Clinical Significance of Repolarization Parameters in Brugada Syndrome Patients

GİRİŞ ve AMAÇ: Brugada Sendromu (BS) ani ölüm riskinin arttığı kalıtsal bir hastalıktır. Mevcut risk parametreleri yetersizdir. Artmış T dalga alternansı (TDA) ve uzamış T dalgası pik-son süresi (Tp-e) ani kardiyak ölüm ile ilişkilidir. Bu çalışmada TDA ve Tp-e süresinin BS hastalarındaki rolü araştırılmıştır YÖNTEM ve GEREÇLER: Çalışmaya 13 BS hastası ve 11 kontrol alınmıştır. BS ve kontrollerde TDA ve EKG kaydedilmiştir. Hastalar ve kontroler ventriküler aritmi açısından takip edilmiştir. BULGULAR: BS ve kontrollerde TDA negatif saptanmıştır. Ancak BS hastalarında Tp-e süresi kontrollere göre daha uzun saptanmıştır. Ayrıca takipte ventriküler aritmi gelişen hastaların tümünde Tp-e 100 ms' nin üzerindedir. TARTIŞMA ve SONUÇ: BS hastalarında TDA uygun olmayan bir testtir, Tp-e süresinin uzaması BS hastalarında artmış risk ile ilişkili olabilir.INTRODUCTION: Brugada syndrome (BS) is a genetic disease with increased risk of sudden cardiac death. Increased T wave alternans (TWA) and prolonged T wave peak to end (Tp-e) interval are linked to sudden cardiac death. In the present study, we investigated the role of TWA and Tp-e interval in BS. METHODS: Thirteen BS and 11 controls were included. TWA and ECG were recorded. Patients and controls were followed for ventricular arrhythmias. RESULTS: TWA study was negative in BS and controls. Tp-e interval was longer in BS than controls. Furthermore, during f/u all patients with ventricular arrhythmiashad Tp-e interval longer than 100 ms DISCUSSION and CONCLUSION: TWA is an inappropriate test for BS, prolonger Tpe may be related to increased risk in BS patient

Prognostic value role of radiofrequency lesion size by cardiac magnetic resonance imaging on outcomes of ablation in patients with ischemic scar-related ventricular tachycardia A single center pilot study

Inadequate ablation lesion formation may be responsible for post-ablation ventricular tachycardia (VT) recurrences

The impact of the clinical diagnosis on the vagal response and heart rate after ganglionated plexus ablation

Background Ganglionated plexi (GP) ablation may be associated with improved syncope or arrhythmia-free survival arrhythmia patients with vasovagal syncope (VVS) and atrial fibrillation (AF), respectively. We aimed to compare the characteristics of vagal response (VR) and clarify the effect on heart rate after GP ablation based on clinical diagnosis

The opinion of Turkish cardiologists on current malpractice system and an alternative patient compensation system proposal: PCS study group

Amaç: Kardiyologlar birçok riskli hastanın teşhis, tedavi ve girişimsel tedavisiyle uğraşmaktadırlar. Bu çalışmada Türkiye'deki mevcut "malpraktis" sisteminin kardiyologların tanı ve tedavi yaklaşımlarını nasıl etkilediğini ve önerdiğimiz yeni hasta tazminat sistemine yaklaşımlarını inceledik.Yöntemler: Bu kesitsel çalışmada Türk sağlık sisteminin farklı seviyelerinde çalışan kardiyologların mesleki risk algılarının uygulamalarına etkisini araştırma amacıyla 24 soruluk bir anketi asistan, uzman ve öğretim üyelerine elektronik posta, basılı evrak ve cep telefonu mesajı ile gönderildi.Bulgular: Ankete toplam 253 kardiyolog cevap verdi. Bunların 29'una (%11.6) geçmişte malpraktis talepleri için dava açılmıştı. Dava edilen kardiyologların 2'sine (%6.9) maddi tazminat talebinde bulunuldu, 1'ine (%3.4) ihmal nedeniyle hapis cezası verildi. Bunun yanında 132 (%52.8) kardiyolog "malpraktis" korkusu nedeni ile pratiklerinde değişiklik yaptıklarını bildirmekteydi. Ayrıca 232 (%92.8) kardiyolog önerdiğimiz hasta tazminat sistemini tercihe değer buluyordu. Kardiyologların %78.8'i bilgisayarlı tomografik anjiyografi (BTA) veya perfüzyon sintigrafisi, %71.6'sı koroner anjiyografi, %20'si stent implantasyonu, %83.2'si ise yüksek riskli hastalardan kaçınma kararlarında malpraktisten kaçınmanın etkili olduğu kanaatindeydi.Sonuç: "Malpraktis" korkusu kardiyologlarda yüksek oranlarda gereksiz test isteme, girişim yapma veya yüksek riskli hastalardan kaçınma eğilimi yaratmaktadır. Önerdiğimiz yeni "malpraktis" sistemi çalışmaya katılan kardiyologların büyük çoğunluğu tarafından mevcut sisteme tercih edilir bulunmuşturObjective: Cardiologists participate in the diagnosis and interventional treatment of numerous high-risk patients. The goal of this study was to investigate how the current malpractice system in Turkey influences cardiologists’ diagnostic and interventional behavior and to obtain their opinions about an alternative patient compensation system.Methods: The present cross-sectional study assessed the practice of defensive medicine among cardiologists who are actively working in various types of workplace within the Turkish healthcare system. A 24-item questionnaire was distributed to cardiology residents, specialists, and academics in Turkey in print format, by electronic mail, or via cell phone message.Results: A total of 253 cardiologists responded to the survey. Among them, 29 (11.6%) had been sued for malpractice claims in the past. Of the cardiologists who had been sued, 2 (6.9%) had been ordered to pay financial compensation, and 1 (3.4%) was given a sentence of imprisonment due to negligence. In all, 132 (52.8%) of the surveyed cardiologists reported that they had changed their practices due to fear of litigation, and 232 (92.8%) reported that they would prefer the new proposed patient compensation system to the current malpractice system. Among the cardiologists surveyed, 78.8% indicated that malpractice fear had affected their decision-making with regard to requesting computed tomography angiography or thallium scintigraphy, 71.6% for coronary angiography, 20% for stent implantation, and 83.2% for avoiding treating high-risk patients.Conclusion: The results of this survey demonstrated that cardiologists may request unnecessary tests and perform unneeded interventions due to the fear of malpractice litigation fear. Many also avoid high-risk patients and interventions. The majority indicated that they would prefer the proposed alternative patient compensation system to the current malpractice syste

Catheter Ablation for Atrial Fibrillation in Patients <= 30 Years of Age

Pulmonary vein (PV) automaticity is an established trigger for paroxysmal atrial fibrillation (PAF), making PV isolation (PVI) the cornerstone of catheter ablation. However, data on triggers for atrial fibrillation (AF) and catheter ablation strategy in very young patients aged 30 seconds after a 3-month blanking period. A total of 2 patients with atrioventricular nodal reentrant tachycardia, 1 with left atrial appendage tachycardia, experienced AF recurrence within the first 3 months and received PVI. After the 3-month blanking period, during a median follow-up of 17.0 +/- 10.1 months, 44 of 51 patients (86.2%) were free of ATA recurrence. In the PVI group, 33 of 39 patients (84.6%) experienced no ATA recurrence. In conclusion, SVT substrate is identified in around a quarter of young adult patients with history of AF, and targeted ablation without PVI may be sufficient in the majority of these patients. PVI is needed in the majority and is safe and effective in this population. (C) 2021 Published by Elsevier Inc