Paroksismal atriyal fibrilasyonlu hastalarda ablasyon sonrası rekürrens ile otonom sinir sistemi aktivitesi arasındaki ilişkinin değerlendirilmesi

Introduction: In this study, we aimed to investigate the relationship between autonomic dysfunction (AD) deter- mined according to the blood pressure (BP) and heart rate (HR) response in exercise treadmill test (ETT) prior to cryoballoon ablation (CBA), and the recurrence of atrial fibrillation (AF) after CBA in patients with paroxysmal AF. Patients and Methods: Seventy-six patients (mean age 53 ± 11 years, 61.8% male) with paroxysmal AF who underwent CBA were enrolled. Before CBA the ETT was performed by all patients. BP and HR responses in ETT were compared between patients with and without AF recurrence. Results: AD rate was significantly higher in the group with recurrence compared to the non-recurrent group (p 0.05 for all). Examining AD parameters, systolic blood pressure at peak exercise (SBPpeak) (p 0.05 for all ). OD parametreleri incelendiğinde, maksimum egzersizdeki sistolik kan basıncı (188.89 ± 28.13 vs 157.60 ± 28.82, p< 0.001), maksimum egzersizdeki diyastolik kan basıncı (87.47 ± 16.89 vs. 72.02 ± 15.43, p< 0.001), yavaş kalp hızı iyileşmesi [11 (%57.9) vs. 8 (%14), p< 0.001] CBA sonrası AF rekürrensi ile ilişkili bulunmuştur. Sonuç: OD lone AF’li hastalarda CBA sonrası AF rekürrensi ile ilişkili olabilir. Maksimum egzersizdeki sistolik kan basıncı, maksimum egzersizdeki diyastolik kan basıncı, yavaş kalp hızı iyileşmesi ablasyon sonrası AF rekürrens prediktörü olarak bulunmuştur

Changes in electrocardiographic p wave parameters after cryoballoon ablation and their association with atrial fibrillation recurrence

Background: Changes in P wave parameters after circumferential pulmonary vein isolation (CPVI) have been previously identified. In this study, we aimed to determine the changes in P wave parameters surface electrocardiogram (ECG) after cryoballoon ablation (CBA) for atrial fibrillation (AF) and evaluate their relationship with AF recurrence. Methods: Sixty-one patients (mean age 53 ± 11 years, 50.8% male) with paroxysmal AF who underwent CBA were enrolled. A surface ECG was obtained from all patients immediately before the procedure, and repeated 12 hours after the procedure. P wave amplitude (Pamp), P wave duration (Pwd), and P wave dispersion (Pdis) values in preprocedural and postprocedural ECGs were measured and compared. Recurrence rates of AF in 3, 6, and 9 months following ablation were recorded for all patients. Changes in P wave parameters were compared between patients with and without AF recurrence. Results: Compared to preprocedural measurements, Pamp (from 0.58 ± 0.18 mV at baseline to 0.48 ± 0.17 mV, P 0.05). Conclusion: Pamp, Pwd, and Pdis parameters exhibited significant decrease after CBA compared to preprocedural measurements. Decreased Pamp was shown to be a predictor for good clinical outcomes following CBA

Tako-tsubo cardiomyopathy following catheter ablation of atrial fibrillation

WOS: 000351601600012PubMed ID: 25355779Tako-tsubo cardiomyopathy is characterized by reversible left ventricular dysfunction following emotional or surgical stress. Unlike the well-known complications of catheter ablation (CA) of atrial fibrillation (AF), Tako-tsubo cardiomyopathy has been rarely reported so far. We report a case of acute reversible left heart failure following successful CA of paroxysmal AF in a patient with a history of panic disorder

Pnömonektomili hastada pulmoner venlerin başarılı radyofrekans izolasyonu

Among electrophysiologic procedures, catheter ablation of atrial fibrillation (AF) is challenging, requiring the isolation of all pulmonary veins (PVs). AF is associated with serious complications including PV stenosis. Presently described was a technically challenging case of PV isolation in a patient with left-sided pneumonectomy due to lung cancer.Atriyum fibrilasyonunun kateter ablasyonu invaziv elektrofizyoloji çalışmaları arasında zor bir işlemdir. Pulmoner venlerin izolasyonu tedavinin köşe taşını oluşturmaktadır. İşlem pulmoner ven stenozu gibi bazı ciddi komplikasyonlarla eşlik edebilir. Bu yazıda, akciğer kanseri nedeniyle sol taraflı pnömonektomi olan hastada teknik olarak zor olan pulmoner ven izolasyonu yapılan olgu sunuldu

The effects of cigarette smoking on the Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio

Background. Cigarette smoking increases the risk of sudden cardiac death. Smoking may predispose individuals to ventricular fibrillation and sudden cardiac death by altering ventricular repolarization and stimulating sympathetic nervous system activity. Objectives. The aim of the study was to investigate the instantaneous effects of smoking on ventricular repolarization. Material and Methods. The study included 47 healthy subjects; 24 long-term heavy smokers (10 women, mean age: 40 ± 5 years) constituted the study group, and 23 non-smokers (10 women, mean age: 42 ± 10 years) constituted the control group. ECGs were performed on all the subjects. The Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were measured and compared between the groups. Results. There were no significant differences between smokers and nonsmokers in the basic clinical and echocardiographic variables (p > 0.05). The QT interval and QTc interval were similar in both groups. The Tp-e interval (p = 0.02) and Tpe/QT ratio (p = 0.001) were higher in the heavy smokers than in the non-smokers. The Tpe/QTc ratio (p = 0.001) was also higher in the smokers. Other ECG parameters were similar between the smokers and nonsmokers. Conclusions. The results show that chronic cigarette smoking is associated with a prolonged Tp-e interval, increased Tp-e/QT ratio and Tp-e/QTc ratio. These observations may indicate that there may be a relationship between smoking and altered ventricular repolarization. Abnormal ventricular repolarization values on an ECG may explain the increased cardiovascular event risk in long-term heavy cigarette smokers

