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Refractory svt

Amee M Bigelow, Brandon S Arnold, Gregory C Padrutt, John M Clark
In current practice, children with anatomically normal hearts routinely undergo fluoroscopy-free ablations. Infants and children with congenital heart disease (CHD) represent the most difficult population to perform catheter ablation without fluoroscopy. We report two neonatal patients with CHD in whom cardiac ablations were performed without fluoroscopy. The first infant had pulmonary atresia with intact ventricular septum with refractory supraventricular tachycardia, and the second infant presented with Ebstein's anomaly of the tricuspid valve along with persistent supraventricular tachycardia...
October 21, 2016: Cardiology in the Young
Guangzhi Chen, Ge Sun, Renfan Xu, Xiaomei Chen, Li Yang, Yang Bai, Shanshan Yang, Ping Guo, Yan Zhang, Chunxia Zhao, Dao Wen Wang, Yan Wang
BACKGROUND: Cardiac arrhythmias can occur during pregnancy. Owing to radiation exposure and other uncertain risks for the mother and fetus, catheter ablation has rarely been performed and is often delayed until the postpartum period. We reported 2 pregnant women who were experiencing severe arrhythmias and were successfully ablated without fluoroscopic guidance. We also carried out a literature review of cases of pregnant women who underwent zero-fluoroscopy ablation. METHODS AND RESULTS: One woman had drug-resistant and poorly tolerated frequent premature ventricular contraction (PVC) and ventricular tachycardia (VT)...
August 2016: Medicine (Baltimore)
Atsushi Doi, Masahiko Takagi, Kouhei Fujimoto, Jun Kakihara, Yusuke Hayashi, Hiroaki Tatsumi, Minoru Yoshiyama
A 71-year-old man with palpitation was referred for electrophysiological study and radiofrequency ablation. Baseline findings of 12-lead electrocardiogram during sinus rhythm and echocardiography were normal. Atrio-His (AH) and His-ventricular (HV) intervals were measured as 113 and 40 ms, respectively. Dual atrioventricular (AV) nodal physiology was observed during programmed atrial stimulation. The earliest atrial activation during ventricular constant pacing was recorded at His bundle region, and para-Hisian pacing showed AV nodal pattern...
April 19, 2016: Journal of Cardiovascular Electrophysiology
Jung Myung Lee, Hancheol Lee, Ajit H Janardhan, Junbeom Park, Boyoung Joung, Hui-Nam Pak, Moon-Hyoung Lee, Sung Soon Kim, Hye Jin Hwang
BACKGROUND: Tissue refractoriness to conduction is a crucial electrophysiological factor in determining susceptibility to fibrillation. The relationship between atrial refractoriness and future onset of atrial fibrillation (AF) has not been well studied. OBJECTIVES: We investigated whether atrial effective refractory period (AERP) was associated with AF occurrence in a relatively healthy population. METHODS: A total of 1308 patients with no overt structural heart diseases and no evidence of congestive heart failure who underwent electrophysiology studies for paroxysmal supraventricular tachycardia from January 1986 to January 2011 were included in the study (626 male, mean age 44 ± 16 years)...
August 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Ayelet Shauer, Asaf Danon, Sheldon M Singh
No abstract text is available yet for this article.
June 2016: Pacing and Clinical Electrophysiology: PACE
Abby M Bailey, Regan A Baum, Justin Rose, Roger L Humphries
BACKGROUND: Symptomatic tachycardia is a common admission diagnosis in the emergency department (ED). This can be a life-threatening condition and requires immediate attention. Supraventricular tachycardia (SVT) is commonly treated with adenosine, and successful treatment is limited to atrioventricular (AV) node-dependent SVTs as adenosine causes a transient heart block. However, there are limited data available for instances when the recommended dosing regimen (6 mg, 12 mg, 12 mg) fails to terminate SVT...
