Cases reported "Tachycardia, Sinus"

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1/15. Basket catheter localization of the origin of atrial tachycardia with atypical morphology after atrial flutter ablation.

    Atrial activation from a site in the low lateral right atrium will typically proceed in a superior direction. We present a case of a low lateral right atrial tachycardia with a surface electrocardiographic P wave morphology that appeared to have an inferiorly directed axis. The tachycardia occurred 2 years after successful atrial flutter ablation. The use of a multipolar basket catheter allowed confirmation of the focal origin of the tachycardia, permitted its rapid localization, facilitated catheter ablation, and provided clues to atrial activation that helped describe the appearance of the P wave.
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keywords = ablation
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2/15. Electrophysiologic findings of a patient with inappropriate sinus tachycardia cured by selective radiofrequency catheter ablation.

    Radiofrequency catheter ablation (RFCA) for inappropriate sinus tachycardia (IST) is associated with a high recurrence rate and sometimes requires pacemaker implantation, especially after extensive ablation. We report a patient with drug-refractory IST who was successfully treated by selective RFCA to the 2 earliest activation sites. During tachycardia, the earliest atrial activation preceded the surface P wave by 50 ms or more, whereas it was only 27 ms for the rest of the right atrium after ablation. Our patient had the longest activation period during tachycardia among the reported patients. In IST patients, a longer activation time at the site of the earliest atrial activation may imply that the abnormality is confined to a small area within the sinus node and may predict the efficacy of selective RFCA.
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ranking = 1.1666666666667
keywords = ablation
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3/15. Evidence of sinoatrial block as a curative mechanism in radiofrequency current ablation of inappropriate sinus tachycardia.

    Inappropriate sinus tachycardia is a nonparoxysmal tachycardia characterized by high resting heart rates and a disproportionate response to activity. Sinus node modification with radiofrequency current has been used successfully as treatment for this arrhythmia. However, the electrophysiologic mechanisms leading to successful modification are not yet fully elucidated. We report a case of a patient with drug-resistant inappropriate sinus tachycardia in whom successful treatment of the arrhythmia was achieved by documented sinoatrial exit block induced by radiofrequency current applications.
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ranking = 0.66666666666667
keywords = ablation
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4/15. Right diaphragm paralysis following cardiac radiofrequency catheter ablation for inappropriate sinus tachycardia.

    We describe a case of permanent right diaphragm paralysis following a radiofrequency cardiac ablation procedure. The relationship between the procedure and the phrenic nerve lesion is discussed with respect to the possible pathogenetic mechanisms. Radiofrequency current used in cardiac electrophysiology may cause serious thoracic nerve injuries. Means to avoid this complication are pointed out.
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ranking = 0.83333333333333
keywords = ablation
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5/15. Radiofrequency catheter ablation using non-contact mapping for inappropriate sinus tachycardia.

    INTRODUCTION: In this report we describe our experience using non-contact mapping for radiofrequency ablation in patients with inappropriate sinus tachycardia. methods AND RESULTS: Two female patients with persistent complaints of palpitations and documented inappropriate sinus tachycardia with failed medical management underwent radiofrequency ablation using non-contact mapping. Non-contact mapping provided a continuous determination of the site of earliest breakthrough, facilitating the delivery and the assessment of the results of each radiofrequency application. CONCLUSION: Non-contact mapping is an effective mapping modality in the interventional treatment of inappropriate sinus tachycardia.
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ranking = 1
keywords = ablation
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6/15. Combined epicardial-endocardial approach to ablation of inappropriate sinus tachycardia.

    A combined epicardial-endocardial approach to ablation of inappropriate sinus tachycardia in a highly symptomatic patient who failed to respond to medical therapy and endocardial ablation is described. The anatomy and physiology of the sinus node is discussed, providing a basis for performing this procedure. This case provides an additional therapeutic option for a condition that often is difficult to manage.
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ranking = 1
keywords = ablation
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7/15. Recurrent syncope triggered by inappropriate sinus tachycardia.

    A 25-year-old woman with daily episodes of syncope and several related traumatic injuries was referred for electrophysiological study. Structural heart disease was excluded. Electrophysiological study revealed inappropriate sinus tachycardia with heart rates up to 190 beats/min. A sinus node modulation was performed. However, 5 days later the patient again developed syncope during sinus tachycardia at rates of 140 beats/min with systolic blood pressure of 60 mmHg. The patient subsequently underwent AVN ablation and implantation of a dual chamber pacemaker. The patient has remained asymptomatic during a 12-month follow-up. This article reports on the first case of a moderate sinus tachycardia in a structurally normal heart as an underlying mechanism of recurrent episodes of syncope. While moderate supraventricular tachycardia in a structurally normal heart alone is unlikely to explain the severe symptoms, additional sympathovagal or humoral mechanisms induced by sinus tachycardia may contribute to syncopal events in this patient.
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ranking = 0.16666666666667
keywords = ablation
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8/15. Superior vena cava rupture caused during balloon dilation for treatment of SVC syndrome due to repetitive catheter ablation--a case report.

    A 29-year-old woman with an implanted AAI mode permanent pacemaker, who had undergone catheter ablation for inappropriate sinus tachycardia 4 times, experienced complications of superior vena cava (SVC) syndrome. Severe stenosis of the SVC wall was observed in computed tomograms. During balloon dilation for the treatment of SVC syndrome, the SVC was ruptured, resulting in cardiac tamponade. An emergency operation was performed using percutaneous cardiopulmonary support (PCPS). A longitudinal tear 1 cm in length was identified at the junction of the right atrium and the SVC, requiring a patch plasty using an autologous pericardium 2.5 cm x 3 cm in size. SVC rupture is a complication to be completely avoided when we perform balloon dilation for the treatment of SVC syndrome. Therefore, the indication of balloon dilation for the treatment of SVC syndrome requires critical examination and attention.
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ranking = 0.83333333333333
keywords = ablation
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9/15. Persistent inappropriate sinus tachycardia after radiofrequency ablation of left lateral accessory pathway.

    A patient with palpitations and narrow QRS tachycardia was evaluated. In the EP study an atrioventricular reentrant tachycardia mediated by a left lateral accessory pathway was identified and catheter ablation was performed with success. A week later she returned with palpitations and pre-syncope. The resting ECG showed a sinus tachycardia with 110 bpm. After unsuccessful clinical treatment with beta-blockers, diltiazem and digoxin she underwent sinus node modification using radiofrequency catheter ablation with success. We postulated that RF application to ablate the lateral accessory pathway damaged the parasympathetic innervation in the left atrioventricular groove, causing inappropriate sinus tachycardia.
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ranking = 1
keywords = ablation
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10/15. Pseudosinus tachycardias originating from left pulmonary veins.

    The case of a 55-year-old man with LV dysfunction in whom the baseline cardiac rhythm falsely mimicked a sinus rhythm (SR) but actually originated from the left superior and inferior pulmonary vein (PV) is reported. The P waves before ablation were flat in leads I and V1, negative in lead aVL, and positive in leads II, III, aVF. After the left superior PV was isolated from the left atrium, another ectopic rhythm newly appeared from the left inferior PV. Interestingly, the LV systolic function improved after the resumption of the SR, thus suggesting that tachycardia-induced cardiomyopathy might be involved in the mechanism of LV systolic disturbance.
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ranking = 0.16666666666667
keywords = ablation
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