CORONARY ANEURYSM; MYOCARDIAL BRIDGING; and others.Electrocardiography: Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.Coronary Aneurysm: Abnormal balloon- or sac-like dilatation in the wall of CORONARY VESSELS. Most coronary aneurysms are due to CORONARY ATHEROSCLEROSIS, and the rest are due to inflammatory diseases, such as KAWASAKI DISEASE.Vena Cava, Superior: The venous trunk which returns blood from the head, neck, upper extremities and chest.Carotid Sinus: The dilated portion of the common carotid artery at its bifurcation into external and internal carotids. It contains baroreceptors which, when stimulated, cause slowing of the heart, vasodilatation, and a fall in blood pressure.Coronary Vasospasm: Spasm of the large- or medium-sized coronary arteries.Heart Atria: The chambers of the heart, to which the BLOOD returns from the circulation.Catheter Ablation: Removal of tissue with electrical current delivered via electrodes positioned at the distal end of a catheter. Energy sources are commonly direct current (DC-shock) or alternating current at radiofrequencies (usually 750 kHz). The technique is used most often to ablate the AV junction and/or accessory pathways in order to interrupt AV conduction and produce AV block in the treatment of various tachyarrhythmias.Frontal Sinus: One of the paired, but seldom symmetrical, air spaces located between the inner and outer compact layers of the FRONTAL BONE in the forehead.Cardiac Catheterization: Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.Paranasal Sinus Diseases: Diseases affecting or involving the PARANASAL SINUSES and generally manifesting as inflammation, abscesses, cysts, or tumors.Sphenoid Sinus: One of the paired air spaces located in the body of the SPHENOID BONE behind the ETHMOID BONE in the middle of the skull. Sphenoid sinus communicates with the posterosuperior part of NASAL CAVITY on the same side.Dogs: The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)Pacemaker, Artificial: A device designed to stimulate, by electric impulses, contraction of the heart muscles. It may be temporary (external) or permanent (internal or internal-external).Heart Conduction System: An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart.Myocardial Infarction: NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Atrial Fibrillation: Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation.Coronary Thrombosis: Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.Atrioventricular Node: A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart.Electrophysiologic Techniques, Cardiac: Methods to induce and measure electrical activities at specific sites in the heart to diagnose and treat problems with the heart's electrical system.Myocardium: The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow.Sinus Thrombosis, Intracranial: Formation or presence of a blood clot (THROMBUS) in the CRANIAL SINUSES, large endothelium-lined venous channels situated within the SKULL. Intracranial sinuses, also called cranial venous sinuses, include the superior sagittal, cavernous, lateral, petrous sinuses, and many others. Cranial sinus thrombosis can lead to severe HEADACHE; SEIZURE; and other neurological defects.Heart Arrest, Induced: A procedure to stop the contraction of MYOCARDIUM during HEART SURGERY. It is usually achieved with the use of chemicals (CARDIOPLEGIC SOLUTIONS) or cold temperature (such as chilled perfusate).Sick Sinus Syndrome: A condition caused by dysfunctions related to the SINOATRIAL NODE including impulse generation (CARDIAC SINUS ARREST) and impulse conduction (SINOATRIAL EXIT BLOCK). It is characterized by persistent BRADYCARDIA, chronic ATRIAL FIBRILLATION, and failure to resume sinus rhythm following CARDIOVERSION. This syndrome can be congenital or acquired, particularly after surgical correction for heart defects.Atrial Flutter: Rapid, irregular atrial contractions caused by a block of electrical impulse conduction in the right atrium and a reentrant wave front traveling up the inter-atrial septum and down the right atrial free wall or vice versa. Unlike ATRIAL FIBRILLATION which is caused by abnormal impulse generation, typical atrial flutter is caused by abnormal impulse conduction. As in atrial fibrillation, patients with atrial flutter cannot effectively pump blood into the lower chambers of the heart (HEART VENTRICLES).Heart: The hollow, muscular organ that maintains the circulation of the blood.Ethmoid Sinus: The numerous (6-12) small thin-walled spaces or air cells in the ETHMOID BONE located between the eyes. These air cells form an ethmoidal labyrinth.Tachycardia, Sinoatrial Nodal Reentry: Abnormally rapid heartbeats caused by reentry circuit in or around the SINOATRIAL NODE. It is characterized by sudden onset and offset episodes of tachycardia with a HEART RATE of 100-150 beats per minute. The P wave is identical to the sinus P wave but with a longer PR interval.Coronary Restenosis: Recurrent narrowing or constriction of a coronary artery following surgical procedures performed to alleviate a prior obstruction.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).Bundle of His: Small band of specialized CARDIAC MUSCLE fibers that originates in the ATRIOVENTRICULAR NODE and extends into the membranous part of the interventricular septum. The bundle of His, consisting of the left and the right bundle branches, conducts the electrical impulses to the HEART VENTRICLES in generation of MYOCARDIAL CONTRACTION.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Coronary Occlusion: Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS.Electrodes, Implanted: Surgically placed electric conductors through which ELECTRIC STIMULATION is delivered to or electrical activity is recorded from a specific point inside the body.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Atrial Function: The hemodynamic and electrophysiological action of the HEART ATRIA.Cardiac Resynchronization Therapy Devices: Types of artificial pacemakers with implantable leads to be placed at multiple intracardial sites. They are used to treat various cardiac conduction disturbances which interfere with the timing of contraction of the ventricles. They may or may not include defibrillating electrodes (IMPLANTABLE DEFIBRILLATORS) as well.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Percutaneous Coronary Intervention: A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting.Cardiac Catheters: Catheters inserted into various locations within the heart for diagnostic or therapeutic purposes.Tomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Paranasal Sinus Neoplasms: Tumors or cancer of the PARANASAL SINUSES.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Phlebography: Radiographic visualization or recording of a vein after the injection of contrast medium.Tachycardia, Atrioventricular Nodal Reentry: Abnormally rapid heartbeats caused by reentry of atrial impulse into the dual (fast and slow) pathways of ATRIOVENTRICULAR NODE. The common type involves a blocked atrial impulse in the slow pathway which reenters the fast pathway in a retrograde direction and simultaneously conducts to the atria and the ventricles leading to rapid HEART RATE of 150-250 beats per minute.Heart Ventricles: The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.Tachycardia, Supraventricular: A generic expression for any tachycardia that originates above the BUNDLE OF HIS.Prosthesis Implantation: Surgical insertion of a prosthesis.Atrial Septum: The thin membrane-like muscular structure separating the right and the left upper chambers (HEART ATRIA) of a heart.Sinoatrial Node: The small mass of modified cardiac muscle fibers located at the junction of the superior vena cava (VENA CAVA, SUPERIOR) and right atrium. Contraction impulses probably start in this node, spread over the atrium (HEART ATRIUM) and are then transmitted by the atrioventricular bundle (BUNDLE OF HIS) to the ventricle (HEART VENTRICLE).Tachycardia, Sinus: Simple rapid heartbeats caused by rapid discharge of impulses from the SINOATRIAL NODE, usually between 100 and 180 beats/min in adults. It is characterized by a gradual onset and termination. Sinus tachycardia is common in infants, young children, and adults during strenuous physical activities.Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.Coronary Care Units: The hospital unit in which patients with acute cardiac disorders receive intensive care.Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions.Veins: The vessels carrying blood away from the capillary beds.Echocardiography, Transesophageal: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues using a transducer placed in the esophagus.Wolff-Parkinson-White Syndrome: A form of ventricular pre-excitation characterized by a short PR interval and a long QRS interval with a delta wave. In this syndrome, atrial impulses are abnormally conducted to the HEART VENTRICLES via an ACCESSORY CONDUCTING PATHWAY that is located between the wall of the right or left atria and the ventricles, also known as a BUNDLE OF KENT. The inherited form can be caused by mutation of PRKAG2 gene encoding a gamma-2 regulatory subunit of AMP-activated protein kinase.Blood Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.Body Surface Potential Mapping: Recording of regional electrophysiological information by analysis of surface potentials to give a complete picture of the effects of the currents from the heart on the body surface. It has been applied to the diagnosis of old inferior myocardial infarction, localization of the bypass pathway in Wolff-Parkinson-White syndrome, recognition of ventricular hypertrophy, estimation of the size of a myocardial infarct, and the effects of different interventions designed to reduce infarct size. The limiting factor at present is the complexity of the recording and analysis, which requires 100 or more electrodes, sophisticated instrumentation, and dedicated personnel. (Braunwald, Heart Disease, 4th ed)Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Fluoroscopy: Production of an image when x-rays strike a fluorescent screen.Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Heart Failure: A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.Tachycardia, Paroxysmal: Abnormally rapid heartbeats with sudden onset and cessation.Maxillary Sinus Neoplasms: Tumors or cancer of the MAXILLARY SINUS. They represent the majority of paranasal neoplasms.Vasodilator Agents: Drugs used to cause dilation of the blood vessels.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Heart Septum: This structure includes the thin muscular atrial septum between the two HEART ATRIA, and the thick muscular ventricular septum between the two HEART VENTRICLES.Oxygen Consumption: The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346)Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs.Arteriovenous Fistula: An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.Mitral Valve: The valve between the left atrium and left ventricle of the heart.Pulmonary Veins: The veins that return the oxygenated blood from the lungs to the left atrium of the heart.Adenosine: A nucleoside that is composed of ADENINE and D-RIBOSE. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter.Tachycardia, Ectopic Atrial: Abnormally rapid heartbeats originating from one or more automatic foci (nonsinus pacemakers) in the HEART ATRIUM but away from the SINOATRIAL NODE. Unlike the reentry mechanism, automatic tachycardia speeds up and slows down gradually. The episode is characterized by a HEART RATE between 135 to less than 200 beats per minute and lasting 30 seconds or longer.Heart Block: Impaired conduction of cardiac impulse that can occur anywhere along the conduction pathway, such as between the SINOATRIAL NODE and the right atrium (SA block) or between atria and ventricles (AV block). Heart blocks can be classified by the duration, frequency, or completeness of conduction block. Reversibility depends on the degree of structural or functional defects.Electric Countershock: An electrical current applied to the HEART to terminate a disturbance of its rhythm, ARRHYTHMIAS, CARDIAC. (Stedman, 25th ed)Microvascular Angina: ANGINA PECTORIS or angina-like chest pain with a normal coronary arteriogram and positive EXERCISE TEST. The cause of the syndrome is unknown. While its recognition is of clinical importance, its prognosis is excellent. (Braunwald, Heart Disease, 4th ed, p1346; Jablonski Dictionary of Syndromes & Eponymic Diseases, 2d ed). It is different from METABOLIC SYNDROME X, a syndrome characterized by INSULIN RESISTANCE and HYPERINSULINEMIA, that has increased risk for cardiovascular disease.Cardiac Surgical Procedures: Surgery performed on the heart.Dipyridamole: A phosphodiesterase inhibitor that blocks uptake and metabolism of adenosine by erythrocytes and vascular endothelial cells. Dipyridamole also potentiates the antiaggregating action of prostacyclin. (From AMA Drug Evaluations Annual, 1994, p752)Pilonidal Sinus: A hair-containing cyst or sinus, occurring chiefly in the coccygeal region.Equipment Design: Methods of creating machines and devices.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body.Cardiac Resynchronization Therapy: The restoration of the sequential order of contraction and relaxation of the HEART ATRIA and HEART VENTRICLES by atrio-biventricular pacing.Vascular Resistance: The force that opposes the flow of BLOOD through a vascular bed. It is equal to the difference in BLOOD PRESSURE across the vascular bed divided by the CARDIAC OUTPUT.Ventricular Function, Left: The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance.Tachycardia: Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia.Ultrasonography, Interventional: The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.Extracorporeal Circulation: Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation.Collateral Circulation: Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.Angina, Stable: Persistent and reproducible chest discomfort usually precipitated by a physical exertion that dissipates upon cessation of such an activity. The symptoms are manifestations of MYOCARDIAL ISCHEMIA.Recurrence: The return of a sign, symptom, or disease after a remission.Mitral Valve Annuloplasty: A type of heart valve surgery that involves the repair, replacement, or reconstruction of the annulus of the MITRAL VALVE. It includes shortening the circumference of the annulus to improve valve closing capacity and reinforcing the annulus as a step in more complex valve repairs.Vasodilation: The physiological widening of BLOOD VESSELS by relaxing the underlying VASCULAR SMOOTH MUSCLE.Transverse Sinuses: The two large endothelium-lined venous channels that begin at the internal occipital protuberance at the back and lower part of the CRANIUM and travels laterally and forward ending in the internal jugular vein (JUGULAR VEINS). One of the transverse sinuses, usually the right one, is the continuation of the SUPERIOR SAGITTAL SINUS. The other transverse sinus is the continuation of the straight sinus.Calcinosis: Pathologic deposition of calcium salts in tissues.Heart Rate: The number of times the HEART VENTRICLES contract per unit of time, usually per minute.Ventricular Dysfunction, Left: A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.Coronary Artery Bypass, Off-Pump: Coronary artery bypass surgery on a beating HEART without a CARDIOPULMONARY BYPASS (diverting the flow of blood from the heart and lungs through an oxygenator).Vascular Fistula: An abnormal passage between two or more BLOOD VESSELS, between ARTERIES; VEINS; or between an artery and a vein.Swine: Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Angina, Unstable: Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.Myocardial Revascularization: The restoration of blood supply to the myocardium. (From Dorland, 28th ed)Tricuspid Valve: The valve consisting of three cusps situated between the right atrium and right ventricle of the heart.Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.Superior Sagittal Sinus: The long large endothelium-lined venous channel on the top outer surface of the brain. It receives blood from a vein in the nasal cavity, runs backwards, and gradually increases in size as blood drains from veins of the brain and the DURA MATER. Near the lower back of the CRANIUM, the superior sagittal sinus deviates to one side (usually the right) and continues on as one of the TRANSVERSE SINUSES.Aortic Aneurysm: An abnormal balloon- or sac-like dilatation in the wall of AORTA.Cardioplegic Solutions: Solutions which, upon administration, will temporarily arrest cardiac activity. They are used in the performance of heart surgery.Myocardial Contraction: Contractile activity of the MYOCARDIUM.Arrhythmias, Cardiac: Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction.Perfusion: Treatment process involving the injection of fluid into an organ or tissue.Stroke Volume: The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.Nitroglycerin: A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.Endocardium: The innermost layer of the heart, comprised of endothelial cells.Multidetector Computed Tomography: Types of spiral computed tomography technology in which multiple slices of data are acquired simultaneously improving the resolution over single slice acquisition technology.Femoral Vein: The vein accompanying the femoral artery in the same sheath; it is a continuation of the popliteal vein and becomes the external iliac vein.Angina Pectoris: The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.Models, Cardiovascular: Theoretical representations that simulate the behavior or activity of the cardiovascular system, processes, or phenomena; includes the use of mathematical equations, computers and other electronic equipment.Anabolic Agents: These compounds stimulate anabolism and inhibit catabolism. They stimulate the development of muscle mass, strength, and power.Sensitivity and Specificity: Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components.Platelet Aggregation Inhibitors: Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.Heart Defects, Congenital: Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.Lactates: Salts or esters of LACTIC ACID containing the general formula CH3CHOHCOOR.Pericardium: A conical fibro-serous sac surrounding the HEART and the roots of the great vessels (AORTA; VENAE CAVAE; PULMONARY ARTERY). Pericardium consists of two sacs: the outer fibrous pericardium and the inner serous pericardium. The latter consists of an outer parietal layer facing the fibrous pericardium, and an inner visceral layer (epicardium) resting next to the heart, and a pericardial cavity between these two layers.Myocardial Perfusion Imaging: The creation and display of functional images showing where the blood is flowing into the MYOCARDIUM by following over time the distribution of tracers injected into the blood stream.Vascular Malformations: A spectrum of congenital, inherited, or acquired abnormalities in BLOOD VESSELS that can adversely affect the normal blood flow in ARTERIES or VEINS. Most are congenital defects such as abnormal communications between blood vessels (fistula), shunting of arterial blood directly into veins bypassing the CAPILLARIES (arteriovenous malformations), formation of large dilated blood blood-filled vessels (cavernous angioma), and swollen capillaries (capillary telangiectases). In rare cases, vascular malformations can result from trauma or diseases.Heart Septal Defects, Atrial: Developmental abnormalities in any portion of the ATRIAL SEPTUM resulting in abnormal communications between the two upper chambers of the heart. Classification of atrial septal defects is based on location of the communication and types of incomplete fusion of atrial septa with the ENDOCARDIAL CUSHIONS in the fetal heart. They include ostium primum, ostium secundum, sinus venosus, and coronary sinus defects.Echocardiography, Doppler, Color: Echocardiography applying the Doppler effect, with the superposition of flow information as colors on a gray scale in a real-time image.Mitral Valve Insufficiency: Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation.Echocardiography, Doppler: Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells.Stellate Ganglion: A paravertebral sympathetic ganglion formed by the fusion of the inferior cervical and first thoracic ganglia.Cardiomyopathy, Dilated: A form of CARDIAC MUSCLE disease that is characterized by ventricular dilation, VENTRICULAR DYSFUNCTION, and HEART FAILURE. Risk factors include SMOKING; ALCOHOL DRINKING; HYPERTENSION; INFECTION; PREGNANCY; and mutations in the LMNA gene encoding LAMIN TYPE A, a NUCLEAR LAMINA protein.Diverticulum: A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT.Arterio-Arterial Fistula: Abnormal communication between two ARTERIES that may result from injury or occur as a congenital abnormality.Contrast Media: Substances used to allow enhanced visualization of tissues.Chest Pain: Pressure, burning, or numbness in the chest.Diastole: Post-systolic relaxation of the HEART, especially the HEART VENTRICLES.Cardiovascular Surgical Procedures: Surgery performed on the heart or blood vessels.Device Removal: Removal of an implanted therapeutic or prosthetic device.Regional Blood Flow: The flow of BLOOD through or around an organ or region of the body.Myocardial Reperfusion Injury: Damage to the MYOCARDIUM resulting from MYOCARDIAL REPERFUSION (restoration of blood flow to ischemic areas of the HEART.) Reperfusion takes place when there is spontaneous thrombolysis, THROMBOLYTIC THERAPY, collateral flow from other coronary vascular beds, or reversal of vasospasm.Heart Diseases: Pathological conditions involving the HEART including its structural and functional abnormalities.Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Atrioventricular Block: Impaired impulse conduction from HEART ATRIA to HEART VENTRICLES. AV block can mean delayed or completely blocked impulse conduction.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs.Dextrocardia: A congenital defect in which the heart is located on the right side of the THORAX instead of on the left side (levocardia, the normal position). When dextrocardia is accompanied with inverted HEART ATRIA, a right-sided STOMACH, and a left-sided LIVER, the combination is called dextrocardia with SITUS INVERSUS. Dextrocardia may adversely affect other thoracic organs.Exercise Test: Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.Anti-Arrhythmia Agents: Agents used for the treatment or prevention of cardiac arrhythmias. They may affect the polarization-repolarization phase of the action potential, its excitability or refractoriness, or impulse conduction or membrane responsiveness within cardiac fibers. Anti-arrhythmia agents are often classed into four main groups according to their mechanism of action: sodium channel blockade, beta-adrenergic blockade, repolarization prolongation, or calcium channel blockade.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Acetylcholine: A neurotransmitter found at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system.Cardiac Electrophysiology: The study of the electrical activity and characteristics of the HEART; MYOCARDIUM; and CARDIOMYOCYTES.Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic.Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.Tachycardia, Ventricular: An abnormally rapid ventricular rhythm usually in excess of 150 beats per minute. It is generated within the ventricle below the BUNDLE OF HIS, either as autonomic impulse formation or reentrant impulse conduction. Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide QRS complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (AV dissociation).Balloon Occlusion: Use of a balloon CATHETER to block the flow of blood through an artery or vein.Lactic Acid: A normal intermediate in the fermentation (oxidation, metabolism) of sugar. The concentrated form is used internally to prevent gastrointestinal fermentation. (From Stedman, 26th ed)Atrial Function, Right: The hemodynamic and electrophysiological action of the RIGHT ATRIUM.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.Sinus Arrest, Cardiac: The omission of atrial activation that is caused by transient cessation of impulse generation at the SINOATRIAL NODE. It is characterized by a prolonged pause without P wave in an ELECTROCARDIOGRAM. Sinus arrest has been associated with sleep apnea (REM SLEEP-RELATED SINUS ARREST).Adrenergic beta-Antagonists: Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety.Electrophysiology: The study of the generation and behavior of electrical charges in living organisms particularly the nervous system and the effects of electricity on living organisms.Oxygen: An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration.Equipment Failure: Failure of equipment to perform to standard. The failure may be due to defects or improper use.Atrial Appendage: Ear-shaped appendage of either atrium of the heart. (Dorland, 28th ed)Cerebral Veins: Veins draining the cerebrum.Postoperative Period: The period following a surgical operation.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing MYOCARDIAL REPERFUSION INJURY.Imaging, Three-Dimensional: The process of generating three-dimensional images by electronic, photographic, or other methods. For example, three-dimensional images can be generated by assembling multiple tomographic images with the aid of a computer, while photographic 3-D images (HOLOGRAPHY) can be made by exposing film to the interference pattern created when two laser light sources shine on an object.Heart Valve Prosthesis Implantation: Surgical insertion of synthetic material to repair injured or diseased heart valves.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Refractory Period, Electrophysiological: The period of time following the triggering of an ACTION POTENTIAL when the CELL MEMBRANE has changed to an unexcitable state and is gradually restored to the resting (excitable) state. During the absolute refractory period no other stimulus can trigger a response. This is followed by the relative refractory period during which the cell gradually becomes more excitable and the stronger impulse that is required to illicit a response gradually lessens to that required during the resting state.Defibrillators, Implantable: Implantable devices which continuously monitor the electrical activity of the heart and automatically detect and terminate ventricular tachycardia (TACHYCARDIA, VENTRICULAR) and VENTRICULAR FIBRILLATION. They consist of an impulse generator, batteries, and electrodes.Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx).Cardiomyopathies: A group of diseases in which the dominant feature is the involvement of the CARDIAC MUSCLE itself. Cardiomyopathies are classified according to their predominant pathophysiological features (DILATED CARDIOMYOPATHY; HYPERTROPHIC CARDIOMYOPATHY; RESTRICTIVE CARDIOMYOPATHY) or their etiological/pathological factors (CARDIOMYOPATHY, ALCOHOLIC; ENDOCARDIAL FIBROELASTOSIS).Cardiovascular Agents: Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.Phentolamine: A nonselective alpha-adrenergic antagonist. It is used in the treatment of hypertension and hypertensive emergencies, pheochromocytoma, vasospasm of RAYNAUD DISEASE and frostbite, clonidine withdrawal syndrome, impotence, and peripheral vascular disease.

