scholarly journals Experience in the management of infants with multifocal atrial tachycardia

2021 ◽  
Vol 28 (4) ◽  
pp. 24-33
Author(s):  
T. S. Kovalchuk ◽  
T. K. Kruchina ◽  
R. B. Tatarskiy ◽  
T. M. Pervunina ◽  
M. Sh. Malyarova ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Disease ◽  
Sinus Rhythm ◽  
Atrial Tachycardia ◽  
Structural Heart Disease ◽  
Good Prognosis ◽  
Term Selection ◽  
Selection Of

Purpose. To study the clinical course of multifocal atrial tachycardia (MAT) and to evaluate the effectiveness of antiarrhythmic therapy (AAT) in patients with onset of arrhythmia before the age of 1 year.Methods. The study included 15 children with primary registration of MAT at the age of 2.04±2.27 months, 4 of them - in utero. The follow-up period was 35.9±26.9 months (Me 29 months). All patients underwent laboratory monitoring, 12-lead ECG recording, 24-hour ECG monitoring, echocardiography at baseline and during time of observation.Results. Tachycardia was persistent in 80% of patients. Tachycardia-induced cardiomyopathy (TIC) was present in 7 (46%) patients. Structural heart disease was detected in 6 patients. The average heart rate at the onset of the disease was 157.9±23.78 bpm, the maximum - 256.7±35.84 bpm. Fourteen (93.3%) children received AAT. Seven patients were prescribed propranolol first, 6 - amiodarone, 1 - digoxin. Monotherapy was effective in 2 patients. Combined AAT was used in 12 patients, including three children with three drugs combination. No benefits were found for any of the drugs combinations. Stable sinus rhythm at the time of discharge was observed in 4 (28,6%) patients, sinus rhythm with atrial ectopic activity was registered in 2 of them; criteria for normosystole were achieved in 7 patients; in one child with TIC daytime tachysystole persisted despite three-component AAT, but echocardiography parameters improved. Arrhythmia was disappeared in 13 (86.6%) patients; the duration of arrhythmia in them from 1 to 15 months, duration of AAT - 1 ±7.5 months (Me 9.5 months). MAT persists in two patients with structural heart disease. One patient underwent radiofrequency ablation at the age of 5, with no effect. One patient had side effects from therapy that required correction. There were no lethal outcomes.Conclusion. MAT with a debut at the age of 1 year with timely prescribed treatment has a favorable course and a good prognosis, but the probability of AAT resistance is high. These cases require a long-term selection of therapy using various combinations of antiarrhythmic drugs. Heart rate control strategy can be sufficient to prevent the development of TIC.

Long-term management of adults with conotruncal lesions: the diagnostic approach at All Children's Hospital

2012 ◽  
Vol 22 (6) ◽  
pp. 768-779
Author(s):  
Gul H. Dadlani ◽  
Katherine Braley ◽  
Anthony Sochet ◽  
Kristen Marcet ◽  
Jennifer Leshko ◽  
...  
Keyword(s):  
Heart Disease ◽  
Structural Heart Disease ◽  
Future Research ◽  
Care Plans ◽  
Routine Surveillance ◽  
Congenital Cardiac Disease ◽  
Long Term Follow Up ◽  
Children And Young Adults

AbstractImproved survival in children with complex congenital cardiac disease, such as conotruncal abnormalities, has created a sub-population of children and young adults who need comprehensive multi-disciplinary long-term follow-up. Routine surveillance with comprehensive screening for structural heart disease, functional heart disease, thromboembolic disease, arrhythmias, and associated end-organ dysfunction is important. Future research will better define the care plans for routine surveillance in patients with conotruncal abnormalities.

Predictors of long-term mortality after catheter ablation of ventricular tachycardia in a contemporary cohort of patients with structural heart disease

EP Europace ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. 1672-1679
Author(s):  
Angeliki Darma ◽  
Livio Bertagnolli ◽  
Borislav Dinov ◽  
Federica Torri ◽  
Alireza Sepehri Shamloo ◽  
...  
Keyword(s):  
Heart Disease ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Male Gender ◽  
Electrical Storm ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ischaemic Cardiomyopathy

