Browsing by Author "Karagoz, Tevfik"

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Clinical and electrophysiological evaluation of pediatric Wolff-Parkinson-White patients
(TURKISH SOC CARDIOLOGY, 2015-01-01) Yildirim, Isil; Ozer, Sema; Karagoz, Tevfik; Sahin, Murat; Ozkutlu, Suheyla; Alehan, Dursun; Celiker, Alpay
Objective: Wolff-Parkinson-White (WPW) syndrome presents with paroxysmal supraventricular tachycardia and is characterized by electro-cardiographic (ECG) findings of a short PR interval and a delta wave. The objective of this study was to evaluate the electrophysiological properties of children with WPW syndrome and to develop an algorithm for the management of these patients with limited access to electrophysiological study. Methods: A retrospective review of all pediatric patients who underwent electrophysiological evaluation for WPW syndrome was performed. Results: One hundred nine patients underwent electrophysiological evaluation at a single tertiary center between 1997 and 2011. The median age of the patients was 11 years (0.1-18). Of the 109 patients, 82 presented with tachycardia (median age 11 (0.1-18) years), and 14 presented with syncope (median age 12 (6-16) years)
Is transesophageal electrophysiologic study valuable in children with successful radiofrequency ablation of supraventricular tachycardia on follow-up for recurrence?
(TURKISH SOC CARDIOLOGY, 2016-01-01) Gulgun, Mustafa; Ozer, Sema; Karagoz, Tevfik; Akin, Alper; Aykan, Hayrettin Hakan; Ozkutlu, Suheyla; Alehan, Dursun; Celiker, Alpay
Objective: The aim of this study was to evaluate the efficacy of transesophageal electrophysiologic study (TEEPS) for the determination of supraventricular tachycardia (SVT) recurrences in symptomatic and asymptomatic children after successful radiofrequency ablation (RFA) for SVT. Methods: A total of 66 patients who underwent TEEPS after successful RFA were included. The demographic features, symptoms of the patients, and the characteristics of the recurrences induced by TEEPS were evaluated. The arrhythmia types induced during RFA were compared with those induced by TEEPS in terms of the compatibility of the diagnosis. Results: Forty-two (63.6\%) girls and 24 (36.4\%) boys with a mean age of 11.8 +/- 3.4 years were followed-up for 44.1 +/- 15.7 months. The average time between RFA and TEEPS was 5.2 +/- 5.9 months. The diagnoses during RFA were atrioventricular nodal reentrant tachycardia (AVNRT) in 47 of 66 patients, atrioventricular reentrant tachycardia (AVRT) in 18 of 66 patients, and ectopic atrial tachycardia in 1 of 66 patients. SVT was induced by TEEPS in 2 of 25 symptomatic and 5 of 41 asymptomatic patients. The SVT inducibility rate was 5.5\% (1/18) and 12.7\% (6/47) in patients with AVRT and AVNRT, respectively. In addition, 85.7\% (6/7) of all recurrences occurred within 3.5 months. The recurrences as AVNRT in 2 of 25 symptomatic patients occurred in the first month after RFA. AVNRT in 4 of 41 and AVRT in 1 of 41 asymptomatic patients were induced within 3.5 months and 15 months, respectively. Conclusion: TEEPS seems to be a valuable screening and diagnostic method for the determination of recurrence in symptomatic and asymptomatic children who underwent successful RFA.
