Scholars@Duke
Ronald Jay Kanter

Ronald Jay Kanter

Professor Emeritus of Pediatrics
Pediatrics, Cardiology
kante001@mc.duke.edu
Box 3090 Med Ctr, Durham, NC 27710
7618 Hosp North, Durham, NC 27710

Selected Publications

Thoracoscopic resection of the left atrial appendage after failed focal atrial tachycardia ablation.

Journal Article Ann Thorac Surg · April 2014 BACKGROUND: This case series describes 3 patients with the unusual location of focal atrial tachycardia in the left atrial appendage who failed catheter ablation but were successfully treated by left atrial appendage resection by a totally thoracoscopic su ... Full text Link to item Cite

Right ventricular mechanics using a novel comprehensive three-view echocardiographic strain analysis in a normal population.

Journal Article J Am Soc Echocardiogr · April 2014 BACKGROUND: Although quantitative right ventricular (RV) strain analysis may be useful in congenital and acquired heart disease populations with RV failure, a comprehensive, standardized approach is lacking. An 18-segment RV strain analysis obtained from t ... Full text Link to item Cite

Radiofrequency catheter ablation for dyssynchrony-induced dilated cardiomyopathy in an infant.

Journal Article Congenit Heart Dis · 2014 The relationship between accessory pathway-mediated ventricular preexcitation and left ventricular dyssynchrony-induced dysfunction has been described in patients with Wolff-Parkinson-White (WPW) syndrome in the absence of sustained supraventricular tachyc ... Full text Link to item Cite

Laser lead extraction in congenital heart disease: a case-controlled study.

Journal Article Pacing Clin Electrophysiol · March 2013 INTRODUCTION: Patients with congenital heart disease (CHD) and implanted cardiac rhythm management devices have a high rate of endocardial lead issues requiring lead extraction. Laser lead extraction (LLE) is a promising modality for lead management though ... Full text Link to item Cite

The multicenter pediatric and adult congenital EP quality (MAP-IT) initiative-rationale and design: Report from the pediatric and congenital electrophysiology society's MAP-IT taskforce

Journal Article Congenital Heart Disease · 2013 Multicenter clinical registries are increasingly recognized as valuable tools for establishing benchmarks, facilitating patient-centered quality improvement and research. In 2010, the Pediatric and Congenital Electrophysiology Society convened a taskforce ... Full text Cite

The study of antiarrhythmic medications in infancy (SAMIS): a multicenter, randomized controlled trial comparing the efficacy and safety of digoxin versus propranolol for prophylaxis of supraventricular tachycardia in infants.

Journal Article Circ Arrhythm Electrophysiol · October 2012 BACKGROUND: Supraventricular tachycardia (SVT) is one of the most common conditions requiring emergent cardiac care in children, yet its management has never been subjected to a randomized controlled clinical trial. The purpose of this study was to compare ... Full text Link to item Cite

Brugada-like syndrome in infancy presenting with rapid ventricular tachycardia and intraventricular conduction delay.

Journal Article Circulation · January 3, 2012 BACKGROUND: Brugada syndrome is a potentially serious channelopathy that usually presents in adulthood and has only rarely been described in infancy. In the absence of metabolic or structural cardiac disease, rapid ventricular tachycardia (>200 bpm) and pr ... Full text Link to item Cite

Multiple arrhythmic syndromes in a newborn, owing to a novel mutation in SCN5A.

Journal Article Can J Physiol Pharmacol · October 2011 BACKGROUND: Mutations in the SCN5A gene have been linked to Brugada syndrome (BrS), conduction disease, Long QT syndrome (LQT3), atrial fibrillation (AF), and to pre- and neonatal ventricular arrhythmias. OBJECTIVE: The objective of this study is to charac ... Full text Link to item Cite

Preoperative diagnosis of long QT syndrome in an infant with tetralogy of Fallot.

Journal Article Pediatr Cardiol · August 2011 Long QT syndrome is a well-described entity in infants. Its presentation in the context of congenital heart disease is rare and is almost exclusively diagnosed postoperatively. For patients undergoing surgical intervention, preoperative knowledge of the di ... Full text Link to item Cite

Quality of life in pediatric patients with implantable cardioverter defibrillators.

