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Resumo Fundamento O diagnóstico diferencial de taquicardia de QRS largo, entre taquicardia ventricular (TV) ou taquicardia supraventricular com condução aberrante (TSV-A) é algumas vezes difícil de ser feito na sala de emergência. Objetivo Avaliar a acurácia de um algoritmo novo e simples para a detecção de TV no eletrocardiograma (ECG) em pacientes com taquicardia de QRS largo. Métodos ECGs de 12 derivações para detecção de taquicardia de QRS largo foram obtidos prospectivamente de 120 pacientes durante estudo eletrofisiológico. Seis médicos com diferentes experiências analisaram os ECGs, e fizeram o diagnóstico com base no algoritmo D12V16, que envolve a análise da polaridade predominante do complexo QRS nas derivações I, II, V1 e V6. O diagnóstico foi comparado com os obtidos pelo algoritmo tradicional de Brugada e pelo estudo eletrofisiológico, o qual é considerado padrão ouro. Adotou-se um nível de significância de 5% (p<0,05) nas análises estatísticas. Resultados De acordo com o estudo eletrofisiológico, 82 ECGs eram de TV e 38 de TSV-A. Doenças cardíacas estruturais estavam presentes em 71 (86,6%) dos pacientes com TV e em oito (21,1%) com TSV-A. O algoritmo de Brugada teve uma maior sensibilidade global (87,2%), enquanto o algoritmo D12V16 apresentou maior especificidade global (85,1%) para TV. Tanto o algoritmo D12V16 como o de Brugada apresentou um alto valor preditivo positivo (90,9% vs. 85,8%, respectivamente) e acurácia similar (73,8% vs. 81,4%, respectivamente) para o diagnóstico de TV. Nos avaliadores experientes, a acurácia foi maior utilizando o algoritmo de Brugada que o algoritmo D12V16, mas a acurácia dos dois algoritmos foi similar segundo os avaliadores menos experientes. Conclusão O algoritmo simplificado pode ser um método útil para reconhecer TV no ECG, principalmente para médicos menos experientes. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)
Abstract Background The differential diagnosis of wide QRS complex tachycardia (WCT) between ventricular tachycardia (VT) or supraventricular tachycardia with aberrant conduction (SVT-A) is sometimes difficult in the emergency room. Objective The aim of this study was to evaluate the accuracy of a new simple electrocardiographic algorithm to recognize VT in patients with wide complex tachycardia. Methods The 12-lead electrocardiograms (ECG) for WCT were prospectively obtained from 120 patients during electrophysiological study. Six physicians with different expertise analyzed the electrocardiographic recordings, and made the diagnosis based on the D12V16 algorithm, that involves the analysis of the predominant polarity of QRS in leads I, II, V1 and V6. The diagnosis was compared with that made using the traditional Brugada algorithm and the "gold-standard" electrophysiological study. Statistical analyses were performed with a significance level of 5% (p<0.05). Results According to the EPS study, 82 ECG recordings were VT and 38 SVT-A. Structural heart diseases were present in 71 (86.6%) patients with VT and in 8 (21.1%) with SVT-A. The Brugada algorithm had higher global sensitivity (87.2%), and the D12V16 algorithm had higher global specificity (85.1%) for VT. Both D12V16 and Brugada's algorithms presented a high positive predictive value (90.9% vs 85.8%, respectively) and similar accuracy (73.8% vs 81.4%, respectively) for the diagnosis of VT. Experienced evaluators were more accurate using Brugada algorithm than the D12V16 algorithm, but the accuracy of both algorithms was similar according to less experienced examiners. Conclusion The simplified algorithm may be a useful method to recognize VT in the ECG, especially for less experienced doctors. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)
