scispace - formally typeset
Search or ask a question
Author

Sebastian Stec

Other affiliations: Medical University of Warsaw
Bio: Sebastian Stec is an academic researcher from Rzeszów University. The author has contributed to research in topics: Tachycardia & Cardiomyopathy. The author has an hindex of 4, co-authored 23 publications receiving 96 citations. Previous affiliations of Sebastian Stec include Medical University of Warsaw.

Papers
More filters
Journal ArticleDOI
01 Apr 2016-Europace
TL;DR: A novel ECG-based method that provides a certain diagnosis of VT in the majority of patients with VT, identifies unequivocal ECGs, and has superior overall diagnostic accuracy to other ECG methods is constructed.
Abstract: Aims Electrocardiographic diagnosis of wide QRS complex tachycardia (WCT) continues to be challenging as none one of the available methods is specific for ventricular tachycardia (VT) diagnosis. We aimed to construct a method for WCT differentiation based on a scoring system, in which ECGs are graded according to the number of VT-specific features. This novel method was validated and compared with Brugada algorithm and other methods. Methods and results A total of 786 WCTs (512 VTs) from 587 consecutive patients with a proven diagnosis were analysed by two blinded observers. The VT score method was based on seven ECG features: initial R wave in V1, initial r > 40 ms in V1/V2, notched S in V1, initial R in aVR, lead II R wave peak time ≥50 ms, no RS in V1-V6, and atrioventricular dissociation. Atrioventricular dissociation was assigned two points, and each of the other features was assigned one point. The overall accuracy of VT score ≥1 for VT diagnosis (83%) was higher than that of the aVR (72%, P = 0.001) and Brugada (81%) algorithms. Ventricular tachycardia score ≥3 was present in 66% of VTs and was more specific (99.6%) than any other algorithm/criterion for VT diagnosis. Ventricular tachycardia score ≥4 was present in 33% of VTs and was 100% specific for VT. Conclusion The new ECG-based method provides a certain diagnosis of VT in the majority of patients with VT, identifies unequivocal ECGs, and has superior overall diagnostic accuracy to other ECG methods.

58 citations

Journal ArticleDOI
TL;DR: This is the first case of a pregnant patient who underwent successful ZF CA of symptomatic pre-excitation from non-coronary cusp (NCC), and a multidisciplinary consultation reached the consensus that only pre- Excitation is a substrate for syncope recurrences and poses a potential risk to the foetus and mother.
Abstract: Current recommendations avoid the use of antiarrhythmic drugs in pregnancy and support catheter ablation (CA) due to symptomatic arrhythmias prior to pregnancy. Zero-fluoroscopy (ZF) mapping and navigation with three-dimensional electroanatomical mapping systems (3D-EAMS) allowed routine and safe non-fluoroscopic guidance of the procedure without X-ray exposure. We present the first case of a pregnant patient who underwent successful ZF CA of symptomatic pre-excitation from non-coronary cusp (NCC). A 24-year-old Caucasian pregnant without structural heart disease at the 24th week of pregnancy was referred for CA due to three recurrences of syncope and drug-refractory palpitations associated with Wolf-Parkinson-White (WPW) syndrome. Twelve months prior to pregnancy the woman had failed radiofrequency (RF) ablation procedure in another centre for para-Hisian right-sided pathway. A 12-lead electrocardiogram (ECG) showed pre-excitation with a positive delta wave in leads I, II, aVF, V4, and V5 and a negative delta wave in lead V1, suggesting a para-Hisian accessory pathway (Fig. 1). She was referred to our hospital for rescue CA with ZF. Our centre had at least five years of experience with the minimally invasive non-fluoroscopic imaging and navigation approach using the Ensite NavX system (St. Jude Medical, St. Paul, MN) for CA of regular supraventricular arrhythmias and idiopathic ventricular arrhythmias. A multidisciplinary consultation reached the consensus that only pre-excitation is a substrate for syncope recurrences and poses a potential risk to the foetus and mother. The right femoral vein was cannulated with a 7 F or 8 F sheath and one ablation 4 mm Gold tip catheter and one diagnostic decapolar catheter (Biotronik, Berlin, Germany) were introduced. Atrial pacing protocols demonstrated a septal accessory pathway, but no isoproterenol was given to induce tachycardia. The refractory period of the accessory pathway was 300 ms. After six failed right-sided applications right sided mapping was stopped due to frequent junctional beats and proximity of His potential recordings. Then, the right femoral artery was cannulated with an 8 F introducer, and the ablation catheter was removed using a right to left retrograde approach (Fig. 2). Finally, six RF applications (240 s) were delivered approximately in the NCC and the accessory pathway was successfully ablated (Fig. 1). The procedure time was 71 min and no fluoroscopy was used. Several ECGs and Holter monitoring confirmed no pre-excitation and arrhythmias within 14 months. The patient delivered a healthy male child at 35 weeks of gestation by Caesarean section. Both mother and child had an uneventful postoperative course. The case documents that routinely using ZF for CA may support this approach even for unfavourable locations (e.g. NCC) and not only as the last resort for several arrhythmias including WPW-syndrome in pregnant patients.

