V. Zimina, G. Aĭrapetian, Y. Grishkin, S. Sayganov
Modern cardiology is impossible without implantation of intracardiac devices, such as cardiac pacemakers, resynchronization therapy devices, implantable cardioverter-defibrillators. Meanwhile, as the number of implanted devices increases, so does the number of cases of their infection [1]. At present, sufficient clinical material has been accumulated, demonstrating the obvious features of the course of this type of IE, leading to late diagnosis, the spread of infection to the tricuspid valve and, as a result, to a poor prognosis. The frequency of purulent complications after implantation of pacemakers is from 0.6 to 5.7%; mortality rate varies from 0.13% in local purulent inflammation to 19.9% in bacterial endocarditis and sepsis [2]. Abroad, term electrode sepsis is widely used to reflect the main features of the course of cardiac implantable electronic device infection, which are the predominance of systemic inflammation symptoms and the long-term absence of heart damage signs. We present two typical cases of the course of cardiac implantable electronic device infection, illustrating the difficulties of diagnosing and treating this disease.
{"title":"Late Electrode Sepsis: Clinical Features, Diagnostics and Management. Clinical Cases","authors":"V. Zimina, G. Aĭrapetian, Y. Grishkin, S. Sayganov","doi":"10.17816/cardar71367","DOIUrl":"https://doi.org/10.17816/cardar71367","url":null,"abstract":"Modern cardiology is impossible without implantation of intracardiac devices, such as cardiac pacemakers, resynchronization therapy devices, implantable cardioverter-defibrillators. Meanwhile, as the number of implanted devices increases, so does the number of cases of their infection [1]. At present, sufficient clinical material has been accumulated, demonstrating the obvious features of the course of this type of IE, leading to late diagnosis, the spread of infection to the tricuspid valve and, as a result, to a poor prognosis. The frequency of purulent complications after implantation of pacemakers is from 0.6 to 5.7%; mortality rate varies from 0.13% in local purulent inflammation to 19.9% in bacterial endocarditis and sepsis [2]. \u0000Abroad, term electrode sepsis is widely used to reflect the main features of the course of cardiac implantable electronic device infection, which are the predominance of systemic inflammation symptoms and the long-term absence of heart damage signs. \u0000We present two typical cases of the course of cardiac implantable electronic device infection, illustrating the difficulties of diagnosing and treating this disease.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89166939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Zhelyakov, A. Ardashev, Amen A. Kocharian, Mikhail L. Ginsburg, E. Daniels
A 60 year-old male with a previous (40 years ago) history of rheumatic carditis without valve involvement and 5 years history of paroxysmal atrial fibrillation underwent ablation (PV isolation with roof and mitral isthmus lines). The following day patient developed AF episode with severe mid-sternal chest pain with widespread concave ST elevation throughout most of the limb leads (I, II, III, aVL, aVF) and precordial leads (V2-6). Serum troponin I was 87.2 ng/ml with a creatinine concentration of 0.88 mg/dl and hemoglobin level of 15 g/dl. 2D transthoracic echocardiogram excluded wall motion abnormalities, or significant pericardial effusions. Recurrence of acute rheumatic fever was excluded based on revised Jones criteria. Careful analysis of ECG allowed us to recognize the ECG criteria of pericarditis and to avoid unnecessary emergent coronary angiography. Ultimately, the patient was diagnosed with pericarditis. After diagnosis, the patients presenting symptoms resolved with treatment including sotalol 160 mg per day, nonsteroidal anti-inflammatory agents. Conclusions: This is the first reported case study of post-cardiac ablation pericarditis in patient with prior history of rheumatic carditis.
