ABSTRACT
A case of a 48-year-old male admitted to the hospital because of recurrent chest pain, is described. Further diagnostic tests did not confirm ischemia, but revealed the presence of arrhythmogenic right ventricular cardiomyopathy. During hospital stay, the patient developed syncopal episode due to ventricular tachycardia. A cardioverter-defibrillator was implanted.
Subject(s)
Arrhythmogenic Right Ventricular Dysplasia/complications , Arrhythmogenic Right Ventricular Dysplasia/therapy , Chest Pain/etiology , Defibrillators, Implantable , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
Heart pacing with algorithms preventing episodes of paroxysmal atrial fibrillation (PAF) is one of the modern methods of PAF treatment. The usefulness of AF suppression TM pacing algorithm in Integrity AFx DR pacing was evaluated. The study group consisted of 7 patients with paroxysmal AF (for average 2,5 year; requiring on average 6 cardioversions in ICCU per year) and standard pacemaker indications. The small number of enrolled patients resulted from high cost of the pacemaker. In our study we turned on AF suppression TM pacing algorithm 3 months after pacemaker implantation and evaluated the number of PAF episodes at 3 and 6 months. Pharmacotherapy was not changed. Antiarrhythmic stimulation resulted in reduction of the number of PAF (on average by 11) at 3 months and was well-tolerated by the patients. AF Suppression(tm) pacing algorithm is effective only if PAF is preceded by supraventricular extrasystole.
Subject(s)
Algorithms , Anti-Arrhythmia Agents/therapeutic use , Atrial Fibrillation/therapy , Bradycardia/therapy , Cardiac Pacing, Artificial/methods , Adult , Aged , Atrial Fibrillation/complications , Bradycardia/complications , Cross-Over Studies , Female , Humans , Male , Middle Aged , Sick Sinus Syndrome/therapyABSTRACT
BACKGROUND: Atrial fibrillation (AF) in patients with WPW syndrome may be a life-threatening arrhythmia. AIM: To identify risk factors of AF and their prognostic significance in patients with WPW syndrome. METHODS: Clinical and electrophysiological parameters of 239 patients with WPW syndrome, who underwent successful RF ablation, were analysed using logistic regression and multivariate analysis. One hundred eight patients had no history of AF whereas the remaining 81 patients had previous spontaneous AF episodes. Long-term follow-up data (mean 29+/-23 months, range 1-99 months) were available in 136 patients (87 without AF and 49 with AF). RESULTS: Patients with AF were significantly older, more frequently of male gender and had more often a history of syncope than patients without AF. There were two peaks of AF occurrence - in the third and in the fifth decade of life. Fourteen patients had a history of ventricular fibrillation - 11 patients with AF vs 3 patients without AF (p=0.0016). Patients with a history of AF were more prone to AF induced during electrophysiological study and had less frequently concealed accessory pathways. CONCLUSIONS: Age, gender and a history of syncope are the independent risk factors of AF in patients with WPW syndrome. Anterograde conduction via accessory pathway is of major importance in the development of AF. RF ablation of an accessory pathway should be performed early because the risk of the procedure is small and there is an increasing risk of AF with ageing.
