1/431. ECG diagnosis of native heart ventricular tachycardia in a heterotopic heart transplant recipient.A case is reported of haemodynamic collapse in a 51 year old male heterotopic heart transplant recipient caused by native heart ventricular tachycardia. An accurate diagnosis was made by selective right and left sided electrocardiography. Synchronised electrical cardioversion of the native heart (200 J) resulted in restoration of sinus rhythm with prompt relief of symptoms and amelioration of the clinical situation.- - - - - - - - - - ranking = 1keywords = heart (Clic here for more details about this article) |
2/431. Potential proarrhythmic effects of implantable cardioverter-defibrillators.Implantable cardioverter-defibrillator (ICD) interventions have the potential to be proarrhythmogenic. New arrhythmias can occur in the setting of clinically appropriate therapies, as well as during a cardiac rhythm for which therapy is not intended. Cardioversion/defibrillation therapies, antitachycardia pacing, and antibradycardia pacing are potential triggers for the development of new arrhythmias. Newer ICDs allow better recognition and interpretation of the arrhythmias that are induced by delivered therapies. Two cases of ICD-induced proarrhythmias are described. Based on the course of these patients and review of previous reports, proarrhythmic effects of ICD interventions along with prevention and management strategies are discussed.- - - - - - - - - - ranking = 0.37385026680386keywords = cardiac (Clic here for more details about this article) |
3/431. Cardiac involvement in proximal myotonic myopathy.Proximal myotonic myopathy (PROMM) is a recently described autosomal dominantly inherited disorder resulting in proximal muscles weakness, myotonia, and cataracts. A few patients with cardiac involvement (sinus bradycardia, supraventricular bigeminy, conduction abnormalities) have been reported. The cases of three relatives with PROMM (weakness of neck flexors and proximal extremity muscles, calf hypertrophy, myotonia, cataracts) are reported: a 54 year old man, his 73 year old mother, and 66 year old aunt. All three presented with conduction abnormalities and one had repeated, life threatening, sustained monomorphic ventricular tachycardia. This illustrates that severe cardiac involvement may occur in PROMM.- - - - - - - - - - ranking = 0.74770053360772keywords = cardiac (Clic here for more details about this article) |
4/431. A new approach: a single triple electrode lead system interfaced with a third generation defibrillator.The efficacy of implantable third generation cardioverter defibrillators has been well established for the treatment of patients with malignant ventricular arrhythmias and survivors of cardiac arrest. However, many patients have been reluctant or unwilling to endure the discomfort of an open chest procedure, despite their need for the device. Furthermore, morbidity (pneumothorax, pneumonia, sepsis, pleural effusion, hemorrhage, pericarditis, etc.) and mortality associated with the application of epicardial lead systems is of concern. Finally, the mean overall expense of $80,433 for the epicardial method of defibrillator implantation is a consideration in an era of increasing cost-awareness in health care. Fortunately, the recent market-release of a single lead transvenous defibrillation system [Endotak, Cardiac Pacemakers, Inc. (CPI), St. Paul, minnesota] may address these pressing issues. The specific purpose of this report is to demonstrate the patient benefit derived from interfacing a single endocardial lead system with a biphasic third generation defibrillator.- - - - - - - - - - ranking = 0.37385026680386keywords = cardiac (Clic here for more details about this article) |
5/431. Radiofrequency catheter ablation as primary therapy for symptomatic ventricular tachycardia.Most applications of radiofrequency (RF) catheter ablation for treatment of ventricular tachycardia (VT) have been as a treatment of last resort. The purpose of this study was to determine the efficacy and safety of RF catheter ablation as the primary treatment for symptomatic single morphology VT. Eleven of 81 patients (14%) with inducible sustained monomorphic VT underwent RF ablation as the primary treatment. One of these 11 patients had successful RF ablation of bundle branch reentry VT and was excluded from this series. The remaining 10 patients had a mean age of 58 /- 19 years (range 20 to 73 years), were mostly men (7 of 10 patients), and all presented with documented evidence of symptomatic sustained monomorphic VT, at a mean cycle length of 340 /- 60 milliseconds (ms) (range 250 to 430 ms). Six patients had coronary artery disease (CAD), one had surgical repair for tetralogy of fallot, one had surgical repair of a ventricular septal defect, and two had a normal cardiac substrate. The VT origin was mapped using a combination of activation mapping, mid-diastolic potentials, pace mapping, and concealed entrainment. A mean of 5 /- 3 (range 2 to 11) RF applications were administered to the putative VT foci. Eight of 10 (80%) clinical VTs were successfully ablated. There were no serious complications. patients with VT originating from the left ventricle were offered implantable cardioverter-defibrillator back-up; however, only one patient accepted this option. At a mean follow-up of 12 /- 7 months, only one patient had a possible arrhythmia recurrence.- - - - - - - - - - ranking = 0.37385026680386keywords = cardiac (Clic here for more details about this article) |