Subject(s)
Humans , Tachycardia, Supraventricular , Tachycardia, Ventricular/diagnosis , Algorithms , Sensitivity and Specificity , Diagnosis, Differential , Electrocardiography , Heart RateABSTRACT
SUMMARY OBJECTIVE: Inflammation has been suggested as a potential mechanism in the pathogenesis of arrhythmia. Hemogram parameters such as monocyte count to high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) have been considered to be markers of inflammation and new cardiovascular risk predictors. This retrospective study aimed to investigate the relationship between MHR, NLR, and MLR in patients with paroxysmal supraventricular tachycardia (PSVT). METHODS: A retrospective study conducted at a university hospital in Bolu, Turkey, between 2017 and 2019. Our study included 196 patients who underwent electrophysiological study (EPS) due to palpitation or documented PSVT on electrocardiography (ECG). Patients having documented atrioventricular nodal re-entrant tachycardia (AVNRT) on ECG or inducible AVNRT on EPS were included in the PSVT group (n=130), and patients with palpitation but without inducible arrhythmia on EPS (n=66) were included in the control group. Routine biochemical and hemogram tests were performed before the EPS procedure. RESULTS: When hemogram parameters were compared, there was no statistically significant difference in MHR values [0.010 (0.001-0.030) vs 0.010 (0.001-0.020) p =0.67]. Additionally, both NLR [2.21(0.74-11.36) vs 1.98(0.72-24.87) p=0.13] and MLR [0.25 (0.03-1.05) vs 0.24(0.07-1.39) p=0.41] were not statistically significant between the two groups. CONCLUSION: There is no significant difference in PSVT patients regarding hemogram parameters including white blood cell subtypes, MLR, NLR, and MHR. Therefore the evaluation of hemogram parameters may not be clinically relevant for PSVT patients.
RESUMO OBJETIVO: A inflamação tem sido sugerida como um mecanismo potencial na patogênese da arritmia. Parâmetros do hemograma, como contagem de monócitos e razão de colesterol lipoproteína de alta densidade (MHP), proporção de neutrófilos / linfócitos (NLP) e proporção de monócitos / linfócitos (MLR), foram considerados marcadores de inflamação e novos preditores de risco cardiovascular. Este estudo retrospectivo teve como objetivo investigar a relação entre MHP, NLP e MLP em pacientes com taquicardia paroxística supraventricular (PSVT). MÉTODOS: Estudo retrospectivo realizado em um hospital universitário em Bolu, Turquia, entre 2017 e 2019. Nosso estudo incluiu 196 pacientes submetidos a estudo eletrofisiológico (EPS) devido a palpitações ou PSVT documentada na eletrocardiografia (ECG). Os pacientes com taquicardia nodal atrioventricular reentrante (AVNRT) no ECG ou AVNRT indutível no EPS foram incluídos no grupo PSVT (n = 130) e os pacientes com palpitações sem arritmia induzível no EPS (n = 66) foram incluídos no grupo controle. Testes bioquímicos e de hemograma de rotina foram realizados antes do procedimento de EPS. RESULTADOS: Quando os parâmetros do hemograma foram comparados, não houve diferença estatisticamente significante nos valores de MHP (0,010 (0,001-0,030) vs 0,010 (0,001-0,020) p = 0,67). Além disso, tanto o NLP (2,21 (0,74-11,36) vs 1,98 (0,72-24,87) p = 0,13) quanto o MLP (0,25 (0,03-1,05) vs 0,24 (0,07-1,39) p = 0,41) não foram estatisticamente significantes entre os dois grupos. CONCLUSÃO: Não há diferença significativa nos pacientes com PSVT em relação aos parâmetros do hemograma, incluindo os subtipos de glóbulos brancos, MHP, NLP e MHP. Portanto, a avaliação dos parâmetros do hemograma pode não ser clinicamente relevante para pacientes com PSVT.
