China
Africa
Explore chapters and articles related to this topic
Basics of Electrophysiology Study
Published in Andrea Natale, Oussama M. Wazni, Kalyanam Shivkumar, Francis E. Marchlinski, Handbook of Cardiac Electrophysiology, 2020
Jonathan R. Hoffman, Marmar Vaseghi
The clinical electrophysiology (EP) study plays an important role in the evaluation and diagnosis of both tachy- and brady-arrhythmias as well as in assessing the heart’s atrial and ventricular conduction system. During the standard EP study, multipolar catheters are placed in various locations within the heart. The particular locations can vary depending on the purpose of the study, but typical locations include the high right atrium, the right ventricular apex or base, the His bundle, and the coronary sinus (Figure 18.1). These catheters are used to record electrograms, which can be measured as difference between electromyographic signals from two different electrodes (bipolar recording), or in relation to a single electrode (unipolar recording). Using these catheters, the electrophysiologic properties of the heart’s conduction system, including the sinus node, the atrioventricular node, the His Purkinje system, and the atrial and ventricular myocardium can be assessed both at baseline and in response to pharmacologic agents such as isoproterenol, adenosine, atropine, procainamide, and epinephrine, among others. In addition, multiple pacing maneuvers are performed using these catheters, both to assess the response of the heart’s conduction system to stress, as well as to attempt to induce various arrhythmias.
Setting up a catheterization laboratory: Organizational, architectural, and equipment considerations
Published in Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead, Cardiovascular Catheterization and Intervention, 2017
Clinical electrophysiology laboratories are similar to cardiac catheterization laboratories in that both are built around X-ray fluoroscopic equipment. Consequently, there is pressure to combine both functions into a single proce- dure room, particularly for laboratories with low utilization levels. This pressure should be resisted. The equipment used and procedures performed in the two types of facilities are very different. Converting from a catheterization function to a clinical electrophysiology function can be complex. Thus, while catheterization and clinical electrophysiology labs can be located in a common suite and share support space, it is ideal to have separate procedure rooms for each function.
Peripheral neuropathies
Published in Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen, Clinical Pain Management, 2008
Ravikiran Shenoy, Katherine Roberts, Praveen Anand
Other useful tests include the following: blood tests – to identify metabolic, nutritional, or toxic states, to measure immunoglobulins and antineural antibodies that relate to immune-mediated neuropathies,13 and to perform genetic screens in the diagnosis of inherited neuropathies;cerebrospinal fluid examination – increased protein levels and cellular responses indicate radicular or meningeal involvement;nerve and muscle biopsy – progress in clinical electrophysiology and molecular genetics has resulted in fewer indications for nerve biopsy in clinical practice.14 Biopsy should be reserved for carefully selected cases.15 The main indications include: – mononeuritis multiplex, in which the etiology is still undetermined after extensive laboratory investigations, and the diagnostic possibilities include vasculitis, amyloidosis, leprosy, and sarcoidosis;– distal, symmetric, polyneuropathies of subacute or chronic evolution when all other diagnostic measures have been exhausted and the condition continues to progress;– in establishing diagnosis in genetically determined pediatric disorders, such as metachromatic leukodystrophy, Krabbe’s disease, giant axonal neuropathy, and infantile neuroaxonal dystrophy.
Harel Yoon syndrome: a novel mutation in ATAD3A gene and expansion of the clinical spectrum
Published in Ophthalmic Genetics, 2023
Caroline Atef Tawfik, Raghda Zaitoun, Aliaa Ahmed Farag
The child underwent complete ophthalmological examination including recording of medical, ocular, and family histories, unaided distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) testing using the Snellen chart, subjective refraction, color vision testing by Ishihara chart, ocular motility examination, intraocular pressure measurements using Goldmann applanation tonometry, as well as slit-lamp biomicroscopy and a dilated fundus examination. Moreover, color fundus photography, infrared fundus imaging and fundus autofluorescence (FAF) using Heidelberg Retinal Angiogram (HRA-2; Heidelberg Engineering GmbH, Dossenheim, Germany), spectral domain optical coherence tomography (SD-OCT) using Heidelberg Spectralis OCT (Heidelberg Engineering GmbH; Dossenheim, Germany) of both the macula and optic nerve head were obtained. Additionally, full field electroretinogram (ERG) was recorded using the RETIscan (Version 6.14.1.4, Roland Consult; Stasche & Finger GmbH, Brandenburg an der Havel, Germany) according to the International Society for Clinical Electrophysiology (ISCEV) standards as well as a visual field perimetry by Humphrey field analyzer 3 (Version 1.5.2.431, Zeiss Humphrey System, Dublin, CA).
High-resolution photoreceptor imaging analysis of patients with autosomal dominant retinitis pigmentosa (adRP) caused by HK1 mutation
Published in Ophthalmic Genetics, 2020
Daiki Kubota, Kaori Matsumoto, Mika Hayashi, Noriko Oishi, Kiyoko Gocho, Kunihiko Yamaki, Shinichiro Kobayakawa, Tsutomu Igarashi, Hiroshi Takahashi, Shuhei Kameya
The ophthalmological examinations included measurements of the best-corrected visual acuity (BCVA) and refractive error (spherical equivalent), slit-lamp biomicroscopy, ophthalmoscopy, Goldman kinetic perimetry, fundus photography (CLARUS, Carl Zeiss Meditec), fundus autofluorescence imaging with short-wavelength excitation (FAF; CLARUS, 500–585 nm, Carl Zeiss Meditec and TRC-NW8Fplus retinal camera, 488 nm, TOPCON, Tokyo, Japan), spectral domain optical coherence tomography (SD-OCT; Cirrus HD-OCT, Carl Zeiss Meditec), full-field electroretinography (ERG), and multifocal ERGs (mfERGs). The ERGs were recorded using the extended testing protocol conforming to the International Society for Clinical Electrophysiology of Vision protocol (15). The ERGs were elicited and recorded with a contact lens with a built-in LED electrode (LE4000, TOMEY, JAPAN). ERG responses of patients were compared to controls (9 men and 15 women, median age 44.5 ± 19.8 years). The mfERGs were recorded with a commercial mfERG system (LE4100, TOMEY, JAPAN).
Pattern electroretinography in patients with unilateral acute central serous chorioretinopathy
Published in Clinical and Experimental Optometry, 2020
Sibel Doguizi, Mehmet Ali Sekeroglu, Dilara Ozkoyuncu, Pelin Yilmazbas
PERG was performed twice (at the time of diagnosis and after spontaneous resolution) in each patient using a Metrovision MonPack One model electrophysiological device (MonPack One, Metrovision, France). For the recordings, subjects were refracted as needed for best corrected vision outcome. The tests were performed by the same technician using HK loop electrodes and in compliance with the International Society for Clinical Electrophysiology of Vision (ISCEV) standards.2013 To eliminate the luminance artefact of standard liquid crystal monitors, the stimulator liquid crystal monitors with feedback model were used in the Metrovision MonPack One electrophysiological device. In accordance with the ISCEV standards,2013 the stimulus for the PERG was a black and white reversing checkerboard with a 0.8° check size. A photopic luminance greater than 80-cd/m2 was used for the white areas. The contrast between black and white squares was maximal (close to 100 per cent) with a reversal rate of 4.0 ± 0.8 reversals per second. PERG recording was done binocularly after placing the head of the patient 30-cm to the fixation mark in the centre of the screen with appropriate optical correction for the test distance and without dilation of the pupils to maximise retinal image quality. During the test, patients were monitored whether they kept their eyes open or complied with the requirements of the test. The patient was asked to blink after every 10-seconds to avoid blurring of image due to tearing.