Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Ventricular tachycardia [keywords]
- Age, Sex, and Hospital Factors Are Associated With the Duration of Cardiopulmonary Resuscitation in Hospitalized Patients Who Do Not Experience Sustained Return of Spontaneous Circulation. [JOURNAL ARTICLE]
- J Am Heart Assoc 2014; 3(6)
Variability in the duration of attempted in-hospital cardiopulmonary resuscitation (CPR) is high, but the factors influencing termination of CPR efforts are unknown.We examined the association between patient and hospital characteristics and CPR duration in 45 500 victims of in-hospital cardiac arrest who did not experience return of spontaneous circulation (ROSC) and who were enrolled in the Get With the Guidelines registry between 2001 and 2010. In a secondary analysis, we performed analyses in 46 168 victims of in-hospital cardiac arrest who experienced ROSC. We used ordered logistic regression to identify factors associated with CPR duration. Analyses were conducted by tertile of CPR duration (tertiles: ROSC group: 2 to 7, 8 to 17, and 18 to 120 minutes; no-ROSC group: 2 to 16, 17 to 26, 27 to 120 minutes). In those without ROSC, younger age (aged 18 to 40 versus >65 years; odds ratio [OR] 1.81; 95% CI 1.69 to 1.95; P<0.001), female sex (OR 1.05; 95% CI 1.02 to 1.09; P=0.005), ventricular tachycardia or fibrillation (OR 1.50; 95% CI 1.42 to 1.58; P<0.001), and the need to place an invasive airway (OR 2.59; 95% CI 2.46 to 2.72; P<0.001) were associated with longer CPR duration. In those with ROSC, ventricular tachycardia or fibrillation (OR 0.89; 95% CI 0.85 to 0.93; P<0.001) and witnessed events (OR 0.87; 95% CI 0.82 to 0.91; P<0.001) were associated with shorter duration.Age and sex were associated with attempted CPR duration in patients who do not experience ROSC after in-hospital cardiac arrest but not in those who experience ROSC. Understanding the mechanism of these interactions may help explain variability in outcomes for in-hospital cardiac arrest.
- [Efficacy and safety of balloon valvuloplasty as a treatment of choice for pulmonary stenosis in children and adolescents]. [English Abstract, Journal Article]
- Srp Arh Celok Lek 2014 Sep-Oct; 142(9-10):542-6.
Pulmonary artery stenosis (PS) is a congenital heart defect which occurs in 10% of all congenital heart defects. Pulmonary balloon valvuloplasty (BVP) has been the treatment of choice of PS over the last 30 years.The purpose of this study was to evaluate the effi- cacy of this method based on middle-term hospital follow-up, and safety of BVP based on our experience.The study included 88 patients diagnosed with PS.The patients were divided into three groups based on the severity of the disease. Also, they were divided into two age groups in order to analyze the frequency of complications. Hemodynamic measurements and echocardiography results were recorded before, 24-36 hours after BVP and at the end of follow-up.The studied group involved patients of average age 3.75 ± 4.3 years (20 days to 17 years). Immediately after BVP a significant decrease of pressure gradient across the pulmonary valve (PV) was recorded in all patients; this result was similar in all 3 groups of patients regardless of the severity of stenosis (p < 0.001). Complications of BVP occurred most commonly in children up to 12 months of age (ventricular tachycardia 4.5% and supraventricular tachycardia 6.8%). Pulmonary valve in- sufficiency after dilatation occurred in 6.6% of cases, and was most common in children aged up to 12 months. In 87 (98.9%) patients BVP was a definitive solution, and a significant residual stenosis was not recorded during follow-up.BVP is a safe and effective procedure in the treatment of isolated PS in children, regardless of the severity of stenosis but also regardless of patients' age.
- Isolation of an automatic purkinje focus for ablation of an incessant ventricular tachycardia. [Journal Article]
- Circ Arrhythm Electrophysiol 2014 Dec; 7(6):1275-6.