Subject(s)
Tachycardia, Paroxysmal , Tachycardia, Supraventricular , Tachycardia, Ventricular , Turkey , Retrospective Studies , ElectrocardiographyABSTRACT
Objective@#To observe the efficacy and safety of postural modified Valsalval manoeuvre in terminating paroxysmal supraventricular tachycardia (PSVT).@*Methods@#From January 2017 to June 2018, a total of 98 patients with PSVT were selected in the Affiliated Hospital of Xuzhou Medical University.They were randomly allocated to standard Valsalval manoeuvre group(48 cases) and postural modified Valsalval manoeuvre group(50 cases) according to sealed envelope method.The patients in standard Valsalval manoeuvre group carried out standard semi-recumbent Valsalva manoeuvre, while the other group received semi-recumbent with supine repositioning and passive leg raise immediately after the Valsalva strain.The general clinical data, total cardioversion success rate, first-time cardioversion success rate and the incidence of adverse reactions were compared between the two groups.@*Results@#There were no statistically significant differences in male proportion, age, history of PSVT or coronary heart disease, incidence of hypertension, diabetes and heart rate, systolic and diastolic blood pressure at attack between the two groups(all P>0.05). The total cardioversion success rate [40.0%(20/50)], first-time cardioversion success rate [28.0%(14/50)] in the modified group were significantly higher than those in the standard group [16.7%(8/48), 12.5%(6/48)](χ2=27.924, 16.308, all P<0.05). The incidence of adverse reactions was low in both two groups, and there was no statistically significant difference(P>0.05).@*Conclusion@#Postural modified Valsalval manoeuvre can effectively improve the cardioversion success rate of PSVT, and has high safety, which is worthy of clinical promotion.
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Objective :To compare therapeutic effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia (PSVT) and their safety .Methods : A total of 90 PSVT patients ,who were treated in our hospital from Jan 2013 to May 2018 ,were selected .Patients were randomly and equally divided into propafenone group and amio—darone group ,each group received corresponding medication based on routine treatment for 24h.Blood pressure , heart rate ,cardiac function indexes :LVEDV ,LVESV and LVEF before and after treatment ,cardioversion time , successful cardioversion rate within 60 min and incidence of adverse reactions during treatment were observed and compared between two groups .Results : There was no significant difference in successful cardioversion rate (propafenone group 91.11% vs.amiodarone group 93.33%, P＝1.000) between two groups .Compared with be—fore treatment ,on 24h after treatment ,there were significant reductions in blood pressure and heart rate in two groups , P＝0. 001 all ;but there was no significant difference between two groups before and after treatment , P＞0.05 all.Cardioversion time of propafenone group was significantly shorter than that of amiodarone group [ (12. 66 ± 2.06) min vs .(22. 80 ± 2.28 ) min ] , P＝ 0. 001 .Compared with propafenone group on 24h after treatment , there was significant rise in LVEF [ (63. 24 ± 3.67)% vs.(66. 83 ± 4.01)%] ,significant reductions in LVEDV [ (96.65 ± 5.24) ml vs.(92. 09 ± 4.37) ml] and LVESV [ (38.40 ± 2.87) ml vs.(30. 13 ± 7.34) ml] in amioda—rone group , P＝ 0. 001 all.Total incidence rate of adverse reactions in amiodarone group was significantly lower than that of propafenone group (8.89% vs.24. 44%) , P＝0. 048. Conclusion : Propafenone and amiodarone possess significant therapeutic effect on PSVT .Propafenone possesses shorter cardioversion time ,while amiodarone posses— ses less adverse reactions and improve cardiac function .Therefore ,medication should be selected properly according to patient′s specific condition in clinic .
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Supraventricular tachycardia is one of the tachyarrhythmias that do not have its origin in one organic cardiomyopathy. Generally, they have a good prognosis, and its clinical spectrum varies from asymptomatic patients to those with low cardiac output. Treatment will depend on the hemodynamic stability of the pa- tient. The objective of this case report is to make a review on existent literature about adverse cardiac effects with the use of Glycine in patients after urologic surgery.
