O Jurkovicová

Comenius University Bratislava

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S Cagán

Slovak Medical University

Jozef Kalužay

Comenius University Bratislava

V. Pokorná

University Hospital Bratislava

Slavomíra Filipová

National Institute of Cardiovascular Diseases

Juraj Dúbrava

University Hospital Bratislava

Ján Hluchý

University Hospital Bratislava

Katarina Cenkerova

National Institute of Cardiovascular Diseases

T. Trnovec

Slovak Medical University

Georg Sabin

Elisabeth-Krankenhaus Essen

Soňa Wimmerová

Slovak Medical University

Cooperative Institutions

Comenius University Bratislava

University Hospital Bratislava

Slovak Medical University

Detská Fakultná Nemocnica s Poliklinikou

National Institute of Cardiovascular Diseases

Elisabeth-Krankenhaus Essen

St. Elisabeth-Hospital Bochum

University of Ss. Cyril and Methodius in Trnava

University Teaching Hospital

Masaryk University

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Acute limb ischemia due to paradoxical embolism treated with systemic thrombolysis

Vnitřní lékařství (2020)

V. Pokorná Svetlana Bodikova Jozef Kalužay Zuzana Liskova O Jurkovicová

We present a case report of a patient with acute upper and lower limb ischemia due to paradoxical embolism. A 67-year old woman without history of venous thromboembolism suffered dislocated patellar fracture requiring surgery in November 2017. Two months after surgery she presented to the emergency room with bilateral pulmonary embolism, occlusion of the left subclavian artery, left common femoral artery and superior mesenteric artery. Transesophageal echocardiography detected patent foramen ovale. Vascular surgeon decided against embolectomy, interventional radiologist against pharmacomechanical thrombolysis due to the extent of the occlusions. Systemic thrombolysis (alteplase) was administered successfully with resolution of the emboli in the left subclavian artery, left common femoral artery and superior mesenteric artery.

Embolectomy

Paradoxical Embolism

10.36290/vnl.2020.090

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Citations (2)

Radiofrequency catheter ablation of a right atriofascicular (mahaim) and two atrioventricular (kent) accessory pathways in a single session

Clinical Cardiology (1996)

Ján Hluchý M Wieczorek Mohsen Tekiyeh O Jurkovicová Georg Sabin

Abstract This report describes the case of a 19‐year‐old patient with Ebstein's anomaly, who had an unusual combination of a right atriofascicular (Mahaim) and two ipsilateral right atrioventricular (Kent) accessory pathways participating in three types of antidromic and orthodromic reciprocating tachycardias in the absence of retrograde conduction over the bundle of His‐atrioventricular node axis. All three pathways were ablated in a single session using temperature‐guided radiofrequency current.

Orthodromic

Bundle of His

Atrioventricular node

10.1002/clc.4960190915

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Citations (13)

The AUDIT Project: Factors Affecting Thrombolytic Therapy in 3,123 Patients With Acute Myocardial Infarction

Journal of clinical and basic cardiology (2002)

S Cagán I Besedová O Jurkovicová I Riečanský T. Trnovec

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Prognostic value of echocardiography and ECG in heart failure with preserved ejection fraction

Bratislavské lekárske listy/Bratislava medical journal (2016)

Katarina Cenkerova Juraj Dúbrava V. Pokorná Jozef Kalužay O Jurkovicová

OBJECTIVE: The aim of this study was to evaluate characteristics of patients with heart failure (HF) with preserved ejection fraction (HFPEF) and to assess prognostic predictors in 2-year follow-up.METHODS: We included prospectively 109 patients admitted to the internal department for HF, grouped into HFPEF (EF>40 %, n = 63) and HF with reduced EF (HFREF) (EF ≤ 40 %, n = 46).Preserved right ventricular systolic function (PRV) was defi ned as the peak systolic tricuspid annular velocity (S') > 10.8 cm/s.RESULTS: HFPEF and HFREF patients had non-signifi cantly different 2-year all-cause and CV mortality (28.6 % vs 37.0 %, 17.5 % vs 21.7 %).Patients with HFPEF and PRV vs dysfunctional RV had a better survival (76.6 % vs 56.3 %, p=0.045).In HFPEF, the patients who survived had a trend to better S' (13.6 ± 3.1 cm/s vs 11.9 ± 3.4 cm/s, p=0.055), shorter QTc (427 ± 42ms vs 454 ± 42ms, p = 0.058), and all-cause mortality was lowered only by anticoagulants (12.0 % vs 39.5 %, p = 0.02).QTc interval and PRV emerged as predictors of all-cause mortality (HR 1.7 per 40 ms change, 95 % CI 1.1-2.6,p = 0.02, HR 0.38, 95 % CI 0.15-0.93,p = 0.03).CONCLUSIONS: In HFPEF, we observed a trend to lower all-cause and CV mortality compared to HFREF and anticoagulants were the only therapy that signifi cantly lowered mortality.PRV and QTc interval emerged as independent predictors of survival (Tab.6, Fig. 2, Ref. 26).

