3.Mid-ventricular obstructive hypertrophic cardiomyopathy with apical aneurysm and sustained ventricular tachycardia: a case report and literature review.
Xiao-Jin GAO ; Lian-Ming KANG ; Jian ZHANG ; Ke-Fei DOU ; Jian-Song YUAN ; Yue-Jin YANG
Chinese Medical Journal 2011;124(11):1754-1757
The case is a 54-year-old man with hypertrophic cardiomyopathy, mid-ventricular obstruction, apical aneurysm, and recurrence sustained monomorphic ventricular tachycardia (VT). A coronary angiogram revealed myocardial bridging located in the middle of the left anterior descending coronary artery (LAD), and the left ventriculogram showed an hour-glass appearance of the left ventricular cavity. There was a significant pressure gradient of 60 mmHg across the mid-ventricular obliteration at rest. A successful myectomy of the inappropriate hypertrophy myocardium and excision of the apical aneurysm were performed. Pathologic analysis demonstrated fibrosis in the apical aneurysm and thickened and narrowed vessels in the adjacent area. During the follow-up of eighteen months, the patient remained clinically stable and free from arrhythmic recurrence.
Cardiomyopathy, Hypertrophic
;
diagnosis
;
physiopathology
;
Female
;
Heart Aneurysm
;
physiopathology
;
Humans
;
Male
;
Middle Aged
;
Tachycardia, Ventricular
;
physiopathology
6.Ablation of manifest left free wall accessory pathways with polarity reversal mapping: ventricular approach.
Moon Hyoung LEE ; Shinki AHN ; Sung Soon KIM
Yonsei Medical Journal 1998;39(3):202-213
Polarity reversal mapping for localization of the left free wall accessory pathway (AP) at the atrial insertion site has been shown to be effective for successful ablation, but this technique requires atrial septal puncture. We evaluated the safety, efficacy, and reproducibility of two dimensional polarity reversal mapping at the ventricular insertion site of the accessory pathway without atrial septal puncture in symptomatic patients with manifested left free wall AP. Polarity reversal mapping under the mitral annulus by transaortic approach was performed in 10 consecutive patients with conventional ablation catheter (6 French, 4 mm tip, 2 mm interelectrode distance), during sinus rhythm or atrial pacing. A low set high, bandpass filter (0.005-400Hz) was used. Radiofrequency (RF) ablation was performed at the site of ventricular electrocardiogram polarity reversal during sinus rhythm. Polarity reversal was identified in all patients at the ventricular side of the mitral annulus. Ablation was successful in all patients without complications. The procedure time was 86.0 +/- 21.1 min, the fluoroscopic exposure time was 16 +/- 12 min, the number of RF applications was 8 +/- 6, the power level 21 +/- 7 watts, and the time to initial AP block was 3.0 +/- 0.9 sec. Polarity reversal mapping is a safe and efficient technique at the ventricular insertion site. This technique might be complementary to the currently-utilized activation mapping technique.
Adult
;
Catheter Ablation/methods*
;
Electrocardiography
;
Electrodiagnosis*
;
Female
;
Heart Conduction System/physiopathology
;
Human
;
Male
;
Middle Age
;
Radiography, Thoracic
;
Tachycardia, Supraventricular/surgery*
;
Tachycardia, Supraventricular/physiopathology
;
Tachycardia, Supraventricular/diagnosis*
7.Hurst index based analysis of ventricular tachycardia and ventricular fibrillation.
Journal of Biomedical Engineering 2010;27(6):1229-1232
In our laboratory, the normal ECG signal, the ECG signals of ventricular tachycardia (VT) and of ventricular fibrillation (VF) are studied with the use of Hurst index value. The Hurst index values of the normal ECG signal, VT, VF are calculated separately. There exist obvious differences among the Hurst values of the three kinds of signals,but they are all higher than 0.5 which is a value indicating the long-term relevant character. The long-term relevant character of the normal ECG signal is the best, and the character of VT is better than that of VF. Therefore, the Hurst Index can be used as an identification criterion for distinguishing normal ECG, VT and VF.
Algorithms
;
Electrocardiography
;
methods
;
Humans
;
Signal Processing, Computer-Assisted
;
Tachycardia, Ventricular
;
diagnosis
;
physiopathology
;
Ventricular Fibrillation
;
diagnosis
;
physiopathology
9.A tale of two tachycardias.
Colin YEO ; Jeremy CHOW ; Gerard LEONG ; Kah Leng HO
Singapore medical journal 2015;56(1):e10-3
A patient with non-ischaemic cardiomyopathy, and pre-existing atypical atrial flutter and left bundle branch block, developed broad complex tachycardia. In this unique and uncommon case of double tachycardia, we discuss the diagnostic approach of ventricular tachycardia in patients with broad complex tachycardia, and the use of different contemporary algorithms to help diagnose ventricular tachycardia and differentiate it from supraventricular tachycardia with aberrant conduction.
Algorithms
;
Atrial Flutter
;
complications
;
diagnosis
;
Bundle-Branch Block
;
physiopathology
;
Cardiomyopathies
;
complications
;
diagnosis
;
Diagnosis, Differential
;
Echocardiography
;
Electrocardiography
;
Humans
;
Male
;
Middle Aged
;
Tachycardia, Supraventricular
;
diagnosis
;
physiopathology
;
Tachycardia, Ventricular
;
diagnosis
;
physiopathology