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Biomedical subjects

W S Teo

Publications and source records attributed to W S Teo.

At least 55 records · Page 3Linked to original sources
PubMed1995

Left ventricular hypertrophy in a young adult.

A 21-year-old male was referred for investigation of complaint of chest pain associated with breathlessness duringexertion. There was no history of leg swelling, orthopnoea or paroxysmal nocturnal dyspnoea. He had no history of hypertension, family history of heart disease or sudden death. On clinical examination, he was well built. The blood pressure was normal. The pulse had a jerky nature. There was an additional fourth heart sound and a short late systolic murmur over the left sternal edge.

Adult↗
PubMed1994

Anaesthetic management of idiopathic long QT syndrome--a case report.

This report describes the management of a patient with Idiopathic Long QT Syndrome (LQTS). The patient had life-threatening ventricular arrhythmias which did not respond to drug therapy with propranolol and phenytoin. A series of left stellate ganglion blocks were performed to control the arrhythmias. After stabilisation a high left thoracic sympathectomy was performed for a more permanent control of arrhythmias. Perioperative anaesthetic management is described and the usefulness of stellate ganglion block is demonstrated.

Adult↗
PubMed1994

Radiofrequency catheter ablation of accessory pathways: the initial experience in Singapore.

Radiofrequency catheter ablation is a recently introduced non-surgical technique for curing patients with arrhythmias as a result of conduction over an accessory pathway in patients with the Wolff-Parkinson-White (WPW) syndrome. We present our initial experience with this technique. There were 90 patients (61 males, 29 females) with a mean age of 37 +/- 14.4 years (range: 13-73 years). All except one were symptomatic with a mean duration of symptoms of 10 +/- 9.4 years (range: 0.1-40 years). The indications for catheter ablation were failure of drug therapy in 71, patient's preference in 10, increased risk of sudden death in 6 and almost incessant tachycardia in 3. The radiofrequency ablation was performed using a deflectable 7 French 4 mm tip electrode catheter positioned at the mitral or tricuspid annulus. The site of the accessory pathway was localised by electrophysiological study and radiofrequency energy applied via the tip of the catheter. There were 100 accessory pathways as 10 (10%) patients had multiple accessory pathways. There were 69 (69%) left free wall, 11 (11%) posteroseptal, 13 (13%) right free wall, 6 (6%) right anteroseptal accessory pathways and one (1%) midseptal accessory pathways. Ninety-six percent (96%) of the accessory pathways were successfully ablated on the first ablation. Two of the 4 initially unsuccessful ablations were successfully reablated, giving an overall success rate of 98%. There were no major complications. In conclusion, radiofrequency catheter ablation of accessory pathways is highly successful and safe and provides a definitive cure for patients with the WPW syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Bundle branch block and syncope? Right bundle branch block with left anterior hemiblock and prolonged PR interval-trifascicular block.

An 84-year-old Indian man was admitted with a history of recurrent episodes of giddiness for the last 5 years. He also had 3 previous episodes of transient loss of consciousness. He has a history of hypertension for the past 28 years and angina pectoris for the past 10 years. The clinical examination was unremarkable and no postural hypotension was detected. The electrocardiogram is illustrated in Fig 1.

Aged↗
PubMed1993

New directions in cardiovascular mapping and therapy.

Cardiovascular mapping has allowed us to fully understand the mechanisms of some of the cardiac arrhythmias and enabled us to devise new therapeutic options for them. Endocardial mapping by electrophysiological studies using three to four endocardial catheters introduced via the vein or artery to the heart allows us to directly map the electrical activity of the heart during sinus rhythm and during abnormal tachyarrhythmias. The simultaneous recording of electrical activity from the surface electrocardiogram, right ventricular apex, His bundle, high right atrium, coronary sinus, with or without a roving mapping catheter, enables us to precisely map the electrical activation sequence in the heart. This technique has been especially useful for mapping supraventricular tachycardias and the precise mapping of the accessory pathway or slow pathway potentials have now allowed us to selectively ablate them using radiofrequency energy delivered via the tip of the endocardial catheter. Intraoperative direct cardiac mapping has allowed us to reconfirm the findings of endocardial catheter mapping immediately prior to surgery. The intraoperative mapping is more precise and allows direct visualisation of the abnormal site for the surgeon to operate. Computerised mapping using multichannel recordings has facilitated mapping of the abnormal site for patients with haemodynamically unstable or nonsustained ventricular tachycardia, and thus allows the surgeon to perform surgical resection or cryoablation of the abnormal site. Cardiovascular mapping has thus enabled us not only to understand the mechanisms of cardiac arrhythmias but allows us to provide curative therapy for patients who are at risk from sudden arrhythmic death or otherwise need life long drug therapy.

Adult↗
PubMed1992

A unique preexcitation pattern related to an atypical anteroseptal accessory pathway.

Accessory atrioventricular pathways have traditionally been classified by anatomical location to four areas, namely anteroseptal, posteroseptal, and right and left free walls. Each of these have been associated with a relatively distinct preexicitation pattern electrocardiographically. We describe a patient with a unique ECG pattern suggesting preexicitation to the right ventricular outflow region. Preoperative and intraoperative electrophysiological testing confirmed the presence of an accessory pathway with an atrial insertion site near the His bundle, decremental anterograde conduction, and a ventricular insertion site in the upper part of the interventricular septum. Operative ablation near the atrial insertion site eliminated preexicitation.

Adult↗