10.4149/bll_2016_080

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Prognostic value of atrial fibrillation in heart failure with preserved ejection fraction at mid-term follow-up

Cardiologia Croatica (2014)

Katarina Cenkerova Juraj Dúbrava V. Pokorná Jozef Kalužay O Jurkovicová

10.15836/ccar.2014.230

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Electrophysiologic Characteristics and Radiofrequency Ablation of Concealed Nodofascicular and Left Anterograde Atriofascicular Pathways

Journal of Cardiovascular Electrophysiology (2000)

Ján Hluchý STEFAN SCHICKEL U. Jörger O Jurkovicová Georg Sabin

Nodofascicular and Atriofascicular Pathway Ablation. Introduction: True nodoventricular or nodofascicular pathways and left‐sided anterograde decremental accessory pathways (APs) are considered rare findings. Methods and Results: Two unusual patients with paroxysmal supraventricular tachycardia were referred for radiofrequency (RF) ablation. Both patients had evidence of dual AV nodal conduction. In case 1, programmed atrial and ventricular stimulation induced regular tachycardia with a narrow QRS complex or episodes of right and left bundle branch block not altering the tachycardia cycle length and long concentric ventriculoatrial (VA) conduction. Ventricular extrastimuli elicited during His‐bundle refractoriness resulted in tachycardia termination. During the tachycardia, both the ventricles and the distal right bundle were not part of the reentrant circuit. These findings were consistent with a concealed nodofascicular pathway. RF ablation in the right atrial mid‐septal region with the earliest atrial activation preceded by a possible AP potential resulted in tachycardia termination and elimination of VA conduction. In case 2, antidromic reciprocating tachycardia of a right bundle branch block pattern was considered to involve an anterograde left posteroseptal atriofascicular pathway. For this pathway, decremental conduction properties as typically observed for right atriofascicular pathways could be demonstrated. During atrial stimulation and tachycardia, a discrete AP potential was recorded at the atrial and ventricular insertion sites and along the AP. Mechanical conduction block of the AP was reproducibly induced at the annular level and at the distal insertion site. Successful RF ablation was performed at the mitral annulus. Conclusion: This report describes two unusual cases consistent with concealed nodofascicular and left anterograde atriofascicular pathways, which were ablated successfully without impairing normal AV conduction system.

Orthodromic

Antidromic

Supraventricular Tachycardia

10.1111/j.1540-8167.2000.tb00323.x

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Citations (34)

Determination of the preexcitation focus in the W-P-W picture by isopotential body-surface mapping.

PubMed (1985)

S Cagán Slavomíra Filipová O Jurkovicová L Kuchárová

Experiences with the determination of the preexcitation focus in 13 patients with W-P-W syndrome aged 18-62 years are presented. The data of ECG mapping from the chest surface and the abdominal wall were processed by computer. For classification of the maps the criteria elaborated by Yamada et al., da Ambroggi et al., and Benson et al. were used. It was possible to determine on their basis the preexcitation focus in all examined subjects, although a reduced system of ECG leads was employed. Surface ECG mapping makes possible a more precise location of the preexcitation, which is of great clinical importance for the indication of surgical treatment, determination of prognosis and of working ability.

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[Analysis of arrhythmias using Holter electrocardiographic monitoring in patients with ventricular preexcitation].

