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Biomedical subjects

A Haggui

Publications and source records attributed to A Haggui.

5 recordsLinked to original sources

[Comparison between three-dimensional electro-anatomical mapping and conventional mapping in the ablation of atrial tachycardias].

In atrial tachycardias, catheter ablation using conventional mapping system is associated with high immediate success and low recurrence. Three-dimensional electroanatomical mapping system combined to catheter ablation of atrial tachycardias has reached, in small uncontroled series, success rates of 100%. However, limited data are available about rates of recurrence or complication using this approach. In order to compare both mapping systems, we have conducted a study of 65 consecutive patients (36 women and 29 men) that underwent both electrophysiologic study and catheter ablation for suspected atrial tachycardias. Pre-existing heart disease was noted in 43%, hypertension in 32% and a history of atrial fibrillation of flutter in 52%. Catheter ablation guided by conventional mapping was undertaken in 44 patients and by three-dimensional electroanatomical mapping in 21. Successful ablation was performed in 68% of patients with conventional mapping and in 90% with three-dimensional electroanatomical mapping. No complication and recurrence were observed with the latter approach, while 5 patients had a recurrence and 2 had immediate complication with conventional mapping. Catheter ablation of atrial tachycardias combined with three-dimensional electroanatomical mapping appeared to be effective and safe, however, conventional mapping system still remains a reliable approach that must be considered as the first choice for atrial tachycardias ablation.

Adult↗

[Which place for VDD mode single electrode pacemaker?].

VDD mode single electrode pacemaker is a technique of cardiac stimulation which preserves auriculo-ventricular synchronism using a single electrode. Its importance has decreased because of the numerous satisfactions previous by the DDD mode. We describe our experience with this mode and we discuss the advantages, limits and indications of this mode of cardiac stimulation.

Arrhythmias, Cardiac↗

[Value and limitations of programmed ventricular stimulation].

The electrocardiogramme and methods of prolonged ECG recording are sufficient for diagnosing most cardiac arrhythmias. They also provide some prognostic information and allow evaluation and follow-up of treatment. However, in some situations, endocavitary electrophysiological investigations are required when the diagnosis is uncertain, that more prognostic information is required or interventional techniques (endocavitary ablation) are envisaged. The aim of this report is to summarise the value and limitations of programmed ventricular stimulation. Many of its indications have been abandoned in terms of rhythm stratification in the face of more robust parameters, in particular the left ventricular ejection fraction. However, it retains a potential utility in terms of prognosis in arrhythmogenic right ventricular dysplasia, the Brugada syndrome and operated Tetralogy of Fallot. In any event, it is important to remember that studies resulting in diagnostic or therapeutic recommendations were performed with strict protocols of stimulation in selected patients and that these recommendations can only be applied when the evaluation protocols are respected. The indications of programmed ventricular stimulation will increase in the therapeutic field with the development of new techniques of 3D mapping, new systems of catheter guiding which should extend the indications of endocavitary ablation.

Arrhythmias, Cardiac↗

[Primary anomalies of ventricular repolarisation].

The duration of repolarisation is the main determinant of the refractory period and therefore plays a major electrophysiological role. Ventricular repolarisation can be influenced or modified by very many extrinsic factors responsible for so-called secondary changes or anomalies. On the contrary, primary anomalies of ventricular repolarisation correspond to intrinsic anomalies of ionic conduction which in turn affect repolarisation. Primary anomalies of ventricular repolarisation are the consequences of vascular disease, which is the origin of both electrocardiographic anomalies and rhythm disorders, and which can result in sudden death from ventricular fibrillation. Three clinical syndromes correspond with these definitions: long QT syndrome, short QT syndrome, and Brugada syndrome. Much of the experimental work seems to show that arrhythmogenic action results mostly from an increase in the heterogeneity of the refractory periods, whether this involves a prolonged, short or even normal repolarisation time. The various experimental models also give a better understanding of the repolarisation changes observed on the electrocardiogram. Knowledge of the mechanisms responsible for arrhythmias due to primary anomalies of ventricular repolarisation could provide a model for secondary anomalies.

Action Potentials↗

[Ventricular extrasystoles].

Ventricular extrasystoles result from premature excitation of the heart from a site beyond the bifurcation of the bundle of His, at the level of the conductive tissue or myocardial cells. In practice they represent a daily problem for cardiologists due to their frequent occurrence. They can be detected in symptomatic patients and also in asymptomatic subjects, for example during routine health checks. It is therefore important to distinguish benign ventricular extrasystoles from those which are potentially serious, so that a useless or even dangerous treatment is not undertaken and severe anxiety is not caused in patients who have become 'medicalised'. The decision about treatment is only made following electrocardiographic and echographic clinical investigation, with the presence of cardiopathy being one of the major deciding factors.

Adrenergic beta-Antagonists↗