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wide complex tachycardia

Dandan Wang, Guoguang Chen, Lili Ren
Amiodarone hydrochloride (AMD) is used in the treatment of a wide range of cardiac tachyarrhythmias, including both ventricular fibrillation (VF) and hemodynamically unstable ventricular tachycardia (VT). The objectives of this study were to improve the solubility and bioavailability in fasted state and to reduce the food effect of AMD by producing its inclusion complex with sulfobutylether-β-cyclodextrin (SBE-β-CD). The complex was prepared through a saturated water solution combined with the freeze-drying method and then characterized by Fourier transform infrared spectroscopy, proton nuclear magnetic resonance spectroscopy, and differential scanning calorimetry...
October 18, 2016: AAPS PharmSciTech
Maximilian D Hien, Fernando Benito Castro, Philippe Fournier, Anne Filleron, Tu-Anh Tran
OBJECTIVES: We report on a rare but severe complication of adenosine use in a child with reentry tachycardia. METHODS AND RESULTS: Treatment with adenosine, which is the standard medical therapy of atrioventricular reentry tachycardia, led to the development of an irregular wide complex tachycardia, caused by rapid ventricular response to atrial fibrillation. The girl was finally stabilized with electrical cardioversion. We analyze the pathomechanism and discuss possible treatment options...
October 8, 2016: Pediatric Emergency Care
Uğur Aksu, Kamuran Kalkan, Oktay Gülcü, Selim Topcu, Serdar Sevimli, Enbiya Aksakal, Emrah Ipek, Mahmut Açıkel, Ibrahim Halil Tanboğa
BACKGROUND: The atrioventricular (AV) dissociation, which is frequently used in differential diagnosis of wide QRS complex tachycardia (WQCT), is the most specific finding of ventricular tachycardia (VT) with lower sensitivity. Herein, we aimed to show the importance of Lewis lead ECG records to detect 'visible p waves' during WQCT. METHOD: A total of 21 consecutive patients who underwent electrophysiologic study (EPS) were included in the study. During EPS, by using a quadripolar diagnostic catheter directed to the right ventricular apex, a fixed stimulus was given and the ventriculoatrial (VA) Wenkebach point was found, and a VT was simulated by a RV apical stimulus at 300ms...
September 26, 2016: International Journal of Cardiology
Vincenzo Carbone, Alessio Poggi, Vincenzo Marafioti, Giuseppe Oreto
No abstract text is available yet for this article.
October 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Ali Kazemi Saeid, George J Klein, Peter Leong-Sit
Sustained monomorphic ventricular tachycardia or repetitive premature ventricular complexes can be seen in patients with structurally normal hearts. Among these types of patients, the prognosis is predominantly benign and the treatment mostly focused on elimination of symptoms rather than improving survival or reduction of mortality. This article focuses on the pharmacologic options for management and compares them with invasive options. Based on the current literature, we demonstrate that medical therapies should be used as first-line management and favored over invasive therapies...
September 2016: Cardiac Electrophysiology Clinics
Raphael Sung, Melvin Scheinman
Fascicular arrhythmias encompass a wide spectrum of ventricular arrhythmias that depend on the specialized conduction system of the right and left ventricles. These arrhythmias include premature ventricular complexes, monomorphic ventricular tachycardia, polymorphic ventricular tachycardia, and ventricular fibrillation. These arrhythmias may be organized by mechanism, including intrafascicular reentry, interfascicular reentry, and focal. Mapping and ablation of the fascicular system can result in high cure rates of debilitating and potentially life-threatening arrhythmias...
September 2016: Cardiac Electrophysiology Clinics
Joseph E Marine
Nonsustained ventricular tachycardia (NSVT) may trigger concern, particularly in patients with known congestive heart failure, structural heart disease, or prolonged QT interval. When NSVT occurs in patients with normal hearts, it usually has a benign prognosis. Therefore, establishing the presence or absence of structural or inherited heart disease is a critical step in each patient's evaluation. It is important to approach a wide-complex tachycardia in a systematic manner, to ensure correct diagnosis and treatment...
