- Successful cryoablation of incessant fast-slow atypical atrioventricular nodal reentrant tachycardia in a child with tachycardia-induced cardiomyopathy. [Journal Article]
- TKTurk Kardiyol Dern Ars 2018; 46(5):406-410
- A 15-year-old female patient presented at the clinic with heart failure (HF). A 12-lead electrocardiogram showed a heart rate of 170 bpm; negative P waves in leads DII, DIII, aVF; and long RP tachyca...
A 15-year-old female patient presented at the clinic with heart failure (HF). A 12-lead electrocardiogram showed a heart rate of 170 bpm; negative P waves in leads DII, DIII, aVF; and long RP tachycardia (LRPT). Echocardiography demonstrated a shortening fraction (SF) of 20%. An electrophysiology study during tachycardia revealed an atrial-His time of 52 milliseconds and a His-atrial interval of 295 milliseconds. During ventricular entrainment, the postpacing interval-tachycardia cycle length was measured at 225 milliseconds. There was a pseudo V-A-A-V response. These findings confirmed the diagnosis of atypical atrioventricular nodal re-entrant tachycardia (aAVNRT). Successful slow pathway cryoablation was performed with an 8-mm-tip cryocatheter. After 2 weeks, the SF was measured as 34%. During a 2-year follow-up period, no recurrence was observed. In conclusion, fast-slow aAVNRT should be a part of the differential diagnosis of incessant LRPT leading to HF. Cryoablation can be used successfully in cases of aAVNRT.
- Adrenoceptor blockade modifies regional cerebral blood flow responses to hyperbaric hyperoxia: Protection against CNS oxygen toxicity. [Journal Article]
- JAJ Appl Physiol (1985) 2018 Jul 19
- Exposure to extreme-hyperbaric oxygen (HBO2), > 5-6 atmospheres absolute (ATA), produces baroreflex impairment, sympathetic hyperactivation, hypertension, tachycardia, and cerebral hyperemia, know...
Exposure to extreme-hyperbaric oxygen (HBO2), > 5-6 atmospheres absolute (ATA), produces baroreflex impairment, sympathetic hyperactivation, hypertension, tachycardia, and cerebral hyperemia, known as Phase II, culminating in seizures. We hypothesized that attenuation of the effects of high sympathetic outflow would preserve regional cerebral blood flow (rCBF) and protect against HBO2-induced seizures. To explore this possibility, we tested four adrenoceptor antagonists in conscious and anesthetized rats exposed to HBO2 at 5 and 6 ATA, respectively: phentolamine (nonselective α1 and 2), prazosin (selective α1), propranolol (nonselective β1 and 2) and atenolol (selective β1). In conscious rats, 4 drug-doses were administered to rats prior to HBO2 exposures, and seizure latencies were recorded. Drug-doses that provided similar protection against seizures were administered before HBO2 exposures in anesthetized rats to determine the effects of adrenoceptor blockade on mean arterial pressure, heart rate, rCBF and EEG spikes. All four drugs modified cardiovascular and rCBF responses in HBO2 that aligned with epileptiform discharges, but only phentolamine and propranolol effectively increased EEG spike latencies by ~20 and 36 min, respectively. When phentolamine and propranolol were delivered during HBO2 at the onset of phase II, only propranolol led to sustained reductions in heart rate and rCBF, preventing the appearance of epileptiform discharges. The enhanced effectiveness of propranolol may extend beyond β-adrenoceptor blockade, i.e. membrane stability and reduced metabolic activity. These results indicate that adrenoceptor drug pre-treatment will minimize the effects of excessive sympathetic outflow on rCBF and extend HBO2 exposure time.
- Video-assisted thoracoscopic surgery to displace the phrenic nerve during endocardial ablation of right atrial tachycardia. [Journal Article]
- HCHeartRhythm Case Rep 2018; 4(7):304-306
- Arrhythmias and myocardial fragility in Ehlers-Danlos syndrome: Complications after routine ICD placement. [Journal Article]
- HCHeartRhythm Case Rep 2018; 4(7):301-303
- Bundle branch reentry: A novel mechanism for sustained ventricular tachycardia in Chagas heart disease. [Journal Article]
- HCHeartRhythm Case Rep 2018; 4(7):293-297
- Intramyocardial radiofrequency ablation of ventricular arrhythmias using intracoronary wire mapping and a coronary reentry system: Description of a novel technique. [Journal Article]
- HCHeartRhythm Case Rep 2018; 4(7):285-292
- Nonreentrant proximal fascicular ventricular tachycardia, with normal QRS duration and normal axis, originating from a region remote from the His bundle. [Journal Article]
- HCHeartRhythm Case Rep 2018; 4(7):281-284
- Intracoronary focal nitroglycerin injection through drilled balloon is very effective in the resolution of coronary spasm versus into proximal coronary artery: A prospective randomized comparison study. [Journal Article]
- JIJ Interv Cardiol 2018 Jul 19
- CONCLUSIONS: Intracoronary injection with a perforated balloon, a simple technique introduced worldwide with our publication, can be used for administration of local NTG. Using this method, NTG can be better delivered with the perforated balloon to the vascular epithelium because of lower output, higher eruption rate, and perpendicularity to the endothelium. In this application, the balloon can better deliver drugs to the desired area via back-and-forth movements using a 0.014 guidewire.The local administration of NTG to a spasming area through a perforated balloon is more effective and safer than the proximal administration of NTG.
- Autonomic dysfunction in the neurological intensive care unit. [Review]
- CAClin Auton Res 2018 Jul 18
- Autonomic dysfunction is common in neuro-critical care patients and may compromise the function of various organs. Among the many diseases causing or being associated with autonomic dysfunction are t...
Autonomic dysfunction is common in neuro-critical care patients and may compromise the function of various organs. Among the many diseases causing or being associated with autonomic dysfunction are traumatic brain injury, cerebrovascular diseases, epilepsy, Guillain-Barré syndrome (GBS), alcohol withdrawal syndrome, botulism and tetanus, among many others. Autonomic dysfunction may afflict various organs and may involve hyper- or hypo-activity of the sympathetic or parasympathetic system. In this short overview, we address only a small number of neuro-intensive care diseases with autonomic dysfunction. In GBS, autonomic dysfunction is frequent and may account for increased mortality rates; rapid changes between sympathetic and parasympathetic hypo- or hyper-activity may cause life-threatening cardiovascular complications. Paroxysmal sympathetic hyperactivity occurs after brain injury, hypoxia and cerebrovascular and other events, causes paroxysmal tachycardia, hypertension, tachypnoea and hyperthermia and is associated with a poorer prognosis and prolonged intensive care treatment. Other, at times life-threatening autonomic complications with exaggerated sympathetic activity and compromised baroreflex sensitivity arise during the alcohol withdrawal syndrome triggered by abrupt cessation of alcohol consumption. Botulism and tetanus are examples of life-threatening autonomic dysfunction caused by bacterial neurotoxins. Common neurological diseases, such as epilepsy, stroke or subarachnoid haemorrhage, are also associated with autonomic dysfunction that can on occasion cause critical deterioration of disease severity and prognosis.
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- Effects of small-dose remifentanil combined with index of consciousness monitoring on gastroscopic polypectomy: a prospective, randomized, single-blinded trial. [Journal Article]
- TTrials 2018 Jul 18; 19(1):392
- CONCLUSIONS: With the help of IOC monitoring, we found that a target concentration of remifentanil 4 ng/mL is comparatively ideal in patients under gastroscopic polypectomy.