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Biomedical subjects

C C Cheng

Publications and source records attributed to C C Cheng.

At least 55 records · Page 3Linked to original sources
PubMed1996

Effects of dietary gluten on the hepatotoxic action of galactosamine and/or endotoxin in rats.

This study was done to clarify the effects of dietary wheat gluten on the hepatotoxic action of D-galactosamine (GalN) and endotoxin (Etx). Male Wistar rats fed a high casein or high gluten (supplemented with L-Lys and L-Thr) diet were injected with GalN or Etx, and the plasma glutamate oxaloacetate transaminase, glutamate pyruvate transaminase, and lactase dehydrogenase activities were examined 20 h later. In rats fed the high gluten diet, these enzyme activities were lower than in the high casein group after injection of 800 mg/kg of GalN. But such a difference between the casein and gluten groups was not clear when they were treated with 400 mg/kg of GalN nor observed even after injection of Etx or Etx+GalN (400 mg/kg). Similarly these was no difference in the plasma concentrations of Etx, tumor necrosis factor-alpha, or interferon-gamma in the rats receiving an injection of 800 mg/kg of GalN between both dietary groups. These results suggest that dietary gluten affords protection against hepatic injury by a high dose of GalN but not by a low dose of GalN and/or Etx.

Alanine Transaminase↗
PubMed1996

Dietary wheat gluten alleviates the elevation of serum transaminase activities in D-galactosamine-injected rats.

The effects of dietary protein on the elevation of activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in D-galactosamine-injected rats were investigated. The rats fed with experimental diets containing test protein sources for 2 weeks were injected with D-galactosamine (0.8 g.kg-1 body weight). The activities of AST and ALT in serum were assayed after 20 h. According to the results, these enzyme activities in the rats fed 40% casein diet were higher than those of 5, 10, or 20% casein groups. In the 40% gluten group, these enzyme activities were lower than in the 40% casein group. This difference was not considered to be caused by the deficit of L-lysine and L-threonine in gluten. The extent of the reduction of UTP and UDP-glucose in liver by D-galactosamine was almost the same in the 40% gluten and 40% casein groups. These results suggest that levels and quality of dietary protein affect the susceptibility of animals to the hepatotoxin D-galactosamine and dietary gluten was found to alleviate the elevation of serum transaminases in rats by the drug.

Alanine Transaminase↗
PubMed1996

Modulation of [3H]quinpirole binding in brain by monoamine oxidase inhibitors: evidence for a potential novel binding site.

[3H]Quinpirole is a dopamine agonist with high affinity for the D2 and D3 dopamine receptor subtypes. A variety of drugs, most notably monoamine oxidase inhibitors (MAOls), inhibit the binding of [3H]quinpirole, but not [3H]spiperone or [3H](-)N-n-Propylnorapomorphine, in rat striatal membranes by a mechanism that does not appear to involve the enzymatic activity of MAO. This study extends the characterization of MAOI-displaceable [3H]quinpirole binding in rat brain. Clinically antidepressant MAOIs exhibited selectivity between sites labeled by [3H]quinpirole and [3H]spiperone as did a number of structurally related propargylamines and N-acylethylenediamine derivatives and other drugs such as debrisoquin and phenylbiguanide. The MAOIs clorgyline and Ro 41-1049 were the most potent. Anti-depressant MAOIs inhibited [3H]quinpirole binding with the following rank order of potency: phenelzine > pargyline > tranyl-cypromine > isocarboxazid > nialamide > moclobemide. In striatal membranes, MAOI Ro 41-1049 inhibited [3H]quinpirole binding with similar potency at a variety of incubation temperatures (4-37 degrees C), assay tissue concentrations (5-20 mg original wet weight/ml), and time points (2 min-4 hr) and in the presence or absence of K+, Mg2+, Ca2+ ions, ascorbate, EDTA and NaCl. The regional distribution of Ro 41-1049-displaceable [3H]quinpirole binding in brain paralleled that of D2-like receptors. These data suggest that MAOIs interact with a novel binding site that is labeled by [3H]quinpirole or that modulates [3H]quinpirole binding. This site may be associated with D2-like dopamine receptors.

Animals↗
PubMed1996

Accessory atrioventricular pathway at the antero-medial mitral annulus--electrophysiologic characteristics and radiofrequency catheter ablation: a case report.

