case_images: PMC11190324_01
case_images: Patient characteristics: (A) 12-lead electrocardiogram showed a small-complex supraventricular tachycardia; (B) esophageal electrocardiogram showed RP' < P'R and RP' interval of 120 ms in V1; (C,D) jumping phenomenon caused by S2R stimulation.
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case_images: F1
case_images: A 12-lead electrocardiogram (ECG) showed a narrow QRS complex tachycardia (Figure 1A), which was refractory to intravenous therapy with propafenone and adenosine triphosphate. AVRT (Figures 1B-D). After obtaining patient and family consent, electrophysiology study and radiofrequency catheter ablation were performed using the Carto 3  system. A decapolar catheter was advanced into the coronary sinus (CS) and a quadripolar catheter was positioned in the right ventricular apex.
case_images: Electrophysiology study was performed with zero-fluoroscopy-approach-guided Carto 3TM system. (A) The earliest atrial activation was at CS7/8 with fixed retrograde atrial conduction under ventricular pacing. (B) The earliest atrial activation changed to CS1/2 with fixed retrograde atrial conduction under ventricular pacing. (C) The ablation targets of left lateral and septal accessory pathways. (D) The ablation targets of slow pathway modification. Red dots: ablation target; yellow dots: His bundle.
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case_images: F2
case_images: The ablation catheter gained access to the left ventricle via a retrograde aortic approach, and the earliest atrial activation and local VA fusion was detected at CS7/8 under ventricular pacing (Figure 2A). After ablation with a 35 W discharge, the earliest atrial activation changed to CS1/2 with ventricular pacing (Figure 2B). Therefore, the patient appeared to have another concealed left lateral accessory pathway (Figure 2C). A wave in the coronary sinus electrode remained in a straight line, leading to the diagnosis of slow-fast atrioventricular nodal re-entrant tachycardia. A slow pathway ablation was performed (Figure 2D), eliminating the dual AV node physiology even with programed atrial stimulation with and without isoproterenol.
case_images: Genes that are potentially associated with AVNRT and AVRT.
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case_images: PMC11190324_01_fcvm-11-1367893-g003.jpg
case_images: F3
case_images: Possible mechanisms underlying the crosstalk between cancer cells and cardiomyocytes. Molecules secreted from cancer cells translocate into the heart, either through sEVs or other forms of particles, and regulate the expression or activity of cardiomyocytes localized ion channels. Alternatively, neurotransmitters, hormones, and growth factors secreted from cancer cells might mediate the crosstalk between cancer cells and cardiomyocytes.
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case_images: F4
case_images: Regulatory pattern of chemotherapy drugs on cardiomyocytes. (1) Chemotherapeutic agents act upon cancer cells, leading to cancer cell death and subsequent release of chemical messages to indirectly influence cardiomyocytes localized ion channels; (2) direct action of chemotherapeutic agents on ion channels in cardiomyocytes.
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case_images: PMC11190324_01_fcvm-11-1367893-g005.jpg
case_images: F5