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1.
Artigo em Inglês | MEDLINE | ID: mdl-32462550

RESUMO

PURPOSE: The prospective, multicenter SMART SF trial demonstrated the acute safety and effectiveness of the 56-hole porous tip irrigated contact force (CF) catheter for drug-refractory paroxysmal atrial fibrillation (PAF) ablation with a low primary adverse event rate (2.5%), leading to FDA approval of the catheter. Here, we are reporting the long-term effectiveness and safety results that have not yet been reported. METHODS: Ablations were performed using the 56-hole porous tip irrigated CF catheter guided by the 3D mapping system stability module. The primary effectiveness endpoint was freedom from atrial tachyarrhythmia (including atrial fibrillation, atrial tachycardia, and/or atrial flutter), based on electrocardiographic data at 12 months. Atrial tachyarrhythmia recurrence occurring 3 months post procedure, acute procedural failures such as lack of entrance block confirmation of all PVs, and undergoing repeat procedure for atrial fibrillation in the evaluation period (91 to 365 days post the initial ablation procedure) were considered to be effectiveness failures. RESULTS: Seventy-eight patients (age 64.8 ± 9.7 years; male 52.6%; Caucasian 96.2%) participated in the 12-month effectiveness evaluation. Mean follow-up time was 373.5 ± 45.4 days. The Kaplan-Meier estimate of freedom from 12-month atrial tachyarrhythmia was 74.9%. Two procedure-related pericardial effusion events were reported at 92 and 180 days post procedure. There were no pulmonary vein stenosis complications or deaths reported through the 12-month follow-up period. CONCLUSIONS: The SMART SF 12-month follow-up evaluation corroborates the early safety and effectiveness success previously reported for PAF ablation with STSF.

3.
Medicina (B Aires) ; 79(3): 197-200, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31284254

RESUMO

Functional bundle branch block during a supraventricular tachycardia can be observed with shorter cycle lengths and represent a physiologic response by the specialized intraventricular conduction system to accelerated AV nodal conduction. The present case corresponds to a young patient with exercise induced orthodromic A-V reentrant tachycardia and alternating bundle branch block. This unusual response is explained by the finding obtained during the electrophysiology study. An accelerated AV nodal conduction made the depolarizing wave front reach the bundle branches during their refractory period. Once block in one bundle was stablished, block persisted due to the linking phenomenon that is repetitive retrograde concealed conduction from the contralateral bundle. After catheter ablation of a concealed left-sided accessory A-V pathway, rapid atrial pacing at the same cycle length of the tachycardia reproduced the same aberrancies observed during tachycardia. This response proved that functional bundle branch block is due to the short cycle length and not the presence of an accessory A-V pathway.


Assuntos
Bloqueio de Ramo/diagnóstico por imagem , Taquicardia Supraventricular/diagnóstico por imagem , Adolescente , Bloqueio de Ramo/etiologia , Ablação por Cateter , Eletrocardiografia , Eletrofisiologia , Sistema de Condução Cardíaco/diagnóstico por imagem , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Masculino , Taquicardia Supraventricular/complicações
4.
Oxf Med Case Reports ; 2019(3): omz021, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30949358

RESUMO

Isolated left ventricular noncompaction (LVNC) was described for the first time in 1984. It is a rare congenital disease, characterized by prominent trabecular meshwork pattern and deep intertrabecular recesses, communicated with the left ventricular chamber. Clinical presentation varies from asymptomatic patients, to those developing supraventricular and ventricular arrhythmias, thromboembolism, heart failure and sudden cardiac death. We present an unusual case, where the patient with Neurofibromatosis type 1 presented with a wide complex orthodromic atrioventricular reentrant tachycardia (AVRT) and a diagnosis of left posterior paraseptal accessory pathway in association with LVNC.