Accessory atrioventricular (AV) pathway located at or near the region of aorta-mitral continuity has rarely been mentioned. This report describes one such case with a concealed accessory AV pathway at the anteromedial mitral annulus adjacent to aorta-mitral continuity. The location of the accessory pathway was confirmed by successful radiofrequency catheter ablation. This patient was a 26-year-old male. His 12-lead surface ECG showed no evidence of ventricular preexcitation during sinus rhythm. The earliest retrograde atrial depolarization recorded from the routine catheters was at the His bundle area during ventricular pacing and orthrodromic AV reentrant tachycardia; paradoxically, the earliest left-sided atrial activation recorded from the coronary sinus catheters was at the distal coronary sinus area. The unique retrograde atrial activation sequence over the left atrium and His bundle area was not true for patients with left lateral or anterolateral accessory pathway. During tachycardia, the local electrogram from the successful ablation site showed local VA fusion in the anteromedial mitral annulus. After delivering one pulse of radiofrequency energy (30W), the accessory AV pathway was successfully eliminated without complication. This report presents a concealed left-sided accessory AV pathway at an unusual location. It is very important to describe special electrophysiologic characteristics and ablation technique in this unusual accessory pathway to improve knowledge in the era of interventional electrophysiology.

Adult↗
PubMed1995

Effects of pregnancy on first onset and symptoms of paroxysmal supraventricular tachycardia.

It is important for women to understand the risk of first onset and symptomatic exacerbation of paroxysmal supraventricular tachycardia (SVT) during pregnancy. Reports regarding the effects of pregnancy on first onset and symptomatic exacerbation of paroxysmal SVT have been controversial, and have not been conducted in a systematic fashion. Two hundred seven consecutive female patients diagnosed with symptomatic paroxysmal SVT were requested to respond to multiple questionnaires before electrophysiologic study and catheter ablation. A person-years data method was used to estimate risk of first onset of paroxysmal SVT during pregnancy. Exacerbation of paroxysmal SVT was assessed by a score scale including each of the following symptoms: palpitation, fatigue, rest dyspnea, effort dyspnea, dizziness, chest oppression, blurred vision, and syncope (total score change > 2 points). In the 107 patients with accessory pathway-mediated tachycardia, 7 patients had had a first onset of tachycardia during pregnancy (relative risk ratio 0.86, confidence interval 0.4 to 1.9, p = 0.35). In the 100 patients with atrioventricular nodal reentrant tachycardia, 1 patient had had the first onset of tachycardia during pregnancy (relative risk ratio 0.11, confidence interval 0.02 to 0.56, p = 0.004). Otherwise, 14 of the 63 patients (22%) with tachycardia in the pregnant and nonpregnant periods had exacerbation of symptoms during pregnancy. Thus, first onset of paroxysmal SVT during pregnancy was rare (3.9%), and pregnancy was associated with a low risk of first onset of paroxysmal SVT. However, symptoms of paroxysmal SVT were exacerbated during pregnancy in some patients.

Adolescent↗
PubMed1995

Recurrent tachycardia after selective ablation of slow pathway in patients with atrioventricular nodal reentrant tachycardia.

Recurrence rate of atrioventricular (AV) nodal reentrant tachycardia after successful radiofrequency ablation varies widely, and the determinants of recurrent AV nodal reentrant tachycardia remain controversial. Furthermore, true or pseudorecurrence of tachycardia after successful ablation in patients with different forms of AV nodal reentrant tachycardia has not been evaluated systematically. Three hundred sixty-two patients (161 men and 201 women [mean age 52 +/- 16 years]), including 314 patients with typical-form, 10 patients with atypical-form, 4 patients with variant-form, and 34 patients with multiple-form AV nodal reentrant tachycardias, received selective radiofrequency ablation of the anterograde and/or retrograde slow AV nodal pathway. During a mean follow-up of 27 +/- 11 months, 9 patients (2.5%) experienced recurrent AV nodal reentrant tachycardia (true recurrence, group A), and 8 (2.2%) had inappropriate sinus tachycardia or paroxysmal atrial tachyarrhythmias (pseudorecurrence, group B). Neither the true nor pseudorecurrence rate was different among the 4 different forms of tachycardia. Factors including presence of residual slow pathway conduction, a single AV nodal reentrant echo beat, absence of an accelerated junctional rhythm during successful ablation, facilitating induction of tachycardia by isoproterenol, radiofrequency pulse number, and successful ablation site were not associated with an increased risk of recurrent AV nodal reentrant tachycardia. The onset time of recurrent tachycardia was significantly late in group B patients (30 +/- 21 vs 292 +/- 240 days, p = 0.04). Thus, this study demonstrated that both true and pseudorecurrence could occur after successful ablation.

