Ventricular fibrillation as a primary manifestation of Wolff–Parkinson–White syndrome

Wolff–Parkinson–White syndrome (WPW) is defined as a condition involving an accessory pathway associated with symptoms. A typical ECG pattern of a pre-excitation shows a short PQ interval, presence of delta wave and a broad QRS complex on surface ECG. The underlying mechanism involves an accessory pathway, which enables conduction of a depolarization wave from atria to ventricles bypassing the AV node and predisposes to arrhythmias and sudden cardiac death. The most common arrhythmia in patients with WPW syndrome is atrioventricular reentrant tachycardia. However, it is not present in all patients with pre-excitation [1], [2], [3], [4]. Up to 1/3 of patients with AVRT experience atrial fibrillation, which may be conducted to ventricular myocardium via the accessory pathway and lead to a life-threatening ventricular fibrillation. The most effective treatment of the WPW syndrome is a radiofrequency catheter ablation [2], [5], [6], [7], [8]. This paper describes a case of a 40-year-old woman after a cardiopulmonary resuscitation for ventricular fibrillation, which was a primary manifestation of the WPW syndrome. It focuses on pathophysiology, clinical pattern and treatment possibilities of patients with WPW syndrome.     

Combination radiofrequency thermal ablation and adjuvant IV liposomal doxorubicin increases tissue coagulation and intratumoural drug accumulation

There has been marked interest in minimally-invasive, image-guided radiofrequency (RF) tumour ablation (i.e. coagulating tumour using short duration heating (<15?min) by directly applying temperatures >50°C via needle electrodes) to treat focal liver, renal, breast, bone and lung tumours. In spite of advances in RF technology and improved understanding of tumour biophysiology that now enable experimental treatment of tumours up to 5?cm, investigators have been unable to achieve complete ablation in many cases, particularly at the tumour margins and adjacent to blood vessels. One strategy for overcoming these limitations has been to take advantage of complementary interactions between RF thermal ablation and chemotherapy, particularly liposomal doxorubicin preparations, to attempt more complete tumour destruction. This paper will review published laboratory investigations demonstrating that this combined treatment paradigm has the unique potential both to potentiate preferential delivery of cytotoxic agents in liposome vehicles and to maximize the completeness of ablation of a treated tumour. New confirmatory data describing increased tumour destruction with RF ablation combined with different liposome preparations, documenting increased lipid peroxidation and expanding on previously published tumour growth studies is presented. Additionally, early clinical data including a randomized, pilot clinical study on 10 patients with primary and metastatic liver tumours, in which a non-optimized combination of RF ablation and IV liposomal doxorubicin (Doxil) increased the volume of tumour destruction 25–30% compared to RF alone, will also be described in detail.     

等离子射频辅助双侧声带后端切断术治疗双侧声带麻痹导致的上气道梗阻患者13例

目的 评估内镜下等离子射频辅助双侧声带后端切断术治疗双侧声带麻痹导致上气道梗阻患者的疗效。 方法 回顾性分析13例双侧声带麻痹导致的上气道梗阻患者的病例资料,其中男6例、女7例,27~73岁,所有患者均接受等离子射频辅助双侧声带后端切断术。总结评估该手术的临床疗效。 结果 13例随访时间1年1个月~2年11个月,所有患者无严重并发症发生。一次拔管率为84.44%(10/13),二次手术拔管率为88.89%(11/13),拔管时间1~3个月,中位数1个月,上气道梗阻均未复发。 结论 内镜下等离子射频辅助双侧声带切断术操作简单、手术风险小,同时治疗双侧声带麻痹效果可靠,是双侧声带麻痹导致上气道梗阻的有效治疗方法之一,也可作为其他治疗失败的补救治疗措施。     

综合性康复干预对房颤射频消融术后患者负性情绪和生活质量的影响

目的探讨综合性康复干预对房颤射频消融术后患者负性情绪和生活质量的影响。方法选取2016年1月～2017年12月拟行射频消融术治疗的阵发性房颤患者78例,分为干预组和对照组。两组均采取射频消融术,对照组术后给予心理安慰、健康教育、饮食干预和心电图检测等干预措施。干预组在对照组基础上加用综合性康复干预,两组均干预12周。评估两组干预前后负性情绪和生活质量变化。结果干预12周后,两组SDS和SAS评分均较前下降(P0.05或P0.01),且干预组下降幅度更显著(P0.05);同时两组躯体功能、心理情感、社会功能和物质生活等4个分项评分均较前明显上升(P0.05或P0.01),且干预组上升值更显著(P0.05)。结论综合性康复干预对房颤射频消融术后患者具有较好的效果,不仅可显著改善其焦虑、抑郁等负性情绪,改善其心理状态,而且可显著提高其生活质量,改善预后。