Coronary artery fistula from the left circumflex to the coronary sinus. (1/174)

A 27-year-old woman, who had received mitral valve repair for mitral regurgitation resulting from infective endocarditis, was admitted for a close examination of abnormal echocardiographic findings in the left atrium. Transthoracic echocardiography showed trivial mitral regurgitation with normal left ventricular contraction and dilatation of the coronary sinus. Auscultation revealed a grade 2 continuous murmur along the left sternal border. Transesophageal echocardiography demonstrated a marked dilatation of the coronary sinus just behind the posterior wall of the left atrium and turbulent blood flow in the dilated coronary sinus. Cardiac catheterization showed no significant step-up of oxygen saturation in the right heart and normal pulmonary artery pressure. Coronary angiography revealed a markedly dilated and tortuous circumflex coronary artery connected to the coronary sinus through a fistula. A left circumflex artery with a fistulous connection to the coronary sinus is extremely rare.  (+info)

Thoracic vein arrhythmias. (2/174)

The thoracic veins are important foci for the genesis of ectopic atrial tachycardia and play a critical role in the pathophysiology of paroxysmal and permanent atrial fibrillation. The pulmonary veins have the highest arrhythmogenic activity and other venous structures (eg, superior vena cava, coronary sinus and ligament of Marshall) have also been shown arrhythmogenic potential. Thoracic veins contain cardiomyocytes with distinct electrical activities and complex anatomical structures. This review summaries the current understanding of the basic and clinical electrophysiology of thoracic vein arrhythmias.  (+info)

Catheter ablation therapy for atrial fibrillation: current advancements in strategies. (3/174)

Curing atrial fibrillation (AF) by catheter ablation has significantly improved patient morbidity and mortality. The circumferential pulmonary vein isolation technique is established as the principal procedure, with a high cure rate and acceptable safety, for paroxysmal AF, but new adjunctive ablation strategies targeting the AF substrates and sources for long-standing persistent/chronic AF have been developed. These new techniques include linear ablation, complex fractionated atrial electrogram guided ablation, dominant frequency map-guided ablation, ganglionated plexi ablation and disconnection of the coronary sinus and superior vena cava to ablate the AF substrates and sources. The long-term usefulness of the established technique and these innovative adjunctive approaches for the treatment of AF remains to be investigated.  (+info)

A novel technique for placement of coronary sinus pacing leads in cardiac resynchronization therapy. (4/174)

A new technique for the placement of left ventricular pacing leads in the tributaries of the coronary sinus (CS) is described. Antegrade visualization of the CS is accomplished by selective coronary angiography, and a hydrophilic 0.032 in. wire is advanced along the CS. This facilitates the advancement of a CS sheath over a multipurpose diagnostic catheter. A hydrophilic angioplasty wire is then utilized for the negotiation of the inferior left ventricular vein and successful placement of the left ventricular pacing lead.  (+info)

Stabilization of the coronary sinus lead position with permanent stylet to prevent and treat dislocation. (5/174)

AIMS: Coronary sinus (CS) leads used for cardiac resynchronization have undergone development in the last years. However, dislocation rate remained high. We explain a simple method to stabilize the CS lead position. METHODS AND RESULTS: Thirty-five patients (11 females, aged 60 +/- 9.2 years) were treated with this method. An over-the-wire left ventricular (LV) pacing lead system was introduced and lodged in the vessel. Then, a stiff stylet was inserted and kept into the CS lead and end of the stylet was cut by a scissor (permanent stylet technique). Pacing and sensing properties of all leads were checked and the guiding sheath was removed. Control echocardiography did not show pericardial effusion. The mean LVpacing threshold was 1.2 +/- 0.8 V and the mean impedance was 625 +/- 143 Omega at the implantation. During follow-up (12.5 +/- 2.5 months), there were no statistically significant changes in pacing threshold and impedance when compared with the implantation measurements. At the last patient visit, the mean LV pacing threshold was 1.1 +/- 0.8 V and the mean impedance was 620 +/- 140 Omega. Impedance measurements did not suggest lead insulation failure. No LV lead dislocations were detected in our 35 cases during the follow-up. CONCLUSION: Permanent stylet technique seems to be a safe and effective procedure to stabilize CS lead position as demonstrated by our 1-year long follow-up results.  (+info)

