A Terrier de la Chaise

Centre Hospitalier Universitaire de Nancy, Nancy, Lorraine, France

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Publications (116)265.9 Total impact

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    ABSTRACT: Arrhythmic disorders are infrequent in young adult and should evoke myopathy associated cardiomyopathy, even though muscular symptoms are moderate or absent.
    La Revue de medecine interne / fondee ... par la Societe nationale francaise de medecine interne. 06/2014;
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    ABSTRACT: IntroductionAtrial fibrillation (AF) and flutter (AFL) are frequently associated. We assessed the frequency and identify the predictors of AF occurrence after AFL ablation.Methods and Results1121 patients referred for AFL ablation were followed for a mean duration of 2.1±2.7 years. Antiarrhythmic drugs were stopped after ablation in patients with no AF prior to ablation, or continued otherwise.Three-hundred fifty-six patients (31.7%) had a history of AF prior to AFL ablation. Patients with AF prior to ablation were more likely to be female (OR = 1.35, CI = 1.00–1.83, p = 0.05).After ablation, 260 (23.2%) patients experienced AF. In the multivariable model, AF prior to ablation (OR = 1.90, CI = 1.42–2.54, p<0.001) and female gender (OR = 1.77, CI = 1.29–2.42, p<0.001) were associated with a higher risk of AF after ablation. In patients without prior AF, Class I antiarrhythmics and Amiodarone prior to AFL ablation were independently associated with higher risk of AF after ablation (OR = 2.11, CI = 1.15–3.88, p = 0.02 and OR = 1.60, CI = 1.08–2.36, p = 0.02 respectively). In patients who experienced AF after ablation, 201/260 (77.3%) had a CHA2DS2-VASc≥1. Two patients with AF prior to ablation had a stroke during the follow-up whereas none of the patients without AF prior to ablation had a stroke.ConclusionsAF occurrence after AFL ablation is frequent (>20%), especially in patients with a history of AF, in female patients, and in patients treated with Class I antiarrythmics/Amiodarone prior to AFL. Since most patients who experience AF after AFL ablation have a CHA2DS2-VASc≥1, the decision to stop anticoagulants after ablation should be considered on an individual basis.This article is protected by copyright. All rights reserved.
    Journal of Cardiovascular Electrophysiology 03/2014; · 3.48 Impact Factor
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    ABSTRACT: Introduction Arrhythmic disorders are infrequent in young adult and should evoke myopathy associated cardiomyopathy, even though muscular symptoms are moderate or absent. Case report We report a 25-year-old woman who developed severe supraventricular rhythm disturbances with exercise intolerance and elevated serum creatine kinase level. Initially the echocardiography showed normal ventricular function. Mutation in the lamin gene (LMNA) was identified. During the disease course, arrhythmia and ventricular function worsened and required cardioverter defibrillator implantation. Conclusion Laminopathies are genetic disorders among which dilated cardiomyopathy associated with skeletal muscular involvement is the most frequent phenotype, usually like Emery-Dreifuss muscular dystrophy. Other phenotypes are progeria, lipodystrophic syndromes and peripheral neuropathy. Cardiac involvement is responsible for syncope, thromboembolic events and sudden death and often requires early cardioverter defibrillator implantation.
    La Revue de Médecine Interne. 01/2014;
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    ABSTRACT: Little is known about the epidemiology of 1:1 atrial flutter (AFL). Our objectives were to determine its prevalence and predisposing conditions. METHODS: 1037 patients aged 16 to 93years (mean 64±12) were consecutively referred for AFL ablation. 791 had heart disease (HD). Patients admitted with 1/1 AFL were collected. Patients were followed 3±3years. RESULTS: 1:1 AFL-related tachycardiomyopathy was found in 85 patients, 59 men (69%) with a mean age of 59±12years. The prevalence was 8%. They were compared to 952 patients, 741 men (78%, 0.04), with a mean age of 65±12years (0.002) without 1:1 AFL. Factors favoring 1:1 AFL was the absence of HD (35 vs 23%, 0.006), the history of AF (42 vs 30.5%)(0.025) and the use of class I antiarrhythmic drugs (34 vs 13%)(p<0.0001), while use of amiodarone or beta blockers was less frequent in patients with 1:1 AFL (5, 3.5%) than in patients without 1:1 AFL (25, 15%) (p<0.0001, 0.03). The failure of ablation (9.4 vs 11%), ablation-related complications (2.3 vs 1.4%), risk of subsequent atrial fibrillation (AF) (20 vs 24%), risk of AFL recurrences (19 vs 13%) and risk of cardiac death (5 vs 6%) were similar in patients with and without 1:1 AFL. CONCLUSIONS: The prevalence of 1:1 AFL in patients admitted for AFL ablation was 8%. These patients were younger, had less frequent HD, had more frequent history of AF and received more frequently class I antiarrhythmic drugs than patients without 1:1 AFL. Their prognosis was similar to patients without 1:1 AFL.
