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Jean Luc Pasquié

Publications and source records attributed to Jean Luc Pasquié.

9 recordsLinked to original sources
PubMed2006

Ablation of a concealed accessory pathway within a persistent left superior vena cava: role of the LocaLisa navigation system.

We report the ablation procedure of a concealed accessory pathway (AP) localized within a persistent left superior vena cava (PLSVC) in which the use of the LocaLisa system was of great value. The AP was the source of symptomatic AV re-entrant tachycardia and located in the initial portion of a PLSVC. The LocaLisa system allowed correct catheter placement and monitoring of stability. Five cooled-radiofrequency applications within the PLSVC suppressed the AP. PLSVC is a very unusual site of APs. The use of a navigation system may be extremely helpful in improving catheter ablation placement and stability in a very dilated vessel.

Catheter Ablation↗
PubMed2006

Evidence for an incomplete mitral isthmus block after failed ablation of a left postero-inferior concealed accessory pathway.

We report the case of a young woman in whom previous ablation of a concealed left-sided accessory pathway (AP) created an iatrogenic mitral block. The mitral block was responsible for a split retrograde atrial activation pattern during orthodromic atrioventricular re-entrant tachycardia (AVRT). The differential diagnoses are discussed. The AP was ablated at the site with the shortest interval between the ventricular signal and the earliest component of the retrograde atrial activation. Meticulous mapping is paramount during AVRT with an unusual retrograde atrial activation pattern.

Adult↗
PubMed2006

Long-term safety and efficacy of slow pathway ablation in patients with atrioventricular nodal re-entrant tachycardia and pre-existing prolonged PR interval.

The association of atrioventricular nodal re-entrant tachycardia (AVNRT) and pre-existing prolonged PR interval is unusual. Radiofrequency (RF) ablation in such patients may be associated with an increased risk of immediate and delayed AV block. The aim of our study is to assess the long-term efficacy and safety of slow pathway ablation in this population. We studied 10 patients (4 males and 6 females) with pre-existing prolonged PR interval of 68 consecutive patients with AVNRT. All had slow-fast subtype of AVNRT. The mean PR interval was 222 +/- 15 ms before RF. The patients with pre-existing prolonged PR were older (69 +/- 15 vs. 54 +/- 17, P = 0.008) and their tachycardias were slower (387 +/- 102 vs. 323 +/- 73 ms; P < 0.05). Transient complete AV block (<5 s) occurred in two patients. None had permanent complete AV block. One patient had a significant increase in PR interval (from 220 to 320 ms). The mean post-RF PR interval was 232+/-37 ms (P = n.s.). Over a mean follow-up of 39 +/- 21 months, none had a recurrence of tachycardia nor developed higher degree AV block. In conclusion, in patients with AVNRT and pre-existing prolonged PR interval, a slow pathway ablation appeared efficient and safe. From our data, no delayed AV block developed on a long follow-up. Most of the patients with periprocedural transient AV block had no evidence of dual AV node physiology, suggesting that, in this population, absence of dual AV node physiology may be associated with a higher risk of AV block during slow pathway ablation.

Adult↗
PubMed2005

Atrial fibrillation and its determinants after radiofrequency ablation of chronic common atrial flutter.

AIM: Atrial fibrillation (AFib) is a major clinical issue and its occurrence is the main problem after catheter ablation of atrial flutter. The long-term occurrence of AFib after common atrial flutter ablation is still matter of debate as it may influence the therapeutic approach. So, the aim of our study was to analyze the determinants and the time course of AFib after radiofrequency catheter ablation of chronic common atrial flutter. METHODS AND RESULT: 89 consecutive patients (67.5 +/- 12.0 yrs) underwent RF ablation of chronic common atrial flutter. 38.2 % had previous history of paroxysmal AFib. 51% had no underlying structural heart disease. Over a mean follow-up of 38 +/- 13 months, the occurrence rate of AFib progressively increased up to 32.9% at the end of follow-up. The median occurrence time for AFib was 8 months. AFib occurrence was significantly associated with previous AFib history (P=0.01) but not with the presence of underlying heart disease (P=n.s.). Of particular interest, in our study, AFib never occurred in patients without previous AFib history. Palpitations after chronic common atrial flutter ablation was mostly related to AFib. CONCLUSION: In conclusion, after chronic common atrial flutter ablation, AFib incidence progressively increased over the follow-up in all patients. Patients with prior AFib history appeared to be a very high risk group. In these patients, closer monitoring is mandatory and the persistent risk of AFib recurrences may justify prolonged anticoagulation policy.

Journal Article↗
PubMed2005

May fever trigger ventricular fibrillation?

The clinical precipitants of ventricular fibrillation (VF) remain poorly understood. Clinical factors such as hypoxemia, acidosis or electrolyte imbalance, drug-related toxicity, autonomic nervous system disorders as well as viral myocarditis have been proposed to be associated with sudden cardiac death particularly in patients with structural heart disease. However, In the Brugada syndrome, concurrent febrile illness has been reported to unmask the electrocardiographic features of the Brugada syndrome and be associated with an increased propensity for VF. More recently, a febrile illnesses of infectious etiology was associated to polymorphic ventricular tachycardia or VF in patients with normal hearts and without known repolarization abnormality. In this review we detail this phenomenon and its putative mechanisms.

Journal Article↗
PubMed2004

Fever as a precipitant of idiopathic ventricular fibrillation in patients with normal hearts.

INTRODUCTION: Ventricular fibrillation (VF) is the main mechanism of sudden cardiac death. The clinical precipitants of sudden cardiac death due to idiopathic VF are poorly characterized. Emerging evidence implicates triggers originating predominantly from the distal Purkinje arborization and the right ventricular outflow tract. METHODS AND RESULTS: We report three patients without structural heart disease or repolarization abnormalities in whom a febrile illness was the only concurrent disease associated with unexpected sudden cardiac death due to VF storm. An automated defibrillator was implanted in all three patients. In one patient with persistent recurrent VF episodes, mapping demonstrated the origin of these triggers was from the Purkinje arborization of the anterior wall of the right ventricle. Ablation at a site of earliest activation during ectopy, where pace mapping was concordant and Purkinje potential preceded the onset of ventriculogram, resulted in suppression of all arrhythmias. After follow-up of 22, 9, and 18 months in the three patients, no ventricular arrhythmias have been recorded. CONCLUSION: We present a series of patients in whom an apparently benign febrile illness was associated with malignant ventricular arrhythmias in the absence of cardiac disease or other factors known to precipitate sudden cardiac death. Physicians should be aware of this possible phenomenon in cases of febrile illness associated with syncope.

Aged↗