PubMed (1995)

O Jurkovicová Ján Hluchý L Scheidová S Cagán

It is known that patients with preexcitation of ventricles (PE) have a predisposition to paroxysmal supraventricular tachyarrhythmias (PSVT). There is a relatively small amount of knowledge concerning the occurrence and clinical significance of other disturbances of the cardiac rhythm in these patients.1. To consider the possibility of utilization of Holter monitoring (HM) of electrocardiograms (ECG) in the detection of PSVT; 2. To find out the occurrence and evaluate the significance of other than paroxysmal tachycardias; 3. By means of correlation of subjective complaints with objectively documented arrhythmias to consider the extent, to which the subjective complaints are determined by disturbances of cardiac rhythm.24-hour HM ECG was performed under clinical conditions in 50 patients, 23 male and 27 female patients at the average age of 35 +/- 13 (ranging 15-17) years, with manifestant PE on ECG. 21 (42%) patients with documented PSVT and/or atrial paroxysmal fibrillation (APF) constituted a group with Wolff-Parkinson-White (WPW) syndrome. 29 (58%) patients without these arrhythmias were ranked among the group with WPW pattern. 22 (44%) patients had concomitant organic heart disease (OHD). Each long-term electrocardiographic ECG recording was judged in order to specify the occurrence of individual types of arrhythmias and to perform their quantitative analysis per 24 hours. Subjective complaints presented by patients during HM were correlated with the objectively documented arrhythmias.Arrhythmias were recorded in HM in 35 (70%) of patients with PE. Supraventricular premature beats (SVPBs) occurred in 32 (64%) and ventricular premature beats (VPBs) in 15 (32%) patients with PE. When comparing the patients with PE and OHD with subjects with PE without OHD, no statistical differences in the occurrence of SVPBs and VPBs as well as in numbers per 24 hours were discovered. PSVT were recorded by HM only in 2 patients, and AV reciprocating echoes in another patient with WPW syndrome. Short runs of atrial tachycardia occurred in 2 patients with WPW syndrome.

Supraventricular arrhythmia

Paroxysmal supraventricular tachycardia

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[Electrocardiographic Holter monitoring in patients with ventricular pre-excitation: possibilities of its uses and pitfalls].

PubMed (1995)

O Jurkovicová Ján Hluchý S Cagán

Holter monitoring (HM) of the electrocardiogram (ECG) is used currently for the management of patients with ventricular preexcitation (PE). It makes it possible to detect inconstant PE which is considered a marker of a favourable clinical development. HM of ECG is not suitable for the detection of paroxysmal supraventricular tachycardias (PSVT) in patients with PE, as their presence is detected only exceptionally during HM. It can be used for the detection of other disorders of the cardiac rhythm than PSVT, in particular in supraventricular and ventricular extrasystoles (SVES and VES). Frequent SVES and VES detected during HM can as potential triggers of PSVT indicate a higher risk of these arrhythmias. HM is used for the objectivization of relatively frequent, sometimes quite polymorphous subjective complaints of patients with PE. Subjective data of these patients are very unreliable and from these data it is not possible to draw conclusions on the presence or absence of disorders of the cardiac rhythm. HM of ECG is not a suitable method for the evaluation of the effectiveness of medicamentous antiarrhythmic treatment of PSVT because of their considerable spontaneous variability. It may be, however, used partly for the evaluation of success of radiofrequency ablation treatment. Evaluation of long-term ambulatory ECG Holter tracings in patients with PE is more complicated and more time consuming than in subjects without PE. In any case it is essential that the record should be evaluated by an experienced physician with sufficient knowledge in arrhythmology.

Holter monitor

Supraventricular arrhythmia

Ambulatory ECG

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[Biorhythms and disorders of heart rhythm].

PubMed (1990)

O Jurkovicová S Cagán

Several factors are involved in the development of derangements of the rhythm of the heart. The role of some of them in the genesis of arrhythmias has not been fully elucidated as yet. It is still an enigma why some individuals develop derangements of the heart rhythm while others fail to do so under apparently equal conditions. Information on the value of biorhythms and their relevance to the development and course of arrhythmias is scarce and even controversial. Insight into these relationships and elucidation of the rhythmic nature of derangements of heart rhythm could be of great value in their prevention and treatment as well as in the prevention of sudden death.

Heart Rhythm

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