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Yuji Sato, Toshihide Hayashi, Nobuhiko Joki, Shouichi Fujimoto
In dialysis patients, electrocardiogram (ECG) abnormalities are common. However, the associations between the T-wave of the lead aVR (aVRT) amplitude and cardiovascular (CV) events or total mortality are unknown. We performed a prospective, observational cohort study of prevalent hemodialysis patients (N = 474), followed for 4 years. Outcomes were composite CV events and all-cause mortality. Predictors were baseline aVRT and other ECG findings. ECG parameters were analyzed in three models: model 1, univariate; model 2, basic adjustments; and model 3, model 2 plus serum albumin, C-reactive protein level, and NT-proBNP...
March 10, 2017: Therapeutic Apheresis and Dialysis
Mansour Razminia, Michael Cameron Willoughby, Hany Demo, Hesam Keshmiri, Theodore Wang, Oliver J D'Silva, Terry A Zheutlin, Hakeem Jibawi, Paul Okhumale, Richard F Kehoe
BACKGROUND: Catheter ablations have been traditionally performed with the use of fluoroscopic guidance, which exposes the patient and staff to the inherent risks of radiation. We have developed techniques to eliminate the use of fluoroscopy during cardiac ablations and have been performing completely fluoroless catheter ablations on our patients for over 5 years. METHODS: We present a retrospective analysis of the safety, efficacy, and feasibility data from 500 consecutive patients who underwent nonfluoroscopic catheter ablation, targeting a total of 639 arrhythmias, including atrioventricular reciprocating tachycardia (AVRT), atrioventricular nodal reentrant tachycardia (AVNRT), atrial tachycardia (AT), atrial fibrillation (AF), premature ventricular contractions (PVCs), and ventricular tachycardia (VT)...
February 3, 2017: Pacing and Clinical Electrophysiology: PACE
Renguang Liu, Q I Chen, Yang Chen, Yingjie Zhang, Zhaolong Xu, Gaopin Wang
BACKGROUND: Ventricle preexcitation through accessory pathway changes QRS initial vector, and manifests as delta wave on electrocardiogram (ECG). However, QRS terminal vector can also be affected. METHODS: A total of 158 patients who had single accessory pathway (AP) with antegrade conduction capacity were included and divided into two groups according to the ECG with or without delta wave. Note that 150 patients had delta wave (overt AP group) on ECG; classical preexcitation syndrome was diagnosed before radiofrequency ablation...
March 2017: Pacing and Clinical Electrophysiology: PACE
Ryan T Kipp, Raed Abu Sham'a, Ito Hiroyuki, Frederick T Han, Marwan Refaat, Jonathan C Hsu, Michael E Field, Douglas E Kopp, Gregory M Marcus, Melvin M Scheinman, Kurt S Hoffmayer
BACKGROUND: Atrioventricular reciprocating tachycardia (AVRT) utilizing a concealed accessory pathway is common. It is well appreciated that some patients may have multiple accessory pathways with separate atrial and ventricular insertion sites. METHODS: We present three cases of AVRT utilizing concealed pathways with evidence that each utilizing a single ventricular insertion and two discrete atrial insertion sites. RESULTS: In case one, two discrete atrial insertion sites were mapped in two separate procedures, and only during the second ablation was the Kent potential identified...
March 2017: Pacing and Clinical Electrophysiology: PACE
Syamkumar M Divakara Menon, Maryam Ayati, Jeff S Healey
Slowing of the tachycardia with increase in cycle length and increase in VA time with ipsilateral bundle branch block is a characteristic feature of accessory pathway mediated AVRT. Contralateral bundle branch block has no effect on the tachycardia as it is not a part of the tachycardia circuit. We present an interesting phenomenon in which contralateral bundle branch block resulted in tachycardia slowing in a case of WPW syndrome.
