Objective : To observe the efficacy of implantable cardioverter defibrillator to treat ventricular tachyarrhythmias- Methods : Twenty six patients ,23 males and 3 females , mean age of 48-08 years were implanted nonth...
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Objective : To observe the efficacy of implantable cardioverter defibrillator to treat ventricular tachyarrhythmias- Methods : Twenty six patients ,23 males and 3 females , mean age of 48-08 years were implanted nonthoracotomy ICDsystems- The indications for implantation were VFin 18 patients and refractory VTin 8- All patients had syncope out of hospital- The device is the third generation ICD with multitherapies including antitachycardia pacing (ATP) , cardiovertion and defibrillation and data storing functions- All patients were followed up at least once after ICDimplantation- Results :In the follow up of 9-4 (2 ～26) months ,13 out of 26 patients (50 % ) received ICD therapy- The data stored in ICD showed that totally 187 episodes were detected by the devices- 54 of them were nonsustained VT which spontaneously terminated- 133 VT/ VF episodes were treated by ICD- 110 ofthem were VT,42 were terminated by ATPand 61 by low energy cardiovertion- 2 episodes were sinus tachycardia- Another 5 VT were accelerated to VFand terminated by high energy shocks- There were 23 VFepisodes diagnosed by the devices , however 4 of them were confirmed VT with rate over VFdetection criterion by reviewing the stored electrocardiogram- Allthe episodes were terminated by shocks- 2 patients died of heartfailure during the follow up- Conclusion : The third generation ICD with multitherapy function has high efficacy in the termination of ventricular tachyarrhythmias- It is importantto follow up the patients and set appropriate parameters for diagnosis and therapy by ICD-
Objective:We report our clinical use of dual chamber pacing in patients with hypertrophic obstructive cardiomyopathy (HOCM) and its hemodynamiceffects- Methods:Twenty three patients,16 males and 7 females, mean age of...
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Objective:We report our clinical use of dual chamber pacing in patients with hypertrophic obstructive cardiomyopathy (HOCM) and its hemodynamiceffects- Methods:Twenty three patients,16 males and 7 females, mean age of 39 years, with HOCM, were implanted permanent dual chamber pacemaker- Allpatients had clinicalsymptomsrefractoryto medicaltherapy (βblockersand/orCa2 + blockers) and12 ofthem hadsyncope- Mean thickenessoftheventricularseptum was2-1 cm- Results:Thesymptoms weresignificantlyimprovedin20 patientsafter pacing withshort A Vdelay comparedtothose before pacing- Theleft ventricularoutfolwtract(LVOT) pressure gradients werereducedfrom 51-05to 19-07 mmHgafterpacing(p<0-05)-In afollow up of9 months (5～23 months),no patients had syncope- Conclusion:Dual chamberpacingisan effective new methodtotreatpatients with HOCM
Objective : To explore the diagnostic value of STsegment depression Twave inversion on inferior leads during narrow QRScomplex tachycardia- Methods : We analyzed 12 lead electrocardiograms of 205 patients (112 males) ...
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Objective : To explore the diagnostic value of STsegment depression Twave inversion on inferior leads during narrow QRScomplex tachycardia- Methods : We analyzed 12 lead electrocardiograms of 205 patients (112 males) during narrow QRS complex supraventricular tachycardia to evaluate the significance of STsegment depression/T wave inversion- All patients underwent complete electrophysiologic evaluation and successful radiofrequency catheter ablation- None ofthem had pre excitation in sinus rhythm- Results : There were 99 atrioventricular node reentrant tachycardias (AVNRT) and 116 AV reciprocating tachycardias (AVRT)- STsegment depression or T wave inversion > 1-5 m V on inferior lead was present more often in AVRTthan in AVNRT, and the sensitivity were 62-5 % vs- 6-7 % ,70-2 % vs- 16-3 % and 64-4 % vs- 6-7 % on lead Ⅱ, Ⅲand aVF,respectively- The mean magnitude of Tinversion of AVRTon lead Ⅱ, Ⅲand aVF1-7 ±0-8 m V,1-6 ±0-8 m Vand 1-5 ±0-8 m V- For AVRT,the specificity of STdepression/Twave inversion were 93 % ,90 % and 93 % on lead Ⅱ, Ⅲand aVF- The percentages of STsegment/T wave inversion on lead Ⅱ, Ⅲand aVFin AVRT with right side accessory pathway were significantly higherthan those with left side accessory pathway (84 % vs- 48 % ,86 % vs- 53 % and 82 % vs- 50 % ,respectively ,all p < 0-001)- Conclusion : The presence of STsegment depression/T wave inversion > 1-5 m V on inferior leads during narrow QRS complex tachycardia , strongly suggests arioventricular reciprocating tachycardia- This finding is helpful for the promptly distinguisgment of orthodromic AVRT using a concealed accessory pathway-
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