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

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

Ebstein anomalisi olan çocukta Mahaim taşikardi ve sağ arka aksesuvar yol birlikteliğinin başarılı ablasyonu

WOS: 000380170200012PubMed ID: 27439929The atriofascicular accessory pathway (AP), known as the Mahaim pathway, is a rare form of pre-excitation, comprising less than 3% of all APs. Mahaim AP is characterized by decremental, anterograde-only conduction, and antidromic tachycardia with left bundle branch morphology. Prevalence of Mahaim AP in Ebstein's anomaly is significantly high. In addition, combination of Wolff-Parkinson-White (WPW) syndrome and Mahaim AP in patients with Ebstein's anomaly has been reported. Presently described is the coexistence of Mahaim AP and manifest WPW syndrome in a patient with Ebstein's anomaly, who was successfully ablated without fluoroscopy.Atriyofasiküler aksesuvar yolak (AY) diğer deyimle Mahaim yolakları preeksitasyonun nadir formu olup aksesuvar yolakların %3’den daha azını oluşturmaktadır. Mahaim aksesuvar yolak dekremental, sadece önedoğru iletisi olan ve sol dal bloklu antidromik taşikardi ile kendini gösterir. Mahaim aksesuvar yolağın Ebstein anomalisindeki prevalansı oldukça yüksektir. Ayrıca Wolf-Parkinson-White (WPW) sendromu ve Mahaim AY birlikteliği Ebstein anomalisinde gösterilmiştir. Bu yazıda, Ebstein anomalisi olan hastada WPW ve Mahaim AY birlikteliğinin floroskopisiz başarılı ablasyonunu sunuyoruz

Successful ablation of coexistent mahaim tachycardia and right posterior accessory pathway in a patient with ebstein's anomaly

WOS: 000317946500481The atriofascicular accessory pathway (AP) referred as the Mahaim pathway is rare form of preexcitation. Mahaim AP is characterized with decremental anterograde-only conduction and antidromic tachycardia with LBBB morphology. The prevalence of Mahaim AP in Ebstein’s anomaly is significantly high. In this case, we report coexistence of Mahaim AP and manifest WPW in a patient with Ebstein’s anomaly who was successfully ablated without fluoroscopy

Validation of a smartphone-based electrocardiography in the screening of QT intervals in children

WOS: 000460612600008PubMed ID: 31180383OBJECTIVE: A 12-lead electrocardiography is a critical component for the screening of long QT syndrome; however, besides, an electrocardiograph, trained personnel are also necessary which limits the screening capability of conventional electrocardiographs. The development of smartphone electrocardiography technologies provides a potential alternative platform for electrocardiography screening for selective purposes such as arrhythmias and QT interval abnormalities. The aim of this pilot study was to assess the reliability of a smartphone-based electrocardiography device in the measurement of QT and corrected QT intervals in children. METHODS: In all participants, 10-s smartphone electrocardiography tracing from AliveCor device and a standard 12-lead electrocardiograph were obtained simultaneously. Two pediatric electrophysiologists performed the measurements of QT and corrected QT intervals in a blinded manner with Bazett's formula. The results were compared statistically. RESULTS: A total of 285 children (mean age 9.8 +/- 4.9 years) who presented to our clinic were included in the study. The mean QT intervals obtained from 12-lead electrocardiographs and AliveCor devices were 343 +/- 40 ms and 340 +/- 41 ms, respectively. The mean corrected QT intervals obtained from 12-lead electrocardiographs and AliveCor devices were 419 +/- 28 ms and 415 +/- 33 ms, respectively. There was high correlation between the QT intervals of 12-lead electrocardiographs and AliveCor recordings (Pearson's correlation coefficient: 0.83 [p<0.001]) and significant correlation between the corrected QT intervals of 12-lead electrocardiographs and AliveCor recordings (Pearson's correlation coefficient: 0.57 [p<0.001]). CONCLUSION: AliveCor recordings can accurately detect QT intervals and can potentially be used for the screening of congenital long QT syndrome in children

Catheter ablation of idiopathic right ventricular arrhythmias in children with limited fluoroscopy