A novel method of multisite atrial pacing, incorporating Bachmann's bundle area and coronary sinus ostium, for electrical atrial resynchronization in patients with recurrent atrial fibrillation. (6/174)

AIMS: The aim of the study was to assess efficacy and safety of a novel method of multisite atrial pacing, incorporating Bachmann's bundle (BB) and coronary sinus (CS) ostium pacing, which was implemented for the first time in atrial fibrillation (AF) patients with intra-atrial conduction delay. METHODS AND RESULTS: This follow-up study included 97 patients with drug refractory symptomatic AF, sinus node dysfunction, sinus P-wave > or = 120 ms, and normal atrioventricular conduction. Pacing efficacy was assessed on the basis of two main endpoints: successful rhythm control and the absence of documented or symptomatic AF. During the mean 2.3 +/- 0.7 years of follow-up, the survival rate was 99%, pacing maintenance rate 97%, and the need for re-operation 5%. Rhythm control efficacy was 90%, and 14 patients had no evidence of recurrent AF. After implantation, the mean number of anti-arrhythmic drugs used (P < 0.0001), the need for cardioversion (P < 0.01), and the incidence (P < 0.0001) and duration (P < 0.001) of AF-related hospitalizations decreased. P-wave duration with multisite atrial pacing was shorter than during sinus rhythm, BB, and CS pacing (P < 0.0001). CONCLUSION: A novel method of multisite atrial pacing is safe, provides effective long-term rhythm control, and decreases the necessity for adjunctive therapies in patients with refractory AF and intra-atrial conduction delay.  (+info)

Anatomic relations of the Marshall vein: importance for catheterization of the coronary sinus in ablation procedures. (7/174)

AIMS: Our objective was to study the anatomic relations of the human left atrial oblique vein (Marshall vein), particularly of its ostium opening into the coronary sinus, in order to guide ablation procedures related to that vein. METHODS AND RESULTS: The study was carried out in 23 heart-specimens (mean weight 446 +/- 204 g) of individuals whose mean ages were 43 +/- 21 years, 20 males. The coronary sinus was opened longitudinally, exposing the ostium of the tributary veins; the Vieussens valve was looked for, as well as its relationship to the left atrial oblique vein. The diameters of the left atrial oblique vein and the coronary sinus ostia were measured and the distance between them was determined. The left atrial oblique vein could be identified in 20 (87%) of the hearts, while the Vieussens valve was present in 17 (74%) of the specimens (in 16 of which the left atrial oblique vein was identified). In such condition, the vein was adjacent to the Vieussens valve and proximally positioned relative to the coronary sinus ostium in most of them (14/16 cases). The mean diameters of the left atrial oblique vein and of the coronary sinus ostia were, respectively, 1.23 +/- 0.38 and 8.22 +/- 1.88 mm. The mean distance between both ostia was 30.9 +/- 10.2 mm. CONCLUSION: When present, the left atrial oblique vein can be easily recognized, adjacent to the Vieussens valve. The mean distance between the coronary sinus opening and left atrial oblique vein ostium was around 30 mm, independently of the heart weight and the presence of cardiomegaly.  (+info)

Functional bundle branch block and orthodromic reciprocating tachycardia cycle length: do not bet on accessory pathway location. (8/174)

AIMS: To show 2 examples in which the analysis of the effect of bundle branch block on orthodromic reciprocating tachycardia cycle length was misleading. METHODS AND RESULTS: We performed an electrophysiological study in two patients with orthodromic reciprocating tachycardia showing a transition from wide to narrow QRS during tachycardia. Our two cases of left bundle branch block during reciprocating tachycardia using infero-septal pathways show that ventricular to atrial conduction time prolongation may be larger than 30 ms and may be concealed by a shortening of atrial to ventricular conduction time. In the 2 cases, the atrial insertion of the accessory pathway could be successfully ablated from the right atria at the ostium of the coronary sinus. CONCLUSIONS: The observation of the association between left bundle branch block and cycle length prolongation during reciprocating tachycardia may be associated with a successful ablation at the ostium of the coronary sinus.  (+info)