Abstract Aims Ablation of ventricular tachycardias (VTs) in patients with structural heart disease has been established in the past decades as an effective and safe treatment. However, the prognosis and long-term outcome remains poor. Methods and results We investigated 309 patients with ischaemic cardiomyopathy (ICM) and non-ischaemic cardiomyopathy (NICM) (186 ICM, 123 NICM; 271 males; mean age 64.1 ± 12 years; ejection fraction 34 ± 13%) after ≥1 VT ablations over a mean follow-up period of 34 ± 28 months. Electrical storm was the indication for 224 patients (73%), whereas 86 patients (28%) underwent epicardial as well as endocardial ablation. During follow-up, 132 patients (43%) experienced VT recurrence and 97 (31%) died. Ischaemic cardiomyopathy and NICM patients showed comparable results, regarding procedural endpoints, complications, VT recurrence and survival. The Cox-regression analysis for all-cause mortality revealed that the presence of higher left ventricular end-diastolic volume (LVEDV; P < 0.001), male gender (P = 0.018), atrial fibrillation (AF; P < 0.001), chronic obstructive pulmonary disease (COPD; P = 0.001), antiarrhythmic drugs during the follow-up (P < 0.001), polymorphic VTs (P = 0.028), and periprocedural complications (P = 0.001) were independent predictors of mortality. Conclusion Ischaemic cardiomyopathy and NICM patients undergoing VT ablation had comparable results regarding procedural endpoints, complications, VT recurrence and 3-year mortality. Higher LVEDV, male gender, COPD, AF, polymorphic VTs, use of antiarrhythmics, and periprocedural complications are strong and independent predictors for increased mortality. The PAINESD score accurately predicted the long-term outcome in our cohort.

Abstract 1738: Lone Atrial Fibrillation: Long-Term Clinical and Echocardiographic Follow-up from the Canadian Registry of Atrial Fibrillation

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Peter Leong-Sit ◽  
Karin H Humphries ◽  
May Lee ◽  
George J Klein ◽  
Robert Sheldon ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Structural Heart Disease ◽  
Lone Atrial Fibrillation ◽  
Lv Mass ◽  
Significant Difference ◽  
History Of ◽  
New Onset

Background: The natural history of lone atrial fibrillation (AF) is unclear with conflicting data in the literature. We aimed to better describe the clinical outcomes and echocardiographic changes associated with lone AF. Methods: The Canadian Registry of Atrial Fibrillation (CARAF) enrolled 803 non-surgical and non-flutter patients with new onset AF between 1990 and 1996. At enrollment, patients were classified as lone AF (LAF) or not lone AF (Not LAF) based on structural heart disease or hyperthyroidism. Clinical data was prospectively collected with follow-up at 3 months, 1 year, then annually; echocardiograms were performed at enrollment and years 2, 4, and 7. Results: The LAF group (n=212) had a median age of 57 (1 st quartile 44, 3 rd quartile 67) while the Not LAF group (n=591) had a median age of 67 (59, 73), p<0.0001. During the median follow-up of 8 years in the LAF group and 7 years in the Not LAF group, there was a significant difference in survival free from stroke or embolism favoring the LAF group (Figure ). At 8 years, the probability of remaining free of chronic AF was 78.8% vs 69.3% (p=0.02) and free of symptomatic or documented recurrence of AF was 40.1% vs 26.9% (p<0.01) in the LAF vs Not LAF group. The LAF group had smaller LV diastolic and systolic dimensions by 5.5% and 10.2%, respectively, vs the Not LAF group (p<0.0001). The LV mass was smaller at baseline by 21.1% (p<0.0001) vs the Not LAF group, but increased at a greater rate (4.0% vs 0.9%/2 years, p<0.0001). Conclusions: Lone AF, compared to non-lone AF, is associated with a lower rate of death, stroke or embolism, recurrence and progression to chronic AF. Interestingly, LV mass increased significantly only in the Lone AF group.

scholarly journals Tachycardiomyopathy in Patients without Underlying Structural Heart Disease

2019 ◽  
Vol 8 (9) ◽  
pp. 1411 ◽  
Author(s):  
Giulia Stronati ◽  
Federico Guerra ◽  
Alessia Urbinati ◽  
Giuseppe Ciliberti ◽  
Laura Cipolletta ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Term Survival ◽  
Ventricular Ejection Fraction ◽  
Obstructive Sleep