Adolescent↗
PubMed1995

An accurate stepwise electrocardiographic algorithm for localization of accessory pathways in patients with Wolff-Parkinson-White syndrome from a comprehensive analysis of delta waves and R/S ratio during sinus rhythm.

Prediction of accessory pathway location before radio-frequency ablation has become increasingly important for patients with Wolff-Parkinson-White syndrome. However, existing electrocardiographic (ECG) criteria for localization of accessory pathways have several limitations, and the polarity of delta waves has not been well defined. In the present study, 369 patients with a single anterogradely conducting accessory pathway who underwent successful radiofrequency ablation were included. The polarity of delta waves was defined and categorized in detail, and various ECG characteristics of the most preexcited QRS complexes were examined and compared with QRS complexes after successful ablation in the initial 182 patients, which included morphology and polarity of delta waves, initial 20, 40, and 60 ms segments of the preexcited QRS complex, R/S ratio in the precordial leads, R/S ratio in the frontal leads, delta wave axis in the frontal plane, polarity of delta waves in the frontal leads, and polarity of delta waves in the precordial leads. The polarity of the initial 40 ms segment of the most preexcited QRS complexes in each of the frontal leads, and the polarity of the initial 60 ms segment of the most preexcited QRS complex in each of the precordial leads proved to be the best representatives of delta wave polarity in the respective leads.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed1995

Radiofrequency catheter ablation of paroxysmal supraventricular tachycardia in patients with congenital heart disease.

Radiofrequency catheter ablation was performed in 21 patients who had congenital heart diseases associated with accessory pathway (AP)-mediated tachycardia (14 patients), with atrioventricular (AV) nodal reentrant tachycardia (4 patients), with intraatrial reentrant tachycardia (1 patient), with coexistent AP mediated tachycardia and AV nodal reentrant tachycardia (1 patient) and with coexistent AV nodal reentrant tachycardia and atrial tachycardia (1 patient). Congenital heart diseases diagnosed were seven with Ebstein's anomaly and six with septal defect; the others included patent ductus arteriosus, supravalvular aortic stenosis and left superior vena cava-coronary sinus fistula. Incidence of multiple APs (26.7 vs. 7.7%, P = 0.027), antidromic tachycardia (20.0 vs. 2.9%, P = 0.011), tachyarrhythmia-related syncope (26.7 vs. 7.2%, P = 0.022) and cardiac arrest (13.3 vs. 0%, P = 0.001) was higher in patients with AP and congenital heart diseases. Longer procedure (3.9 +/- 0.7 vs. 2.4 +/- 1.3 h for AP, P = 0.001; 3.0 +/- 0.7 vs. 2.5 +/- 0.8 h for AV nodal reentrant tachycardia, P = 0.001), and radiation exposure times (102 +/- 27 vs. 35 +/- 23 min for AP, P = 0.001; 62 +/- 23 vs. 20 +/- 11 min for AV nodal reentrant tachycardia, P = 0.001) were necessary to achieve a high success rate (95%) in patients with congenital heart disease.

Adolescent↗
PubMed1995

Initial onset of accessory pathway-mediated and atrioventricular node reentrant tachycardia after age 65: clinical features, electrophysiologic characteristics, and possible facilitating factors.

