A Syndrome of Transient Left Ventricular Apical Wall Motion Abnormality in the Absence of Coronary Disease: A Perspective from the United States

Cardiology ◽  
2003 ◽  
Vol 100 (2) ◽  
pp. 61-66 ◽  
Author(s):  
Paula S. Seth ◽  
Gerard P. Aurigemma ◽  
Joshua M. Krasnow ◽  
Dennis A. Tighe ◽  
William J. Untereker ◽  
...  
2021 ◽  
Vol 14 (8) ◽  
pp. e243326
Author(s):  
Dario Manley-Casco ◽  
Stephanie Crass ◽  
Rana Alqusairi ◽  
Steven Girard

We describe a case of a woman in her 80s with persistent atrial fibrillation (AF) despite being on flecainide who was admitted for AF with rapid ventricular response. Attempts with direct-current cardioversions were unsuccessful despite increased doses of the antiarrhythmic therapy. At atrioventricular (AV) nodal ablation, very high right ventricular capture thresholds resulted in abortion of the procedure as back-up ventricular pacing could not be assured with adequate margin for safety. Shortly following the electrophysiology (EP) study, the patient developed cardiogenic shock with new apical left ventricular regional wall motion abnormality suggestive of apical ballooning and a toxic-appearing wide QRS complex electrocardiogram (EKG). The patient was successfully treated with sodium bicarbonate infusion for presumed flecainide toxicity. The regional wall motion abnormality and EKG changes resolved along with normalisation of capture thresholds after 2 days of treatment. The patient underwent an uncomplicated successful AV nodal ablation several weeks later.


2007 ◽  
Vol 102 (6) ◽  
pp. 2104-2111 ◽  
Author(s):  
Junya Takagawa ◽  
Yan Zhang ◽  
Maelene L. Wong ◽  
Richard E. Sievers ◽  
Neel K. Kapasi ◽  
...  

Efficacy of potential treatments for myocardial infarction (MI) is commonly assessed by histological measurement of infarct size in rodent models. In experiments involving an acute MI setting, measurement of the infarcted area in tissue sections of the left ventricle is a standard approach to determine infarct size. This approach has also been used in the chronic infarct setting to measure infarct area several weeks post-MI. We tested the hypothesis that, because wall thinning is known to occur in the chronic setting, the area measurement approach would be less appropriate. We compared infarct measurements in tissue sections based on 1) infarct area, 2) epicardial and endocardial infarct arc lengths, and 3) midline infarct arc length. Infarct sizes from all three measurement approaches correlated significantly with left ventricular ejection fraction and wall motion abnormality. However, the infarct size values derived from the area measurement approach were significantly smaller than those from the other two measurement approaches, and the range of values obtained was compressed 0.4-fold. The midline method allowed detection of the expected size differences between infarcts of variable severity resulting from proximal vs. distal ligation of the coronary artery. Segmental infarct size was correlated with segmental wall motion abnormality. We conclude that both area- and length-based measurements can be used to determine relative infarct size over a wide range of severity, although the area-based measurements are substantially more compressed due to wall thinning, and that the estimation of infarct midlines is a simple, reliable approach to infarct size assessment.


2015 ◽  
Vol 100 (5) ◽  
pp. 1660-1665 ◽  
Author(s):  
Fenton H. McCarthy ◽  
Dale Kobrin ◽  
J. Eduardo Rame ◽  
Peter W. Groeneveld ◽  
Katherine M. McDermott ◽  
...  

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