1/38. Radiofrequency catheter ablation of atrial flutter after orthotopic heart transplantation: insights into the redefined critical isthmus.We report a case of successful radiofrequency catheter ablation of recurrent atrial flutter in a heart transplant recipient and discuss technical aspects of the procedure. A counterclockwise flutter circuit was defined during endocardial mapping of the donor atrium. Termination of atrial flutter was achieved by creating lines of radiofrequency lesions from the tricuspid ring to the suture line between donor and recipient atria. Creation of bidirectional conduction block in the tricuspid ring-suture line isthmus resulted in abolition of atrial flutter.- - - - - - - - - - ranking = 1keywords = atrial flutter, flutter (Clic here for more details about this article) |
2/38. tachycardia-dependent right bundle-branch block with supernormal conduction.This paper reports the case of a 76-year-old man in whom atrial flutter with varying atrioventricular block and intermittent right bundle-branch block was found. This is the first report on tachycardia-dependent right bundle-branch block associated with supernormal conduction in a case of atrial flutter. When an impulse is conducted to the ventricles beyond 0.72 s after a QRS complex of right bundle-branch block configuration, the impulse falls after the abnormally long effective refractor period of the right bundle branch and passes through the right bundle branch. When the conducted impulse occurs within 0.72 s after a QRS complex of right bundle-branch block configuration, the impulse usually falls in the refractory period and is blocked in the right bundle branch; however, only when the impulse occurs 0.48 or 0.49 s after that does it fall in the supernormal period and passes through the right bundle branch. The findings in the present report strengthen our previous suggestion that the presence of supernormal conduction plays an important role in the initiation of reentrant ventricular tachycardia.- - - - - - - - - - ranking = 0.27163815826194keywords = atrial flutter, flutter (Clic here for more details about this article) |
3/38. The Mount Sinai Hospital clinicalpathological conference: a 45-year-old man with Pompe's disease and dilated cardiomyopathy.This is an unusual case of a 45-year-old man, born in ecuador, with evidence of profound left ventricular dysfunction, dilated cardiomyopathy and marked myocardial hypertrophy. Preceding events were advanced atrioventricular block (necessitating pacemaker implantation) and atrial flutter. The diagnosis of Pompe's disease was established by endomyocardial biopsy and appropriate staining, which indicated abnormal glycogen storage.- - - - - - - - - - ranking = 0.13581907913097keywords = atrial flutter, flutter (Clic here for more details about this article) |
4/38. Ectopic atrial rhythm with exit block following catheter ablation for focal atrial tachycardias in a patient with prior surgery for atrial septal defect.The patient was a 40-year-old woman with a history of surgery for atrial septal defect and catheter ablation for typical atrial flutter. An electrophysiological study was performed because she had palpitation and syncope. She had ectopic atrial rhythm originating from low lateral RA. Two focal atrial tachycardias ([1] superior vena cava-RA junction and [2] a lowposteroseptal RA) were successfully ablated. Following catheter ablation for the second atrial tachycardia, she developed junctional rhythm because ectopic atrial rhythm showed exit block. However, atrial activation of junctional rhythm could conduct into the ectopic atrial rhythm focus and reset the rhythm when atrial activation of junctional rhythm reached the blocked line after atrial refractoriness by preceding ectopic atrial rhythm.- - - - - - - - - - ranking = 0.13581907913097keywords = atrial flutter, flutter (Clic here for more details about this article) |
5/38. Clinical implications of fetal magnetocardiography.OBJECTIVES: To test the usefulness and reliability of fetal magnetocardiography as a diagnostic or screening tool, both for fetuses with arrhythmias as well as for fetuses with a congenital heart defect. methods: We describe 21 women with either a fetal arrhythmia or a congenital heart defect discovered during prenatal evaluation by sonography. Four fetuses showed a complete atrioventricular block, two an atrial flutter, nine ventricular extrasystole, and one a complete irregular heart rate. Five fetuses were suspected to have a congenital heart defect. In all cases magnetocardiograms were recorded. RESULTS: Nine fetuses with extrasystole showed a range of premature atrial contractions, premature junctional beats or premature ventricular contractions. Two fetuses with atrial flutter showed typical flutter waves and four fetuses with complete atrioventricular block showed an uncoupling of P-wave and QRS complex. One fetus showed a pattern suggestive of a bundle branch block. In three of four fetuses with confirmed congenital heart defects the magnetocardiogram showed abnormalities. CONCLUSION: Fetal magnetocardiography allows an insight into the electrophysiological aspects of the fetal heart, is accurate in the classification of fetal arrhythmias, and shows potential as a tool in defining a population at risk for congenital heart defects.- - - - - - - - - - ranking = 0.32090460434516keywords = atrial flutter, flutter (Clic here for more details about this article) |
