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81.
Thachil J 《Journal of hepatology》2011,54(3):593-4; author reply 594-5
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Three dimensional epicardial mapping and ablation of recurrent non-ischaemic ventricular tachycardia
Radiofrequency ablation is a therapeutic option for recurrent ventricular tachycardia (VT) in both ischaemic and non-ischaemic subsets. Usually this is attempted by mapping endocardially; however, in some situations epicardial approach may be needed to access the VT circuit. We report two cases in which epicardial approach was used to successfully ablate the VT, when endocardial ablation was ineffective. 相似文献
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Sharma G Senguttuvan NB Thachil A Leong D Naik N Yadav R Juneja R Bahl VK 《The Canadian journal of cardiology》2012,28(5):542-546
Background
The intrathoracic subclavian venous technique for pacemaker implantation may be associated with serious complications. We describe an alternative technique for obtaining venous access for pacemaker implantation through axillary vein under fluoroscopic guidance and compare it with the conventional, subclavian approach.Methods
We conducted a single-centre, prospective, nonrandomized study. All adult patients with indication for permanent pacing who consented were recruited during a 3-year period. To access the axillary vein, we used the alternative technique with a new fluoroscopic landmark. The subclavian access was obtained as per the usual approach.Results
We studied 478 lead placements during 3 years; 315 lead placements through axillary venous technique (group 1) were compared with 163 lead placements through subclavian venous technique (group 2). Both routes had a high and comparable success rate, 98.09% in group 1 and 96.93% in group 2. The axillary approach was successful at the first attempt in 194 punctures (61.6%), as vs 60 in group 2 (36.8%) P < 0.0001. The average number of attempts in group 1 was 2.06 per patient and 2.56 in group 2 (P < 0.001). There were 3 (2.94%) pneumothoraxes in group 2 and none in group 1. During a mean follow-up period of 3.2 months in group1 and 3.7 months in group 2, 1 patient in group 2 had a lead fracture.Conclusions
The fluoroscopically guided axillary venous approach for implanting permanent pacemakers is equivalent to the traditional anatomic landmark–guided intrathoracic subclavian approach and has fewer complications and shorter procedural time to access the vein. 相似文献87.
Occipital condylar fractures (OCFs) are rare and difficult to diagnose. The routine use of computed tomography (CT) scan in traumatology has however now made their diagnosis easier, with an estimated frequency of 4 to 19% of craniospinal traumatized patients and 0.4 to 0.7% of all severe traumatized patients in emergencies. This paper describes a patient who was not diagnosed with OCF during his first hospitalization after a road accident. However, 15 days later a left sided hypoglossal nerve palsy occurred. In this case report, we underline that an examination of the cranial nerve is a quick and easy procedure to screen each head trauma patient for occipital foramen fractures. Also, careful attention must be paid to X-Rays, CT scans and magnetic resonance imaging of the craniocervical junction. 相似文献
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Jecko Thachil 《Journal of thrombosis and haemostasis》2020,18(8):1849-1852
Hypercoagulability has been recognized as a common complication of COVID‐19. Exact mechanisms for this extreme coagulation activation have not yet been elucidated. However, one of the consistent laboratory finding is the increase in fibrinogen, in some cases, marked elevation. High circulating levels of fibrinogen have been linked to thrombosis for years and for this reason, hyperfibrinogenemia is considered one of the mechanisms for COVID‐19 coagulopathy. In this forum article, instead of the prothrombotic role, a protective function for fibrinogen is discussed. Fibrinogen, like the other well‐known acute phase reactants, is increased in COVID‐19 possibly to protect the host. 相似文献
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Hunter B. Moore Satoshi Gando Toshiaki Iba Paul Y. Kim Calvin H. Yeh Karim Brohi Beverley J. Hunt Jerrold H. Levy Dominik F. Draxler Simon Stanworth Klaus Grlinger Matthew D. Neal Martin A. Schreiber Christopher D. Barrett Robert L. Medcalf Ernest E. Moore Nicola J. Mutch Jecko Thachil Tetsumei Urano Scott Thomas Ecaterina Scrltescu Mark Walsh 《Journal of thrombosis and haemostasis》2020,18(3):740-747