Lead Extraction in Children and Young Adults Using Different Techniques
(KARGER, 2009-01-01) Dilber, Embiya; Karagoz, Tevfik; Celiker, Alpay
Objective: To describe our experience with removal of pacing lead in children using different techniques. Patients and Methods: Between 1999 and 2006, removal of 39 leads was attempted in 30 patients: 21 males and 9 females aged 4-21 years (mean 12 +/- 5 years). Sixteen patients had previous corrective cardiac surgery. The leads had been implanted for 46 +/- 31 months (range 1-120 months). The reasons for removal included lead fracture in 14, upgrading in 8, infection in 7, dislodgment in 5, pacing system not needed in 2, and other reasons in 3. Results: Of the 39 leads, 29 (74.3\%) were completely removed. Twelve leads were removed with simple traction and rotation and 9 were removed using a locking stylet combined with simple traction and rotation
Midterm experience with implantable cardioverter-defibrillators in children and young adults(dagger)
(OXFORD UNIV PRESS, 2010-01-01) Celiker, Alpay; Olgun, Hasim; Karagoz, Tevfik; Ozer, Sema; Ozkutlu, Suheyla; Alehan, Dursun
This single-centre study was undertaken to review our experience with implantable cardioverter-defibrillator (ICD) implantation in children with relatively different aetiologies. We retrospectively reviewed the records of the paediatric patients who underwent ICD implantation between October 2001 and December 2008. The data of these patients were collected by reviewing the patients' medical records and computerized departmental pacemaker databases. A total of 28 patients who underwent ICD implantation during this period were included in this study. The median age was 12 years and median weight was 32 kg. Most of the patients had ion-channel diseases (n = 13) or cardiomyopathy (n = 11). Devices were implanted for either secondary (n = 22) or primary (n = 6) prevention. The selected ICD generator type was single chamber in 22 patients, dual chamber in 5 patients, and biventricular in 1. Nineteen patients received 122 shocks. Fifteen of 22 patients (68.2\%) from the secondary prevention group and 2 of 6 patients (33.3\%) from the primary prevention group experienced at least one appropriate shock during a median period of 11.3 months (range: 4 days-6.5 years). Forty-two inappropriate shocks were delivered in seven (31.8\%) patients from the secondary prophylaxis group during a median period of 11.3 months. The most important reason for inappropriate shocks was T-wave oversensing. In six patients, lead-related acute or chronic complications occurred. The ICD was safe and effective in interrupting malignant arrhythmias in children and adolescents with a high risk of sudden cardiac death. However, the occurrence of lead complications is significant. The incidence of therapies delivered by the device, with appropriate and inappropriate shocks, was high and interfered with the quality of life. The most important reason for inappropriate shocks was T-wave oversensing. Careful programming is mandatory to reduce the inappropriate shocks.
Results of radiofrequency ablation in children with tachycardia-induced cardiomyopathy
(TURKISH SOC CARDIOLOGY, 2014-01-01) Aykan, Hayrettin Hakan; Karagoz, Tevfik; Akin, Alper; Irdem, Ahmet; Ozer, Sema; Celiker, Alpay
Objective: Tachycardia-induced cardiomyopathy (TIC) is a rare but potentially curable cause of dilated cardiomyopathy. Data on radiofrequency ablation (RFA) for TIC is limited. The aim of this study is to present our experience with RFA in children with TIC, retrospectively. Methods: The medical records of patients with TIC and those underwent RFA between 2000-2011 were systematically reviewed. Demographics and echocardiographic features were recorded. Tachycardia-induced cardiomyopathy is defined as dilatation of the heart chambers or heart failure with chronic or very frequent cardiac arrhythmia. Diagnosis was confirmed with normalization of functions after sinus rhythm has been achieved. Results: A total of 12 patients with a mean age of 6.3 +/- 4.1 years (in utero-11.5 years) at diagnosis were enrolled in the study consisting of 7 patients with permanent junctional reciprocating tachycardia and 5 patients with focal atrial tachycardia. The mean pre-RFA left ventricular end-diastolic diameter and left ventricular ejection fraction (LVEF) values were 49.1 +/- 9.6 mm (32-66) and 40.8 +/- 13.4\% (23-57\%), respectively. One month after RFA, the mean LVEF value was 62 +/- 4.9\% (52-69), with only 2 out of 12 patients' LVEF values were still lower than 58\%. Tachycardia recurrence was observed in 4 patients, 3 of which had successful repeated RFA procedure. Overall, cure for arrhythmia was achieved in 11 patients (92\%), while reversal of heart failure achieved in all patients. In 1 patient permanent complete AV block was developed after the procedure. Conclusion: Treatment of tachycardia with RFA, particularly in patients with arrhythmia refractory to medical therapy, is a feasible and effective treatment option regardless of age.