患者为60岁男性，既往(40年前)风湿性心炎，无瓣膜受累性病史，5年阵发性心房颤动病史，行消融术(椎弓根和二尖瓣峡线PV隔离)。第二天，患者出现房颤发作，伴有严重的胸骨中胸痛，大部分肢体导联(I, II, III, aVL, aVF)和心前导联(V2-6)广泛凹ST抬高。血清肌钙蛋白I为87.2 ng/ml，肌酐浓度为0.88 mg/dl，血红蛋白水平为15 g/dl。二维经胸超声心动图排除壁运动异常或明显的心包积液。根据修订后的Jones标准排除急性风湿热复发。仔细的心电图分析使我们能够识别心包炎的心电图标准，并避免不必要的急诊冠状动脉造影。最终，患者被诊断为心包炎。诊断后，出现症状的患者通过每天160mg索他洛尔、非甾体抗炎药等治疗得以缓解。结论:这是首个有风湿性心炎病史的患者心脏消融后心包炎的病例研究。
{"title":"Postabaltive Pericarditis in Patient with a Prior History of Rheumatic Disease: a Case Report","authors":"E. Zhelyakov, A. Ardashev, Amen A. Kocharian, Mikhail L. Ginsburg, E. Daniels","doi":"10.17816/cardar71371","DOIUrl":"https://doi.org/10.17816/cardar71371","url":null,"abstract":"A 60 year-old male with a previous (40 years ago) history of rheumatic carditis without valve involvement and 5 years history of paroxysmal atrial fibrillation underwent ablation (PV isolation with roof and mitral isthmus lines). The following day patient developed AF episode with severe mid-sternal chest pain with widespread concave ST elevation throughout most of the limb leads (I, II, III, aVL, aVF) and precordial leads (V2-6). Serum troponin I was 87.2 ng/ml with a creatinine concentration of 0.88 mg/dl and hemoglobin level of 15 g/dl. 2D transthoracic echocardiogram excluded wall motion abnormalities, or significant pericardial effusions. Recurrence of acute rheumatic fever was excluded based on revised Jones criteria. Careful analysis of ECG allowed us to recognize the ECG criteria of pericarditis and to avoid unnecessary emergent coronary angiography. Ultimately, the patient was diagnosed with pericarditis. After diagnosis, the patients presenting symptoms resolved with treatment including sotalol 160 mg per day, nonsteroidal anti-inflammatory agents. \u0000Conclusions: This is the first reported case study of post-cardiac ablation pericarditis in patient with prior history of rheumatic carditis.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83079638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Bitakova, V. Gumerova, E. Zbyshevskaya, V. Zimina, T. Novikova, Rodion V. Ratmanov, Sergey A. Saiganov, Vladislava A. Shcherbakova
Dilated cardiomyopathy (DCM) is a steadily developing disease characterized by progressive chronic heart failure (CHF) resistant to drug therapy. Cardiac resynchronization therapy (CRT) significantly improves the prognosis in these patients if they have indications for implantation of resynchronization devices. The article presents a clinical case of successful implantation of a cardioversion-defibrillation cardiac resynchronization device in a patient suffering from DCM in combination with permanent atrial fibrillation (AF). The nuances of ventricular rate control and the role of the catheter procedure for modifying the atrioventricular junction are discussed.
{"title":"Nuances of Cardiac Resynchronization Therapy in Patients with Dilated Cardiomyopathy and Atrial Fibrillation (a Clinical Case)","authors":"F. Bitakova, V. Gumerova, E. Zbyshevskaya, V. Zimina, T. Novikova, Rodion V. Ratmanov, Sergey A. Saiganov, Vladislava A. Shcherbakova","doi":"10.17816/cardar75647","DOIUrl":"https://doi.org/10.17816/cardar75647","url":null,"abstract":"Dilated cardiomyopathy (DCM) is a steadily developing disease characterized by progressive chronic heart failure (CHF) resistant to drug therapy. Cardiac resynchronization therapy (CRT) significantly improves the prognosis in these patients if they have indications for implantation of resynchronization devices. The article presents a clinical case of successful implantation of a cardioversion-defibrillation cardiac resynchronization device in a patient suffering from DCM in combination with permanent atrial fibrillation (AF). The nuances of ventricular rate control and the role of the catheter procedure for modifying the atrioventricular junction are discussed.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84044514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Snezhitskiy, L. V. Kalatsei, Marina Ch. Matyukevich, S. N. Grib, Elena А. Snezhickaya, G. A. Madekina, Zh. G. Epifanova, E. N. Chernaya
Chronic heart failure is the final stage of the cardiovascular continuum, which is an important cause of disability and reduced life expectancy in developed countries. Optimal medical therapy recommended for patients with symptomatic HF and reduced left ventricular ejection fraction includes angiotensin-converting enzyme inhibitors (or angiotensin II receptor antagonists), beta-blockers and mineralocorticoid receptor antagonists. However, the use of optimal medical therapy does not always lead to the elimination of symptoms, improvement of the quality of life and functional capabilities of patients. Sakubitril/valsartan is a novel combination drug that includes the angiotensin II receptor blocker valsartan and the neprilisin inhibitor sacubitril. In a large PARADIGM-HF clinical trial it demonstrated a 20% reduction in cardiovascular mortality and hospitalization due to decompensation of heart failure compared with standard therapy with enalapril. We report a case of successful use of sacubitril/valsartan in a 61-year-old patient with dilated cardiomyopathy, chronic heart failure with reduced ejection fraction and ventricular arrhythmias. After 6 months of therapy, the patient achieved marked positive dynamics of the clinical status, laboratory and instrumental parameters in absence of any adverse reactions and complications.
