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Sharp A, Patient C, Pickett J, Belham M. Pregnancy-related inappropriate sinus tachycardia: A cohort analysis of maternal and fetal outcomes. Obstet Med 2021; 14:230-234. [PMID: 34880936 DOI: 10.1177/1753495x21990196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/30/2020] [Indexed: 11/15/2022] Open
Abstract
Background Little literature exists regarding the syndrome of inappropriate sinus tachycardia during pregnancy. We aimed to further understand the natural history of inappropriate sinus tachycardia in pregnancy, and to explore maternal and fetal outcomes. Methods A retrospective, observational cohort analysis of 19 pregnant women who presented with inappropriate sinus tachycardia. Results 42% attended the emergency department on more than one occasion with symptoms of inappropriate sinus tachycardia; 32% required hospital admission and 26% required pharmacological therapy. There were no maternal deaths, instances of heart failure or acute coronary syndrome, and no thromboembolic or haemorrhagic complications during pregnancy. Rates of caesarean section were similar to the background rate of our unit (32% and 27%, respectively). Rates of induction were notably elevated (58% vs 25%). Conclusion Inappropriate sinus tachycardia in pregnancy is associated with high rates of hospitalization and induction of labour, which may not be mandatory given the clinical findings in this group of women.
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Affiliation(s)
- Alexander Sharp
- Department of Cardiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Charlotte Patient
- Department of Obstetrics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Janet Pickett
- Department of Anaesthesia, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mark Belham
- Department of Cardiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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2
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Sinus node sparing novel hybrid approach for treatment of inappropriate sinus tachycardia/postural sinus tachycardia: multicenter experience. J Interv Card Electrophysiol 2021; 63:531-544. [PMID: 34424446 PMCID: PMC9151552 DOI: 10.1007/s10840-021-01044-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/27/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND The ideal treatment of inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS) still needs to be defined. Medical treatments yield suboptimal results. Endocardial catheter ablation of the sinus node (SN) may risk phrenic nerve damage and open-heart surgery may be accompanied by unjustified invasive risks. METHODS We describe our first multicenter experience of 255 consecutive patients (235 females, 25.94 ± 3.84 years) having undergone a novel SN sparing hybrid thoracoscopic ablation for drug-resistant IST (n = 204, 80%) or POTS (n = 51, 20%). As previously described, the SN was identified with 3D mapping. Surgery was performed through three 5-mm ports from the right side. A minimally invasive approach with a bipolar radiofrequency clamp was used to ablate targeted areas while sparing the SN region. The targeted areas included isolation of the superior and the inferior caval veins, and a crista terminalis line was made. All lines were interconnected. RESULTS Normal sinus rhythm (SR) was restored in all patients at the end of the procedure. All patients discontinued medication during the follow-up. After a blanking period of 6 months, all patients presented stable SR. At a mean of 4.07 ± 1.8 years, normal SN reduction and chronotropic response to exercise were present. In the 51 patients initially diagnosed with POTS, no syncope occurred. During follow-up, pericarditis was the most common complication (121 patients: 47%), with complete resolution in all cases. Pneumothorax was observed in 5 patients (1.9%), only 3 (1.1%) required surgical drainage. Five patients (1.9%) required a dual-chamber pacemaker due to sinus arrest > 5 s. CONCLUSIONS Preliminary results of this multicenter experience with a novel SN sparing hybrid ablation of IST/POTS, using surgical thoracoscopic video-assisted epicardial ablation combined with simultaneous endocardial 3D mapping may prove to be an efficient and safe therapeutic option in patients with symptomatic drug-resistant IST and POTS. Importantly, in our study, all patients had a complete resolution of the symptoms and restored normal SN activity.