6/38. Clinical implication of the double potentials at the cavotricuspid isthmus for radiofrequency catheter ablation of typical atrial flutter.An 87-year-old man was referred to our institution to undergo radiofrequency catheter ablation for typical atrial flutter. A decapolar electrode catheter with an interelectrode spacing of 1mm positioned at the cavotricuspid isthmus (CTI) exhibited 2 discrete potentials. The first electrogram was recorded at a site close to the tricuspid annulus and the second at a site close to the inferior vena cava at the CTI. Entrainment study showed that the first component was crucial to maintain the artrial flutten; however, the second one was found to function as a bystander portion of the reentrant circuit. Radiofrequency energy application at the site where the first potential was inscribed could terminate the atrial flutter creating a complete bidirectional conduction block at the CTI.- - - - - - - - - - ranking = 0.81491447478581keywords = atrial flutter, flutter (Clic here for more details about this article) |
7/38. Enlarged effects of adenosine in a septic patient with multiple myeloma and atrial flutter.We report the history of a 60-year-old patient with a multiple myeloma and staphylococcus aureus associated sepsis to whom adenosine in a dose of 6 mg was administered, when a regular, narrow QRS complex tachycardia at a heart rate of 120 beats/minute started. adenosine led to a complete AV-block and revealed atrial flutter. atrial flutter waves persisted for about 15 seconds and were followed by atrial and ventricular asystole for about 20 seconds. Repeated nonsustained polymorphic ventricular tachycardias followed and after about 90 seconds sinus rhythm was restored.- - - - - - - - - - ranking = 0.72836184173806keywords = atrial flutter, flutter (Clic here for more details about this article) |
8/38. Cardiac involvement in the Kugelbert-Welander syndrome.Two cases of the Kugelberg-Welander syndrome (juvenile form of progressive spinal muscular atrophy) associated with cardiomyopathy and cardiomegaly are presented. The first patient, a 24 year old man, had atrial flutter with complete atrioventricular (A-V) block due to A-H block. echocardiography revealed an increase in the left atrial and right ventricular dimensions. The second patient was a 26 year old man whose electrocardiogram revealed an A-V junctional rhythm, deep Q wave in leads I, aVL and V5 to V6 and an RS pattern in lead V1. Histologic examination of the myocardium in Case 2 showed slight interstitial fibrosis. review of previously reported cases shows that (1) the atrium, the ventricular myocardium and A-V conducting tissue may be involved, and (2) atrial arrhythmias, A-V conduction disturbances and congestive heart failure may occur in the Kugelberg-Welander syndrome.- - - - - - - - - - ranking = 0.13581907913097keywords = atrial flutter, flutter (Clic here for more details about this article) |
9/38. Pacemaker lead endocarditis caused by achromobacter xylosoxidans.We report the case of a 35-yr-old patient who presented with high fever and chills. He had undergone a patch closure of the ventricular septal defect 18 yr before. One year later, a VVI pacemaker was implanted via the right subclavian vein because of complete heart block. Nine years after that, a new VVI pacemaker with another right ventricular electrode was inserted controlaterally and the old pacing lead was abandoned. Trans-thoracic and trans-esophageal echocardiogram identified the pacemaker lead in the right ventricle (RV) attaching hyperechoic materials and also a fluttering round hyperechoic mass with a stalk in the RV outflow tract. Cultures in blood and pus from pacemaker lead grew achromobacter xylosoxidans. A diagnosis of pacemaker lead endocarditis due to achromobacter xylosoxidans was made. In this regards, the best treatment is an immediate removal of the entire pacing system and antimicrobial therapy.- - - - - - - - - - ranking = 0.049266446083227keywords = flutter (Clic here for more details about this article) |
10/38. Wenckebach's periods or alternating Wenckebach's periods during 4:1 atrioventricular block?This article deals with the tracings of a patient having episodes of atrial flutter with 4:1 atrioventricular (AV) block increasing to 8:1 AV block. This phenomenon was attributed to the coexistence of 3-level block due to transverse dissociation with 2:1 AV block in the most proximal level, or first level as well as in the second level coexisting with a Wenckebach's period in the most distal, or third level. It is suggested that perhaps the term Wenckebach's periods during progression of 4:1 AV block best describes this arrhythmia so as to maintain the term alternating Wenckebach's periods only to those occurring when 2:1 block increases to higher degrees of AV block.- - - - - - - - - - ranking = 0.13581907913097keywords = atrial flutter, flutter (Clic here for more details about this article) |
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