Overdrive pacing for entrainment mapping rarely alters or terminates after atrial fibrillation AT, provided that AT is stable before pacing and that the PCL is ≤20 ms shorter than the AT CL. 007), but the mean difference between sequential PP intervals expressed as a percentage of the AT CL was not significantly different (3.8% ± 2.6% vs 1.9% ± 2.1% P =. The difference between the shortest and the longest CL expressed as a percentage of the CL was significantly greater in ATs that were altered or terminated by pacing than in those unchanged (11.0% ± 9.6% vs 4.5% ± 4.5% P =. When the TCL − PCL difference was >20 ms, 3 of 33 (9%) attempts altered or terminated AT. When the TCL − PCL difference was ≤20 ms, only 2 of 353 (0.5%) attempts altered or terminated AT. Of 386 total pacing attempts (tachycardia CL – pacing CL difference 15 ± 6 ms), 5 (1.3%) altered or terminated AT and 381 did not change AT (98.7%). The variability in the PP intervals was determined over 10 beats from 2 measures: (1) the difference between the shortest and the longest CL expressed as a percentage of the CL and (2) the mean difference between sequential PP intervals expressed as a percentage of the AT CL (CLD mean). AT was classified as altered if the CL or activation pattern remained altered 10 seconds after pacing. In 30 consecutive patients, 62 ATs (mean cycle length 268 ± 53 ms) in which overdrive pacing for entrainment mapping was performed were retrospectively analyzed. We aimed to determine the incidence and risk factors for AT alteration or termination.

The epinephrine phase of the alarm reaction and the circulatory imbalance could be responsible for the general symptomatology of the dumping syndrome.Įntrainment can be useful for mapping atrial tachycardias (ATs) after atrial fibrillation (AF) ablation but may result in AT alteration or termination.

The digestive complaints could arise from the intestine. The rapid distention of the intestine by food due to the absence of the reservoir function of the stomach seems to be the fundamental mechanism of the dumping syndrome. The hematologic and circulatory alterations and the symptoms of the dumping syndrome were produced in two normal subjects by direct tube feeding into the upper jejunum. There was also a circulatory imbalance, with a fall in blood pressure and tachycardia. During the dumping syndrome there was an increase in urinary excretion of uric acid and a decrease in excretion of sodium and chloride. Leukocytosis with neutrophilia and shift to the left, absolute eosinopenia and relative lymphopenia were present. In patients with subtotal gastrectomy in whom the ingestion of food produced the dumping syndrome, hematologic and biochemical alterations were found that favor the hypothesis of adrenal stimulation.

Adrenal dumping syndrome