scholarly journals Hypervagotonic binodal dysfunction in children. Features of the natural course

2015 ◽  
Vol 96 (4) ◽  
pp. 609-615
Author(s):  
E S Vasichkina ◽  
T K Kruchina ◽  
D S Lebedev ◽  
D F Egorov
Keyword(s):  
Atrioventricular Block ◽  
Clinical Course ◽  
Sinus Node ◽  
Atrioventricular Node ◽  
Heart Rhythm ◽  
Sinus Node Dysfunction ◽  
Electrophysiologic Study ◽  
Point Position ◽  
Conduction Disorders ◽  
Normal Heart Rate

Aim. To evaluate the clinical and electrophysiological picture of binodal disease in children, as well as studying the clinical course of this disease. Methods. To study the clinical and electrophysiological picture of autonomic binodal disease, 426 patients under 18 years old were examined; the average age was 15.35±2.43 years (3-17.9). Patient’s complaints, medical history were examined, ECG, 24-hour ECG, stress ECG (treadmill or bicycle test), echocardiography, transesophageal electrophysiologic study were performed. In the case of a combination with pathological signs of sinus node dysfunction and atrioventricular node conduction disorders with the normalization of all parameters after the atropine administration, hypervagotonic binodal dysfunction was diagnosed. To assess the clinical course of the disease, a group of 72 children was selected, who were monitored repeatedly. Mean follow-up duration was 33 months. Results. During the study period, sinus node dysfunction and atrioventricular blocks completely resolved in 14 (19.44%), seen as normal clinical picture with no complaints, normal heart rate, no signs of sinoatrial block or atrioventricular block, normalization of Wenckebach point position. Another 35 (48.62%) had only one node dysfunction resolved (either sinoatrial or atrioventricular - Wenckebach point position within the age normal values and/or atrioventricular block resolved). In 23 (31.94%) - deterioration of the sinus node and atrioventricular node dysfunction was observed. Conclusion. There are significant differences in the frequency characteristics of heart rhythm and electrophysiological parameters of sinus node function in children with a favorable clinical course of binodal disease and progressive course of the disease.

Differential diagnosis of sinus node dysfunction vs advanced atrioventricular block by analysis of venous flow patterns in patients with ventricular pacemakers

1987 ◽  
Vol 113 (5) ◽  
pp. 1243-1245
Author(s):  
Takashi Yamagishi ◽  
Toshiaki Maeda ◽  
Masatsugu Yamauchi ◽  
Kenichi Yuki ◽  
Michihiro Kohno ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Atrioventricular Block ◽  
Sinus Node ◽  
Flow Patterns ◽  
Sinus Node Dysfunction ◽  
Venous Flow

Combined atrioventricular block and sinus node dysfunction in Fabry's disease

1990 ◽  
Vol 120 (2) ◽  
pp. 438-440 ◽  
Author(s):  
Masayuki Suzuki ◽  
Tadashi Goto ◽  
Rinya Kato ◽  
Kazunobu Yamauchi ◽  
Hiroshi Hayashi
Keyword(s):  
Atrioventricular Block ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Fabry’S Disease ◽  
Fabry's Disease

scholarly journals Carbamazepine-induced Sinus Node Dysfunction and Atrioventricular Block in Elderly Women.

1998 ◽  
Vol 39 (4) ◽  
pp. 469-479 ◽  
Author(s):  
Kan TAKAYANAGI ◽  
Itaru HISAUCHI ◽  
Jun-ichirou WATANABE ◽  
Yoshiaki MAEKAWA ◽  
Tsuneo FUJITO ◽  
...  
Keyword(s):  
Atrioventricular Block ◽  
Elderly Women ◽  
Sinus Node ◽  
Sinus Node Dysfunction

scholarly journals Randomized investigation of the left atrial sweet spot for vagal denervation of atrioventricular node during the cardioneuroablation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Jansova ◽  
D Wichterle ◽  
P Stiavnicky ◽  
P Peichl ◽  
R Cihak ◽  
...  
Keyword(s):  
Left Atrial ◽  
Sinus Node ◽  
Atrioventricular Node ◽  
Heart Rhythm ◽  
Mitral Annulus ◽  
Maximum Effect ◽  
High Frequency Stimulation ◽  
Radiofrequency Energy ◽  
Frequency Stimulation ◽  
Radiofrequency Energy Delivery

