Cardiology Commons^™

Pulmonary Vein Isolation Using A High Density Mesh Ablator Catheter: Incorporation Of Three-Dimensional Navigation And Mappin, Jiun Tuan, Jeilan Mohamed, Faizel Osman, Suman Kundu, Rajkumar Mantravadi, Peter J. Stafford, G. André Ng

Internal Medicine, East Africa

Background: We evaluated the use of a novel High Density Mesh Ablator (HDMA) catheter in combination with three-dimensional navigation for the treatment of paroxysmal atrial fibrillation.

Methods: The HDMA catheter was used to carry out pulmonary vein isolation in a consecutive series of patients. Three-dimensional geometry of the left atrial-pulmonary vein (LA-PV) junctions were first created with the HDMA catheter. Ostial, proximal and distal sites within the pulmonary veins were tagged with catheter shadows on the created geometry to allow for re-interrogation of these exact sites after ablation.

Results: The HDMA catheter was successfully used to create three dimensional geometry …

Letter By Jeilan Et Al Regarding Article, "Longitudinal Strain Delay Index By Speckle Tracking Imaging: A New Marker Of Response To Cardiac Resynchronization Therapy"., Jeilan Mohamed, Jiun H. Tuan, G. Andre' Ng

Internal Medicine, East Africa

We read with interest the recent article by Lim et al.1 This article demonstrated a strong correlation between a novel longitudinal strain delay index and left ventricular end-systolic volume reduction in both ischemic and nonischemic patients.

The principle outlined by the authors is that an increased longitudinal strain delay index requires both dyssynchrony (defined in their article as a discrepancy between the time of end-systolic contraction and the time to peak strain) and residual contractility. Their concept elegantly considers the problem of cardiac resynchronization therapy (CRT) nonresponse in heart failure patients who have myocardial segments with delayed contraction due …

Hiv-Associated Pulmonary Hypertension: Case Report, Jay Shavadia, S. Das, Gerald Yonga

Internal Medicine, East Africa

With the advent of highly active antiretroviral therapy, there has been a significant change in the epidemiology of pulmonary disease in HIV/AIDS. The relative prevalence of non-infectious manifestations is likely to rise. HIV associated pulmonary hypertension (HIV-PH), albeit low prevalence, is associated with significant morbidity and mortality. Presently, despite having scanty evidence on the management modalities of HIV-PH, evidence extrapolated from idiopathic pulmonary hypertension is being utilised to effectively manage some of these patients. Efforts should therefore be made to screen, diagnose and treat these patients. A case of a thirty year old female with HIV disease and severe pulmonary …

Images In Cardiovascular Medicine. Cardiac Tuberculoma., Jeilan Mohamed, Matthias Schmitt, Gerry Mccann, Joan Davies, Joseph Leverment, Derek Chin

Internal Medicine, East Africa

A 43-year–old man with a 6-month history of cough, dyspnea, nocturnal sweats, and weight loss was reviewed in the clinic. Clinical examination revealed cervical lymphadenopathy and indicated constrictive physiology. Initial tests, including chest radiography, sputum examination, QuantiFERON-TB Gold test, and lymph node biopsy, were unyielding. HIV serology was nonreactive.

Osmotic Demyelination Syndrome: Case Report, Mzee Ngunga, R. Harania, K. Hameed, J. O. Jowi

Internal Medicine, East Africa

We present a 40 year old man who was admitted to the hospital with convulsions. His final diagnosis was osmotic demyelination syndrome (ODS).We discuss the diagnostic and management challenges and the possible complications of this rare diagnosis.