Search

The catheter ablation of idiopathic ventricular arrhythmias is accepted as a first-line treatment as it successfully eliminates about 90.0% of such arrhythmias. One of the most challenging ventricular arrhythmias originates from the left ventricular summit (LVS), a triangular epicardial space with the left main bifurcation as its apex. This area accounts for about 14.0% of LV arrhythmias. The complex anatomy of this region, accompanied by proximity to the major epicardial coronary arteries and the presence of a thick fat pad in this region, renders it a challenging area for catheter ablation. This article presents a review of the anatomy of the LVS and relevant regions and discusses novel mapping and ablation techniques for eliminating LVS ventricular arrhythmias. Additionally, we elaborate on the electrocardiographic (ECG) manifestations of arrhythmias from the LVS and their successful ablation via the direct approach and the adjacent structures.

Background: The prevalence of metabolic syndrome (MetSyn) is increasing in Iran. This study was an attempt to determine the effects of a short message service (SMS)-based education intervention on knowledge, attitudes, and the adoption of preventive behaviors concerning MetSyn among a sample of employees of Iran University of Medical Sciences (IUMS). Methods: In this randomized controlled trial, conducted from January through April 2021, IUMS 144 were assigned either to the intervention group (n=72) or to the control group (n=72). Thirty-two text messages were designed, pretested, and sent to the participants’ phones in the intervention group in 32 days. Knowledge, attitudes, and the adoption of preventive behaviors vis-à-vis MetSyn were measured in the intervention group before and 1 month after the intervention and compared with those in the control group at the same time points. The data were analyzed using paired t tests and ANCOVA. Results: The mean age of the employees in the intervention and control groups was 42.97±8.80 and 40.81±9.58 years, respectively. The results showed that the mean scores of knowledge (P

Takayasu’s arteritis (TA) is a rare case of granulomatous arteritis which mainly involves the aorta and its large branches. Although arterial hypertension is the most common feature of the disease in both adults and children, patients with TA may present with numerous clinical manifestations. Our patient was a 45-year-old woman, known to have hypertension from 3 years earlier following assessments made for severe headache. One year after the diagnosis of hypertension, she developed a left-sided lower motor neuron facial palsy, which was treated with oral corticosteroids (Prednisolone). Notably, the patient's headache was relieved after she took corticosteroid therapy. Transthoracic echocardiography revealed severe aortic insufficiency and aneurysmal changes in the ascending aorta, and she was referred to our center for further evaluation. In multi-slice computed-tomography angiography, significant long stenosis of the left subclavian artery was seen and the diameter of the ascending aorta was 50 mm. The patient underwent the Bentall operation. The pathologic examination of the aortic wall specimen was compatible with giant cell aortitis and more in favor of TA with the ascending aortic aneurysm. At 6months' follow-up, the patient was in good condition and had almost recovered from facial palsy.