RESUMEN
A 8-year-old female patient with refractory incessant atrial tachycardia, very symptomatic and with left ventricular ejection fraction of 0.25. Electrophysiological study and endocardial mapping localized the site of the origin of atrial tachycardia in the superior right atrium. In this site 2 applications of radiofrequency current (25V, 20 and 50 seconds) resulted in termination of the atrial tachycardia. She was discharged off antiarrhythmic drugs and after 2 months ejection fraction was 0.52. She was completely asymptomatic 6 months after ablation procedure.
Asunto(s)
Ablación por Catéter/métodos , Taquicardia Atrial Ectópica/cirugía , Niño , Femenino , Estudios de Seguimiento , Ventrículos Cardíacos/fisiopatología , Humanos , Taquicardia Atrial Ectópica/diagnósticoRESUMEN
PURPOSE: To localize the site of the origin of sustained ventricular tachycardia in chronic chagasic cardiomyopathy patients refractory to antiarrhythmic therapy by radionuclide angiography techniques. METHODS: Five patients underwent radionuclide angiography by intravenous administration of 25mCi 99mTc. The images were obtained in sinus rhythm and during sustained ventricular tachycardia induced in the electrophysiologic laboratory for endocardial mapping. Amplitude and phase images were obtained resulting in a contraction wave synchronic to ventricular dispolarization. RESULTS: All patients had haemodynamic stability during the arrhythmia. One patient had incessant ventricular tachycardia. Mean ejection fraction was 0.38. In 4 patients the site of the origin of ventricular tachycardia was posterior and in one it was localized in the interventricular septum. There was identity in the site of the origin of ventricular tachycardia obtained by endocardial mapping or radionuclide angiography in all patients. The therapy was chemical ablation in 3 patients, surgical aneurysmectomy in one and pharmacologic therapy in the last patient. CONCLUSION: The site of the origin of ventricular tachycardia can be estimated by analyzing the contraction wave obtained by radionuclide angiography techniques in patients with hemodynamic stable sustained ventricular tachycardia.
Asunto(s)
Cardiomiopatía Chagásica/diagnóstico por imagen , Taquicardia Ventricular/diagnóstico por imagen , Adulto , Anciano , Enfermedad Crónica , Electrofisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Angiografía por RadionúclidosRESUMEN
PURPOSE: evaluate the efficacy of radiofrequency catheter ablation in patients with refractory cardiac arrhythmias. METHODS: twenty patients with refractory cardiac arrhythmias were undertaken to electrophysiologic studies for diagnosis and radiofrequency catheter ablation of their reentrant arrhythmias. Ten patients were men and 10 women with ages varying from 13 to 76 years (mean = 42.4 years). Nineteen patients had supraventricular tachyarrhythmias: One patient had atrial tachycardia and 1 atrial fibrillation with rapid ventricular rate, 5 patients had reentrant nodal tachycardia, 12 patients had reentrant atrioventricular tachycardia and 1 patient had right ventricular outflow tract tachycardia. RESULTS: the mean time of the procedure was 4.1 hours. The radiofrequency current energy applied was 40-50 V for 30-40 seconds. Ablation was successful in 18/20 (90%) patients; in 15/18 (83%) of successfully treated patients the same study was done for diagnosis and radiofrequency ablation. One patient had femoral arterial occlusion and was treated with no significant sequelae. During a mean follow-up of 4 months no preexcitation or reentrant tachycardia occurred. CONCLUSIONS: the results of our experience with radiofrequency catheter ablation of cardiac arrhythmias suggest that this technique can benefit an important number of patients with cardiac arrhythmias.
Asunto(s)
Ablación por Catéter/métodos , Taquicardia Supraventricular/cirugía , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Taquicardia Supraventricular/diagnósticoAsunto(s)
Cateterismo , Vasos Coronarios , Nodo Sinoatrial , Taquicardia Sinusal/terapia , Adulto , Cateterismo/efectos adversos , Enfermedad Crónica , Angiografía Coronaria , Electrocardiografía , Femenino , Humanos , Infarto del Miocardio/etiología , Taquicardia Sinusal/diagnóstico por imagen , Taquicardia Sinusal/fisiopatologíaRESUMEN
The authors present a case of malakoplakia, involving colon, rectum, bladder and retroperitoneum. This rare pathology, generally associated to Escherichia coli infections, result in a granulomatous disease, that can involve one or more organs. Nowadays, it is believed that the illness is due to a failure in the bactericide activity of the macrophage. This case, the first reported in our country, was treated clinically with ascorbic acid and trimethoprim-sulfamethoxazole, and is also unique in the world literature.