OBJECTIVE: To evaluate the clinical features electrophysiologic characteristics, and possible facilitating factors in older patients (> or = 65 years) with initial onset of accessory pathway-mediated and atrioventricular (AV) node reentrant tachycardia. DESIGN: Of the patients undergoing electrophysiologic study and radiofrequency catheter ablation of accessory pathway-mediated and AV node reentrant tachycardia at this institution, patients with initial tachyarrhythmia after age 65 years were compared with those presenting initially before age 30. SETTING: A tertiary medical center for the general public. PARTICIPANTS: Sixty-six patients had their initial symptoms after age 65: Group I, 32 patients with accessory pathway-mediated tachycardia, and Group II, 34 patients with AV node reentrant tachycardia. Four-hundred forty patients had their initial symptoms before age 30: Group III, 283 with accessory pathway mediated tachyarrhythmia, and Group IV, 157 with AV node reentrant tachycardia. INTERVENTION: All patients underwent electrophysiological study to determine the mechanisms of tachyarrhythmia, and radiofrequency catheter ablation for treatment of tachycardia. RESULTS: (1) Older patients with initial arrhythmia had incidence of critical clinical manifestations, including tachyarrhythmia-related syncope and cardioversion, similar to those with initial arrhythmia at a younger age. (2) Patients in Group III, showed anterograde effective refractory period (ERP) of the AV node (P = .432), longer anterograde ERP of the accessory pathway (P = .004), and greater difference of the anterograde ERP between the AV node and the accessory pathway (D-ERP) (P = .003) similar to patients in group I. In Group II, the ERP and Wenckebach cycle length of the retrograde fast pathway was significantly longer than in Group IV (P = .037 and P < .001, respectively), and a greater percentage of patients in Group II than in Group IV AV node reentrant tachycardia needed isoproteronol to facilitate the induction of reentrant tachycardia (P = .034). (3) Patients in Group I and Group II had a higher incidence of supraventricular and ventricular ectopic activity than those in Group III (P = .002 and P = .005, respectively) and Group IV (P = .024 and P = .012, respectively) in 24-hour ambulatory electrocardiograms. CONCLUSION: The initial onset of accessory pathway-mediated tachycardia after age 65 may be caused by changes of electrophysiologic properties (greater D-ERP) as well as increased supraventricular and ventricular ectopic activity. Influence of the autonomic nervous system, rather than changes of conduction properties in the AV node, and increase in ectopic activity may contribute to the new onset of AV node reentrant tachycardia in older adults. The choice of antiarrhythmic drugs and radiofrequency ablation require attention to the clinical profile and facilitating factors of reentrant tachycardia in this group of patients.

Adult↗
PubMed1995

Type IV hyperlipoproteinemia and moderate instability of CAG triplet expansion in the androgen-receptor gene. Lipid, sex hormone and molecular study in a Chinese family with Kennedy-Alter-Sung disease.

Kennedy-Alter-Sung (KAS) disease in a hereditary lower motor neuron disease. In this study, we investigate 2 KAS patients presenting with progressive muscle weakness and wasting, action tremor, perioral fasciculation and gynecomastia. Three carriers and 5 healthy members from this 3-generation KAS Chinese family and 60 normal Chinese controls were included in this study. Hormone studies revealed normal serum level in thyrotropin, prolactin, testosterone, leuteinizing hormone, follicle stimulating hormone, and estradiol. Lipid study disclosed type IV hyperlipoproteinemia in 2 KAS patients and 3 healthy members. Molecular studies revealed that the number of CAG triplet repeats in the first exon of androgen receptor gene of the normal allele is in the range of 15-19 and 12-25 in this family and normal controls, respectively. However, the number of CAG repeat of androgen receptor gene were unstable in the mutant alleles with a range of 41-45 and increased from generation to generation (genomic anticipation) in the 2 KAS patients and 3 female carriers. We conclude that the CAG triplet repeats in mutant allele were unstable in the family with the KAS disease. Furthermore, type IV hyperlipoproteinemia may be a co-transmitted syndrome in the family with KAS disease.

Alleles↗
PubMed1995

Embolization of carotid cavernous fistula by means of direct puncture through the superior orbital fissure.

PURPOSE: To embolize carotid cavernous fistulas (CCFs) by means of transorbital puncture of the cavernous sinus (CS) and the cavernous segment of the internal carotid artery (ICA) through the superior orbital fissure. MATERIALS AND METHODS: Five patients with CCF were treated with embolization of the CS, and six were treated with embolization of both the CS and the cavernous portion of the ICA after transorbital puncture. All except one had previously undergone occlusion of the ipsilateral proximal ICA before direct transorbital puncture. RESULTS: The fistulas in these cases were all obliterated completely. Only two patients had temporary ptosis. No other remarkable complications were noted. The patent ICA on the side of the fistula in one patient remained patent after embolization. CONCLUSION: Direct transorbital puncture through the superior orbital fissure is an alternate treatment for CCF, especially when the ipsilateral ICA has been occluded.

Adult↗
PubMed1995

Accessory atrioventricular pathways and atrioventricular nodal reentrant tachycardia in teenagers. Electrophysiologic characteristics and radiofrequency catheter ablation.

