Division of Cardiac Electrophysiology, Department of Cardiology, Methodist Hospital, Houston, Texas. Electronic address:
Published: March 2017
AI Article Synopsis
Article Abstract
Objectives: The goal of this study was to describe short- and long-term outcomes in all patients referred for inappropriate sinus tachycardia ablation, along with the potential complications of the intervention.
Background: Sinus node (SN) ablation/modification has been proposed for patients refractory to pharmacological therapy. However, available data derive from limited series.
Methods: The electronic databases MEDLINE, Embase, CINAHL, Cochrane, and Scopus were systematically searched (January 1, 1995-December 31, 2015). Studies were screened according to predefined inclusion and exclusion criteria.
Results: A total of 153 patients were included. Their mean age was 35.18 ± 10.02 years, and 139 (90.8%) were female. All patients had failed to respond to maximum tolerated doses of pharmacological therapy (3.5 ± 2.4 drugs). Mean baseline heart rates averaged 101.3 ± 16.4 beats/min according to electrocardiography and 104.5 ± 13.5 beats/min according to 24-h Holter monitoring. Two electrophysiological strategies were used, SN ablation and SN modification, with the latter being used more. Procedural acute success (using variably defined pre-determined endpoints) was 88.9%. Consistently, all groups reported high-output pacing from the ablation catheter to confirm absence of phrenic nerve stimulation before radiofrequency delivery. Need of pericardial access varied between 0% and 76.9%. Thirteen patients (8.5%) experienced severe procedural complications, and 15 patients (9.8%) required implantation of a pacemaker. At a mean follow-up interval of 28.1 ± 12.6 months, 86.4% of patients demonstrated successful outcomes. The symptomatic recurrence rate was 19.6%, and 29.8% of patients continued to receive antiarrhythmic drug therapy after procedural intervention.
Conclusions: Inappropriate sinus tachycardia ablation/modification achieves acute success in the vast majority of patients. Complications are fairly common and diverse. However, symptomatic relief decreases substantially over longer follow-up periods, with a corresponding high recurrence rate.
Department of Functional Sciences, Equine Division, Sports Medicine Section, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium. Electronic address:
A Standardbred racehorse was presented for exercise intolerance, weight loss, pyrexia and facial deformity. Radiography and ultrasonography revealed periostitis and regional soft tissue swelling of maxillary bones. Computed tomography excluded any dental or sinus origin of these abnormalities.
Sinusitis is common in horses. Sinoscopy is used for visualization of sinus cavities and can be used for diagnostic and therapeutic purposes. In this surgical procedure, a larger chamber is created and communication with other sinus compartments facilitated.
Background- Subclinical electrophysiological derangements occur at birth in foals. Smartphone-based ECG (spECG) is practical tools to assess heart rhythm and was recently validated in foals. Objectives-To assess the heart rate (HR) and rhythm at birth in clinically healthy foals born after spontaneous and induced parturition using a spECG.
In-office tympanostomy tube insertion (TTI) is becoming more available in the practice of pediatric otolaryngology. This study evaluated the tolerability of this procedure in young children. Four methods were used to assess tolerability.
