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Radiofrequency catheter ablation in patients with symptomatic atrial flutter/tachycardia after orthotopic heart transplantation

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Chinese Medical Journal 2006年第24期119卷 2036-2041页

作者： LI Yi-gang Gerian Gronefeld Carsten Israel LU Shang-biao WANG Qun-shan Stefan H Hohnloser Department of Cardiology Xinhua Hospital Shanghai Jiaotong University Shanghai 200092 China Department of Medicine Division of Cardiology J.-W.Goethe-University Frankfurt Germany

Background atrial tachycardia or flutter is common in patients after orthotopic heart transplantation. Radiofrequency catheter ablation to treat this arrhythmia has not been well defined in this setting. This study was conducted to assess the incidence of various symptomatic atrial arrhythmias and the efficacy and safety of radiofrequency catheter ablation in these patients. Methods Electrophysiological study and catheter ablation were performed in patients with symptomatic tachyarrhythmia. One Halo catheter with 20 poles was positioned around the tricuspid annulus of the donor right atrium, or positioned around the surgical anastomosis when it is necessary. Three quadripolar electrode catheters were inserted via the right or left femoral vein and positioned in the recipient atrium, the bundle of His position, the coronary sinus. Programmed atrial stimulation and burst pacing were performed to prove electrical conduction between the recipient and the donor atria and to induce atrial arrhythmias. Results Out of 55 consecutive heart transplantation patients, 6 males [（58±12） years] developed symptomatic tachycardias at a mean of （5±4） years after heart transplantation. Electrical propagation through the suture line between the recipient and the donor atrium was demonstrated during atrial flutter or during recipient atrium and donor atrium pacing in 2 patients. By mapping around the suture line, the earliest fragmented electrogram of donor atrium was assessed. This electrical connection was successfully ablated in the anterior lateral atrium in both patients. There was no electrical propagation through the suture line in the other 4 patients. Two had typical atrial flutter in the donor atrium which was successfully ablated by completing a linear ablation between the tricuspid annulus and the inferior vena cava. Two patients had atrial tachycardia which was ablated in the anterior septal and lateral donor atrium. There were no procedure-related complications. Patients w

关键词： atrial flutter atrial tachycardia heart transplantation ablation

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Giant androgen-producing adrenocortical carcinoma with atrial flutter: A case report and review of the literature

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World Journal of Clinical Cases 2021年第20期9卷 5575-5587页

作者： Mircea-Florin Costache Raluca-Elena Arhirii Simona-Juliette Mogos Corina Lupascu-Ursulescu Cezara-Ioana Litcanu Adi-Ionut Ciumanghel Catalina Cucu Cristina-Mihaela Ghiciuc Antoniu-Octavian Petris Nicolae Danila Surgery Clinic Saint Spiridon University Clinical Emergency HospitalIasi 700111Romania Cardiology Clinic Saint Spiridon University Clinical Emergency HospitalIasi 700111Romania Department of Endocrinology Faculty of MedicineGrigore T.Popa University of Medicine and PharmacyIasi 700115Romania Endocrinology Clinic Saint Spiridon University Clinical Emergency HospitalIasi 700111Romania Department of Radiology and Imaging Sciences Grigore T.Popa University of Medicine and PharmacyIasi 700115Romania Radiology Clinic Saint Spiridon University Clinical Emergency HospitalIasi 700111Romania Radiotherapy Clinic Regional Institute of OncologyIasi 700483Romania Anesthesia and Intensive Care Department Grigore T.Popa University of Medicine and PharmacyIasi 700115Romania Anesthesia and Intensive Care Department Saint Spiridon University Clinical Emergency HospitalIasi 700111Romania Histopatology Department Saint Spiridon University Clinical Emergency HospitalIasi 700111Romania Department of Pharmacology Clinical Pharmacology and AlgesiologyFaculty of MedicineGrigore T.Popa University of Medicine and PharmacyIasi 700115Romania Department of Cardiology Faculty of MedicineGrigore T.Popa University of Medicine and PharmacyIasi 700115Romania Surgery Clinic Faculty of MedicineGrigore T.Popa University of Medicine and PharmacyIasi 700115Romania