6/431. Radiofrequency catheter ablation of coexistent atrioventricular reciprocating tachycardia and left ventricular tachycardia originating in the left anterior fascicle.Coexistence of supraventricular tachycardia and ventricular tachycardia is rare. A patient with no structural heart disease and wide QRS complex tachycardia with a right bundle block configuration and right-axis deviation underwent electrophysiological examination. A concealed left atrioventricular pathway (AP) was found, and atrioventricular reciprocating tachycardia (AVRT) and left ventricular tachycardia (VT) originating in or close to the anterior fascicle of the left ventricle were both induced. Radiofrequency (RF) catheter ablation of the concealed left AP was successfully performed. Ten months later, VT recurred and was successfully ablated using a local Purkinje potential as a guide. Coexistent AVRT and idiopathic VT originating from within or near the left anterior fascicle were successfully ablated.- - - - - - - - - - ranking = 0.090909090909091keywords = heart (Clic here for more details about this article) |
7/431. Histopathologic effects of radiofrequency catheter ablation in previously infarcted human myocardium.INTRODUCTION: The use of catheter-based radiofrequency (RF) ablation for the treatment of ventricular tachyarrhythmias due to previous myocardial infarction has been steadily increasing. The histopathologic changes caused by this technique are not well described in humans. methods AND RESULTS: Three patients with hemodynamically tolerated ventricular tachycardias (VTs) due to previous myocardial infarction underwent endocardial mapping and catheter based RF ablation. All patients received between 5 and 11 RF lesions each of 60-second duration. One patient underwent myocardial resection of a left ventricular aneurysm 1 day following RF ablation, one expired 7 days after RF ablation, and one expired 9 months after RF ablation. None of the deaths occurred as a result of RF ablation. Pathologic specimens obtained early after RF ablation revealed areas of focal acute inflammation and fibrin deposition. Later specimens revealed several focal areas of fibrosis and granulation tissue. Specimens obtained late after RF ablation revealed a dense band of fibrosis, measuring 17 x 17 x 5 mm (1,250 mm3). CONCLUSION: Catheter-based RF ablation of ischemic VT in humans causes lesions that initially resemble coagulation necrosis. This is followed by the development of an inflammatory infiltrate and, finally, the development of fibrosis. Repeated application of RF ablation may result in much larger lesions than have been previously reported.- - - - - - - - - - ranking = 3.911088698588keywords = myocardial infarction, infarction (Clic here for more details about this article) |
8/431. Left posterior fascicular tachycardia: a diagnostic and therapeutic challenge.A wide QRS complex tachycardia with right bundle-branch block morphology and left axis deviation observed in a young patient without structural heart disease may pose a diagnostic and therapeutic challenge. The surface ECG may provide several diagnostic clues to make a correct diagnosis of left posterior fascicular tachycardia and may help to differentiate it from both a supraventricular tachycardia with aberrant conduction and a typical ventricular tachycardia related to coronary artery disease. Although this tachycardia is sensitive to verapamil, this medication may probably cause transient infertility in males. The presence of a Purkinje potential preceding the QRS complex during tachycardia and optimal pace mapping may guide radio-frequency ablation resulting in a definite cure.- - - - - - - - - - ranking = 0.090909090909091keywords = heart (Clic here for more details about this article) |
9/431. Reversible catecholamine-induced cardiomyopathy in a heart transplant candidate without persistent or paroxysmal hypertension.BACKGROUND: Both dilated and hypertrophic cardiomyopathy have been reported in patients with pheochromocytoma, who were almost always hypertensive. The outcome frequently has been fatal, yet cardiac dysfunction can be reversible after medical or surgical therapy for the pheochromocytoma. methods: We report the case of a patient with dilated cardiomyopathy without persistent or paroxysmal hypertension, who was found to have a pheochromocytoma during initial medical evaluation. RESULTS: The identification and treatment of the pheochromocytoma led to significant improvement in cardiac function and cardiac transplantation was avoided. CONCLUSIONS: This case illustrates some unusual features in pheochromocytoma-induced cardiomyopathy: (1) absence of persistent or paroxysmal hypertension, (2) initial presentation with acute myocardial infarction and normal coronary arteries, and (3) recurrent episodes of nonsustained ventricular tachycardia.- - - - - - - - - - ranking = 3.4407315133419keywords = myocardial infarction, cardiac, heart, infarction (Clic here for more details about this article) |
10/431. Intravenous amiodarone suppression of electrical storm refractory to chronic oral amiodarone.We report the case of an electrical storm in a cardiac arrest survivor with an ICD, in whom chronic oral amiodarone failed to suppress ventricular arrhythmias, and in whom intravenous amiodarone resulted in stability for 6 weeks prior to successful cardiac transplantation. Intravenous amiodarone can be successful in suppressing life-threatening ventricular arrhythmias, even when chronic oral amiodarone is unsuccessful.- - - - - - - - - - ranking = 0.74770053360772keywords = cardiac (Clic here for more details about this article) |
| | Next -> |