The technique of creating partial fascicular block appears to be a safe and effective approach to ablation of idiopathic left ventricular tachycardia in children.

Late sequelea following a Mustard operation for transposition of the great arteries (TGA) include atrial arrhythmias and dysfunction of the systemic right ventricle. Catheter mapping and ablation of atrial tachycardia in the setting of significant right ventricular dysfunction may result in hemodynamic compromise. We report the novel use of the Impella percutaneous microaxial flow pump to support cardiac output in an adult patient with a Mustard operation for TGA who experienced a cardiac arrest during a prior ablation attempt. The Impella device was placed via a retrograde approach across the aortic valve into the right ventricle providing hemodynamic stability for successful mapping and ablation of intra-atrial reentrant tachycardia.

Syncope and near-syncopal symptoms are common events in the adolescent population. Syncope is defined as the transient loss of postural tone and consciousness with spontaneous recovery. Although most syncopal events are benign, they can generate extreme anxiety in the adolescent and his or her family. The re-occurrence of these events can have a negative impact on an adolescent's participation in daily activities. Understanding the process of assessment, diagnosis, and management of these teens can enable the school nurse to augment initial assessment and to support the prescribed treatment plan. This knowledge then can be used to help allay the adolescent's anxiety and to support efforts at self-management. This article explores current literature in regards to etiology, diagnosis, and medical treatment, and advocates a self-management protocol for neurally mediated syncope in the adolescent population with support of that plan by the school nurse.

No abstract

Syncope and near-syncopal symptoms are common events in the adolescent population. Syncope is defined as the transient loss of postural tone and consciousness with spontaneous recovery. Although most syncopal events are benign, they can generate extreme anxiety in the adolescent and his or her family. The re-occurrence of these events can have a negative impact on an adolescent's participation in daily activities. Understanding the process of assessment, diagnosis, and management of these teens can enable the school nurse to augment initial assessment and to support the prescribed treatment plan. This knowledge then can be used to help allay the adolescent's anxiety and to support efforts at self-management. This article explores current literature in regards to etiology, diagnosis, and medical treatment, and advocates a self-management protocol for neurally mediated syncope in the adolescent population with support of that plan by the school nurse.