Dirección para separatas: Carlos Labadet e:mail:[email protected] La autorización para conducir ... more Dirección para separatas: Carlos Labadet e:mail:[email protected] La autorización para conducir vehículos en pacientes portadores de dispositivos electrónicos implantables suele ser materia de debate a la hora de decidir su permiso. En el caso de los cardiodesfibriladores, el temor obvio es la posibilidad de sufrir un síncope secundario a la terapia de un cardiodesfibrilador (CDI) que ponga en riesgo al conductor y a terceros. He comprobado en una pequeña encuesta personal que muchos cardiólogos no tienen opinión formada al respecto o piensan que estos pacientes no debieran conducir vehículos por la posibilidad de recibir una descarga del aparato durante la conducción y ocasionar un accidente.
Tabla 1. La duración del intervalo QTc (seg) por edad y sexo Ambos sexos > 12 años 1-12 años Homb... more Tabla 1. La duración del intervalo QTc (seg) por edad y sexo Ambos sexos > 12 años 1-12 años Hombre Mujer Normal ³ 0,39 < 0,45 ³ 0,39 < 0,45 ³ 0,39 < 0,46 Prolongado ³ 0,45 ³ 0,45 ³ 0,46
Background and objective: The non-contact mapping system with expandable balloon catheter allows ... more Background and objective: The non-contact mapping system with expandable balloon catheter allows ventricular arrhythmia mapping with few ectopic beats. The aim of this study was to analyze ablation results with this system. Methods: Patients with ventricular arrhythmia were prospectively and consecutively studied with the non-contact mapping system. results: The study included 10 patients, 8 women, with mean age of 45 years (range: 27 to 65). Arrhythmia origin was right ventricular outflow tract in 8 patients, right ventricular inflow tract in 1 and left ventricular outflow tract in 1. Acute success was obtained in 9/10 patients (90%). Mean follow-up was 6 months (range 1 to 16); 8 patients continued with obliterated arrhythmia without medication and 1 patient required pharmacologic treatment. The only complication was femoral arteriovenous fistula. Conclusions: The non-contact mapping system allows a highly efficient and safe approach of right ventricular arrhythmias. future studies with more patients and comparing with other methods may confirm these results.
A 36 year-old man with Wolff Parkinson White syndrome due to a left-sided accessory pathway (AP) ... more A 36 year-old man with Wolff Parkinson White syndrome due to a left-sided accessory pathway (AP) was referred for catheter ablation. Whether abolition of antegrade and retrograde AP conduction during ablation therapy occurs simultaneously, is unclear. At the ablation procedure, radiofrequency delivery resulted in loss of preexcitation followed by a short run of orthodromic tachycardia with eccentric atrial activation, demonstrating persistence of retrograde conduction over the AP after abolition of its antegrade conduction. During continued radiofrequency delivery at the same position, the fifth non-preexcitated beat failed to conduct retrogradely and the tachycardia ended. In this case, antegrade AP conduction was abolished earlier than retrograde conduction.
The aim of this study was to assess use-dependence in patients with ventricular premature contrac... more The aim of this study was to assess use-dependence in patients with ventricular premature contractions (VPC's) treated with propafenone, by means of the increase in heart rate using transesophageal atrial pacing. It was also analyzed whether this phenomenon was related to the antiarrhythmic effect. Fifteen patients with more than 30 symptomatic VPC's/sour were evaluated. Esophageal pacing was performed with cycles of 600 and 400 msec during periods of 1 min and with simultaneous recording of 2 or 3 EKG leads with a paper speed of 100 mm/sec. Holter monitoring (HM) was carried out in all patients. Propafenone was administered in doses of 450 and 900 mg/day, during 5-7 days, at which moment another HM and esophageal stimulation were repeated. The QRS duration (pre-treatment) was 82.6 +/- 13.5 msec (basal) and 82.4 +/- 13 msec during pacing with 600 msec cycle length (p: NS). The QRS duration with P (900 mg/day) was 96.6 +/- 20 msec (basal) (p:NS vs. pre-treatment) but during a...