La taquicardia supraventricular hace parte del grupo de taquiarritmias que no se originan de una cardiopatía orgánica existente y por lo general son de buen pronóstico. Su espectro clínico abarca desde pacientes asintomáticos hasta aquellos con signos de bajo gasto cardíaco que requerirán tratamiento según su estabilidad hemodinámica. El objetivo del presente reporte de caso es realizar una revisión de la literatura sobre los efectos adversos asociados a la irrigación vesical continúa con glicina en un paciente a quien se le realizó prostatectomía.
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Objective@#To evaluate the efficacy and safety of three-dimensional electroanatomical mapping system for catheter ablation of paroxysmal supraventricular tachycardiain (PSVT) children.@*Methods@#Clinical data from 187 children with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation in our department between January 2012 and April 2016 were analyzed. Among the patients, 91 cases were treated with traditional two-dimensional X-ray radiofrequency ablation, 96 cases were treated with radiofrequency ablation guided by three-dimensional electroanatomical mapping system. Postoperative electrocardiogram and echocardiography follow-up was performed at 1, 3, 6, 12, and 24 months. The success rate, recurrence rate, complication rate, operation time and amount of X-ray exposure were compared between the two groups. Kaplan-Meier survival curve was used to analyze the PSVT-free survival rate of the patients between the 2 groups.@*Results@#The mean follow-up time was (739±92) days. The success rate (95.8%(92/96) vs. 94.5%(86/91), P=0.912), recurrence rate (5.4%(5/92) vs. 4.7%(4/86), P=0.807), complication rate (4.2%(4/96) vs. 5.5%(5/91), P=0.379), operation time ((73±31)min vs. (79±36)min, P=0.124) were similar between the two groups. However, X-ray exposure time ((8.1±2.9)min vs. (21.3±8.4)min, P=0.026), amount of X-ray ((23±11)mGy vs. (58±23)mGy, P=0.013) were significantly lower in the three-dimensional electroanatomical mapping system group than in the traditional two-dimensional X-ray radio frequency ablation group. PSVT-free survival rate was similar between the two groups (χ2=0.060, P=0.807) .@*Conclusion@#Three-dimensional electroanatomical mapping system is safe and effective for radiofrequency ablation of paroxysmal supraventricular tachycardia in children, and can significantly reduce the amount of radiation as compared to the traditional two-dimensional X-ray radiofrequency ablation.
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Objective@#The study assessed the clinical characteristics and response to acute intravenous antiarrhythmic drug therapy of supraventricular tachycardia (SVT) in children.@*Methods@#This was a multicenter prospective descriptive study including 257 children from First Hospital of Tsinghua University, Peking University First Hospital, Children's Hospital Affiliated to Capital Institute of Pediatrics and Beijing Anzhen Hospital who received intravenous antiarrhythmic drug therapy for SVT from July 2014 to February 2017. The clinical and tachycardia features, response to intravenous antiarrhythmic drug therapy of these children were characterized. Statistical analyses were performed using t test, Mann-Whitney U test, χ2 test and H test.@*Results@#The onset of SVT occurred at any age with a distribution with positive skewness, 57.6% (n=148) children<1 year, 17.5% (n=45) children1~<3 years, 10.5% (n=27) children 3~<6 years and 14.4% (n=37) children ≥ 6 years of age. The percentages of SVT types were 49.4% (n=127) for atrioventricular reentry tachycardia (AVRT), 4.3% (n=11) for atrioventricular nodal reentry tachycardia (AVNRT), 26.8% (n=69) for unclassified paroxysmal SVT and 19.5% (n=50) for atrial tachycardia (AT), respectively. Tachycardia-induced cardionyopathy (TIC) secondary to SVT developed in 30 of 225 (13.3%). Left ventricular ejection fraction (LVEF) of the 27 children attacked by TIC returned to normal after successful control of SVT (41.1%±6.3% vs. 60.3%±9.2%, t=-10.397, P=0.000). Complete termination of SVT by antiarrhythmic drugs was achieved in 164 of 257 (63.8%), partial termination rate was 18.7% (48 of 257) and failure to terminate rate was 17.5% (45 of 257). Propafenone (complete cardioversion in 98 (73.1%) of 134) and amiodarone (complete cardioversion in 