Journal Article Am J Cardiol · April 1, 2011 Psychosocial and quality-of-life (QOL) outcomes in adult patients with implantable cardioverter-defibrillators (ICDs) are well studied. Minimal research exists regarding pediatric adjustment, despite a potentially more challenging adjustment process. The p ... Full text Link to item Cite

Arrhythmias in patients with hypoplastic left heart syndrome.

Journal Article Am Heart J · January 2011 BACKGROUND: Mortality between stage I and II palliation for hypoplastic left heart syndrome (HLHS) has been associated with arrhythmias. The stage-related proportion, associations, and clinical impact of arrhythmias in patients with HLHS have not been eval ... Full text Link to item Cite

Transesophageal electrophysiological evaluation of children with a history of supraventricular tachycardia in infancy

Journal Article Pediatric Cardiology · 2011 Supraventricular tachycardia (SVT) presenting in the neonatal period may resolve by 1 year of age. Predicting which patients require therapy beyond 1 year of age is desirable. Pediatric electrophysiology databases from two institutions were reviewed for pa ... Full text Cite

Two children with "dropped head" syndrome due to lamin A/C mutations.

Journal Article Muscle Nerve · November 2010 LMNA-related congenital muscular dystrophy (L-CMD) is a recently described disorder characterized by infantile-onset myopathy due to mutations in the lamin A/C (LMNA) gene. We report the genetic and clinical characteristics of two unrelated L-CMD patients. ... Full text Link to item Cite

LAMP2 microdeletions in patients with Danon disease.

Journal Article Circ Cardiovasc Genet · April 2010 BACKGROUND: Danon disease is an X-linked dominant disorder characterized by the clinical triad of hypertrophic cardiomyopathy, skeletal myopathy, and variable mental retardation. Pathologically, autophagic vacuoles are noted in both skeletal and cardiac mu ... Full text Link to item Cite

Pearls for ablation in congenital heart disease.

Journal Article J Cardiovasc Electrophysiol · February 2010 Tachyarrhythmias occur in patients having congenital heart disease most commonly related to surgically created or naturally occurring conduction obstacles, and to postoperative hemodynamic effects on cardiac muscle. Less frequently, the underlying disease ... Full text Link to item Cite

Double aortic arch with aortic atresia and left-sided type B interruption.

Journal Article Congenit Heart Dis · 2010 Aortic valve atresia with interruption of the aortic arch is an extremely rare anomaly; only eleven cases of this anomaly have been reported to date. In the absence of additional sources of blood flow to the ascending aorta, aortic valve atresia with inter ... Full text Link to item Cite

Mutations in the cardiac L-type calcium channel associated with inherited J-wave syndromes and sudden cardiac death

Journal Article Heart Rhythm · 2010 Background L-type calcium channel (LTCC) mutations have been associated with Brugada syndrome (BrS), short QT (SQT) syndrome, and Timothy syndrome (LQT8). Little is known about the extent to which LTCC mutations contribute to the J-wave syndromes associate ... Full text Cite

Arrhythmias in children having a single left superior vena cava and minimal structural heart disease.

Journal Article J Cardiovasc Electrophysiol · February 2009 BACKGROUND: The presence of a single left superior vena cava in the absence of complex congenital heart disease is uncommon, and, in the absence of hemodynamic consequences, it would not be expected to result in cardiovascular signs or symptoms. Single cas ... Full text Link to item Cite

Arrhythmias in patients receiving enzyme replacement therapy for infantile Pompe disease.

Journal Article Genet Med · October 2008 PURPOSE: Enzyme replacement therapy in infants with Pompe disease prolongs survival, decreases cardiomegaly, and improves muscle function. Because ectopy has been previously described in these patients, we sought to determine the prevalence and types of ar ... Full text Link to item Cite

Functional status, heart rate, and rhythm abnormalities in 521 Fontan patients 6 to 18 years of age.

Journal Article J Thorac Cardiovasc Surg · July 2008 OBJECTIVES: Our objective was to determine the relationship between functional outcome and abnormalities of heart rate and rhythm after the Fontan operation. METHODS: The National Heart, Lung, and Blood Institute Pediatric Heart Network conducted a cross-s ... Full text Link to item Cite

A patient with congenital heart disease and ventricular tachycardia: what is the course of the device lead?

