scholarly journals Safety and efficacy of electrophysiological studies and radiofrequency ablation of paroxysmal supraventricular tachycardia

2020 ◽  
Vol 4 (3) ◽  
pp. 818-821
Author(s):  
Abdul Khaliq Monib ◽  
Rajesh Nepal ◽  
Sahadeb Prasad Dhungana ◽  
Roshan Raut
Keyword(s):  
Radiofrequency Ablation ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Study Data ◽  
Female Dominance ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Safety And Efficacy ◽  
Efficacy Analysis ◽  
Early Results ◽  
Reentry Tachycardia

Introduction: Cardiac electrophysiological study (EPS) and radiofrequency ablation (RFA) is an established mode of treatment either as first-line or for drug-refractory arrhythmias. Our center has recently started this service under 2-D mapping outside Kathmandu valley Objective: The aim was to evaluate the safety and efficacy of EPS and RFA for paroxysmal supraventricular tachycardias (PSVT). Methodology: This is an observational prospective study carried out in the Cardiac Unit of Nobel medical college, Biratnagar, Nepal. All cases diagnosed to have PSVT based on electrocardiogram or Holter recordingfromAugust 2018 and May2019wereincluded in the study. Data on clinical profile and findings of EPS were recorded. Fifty-nine cases were chosen for safety and efficacy analysis, using SPSS statistical software version 19. Results: There were 59 patients, 28(47.5%) males, and 31(52.5%) females. The mean age was 38.2 ± 15.9 years. Fifty-three patients underwent RFA while 6 patients underwent only EPS. In the Atrioventricular nodal reentry tachycardia (AVNRT) group, there was female dominance (P=0.2) while in Atrioventricular reentry tachycardia (AVRT) group, there was no significant gender difference (p=0.4). Left-sided pathway (68%) was more common in the AVRT group. Among the left accessory pathway (AP), left lateral AP (44%) was more common. No major complications including death were noted. Two cases of successful ablation relapsed in one month follow up. Conclusions: Early results of this small study in patients with PSVT confirm the efficacy and safety of RFA in newly established electrophysiology (EP) laboratory.

scholarly journals SEVEN TYPES OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA IN ONE PATIENT

2019 ◽  
Vol 8 (1) ◽  
pp. 140-145
Author(s):  
S. E. Mamchur ◽  
E. A. Khomenko ◽  
M. P. Romanova ◽  
T. Yu. Chichkova
Keyword(s):  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Electrophysiological Study ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Crista Terminalis ◽  
Superior Pulmonary Vein ◽  
Pulmonary Vein Ostium ◽  
Atrioventricular Nodal Reentry Tachycardia ◽  
Reentry Tachycardia

The report describes the case of electrophysiological study and catheter ablation of seven types of supraventricular tachycardia in one patient. During radiofrequency ablation for WPW-syndrome three functionated discrete retrograde conductive accessory atrioventricular pathways were documented and were successfully ablated. Further incessant activity of two ectopic atrial focuses was revealed. First localized in upper part of crista terminalis and another – in left superior pulmonary vein ostium. Five months after patient had a recurrence of supraventricular tachycardia. EPI-study demonstrated evidence for retrograde ventriculoatrial dissociation with induction of atypical fast/slow and typical slow/fast atrioventricular nodal reentry tachycardia, wich were successfully ablated. With further observation, rhythm disturbances did not recur.

scholarly journals Cardiac Electrophysiological Study & Radiofrequency Ablation: Our Experience in Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 4-7
Author(s):  
Sujeeb Rajbhandari ◽  
Man Bdr KC ◽  
Roshan Raut ◽  
Murari Dhungana ◽  
Rajesh Shaha ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Radiofrequency Ablation ◽  
Success Rate ◽  
Complication Rate ◽  
Cardiac Arrhythmias ◽  
Electrophysiological Study ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Radiofrequency Energy ◽  
Supraventricular Arrhythmias ◽  
Cardiac Intervention

Background and aim - Cardiac Electrophysiological Study and Radiofrequency ablation is a form of cardiac intervention for diagnosing and treating cardiac arrhythmias. Various catheters are placed in the various parts of the heart to record signals and radiofrequency energy is used for the ablation. Methods - A total of 768 patients with paroxysmal supraventricular arrhythmias underwent the procedure at Shahid Gangalal National Heart Centre, Kathmandu, Nepal in a period between October 2003 to September 2011. Results - The success rate is high (92%) and the complication rate is low (0.8%) which is comparable to the results shown in various literatures. Conclusion - Cardiac Electrophysiological study and Radiofrequency ablation is fairly safe and provides a definitive cure to the patients with paroxysmal supraventricular tachycardia. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5831 Journal of Advances in Internal Medicine. 2012; 1(1): 4-7

scholarly journals Terhességi ritmuszavarok modern terápiás megközelítései

2021 ◽  
Vol 162 (41) ◽  
pp. 1643-1651
Author(s):  
Ádám Riba ◽  
Barnabás Németh ◽  
Ferenc Árvai ◽  
Géza Lupkovics ◽  
Tamás Tahin
Keyword(s):  
Catheter Ablation ◽  
Pregnant Women ◽  
Cardiac Electrophysiology ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Ventricular Rate ◽  
Paroxysmal Supraventricular Tachycardia ◽  
X Rays ◽  
X Ray ◽  
First Case