Tachycardiomyopathy (TCM) is an underestimated cause of reversible left ventricle dysfunction. The aim of this study was to identify the predictors of recurrence and incidence of major cardiovascular events in TCM patients without underlying structural heart disease (pure TCM). The prospective, observational study enrolled all consecutive pure TCM patients. The diagnosis was suspected in patients admitted for heart failure (HF) with a reduced ejection fraction and concomitant persistent arrhythmia. Pure TCM was confirmed after the clinical and echocardiographic recovery during follow-up. From 107 pure TCM patients (9% of all HF admission, the median follow-up 22.6 months), 17 recurred, 51 were hospitalized for cardiovascular reasons, two suffered from thromboembolic events and one died. The diagnosis of obstructive sleep apnoea syndrome (OSAS, hazard ratio (HR) 5.44), brain natriuretic peptide on admission (HR 1.01 for each pg/mL) and the heart rate at discharge (HR 1.05 for each bpm) were all independent predictors of TCM recurrence. The left ventricular ejection fraction at discharge (HR 0.96 for each%) and the heart rate at discharge (HR 1.02 for each bpm) resulted as independent predictors of cardiovascular-related hospitalization. Pure TCM is more common than previously thought and associated with a good long-term survival but recurrences and hospitalizations are frequent. Reversing OSAS and controlling the heart rate could prevent TCM-related complications.

scholarly journals Serial Echocardiographic Follow-up of Structural Heart Interventions Performed During Pacific Partnership Interventional Cardiology Subject Matter Exchanges From 2015 to 2017 in Da Nang, Vietnam

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 833-838
Author(s):  
Keshav R Nayak ◽  
Nguyen Ba Trieu ◽  
Jeffrey O’Dell ◽  
Shellie Kendall ◽  
Kelly Stanton ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ductus Arteriosus ◽  
Structural Heart Disease ◽  
Patient Registry ◽  
Long Term Outcomes ◽  
Atrial Septal Defect Closure ◽  
Procedural Complications ◽  
Age Range

ABSTRACT Introduction The U.S. Navy Medicine has a long history of conducting global health missions that foster international diplomacy through medical knowledge exchange with a goal of increasing partner nation’s health care capacity. Pacific Partnership is an annual U.S. Navy-sponsored joint operation that enhances medical collaboration with participating nations throughout the Indo-Asia-Pacific region. Since 2015, a U.S. Navy Cardiology team has conducted a structural heart disease interventional workshop focused on congenital heart disease with the cardiologists at the Da Nang General Hospital, Da Nang, Vietnam. Herein, we describe the multinational collaborative project including the patient registry we developed to monitor the short- and long-term outcomes of structural heart disease interventions preformed during Pacific Partnership 2015 and 2016. Materials and Methods Our team developed a sustainable procedural registry with the goal of following the long-term outcomes of cardiac interventions for congenital heart disease in Vietnamese patients. Specifically, the registry was designed to record the changes in symptoms referable to the cardiovascular system and for device placement–associated complications for devices placed in 2015 and 2016 and has been updated annually thereafter. Results Twelve patients (age range, 7 months to 31 years) underwent successful atrial septal defect closure in 2015 without procedural complications. The follow-up rate was 75% at 1 year and 67% at 2 years, and all devices were in appropriate position with no complications identified. Fifteen patients (age range, 20-66 years) underwent successful atrial septal defect closure in 2016. The follow-up rate was 62.5% at 1 year, and all devices were in appropriate position with no complications identified. Three patients (age range, 5-25 months) underwent successful device closure of the patent ductus arteriosus in 2015 without complications. The follow-up rate was 67% in 2016 and again in 2017. Six patients (age range, 9-74 years) underwent successful patent ductus arteriosus closure in 2016 without complications. The follow-up rate was 67% in 2017, and all devices were in appropriate position with no device-related complications identified. Conclusions The development of a patient registry during these missions allowed for the longitudinal monitoring of outcomes for cardiac interventions. Notably, treated patients experienced symptomatic improvement without significant long-term procedural complications. Following patients longitudinally across medical missions is of recognized importance but remains a difficult objective to achieve for a multitude of factors including administrative and financial burdens on both the medical systems and the patients of host nations. Despite these limitations, longitudinal follow-up of patient care facilitated by a patient registry has a vital role in monitoring the quality of care provided and should be an integral part of all future global medical missions.