Journal Article Pacing Clin Electrophysiol · November 2007 A 16-year-old boy with Ebstein's anomaly of the tricuspid valve developed exercise-induced rapid ventricular tachycardia. He had previously undergone tricuspid valvuloplasty and bidirectional cavopulmonary anastamosis due to progressive symptoms. A single- ... Full text Link to item Cite

Pacemaker lead prolapse through the pulmonary valve in children.

Journal Article Pacing Clin Electrophysiol · October 2007 BACKGROUND: Transvenous pacemaker leads in children are often placed with redundant lead length to allow for anticipated patient growth. This excess lead may rarely prolapse into the pulmonary artery and potentially interfere with valve function. We sought ... Full text Link to item Cite

The Fontan right atrium--in context.

Journal Article Circulation · April 3, 2007 Full text Link to item Cite

The use of transcranial Doppler during tilt table testing in children presenting with syncope

Journal Article Journal for Vascular Ultrasound · January 1, 2007 Childhood syncope is common, and there are three categories of causes of syncope: noncardiovascular pseudosyncope, cardiovascular syncope, and neurally mediated syncope. Tilt table testing has become a valuable tool in the evaluation for the cause of synco ... Full text Cite

Pediatric Arrhythmias

Journal Article · December 1, 2006 Full text Cite

Sudden cardiac death in young children with neurofibromatosis type 1.

Journal Article J Pediatr · November 2006 Patients with neurofibromatosis type 1 (NF1) can manifest a characteristic vasculopathy that in adults is rarely associated with fatal coronary artery occlusion. We describe the clinical and pathological findings from 2 unrelated young children with NF1, a ... Full text Link to item Cite

Anorexia nervosa and second-degree atrioventricular block (Type I).

Journal Article Int J Eat Disord · November 2006 OBJECTIVE: This is the first case report of a second-degree heart block (Mobitz Type I) described in a patient with anorexia nervosa (AN). METHOD: We present the case of a 20-year-old woman with AN and second-degree heart block. Pertinent reports in the li ... Full text Link to item Cite

Anaesthetic management of a parturient with the postural orthostatic tachycardia syndrome: a case report.

Journal Article Br J Anaesth · August 2006 Postural orthostatic tachycardia syndrome encompasses a group of disorders characterized by orthostatic intolerance. We describe the anaesthetic management of analgesia for labour and of Caesarean section in a parturient suffering from this disorder. Worse ... Full text Link to item Cite

Electrocardiographic response to enzyme replacement therapy for Pompe disease.

Journal Article Genet Med · May 2006 PURPOSE: Electrocardiogram (ECG) abnormalities are universal in infantile Pompe disease or glycogen storage disease type II, a fatal genetic muscle disorder caused by deficiency of acid alpha-glucosidase (GAA). Hallmarks of this disease include a shortened ... Full text Link to item Cite

Ambulatory electrocardiogram analysis in infants treated with recombinant human acid alpha-glucosidase enzyme replacement therapy for Pompe disease.

Journal Article Genet Med · May 2006 PURPOSE: Infantile Pompe disease is caused by deficiency of lysosomal acid alpha-glucosidase. Trials with recombinant human acid alpha-glucosidase enzyme replacement therapy (ERT) show a decrease in left ventricular mass and improved function. We evaluated ... Full text Link to item Cite

Efficacy of signal-averaged electrocardiography in the young orthotopic heart transplant patient to detect allograft rejection.

Journal Article Pediatr Cardiol · 2006 Endomyocardial biopsy is the gold standard survey for cardiac graft rejection. Signal-averaged electrocardiography (SAECG) identifies slowly conducting, diseased myocardium. We sought to determine whether SAECG is a sensitive, noninvasive transplant survei ... Full text Link to item Cite

Resynchronization therapy in pediatric and congenital heart disease patients: an international multicenter study.

Journal Article J Am Coll Cardiol · December 20, 2005 OBJECTIVES: Our objective was to evaluate the short-term safety and efficacy of cardiac resynchronization therapy (CRT) in children. BACKGROUND: Cardiac resynchronization therapy has been beneficial for adult patients with poor left ventricular function an ... Full text Link to item Cite

Glycogen storage diseases presenting as hypertrophic cardiomyopathy.