Összefoglaló. A ritmuszavarok előfordulása gyakoribb a terhes nők esetén, mint a nem várandósok körében. A legtöbb esetben terápiás beavatkozás nélkül is kihordható a magzat. Hemodinamikai instabilitás és magzatkárosodáshoz vezető fetalis hypoperfusio jöhet létre, amennyiben tartós, magas kamrai frekvenciával járó epizódok jelentkeznek. Ezekben az esetekben a ritmuszavar megszüntetése indokolttá válhat. Az antiarrhythmiás gyógyszerek korlátozottan és nagy körültekintéssel alkalmazhatók a gyermeket várók körében, így a katéterablatio jelenthet biztonságos és használható alternatívát. Ezen beavatkozásokat hagyományosan röntgensugár segítségével végzik, ez azonban az ionizáló sugárzásnak a magzati fejlődésre gyakorolt hatása miatt magas rizikót jelentene. Több éve elérhető a szív-elektrofiziológiában az ún. zéró fluoroszkópiás ablatio, mely a pitvarfibrilláció kezelésében és más ritmuszavarok esetében egyaránt alkalmazható. A terheseknél alkalmazott eljárást két eseten keresztül mutatjuk be. A röntgensugár használatát, a jelen cikkben bemutatott beavatkozások esetén is, sikerült teljesen kiküszöbölnünk. Az első, 23 hetes gravid páciensnél recidív paroxysmalis supraventricularis tachycardia miatt végeztünk elektrofiziológiai vizsgálatot. E vizsgálat során atrioventricularis nodalis reentry tachycardiát igazoltunk és abláltunk sikerrel. Második esetbemutatásunkban egy anteroseptalis járulékos köteg katéterablatiós megoldását mutatjuk be. A terhesség során jelentkező, az anyára és/vagy magzatára veszélyt jelentő ritmuszavar esetén a háromdimenziós térképező rendszer (szükség esetén intracardialis ultrahangvizsgálattal kiegészítve) biztonságos és hatásos alternatívát jelent, olyan esetekben, ha röntgensugár nem használható. Orv Hetil. 2021; 162(41): 1643–1651. Summary. Arrhythmias are more common in pregnant women than in others. In most cases, the fetus can be delivered without therapeutic intervention. Hemodynamic instability and fetal hypoperfusion leading to fetal harm may occur if persistent episodes of high ventricular rate occur. In these cases, resolution of the arrhythmia may be advised. Antiarrhythmic drugs can be used with limitations and great caution in those expecting a child, so catheter ablation may be a safe and usable alternative. These interventions are traditionally performed using X-ray, however, due to the effect of ionizing radiation on fetal development, this would pose a high risk. Zero-fluoroscopic ablation has been available for several years in cardiac electrophysiology, which can be used both in the treatment of atrial fibrillation and in other arrhythmias. The procedure which we used in pregnant women is presented in two cases. We also managed to completely eliminate the use of X-ray during the interventions presented in this article. In the first case, a 23-week-old gravid patient underwent electrophysiological examination for recurrent paroxysmal supraventricular tachycardia. In the electrophysiological study, atrioventricular nodal reentry tachycardia was confirmed and successfully ablated. In our second case study, we present a catheter ablation for anteroseptal accessory pathway. Three-dimensional mapping system (supplemented with intracardiac ultrasound, if necessary), in the case of significant arrhythmia, is a safe and effective alternative where X-rays, which poses a risk to the mother and/or the fetus, cannot be used during pregnancy. Orv Hetil. 2021; 162(41): 1643–1651.

scholarly journals Discordant Pacing Manoeuvers and a Narrow QRS Tachycardia – What is the Tachycardia Mechanism?

2015 ◽  
Vol 01 (01) ◽  
pp. 32 ◽  
Author(s):  
Hussam Ali ◽  
Pierpaolo Lupo ◽  
Sara Foresti ◽  
Guido De Ambroggi ◽  
Gianluca Epicoco ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Electrophysiological Study ◽  
Correct Diagnosis ◽  
Accessory Pathway ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Ventricular Pacing ◽  
Reentrant Tachycardia ◽  
Narrow Qrs ◽  
Atrial Activation

A 24-year-old female underwent an electrophysiological study because of recurrent episodes of drug-refractory, paroxysmal supraventricular tachycardia. During adrenergic stress, a narrow QRS tachycardia with eccentric atrial activation was reproducibly inducible. The response to premature ventricular extrastimulation during tachycardia suggested the presence of a slowly conducting accessory pathway. However, a comprehensive appraisal of the electrophysiological study delineated the tachycardia substrate as an atypical atrioventricular nodal reentrant tachycardia in the presence of a bystander nodofascicular pathway. Careful analysing of the basal pacing manoeuvers during sinus rhythm (para-Hisian and differential ventricular pacing) was crucial to establish the correct diagnosis and to avoid unnecessary left-side access to ablate this tachycardia.