{"title":"Clinical Experience of Use of Sacubitril/Valsartan in a Patient with Dilated Cardiomyopathy, Chronic Heart Failure with Reduced Ejection Fraction and Ventricular Arrhythmias","authors":"V. Snezhitskiy, L. V. Kalatsei, Marina Ch. Matyukevich, S. N. Grib, Elena А. Snezhickaya, G. A. Madekina, Zh. G. Epifanova, E. N. Chernaya","doi":"10.17816/cardar65220","DOIUrl":"https://doi.org/10.17816/cardar65220","url":null,"abstract":"Chronic heart failure is the final stage of the cardiovascular continuum, which is an important cause of disability and reduced life expectancy in developed countries. Optimal medical therapy recommended for patients with symptomatic HF and reduced left ventricular ejection fraction includes angiotensin-converting enzyme inhibitors (or angiotensin II receptor antagonists), beta-blockers and mineralocorticoid receptor antagonists. However, the use of optimal medical therapy does not always lead to the elimination of symptoms, improvement of the quality of life and functional capabilities of patients. \u0000Sakubitril/valsartan is a novel combination drug that includes the angiotensin II receptor blocker valsartan and the neprilisin inhibitor sacubitril. In a large PARADIGM-HF clinical trial it demonstrated a 20% reduction in cardiovascular mortality and hospitalization due to decompensation of heart failure compared with standard therapy with enalapril. We report a case of successful use of sacubitril/valsartan in a 61-year-old patient with dilated cardiomyopathy, chronic heart failure with reduced ejection fraction and ventricular arrhythmias. After 6 months of therapy, the patient achieved marked positive dynamics of the clinical status, laboratory and instrumental parameters in absence of any adverse reactions and complications.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86163498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. We have discussed the role of hyperuricemia as a predisposing factor for the onset of AF. Numerous clinical and experimental investigators demonstrated the correlation between serum uric acid (SUA) level and arrhythmia development and its complications. The development and progression of AF are connected to a complex of changes in atrial cardiac muscle tissue. The electrical, structural, contractile remodeling, neurohumoral systems, inflammation, fibrosis, oxidative stress, endothelial dysfunction, activation of NLRP3 inflammasome induced by crystals of monosodium urate (MSU), heat shock proteins (HSP), cytokines all have a role in the development of this process. Furthermore, the role of xanthine oxidase (XO) is considered in the pathogenesis of AF through activation of systemic inflammation and oxidative stress, preparing that substrate for AF. The overwhelming data suggest a direct pathophysiological role of the increased SUA and XO activity as risk factors for AF. This article offers a comprehensive review of investigations that shows the interrelation between hyperuricemia and the risk of AF.
