Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 4 de 4
Filter
1.
Pacing Clin Electrophysiol ; 38(2): 209-15, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25469902

ABSTRACT

BACKGROUND: Catheter ablation of idiopathic left ventricular tachycardia in the pediatric population remains challenging. A recent multicenter study reported limited success with 14% not undergoing ablation due to inability to induce ventricular tachycardia (VT) or blood pressure instability during tachycardia. Creating complete or partial fascicular block with radiofrequency catheter ablation is a technique that may eliminate VT. This approach is performed during sinus rhythm, enabling atrioventricular conduction monitoring and maintaining stable hemodynamics. Importantly, induction of VT is not necessary for mapping or assessing efficacy of the procedure. METHODS: A retrospective review of pediatric patients (3-17 years) with recurrent, documented idiopathic left ventricular tachycardia by electrocardiogram who received catheter ablation by creating fascicular block as a therapeutic endpoint was performed. All had ablation at the site of an identified Purkinje potential. RESULTS: There were six patients with idiopathic left ventricular tachycardia, five originating from the posterior fascicle and one from the anterior fascicle. VT was not induced or spontaneous in four patients using programmed stimulation and isoproterenol infusion. All patients had a QRS axis shift following ablation, though none met criteria for fascicular block. At follow up (7-49 months, mean 27 months), all patients had persistence of this shift. There were no recurrences of VT and none of the patients were taking antiarrhythmic medication. CONCLUSION: The technique of creating partial fascicular block appears to be a safe and effective approach to ablation of idiopathic left ventricular tachycardia in children.


Subject(s)
Bundle-Branch Block/surgery , Catheter Ablation/methods , Heart Conduction System/surgery , Nerve Block/methods , Tachycardia, Ventricular/surgery , Ventricular Dysfunction, Left/surgery , Adolescent , Bundle-Branch Block/complications , Bundle-Branch Block/diagnosis , Child , Child, Preschool , Female , Humans , Male , Tachycardia, Ventricular/complications , Tachycardia, Ventricular/diagnosis , Treatment Outcome , Ventricular Dysfunction, Left/diagnosis , Ventricular Dysfunction, Left/etiology
2.
Pediatr Cardiol ; 33(4): 652-5, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22311567

ABSTRACT

This report describes a teenager found to have both Addision's disease and long-QT syndrome type 1. This association is unique, but congenital long-QT channelopathies have been associated with other endocrinopathies. It remains to be seen whether genetic investigation should be performed for all patients with long-QTc's and endocrinopathies.


Subject(s)
Addison Disease/complications , Electrocardiography , Long QT Syndrome/congenital , Addison Disease/diagnosis , Adolescent , Diagnosis, Differential , Follow-Up Studies , Humans , Long QT Syndrome/complications , Long QT Syndrome/diagnosis , Male
3.
J Interv Card Electrophysiol ; 29(1): 69-72, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20386974

ABSTRACT

Late sequelea following a Mustard operation for transposition of the great arteries (TGA) include atrial arrhythmias and dysfunction of the systemic right ventricle. Catheter mapping and ablation of atrial tachycardia in the setting of significant right ventricular dysfunction may result in hemodynamic compromise. We report the novel use of the Impella percutaneous microaxial flow pump to support cardiac output in an adult patient with a Mustard operation for TGA who experienced a cardiac arrest during a prior ablation attempt. The Impella device was placed via a retrograde approach across the aortic valve into the right ventricle providing hemodynamic stability for successful mapping and ablation of intra-atrial reentrant tachycardia.


Subject(s)
Cardiac Pacing, Artificial/methods , Catheter Ablation/methods , Heart-Assist Devices , Tachycardia, Ectopic Atrial/surgery , Transposition of Great Vessels/surgery , Adult , Body Surface Potential Mapping , Cardiac Output/physiology , Cardiac Surgical Procedures/methods , Combined Modality Therapy , Electrocardiography , Follow-Up Studies , Hemodynamics/physiology , Humans , Male , Severity of Illness Index , Tachycardia, Ectopic Atrial/diagnosis , Tachycardia, Ectopic Atrial/therapy , Transposition of Great Vessels/complications , Transposition of Great Vessels/diagnosis , Treatment Outcome
4.
J Sch Nurs ; 21(4): 200-7, 2005 Aug.
Article in English | MEDLINE | ID: mdl-16048364

ABSTRACT

Syncope and near-syncopal symptoms are common events in the adolescent population. Syncope is defined as the transient loss of postural tone and consciousness with spontaneous recovery. Although most syncopal events are benign, they can generate extreme anxiety in the adolescent and his or her family. The re-occurrence of these events can have a negative impact on an adolescent's participation in daily activities. Understanding the process of assessment, diagnosis, and management of these teens can enable the school nurse to augment initial assessment and to support the prescribed treatment plan. This knowledge then can be used to help allay the adolescent's anxiety and to support efforts at self-management. This article explores current literature in regards to etiology, diagnosis, and medical treatment, and advocates a self-management protocol for neurally mediated syncope in the adolescent population with support of that plan by the school nurse.


Subject(s)
Health Knowledge, Attitudes, Practice , Nurse's Role , School Health Services/standards , School Nursing/standards , Syncope , Activities of Daily Living , Adolescent , Adolescent Behavior/psychology , Adolescent Health Services/standards , Anxiety/prevention & control , Depression/prevention & control , Humans , Patient Education as Topic/standards , Psychology, Adolescent , Risk Factors , Syncope/diagnosis , Syncope/etiology , Syncope/nursing , United States
SELECTION OF CITATIONS
SEARCH DETAIL
...