scholarly journals Electrocardiographic and electrophysiological characteristics of idiopathic ventricular arrhythmias originating from the vicinity of tricuspid annulus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manli Yu ◽  
Liangliang Hou ◽  
Hang Yu ◽  
Junwei Ge ◽  
Pan Li ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Localization Algorithm ◽  
Tricuspid Annulus ◽  
Critical Factors ◽  
X Ray ◽  
Successful Ablation ◽  
Atrial Electrograms ◽  
Chest X Ray ◽  
Fractionated Electrograms

AbstractElectrocardiographic and electrophysiological characteristics of VAs originating from the vicinity of the TA are not fully understood. Hence, 104 patients (mean age 52.6 ± 17.9 years; 62 male) with VAs originating from the vicinity of the TA were enrolled. After electrophysiological evaluation and ablation, data were compared among those patients. The ECGs and the correction of the ECGs based on the long axis of the heart calculated from the chest X-Ray were also analyzed. VAs originating from the vicinity of TA had distinctive ECG characteristics that were useful for identifying the precise origin. Our localization algorithm adjusted by the angle between the cardiac long axis and the horizon was found to be accurate in predicting the exact ablation site in 92.3% (n = 96) cases. Logistic regression analysis showed fractionated electrograms, the magnitudes of the local atrial electrograms and a/V ratio were critical factors for successful ablation. Among the 104 patients with VAs, complete elimination could be achieved by RFCA in 96 patients (success rate 92.3%) during a follow-up period of 35.2 ± 19.6 months. This study suggests that the ablation site could be localized by ECG analysis adjusted by the angle between the cardiac long axis and the horizon. Fractionated electrograms, the magnitudes of the local atrial electrograms and a/V ratio were demonstrated to be critical factors for successful ablation.

scholarly journals Undetected displacement of a subcutaneous implantable cardioverter-defibrillator lead. importance of performing a chest X-ray during the first weeks post-implant: a case report

2019 ◽  
Author(s):  
Jose Apolo ◽  
Rodolfo San Antonio ◽  
Lluís Mont ◽  
José María Tolosana
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Ventricular Arrhythmias ◽  
Xiphoid Process ◽  
Icd Implantation ◽  
X Ray ◽  
Cardioverter Defibrillator ◽  
Case Summary ◽  
Chest X Ray ◽  
Defibrillator Lead

Abstract Background In recent years, subcutaneous implantable cardioverter-defibrillator (S-ICD) implants have progressively increased and have been shown to be safe and highly successful, affording low reintervention rates regardless of the technique used. Case summary We present a case of S-ICD implantation in a patient diagnosed with idiopathic ventricular fibrillation. In the first follow-up consultation the patient showed appropriate detection parameters in the three configurations. However, chest X-ray revealed lead displacement with a tip migration from the manubrium area of the sternum to the xiphoid process. Discussion This case highlights the importance of performing at least one chest X-ray during the first weeks after S-ICD implantation, allowing the detection of a problem such as lead displacement, which can lead to undersensing of ventricular arrhythmias or S-ICD oversensing.

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

scholarly journals Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş
Keyword(s):  
Computed Tomography ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Scoring System ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
X Ray ◽  
Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

Childhood Fever: Correlation of Diagnosis With Temperature Response to Acetaminophen

PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 315-318
Author(s):  
M. Douglas Baker ◽  
Patricia D. Fosarelli ◽  
Richard O. Carpenter
Keyword(s):  
Patient Management ◽  
Temperature Response ◽  
Pediatric Emergency ◽  
Bacterial Disease ◽  
X Ray ◽  
Chest X Ray ◽  
Antipyretic Treatment ◽  
Fever Response ◽  
Childhood Fever

