Araştırma Çıktıları

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    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.
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    Urodynamic Findings in Children with Cerebral Palsy Before Dorsal Rhizotomy Surgery
    (GALENOS YAYINCILIK, 2021-01-01) Tanidir, Yiloren; Ozgen, Mahir Bulent; Ozek, Memet; Tarcan, Tufan
    Objective: This study aims to investigate the neurourological and urodynamic findings of children with cerebral palsy (CP) that referred for dorsal rhizotomy surgery (DRS). Materials and Methods: All children with CP who were scheduled for selective DRS were assessed with a detailed medical history, physical exam, urinalysis and urodynamic studies to assess bladder function and urinary problems. Urodynamic studies included filling and voiding cystometry, detrusor leak point pressure, external anal sphincter electromyography, flow rate and residual urine volume. All investigations and definitions relied on the standardisation of the International Continence Society. Results: Overall, 24 boys and 10 girls were evaluated. The mean age of boys, and girls and the study group was 6.6 (1.7-9.8), 6.5 (3.5-11.4) and 6.6 (1.7-11.4) years, respectively. The most common complaints of the study group were urinary incontinence (58.8\%), encopresis (32.4\%) and constipation (17.6\%) and 41.2\% of patients needed diapers due to these problems. Twenty-five per cent (n=5) of male patients had an undescended testis. The most common clinical conditions at urodynamics, were low bladder compliance (85.3\%), detrusor overactivity (67.6\%), hyposensitive bladder (52.6\%) and low bladder capacity (41.2\%). Conclusion: Upper motor neuron lesions, like CP, may present with various urodynamic findings. However, patients with CP are not routinely seen by urologists. Our findings revealed serious neurological problems in children referred for DRS. Therefore, every child with CP who has a DRS plan should undergo a detailed urological examination at least once before the procedure.
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    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.