Primary percutaneous coronary intervention in acute myocardial infarction at Siriraj Hospital: the improvement over time.

OBJECTIVE: To evaluate the efficacy of the acute ST segment elevation treatment guidelines in reducing the door-to-balloon time at Siriraj Hospital. MATERIAL AND METHOD: Retrospective analysis of the data and records obtained from one hundred and twenty eight patients who underwent primary percutaneous intervention for acute ST segment elevation myocardial infarction at Siriraj Hospital between June 2002 and February 2006. Control chart analysis was applied to evaluate the efficacy of the guidelines. RESULTS: The mean door-to-balloon time was consistently reduced from 243.23 minutes before to 137.13 minutes after the guidelines implementation. Control chart analysis showed that this reduction in door-to-balloon time reached statistical significance. CONCLUSION: The guidelines developed by a multidisciplinary approach could effectively reduce the door-to-balloon time.

Radiofrequency catheter ablation of ventricular tachycardia from right ventricular outflow tract.

From January 1996 to May 2002, 61 patients with ventricular tachycardia from right ventricular outflow tract were referred to Siriraj hospital. All patients underwent clinical examination, Doppler echocardiography and electrophysiologic study. Mapping of ventricular tachycardia was performed by activation mapping and pacemapping. There were 44 females and 17 males with an average age of 41.7 +/- 9.9 years. Presenting symptoms were palpitation (95.1%), presyncope (39.3%), and syncope (26.2%). Six patients were found to have underlying cardiac disease. Radiofrequency catheter ablation was successful in 56 patients (91.8%). There were no major complications. Seven patients (12.5%) had recurrent ventricular tachycardia. Five of them were successfully reablated. The authors concluded that radiofrequency ablation is an effective treatment in patients with ventricular tachycardia from right ventricular outflow tract.