Many people believe that temperature response to antipyretics in febrile children varies according to diagnosis. To evaluate the validity of this premise, we prospectively studied the temperature response to acetaminophen of febrile children who came to an urban pediatric emergency and walk-in facility. The study group consisted of 1,559 patients between the ages of 8 weeks and 6 years whose temperatures when seen were greater than 38.4°C and who had not received antipyretic treatment within the previous four hours. Acetaminophen (15 mg/kg) was administered to each child and repeat temperatures were taken one and two hours later. Patient management was unaffected by the study, and physicians were unaware of the repeat temperature measurements. Telephone follow-up was conducted with the parents of each child within five days of the initial visit. Children with cultures positive for bacterial disease or chest x-ray films positive for pneumonia had slightly greater one- and two-hour temperature decreases compared with children with other diagnoses. Although statistically significant, we do not consider these differences in response to be clinically useful. We conclude that fever response to acetaminophen is not a clinically useful indicator by which to differentiate the causes of febrile illnesses in young children.

scholarly journals Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Kambiz Sheikhy ◽  
Azizollah Abbasi Dezfouli ◽  
Farahnaz Sadegh Beigee
Keyword(s):  
Chest Wall ◽  
Aneurysmal Bone Cyst ◽  
Bone Cyst ◽  
Large Mass ◽  
Good Cosmetic Result ◽  
X Ray ◽  
Anterior Aspect ◽  
Good Cosmetic ◽  
Chest X Ray

A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result.

scholarly journals Urinothorax Caused by Xanthogranulomatous Pyelonephritis

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Waiel Abusnina ◽  
Hazim Bukamur ◽  
Zeynep Koc ◽  
Fauzi Najar ◽  
Nancy Munn ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Obstructive Uropathy ◽  
Xanthogranulomatous Pyelonephritis ◽  
Robot Assisted ◽  
Rare Form ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Tract Infections

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis that generally afflicts middle-aged women with a history of recurrent urinary tract infections. Its pathogenesis generally involves calculus obstructive uropathy and its histopathology is characterized by replacement of the renal parenchyma with lipid filled macrophages. This often manifests as an enlarged, nonfunctioning kidney that may be complicated by abscess or fistula. This case details the first reported case of xanthogranulomatous pyelonephritis complicated by urinothorax, which resolved on follow-up chest X-ray after robot-assisted nephrectomy.

scholarly journals Chest CT as a Complement to RT-PCR to Confirm and Follow-up COVID-19 Patients

Medicinus ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Aziza Ghanie Icksan ◽  
Muhammad Hafiz ◽  
Annisa Dian Harlivasari
Keyword(s):  
Chest Ct ◽  
Rt Pcr ◽  
High Resolution Computed Tomography ◽  
X Ray ◽  
First Case ◽  
Chest X Ray ◽  
Polymerase Chain

<p><strong>Background : </strong>The first case of COVID-19 in Indonesia was recorded in March 2020. Limitation of reverse-transcription polymerase chain reaction (RT-PCR) has put chest CT as an essential complementary tool in the diagnosis and follow up treatment for COVID-19. Literatures strongly suggested that High-Resolution Computed Tomography (HRCT) is essential in diagnosing typical symptoms of COVID-19 at the early phase of disease due to its superior sensitivity  (97%) compared to chest x-ray (CXR).</p><p>The two cases presented in this case study showed the crucial role of chest CT with HRCT to establish the working diagnosis and follow up COVID-19 patients as a complement to RT-PCR, currently deemed a gold standard.<strong></strong></p>

scholarly journals The Hanging Chin Sign As A Mortality Predictor In Geriatric Patients At The Emergency Department: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Anneloes NJ Huijgens ◽  
Laurens J van Baardewijk ◽  
Carolina JPW Keijsers
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Geriatric Patients ◽  
Lateral View ◽  
X Ray ◽  
Hospital Patients ◽  
Chest X Ray