UNLABELLED: Accessory pathway-mediated tachyarrhythmias and AV nodal reentrant tachycardia represent a large portion of supraventricular tachycardia in younger patients. Reports comparing electrophysiologic characteristics and results of radiofrequency ablation between teenagers and adults from the same electrophysiology laboratory are rare, and these deserve further study. This study included 49 teenage patients (mean age 17 +/- 3 years, range from 10 to 20) and 1008 adult patients (mean age 50 +/- 13 years, range from 21 to 92) referred for electrophysiologic study and radiofrequency ablation for treatment of accessory pathway-mediated and AV nodal reentrant tachycardia. The results showed that: (1) mean duration of tachyarrhythmia was shorter in teenagers, but incidences of syncope, cardioversion for hemodynamic compromise and associated cardiovascular diseases were similar in both groups; (2) teenagers had a higher incidence of right-sided free wall accessory pathways (34.1% vs 14.9%, p = 0.048) and better conduction properties of accessory pathways and AV nodal pathways; (3) fast-slow and multiple forms of AV nodal reentrant tachycardia were significantly less frequent (p = 0.026) in teenagers, whereas atrial fibrillation with ventricular preexcitation was common in adults; (4) success rate, incidence of recurrent tachycardia, total procedure time, radiation exposure time and number of radiofrequency pulses for successful ablation did not differ significantly between teenagers and adults. IN CONCLUSION: (1) different electrophysiologic characteristics were found between teenagers and adults; and (2) radiofrequency ablation was effective and safe in teenagers with paroxysmal supraventricular tachycardia.

Adolescent↗
PubMed1995

The effects of accumulated experience on radiofrequency ablation of accessory pathways.

Increasing experience in radiofrequency ablation for accessory pathways appears to reduce the procedure time, radiation time and radiofrequency pulse number, and results in a higher success rate. However, the effect of a learning curve on this procedure from the perspective of location and conduction direction of accessory pathways has not been reported before. The purpose of this study was to determine the effect of accumulated experience on the outcomes of radiofrequency ablation for accessory pathways and on the duration of the procedure parameters by analyzing the results of a dedicated ablation team. The first 512 patients with a single accessory pathway treated in this laboratory were included for analysis of the procedure parameters with respect to locations and conduction directions of accessory pathways. The results showed that the average procedure time, radiation time, and radiofrequency pulse number differed significantly among the different subgroups (left free wall, right free wall, posteroseptal and anteromidseptal location; manifest or concealed conduction). All subgroups except the anteromidseptal pathways showed a significant improvement of the procedure parameters with increased ablation experience. Although the initial rate of improvement was similar among the different subgroups, the rate of improvement in left free wall pathways nearly reached a plateau after 120 ablation procedures. Thus it was concluded that a certain number of ablation procedures was necessary before achievement of a high success rate with shorter procedure and radiation times and a lower radiofrequency pulse number.

Catheter Ablation↗
PubMed1995

Integrating a health IC card system into a hospital information system.

As an experiment, a health IC card has been linked into the hospital information system of the National Cheng Kung University (NCKU) Hospital. The NCKU Hospital Information System (NCKU-HIS) services all the procedures for patient registration, billing, prescriptions, and the processing and storing of test results. The health IC card system provides good quality information to the doctors, the hospital, the patients, and the insurance organizations. For a fully comprehensive system, it is essential to integrate the health IC card system into the operational NCKU-HIS, the communication protocols, and the national insurance procedures. The experiment was designed to see if the development of such a system was feasible, and the results have been impressive. It has proved possible to operate the health IC card system, linking into different machines under different computing environments. A single computer system to store all the data of all the patients and to process all the nation's healthcare information would require almost unlimited mainframe processing power and unlimited storage. It would be very difficult to construct such a large computerized information system. All the hospitals would be required to use the same data format to process their information, and a large national healthcare network would have to be built, making the collection and storage of personal medical information very difficult and probably inefficient and unsatisfactory. Even if it was possible, it would be a very costly and time-consuming task. An IC card is cheap and easy to use, and offers an alternative solution to the problem of handling the nation's healthcare information. The original healthcare IC card experiment (started in 1990) was limited to the NCKU Hospital and the Taiwan Government Employees' Clinic. The experimental system was designed to be fully integrated into the NCKU-HIS and has been widely accepted by the users, especially the IC card-holding patients. It is also well-suited to the management of healthcare insurance. An expanded healthcare IC card system was implemented from the end of 1993 and covers six clinics and six hospitals in Penghu County. The operation of the registration and billing subsystems are supported by PC workstations in a client/server network as these subsystems are used very frequently. Some of the other computerized functions in the NCKU-HIS are supported by the mainframe TANDEM computer system. The interfaces with the communication protocols and application software provide for the effective two-way transfer of data and programs. For future use, consideration is being given to the employment of the Health Level Seven (HL/7) protocol for electronic data interchange. National standards such as Chinese information processing, the use of standard codes, the authorization of the content of the IC card, and communication protocols are already incorporated in the system.