Journal Article N Engl J Med · January 27, 2005 BACKGROUND: Unexplained left ventricular hypertrophy often prompts the diagnosis of hypertrophic cardiomyopathy, a sarcomere-protein gene disorder. Because mutations in the gene for AMP-activated protein kinase gamma2 (PRKAG2) cause an accumulation of card ... Full text Link to item Cite

Cryoablation of a nodoventricular Mahaim fiber

Journal Article Journal of Interventional Cardiac Electrophysiology · 2005 An 11-year old female presented with paroxysmal tachycardia and was diagnosed with a Mahaim fiber during electrophysiologic study. A preexcited tachycardia and the typical variety of AV nodal reentry tachycardia were induced at different times. During pree ... Full text Cite

Highlights of Heart Rhythm 2004, the Annual Scientific Sessions of the Heart Rhythm Society: May 19 to 22, 2004, in San Francisco, California.

Journal Article J Am Coll Cardiol · October 19, 2004 Heart Rhythm 2004, the 25th Annual Scientific Sessions of the Heart Rhythm Society (formerly the North American Society of Pacing and Electrophysiology), met in San Francisco in May 2004. The meeting is the world's premier forum for the presentation of res ... Full text Link to item Cite

Prospective assessment after pediatric cardiac ablation: demographics, medical profiles, and initial outcomes.

Journal Article J Cardiovasc Electrophysiol · July 2004 INTRODUCTION: A multicenter prospective study was designed and implemented to assess the short- and longer-term results and risks associated with radiofrequency (RF) ablation in children. METHODS AND RESULTS: Patients recruited for the study were aged 0 to ... Full text Link to item Cite

Prospective assessment after pediatric cardiac ablation: recurrence at 1 year after initially successful ablation of supraventricular tachycardia.

Journal Article Heart Rhythm · July 2004 OBJECTIVES: A multicenter prospective study was performed to assess the results and risks associated with radiofrequency ablation in children. This report focuses on recurrences following initially successful ablation. METHODS: Patients recruited for the s ... Full text Link to item Cite

Measures of cardiac repolarization and body position in infants.

Journal Article Clin Pediatr (Phila) · 2003 Sudden Infant Death Syndrome (SIDS) is the most common cause of death in children between 1 and 6 months of age. Recent data suggest that a prolonged QTc interval on the 12-lead electrocardiogram (ECG) is associated with SIDS. Prone body position during sl ... Full text Link to item Cite

Postoperative nausea and vomiting in children and adolescents undergoing radiofrequency catheter ablation: a randomized comparison of propofol- and isoflurane-based anesthetics.

Journal Article Anesth Analg · December 2002 UNLABELLED: In children, radiofrequency catheter ablation (RFCA) is typically performed under general anesthesia. With the use of volatile anesthetics, postoperative nausea and vomiting (PONV) are common, with an incidence of emesis as frequent as 60%. We ... Full text Link to item Cite

Comparison of electrophysiologic effects of propofol and isoflurane-based anesthetics in children undergoing radiofrequency catheter ablation for supraventricular tachycardia.

Journal Article Anesthesiology · June 2002 BACKGROUND: Radiofrequency catheter ablation (RFCA), which is typically performed with general anesthesia in children, is an interventional therapy for tachyarrhythmia. Although the electrophysiologic (EP) effects of isoflurane- and propofol-based anesthet ... Full text Link to item Cite

Quantitative assessment of the recovery property of atriofascicular/atrioventricular-type Mahaim fiber.

Journal Article J Cardiovasc Electrophysiol · June 2002 INTRODUCTION: One of the characteristics of the Mahaim fiber is that it possesses a decremental property related to the slow rate of recovery of its excitability similar to that of AV node. The aim of this study was to evaluate the recovery property of the ... Full text Link to item Cite

Atrioventricular nodal reentrant tachycardia in children: effect of slow pathway ablation on fast pathway function.