5.
Am J Physiol Heart Circ Physiol ; 316(3): H476-H484, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30525895

RESUMO

Radiofrequency catheter ablation (RFCA) is a frequently performed procedure in patients with atrial fibrillation. Prior studies have shown that the RFCA may directly stimulate vagal afferents during the procedure, whereas the vagal tone assessed by heart rate variability (HRV) is lowered weeks after the RFCA procedure. The effects of RFCA performed in the left atrium on sympathetic nerve activity have not been assessed. In the present study, we hypothesized that RFCA would lower muscle sympathetic nerve activity (MSNA) during ablation and would raise MSNA 1 day postablation. A total of 18 patients were studied. In protocol 1 ( n = 10), electrocardiogram, blood pressure, and MSNA in the peroneal nerve were recorded through the RFCA procedure performed in the electrophysiology laboratory. In protocol 2, eight patients were studied before the procedure and 1 day postablation. RFCA led to a decrease in MSNA immediately after the procedure (25.4 ± 3.2 to 17.2 ± 3.8 bursts/min, P < 0.05). Cardiac parasympathetic activity was determined using indexes of HRV and increased during the procedure. One day postablation, MSNA was above baseline values (21.3 ± 3.7 to 35.7 ± 2.6 bursts/min, P < 0.05). HRV indexes of cardiac parasympathetic activity fell, and the HRV index of sympathovagal balance was not significantly altered. The results show that RFCA raised cardiac parasympathetic activity and decreased MSNA during the procedure. One day postablation, MSNA rose and cardiac parasympathetic activity fell. In addition, RFCA evokes differentiated sympathetic responses directed to the heart and skeletal muscles. NEW & NOTEWORTHY The effects of radiofrequency catheter ablation performed in the left atrium on muscle sympathetic nerve activity (MSNA) have not been assessed. The results of this study show that radiofrequency catheter ablation raised cardiac parasympathetic activity and decreased MSNA during the procedure. One day postablation, MSNA rose and cardiac parasympathetic activity fell. We speculate that the partial autonomic afferent denervation induces these effects on autonomic activity.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/efeitos adversos , Complicações Pós-Operatórias/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Feminino , Átrios do Coração/inervação , Átrios do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia
6.
J Cardiovasc Electrophysiol ; 30(4): 503-510, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30580467

RESUMO

INTRODUCTION: Recurrent ventricular tachycardia (VT) and ventricular fibrillation (VF) in patients with myocardial ischemia requiring hemodynamic support can be refractory to available antiarrhythmic agents and even to cardioversion and defibrillation. The purpose of this study was to report the effect of intravenous ibutilide in patients with a VT and/or VF storm in the presence of incomplete revascularization requiring hemodynamic support. METHODS AND RESULTS: Standard continuous telemetry and frequent 12-lead electrocardiograms were obtained to determine the effect of intravenous Ibutilide in these patients. We studied six consecutive patients (age 60 ± 12 years; five males) with incomplete revascularization and mechanical support (extracorporeal membrane of oxygenation = 2; left ventricular assist device = 4) with VT/VF refractory to lidocaine and amiodarone. Intravenous ibutilide was given as a last resort for management of their ventricular arrhythmias. Intravenous ibutilide (1-2 mg) allowed restoration of sinus rhythm in three patients with persistent VF that were refractory to multiple defibrillation shocks. When the 24-hour period before and after ibutilide administration was compared, this drug markedly reduced the number of required cardioversions/defibrillations in all patients from 20 ± 9 to 0.7 ± 0.8 shocks ( P = 0.036). CONCLUSIONS: In patients with myocardial ischemia requiring hemodynamic support, intravenous Ibutilide demonstrates a potent antiarrhythmic effect and can facilitate defibrillation in patients with refractory VF.