March 2016: Journal of Emergency Medicine
Sriram Pothapregada, Banupriya Kamalakannan, Mahalakshmy Thulasingam
OBJECTIVES: To study the clinical profile and outcome of the atypical manifestations of dengue fever in children. METHODS: All children (0-12 y of age) diagnosed and confirmed as dengue fever at a tertiary care hospital at Puducherry, between the 1st of August 2012 and January 31st 2015 were reviewed retrospectively from hospital case records as per the revised World Health Organization (WHO) guidelines 2011 for dengue fever. The diagnosis was confirmed by NS1 antigen-based ELISA test or dengue serology for IgM and IgG antibodies and the data was analyzed using SPSS 16...
June 2016: Indian Journal of Pediatrics
Kentaro Miyake, Yoshihito Fujita, Saya Yoshizawa, Maiko Tomita, Mitsunori Miyazu, Yoshiki Sento, Shinichiro Yoshimura, Kazuya Sobue
The onset of tachyarrhythmia after the Fontan procedure (total cavopulmonary connection; TCPC) should be considered a medical emergency. Landiolol is an ultra-short-acting β1-selective blocker whose effect on tachyarrhythmia after TCPC is unclear. We evaluated the efficacy and safety of landiolol for tachyarrhythmia after TCPC. Consecutive patients undergoing TCPC were enrolled from January 2007 to December 2011. Of 435 pediatric open heart surgeries, 28 patients underwent TCPC. Of the 28 patients, 13 were treated with landiolol for critical tachyarrhythmia...
April 2016: Journal of Anesthesia
Paul Chun Yih Lim, Daniel Thuan Tee Chong, Boon Yew Tan, Kah Leng Ho, Wee Siong Teo, Chi Keong Ching
No abstract text is available yet for this article.
May 2016: Journal of Cardiovascular Electrophysiology
Yakup Ergül, İsa Özyılmaz, Murat Saygı, Hasan Tahsin Tola, Celal Akdeniz, Volkan Tuzcu
OBJECTIVE: This study aimed to evaluate the efficacy of flecainide therapy in neonates and infants with drug resistant incessant supraventricular tachycardia. METHODS: The study included 11 neonates and infants who received medical and/or ablation therapy between January 2010 and December 2013. Mean patient age and weight were 101.6 ± 96 days and 5.3 ± 1.9 kg respectively. Of the 12 patients, 5 underwent ablation between January 2010 and December 2011, and 6 were treated medically between January 2012 and December 2013...
October 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Tomas Robyns, Hua Rong Lu, David J Gallacher, Christophe Garweg, Joris Ector, Rik Willems, Stefan Janssens, Dieter Nuyens
BACKGROUND: Recently a new risk marker for drug-induced arrhythmias called index of cardio-electrophysiological balance (iCEB), measured as QT interval divided by QRS duration, was evaluated in an animal model. It was hypothesized that iCEB is equivalent to the cardiac wavelength λ (λ = effective refractory period (ERP) x conduction velocity) and that an increased or decreased value of iCEB would potentially predict an increased susceptibility to TdP or non-TdP mediated VT/VF, respectively...
May 2016: Annals of Noninvasive Electrocardiology
Işıl Yıldırım, Sema Özer, Tevfik Karagöz, Murat Şahin, Süheyla Özkutlu, Dursun Alehan, Alpay Çeliker
OBJECTIVE: Wolff-Parkinson-White (WPW) syndrome presents with paroxysmal supraventricular tachycardia and is characterized by electrocardiographic (ECG) findings of a short PR interval and a delta wave. The objective of this study was to evaluate the electrophysiological properties of children with WPW syndrome and to develop an algorithm for the management of these patients with limited access to electrophysiological study. METHODS: A retrospective review of all pediatric patients who underwent electrophysiological evaluation for WPW syndrome was performed...
June 2015: Anatolian Journal of Cardiology
Gavin D Smith, Meagan M Fry, David Taylor, Amee Morgans, Kate Cantwell
BACKGROUND: People with the cardiac arrhythmia supraventricular tachycardia (SVT) frequently present to clinicians in the prehospital and emergency medicine settings. Restoring sinus rhythm by terminating the SVT involves increasing the refractoriness of atrioventricular nodal tissue within the myocardium by means of vagal manoeuvres, pharmacological agents, or electrical cardioversion. A commonly used first-line technique to restore the normal sinus rhythm (reversion) is the Valsalva Manoeuvre (VM)...
