Stefan Andreas Lange1, Jens Jung. 1. Medizinische Klinik I, Kardiologie und Angiologie, Klinikum Worms, Academic Teaching Hospital of the Johannes-Gutenberg-University, Mainz, Gabriel-von-Seidl-Str. 81, 67550, Worms, Germany. StefanAndreas.Lange@googlemail.com
Abstract
PURPOSE: Here, we describe the efficiency of interventional electrophysiology therapy in a critically ill patient with heart failure because of incessant AV node reentrant tachycardia after surgical port implantation. METHODS: Electrophysiology diagnostic and radio frequency ablation were utilized in the study. RESULT: We presented a 78-year-old patient with colorectal cancer, surgical port implantation, and progressive heart failure due to an incessant AV node reentrant tachycardia (AVNRT). This rhythm disturbance was refractory to any conventional pharmaceutical treatment. The electrophysiology diagnostic obtained an AVNRT. During fluoroscopy, an oversized port catheter with a loop touching the tricuspid valve annulus was discovered. This port catheter was responsible for premature beats, which induced incessant AVNRT. A manual reposition of the port edge and additional AV node slow pathway modification terminated further tachycardia. CONCLUSION: Electrophysiology diagnostic and radiofrequency ablation procedures are promising techniques also in critically ill patients with hemodynamic compromising supraventricular tachycardia.
PURPOSE: Here, we describe the efficiency of interventional electrophysiology therapy in a critically illpatient with heart failure because of incessant AV node reentrant tachycardia after surgical port implantation. METHODS: Electrophysiology diagnostic and radio frequency ablation were utilized in the study. RESULT: We presented a 78-year-old patient with colorectal cancer, surgical port implantation, and progressive heart failure due to an incessant AV node reentrant tachycardia (AVNRT). This rhythm disturbance was refractory to any conventional pharmaceutical treatment. The electrophysiology diagnostic obtained an AVNRT. During fluoroscopy, an oversized port catheter with a loop touching the tricuspid valve annulus was discovered. This port catheter was responsible for premature beats, which induced incessant AVNRT. A manual reposition of the port edge and additional AV node slow pathway modification terminated further tachycardia. CONCLUSION: Electrophysiology diagnostic and radiofrequency ablation procedures are promising techniques also in critically illpatients with hemodynamic compromising supraventricular tachycardia.
Authors: W M Jackman; K J Beckman; J H McClelland; X Wang; K J Friday; C A Roman; K P Moulton; N Twidale; H A Hazlitt; M I Prior Journal: N Engl J Med Date: 1992-07-30 Impact factor: 91.245