Search results for "Paroxysm"
showing 10 items of 69 documents
Automatic detection of paroxysmal atrial fibrillation in patients with ischaemic stroke: better than routine diagnostic workup?
2016
Background and purpose Prolonged electrocardiogram (ECG) monitoring after ischaemic stroke increases the diagnostic yield of paroxysmal atrial fibrillation (pAF). In order to facilitate the additional workload involved in ECG analysis due to prolonged monitoring times, we investigated the effectiveness of pAF detection with an automated software algorithm (SA) in comparison to the routine staff-based analysis (RA) during standard stroke-unit care. Therefore, patients with acute ischaemic stroke or transitory ischaemic attack presenting with sinus rhythmus on the admission ECG and no history of atrial fibrillation were prospectively included. Methods A 24-h Holter ECG assessment was performe…
Impact of biatrial defragmentation in patients with paroxysmal atrial fibrillation: Results from a randomized prospective study
2014
Single procedure success rates of pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF) are still unsatisfactory. In patients with persistent atrial fibrillation (AF), ablation of complex fractionated atrial electrograms (CFAEs) after PVI results in improved outcomes.We aimed to investigate if PAF-patients with intraprocedurally sustained AF after PVI might benefit from additional CFAE ablation.A total of 1134 consecutive patients underwent a first catheter ablation procedure of PAF between June 2008 and December 2012. In most patients, AF was either not inducible or terminated during PVI. In 68 patients (6%), AF sustained after successful PVI. These patients …
Simplifying atrial fibrillation ablation: how far can we go?
2013
The procedural end point of electrical isolation of the pulmonary veins (PVs) for the treatment of atrial fibrillation (AF) has been debated extensively. After identifying the PVs as the dominant arrhythmogenic site of paroxysmal AF, 2 fundamentally different approaches to the interventional treatment of AF were introduced. Haissaguerre et al developed a technique to electrically isolate the PVs by targeting electrophysiological (EP) breakthroughs from the left atrium to the PVs guided by a circular mapping catheter. In contrast, Pappone et al implemented an anatomical approach that used circumferential ablation lines around the PVs guided by a 3-dimensional mapping system. This latter appr…
Hemolytic uremic syndrome in an infant following Bordetella pertussis infection.
2006
Reported here is the case of a 6-week-old female infant with a severe Bordetella pertussis infection requiring supportive pressure-positive ventilation in the intensive care unit. After being discharged from the intensive care unit, she developed hemolytic anemia, thrombocytopenia and acute renal failure, which suggested a diagnosis of hemolytic uremic syndrome. The clinical outcome was favorable with no renal consequences. This case suggests there may be a direct cause-effect relationship between B. pertussis infection and hemolytic uremic syndrome.
A multicenter observational study on the role of comorbidities in the recurrent episodes of benign paroxysmal positional vertigo
2014
Objective: Primary objective of this study was to find a statistical link between the most worldwide comorbidities affecting the elderly population (hypertension, diabetes, osteoarthrosis, osteoporosis and depression) and recurrent episodes of BPPV. Secondary objective was defining possible "groups of risk" for people suffering recurrent positional vertigo related to the presence of a well documented comorbidity. Methods: This was an observational, cross-sectional, multicenter, spontaneous, non-pharmacological study. The data of 1092 patients suffering BPPV evaluated in 11 different Departments of Otolaryngology, Otoneurology and Neurology, referring Centers for positional vertigo evaluatio…
Neue Aspekte der elektrischen Defibrillation
1998
In allen internationalen Empfehlungen stellt die schnellstmogliche Defibrillation die Masnahme der Wahl bei Kammerflimmern (VF) und pulsloser ventrikularer Tachykardie (VT) dar. Der Defibrillation kommt eine Schlusselrolle bei der Bekampfung des plotzlichen Herztodes zu. Technische Neuerungen: Entwicklungen auf technischem Gebiet haben einerseits eine weitere Miniaturisierung und Vereinfachung der Gerate, andererseits eine Anpassung der Energiemenge an die individuellen Patientenbedingungen zum Ziel. Implantierbare Kardioverter-Defibrillatoren (ICD) und automatisierte externe Defibrillatoren (AED) basieren auf der gleichen Technologie, einer gerateinternen Analyse des EKG-Signals mit nachfo…
Scrotal swelling in a patient with paroxysmal supraventricular tachycardia
2017
We present a case of a patient with paroxysmal supraventricular tachycardia and a history of chronic ischemic disease evolved into dilated cardiomyopathy. During hospitalization, the occurrence of arrhythmic crisis, our patient felt sporadic palpitations associated with dyspnea, distended jugular veins and scrotal swelling, quite unexpected clinical sign that caught our attention. Echocardiography showed dilated left ventricle, severely reduced systolic function, dilated right-sided, dilated inferior vena cava with reduced respiratory excursions. Echography of both testicles showed bilateral expansion of pampiniform plexus with reflux to the functional maneuvers, such as varicocele of grade…
Development Of a Disease Specific Quality Of Life Questionnaire For Patients With Aplastic Anemia and/Or Paroxysmal Nocturnal Hemoglobinuria (QLQ-AA/…
2013
Abstract Introduction Acquired Aplastic Anemia (AA) and Paroxysmal Nocturnal Hemoglobinuria (PNH) are ultra-rare diseases with a yearly incidence 2 to 4 per million (AA) and of 1.3 to 2 per million (PNH. While much is known about pathophysiology and treatment of these interrelated diseases, less is known about patients (pts.) psycho-social issues. Quality of life (QoL) evaluation tools used in all studies for AA and PNH are rather unspecific and were initially designed for cancer patients (e.g. the European Organization of Research and Treatment (EORTC) QLQ-C30). Given the complexity of AA and PNH, the variation in symptoms and different treatment approaches (immunosuppression, bone marrow …
Exercising recommendations for paroxysmal AF in young and middle-aged athletes (PAFIYAMA) syndrome.
2017
We have recently described a new syndrome: strenuous endurance exercise-related atrial fibrillation (AF) under the acronym of ‘paroxysmal AF in young and middle-aged athletes’ (‘PAFIYAMA’). Provided that other risk factors for AF and underlying conditions have been excluded (1), the diagnostic criteria for this syndrome entail a number of conditions, classified as major and minor. An enhanced risk of AF has been clearly documented in endurance athletes (top-class, elite and recreational) (2-5), and such risk typically ranges between 1.2- to 15-fold compared to the general, sedentary population (the better cardiovascular fitness, the higher incidence of AF) (6-11). Anecdotally, the last auth…
Reliable Paroxysmal Atrial Fibrillation Substrate Assessment During Sinus Rhythm Through Optimal Estimation of Local Activation Waves Dynamics
2020
[EN] The analysis of coronary sinus (CS) electrograms (EGMs) during catheter ablation (CA) of atrial fibrillation (AF) is highly important for AF substrate evaluation. However, channels of the CS catheter may be affected by vigorous cardiac movement and bad contact. This work investigates the most reliable channels in preserving the AF dynamics during sinus rhythm (SR). Local activation waves (LAWs) were detected in 44 bipolar CS recordings of 60-300 seconds duration in 28 paroxysmal AF patients undergoing CA. Recordings consisted of five channels: distal, mid-distal, medial, mid-proximal and proximal. LAW duration, amplitude, area and correlation between dominant morphologies of each chann…