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1.
BMC Cardiovasc Disord ; 17(1): 143, 2017 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-28577360

RESUMO

BACKGROUND: Air embolus penetrating into heart chamber as a complication during percutaneous radiofrequency catheter ablation has been infrequently reported. CASE PRESENTATION: A 55-year-old man with dextrocardia who suffered from abdominal pain was suspected to have multiple arterial thromboembolisms, which might have originated from left atrium thrombosis since he had atrial fibrillation. He received oral anticoagulant therapy and catheter ablation of the arrhythmia. During the ablation procedure, an iatrogenic aeroembolism penetrated into the left atrium due to improper operation. Ultimately, the entire air embolus was extracted from the patient, who was free of any aeroembolism events thereafter. CONCLUSIONS: It is essential for an operator to pay full attention to all details of the procedure to avoid an aeroembolism during catheter ablation. In case of aeroembolism, removal by aspiration is an optimal and effective treatment.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/efeitos adversos , Dextrocardia/complicações , Embolia Aérea/etiologia , Doença Iatrogênica , Administração Oral , Anticoagulantes/administração & dosagem , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Dextrocardia/diagnóstico por imagem , Eletrocardiografia , Embolia Aérea/diagnóstico por imagem , Embolia Aérea/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Intervencionista , Resultado do Tratamento
2.
Int J Cardiol ; 234: 1-6, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28256321

RESUMO

Trimetazidine (TMZ) has traditionally been used as an anti-ischemic drug for coronary artery disease by selectively inhibiting the mitochondrial long-chain 3-ketoacyl-CoA thiolase. Recently, new applications for this therapy have been investigated. This article reviews alternative uses for TMZ in non-coronary artery diseases, such as non-ischemic cardiomyopathy, sepsis, myocardial dysfunction induced by anti-cancer drugs, diabetic cardiomyopathy and contrast-induced nephropathy.


Assuntos
Antineoplásicos/efeitos adversos , Distúrbios Induzidos Quimicamente/tratamento farmacológico , Doença da Artéria Coronariana , Cardiomiopatias Diabéticas/tratamento farmacológico , Nefropatias , Trimetazidina/farmacologia , Acetil-CoA C-Aciltransferase/metabolismo , Distúrbios Induzidos Quimicamente/etiologia , Doença da Artéria Coronariana/tratamento farmacológico , Doença da Artéria Coronariana/metabolismo , Reposicionamento de Medicamentos , Humanos , Nefropatias/induzido quimicamente , Nefropatias/tratamento farmacológico , Mitocôndrias Cardíacas/metabolismo , Vasodilatadores/farmacologia
3.
Int J Cardiol ; 228: 666-671, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-27883979

RESUMO

BACKGROUND: N-terminal pro-brain natriuretic peptide (NT-proBNP) is seen to be mostly elevated in patients with acute heart failure (AHF). However, cases of AHF presenting with low NT-proBNP levels have been reported. In this study designed to investigate the factors associated with low NT-proBNP levels in AHF patients, we discovered that etiology and related factors have an influence on NT-proBNP levels. METHODS: In this study, 154 AHF patients met the study criteria (117 men, median age 74years; left ventricular ejection fraction [LVEF] 46±13%; New York Heart Association [NYHA] classes II-IV). We analyzed the different clinical variables of patients based on plasma NT-proBNP levels. In addition, we identified the differences in NT-proBNP levels between ischemic and non-ischemic etiologies, as well as the relationships between time from symptom onset to ED visit and NT-proBNP levels. RESULTS: The group with low NT-proBNP levels showed an ischemic association, higher LVEF, lower NYHA class and shorter time from symptom onset to ED visit. Plasma NT-proBNP levels were lower in the ischemic group than in the non-ischemic group (P<0.01). Meanwhile, NT-proBNP levels were relatively low in patients during early phases of AHF hospitalization and increased with time from symptom onset to ED visit (P<0.01). CONCLUSION: We inferred that low NT-proBNP levels may infer the ischemic etiology especially in patients with normal LVEF in the early phases of AHF hospitalization.


Assuntos
Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/diagnóstico , Isquemia Miocárdica/sangue , Isquemia Miocárdica/diagnóstico , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Estudos de Coortes , Serviço Hospitalar de Emergência , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/complicações , Volume Sistólico
4.
Medicine (Baltimore) ; 95(43): e5134, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27787367

RESUMO

INTRODUCTION: Atrial-esophageal fistula (AEF) is a rare severe disease, which may be associated with radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) or intraoperative radiofrequency ablation of atrial fibrillation (IRAAF). CLINICAL FINDINGS: We reported a case of a 67-year-old man with AEF following RFCA of AF, who treated with esophageal stenting and surgical repair. OUTCOMES: He was attacked by out-of-control sepsis and infectious shock after surgery and died. LITERATURE REVIEW: We analyzed 57 relevant articles about AEF from 2003 to 2015 by searching PubMed database. According literatures, the most common symptoms were fever, rigor, sepsis, and neurologic symptoms. Chest computer tomography (CT) and contrast enhanced CT may be the reliable noninvasive diagnosis methods because of high sensitive for AEF. CONCLUSION: Make a definition diagnosis in time with early primary surgical repair may save their lives. Conservative treatment or esophageal stenting alone may not be a better choice for AEF patients.


Assuntos
Fístula Esofágica/cirurgia , Esôfago/cirurgia , Átrios do Coração , Cardiopatias/cirurgia , Stents , Idoso , Fístula Esofágica/diagnóstico , Esôfago/diagnóstico por imagem , Fístula/diagnóstico , Fístula/cirurgia , Cardiopatias/diagnóstico , Humanos , Masculino , Tomografia Computadorizada por Raios X
5.
Zhonghua Xin Xue Guan Bing Za Zhi ; 40(7): 565-8, 2012 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-22943683

RESUMO

OBJECTIVE: To explore the feasibility and methodology of radiofrequency catheter ablation (RFCA) guided by 3D navigation system (Ensite-NavX) for right atrioventricular accessory pathway. METHOD: Thirty-three cases of right accessory pathway atrioventricular reentrant tachycardia including 16 cases in right free wall, 3 in right middle septum, 14 in right posterior septum; 23 cases of dominant accessory pathway and 10 cases of concealed were treated by RFCA guided by NavX navigation. NavX navigation modeling method or spatial localization method was exploited to locate target positioning. RESULT: All patients were successfully ablated without serious complications. Among them, 25 cases were operated without exposure to X-ray, 7 patients were exposed for several seconds to verify catheter position, 1 case in right free wall was ablated under X-ray combined with Swartz sheath ablation. CONCLUSION: Nonfluoroscopy or less fluoroscopy RFCA for right atrioventricular accessory pathway with Ensite-NavX is safe and feasible, modeling or spatial orientation method are helpful to locate the ablation target positioning.


Assuntos
Ablação por Cateter/métodos , Cirurgia Assistida por Computador , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Adolescente , Adulto , Idoso , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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