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11.
Bratisl Lek Listy ; 124(2): 121-127, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36598298

RESUMO

The relevance of the study is conditioned by the problem of implantation of an artificial cardiac pacemaker in atrial fibrillation in patients with tachy-brady syndrome according to the standard scheme related to the presence of a congenital anomaly, such as persistent left superior vena cava. The purpose of the study is to develop an operative method of implantation of a permanent two-chamber pacemaker in patients with tachy-brady syndrome with concomitant pathology of the persistent left superior vena cava. Research methods are the generally accepted clinical and instrumental examination of the patient, including taking anamnesis and a standard cardiological examination, electrocardiography, transthoracic echocardiography, plain radiography, angiocardiographic examination, and multispiral computed tomography, which, along with a general analysis, confirm the presence of tachy-brady syndrome with atrial fibrillation and congenital anomaly in the form of persistent left superior vena cava in patients. The study presents a developed model of surgical implantation of a permanent two-chamber pacemaker to stabilise the condition of patients with atrial fibrillation related to tachy-brady syndrome with concomitant persistent left superior vena cava; the standard implantation mechanism included the introduction of a radiopaque agent to clarify the anatomical structure of the vascular bed, further, its entry from the subclavian veins into the persistent left superior vena cava and into the cavity of the right atrium through the venous coronary sinus was detected, and then a gradual introduction of an endocardial right ventricular electrode was performed into the subclavian vein through the tricuspid valve along with its further positioning in the apex of the right ventricle; therefore, a permanent two-chamber pacemaker can be successfully installed, creating conditions for restoring sinus rhythm in this group of patients, which is of practical importance for the field of medicine (Tab. 3, Fig. 4, Ref. 20). Keywords: atrial fibrillation, persistent left superior vena cava, sick sinus syndrome, pacemaker implantation, cardiac surgery.


Assuntos
Fibrilação Atrial , Marca-Passo Artificial , Veia Cava Superior Esquerda Persistente , Humanos , Fibrilação Atrial/complicações , Fibrilação Atrial/terapia , Síndrome do Nó Sinusal/terapia , Veia Cava Superior/anormalidades , Bradicardia , Taquicardia
12.
Biosens Bioelectron ; 223: 115034, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36574741

RESUMO

The ectopic co-expression of taste and olfactory receptors in cardiomyocytes provides not only possibilities for the construction of biomimetic gustatory and olfactory sensors but also promising novel therapeutic targets for tachycardia treatment. Here, bitter taste and olfactory receptors endogenously expressed in HL-1 cells were verified by RT-PCR and immunofluorescence staining. Then HL-1 cardiomyocyte-based integrated gustatory and olfactory sensing array coupling with the microelectrode array (MEA) was first constructed for drugs screening and evaluation for tachycardia treatment. The MEA sensor detected the extracellular field potentials and reflected the systolic-diastolic properties of cardiomyocytes in real time in a label-free and non-invasive way. The in vitro tachycardia model was constructed using isoproterenol as the stimulator. The proposed sensing array facilitated potential drug screening for tachycardia treatment, such as salicin, artemisinin, xanthotoxin, and azelaic acid which all activated specific receptors on HL-1 cells. IC50 values for four potential drugs were calculated to be 0.0036 µM, 309.8 µM, 14.68 µM, and 0.102 µM, respectively. Visualization analysis with heatmaps and PCA cluster showed that different taste and odorous drugs could be easily distinguished. The mean inter-class Euclidean distance between different bitter drugs was 1.681, which was smaller than the distance between bitter and odorous drugs of 2.764. And the inter-class distance was significantly higher than the mean intra-class Euclidean distance of 1.172. In summary, this study not only indicates a new path for constructing novel integrated gustatory and olfactory sensors but also provides a powerful tool for the quantitative evaluation of potential drugs for tachycardia treatment.


Assuntos
Técnicas Biossensoriais , Receptores Odorantes , Humanos , Miócitos Cardíacos , Avaliação Pré-Clínica de Medicamentos , Biomimética , Olfato , Paladar , Taquicardia
15.
J Cardiovasc Electrophysiol ; 34(1): 231-234, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36571151

RESUMO

INTRODUCTION: A 13 old girl presented with recurrent wide QRS tachycardia since she was 4. METHODS: An electrophysiologic study was performed. RESULTS: The electrophysiologic study showed that QRS complexes identical to those of the tachycardia could be elicited with premature atrial extrastimuli but with a shorter atrioventricular (AV) delay when the QRS was wide compared with narrow QRS complexes. The tachycardia was ablated at 9 o'clock on the tricuspid annulus demonstrating the presence of an atriofascicular fiber. CONCLUSION: We believe that this atypical behavior can be explained by AV nodal like longitudinal dissociation of a slowly conducting accessory pathway.


