ABSTRACT
Chronic right ventricular (RV) pacing can exacerbate heart failure in patients with a low left ventricular ejection fraction (LVEF). Left bundle branch area pacing (LBBAP) has emerged as a novel physiological pacing technique; however, information remains limited on its use among patients with a low EF. This study investigated the safety and short-term clinical outcomes of LBBAP among patients with impaired left ventricular (LV) function. This retrospective analysis of pacemakers at Chosun University Hospital, South Korea, included all patients with impaired LV function (EF＜50%) who underwent pacemaker implantation for atrioventricular blockage from 2019-2022. Clinical characteristics, 12-lead electrocardiography findings, echocardiography findings, and laboratory parameters were evaluated. Composite outcomes were defined as all-cause mortality, cardiac death, and hospitalization due to heart failure during the 6-month follow-up. Altogether 57 patients (25 men; mean age, 77.4±10.8 y; LVEF, 41.5±3.8%) were divided into LBBAP (n=16), biventricular pacing (BVP; n=16), and conventional RV pacing (RVP; n=25) groups. In the LBBAP group, the mean paced QRS duration (pQRSd) was narrower (119.5±14.7 vs. 140.2±14.3 vs. 163.2±13.9; p＜0.001) and cardiac troponin I level was elevated post-pacing (1.14±1.29 vs. 0.20±0.29 vs.0.24±0.51, p=0.001). Lead parameters were stable. One patient was hospitalized, and four died (one patient each from heart failure admission, myocardial infarction, unexplained death, and pneumonia in RVP vs. one from intracerebral hemorrhage in BVP) during the follow-up period. In conclusion, LBBAP is feasible in patients with impaired LV function without acute or significant complications and provides a remarkably narrower pQRSd with a stable pacing threshold.
ABSTRACT
The clinical features of the Mayer-Rokitansky-K ster-Hauser(MRKH) syndrome include normal female secondary sex characteristics, normal genitalia, congenital absence of vagina, rudimentary or bipartite uterus, normal ovarian function and normal ovulation, 46, XX, karyotype, frequent association of renal, skeletal and other congenital anomalies. We experienced a case of a premature infant with MRKH syndrome who had imperforate anus and unilateral renal agenesis.
Subject(s)
Female , Humans , Infant, Newborn , Anus, Imperforate , Genitalia , Infant, Premature , Karyotype , Ovulation , Sex Characteristics , Uterus , VaginaABSTRACT
PURPOSE: We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. MATERIALS AND METHODS: The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server(R) operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. RESULTS: The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. CONCLUSION: Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web PACS by using a system independent from PACS in the hospital and minimizing the information patients.