Abstract Background Radiofrequency catheter ablation of inferior atrial ganglionic plexi frequently results in vagal denervation of the atrioventricular (AV) node. The effective sites are, however, considerably variable. Purpose We prospectively sought the left atrial (LA) ablation site with the maximum effect on AV nodal modulation. Methods The study included 16 patients (age: 46±14 years, 56% males) who underwent cardioneuroablation for recurrent reflex cardioinhibitory syncope in general anesthesia. After targeting the superior paraseptal ganglionic plexi and achieving the denervation of the sinus node, study ablations were performed at the bottom of the LA to accomplish the AV nodal denervation (Figure). Five equidistantly distributed ablation lesions (30W / 30s / 20ml/min) were created on the virtual line connecting inferior ostium of right inferior pulmonary vein (RIPV) and inferior mitral annulus (MA). Lesions were centered symmetrically relative to the posterior mid-left-atrial line. They were numbered in ascending order from #1 (more septal, closer to the RIPV) to #5 (more lateral, closer to the MA). Patients were randomly (1:1) assigned to mutually opposite direction of ablation (from site #1 to #5 or from site #5 to #1). The response of heart rhythm to extracardiac vagal nerve high-frequency stimulation (50Hz/0.05ms/1V/kg [<70V]/5s) were recorded at baseline and after each radiofrequency energy delivery. Results Study protocol ablations overall resulted in elimination or attenuation of inducible AV block (maximum R-R interval: 2.9±2.8 vs. 5.2±2.4s, P<0.001). Temporal development of effect with the progression of ablation is shown in the Figure indicating that the most lateral lesion alone produces the maximum effect. The AV nodal denervation was incomplete after per-protocol ablations in 7/16 patients. In the majority of them, the final success was achieved by extension of ablation lesion toward the inferior mitral annulus either endocardially or via the proximal coronary sinus. Conclusion Ablation of perimitral region of the inferior LA conveyed the maximum effect in terms of AV nodal denervation. Funding Acknowledgement Type of funding source: None

scholarly journals Emery-Dreifuss muscular dystrophy presenting as a heart rhythm disorders in children

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T S Kovalchuk ◽  
E V Yakovleva ◽  
S G Fetisova ◽  
T L Vershinina ◽  
T M Pervunina ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Skeletal Muscle ◽  
Muscular Dystrophy ◽  
Atrial Flutter ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Sinus Node Dysfunction ◽  
Supraventricular Arrhythmias ◽  
Heart Rhythm Disorders ◽  
The Mean

Abstract Introduction Emery-Dreifuss muscular dystrophy (EDMD) is an inherited muscle dystrophy often accompanied by cardiac abnormalities in the form of supraventricular arrhythmias, conduction defects, sinus node dysfunction. Cardiac phenotype typically arises years after skeletal muscle presentations, though, can be severe and life-threatening. The disease usually manifests during the third decade of life with elbow joint contractions and progressive muscle weakness and atrophy. Objective To present our clinical experience of diagnosis and treatment of arrhythmias in children with Emery-Dreifuss muscular dystrophy Materials and methods We enrolled 5 patients with different forms of EDMD (X-linked and autosomal dominant) linked to the mutations in EMD and LMNA genes, presented with early onset of cardiac abnormalities and no leading skeletal muscle phenotype. The predominant forms of cardiac pathology were atrial flutter, atrial fibrillation and conduction disturbances that progress over time. Clinical examination included physical examination, 12-lead electrocardiography, Holter ECG monitoring (HM), transthoracic echocardiography, neurological examination and biochemical and hormone tests. Also we performed CMR, electrophysiological study (EPS), treadmill test of some patients. One patient underwent an endomyocardial biopsy to exclude inflammatory heart disease. Target sequencing was performed using a panel of 108 or 172 genes Results We observed five patients with EDMD and cardiac debut during first-second decades of life: 3 with 1st subtype (variants in EMD gene) and 2 with 2nd subtype (variants in LMNA gene). All patients were males. The mean age of cardiac manifestation was 13,2±3,11 (from 9 to 16 y.o.). The mean follow-up period was 7,4±2,6 years. All patients presented with sinus node dysfunction and four out of five with AV conduction abnormalities. The leading arrhythmic phenotypes included various types of supraventricular arrhythmias: multifocal atrial tachycardia (AT) (n=4), premature atrial captures (PACs) (n=4), atrial flutter, (AF) (n=3), atrial fibrillation (AFib) (n=3) and AV nodal recurrent tachycardia (AVRNT). Heart rhythm disorders were the first manifestation in all three patients with 1st EDMD subtype. Radiofrequency ablation was performed in 2 patients, one of them received permanent pacemaker implantation. Conclusions In conclusion, while being the rare cases, heart rhythm disorders can represent the first and for a long time, the only clinical symptom of EDMD even in the pediatric group of patients. Therefore, thorough laboratory and neurological screening along with genetic studies, are of importance in each pediatric patient presenting with complex heart rhythm disorders of primary supraventricular origin to exclude EDMD or other neuromuscular disorders. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Exercise Stress Tests in Arrhythmology

2019 ◽  
Vol 6 (3) ◽  
pp. 5-14
Author(s):  
E. R. Berngardt ◽  
E. S. Zhabina ◽  
T. V. Treshkur
Keyword(s):  
Patient Management ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Sinus Node Dysfunction ◽  
Exercise Stress ◽  
Stress Tests ◽  
Electrocardiographic Parameters ◽  
Management Tactics

The review presents an analysis of literature data on the use of exercise stress tests in patients with disorders of heart rhythm and conduction, such as sinus node dysfunction, atrioventricular blockade, WPW-phenomenon, atrial fi brillation, canalopathy. The value of clinical and electrocardiographic parameters registered during the exercise stress tests for verifi cation of the diagnosis and determination of the patient management tactics is shown. Clinical examples from own practice are given.

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