Mo1268 Endoscopic Ultrasound Guided Radiofrequency Ablation (EUS-RFA): Initial Assessment of Safety and Efficacy

2017 ◽  
Vol 85 (5) ◽  
pp. AB484 ◽  
Author(s):  
Tom Malikowski ◽  
Ferga C. Gleeson ◽  
Matthew Block ◽  
Suresh T. Chari ◽  
Barham K. Abu Dayyeh ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Endoscopic Ultrasound ◽  
Initial Assessment ◽  
Ultrasound Guided ◽  
Safety And Efficacy

scholarly journals Accessory pathway analysis using a multimodal deep learning model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Nishimori ◽  
Kunihiko Kiuchi ◽  
Kunihiro Nishimura ◽  
Kengo Kusano ◽  
Akihiro Yoshida ◽  
...  
Keyword(s):  
Deep Learning ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Learning Model ◽  
X Rays ◽  
X Ray ◽  
Wpw Syndrome ◽  
Chest X Ray ◽  
Deep Learning Model ◽  
Ecg Data

AbstractCardiac accessory pathways (APs) in Wolff–Parkinson–White (WPW) syndrome are conventionally diagnosed with decision tree algorithms; however, there are problems with clinical usage. We assessed the efficacy of the artificial intelligence model using electrocardiography (ECG) and chest X-rays to identify the location of APs. We retrospectively used ECG and chest X-rays to analyse 206 patients with WPW syndrome. Each AP location was defined by an electrophysiological study and divided into four classifications. We developed a deep learning model to classify AP locations and compared the accuracy with that of conventional algorithms. Moreover, 1519 chest X-ray samples from other datasets were used for prior learning, and the combined chest X-ray image and ECG data were put into the previous model to evaluate whether the accuracy improved. The convolutional neural network (CNN) model using ECG data was significantly more accurate than the conventional tree algorithm. In the multimodal model, which implemented input from the combined ECG and chest X-ray data, the accuracy was significantly improved. Deep learning with a combination of ECG and chest X-ray data could effectively identify the AP location, which may be a novel deep learning model for a multimodal model.

scholarly journals Implantable loop recorder: experience of a center

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
C Marques Pires ◽  
P Medeiros ◽  
C Oliveira ◽  
I Campos ◽  
M Flores ◽  
...  
Keyword(s):  
Positive Impact ◽  
Blood Pressure Monitoring ◽  
Electrophysiological Study ◽  
Stress Test ◽  
Sinus Node ◽  
Oral Anticoagulants ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Implantable Loop Recorder ◽  
Diagnostic Challenge ◽  
Loop Recorder

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION Symptoms like syncope and palpitations are frequent and represent a diagnostic challenge. The implantable loop recorder (LR) is an important diagnostic tool, in selected cases. AIM To describe the main implantation indications of LR and to evaluate the diagnostic findings and therapeutic interventions. METHODS A retrospective study of patients (pts) that underwent LR implantation in our hospital from 2014 to 2019. For each pt the indication for implantation, baseline characteristics, previous study, recorded tracing and interventions were evaluated. RESULTS A total of 52 pts were included, 56% women, with a mean age of 60 years old. The implantation indications were recurrent syncope/ presyncope in 47 pts (90%) and palpitations in 5 pts (10%). All pts had a baseline echocardiogram and electrocardiogram, with 90% in sinus rhythm. QRS complex and atrial-ventricular conduction was normal in 50% of the pts. Previous to LR implantation, 46 pts (89%) had performed Holter, 19 (37%) carotid sinus massage, 14 (27%) Tilt table test, 29 (56%) stress test, 11(21%) ambulatory blood pressure monitoring and 9 (17%) electrophysiological study. During the monitoring period, 27 pts (52%) had recurrence of the symptoms. In this subgroup, we observed that 67% had a rhythmic cause capable of justified the symptoms, with a median of 5 months since implantation until diagnosis. In addition, the LR was useful in ruling out a rhythmic cause for symptoms in 33% of the cases. In the 47 pts with syncope/presyncope: 6(13%) had sinus node dysfunction, 4 (9%) had atrioventricular conduction disturbance, 1(2%) had atrial fibrillation (AF) and 3 (6%) had ventricular dysrhythmias. In the 5 pts with palpitations: 1(20%) had AF ad 3 (60%) had paroxysmal supraventricular tachycardia. LR results led to cardiac device implantation in 13 pts (pacemaker-9, implantable cardioverter desfibrillator-4). In addition, 2 pts are waiting for electrophysiological study and eventual ablation and 3 pts initiated antiarrhythmic therapy, and those with new diagnosis of AF also initiated oral anticoagulants. CONCLUSION In this study, the implantation of LR was useful to clarify the cause of the symptomology in 52% of the pts. In 35% of pts with symptom-rhythm correlation it ensured timely introduction of therapeutic approach with a positive impact on life quality.

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