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2.
J Electrocardiol ; 86: 153778, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39153289

RESUMEN

Bigeminy is a cardiac arrhythmia in which there is a single ectopic beat, or irregular heartbeat, following each regular heartbeat. This case demonstrates the diagnostic challenges that can be encountered while interpreting ECGs of patients with "apparent ventricular bigeminy'.


Asunto(s)
Electrocardiografía , Complejos Prematuros Ventriculares , Humanos , Diagnóstico Diferencial , Complejos Prematuros Ventriculares/diagnóstico , Complejos Prematuros Ventriculares/fisiopatología , Masculino , Síndromes de Preexcitación/diagnóstico , Síndromes de Preexcitación/fisiopatología , Persona de Mediana Edad
3.
J Vet Cardiol ; 55: 15-18, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39059142

RESUMEN

An 18-year-old female neutered Domestic Shorthair cat was referred for investigation of seizure-like episodes. Physical and neurological examination were unremarkable, as were systemic arterial blood pressure, cardiac troponin I, complete blood count and biochemistry profile. Diagnostic tests included transthoracic echocardiography which ruled out any structural cardiomyopathy, and electrocardiography which showed an underlying regular wide QRS-complex rhythm with pronounced shortening of the PR interval. Considering the findings, a diagnosis of suspected ventricular pre-excitation secondary to an accessory pathway was made. Further investigations were declined and, as no periods of tachycardia were seen on the five-minute electrocardiogram, no antiarrhythmic treatment was started.


Asunto(s)
Enfermedades de los Gatos , Electrocardiografía , Animales , Femenino , Gatos , Electrocardiografía/veterinaria , Enfermedades de los Gatos/diagnóstico , Ecocardiografía/veterinaria , Síndromes de Preexcitación/veterinaria , Síndromes de Preexcitación/diagnóstico
7.
Arch Gynecol Obstet ; 310(2): 1027-1035, 2024 08.
Artículo en Inglés | MEDLINE | ID: mdl-38431699

RESUMEN

INTRODUCTION: Pregnant women with pre-excitation syndrome are more likely to develop supraventricular tachycardia (SVT) during pregnancy and delivery, leading to an increased risk of adverse events. METHOD: This was a retrospective study of 309 pregnancies in 280 women (29 women had two pregnancies in this series) with pre-excitation syndrome who delivered at West China Second University Hospital from June 2011 to October 2021. All the 309 pregnant women with pre-excitation syndrome were divided into SVT and non-SVT groups to analyze the cardiac and obstetric complications. RESULTS: Among the included pregnant women in the past 10 years, the prevalence of pre-excitation syndrome was 0.24% (309/127725). There were 309 cases with pre-excitation syndrome in all hospitalized pregnant women. Among them, 62 (20.1%, 62/309) had a history of SVT. In the 62 cases with SVT during pregnancy, 22 (35.5%) cases had a history of SVT. Gestational diabetes mellitus was associated with SVT during pregnancy. The cesarean section rate was 88.7% in the SVT group, which was significantly higher than that in the non-SVT group (64.8%) (P < 0.001). Cases with SVT during pregnancy had more cardiac and obstetric complications. Four fetal deaths were recorded in the SVT group. Additionally, 29 women experienced two pregnancies during the study period, among whom, five received radiofrequency ablation after the first delivery and obtained better outcomes in the second pregnancy. CONCLUSION: The adverse outcomes such as cardiac complications, maternal and fetal complications (PROM, prematurity, SGA, fetal distress, etc.) in pregnant women with pre-excitation syndrome were closely related to SVT, with possible risk factors including history of SVT before pregnancy, cardiac function, heart organic abnormalities, and gestational diabetes mellitus.