    International journal of cardiology 04/2013; · 6.18 Impact Factor
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    ABSTRACT: An electrophysiologic study (EPS) of children and teenagers with paroxysmal supraventricular tachycardia (SVT) and normal electrocardiography (ECG) in sinus rhythm was evaluated. Generally, EPS is performed only before paroxysmal SVT ablation in these patients. In this study, 140 patients (mean age, 15 ± 3 years) with normal ECG in sinus rhythm were studied for SVT by a transesophageal route in baseline state and after isoproterenol. Idiopathic left or right ventricular tachycardia was diagnosed in four patients (3 %). Anterograde conduction over an atrioventricular (AV) left lateral (n = 10) or septal (n = 9) accessory pathway (AP) was noted in 19 patients (13.5 %) at atrial pacing. Orthodromic AV reentrant tachycardia (AVRT) was induced in these children. Five of the patients had a high rate conducted over AP (>240 bpm in baseline state or >290 bpm after isoproterenol). Two of the patients (a 10-year-old girl with well-tolerated SVT and a 17-year-old with syncope-related SVT) had the criteria for a malignant form with the induction of atrial fibrillation conducted over AP at a rate exceeding 290 bpm in baseline state. Of the 140 patients, 74 (53 %) had typical AV node reentrant tachycardia (AVNRT), nine had atypical AVNRT (6 %), 1 had atrial tachycardia (0.7 %), and 33 (23.5 %) had AVRT related to a concealed AP with only retrograde conduction. Electrophysiologic study is recommended for children with paroxysmal SVT and normal ECG in sinus rhythm. The data are helpful for guiding the treatment. Ventricular tachycardia or atrial tachycardia can be misdiagnosed. Masked preexcitation syndrome with anterograde conduction through AP was present in 13.5 % of the patients, and 1.4 % had a malignant preexcitation syndrome.
    Pediatric Cardiology 04/2013; · 1.20 Impact Factor
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    ABSTRACT: Sex-related differences were not reported for the atrial flutter (AF). The purpose of the study was to look for the influence of gender on indications, clinical data and long-term results of AFl ablation. METHODS: 985 patients, [227 females (23%)] were referred for radiofrequency AFl ablation. Clinical history, echocardiography were collected. Patients were followed from 3months to 10years. RESULTS: Age of women and men was similar (65.5±12 vs 64±11.5years). Underlying heart disease (HD) was as frequent in women as men (77.5 vs 77%), but women had more congenital HD (10 vs 2%;p<0.001), valvular HD (18 vs 10%;p<0.002), hypertensive HD (24 vs 18%;p<0.05), and less chronic lung disease (5 vs 10%;p<0.01), and ischemic HD (5 vs 20%;p<0.001). Atrial fibrillation (AF) history was more frequent in women (36 vs 27%;p<0.001). AFl-related tachycardiomyopathy (4.5 vs 8%;p<0.03) was more frequent, but 1/1 AFl (10 vs 6%;p=NS) as frequent. Failure of ablation (16 vs 10%;p<0.01), ablation-related major complications (3.5 vs 0.9%;p<0.005) were more frequent in women. After 3±3years, AFl recurrences were as frequent in women and men (10 vs 14%), AF occurrence more frequent in women (34 vs 19.5%; p<0.001). After excluding patients with previous AF, AF risk remained higher in women (19 vs 12%; p<0.004). CONCLUSIONS: In patients admitted for ablation, AFL was less common in women than in men, despite similar age and similarly prevalent HD. More than men, women had frequent AF history, a higher risk of failure of ablation and AFl ablation-related major complications and a higher risk of AF after ablation.
