Biomedical subjects

Michał Orczykowski

Publications and source records attributed to Michał Orczykowski.

9 recordsLinked to original sources

PubMed2006

[Ablation of incisional right atrial tachycardia with critical region between surgical scar and crista terminalis in a patient with corrected transposition of great arteries after correction of Fallot-like pentalogy, Ebstein-like tricuspid valve anomaly and WPW syndrome].

In a 14 year old boy with corrected transposition of great arteries after correction of Fallot-like pentalogy, Ebstein-like tricuspid valve anomaly and WPW syndrome that was treated surgically, atrial tachycardia (AT) 260-280 ms was diagnosed and ablated. Due to earlier therapy it was impossible to insert catheters through femoral veins, and a subclavian and carotid veins access was used. The arrhythmia was a peri-incisional right AT. The isthmus was diagnosed with the use of entrainment pacing between a scar near VCI and the surgical incision along crista terminalis. Application in that region terminated AT and it was not inducible after the procedure.

Adolescent↗

PubMed2006

[Ablation of atypical, fast atrio-ventricular nodal tachycardia in a pregnant woman--a case report].

We describe a case of a 24-year-old pregnant woman (35 hbd) who was admitted because of fast (240 bpm) supraventricular tachycardia which required electrical external cardioversion (transesophageal atrial pacing and drugs were ineffective). She underwent RF ablation during which a single RF application effectively cured atypical atrio-ventricular nodal tachycardia. The duration of fluoroscopy was 53 seconds. The child was delivered on time and with no complications.

Adult↗

PubMed2006

[Ventricular fibrillation in a patient with three accessory pathways, Ebstein anomaly and intermittent long QT interval. RF ablation and electrophysiologic considerations].

We present a case of a 19-year old man with minor Ebstein's anomaly, intermittent long QT interval and WPW syndrome in whom atrial fibrillation, degenerating into ventricular fibrillation was the first symptom. QRS complex morphologies during atrial fibrillation revealed the presence of three accessory pathways (septal, right inferior paraseptal and antero-inferior). Immediately after resuscitation the patient was treated with amiodarone, which resulted in a significant prolongation of QT interval to 700 ms. After RF ablation of accessory pathways patient remains asymptomatic during 6-month follow up, however QTc interval is about 500 ms.

Adult↗

PubMed2006

[Post-traumatic stress disorder in a patient with recurrent ICD shocks. The role of RF ablation].

In patients with frequent ICD discharges an acute stress disorder (ASD), and afterwards a post-traumatic stress disorder (PTSD) is commonly observed. We present a case of a 53-year-old patient with ASD and PTSD in whom RF ablation of VT was performed. After the successful procedure the symptoms of PTSD were significantly diminished. We conclude that in patients with PTSD after ICD discharges RF ablation should be performed as soon as possible.

Adaptation, Psychological↗

PubMed2006

[Application of spectral frequency analysis in atrial fibrillation mechanism assessment].

Recent studies have demonstrated spatio-temporal organisation in atrial fibrillation (AF), with a highest dominant frequencies (DF) at pulmonary veins ostia (PVo). We present a case of 58-year-old woman with AF evaluated by spectral frequency analysis. Simultaneous recordings at each veno-atrial junction and coronary sinus were obtained. Sequential fast Fourier transforms (FFT) of digitalized signals were performed. FFT profiles were analysed to determine DF. Low DF recorded at right inferior PVo suggested no contribution to AF process. Ablation of high DF PVo and low DF SVC with nonuniform anisotropic conduction resulted in AF termination and good clinical outcome in 1-year follow-up.

Atrial Fibrillation↗

PubMed2006

Atrial fibrillation onset circumstances and their relation to patients' quality of life.

INTRODUCTION: As assessed by patients, paroxysmal atrial fibrillation (AF) is very bothersome and significantly decreases quality of life (QoL). AIM: To learn the circumstances that patients attribute to the onset of episodes of paroxysmal AF and attempt to characterise the psychological importance of these situations and their influence on patients' QoL. METHODS: The study involved 76 patients (54 males, aged 17-74 years, mean 53.2), referred for ablation of paroxysmal AF. Disease duration ranged from 1 to 30 years, mean 8.3 years. Physical examination included searching for comorbidities and maximum ventricular rate during AF. Patients underwent psychological evaluation prior to ablation. The QoL was assessed with the SF-36v2 questionnaire. Questionnaire detailing the symptoms was also used. RESULTS: Fifty-five (72%) patients were able to indicate situations accompanying onset of paroxysmal AF. From depicted situations cluster analysis distinguished three clusters: I--heavy meals, alcohol and coffee intake, exercise or stress; II--single sudden movement and rest following stressful events; III--sleep. Significant difference in QoL assessment was observed between these 3 groups. Patients in whom paroxysmal AF occurred after a single sudden movement and at rest find their QoL definitely the worst. The best QoL was in subjects with AF starting at night. Maximum ventricular rate during AF did not correlate with QoL in the whole study group; however, gender-matched analysis revealed significant correlation in females (r=-0.58; p=0.03). There was no significant correlation between other analysed variables and QoL. CONCLUSIONS: Objective indicators between patient health, such as disease duration or comorbidities, do not affect patients' subjective assessment of QoL. Maximum ventricular rate during AF correlated with QoL only in females. Circumstances of AF event onsets, their relationship with disorganisation of activities and psychological value significantly influence QoL of the patients.