Asunto(s)
Cesárea , Diabetes Gestacional , Síndromes de Preexcitación , Resultado del Embarazo , Taquicardia Supraventricular , Humanos , Femenino , Embarazo , Estudios Retrospectivos , Adulto , Resultado del Embarazo/epidemiología , Síndromes de Preexcitación/epidemiología , Síndromes de Preexcitación/complicaciones , China/epidemiología , Taquicardia Supraventricular/epidemiología , Taquicardia Supraventricular/etiología , Cesárea/estadística & datos numéricos , Diabetes Gestacional/epidemiología , Complicaciones Cardiovasculares del Embarazo/epidemiología , Adulto Joven
8.
J Electrocardiol ; 84: 1-8, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38430664

RESUMEN

BACKGROUND: Accurate estimation of accessory pathway (AP) localization in patients with ventricular pre-excitation or Wolff-Parkinson-White (WPW) syndrome remains a diagnostic challenge. Existing algorithms have contributed significantly to this area, but alternative algorithms can offer additional perspectives and approaches to AP localization. OBJECTIVE: This study introduces and evaluates the diagnostic accuracy of the EPM algorithm in AP localization, comparing it with established algorithms Arruda and EASY. METHODS: A retrospective analysis was conducted on 138 patients from Hospital São Paulo who underwent catheter ablation. Three blinded examiners assessed the EPM algorithm's diagnostic accuracy against the Arruda and EASY algorithms. The gold standard for comparison was the radioscopic position of the AP where radiofrequency ablation led to pre-excitation disappearance on the ECG. RESULTS: EPM showed a diagnostic accuracy of 51.45%, closely aligning with Arruda (53.29%) and EASY (44.69%). Adjacency accuracy for EPM was 70.67%, with Arruda at 66.18% and EASY at 72.22%. Sensitivity for EPM in distinguishing left vs. right APs was 95.73%, with a specificity of 74.33%. For identifying septal vs. lateral right APs, EPM sensitivity was 82.79% with a specificity of 46.15%. These measures were comparable to those of Arruda and EASY. Inter-observer variability was excellent for EPM, with Kappa statistics over 0.9. CONCLUSION: The EPM algorithm emerges as a reliable tool for AP localization, offering a systematic approach beneficial for therapeutic decision-making in electrophysiology. Its comparable diagnostic accuracy and excellent inter-observer variability underscore its potential clinical applicability. Future research may further validate its efficacy in a broader clinical setting.


Asunto(s)
Fascículo Atrioventricular Accesorio , Algoritmos , Electrocardiografía , Sensibilidad y Especificidad , Síndrome de Wolff-Parkinson-White , Humanos , Fascículo Atrioventricular Accesorio/fisiopatología , Fascículo Atrioventricular Accesorio/cirugía , Masculino , Femenino , Síndrome de Wolff-Parkinson-White/fisiopatología , Síndrome de Wolff-Parkinson-White/cirugía , Síndrome de Wolff-Parkinson-White/diagnóstico , Estudios Retrospectivos , Adulto , Ablación por Catéter , Reproducibilidad de los Resultados , Síndromes de Preexcitación/fisiopatología , Síndromes de Preexcitación/diagnóstico , Persona de Mediana Edad
9.
Herzschrittmacherther Elektrophysiol ; 35(Suppl 1): 118-126, 2024 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-38427036

RESUMEN

In 1930, Wolff, Parkinson and White described the syndrome that bears their names. The mechanisms of supraventricular tachycardias were analyzed by brilliant electrocardiography interpretation by Pick and Langendorf. Wellens and Durrer using electrophysiologic studies analyzed the tachycardia mechanism invasively. In Germany the group by Seipel and Breithardt as well as Neuss and Schlepper studied the tachycardia mechanisms and response to antiarrhythmic drugs invasively by electrophysiological studies. Following the first successful interruption of an accessory pathway by Sealy in 1967, surgeons and electrophysiologists cooperated in Germany. Two centers, Hannover and Düsseldorf were established. Direct current (DC) ablation of accessory pathways was introduced by Morady and Scheinman. Because of side effects induced by barotrauma of DC, alternative strategies were studied. In 1987, radiofrequency ablation was introduced and thereafter established as curative therapy of accessory pathways in all locations.