8.
J Interv Card Electrophysiol ; 52(3): 263-270, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30112616

RESUMO

PURPOSE: The purpose of this report was to review the basic mechanisms underlying cardiac automaticity. Second, we describe our clinical observations related to the anatomical and functional characteristics of sinus automaticity. METHODS: We first reviewed the main discoveries regarding the mechanisms responsible for cardiac automaticity. We then analyzed our clinical experience regarding the location of sinus automaticity in two unique populations: those with inappropriate sinus tachycardia and those with a dominant pacemaker located outside the crista terminalis region. RESULTS: We studied 26 patients with inappropriate sinus tachycardia (age 34 ± 8 years; 21 females). Non-contact endocardial mapping (Ensite 3000, Endocardial Solutions) was performed in 19 patients and high-density contact mapping (Carto-3, Biosense Webster with PentaRay catheter) in 7 patients. The site of earliest atrial activation shifted after each RF application within and outside the crista terminalis region, indicating a wide distribution of atrial pacemaker sites. We also analyzed 11 patients with dominant pacemakers located outside the crista terminalis (age 27 ± 7 years; five females). In all patients, the rhythm was the dominant pacemaker both at rest and during exercise and located in the right atrial appendage in 6 patients, in the left atrial appendage in 4 patients, and in the mitral annulus in 1 patient. Following ablation, earliest atrial activation shifted to the region of the crista terminalis at a slower rate. CONCLUSIONS: Membrane and sub-membrane mechanisms interact to generate cardiac automaticity. The present observations in patients with inappropriate sinus tachycardia and dominant pacemakers are consistent with a wide distribution of pacemaker sites within and outside the boundaries of the crista terminalis.


Assuntos
Adaptação Fisiológica/fisiologia , Mapeamento Potencial de Superfície Corporal , Estimulação Cardíaca Artificial/métodos , Taquicardia Sinusal/diagnóstico por imagem , Taquicardia Sinusal/terapia , Adulto , Cateterismo Cardíaco , Ablação por Cateter/métodos , Estudos de Coortes , Ecocardiografia/métodos , Feminino , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Nó Sinoatrial/fisiopatologia , Resultado do Tratamento , Ultrassonografia de Intervenção
11.
J Electrocardiol ; 51(3): 357-361, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29779522

RESUMO

We describe a neonate that developed alternating wide and narrow complex tachycardias following heart surgery for congenital heart defect. Although the etiology was sinus tachycardia, a premature atrial complex initiated aberrancy due to phase 3 block that was perpetuated due to 'linking' at similar or even slower heart rates. Similarly, there was abrupt transition from wide to narrow complex tachycardia following a premature ventricular complex without a change in subsequent heart rate. This was explained by interruption of linking phenomenon by premature ventricular activation. While the above mechanisms are described in the setting of a supraventricular tachyarrhythmia, this has not been reported during sinus tachycardia.


Assuntos
Taquicardia Sinusal/diagnóstico , Diagnóstico Diferencial , Eletrocardiografia , Humanos , Recém-Nascido , Masculino , Taquicardia Sinusal/fisiopatologia
12.
Clin Case Rep ; 5(8): 1362-1368, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28781860

RESUMO

We describe the induction of a masquerading bundle branch block in two patients with Brugada syndrome following the administration of Ajmaline. The development of this conduction disturbance prevented the correct electrocardiographic diagnosis. However, the simultaneously obtained vectocardiogram identified both the Brugada pattern and the masquerading bundle branch block.

13.
J Interv Card Electrophysiol ; 48(2): 223-233, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27771820

RESUMO

BACKGROUND: Apixaban is a Factor Xa inhibitor increasingly being used for stroke prevention in atrial fibrillation (AF). Although several studies have been done, the efficacy and safety of apixaban during the peri-procedural period of AF ablation remains unclear. We sought to systematically review pooled data from these various studies to evaluate thromboembolic and bleeding risks in patients undergoing catheter ablation for AF who are treated with apixaban (interrupted and uninterrupted). METHODS: Studies comparing anticoagulation with apixaban or vitamin K antagonists (VKA) in patients undergoing ablation for AF were identified via an electronic search of MEDLINE, EMBASE, clinical trials.gov, and Cochrane Library from inception to January 2016. Study-specific risk ratios were calculated and combined with a fixed-effects model meta-analysis. RESULTS: In the analysis of 2100 pooled patients, thromboembolic complications (TE) occurred in 14/778 (1.80 %) patients in the apixaban group (AG) compared to 20/1322 patients in the VKA group (RR 1.03, 95 % CI 0.55-1.90, p = 0.93, I 2 = 0 %). Major bleeding occurred in 9/778 (1.2 %) of the AG compared to 20/1322 (1.51 %) in the VKA group (RR 1.03, 95 % CI 0.55-1.90, p = 0.93, I 2 = 0 %). In uninterrupted apixaban group (uAG), TE occurred in 4/585 (0.68 %) patients in the uAG compared to 6/910 (0.66 %) in VKA group (RR 0.86, 95 % CI 0.25-2.95, p = 0.81, I 2 = 0 %). Major bleeding occurred in 5/585 (0.85 %) in uAG compared to 7/910 (0.77 %) in the VKA group (RR 1.20, 95 % CI 0.37-3.88, p = 0.76, I 2 = 0 %). CONCLUSION: Our study demonstrates patients treated with apixaban and VKA during the peri-procedural period for AF ablation have similar rates of TE and bleeding complications. Interrupted and uninterrupted apixaban strategies were associated with similar outcomes.


