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    Asthma-like attacks terminated by slow pathway ablation
    (Wolters Kluwer Medknow Publications, 2017) Ozturk, Selcuk; Turhan, Hasan; Yetkin, Ertan
    Asthma is a chronic airway disease in which the pathological mechanisms are reversible airway obstruction, bronchial hyper reactivity, and constriction of the lower airways. Supraventricular tachycardia (SVT) is a common arrhythmia which originates above the bundle of His and causing heart rates exceeding 150 beats/min. SVT patients present with palpitation, chest pain, chest discomfort, dyspnea, hyperventilation, and lightheadedness, occasionally. Besides, extraordinary presentations of SVT are available in literature. In this report, we describe a case of a patient presenting with treatment-resistant asthma-like attacks lasting for 20 years whom was suspected SVT as an underlying etiology and treated by slow pathway radiofrequency ablation.
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    Where to begin: from the electrocardiogram or the symptoms?
    (Elsevier Ireland Ltd, 2016) Öztürk, Selçuk; Turhan, Hasan; Yetkin, Ertan
    Dear Editor, We have read the article published by Brembilla-Perrot et al. [1] with great interest. In their study, they have aimed to search the symptom characteristics in patients suspected of supraventricular tachycardiam (SVT) in which the SVT cannot be documented noninvasively. Briefly, they have analyzed 2650 patients, age ranging from 6 to 97, and ran- domized them according to their electrophysiological study (EPS) re- sults whether SVT was inducible during EPS or not. In their study, they have found that among patients whom suspected of SVT but not docu-mented noninvasively, chest pain and/or syncope and age b 40 years is associated with negative EPS results. They have concluded that, in this patient group in the absence of documented SVT, EPS is not indicated [1]. Although, there are several take home messages that might be gath-ered from these results, we believe that symptomatology of SVT pa-tients needs to be discussed in the light of this study. The main and most common types of symptoms in SVT are palpita-tion, pulsation in the neck, chest discomfort, dyspnea, hyperventilation, lightheadedness and anxiety. Chest pain, nausea and syncope are less frequent symptoms in this patient group. Sometimes, these patients can survive asymptomatic [2]. In non-documented tachycardia attacks, symptoms of the patients can be misleading because of the short dura- tion and atypical presentation of the episodes. Due to the elevation of troponin levels and chest pain or chest discomfort, these patients are diagnosed as acute coronary syndrome occasionally and sometimes coronary angiography is performed [3]. Although it is not the aim of this study, it would be nice to know whether coronary angiography was performed in these patients. And their biomarker levels might be suggestive of myocardial ischemia, especially in the older patient group. Moreover possible cross-talk through the cardiac plexus, cervi-cal, thoracic plexus, and cranial nerves has been supposed to be the mechanism of extraordinary symptoms of SVT such as burping, tinnitus, and cough attacks.