Asunto(s)
Fascículo Atrioventricular Accesorio , Ablación por Catéter , Síndromes de Preexcitación , Taquicardia Supraventricular , Síndrome de Wolff-Parkinson-White , Humanos , Síndrome de Wolff-Parkinson-White/diagnóstico , Síndrome de Wolff-Parkinson-White/cirugía , Síndromes de Preexcitación/diagnóstico , Síndromes de Preexcitación/terapia , Taquicardia Supraventricular/cirugía , Taquicardia/cirugía , Fascículo Atrioventricular Accesorio/diagnóstico , Fascículo Atrioventricular Accesorio/cirugía , Electrocardiografía
10.
Intern Med ; 63(20): 2795-2799, 2024 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-38369356

RESUMEN

A 20-year-old man was resuscitated after ventricular fibrillation (VF). Electrocardiography revealed Wolff-Parkinson-White (WPW) syndrome. Intracoronary acetylcholine provocation (ACH test) testing was performed to induce VF secondary to the coronary vasospasm. The administration of acetylcholine to the coronary artery induced atrial fibrillation (AF) with preexcitation, followed by VF without coronary vasospasm. Electrophysiological studies revealed an accessory pathway managed by catheter ablation. Subsequent intracoronary ACH test induced the occurrence of AF without preexcitation. To our knowledge, this case report is the first to demonstrate the utility of the ACH test in confirming WPW syndrome as a cause of VF.


Asunto(s)
Acetilcolina , Fibrilación Atrial , Electrocardiografía , Fibrilación Ventricular , Síndrome de Wolff-Parkinson-White , Humanos , Masculino , Síndrome de Wolff-Parkinson-White/diagnóstico , Síndrome de Wolff-Parkinson-White/complicaciones , Síndrome de Wolff-Parkinson-White/fisiopatología , Acetilcolina/administración & dosificación , Fibrilación Atrial/diagnóstico , Fibrilación Ventricular/diagnóstico , Fibrilación Ventricular/etiología , Adulto Joven , Vasoespasmo Coronario/diagnóstico , Vasoespasmo Coronario/inducido químicamente , Vasoespasmo Coronario/complicaciones , Ablación por Catéter , Vasos Coronarios/fisiopatología , Vasos Coronarios/diagnóstico por imagen , Síndromes de Preexcitación/diagnóstico , Síndromes de Preexcitación/complicaciones
11.
Europace ; 26(2)2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38363996

RESUMEN

AIMS: Controversy remains as to whether the exercise stress test (EST) is sufficient for risk evaluation in patients with pre-excitation. This study aims to clarify the usefulness of EST in risk stratification in both asymptomatic and symptomatic patients presenting with pre-excitation. METHODS AND RESULTS: This prospective study includes consecutive asymptomatic and symptomatic patients with pre-excitation referred for risk assessment. All participants performed an incremental EST (bicycle) prior to an electrophysiology study (EPS). Primary data from the EST included loss of pre-excitation during exercise, and primary data from the EPS included the measurement of accessory pathway effective refractory period (APERP), shortest pre-excited RR interval (SPERRI), and inducible arrhythmia with the use of a beta-adrenergic receptor agonist if deemed necessary. One hundred and sixty-four patients (59 asymptomatic, 105 symptomatic) completed an EST and EPS. Forty-five patients (27%) demonstrated low-risk findings on EST, of which 19 were asymptomatic and 26 were symptomatic. Six patients with low-risk EST findings had SPERRI/APERP ≤ 250 ms at EPS, and two of them were asymptomatic. The sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy of low-risk EST for excluding patients with SPERRI/APERP ≤ 250 ms were 40, 91, 87, 51, and 60%, respectively. The number of patients with inducible arrhythmia at EPS was similar in the asymptomatic (36, 69%) and symptomatic (73, 61%) groups. CONCLUSION: Sudden loss of pre-excitation during EST has a low NPV in excluding high-risk APs. The EPS with the use of isoproterenol should be considered to accurately assess the risk of patients with pre-excitation regardless of symptoms (ClinicalTrials.gov Identifier: NCT03301935).