Assuntos
Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/epidemiologia , Ablação por Cateter/estatística & dados numéricos , Hemorragia/epidemiologia , Pirazóis/administração & dosagem , Piridonas/administração & dosagem , Tromboembolia/epidemiologia , Tromboembolia/prevenção & controle , Idoso , Causalidade , Comorbidade , Relação Dose-Resposta a Droga , Feminino , Fibrinolíticos/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Prevalência , Fatores de Risco , Resultado do Tratamento , Vitamina K/antagonistas & inibidores
14.
J Am Coll Cardiol ; 67(6): 674-683, 2016 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-26868693

RESUMO

BACKGROUND: Radiofrequency catheter ablation is used to treat recurrent ventricular tachycardia (VT). OBJECTIVES: This study evaluated long-term safety and effectiveness of radiofrequency catheter ablation using an open-irrigated catheter. METHODS: Patients with sustained monomorphic ventricular tachycardia associated with coronary disease were analyzed for cardiovascular-specific adverse events within 7 days of treatment, hospitalization duration, 6-month sustained monomorphic ventricular tachycardia recurrence, quality of life measured by the Hospital Anxiety and Depression Scale, long-term (1-, 2-, and 3-year) survival, symptomatic VT control, and amiodarone use. RESULTS: Overall, 249 patients, mean age 67.4 years, were enrolled. The cardiovascular-specific adverse events rate was 3.9% (9 of 233) with no strokes. Noninducibility of targeted VT was achieved in 75.9% of patients. Post-ablation median hospitalization was 2 days. At 6 months, 62.0% (114 of 184) of patients had no sustained monomorphic ventricular tachycardia recurrence; the proportion of patients with implantable cardioverter-defibrillator shocks decreased from 81.2% to 26.8% (p < 0.0001); the frequency of VT in implantable cardioverter-defibrillator patients with recurrences was reduced by ≥50% in 63.8% of patients; and the proportion with normal Hospital Anxiety and Depression Scale scores increased from 48.8% to 69.1% (p < 0.001). Patient-reported VT remained steady for 1, 2, and 3 years at 22.7%, 29.8%, and 24.1%, respectively. Amiodarone use and hospitalization decreased from 55% and 77.2% pre-ablation to 23.3% and 30.7%, 18.5% and 36.7%, 17.7% and 31.3% at 1, 2, and 3 years, respectively. CONCLUSIONS: Radiofrequency catheter ablation reduced implantable cardioverter-defibrillator shocks and VT episodes and improved quality of life at 6 months. A steady 3-year nonrecurrence rate with reduced amiodarone use and hospitalizations indicate improved long-term outcomes. (NaviStar ThermoCool Catheter for Endocardial RF Ablation in Patients With Ventricular Tachycardia [THERMOCOOL VT]; NCT00412607).


Assuntos
Ablação por Cateter/métodos , Frequência Cardíaca/fisiologia , Taquicardia Ventricular/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ablação por Cateter/instrumentação , Aprovação de Equipamentos , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Recidiva , Estudos Retrospectivos , Taquicardia Ventricular/fisiopatologia , Irrigação Terapêutica/métodos , Fatores de Tempo , Resultado do Tratamento
16.
Med Clin North Am ; 99(4): 781-94, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26042882

RESUMO

Atrial fibrillation is a very common clinical problem with a high prevalence that is expected to rise over time because of increasing risk factors (eg, age, obesity, hypertension). This high prevalence is also associated with high cost, because atrial fibrillation represents about 1% of overall health care spending. The management of atrial fibrillation involves multiple facets: (1) management of underlying disease if present and the management of atrial fibrillation risk factors, (2) prevention of thromboembolism, (3) control of the ventricular rate during atrial fibrillation, and (4) restoration and maintenance of normal sinus rhythm.


