1
|
Kumar N, Pasi R, Chacham S, Verma PK. Texidor’s twinge a rare cause of benign paroxysmal chest pain. HEART, VESSELS AND TRANSPLANTATION 2020; 5:32. [DOI: 10.24969/hvt.2020.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
Objective: Precordial catch syndrome was described by Miller and Texidor in 1955. It deserves wider recognition because it is rarely discussed in the differential diagnosis of precordial pain. Case summary: Case characteristics include a young 8-year-old female that presented with 4th episode of chest pain to the hospital. On attempting maneuver like deep breaths slowly in lying down position, pain subsided within 5 minutes although all other modalities of chest pain investigation as electrocardiography, echocardiography, chest high-resolution computed tomography, cardiac enzymes were normal. Discussion and conclusion: Various maneuvers like lying down or sitting upright and attempting deep inspiration tends to help in such conditions. This case report is reporting an unusual presentation of this syndrome due to its long duration of episode than the duration described in the previous reports. Prognosis is good.
Key words: precordial catch syndrome, sharp chest pain, sagged posture, Texidor’s twinge, case report
Collapse
|
2
|
Kulkarni N, Su W, Wu R. How to Prevent, Detect and Manage Complications Caused by Cryoballoon Ablation of Atrial Fibrillation. Arrhythm Electrophysiol Rev 2018; 7:18-23. [PMID: 29636968 DOI: 10.15420/aer.2017.32.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Atrial fibrillation is the most common cardiac arrhythmia and the prevalence is increasing every year. Patients who fail to maintain sinus rhythm with use of anti-arrhythmic drug therapy are referred for catheter ablation. Cryoballoon (CB) ablation has emerged as an effective and alternative treatment option to traditional point-by-point radiofrequency ablation, but there can be complications. This article reviews the incidence, presentation, risk factors, management and preventative strategies of three major complications associated with CB ablation: phrenic nerve injury, atrial oesophageal fistula and bronchial injury. Although these complications are rare, electrophysiologists should institute measures to identify high-risk patients, implement best-practice techniques to minimise risks and maintain a high index of suspicion to recognise the complications quickly and implement correct treatment strategies.
Collapse
Affiliation(s)
- Nitin Kulkarni
- University of Texas Southwestern Medical CenterDallas, TX, USA
| | - Wilber Su
- Banner University Medical Center, University of ArizonaPhoenix, AZ, USA
| | - Richard Wu
- University of Texas Southwestern Medical CenterDallas, TX, USA
| |
Collapse
|
3
|
Affiliation(s)
- Leonardo Calò
- Division of Cardiology, Policlinico Casilino, Rome, Italy.
| | - Luigi Sciarra
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| |
Collapse
|
4
|
Kumar N, Dinh T, Phan K, Timmermans C, Philippens S, Dassen W, Vranken N, Pison L, Maessen J, Crijns HJ. Adenosine testing after second-generation cryoballoon ablation (ATSCA) study improves clinical success rate for atrial fibrillation. Europace 2015; 17:871-876. [PMID: 25972302 DOI: 10.1093/europace/euu352] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/21/2014] [Indexed: 09/12/2023] Open
Abstract
AIMS Adenosine administration after pulmonary vein (PV) isolation using radiofrequency, laser, and cryoablation can cause acute recovery of conduction to the PVs and predict atrial fibrillation (AF) recurrence. This study evaluates whether ablation of dormant potentials post-adenosine administration following second-generation cryoballoon (CB-2G) ablation may improve the success rate for AF. METHODS AND RESULTS In 45 of 90 patients after a waiting period of 30 min, a bolus 15-21 mg of adenosine was administered followed by rapid saline flush. The response was assessed for each PV using a circular octapolar catheter. If needed, further ablation using a cryoballoon and/or cryocatheter was performed until no reconduction was observed after repeat adenosine administration. The remaining 45 patients did not receive adenosine after the procedure. Acute PV isolation was achieved in 352 of 358 PVs (98.3%) of 86 of 90 patients (95.6%) using CB-2G. The adenosine group showed dormant reconduction in 5 of 45 patients (11%), 8 of 179 PVs (4.5%), including 1 left superior pulmonary vein, 3 left inferior pulmonary vein, 1 right superior pulmonary vein, and 3 right inferior pulmonary vein. The success rate for adenosine and without adenosine group was 84 and 79%, respectively, after a mean follow-up of 397 ± 47 and 349 ± 66 days, without any AF recurrence in patients in whom adenosine-induced dormant conduction was ablated. CONCLUSION Adenosine testing after second-generation cryoballoon ablation study showed that reablation of initially isolated PVs increases the clinical success rate for AF.
