Radiofrequency atrial flutter and atrial fibrillation ablation in a patient with deep brain stimulation.

Radiofrequency ablation for atrial fibrillation or atrial flutter is feasible in patients with deep brain stimulation but with extreme caution given the possibility of life-threatening complications.

A very unusual wide QRS tachycardia: VT or SVT?

Introduction: A 13 old girl presented with recurrent wide QRS tachycardia since she was 4.

Methods: An electrophysiologic study was performed.

Results: The electrophysiologic study showed that QRS complexes identical to those of the tachycardia could be elicited with premature atrial extrastimuli but with a shorter atrioventricular (AV) delay when the QRS was wide compared with narrow QRS complexes.

Slow pseudo sinus rhythm and atrial tachycardia of right superior venous pulmonary origin.

Paroxysmal atrial tachycardia usually presents as a sudden acceleration of the atrial rate combined with modifications of the P wave morphology. A 22-year-old patient presented with very fast and very slow atrial ectopic activity. He complained of repetitive episodes of fast tachycardia, some accompanied with dizziness.

Uncommon presentation of a common arrhythmia.

This case report demonstrates that atrioventricular and ventricular atrial conduction at rest may be unreliable in assessing the presence of reentrant atrioventricular nodal tachycardia.

D-dimer blood concentrations to exclude left atrial thrombus in patients with atrial fibrillation.

Objective: Left atrial (LA) thrombus is routinely excluded by transoesophageal echocardiography (TOE) before cardioversion for non-valvular atrial fibrillation (AF). In the D-dimer blood concentrations to exclude LA thrombus in patients with AF study, two D-dimer cut-offs were compared to exclude LA thrombus prior to cardioversion. One was fixed to 500 ng/mL (DD500), based on clinical practice where such values are commonly accepted to exclude a thrombus.

A recurrent concealed parahisian accessory pathway.

This case demonstrates the interest of ablating in the aortic root in case of resistant parahisian accessory pathways with failure of the right side approach. Failure on the right side may be due to fear of creating an AV block of failure to ablate critical fibers in the parahisian position.

Quality assessment in Belgian arrhythmology: the Belgian heart rhythm association (BeHRA) databases.

This report presents and discusses, on behalf of the Belgian College of Cardiology, the evolution of the peer review process in arrhythmology, focussing on pacemaker implantation. Data from the last 22 years are compared. The national annual increase in implants is around 1%, clinical patient characteristics remained stable over the years while dual chamber pacing was proportionally increasing.

The left atrial septal pouch as a risk factor for stroke: A systematic review.

The left atrial septal pouch (LASP) is formed by incomplete fusion of the septum primum and septum secundum, leaving a cavity open towards the left atrium, but without interatrial shunting. There is no recommendation concerning strategy in the presence of a LASP, especially in the setting of stroke. The aim of this review was to determine whether the LASP could be incriminated as the aetiology of a stroke.

Multicentre evaluation of non-invasive biatrial mapping for persistent atrial fibrillation ablation: the AFACART study.

Aims: Non-invasive electrocardiogram (ECG) mapping allows the activation of the entire atrial epicardium to be recorded simultaneously, potentially identifying mechanisms critical for atrial fibrillation (AF) persistence. We sought to evaluate the utility of ECG mapping as a practical tool prior to ablation of persistent AF (PsAF) in centres with no practical experience of the system.

Methods And Results: A total of 118 patients with continuous AF duration <1 year were prospectively studied at 8 European centres.

Does diffuse irrigation result in improved radiofrequency catheter ablation? A prospective randomized study of right atrial typical flutter ablation.

Aims: Recent developments of open irrigated catheters have sought to create uniform cooling of the entire ablating electrode. The aim of this randomized study was to assess whether the diffuse irrigation of the Coolflex(®) (CF) catheter results in improved short-term procedural benefits in patients undergoing ablation of right atrial typical flutter.

Methods And Results: Sixty consecutive patients (age 62 ± 13) with typical atrial flutter were prospectively randomized to ablation of the cavotricuspid isthmus (CTI) using either a standard 3.

Does congenital heart disease severely jeopardise family life and pregnancies? Obstetrical history of women with congenital heart disease in a single tertiary centre.

Aim: Women with congenital heart disease are often considered to be restricted in their obstetrical life and even their marital life. Our single-centre study aimed to determine the real-life situation of these women with regard to successful family life and any pregnancy complications they may experience.

Methods: From our database of adults with congenital heart disease, 160 of 178 women completed a questionnaire and had their files reviewed.

Long-term electrocardiographic follow-up after repair of tetralogy of Fallot.

Background: Fallot patients with conduction disturbances are prone to sudden cardiac death. However, knowledge about long-term electrocardiographic changes after Fallot repair is limited.

Methods: Measurements were performed on electrocardiograms recorded preoperatively, postoperatively, and during annual follow-up in 35 Fallot patients included in three groups: G1 if they received no patch (n = 7), G2 if they received a transannular patch (n = 13), and G3 if they received a pulmonary homograft (n = 15).

Is there a potential benefit to increased irrigation channels during radiofrequency ablation? Results from a two-center prospective randomized study.

Introduction: Open irrigation during radiofrequency (RF) application allows a higher power delivery in the setting of temperature-controlled ablation, without causing blood clots. This study sought to evaluate the clinical value of the additional 6 supplementary channels at the proximal catheter tip compared to a standard irrigated RF catheter with 6 conventional channels present at the distal tip only.

Methods And Results: Ninety-five consecutive patients were prospectively randomized to cavotricuspid isthmus ablation using an 3.

Complicated forms of tachycardia-mediated cardiomyopathy associated with idiopathic left ventricular tachycardia.

Idiopathic left ventricular tachycardia is an infrequent form of ventricular tachycardia associated with a structurally normal heart. The prognosis is usually benign; however, sustained cases have been reported. In this report, we describe two cases of persistent idiopathic left ventricular tachycardia complicated by tachycardia-mediated cardiomyopathy.

Prevalence of preoperative arrhythmias in children with delayed treatment of severe congenital heart disease.

Aim: Our aim was to determine the real importance of rhythm and conduction disorders in children with unoperated severe congenital heart disease.

Methods: Consecutive children with delayed treatment of severe congenital heart disease were prospectively studied for the occurrence of arrhythmias before any invasive investigation or surgical procedure was performed.

Results: All 168 children were in sinus rhythm.

Long-term follow-up of idiopathic ventricular fibrillation ablation: a multicenter study.

Objectives: This multicenter study sought to evaluate the long-term follow-up of patients ablated for idiopathic ventricular fibrillation (VF).

Background: Catheter ablation of idiopathic VF that targets ventricular premature beat (VPB) triggers has been shown to prevent VF recurrences on short-term follow-up.

Methods: From January 2000, 38 consecutive patients from 6 different centers underwent ablation of primary idiopathic VF initiated by short coupled VPB.

Multidetector 16-slice CT scan evaluation of cavotricuspid isthmus anatomy before radiofrequency ablation.

Introduction: The anatomy of the cavotricuspid isthmus (CTI) is an important determinant of the ease of radiofrequency ablation. We evaluated the anatomy of the region with a multidetector 16-slice computed tomography (CT) scan and correlated this with subsequent procedural difficulty.

Methods: Twenty-nine patients (mean age 64 +/- 15 years) with typical atrial flutter or paroxysmal atrial fibrillation underwent ablation of the CTI.