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S Chaithiraphan

Publications and source records attributed to S Chaithiraphan.

At least 37 records · Page 2Linked to original sources
PubMed1998

Radiofrequency catheter ablation for frequent premature ventricular contractions: a preliminary report of 15 cases.

Between February 1995 and March 1997, 15 patients, 13 women and 2 men, underwent radiofrequency catheter ablation (RFCA) for symptomatic frequent premature ventricular contractions (PVC's). The mean age was 43.3 +/- 11.9 years. Thirteen patients (86.7%) had right PVC's and the remainder had both right and left PVC's. RFCA were done under local anesthesia, using both earliest endocardial activation time and pace mapping in complement. The immediate success rate was 14/15 (93%) with only minor complications in 2 patients (13.3%). The fluoroscopic and procedure times were 40.6 +/- 24.0 and 170.7 +/- 81.2 minutes, respectively. From the Holter monitoring, total PVC count, per cent of PVC per total heart beat in 24 hours and couplets count were significantly reduced, (more than 90%, p < 0.05), by RFCA. Triplets and repetitive ventricular tachycardia were totally abolished. During the follow-up period of 10.1 +/- 7.5 months, 2 patients (14.3%) had recurrences of right PVC's within 2 weeks after ablation. Reablation was successfully done in both patients without recurrence, giving the final success rate of 93 per cent. In conclusion, RFCA could be safely performed with a high success rate in patients with symptomatic frequent PVC's. It can be considered an alternative treatment in patients resistant to medical therapy.

Adult↗
PubMed1998

Short-term effects of atenolol in patients with dilated cardiomyopathy.

Dilated cardiomyopathy is a common cause of heart failure with systolic dysfunction. Medications used to treat this condition are usually for symptomatic relief. We studied the effect of atenolol in heart failure caused by dilated cardiomyopathy in a double blinded randomized fashion. There were 17 males and 5 females. All patients underwent right and left heart catheterization, coronary angiography, endomyocardial biopsy, exercise testing and doppler echocardiography. By 3 months, atenolol significantly reduced resting and exercise heart rate and pulmonary capillary wedge pressure. There was no difference in exercise capacity. We conclude from this study that atenolol improve hemodynamic condition in patients with dilated cardiomyopathy without improving exercise capacity during this short observation period.

Adrenergic beta-Antagonists↗
PubMed1997

Radiofrequency catheter ablation in symptomatic ventricular arrhythmia.

BACKGROUND: Radiofrequency catheter ablation (RFCA) is an effective method to cure both supraventricular and ventricular arrhythmia (VA) in certain centres. AIM: To assess the results of RFCA in VA at Siriraj Hospital. METHOD: Electrophysiologic study, mapping, using both earliest endocardial activation and pace mapping, and ablation were performed. RESULTS: Thirty patients with symptomatic VA underwent RFCA. The mean age was 44 years. Eight patients had underlying heart disease (two prolapsed mitral valve, three myocarditis, two dilated cardiomyopathy and one mitral stenosis). Thirty-six morphologies of VA were detected from the study. Thirty-three morphologic tachycardias attempted were successfully ablated; 17, 10 and six were right VT, left VT and premature ventricular contraction (PVC), respectively. Failure of ablation occurred in one patient with left VT. Only minor complications occurred in this study. There was no difference in cycle length and endocardial activation time between right and left VT. 12/12 identical pace mapping was more easily performed in right VT than in left VT. The fluoroscopic and procedure times in left VT were significantly longer than in right VT. Relapse occurred in six patients. Re-ablation was successfully performed in four patients, giving a final success rate of 93%. CONCLUSION: RFCA is an effective treatment and should be considered as an alternative method to cure VT and refractory PVC.

Adolescent↗
PubMed1997

Ticlopidine in the prevention of thrombus formation after percutaneous transluminal coronary angioplasty (PTCA).

We studied the additive effect of ticlopidine to aspirin compared with aspirin in the prevention of thrombus formation after PTCA in two groups of 21 patients who underwent PTCA at Her Majesty's Cardiac Centre, Siriraj Hospital from January to April 1993. Patients in both groups were comparable in baseline patient data and characteristics of angiographic lesions. There was no difference in angiographic outcome including the presence of intracoronary thrombus between the two groups. We concluded that ticlopidine had no additive effect to aspirin in the prevention of thrombus formation after PTCA.

Angioplasty, Balloon, Coronary↗
PubMed1997

Perforation of interventricular septum in acute myocardial infarction.

