Supraventricular tachycardia

2020 ◽  
pp. 99-116
Author(s):  
Will Regan ◽  
Jasveer Mangat
Keyword(s):  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Medical Management ◽  
Treatment Strategies ◽  
Invasive Treatment ◽  
Child Benefits ◽  
Acute Presentation ◽  
Clinical Presentations ◽  
Current Guidelines ◽  
Case Based

This chapter is a case-based discussion of the management of supraventricular tachycardia (SVT) in children. The case illustrates the challenges of medical management of SVT in neonatal life and infancy, both in terms of acute presentation, as well as longer-term medical care and outpatient monitoring to reduce recurrences of paroxysmal tachycardias as the child grows. Ultimately, the child benefits from an electrophysiology study (EPS) and catheter ablation. The chapter more broadly covers the varying clinical presentations of SVT in children and common treatment strategies employed. The electrophysiological mechanisms of SVT commonly seen in children are outlined. There is a review of the evidence behind the medical management of SVT in children, including a practical guide on the choice of anti-arrhythmic medication for different mechanisms of tachycardia, based on current guidelines. Finally, the chapter summarizes the invasive treatment option of EPS and ablation in children.

Free-Floating Thrombus in the Distal Internal Carotid Artery Causing a Stroke

2020 ◽  
Author(s):  
Spyros Papadoulas ◽  
Konstantinos Moulakakis ◽  
Natasa Kouri ◽  
Petros Zampakis ◽  
Stavros K. Kakkos
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Medical Management ◽  
Internal Carotid ◽  
Treatment Strategies ◽  
Rare Condition ◽  
Residual Stenosis ◽  
Floating Thrombus ◽  
Distal Internal Carotid Artery ◽  
Carotid Bulb

AbstractWe present a patient suffering from a stroke with a free-floating thrombus extending up to the distal internal carotid artery. The thrombus was totally resolved after a 2-week anticoagulation regimen without leaving behind any severe residual stenosis in the carotid bulb. The optimal treatment of this rare condition remains uncertain. We report some important treatment strategies that have been used in the literature, emphasizing the anticoagulation as the mainstay of therapy. Immediate surgical and interventional manipulations carry the risk of thrombus dislodgement and embolization and should be considered if there are recurrent symptoms despite medical management.

Non-fluoroscopic cardiac ablation of neonates with CHD

2016 ◽  
Vol 27 (3) ◽  
pp. 592-596 ◽  
Author(s):  
Amee M. Bigelow ◽  
Brandon S. Arnold ◽  
Gregory C. Padrutt ◽  
John M. Clark
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Tricuspid Valve ◽  
Congenital Heart ◽  
Current Practice ◽  
Pulmonary Atresia ◽  
Intact Ventricular Septum ◽  
Cardiac Ablation

AbstractIn current practice, children with anatomically normal hearts routinely undergo fluoroscopy-free ablations. Infants and children with congenital heart disease (CHD) represent the most difficult population to perform catheter ablation without fluoroscopy. We report two neonatal patients with CHD in whom cardiac ablations were performed without fluoroscopy. The first infant had pulmonary atresia with intact ventricular septum with refractory supraventricular tachycardia, and the second infant presented with Ebstein’s anomaly of the tricuspid valve along with persistent supraventricular tachycardia. Both patients underwent uncomplicated, successful ablation without recurrence of arrhythmias. These cases suggest that current approaches to minimising fluoroscopy may be useful even in challenging patients such as neonates with CHD.

Cases in Paediatric Critical Care Transfer and Retrieval Medicine

2021 ◽  
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Intensive Care ◽  
Critically Ill ◽  
Transfer Process ◽  
The Past ◽  
Clinical Presentations ◽  
Paediatric Critical Care ◽  
Care Transfer ◽  
Case Based

Critically ill paediatric transfers have expanded rapidly over the past ten years and, as such, the need for transfer teams to recognise, understand and treat the various illnesses that they encounter is greater than ever. This highly illustrated book covers a multitude of clinical presentations in a case-based format to allow an authentic feel to the transfer process. Written by clinicians with experience in thousands of transfers, it brings together many years of experience from a world-renowned hospital. Following the case from initial presentation, to resuscitation and referral and finally with the transfer itself; the book explores the clinical stabilisation, human factors decisions and logistical challenges that are encountered every day by these teams. Following the entire journey, this is an ideal resource for all professionals who may be involved in critical care transfer and retrieval medicine, particularly those working in paediatrics, emergency medicine, anaesthesiology, intensive care, or pre-hospital settings.

