scholarly journals Catheter ablation of drug resistant supraventricular tachycardia in neonates and infants

2013 ◽  
Vol 20 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Celal Akdeniz ◽  
Yakup Ergul ◽  
Neslihan Kiplapinar ◽  
Volkan Tuzcu
Keyword(s):  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Drug Resistant ◽  
Neonates And Infants

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.

Ventricular tachycardia ablation in nonischemic cardiomyopathy

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
D Nascimento Matos ◽  
D Cavaco ◽  
P Carmo ◽  
MS Carvalho ◽  
G Rodrigues ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Left Ventricular ◽  
Scientific Development ◽  
Left Ventricular Ejection ◽  
Drug Resistant ◽  
Nonischemic Cardiomyopathy ◽  
Epicardial Ablation ◽  
Ventricular Ejection Fraction ◽  
Ventricular Tachycardia Ablation

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION Catheter ablation outcomes for drug-resistant ventricular tachycardia (VT) in nonischemic cardiomyopathy (NICM) are suboptimal when compared to ischemic cardiomyopathy. We aimed to analyse the long-term efficacy and safety of percutaneous catheter ablation in this subset of patients. METHODS Single-center observational retrospective registry including consecutive NICM patients who underwent catheter ablation for drug-resistant VT during a 10-year period. The efficacy endpoint was defined as VT-free survival after catheter ablation, while safety outcomes were defined by 30-days mortality and procedure-related complications. Independent predictors of VT recurrence were assessed by Cox regression. RESULTS In a population of 68 patients, most were male (85%), mean left ventricular ejection fraction (LVEF) was 34 ± 12%, and mean age was 58 ± 15 years. All patients had an implantable cardioverter-defibrillator. Twenty-six (38%) patients underwent epicardial ablation (table 1). Over a median follow-up of 3 years (IQR 1-8), 41% (n = 31) patients had VT recurrence and 28% died (n = 19). Multivariate survival analysis identified LVEF (HR= 0.98; 95%CI 0.92-0.99, p = 0.046) and VT storm at presentation (HR = 2.38; 95%CI 1.04-5.46, p = 0.041) as independent predictors of VT recurrence. The yearly rates of VT recurrence and overall mortality were 21%/year and 10%/year, respectively. No patients died at 30-days post-procedure, and mean hospital length of stay was 5 ± 6 days. The complication rate was 7% (n = 5, table 1), mostly in patients undergoing epicardial ablation (4 vs 1 in endocardial ablation, P = 0.046). CONCLUSION LVEF and VT storm at presentation were independent predictors of VT recurrence in NICM patients after catheter ablation. While clinical outcomes can be improved with further technical and scientific development, a tailored endocardial/epicardial approach was safe, with low overall number of complications and no 30-days mortality. Abstract Figure.

scholarly journals SVT and Gram Negative Sepsis in Neonates

2019 ◽  
Vol 39 (3) ◽  
pp. 197-199
Author(s):  
Om Krishna Pathak ◽  
Yengkhom Rameshwor Singh ◽  
Sunil Purswani ◽  
Pradeep Suryawanshi
Keyword(s):  
Heart Rate ◽  
Case Report ◽  
Supraventricular Tachycardia ◽  
Cardiac Failure ◽  
Neonatal Sepsis ◽  
Congestive Cardiac Failure ◽  
Gram Negative ◽  
Neonates And Infants ◽  
Culture Positive ◽  
Insight Into

Supraventricular tachycardia is the most common tachyarrhythmia seen in fetuses, neonates and infants. Sustained SVT may lead to congestive cardiac failure. Neonatal supraventricular tachycardia is more commonly associated with other cardiorespiratory and congenital problems and is uncommon in an otherwise healthy infant. Supraventricular tachycardia is also caused by neonatal sepsis but has rarely been reported. Here, we report two cases of SVT (Supraventricular tachycardia) induced by neonatal sepsis. Two neonates, one male and another female, both born to Indian mother had tachycardia with heart rate > 220 beats/minute along with poor perfusion, tachypnoea, fever and deranged coagulation profile. Both the babies had culture positive gram negative sepsis with normal echocardiography and supraventricular tachycardia on electrocardiograms which were treated with anti arrhythmic drugs and treatment of sepsis. This case report gives further insight into one more presentation and complication of neonatal sepsis.