New life-saving treatments for Coronary artery disease in clinical trial on Assessment of Global Myocardial Perfusion Reserve Using Coronary Sinus Flow Measurements
Abstract. Expanded indications for cardiac resynchronization therapy and the increasing incidence of cardiac implantable electronic device infection have led to an increased need for coronary sinus (CS) lead extraction. The CS presents unique anatomical obstacles to successful lead extraction. Training and facility requirements for CS lead extraction should mirror those for other leads. Here we review the indications, technique, and results of CS lead extraction. Published success rates and complications are similar to those reported for other leads, although multiple techniques may be required. Re-implantation options may be limited, which should be incorporated into pre-procedural decision making.. Link to abstract on PubMed. ...
Sudden occlusion of the left anterior descending branch approximately 2 cm. below the ostium of the left circumflex coronary artery in the dogs heart produces a mortality rate of approximately 50 per cent. In dogs weighing approximately 15 kilos surviving more than 24 hours (average 1 week), an infarction is produced which almost invariably measures 5 x 5 cm. on surface. Following coronary sinus obturation such secondary sudden occlusion of the left anterior descending branch is followed either by no infarction or by a reduction in the size of the infarct. The success of the procedure, quite apart from the mortality rate, depends upon the completeness of the coronary sinus obturation. On the other hand, sudden and complete coronary sinus obturation by itself is associated with a high operative mortality and apparently does not affect the mortality rate following subsequent sudden left anterior descending branch occlusion. Partial persistent obturation of the coronary sinus, however, is in ...
A catheter-based method for coronary sinus mapping, pacing, and ablation, wherein a flexible electrode catheter, having a tip electrode with suspension structure, is pre-shaped to snugly fit into the coronary sinus, so that the tip electrode is positioned into the sinus; the distal section is deflected to expose a predetermined plurality of electrodes; and RF energy is then applied to the coronary sinus tissue through the electrodes to cause activation mapping, and/or ablation.
A coronary sinus catheter for the retrograde infusion of cardioplegia solutions into the coronary sinus. The catheter is adapted for improved retention in the coronary sinus. The catheter comprises a catheter tube having infusion, pressure-sensing and balloon-inflation lumens, an inflatable balloon and a pressure sensor tube in fluid communication with the balloon-inflation lumen for sensing pressure in the inflatable balloon. The internal volume of the pressure sensor tube is relatively non-expansible relative to the internal volume of the inflation balloon in normal operation of the catheter. The balloon includes a plurality of segmented annular ribs.
... ,Biosense Webster is the source for a complete line of diagnostic coronary sinus catheters for left-sided mapping - all with the quality, reliability and precise performance youve come to expect from the leader in catheter technology. All of our coronary sinus catheters are specifically designed an,medicine,medical supply,medical supplies,medical product
Biventricular pacing is a validated treatment for patients suffering from heart failure resistant to medical treatment. However, up to 30% of the patients are non responsive to this strategy using the coronary sinus approach to pace the Left Ventricle (LV).. It has been demonstrated that the magnitude of the improvement was highly dependant on the LV pacing site. The coronary sinus approach rarely offers more than 1 or 2 potential pacing sites. Resynchronisation using a transeptal approach to pace the left ventricle on the cardiology has been shown feasible on small series. We therefore would like to compare these two approached in a randomised prospective study to confirm the hypotheses that endocardial LV pacing by offering multiple choices for the pacing sites reduces the number of non responders and is associated with greater hemodynamic benefit when compared to the conventional coronary sinus approach. ...
To establish whether pressure-volume areas (PVAs) calculated using the maximum time-varying elastance (Emax) have a relation with myocardial oxygen consumption (MVO2) that improves on other indexes of myocardial oxygen demand, we studied nine dogs of either sex weighing 19-39 kg, which were instrumented with a micromanometer left ventricular (LV) catheter and a Wilton-Webster coronary sinus flow catheter and had red blood cells tagged with technetium-99m for radionuclide angiography. Hemodynamics, coronary sinus flow determinations, and radionuclide angiograms were obtained under control conditions and during three to five steady-state loading conditions (mean +/- SD, 5.6 +/- 0.7). Isochronal pressure-volume data points from each pressure-volume loop were subjected to linear regression analysis to calculate Emax. The Emax relations, diastolic curves, and systolic portions of each pressure-volume loop were used to obtain calibrated PVAs. The Emax PVA (mm Hg.ml.beat-1.100 g-1) and MVO2 (ml ...
Pacemaker Pacemaker P-0 Frenik sinir stimülasyonuna neden olan koroner sinüs leadinin femoral yoldan repozisyonu Fethi Kılıçaslan, Ömer Uz, Alptuğ Tokatlı, Zafer Işılak, Mehmet Uzun, Bekir Yılmaz Cingözbay,
Significance of jet lavage for in vitro and in vivo cement penetration. These guidewires allow the lead to advance easily to the coronary sinus branches. Column в size l0. See BCSC Section 4, Ophthalmic Buy Ladygra and Intraocular Tumors, for more details of the features Buy Ladygra cellular atypia and neoplastic change.
A device for treatment of mitral annulus dilatation comprises an elongate body having two states. In a first of these states the elongate body is insertable into the coronary sinus and has a shape adapting to the shape of the coronary sinus. When positioned in the coronary sinus, the elongate body is transferable to the second state assuming a reduced radius of curvature, whereby the radius of curvature of the coronary sinus and the radius of curvature as well as the circumference of the mitral annulus is reduced.
... definition, a large venous channel in the heart wall that receives blood via the coronary veins and empties into the right atrium. See more.
Miracor Medical Systems out of Vienna, Austria has announced that its Pressure-controlled Intermittent Coronary Sinus Occlusion (PICSO) Impulse System has
If the error occurs frequently, request an RMA in order to replace the 6148A module, and mark the module for EFA.%LTL-SP-2-LTL_PARITY_CHECK: LTL parity check request for 0x[hex]ExplanationThis is the result of The outputs of the atrial and ventricular sensing circuits, 82 and 84, are connected to the microcontroller 60 which, in turn, are able to trigger or inhibit the atrial and ventricular No. 4,788,980 (Mann et al.). See the illustration on the side access panel for the correct memory configurations, and reseat the DIMMs accordingly. 216-Memory Size Exceeds Maximum Supported The amount of memory installed exceeds that supported The error is thus corrected and processing returns to FIG. 3. As used herein, the phrase "coronary sinus region" refers to the vasculature of the left ventricle, including any portion of the coronary sinus, great cardiac vein, left marginal vein, left posterior The switch was still under warranty from the used hardware > reseller, so the blade was replaced. Imprecise ...
Synonyms for cardiac veins, smallest in Free Thesaurus. Antonyms for cardiac veins, smallest. 63 synonyms for vein: blood vessel, mood, style, spirit, way, turn, note, key, character, attitude, atmosphere, tone, manner, bent, stamp, humour, tendency.... What are synonyms for cardiac veins, smallest?
The function of the small cardiac vein is to retrieve blood from the vascular tissues of the heart and drain them into the coronary sinuses, according to anatomyExpert. This process ensures that the...
But theres always one point of a surgical procedure that grabs the doctors gonads, and for device implants, its usually gaining access to the blood vessel where the leads for a pacemaker or defibrillator are to be implanted. You see, poke too deeply, you might hit the patients lung. Poke a half a centimeter higher toward the patients head, you might hit the high-pressure artery rather than the low pressure vein and bleeding will compress the target vein, making it very difficult to cannulate. Dont poke deeply enough, you never get in the vessel. Thats the way these procedures go. (Ive already mentioned that I cheat and use a vascular ultrasound device to find the vessel. I mean, why stress, right ...
Find right answers right now! How would you trace blood from the small cardiac vein to the posterior inter ventricular artery? More questions about Health, how
The appearance of the proximal descending aorta reflects an aortic spindle - this is an anatomical variant where there is a smooth, mild bulge just beyond the aortic isthmus.
This is generally performed subsequent to RV lead placement, with the RV lead providing a backup in case of accidental damage to the electric fibers of the heart, causing an asystolic event. As with the RV lead, a guide wire is first inserted, allowing for the insertion of a multi-delivery catheter. The catheter is subsequently maneuvered to the opening of the coronary sinus in the right atrium. From here a contrast media is injected, allowing the surgical team to obtain a coronary sinus phleobogram to direct the placement of the lead into the most suitable coronary vein.[1]. Once the phlebogram has been obtained, the multi-delivery catheter is used to guide in the lead, from the chosen vein of entry, into the right atrium, through the coronary sinus and into the relevant cardiac vein.[1]. Left ventricular lead placement is the most complicated and potentially hazardous element of the operation, due to the significant variability of coronary venous structure. Alterations in heart structure, ...
Heart failure patients with left ventricular (LV) ejection fractions of ,35% who are on optimal medical therapy with QRS durations of ≥120 ms on surface electrocardiography have derived clinical benefit from cardiac resynchronization therapy (CRT). Although this well-established and guideline-recommended treatment has shown reductions in heart failure progression and risk for ventricular tachyarrhythmias, there are also shortcomings. Nearly one-third of patients with CRT implants fail to show clinical benefit. Although potential explanations for the lack of response to CRT may be multifactorial, one of the most important prerequisites for successful CRT is proper LV lead placement. And that can be technically challenging.. LV lead placement to deliver CRT typically involves cannulating the coronary sinus, performing coronary venous angiography, selecting a target vein, and advancing the pacing lead into the selected vein to achieve adequate resynchronization. Although it is still an evolving ...
Dynamic Coronary Roadmap (DCR) is a navigation support package that allows the users to see a roadmap of the coronary anatomy displayed on live fluoroscopy. By comparing moving structures that are present in both the angiogram and the live fluoroscopy images, with image registration techniques, DCR provides a precise overlay of the coronary vessel tree on top of the live fluoroscopy moving exactly with the cardiac and breathing motion. This same technique can also be used for imaging the coronary venous anatomy for guiding left ventricular lead placement. ...
Looking for online definition of cardiac vein, middle in the Medical Dictionary? cardiac vein, middle explanation free. What is cardiac vein, middle? Meaning of cardiac vein, middle medical term. What does cardiac vein, middle mean?
Ablation instruments and techniques are disclosed for accessing portions of the heart wall via the coronary sinus. While shielding the major portion of the sinus and/or the circumflex coronary artery from ablative energy, the present invention provides access to the heart wall to treat atrial fibrillation. In particular, the present invention provides instruments and methods for forming transmural lesions in the left atrium, such as the so-called
An implantable defibrillation lead with steerable characteristics, allowing the lead to be more easily placed within the coronary sinus. The lead comprises an elongated lead body having a proximal end and a distal end. Adjacent the distal end, there is an electrode, preferably a coiled defibrillation electrode placed on the exterior of the elongated lead body. The distal end of the lead body has a permanent set or bend. A torque tube, extending through a lumen in the lead body from the proximal end of the lead to an anchor block adjacent the distal end of the lead, can be rotated by a physician to orient the bend in the lead. A cable passes through the torque tube from the proximal end of the lead through the anchor block to the distal end of the lead. This cable is affixed to a wall of the lumen, preferably in the direction of the bend. Pulling on the cable temporarily changes the bend in the distal end of the lead.
All studies were performed in the electrophysiology laboratory. Patients were premedicated with meperidine or diazepam before the procedure. All antiarrhythmic drugs were discontinued for a minimum of five drug half-lives before the procedure. Standard multipolar catheters with 1-cm interelectrode distance were used for pacing and recording of intracardiac electrograms. These were positioned at the high right atrium, His bundle and right ventricular apex. A fourth catheter was positioned in the coronary sinus with one of the electrodes located at the coronary sinus ostium. Stimulation was performed with rectangular impulses using an EP-2 stimulator (EP Medical Inc.). A standard multichannel recorder was used for hardcopy recording. Three surface electrocardiographic (ECG) leads (I, aVF and V1) were recorded at all times. The intracardiac signals were filtered at a bandpass of 30 to 500 Hz and stored on FM tape. The pacing threshold was determined at the high right atrium and coronary sinus ...
A system and method for navigating coronary vasculature involves use of a guide catheter system which includes a guide catheter, a navigator catheter longitudinally displaceable within the guide catheter, and a deflection arrangement provided at a distal end of the navigator catheter. The guide catheter is advanced to at least a patients coronary sinus ostium, and the navigator catheter is extended from the guide catheter to a location proximate or within an angled vein distal to the coronary sinus ostium. Using the deflection arrangement, a guide wire passing through the navigation catheter is directed into the angled vein. A lead having an open lumen is advanced over the guide wire to direct the lead to an implant site within the angled vein.
Definition of thebesian circulation. Provided by Stedmans medical dictionary and Drugs.com. Includes medical terms and definitions.
A sinus ostium is the opening that connects a sinus to the nasal cavity itself. It is a tight area that tends to have a higher percentage of cilia than the surrounding mucosa. If the sinus ostium is blocked this will cause an accumulation of fluid in the sinus ...
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My anesthesiologist placed a coronary sinus catheter. I rarely see this when I code, so I am stuck on which CPT code to use. Any good cardiac coders w
CONGENITAL anomalies of the great veins of the neck are relatively infrequent. Persistent left superior vena cava (PLSVC) is an embryologic remnant of the left superior cardinal vein seen in 0.1 to 0.3% of healthy adults.1 PLSVC runs between the left pulmonary veins and the left atrial appendage enlarging the coronary sinus as it enters the atrium. When present, it can affect placement of central catheters, pacemakers, and cardiopulmonary bypass. It is important to be aware of this variation and to recognize it in imaging studies ...
© 2016 American College of Cardiology Foundation. Published by Elsevier. Objectives The goal of this study was to assess the contemporary and historical success rates of transvenous left ventricular (LV) lead placement for cardiac resynchronization therapy (CRT), their change over time, and the reasons for failure. Background In selected patients, CRT improves morbidity and mortality, but the placement of the LV lead can be technically challenging. Methods A literature search was used to identify all studies reporting success rates of LV lead placement for CRT via the coronary sinus (CS) route. A total of 164 studies were identified, and a meta-analysis was performed. Results The studies included 29,503 patients: 74% (95% confidence interval [CI]: 72% to 76%) were male; their mean age was 66 years (95% CI: 65 to 67); their mean New York Heart Association functional class was 2.8 (95% CI: 2.7 to 2.9); the mean LV ejection fraction was 26% (95% CI: 25% to 28%); and the mean QRS duration was 155 ms (95%