Asunto(s)
Fascículo Atrioventricular Accesorio , Síndromes de Preexcitación , Síndrome de Wolff-Parkinson-White , Humanos , Síndrome de Wolff-Parkinson-White/diagnóstico , Estudios Prospectivos , Síndromes de Preexcitación/diagnóstico , Fascículo Atrioventricular Accesorio/diagnóstico , Medición de Riesgo/métodos , Electrocardiografía/métodos
12.
Herzschrittmacherther Elektrophysiol ; 35(Suppl 1): 88-97, 2024 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-38416160

RESUMEN

The history of surgical treatment of ventricular tachycardias (VT) is short, lasting from 1978 until 1993. "Indirect procedures" with infarct scar resection were performed without electrophysiologic studies, whereas "direct procedures" consisted of either complete endocardial incisions ("encircling endocardial ventriculotomy") or large endocardial resections ("endocardial peel-off" technique) after precise epicardial and endocardial mapping procedures. In Germany, the first to report on intra-operative electrophysiologic mapping for VT treatment were Ostermeyer, Breithardt and Seipel in 1979. In 1981, the Hannover group (Frank, Klein) published their first results of surgical treatment of VT. In 1984, Ostermeyer et al. demonstrated that a partial endocardial incision resulted in more beneficial results with less myocardial damage (8% versus 46%) than applying a complete encircling incision. In 1987, the Düsseldorf group reported treatment results of 93 patients. After 5 years, 77% had no VT recurrence, while total mortality after 1 year was 11% and after 5 years 30%. In 1992, the Hannover group reported results of 147 patients after endocardial resection for VT. Total mortality after 3 years was 27%; recurrence of VT events occurred in 18% of the surviving cohort.The history of surgical procedures for supraventricular tachycardia (SVT), in particular Wolff-Parkinson-White (WPW) syndrome, is even shorter than that of surgery for VT. As early as 1969, Sealy, Gallagher and Cox reported the first cases of surgical intervention for WPW syndrome via endocardial access in cardioplegic arrest. In 1984, Guiraudon and Klein reported on a new procedure with epicardial access to the accessory bundle without cardioplegia in laterally localised conduction pathways. In Germany, too, the groups in Düsseldorf (Ostermeyer, Seipel, Breithardt, Borggrefe) from 1980 and the Hannover group (Frank, Klein and Kallfelz) from 1981 performed surgical procedures for WPW syndrome. In 1987, Borggrefe reported on 18 patients with WPW syndrome and atrial fibrillation who had undergone surgery. After 2 years, 14 of 18 patients had no recurrences of tachycardia; in 1989, Frank, Klein and Kallfelz (Hannover) reported on 10 children (2-14 years) operated on using the cryoablation technique. Between 1984 and 1992, a total of 120 patients with SVT, mostly WPW syndrome, were operated on in Hannover; after 42 months, 12 patients had a recurrence of SVT. Two patients died during the reoperation.


Asunto(s)
Fibrilación Atrial , Síndromes de Preexcitación , Taquicardia Supraventricular , Taquicardia Ventricular , Síndrome de Wolff-Parkinson-White , Niño , Humanos , Síndrome de Wolff-Parkinson-White/cirugía , Taquicardia Ventricular/cirugía , Fibrilación Atrial/cirugía
14.
Circ Arrhythm Electrophysiol ; 16(11): e012191, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37877314

RESUMEN

BACKGROUND: The cause of hypertrophic cardiomyopathy (HCM) in the young is highly varied. Ventricular preexcitation (preexcitation) is well recognized, yet little is known about the specificity for any cause and the characteristics of the responsible accessory pathways (AP). METHODS: Retrospective cohort study of patients <21 years of age with HCM/preexcitation from 2000 to 2022. The cause of HCM was defined as isolated HCM, storage disorder, metabolic disease, or genetic syndrome. Atrioventricular AP (true AP) were distinguished from fasciculoventricular fibers (FVF) using standard invasive electrophysiology study criteria. AP were defined as high risk if any of the following were <250 ms: shortest preexcited RR interval in atrial fibrillation, shortest paced preexcited cycle length, or anterograde AP effective refractory period. RESULTS: We identified 345 patients with HCM and 28 (8%) had preexcitation (isolated HCM, 10/220; storage disorder, 8/17; metabolic disease, 5/19; and genetic syndrome, 5/89). Six (21%) patients had clinical atrial fibrillation (1 with shortest preexcited RR interval <250 ms). Twenty-two patients underwent electrophysiology study which identified 23 true AP and 16 FVF. Preexcitation was exclusively FVF mediated in 8 (36%) patients. Five (23%) patients had AP with high-risk conduction properties (including ≥1 patient in each etiologic group). Multiple AP were seen in 8 (36%) and AP plus FVF in 10 (45%) patients. Ablation was acutely successful in 13 of 14 patients with recurrence in 3. One procedure was complicated by complete heart block after ablation of a high-risk midseptal AP. There were significant differences in QRS amplitude and delta wave amplitude between groups. There were no surface ECG features that differentiated AP from FVF. CONCLUSIONS: Young patients with HCM and preexcitation have a high likelihood of underlying storage disease or metabolic disease. Nonisolated HCM should be suspected in young patients with large QRS and delta wave amplitudes. Surface ECG is not adequate to discriminate preexcitation from a benign FVF from that secondary to potentially life-threatening AP.