{"title":"The Role of Hyperuricemia in the Development of Atrial Fibrillation","authors":"T. Barysenka, V. Snezhitskiy","doi":"10.17816/cardar66609","DOIUrl":"https://doi.org/10.17816/cardar66609","url":null,"abstract":"Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. We have discussed the role of hyperuricemia as a predisposing factor for the onset of AF. Numerous clinical and experimental investigators demonstrated the correlation between serum uric acid (SUA) level and arrhythmia development and its complications. The development and progression of AF are connected to a complex of changes in atrial cardiac muscle tissue. The electrical, structural, contractile remodeling, neurohumoral systems, inflammation, fibrosis, oxidative stress, endothelial dysfunction, activation of NLRP3 inflammasome induced by crystals of monosodium urate (MSU), heat shock proteins (HSP), cytokines all have a role in the development of this process. Furthermore, the role of xanthine oxidase (XO) is considered in the pathogenesis of AF through activation of systemic inflammation and oxidative stress, preparing that substrate for AF. The overwhelming data suggest a direct pathophysiological role of the increased SUA and XO activity as risk factors for AF. This article offers a comprehensive review of investigations that shows the interrelation between hyperuricemia and the risk of AF.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78368617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Borges, G. Gazzoni, J. Yáñez, K. Andrade, Celine de Oliveira Boff, F. V. Ferreira, E. Bartholomay, Á. Rösler, F. Lucchese, C. Kalil
Objective: Catheter ablation has been a common procedure used for the management of atrial fibrillation (AF). Atrioesophagel fistula (AEF) is one of the most feared complications of AF ablation. Although it is a rare complication, severe esophageal thermal injury must be avoided. It is important to describe a safe method of preventing esophageal injuries without increasing AF recurrence. Methods: A retrospective cohort study of consecutive patients who underwent radiofrequency AF catheter ablation during 1 year-period wa conducted. One hundred and four patients were enrolled divided in two groups: one with a maximum recorded esophageal temperature (ET) < 38 °C and other with a maximum recorded ET ≥ 38 °C. The primary endpoint was detection of endoscopic esophageal lesions after AF ablation and the secondary endpoint was AF recurrence according to the maximum ET reached during the procedure. Results: The maximum ET was on average 37.3 ± 1.0 °C. Only 4 (3.8%) patients had esophageal lesion diagnosed by upper gastrointestinal endoscopy. There were no cases of esophageal perforation. The AF recurrence rate was 9.6% during the follow-up (10 patients, 3 from the ET max < 38 °C group and 7 from the ET max ≥ 38 °C group; p = 0.181). The maximum ET was not associated with AF recurrence after catheter ablation (OR = 1.65, 95% CI = 0.84-3.24, p = 0.14). Conclusions: A low incidence of esophageal injury after AF ablation with the use of a specific esophageal protection protocol was found. There was no esophageal perforation. The AF recurrence rate was similar to that described in the literature.
{"title":"Incidence of Esophageal Thermal Injury Using a Safety Protocol During Atrial Fibrillation Ablation","authors":"A. Borges, G. Gazzoni, J. Yáñez, K. Andrade, Celine de Oliveira Boff, F. V. Ferreira, E. Bartholomay, Á. Rösler, F. Lucchese, C. Kalil","doi":"10.24207/jca.v33i4.3413","DOIUrl":"https://doi.org/10.24207/jca.v33i4.3413","url":null,"abstract":"Objective: Catheter ablation has been a common procedure used for the management of atrial fibrillation (AF). Atrioesophagel fistula (AEF) is one of the most feared complications of AF ablation. Although it is a rare complication, severe esophageal thermal injury must be avoided. It is important to describe a safe method of preventing esophageal injuries without increasing AF recurrence. Methods: A retrospective cohort study of consecutive patients who underwent radiofrequency AF catheter ablation during 1 year-period wa conducted. One hundred and four patients were enrolled divided in two groups: one with a maximum recorded esophageal temperature (ET) < 38 °C and other with a maximum recorded ET ≥ 38 °C. The primary endpoint was detection of endoscopic esophageal lesions after AF ablation and the secondary endpoint was AF recurrence according to the maximum ET reached during the procedure. Results: The