Effect of radiofrequency catheter ablation of accessory pathways on autonomic tone in children

1999 ◽  
Vol 9 (4) ◽  
pp. 377-383 ◽  
Author(s):  
Ruchir Sehra ◽  
Joyce E. Hubbard ◽  
Susan P. Straka ◽  
Naomi S. Fineberg ◽  
Douglas P. Zipes ◽  
...  
Keyword(s):  
Heart Rate ◽  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Radiofrequency Catheter Ablation ◽  
Autonomic Function ◽  
Accessory Pathways ◽  
Non Invasive ◽  
Autonomic Changes ◽  
Before And After ◽  
Autonomic Blockade

AbstractBackgroundRadiofrequency catheter ablation is standard treatment for children with re-entrant supraventricular tachycardias. Autonomic changes have been noted after such ablation for atrioventricular nodal re-entry tachycardia, but not as well documented with atrioventricular re-entry over an accessory pathway.Methods and resultsIn 10 normal paediatric volunteers and 12 children referred for electrophysiologic testing and radiofrequency ablation of supraventricular tachycardia, non-invasive autonomic function tests and tilt-table testing were performed, and the variability in 24-h heart rate was analysed. Patients with supraventricular tachycardia underwent these tests both 24–72 h before and 24 h after ablation. Patients with tachycardia underwent additional autonomic testing to assess the sensitivity of baroreceptors and the intrinsic heart rate with autonomic blockade immediately before and after ablation. One non-invasive autonomic function test, namely handgrip, demonstrated significant differences (p < 0.05) in diastolic blood pressure before and after ablation, though these values did not differ from controls. Significant decreases were noted in two indexes of the variability of heart rate before and after ablation (p < 0.05). Certain tilt test variables also demonstrated significant differences between controls and those with tachycardia subsequent to ablation. Intracardiac testing demonstrated changes (p < 0.05) in sinus cycle lengths, effective refractory periods and/or blood pressures at baseline and during testing of the sensitivity of baroreceptors before and after ablation. These changes were consistent with increased sympathetic or decreased parasympathetic tone. With autonomic blockade, these differences were abolished.ConclusionsCatheter ablation of accessory pathways in children was associated with changes consistent with increased sympathetic or decreased parasympathetic tone. These autonomic changes persisted 24 h after the ablation procedure.

scholarly journals Drug Resistant Fetal Arrhythmia in Obstetric Cholestasis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Nahide Altug ◽  
Ayse Kirbas ◽  
Korkut Daglar ◽  
Ebru Biberoglu ◽  
Dilek Uygur ◽  
...  
Keyword(s):  
Liver Disease ◽  
Bile Acid ◽  
Supraventricular Tachycardia ◽  
Preterm Labor ◽  
Fetal Distress ◽  
Intrauterine Death ◽  
Drug Resistant ◽  
Fetal Arrhythmia ◽  
Antiarrhythmic Treatment

Obstetric cholestasis (OC) is a pregnancy specific liver disease characterized by increased levels of bile acid (BA) and pruritus. Raised maternal BA levels could be associated with intrauterine death, fetal distress, and preterm labor and also alter the rate and rhythm of cardiomyocyte contraction and may cause fetal arrhythmic events. We report a case of drug resistant fetal supraventricular tachycardia and concomitant OC.Conclusion.If there are maternal OC and concomitant fetal arrhythmia, possibility of the resistance to antiarrhythmic treatment should be kept in mind.

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