    International journal of cardiology 01/2013; · 6.18 Impact Factor
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    ABSTRACT: AIMS: Orthodromic atrioventricular reentrant tachycardia (ORT) is the most common arrhythmia at electrophysiological study (EPS) in patients with pre-excitation. The purpose of the study was to determine the clinical significance and the electrophysiological characteristics of patients with inducible antidromic tachycardia (ADT).METHODS AND RESULTS: Electrophysiological study was performed in 807 patients with a pre-excitation syndrome in control state and after isoproterenol. Antidromic tachycardia was induced in 63 patients (8%). Clinical and electrophysiological data were compared with those of 744 patients without ADT. Patients with and without ADT were similar in term of age (33 ± 18 vs. 34 ± 17), male gender (68 vs. 61%), clinical presentation with spontaneous atrioventricular reentrant tachycardia (AVRT) (35 vs. 42%), atrial fibrillation (AF) (3 vs. 3%), syncope (16 vs. 12%). In patients with induced ADT, asymptomatic patients were less frequent (24 vs. 37%; <0.04), spontaneous ADT and spontaneous malignant form more frequent (8 vs. 0.5%; <0.001) (16 vs. 6%; <0.002). Left lateral accessory pathway (AP) location was more frequent (51 vs. 36%; P < 0.022), septal location less frequent (40 vs. 56%; P < 0.01). And 1/1 conduction through AP was more rapid. Orthodromic AVRT induction was as frequent (55.5 vs. 55%), but AF induction (41 vs. 24%; P < 0.002) and electrophysiological malignant form were more frequent (22 vs. 12%; P < 0.02). The follow-up was similar; four deaths and three spontaneous malignant forms occurred in patients without ADT. When population was divided based on age (<20/≥20 years), the older group was less likely to have criteria for malignant form.CONCLUSION: Antidromic tachycardia induction is rare in pre-excitation syndrome and generally is associated with spontaneous or electrophysiological malignant form, but clinical outcome does not differ.
    Europace 11/2012; · 2.77 Impact Factor
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    ABSTRACT: Electrocardiographic criteria of preexcitation syndrome are sometimes not visible on ECG in sinus rhythm (SR). The purpose of the study was to evaluate the significance of unapparent preexcitation syndrome in SR, when overt conduction through accessory pathway (AP) was noted at atrial pacing.Methods Anterograde conduction through atrioventricular AP was identified at electrophysiological study (EPS) in 712 patients, studied for tachycardia (n = 316), syncope (n = 89) or life-threatening arrhythmia (n = 55) or asymptomatic preexcitation syndrome (n = 252). ECG in SR at the time of EPS was analysed.Results78 patients (11%) (group I) had a normal ECG in SR and anterograde conduction over AP at atrial pacing; 634 (group II) had overt preexcitation in SR. Group I was as frequently asymptomatic (35%) as group II (35%), had as frequently tachycardias, syncope or life-threatening arrhythmia as group II (43, 5, 2% vs 43, 13, 8%). AP was more frequently left lateral in group I (57%) than in group II (36%)(p < 0.001). AV re-entrant tachycardia, atrial fibrillation (AF), antidromic tachycardia were induced as frequently in group I (54, 18, 10%) as in group II (54, 27, 7%). Malignant forms (induced AF with RR intervals between preexcited beats < 250 ms in control state or < 200 ms after isoproterenol) were as frequent in group I (11.5%) as II (14%).Conclusions The frequency of unapparent preexcitation syndrome represents 11% of our population with anterograde conduction through an AP and could be underestimated. The risk to have a malignant form is as high as in patients with overt preexcitation syndrome in SR.Research highlights► 11% of patients with conduction through accessory pathway had unapparent preexcitation syndrome. ► It is recommended repeating the ECG recordings in subjects who practice sports. ► Do not hesitate to indicate electrophysiological study in a patient who complains of tachycardia.
    International journal of cardiology 06/2011; · 6.18 Impact Factor
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    ABSTRACT: Atrioventricular reentrant tachycardia (AVRT) is frequent in Wolff-Parkinson-White syndrome (WPW). Atrial fibrillation (AF) is rare. The purpose of the study was to determine the factors of spontaneous AF in WPW according to the initial presentation. Electrophysiological study (EPS) was performed among 709 patients with a preexcitation syndrome. First event was AF in 44 patients. Remaining patients were studied for AVRT (314), syncope (94), adverse presentation without AF (9) or systematically (248 asymptomatic patients). Patients with AF were older than other patients (44 ± 16 years vs 34.5 ± 17) (0.0003); maximal rate conducted over accessory pathway (AP) was higher in patients with AF than in other patients except in adverse presentation (0.0002); AVRT was induced more frequently in patients with AF than in asymptomatic patients (57% vs 14.5%) but less than in patients with AVRT (89%). AF was induced more frequently in patients with AF than in other patients except in adverse presentation (<0.0001). During follow-up AF occurred more frequently in patients with AF (5; 11%) than in patients with AVRT (7; 2%), with syncope (1%) and asymptomatic patients (4; 1.6%). Older age predicted recurrence (54 ± 16 vs 40 ± 17). AF was the first event in only 6% of patients with WPW and was a rare event in other patients. They are older but 10% are less than 18 years and have a more rapid conduction over AP than other patients.
