- [Analysis of arrhythmia and recovering in early stage pregnancy of older pregnant women]. [Journal Article]
- ZYZhongguo Ying Yong Sheng Li Xue Za Zhi 2017 Apr 08; 33(4):342-345
- CONCLUSIONS: There is a positive correlation between the old age and the incidence of arrhythmia in the early stage of pregnancy, and old age factors can reduce the recovery rate but increase the incidence of deterioration of arrhythmia. And older pregnant women with abnormal ECG have undesirable effect to perinatal infant.
- Clozapine-related Paroxysmal Supraventricular Tachycardia: a Case Report. [Case Reports]
- EAEast Asian Arch Psychiatry 2018; 28(2):68-70
- Clozapine is considered to be more effective than other antipsychotic drugs for treating treatmentresistant schizophrenia. However, side effects of clozapine include agranulocytosis and, less commonl...
Clozapine is considered to be more effective than other antipsychotic drugs for treating treatmentresistant schizophrenia. However, side effects of clozapine include agranulocytosis and, less commonly, cardiovascular disease, which is occasionally fatal. We describe a 56-year-old woman who developed clozapine-related paroxysmal supraventricular tachycardia during clozapine dose titration and had a recurrence despite being treated with verapamil. For treatment-resistant schizophrenia, a slow titration of the clozapine dose is necessary, and potential cardiac side-effects should be monitored.
- [Dual atrioventricular nodal pathways: physiology, arrhythmic findings, and electrocardiographic manifestations]. [Journal Article]
- GIG Ital Cardiol (Rome) 2018; 19(4):222-231
- The atrioventricular (AV) node is an anatomically well-defined structure, conveniently housed in the triangle of Koch. There are two distinct atrial impulse approaches to the AV node, one of which (i...
The atrioventricular (AV) node is an anatomically well-defined structure, conveniently housed in the triangle of Koch. There are two distinct atrial impulse approaches to the AV node, one of which (in the anterior portion of triangle of Koch) has a faster conduction, while the other one (in the posterior portion) has a slower conduction. However, it is not said that such a conductive duality translates into any arrhythmic phenomena. Actually, these arrhythmias are due to an imbalance of the two pathways electrophysiological properties, which does not always exist. In the presence of such an imbalance, the dual AV nodal physiology is, however, the substrate for various arrhythmias and curious electrocardiographic behaviors. Often the fast pathway is characterized by a relatively long refractory period. In contrast, the slow approach is often characterized by shorter refractoriness.The unbalanced refractoriness of the two nodal pathways constitutes the prerequisite for the most common form of paroxysmal supraventricular tachycardia: the AV nodal reentrant tachycardia (AVNRT). In subjects prone to this type of arrhythmia, during sinus rhythm, nodal conduction usually occurs from the anterior approach (fast pathway). However, a premature atrial beat may find this pathway refractory and cross the AV node through the posterior approach (slow pathway), resulting in a sudden prolongation of the AV conduction time ("jump"). This allows the impulse, once it reaches the common end, to excitate the fast pathway in a retrograde direction and to return backwards to the atrium, thus triggering a circus movement that can result in a "slow-fast" AVNRT. More rarely, an AVNRT can take place in an opposite direction of the reentrant impulse ("fast-slow" variety of AVNRT). A paroxysmal supraventricular tachycardia may seldom occur with a regularly alternating RR cycle, if the reentrant mechanism involves retrogradely an accessory AV pathway and, in anterograde direction, a fast and a slow AV nodal pathway, alternately. Among the mechanisms underlying the total RR irregularity during atrial fibrillation, there is probably also the possibility that the AV node may offer to the atrial impulses two distinct pathways to reach the His bundle. Not too rarely, a dual AV nodal physiology can occur during sinus rhythm, through unexpected and sudden changes in the AV conduction time, so that two distinct PR families can be observed. It is likely that the presence of dual AV nodal pathways can facilitate or promote a Wenckebach conduction mechanism at nodal site.
- Flecainide toxicity in renal failure. [Journal Article]
- PProc (Bayl Univ Med Cent) 2018; 31(3):328-330
- Flecainide, a class Ic antiarrhythmic, is used for the prevention of paroxysmal supraventricular tachycardia, paroxysmal atrial fibrillation/flutter, and sustained ventricular tachycardia. Flecainide...
Flecainide, a class Ic antiarrhythmic, is used for the prevention of paroxysmal supraventricular tachycardia, paroxysmal atrial fibrillation/flutter, and sustained ventricular tachycardia. Flecainide is primarily metabolized by the liver and to a lesser extent (30%) is excreted unchanged in the kidney. We present a case of flecainide toxicity in the setting of renal impairment that was successfully treated with intravenous sodium bicarbonate.
- Value of an old school approach: safety and long-term success of radiofrequency current catheter ablation of atrioventricular nodal reentrant tachycardia in children and young adolescents. [Journal Article]
- JIJ Interv Card Electrophysiol 2018 May 15
- CONCLUSIONS: RFC-guided ablation for AVNRT in children and adolescents is safe and leads to an acceptable long-term freedom from recurrences. SP modulation and SP ablation resulted in comparable acute and long-term success rates. Late AVNRT recurrences can occur even after years of freedom from tachycardia-related symptoms.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- The atrioventricular (AV) node is a subendocardial structure located in the inferior-posterior right atrium. In an average adult, an AV node measures approximately 1 x 3 x 5 millimeters and sits with...