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Lakkireddy D, Garg J, DeAsmundis C, LaMeier M, Romeya A, Vanmeetren J, Park P, Tummala R, Koerber S, Vasamreddy C, Shah A, Shivamurthy P, Frazier K, Awasthi Y, Chierchia GB, Atkins D, Bommana S, Di Biase L, Al-Ahmad A, Natale A, Gopinathannair R. Sinus Node Sparing Hybrid Thoracoscopic Ablation Outcomes in Patients with Inappropriate Sinus Tachycardia (SUSRUTA-IST) Registry. Heart Rhythm 2021; 19:30-38. [PMID: 34339847 DOI: 10.1016/j.hrthm.2021.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Medical treatment of inappropriate sinus tachycardia (IST) remains suboptimal. Radiofrequency sinus node (RF-SN) ablation has poor success and higher complication rates. OBJECTIVE We aimed to compare clinical outcomes of the novel SN sparing hybrid ablation technique with those of RF-SN modification for IST management. METHODS This is a multicenter prospective registry comparing the SN sparing hybrid ablation strategy with RF-SN modification. The hybrid procedure was performed using an RF bipolar clamp, isolating superior vena cava/inferior vena cava with the creation of a lateral line across the crista terminalis while sparing the SN region (identified by endocardial 3-dimensional mapping). RF-SN modification was performed by endocardial and/or epicardial mapping and ablation at the site of earliest atrial activation. RESULTS Of the 100 patients (hybrid ablation group, n = 50; RF-SN group, n = 50), 82% were women, and the mean age was 22.8 years. Normal sinus rhythm and rate were restored in all patients in the hybrid group (vs 84% in the RF-SN group; P = .006). Hybrid ablation was associated with significantly better improvement in mean daily heart rate and peak 6-minute walk heart rate compared with RF-SN ablation. The RF-SN group had a significantly higher rate of redo procedures (100% vs 8%; P < .001), phrenic nerve injury (14% vs 0%; P = .012), lower acute pericarditis (48% vs 92%; P < .0001), permanent pacemaker implantation (50% vs 4%; P < .0001) than did the hybrid ablation group. CONCLUSION The novel sinus node sparing hybrid ablation procedure appears to be more efficacious and safer in patients with symptomatic drug-resistant IST with long-term durability than RF-SN ablation.
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Affiliation(s)
| | - Jalaj Garg
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, Loma Linda, California
| | - Carlo DeAsmundis
- Heart Rhythm Management Center, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, Belgium
| | - Mark LaMeier
- Cardiac Surgery Department, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, Belgium
| | - Ahmed Romeya
- Kansas City Heart Rhythm Institute, Overland Park, Kansas
| | | | - Peter Park
- Kansas City Heart Rhythm Institute, Overland Park, Kansas
| | | | - Scott Koerber
- Kansas City Heart Rhythm Institute, Overland Park, Kansas
| | | | - Alap Shah
- Kansas City Heart Rhythm Institute, Overland Park, Kansas
| | | | | | | | - Gian Battista Chierchia
- Heart Rhythm Management Center, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, Brussels, Belgium
| | - Donita Atkins
- Kansas City Heart Rhythm Institute, Overland Park, Kansas
| | - Sudha Bommana
- Kansas City Heart Rhythm Institute, Overland Park, Kansas
| | - Luigi Di Biase
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Amin Al-Ahmad
- Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, Texas
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, Texas
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4
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de Asmundis C, Chierchia GB, Sieira J, Ströker E, Umbrain V, Poelaert J, Brugada P, La Meir M. Sinus Node Sparing Novel Hybrid Approach for Treatment of Inappropriate Sinus Tachycardia/Postural Orthostatic Sinus Tachycardia With New Electrophysiological Finding. Am J Cardiol 2019; 124:224-232. [PMID: 31084999 DOI: 10.1016/j.amjcard.2019.04.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 10/27/2022]
Abstract
The ideal treatment of Inappropriate Sinus Tachycardia (IST) and Postural Orthostatic Tachycardia Syndrome (POTS) still needs to be defined. Medical treatment yields suboptimal results, endocardial ablation of the sinus node (SN) may risk phrenic nerve damage and open heart surgery may be accompanied by unjustified invasive risks. We describe our first experience of 50 consecutive patients (41 females, 22.83 ± 3.91 years) having undergone a novel hybrid thoracoscopic ablation for drug resistant IST (n = 39, 78%) or POTS (n = 11, 22%). The SN was identified with the help of 3D mapping. Surgery was performed through 3 (5 mm) ports from the right side. A minimally invasive approach with a radio frequency bipolar clamp was utilized to a new target sparing the SN region, to isolate the superior and the inferior caval veins, and a crista terminalis line was made. All lines were interconnected. Normal SR was restored in all patients at the end of the procedure. All patients discontinued medication during the follow-up. After a blanking period of 6 months all patients presented stable SR. At a mean of 28.4 ± 1.2 months, normal SN ruction and chronotropic response to exercise was present. In the 11 patients initially diagnosed with POTS, no syncope occurred. During the follow-up, pericarditis was the most common complication (39 patients; 78%) with complete resolution in all cases. In conclusions the preliminary results of our first experience with a SN sparing novel hybrid ablation of IST/POTS, using surgical thoracoscopic video-assisted epicardial ablation combined with concomitant endocardial 3D mapping may prove an efficient and safe therapeutic option in patients with symptomatic drug resistant IST and POTS. Importantly, in our study all patients had a complete resolution of the symptoms and restored normal SN activity.
