Biomedical subjects

Valentino Ducceschi

Publications and source records attributed to Valentino Ducceschi.

3 recordsLinked to original sources

PubMed2004

Intracardiac echocardiography to guide transseptal catheterization for radiofrequency catheter ablation of left-sided accessory pathways: two case reports.

Intracardiac echocardiography (ICE) is a useful tool for guiding transseptal puncture during electrophysiological mapping and ablation procedures. Left-sided accessory pathways (LSAP) can be ablated by using two different modalities: retrograde approach through the aortic valve and transseptal approach with puncture of the fossa ovalis. We shall report two cases of LSAP where transcatheter radiofrequency ablation (TCRFA) was firstly attempted via transaortic approach with ineffective results. Subsequently, a transseptal approach under ICE guidance has been performed. During atrial septal puncture ICE was able to locate the needle tip position precisely and provided a clear visualization of the "tenting effect" on the fossa ovalis. ICE allowed a better mapping of the mitral ring and a more effective catheter ablation manipulation and tip contact which resulted in a persistent and complete ablation of the accessory pathway with a shorter time of fluoroscopic exposure. ICE-guided transseptal approach might be a promising modality for TCRFA of LSAP.

Adult↗

PubMed2004

A "multisite" atrioventricular block.

A 6-year-old child, operated for a perimembranous ventricular septal defect, underwent an electrophysiologic study for the presence of first degree atrioventricular (AV) block and bifascicular block with episodes of type 1 and type 2 second degree AV block. Electrophysiologic study showed a considerable infra-His conduction delay (HV interval 170 ms) and spontaneous phases of infra-His type 1 second degree AV block. During incremental atrial pacing supra-His type 1 second degree AV block and 2:1 infra-His AV block were simultaneously observed and this condition persisted unmodified despite the intravenous injection of atropine. The block distal to the His bundle was considered functional.

Child↗

PubMed2002

Ventricular interdependence in patients with dual-chamber pacing: a Doppler tissue imaging study.

PURPOSE: To analyze pulsed-Doppler tissue imaging (DTI) of the right ventricular (RV) tricuspid annulus and left ventricular (LV) mitral annulus in patients paced in the DDD mode at three different pacing modes as compared with healthy subjects, and to investigate possible physiologic interaction between the RV and LV in this subgroup of patients. METHODS: We selected a population of 22 subjects with pacemakers (PM) for atrioventricular (AV) block and/or sick sinus syndrome and compared them to 20 healthy subjects. Standard echo Doppler and DTI parameters were measured at baseline (heart rate [HR] 70 beats/min; AV delay 125 msec) and after at least 5 minutes of constant stimulation at two different pacing modes: (1) HR 70 beats/min, AV delay 188 msec, and (2) HR 89 beats/min, AV delay 125 msec. LV stroke volume was obtained by LV outflow Doppler method. RESULTS: In the PM group, RV and LV annulus exhibited significantly higher peak systolic (S(m)) and early (E(m)) diastolic wall velocities than controls. In the PM population, LV stroke volume was strongly associated to RV E(m) peak velocity (r = 0.83; P < 0.00001) and RV S(m) peak velocity (r = 0.81; P < 0.0001). These associations between LV stroke volume and RV DTI parameters remained significant even after increase of HR and AV delay in the pacing modalities. Moreover, univariate relations were found in the PM group between DTI indexes of RV tricuspid annulus and the homologous indexes of LV mitral annulus. In a multiple linear regression analysis, both RV E(m) (P < 0.001) and RV S(m) (P < 0.001) were related independently to LV stroke volume (cumulative R(2) = 0.85, P < 0.00001). CONCLUSIONS: Our findings suggest the usefulness of pulsed-DTI to display physiologic ventricular interaction in patients with PM. Therefore, DTI may be taken into account as a valuable supporting tool to predict LV systolic performance and to select the most appropriate pacing mode in individual PM patients.

Aged↗