Background Left bundle branch area pacing (LBBaP) is a new physiological pacing strategy that produces comparable clinical effects to His bundle pacing (HBP). Objective The purpose of this study was to investigate the immediate clinical outcomes of LBBaP vs RVP. Methods and Results From April 2018 to September 2018, we included 44 patients under continuous pacemaker implantation. Patients were randomly divided into the LBBaP group and conventional RVP group. Compared to the RVP group, the LBBaP group displayed significantly increased operative (90.10 ± 19.68 minutes vs 61.57 ± 6.62 minutes, P < .001) and X‐ray exposure times (15.55 ± 5.62 minutes vs 4.67 ± 2.06 minutes, P < .001). The lead threshold of the LBBaP group was increased (0.68 ± 0.20 mV vs 0.51 ± 0.0 mV, P = .001), while the R‐wave amplitude and ventricular impedance did not significantly differ between the two groups. The conventional RVP procedure significantly widened the QRS complex (93.62 ± 8.28 ms vs 135.19 ± 12.21 ms, P = .001), whereas the LBBaP had no effect on QRS complex (130.13 ± 43.30 ms vs 112.63 ± 12.14 ms, P = .904). Furthermore, the LBBaP procedure significantly narrowed the QRS complex in patients with left bundle branch block (LBBB) (168.43 ± 38.870 ms vs 119.86 ± 6.69 ms, P = .019). Conclusion LBBaP is a new physiological, safe and effective pacing procedure with a high overall success rate. Compared to conventional RVP, LBBaP can correct LBBB, thereby improving cardiac electrical dyssynchrony.

I ntravenous leiomyoma (IVL) is a rare, histologically benign smooth-muscle-cell tumor that occurs only in women. This neoplasm occupies vascular spaces from the intrauterine venules to the systemic veins, including the iliac vein and inferior vena cava (IVC), and it does not invade the tissue. The mass can extend into the right heart chambers and pulmonary arteries. 1,2 Its extrauterine involvement occurs in approximately 30% of cases, and intracardiac extension accounts for about 10%. [3][4][5] This extension of IVL into the right side of the heart is called intracardiac leiomyomatosis (ICL).The diagnosis of ICL can be overlooked. Echocardiography, abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) are available for detection and diagnosis. Echocardiography is important in the initial diagnosis of ICL. To our knowledge, the literature about ICL chiefly comprises case reports, and the authors of the few case series have not in general discussed the echocardiographic characteristics and extending pathways of ICL. We retrospectively studied the cases of 7 patients with ICL who underwent successful tumor resection in our hospital. We outlined the echocardiographic characteristics of the tumors and analyzed their clinical features, confirmed the extending pathways by means of CT reports, and studied the surgical and pathologic results. We discuss the echocardiographic diagnosis of ICL and briefly review the pertinent medical literature. Patients and MethodsWe reviewed our hospital's clinical database and identified 7 women who had undergone surgical resection of ICL tumors from January 2003 through July 2012. The echocardiographic images included parasternal, apical, and subcostal views. In addition, M-mode, pulsed and continuous-wave Doppler, and color-flow Doppler images

No abstract

No abstract

We sought to validate the hypothesis that the development of atherosclerosis can be suppressed by the interleukin-1 receptor antagonist (IL-1Ra) in murine models of atherosclerosis in vivo, noninvasively seen by means of high-resolution ultrasound biomicroscopy, and we studied changes in inflammatory markers such as IL-1 and C-reactive protein (CRP) plasma levels in these models of atherosclerosis. We divided IL-1Ra+/−/apolipoprotein-E (apoE)−/− and IL-1Ra+/+/apoE−/− mice into 2 age groups, used as atherosclerotic models. The control groups were age-matched IL-1Ra+/+/apoE+/+ mice. Plaque thickness was measured in the ascending aorta in short-axis images by means of ultrasound and histology. Plasma levels of IL-1 and CRP were quantified in the 3 murine groups. At 16 weeks, plaque thickness in the ascending aortas of the IL-1Ra+/−/apoE−/− mice was significantly greater than that in the IL-1Ra+/+/apoE−/− mice, on ultrasound and histology (P &lt;0.01). In contrast, at 32 weeks, the differences between these 2 genotypes were not statistically significant. Serum IL-1 levels were lower in the IL-1Ra+/−/apoE−/− mice than in the IL-1Ra+/+/apoE−/− mice at 16 and 32 weeks (P &lt;0.05). At 16 weeks, serum CRP levels in the IL-1Ra+/−/apoE−/− mice were higher than in the IL-1Ra+/+/apoE−/− mice (P &lt;0.01). Our results suggest that ultrasound biomicroscopy enables evaluation of atherosclerotic lesions in vivo, noninvasively and in real-time, in apoE−/− mice. Partial IL-1Ra deficiencies might promote early plaque development in 16-week-old apoE−/− mice. The balance of IL-1 and IL-1Ra might influence atherosclerotic development. Finally, CRP might affect the initiation of atherosclerosis, rather than its progression.