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5
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Aalaei-Andabili SH, Miles WM, Burkart TA, Panna ME, Conti JB, McKillop MS, Beaver TM. Minimally invasive thoracoscopic surgery is an effective approach for treating inappropriate sinus tachycardia. J Cardiovasc Electrophysiol 2019; 30:1297-1303. [PMID: 31222889 DOI: 10.1111/jce.13970] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 03/28/2019] [Accepted: 04/11/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Inappropriate sinus tachycardia (IST) is characterized by increased heart rate out of proportion to normal physiologic demand. IST ablation is challenging for the electrophysiology community due to the epicardial location of the sinus node and the risk of phrenic nerve (PN) injury during catheter ablation. In this study, we investigated the safety and efficacy of a minimally invasive thoracoscopic surgery for elimination of IST. METHODS Patients with IST who failed medical therapy or endocardial ablation underwent minimally invasive thoracoscopic epicardial ablation. Epicardial activation mapping was performed to identify the earliest activation site and any possible migration of earliest activation along the lateral right atrium. The PN in each patient was protected by a pericardial retraction suture. RESULTS From 1 January 2000 to 15 June 2018, 10 patients (eight females and two males) underwent minimally invasive thoracoscopic IST ablation. Mean age of the patients was 36.7 ± 12.5 years. Mean baseline sinus rate was 113.8 ± 21.8 beats per minute. After surgery, the mean heart rate significantly decreased to 79.8 ± 8.2 at postoperative day 1 and to 75.8 ± 8.1 at day 30 (both P < .001). No in-hospital death, stroke, or PN injury occurred. One patient required reintubation, one patient developed postoperative pericarditis, and another patient had a pulmonary embolus. Median follow-up was 6 months (range, 1-50). Freedom from reintervention was 88% at 6 months. CONCLUSION Minimally invasive thoracoscopic ablation for IST is a safe and effective approach that preserves the phrenic nerve. Due to the possibility of IST activation site migration, continued follow-up after surgery is required.
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Affiliation(s)
- Seyed Hossein Aalaei-Andabili
- Division of Cardiology, University of Florida, Gainesville, Florida.,Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - William M Miles
- Division of Cardiology, University of Florida, Gainesville, Florida
| | - Thomas A Burkart
- Division of Cardiology, University of Florida, Gainesville, Florida
| | - Mark E Panna
- Division of Cardiology, University of Florida, Gainesville, Florida
| | - Jamie B Conti
- Division of Cardiology, University of Florida, Gainesville, Florida
| | | | - Thomas M Beaver
- Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
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Affiliation(s)
- Brian Olshansky
- Professor Emeritus, Cardiology, University of Iowa Hospitals, 200 Hawkins Drive, Iowa, IA, USA
- Mercy Hospital-North Iowa, 1000 4th St SW, Mason, IA, USA
| | - Renee M Sullivan
- Medical Director, Clinical development Services, Covance, 2501 McGavock Pike, Nashville, TN, USA
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Yasin OZ, Vaidya VR, Chacko SR, Asirvatham SJ. Inappropriate Sinus Tachycardia: Current Challenges and Future Directions. J Innov Card Rhythm Manag 2018; 9:3239-3243. [PMID: 32479576 PMCID: PMC7252682 DOI: 10.19102/icrm.2018.090706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Omar Z. Yasin
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA
| | | | | | - Samuel J. Asirvatham
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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Belham M, Patient C, Pickett J. Inappropriate sinus tachycardia in pregnancy: a benign phenomena? BMJ Case Rep 2017; 2017:bcr-2016-217026. [PMID: 28275013 DOI: 10.1136/bcr-2016-217026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The syndrome of inappropriate sinus tachycardia (IST) is a well-described and generally benign condition outside pregnancy. There is, however, little information in the literature about IST during pregnancy and nothing about the likely mechanism in such cases. Equally there is a paucity of information about the effects on maternal and fetal well-being in patients who develop IST during pregnancy. Here, we describe the case of a woman who developed IST for the first time during pregnancy. We have first given a brief clinical summary of events and then follow this with the patient's personal account which she has written herself specifically for this case report. We believe that this case highlights some of the important issues associated with the condition when it occurs during pregnancy. We hope that the publication of this case report will increase the awareness of IST during pregnancy. This is important as we believe that the correct diagnosis and understanding of the condition and its consequences will allow clinicians to manage women afflicted by the condition empathetically and appropriately.