September 2016: Cardiac Electrophysiology Clinics
Amit Noheria, Siva K Mulpuru, Peter A Noseworthy, Samuel J Asirvatham
We present a case of incessant wide-complex tachycardia in a patient with left-ventricular assist device, and discuss the differential diagnosis with an in-depth analysis of the intracardiac tracings during the invasive electrophysiologic study, including interpretation of the relative timing of the fascicular signals during tachycardia and in sinus rhythm, and interpretation of pacing and entrainment maneuvers.
January 2016: Indian Pacing and Electrophysiology Journal
Mercedes Ortiz, Alfonso Martín, Fernando Arribas, Blanca Coll-Vinent, Carmen Del Arco, Rafael Peinado, Jesús Almendral
AIMS: Intravenous procainamide and amiodarone are drugs of choice for well-tolerated ventricular tachycardia. However, the choice between them, even according to Guidelines, is unclear. We performed a multicentre randomized open-labelled study to determine the safety and efficacy of intravenous procainamide and amiodarone for the acute treatment of tolerated wide QRS complex (probably ventricular) tachycardia. METHODS AND RESULTS: Patients were randomly assigned to receive intravenous procainamide (10 mg/kg/20 min) or amiodarone (5 mg/kg/20 min)...
June 28, 2016: European Heart Journal
Stéphane Boulé, Marc Sémichon, Laurence Guédon-Moreau, Élodie Drumez, Claude Kouakam, Christelle Marquié, François Brigadeau, Salem Kacet, Charlotte Potelle, William Escande, Zouheir Souissi, Dominique Lacroix, Alain Duhamel, Didier Klug
BACKGROUND: Little is known about the long-term outcomes of patients who receive an implantable cardioverter-defibrillator (ICD) for purely secondary prevention indications. AIMS: To assess the rates and predictors of appropriate therapies over a very long-term follow-up period in this population. METHODS: Between June 2003 and August 2006, 239 consecutive patients with structural left ventricular disease and a secondary prophylaxis indication for ICD therapy (survivors of life-threatening ventricular tachyarrhythmias) were prospectively enrolled...
June 21, 2016: Archives of Cardiovascular Diseases
Anishkumar Nair, Kader Muneer, Chakanalil Govindan Sajeev
No abstract text is available yet for this article.
2016: Heart Asia
Luisa Muraro, Laura Longo, Federico Geraldini, Andrea Bortot, Andrea Paoli, Annalisa Boscolo
Caffeine is arguably the most widely used stimulant drug in the world. Here we describe a suicide attempt involving caffeine overdose whereby the patient's severe intoxication was successfully treated with the prompt infusion of Intralipid. A 19-year-old man was found in an agitated state at home by the volunteer emergency team about 1 h after the intentional ingestion of 40 g of caffeine (tablets). His consciousness decreased rapidly, followed quickly by seizures, and electrocardiographic monitoring showed ventricular fibrillation...
October 2016: Journal of Anesthesia
Barbara Bellmann, Patrick Nagel, Verena Tscholl, Mattias Roser, Andreas Rillig
We report a 49-year-old patient who presented with tachycardia in our emergency room. The 12-lead ECG showed a wide complex tachycardia with a heart rate of 234 beats per minute. After structural heart disease was excluded via echocardiography, coronary angiography and magnetic resonance imaging, an electrophysiological study was performed. During programmed ventricular stimulation, a fascicular tachycardia was induced, which was successfully treated by radiofrequency ablation. Fascicular ventricular tachycardia is a rare tachycardia that occurs in patients without structural heart disease...