Asunto(s)
Fascículo Atrioventricular Accesorio , Fibrilación Atrial , Cardiomiopatía Hipertrófica , Enfermedades Metabólicas , Síndromes de Preexcitación , Síndrome de Wolff-Parkinson-White , Humanos , Estudios Retrospectivos , Electrocardiografía/métodos , Síndromes de Preexcitación/diagnóstico , Fascículo Atrioventricular Accesorio/diagnóstico , Cardiomiopatía Hipertrófica/diagnóstico , Síndrome de Wolff-Parkinson-White/diagnóstico , Síndrome de Wolff-Parkinson-White/cirugía
15.
Eur Rev Med Pharmacol Sci ; 27(17): 7882-7890, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37750616

RESUMEN

OBJECTIVE: Our study aimed at analyzing the echocardiographic multi-indicator evaluation of the risk of Wolff-Parkinson-White syndrome (WPW) on the left ventricular function and ventricular wall motion disorders, as well as the effect of radiofrequency ablation treatment. PATIENTS AND METHODS: The clinical data of 55 WPW patients treated with radiofrequency (RF) ablation at the Children's Hospital of Nanjing Medical University between January 2018 and December 2022 were retrospectively analyzed and included in the observation group, while other 50 healthy children were included in the control group during the same time. We analyzed the echocardiographic indices of the patients, assessed the effects of the disease on left ventricular myocardial function and ventricular wall motion disorders, and evaluated the effects of radiofrequency ablation treatment on the myocardium of the left ventricle. The echocardiographic parameters were analyzed to assess the effect of the disease on left ventricular myocardial function and ventricular wall dyskinesia. RESULTS: Of the 55 patients with pre-excited syndrome, 20 had type A bypass and 35 had type B bypass. Ten patients had pre-excited dilated cardiomyopathy with significant enlargement of the left ventricular cavity, reduced left ventricular systolic function, and a significant impairment of ventricular wall motion; the other 5 patients had basal segmental septal motion incoordination. Compared to the control group, patients with left ventricular end-diastolic diameter (LVEDD) (42.9±5.0 mm vs. 39.2±3.0 mm), peak strain dispersion (PSD) (38.8±15.3 ms vs. 21.7±2.2 ms), maximum peak time difference (MPTD) (200.2±92.8 ms vs. 89.5±9.8 ms) and interventricular mechanical delay (IVMD) (36.2±13.7 ms vs. 21.2±2.1 ms) before RF ablation were increased. Left ventricular ejection fraction (LVEF) (57.1±9.1% vs. 65.9±2.6%), E/A (1.1±0.2 vs. 1.8±0.2) and global longitudinal strain (GLS) (-18.7±2.2% vs. -22.4±0.5%) decreased, with statistically significant differences (p<0.05). All 55 patients had a successful procedure, and all postoperative echocardiographic parameters were found to be improved, compared to the preoperative period. The results of the postoperative review after 3 months showed differences in E/A, PSD, MPTD, and IVMD compared to the healthy group, suggesting that left ventricular diastolic function and synchrony had not fully returned to normal. CONCLUSIONS: Echocardiography can better evaluate myocardial motion and function in patients with Wolff-Parkinson-White syndrome and monitor the effect and progress of disease treatment, and has high clinical application value.