April 2017: Journal of Cardiovascular Electrophysiology
Masaki Ota, Yoshiaki Kaneko, Tadashi Nakajima, Tadanobu Irie, Takafumi Iijima, Akihiro Saito, Masahiko Kurabayashi
BACKGROUND: The direction of impulse propagation across the coronary sinus (CS) musculature (CSM) is an important piece of the mechanistic puzzle underlying atrial tachyarrhythmias. We hypothesized that in the general population, the sequence of left atrial (LA) to CSM electrograms recorded in the CS reflects the direction of impulse propagation over the CSM. METHODS: We studied 19 patients with atrioventricular (AV) reentrant tachycardia (RT) utilizing a left-sided accessory pathway (AP) and 21 patients with typical counterclockwise atrial flutter (AFL)...
December 2016: Journal of Arrhythmia
Michał Orczykowski, Paweł Derejko, Robert Bodalski, Piotr Urbanek, Joanna Zakrzewska-Koperska, Radosław Sierpiński, Katarzyna Kalin, Andrzej Hasiec, Grzegorz Warmiński, Maria Miszczak-Knecht, Katarzyna Bieganowska, Rafał Baranowski, Maria Bilińska, Elżbieta Biernacka, Piotr Hoffman, Łukasz Szumowski
BACKGROUND: Data regarding long-term follow-up of radiofrequency catheter ablation (RFCA) of accessory pathways (APs) in patients with Ebstein's anomaly (EA) are limited. The procedures are challenging due to multiple or wide APs. METHODS: Analysis was performed on clinical and periprocedural data of patients with EA referred to the centre in order to perform catheter ablation of AP. The group consisted of 22 patients (female 40.9%, mean age 33.6 ± 19.1 years)...
2017: Cardiology Journal
Frederik Voss, Lars Eckardt, Sonia Busch, Heidi L Estner, Daniel Steven, Philipp Sommer, Christian von Bary, Hans-Ruprecht Neuberger
The AV-reentrant tachycardia (AVRT) is a supraventricular tachycardia with an incidence of 1-3/1000. The pathophysiological basis is an accessory atrioventricular pathway (AP). Patients with AVRT typically present with palpitations, an on-off characteristic, anxiety, dyspnea, and polyuria. This type of tachycardia may often be terminated by vagal maneuvers. Although the clinical presentation of AVRT is quite similar to AV-nodal reentrant tachycardias, the correct diagnosis is often facilitated by analyzing a standard 12-lead ECG at normal heart rate showing ventricular preexcitation...
December 2016: Herzschrittmachertherapie & Elektrophysiologie
Michal M Farkowski, Mariusz Pytkowski, Aleksander Maciag, Dominik Golicki, Ilona Kowalik, Marcin Czech, Piotr Rucinski, Hanna Szwed
PURPOSE: Radiofrequency ablation (RFA) is considered the treatment of choice in cases of atrioventricular nodal reciprocating tachycardia (AVNRT) and atrioventricular reciprocating tachycardia (AVRT). Published studies suggest a considerable time gap between the onset of the arrhythmia, correct diagnosis, and RFA which may reach 10-15 years. The cost of medical treatment during that period may be substantial. The aim of the study was to calculate the annual direct medical cost of medical treatment of patients with AVNRT and AVRT and identify potential factors influencing this cost...
November 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Koichi Nagashima, Ichiro Watanabe, Yasuo Okumura, Yoshiaki Kaneko, Kazumasa Sonoda, Rikitake Kogawa, Naoko Sasaki, Kazuki Iso, Keiko Takahashi, Sayaka Kurokawa, Toshiko Nakai, Kimie Ohkubo, Atsushi Hirayama
BACKGROUND: Although a ventriculoatrial interval (VAI) of ≤70 ms is used to distinguish atrioventricular nodal reentrant tachycardia from orthodromic atrioventricular reciprocating tachycardia (AVRT), a VAI of ≤70 ms is sometimes observed in cases of AVRT. The study aimed to evaluate the short VAI that is seen in AVRT and to understand its underlying mechanism. METHODS: Electrophysiologic studies of 46 consecutive patients with AVRT involving an accessory pathway (AP) were examined retrospectively...