The atrioventricular (AV) node is a subendocardial structure located in the inferior-posterior right atrium. In an average adult, an AV node measures approximately 1 x 3 x 5 millimeters and sits within an anatomic region bordered posteriorly by the coronary sinus ostium, superiorly by the tendon of Todaro, and anteriorly by the septal tricuspid valve annulus. This anatomic region is also commonly referred to as the triangle of Koch. The blood supply to the AV node is from the AV nodal branch of the right coronary artery (90%) or the left circumflex artery (10%) depending on the right or left dominant blood supply to the heart. The first septal perforator of the left anterior descending artery also supplies blood to the AV node. Atrioventricular nodal reentrant tachycardia (AVNRT) is a type of paroxysmal supraventricular tachycardia that results due to the presence of a re-entry circuit within or adjacent to the AV node. Diagnosis of AVNRT requires visualization of an electrocardiogram (ECG). In most cases, an ECG will show heart rate between 140 and 280 beats per minute (bpm), and in the absence of aberrant conduction, a QRS complex of fewer than 120 milliseconds. ECG criteria based on the re-entrant circuits are as follows: Slow-Fast AVNRT: Pseudo-S wave in Leads II, III, and AVF. Pseudo-R' in lead V1. Fast-Slow AVNRT P waves between the QRS and T waves (QRS-P-T complexes). Slow-Slow AVNRT Late P waves after a QRS. Often appears as atrial tachycardia.
- Dexmedetomidine Sedation for Paroxysmal Supraventricular Tachycardia Ablation Is Not Associated With Alteration of Arrhythmia Inducibility. [Journal Article]
- A&AAnesth Analg 2018 Apr 11
- CONCLUSIONS: Dex sedation during EPSs is not associated with a reduction in PSVT inducibility. The therapeutic utility of Dex during EPS arises from the predictable sedation Dex affords but is associated with an increased incidence of intraprocedure hypotension.
- INFLUENCE OF CATHETER ABLATION OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA ON PATIENTS' ANXIETY. [Journal Article]
- GMGeorgian Med News 2018; (Issue):58-60
- The aim of the study was to investigate the influence of catheter ablation of paroxysmal supraventricular tachycardia on patients' anxiety levels. We investigated 70 consecutive patients with paroxys...
The aim of the study was to investigate the influence of catheter ablation of paroxysmal supraventricular tachycardia on patients' anxiety levels. We investigated 70 consecutive patients with paroxysmal supraventricular tachycardia (AV Nodal Reentrant Tachycardia (AVNRT), AV Reentrant Tachycardia (AVRT) or Atrial Tachycardia (AT)) who underwent a catheter ablation. The patients filled out the State and Trait Anxiety Inventory (STAI) before the ablation on the day of the procedure and after 3 months of a successful catheter ablation. State and trait anxiety scores were compared before and after 3 months of ablation. The results were analyzed between different age (<50 vs ≥50 y), gender and the type of paroxysmal supraventricular tachycardia (AVNRT vs AVRT/AT). Both state and trait anxiety scores improved significantly after catheter ablation. State anxiety score improved from mean 42.21±9.53 to 31.43±8.02 (p<0.001). Trait anxiety score improved from mean 45.76±7.80 to 39.80±7.33 (p<0.001). Present study demonstrates that the radiofrequency catheter ablation of paroxysmal supraventricular tachycardia by providing cure and eliminating the arrhythmia episodes significantly reduces both situational and general anxiety levels.
- IMPACT OF RADIOFREQUENCY CATHETER ABLATION ON HEALTH-RELATED QUALITY OF LIFE ASSESSED BY THE SF-36 QUESTIONNAIRE IN PATIENTS WITH PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA. [Journal Article]
- GMGeorgian Med News 2018; (Issue):54-57
- The aim of the study was to investigate the effect of catheter ablation on different aspects of health-related quality of life in association with patients' age, gender and the type of paroxysmal sup...
The aim of the study was to investigate the effect of catheter ablation on different aspects of health-related quality of life in association with patients' age, gender and the type of paroxysmal supraventricular tachycardia. We investigated 70 consecutive patients with paroxysmal supraventricular tachycardia (AV Nodal Reentrant Tachycardia (AVNRT), AV Reentrant Tachycardia (AVRT) or Atrial Tachycardia (AT)) who underwent a catheter ablation. The patients were asked to fill out the short form (SF-36) health questionnaire before the ablation on the day of the procedure and after 3 months of a successful catheter ablation and eight health concept scores (1. Physical functioning; 2. Role limitations due to physical health; 3. Role limitations due to emotional problems; 4. Energy/fatigue; 5. Emotional wellbeing; 6. Social functioning; 7. Bodily pain; and 8. General health) were assessed before and after ablation. All health concept scores improved significantly after successful catheter ablation procedure. The result for the whole group were as follows: 1. physical functioning improved from mean 61.42±24.82 to 77.15±18.80 (p<0.001). 2. Score for the role limitations due to physical health improved from 41.78±39.17 to 75.35±33.91 (p<0.001). 3. Score for the role limitations due to emotional problems improved from 48.07±42.32 to 80.46±33.81 (p<0.001). 4. Energy/Fatigue score improved from 56.71±19.97 to 68.78±16.40 (p<0.001). 5. Emotional wellbeing score improved from 58.22±17.31 to 71.88±14.33 (p<0.001). 6. Social functioning score improved from 68.39±24.51 to 81.00±19.12 (p<0.001). 7. Pain score improved from 59.82±28.65 to 80.57±20.58 (p<0.001) and 8. General health score improved from 48.42±15.26 to 62.57±15.43 (p<0.001). This study shows that catheter ablation which can effectively cure the patients from the paroxysmal supraventricular tachycardia significantly improves physical, emotional and social health scores by eliminating the arrhythmia episodes and associated symptoms and anxiety in patients with paroxysmal supraventricular tachycardia irrespective of patient demographics and the type of the SVT.
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- Case of mild X-linked ichthyosis complicated with paroxysmal supraventricular tachycardia and anemia. [Letter]
- JDJ Dermatol 2018 Mar 22