13 citations

Journal ArticleDOI
TL;DR: ICD therapy is effective in nearly half the patient population; however, the rates of early and late complica-tions are high and the number of unnecessary ICD shocks and reimplantation procedures may be lowered by modern programming and increased longevity of newer ICD generators.
Abstract: Background: Implantable cardioverter-defibrillator (ICD) therapy has been proven effective in the prevention of sudden cardiac death, but data on outcomes of ICD therapy in the young and otherwise healthy patients with long QT syndrome (LQTS) are limited. Aim: We sought to collect data on appropriate and inappropriate ICD discharges, risk factors, and ICD-related complications. Methods: All LQTS patients implanted with an ICD in 14 centres were investigated. Demographic, clinical, and ICD therapy data were collected. Results: The study included 67 patients (88% female). Median age at ICD implantation was 31 years (12–77 years). ICD indication was based on resuscitated cardiac arrest in 46 patients, syncope in 18 patients, and malignant family history in three patients. During a median follow-up of 48 months, 39 (58%) patients received one or more ICD therapies. Time to first appropriate discharge was up to 55 months. Inappropriate therapies were triggered by fast sinus rhythm, atrial fibrillation, and T-wave oversensing. No predictors of inappropriate shocks were identified. Risk factors for appropriate ICD therapy were: (1) recurrent syncope despite b-blocker treatment before ICD implantation, (2) pacemaker therapy before ICD implantation, (3) single-chamber ICD, and (4) noncompliance to b-blockers. In 38 (57%) patients, at least one complication occurred. Conclusions: ICD therapy is effective in nearly half the patient population; however, the rates of early and late complica­tions are high. Although the number of unnecessary ICD shocks and reimplantation procedures may be lowered by modern programming and increased longevity of newer ICD generators, other adverse events are less likely to be reduced.

10 citations

Patent
27 Aug 2012
TL;DR: In this article, a pneumatic pressure dressing was used for preventing hemorrhagic complications after implanting medical devices in cardiac electrotherapy, consisting of attaching means and a PNEumatic pressure cushion.
Abstract: The object of the invention is a pressure dressing, especially for preventing hemorrhagic complications after implanting medical devices in cardiac electrotherapy, comprising attaching means and a pneumatic pressure cushion (4), characterized in that it comprises a pressure sensor connected with an electric control and pumping system (6) provided with an integrated circuit for controlling pressure in the pressure cushion (4).

8 citations

Journal ArticleDOI
TL;DR: The history of this three-generation family with 6 women having normal hearts and presenting with a history of paroxysmal tachycardia with onset of symptoms in the adulthood shows the importance of family screening in AVNRT patients.
Abstract: We report a three-generation family coming from southeastern region of Poland (Podkarpackie voivodship) with 6 women having normal hearts and presenting with a history of paroxysmal tachycardia with onset of symptoms in the adulthood. Recordings of clinical SVT, dual AVN electrophysiology, induction of typical AVNRT and results of RFCA are available. The history of this family shows the significance of a careful and detailed collection of medical history, and point towards the importance of family screening in AVNRT patients.