Journal Article J Cardiovasc Electrophysiol · March 2002 INTRODUCTION: Prior studies in adults have shown significant shortening of the fast pathway effective refractory period after successful slow pathway ablation. As differences between adults and children exist in other characteristics of AV nodal reentrant ... Full text Link to item Cite

Constitutively active AMP kinase mutations cause glycogen storage disease mimicking hypertrophic cardiomyopathy

Journal Article Journal of Clinical Investigation · January 1, 2002 Mutations in PRKAG2, the gene for the γ2 regulatory subunit of AMP-activated protein kinase, cause cardiac hypertrophy and electrophysiologic abnormalities, particularly preexcitation (Wolff-Parkinson-White syndrome) and atrioventricular conduction block. ... Full text Cite

Radiofrequency catheter ablation of supraventricular tachycardia substrates after mustard and senning operations for d-transposition of the great arteries.

Journal Article J Am Coll Cardiol · February 2000 OBJECTIVES: The purpose of this study was to determine the efficacy and risks of radiofrequency ablation of various forms of supraventricular tachycardia after Mustard and Senning operations for d-transposition of the great arteries. BACKGROUND: In this pa ... Full text Link to item Cite

Coexisting preexcitation syndrome and intermittent heart block presenting as neonatal seizures.

Journal Article J Cardiovasc Electrophysiol · May 1999 An infant presented with neonatal syncope and seizures. An ECG showed a preexcitation pattern, most compatible with Wolff-Parkinson-White (WPW) syndrome. Rhythm monitoring during an event demonstrated prolonged periods of complete AV block with no ventricu ... Full text Link to item Cite

Evaluation of the change in QTc interval in infants receiving cisapride therapy and plasma concentration monitoring

Journal Article Critical Care Medicine · January 1, 1999 Introduction: Cisapride therapy has been associated with life threatening arrhythmias (Torsades de pointes) and prolongation of the QTc interval in adults and children. Cisapride exhibits a dose dependent class III anti-arrhythmic effect. Infants have a de ... Full text Cite

Radiofrequency catheter ablation of multiple haemodynamically unstable ventricular tachycardias in a patient with surgically repaired tetralogy of Fallot.

Journal Article Cardiol Young · July 1998 A patient with repaired tetralogy of Fallot presented with recurrent syncope and had multiple haemodynamically unstable ventricular tachycardias unresponsive to antiarrhythmic medications. Ventricular tachycardias became haemodynamically tolerated with ami ... Full text Link to item Cite

Management of the child with Wolff-Parkinson-White syndrome and supraventricular tachycardia: model for cost effectiveness.

Journal Article J Cardiovasc Electrophysiol · November 1997 In the next decade, "better" management will be defined by cost effectiveness including morbidity, mortality, and cost. We used a cost-effectiveness model for children with Wolff-Parkinson-White syndrome (WPW) and supraventricular tachycardia (SVT) compari ... Full text Link to item Cite

Effect of repair strategy on hospital cost for infants with tetralogy of Fallot.

Journal Article Ann Surg · June 1997 OBJECTIVE: This study compares the total hospital cost (HC) for one-stage versus "two-stage" repair of tetralogy of Fallot (TOF) in infants younger than 1 year of age. SUMMARY BACKGROUND DATA: Total (one-stage) correction of TOF is now being performed with ... Full text Link to item Cite

Pathologic findings following sudden death in an infant with hypertrophic cardiomyopathy and supraventricular tachycardia.

Journal Article J Cardiovasc Electrophysiol · February 1997 The cardiac conduction system from infants suddenly dying with hypertrophic cardiomyopathy has not been described. We studied by serial section examination the conduction system from a 13-month old infant also known to have had supraventricular tachycardia ... Full text Link to item Cite

Atrial arrhythmias during chronic follow-up of surgery for complex congenital heart disease.

Journal Article Pacing Clin Electrophysiol · February 1997 After surgery for complex congenital heart disease, clinically important atrial tachyarrhythmias have a higher than normal incidence if sufficiently large regions of conduction block occur within the atria, especially in the presence of hemodynamic alterat ... Full text Link to item Cite

Experience with moricizine HCl in children with supraventricular tachycardia.

Journal Article Int J Cardiol · November 15, 1996 Eight children, age between 4.5 and 19 years were treated with moricizine for supraventricular tachycardia during the last 3 years. The tachycardia was documented by surface electrocardiogram (ECG), and/or by ambulatory ECG in all the children and the mech ... Full text Link to item Cite

Internal cardioversion in two patients with atrial fibrillation refractory to external cardioversion.