maximum ET was on average 37.3 ± 1.0 °C. Only 4 (3.8%) patients had esophageal lesion diagnosed by upper gastrointestinal endoscopy. There were no cases of esophageal perforation. The AF recurrence rate was 9.6% during the follow-up (10 patients, 3 from the ET max < 38 °C group and 7 from the ET max ≥ 38 °C group; p = 0.181). The maximum ET was not associated with AF recurrence after catheter ablation (OR = 1.65, 95% CI = 0.84-3.24, p = 0.14). Conclusions: A low incidence of esophageal injury after AF ablation with the use of a specific esophageal protection protocol was found. There was no esophageal perforation. The AF recurrence rate was similar to that described in the literature.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45667029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clóvis Fröemming Junior, T. Leiria, G. G. Lima, L. M. Pires, M. Kruse, T. C. Moreira, Javier Pinos, B. Finkler, D. Zanotta
Objective: The diagnosis of ventricular preexcitation syndromes is often occasional and with underestimated risk, showing controversies in its stratification and indication of prophylactic ablation. This work aims to explore and summarize the data in the literature, exposing the authors’ conclusions regarding this review. Methods: The authors prepared this work based on the latest guideline of the European Society of Cardiology plus a search for articles published in MEDLINE whose titles related to sudden death from ventricular fibrillation in patients with ventricular preexcitation. Discussion: Sudden death secondary to preexcited atrial fibrillation with degeneration to ventricular fibrillation is the most feared event in Wolff-Parkinson-White syndrome, has an average annual incidence of 0.15 to 0.39%, affecting individuals with structurally normal heart. The noninvasive stratification methods do not demonstrate adequate efficacy, and an electrophysiological study is recommended for all cases at the time of diagnosis. The most severe criteria for sudden death are shortest preexcited RR interval ≤ 250 ms (SPERRI or SPRRI); accessory pathway effective refractory period (APERP) ≤ 250 ms; presence of multiple accessory bundles; shortest paced cycle length with preexcitation during atrial pacing ≤ 250ms (SPPCL); Ebstein anomaly; induction of sustained supraventricular tachycardia. Conclusion: The low rate of complications during the diagnostic exam as well as in the therapeutic procedure, added to the high percentage of success of radiofrequency ablation, leads to indicate early the execution of electrophysiological study as a more diligent and accurate measure in the reduction of sudden death events in patients with ventricular preexcitation syndromes.
目的:室性预兴奋综合征的诊断往往是偶然的，且风险被低估，在其分层和预防性消融的指征方面存在争议。本工作旨在探索和总结文献中的数据，揭示作者关于本综述的结论。方法:作者根据欧洲心脏病学会的最新指南，并检索MEDLINE上发表的与心室预激患者室性颤动猝死相关的文章，准备了这项工作。讨论:预兴奋性房颤并发室颤的猝死是Wolff-Parkinson-White综合征中最可怕的事件，平均年发病率为0.15 - 0.39%，影响心脏结构正常的个体。无创分层方法没有显示出足够的疗效，在诊断时建议对所有病例进行电生理研究。最严重的猝死标准为最短预激RR间期≤250 ms (SPERRI或SPRRI);副通路有效不应期(APERP)≤250 ms;存在多个附属束;心房起搏时预激最短周期长度≤250ms (SPPCL);原发异常;诱导持续性室上性心动过速。结论:在诊断检查和治疗过程中并发症发生率低，再加上射频消融成功率高，提示电生理研究在减少心室预兴奋综合征患者猝死事件方面更有效、更准确。
{"title":"A Brief review of the risks and the stratification of sudden death in the ventricular Pre-excitation syndrome.","authors":"Clóvis Fröemming Junior, T. Leiria, G. G. Lima, L. M. Pires, M. Kruse, T. C. Moreira, Javier Pinos, B. Finkler, D. Zanotta","doi":"10.24207/jca.v33i4.3400","DOIUrl":"https://doi.org/10.24207/jca.v33i4.3400","url":null,"abstract":"Objective: The diagnosis of ventricular preexcitation syndromes is often occasional and with underestimated risk, showing controversies in its stratification and indication of prophylactic ablation. This work aims to explore and summarize the data in the literature, exposing the authors’ conclusions regarding this review. Methods: The authors prepared this work based on the latest guideline of the European Society of Cardiology plus a search for articles published in MEDLINE whose titles related to sudden death from ventricular fibrillation in patients with ventricular preexcitation. Discussion: Sudden death secondary to preexcited atrial fibrillation with degeneration to ventricular fibrillation is the most feared event in Wolff-Parkinson-White syndrome, has an average annual incidence of 0.15 to 0.39%, affecting individuals with structurally normal heart. The noninvasive stratification methods do not demonstrate adequate efficacy, and an electrophysiological study is recommended for all cases at the