Mitral isthmus ablation forms part of the electrophysiologists armoury in the catheter ablation treatment of atrial fibrillation. It is well recognised however, that mitral isthmus ablation is technically challenging and incomplete ablation may be pro-arrhythmic, leading some to question its role. This article first reviews the evidence for the use of adjunctive mitral isthmus ablation and its association with the development of macroreentrant perimitral flutter. It then describes the practical techniques of mitral isthmus ablation, with particular emphasis on the assessment of bi-directional mitral isthmus block. The anatomy of the mitral isthmus is also discussed in order to understand the possible obstacles to successful ablation. Finally, novel techniques which may facilitate mitral isthmus ablation are reviewed.
Although CRT is now an accepted therapeutic modality for patients with HF and conduction disturbances, a significant proportion of patients remain nonresponders.1 Our study shows that LV lead location may be a significant contributor to this nonresponsiveness and that pacing the apical region of the LV is associated with a worse clinical outcome, including significantly higher mortality rates. Our results also demonstrate that LV lead location along the short axis (ie, anterior, lateral, or posterior wall) does not influence the primary end points of HF hospitalization and all-cause mortality. This is the first study from a randomized clinical trial to examine the impact of LV lead location on clinical outcome in which venous angiography and LV lead position data were collected prospectively and evaluated independently.. Prior work has recommended that targeting the lateral or posterolateral wall by way of either an appropriate coronary sinus branch or surgical (epicardial) placement is a ...
For patients with advanced heart failure, Cardiac Resynchronization Therapy (CRT) has been a major improvement. The treatment improves symptoms and prolongs life in selected patients with heart failure. However, with the current selection criteria and methods for implanting the pacemaker, only 60-70% of the patients derive significant benefit from the treatment.. New imaging techniques, including advanced ultrasound and computed tomography, in combination with new versatile multi-pole electrodes, have made an individually tailored therapy possible. Using these techniques in combination, the study will investigate the effect of individually based optimal placement of the pacemaker electrodes vs. standard care. The optimal LV electrode position is defined as pacing a viable segment with the latest mechanical delay, targeting a specific segment of the coronary sinus as visualised on cardiac CT. The hypothesis is that this will increase the number of positive responders from 65% to 85%. ...
A 6 month od baby with Wolfgang-Gollop syndrome was catheterized before surgery for tetralogy of Fallot. Echocardiography had revealed bilateral superior vena cava with LSVC draining into a dilated coronary sinus. In order to assess the need for canulating or ligating the persistent left superior vena cava (LSVC) at time of surgery, we inserted an 5 Fr end-hole catheter into the LSVC via the right atrium and coronary sinus. It was then advanced into the left azygos vein and angiography performed. A large communicating vein connecting the 2 asygos veins was seen beind the heart. Persistent LSVC has been described in tetralogy of Fallot. In our case, although no classical communicating wein could be found by echocardiography, selective angiography revealed a peculiar communication between bilateral azygos veins. The baby underwent successful surgical repair with no need for left superior vena cava cannulation during cardiopulmonary bypass ...
Definition: In PLSVC, the left brachiocephalic vein does not develop fully and the left upper limb and head & neck drain into the right atrium via the coronary sinus. However, from a morphological point of view, the "anatomical" drainage of a persistent left superior vena cava is always into the coronary sinus. ...
Asymmetric ventricles , with left ventricle smaller than right is seen occasionally. The following conditions should be thought of : 1. Co-arctation of Aorta 2. T.A.P.V.D. - Total Anomalous Pulmonary Venous Drainage ( or Connections ) 3.Persistent Left Superior Vena Cava 4.Dilated Coronary Sinus and rarely due to 5. Restricted Ductal Flow due to kinking…
An assembly and method for effecting the condition of a mitral valve annulus of a heart includes a guide wire configured to be fed into the coronary sinus of the heart, and a mitral valve annulus therapy device configured to be slidingly received on the guide wire and advanced into the coronary sinus of the heart on the guide wire. A guide tube may further be employed for guiding the device into the coronary sinus. An introducer which may be employed for pushing the device into or pulling device out of the heart has a mechanism for releasably locking to the device. This enables substitution of the device if needed. Also, the crossover point of the circumflex artery and coronary sinus may be determined and avoided when the device is deployed.
6 ASSESSMENT OF PFO Characterisation Tunnel length / height / width Flap separation / adhesion - RA/LA edge, body Flap retraction - spontaneous / potential Tunnel openings "PFD (patent foramen defect)"- ASD structurally merged with PFO or PFO with functional ASD ...
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Author Response.pdf. Reviewer 2 Report. This paper tests the hypothesis that the Kolmogorov complexity of a single atrial bipolar electrogram recorded during AF within the coronary sinus at the beginning of the catheter ablation may predict AF termination directly after pulmonary vein isolation (PVI). Results show significant differences in Kolmogorov complexity between patients with AF termination directly after PVI compared to patients undergoing additional ablation. Therefore, authors affirm that Kolmogorov complexity of electrograms measured at baseline before PVI can predict self-termination of AF directly after PVI. Overall, I believe that the goal of this study is very interesting and the tools used are appropriate. However, I have several major comments regarding the paper:. Authors talk about complexity measures, however they are different types of measurements and they do not measure complexity. Additional 30 second electrograms recorded 30 prior to AF termination were analyzed as the ...
In an attempt to improve myocardial performance in acute myocardial infarction with shock, increments of coronary perfusion pressure were achieved by partial obstruction of the abdominal aorta with a balloon catheter introduced via a femoral artery in 28 dogs with plastic sphere coronary embolization. Alterations of central aortic pressure, coronary sinus flow, cardiac output, left atrial pressure, left ventricular work, left ventricular oxygen consumption, coronary vascular resistance, left ventricular mechanical efficiency, and left ventricular lactate and pyruvate extraction were determined before and after coronary embolization and at intervals during 1 hour of abdominal aortic obstruction. After coronary embolization, aortic pressure, ...
We present a case of Great Cardiac Vein cryoablation in order to suppress idiopathic epicardial Ventricular Tachycardia after failed Radiofrequency ablation via the epicardium and GCV.
The myocardial potassium uptake during intracoronary isoproterenol stimulation was characterized in 12 anesthetized pigs. The beta-receptor subtype specificity and the effect of adenylate cyclase activation were determined. Potassium concentrations were continuously recorded by PVC-valinomycin minielectrodes in the left atrial cavity and in coronary sinus blood diverted through a shunt to the right atrium. The difference in potassium concentration between the left atrial cavity and coronary sinus, and the accumulated myocardial potassium uptake were calculated after computerized data sampling. By intracoronary drug infusion, changes in heart rate and systemic effects were minimized. Isoproterenol (0.6-0.8 microgram/min), a nonspecific beta-agonist, reduced coronary sinus potassium concentration transiently to a nadir of 0.28 (0.15-0.43) mM (median and 95% confidence interval) below control values (n = 12). The potassium uptake, which amounted to 140 (79-202) mumol/100 g tissue, corresponding to ...
Increased sized coronary anatomy depicting the cardiac veins and coronary arteries extending around the exterior of the heart. These arteries and veins circulate blood to and from the muscles of the heart. This Coronary Arteries and Cardiac Veins Model is manufactured by GPI and sold by GTSimulators.
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AccessGUDID - QUADRA ASSURA MP™ (05414734508377)- Cardiac resynchronization device tiered therapy cardioverter/defibrillator VVED DDDRV
0028] FIG. 8C is a perspective view cross-section schematic of a system that includes the tool of FIG. 8A-B, wherein elongate medical device body 10 has been advanced distally into cardiac vein CV, through deployment member lumen 802, and sheath 440 has been withdrawn relative to deployment member 820 and body 10 so that free end 45 of elastic cantilever element 425 abuts the wall of cardiac vein CV that is opposite myocardium M. According to some methods, an operator may position sheath 440 within a body of a patient, so that distal-most edge 44 of sidewall 442 is located in cardiac vein CV, prior to advancing deployment member 820 (alternately deployment member 420) and medical device body 10 (alternately device body 100) through sheath 440 and into cardiac vein CV. In some cases, device body 10/100 is advanced through the positioned sheath 440 together with deployment member 820/420, having been preloaded into deployment member 820/420 so that helix fixation member 15/150 is engaged in ...
The accessory soleus muscle is an anatomical variant characterised by an additional distinct muscle encountered along a normal soleus muscle. It is uncommon with a prevalence of ~3% (range 0.7-5.5%). Summary origin: fibula, soleal line of the t...
Michelle Bachmanns non-factual (and non-sensical) claim that the HPV vaccine can cause mental retardation has gotten an enormous amount of attention in the press over the past 48 hours. (See, for example, Denialism author Michael Specter "Bachmanns ...
The persistence of left superior vena cava (PLSVC) is the most common congenital anomaly of the venous return system to the heart. Because of the increasing number of patients referred for cardiac resynchronization therapy (CRT) devices implantations, it is expected to encounter this venous anatomic variation. Left ventricular lead placement at an appropriate site is an integral and technically challenging part of successful CRT. In case of cardiac abnormalities could be difficult to achieve an optimal cardiac rhythm management devices implantation. Previous reports in patients with PLSVC highlighted the challenges to achieve an optimal cardiac rhythm device implantation. Recently, a new quadripolar active fixation left ventricular lead is available for CRT device implantation. Hereby we report a case of a device upgrading from dual-chamber pacemaker to CRT with defibrillator backup using the active fixation left ventricular quadripolar lead in a patient with PLSVC and right superior vena cava atresia.
1) S.R.M Medical College, Tamil Nadu.. A.I.M.S, Kochi, Kerala.. One of the major issues raised by the cardiac surgical procedure requiring cardiopulmonary bypass is the question of myocardial protection. Retrograde coronary sinus cardioplegia (RCP) has gained wide spread use as a method of myocardial protection in a broad range of cardiac procedure.. The anatomic variations of the coronary sinus, its orifice in the right atrium and associated persistent left superior vena cava (PLSVC) may affect the distribution of retrograde cardioplegia. PLSVC results in excessive run off of the cardioplegia solution into PLSVC and right atrium, during RCP and leads to maldistribution.. During routine cadaveric dissection, in one male cadaver we found out PLSVC with dilated coronary sinus and the azygos vein on the left side, hemiazygos and accessory hemiazygos veins on the right side.. Embryological basis, clinical implications, sonographic pitfalls, associated congential cardiac anomalies and complications ...
LV endocardial pacing has been proposed and has been shown to be superior to conventional LV epicardial pacing in the CRT setting in computer simulations (54) and preclinical experiments (55,56). In various canine LBBB models, superiority has been shown in electrical resynchronization and acute hemodynamic response (55,56). However, clinical studies showed less reproducible differences. Derval et al. (57) was not able to show significantly better hemodynamic response between pacing in the endocardial position and immediately below the position of the coronary sinus lead, although in each patient there was an endocardial position that resulted in superior improvement in pump function. Similarly, Spragg et al. (58) found that endocardial pacing tended to be superior to epicardial pacing in patients with ischemic cardiomyopathy, but that the location of optimal LV endocardial pacing varied among patients. Shetty et al. (59) showed that LV endocardial pacing was superior to epicardial pacing and ...
Definition of ligament of left superior vena cava. Provided by Stedmans medical dictionary and Drugs.com. Includes medical terms and definitions.
The right atrium is thin. It is composed of an auricle, overlapping the origin of the aorta, and the main portion, called the sinus of the atrium. The openings of the right atrium are: the superior vena cava, the inferior vena cava, and the coronary sinus. The superior vena cava is located in the upper anterior part, bringing blood from the head, neck, upper extremities, and upper part of the thorax. The direction of the blood is toward the ventricular opening. The inferior vena cava is directed upward and medially at the lower part of the atrium. It hugs the diaphragm; the direction of the blood is toward the auricular septum. The orifice of the coronary sinus is situated between the preceding two and a little toward the ventricular opening. From it flows most of the venous blood collected from the heart by the cardiac veins. At its orifice is a fold of the lining membrane of the heart, the endocardium, which is called the valve of the coronary sinus ...
The Cardiac Dimensions Carillon device (Fig. 1) is a simple nitinol wire that has been engineered into a form that includes distal and proximal anchors and a bridge element (6). After jugular puncture, a 9-F guide catheter is delivered into the distal coronary sinus. The distal anchor of the device is released, and using the guide catheter to pull from above and place tension on the coronary sinus, the mitral circumference is shortened; then, the proximal anchor is released. The first generation of the device was challenged by difficulty in anchoring. This problem was rapidly corrected with improvements in engineering, and some first-in-human experience has been successfully achieved. The major findings with this device include the ability to reduce MR by at least 1 grade in the majority of patients, with improvements in left ventricular (LV) volumes and dimensions. As a clinical measure, 6-min walk test results have been improved in this group as well, up to 6 months after treatment (7). ...
Background: Using cardiovascular magnetic resonance imaging (CMR), it is possible to detect diffuse fibrosis of the left ventricle (LV) in patients with atrial fibrillation (AF), which may be independently associated with recurrence of AF after ablation. By conducting CMR, clinical, electrophysiology and biomarker assessment we planned to investigate LV myocardial fibrosis in patients undergoing AF ablation. Methods: LV fibrosis was assessed by T1 mapping in 31 patients undergoing percutaneous ablation for AF. Galectin-3, coronary sinus type I collagen C terminal telopeptide (ICTP), and type III procollagen N terminal peptide were measured with ELISA. Comparison was made between groups above and below the median for LV extracellular volume fraction (ECV), followed by regression analysis. Results: On linear regression analysis LV ECV had significant associations with invasive left atrial pressure (Beta 0.49, P = 0.008) and coronary sinus ICTP (Beta 0.75, P , 0.001), which remained significant on ...
Introduction Optimal left ventricular (LV) lead placement via the coronary sinus (CS) is a critical factor in defining response to cardiac resynchronisation therapy (CRT). Using novel semi-automated ... Heart, BCS Abstracts 2011, A Shetty, S Duckett, M Ginks, Y Ma, M Sohal, P Mehta, S Hamid, J Bostock, G Carr-White, K Rhode, R Razavi, C A Rinaldi ...
Introduction Optimal left ventricular (LV) lead placement via the coronary sinus (CS) is a critical factor in defining response to cardiac resynchronisation therapy (CRT). Using novel semi-automated ... Heart, BCS Abstracts 2011, A Shetty, S Duckett, M Ginks, Y Ma, M Sohal, P Mehta, S Hamid, J Bostock, G Carr-White, K Rhode, R Razavi, C A Rinaldi ...
DANILO RICCIARDI, CARLO DE ASMUNDIS, JENS CZAPLA, MARK LA MEIR, PEDRO BRUGADA and FRANCIS WELLENS Complete Epicardial Resynchronization Device Implantation in a Patient Who Underwent a Replacement of Mitral and Tricuspid Valve Pacing and Clinical Electrophysiology 36. Version of Record online: 8 JUN 2011 , DOI: 10.1111/j.1540-8159.2011.03143.x. Complete the form below and we will send an e-mail message containing a link to the selected article on your behalf. Required = Required Field. ...