October 2016: Pacing and Clinical Electrophysiology: PACE
Béatrice Brembilla-Perrot, Jean-Marc Sellal, Arnaud Olivier, Thibaut Villemin, Anne Moulin-Zinsch, Daniel Beurrier, Jean-Paul Lethor, François Marçon, Christian DE Chillou, Jacques Felblinger, Julie Vincent
BACKGROUND: With ablation, the follow-up of preexcitation syndrome now is difficult to assess. The purpose was to collect data of children with a preexcitation syndrome studied on two separate occasions within a minimal interval of 1 year. METHODS: This is a retrospective chart review of 47 children initially aged 12 ± 4 years, who underwent two or more invasive electrophysiological studies (EPS) within 1-25 years of one another (6.3 ± 4.8) for occurrence of symptoms or new evaluation...
September 2016: Pacing and Clinical Electrophysiology: PACE
Béatrice Brembilla-Perrot, Arnaud Olivier, Thibaut Villemin, Julie Vincent, Vladimir Manenti, Daniel Beurrier, Arnaud Terrier de la Chaise, Olivier Selton, Pierre Louis, Christian de Chillou, Jean Marc Sellal
BACKGROUND: Atrial fibrillation (AF) and other supraventricular tachyarrhythmias (SVTA) [atrial flutter (AFL), atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT) and preexcitation syndrome (PS)] are frequently associated. We assessed the AF occurrence frequency and predictors according to the nature of SVTA and completion of SVTA ablation. METHODS AND RESULTS: 4169 patients were referred for SVTA (typical AVNRT: 1338, AVRT over a concealed accessory pathway: 329, atypical AVNRT: 205, AFL: 1321; PS: 976); mean age was 50±20years; electrophysiological study (EPS) was systematic; patients were followed for a mean duration of 3±4...
October 1, 2016: International Journal of Cardiology
Takahiko Kinjo, Shingo Sasaki, Masaomi Kimura, Shingen Owada, Daisuke Horiuchi, Kenichi Sasaki, Taihei Itoh, Yuji Ishida, Yoshihiro Shoji, Kimitaka Nishizaki, Yuichi Tsushima, Hirofumi Tomita, Ken Okumura
BACKGROUNDS: Postpacing interval (PPI) measured after entrainment pacing describes the distance between pacing site and reentrant circuit. However, the influential features to PPI remain to be elucidated. METHODS AND RESULTS: This study included 22 cases with slow/fast atrioventricular (AV) nodal reentrant tachycardia (AVNRT), 14 orthodromic AV reciprocating tachycardia (AVRT) using an accessary pathway, 22 typical atrial flutter (AFL), and 18 other macroreentrant atrial tachycardia (atypical AFL)...
August 2016: Journal of Cardiovascular Electrophysiology
Ivan Zeljković, Ivica Benko, Šime Manola, Vjekoslav Radeljić, Nikola Pavlović
We report the case of a 46-year old patient in whom an electrophysiology study (EP) was performed due to paroxysmal supraventricular tachycardia documented in 12-lead ECG. During the EP study, supraventricular tachycardia was induced easily and it corresponded to orthodromic AV reentry tachycardia (AVRT) using a concealed left free wall accessory pathway. However, during the study AVRT spontaneously and repeatedly converted to the typical slow-fast AV node reentry tachycardia (AVNRT). Both accessory and AV nodal slow pathways were ablated, due to the finding that both AVRT and AVNRT were independently inducible during the EP study...
September 2015: Indian Pacing and Electrophysiology Journal
Arttu O Lehtonen, Pauli Puukka, Juha Varis, Kimmo Porthan, Jani T Tikkanen, Markku S Nieminen, Heikki V Huikuri, Ismo Anttila, Kjell Nikus, Mika Kähönen, Antti Jula, Teemu J Niiranen
OBJECTIVE: To define the prevalence and prognosis of ECG abnormalities in hypertensive individuals. METHODS: ECG, blood pressure and other cardiovascular risk factors were recorded in a nationwide population sample of 5800 Finns. The presence of 15 ECG abnormalities was evaluated. Participants were divided into categories by blood pressure and followed for coronary heart (CHD) and cardiovascular disease (CVD) events. RESULTS: Mean follow-up was 10...
