RESUMEN
BACKGROUND: Potential interference between implanted cardiac devices and other medical instruments is an important concern. Therefore, we aimed to investigate the possible device interaction between implantable cardioverter defibrillators (ICDs) and external enhanced counterpulsation (EECP) treatment. METHODS: Twenty-one patients with an implanted ICD or cardiac resynchronization therapy with defibrillator (CRT-D) were enrolled into the study. EECP had applied as two sessions of 5 minutes. Data from device interrogations before and after the first EECP session and during second EECP session were recorded and analyzed for signs of possible device interaction. RESULTS: There was no sign of inappropriate sensing or noise during EECP session. There was no difference regarding electrode impedance, pacing, and sensing values before and after EECP. There was a statistically significant difference regarding heart rates during EECP therapy between rate response off and on modes (68.69 ± 5.92 beats/min and 90.32 ± 11.05 beats/min, respectively P = 0,001). In four patients with CRT-D and unipolar left ventricular pacing, counterpulsation could not be done because of QRS sensing problems. CONCLUSIONS: EECP seems to be a safe treatment modality in patients with implanted ICD and CRT-D devices. It should be kept in mind that in those patients with CRT-D, rate responsive mode is on; inappropriate sinus tachycardia can be seen during EECP therapy. Also in patients with CRT-D using a unipolar sensing mode, problems of QRS complex sensing by the EECP may occur and, therefore, this effects synchronization and success of EECP therapy.
Asunto(s)
Arritmias Cardíacas/prevención & control , Terapia de Resincronización Cardíaca , Desfibriladores Implantables , Traumatismos por Electricidad/etiología , Arritmias Cardíacas/complicaciones , Contraindicaciones , Falla de Equipo , Humanos , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
We report here the case of a 27-year-old woman with Noonan syndrome presenting with ventricular fibrillation. After successful defibrillation, echocardiography revealed hypertrophic cardiomyopathy associated with left ventricular outflow tract obstruction. Normal echocardiographic cardiac structure and function were reported 11 years ago. This case emphasises the importance of regular follow-up in patients with congenital disorders in which cardiac manifestations might develop in early adulthood or later.
Asunto(s)
Muerte Súbita/etiología , Síndrome de Noonan/complicaciones , Fibrilación Ventricular/complicaciones , Adulto , Angiografía Coronaria , Diagnóstico Diferencial , Ecocardiografía , Cardioversión Eléctrica , Femenino , Estudios de Seguimiento , Humanos , Síndrome de Noonan/diagnóstico , Fibrilación Ventricular/diagnóstico , Fibrilación Ventricular/terapiaRESUMEN
We report the case of a 32-year-old male patient with symptoms of cerebrovascular accident manifesting with dysarthria. A transesophageal echocardiogram showed a floating mass localized in the ascending aorta, and a multislice computed tomography evaluation confirmed the diagnosis. With a comprehensive assessment of the mass, we decided on surgical intervention. A pedunculated and fragile mass was seen just near the right coronary ostium. The measured dimensions were 7.7 x 1.0 x 1.5 cm. The removed mass has been analyzed histopathologically and found to be the cause of the neurologic findings with an uncertain underlying etiology.