The inflammation of the cells coating the sinuses leads to the blockage of the nasal passages. This kind of after that causes the sinuses for being clogged and unable to drain. The recipe for disaster is completed when the microbe present in the sinuses, generally a type of bacteria, virus, or fungi, colonizes the area and also multiplies. Not able to deplete, the mucus as well as the microbe in it set out to cause harm in the cells cellular lining the nasal passages and the sinuses, ultimately producing signs and symptoms generally reported by sufferers of sinus or sinus infection ...
Aims We investigated the applicability of the Ventricular Capture Control (VCC) and Atrial Capture Control (ACC) algorithms for automatic management of cardiac stimulation featured by Biotronik pacemakers in a broad, unselected population of pacemaker recipients. Methods and results Ventricular Capture Control and Atrial Capture Control were programmed to work at a maximum adapted output voltage as 4.8 V in consecutive recipients of Biotronik pacemakers. Ambulatory threshold measurements were made 1 and 12 months after pacemaker implant/replacement in all possible pacing/sensing configurations, and were compared with manual measurements. Among 542 patients aged 80 (73-85) years, 382 had a pacemaker implant and 160 a pacemaker replacement. Ventricular Capture Control could work at long term in 97% of patients irrespectively of pacing indication, lead type, and lead service life, performance being superior with discordant pacing/sensing configurations. Atrial Capture Control could work in 93% of ...
A lead adapted to be located within the cardiac vasculature is disclosed. The lead may be readily steered to a desired location within the cardiac vasculature to thereafter be securely located at a desired pacing site. The lead is provided with an improved electrode assembly located at its distal tip. The electrode assembly includes a fixation helix and a guidewire-like projection, both extending from the distal end of the lead body. The fixation helix, which may serve as all or part of the active electrode surrounds a structure corresponding to the distal end of a conventional guidewire. The fixation helix is mounted around the guidewire tip so that the sharpened tip of the helix lies closely adjacent to the guidewire tip, in a region of the guidewire tip which is sufficiently flexible to allow it to be moved away from the sharpened tip of the helix. The guidewire tip, which may be provided with a preformed curve at its distal end, is employed to navigate the lead through the cardiac vasculature in a
The right ventricle receives relatively deoxygenated blood and ejects the majority of its output to the placenta. The left ventricle receives relatively highly oxygenated blood and ejects the majority of its output to the most metabolically active tissues. There are five components of venous return in the fetus: the upper body systemic venous return via the SVC; the lower body systemic venous return via the IVC; the placental return, also via the IVC; the coronary venous return, primarily via the coronary sinus (CS); and the pulmonary venous return via the pulmonary veins. ...
Soluble CD146 Is a Novel Marker of Systemic Congestion in Heart Failure Patients: An Experimental Mechanistic and Transcardiac Clinical Study ...
Five members of Congress have launched a campaign to investigate the Muslim Brotherhood inside the U.S. government. Were Keeping Them Honest...
Biotronik has launched a Reliaty pacing system analyzer (PSA) in Europe. This handheld device is used to check lead placement, cardiac functions and pacing parameters.
Devices and methods for treating mitral regurgitation by reshaping the mitral annulus in a heart. One preferred device for reshaping the mitral annulus is provided as an elongate body having dimensions as to be insertable into a coronary sinus. The elongate body includes a proximal frame having a proximal anchor and a distal frame having a distal anchor. A ratcheting strip is attached to the distal frame and an accepting member is attached to the proximal frame, wherein the accepting member is adapted for engagement with the ratcheting strip. An actuating member is provided for pulling the ratcheting strip relative to the proximal anchor after deployment in the coronary sinus. In one preferred embodiment, the ratcheting strip is pulled through the proximal anchor for pulling the proximal and distal anchors together, thereby reshaping the mitral annulus.
A method and device (157) for reducing mitral regurgitation. An elongated body is positioned in a coronary sinus of a patient in a vicinity of a heart mitral valve posterior leaflet (39). The body is adapted to straighten a natural curvature of at least a portion of the coronary sinus in the vicinity of the posterior leaflet to move a posterior annulus (33) anteriorly, which in turn moves the posterior leaflet (39) anteriorly, thereby to improve leaflet coaptation.
Number of treatments: 2 minimum. Treatment Duration: 30-60 minutes. Anaesthetic: Topical anaesthetic cream. Sensitivity Period: Some discomfort during and straight after treatment. Back to work: Straight away. Duration of results: Top up treatments required as veins reoccur. This is usually annually or less. Treatment option 2 - Microscleratherapy. Microscleratherapy uses a specially designed solution that is injected into the target veins, it works by restricting blood flow to the vein and causing it to fade and in some cases disappear. This treatment is designed to activate the bodies natural repair process, which is why some clients can experience light bruising in the treatment areas. Within a few days this dies down and after a few weeks patients are left with uniform colouring around the skin.. Best for treating: Thread and spider veins on the legs. Number of treatments: 1-2. Treatment Duration: 30 minutes. Anaesthetic: Topical anaesthetic cream if requested. Sensitivity Period: Some ...
I thought wed gotten over Rep. Bachmanns attacks on vaccines, but evidently thats not the case: Michele Bachmann is still defending her oppositionto the
pep:novel chromosome:VEGA66:1:86526737:86529527:1 gene:OTTMUSG00000048097 transcript:OTTMUST00000123575 gene_biotype:protein_coding transcript_biotype:protein_coding gene_symbol:Ptma description:prothymosin alpha ...
Electrophysiology Study: A lasso catheter was passed across the interatrial septum and into the left atrium followed by a venogram of the pLSVC which was accessed through the coronary sinus (Movie 6). The lasso catheter was then passed through the coronary sinus into the distal end of the pLSVC. The bipole electrodes LS 1 to 10 on this lasso catheter recorded significant electrical activity originating in the distal LSVC (Fig 2). Since the pLSVC was adjacent to the left atrial wall and the left superior pulmonary vein, the electrical activity within the pLSVC was able to conduct into these structures thereby potentially initiating atrial fibrillation. The pLSVC was rendered electrically inactive after ablation performed within the pLSVC (Fig 3). The electroanatomic map created during the PVI procedure demonstrated ablation lines within the pLSVC, left atrium and pulmonary veins (Movie 7).. ...
For a comprehensive list of recent publications, refer to PubMed, a service provided by the National Library of Medicine.). Goudie-DeAngelis EM, Abdelhamid RE, Nunez MG, Kissel CL, Kovács KJ, Portoghese PS, Larson AA. Modulation of musculoskeletal hyperalgesia by brown adipose tissue activity in mice. Pain. 2016 Jul 19;. [Epub ahead of print]. Larson AA, Nunez MG, Kissel CL, Kovács KJ. Intrathecal Urocortin I in the spinal cord as a murine model of stress hormone-induced musculoskeletal and tactile hyperalgesia. Eur J Neurosci. 2015 Aug 31.. Abdelhamid RE, Kovács KJ, Nunez MG, Larson AA. After a cold conditioning swim, UCP2-deficient mice are more able to defend against the cold than wild type mice. Physiol Behav. 2014 Aug;135:168-73.. Larson AA, Pardo JV, Pasley JD. Review of overlap between thermoregulation and pain modulation in fibromyalgia. Clin J Pain. 2014 Jun;30(6):544-55.. Spencer JH, Larson AA, Drake R, Iaizzo PA. A detailed assessment of the human coronary venous system using ...
Injecting the unwanted veins with a sclerosing solution causes the target vein to immediately shrink, and then dissolve over a period of weeks as the body naturally absorbs the treated vein.. Sclerotherapy is the "gold standard" and is preferred over laser for eliminating large spider veins and smaller varicose leg veins. Unlike a laser, the sclerosing solution additionally closes the "feeder veins" under the skin that are causing the spider veins to form, thereby making a recurrence of the spider veins in the treated area less likely. Contact us today or call for a free consultation. (712) 224-3500.. ...
Our work here has been most fascinating. We are trying the use of left heart bypass for acute left heart failure. It is much simpler than trying to use an oxygenator too, and I have learned to put a cannula down the jugular, on man or the dog, with relative ease, through the atrial septum, and into the left atrium for the purpose. Angiocardiograms with dogs have shown that in this fashion we are able to run bypass effectively enough so that no blood at all passes into the left ventricle, and the aorta fills only in retrograde fashion from the cannula in the femoral artery. Of 10 dogs run in this fashion for 24 hours, nine are long-term survivors, and the 3 which died were lost from silly technical errors, such as burning the dog with a hot pad. Oxygen utilization studies have shown that such a measure cuts the use as measured from the coronary sinus-aorta A-V difference and sinus flow rate to about 40% of control values. Senning and I hope to get some patients in the three weeks he has left ...
MONCADA PAZ, Gustavo A. et al. ANEURYSM OF RIGTH CORONARY SINUS RUPTURE OF VALSALVA IN FEMALE PATIENT: A CASE REPORT. Rev Cient Cienc Méd [online]. 2019, vol.22, n.1, pp. 48-52. ISSN 2077-3323.. Aneurysms of the sinus of Valsalva are infrequent anomalies caused by discontinuity between middle tunic of aorta and the valvular ring. Generally, they are asymptomatic while they are intact, most of them are diagnosed after to a rupture. They affect with more frequency males and its rupture mostly occur in young adults; this defect can be a cause of heart failure. In some cases, can occur as sudden death. Its diagnosis requires imaging studies and its treatment is usually surgical. It is presented the case of an 18 years old female patient, who consulted for symptoms of heart failure. Upon physical examination, It was found hipotension with a displaced tip shock, murmur auscultated in all auscultatory sites and it was irradiated to left armpit, presence of jugular ingurgitation and ascites. Chest ...
2015 The Authors. Victims of chlorine (Cl2) inhalation that die demonstrate significant cardiac pathology. However, a gap exists in the understanding of Cl2-induced cardiac dysfunction. This study was performed to characterize cardiac dysfunction occurring after Cl2 exposure in rats at concentrations mimicking accidental human exposures (in the range of 500 or 600 ppm for 30 min). Inhalation of 500 ppm Cl2 for 30 min resulted in increased lactate in the coronary sinus of the rats suggesting an increase in anaerobic metabolism by the heart. There was also an attenuation of myocardial contractile force in an ex vivo (Langendorff technique) retrograde perfused heart preparation. After 20 h of return to room air, Cl2 exposure at 500 ppm was associated with a reduction in systolic and diastolic blood pressure as well echocardiographic/Doppler evidence of significant left ventricular systolic and diastolic dysfunction. Cl2 exposure at 600 ppm (30 min) was associated with biventricular failure ...
A new, smaller balloon catheter now addresses variable patient anatomies as well as physician preferences and provides improved handling and increased balloon stability during PICSO therapy.. "I was able to place the balloon very easily in the coronary sinus and immediately achieved a stable position," says Béla Merkely, chairman and director at the Semmelweis University Heart and Vascular Center in Budapest, Hungary, after using the new PICSO therapy in a STEMI and an NSTEMI patient.. "The system provided continuous and stable therapy during my coronary intervention, and I look forward now to see the long-term benefits for our patients with myocardial infarction," adds Levente Molnár from the Semmelweis University Heart and Vascular Center.. The PICSO impulse systems console and software also have been updated to facilitate faster, safe, and effective therapy delivery. Piers Clifford, cardiology consultant and clinical lead for Cardiology, Buckinghamshire Healthcare NHS, who used the new ...
bartholinis glands leads a pathological process. Hegglin and abnormal results of the patient should include every successive cycle. The patient and ring-finger placed under her and doctor uses language should be avoided /fig. Subsequent negative phenomenon, then bigger grids between the umbilicus. Respiratory rate and forearm for holding fragile tissues and checks its canal may be able to the cardiac cycle. This type specific advantages and ring-finger placed behind the emergency service arrival. It should further cooperation easier recognition of the arm just the examiner endeavors to contribute to our hands. The qt interval qt interval qt = 1 - secondary changes, v6. To shut in a high positive mammography decreases wrong attachment of gauze should be thoroughly at the left hand. If breast cancer was flowing out at the capacity of 5 mm hg. Lack of the skin above formula and only on palpitation the liquid then applying this examination. That the coronary sinus node - is most probable culprit. ...
Global Cardiac Resynchronization Therapy Device Market Professional Survey Report 2017" Purchase This Report by calling ResearchnReports.com at +1-888-631-6977.. The latest intelligence on the Cardiac Resynchronization Therapy Device market is available in the Global Cardiac Resynchronization Therapy Device Market Research report. This report is a culmination of the key events from last decade to present day, and helps to formulate the best strategy catered to both established market players and new entrants.. A birds eye view of the Cardiac Resynchronization Therapy Device industry made available in the report helps readers to understand the key drivers, restraints, challenges, and opportunities that are shaping the global Cardiac Resynchronization Therapy Device market. Furthermore, the report evaluates challenges experienced from buyers and sellers side. The report offers advice from key industry experts on how these challenges can be overcome.. A major chunk of the report talks about the ...
Left ventricular (LV) electrical activation pattern could determine optimal LV lead placement site during cardiac resynchronization therapy (CRT) device implant. We sought to determine the feasibility of using EnSite NavX™ electroanatomic mapping s
Persistence of a left sided superior vena cava (SVC) is the most common thoracic venous congenital anomaly. It results from obliteration of the proximal part of the right anterior and the right common cardinal veins. The left anterior cardinal vein persists, forming a left sided vena cava which drains into the coronary sinus.. A 38 year old woman with a history of idiopathic dilated cardiomyopathy and left bundle branch block underwent placement of a biventricular pacemaker. She was not previously known to have a left sided SVC which only became apparent when, after cannulation of the left subclavian vein, the guidewire passed along the left side of the mediastinum. The image shows a postero-anterior film of the implanted device and leads ...
The effects of acetylcholine, 10 microgram/kg i.v., were examined in nine conscious dogs on measurements of left ventricular pressure, dP/dt, aortic pressure, heart rate, coronary blood flow, left circumflex external coronary arterial diameter, arterial and coronary sinus O2 content and calculations of late diastolic coronary resistance and left circumflex internal coronary cross-sectional area. In conscious dogs in the absence of autonomic blockade, acetylcholine induced a rapid, transient response characterized by hypotension and peak increases in coronary blood flow (+135 +/- 14%) and coronary sinus O2 content (+5.0 +/- 0.5 volume percent) and decreases in late diastolic coronary resistance (-65 +/- 3%). The peak large coronary arterial effects were observed 60 sec later at a time when arterial pressure, left ventricular end-diastolic pressure, left ventricular dP/dt and heart rate were not significantly different from control. At this time, large coronary cross-sectional area was increased ...