23 (76.7%) of 30) showed better efficacy for SVT termination than adenosine (complete cardioversion in 26 (44.1%) 59) (χ2=20.524, P=0.000). Paroxysmal SVT had a higher termination rate on pharmacological therapy than AT (67.1% vs. 50.0%, χ2=6.337, P=0.042). Patients of different age groups had significantly different response to antiarrhythmic therapy (χ2=13.904, P=0.031). Children<1 year of age showed the least response to antiarrhythmic drug therapy with complete termination in 51 (55.4%) of 92. Adverse effects occurred in 9 patients (3.5%): Four patients had severe hypotensive shock using propafenone (n=3) and adenosine (n=1), and 3 patients had sinus arrest using adenosine.@*Conclusion@#Most (57.6%) children with SVT have their first clinical episode within 1 year of age, and AVRT is the most common type. TIC occurs in 13.3% of children with SVT. Intravenous antiarrhythmic drug therapy has a 63.8% complete termination rate for children with SVT and incidence of adverse effects is 3.5%. Propafenone and amiodarone are more effective for SVT termination in children than adenosine. Serious adverse effects may occur when using propafenone.
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Atrial fibrillation (AF), the most common chronic arrhythmia in adults, is rarely reported in children. Moreover, most of the previously reported children with AF have comorbidities, such as structural heart diseases, rheumatic diseases, and thyroid diseases. This case report is about a healthy 9-year-old boy who was diagnosed with AF without cardiac anomaly. He visited the emergency department with chest pain and palpitation, lasting 2 hours. His electrocardiogram showed narrow-complex tachycardia, which led to the diagnosis of supraventricular tachycardia. The administration of adenosine revealed rapid irregular P waves. After electrical cardioversion, cardiac rhythm was converted to normal sinus rhythm. This case report suggests that when children with narrow-complex tachycardia visit the emergency department, the possibility of AF, in addition to supraventricular tachycardia, should be considered if the RR intervals are markedly irregular.
Subject(s)
Adult , Child , Humans , Male , Adenosine , Arrhythmias, Cardiac , Atrial Fibrillation , Cardiovascular Diseases , Chest Pain , Comorbidity , Diagnosis , Electric Countershock , Electrocardiography , Emergency Service, Hospital , Pediatrics , Rheumatic Heart Disease , Tachycardia , Tachycardia, Supraventricular , Thyroid DiseasesABSTRACT
Objective To compare the curative effect and safety of non-X-ray fluoroscopic radiofrequency catheter ablation and conventional X-ray fluoroscopic radiofrequency catheter ablation in treating paroxysmal supraventricular tachycardia by Ensite Velocity three-dimensional electroanatomical mapping system.Methods One hundred cases diagnosed as paroxysmal supraventricular tachycardia in this hospital during 2014-2016 were selected and randomly divided into the control group (conventional X-ray exposure) and the experimental group(non-X-ray exposure by three-dimensional electroanatomical mapping system),50 cases in each group.The operation time,X-ray exposure time,complication rate,immediate and follow-up success rate were compared between two groups.Results There was no statistically significant difference in the operation time between the two groups (P＞0.05),but the X-ray exposure time in the experimental group [(0.46±0.14) min] was significantly lower than that of the control group [(13.87 ±4.03) min] and the complication rate (0 ％) was also significantly lower than that of the control group (8.00％);the immediate success rate (98.00 ％) was significantly was significantly decreased compared with the control group[(0.46± 0.14)min vs.(13.87 ±4.03)min],the complication rate was significantly lower than that in the control group(0 ％ vs.8 ％),the immediate success rate was significantly higher than that in the control group(98.00 ％ vs.84.00 ％),the follow up success rate was also significantly higher than that in the control group (94.00 ％ vs.74.00 ％),the differences were statistically significant (P＜0.05).Conclusion Using Ensite Velocity three-dimensional electroanatomical mapping system to conduct radiofrequency catheter ablation has an ideal clinical effect in the treatment of paroxysmal supraventricular tachycardia,which is safe and reliable.