Adolescent↗

PubMed2006

[Focus from superior vena cava and atypical atrioventricular nodal reentrant tachycardia in patient with paroxysmal atrial fibrillation--selective RF ablation].

We describe a case of a 34-year-old woman with atrial fibrillation induced by focal frequent tachycardias from superior vena cava and atypical atrioventricular nodal reentrant tachycardia. Selective isolation of SVC and slow pathway RF ablation cured all types of atrial arrhythmias. The slow pathway was localised in the postero-septal mitral anulus and ablated from the left atrium.

Adult↗

PubMed2005

[Tachycardia with rSr' <110 ms in lead V1 -- is it always an atrio-ventricular nodal tachycardia?].

We present a case of a 15-year old girl in whom supraventricular tachycardia (SVT) with rSr' pattern in lead V1 and the QRS width of less than 110 ms, suggesting typical slow-fast AVNRT, was the presenting arrhythmia. During sinus rhythm no preexcitation was observed. Considerable variability of the tachycardia cycle length (240-370 ms), attributable to the presence of the fast and slow nodal pathways, was also observed. However, during the electrophysiological study only orthodromic atrio-ventricular reciprocating tachycardia with the left-sided superior accessory pathway as the retrograde limb was documented. Thus, rSr' pattern was due to incomplete right bundle branch block. We describe how the correct diagnosis and the site of the atrial insertion of the accessory pathway could be inferred from the careful analysis of the P' wave morphology during the tachycardia.

Adolescent↗

PubMed2004

[Regional aortic function studied by three-dimensional echocardiography].

UNLABELLED: Aortic pulsation is caused by the arterial blood pressure variation during the cardiac cycle. Thickening of arterial intima, as well as the presence of atherosclerotic plaques may influence vessel pulsation by increasing wall stiffness. There is no data available concerning regional changes in aortic elasticity in relation with local wall thickness and the magnitude of atherosclerosis. The study group comprised 36 patients (27 men, 9 women, mean age 53 +/- 10 years) referred to our echocardiographic laboratory for transesophageal echocardiography (TEE). TEE probe was placed at the depth of 35 cm. The spatial interval between acquired images was 3 degrees. The reconstructed data sets were reviewed and the border between the aortic wall, plaque and lumen was determined. The reconstruction of a two-centimeter-long segment of aorta was divided by coaxial planes into four longitudinal sections. Thereafter the diastolic and systolic radius of each section, thickness of atherosclerotic plaques and intima-media thickness in each section were measured. The regional beta-index was calculated as Ln (systolic pressure/diastolic pressure)/relative change in regional aortic lumen, where relative change in regional aortic lumen was calculated as the difference between aortic lumen volume in systole and diastole divided by aortic lumen volume in diastole. In total, 144 aortic sections were analyzed. The volume of two-centimeter-long segments of descending aorta ranged from 6.9 cm3 to 31.5 cm3 (mean 12.8 +/- 5.2 cm3) in systole and from 4.9 cm3 to 29.2 cm3 (mean 11.2 +/- 4.9 cm3) in diastole. The volume of the examined sections of the aortic segments ranged from 1.3 cm3 to 10.6 cm3 (mean 3.2 +/- 2.6 cm3) in systole and from 1.1 cm3 to 8.7 cm3 (mean 2.8 +/- 1.5 cm3) in diastole. The pulsation of the aortic sections varied from 0.01 cm3 to 2.7 cm3 (mean 0.4 +/- 0.3 cm3), which constituted 0 to 37% (mean 13 +/- 8%) of the section volume. The thickness of atherosclerotic plaques in the studied aortic sections ranged from 0.0 mm to 1.1 mm (mean 0.3 +/- 0.2 mm) and the intima-media thickness was within the range 1.3 mm to 2.5 mm (mean 1.9 +/- 0.3 mm). The regional beta-index of the individual section ranged from 1.1 to 253.9 (mean 9.3 +/- 24.3). The regional beta-index was statistically significantly dependent on the intima-media thickness (p=0.02). We found no significant correlation between beta-index and the thickness of atherosclerotic plaques in the studied segments (p=0.38). CONCLUSIONS: Transoesophageal three-dimensional echocardiography facilitates quantitative analysis of aortic wall stiffness and regional beta-index measurements. The local variability of beta-index is correlated with intima-media thickness, whereas the correlation with the thickness of atherosclerotic plaques is not statistically significant. These measurements may be of importance in the assessment of the degree of atherosclerosis advancement. It forms new perspectives in diagnostics with the ability to evaluate the influence of pharmacotherapy and life-style modifications.

Aorta↗