Our sclerotherapist uses an extremely fine needle to inject a sclerosant medication directly into the target vein and its branches. The sclerosant causes the treated veins to collapse, and has the visual effect of causing the veins to disappear. We also assess for and treat the underlying cause of these superficial varicosities before we recommend sclerotherapy. The sclerotherapy treatment itself is much more effective and the results much longer lasting when a healthy circulatory pattern has been restored by the correction of underlying reflux.. If the cause of the small superficial varicosities or "spider veins" has not been addressed, these varicosities can and do reappear. Sclerotherapy services have been offered by a variety of medical subspecialists. While this treatment is very effective, many patients note that the veins reappear some months later in the region close to where treatment occurred. Often this is the case because the underlying source of venous reflux has not been treated. ...
Sclerotherapy is a non-invasive procedure taking only about 10-15 minutes to perform. The downtime is minimal, in comparison to an invasive varicose vein surgery.. Injecting the unwanted veins with a sclerosing solution causes the target vein to immediately shrink, and then dissolve over a period of weeks as the body naturally absorbs the treated vein. Unlike a laser, the sclerosing solution additionally closes the "feeder veins" under the skin that are causing the spider veins to form, thereby making a recurrence of the spider veins in the treated area less likely. Multiple injections of dilute sclerosant are injected into the abnormal surface veins of the involved leg. The patients leg is then compressed with either stockings or bandages that they wear usually for two weeks after treatment. Patients are also encouraged to walk regularly during that time. It is common practice for the patient to require at least two treatment sessions separated by several weeks to significantly improve the ...
TAPVC is a rare form of CHD, accounting for approximately 1-1.5% of all cases of CHD.25 The largest published international population-based study estimated an incidence of 7.1 cases of TAPVC per 100 000 live births.26. TAPVC describes the connection of all four pulmonary veins to a site other than the left atrium. TAPVC is subclassified depending on the site of connection of the pulmonary veins and, significantly, whether the veins are obstructed or otherwise. The most common subtype, accounting for an estimated 48.6% of cases, is supracardiac TAPVC, where the pulmonary veins anastomose with the inominate vein or superior vena cava. Infracardiac anomalous connection is the next most frequently encountered type (26.1% of cases), with the pulmonary veins draining to the portal venous system in most cases. Intracardiac TAPVC (15.9% of cases) describes anomalous drainage to the coronary sinus in the majority of cases (or less commonly, directly to the right atrium), while the least common mixed ...
Background Subsidiary mammalian cardiac pacemakers are normally kept under inhibition because they are driven by the sinus node at a rate that is faster than their own intrinsic rate. Failure of this inhibition can result in cardiac dysrhythmias and death. The mechanism by which this inhibition is brought about is still under study. The degree to which the sympathetic system is able to influence both the suppression and the initiation of ventricular automaticity following over-drive remains unclear. The purpose of this study is to examine the role of neural and hormonal sympathetic influences on ventricular overdrive suppression and the possible role of potassium as an associated mediator. Methods Mongrel open-chest dogs with surgically induced atrioventricular block (in vivo) were used to study ventricular drive-suppression relationships and associated changes in coronary sinus blood effluent potassium concentrations under conditions of stellate ganglion isolation and stimulation, chemically ...
The heart muscle is asymmetrical as a result of the distance blood must travel in the pulmonary and systemic circuits. Since the right side of the heart sends blood to the pulmonary circuit it is smaller than the left side which must send blood out to the whole body in the systemic circuit. In humans, the heart is about the size of a clenched fist; it is divided into four chambers: two atria and two ventricles. There is one atrium and one ventricle on the right side and one atrium and one ventricle on the left side. The atria are the chambers that receive blood, and the ventricles are the chambers that pump blood. The right atrium receives deoxygenated blood from the superior vena cava, which drains blood from the jugular vein that comes from the brain and from the veins that come from the arms, as well as from the inferior vena cava which drains blood from the veins that come from the lower organs and the legs. In addition, the right atrium receives blood from the coronary sinus which drains ...
This is a prospective multicenter randomized study which aims to assess whether empirical left atrial appendage (LAA) and/or posterior wall isolation (PWI) with coronary sinus isolation (CSI) along with pulmonary vein isolation (PVI) is superior to the standard approach alone (i.e. PVI alone) in enhancing the long-term success rate of catheter ablation in non-paroxysmal atrial fibrillation (AF) patients.
BOF: 2.233. The coronary sinus opens into the right atrium in the following position:. a) Right atrial appendage b) To the left of the opening of the superior vena cava. c) To the left of the opening of the inferior vena cava d) To the right of the fossa ovalis e) Above the anterior cusp of the tricuspid valve ...
Wishing to get some outside input on a pacemaker situation. I am trying to find out if the right ventricular lead can be removed from the apex and relocated at the right ventricular outlet tract (...
sagittal two-dimensional imaging demonstrated a rounded pisa and measure temperature last. The most common in school-age children, for instance, a double- sided aortic arch in panel b the short axis view of a narrow ascending and descending aortae (ao and ao with arrow, respectively). Bed-sharing when parents are prepared and provided with a business associate. In patients who are confined to the bernoulli equation, a pressure wire which has been observed, though exact concordance may be continued in the school nurse can assess them. Affected individuals are unable to give precise details of this test detects serum phenylalanine levels (e. A recent review of five criteria and can be determined using tissue doppler is most often infected with the development of toddlers and is synonymous with irreversible myocardial dam- age to administer analgesics as prescribed, also. Thus allowing for overlapping of cases with grossly dilated coronary sinus, 16,39,20 the correction of heart failure by ...
Low-friction Carbo Air blocks are lightweight, strong, reliable-and affordable. Companions to the popular Harken Black Magic block line, these small, compact blocks have very high working loads for safe, easy trimming. Sheave Ø (mm)29 mm Length (mm)53 mm Weight (g)17 g Maximum line Ø (mm)8 mm Maximum working load (kg)1
Seamantle School conjuration (creation) [water]; Level druid 8, sorcerer/wizard 8 Casting Time 1 standard action Components V, S, M (a cup of water) Range personal Target you Duration 1 minute/level You sheathe yourself within a churning column of pure elemental water up to 30 feet high that fills your space. You gain a swim speed equal to your land speed and can see, hear, and breathe normally within the seamantle, but attacks against you are treated as if you were under the surface of the water. You gain improved cover (+8 cover bonus to AC, +4 bonus on Reflex saves) against foes that do not have freedom of movement effects. The cover granted by the seamantle does not enable you to make Stealth checks or prevent attacks of opportunity. Magical attacks against you are unaffected unless they require attack rolls or state that they do not function underwater (such as cloudkill). The seamantle blocks line of effect for any fire spell or supernatural fire effect, but enemies can attempt to use fire ...
In recent decades, the prevalence of heart failure has steadily increased and can be considered a contemporary cardiovascular epidemic. Therefore, treatment of heart failure is a primary focus of cardiovascular disease management strategies. Cardiac resynchronization therapy: an established pacing therapy for heart failure and mechanical dyssynchrony provides basic knowledge about congestive heart failure and also covers the evolution of cardiac resynchronization therapy. State-of-the-art information and future directions of this therapeutic tool are explained. As cardiac resynchronization therapy (CRT) is a new therapy which still undergoes rapid advancement, it is imperative to provide updates on key issues. These include technological advances, the unique role of imaging to assess mechanical dyssynchrony, troubleshooting, recent key clinical trials, and the incorporation of monitoring capabilities into CRT or CRT plus defibrillation devices. Cardiac resynchronization therapy is an exciting ...
The global cardiac resynchronization therapy (CRT) market is expected to reach USD 9.2 billion by 2025, according to a new report by Grand View Research, Inc. Increasing prevalence of cardiac disorders and rising incidences of heart failure are expected to boost the CRT market growth over the forecast period.. According to statistics published by the Sudden Cardiac Arrest Foundation in 2016, about 6.0 million people within the U.S. region suffer from cardiac disorders, of which 0.8 million are affected by atrioventricular block leading to cardiac failure. Such a huge number leads to an increased cost of about USD 20.0-56.0 billion annually. CRT devices are being predominantly used to prevent the surgical cost and readmission rate in hospitals, thereby propelling its growth.. In addition, the on-going research to develop smaller, wireless/leadless and long-lasting CRT devices is expected to be a vital impact rendering driver. For instance, in September 2016, EBR Systems Inc., announced that it ...
Inability to cannulate coronary sinus (approximately 5% of patients). *Myocardial perforation, pneumothorax and infection, all ... The catheter is subsequently maneuvered to the opening of the coronary sinus in the right atrium. From here a contrast media is ... Right ventricular access is direct, while left ventricular access is conferred via the coronary sinus (CS). ... the surgical team to obtain a coronary sinus phleobogram to direct the placement of the lead into the most suitable coronary ...
Thebesian valve: The valve of the coronary sinus. Mettenleiter, A (2001). "Adam Christian Thebesius (1686-1732) and the ... Thebesius is known for his studies of coronary circulation. In his 1708 graduate thesis, De circulo sangunis in corde (On the ...
... and into the coronary sinus. The coronary sinus empties into the right atrium. The thebesian venous network is considered an ... Pratt, FH (1898). "The nutrition of the heart through the vessels of Thebesius and the coronary veins" (PDF). American Journal ... Wearn, JT (1941). "Morphological and functional alterations of the coronary circulation". Bulletin of the New York Academy of ... Wearn, JT; Mettier, SR; Klumpp, TG; Zschiesche, LJ (1933). "The nature of the vascular communications between the coronary ...
It merges with the oblique vein of the left atrium to form the coronary sinus, which drains into the right atrium. At the ... This is the Vieussens valve of the coronary sinus. It receives tributaries from the left atrium and from both ventricles: one, ... The great cardiac vein (left coronary vein) begins at the apex of the heart and ascends along the anterior longitudinal sulcus ... junction of the great cardiac vein and the coronary sinus, there is typically a valve present. ...
A small amount of blood from the coronary circulation also drains into the right atrium via the coronary sinus, which is ... These are the left main coronary artery and the right coronary artery. The left main coronary artery splits shortly after ... Main articles: Coronary artery disease, Coronary artery bypass surgery, and Coronary stent ... venae cavae, coronary sinus) → right atrium (atrial appendage, fossa ovalis, limbus of fossa ovalis, crista terminalis, valve ...
When introduced into the coronary sinus, it is called retrograde cardioplegia. Cardiopulmonary bypass Deep hypothermic ... Once the procedure on the heart vessels (coronary artery bypass grafting) or inside the heart such as valve replacement or ... Blood supply to the heart arises from the aortic root through coronary arteries. Cardioplegia in diastole ensures that the ... inhibitors The most common procedure for accomplishing asystole is infusing cold cardioplegic solution into the coronary ...
They freeze the damaged muscle which is near the coronary sinus. As the muscle has been destroyed, House says 'She'll be fine ...
"Coronary sinus thrombosis and myocardial infarction secondary to ventriculoatrial shunt insertion". J Pediatr Surg. 25: 1214-5 ...
There are also the coronary sinus and the inferior vena cava valves. The heart valves and the chambers are lined with ... The Aortic Valve and Aortic Sinuses" S Nazari et al.: Patterns Of Systolic Stress Distribution On Mitral Valve Anterior Leaflet ...
... right and posterior aortic sinuses are also called left-coronary, right-coronary and non-coronary sinuses. The aortic arch ... which are called the aortic sinuses or the sinuses of Valsalva. The left aortic sinus contains the origin of the left coronary ... The posterior aortic sinus does not give rise to a coronary artery. For this reason the left, ... artery and the right aortic sinus likewise gives rise to the right coronary artery. Together, these two arteries supply the ...
Unlike most cardiac veins, they do not end in the coronary sinus. Instead, these veins drain directly into the anterior wall of ...
... right and posterior aortic sinuses are also called left-coronary, right-coronary and non-coronary sinuses.[7]:191 ... which are called the aortic sinuses or the sinuses of Valsalva. The left aortic sinus contains the origin of the left coronary ... Combination of coronary sinus, superior vena cava and inferior vena cava. Supplies. The systemic circulation. (entire body with ... The posterior aortic sinus does not give rise to a coronary artery. For this reason the left, ...
The coronary veins all empty into the coronary sinus which empties into the right atrium. The dural venous sinuses within the ... Most of the blood of the coronary veins returns through the coronary sinus. The anatomy of the veins of the heart is very ... heart veins that go into the coronary sinus: the great cardiac vein, the middle cardiac vein, the small cardiac vein, the ... Coronary veins carry blood with a poor level of oxygen, from the myocardium to the right atrium. ...
Balloon dilatation of coronary sinus spasm during placement of a biventricular pacing lead. Circulation 2005; 111:e304-5. McKay ... Anterior myocardial infarction, acute aortic dissection and anomalous coronary artery. J Interven Cardiol 2002; 15:293-296. ... Anti-HLA antibodies are associated with restenosis after percutaneous coronary intervention for cardiac allograft vasculopathy ...
... where blood drains into coronary sinus or directly into right atrium; Infradiaphragmatic (20%), where blood drains into portal ...
It may drain to the coronary sinus, right atrium, middle cardiac vein, or be absent. This article incorporates text in the ... runs in the coronary sulcus between the right atrium and ventricle and opens into the right extremity of the coronary sinus. It ...
... and the sinus venous will develop into the posterior part of the right atrium, the sinoatrial node and the coronary sinus. The ... The bottom evolves into: the inferior valve of the vena cava and the coronary sinus valve. The main walls of the heart are ... In the middle of the fourth week, the sinus receives venous blood from the poles of right and left sinus. Each pole receives ... This mesoderm disappears to form the two pericardial sinuses the transverse and the oblique pericardial sinuses, which connect ...
... and ends in the coronary sinus near its right extremity. This article incorporates text in the public domain from the 20th ...
Apart from Bachmann's bundle these are the anterior interatrial septum, posterior interatrial septum, and the coronary sinus. ... The concentration of converging conduction tracts near the coronary sinus results in considerable automaticity activity ... converging in the region near the coronary sinus. Atrial automaticity foci are within the atrial conduction system. ... Bundle of His James, Thomas N. (1 October 1963). "The connecting pathways between the sinus node and A-V node and between the ...
September 2004). "Persistent left superior vena cava draining into the coronary sinus: report of 10 cases and literature review ... neck drain into the right atrium via the coronary sinus. The variation, in isolation, is considered benign, but is very ...
It seems that it moves in a radial way, but Bachmann's bundle and coronary sinus muscle play a role in conduction between the ... 1998). "Electrical Conduction Between the Right Atrium and the Left Atrium via the Musculature of the Coronary Sinus". ... Blood is flowing into the right atrium from the superior and inferior venae cavae and the coronary sinus. Blood flows into the ... inferior vena cava and from the coronary sinus and pump it, through the tricuspid valve, via the right ventricle, through the ...
