ABSTRACT
BACKGROUND/AIMS: The purpose of this study was to analyze the clinical features of the patients who underwent implantable cardioverter- defibrillator (ICD) treatment. METHODS: The clinical features and the test data of the intracardiac electrograms for the patients who underwent ICD implantation between 1996 and 2005 at Asan Medical Center were retrospectively analyzed. RESULTS: One hundred thirty five patients (109 males and 26 females, a mean age of 54+/-13 years) were included in this study. The underlying cardiovascular diseases were post-myocardial infarction (MI) ventricular tachycardia (VT), Brugada syndrome, hypertrophic cardiomyopathy (CM) and dilated CM. During a mean of 2.9+/-2.0 years of follow-up, appropriate shocks were delivered in 43 (31.9%) and inappropriate shocks were delivered in 39 (28.9%) patients. Anti-tachycardia pacing therapy was effective in 17 patients. Inappropriate shocks were caused by atrial fibrillation with rapid ventricular responses, T wave oversensing or electromagnetic interference. Major complications of ICD therapy during follow-up included ICD infection, lead problems, electromagnetic interference and generator malfunction. CONCLUSIONS: The three major cardiovascular diseases in patients with ICD implantation were post MI VT, Brugada syndrome and hypertrophic CM. Inappropriate shocks were delivered to a significant proportion of the patients, which emphasize the need for an aggressive rate control strategy in patients with atrial fibrillation. Most complications of ICD therapy were caused by device malfunction.
Subject(s)
Female , Humans , Male , Atrial Fibrillation , Brugada Syndrome , Cardiomyopathy, Hypertrophic , Cardiovascular Diseases , Death, Sudden, Cardiac , Defibrillators , Electrophysiologic Techniques, Cardiac , Follow-Up Studies , Infarction , Magnets , Retrospective Studies , Shock , Tachycardia, VentricularABSTRACT
BACKGROUND AND OBJECTIVES: The postoperative outcomes of patients with severe aortic regurgitation (AR) and a low ejection fraction (EF) were elucidated. SUBJECTS AND METHODS: The study group consisted of 201 consecutive patients that underwent corrective surgery for isolated AR. The clinical data of patients with a preoperative EF or =50% (n=142, group II) were compared. The clinical follow-up duration was 3.2+/-2.4 years. RESULTS: There was no operative mortality for patients in both groups. Group I patients showed significant improvement of the EF after surgery, from 41+/-6% to 53+/-12% (p<0.001) and the EF (53+/-12 vs 56+/-1%, p=0.09) at follow-up was not significantly different between patients in the two groups. The 5-year survival rate was 70.5+/-8.9% for group I patients and 88.0+/-3.5% for group II patients (p=0.06). The cumulative incidence of congestive heart failure at 5 years was significantly higher in group I patients (32.1+/-9.7% vs 8.5+/-3.1%, p=0.003). Independent determinants of development of congestive heart failure in group I patients were age [hazards ratio (HR)=1.1, 95% confidence interval (CI)=1.02-1.16, p=0.01] and EF (HR=0.82, 95% CI=0.69-0.97, p=0.02). The best cut-off value of the preoperative EF in predicting the development of congestive heart failure was 41.5%, with a sensitivity and specificity of 90.9% and 68.9%, respectively. CONCLUSION: A relatively high 5-year survival rate without operative mortality is anticipated in patients with reduced a preoperative left ventricular ejection fraction (LVEF) and the incidence of congestive heart failure was higher when compared to patients with a normal preoperative LVEF, which could be predicted by the level of the preoperative LVEF.
Subject(s)
Humans , Aortic Valve Insufficiency , Echocardiography , Follow-Up Studies , Heart Failure , Incidence , Mortality , Sensitivity and Specificity , Stroke Volume , Survival Rate , Ventricular Dysfunction, LeftABSTRACT
Uterine perforation is a serious complication in users of intrauterine devices for contraception. Authors encountered one case of displacement of Copper-T IVD into urinary blpossibly due to uterine perforation on insertion of the Copper-T IUD in a 28 year old 1-multipara, who experienced normal intrauterine pregnancy in the circumstances. This patient was in silent, asymptomatic condition and underwent cesarean section. And Copper-T IUD was removed under the cystotomy. So we report one case with brief review of literatures
Subject(s)
Adult , Female , Humans , Pregnancy , Asymptomatic Diseases , Cesarean Section , Contraception , Copper , Cystotomy , Intrauterine Devices , Urinary Bladder , Uterine PerforationABSTRACT
No abstract available.