May 2016: Journal of Hypertension
Jason See, Jonah L Amora, Sheldon Lee, Paul Lim, Wee Siong Teo, Boon Yew Tan, Kah Leng Ho, Chee Wan Lee, Chi-Keong Ching
INTRODUCTION: The use of non-fluoroscopic systems (NFS) to guide radiofrequency catheter ablation (RFCA) for the treatment of supraventricular tachycardia (SVT) is associated with lower radiation exposure. This study aimed to determine if NFS reduces fluoroscopy time, radiation dose and procedure time. METHODS: We prospectively enrolled patients undergoing RFCA for SVT. NFS included EnSiteTM NavXTM or CARTO® mapping. We compared procedure and fluoroscopy times, and radiation exposure between NFS and conventional fluoroscopy (CF) cohorts...
July 2016: Singapore Medical Journal
Ai Matsukane, Toshihide Hayashi, Yuri Tanaka, Masaki Iwasaki, Shun Kubo, Takasuke Asakawa, Yasunori Takahashi, Yoshihiko Imamura, Koichi Hirahata, Nobuhiko Joki, Hiroki Hase
BACKGROUND/AIMS: An upright T-wave in lead aVR (aVRT) has recently been reported to be associated with cardiovascular death and mortality among the general population and patients with prior cardiovascular disease (CVD). However, evidence for the predictive ability of aVRT in patients with chronic kidney disease is lacking. Therefore, a hospital-based, prospective, cohort study was conducted to evaluate the predictive ability of an upright aVRT for the short-term prognosis in incident hemodialysis patients...
October 2015: Cardiorenal Medicine
Yosuke Nakatani, Koichi Mizumaki, Tamotsu Sakamoto, Naoya Kataoka, Kunihiro Nishida, Yoshiaki Yamaguchi, Yasushi Tsujino, Hiroshi Inoue
BACKGROUND: This study aimed to clarify whether retrograde P-wave amplitude during tachycardia can be used to differentiate slow-slow form of atrioventricular nodal reentrant tachycardia (S/S-AVNRT) from atrioventricular reentrant tachycardia through a posteroseptal accessory pathway (PS-AVRT). METHODS: Sixteen patients with S/S-AVNRT and 14 patients with PS-AVRT constituted the study group. Electrocardiographic and electrophysiological parameters were compared between both the groups...
March 2016: Pacing and Clinical Electrophysiology: PACE
Mustafa Gülgün, Sema Özer, Tevfik Karagöz, Alper Akın, Hayrettin Hakan Aykan, Süheyla Özkutlu, Dursun Alehan, Alpay Çeliker
OBJECTIVE: The aim of this study was to evaluate the efficacy of transesophageal electrophysiologic study (TEEPS) for the determination of supraventricular tachycardia (SVT) recurrences in symptomatic and asymptomatic children after successful radiofrequency ablation (RFA) for SVT. METHODS: A total of 66 patients who underwent TEEPS after successful RFA were included. The demographic features, symptoms of the patients, and the characteristics of the recurrences induced by TEEPS were evaluated...
February 2016: Anatolian Journal of Cardiology
David Calvo, Pablo Ávila, F Javier García-Fernández, Marta Pachón, Loreto Bravo, Gabriel Eidelman, Jesús Hernández, Ángel L Miracle, José Rubín, Diego Pérez, Ángel Arenal, Felipe Atienza, Javier Jimenez-Candil, Miguel Ángel Arias, Tomás Datino, Pablo Martínez-Camblor, Esteban Gonzalez-Torrecilla, Jesús Almendral
BACKGROUND: Differential diagnosis between tachycardia mediated by septal accessory pathways (AP) and atypical atrioventricular nodal reentry can be challenging. We hypothesized that an immediate versus delayed pace-related advancement of the atrial electrogram, once the local septal parahisian ventricular electrogram (SVE) has been advanced, may help in this diagnosis. METHODS AND RESULTS: We focused on differential timing between SVE and atrial signals at the initiation of continuous right ventricular apical pacing during tachycardia...
October 2015: Circulation. Arrhythmia and Electrophysiology
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