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Objective@#This study aimed to investigate the correlation between supraventricular tachycardia (SVT) and tachycardia-induced cardiomyopathy(TIC) in children and assess the risk factors for the development of TIC.@*Method@#One hundred and eighty-three patients were recruited in four hospitals of Beijing diagnosed as SVT were divided into two groups depending on whether or not complicated with TIC. The age, gender, tachycardia type, ventricular rate during tachycardia, frequency of tachycardia episodes and duration of tachycardia were compared between the two groups and risk factors associated with TIC were analyzed. Statistical analyses were performed using t test, Mann-Whitney U and χ2 test.@*Result@#Totally 183 patients were included in this study (paroxysmal supraventricular tachycardia, PSVT, n=149; atrial tachycardia, AT, n=34). The incidence of TIC was 13.1%. There was significant difference regarding the incidence of TIC between children with AT and children with PSVT (26.5% vs. 10.1%, χ2=6.537, P=0.011). The percentage of AT in patients with TIC was significantly higher than patients without TIC (37.5% vs. 15.7%, χ2=6.537, P=0.011). Patients with TIC had a higher frequency of tachycardia episodes(2.5(1.0-4.8) beats/year vs 4.0(1.0-10.0) beats/year, Z=-2.223, P=0.026)and longer duration of tachycardia(11.0(1.1-36.0) h vs 2.5(1.0-12.0) h, Z=-2.154, P=0.031)compared with patients without TIC. Multivariate predictors of TIC was longer duration of tachycardia (OR=2.041, P=0.028).@*Conclusion@#TIC occurs in 13.1% of children with SVT. The incidence of TIC in children with AT is higher than in children with PSVT. Risk factor for the development of TIC is longer duration of tachycardia.
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Objective@#To evaluate the feasibility and efficiency of a low dose imaging protocol on reducing X-ray dose level in pediatric supraventricular tachycardia (SVT) ablation procedure.@*Method@#Data were collected from 103 patients who underwent catheter ablation for SVT in Children′s Hospital of Fudan University from January 2014 to October 2016 in terms of body weight, body surface area (BSA), SVT types, accessory pathway location, fluoroscopy time and the radiation dose (including AIR KERMA and dose area product) in a case observational study.The fluoroscopy protocols were operated at 36 nGy/frame and 10 frames/s (Standard group, n=47) from January 2014 to September 2015, 36 nGy/frame and 10 frames/s with removal of the grid (Grid-out group, n=24) from October 2015 to April 2016, as well as 23 nGy/frame and 4.0-7.5 frames/s without the grid (Grid-out plus low dose group, n=32) from May 2016 to October 2016, respectively.Comparisons among groups were performed by independent-sample t-test or one-way analysis of variance for normally distributed continuous variables, and χ2 test for categorical variables.@*Result@#The average body weight, BSA, fluoroscopy time and AIR KERMA of the three groups was (34±14) kg, (1.14±0.33) m2, (11±8) minutes and (12.97±12.43) mGy, respectively.No significant differences in body weight (F=2.551), BSA (F=2.359), SVT types (χ2=6.15), and accessory pathway location (χ2=3.438) were observed among these three groups (P>0.05). Images acquired by low dose protocol could provide enough information for procedures, and no complication occurred.The acute success rates were 100% in all of these three groups, and there was no significant difference in mean fluoroscopy time (F=0.004, P>0.05) among them.However, the radiation dose (AIR KERMA) in the Grid-out plus low dose group was much lower than that in the Standard group ((7.54±7.31) mGy vs. (16.25±12.08) mGy, F=6.112, P<0.01)).@*Conclusion@#The new strategy of combination of low dose fluoroscopy protocol with removal of grid markedly reduced radiation exposure to children undergoing supraventricular tachycardia ablation while maintaining procedural efficacy and safety.