WOS: 000387109800019PubMed ID: 27184808Introduction Definitive therapy of idiopathic right ventricular arrhythmias (VA) remains a challenge in interventional electrophysiology. The aim of this study was to evaluate the utility of EnSite Velocity system in the catheter ablation of RV tachycardia in children. Methods Thirty-five children with idiopathic right VA underwent catheter ablation procedure using the EnSite Velocity system guidance. Results The mean patient age was 12.0 +/- 3.7 years and the mean patient weight was 43.6 +/- 18.7 kg. The origin of right VA was divided into right ventricular outflow tract (RVOT) (30 patients) and other right ventricular localizations (five patients). The mean procedure and fluoroscopy times were 175 +/- 67 min and 2.35 +/- 1.89 min, respectively. No fluoroscopy was used in 19 patients. Acute success was achieved in 29 patients (83 %). The focus of VA was epicardial in three failed procedures. Cryocatheter (6-mm or 8-mm tip) was used in six patients, radiofrequency ablation (RFA) (4-mm or 8-mm tip) in 26 patients, and 4-mm tip irrigated RFA in three patients. During a mean follow-up of 15.9 +/- 7.1 months, ventricular tachycardia recurred in six patients (20 %). There were three complications (transient atrioventricular block developed in one patient during parahissian cryoablation and two patients developed transient complete right bundle branch block). Conclusions Catheter ablation of idiopathic right VA in children can be performed safely and effectively with limited fluoroscopy using the EnSite Velocity system

Comparison of 6-mm versus 8-mm-tip cryoablation catheter for the treatment of atrioventricular nodal reentrant tachycardia in children: A prospective study

WOS: 000405798800018PubMed ID: 28612086Due to its safety profile, cryoablation (Cryo) for atrioventricular nodal reentrant tachycardia (AVNRT) is more commonly preferred over radiofrequency (RF) ablation in children in recent years. Recent studies demonstrated high long-term success rates comparable to radiofrequency ablation. The aim of this prospective study was to compare the efficacy and safety of an 8-mm-tip versus 6-mm-tip Cryo catheter in the treatment of AVNRT in children. A total of 125 consecutive patients over 10 years of age with AVNRT were included. EnSite system (St. JudeMedical, St Paul, MN, USA) was used to reduce or eliminate fluoroscopy. The acute procedural success was 100% in both groups. The prodecure duration for the 8-mm-tip group was shorter (151.6 +/- 63.2 vs. 126.6 +/- 36.7 min, p < 0.01, respectively). Fluoroscopy was used in only 7 patients. The mean follow-up duration was 14.6 +/- 8.4 months (median 13.5 months, min. 3 months and max. 27 months). The recurrence rate for AVNRT was also comparable between the two groups (6-mm tip: 9.6 vs. 8-mm tip: 8%). Cryo of AVNRT is a safe and effective procedure with comparable acute and mid-term follow-up success rates using 6-mm and 8-mm-tip catheters in children. In addition, procedure duration is shorter with an 8-mm-tip Cryo catheter

ПСИХОДИЗАЙН – ИНТЕРЬЕР ПО НАУКЕ

WOS: 000317946500480The prevalence of coexistent AVNRT and AVRT has been rarely reported in the literature. The bypass tract is usually first targeted for ablation because of the concept that dual AV nodal physiology is more physiological for the heart than AP. In this paper, we briefly discuss that multiple supraventricular arrhythmia substrates can be successfully eliminated without fluoroscopy with the aid of electroanatomical systems

Successful pacemaker implantation for sinus node dysfunction in a patient with duschenne muscular dystrophy

Duschenne müsküler distrofisi (DMD) müsküler distrofiler içerisinde en sık görülen ve en ciddi seyreden formudur. Distrofin proteinindeki mutasyon sonucu iskelet ve kalp kasında dejenerasyon ve bunun yerini alan yağ dokusu ve fibrosiz ile karakterize kalıtsal bir hastalıktır. Kardiyak tutulumun %90 olduğu bu hastalıkta kalp yetersizliğine ek olarak ritim problemleri de olabilmektedir. Bu olguda DMD ile takip edilen ve senkop şikayeti olan bir hastaya elektrokardiyogramda (EKG) sinüs duraklamaları olması nedeniyle kalıcı pacemaker implantasyonu yapıldı. DMD’nin aritmik komplikasyonlarını bu vaka takdiminde kısaca tartışmaya çalıştık.Duschenne muscular dystrophy (DMD) is the most frequent and severe form of the muscular dystrophies. The syndrome is hereditary disease which is characterized with degeneration in the sceletal and cardiac muscle cells as a cause of mutation in the dystrophin pro- tein. Cardiac involvement is about 90% and in addition to heart failure, rhythm disorders may also develop. In this case report, patient with a diagnosis of DMD presented with syncope and sinus pause in the electrocardiogram was referred to the cardiology and pacemaker implantation was performed. We briefly discuss arrhythmic ccomplications of DMD in this case presentation