    International journal of cardiology 01/2011; 157(3):359-63. · 6.18 Impact Factor
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    ABSTRACT: Ventricular tachycardia (VT) is considered as the main cause for syncope after myocardial infarction (MI). Multiple other causes have been reported. When left ventricular ejection fraction (LVEF) is low (35%), the implantation of a defibrillator (ICD) is recommended. The mortality of these patients (pts) remains relatively high. The purpose of study was to evaluate the main causes implicated in syncope after MI and the clinical factors associated with the diagnosis. Methods 363 pts, 307 men, 56 women, consecutively admitted for syncope and history of MI (> 1 month), without VT underwent echocardiography, Holter monitoring, head-up tilt-test, exercise testing, signal-averaged ECG, electrophysiological study (EPS) and evaluation of coronary status. They were followed 4 ± 2 years. Results The presumed cause of syncope was attributed after EPS to a ventricular arrhythmia in 151 pts (monomorphic VT 88, ventricular flutter or fibrillation (VF) 63), to a supraventricular tachyarrhythmia (SVT) in 39 pts, to conduction disturbances in 24 pts; 57 pts had several electrophysiological abnormalities: 26 had inducible VT or SVT and coronary ischemia; hypervagotonia was noted in 8 pts with induced VT or SVT. In the case of negative EPS, coronary ischemia alone was identified in 41 pts, hypervagotonia in 27pts. All studies were negative and syncope remains unexplained in 86 pts (24%), mainly women (p<0.001)(27% vs 20%***). Male gender (90% vs 80%**), a longer QRS duration (139 ± 31 vs 115 ± 28 ms**), a lower LVEF (36 ± 11.5 vs 46 ± 12%***) and grade IVa,b of Lown on Holter ECG (53 vs 31.5%***) were associated with VT induction. LVEF < 40% and VT/VF induction were predictors of cardiac mortality, VT predictor of sudden death, low LVEF and advanced age predictors of death by heart failure. Conclusions Several causes were frequently implicated; therefore complete evaluation remains necessary. Coronary ischemia was present in 18% of patients with syncope after myocardial infarction; it was the sole cause in 11% of our population. Syncope remained unexplained more frequently in women than in men. Hypervagotonia explains syncope in only 8% of our population.
    Archives of Cardiovascular Diseases Supplements 01/2011; 3(1):12.
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    ABSTRACT: Programmed ventricular stimulation (PVS) was proposed after myocardial infarction (MI) more than 25 years ago, but the management of MI has changed during this period. The purpose of the study was to look for the results of systematic PVS after MI according to the period of indication and remaining indications. Methods PVS was performed between 1982 and march 2010, from 4 to 8 weeks after acute MI in 797 patients (pts) without syncope or ventricular tachycardia (VT) to stratify the risk of arrhythmias: 301 (group I) were studied between 1982 and 1989, 315 (group II) between 1990 and 1999 and 179 (group III) between 2000 and 2010. PVS used the same protocol (up to 3 extrastimuli in 2 sites of right ventricle). Results Group III pts were older (61 ± 10 years) than group I (56 ± 11) and group II pts (58 ± 11) (p<0.002). LVEF was lower in group III (36 ± 11%) than in group I (44 ± 15) and II (41 ± 12) (p<0.05). PVS was as frequently negative in group III (58.5%) as in group I (52%) and II (47%). Monomorphic VT < 270 b/min was induced as frequently in group III (27%) as in group I (20%) and II (21.5%). Ventricular fibrillation was induced less frequently in group III (7%) than in group II (12%) and I (13%) (p<0.04). Ventricular flutter (VT > 265 b/min) was induced less frequently in group III (8%), than in group II (18%, p<0.001) and I (15%) (p < 0.03). The only significant difference was the primary angioplasty with recanalization of occluded coronary artery, more systematic since 2000: total revascularization was obtained in 39% of group III and 27% of groups II and I (p<0.05). Conclusions The interpretation of PVS are now easier to interpret, because the induction of non specific arrhythmias, the ventricular flutter and fibrillation, is rarer than before 2000, although PVS was indicated in patients with lower LVEF. The decrease of the induction of this arrhythmia could be related to the more systematic indication of primary angioplasty in MI since 2000. PVS remains useful in pts with debatable indications of defibrillator to help to take a decision.
