Yazar "Koca, Serhat" seçeneğine göre listele

Listeleniyor 1 - 6 / 6
  • Küçük Resim
    Öğe
    Catheter ablation for supraventricular tachycardia in children 20kg using an electroanatomical system
    (Springer, 2019) Koca, Serhat; Akdeniz, Celal; Tuzcu, Volkan
    PurposeCatheter ablation is the only choice of treatment in some small children with medically refractory supraventricular tachycardia (SVT). Electroanatomical mapping systems (EMS) are more commonly utilized in electrophysiological procedures in recent years, which resulted in a significant decrease in fluoroscopy exposure. The potential benefit of EMS in small children has not been studied. Therefore, we investigated the outcomes of children undergoing catheter ablation weighing 20kg using an electroanatomical mapping system.MethodsThis study evaluated the outcomes, characteristics, and follow-ups of children 20kg who underwent SVT ablations between April 2012 and April 2018 in a pediatric electrophysiology center where EMS were routinely used.ResultsIn a 6-year period, 1129 children underwent SVT catheter ablation under EMS guidance at our institution. A total of 84 of them were weighing 20kg. The acute success rate was 97.6% in 85 tachycardia substrates. No fluoroscopy was used in 58 of the patients, while a median of 5 (4-14)min of fluoroscopy was used in the remaining 26 patients. Recurrences were seen in 4 patients (4.8%) at a mean follow-up of 3.892.08years. Five patients developed non-vital complications (2 right bundle block and 3 temporary complete block that spontaneously resolved during the procedure). Conclusions The outcome of catheter ablation with the guidance of EMS for the treatment of SVT in small children is favorable. Fluoroscopy exposure can be decreased and even eliminated in most patients.
  • Küçük Resim
    Öğe
    Catheter ablation of left posterior fascicular ventricular tachycardia in children with limited fluoroscopy exposure
    (Cambridge University Press, 2019) Koca, Serhat; Akdeniz, Celal; Karacan, Mehmet; Tuzcu, Volkan
    Introduction:Catheter ablation of left posterior fascicular ventricular tachycardia in the pediatric population remains challenging, and most studies about this topic have been conducted on adult patients. This study aimed to assess the clinical presentation features and outcomes of catheter ablations performed using limited fluoroscopy with three-dimensional electroanatomic mapping system guidance in a pediatric left posterior fascicular ventricular tachycardia patient group.Methods:A total of 20 consecutive patients undergoing left posterior fascicular ventricular tachycardia ablation at a single tertiary centre were enrolled. All children with left posterior fascicular ventricular tachycardia underwent electrophysiological studies using the EnSite NavX system guidance. Ablations were performed during the sinus rhythm based on the Purkinje potentials in all patients.Results:The mean patient age was 12.7 years (range 2-16), and the mean patient weight was 51 kg (range 11-84). The mean procedure and median fluoroscopy times were 143.1 minutes and 3.4 minutes, respectively. No fluoroscopy was used in three patients. Acute success was achieved in 19 patients (95%). During a mean follow-up of 38.6 ± 19.35 months, left posterior fascicular ventricular tachycardia recurred in four patients (20%). Repeat ablations were performed successfully in those patients who developed recurrences. No complications were seen.Conclusions:Catheter ablation of left posterior fascicular ventricular tachycardia in children can be performed safely and effectively with low fluoroscopy exposure using a three-dimensional electroanatomic mapping system.
  • Küçük Resim
    Öğe
    Electroanatomic mapping-guided catheter ablation of supraventricular tachycardia in children with ebstein's anomaly
    (Springer, 2018) Ergül, Yakup; Koca, Serhat; Akdeniz, Celal; Tuzcu, Volkan
    In Ebstein's anomaly (EA), tachycardia substrates are complex, and accessory pathway (AP) ablations are often challenging. This study demonstrates the utility of the EnSite Velocity system (St. Jude Medical, St Paul, MN) in the catheter ablation of supraventricular tachycardia in children with EA. Twenty patients [Female/Male=8/12, median age 11.5years (2.6-18)] with EA who underwent catheter ablation guided by the EnSite Velocity system between December 2011 and December 2016 were retrospectively evaluated. Five patients had severe EA, and two of them were at Fontan palliation pathway. The most common indications for ablations were palpitations/syncope and treatment-resistant arrhythmias. Thirty-one tachycardia substrate foci (21 manifest AP, 2 concealed AP, 4 Mahaim AP, 3 focal atrial tachycardias, and 1 typical atrioventricular nodal reentrant tachycardia) were detected in 20 patients. There were multiple tachycardia substrates in 11 patients (55%). The patient-based acute procedure success rate was 19/20 (95%), and the tachycardia-based success rate was 30/31 (97%). The mean procedure time was 170 +/- 43min (90-265). Fluoroscopy was not used in 15 (75%) patients. The mean fluoroscopy time in the remaining five patients was 3.6 +/- 2.9min (0.7-7.8). During a mean follow-up of 35.1 +/- 20.3months (6-60), tachycardia recurred in four patients (4/19, 21%). No complications were seen. Catheter ablation of arrhythmias can be performed effectively and safely in pediatric EA patients by using a limited fluoroscopic approach with the help of electroanatomical mapping systems. However, the rate of tachycardia recurrence at follow-up remains high.