Mechanical support to the lead extraction

WOS: 000421966900001PubMed ID: 26142784Son yıllarda teknolojik ve tıbbi gelişmelere paralel olarak kardiyak ritim cihazlarının (pacemaker – PM) ve yerleştirilebilen kardiyoverter defibrilatör (Implantable Cardioverter Defibrillator – ICD) yerleştirme endikasyonu genişlemiştir.[1] Özellikle kalp yetersizliği bulunan hastalarda ICD ve/veya biventriküler PM yerleştirilmesiyle kardiyak mortalite ve morbiditenin azaltılmasının mümkün olduğunu gösteren randomize klinik çalışmaların sonuçları bu cihazların yaygın olarak kullanılmasına neden olmuştur.[2] Bu nedenle yerleştirilebilen kardiyak ritim cihazı sayısında belirgin bir artış söz konusudur. Ayrıca tıbbi tanı ve tedavi olanaklarının gelişmesi ile hastaların daha uzun yaşamaları mümkün olmaktadır. Böylece klinikte gittikçe daha fazla sayıda PM ve ICD yerleştirilmiş hasta ile ve bunun sonucu olarak gittikçe artan sayıda PM ve ICD elektrot sorunları ile karşılaşmaktayız

Prolonged Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with Type 2 diabetes mellitus

WOS: 000407801900016PubMed ID: 26676332Background: Type 2 diabetes mellitus (T2DM) is associated \vith increased risk of malignant ventricular arrhythmias. Cardiac electrical inhomogeneity may be the leading cause of the increased arrhythmic risk in patients with T2DM. The peak and the end of the T wave (Tp-e) interval and associated Tp-e/QT ratio are promising measures of ventricular repolarization indicating trans mural dispersion of repolarization. The aim of this study was to assess ventricular repolarization in patients with T2DM by using Tp-e interval, Tp-e'QT ratio and Tp-e'corrected QT interval (QTc) ratio. Method: Forty-three patients with T2DM and 43 healthy control subjects, matched by gender and age, were studied. All participants underwent electrocardiography (ECG) recording. PR. RR and QT intervals represents the ECG intervals. These are not abbreviations. In all literature these ECG intervals are written like in this text. Tp-e intervals were measured from 12 -lead ECG. Rate QTc was calculated by using the l3azett's formula. Tp-e/QT ratio and Tp-e/Q-fc ratio were also calculated. Result: Mean Tp-e interval was significantly prolonged in patients with T2DM compared to controls (79.4 +/- 10.3, 66.4 +/- 8.1 respectively: P<0.001). We also found significantly higher values of Tp-e/QT ratio and Tp-e/QTc ratio in patients with diabetes than controls (0.21 +/- 0.03, 0.17 +/- 0.02 and 0.19 +/- 0.02, 0.16 +/- 0.02, respectively; P<0.001). There was no difference in terms of the other ECG parameters between the groups. Conclusion: Tp-e interval. Tp-e/QT ratio and Tp-e/QTc ratio were prolonged in patients with T2DM. We concluded that T2DM leads to augmentation of transmural dispersion of repolarization suggesting increased risk lbr ventricular arrhythmogenesis

Effect of oxidative stress on ventricular repolarization in patients with type 2 diabetes: Non-invasive quantification via transmural dispersion of repolarization

WOS: 000376668100031PubMed ID: 26553108We read the article entitled ‘Increased serum gamma-glutamyltransferase levels are associated with ventricular instability in type 2 diabetes’ by Wang et al. with great interest [1]. In this article, it was focused on association between serum gamma glutamyltransferase (GGT) levels and ventricular instability in patients with type 2 diabetes mellitus (T2DM). In this well-designed research, they reported that increased serum GGT levels are associated with some markers of ventricular repolarization abnormalities in the early stage of T2DM

Transmural dispersion of repolarization and atrial electromechanical coupling: Complementary indices for quantifying cardiac electrical heterogeneity in patients with conversion disorder

WOS: 000358183300001PubMed ID: 26229478We read with great interest the article entitled “P-wave and QT dispersion in patients with conversion disorder” by Izci et al1 in Therapeutics and Clinical Risk Management. In this well designed research, Izci et al studied QT dispersion (QTd) and P-wave dispersion (Pd) in patients with conversion disorder (CD). In conclusion, they reported that corrected QT (QTc) and QTd values were significantly altered in patients with CD when compared to healthy controls, but that there was no significant difference in terms of Pd

Near zero fluoroscopy radiation exposure during successful catheter ablation of atrial tachycardia from the non-coronary aortic cusp using 3-dimentional electroanatomic mapping system

Atrial tachycardia (AT) rarely originates from the paraHisian region (1). Catheter ablation of paraHisian AT carries a substantial risk of atrioventricular (AV) block. Cryoablation offers a safer ablation strategy for these patients (2). There is a small risk of AV block with cryoablation. Ablation of paraHisian AT from the non-coronary aortic cusp (NCC) is an option in these patients. We report a patient with paraHisian AT that was successfully ablated from the NCC by 3-Dimentional (3-D) mapping system with using near zero fluoroscopy (NZF)