Hospital Information Systems↗
PubMed1995

Complications after treatment of cervical intraepithelial neoplasia in women infected with the human immunodeficiency virus.

OBJECTIVE: To compare the frequency of complications after treatment of cervical intraepithelial neoplasia (CIN) in human immunodeficiency virus (HIV)-infected and -seronegative women in an ambulatory setting. STUDY DESIGN: A retrospective record review of 15 HIV-infected and 44 HIV-negative women treated by laser therapy or cone biopsy and retrospective interviews of 20 HIV-infected and 44 HIV-negative women treated by cryotherapy. RESULTS: Four of 35 (11%) HIV-infected women had excessive bleeding after laser/cone or cryotherapy as compared to one of 88 (1%) HIV-negative women (odds ratio 11.27, P = .02). After laser/cone therapy, significantly more HIV-infected women (53%) had cervicovaginal infections than did HIV-negative women (18%). A higher prevalence of infection was associated with more severe immunodeficiency. CONCLUSION: HIV-infected women are vulnerable to complications after treatment of CIN and should be monitored closely.

Cryosurgery↗
PubMed1994

Accessory pathway and atrioventricular node reentrant tachycardia in elderly patients: clinical features, electrophysiologic characteristics and results of radiofrequency ablation.

OBJECTIVES: This study was designed to evaluate the clinical features, electrophysiologic characteristics and results of radiofrequency ablation in elderly patients with accessory atrioventricular (AV) pathways or AV node reentrant tachycardia. BACKGROUND: Radiofrequency ablation in elderly patients with paroxysmal supraventricular tachycardia has not been well described, and comparative study between elderly and younger patients is limited. METHODS: Electrophysiologic studies and radiofrequency ablation were performed in 92 elderly patients (45 with an accessory pathway, 47 with AV node reentrant tachycardia). RESULTS: The elderly patients had poorer electrophysiologic properties in accessory pathways and dual AV node pathways than those of younger patients. The success rate of radiofrequency ablation was similar in elderly and younger patients. However, elderly patients had more complications (14%) in left-sided accessory pathways. CONCLUSIONS: Radiofrequency ablation in elderly patients with supraventricular tachycardia was effective. However, it must be performed cautiously in those patients with left-sided accessory pathways.

Adult↗
PubMed1994

Major coronary sinus abnormalities: identification of occurrence and significance in radiofrequency ablation of supraventricular tachycardia.

Coronary sinus catheterization is important in electrophysiologic study of patients with supraventricular tachycardia. It can provide an anatomic guide for localization of slow atrioventricular nodal pathway and accessory pathways in the posteroseptal area and left-sided atrioventricular ring. However, the morphologic features of the coronary sinus and its significance in patients with supraventricular tachycardia have not been determined. Four hundred eight patients with accessory pathway-mediated tachyarrhythmia and atrioventricular nodal reentrant tachycardia underwent coronary arteriography for a coronary sinus venogram before electrophysiologic study and radiofrequency ablation. The venous phase of left coronary arteriography that delineated the morphologic features of the coronary sinus was carefully evaluated and recorded in multiple projections. Major coronary sinus abnormalities were defined, and they were found in 12 patients (2.9%). Six patients had angulation of the coronary sinus, 4 patients had hypoplasia of the coronary sinus, 1 patient had narrowing of the proximal coronary sinus, and 1 patient had a fistula from persistent left superior vena cava to the coronary sinus. Of 175 patients with atrioventricular nodal reentrant tachycardia, only 1 patient had major coronary sinus abnormalities (proximal angulation), whereas of 233 patients with accessory pathway-mediated tachycardia, 11 patients had major coronary sinus abnormalities (0.6% vs 4.7%, p < 0.05). The accessory pathways in patients with major coronary sinus abnormalities were located exclusively in the left free wall and posteroseptal area. Proper coronary sinus catheterization could be accomplished in 396 patients with a normal coronary sinus, whereas it could be accomplished in only 1 of the 12 patients with major coronary sinus abnormalities (396/396 vs 1/12, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