- Modern approach to the sudden unexpected death investigation. [Editorial]
- Circ Arrhythm Electrophysiol 2014 Dec; 7(6):1003-5.
- Cardiac resynchronization therapy-induced proarrhythmia: understanding preferential conduction within myocardial scars. [Editorial]
- Circ Arrhythm Electrophysiol 2014 Dec; 7(6):1000-2.
- Sudden Cardiac Arrest during Sex in Patients with either Catecholaminergic Polymorphic Ventricular Tachycardia or Long QT Syndrome: a Rare but Shocking Experience. [JOURNAL ARTICLE]
- J Cardiovasc Electrophysiol 2014 Dec 16.
Patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) and long-QT syndrome (LQTS) are susceptible to cardiac events during sympathetic nervous system (SNS) activation. Herein, we sought to determine the risk of cardiac events associated with sex in CPVT and LQTS patients.We reviewed the electronic medical record of patients seen in Genetic Heart Rhythm Clinic. There were 445 patients ≥ 18 years diagnosed with LQTS (N = 402, age at diagnosis 30 ± 16 years) or CPVT (N = 43, age at diagnosis 25 ± 15 years). No sex-induced cardiac events occurred in the LQTS population, and 2 occurred in the CPVT population. Sex-induced events were more likely in CPVT (2/43, 4.7%) than LQTS (0/402, 0%, p = 0.008). One case involved a 22-year-old CPVT1 female with prior cardiac arrest, who experienced several appropriate ICD shocks during intercourse while taking beta-blockers. The second case was a 52-year-old CPVT1 male with history of recurrent exercise-triggered syncope, who had syncope during sex in the setting of beta-blocker noncompliance. Extrapolating from published estimates of intercourse frequency by age, the overall event rate was only 0.0004%, and 0.005% among the CPVT cohort.Potentially life-threatening cardiac events during sex in CPVT patients are rare and even rarer in LQTS. Overall, the cardiac event per intercourse rate is extremely low. Patients and their partners should be reassured that sex is a low risk activity from a cardiac standpoint. This article is protected by copyright. All rights reserved.
- Incessant tachycardic bursts: What is the mechanism? [JOURNAL ARTICLE]
- J Cardiovasc Electrophysiol 2014 Dec 16.
A 38-year-old man was scheduled for an electrophysiological study because of highly symptomatic incessant short "tachycardic bursts". Clinical history started approximately 3 months previously, when he first realized palpitations and subsequently shortness of breath during exercise. Echocardiography on admission showed a moderately severe depressed left ventricular function (left ventricular ejection fraction (LVEF) 35%) with slight dilatation of the left ventricular chamber (left ventricular enddiastolic diameter (LVEDD) 61mm). This article is protected by copyright. All rights reserved.
- Hemodynamic deterioration during extracorporeal membrane oxygenation weaning in a patient with a total artificial heart. [Journal Article]
- Crit Care Med 2015 Jan; 43(1):e19-22.
The Total Artificial Heart (Syncardia, Tucson, AZ) is approved for use as a bridge-to-transplant or destination therapy in patients who have irreversible end-stage biventricular heart failure. We present a unique case, in which the inferior vena cava compression by a total artificial heart was initially masked for days by the concurrent placement of an extracorporeal membrane oxygenation cannula.This is the case of a 33-year-old man admitted to our institution with recurrent episodes of ventricular tachycardia requiring emergent total artificial heart and venovenous extracorporeal membrane oxygenation placement.This interesting scenario highlights the importance for critical care physicians to have an understanding of exact anatomical localization of a total artificial heart, extracorporeal membrane oxygenation, and their potential interactions. In total artificial heart patients with hemodynamic compromise or reduced device filling, consideration should always be given to venous inflow compression, particularly in those with smaller body surface area. Transesophageal echocardiogram is a readily available diagnostic tool that must be considered standard of care, not only in the operating room but also in the ICU, when dealing with this complex subpopulation of cardiac patients.
