ABSTRACT
Introduction: The superior vena cava (SVC) is an important non-pulmonary venous foci of atrial fibrillation (AF) and is known as the arrhythmogenic site of scar-related atrial tachycardia (AT). Scar-related ATs may occur after catheter ablation and open heart surgery; however, idiopathic AT rarely occurs. Case Presentation. A 77-year-old male with terminal diabetic nephropathy complained of dialysis-induced hypotension due to AF and was admitted to our hospital for catheter ablation. Here, we report a case of non-iatrogenic localized-reentrant figure of eight AT in the SVC. Conclusion: SVC has the arrhythmogenic potential for re-entrant tachycardia, and the development of mapping technology can reveal arrhythmogenic mechanisms.
Subject(s)
Cardiac Surgical Procedures/methods , Cardiomyopathy, Hypertrophic/surgery , Catheter Ablation/methods , Electrophysiologic Techniques, Cardiac , Heart Aneurysm/surgery , Plastic Surgery Procedures/methods , Surgery, Computer-Assisted , Tachycardia, Ventricular/surgery , Aged , Cardiomyopathy, Hypertrophic/complications , Cardiomyopathy, Hypertrophic/diagnosis , Cardiomyopathy, Hypertrophic/physiopathology , Electrocardiography , Female , Heart Aneurysm/complications , Heart Aneurysm/diagnosis , Heart Aneurysm/physiopathology , Humans , Predictive Value of Tests , Recovery of Function , Recurrence , Tachycardia, Ventricular/diagnosis , Tachycardia, Ventricular/etiology , Tachycardia, Ventricular/physiopathology , Treatment Outcome , Ventricular Function, LeftABSTRACT
Takotsubo cardiomyopathy (TCM) is a poorly understood condition in which patients with chest pain have a transient ampulla-shaped abnormality of the left ventriculogram, and intact coronary arteries. We report TCM in combination with autoimmune polyendocrine syndrome type II (APS II), which raises new questions about the pathogenesis of TCM.
Subject(s)
Takotsubo Cardiomyopathy/complications , Humans , Male , Middle Aged , Polyendocrinopathies, Autoimmune/complications , Takotsubo Cardiomyopathy/etiologyABSTRACT
The objective of the present prospective multicenter case-control study was to investigate the long-term clinical outcome (5 years) of primary stenting compared to primary percutaneous transluminal coronary angioplasty (PTCA) without stenting (POBA) in patients with acute myocardial infarction at 7 cardiovascular centers in Hokkaido, Japan. Forty-one patients with acute myocardial infarction treated with successful primary stenting (stent group: case) and paired with 41 matched control subjects with acute myocardial infarction treated by successful primary PTCA without stenting (POBA group: control) were analyzed. After 1 year, the stent group had a lower incidence of the combined clinical endpoint (death, rehospitalization due to congestive heart failure, nonfatal myocardial infarction, repeat angioplasty, CABG, or cerebrovascular events) compared to the POBA group (17.1% versus 39.0%, P = 0.049). After 5 years, the incidences of congestive heart failure and cardiac death were the same in both groups. However, compared to the POBA group, the stent group had a lower combined clinical endpoint (34.1% versus 61.0%, P = 0.027). The Kaplan-Meier event-free survival curves of the stent group showed a significantly lower occurrence of clinical events compared to the POBA group (P = 0.0116). Multiple logistic regression analysis of clinical events identified age > or = 69 years (P = 0.0092, odds ratio = 4.179) and stenting (P = 0.0158, odds ratio = 0.279) as explanatory factors. Compared with POBA, primary stenting for acute myocardial infarction results in a better long-term clinical outcome.