7 citations


Cited by
More filters
Journal ArticleDOI
TL;DR: The ESC Guidelines for the management of patients with supraventricular tachycardia as discussed by the authors were developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC).
Abstract: 2019 ESC Guidelines for the management of patients with supraventricular tachycardia : The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC): Developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC)

490 citations

01 Jan 2015
TL;DR: This research presents a novel and scalable approach called “SmartCardiology” that addresses the challenge of “spatially aggregating” ACEs in the blood.
Abstract: 美国心脏病学院(ACC)、美国心脏协会(AHA)、美国心律学会(HRS)专家工作组历时1年,于近期联合发布了新版成人室上性心动过速(SVT)指南,全文于2015年9月23日全文刊登在Circulation、Journal of the American College of Cardiology和Heart Rhythm Journal三大重要杂志上。

135 citations

Journal ArticleDOI
TL;DR: This case suggests rivaroxaban has fibrinolytic effects on thrombi even in the LV, and indicates cardiogenic embolism can be treated with limb thrombectomy followed by anticoagulation.
Abstract: A 42-year-old man was admitted to our hospital because of lumbago and tachycardia-induced heart failure. Transthoracic echocardiography revealed impaired left ventricular function and a ball mass of thrombus in the left ventricle (LV). He was found to have systemic embolism in the spleen, kidneys, brain, and limbs. The patient was treated with limb thrombectomy followed by anticoagulation. Seven days after the direct factor Xa inhibitor, rivaroxaban, was initiated, transthoracic echocardiography was repeated, revealing disappearance of the LV thrombus without any clinical signs of cardiogenic embolism. His heart failure responded well and the LV wall motion had improved. This case suggests rivaroxaban has fibrinolytic effects on thrombi even in the LV.

38 citations

Journal ArticleDOI
TL;DR: This review provides an in‐depth analysis of traditional and more contemporary methods to differentiate ventricular tachycardia and supraventricular wide complex tachycardsia automatically and discusses practical limitations of manually applied ECG interpretation approaches.
Abstract: The primary goal of the initial ECG evaluation of every wide complex tachycardia is to determine whether the tachyarrhythmia has a ventricular or supraventricular origin. The answer to this question drives immediate patient care decisions, ensuing clinical workup, and long-term management strategies. Thus, the importance of arriving at the correct diagnosis cannot be understated and has naturally spurred rigorous research, which has brought forth an ever-expanding abundance of manually applied and automated methods to differentiate wide complex tachycardias. In this review, we provide an in-depth analysis of traditional and more contemporary methods to differentiate ventricular tachycardia and supraventricular wide complex tachycardia. In doing so, we: (1) review hallmark wide complex tachycardia differentiation criteria, (2) examine the conceptual and structural design of standard wide complex tachycardia differentiation methods, (3) discuss practical limitations of manually applied ECG interpretation approaches, and (4) highlight recently formulated methods designed to differentiate ventricular tachycardia and supraventricular wide complex tachycardia automatically.

26 citations

Patent
21 Nov 2013
TL;DR: In this article, a radial compression band and a Doppler probe are coupled to the arm band adjacent the pressure surface and configured to sense blood flow through the artery to ensure patency of the artery.
Abstract: A hemostatic compression system facilitates patent hemostasis of an arterial access site on the arm of a wearer. The system includes a radial compression band and a Doppler probe. The radial compression band includes an elongated arm band sized to receive the arm. The compression band also includes a pressure surface coupled to the arm band and facing radially inward for compressive engagement with the access site. The Doppler probe is coupled to the arm band adjacent the pressure surface and is configured to sense blood flow through the artery. Hemostatic compression applied by the radial compression band is variable in response to the sensed blood flow so as to ensure patency of the artery during hemostasis of the site.

22 citations