- Relationship Between Serum Uric Acid and Electrocardiographic Alterations in a Large Sample of General Population: Data From the Brisighella Heart Study. [JOURNAL ARTICLE]
- High Blood Press Cardiovasc Prev 2014 Dec 16.
Serum uric acid (SUA) may contribute to the increased cardiovascular damage through direct injury to the endothelium and alteration of cardiovascular function.To evaluate the association of SUA with the presence of the most recurrent electrographic alterations and with the length of the main ECG intervals in a large sample of general population.For this study, on the database of the Brisighella Heart Study, we evaluated the available data of 790 men and 849 women, excluding subjects affected by gout or taking antihyperuricemic agents, those taking drug increasing the QT interval and those using beta-blockers or non-dihydropyridine calcium channel blockers at the moment of the ECG registration. Multiple ascending stepwise regression analyses were carried out to determine the independent predictors of the predefined ECG alterations.The prevalence of predefined ECG alterations was comparable between genders, with the exception of sinus bradicardia, left-anterior fascicular block, atrio-ventricular blocks and left ventricular hypertrophy (LVH), which appeared to be more frequent in men. The multivariate analysis revealed that SUA was associated to ischaemic alterations, LVH, sinus tachycardia and tachyarrhytmias. Age was associated to all evaluated ECG alterations beyond sinus tachycardia and LVH. Male sex was associated to sinus bradicardia, atrio-ventricular blocks, anterior-left fascicular block and LVH. Blood pressure was associated to different ECG alterations, but with clinically relevant OR with ischaemic alterations and LVH.SUA level is related the prevalence of both organic and rhythm ECG alterations in a wide sample of general population.
- Percutaneous balloon aortic valvuloplasty at the Queen Sirikit National Institute of Child Health: 25 years' experience. [Journal Article]
- J Med Assoc Thai 2014 Nov.:S117-21.
Percutaneous balloon aortic valvuloplasty (BAV) is the treatment of choice in moderate and severe valvular aortic stenosis. In Thailand, the first procedure was performed at the Queen Sirikit National Institute of Child Health (QSNICH) in 1988. No previous studies have been reported regarding the outcome of these procedures at QSNICH.To study the efficacy and complications of percutaneous balloon aortic valvuloplasty in the treatment of severe aortic stenosis.A retrospective study from the medical records was performed. All patients with a diagnosis of moderate or severe valvular aortic stenosis treated with BAV from January 1988-December 2012 were recruited. Before 2008, the procedures were performed under local anesthesia with light systemic sedation. After that, most of the cases were performed under general anesthesia. The response to treatment was classified as good response, partial response or failure. The short-term complications were classified as vascular complications, arrhythmias and others.Sixty-eight recorded attempts on 60 patients (47 males = 71.67%) were enlisted in the study. The ages at the time of procedures ranged from 1 day to 15 years (mean 65.25, SD 53.54, median 51 months). Fourteen cases were under one year of age (20.58%). Immediate success comprised 85.29% with 65.51% classified as good response. Ten failures in nine cases all occurred before 1997. One of the cases was an attempted balloon aortic valvuloplasty with repeated failure. Three of the cases underwent open aortic valvuloplasty where one case (33.33%) survived. The other six cases refused to continue treatment and were lost to follow-up. Four deaths were reported. Repeated balloon aortic valvuloplasties were performed in eight cases. During the early phases (1988-1996), failures and mortality rates were extremely high. Experience and improved technology improved outcomes. Excluding the four dead cases, the only significant major complication occurred in a three-year-old boy with severe aortic stenosis who tore the chordae tendinae, producing severe, acute mitral regurgitation, together with ventricular tachycardia, requiring direct current cardioversion during the procedure and double valvuloplasty five years later. Other minor complications included transient cardiac arrhythmia in 12 cases, partial occlusion of femoral artery in 11 cases and groin hematoma in 8 cases.Percutaneous balloon aortic valvuloplasty was effective and safe for the treatment of moderate and severe aortic valve stenosis in pediatric patients without significant complications.