Eight cases of ruptured interventricular septum associated with myocardial infarction were diagnosed at Siriraj Hospital between 1985-1995. Clinical congestive heart failure and holosystolic murmur were found in all. Diagnosis was confirmed by echocardiogram and right heart catheterization in all patients. Two patients died from congestive heart failure preoperatively and the third case died from organ failure and sepsis postoperatively. Another five cases underwent successful ventricular septal defect closure and coronary artery bypass with good results.

Aged↗
PubMed1997

Radiofrequency catheter ablation in type I atrial flutter: preliminary experience of 10 cases.

Common atrial flutter results from macroreentry in the right atrium. Catheter ablation of slow conduction, between tricuspid annulus and inferior vena cava (TA-IVC) or tricuspid annulus and coronary sinus ostium (TA-CS os) has been reported to terminate and prevent recurrence of this arrhythmia. We reported 10 consecutive patients, 7 men and 3 women, who underwent radiofrequency catheter ablation of common atrial flutter. The mean age was 59.4 +/- 11.2 years (range 42-82 years). During the paroxysmal atrial flutter, all patients had palpitation, 4 had dyspnea on exertion, 3 patients had syncope and 1 patient had presyncope. The mean duration of symptoms was 5.7 +/- 4.9 years (range 0.5-13 years). Two patients had dilated cardiomyopathy, 1 Ebstein's anomaly and 1 chronic obstructive pulmonary disease. Four patients (40%) had history of atrial fibrillation (AF) before ablation. The mean cycle length of atrial rhythm was 257.2 +/- 36.6 ms. Ablation was done by anatomical approach and could terminate arrhythmia in 9 patients (90%), 7 from TA-IVC, 2 from TA-CS os without major complication. The mean number of applications was 20.4 +/- 16.9 and turned atrial flutter to normal sinus rhythm in 13.5 +/- 10.7 seconds. Fluoroscopic and procedure times were 38.4 +/- 31.4 and 157.2 +/- 68.8 minutes, respectively. During the follow-up period of 24.0 +/- 28.7 weeks, 2 patients had recurrent atrial arrhythmia, 1 atrial fibrillation and 1 atrial flutter type I, giving the final success rate of 70 per cent. All patients who had recurrence or failure had a history of paroxysmal AF before ablation. In conclusion, radiofrequency catheter ablation in atrial flutter type I, using anatomical approach, is an effective treatment to terminate and prevent this arrhythmia in short term follow-up. It may be considered as an alternative treatment in patients with atrial flutter who were refractory to antiarrhythmic agents.

Adult↗
PubMed1997

Transcatheter coronary revascularization registry 1995.

In 1995, from 12 participating units, there were 1108 PTCA compared to 697 in 1994, 24 rotational atherectomy and 109 intracoronary stent placements performed. These were complicated by 6 acute myocardial infarction, 10 emergency surgeries and 11 deaths. Success rate was 92 per cent. Indication for transcatheter revascularization were stable angina pectoris in 60 per cent of cases, unstable angina in 18 per cent and post infarct angina in 16 per cent. Thirty cases were done in AMI setting. Of those 1108 vessels approached, 1297 lesions were in native arteries and 9 were in saphenous vein grafts. Most lesions were in AHA/ACC type B category. One hundred and fourteen stents were placed in 109 patients in 1995. Seven stents emboli occurred in addition to one myocardial infarction, 2 CABG, 2 death and 2 major bleeding. Transcutaneous coronary revascularization has increased in number with acceptable results. Coronary stenting was done in an average of 10 per cent of all procedures and also with reasonable complication rates.

Angina Pectoris↗
PubMed1996

Resolution of dilated cardiomyopathy after radio-frequency catheter ablation of atrial tachycardia.

The dilated cardiomyopathies are characterized by an increase in left ventricular internal dimensions without an appropriate increase in ventricular wall thickness. Sustained tachyarrhythmia, either supraventricular or ventricular, may be associated with this condition and may improve after termination of the tachycardia. We report a case of secondary dilated cardiomyopathy caused by incessant atrial tachycardia who underwent successful radiofrequency catheter ablation and left ventricle returned to normal size and function in six months post ablation.

Cardiomyopathy, Dilated↗
PubMed1996

Non-invasive diagnostic approaches of the dissection of the aorta: transesophageal echocardiography vs computed tomography.

The accuracy of non-invasive diagnosis of aortic dissection between transesophageal echocardiography (TEE) and computed tomography (CT) was studied in 21 patients. All patients had both diagnostic procedures. With TEE examination, De Bakey's type I was found in 9 patients, type II in 1 and type III in 10 while CT imaging revealed aortic dissection in 19 out of 21 patients. If the dissection found by both diagnostic procedures was considered definitive then both examinations were similarly sensitive. TEE is a preferred choice of non invasive work up for aortic dissection. Medical and surgical therapy in appropriate cases evaluated by TEE give rise to good results in the majority of patients.

