Objective :To report the results of electrophysiologic study and radiofrequency ablation for patients with atrial tachycardia and patients with typical atrialflutter- Methods : There were fifty six patients ,including...
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Objective :To report the results of electrophysiologic study and radiofrequency ablation for patients with atrial tachycardia and patients with typical atrialflutter- Methods : There were fifty six patients ,including thirty two with atrialtachycardia ( AT, mean age 37 ±17 years , paroxysmal ATin 30 cases and chronic ATin 2 cases) and twenty four patients with atrialflutter ( AFL, mean age 55 ±14 years ,paroxysmal AFLin 8 cases and persistent AFL in 16 cases)- AT was induced by atrial stimuli,and intravenous adenosine triphosphate ( ATP) 20 ～30 mg was given during AT- The mapping and ablating catheter is positioned in the right or left atrium to locate the ablation target site with earliest atrial activation of AT- Radiofrequency ablation at the inferior vena cava tricuspid annulus or the tricuspid annulus Eustachian ridge isthmus was performed in 24 patients with AFL- Successful ablation endpoints : ATnot induced for AT patients ; and bidirectional conduction block atisthmus for AFL patients- Results :The suspected mechanism of paroxysmal AT in 30 patients was related to reentry , and in the other 2 cases with chronic AT was probably due to abnormal automaticity- ATPwas effective in terminating 87 % ofthe paroxysmal AT- ATwas successfully ablated in 31 patients- The mean local endocardial electrogram timing relative to P wave onset was 38 ±11 ms at successful ablation sites , which was significantly longer than that at unsuccessful ablation sites (26 ±7 ms , p < 0-05)- Radiofrequency ablation was performed during atrial flutter in 16 patients or during sinus rhythm in the other 8 patients ;complete ischmus bidirectional block was achieved in all 24 patients- During a follow up of 15 months ,tachycardia recurred in 2 patients with ATand in 1 with AFL- However ,second ablation was successful in these three patients- Conclusion : Radiofrequency ablation had shown to be an effective method to treat ATand AFL- Itis suggested thatthe major mechanism of AT in adult patien
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:Toelucidatethe differentclinicalfeaturesbetween adultsand children with congenitalcardiac diverticulum- Methods:The clinicalcharacteristicofpatients with congenitalcardiacdiverticulum confirmed by ventriculo...
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Objective:Toelucidatethe differentclinicalfeaturesbetween adultsand children with congenitalcardiac diverticulum- Methods:The clinicalcharacteristicofpatients with congenitalcardiacdiverticulum confirmed by ventriculograpyhyorsurgicaloperationin nine casesinourhospitalwereanalyzedretrospectively-Fourcaseswereadultswith a mean ageof59-3±7-6 years(50～68 years);and5 were children ofage6-5±4-4years(2-5～14 years)- Results: ①Four adults with the left ventricular diverticulum were allincidentally discovered and confirmed by left ventriculography for differential diagnosis- Five children were confirmedin corrected operationforotherseverecongenitalheart malformation- ②The averagediameterof the diverticulum were36-3±11-8 mm (20～48 mm) andthe neck of diverticulum were14-0 ±2-9 mm (10～17 mm) in 4 adults;while the average diameterofthediverticulum were42-0 ±22-0 mm (25 ～80 mm) and the neck ofdiverticulum were 8-6 ±3-9 mm (4 ～12 mm) in 5 children- ③Alladult patients had isolated left ventricular muscular diverticulum with no related complications thus did not been operated- All children,1 with isolateralleft ventricular muscular diverticulum , with bioverticular muscular diverticulum ,2 with right ventricular muscular diverticulum ,and 1 withleftatrialfibrous diverticulum ,underwentsurgicaloperationsuch assuturationofthediverticulum andrepairing ofatrialor verticularseptum ,valvuloplastyoftricuspid valve,replacementof mitralvalve orligation ofartery duct,accordingtothetypes of congenital heart anomales- Conclusion:There are many differentclinicalfeaturesbetweenadults (olderand middle) and children with congenitalcardiacdiverticulum-
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