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Medical and catheter-based ablation therapies have been successfully applied in treating supraventricular tachycardia, supported by abundant evidences from clinical trials. However, Special populations such as pediatric populations, pregnant patients, or patients with congenital heart diseases are easily excluded from clinical trials; thus, caution is needed when adopting results from clinical trials conducted in the usual adult population.
Subject(s)
Adult , Humans , Pregnancy , Heart Defects, Congenital , Heart Diseases , Pediatrics , Tachycardia, SupraventricularABSTRACT
Among patients with Wolff-Parkinson-White syndrome, atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) can coexist in a single patient. Direct transition of both tachycardias is rare; however, it can occur after premature atrial or ventricular activity if the cycle lengths of the two tachycardias are similar. Furthermore, persistent atrial activation by an accessory pathway (AP) located outside of the AV node during ongoing AVNRT is also rare. This article describes a case of uncommon atrial activation by an AP during AVNRT and gradual transition of the two supraventricular tachycardias without any preceding atrial or ventricular activity in a patient with preexcitation syndrome.
Subject(s)
Humans , Atrioventricular Node , Pre-Excitation Syndromes , Tachycardia , Tachycardia, Atrioventricular Nodal Reentry , Tachycardia, Paroxysmal , Tachycardia, Reciprocating , Tachycardia, Supraventricular , Wolff-Parkinson-White SyndromeABSTRACT
The delivery of single His-refractory ventricular extra-stimulus during supraventricular tachycardia is useful to identify the mechanism of the tachycardia. We present the different responses based on the ventricular extra-stimulus site. Our findings demonstrate that the atrial activation via an accessory pathway was not advanced based on the ventricular pacing site. Therefore, atrioventricular tachycardia could masquerade as atrioventricular nodal reentrant tachycardia.
Subject(s)
Tachycardia , Tachycardia, Atrioventricular Nodal Reentry , Tachycardia, SupraventricularABSTRACT
The best available evidence indicates that the prevalence of supraventricular tachycardia (SVT) in the general population is 2.29 per 1,000 persons. Women have twice the risk of developing paroxysmal supraventricular tachycardia (PSVT) compared to men. Individuals aged >65 years have >5 times the risk of developing PSVT compared to younger persons. Twelve-lead electrocardiograms (ECGs) obtained during both tachycardia and sinus rhythm may reveal the etiology and help diagnose SVT. It is important to conduct a 12-lead ECG to differentiate tachycardia mechanisms according to whether the atrioventricular (AV) node is an obligate component. Invasive electrophysiologic (EP) study and catheter ablation have become a standard treatment for SVT, in addition to being an acute medical treatment. Diagnostic EP study complications are rare, but can be life threatening.
Subject(s)
Female , Humans , Male , Catheter Ablation , Electrocardiography , Prevalence , Tachycardia , Tachycardia, SupraventricularABSTRACT
Na taquicardia por reentrada nodal atrioventricular, a necessidade do átrio para a manutenção da taquicardia é controverso. Descrevemos um caso de fibrilação atrial ocorrendo durante taquicardia por reentrada nodal atrioventricular sem afetar o ciclo da arritmia, e discutimos as evidências favorecendo a presença de umavia comum superior.
In Atrioventricular Nodal Reentry Tachycardia the requirement of the atrium for the maintenance oftachycardia is controversial. We describe a case of atrial fibrillation that occurred during Atrioventricular Nodal Reentry Tachycardia without affecting the arrhythmia cycle, and discuss the evidences favoring the presence ofan upper common pathway.
