Archives of cardiovascular diseases
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Arch Cardiovasc Dis · Nov 2017
Follow-up of children or teenagers with paroxysmal supraventricular tachycardia, but without pre-excitation syndrome.
Paroxysmal supraventricular tachycardia (SVT) is considered benign in children if the electrocardiogram in sinus rhythm is normal, but causes anxiety in parents, children and doctors. ⋯ At the time of ablation, SVT management remains difficult in children. Indications for ablation are more common in AVRT than in AVNRT, but failures are frequent; 22.0% remained symptomatic after successful ablation, but false recurrences were frequent (15.4%). Without ablation, one third had a spontaneous favourable evolution.
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Arch Cardiovasc Dis · Oct 2017
Multicenter StudyDeterminants of left atrial volume index in patients with aortic stenosis: A multicentre pilot study.
Left atrial (LA) enlargement is frequent in patients with aortic stenosis (AS), yet its determinants and prognostic implications are poorly understood. ⋯ LA enlargement is correlated with AS severity, but also with variables reflecting LV systolic and diastolic dysfunction. Further studies are needed to investigate the outcome implication of LA enlargement in patients with AS.
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Arch Cardiovasc Dis · Oct 2017
Two-year clinical outcome after a single cryoballoon ablation procedure: A comparison of first- and second-generation cryoballoons.
The ablation of paroxysmal atrial fibrillation (PAF) by cryoballoon has increased dramatically in recent years. However, there are few data comparing first- and second-generation cryoballoons. ⋯ CB-1 and CB-2 showed similar efficacy for PAF ablation, with similar arrhythmia recurrence 24 months after a single ablation procedure. However, our findings suggest that CB-2 may have more effective cooling capabilities, enabling shorter procedure and fluoroscopy times.
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Pulmonary hypertension due to left heart disease, also known as group 2 pulmonary hypertension according to the European Society of Cardiology/European Respiratory Society classification, is the most common cause of pulmonary hypertension. In patients with left heart disease, the development of pulmonary hypertension favours right heart dysfunction, which has a major impact on disease severity and outcome. Over the past few years, this condition has been considered more frequently. ⋯ In group 2 patients, pulmonary hypertension may be caused by an isolated increase in left-sided filling pressures or by a combination of this condition with increased pulmonary vascular resistance, with an abnormally high pressure gradient between arteries and pulmonary veins. A better understanding of the conditions underlying pulmonary hypertension is of key importance to establish a comprehensive diagnosis, leading to an adapted treatment to reduce heart failure morbidity and mortality. In this review, epidemiology, mechanisms and diagnostic approaches are reviewed; then, treatment options and future approaches are considered.
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Arch Cardiovasc Dis · May 2017
Ten-year outcomes of monomorphic ventricular tachycardia catheter ablation in repaired tetralogy of Fallot.
Monomorphic ventricular tachycardia (MVT) is common in adults with repaired tetralogy of Fallot (TOF), and is associated with sudden cardiac death. Management of MVT is not defined, and results of catheter ablation (CA) are limited. ⋯ CA can safely address macroreentrant MVT in repaired TOF patients with an acceptable long-term rate of recurrence in this high-risk population. Anatomical classification of isthmuses with electroanatomical mapping provides reproducible endpoints for CA. Attention should be given to LV systolic function in risk assessment and selection of candidates for implantable cardioverter-defibrillator.