ABSTRACT
LVNC (left ventricular non-compaction) is a rare congenital cardiomyopathy with a reported incidence of 0.05% in adults. It can occur in isolation or affect both ventricles. It’s characterized by prominent LV trabeculae and deep intertrabecular recesses which are filled with blood from the ventricular cavity without evidence of communication to the epicardial coronary artery system. Frequent premature supra ventricular tachycardia as unique finding in LVNC cardiomyopathy is rare manifestation of this disease. We report a case of a frequent persistent supraventricular tachycardia as first manifestation of a patient with LVNC cardiomyopathy in a young healthy woman who despite radio frequency ablation therapy of the supraventricular tachycardia remains symptomatic. The patient was later placed on medical therapy based on a non-cardio selective beta-blocker with a good clinical outcome without recurrent of supra-ventricular arrythmias.
ABSTRACT
Objective To observe the effect of propafenone for patients with paroxysmal supra-ventricular tachycardia (PSVT) during pre-hospital emergency rescue treatment. Methods A retrospective study was conducted. Seventy-six patients with occurrence of PSVT in the process of pre-hospital emergency treatment in Tianjin Hongqiao Hospital from March 2018 to March 2019 were selected. The patients were divided into amiodarone group and propafenone group according to the difference in medications, 38 cases in each group. The effective rate of rescue, the time of recovery of normal heart rate, the total time of treatment, the levels of heart rate before and after treatment and the incidence of adverse reactions were observed in both groups. Results The total effective rate of propafenone group was significantly higher than that of amiodarone group [94.74% (36/38) vs. 73.68% (28/38), P<0.05]. The times of recovery of normal heart rate and total treatment of propafenone group were significantly lower than those of amiodarone group [times of recovery of normal heart rate (hours): 7.14±1.84 vs. 12.56 ± 2.56, times of total treatment (days): 6.14 ± 2.20 vs. 8.87±2.48, both P<0.05].Before treatment, there was no statistical significant difference in heart rate between propafenone group and amiodarone group (hpm: 171.8 ± 24.4 vs. 173.7 ± 25.5, P>0.05), but after treatment, the heart rate of propafenone group was significantly lower than that in amiodarone group (hpm: 112.9±7.5 vs. 138.4 ± 9.0, P<0.05). The incidence of adverse reactions in propafenone group was significantly lower than that of amiodarone group [2.63% (1/38) vs. 15.79% (6/38), P<0.05]. Conclusion Application of propafenone in the pre-hospital emergency treatment of patients with PSVT can effectively improve their clinical efficacy, and its therapeutic safety is high.
ABSTRACT
Arrhythmogenic Right Ventricular Dysplasia (ARVD) is under diagnosed cardiomyopathy which commonly presents in young adults with ventricular tachycardia or sudden death. It is characterized pathologically by progressive fibrofatty replacement of the myocardium, primarily of the right ventricular free wall. Clinically, it presents with life-threatening malignant ventricular arrhythmias which may lead to sudden death, most often in young people and athletes. ARVD/C is difficult to diagnose, although standardized diagnostic criteria have been proposed, based on the presence of major and minor criteria encompassing electrocardiographic, arrhythmic, morphofunctional, histopathologic, and genetic factors.
ABSTRACT
Objective: To explore the feasibility and safety of three dimensional (3D) electro-anatomical mapping system (Carto3) in treating the patients with paroxysmal supra-ventricular tachycardia (PSVT) by radiofrequency catheter ablation (RCFA). Methods: A total of 180 PSVT patients were divided into 2 groups, n=90 in each group. 3-D group, the patients received RCFA with 3-D reconstructed valve ring model under Carto3 guidance. 2-D group, the patients received RCFA under conventional X-ray guidance. The procedural and X-ray exposure times, rates of success and complications, tachycardia recurrence at 6 months after procedure and the cost were observed and compared between 2 group. Results: The procedural time was similar between 2 groups, P=0.1403. The patients in 3-D group had the lower X-ray exposure time (2.1 ± 0.7 vs 7.8 ± 3.6) min, particularly in those with right-sided accessory pathway (3.4 ± 0.7 vs 20.2 ± 7.1) min, and dual atrio-ventricular (A-V) nodal pathways (1.1 ± 0.3 vs 5.5 ±1.7) min, all P Conclusion: RFCA was feasible for treating PSVT patients under Carto3 guidance, which had the higher success rate with lower X-ray exposure and complication.