Subject(s)
Humans , Male , Adult , Atrial Fibrillation/complications , Atrial Fibrillation/diagnosis , Tachycardia, Supraventricular/complications , Tachycardia, Supraventricular/diagnosis , Tachycardia, Atrioventricular Nodal Reentry/complications , Tachycardia, Atrioventricular Nodal Reentry/diagnosis , Catheters , Heart Atria , Heart VentriclesABSTRACT
La taquicardia supraventricular (TSV) es el tipo de arritmia sostenida más frecuente en los recién nacidos y lactantes. En general, la presentación de la TSV en los recién nacidos es sutil y, a menudo produce insuficiencia cardíaca congestiva. A pesar del amplio uso de los agonistas p2, su toxicidad ha sido cuestionada. En varios estudios se informó un aumento de la incidencia de arritmias cardíacas en los pacientes que reciben estos agentes, y en otros estudios se hallaron tasas elevadas de muerte cardiovascular asociada con el uso de agonistas p2 nebulizados y orales, como el salbutamol, que se utilizan para tratar el broncoespasmo en los recién nacidos con diversas enfermedades. Informamos un caso de TSV después de la administración de salbutamol nebulizado a un recién nacido.
Supraventricular tachycardia (SVT) is the most common sustained arrhythmia in neonates and infants. Presentation of SVT in the neonate is usually subtle and frequently complicated by congestive heart failure. Despite the widespread use of β2-agonists, their safety has been questioned. Several studies have reported an increased incidence of cardiac arrhythmias in patients treated with these agents, and other studies have found increased rates of cardiovascular death associated with the use of oral and nebulized β2-agonists such as salbutamol, which is used to treat bronchospasm in newborns with several diseases. Herein, we report a case of SVT following administration of nebulized salbutamol in a neonate.
Subject(s)
Humans , Female , Infant, Newborn , Tachycardia, Supraventricular , Infant, Newborn , AlbuterolABSTRACT
Objective:To explore therapeutic effect of intravenous injection of propafenone on patients with paroxys‐mal supraventricular tachycardia (PSVT) and its safety .Methods :A total of 80 PSVT patients ,who were treated in our department of cardiology from Mar 2009 to Feb 2014 ,were selected .According to random number table meth‐od ,they were randomly and equally divided into propafenone group (received propafenone intravenously) and amio‐darone group (received amiodarone intravenously) .Heart rate ,cardioversion time ,clinical total effective rate and incidence rates of adverse reactions were recorded and compared between two groups before and 24h after treat‐ment .Results:There was no significant difference in total effective rate between two groups , P>0.05. Compared with amiodarone group ,there were significant reductions in cardioversion time [ (18.9 ± 3.2) min vs .(7.3 ± 1.0) min] , heart rate after treatment 24 h [ (99.6 ± 8.4) beats/min vs .(81.2 ± 5.9) beats/min] in propafenone group , P<0.05 both .Conclusion:Intravenous injections of propafenone and amiodarone possess similar therapeutic effect on paroxysmal supraventricular tachycardia ,but propafenone can achieve rapid cardioversion and reduce heart rate with satisfying safety ,which is worth further extending .
ABSTRACT
Objective To study the clinical efficacy and safety of esophageal pacing in termination of old patients with paroxysmal supraventricular tachycardia heartbeat.Methods A total of 68 elderly cases with paroxysmal supraventricular tachycardia heartbeat were given the esophageal pacing termination of therapy,who were treated with overdrive suppression method and a burst termination,and the clinical curative effect and adverse reaction in the two groups were observed.Results 34 cases were given overdrive suppression method,19 cases were successful,the success rate was 55.9％,the direct restoration of sinus rhythm includes 14 cases after the termination,accounting for 73.6％,heartbeat bradycardia occurred in 3 cases after termination,heart rate less than 50 beats per minute,and then disappeared.With a burst of 34 cases,31 cases were successful,the success rate was 91.2％,the direct restoration of sinus rhythm includes 25 cases after the termination,accounting for 80.6％,heartbeat bradycardia occurred in 4 cases after termination,heart rate less than 50 beats per minute,and then disappeared.Conclusion Esophageal pacing is an electrophysiological examination and treatment method with noninvasive,safe and effective advantages,the termination of PSVT has higher success rate,and it can distinguish between different types of PSVT.Compared with overdrive suppression method,burst terminate PSVT pulse method has higher success rate,it is worthy application in clinical.