scholarly journals Hepatocellular carcinoma treatment strategies – a case-based review

2015 ◽  
Vol 5 (2) ◽  
Author(s):  
Rute Alves ◽  
Manuel Teixeira Gomes ◽  
Carlos Sampaio Macedo ◽  
Helena P. Miranda ◽  
Filipe Nery
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Strategies ◽  
Case Based

scholarly journals Anticoagulant therapy in catheter ablation of atrial fibrillation and flutter

2021 ◽  
Vol 20 (5) ◽  
pp. 2974
Author(s):  
M. V. Serova ◽  
D. A. Andreev ◽  
M. I. Chashkina ◽  
Z. K. Salpagarova
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Anticoagulant Therapy ◽  
Randomized Trials ◽  
Web Of Science ◽  
Evidence Base ◽  
Thromboembolic Events ◽  
Practical Information ◽  
Atrial Fibrillation And Flutter ◽  
Current Guidelines

Catheter ablation (CA) of atrial fibrillation and flutter is associated with a high risk of both perioperative thromboembolic events and bleeding. Adequate anticoagulation is imperative to reduce the risk of complications. The aim of this review was to analyze modern approaches to anticoagulant therapy for CA of atrial fibrillation and flutter, as well as provide practical information based on a comparison of current guidelines and evidence base. The search for literature sources on anticoagulant therapy in CA was carried out in the PubMed, Scopus, Web of Science databases. The results of key randomized trials and meta-analyzes are presented, and a comparison of current Russian and international guidelines is given. Unresolved issues requiring further research are discussed.

Real-world experience of treatment decision-making in carotid stenosis in a neurovascular board

Neurology ◽  
2017 ◽  
Vol 89 (4) ◽  
pp. 399-407 ◽  
Author(s):  
David Leander Rimmele ◽  
Axel Larena-Avellaneda ◽  
Anna C. Alegiani ◽  
Michael Rosenkranz ◽  
Nils Ole Schmidt ◽  
...  
Keyword(s):  
Decision Making ◽  
Carotid Artery ◽  
Medical Management ◽  
Treatment Strategies ◽  
Treatment Decision ◽  
Treatment Recommendations ◽  
Adherence To Treatment ◽  
Treatment Decision Making ◽  
Time Period ◽  
Ica Stenosis

Objective:To describe our experience with consensus-based decision-making for treatment of internal carotid artery (ICA) stenosis by neurologists, interventional neuroradiologists, vascular surgeons, and neurosurgeons in a multidisciplinary neurovascular board and to study adherence to treatment recommendations in the context of uncertainty with respect to the best treatment option.Methods:We established a multidisciplinary neurovascular board meeting twice a week with structured documentation of consensus decisions. Over a time period of 53 months, 614 cases with ICA stenosis were discussed, with 285 (46%) symptomatic and 279 (45%) asymptomatic cases.Results:Recommendation for symptomatic ICA stenosis was revascularization in 76%, medical management alone in 8%, and further diagnostics in 16%. For asymptomatic ICA stenosis, recommendation was randomization in a clinical trial in 29%, revascularization in 27%, medical management alone in 23%, and further diagnostics in 22%. Treatment recommendations were followed in 94% of symptomatic ICA stenosis and 69% of asymptomatic ICA stenosis. Patients in whom carotid artery stenting was recommended for revascularization were younger and showed a higher rate of severe (≥70%) ICA stenosis.Conclusions:Interdisciplinary board decisions are a helpful and transparent tool to assure adherence to guideline recommendations, and to provide consensus-based individualized treatment strategies in clinical practice in the absence of unequivocal evidence.

Fungal keratitis: A review of clinical presentations, treatment strategies and outcomes

2021 ◽  
Author(s):  
Namrata Sharma ◽  
Bhupesh Bagga ◽  
Deepali Singal ◽  
Ritu Nagpal ◽  
Anahita Kate ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Fungal Keratitis ◽  
Clinical Presentations
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