Assuntos
Feixe Acessório Atrioventricular , Nó Atrioventricular , Feminino , Humanos , Nó Atrioventricular/cirurgia , Fascículo Atrioventricular , Taquicardia , Feixe Acessório Atrioventricular/diagnóstico , Feixe Acessório Atrioventricular/cirurgia , Átrios do Coração , Eletrocardiografia
16.
Kardiologiia ; 62(11): 56-62, 2022 Nov 30.
Artigo em Russo, Inglês | MEDLINE | ID: mdl-36521045

RESUMO

Aim    To identify possible predictors of tachycardia-induced cardiomyopathy (TICMP) in patients with newly developed decompensated chronic heart failure (CHF) of nonischemic origin with reduced left ventricular ejection fraction (LV EF) and with persistent atrial tachyarrhythmias. Material and methods    This study included 88 patients with newly developed decompensated CHF of nonischemic origin with reduced LV EF and persistent atrial tachyarrhythmias. Resting 12-lead electrocardiography (EGC) and transthoracic echocardiography (EchoCG) were performed upon admission and following the electrical impulse therapy for all patients. Also, 24-h ECG monitoring was performed to confirm sinus rhythm stability. After recovery of sinus rhythm, outpatient monitoring was performed for three months, including repeated EchoCG to evaluate the dynamics of heart chamber dimensions and LV EF. Results    The patients were divided into two groups based on the increase in LV EF: 68 responders (TICMP patients with a LV EF increase by >10%) and 20 non-responders (patients with an increase in LV EF by <10% during 3 months following the sinus rhythm recovery). According to results of the baseline EchoCG, LV EF did not significantly differ in the two subgroups (TICMP, 40±8.3 %, 18-50 % and non-responders, 38.55±7.9 %, 24-50 %); moreover, the incidence of cases with LV EF <30% did not differ either (9 patients TICMP and 2 non-responders, р=1.0). TICMP patients compared to non-responders, had significantly smaller left atrial dimensions (4.53±1.14 (2-7) cm and 5.68±1.41 (4-8) cm, р=0.034; 80.8±28.9 (27-215) ml and 117.8±41.3 (46-230) ml, р=0.03, respectively) and left ventricular end-systolic volume (ESV) (67.7±33.1 (29-140) ml and 104.5±44.7 (26-172) ml, р=0.02, respectively). The effect of major EchoCG parameters on the probability of TICMP development was assessed by one-factor and multifactor regression analyses with adjustments for age and sex. The probability of TICMP increased with the following baseline EchoCG parameters: end-diastolic volume (EDV) <174 ml [odd ratio (OR), 0.115, 95 % confidence interval (CI): 0.035-0.371], ESV <127 ml [OR, 0.034, 95 % CI: 0.007-0.181], left atrial volume <96 ml [OR, 0.08 , 95 % CI: 0.023-0.274], right ventricular dimension <4 cm [OR, 0.042 , 95 % CI: 0.005-0.389].Conclusion    Among patients with newly developed decompensation of CHF with reduced LV EF of non-ischemic origin and persistent atrial arrhythmias, TICMP was detected in 72 % of patients. The probability of TICMP did not depend on baseline EF and duration of arrhythmias, but increased with the following baseline EchoCG parameters: EDV< 174 ml, ESV< 127 ml, left atrial volume <96 ml, right ventricular dimension <4 cm. The multifactorial analysis showed that a right atrial volume <96 ml is an independent predictor for the development of TICMP.


Assuntos
Fibrilação Atrial , Cardiomiopatias , Insuficiência Cardíaca , Humanos , Volume Sistólico , Função Ventricular Esquerda , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/terapia , Cardiomiopatias/diagnóstico , Cardiomiopatias/epidemiologia , Cardiomiopatias/etiologia , Taquicardia/complicações , Taquicardia/diagnóstico , Taquicardia/epidemiologia , Átrios do Coração/diagnóstico por imagem
18.
Emerg Med Clin North Am ; 40(4): 717-732, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36396218

RESUMO

Narrow-complex tachycardias are commonly seen on shift in the emergency department. Although a portion of patients present with hemodynamic instability because of arrhythmia, it is important to know that the tachycardia can be a result of an underlying condition. Rapid identification of the type and etiology of the arrhythmia is vital to directing appropriate management strategies and disposition decisions.


Assuntos
Eletrocardiografia , Taquicardia , Humanos , Diagnóstico Diferencial , Taquicardia/diagnóstico , Taquicardia/terapia , Arritmias Cardíacas , Serviço Hospitalar de Emergência
20.
Herzschrittmacherther Elektrophysiol ; 33(4): 467-475, 2022 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-36342506

RESUMO

In this article, typical characteristics of focal atrial tachycardias are described and a systematic approach regarding diagnostics and treatment options in the field of invasive cardiac electrophysiology (EP) is presented. Subjects of this article include the definition of focal atrial tachycardias, knowledge about localizing the origin of such, and guidance on how to approach an invasive EP study (e.g., administration of medication during the EP study to provoke tachycardias). Further, descriptions will be found on how to localize the origin of focal atrial tachycardias with the help of the 12-lead ECG and invasive three-dimensional mapping to successfully treat focal atrial tachycardias with catheter ablation.


Assuntos
Ablação por Cateter , Taquicardia Atrial Ectópica , Humanos , Ablação por Cateter/métodos , Taquicardia/cirurgia , Eletrocardiografia/métodos
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