  • Küçük Resim
    Öğe
    Transseptal puncture for catheter ablation in children
    (Springer, 2019) Koca, Serhat; Akdeniz, Celal; Tuzcu, Volkan
    Transseptal puncture (TP) is used in pediatric patients to access the left atrium in left-sided arrhythmia catheter ablation. Performing this procedure can be difficult and risky, especially in small children. In this study, we aimed to evaluate the safety and feasibility of TPs in children <= 30kg. Between April 2012 and April 2018, a retrospective evaluation was conducted of the clinical features, procedural outcomes, and follow-ups of <= 30kg pediatric patients who required TPs for left-sided ablations at a pediatric electrophysiology center in which a three-dimensional mapping system was routinely used. A total of 45 pediatric patients who were <= 30kg, underwent TPs: 10 patients <= 20kg (Group 1) and 35 patients >20kg and <= 30kg (Group 2). The TP success rate was 97.8%. The median procedure and fluoroscopy times were 120min and 5.43min, respectively. One patient developed self-limited pericardial effusion during the procedure; however, there were no incidences of cardiac tamponade. There was no significant difference between the two groups in terms of the procedure time and fluoroscopy time, and pericardial effusion was only observed in Group 2. TPs are safe and feasible in small children. These procedures can be performed with low complication rates in children weighing <= 30kg.
  • Küçük Resim
    Öğe
    Unusual ventricular entrainment response: What is the mechanism?
    (Wiley, 2019) Özeke, Özcan; Çay, Serkan; Özcan, Fırat; Hacılı, Ayten; Karımlı, Emin; Altıparmak, İbrahim Halil; Kara, Meryem; Şahin, Mürsel; Burak, Cengiz; Kuyumcu, Mevlüt Serdar; Koca, Serhat; Demir, Gültekin Günhan; Topaloğlu, Serkan; Aras, Dursun
    Entrainment is an important tool for the diagnosis and location of reentry. The usefulness of this maneuver requires that, prior to cessation of ventricular pacing, the atrial rate accelerates to the ventricular pacing rate. Moreover, it is important to verify the continuation of the tachycardia following cessation of entrainment. The recognizing the last entrained atrial beat is utmost important to avoid erroneous A-A-V labeling.
  • Küçük Resim
    Öğe
    Wolff-Parkinson-White elektrokardiyografik paterni olan asemptomatik çocuk ve ergenlerin elektrofizyolojik özellikleri
    (Turkish Society of Cardiology, 2019) Koca, Serhat; Akdeniz, Celal; Tuzcu, Volkan
    Amaç: Wolff–Parkinson–White (WPW) elektrokardiyografik paterni olan asemptomatik çocuk ve ergenlerde uygun yaklaşım konusunda halen çelişkiler bulunmaktadır. Bu çalışmada tamamen asemptomatik olan çocuk ve ergen WPW olgularının elektrofizyolojik özelliklerinin değerlendirilmesi amaçlandı. Yöntemler: Nisan 2012 ile Nisan 2018 süresince, invaziv elektrofizyolojik çalışma (EFÇ) ve kateter ablasyon uygulanmış, WPW paterni olan asemptomatik çocuk ve ergenlerin, tıbbi kayıtları ve işlem verileri değerlendirildi. Bulgular: Toplamda 149 EFÇ uygulanmış WPW paterni olan asemptomatik çocuk ve ergenin verileri geriye dönük olarak değerlendirildi. Hastaların 39’unda (%26.2) atriyal fibrilasyon esnasında en kısa pre-eksite geçen iki RR dalgası arasındaki mesafenin (SPERRI) ?250 ms ya da aksesuvar yol efektif refrakter periyodunun (APERP) ?270 ms olduğu saptandı. Riskli antegrad iletim saptanan 39 hastaya ve ortodromik atiyoventriküler taşikardi indüklenen 45 hastaya ablasyon uygulandı. Ek olarak aile isteği nedeniyle 14 hastaya da ablasyon uygulandı. Sonuç: Asemptomatik olan çocuk ve ergen WPW olgularının dörtte birinden fazlası, yüksek riskli antegrad iletim özellikleri sergilemektedir. Asemptomatik yüksek riskli çocuk ve ergen WPW olgularında ablasyon ilk sıra tedavi yöntemi olarak düşünülmelidir.