BACKGROUND Adrenocortical carcinoma(ACC),the second most aggressive malignant tumor,lacks epidemiological data worldwide;therefore,every new case can improve the understanding of the pathology and treatment of this *** SUMMARY We present the case of a 66-year-old Caucasian woman with a giant androgenproducing ACC(21 cm×17 cm×12 cm;2100 g),without metastases,which unusually presented with an acute onset of atrial flutter and congestive heart *** cardiac complications observed in our case support the hypothesis that androgen excess in women is a cardiovascular risk *** excess in women can be a rare cause of reversible dilated cardiomyopathy,therefore a comprehensive approach to the patient is essential to improve the recognition of androgen-secreting *** atrial flutter was remitted after initiation of drug treatment during *** severe heart failure was totally remitted at 6 mo after radical open surgery to remove the giant *** Radical open surgery to remove a giant androgen-producing ACC was the firstline treatment to cure the excess of androgen,which determined the total remission of cardiac complications at 6 mo after surgery in the women of this case report.

关键词： Adrenocortical carcinoma Adrenalectomy Androgen secreting tumor Heart failure atrial flutter Case report

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A Case Report of Radiofrequency Ablation of Typical atrial flutter Combined with atrial Tachycardia

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Cardiovascular Innovations and Applications 2021年第4期6卷 113-116页

作者： Chen Chun-hui Ning Li-ye Cardiovascular Medicine Department Dongguan Kanghua HospitalDongguan 523000China

A 63-year-old female patient with a history of pulmonary heart disease underwent radiofrequency ablation because of a persistent atrial fl *** mapping with the carto3 system confi rmed atrial fl utter counterclockwise reentry around the tricuspid *** ablation of the cavo-tricuspid isthmus line to bi-directional block was ***,tachycardia with the same cycle length was induced *** remapping,the tachycardia was confi rmed to be focal atrial tachycardia located in the crista *** ablation,the tachycardia was terminated and could not be induced again.

关键词： atrial flutter atrial tachycardia radiofrequency ablation

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Intraoperative sudden arrhythmias in cervical spine surgery adjacent to the stellate ganglion:A case report

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世界临床病例杂志 2023年第24期11卷 5789-5796页

作者： Jong-Hun Seo Su-Yeon Cho Ji-Hwan Park Jin-Young Seo Hyun-Young Lee Dong-Joon Kim Department of Neurosurgery Chosun University HospitalGwangju 61453South Korea Department of Anesthesiology and Pain Medicine Chosun University HospitalGwangju 61453South Korea Department of Anesthesiology and Pain Medicine College of MedicineChosun UniversityGwangju 61453South Korea

BACKGROUND atrial arrhythmias such as paroxysmal supraventricular tachycardia(PSVT)and atrial flutter(AF)are common in the perioperative *** commonly resolve ***,occasionally,they may continually progress to fatal arrhythmias or cause ***,prompt and appropriate management is *** SUMMARY A 46-year-old female patient diagnosed with cervical C6-7 radiculopathy characterized by decreased sensation in the right third,fourth and fifth fingers underwent C6-7 anterior cervical disc fusion *** showed PSVT and ventricular tachycardia during C6-7 disc ***,the patient remained *** treatment with esmolol and lidocaine for ventricular tachycardia was *** massage and Valsalva maneuver were attempted but PSVT did not *** surgery was paused,and the patient’s fraction of inspired oxygen was set to 100%.Adenosine was administered for pharmacological management of *** arrhythmia temporarily ***,it then transformed into *** was administered,which briefly decreased blood pressure,which immediately *** resumed while the patient was in normal sinus *** was discharged safely on postoperative day 6 without complications or ***,she is living a healthy life without arrhythmia *** Ganglia associated with cardiac arrhythmias in the surgical site should be identified during cervical spine surgery.

