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- Ishigaki Sugako
- Division of Cardiovascular Medicine, Electrophysiology Laboratory, Makiminato Central Hospital
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- Higa Satoshi
- Division of Cardiovascular Medicine, Electrophysiology Laboratory, Makiminato Central Hospital University of the Ryukyus
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- Maesato Akira
- Division of Cardiovascular Medicine, Electrophysiology Laboratory, Makiminato Central Hospital University of the Ryukyus
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- Chinen Ichiro
- University of the Ryukyus
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- Lin Yenn-Jiang
- Taipei Veterans General Hospital, Division of Cardiology
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- Tatsu Kazuhito
- Division of Cardiovascular Medicine, Electrophysiology Laboratory, Makiminato Central Hospital
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- Obunai Kotaro
- Division of Cardiovascular Medicine, Electrophysiology Laboratory, Makiminato Central Hospital
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- Uechi Yoichi
- Division of Cardiovascular Medicine, Electrophysiology Laboratory, Makiminato Central Hospital
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- Sugama Moriichi
- Division of Cardiovascular Medicine, Electrophysiology Laboratory, Makiminato Central Hospital
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- Masuzaki Hiroaki
- University of the Ryukyus
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- Chen Shih-Ann
- Taipei Veterans General Hospital, Division of Cardiology
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Introduction: Hyperthyroidism is a serious medical disorder that can be life threatening and is characterized by a sympathovagal imbalance that can be a cause of rapid AF. However, the electrophysiological characteristics of preexcitation syndrome under hyperthyroid condition are unknown. Methods: N/A. Results: We experienced Lown-Ganong-Levine Syndrome (LGLS) in a 49-year-old woman with Graves’ hyperthyroidism. She could not continue to take 1-Methyl-2-mercaptoimidazole because of agranulocytosis and liver dysfunction. Therefore, fractioned radioiodine therapy, radiation, and steroid were started to control hyperthyroidism (TSH: <0.1 microIU/mL; free T3: >32.6 to 6.3 pg/mL; free T4: >7.77 to 3.57 ng/dL). ECG showed short PR interval with normal QRS interval without any delta-wave. She received propranolol to reduce highly symptomatic sinus tachycardia. The electrophysiological study demonstrated atrio-His bypass tract (James bundle) with highly enhanced atrioventricular conduction (1:1 conduction: >300 bpm; ERP: 200 ms). We localized the earliest atrial activation site during RVP as James bundle site at left mid septum, and delivered temperature-controlled RF energy (<10 W) on James bundle site. Only 1 RF pulse successfully eliminated atrio-His bypass without any complication and recurrence (follow-up 15 months). Conclusion: LGLS combined with hyperthyroidism demonstrated highly enhanced atrio-ventricular conduction. Careful RF application to James bundle was feasible to cure preexcitation and normalize atrio-ventricular conduction.
収録刊行物
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- Journal of Arrhythmia
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Journal of Arrhythmia 27 (Supplement), PE4_100-PE4_100, 2011
日本不整脈学会
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詳細情報 詳細情報について
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- CRID
- 1390282680222335360
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- NII論文ID
- 130002129748
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- ISSN
- 18832148
- 18804276
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- 本文言語コード
- en
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- データソース種別
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- JaLC
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- 抄録ライセンスフラグ
- 使用不可