Adult↗
PubMed1996

Radiofrequency catheter ablation in monomorphic ventricular tachycardia.

Twenty patients with symptomatic monomorphic ventricular tachycardia (VT) underwent radiofrequency (RF) energy catheter ablation. Four patients (20%) had underlying heart disease (1 prolapse mitral valve, 1 dilated cardiomyopathy and 2 myocarditis). Five patients (25%) had left sided VT and right sided VT in the remainder (75%). Radiofrequency catheter ablation was initially successful in all patients without major complication. Recurrence occurred in three patients (15%). In conclusion, RF ablation is an effective treatment for symptomatic monomorphic right and left sided VT especially in patients who do not want long term antiarrhythmic agents.

Adult↗
PubMed1996

Radiofrequency ablation of cardiac arrhythmia: the first fifty cases experience in Siriraj Hospital.

In our series of 50 consecutive patients with a wide variety of cardiac arrhythmia, a combined approach to electrophysiological diagnosis and definitive treatment with catheter ablation was associated with a high degree of efficacy, low procedural complication and low rate of arrhythmia recurrence. The radiofrequency catheter ablation should be considered as the acceptable or preferable first line treatment in patients with supraventricular tachycardia and idiopathic ventricular tachycardia.

Adolescent↗
PubMed1996

Relationship between exercise capacity and left ventricular function in aortic and mitral regurgitation.

The exercise capacity as assessed by treadmill exercise or functional class from clinical history cannot predict standard echocardiographic findings in patients with AR/MR, in terms of EF, LVDs, ESVI. Therefore, exercise capacity cannot be used to predict the timing for surgery in those patients. However, symptomatic patients with dilated LV usually have low LVEF such as in our group.

Adolescent↗
PubMed1996

Left ventricular hypertrophy: relationship of echocardiographic and electrocardiographic findings in idiopathic dilated cardiomyopathy.

Diagnosis of left ventricular hypertrophy is important in patients with cardiac disease. To test the correlation of echocardiographic and electrocardiographic findings for diagnosis of left ventricular hypertrophy in Idiopathic Dilated Cardiomyopathy (IDC), 18 patients with proven IDC were examined. There were 15 males and 3 females, ages ranged from 22-60 years (mean 43 +/- 10.7). LV mass index ranged from 134.4-421.2 g/m2 (mean 187.8 +/- 68.6). All 18 patients had LVH by echocardiography but only 10 patients (55.6%) had LVH by using ECG Romhilt-Estes scoring system. The correlation between echocardiographic and electrocardiographic findings for diagnosis LVH was not significant (r = 0.026; p = 0.935) and echocardiography was better than electrocardiography for diagnosis of LVH in IDC.

Adult↗
PubMed1996

Congenital coronary artery fistula: a report of 24 patients.

Clinical, hemodynamic and angiographic findings of 24 adolescent or adult patients with coronary artery fistula were retrospectively analyzed. There were 7 males and 17 females with the average age of 41.4 years. Nineteen of 24 patients (79.2%) were symptomatic and 18 were older than 20 years of age. Continuous murmur was present in 17 patients, "to and fro' murmur was audible in 2, apical systolic murmur was audible in 1. The remaining 4 patients had no audible murmur. Location of murmur in all patients was unusual for patent ductus arteriosus. Cardiomegaly on chest X-ray was found in 17 patients (70.8%) in whom 8 had prominent pulmonary artery. Electrocardiographic abnormalities were detected in 10 of 24 patients (41.6%) i.e. left ventricular hypertrophy (4 patients) biventricular hypertrophy (2 patients), incomplete right bundle branch block (2 patients), and ischemic changes (2 patients). The intracardiac pressures were slightly elevated and the mean Qp/Qs ratio was only 1.4 +/- 1.2. Angiographically, 28 fistulas were demonstrated in 24 patients. The origins of fistula were from right coronary artery in 12 patients (50%), left coronary artery in 8 patients (33.3%) and both coronary arteries in 4 patients (16.7%). Fistulas drained into the right atrium in 5 patients (20.8%), into coronary sinus in 2 patients (8.3%), into right ventricle in 4 patients (16.7%), into pulmonary arteries in 10 patients (41.7%) and into left ventricle in 3 patients (12.5%).

Adolescent↗