    Archives of Cardiovascular Diseases Supplements 01/2011; 3(1):14-14.
  • Archives of Cardiovascular Diseases Supplements 01/2010; 2(1):70-70.
  • Archives of Cardiovascular Diseases Supplements 01/2010; 2(1):66-66.
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    ABSTRACT: Background Multiple factors, in addition to left ventricular ejection fraction (LVEF) influence the risk of mortality in coronary artery disease. The purpose of this study was to evaluate the main causes of syncope after myocardial infarction (MI) and to propose an algorithm of management.Methods356 patients consecutively admitted for syncope and history of MI (>1 month), without ventricular tachycardia (VT), underwent echocardiography, Holter monitoring, head-up tilt test, exercise testing, signal-averaged ECG, electrophysiological study (EPS) and evaluation of coronary status. The mean follow-up was 4±2 years.ResultsMonomorphic VT, ventricular flutter or fibrillation (VF) and supraventricular tachyarrhythmia were respectively induced at EPS in 87, 63 and 39 patients; conduction disturbances were noted in 23 patients, and 57 patients had several abnormalities. Among the 144 patients with negative EPS, coronary ischaemia was identified in 37 patients, and hypervagotonia in 27 patients. All studies remain negative in 84 patients (23.6%), more frequently women (p
    Heart Asia. 01/2010; 2(1):56-61.
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    ABSTRACT: The results of programmed ventricular stimulation (PVS) may change after myocardial infarction (MI). The objective was to study the factors that could predict the results of a second PVS. Left ventricular ejection fraction (LVEF) and QRS duration were determined and PVS performed within 3 to 14 years of one another (mean 7.5+/-5) in 50 patients studied systematically between 1 and 3 months after acute MI. QRS duration increased from 120+/-23 ms to 132+/-29 (p 0.04). LVEF did not decrease significantly (36+/-12 % vs 37+/-13 %). Ventricular tachycardia with cycle length (CL) > 220ms (VT) was induced in 11 patients at PVS 1, who had inducible VT with a CL > 220 ms (8) or < 220 ms (ventricular flutter, VFl) (3) at PVS 2. VFl or fibrillation (VF) was induced in 14 patients at PVS 1 and remained inducible in 5; 5 patients had inducible VT and 4 had a negative 2nd PVS. 2. 25 patients had initially negative PVS; 7 had secondarily inducible VT, 4 a VFl/VF, 14 a negative PVS. Changes of PVS were related to initially increasing QRS duration and secondarily changes in LVEF and revascularization but not to the number of extrastimuli required to induce VFl. In patients without induced VT at first study, changes of PVS are possible during the life. Patients with initially long QRS duration and those who developed decreased LVEF are more at risk to have inducible monomorphic VT at 2nd study, than other patients.
    Indian pacing and electrophysiology journal 01/2010; 10(4):162-72.
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    ABSTRACT: Ventricular tachycardia (VT) may explain syncope after myocardial infarction (MI) and is in this case is associated with a high risk of sudden death, mainly in association with low left ventricular ejection fraction (LVEF). Programmed ventricular stimulation (PVS) remains the main method to look for VT. The purpose of the study was to look for the changes of the population referred for PVS for unexplained syncope after MI during the last 26 years. Methods 346 patients were recruited for unexplained syncope after MI between 1982 and 2008: 76 patients (group I) were studied between 1982 and 1989; 151 patients (group II) were studied between 1990 and 1999 and 119 patients (group III) were studied between 2000 and 2008. ECG and 24 hour Holter monitoring did not indicate a possible cause of syncope. LVEF was evaluated in all patients by echocardiography. PVS was systematic with the same protocol (up to 3 extrastimuli in 2 sites of right ventricle). Results Clinical and electrophysiological data were similar between groups I and II but differed significantly in group III: age was higher in group III (68±12 years) than in group I (64±11) and II (65±12) (p <0.009); LVEF was higher in group III (45±13%) than in group I (41±16) and II (42±13) (p<0.008). PVS was more frequently negative in group III (74%) than in group I (43%) and II (54%) (p<0.001). Monomorphic VT < 270 b/min was less frequently induced in group III (16%) than in group I (30%) and II (26%) (p<0.01). Ventricular flutter (VT > 270/min) and ventricular fibrillation were less frequently induced in group III (9%) than in group I (26%) and II (19%) (p<0.05).The changes could be related to the ICD implantation recommendations and to recanalization of occluded coronary artery, which is systematic in recent MI since 2000 (38% in group III, 27% in groups I and II) (p <0.05). Conclusions Clinical data and results of PVS in patients admitted for unexplained syncope after MI infarction were identical between 1982 and 199 and have changed since 2000; patients are older and had relatively preserved LVEF. Therefore, the induction of a ventricular tachyarrhythmia is rarer than before the year 2000.
