The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
WCIM 2014 SEOUL KOREA 287
Poster Session
PS 1168 Cardiology
J Point Change During Supraventricular Tachycardia
Hyeongwon Seo1, Kihong Lee1, Hyungwook Park1, Jeonggwan Cho1 Chonnam National University Hospital, Korea1
A 54-year-old man presented with frequent episodes of sudden palpitation. Electro- cardiogram demonstrated a narrow QRS complex tachycardia with a rate of 150/min.
During the tachycardia that J point of the QRS complex occasionally became deeper and sharper(Figure1).Electrophysiologic study was performed. A narrow QRS complex tachycardia was reproducibly induced by a single atrial extrastimulus. The tachycardia showed an intermittent change of the J point (Figure 2). Atrial activity at the high right atrium (HRA) always preceded those of the His bundle and coronary sinus (CS) during the fi rst SVT with an atrial cycle length of 344 ms, but retrograde atrial acti- vation sequence in the CS electrograms changed occasionally. The activation of right anterolateral and left lateral accessory pathway (AP) made the J point deeper and sharper than right anterolateral AP activation alone. Radiofrequency catheter ablation could abolish conduction over right side AP. A single ventricular extrastimulus induced the second tachycardia (388 ms) with the earliest, consistent retrograde atrial activity at distal CS. Electrocardiographic or electrophysiologic fi ndings that demonstrate the multiple AP include 1) changing antegrade delta waves; 2) evidence of multiple routes of retrograde atrial activation; 3) orthodromic SVT with intermittent antegrade fusion complexes.1 In our instance, additional AP could be recognized by more than one atrial breakthrough points. Here were intermittent changes of retrograde atrial activation sequence in the CS while retrograde atrial activation in the HRA was earliest. The constantly earliest activation in the HRA suggests the clinical SVT uses the right an- terolateral AP as a reentry circuit and intermittently the left lateral AP as a bystander.
Atrial fusion due to intermittent activation of the two accessory pathways changed the J point on the electrocardiogram. Careful attention to the J point during the tachycardia could help identify multiple accessory pathways before electrophysiologic study.
PS 1169 Cardiology
Transient Complete Atrioventricular Block Associated with Evening Primrose Oil Intake
In Sun Min1, Ju Young Lee1, Tae Seob Jung2, Nam Kyu Kang2, Bo Bae Park1, Bae Keun Kim1
Sungae Hospital, Korea1, Gwangmyeong Sung Ae Hospital, Korea2
The complete atrioventricular block can be seen in patients with variety of causes including drugs. Resolution of drug-induced atrioventricular block is accomplished by drug discontinuation almost. We report a case of transient complete atrioventricular block in a 31-year-old woman, after intake of evening primrose oils for one month.
With exception of all other causes of conduction disorders, an adverse effect of the evening primrose oils was seemed to most likely diagnosis. After withdrawal of the oils, no associated symptoms and conduction disturbances were observed for 4 months after discharge. We stress reconsideration of taking medicines and functional foods continuously, as most patients are not sure of hazard in posse.
PS 1170 Cardiology
Prevalence of Gastrointestinal Diseases and Status of Treatment in Noncardiac Chest Pain Patients
Sung Hun Park1, Changyu Park1, Jino Na1, Cheolung Choi1, Hongeuy Lim1, Jinwon Kim1, Eungjoo Kim1, Seungwoon Rha1, Hongseog Seo1, Dongjoo Oh1
Korea University Guro Hospital, Korea1
Background: We evaluated the prevalence of gastroesophageal refl ux diseases (GERD) in noncardiac chest pain (NCCP) patients, risk factors for GERD, and status of prescrip- tions for GERD in Korean population.
Methods: This was a retrospective non-interventional observational nation-wide multicenter (45 centers) study. Patients who had a normal coronary angiogram (CAG) and upper gastroendoscopy within 2 years after CAG were enrolled. The prevalence of GERD among them was examined. Other gastrointestinal diseases including pep- tic ulcer diseases or gastritis were also examined. We compared the risk factors for GERD between the GERD group and non-GERD group. The ratio of patients who had a medications for gastrointestinal diseases (antacids or proton-pump inhibitor) was also examined.
Results: Total of nine hundred four patients were enrolled. The prevalence of GERD among NCCP patients was 436(48.2%) of 904 patients. Peptic ulcer disease were present in 154 patients, 17.0%. The prevalence of gastritis was 659(72.9%) of 904 pa- tients. There was no difference in risk factors for GERD between GERD group and non- GERD group. Medications for GERD and other gastrointestinal diseases were prescribed in 742 patients, 82.1% of all the NCCP patients.
Conclusions: GERD were common (42.8%) in Korean NCCP patients and most of them (82.1%) were prescribed for GI medications in Korea. But we could not fi nd any differ- ences in risk factors between GERD and non-GERD groups.
