ABSTRACT
Focal atrial tachycardias (AT) in the right atrium (RA) tend to cluster around the crista terminalis, coronary sinus (CS) region, tricuspid annulus, and para-hisian region. In most cases, the AT focus can be identified by careful activation mapping, and completely eliminated by radiofrequency (RF) catheter ablation. However, RF ablation near the His bundle (HB) carries a risk of inadvertent damage to the atrioventricular (AV) conduction system. Here we describe a patient with an AT originating in the vicinity of the AV node, which was successfully ablated earlier from non-coronary aortic cusp (NCC), and recurred with an exit from para-hisian location. Respiratory excursions of the catheter were associated with migration to the area of HIs. This was successfully ablated during controlled apnoea, using 3D electroanatomic mapping.
Subject(s)
Bundle of His/physiopathology , Catheter Ablation , Tachycardia, Supraventricular/physiopathology , Tachycardia, Supraventricular/surgery , Electrocardiography , Female , Humans , Middle AgedSubject(s)
Atrioventricular Block/complications , Atrioventricular Block/diagnosis , Electrocardiography/methods , Tachycardia, Atrioventricular Nodal Reentry/complications , Tachycardia, Atrioventricular Nodal Reentry/diagnosis , Adult , Atrioventricular Block/surgery , Female , Humans , Tachycardia, Atrioventricular Nodal Reentry/surgery , Treatment OutcomeABSTRACT
Severe QT interval prolongation >500ms occurs in one quarter of cardiac surgical patients in the perioperative period while moderate prolongation occurs in most of them. Prolonged QT interval may be associated with torsades de pointes and lead to sudden cardiac death. Because of the high incidence of prolonged QT in cardiac surgery patients and its perioperative adverse outcomes, it is vital to identify it early and take necessary precautions. We report and discuss the catastrophic events and management of two patients with long QT syndrome complicating mitral valve replacement.
Subject(s)
Electrocardiography , Heart Conduction System/physiopathology , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation/adverse effects , Long QT Syndrome/etiology , Mitral Valve/surgery , Torsades de Pointes/etiology , Aged , Humans , Long QT Syndrome/physiopathology , Male , Postoperative Complications , Torsades de Pointes/physiopathologyABSTRACT
We report on a case of triple-vessel coronary artery ectasia (CAE) in a young patient. This patient presented with anterior wall myocardial infarction (MI) with post-infarct angina. His coronary angiogram revealed coronary artery ectasia involving the left anterior descending, circumflex and right coronary arteries.
Subject(s)
Anterior Wall Myocardial Infarction/etiology , Coronary Aneurysm/etiology , Mucocutaneous Lymph Node Syndrome/complications , Adult , Coronary Aneurysm/diagnostic imaging , Coronary Aneurysm/pathology , Coronary Angiography , Dilatation, Pathologic , Humans , Male , Mucocutaneous Lymph Node Syndrome/diagnostic imaging , Mucocutaneous Lymph Node Syndrome/pathology , Severity of Illness IndexABSTRACT
We report on a case of idiopathic dilated cardiomyopathy with aortic aneurysm involving the aortic root and thoraco-abdominal aorta. This patient presented with exertional chest pain and backache radiating to both the upper limbs. His echocardiogram revealed dilated cardiomyopathy with mild to moderate aortic regurgitation and a hugely dilated aortic root. His angiogram showed normal coronary arteries, a dilated aortic root and thoraco-abdominal aortic aneurysm.