2015: Cochrane Database of Systematic Reviews
Syamkumar M Divakara Menon, Girish M Nair, Gonzalo L Leaplaza, Jeff S Healey, Carlos A Morillo, Stuart J Connolly
No abstract text is available yet for this article.
August 2015: Pacing and Clinical Electrophysiology: PACE
Yakup Ergul, Serkan Unsal, Isa Ozyilmaz, Erkut Ozturk, Hayat Carus, Alper Guzeltas
BACKGROUND: Dexmedetomidine (DEX) is a highly selective alpha-2-adrenergic agonist approved for short-term sedation and monitored anesthesia care in adults. Its effects on the electrocardiography and cardiac conduction tissue are not well described in the literature. Therefore, we aimed to characterize the electrocardiographic and electrophysiologic effects of DEX in children. METHODS: Twenty children (11 boys and nine girls) between the ages of eight and 17 undergoing electrophysiology study and ablation of the supraventricular tachycardia had hemodynamic and cardiac electrophysiologic variables measured before and during the administration of DEX (1 microgram/kg IV over 10 minutes followed by a 10-minute continuous infusion of 0...
June 2015: Pacing and Clinical Electrophysiology: PACE
Gavin D Smith, Meagan M Fry, David Taylor, Amee Morgans, Kate Cantwell
BACKGROUND: People with the cardiac arrhythmia supraventricular tachycardia (SVT) frequently present to clinicians in the prehospital and emergency medicine settings. Restoring sinus rhythm by terminating the SVT involves increasing the refractoriness of atrioventricular nodal tissue within the myocardium by means of vagal manoeuvres, pharmacological agents, or electrical cardioversion. A commonly used first-line technique to restore the normal sinus rhythm (reversion) is the Valsalva Manoeuvre (VM)...
2015: Cochrane Database of Systematic Reviews
Sunil Saharan, Seshadri Balaji
We describe a 7-week-old female infant who presented with refractory supraventricular tachycardia (SVT). During amiodarone infusion, she developed hypotension and cardiac arrest requiring extracorporeal membrane oxygenation (ECMO) support. After successful control of SVT using procainamide infusion, she was weaned from ECMO and discharged home on oral flecainide. We conclude that infants with acidosis, ventricular dysfunction, and prolonged refractory SVT may poorly tolerate intravenous amiodarone.
January 2015: Annals of Pediatric Cardiology
Tiago Luiz Luz Leiria, Leonardo Martins Pires, Marcelo Lapa Kruse, Gustavo Glotz de Lima
Arrhythmias during pregnancy pose a dilemma for the treating physician. Most antiarrhythmic drugs are classified as category C in the FDA labeling system during pregnancy. We describe the case of a pregnant woman who presented syncope due to drug-refractory supraventricular tachycardia who underwent catheter ablation without the use of fluoroscopy.
December 2014: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
C A Capone, J Gebb, P Dar, R U Shenoy
Fetal supraventricular tachycardia (SVT), characterized by a fetal ventricular heart rate faster than 200 beats per minute (bpm), is often diagnosed during routine fetal heart monitoring or prenatal ultrasound examinations. Clinical guidelines for management of fetal SVT have not been determined in standardized trials, nor do we have a clear sense regarding the long-term developmental outcomes and side effects of in utero antiarrhythmic therapy. We describe our approach to the treatment of refractory SVT in a fetus with hydrops using direct umbilical vein treatment with amiodarone coupled with effusion evacuation...
2014: Journal of Neonatal-perinatal Medicine
K Viswanathan, S Patra, B King, C Silversides, E Oechslin, L Roche, D Cameron, V Chauhan, L Harris, E Downar, K Nair
INTRODUCTION: Late arrhythmias are common in adults undergoing Rastelli repair with a right ventricle (RV) to pulmonary artery (PA) conduit. The mechanism of arrhythmias has not been described. We sought to describe the prevalence, clinical predictors and mechanisms of supraventricular (SVT) and ventricular tachycardia (VT) in this population. METHODS: We retrospectively reviewed charts for adults (age >18 years) with discordant ventriculo-arterial connection (d-TGA (and double outlet RV), VSD and pulmonary stenosis (PS) that underwent Rastelli operations who were seen in our clinic...
October 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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