Asunto(s)
Síndromes de Preexcitación , Síndrome de Wolff-Parkinson-White , Humanos , Niño , Síndrome de Wolff-Parkinson-White/diagnóstico por imagen , Síndrome de Wolff-Parkinson-White/cirugía , Función Ventricular Izquierda , Volumen Sistólico , Ventrículos Cardíacos/diagnóstico por imagen , Estudios Retrospectivos , Ecocardiografía
16.
Pacing Clin Electrophysiol ; 46(9): 1049-1055, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37527153

RESUMEN

BACKGROUND: Intermittent ventricular pre-excitation was considered a low-risk marker for sudden death. However, to date, some studies do not exclude the existence of accessory pathways (APs) with high-risk intermittent antegrade conductive properties. According to current European Guidelines, high-risk features of APs are antegrade pathway conduction ≤250 ms in baseline or during the adrenergic stimulus, inducibility of atrioventricular reciprocating tachycardias (AVRT), inducibility of pre-excited atrial fibrillation (AF), and presence of multiple APs. For all of these transcatheter ablation is recommended. The aim of our study was to evaluate the existence of differences in risk characteristics between patients with intermittent pre-excitation (IPX) and those with persistent pre-excitation (PPX), from a sample of adults with ventricular pre-excitation and symptoms like palpitations. METHODS: 293 adults [IPX: 51 (17.4%); PPX: 242 (82.6%)] underwent electrophysiological study and then catheter ablation of their APs if arrhythmia inducibility (AVRT/AF) was noted, or, conversely, if it was appreciated a fast AP antegrade conduction, in baseline or during intravenous isoproterenol infusion, or if multiple APs were detected. RESULTS: There were no statistically significant differences in demographic characteristics (age and gender), AVRT/AF inducibility, antegrade conductive properties, the prevalence of multiple APs, and APs locations between IPX and PPX patients. CONCLUSIONS: In our study, patients with IPX did not show significant differences in clinical and electrophysiological features versus PPX patients.


Asunto(s)
Fascículo Atrioventricular Accesorio , Fibrilación Atrial , Ablación por Catéter , Síndromes de Preexcitación , Síndrome de Wolff-Parkinson-White , Humanos , Adulto , Fascículo Atrioventricular Accesorio/cirugía , Fibrilación Atrial/cirugía , Factores de Riesgo , Electrocardiografía
18.
J Vet Cardiol ; 47: 70-82, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37267820

RESUMEN

OBJECTIVES: Atrioventricular accessory pathways are abnormal electrical connections between the atria and ventricles that predispose to ventricular pre-excitation (VPE) and tachycardias. ANIMALS: Seventeen cats with VPE and 15 healthy matched-control cats. MATERIAL AND METHODS: Multicenter case-control retrospective study. Clinical records were searched for cats with VPE, defined as preserved atrioventricular synchrony, reduced PQ interval, and increased QRS complex duration with a delta wave. Clinical, electrocardiography, echocardiographic, and outcome data were collated. RESULTS: Most cats with VPE were male (16/17 cats), non-pedigree cats (11/17 cats). Median age and mean body weight were 5.4 years (0.3-11.9 years) and 4.6 ± 0.8 kg, respectively. Clinical signs at presentation included lethargy (10/17 cats), tachypnea (6/17 cats), and/or syncope (3/17 cats). In two cats, VPE was an incidental finding. Congestive heart failure was uncommon (3/17 cats). Nine (9/17) cats had tachyarrhythmias: 7/9 cats had narrow QRS complex tachycardia and 2/9 cats had wide QRS complex tachycardia. Four cats had ventricular arrhythmias. Cats with VPE had larger left (P < 0.001) and right (P < 0.001) atria and thicker interventricular septum (P = 0.019) and left ventricular free wall (P = 0.028) than controls. Three cats had hypertrophic cardiomyopathy. Treatment included different combinations of sotalol (5/17 cats), diltiazem (5/17 cats), atenolol (4/17 cats), furosemide (4/17 cats), and platelet inhibitors (4/17 cats). Five cats died, all from cardiac death (median survival time 1882 days [2-1882 days]). CONCLUSIONS: Cats with VPE had a relatively long survival, albeit showing larger atria and thicker left ventricular walls than healthy cats.