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Affiliation(s)
- Mark Belham
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Janet Pickett
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Strategies for phrenic nerve preservation during ablation of inappropriate sinus tachycardia. Heart Rhythm 2016; 13:1238-1245. [PMID: 26804567 DOI: 10.1016/j.hrthm.2016.01.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Radiofrequency (RF) ablation can alleviate drug-refractory inappropriate sinus tachycardia (IST). However, phrenic nerve (PN) injury and other complications limit its use. OBJECTIVE The purpose of this study was to characterize the maneuvers used to avoid PN injury and the long-term clinical outcomes. METHODS The study consisted of a retrospective analysis of consecutive patients who underwent ablation for IST. RESULTS RF ablation was performed on 13 consecutive female patients with drug-refractory IST. Eleven patients exhibited PN capture at desired ablation sites. In 1 patient, PN capture was not continuous throughout the respiratory cycle and ventilation holding sufficed to avoid PN injury. In 10 patients, pericardial access (PA) and balloon insertion was required. Initially (n = 4) a posterior PA was used, which was replaced by an anterior PA in the subsequent 6 cases. PA to optimal balloon positioning time was significantly lower in anterior vs posterior PA (16.3 ± 6 minutes vs 58 ± 21.3 minutes, P = .01), as was fluoroscopy time (15.66 ± 16.72 min vs 35.9 ± 1.8 min, P = .03). RF ablation successfully reduced sinus rate to <90 bpm in 13 of 13 patients. Procedure times and total RF times were not significantly different in anterior vs posterior PA. Major complications occurred in 2 patients, including unremitting pericardial bleeding requiring open-chested repair in 1 patient and sinus pauses mandating pacemaker implantation in the other patient. Long-term symptom control after follow-up of 811 ± 42 days was successful in 84.6%. CONCLUSION Ventilation holding and/or pericardial balloon insertion are frequently warranted in IST ablation. Anterior PA appears to facilitate the procedure over posterior PA.
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10
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Gianni C, Di Biase L, Mohanty S, Gökoğlan Y, Güneş MF, Horton R, Hranitzky PM, Burkhardt JD, Natale A. Catheter ablation of inappropriate sinus tachycardia. J Interv Card Electrophysiol 2015; 46:63-9. [PMID: 26310299 DOI: 10.1007/s10840-015-0040-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/21/2015] [Indexed: 11/30/2022]
Abstract
Catheter ablation for inappropriate sinus tachycardia (IST) is recommended for patients symptomatic for palpitations and refractory to other treatments. The current approach consists in sinus node modification (SNM), achieved by ablation of the cranial part of the sinus node to eliminate faster sinus rates while trying to preserve chronotropic competence. This approach has a limited efficacy, with a very modest long-term clinical success. To overcome this, proper patient selection is crucial and an epicardial approach should always be considered. This brief review will discuss the current role and limitations of catheter ablation in the management of patients with IST.
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Affiliation(s)
- Carola Gianni
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Luigi Di Biase
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.,Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Biomedical Engineering, University of Texas, Austin, TX, USA.,Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
| | - Yalçın Gökoğlan
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
| | - Mahmut F Güneş
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
| | - Rodney Horton
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.,Department of Biomedical Engineering, University of Texas, Austin, TX, USA
| | - Patrick M Hranitzky
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
| | - J David Burkhardt
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA. .,Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. .,Department of Biomedical Engineering, University of Texas, Austin, TX, USA. .,Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH, USA. .,Division of Cardiology, Stanford University, Stanford, CA, USA. .,Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, CA, USA. .,Interventional Electrophysiology, Scripps Clinic, La Jolla, CA, USA. .,Dell Medical School, University of Texas, Austin, TX, USA.
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JACOBSON JASONT, KRAUS ALEXANDRIA, LEE RICHARD, GOLDBERGER JEFFREYJ. Epicardial/Endocardial Sinus Node Ablation After Failed Endocardial Ablation for the Treatment of Inappropriate Sinus Tachycardia. J Cardiovasc Electrophysiol 2013; 25:236-41. [DOI: 10.1111/jce.12318] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 10/03/2013] [Accepted: 10/23/2013] [Indexed: 01/10/2023]
Affiliation(s)
- JASON T. JACOBSON
- Columbia University Division of Cardiology-Mount Sinai Medical Center; Miami Beach FL USA
| | - ALEXANDRIA KRAUS
- University of Alabama at Birmingham School of Medicine; Birmingham AL USA
| | - RICHARD LEE
- Center for Comprehensive Cardiovascular Care; Saint Louis University; Saint Louis MO USA
| | - JEFFREY J. GOLDBERGER
- Division of Cardiology, Feinberg School of Medicine; Northwestern University; Chicago IL USA
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12
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Olshansky B, Sullivan RM. Inappropriate Sinus Tachycardia. J Am Coll Cardiol 2013; 61:793-801. [DOI: 10.1016/j.jacc.2012.07.074] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 07/19/2012] [Accepted: 07/31/2012] [Indexed: 01/01/2023]
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13
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Minimally invasive ablation of a migrating focus of inappropriate sinus tachycardia. J Thorac Cardiovasc Surg 2010; 139:506-7. [DOI: 10.1016/j.jtcvs.2009.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2008] [Accepted: 01/02/2009] [Indexed: 11/20/2022]
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Lee KW, Badhwar N, Scheinman MM. Supraventricular Tachycardia—Part II: History, Presentation, Mechanism, and Treatment. Curr Probl Cardiol 2008; 33:557-622. [DOI: 10.1016/j.cpcardiol.2008.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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