Abstract BACKGROUND: At the emergency department, there is a need for an instrument which is quick and easy to use to identify geriatric patients with the highest risk of mortality. The so- called ‘hanging chin sign’, meaning that the mandibula is seen to project over one or more ribs on the chest X-ray, could be such an instrument. This study aims to investigate whether the hanging chin sign is a predictor of mortality in geriatric patients admitted through the emergency department. METHODS: We performed an observational retrospective cohort study in a Dutch teaching hospital. Patients of ≥ 65 years who were admitted to the geriatric ward following an emergency department visit were included. The primary outcome of this study was mortality. Secondary outcomes included the length of admission, discharge destination and the reliability compared to patient-related variables and the APOP screener.RESULTS: 396 patients were included in the analysis. Mean follow up was 300 days; 207 patients (52%) died during follow up. The hanging chin sign was present in 85 patients (21%). Patients with the hanging chin sign have a significantly higher mortality risk during admission (OR 2.94 (1.61 to 5.39), p < 0.001), within 30 days (OR 2.49 (1.44 to 4.31), p = 0.001), within 90 days (OR 2.16 (1.31 to 3.56), p = 0.002) and within end of follow up (OR 2.87 (1.70 to 4.84),p < 0.001). A chest X-ray without a PA view or lateral view was also associated with mortality. This technical detail of the chest x-ray and the hanging chin sign both showed a stronger association with mortality than patient-related variables or the APOP screener. CONCLUSIONS: The hanging chin sign and other details of the chest x-ray were strong predictors of mortality in geriatric patients presenting at the emergency department. Compared to other known predictors, they seem to do even better in predicting mortality.

Abstract 5659: Regular Atrial Tachycardias After Ablation Of Complex Fractionated Atrial Electrograms (CFAE) For Atrial Fibrillation: Acute Incidence And Recurrence In Clinical Follow-up

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tilko Reents ◽  
Gabriele Hessling ◽  
Stephanie Fichtner ◽  
Jinjin Wu ◽  
Heidi L Estner ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Successful Ablation ◽  
Atrial Electrograms ◽  
Initial Procedure ◽  
The Impact ◽  
External Cardioversion ◽  
Complex Fractionated Atrial Electrograms

Background: The catheter ablation of atrial fibrillation (AF) can be performed by ablation of complex fractionated atrial electrograms (CFAE). Endpoint of CFAE ablation is the regularisation or termination of AF. However, the impact of regular atrial tachycardia (AT) occurring during CFAE ablation on long term outcome has not been investigated. Thus, it is not clear whether these tachycardias should be acutely targeted for ablation. Methods: In 43 patients (31 male, age 62±9 years with paroxysmal (15 patients), persistent (25 patietns) or permanent AF (3 patients) organisation of AF to regular AT was achieved by ablation of CFAE. Mapping of AT with subsequent successful ablation was performed in 14/43 patients (33%), in the remaining 29/43 patients (67%) AT was terminated with external cardioversion or pace overdrive. After ablation procedure, patients were seen in our out-patient clinic with repetitive Holter ECG after 1, 3, and subsequently every 3 months and were intensively screened for the occurrence of regular AT. Results: In follow-up 22/43 patients (51%) developed sustained AT necessitating in 20 patients repeat catheter ablation (12 patients) or external cardioversion (8 patients). AF had been paroxysmal in 7/22 and persisten in 15/22 patients with AT in follow-up. In 14/22 patients (63%), no attempt for ablation of AT had been made during the initial procedure, in 8/22 AT (36%) had been mapped and initially successful ablated. Of 21 patients without AT occurrence during follow-up, AF had been paroxysmal in 8/21 and persistent or permanent in 13/21 patients. AT had been mapped and ablated in 6 (29%) whereas in 15/21 patients (71%), AT had not been targeted. Ablation of AT during initial procedure, number of ablation applications, procedure and fluoroscopy duration were not predictive for freedom of AT in follow-up. Conclusion: In our study, mapping and successful ablation of new onset regular atrial tachycardias (AT) occurring during ablation of CFAE for atrial fibrillation was not predictive for the occurrence of AT in follow-up. Thus, results after termination of AT by cardioversion was in long-term comparable to sometimes time-consuming mapping/ablation for AT.

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