June 2016: Herzschrittmachertherapie & Elektrophysiologie
Jinhua Deng, Tingting Chen, Chujuan Zeng, Nan Lu, Lihong Zhou, Xuerui Tan, Min Yu
BACKGROUND: Wide QRS complex tachycardia (WCT) is a common arrhythmia. How to differentiate between WCTs is a challenge in clinical practice. Recently R-wave peak time (RWPT) at lead II was reported to be a helpful and simple tool for differentiating WCTs. However, it has remained unknown about the reference range of RWPT at lead II. In present study, we aimed to investigate the reference range of RWPT at lead II in Chinese healthy adults. METHODS: A retrospective study was conducted in the First Affiliated Hospital of Shantou University Medical College in Southern China...
2016: BMC Cardiovascular Disorders
Adriana de la Rosa Riestra, José Amador Rubio Caballero, Alfonso Freites Estévez, Javier Alonso Belló, Javier Botas Rodríguez
An 83-year-old male suffering from severe symptomatic aortic valve stenosis received an implant of a biological aortic prosthesis through the femoral artery without complications. Seven days after dischargement he experienced a syncope. The patient was wearing an ECG holter monitor that day, which showed a wide QRS complex tachycardia of 300 beats per minute. The electrophysiological study revealed a bundle-branch reentry ventricular tachycardia as the cause of the syncope. Radio-frequency was applied on the right-bundle branch...
September 2015: Indian Pacing and Electrophysiology Journal
Haifeng Pei, Qiujun Yu, Xiaohua Su, Zhen Wang, Heng Zhao, Dachun Yang, Yongjian Yang, De Li
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a crucial health problem. With sudden death often being the first presentation, early diagnosis for ARVC is essential. Up to date, electrocardiogram (ECG) is a widely used diagnostic method without invasive harms. To diagnose and treat ARVC as well as possible, we should clearly elucidate its pathophysiological alterations. A 66-year-old farmer presented to the Emergency Department with continuous palpitation, chest tightness, profuse sweating, and nausea with no obvious predisposing causes...
April 2016: Medicine (Baltimore)
Marek Jastrzebski, Maciej Pitak, Andrzej Rudzinski, Danuta Czarnecka
No abstract text is available yet for this article.
September 2016: Journal of Cardiovascular Electrophysiology
Christian-Hendrik Heeger, Kentaro Hayashi, Karl-Heinz Kuck, Feifan Ouyang
Ventricular arrhythmias (VA), like premature ventricular contractions (PVC) and ventricular tachycardia (VT) in patients without structural heart disease (idiopathic VA), mainly arise from the right and left ventricular outflow tracts (RVOT/LVOT). The prognosis for OT VA is generally good in the majority of patients, but there is potential for developing dilated cardiomyopathies from the high burden of VA, as well as a certain risk for sudden cardiac death because of fast monomorphic VT or polymorphic VT triggered by short-coupling PVC...
April 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
D Luke Glancy, Allan Chen
Multifocal atrial tachycardia; right bundle branch block. The rhythm is totally irregular at a rate of 103 beats/min and originally was read as atrial fibrillation. Close examination, however, reveals a P wave before each QRS and ≥ 3 different P- wave morphologies with no dominant morphology. These are the criteria for multifocal atrial tachycardia MAT, also known as chaotic atrial rhythm,1 chaotic atrial tachycardia,2 and chaotic atrial mechanism.3 The wide QRS complexes ≥ 0.12 s with broad S waves in leads I, aVL, and the lateral precordial leads and broad R or R´ waves in leads aVR and V1 indicate right bundle branch block...
January 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Colin Yeo, Kelvin Ck Wong
CLINICAL INTRODUCTION: We present the case of a 60-year-old man with history of non-ischaemic cardiomyopathy with left ventricular ejection fraction of 40%. His baseline surface 12-lead ECG shows sinus rhythm with PR interval of 170 ms, no evidence of pre-excitation and a normal QT interval. He had a single-chamber automated implantable cardiac defibrillator (AICD) inserted for sustained wide complex tachycardia associated with palpitations. Subsequently, he presented with recurrent shocks from the AICD coming on at rest despite treatment with amiodarone...
August 15, 2016: Heart: Official Journal of the British Cardiac Society
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