Collapse
Affiliation(s)
- Narendra Kumar
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| | - Trang Dinh
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| | - Kevin Phan
- Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Carl Timmermans
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| | - Suzanne Philippens
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| | - Willem Dassen
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| | - Nousjka Vranken
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| | - Laurent Pison
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| | - Jos Maessen
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| | - Harry J Crijns
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands
| |
Collapse
|
5
|
Kumar N, Dinh T, Magdi Abbas M, Phan K, Manusama R, Philippens S, Maessen J, Timmermans C. Failure to reach the optimal temperature during cryoablation due to refrigerant cylinder problem. Res Cardiovasc Med 2015; 4:e25592. [PMID: 25785255 PMCID: PMC4347794 DOI: 10.5812/cardiovascmed.25592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 12/29/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction: Pulmonary vein (PV) isolation is considered as a key to atrial fibrillation (AF) treatment. Cryoballoon ablation is an effective therapy for PV isolation for AF with minimal side effects and was approved by the US Food and Drug Administration (FDA) several years ago. Successful isolation of PVs during cryoablation depends on the balloon temperature and helps in early identification of noneffective cryoballoon applications. A lower balloon temperature has been associated with long-term success in isolation of PVs. Case Presentation: At the start of the procedure, the cryoconsole displayed “low refrigerant level”. After a few cycles of successful cryoballoon applications, for a fresh application for a new PV, the optimal temperature was not obtained in spite of obtaining good grade of occlusion and ostial positioning for right inferior pulmonary vein (RIPV). Later, immediately after changing the refrigerant cylinder, suitable temperature was obtained. We faced this situation thrice in a span of eight months. Conclusion: Low refrigerant level may cause nonoptimal temperature during cryoablation, which can be resolved by premature change of a gas cylinder.
Collapse
Affiliation(s)
- Narendra Kumar
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Corresponding author: Narendra Kumar, Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, P. O. Box: 58006229, Maastricht, The Netherlands. Tel: +31-433877070, Fax: +31-433875104, E-mail:
| | - Trang Dinh
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | | | - Kevin Phan
- Macquarie University and Westmead Hospital, University of Sydney, Sydney, Australia
| | - Randolph Manusama
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Suzanne Philippens
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Jos Maessen
- Department of Cardiothoracic Surgery, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Carl Timmermans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
6
|
Kumar N, Timmermans C, Das M, Dassen W, Philippens S, Maessen J, Crijns HJ. Hemoptysis after cryoablation for atrial fibrillation: truth or just a myth? Chest 2014; 146:e173-e175. [PMID: 25367491 DOI: 10.1378/chest.14-1600] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Affiliation(s)
- Narendra Kumar
- From the Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
| | - Carl Timmermans
- From the Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Marco Das
- Department of Radiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Willem Dassen
- From the Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Suzanne Philippens
- From the Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Jos Maessen
- Department of Cardiac Surgery, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - Harry J Crijns
- From the Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| |
Collapse
|
7
|
Kumar N, Timmermans C, Das M, Pison L, Maessen J, Crijns H. Re: CT imaging of complications of catheter ablation for atrial fibrillation. Clin Radiol 2014; 69:e367-8. [PMID: 24880756 DOI: 10.1016/j.crad.2014.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/15/2014] [Indexed: 01/11/2023]
|