Introduccion: La ablacion por cateter (AC) es beneficiosa en pacientes con taquicardia ventricula... more Introduccion: La ablacion por cateter (AC) es beneficiosa en pacientes con taquicardia ventricular (TV) recurrente. Nuestro objetivo es revisar los casos de tormenta electrica (TE) tratados con AC. Metodos: Analisis retrospectivo de pacientes con TE debida a TV monomorfa sostenida (TVMS) tratados mediante AC. Se definio exito del procedimiento: ausencia de TV inducible al final del mismo; exito parcial: induccion de TV no clinica; no exito: inducibilidad de la TV clinica. Resultados: Se realizaron 16 procedimientos en 14 pacientes: 10 exitosos, 3 exito parcial y 3 no exitosos. Todos los pacientes evolucionaron sin arritmia ventricular inmediatamente post-ablacion. Diez pacientes (71,4%) evolucionaron sin TV y 86,7% sin TE (seguimiento 8 [3-30] meses). Cinco pacientes (35,7%) murieron de causa no arritmica. Conclusiones: La AC se asocia a una supresion aguda de TV en todos los pacientes con TE debida a TVMS y a una evolucion sin recurrencia en la mayoria de ellos.
Introduction and objective: The non-contact mapping system with expandable balloon catheter allow... more Introduction and objective: The non-contact mapping system with expandable balloon catheter allows ventricular arrhythmia mapping with few ectopic beats. The aim of this study was to analyze ablation results with this system. Methods: Patients with ventricular arrhythmia were prospectively and consecutively studied with the non-contact mapping system. Results: The study included 10 patients, 8 women, with mean age of 45 years (range: 27 to 65). Arrhythmia origin was right ventricular outflow tract in 8 patients, right ventricular inflow tract in 1 and left ventricular outflow tract in 1. Acute success was obtained in 9/10 patients (90%). Mean follow-up was 6 months (range 1 to 16); 8 patients continued with obliterated arrhythmia without medication and 1 patient required pharmacologic treatment. The only complication was femoral arteriovenous fistula. Conclusions: The non-contact mapping system allows a highly efficient and safe approach of right ventricular arrhythmias. Future studies with more patients and comparing with other methods may confirm these results.
Dirección para separatas: Carlos Labadet e:mail:[email protected] La autorización para conducir ... more Dirección para separatas: Carlos Labadet e:mail:[email protected] La autorización para conducir vehículos en pacientes portadores de dispositivos electrónicos implantables suele ser materia de debate a la hora de decidir su permiso. En el caso de los cardiodesfibriladores, el temor obvio es la posibilidad de sufrir un síncope secundario a la terapia de un cardiodesfibrilador (CDI) que ponga en riesgo al conductor y a terceros. He comprobado en una pequeña encuesta personal que muchos cardiólogos no tienen opinión formada al respecto o piensan que estos pacientes no debieran conducir vehículos por la posibilidad de recibir una descarga del aparato durante la conducción y ocasionar un accidente.
Tabla 1. La duración del intervalo QTc (seg) por edad y sexo Ambos sexos > 12 años 1-12 años Homb... more Tabla 1. La duración del intervalo QTc (seg) por edad y sexo Ambos sexos > 12 años 1-12 años Hombre Mujer Normal ³ 0,39 < 0,45 ³ 0,39 < 0,45 ³ 0,39 < 0,46 Prolongado ³ 0,45 ³ 0,45 ³ 0,46
Background and objective: The non-contact mapping system with expandable balloon catheter allows ... more Background and objective: The non-contact mapping system with expandable balloon catheter allows ventricular arrhythmia mapping with few ectopic beats. The aim of this study was to analyze ablation results with this system. Methods: Patients with ventricular arrhythmia were prospectively and consecutively studied with the non-contact mapping system. results: The study included 10 patients, 8 women, with mean age of 45 years (range: 27 to 65). Arrhythmia origin was right ventricular outflow tract in 8 patients, right ventricular inflow tract in 1 and left ventricular outflow tract in 1. Acute success was obtained in 9/10 patients (90%). Mean follow-up was 6 months (range 1 to 16); 8 patients continued with obliterated arrhythmia without medication and 1 patient required pharmacologic treatment. The only complication was femoral arteriovenous fistula. Conclusions: The non-contact mapping system allows a highly efficient and safe approach of right ventricular arrhythmias. future studies with more patients and comparing with other methods may confirm these results.
