In this present case, we restricted our venous access to the femoral vein (two punctures on each side, using a 4-Fr quadripolar catheter and a 5-Fr ablation catheter). Two major challenges exist with this protocol: (1) obtaining venous access and (2) avoiding causing injury to the AV node while ablating the slow pathway. Our case is unique in that the AVNRT was drug-refractory despite optimal therapy and RF ablation was performed instead of cryoablation. Although there are several reports of successful ablation of orthodromic AV-reciprocating tachycardia in infants, AVNRT is rare. The most common arrhythmias are accessory pathway–mediated AVNRT. The child was discharged the next day without any complications and remained symptom-free at 12 months after the procedure.ĭrug-refractory SVTs are rare during childhood. The AH and HV intervals after ablation were 94 ms and 40 ms, respectively ( Figure 3D). Fast-pathway conduction remained intact as programmed atrial stimulation revealed AH block at 400 ms (S1), 350 ms (S2), and 250 ms (S3) ( Figure 3C). Incremental atrial pacing showed AV Wenckebaching at a 380-ms cycle length, confirming the elimination of slow-pathway conduction ( Figure 3B). Postablation tachycardia could not be induced despite an aggressive induction protocol. The total fluoroscopy time was five minutes and the procedure lasted for 30 minutes. CS: coronary sinus HB: His bundle AB: ablation catheter RV: right ventricle.Īblation at the posterior part of Koch’s triangle with a fractionated atrial signal with slow-pathway potential ( Figures 2C and 2D 2D) using a 5-French (Fr) medium-curve RF ablation catheter (Abbott Laboratories, Chicago, IL, USA) resulted in good junctional rhythm at the 400-ms cycle length (30 W power gradually increased to 50 W, temperature of 50☌ for 60 seconds) ( Figure 3A). D: Ablation catheter at the anterior margin of the coronary sinus in the right anterior oblique fluoroscopy view. C: Ablation catheter showing a fractionated atrial signal with slow-pathway potential (white arrowhead).
B: AVNRT with a cycle length of 230 ms with a concentric activation pattern in the coronary sinus. It especially demonstrates the route this institution has taken to engage with fractious issues of diverging linguistic and regional demands.A: Baseline AH and HV intervals were 94 ms and 39 ms. In its in-depth focus on the Lok Sabha, the volume highlights the way the Parliament has come to encompass India's proverbial diversity. It also addresses the intricate issue of relations between the Judiciary and the Parliament. Major debates in the House are scrutinized, and much of the analysis is based on empirical data gathered from surveys circulated among prominent politicians and public intellectuals. Developments in the institutional complex of the Parliament, including the functioning of the Opposition and the Speaker are traced over time, along with the processes of legislation and accountability.
This comprehensive and authoritative study examines the changing social composition and differing modes of representation that make up the Lok Sabha and critically explores its relation with the Rajya Sabha. The authors argue against the widely held notion of its ongoing decline, and demonstrate how it has repeatedly, and successfully, responded to India's changing needs in six decades of existence. In a first-of-its-kind study, this book delves into the lived experience of the Indian Parliament by focusing on three distinct phases-the 1950s, the 1970s, and the 1990s and beyond. It is the epicentre of political life, public institutions of great verve, and a regime of Rights. The Parliament is the visible face of democracy in India.
0 kommentar(er)