Journal Article Pacing Clin Electrophysiol · May 1996 A 26-year-old man underwent an electrophysiological study for evaluation of a history of congenital heart disease, presyncope, and wide complex tachycardia. During the study the patient developed sustained atrial fibrillation with a rapid ventricular respo ... Full text Link to item Cite

Supraventricular tachycardia in four young dogs.

Journal Article J Am Vet Med Assoc · January 1, 1996 Rapid, clinical supraventricular tachycardia (SVT), without apparent underlying heart disease, was identified in 3 young Labrador Retrievers and 1 Labrador Retriever-type dog. The electrocardiographic characteristics, identification of ventricular preexcit ... Link to item Cite

Intraoperative echocardiography during congenital heart operations: experience from 1,000 cases.

Journal Article Ann Thorac Surg · December 1995 BACKGROUND: This article provides an overview of the application of intraoperative echocardiography during repair of congenital heart defects based on our experience with 1,000 patients. METHODS: The patients in this study all underwent repair of a congeni ... Full text Link to item Cite

Hemangioma, supraumbilical midline raphé, and coarctation of the aorta with a right aortic arch: single causal entity?

Journal Article Am J Med Genet · October 23, 1995 Most congenital cutaneous hemangiomas are a sporadic occurrence. Hemangiomas have been found in association with coarctation of the aorta and a right aortic arch. A separate association has been noted of midline ventral defects with hemangiomas. We report ... Full text Link to item Cite

Orthodromic reciprocating tachycardia and heart failure in a dog with a concealed posteroseptal accessory pathway.

Journal Article J Vet Intern Med · 1995 A 4-month-old male Labrador Retriever was presented for recurrent bouts of pulmonary edema associated with tachycardia. Initial physical examination and echocardiography were unremarkable, and the electrocardiogram revealed only an intraventricular conduct ... Full text Link to item Cite

Wide complex bigeminy: unusual presentation of an atriofascicular fiber.

Journal Article J Cardiovasc Electrophysiol · September 1994 Ventricular bigeminy in children is regarded as a benign arrhythmia in the absence of coexisting heart disease. We present the case of a patient with an atriofascicular fiber that electrocardiographically presented as wide complex bigeminy and wide complex ... Full text Link to item Cite

Polysplenia with pulmonary arteriovenous malformations.

Journal Article Pediatr Cardiol · March 1993 A patient with polysplenia syndrome, dextrocardia, left atrial isomerism, normal great vessel relationships, and no intracardiac shunts developed progressive cyanosis and clubbing. Pulmonary arteriovenous malformations (PAVMs) were diagnosed by angiography ... Full text Link to item Cite

Pediatric electrophysiology.

Journal Article Curr Opin Cardiol · January 1993 Our understanding of pediatric arrhythmias continues to evolve through natural history studies of paroxysmal supraventricular tachycardia, the congenital long QT syndrome, and postoperative atrial and ventricular tachyarrhythmias. The influence of the auto ... Full text Link to item Cite

The learning curve for intraoperative echocardiography during congenital heart surgery.

Journal Article Ann Thorac Surg · October 1992 Our group has previously reported a large prospective experience with the use of intraoperative echocardiography with Doppler color-flow imaging (IE-DCFI) during the repair of congenital heart defects. We have now performed IE-DCFI in 621 patients and have ... Full text Link to item Cite

Feasibility of reversible pulmonary artery banding: early results and intermediate-term follow-up.

Journal Article Ann Thorac Surg · July 1990 Development of a reversible pulmonary artery band might obviate the need for a second cardiac surgical procedure in children with some forms of congenital heart disease. We evaluated a segmented Silastic-coated Dacron mesh band 2 to 4 mm wide sewn together ... Full text Link to item Cite

Balloon angioplasty of coarctation of the aorta evaluated with intravascular ultrasound imaging.

Journal Article J Am Coll Cardiol · March 15, 1990 Intravascular ultrasound images were employed to evaluate aortic coarctation before and after balloon angioplasty. Measurements obtained with use of an ultrasound imaging catheter correlated well with measurements made with digital aortography, both in the ... Full text Link to item Cite