RESUMO
Slow pathway (SP) ablation is an acceptable, standard method for atrioventricular nodal re-entrant tachycardia (AVNRT) ablation. The exact role of SP in the human heart and the possible negative implications of SP ablation are unknown. The current case report describes an unusual, brief, functional heart block, following radiofrequency ablation of the SP. Our findings highlight the peculiar property of the SP in maintaining conduction over an atrioventricular (AV) node, in circumstances of extreme autonomic imbalance. SP can be ablated without major conduction problems for AVNRT. Careful pre-ablation evaluation of the AV conduction pattern may assist in predicting occurrences of this type of heart block.
RESUMO
Primary cardiac sarcomas are rare tumors with unfavorable prognosis. We report a 69-year-old male with a right ventricular mass diagnosed as primary malignant cardiac sarcoma with unexpected long survival of 16.5 months.
RESUMO
Coronary artery spasm is an infrequently recognized condition that causes Prinzmetal's angina and specific electrocardiographic changes. A 50-year-old man who suffered a spontaneously aborted acute inferior myocardial infarction is presented. He underwent cardiac catheterization, which initially showed a normal coronary artery. The coronary angiogram was repeated shortly after a second presentation of acute coronary syndrome and ventricular fibrillation. Coronary spasm of very proximal right coronary artery was present, which was reversed completely with intracoronary nitroglycerin. The spasm segment was first stented. Subsequently, an automatic implantable cardioverter defibrillator was inserted because of the uncertainty of future spasm recurrence. The patient was discharged with oral isosorbide dinitrate and Amlodipine. In further follow-up, the patient had two separate shocks within 4 months of implantation. Ventricular fibrillation was the trigger for the shock therapy in both occasions.
