bundle branch reentrant tachycardia treated by transvenous catheter ablation of the right bundle...

Download Bundle branch reentrant tachycardia treated by transvenous catheter ablation of the right bundle branch

Post on 01-Nov-2016




0 download

Embed Size (px)


  • 93

    Electrocardio~aphy in Hypertrophic Cardiomyopathy A. Kibarskis and A. Rudys. Vilnius State University, USSR.

    Hypertrophic cardiomyopathy was diagnosed in 65 pa: tients according to clinical, ECG and echocardiographic data. In 48 cases only hypertrophy of the interventricu- lar septum was present, in 8 cases -symetric hypertrophy of all walls of the left ventricle, in 8 cases -apical hyper- trophy and in 1 -hypertrophy of lateral wall. ECG abnor- malities were present in all cases, the most often deep, negative and symetric T waves in leads V2_ e, I and aVL (46 cases). In cases of symetric hypertrophy of left ven- tricle ECG was typical for left ventricular hypertrophy with systolic overload (8 cases). In 3 cases with left ventricular outflow tract obstruction ECG simulated inferior infarction. In 3 cases with apical hypertrophy involving right ventricular apex, ECG showed conduc- tion disturbances (right bundle branch block, AV block). In 2 cases ECG simulated anterior wall myocardial infarction. (QS in VI_ 2 with ST elevation and positive T waves). In only 3 cases were narrow Q waves in lead I, aVL and Vs_ 6 seen. During examination of the patients after 1-5 years disappearance of T but not Q waves was noticed.

    Discriminant Body Surface Potential Map Patterns in Anterior and Inferior Myocardial Infarction. F. Kornreich, T. Montague~ J. Segers, M. Kavadias and M. Horacek. Free University Brussels (VUB), Brussels, Belgium.

    Data-reduction was performed on 120-lead data re- corded from 236 normal subjects (N), 114 patients with anterior myocardial infarction (AMI) and 144 patients with inferior myocardial infarction (IMI), by expressing sequential body surface potential maps (BSPM) as linear combinations of 12 orthonormal map distributions (basis maps) at each instant. Basis maps were previously com- puted from maps of the entire study population. The ex- pansion coefficients, relating in each individual each actual map to the basis maps are then averaged over the N, AMI and IMI populations, respectively; 12 group- mean time-functions are obtained for each population. By subtracting from AMI and IMI corresponding N waveforms and dividing the resulting differences by the standard deviations of the pooled populations consid- ered for each bigroup comparison, statistically signifi- cant differences were demonstrated. The time instants and basis patterns for each bigroup discrimination are analyzed. In the AMI group, the main feature was the loss of electrical forces in the anterior torso during the first part of QRS and in the precordlal area during the late portion of T, in IMI, abnormal negative voltages were observed in the inferior right anterior chest and the lower left flank at mid- and late QRS and in late T.

    Electromagnetic Field of Heart Contraction Kinetics V. Kr~l, M. Ko6i and J. Hoenig. Institute of physiolog- ical regulations, Czechoslovak Academy of Sciences, Prague, Czechoslovakia.

    We present the theory and clinical applications of a new method "Electromagnetic kinetocardiography" {EM KCG), which transforms the mechanical heart walls movement into the secondary electromagnetic field (EMF) changes.

    The principle is based on inducing the primary RF EMF in the chest resulting in inductive phenomena of magnetic dipoles in the heart cavities, and in the galvanic one, originating on the discontinuities of conductivity and permitivity, mainly on endomyocardial ventricle surfaces. The electrical charges change in space and time with the heart ventricles movement and create the sec- ondary EMF distribution on the chest surface.

    We proved the representation of this EMF in direct measurement of divergence of intensity vector (div E) with special multi-electrode probe. The data measured on the precordium area are presented in a series of "isodivergence" maps and maps of their time differences. The dynamic maps enable a global view on the heart cycle kinetics and differentiate the topic, type and time changes in synergia of both ventricles and septum con- tractility. The results of EM KCG of more than 200 per- sons compared with ACG and 2D-Echcg accord with topographic changes and complete the whole detailed pic- ture of heart walls movement.

    Bundle Branch Reentrant Tachycardia Treated by Transvenous Catheter Ablation of the Right Bundle Branch. H. Kfihnert, H. Volkmann, G. Dannberg, M. Heink~ Divi- sion of Cardiology, Department of Internal Medicine, Friedrich Schiller University, Jena, GDR.

    Recurrent episodes of ventricular tachycardia not re- sponding to medical treatment occurred in a 56-year-old man. Electrophysiological investigation showed ventri- cular tachycardia due to bundle branch reentry. Using a method similar to catheter ablation of the atrioven- tricular junction an ablation of the right bundle branch was performed by an electrical shock of 250 J. While be- fore the ablation ventricular tachycardia occurred several times a day, and its induction by programmed ventricu- lar stimulation was facilitated by the administration of antiarrhythmic drugs, no initiation of ventricular tachy- cardia was possible after ablation of the right bundle branch. Over a follow-up of 15 months, the patient has not suffered from tachycardia and the artificial right bundle branch block persists.



View more >