关键词： Supraventricular tachycardia atrial flutter Stellate ganglion Adenosine Diltiazem Case Report

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Repeated atrial arrhythmia induced by cochineal red poisoning:A case report

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World Journal of Clinical Cases 2023年第34期11卷 8184-8191页

作者： Hao Yang Yu-Jiao Wang Bao-Ping Xu Huai-Wen Peng Qing Xu Huai-Bin Yu Department of Intensive Care Unit Anhui Zhongke Gengjiu Hospital Affiliated To Anhui Medical UniversityHefei 230000Anhui ProvinceChina Graduate School Anhui University of Chinese MedicineHefei 230031Anhui ProvinceChina Department of Intensive Care Unit Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese MedicineLu’an 237000Anhui ProvinceChina

BACKGROUND Cochineal red is an organic compound widely used in food,cosmetics,pharmaceuticals,textiles,and other fields due to its excellent safety *** caused by eating foods containing cochineal red is rare,and repeated atrial arrhythmia due to cochineal red poisoning is even *** SUMMARY An 88-year-old Asian female patient was admitted to hospital due to a disturbance of *** hours prior to presentation,the patient consumed 12 eggs containing cochineal red over a period of 2 *** presentation,the patient was in a coma and had a score of 6 on the Glasgow Coma Scale(E2+VT+M4).The patient’s skin and mucous membranes were ***(ECG)revealed rapid atrial fibrillation without any signs of *** prescribed cedilan and fluid replacement for arrhythmia *** after admission,the atrial fibrillation corrected to a normal sinus *** the day 2 of admission,the patient had a sudden atrial flutter accompanied by hemodynamic instability and rapidly declining arterial oxygen saturation between 85%and 90%.The sinus rhythm returned to normal after two electrical *** days after admission,the skin color of the patient returned to normal,and the ECG results were *** patient was transferred out of the intensive care unit and eventually discharged after 12 d in *** the 2-mo follow-up visit,the patient was in good health with no recurrence of *** Although cochineal red is a safe,natural food additive,excessive consumption or occupational exposure can induce cardiac arrhythmias.

关键词： Cochineal red Poisoning Cardiac arrhythmias atrial fibrillation atrial flutter Case report

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Glucose lowering does not necessarily reduce cardiovascular risk in type 2 diabetes

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World Journal of Cardiology 2022年第4期14卷 266-270页

作者： Angeliki Bourazana Grigorios Giamouzis John Skoularigis Filippos Triposkiadis Andrew Xanthopoulos Department of Cardiology University Hospital of LarissaLarissa 41110Greece

Diabetes mellitus(DM)is a health condition characterized by glucose dysregulation and affects millions of people *** presentation of heart failure in diabetic cardiomyopathy extends over a wide phenotypic spectrum,commencing from asymptomatic,subclinical structural abnormalities to severely symptomatic biventricular dysfunction with increased mortality ***,the spectrum of systolic dysfunction in diabetic-induced heart failure is *** leads also to cardiac electrical remodeling reacting on various *** peptidase-4(DPP-4)inhibitors reduce glucagon and blood glucose levels by raising levels of the endogenous hormones glucagon-like-peptide 1 and glucose-dependent insulinotropic peptide and constitute a safe and effective glucose lowering treatment option in patients with type 2 *** DPP-4 inhibitors’efficacy regarding glycemic control,their effect on cardiovascular outcomes(myocardial infarction,stroke,hospitalization for heart failure,hospitalization for unstable angina,hospitalization for coronary revascularization,and cardiovascular death)in diabetic patients has been *** potential correlation between atrial flutter and DPP-4 inhibitors administration needs further investigation.

关键词： Dipeptidyl peptidase-4 inhibitors Diabetes mellitus Outcomes Metaanalysis Heart failure atrial flutter

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Electro-anatomic mapping of the right atrium:anatomic abnormality is an important substrate

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Chinese Medical Journal 2003年第3期116卷 22-26页

作者：方丕华 Nancy L Radtke Tony W Simmons Wesley K Haisty Jr Karthik Ramaswamy David M.Fitzgerald Department of Cardiology Fuwai HospitalChinese Academy of Medical SciencesBeijing 100037China Wake Forest University School of Medicine Winston-Salem North Carolina 27157 USA