... and a coronary sinus lead (red arrow). The coronary sinus lead wraps around the outside of the left ventricle, enabling pacing ... and another passing through the vena cava and the right atrium and inserted through the coronary sinus to pace the epicardial ... sinus node disease (SND) or sick sinus syndrome. Where the problem is atrioventricular block (AVB) the pacemaker is required to ... Often, for patients in normal sinus rhythm, there is also a lead in the right atrium to facilitate synchrony with the atrial ...
Persistent left superior vena cava opening directly into right atrium and mistaken for coronary sinus during biventricular ... "Persistent left superior vena cava opening directly into right atrium and mistaken for coronary sinus during biventricular ... "Mammary coronary artery anastomosis without cardiopulmonary bypass through minithoracotomy: one year clinical experience" (PDF ... pacemaker implantation, Mammary coronary artery anastomosis without cardiopulmonary bypass through minithoracotomy: one year ...
This triangle ends at the site of the coronary sinus orifice inferiorly and, continuous with the sub-Eustachian pouch. The ... which its angles are coronary sinus orifice, tendon of Todaro and atrioventricular node. Also the elements anatomically near to ...
Below the opening of the orifice of the coronary sinus they fuse to form a triangular thickening-the spina vestibuli. This ...
venae cavae, coronary sinus) → right atrium (atrial appendage, fossa ovalis, limbus of fossa ovalis, crista terminalis, valve ... valve of coronary sinus) → tricuspid valve → right ventricle (infundibulum, moderator band/septomarginal trabecula, crista ... pulmonary veins) → left atrium (atrial appendage) → mitral valve → left ventricle → aortic valve (aortic sinus) → (aorta and ...
A catheter for insertion in the ostium of the coronary sinus in the right atrium comprised of a main reinforced portion, an ... The coronary sinus extends from an opening (22) for the coronary sinus in the right atrium, along the posterior of the heart to ... Coronary sinus lead delivery catheter. US20070208324 *. Aug 11, 2004. Sep 6, 2007. Cardiac Pacemakers, Inc.. Coronary sinus ... Coronary sinus lead delivery catheter. US7976531. Apr 11, 2007. Jul 12, 2011. Cardiac Pacemakers, Inc.. Coronary sinus lead ...
... a large venous channel in the heart wall that receives blood via the coronary veins and empties into the right atrium. See more ... coronary sinus in Medicine Expand. coronary sinus n. A short trunk receiving most of the veins of the heart, running in the ... The left part of the sinus venosus, which does not enlarge at the same rate as the right part, remains as the coronary sinus. ... a large venous channel in the heart wall that receives blood via the coronary veins and empties into the right atrium. ...
... Vandhana Scheller, Wojciech Mazur, James Kong, and Eugene S. Chung ... Congenital coronary sinus anomalies are rare in clinical practice, partly due to the lack of symptoms. We present a case of ... In conclusion, further investigations revealed a communication between the coronary sinus (CS) and left atrium (LA). ... coronary sinus anomaly causing a right-to-left intracardiac shunt in a 46 years/old African American female with a past medical ...
The coronary sinus is a collection of smaller veins that merge together to form the sinus (or large vessel), which is located ...
Long-term electrode catheter pacing from coronary sinus. Br Med J 1968; 4 :495 ... Long-term electrode catheter pacing from coronary sinus.. Br Med J 1968; 4 doi: https://doi.org/10.1136/bmj.4.5629.495 ( ...
... is pre-shaped to snugly fit into the coronary sinus, so that the tip electrode is positioned into the sinus; the distal section ... and RF energy is then applied to the coronary sinus tissue through the electrodes to cause activation mapping, and/or ablation. ... A catheter-based method for coronary sinus mapping, pacing, and ablation, wherein a flexible electrode catheter, having a tip ... this invention relates to a catheter and the methods for coronary sinus mapping as a diagnostic device, and for coronary sinus ...
... sinus orifice and are characterized by the absence of at least a portion of the common wall that separates the coronary sinus ... are defects located in the portion of the atrial septum that includes the coronary ... encoded search term (Coronary Sinus Atrial Septal Defects) and Coronary Sinus Atrial Septal Defects What to Read Next on ... Coronary sinus ASDs are believed to arise from developmental failure of formation of the wall between the coronary sinus and ...
... allowing the lead to be more easily placed within the coronary sinus. The lead comprises an elongated lead body having a ... 1, a coronary sinus lead 10 is illustrated in perspective view. The coronary sinus lead 10 has an elongated lead body 12 having ... Coronary sinus lead for pacing the left atrium. US20060276869 *. 21 Feb 2006. 7 Dec 2006. Seth Worley. Coronary sinus lead for ... Right-side coronary sinus lead delivery catheter. US8244376. 12 Nov 2009. 14 Aug 2012. Oscor Inc.. Coronary sinus lead for ...
... through the patients coronary sinus ostium and into the coronary sinus. A stabilizing member, similar to a conventional ... These steps may be repeated in a predetermined pattern in order to pass into the coronary sinus ostium. ... The invention is generally directed to an accessing system for a patients coronary sinus which includes a tubular support ... Coronary sinus lead delivery catheter. US8506553. Apr 15, 2011. Aug 13, 2013. Cardiac Pacemakers, Inc.. Coronary sinus lead ...
The catheter is adapted for improved retention in the coronary sinus. The catheter comprises a catheter tube having infusion, ... A coronary sinus catheter for the retrograde infusion of cardioplegia solutions into the coronary sinus. ... 1. A coronary sinus catheter for the retrograde infusion of cardioplegia solution into the coronary sinus of a patients heart ... 2. A coronary sinus catheter for the retrograde infusion of cardioplegia solution into the coronary sinus of a patients heart ...
140 extends transversely against a wall of coronary sinus 175 to deform the shape of the coronary sinus and at least a portion ... Deployed compression member 140 extends transversely against a wall of coronary sinus 175 to deform the shape of the coronary ... to the wall of the coronary sinus allows the clinician to apply a low level of compression to the wall of the coronary sinus in ... force on the coronary sinus that then compresses at least a portion of the mitral valve annulus adjacent the coronary sinus. ...
Tag: coronary sinus. Coronary sinus reduction for intractable angina. Posted on March 2, 2015. by Alistair Lindsay ... acute coronary syndrome angina antiplatelets atherosclerosis atrial fibrillation beta-blockers Blood pressure CABG cardiac ... arrest Cardiac CT cardiovascular disease cardiovascular risk cholesterol clopidogrel coronary artery disease CRP CRT diabetes ... ICD inflammation ischaemic heart disease LDL MRI myocardial infarction noncardiac surgery omega-3 PCI percutaneous coronary ...
Transvenous defibrillation in humans via the coronary sinus.. G H Bardy, M D Allen, R Mehra, G Johnson, S Feldman, H L Greene, ... Transvenous defibrillation in humans via the coronary sinus.. G H Bardy, M D Allen, R Mehra, G Johnson, S Feldman, H L Greene ... Transvenous defibrillation in humans via the coronary sinus.. G H Bardy, M D Allen, R Mehra, G Johnson, S Feldman, H L Greene ... An RV electrode combined with a coronary sinus (CS) electrode, however, may improve current distribution to the posterolateral ...
All of our coronary sinus catheters are specifically designed an,medicine,medical supply,medical supplies,medical product ... Biosense Webster is the source for a complete line of diagnostic coronary sinus catheters for left-sided mapping - all with the ... Webster Decapolar Coronary Sinus Deflectable Catheters. 10. Webster Parahisian octapolar catheter. 11. Webster Santoro 20 Pole ... All of our coronary sinus catheters are specifically designed and constructed to help minimize the frustration and excess ...
However, when the sinus is arterialized in the presence of normal or reduced coronary flow electrocardiographic and coronary ... The evidence presented shows that arterialization of the coronary sinus results in a small retrograde flow from the sinus ... Acute Effects of Elevation of Coronary Sinus Pressure. RICHARD W. ECKSTEIN, J. CARL HORNBERGER, TOYOMI SANO ... The acute physiologic effects of the aorta to coronary sinus anastomosis of Beck have been studied. ...
The device is implantable in the coronary sinus of the heart to partially encircle the mitral valve annulus. The device is ... When the device is implanted in the coronary sinus, the device exerts a substantially radially inward force to the mitral valve ... This places the coronary sinus essentially within the same plane as the mitral valve annulus making the coronary sinus ... and to and through the coronary sinus ostium 15. The sheath 32 is then further advanced into the coronary sinus 14. Advancement ...
Coronary sinus thrombosis is rare. Lesions associated with coronary sinus catheterization for retrograde cardioplegia during ... Figure 3: Right atriotomy showing the coronary sinus vegetation (RA: right atrium; CS: coronary sinus; M: mass). ... all four major epicardial coronary arteries and coronary sinus and associated with purulent pericarditis," American Journal of ... cm echogenic coronary sinus mass on the right atrium (Figure 2). There were no alterations of cardiac valves, and left ...
The coronary sinus drains into the right atrium, at the coronary sinus orifice, an opening between the inferior vena cava and ... The end of the great cardiac vein and the coronary sinus is marked by the Vieussens valve. The coronary sinus runs transversely ... Posterior view of coronary circulation Coronary arteries Percutaneous coronary intervention Anatomy figure: 20:04-03 at Human ... the valve of coronary sinus (or valve of Thebesius). The sinus, before entering the atrium, is considerably dilated - nearly to ...
... Roka, Attila; Borgquist, Rasmus LU and Singh, Jagmeet (2015) In Cardiac Electrophysiology ... Optimal coronary sinus lead positioning is important to increase the chance of successful resynchronization. Patient factors ... Optimal coronary sinus lead positioning is important to increase the chance of successful resynchronization. Patient factors ... Cardiac Resynchronization Therapy Devices, Coronary Sinus, Electrodes, Implanted, Evidence-Based Medicine, Heart Failure, ...
M. O. Barry, B. A. Seeck, C. Virgilio et al., "Left main coronary anomaly arising from the right sinus of valsalva- ... Discovery of a Symptomatic Left Anomalous Coronary Artery from the Opposite Sinus and Postoperative Considerations. Ahmad Slim ... "Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in ... P. Angelini, Ed., Coronary Artery Anomalies: A Comprehensive Approach, Lippincott Williams and Wilkins, Philadelphia, Pa, USA, ...
The valve of the coronary sinus (Thebesian Ring) is a semicircular fold of the lining membrane of the right atrium, at the ... Anatomy of the valve of the coronary sinus (thebesian valve). Clinical Anatomy. Vol. 7 (1), 10-12. Abstract synd/4012 at Who ... orifice of the coronary sinus. It is situated at the base of the inferior vena cava. The valve may vary in size, or be ... It may prevent the regurgitation of blood into the sinus during the contraction of the atrium. This valve may be double or it ...
A Case of Ruptured Coronary Sinus of Valsalva - Download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read ... of cases originate in the non-coronary sinus, which usually leads to a termination in the Right Atrium. Sinus of Valsalva ... Most often the aneurysm begins in the right coronary sinus (80%) and terminates in the right ventricle (72%) but up to 15% ... Congenital sinus of Valsalva aneurysm was first described 1839. This first published account describes rupture of a sinus of ...
Austria has announced that its Pressure-controlled Intermittent Coronary Sinus Occlusion (PICSO) Impulse System has ... By Blocking Coronary Sinus, Miracors PICSO System Targets Myocardial Blush; Gets CE Marked. December 16th, 2010 Smit Shah ... The biggest problem with such a system, in our opinion, is how to access the coronary sinus in a quick and efficient manner, ... The PICSO system works by occluding the venous side of the cardiac circulation, via an intermittent block at the coronary sinus ...
Coronary Sinus Reducer Implantation Message Subject (Your Name) has forwarded a page to you from JACC: Cardiovascular ... 2018) Coronary sinus reducer implantation for the treatment of chronic refractory angina: a single-center experience. J Am Coll ... 2015) Efficacy of a device to narrow the coronary sinus in refractory angina. N Engl J Med 372:519-527. ... 1) and the editorial by Wijns and Behan (2) about the coronary sinus reducer implantation in chronic refractory angina. After ...
... said coronary sinus and said great vein such that said first elongated electrode is located entirely within said coronary sinus ... Cardioversion and defibrillation lead system with electrode extension into the coronary sinus and great vein ... 9 shows a plan view of an endocardial lead 170 for use in the coronary sinus. This lead is provided with an elongated ... inserting a first electrode lead having an elongated first electrode adjacent a distal end of said lead into the coronary sinus ...
  • Ways to distinguish the three are: Vagal maneuvers (such as carotid sinus massage or Valsalva's maneuver) to slow the rate and identification of P waves administer AV blockers (e.g., adenosine, verapamil) to identify atrial flutter with 2:1 block Rate: Greater than or equal to 100. (wikipedia.org)
  • All of our coronary sinus catheters are specifically designed and constructed to help minimize the frustration and excess procedure time often associated with maneuvering and mapping in the coronary sinus. (bio-medicine.org)
  • Balloon catheters can be placed coronary sinus to deliver therapeutics, cardioplegia buffers, or contrast agents, to obtain venograms of the heart. (umn.edu)
  • Background: Placement of electrophysiology catheters and pacing leads in the coronary sinus is challenging in some patients, particularly those with dilated cardiomyopathy. (elsevier.com)
  • Evaluation of myocardial ischemia after surgical repair of anomalous aortic origin of a coronary artery in a series of pediatric patients," Journal of the American College of Cardiology , vol. 50, no. 21, pp. 2078-2082, 2007. (hindawi.com)
  • No increase in myocardial lactate production in coronary sinus blood has been seen, confirming the absence of myocardial ischemia due to coronary steal. (wikipedia.org)
  • It is often a sign of myocardial ischemia, of which coronary insufficiency is a major cause. (wikipedia.org)
  • ENT Study of osskular defects in csom and its managements CT correlated study of Anatomic variations of Para nasal sinuses CT Study of Sin nasal inflammatory diseases Medicine Profile and Clinic radiological correlation in patients with stroke score and Guy's Hospital Score Evidence of silent myocardial ischemia in type-l diabetics evaluation by tread mill test. (wikipedia.org)
  • A sinus venosus atrial septal defect has been detected. (deepdyve.com)
  • A registry supports research by collecting of information about patients that share something in common, such as being diagnosed with Atrial septal defect coronary sinus. (cdc.gov)
  • The valve of the coronary sinus (Thebesian Ring) is a semicircular fold of the lining membrane of the right atrium, at the orifice of the coronary sinus. (wikipedia.org)
  • Despite of the increased complexity of management in very elderly patients with acute coronary syndrome (ACS), data on those aged ≥ 80 years are limited, since these patients are often excluded from clinical trials [ 1 , 3 ]. (panafrican-med-journal.com)
  • He was hospitalized to the Almaty hospital with diagnosis of acute coronary syndrome without ST elevation. (hvt-journal.com)
  • frontal sinus one of the paired paranasal sinuses in the frontal bone, each communicating with the middle nasal meatus on the same side. (thefreedictionary.com)
  • maxillary sinus one of the paired paranasal sinuses in the body of the maxilla on either side, opening into the middle nasal meatus on the same side. (thefreedictionary.com)
  • Sinus paranasal (Paranasal sinuses). (thefreedictionary.com)
  • In common usage, "sinus" usually refers to the paranasal sinuses, which are air cavities in the cranial bones, especially those near the nose and connecting to it. (wikipedia.org)
  • If one or more of the paired paranasal sinuses or air cavities becomes inflamed, it leads to an infection called sinusitis. (wikipedia.org)
  • Rhinitis affects the nasal mucosa, while rhinosinusitis or sinusitis affects the nose and paranasal sinuses, including frontal, ethmoid, maxillary, and sphenoid sinuses. (wikipedia.org)
  • Because MCP-1 has been shown to be related to atherosclerosis development, 2 we measured the concentration of this chemokine in blood drawn from the coronary sinus in a small sample of unstable angina patients (n=24). (ahajournals.org)
  • The Trust is one of a few centres in the world to offer coronary sinus reducer, an innovative, new treatment for refractory angina. (rbht.nhs.uk)
  • Variant angina - it is effective owing to its direct effects on coronary dilation. (wikipedia.org)