ABSTRACT
22 year old woman with no previous heart disease history, presented with progressive worsening of right heart failure symptoms due to severe tricuspid valve regurgitation which had become refractory to medical management. Echocardiogram revealed probable rare case of dysplastic tricuspid valve with large calcified mobile masses attached to leaflets. Calcified masses were thought to be due to healed vegetations from silent infective endocarditis of abnormal tricuspid valve which she had suffered in the past. There were no known acquired causes of tricuspid valve endocarditis. She had successfully undergone tricuspid valve replacement with bio-prosthetic valve along with a right atrial reduction surgery after which her heart failure symptoms improved markedly.
Subject(s)
Ebstein Anomaly/epidemiology , Ebstein Anomaly/surgery , Endocarditis/surgery , Female , Heart Failure/surgery , Heart Valve Diseases/surgery , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation/instrumentation , Heart Valve Prosthesis Implantation/methods , Humans , Tricuspid Valve , Young AdultABSTRACT
Non-surgical transpericardial approach for catheter-based epicardial radiofrequency ablation of post-infarction left ventricular tachycardia has been described as an alternative and additive procedure to standard endocardial technique for delivery of radiofrequency energy in difficult situations. We report our initial experience with this approach in three patients of post-infarction recurrent ventricular tachycardia, refactory to multiple antiarrhythmic drugs. Ablation was successful in terminating the tachycardia in two and in modifying the circuit to be amenable for control with single antiarrhythmic drug in one patient. There were no serious acute or long-term complications related to the procedure. Epicardial approach is an effective and safe adjunct to standard endocardial ablative technique for patients of post-infarction ventricular tachycardia.
Subject(s)
Aged , Catheter Ablation , Humans , Male , Middle Aged , Myocardial Infarction/complications , Tachycardia, Ventricular/etiologyABSTRACT
The congenital form of His bundle tachycardia is an uncommon pediatric arrhythmia. We report the case of a 7-year-old child with tachycardiomyopathy. The incessant arrhythmia, detected in infancy, was resistant to amiodarone and beta-blockers. During electrophysiologic study, the tachycardia converted to sinus rhythm with intravenous adenosine and diltiazem. Subsequently, the child is maintaining sinus rhythm on oral verapamil. Calcium-channel blockers should be considered for the treatment of this arrhythmia, which is often resistant to multiple antiarrhythmic drugs.
Subject(s)
Adenosine/therapeutic use , Anti-Arrhythmia Agents/therapeutic use , Bundle of His/abnormalities , Calcium Channel Blockers/therapeutic use , Child , Diltiazem/therapeutic use , Drug Resistance/drug effects , Electrocardiography , Female , Humans , Metoprolol/therapeutic use , Tachycardia, Ventricular/diagnosis , Ventricular Dysfunction, Left/diagnosisABSTRACT
A one-year-old child with a structurally normal heart presented with monomorphic ventricular tachycardia. Electrocardiogram in sinus rhythm showed right bundle branch block with ST segment elevation suggesting a diagnosis of Brugada syndrome. At a later date, when the ST segment was isoelectric. intravenous procainamide caused ST elevation typical of Brugada syndrome.