Assuntos
Antiarrítmicos/uso terapêutico , Anticoagulantes/administração & dosagem , Fibrilação Atrial/terapia , Ablação por Cateter/métodos , Tromboembolia/prevenção & controle , Fatores Etários , Antiarrítmicos/administração & dosagem , Antiarrítmicos/efeitos adversos , Fibrilação Atrial/complicações , Fibrilação Atrial/cirurgia , Doenças Cardiovasculares/complicações , Ablação por Cateter/efeitos adversos , Complicações do Diabetes , Gerenciamento Clínico , Interações Medicamentosas , Humanos , Hipertensão/complicações , Fatores de Risco
17.
Int J Cardiol ; 191: 151-8, 2015 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-25965623

RESUMO

BACKGROUND: Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) often terminate spontaneously, presumably due to changes in the electrophysiological properties of the reentrant circuit. However, the mechanism of spontaneous termination of these arrhythmias is incompletely understood. METHODS: We included 70 consecutive patients with reentrant supraventricular tachycardias (35 AVNRT, 35 AVRT) in whom the arrhythmia ended spontaneously during the electrophysiologic study. We determined in each patient the duration of the induced arrhythmia, site of block, beat-to-beat oscillations in tachycardia cycle-length (CL), A-H, H-V, H-A and V-A intervals. RESULTS: In 21/34 (62%) patients with AVNRT and 19/30 (63%) with orthodromic AVRT, tachycardia termination was preceded by progressive increase in tachycardia CL due to prolongation of the A-H interval (Mobitz type-I pattern). In 13/34 patients with AVNRT (38%) and 11/30 with orthodromic AVRT (37%), termination occurred suddenly without a preceding change in CL, with block ensuing retrogradely either in the fast AV nodal pathway or the accessory pathway (Mobitz type-II pattern). In 4/5 patients with antidromic AVRT the tachycardia ended at the retrograde limb with previous prolongation of the VA interval. CONCLUSION: Spontaneous termination of AVNRT and AVRT is a time-related phenomenon. Despite different pathways being involved in these two reentrant tachycardias, termination can follow antegrade or retrograde block in similar ratio (60% antegradely and 40% retrogradely). Antegrade block is preceded by prolongation of the AH interval (Mobitz type-I), whereas retrograde block occurs unexpectedly in the retrograde limb (Mobitz type-II). Fatigue of conduction appears to be involved in this phenomenon.


Assuntos
Nó Atrioventricular/fisiopatologia , Fascículo Atrioventricular/fisiopatologia , Eletrocardiografia , Taquicardia por Reentrada no Nó Atrioventricular/fisiopatologia , Taquicardia Paroxística/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Remissão Espontânea , Estudos Retrospectivos , Adulto Jovem
18.
J Interv Card Electrophysiol ; 43(3): 227-36, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25935227

RESUMO

BACKGROUND: The role of intracardiac echocardiography (ICE) to detect thrombus within left atrium (LA) before atrial fibrillation (AF) ablation despite a recent transesophageal echocardiogram (TEE) is not well defined. We examined the prevalence of LA/left atrial appendage (LAA) thrombus using ICE immediately prior to AF ablation in patients in whom anticoagulation was not withheld. METHODS: We analyzed 122 consecutive patients (62.6 ± 10.8 years, 90 males, CHA(2)DS(2) -VASc score 2.4 ± 1.5, persistent AF 29.5 %) who underwent an ICE-guided AF ablation 1 day after a negative (n = 120) or inconclusive (n = 2) TEE for LA thrombus. LA was imaged with ICE from the right atrium, coronary sinus, and right ventricular inflow tract (RVIT). ICE and TEE images were compared for LAA area, thrombus, and spontaneous echo contrast (SEC). RESULTS: LAA was adequately visualized in 99 and 100 % of patients with TEE and ICE, respectively. RVIT was the best ICE view for LAA visualization. The LAA 2-D-area measured by TEE was 4.9 ± 0.5 vs. 5 ± 0.5 cm(2) by ICE (P = NS). ICE identified a thrombus in seven patients with a previous negative TEE, leading to cancellation of ablation. It ruled out a thrombus in two patients with an inconclusive TEE. Thrombi were found in the LAA (n = 4), atrial septum (n = 2), and left superior pulmonary vein (n = 1). SEC during TEE was more frequent in patients with thrombus on ICE than those without (85.7 vs. 17.4 %; p = 0.03; positive predictive value 23.1 %, negative predictive value 98.9 %). CONCLUSIONS: The results of our staged imaging approach suggest that ICE has a complimentary value in re-screening the LA/LAA for thrombus after a recent negative or equivocal TEE. The presence of SEC during TEE increases the probability of finding a thrombus with ICE, which could potentially be dislodged during catheter manipulation.


