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Cardiac perforation is an infrequent but potentially life-threatening complication of pacemaker implantation. We report a case of right atrial lead perforation complicated by pneumopericardium shortly after pacemaker lead insertion. Transthoracic echocardiography revealed no evidence of pericardial effusion and pacemaker lead displacement, but a thoracic computed tomography scan illustrated the lead course and confirmed the diagnosis. This case suggests that computed tomography is a sensitive modality to confirm the diagnosis at the early stage of this complication.
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http://dx.doi.org/10.1080/ac.69.2.3017308 | DOI Listing |
Heart Rhythm O2
August 2025
Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Background: The recurrence of arrhythmia following catheter ablation of macro-reentrant atrial tachycardia (MRAT) in repaired tetralogy of Fallot (rTOF) is poorly understood.
Objective: To better describe the incidence, mechanisms, and predictors of recurrent atrial arrhythmia following MRAT ablation in rTOF.
Methods: Patients with rTOF ≥18 years of age who underwent radiofrequency ablation for MRAT (typical/cavotricuspid isthmus-dependent atrial flutter, incisional/scar-mediated MRAT, upper and lower-loop reentry, or left atrial MRAT) at Duke University Hospital from 1996 to 2023 were identified.
Int J Cardiol Cardiovasc Risk Prev
December 2025
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Background: Patients with coronary artery disease (CAD) have increased risk of ischemic stroke (IS). Our aim was to screen for significant electrocardiogram (ECG) features for IS risk in patients treated for acute coronary syndrome (ACS).
Methods: This retrospective registry study is based on 7760 ACS patients treated in Tays Heart Hospital (2007-2018) with follow-up for incident IS until December 31st 2020.
J Electrocardiol
August 2025
Department of Cardiology, Kırşehir Ahi Evran Training and Research Hospital, Kırşehir, Turkey. Electronic address:
Background: Ischemia with non-obstructive coronary arteries (INOCA) represents a diagnostic and therapeutic challenge, often related to coronary microvascular dysfunction (CMD). Identifying non-invasive electrocardiographic markers that predict ischemia in this population remains a clinical priority. P-wave peak time (PWPT), reflecting atrial conduction delay, has been linked to ischemic pathophysiology.
View Article and Find Full Text PDFJ Med Econ
September 2025
Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom.
Background: Medicare plans employ drug utilization management strategies, including prior authorization (PA) and step therapy (ST), or formulary tier increases, to control spending. However, PA and ST can delay treatment access and encourage use of less effective/safe therapies, while formulary tier increases can lead to treatment switching/discontinuation due to higher patient out-of-pocket costs. This study modeled the impact of restricted access to direct oral anticoagulants (DOACs), and a tier increase for apixaban, on incidence and cost of clinical events in patients with non-valvular atrial fibrillation (NVAF) in the United States.
View Article and Find Full Text PDFJACC Case Rep
September 2025
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address:
Background: Masses in the right ventricle are uncommon, but if present, they are most often attributed to either primary cardiac tumors or metastatic disease.
Case Summary: A 50-year-old woman presented with progressive lower extremity edema and was diagnosed with a right ventricular mass causing severe tricuspid insufficiency and near-total obstruction of the pulmonary artery. She had a history of hysterectomy for uterine leiomyomatosis.