Ventricular Tachycardia Detected by Implantable Loop Recorder in a Child with Recurrent Syncope

In this article, we present a 10-year-old boy who was admitted to the hospital with recurrent syncope. There was no remarkable finding in patient’s physical examination, family history, and the diagnostic 12-lead electrocardiogram (ECG), chest x-ray, ECG Holter monitoring, event recording, echocardiography, coronary computed tomography (CT) angiography, Ajmaline test for the diagnosis of Brugada syndrome, brain magnetic resonance imaging, and sleep/wake electroencephalogram. We started beta-blocker therapy because the patient had exercise-induced syncope. An Implantable loop recorder (ILR) was inserted to the patient. Three years later, polymorphic ventricular tachycardia called torsades de pointes was detected by the ILR during syncope occurred with exercise. The patient had been taking high-dose betablocker treatment, an implantable cardioverter defibrillator was implanted into the patient. ILR can play an important role in the diagnosis of life-threatening arrhythmia in children with unexplained syncope. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 123-5

The Relationship of Acute Exacerbation Severity with Uric Acid and Uric Acid to Creatinine Ratio in Patients with Chronic Obstructive Pulmonary Disease

Aim: Acute exacerbation in chronic obstructive pulmonary disease (COPD) may result in a lot of systemic consequences due to hypoxemia and systemic inflammation. We investigated uric acid levels and uric acid to creatinine ratio in COPD patients developing acute exacerbation. Methods: We included 25 patients who had been admitted with acute exacerbation of COPD according to the GOLD diagnosis and treatment guidelines between May and December 2011. Uric acid and creatinine levels were recorded from blood samples of the patients. Results: Average uric acid and uric acid to creatinine ratio values were 5.7±2.09 mg/dl and 7.32±3.0 in patients with mild hypoxemia, 6.4±2.1 mg/dl and 7.01±2.9 in those with moderate hypoxemia, and 6.7±2.0 mg/dl and 9.1±1.8 in those with severe hypoxemia, respectively. While no statistically significant correlation was found between uric acid levels and uric acid to creatinine ratio in the three groups (p=0.97, p=0.76, respectively), these values were found to increase along with increasing severity of hypoxemia. Conclusion: Uric acid levels and the ratio of uric acid to creatinine remained unchanged while severity of hypoxemia increased during acute exacerbations of COPD, however, these values were found to increase with increasing severity of hypoxemia. (The Medical Bulletin of Haseki 2013; 51: 147-50

A rare association with suffered cardiac arrest, long qt interval, and syndactyly: Timothy syndrome (LQT-8)

Timothy syndrome (TS), also referred to as syndactylyassociated long QT syndrome (LQTS) or LQT8, is a multi-system disorder characterized by developmental defects causing dysmorphic facial features, congenital heart abnormalities, neurocognitive impairment, and webbing of the toes and fingers (syndactyly) (1). TS is caused by mutations of the CACNA1C gene, which encodes L-type calcium channel Ca (V) 1.2. Two types of TS have been defined according to the mutation sites: G406R in exon 8A (TS1) and G402S/G406R in exon 8 (TS2). These gain-offunction mutations result in an impaired open-state and voltagedependent inactivation of the L-type calcium channel, ultimately 672 Case Reports Anatol J Cardiol 2015; 15: 671-4 leading to a markedly prolonged myocardial action potential (delayed ventricular repolarization) (1-4)

Working at Night in Hospital Environment is a Risk Factor for Arterial Stiffness

Aim: Arterial stiffness is an independent risk factor for cardiovascular disease. In previous studies, emotional stress has been reported to be a risk factor for cardiovascular disease. In this study, we aimed to investigate the effects of anxiety, stress and fatigue associated with working at night in hospital environment on arterial stiffness in physicians. Methods: The study was carried out with 30 physicians employed in Medical Faculty of Uludağ University between October 2011 and March 2012. Measurements were made using Pulse Wave Sensor HDI system (Hypertension Diagnostics Inc, Eagan, MN)(Set No: CR000344) by radial artery pulse wave at the onset and end of night shift. Results: The mean age of night doctors included in the study was 26 years (range: 22-38) and the female/male ratio was 2/1. It was determined that mean values of arterial stiffness were significantly higher after night shift (1330±360 dyne/sn/cm-5) compared to mean values before night shift (1093±250 dyn/s/cm-5) (p=0.01). In the evaluation of other parameters before and after night shift, no statistically significant difference was detected (p>0.05). Conclusion: The increasing arterial stiffness in hospital employees after night shift could be attributed to the effects of stress and fatigue experienced during night shift. (The Me di cal Bul le tin of Ha se ki 2012; 50: 93-5

Spontaneous Remission of Congenital Complete Atrioventricular Block in Anti-Ro/La Antibody-Negative Monozygotic Twins: Case Report

Background: Congenital complete atrioventricular block without any structural heart disease and anti-Ro/La negativity is very rare. Discordant complete atrioventricular block, which is more frequently defined in the literature as an autoimmune mechanism, is much more rare in monozygotic twins. Case Report: The 26-year-old healthy mother had given birth in her first spontaneous, uneventful pregnancy to monozygotic twins at week 35. While the first twin’s physical examination proved her to be normal with a pulse rate consistent with her age, the second twin had a pulse rate of approximately 40 beats/minute.The patient was confirmed to have congenital complete atrioventricular block. Conclusion: Despite this case appears to be an isolated one, a discordant complete atrioventricular block regression without any autoimmune evidence should be included in the differential diagnosis of bradycardia in infant

Assessment of atrioventricular conduction following cryoablation of atrioventricular nodal reentrant tachycardia in children

WOS: 000337733100008PubMed ID: 24472089Background Early-onset transient atrioventricular block (AVB) is a rare occurrence following cryoablation of atrioventricular nodal reentrant tachycardia (AVNRT), despite lack of any AVB at the end of the procedure. The purpose of this prospective study was to assess AVB shortly after successful cryoablation of AVNRT in children. Methods A 6-mm-tip cryocatheter was used in 39 procedures. An 8-mm-tip catheter was used in 11 procedures. Twelve-lead electrocardiograms (ECGs) and 24-hour ambulatory ECGs were performed 24 hours prior to the procedure and immediately following the procedure. All procedures were done using the EnSite system (St. Jude Medical, St. Paul, MN, USA) without fluoroscopy. Results Although nine (18%) patients developed variable degrees of transient AVB during the procedure, all of them had normal atrioventricular (AV) conduction at the end of the procedure and did not require any intervention. Four of these patients had variable degrees of transient AVB following the procedure despite having normal AV conduction at the end of the procedure. One developed Mobitz type I AVB, which lasted for 11.5 hours, and the other three experienced 2:1 AVB, which lasted for 2, 8, and 24 hours, respectively. All patients had complete resolution of the AVB, which was also documented with the 24-hour ambulatory ECGs after the procedure. Conclusion Early transient AVB can develop following AVNRT cryoablation even if AV conduction is normal at the end of the procedure. Despite the transient AVB in the initial 24 hours after the procedure in some cases, there is no evidence for ongoing AV nodal dysfunction

A rare ventriculoarterial connection: Double outlet of both ventricles

Ventriculoarterial connection is one of the important points of the segmental approach to congenital cardiac malformations. Double outlet of both ventricles is a rare form where both great arterial roots override the interventricular septum. In this article, we aimed to draw attention to this very rare form of ventriculoarterial connection by presenting an infant case diagnosed using echocardiography, CT angiography, and 3-dimensional modelling