Paroxysmal Atrial Tachycardia in Infancy: Long-Term Follow-up Study of 49 Subjects

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 638-642
Author(s):  
Åke Lundberg
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Supraventricular Tachycardia ◽  
Atrial Tachycardia ◽  
Congenital Heart ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
The Mean

A follow-up study of 49 individuals with paroxysmal atrial tachycardia in infancy is reported. Forty subjects had supraventricular tachycardia and nine had atrial flutter/fibrillation. The mean follow-up period was 24 years. Males whose ECGs showed preexcitation displayed the highest rate of recurrences (approximately 60%) in the long-term follow-up. Approximately 30% of the subjects without preexcitation in the ECG displayed episodes of supraventricular tachycardia in their third decade. Eighty-six percent of the children of the subjects in the present series were males. The prognosis is good in the absence of congenital heart disease.

scholarly journals Out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation in patients with normal electrocardiograms: results from a multicentre long-term registry

EP Europace ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. 1670-1677 ◽  
Author(s):  
Giulio Conte ◽  
Bernard Belhassen ◽  
Pier Lambiase ◽  
Giuseppe Ciconte ◽  
Carlo de Asmundis ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Multivariable Analysis ◽  
Structural Heart Disease ◽  
Cardiovascular Death ◽  
Good Prognosis ◽  
Idiopathic Ventricular Fibrillation ◽  
Lethal Event ◽  
Normal Ecgs

Abstract Aims  To define the clinical characteristics and long-term clinical outcomes of a large cohort of patients with idiopathic ventricular fibrillation (IVF) and normal 12-lead electrocardiograms (ECGs). Methods and results Patients with ventricular fibrillation as the presenting rhythm, normal baseline, and follow-up ECGs with no signs of cardiac channelopathy including early repolarization or atrioventricular conduction abnormalities, and without structural heart disease were included in a registry. A total of 245 patients (median age: 38 years; males 59%) were recruited from 25 centres. An implantable cardioverter-defibrillator (ICD) was implanted in 226 patients (92%), while 18 patients (8%) were treated with drug therapy only. Over a median follow-up of 63 months (interquartile range: 25–110 months), 12 patients died (5%); in four of them (1.6%) the lethal event was of cardiac origin. Patients treated with antiarrhythmic drugs only had a higher rate of cardiovascular death compared to patients who received an ICD (16% vs. 0.4%, P = 0.001). Fifty-two patients (21%) experienced an arrhythmic recurrence. Age ≤16 years at the time of the first ventricular arrhythmia was the only predictor of arrhythmic recurrence on multivariable analysis [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.18–0.92; P = 0.03]. Conclusion  Patients with IVF and persistently normal ECGs frequently have arrhythmic recurrences, but a good prognosis when treated with an ICD. Children are a category of IVF patients at higher risk of arrhythmic recurrences.

scholarly journals Mid-term outcomes of thoracoscopic and hybrid therapy of atrial fibrillation

2021 ◽  
Vol 28 (3) ◽  
pp. 5-12
Author(s):  
A. Sh. Revishvili ◽  
I. A. Taimasova ◽  
E. A. Artyukhina ◽  
E. S. Malishenko ◽  
M. V. Novikov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Atrial Tachycardia ◽  
Volume Index ◽  
Hybrid Techniques ◽  
Hybrid Approaches ◽  
Student’S T ◽  
Stable Sinus Rhythm

Aim. To evaluate the efficacy and safety of thoracoscopic and hybrid techniques in patients with various forms of atrial fibrillation (AF).Methods. The results of thoracoscopic ablation of 87 patients with AF were analyzed: 27 (31%) with paroxysmal form, 15 (17%) - with persistent, 45 (52%) - with long-term persistent form at follow-up 18.6±6.7 months. “Box-Lesion” treatments and amputation of left atrial appendage (LAA) were performed in 69 (79.3%) patients, “Box Lesion” without LAA amputation in 12 (13.7%). When atrial tachycardia was recorded for more than 30 seconds after a 3-month “blind” period, patients underwent hybrid catheter intervention.Results. Freedom from atrial arrhythmias in the group of paroxysmal AF was achieved in 84% of patients (21 of 25), in the group of persistent form - in 60% of patients (9 of 15), in the group of long-term persistent form - in 78% (32 of 41) at a given observation period. In the structure of postoperative atrial tachycardia, AF recurrence was 5 (6.25%), typical atrial flutter (AFL) - 3 (3.75%), atypical AFL - 10 (12.5%). The mean LA volume index in patients with stable sinus rhythm was 64.6±11.3 ml/m2 versus 74.65±15.4 ml/m2 in the atrial tachycardia group (Student’s t-test 0.53, p = 0.6). These patients underwent a hybrid intervention. At a follow-up period of 15.9±10.9 months, a stable sinus rhythm was maintained in 15 (83.3%) patients. The overall rate of intra- and postoperative complications of thoracoscopic ablation was 5.7%.Conclusion. Thoracoscopic and hybrid approaches are effective methods for various forms of AF treatment.

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