    Archives of Cardiovascular Diseases Supplements 01/2010; 2(1):12.
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    ABSTRACT: We report the case of a 51-year-old patient who developed a complete atrioventricular (AV) block during the isthmic radiofrequency catheter ablation of a typical atrial flutter. The cause was an acute occlusion of the segment three of the right coronary artery. His recanalization was associated with the immediate restoration of a normal AV conduction. The complication is exceptional (one of 740 consecutive atrial flutter ablations). (PACE 2010; 516-519).
    Pacing and Clinical Electrophysiology 12/2009; 33(4):516-9. · 1.75 Impact Factor
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    ABSTRACT: The purpose of the study was to determine the possible mechanisms of presyncope in patients who have paroxysmal junctional tachycardias (PJT) and a normal surface ECG between tachycardias. Among 419 patients consecutively recruited for PJT, aged from 10 to 88 years (47+/-19), 78 of them had presented at least one syncope; they had a normal ECG in sinus rhythm. Transesophageal programmed atrial stimulation was performed using one and two atrial extrastimuli delivered in control state and if necessary after infusion of 20-30 microg of isoproterenol; arterial blood pressure was monitored; vagal maneuvers and tilt test (n=25) were performed; echocardiogram was systematic. Age, sex, method of induction, tachycardia mechanism and the mean heart rate in tachycardia were similar in patients with and without syncope. Syncope was related to a vagal reaction induced by the PJT in 31 patients, to a fast rate during PJT in 15 patients, to a sinus node dysfunction in six patients, to a coronary ischemia in five patients, to a tetany induced by PJT in three patients, to an advanced age in three patients, to multiple causes in three patients and remained unexplained in eight patients. Radiofrequency ablation of reentrant circuit, performed in 28 patients, suppressed syncope in 26 of them. Presyncope or syncope occurred in 18% of patients who had a history of paroxysmal junctional tachycardia. Several mechanisms were implicated; the most frequent causes were coronary ischemia or sick sinus syndrome in old patients, vasovagal reaction or fast rate in tachycardia or tetany in patients of all ages.
    Annales de cardiologie et d'angeiologie 05/2009; 58(4):215-9. · 0.21 Impact Factor
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    ABSTRACT: Aims Symptoms in children are often difficult to interpret. The purpose of this study was to report the results of transoesophageal electrophysiological study (EPS) performed in children complaining of sudden onset tachycardia with normal non-invasive studies. Methods and results Eighty-two children and teenagers (mean age 15 +/- 3 years) presented with suspected but no documented paroxysmal supraventricular tachycardia (SVT). ECG was normal. Non-invasive studies were negative; 23 children had syncope with tachycardias. They underwent transoesophageal EPS in our out-patient clinic. The mean duration of transoesophageal EPS was 11 +/- 5 min. Electrophysiological study was negative in 25 children. AV nodal re-entrant tachycardia could be induced in 37 children, 11 of them associated with syncope. Wolff-Parkinson-White syndrome (WPW) was diagnosed in five children in which atrioventricular re-entrant tachycardia was inducible. Atrioventricular re-entrant tachycardia due to a concealed AP was induced in 14 children. Verapamil-sensitive ventricular tachycardia was induced in one patient. Factors associated with tachycardia inducibility were an older age (15.5 +/- 2 vs. 14 +/- 4 years) (P < 0.05) and the absence of syncope (81 vs. 52%) (P < 0.05). During a mean follow-up of 3 +/- 1 year, no patient with negative EPS developed documented tachycardia. In 17 children with inducible SVT, radiofrequency ablation of the re-entrant circuit was subsequently performed. Conclusion Transoesophageal EPS is a fast method for proving the nature of paroxysmal tachycardia in children and teenagers presenting with normal ECG and for demonstrating WPW syndrome not visible on standard ECG. The negative predictive value of transoesophageal EPS for the diagnosis of SVT was 100%.
    Europace 04/2009; 11(8):1083-9. · 2.77 Impact Factor