Japanese Journal of Electrocardiology
Online ISSN : 1884-2437
Print ISSN : 0285-1660
ISSN-L : 0285-1660
Volume 30, Issue 1
Displaying 1-10 of 10 articles from this issue
Editorial
  • Hiroaki Sugiyama, Yasushi Imai, Aya Ebihara, Katsuhito Fujiu, Yasunobu ...
    2010 Volume 30 Issue 1 Pages 63-72
    Published: 2010
    Released on J-STAGE: July 14, 2010
    JOURNAL FREE ACCESS
    Heart failure (HF) due to a failing right ventricle (RV) functioning as a systemic chamber in patients with congenitally corrected transposition of great arteries (C-TGA) is often encountered and is now a therapeutic challenge for adult cardiologists. Whether cardiac resynchronization therapy (CRT) may achieve a satisfactory outcome for these patients, especially for those with end-stage HF, has been not established in contrast to its established efficacy in patients with left ventricular dysfunction and electromechanical dyssynchrony. Here, we report a 41-year-old patient with inotrope-dependent RV failure accompanied by C-TGA and dextrocardia drastically improved by CRT, as well as a review of the literature.
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  • Kotaro Fukumoto, Seiji Takatsuki, Kojiro Tanimoto, Nobuhiro Nishiyama, ...
    2010 Volume 30 Issue 1 Pages 73-79
    Published: 2010
    Released on J-STAGE: July 14, 2010
    JOURNAL FREE ACCESS
    A 72-year-old woman who suffered from paroxysmal atrial fibrillation for 6 years referred to our hospital. Although she became free from atrial fibrillation after two sessions of catheter ablation of electrical isolation of the pulmonary veins in March and December 2007, the paroxysmal atrial tachycardia recurred 4 months after the second ablation procedure. During the third ablation in April 2008, electrical reconnection was observed between the right inferior pulmonary vein and left atrium at baseline. Rapid intravenous administration of 20mg of adenosine triphosphate under continuous infusion of isoproterenol revealed transient reconnection between the right superior pulmonary vein and the left atrium. The P wave morphology of clinically detected atrial tachycardia was similar to that during pacing from the right superior pulmonary vein. Hence, the atrial tachycardia was considered to originate from the right superior pulmonary vein. After isolation of the right superior and inferior pulmonary veins, no electrical reconduction was observed with or without drug administration. She has been free from arrhythmia after the ablation for 16 months without antiarrhyrhmic drugs. Transient reconnection between the right superior pulmonary vein and the left atrium caused the clinical symptomatic tachycardia, which was revealed only by administration of adenosine triphosphate during catheter ablation. The functional conduction block between the pulmonary veins and the left atrium can occur in the chronic phase after catheter ablation, and adenosine triphosphate infusion is considered to be important to confirm complete conduction block even after multiple sessions of catheter ablation.
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