Tachy Research Articles

Value of dual Doppler ultrasonography in the evaluation of fetal arrhythmias

Objective To evaluate the value of fetal dual Doppler ultrasonography in the diagnosis of fetal arrhythmias. Methods 77 531 fetuses were examined by echocardiography.If fetal arrhythmias were found, information of pulsed wave Doppler signals in hepatic vein (HV) and descending aorta (DAo) using dual Doppler were collected simultaneously. Results On dual Doppler examination, 131 of the fetuses showed signals of cardiac dysrhythmias, including 60 fetuses with irregular fetal heart rhythm but having normal heart rate, 45 with tachyarrhythmias and 26 with bradyarrhythmias. Sixteen and 2 with tachy- or bradyarrhythmias fetuses complicated fetal malformation or severely maternal systemic diseases. Eighteen and 3 with tachy- or bradyarrhythmias fetuses revealed intrauterine death or intermediate pregnancy induction. The three main kinds of fetal arrhythmias had statistical differences in complicating with fetal malformation, maternal diseases, intrauterine fetal demise or intermediate pregnancy induction(all P<0.05). There was a significant difference in the accuracy of diagnosing rhythm abnormalities in the fetus between conventional ultrasonography and dual Doppler ultrasonography(k=0.562, P<0.05). Sixty cases of irregular fetal heart rhythm, 42 cases of fetal tachyarrhythmias, and 8 cases of fetal bradyarrhythmias were changed to normal rhythm at the third-pregnancy or prenatal period through appropriate treatment. All surviving fetuses were examined by echocardiography within 3 days, without any combination of congenital heart disease, and 1 months after the delivery, the ECG were shown as sinus rhythm. Conclusions Dual Doppler ultrasonography is a precise and rapid method of assessing various types of fetal arrhythmias. Different types of fetal arrhythmias have different fetal prognosis. Key words: Echocardiography, Doppler; Fetal heart; Arrhythmias; Dual Doppler

Progress in the application of radiofrequency catheter ablation in children

Tachyarrhythmia is a common type of arrhythmia in children.Continuous of frequent tachy cardia can bring serious harm to children's physical and mental health.With the help of electrophysiological study,electrophysiological mechanisms of various arrhythmias have been stated constantly,while the medical technology develops rapidly.The treatment strategy in pediatric arrhythinia has undergone major reforms,and radiofrequency catheter ablation has come into being.Through the thermal efficiency of the radiofrequency current,radiofrequency catheter ablation can damage the arrhythmia foci or block the atrioventricular reentrant pathway,so achieve the purpose of cure.The clinical application of radiofrequency catheter ablation can avoid the inconvenience of antiarrhymic drugs.Comprehensive assessments of the impacts and possible prognosis should be achieved by clinicians.Strict indications are very important.Currently the ablation has matured in atrioventricular re entrant tachycardia,atrioventricular nodal reentrant tachycardia,ventricular tachycardia,atrial tachycardia and atrial flutter,with high successful rate and low recurrence rate.Complications are closely related to the experience of the surgeon. Key words: Tachyarrhythmia; Radiofrequency catheter ablation; Children

Stentthrombose als Erstmanifestation einer fulminanten Pneumokokkensepsis

Eine Splenektomie ist mit dem lebenslangen Risiko fur eine fulminant verlaufende Infektion vergesellschaftet (OPSI – „overwhelming postsplenectomy infection“), welche haufig mit einer Dysbalance im Gerinnungssystem und mit hoher Letalitat einhergeht. Wir berichten uber einen 42-jahrigen Mann mit bekannter koronarer Eingefaserkrankung und Zustand nach posttraumatischer Splenektomie vor 20 Jahren, der mit Fieber und dem Bild eines akuten Vorderwandmyokardinfarktes sowie symptomatischen ventrikularen Tachykardien hospitalisiert wurde. Koronarangiographisch fand sich eine akute Stentthrombose in der proximalen LAD. Es erfolgte eine PTCA sowie eine aggressive antithrombotische Therapie. Nach anfanglicher postinterventioneller Beschwerdefreiheit kam es zur progredienten Verschlechterung der respiratorischen Situation sowie des Allgemeinzustands mit der Notwendigkeit der endotrachealen Intubation. Binnen kurzester Zeit entwickelte sich das Vollbild eines septischen Schocks. Trotz fruhzeitig eingesetzter Antibiotika, hochdosierter Katecholamine, Hydrokortison und intraaortaler Ballonpumpe verstarb der Patient 10 Stunden nach Aufnahme an einem „OPSI“ durch Pneumokokken.