Objective To map and compare the right atrium in patients with AF to those with atrioventricular nodal reentrant tachycardias (AVNRT, as control group) and to investigate the anatomical and electrophysiological abnormality of the right atrium in *** The anatomy and electrophysiology of right atrium and cavotricuspid isthmus were evaluated in 20 patients with AF (16 M/4 F, mean age 55.9±10.68 years) and 26 patients with AVNRT (9 M/17 F, mean age 47.50±19.56 years) during coronary sinus pacing at 600 ms prior to ablation with electro-anatomical mapping system. Right atrial volume (RAV), the length and width of cavotricuspid isthmus (IsL, IsW), unipolar and bipolar voltage in the right atrium (UniV-RA, BiV-RA) were measured and compared between patients with AF and those with AVNRT. Results RAV, IsL, IsW, UniV-RA, and BiV-RA were 143.22±40.72 vs 104.35±21.06 ml, 39.31±8.10 vs 32.42±9.77 mm, 30.54±7.48 vs 23.15±6.61 mm, 1.96±1.24 vs 1.53±0.91 mv and 1.47±1.47 vs 1.29±1.12 mv in AF and AVNRT *** The right atrial volume is larger; both the length and width of cavotricuspid isthmus are greater. Unipolar and bipolar voltages in the right atrium are higher in AF than in AVNRT, suggesting that the enlarged right atrium, increased length and width of cavotricuspid isthmus, and concomitant atrial hypertrophy are important substrates for initiation and perpetuation of typical AF.

关键词： atrial flutter right atrium electrophysiology

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Cardiovascular efficacy and safety of dipeptidyl peptidase-4 inhibitors:A meta-analysis of cardiovascular outcome trials

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World Journal of Cardiology 2021年第10期13卷 585-592页

作者： Dimitrios Ioannis Patoulias Aristi Boulmpou Eleftherios Teperikidis Alexandra Katsimardou Fotios Siskos Michael Doumas Christodoulos E Papadopoulos Vassilios Vassilikos Second Propedeutic Department of Internal Medicine Aristotle University of ThessalonikiHippokration General HospitalThessaloniki 54642Greece Third Department of Cardiology Aristotle University of ThessalonikiHippokration General HospitalThessaloniki 54642Greece

BACKGROUND Dipeptidyl peptidase-4(DPP-4)inhibitors are a generally safe and well tolerated antidiabetic drug class with proven efficacy in type 2 diabetes mellitus(T2DM).Recently,a series of large,randomized controlled trials(RCTs)addressing cardiovascular outcomes with DPP-4 inhibitors have been *** To pool data from the aforementioned trials concerning the impact of DPP-4 inhibitors on surrogate cardiovascular efficacy outcomes and on major cardiac *** We searched PubMed and grey literature sources for all published RCTs assessing cardiovascular outcomes with DPP-4 inhibitors compared to placebo until October *** extracted data concerning the following“hard”efficacy outcomes:fatal and non-fatal myocardial infarction,fatal and non-fatal stroke,hospitalization for heart failure,hospitalization for unstable angina,hospitalization for coronary revascularization and cardiovascular *** also extracted data regarding the risk for major cardiac arrhythmias,such as atrial fibrillation,atrial flutter,ventricular fibrillation and ventricular *** We pooled data from 6 trials in a total of 52520 patients with T2DM assigned either to DPP-4 inhibitor or ***-4 inhibitors compared to placebo led to a non-significant increase in the risk for fatal and non-fatal myocardial infarction[risk ratio(RR)=1.02,95%CI:0.94-1.11,I2=0%],hospitalization for heart failure(RR=1.09,95%CI:0.92-1.29,I2=65%)and cardiovascular death(RR=1.02,95%CI:0.93-1.11,I2=0%).DPP-4 inhibitors resulted in a non-significant decrease in the risk for fatal and non-fatal stroke(RR=0.96,95%CI:0.85-1.08,I2=0%)and coronary revascularization(RR=0.99,95%CI:0.90-1.09,I2=0%),Finally,DPP-4 inhibitors demonstrated a neutral effect on the risk for hospitalization due to unstable angina(RR=1.00,95%CI:0.85-1.18,I2=0%).As far as cardiac arrhythmias are concerned,DPP-4 inhibitors did not significantly affect the risk for atrial fibrillation(RR=0.95,95%CI:0.78-1.17,I2=0%),whil

关键词： Dipeptidyl peptidase-4 inhibitors Cardiovascular outcomes atrial fibrillation atrial flutter Type 2 diabetes mellitus

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