A 36 year-old man with Wolff Parkinson White syndrome due to a left-sided accessory pathway (AP) ... more A 36 year-old man with Wolff Parkinson White syndrome due to a left-sided accessory pathway (AP) was referred for catheter ablation. Whether abolition of antegrade and retrograde AP conduction during ablation therapy occurs simultaneously, is unclear. At the ablation procedure, radiofrequency delivery resulted in loss of preexcitation followed by a short run of orthodromic tachycardia with eccentric atrial activation, demonstrating persistence of retrograde conduction over the AP after abolition of its antegrade conduction. During continued radiofrequency delivery at the same position, the fifth non-preexcitated beat failed to conduct retrogradely and the tachycardia ended. In this case, antegrade AP conduction was abolished earlier than retrograde conduction.
The aim of this study was to assess use-dependence in patients with ventricular premature contrac... more The aim of this study was to assess use-dependence in patients with ventricular premature contractions (VPC's) treated with propafenone, by means of the increase in heart rate using transesophageal atrial pacing. It was also analyzed whether this phenomenon was related to the antiarrhythmic effect. Fifteen patients with more than 30 symptomatic VPC's/sour were evaluated. Esophageal pacing was performed with cycles of 600 and 400 msec during periods of 1 min and with simultaneous recording of 2 or 3 EKG leads with a paper speed of 100 mm/sec. Holter monitoring (HM) was carried out in all patients. Propafenone was administered in doses of 450 and 900 mg/day, during 5-7 days, at which moment another HM and esophageal stimulation were repeated. The QRS duration (pre-treatment) was 82.6 +/- 13.5 msec (basal) and 82.4 +/- 13 msec during pacing with 600 msec cycle length (p: NS). The QRS duration with P (900 mg/day) was 96.6 +/- 20 msec (basal) (p:NS vs. pre-treatment) but during a...
Introduccion: La ablacion por cateter (AC) es beneficiosa en pacientes con taquicardia ventricula... more Introduccion: La ablacion por cateter (AC) es beneficiosa en pacientes con taquicardia ventricular (TV) recurrente. Nuestro objetivo es revisar los casos de tormenta electrica (TE) tratados con AC. Metodos: Analisis retrospectivo de pacientes con TE debida a TV monomorfa sostenida (TVMS) tratados mediante AC. Se definio exito del procedimiento: ausencia de TV inducible al final del mismo; exito parcial: induccion de TV no clinica; no exito: inducibilidad de la TV clinica. Resultados: Se realizaron 16 procedimientos en 14 pacientes: 10 exitosos, 3 exito parcial y 3 no exitosos. Todos los pacientes evolucionaron sin arritmia ventricular inmediatamente post-ablacion. Diez pacientes (71,4%) evolucionaron sin TV y 86,7% sin TE (seguimiento 8 [3-30] meses). Cinco pacientes (35,7%) murieron de causa no arritmica. Conclusiones: La AC se asocia a una supresion aguda de TV en todos los pacientes con TE debida a TVMS y a una evolucion sin recurrencia en la mayoria de ellos.
Introduction and objective: The non-contact mapping system with expandable balloon catheter allow... more Introduction and objective: The non-contact mapping system with expandable balloon catheter allows ventricular arrhythmia mapping with few ectopic beats. The aim of this study was to analyze ablation results with this system. Methods: Patients with ventricular arrhythmia were prospectively and consecutively studied with the non-contact mapping system. Results: The study included 10 patients, 8 women, with mean age of 45 years (range: 27 to 65). Arrhythmia origin was right ventricular outflow tract in 8 patients, right ventricular inflow tract in 1 and left ventricular outflow tract in 1. Acute success was obtained in 9/10 patients (90%). Mean follow-up was 6 months (range 1 to 16); 8 patients continued with obliterated arrhythmia without medication and 1 patient required pharmacologic treatment. The only complication was femoral arteriovenous fistula. Conclusions: The non-contact mapping system allows a highly efficient and safe approach of right ventricular arrhythmias. Future studies with more patients and comparing with other methods may confirm these results.
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