Assuntos
Fibrilação Atrial/epidemiologia , Ecocardiografia/estatística & dados numéricos , Trombose do Seio Lateral/diagnóstico por imagem , Trombose do Seio Lateral/epidemiologia , Cirurgia Assistida por Computador/estatística & dados numéricos , Fibrilação Atrial/cirurgia , Ablação por Cateter/estatística & dados numéricos , Comorbidade , Ecocardiografia/métodos , Feminino , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Pennsylvania/epidemiologia , Prevalência , Fatores de Risco , Cirurgia Assistida por Computador/métodos
19.
J Interv Card Electrophysiol ; 42(2): 129-34, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25601562

RESUMO

BACKGROUND: The anatomical reconstruction of the left atrium (LA) and pulmonary veins with fast anatomical mapping (FAM) and intracardiac echocardiography (ICE) using the Carto 3 system (Biosense Webster, Inc) provides real-time guidance to catheter manipulation during ablation of atrial fibrillation (AF). The present study compared real-time LA volume reconstruction using FAM and ICE. In addition, the contribution of respiratory gating was assessed. METHODS: LA reconstruction was created using FAM and ICE in 60 consecutive patients (mean age 63 ± 9 years; 38 males) undergoing AF ablation. In the first 30 patients, FAM and ICE were performed without respiratory gating. In the last 30 patients, FAM and ICE were performed with respiratory gating. RESULTS: LA volumes determined by FAM were larger than those obtained with ICE in the absence of respiratory gating (n = 30; 129.5 ± 44 vs 110 ± 39.7 cm(3); p = 0.001). However, respiratory gating reduced LA volume determined with FAM by 17.7 ± 6.6% resulting in similar LA volumes to those obtained using ICE [n = 30; 100 ± 29.7 (61-154) vs 101.53 ± 40.1 (56-212) cm(3), p = 0.7, NS]. CONCLUSIONS: In the absence of respiratory gating, LA volumes determined by FAM are larger than those obtained with ICE. In contrast, with the addition of respiratory gating, both FAM and ICE provide similar real-time LA volumes.


Assuntos
Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Mapeamento Potencial de Superfície Corporal/métodos , Ablação por Cateter/métodos , Ecocardiografia Tridimensional/métodos , Idoso , Estudos de Coortes , Seguimentos , Átrios do Coração , Humanos , Angiografia por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Tamanho do Órgão , Ventilação Pulmonar/fisiologia , Medição de Risco , Amostragem , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
20.
J Electrocardiol ; 48(3): 445-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25454008

RESUMO

The authors report the unique case of remote onset of exercise induced focal ventricular tachycardia in a 40-year old male patient that originated from the ventricular end of an accessory atrioventricular pathway 18 months after a successful ablation. There was no residual conduction across the pathway after the first ablation. The ventricular tachycardia (VT) was mapped to and successfully ablated at the same site where the ventricular end of the pathway was previously ablated. The VT morphology was similar to that of the pre-excited QRS beats noted before. Thus far, in all reported cases of accessory pathway related automaticity there was intact conduction over the pathway or acute injury to it. To the best of our knowledge a case similar to our patient is not yet reported.


Assuntos
Feixe Acessório Atrioventricular/diagnóstico , Feixe Acessório Atrioventricular/etiologia , Ablação por Cateter/efeitos adversos , Eletrocardiografia/métodos , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/etiologia , Adulto , Diagnóstico Diferencial , Teste de Esforço , Ventrículos do Coração/cirurgia , Humanos , Masculino
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