Asunto(s)
Enfermedades de los Gatos , Síndromes de Preexcitación , Síndrome de Wolff-Parkinson-White , Masculino , Gatos , Animales , Femenino , Síndrome de Wolff-Parkinson-White/veterinaria , Estudios Retrospectivos , Síndromes de Preexcitación/diagnóstico , Síndromes de Preexcitación/veterinaria , Taquicardia/veterinaria , Electrocardiografía/veterinaria , Enfermedades de los Gatos/diagnóstico por imagen
19.
Circ Arrhythm Electrophysiol ; 16(4): e011569, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36891895

RESUMEN

BACKGROUND: To investigate the clinical features of preexcitation-induced dilated cardiomyopathy in infants and evaluate safety and efficacy of radiofrequency ablation (RFCA) in these patients. METHODS: This study included 10 infants (4 males and 6 females) with mean age of 6.78±3.14 months, mean weight of 8.11±1.71 kg, and mean left ventricular ejection fraction (LVEF) was 32.6±10.34%. Tachycardiomyopathy has been excluded and all patients were refractory to the drugs. All of these 10 patients underwent RFCA. RESULTS: All the accessory pathways in these patients were located on right free wall and the acute success rate was 100%. No complication associated with the procedure occurred. In one case preexcitation recurred and was ablated successfully during the second attempt. There were 3 patients with mild cardiac dysfunction (LVEF, 40≤LVEF<50%), 3 with moderate (30≤LVEF<40%), and 4 with severe cardiac dysfunction (LVEF<30%, the ages were 3, 6, 7, and 10 months, respectively). The time for LVEF normalization was 1 week, 1 to 3 months, and ≥3 months, respectively. In 3 of the 4 severe cardiac dysfunction patients, the LVEF normalized at 3, 6, and 12 months after ablation, the LVEF of the remaining case did not recover at 3 months and is still being followed. CONCLUSIONS: Ventricular preexcitation could lead to severe cardiac dysfunction during infancy. RFCA may be a safe and effective treatment option in right free wall accessory pathways, even in infants with cardiac dysfunction. Cases of more severe cardiac dysfunction might require a longer time for LVEF recovery after RFCA.


Asunto(s)
Cardiomiopatía Dilatada , Ablación por Catéter , Cardiopatías , Síndromes de Preexcitación , Masculino , Femenino , Humanos , Lactante , Volumen Sistólico , Cardiomiopatía Dilatada/diagnóstico , Cardiomiopatía Dilatada/cirugía , Función Ventricular Izquierda , Ablación por Catéter/efectos adversos , Síndromes de Preexcitación/diagnóstico , Síndromes de Preexcitación/cirugía , Resultado del Tratamiento
20.
J Electrocardiol ; 78: 21-24, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36731165

RESUMEN

The present case describes a dilated cardiomyopathy associated with both antidromic and orthodromic atrio-ventricular reentrant tachycardias supported by multiple right accessory pathways. Both right accessory pathways were successfully eliminated by catheter ablation and the patient progressively recovered during the follow up. The following etiologies might be involved: 1) primitive dilated cardiomyopathy (or post-inflammatory); 2) septal dyssinchrony due to ventricular pre-excitation; 3) tachycardiomyopathy.


Asunto(s)
Fascículo Atrioventricular Accesorio , Cardiomiopatía Dilatada , Ablación por Catéter , Síndromes de Preexcitación , Taquicardia Ventricular , Síndrome de Wolff-Parkinson-White , Humanos , Síndrome de Wolff-Parkinson-White/complicaciones , Síndrome de Wolff-Parkinson-White/diagnóstico , Síndrome de Wolff-Parkinson-White/cirugía , Cardiomiopatía Dilatada/complicaciones , Cardiomiopatía Dilatada/cirugía , Electrocardiografía , Síndromes de Preexcitación/complicaciones , Fascículo Atrioventricular Accesorio/cirugía , Taquicardia Ventricular/cirugía , Ablación por Catéter/efectos adversos
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