time of diagnosis. The most severe criteria for sudden death are shortest preexcited RR interval ≤ 250 ms (SPERRI or SPRRI); accessory pathway effective refractory period (APERP) ≤ 250 ms; presence of multiple accessory bundles; shortest paced cycle length with preexcitation during atrial pacing ≤ 250ms (SPPCL); Ebstein anomaly; induction of sustained supraventricular tachycardia. Conclusion: The low rate of complications during the diagnostic exam as well as in the therapeutic procedure, added to the high percentage of success of radiofrequency ablation, leads to indicate early the execution of electrophysiological study as a more diligent and accurate measure in the reduction of sudden death events in patients with ventricular preexcitation syndromes.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46740180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paced right bundle branch block pattern in an elderly woman
一位老年妇女的起搏右束支传导阻滞模式
{"title":"What is the diagnosis?","authors":"Oğuzhan Birdal, Y. Koza, Onur Altınkaya, H. Taş","doi":"10.24207/jca.v33i4.3428","DOIUrl":"https://doi.org/10.24207/jca.v33i4.3428","url":null,"abstract":"Paced right bundle branch block pattern in an elderly woman","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42563782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. D. Vale, L. T. M. Silva, J. Rocha, C. S. Margalho, H. Maia
Pulmonary veins electrical isolation as an invasive treatment of atrial fibrillation has been widely used in electrophysiology laboratories. This case report presents a rare and transient complication, during transseptal puncture for atrial fibrillation ablation. ST-segment elevation, hypotension and bradyarrhythmia related to catheterization were observed despite cineangiocoronariography without obstructive lesions. Clinical stability was achieved after administration of intravenous atropine and saline solution. It is speculated that the phenomenon is attributed to an increased vagal tone after the mechanical effect of transseptal puncture in the interatrial vagal network. The procedure was completed despite the phenomenon.
{"title":"ST-Segment Elevation Associated with Mobitz II Atrioventricular Block During Transseptal Puncture for Atrial Fibrillation Ablation","authors":"P. D. Vale, L. T. M. Silva, J. Rocha, C. S. Margalho, H. Maia","doi":"10.24207/jca.v33i4.3427","DOIUrl":"https://doi.org/10.24207/jca.v33i4.3427","url":null,"abstract":"Pulmonary veins electrical isolation as an invasive treatment of atrial fibrillation has been widely used in electrophysiology laboratories. This case report presents a rare and transient complication, during transseptal puncture for atrial fibrillation ablation. ST-segment elevation, hypotension and bradyarrhythmia related to catheterization were observed despite cineangiocoronariography without obstructive lesions. Clinical stability was achieved after administration of intravenous atropine and saline solution. It is speculated that the phenomenon is attributed to an increased vagal tone after the mechanical effect of transseptal puncture in the interatrial vagal network. The procedure was completed despite the phenomenon.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42763253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. T. M. Silva, P. D. Vale, J. Rocha, C. S. Margalho, H. Maia
A 16-year-old female patient was hospitalized due to narrow QRS tachycardia suggestive of fascicular ventricular tachycardia. Initially, the differential diagnosis with supraventricular tachycardia can be challenging. The tachyarrhythmia is well controlled with medication, but electrophysiological study and ablation may be necessary in patients who remain symptomatic.
{"title":"Belhassen Syndrome in Teenager Originating from Left Anterior Fascicle","authors":"L. T. M. Silva, P. D. Vale, J. Rocha, C. S. Margalho, H. Maia","doi":"10.24207/jca.v33i4.3417","DOIUrl":"https://doi.org/10.24207/jca.v33i4.3417","url":null,"abstract":"A 16-year-old female patient was hospitalized due to narrow QRS tachycardia suggestive of fascicular ventricular tachycardia. Initially, the differential diagnosis with supraventricular tachycardia can be challenging. The tachyarrhythmia is well controlled with medication, but electrophysiological study and ablation may be necessary in patients who remain symptomatic.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43693934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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