Objective
This study aimed to investigate the effects of radiofrequency catheter ablation (
RFCA
) and clinical and electrophysiological characteristics in symptomatic patients with premature ventricular contractions (
PVC
s) from near the His‐bundle (His‐
PVC
s).
Methods
The patient characteristics, prevalence of complications with any life style related disease (
ALSRD
) including hypertension, dyslipidemia, or diabetes mellitus, and/or cardiovascular disease (
CVD
) including coronary artery disease, cerebrovascular disease, renal dysfunction, or cardiomyopathy, clinical status, frequency of
PVC
s evaluated by 24hour Holter monitoring, echocardiography including the left ventricular diastolic dysfunction (
LVDD
) parameters, and electrophysiological findings were evaluated in 14 consecutive symptomatic patients with His‐
PVC
s.
Results
The prevalence of males, being elderly and/or slightly obese, current and/or history of smoking,
ALSRD
or
CVD
related complications, and
LVDD
probably resulting from
ALSRD
and/or
CVD
complications were higher in patients with His‐
PVC
s.
RFCA
of His‐
PVC
s steadily decreased the
PVC
frequency and improved the systolic function,
LV
dilation, and clinical status, but not the
LVDD
. There was a significant relationship between the accordance rate of the
QRS
polarity between sinus rhythm and His‐
PVC
s and the distance between the successful ablation site and His‐bundle.
Conclusion
The analysis of the
QRS
duration and accordance rate of the
QRS
polarity between sinus rhythm and His‐
PVC
s before the
RFCA
may help to determine the distance between the origin of the
PVC
s and His‐bundle. Further, the appropriate ablation catheter may be selected during the
RFCA
procedure. Finally,
RFCA
may be one of the most effective, feasible, and safest therapies for symptomatic patients with His‐
PVC
s.
We retrospectively evaluated whether the ratio KL-6 to SLX in serum (K/S ratio) before chemotherapy was a predictor for the occurrence of drug-induced interstitial lung disease (D-ILD) in lung cancer patients with idiopathic interstitial pneumonias (IIPs). D-ILD occurred in 8 of 20 IIPs-positive cases and in 14 of 100 IIPs-negative cases (40 vs. 14%, p = .015). In IIPs-positive cases, the high K/S ratio (>20) before first-line chemotherapy had a tendency to increase the risk of D-ILD (p = .085). Serum K/S ratio may be a useful predictor for the occurrence of D-ILD in lung cancer patients with IIPs.
We experienced a 41-year-old male with premature ventricular complexes/ventricular tachycardia from the left coronary cusp and distal great cardiac vein of the left ventricular outflow tract successfully treated by radiofrequency catheter ablation utilizing a 3D mapping system (EnSiteNavX/Velocity TM Cardiac Mapping System, St. Jude Medical, St. Paul, MN, USA) without any complications.
BackgroundPulmonary vein antrum isolation (PVAI) under sedation has proven to be a useful strategy for catheter ablation of atrial fibrillation (AF).MethodsTo evaluate the clinical benefits of respiratory management using supraglottic airways (SGAs) under deep sedation while monitoring the bispectral (BIS) index during the PVAI and the durations from admission to the catheterization room to starting the radiofrequency energy delivery (Time α), and from starting the radiofrequency energy delivery to completion of the PVAI (Time β), X-ray time, frequency of dislocations of the three-dimensional maps (D3DM), procedure-related complications, and proportion of an AF-free rate 15 months after the PVAI (PAFFR) in patients who received deep sedation without SGAs (Group A: n=48) and those with SGAs (Group B: n=51) were evaluated.ResultsThere were no significant differences in patient characteristics, Time α (77±3 versus 78±2 min; p=0.816), complications of cardiac tamponade (2% versus 2%; p=0.966), or PAFFR (81% versus 88%; p=0.313) between the two groups. However, the Time β (84±4 versus 67±3; p=0.001), X-ray time (53±2 versus 34±2; p<0.001), and minor complications of nasal bleeding (25% versus 0%; p=0.001) were significantly shorter and lower in Group B than in Group A, in accordance with a reduction in the hypoxia (15% versus 0%; p=0.007) and D3DM (31% versus 8%; p=0.003).ConclusionsThese results may demonstrate the clinical benefits of deep sedation with SGAs while monitoring the BIS index without any hypoxia during PVAI in patients with AF.
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