scholarly journals 926-24 Clinical and Electrophysiological Characteristics in Patients with Exercise Induced Idiopathic Multiform Ventricular Tachycardia. Differential Effects of Atrial Pacing and Isoproterenol Infusion on QTc Interval and Induction of Ventricular Arrhythmia

1995 ◽  
Vol 25 (2) ◽  
pp. 107A
Author(s):  
Shogo Suzuki ◽  
Tohru Ohe ◽  
Takashi Kurita ◽  
Wataru Shimizu ◽  
Kazuhiro Suyama ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmia ◽  
Atrial Pacing ◽  
Qtc Interval ◽  
Differential Effects ◽  
Exercise Induced ◽  
Isoproterenol Infusion

scholarly journals SEARCH OF THE STRESS INDUSED VENTRICULAR TACHICARDIA REASONS — THE METABOLIC THERAPY OPPORTUNITIES

2018 ◽  
Vol 8 (5) ◽  
pp. 394-402
Author(s):  
T. V. Treshkur ◽  
A. A. Tatarinova ◽  
E. A. Ryngach
Keyword(s):  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Ventricular Arrhythmia ◽  
Ventricular Arrhythmias ◽  
Clinical Case ◽  
Stable Coronary Artery Disease ◽  
Antiarrhythmic Effect ◽  
Diagnostic Methods ◽  
Metabolic Therapy ◽  
Exercise Induced

A clinical case of a 56-year-old man is presented in which only ventricular tachycardia without clinical and ECG criteria of myocardial ischemia is recorded on the exercise test. The ventricular tachycardia was the only reason for stopping the test. This clinical case demonstrates all the difficulties in determining the genesis of ventricular arrhythmias induced by exercise. The purpose of the work was to show all the difficulties in determining the genesis of exercise-induced ventricular arrhythmia. The literature references related to the exercise-induced ventricular arrhythmia differentiation is rather poor. It is only known that if a patient develops and progresses ventricular arrhythmia, a tredmill test is considered questionable. Exerciseinduced ventricular arrhythmias especially ventricular tachycardia, are the most dangerous. Therefore, additional diagnostic methods were used to reveal the main disease as the background of ventricular tachycardia. Results of pharmacological test with nitroglycerine were the indication of the ischemic origin of ventricular tachycardia. Coronary angiography did not reveal coronary artery stenoses. Positron emission tomography revealed coronary microcirculation disturbance after which a decision about metabolic therapy with Mexicor was made. The correct choice of the drug (Mеxisor) was confirmed by the results of control studies — improvement of metabolism and antiarrhythmic effect. The article concludes that the choice of the treatment exercise-induced ventricular arrhythmia in patients with stable coronary artery disease should be individual and pathogenetic.

The Assessment of Ventricular Arrhythmia Indicators Based on Electrocardiography in Patients With Differentiated Thyroid Cancer Followed Up With Levothyroxine Suppression

Angiology ◽  
2021 ◽  
pp. 000331972199334
Author(s):  
Sema Hepsen ◽  
Davut Sakiz ◽  
Hilal Erken Pamukcu ◽  
Ismail Emre Arslan ◽  
Hakan Duger ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Thyroid Cancer ◽  
Ventricular Arrhythmia ◽  
Differentiated Thyroid Cancer ◽  
Linear Regression Analysis ◽  
Male Gender ◽  
Qtc Interval ◽  
Inclusion Criteria ◽  
Raising Awareness ◽  
Number Of Patients

Levothyroxine suppression therapy (LST) can cause some unfavorable effects on the cardiovascular system in patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate ventricular arrhythmia predictors based on electrocardiography (ECG) in patients with DTC with LST. The ECG parameters including QT, corrected QT (QTc), Tp-e intervals, Tp-e/QT, and Tp-e/QTC ratios of 265 patients with DTC who met the inclusion criteria were compared with 100 controls. No difference was observed in the number of patients with DTC and controls with prolonged and borderline QTc interval ( P = .273). Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were significantly higher in patients ( P = .002, P = .02, P = .003; respectively). Linear regression analysis suggested that male gender was a predictor of higher Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios (β = 4.322, R 2 = 0.024, P = .042; β = 0.016, R 2 = 0.048, P = .005; β = 0.015, R 2 = 0.044, P = .006, respectively). A higher serum fT4 level was found to be associated with a higher Tp-e/QT ratio (β = 0.018, R 2 = 0.089, P = .007). Ventricular arrhythmia indicators were found to be higher in patients with DTC with LST. Defining ventricular arrhythmia predictors through ECG, an easily accessible cardiac diagnostic tool, can be potentially useful in raising awareness of the possible cardiac harm of LST.

Syncope caused by complete heart block and ventricular arrhythmia as early manifestation of systemic lupus erythematosus in a pregnant patient: a case report

Lupus ◽  
2018 ◽  
Vol 27 (10) ◽  
pp. 1729-1731 ◽  
Author(s):  
C H Lo ◽  
J C C Wei ◽  
C F Tsai ◽  
L C Li ◽  
S W Huang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Ventricular Tachycardia ◽  
Ventricular Arrhythmia ◽  
Clinical Features ◽  
Lupus Erythematosus ◽  
Pregnant Patient ◽  
Polymorphic Ventricular Tachycardia ◽  
Av Block ◽  
Systemic Lupus ◽  
Complete Av Block

Systemic lupus erythematosus (SLE) can affect all heart structures including the conduction system, with either reversible or permanent derangement. However, only a few cases of adult SLE and complete atrioventricular (AV) block have been reported. We describe a young pregnant woman who initially presented with complete AV block on electrocardiography before the diagnosis of SLE. Syncope subsequently developed during the postpartum period due to frequent nonsustained polymorphic ventricular tachycardia, suggesting lupus myocarditis. The ventricular arrhythmia was successfully treated by intravenous corticosteroids, lidocaine and implantation of a permanent pacemaker. This may represent the first report of complete AV block with polymorphic ventricular tachycardia, which was identified before the other clinical features of SLE fully manifested. SLE should be considered if a patient presents with complete AV block without other clinical features. It may warn for early diagnosis and appropriate treatment of SLE including lupus-related heart disease.

Incidence, pathophysiology and prognosis of exercise-induced sustained ventricular tachycardia associated with healed myocardial infarction

1992 ◽  
Vol 70 (9) ◽  
pp. 875-878 ◽  
Author(s):  
Gilles E. O'Hara ◽  
Pedro Brugada ◽  
Luz-Maria Rodriguez ◽  
Mitermayer Brito ◽  
Luis Mont ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Sustained Ventricular Tachycardia ◽  
Exercise Induced

scholarly journals Identification and prognostication of the substrate of ventricular arrhythmia with cardiac magnetic resonance (CMR) imaging in patients with normal echocardiography

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Younus ◽  
H Maqsood ◽  
A Gulraiz ◽  
MD Khan ◽  
R Awais
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Ventricular Arrhythmia ◽  
Heart Diseases ◽  
Sustained Ventricular Tachycardia ◽  
Structural Heart Diseases ◽  
Cmr Imaging

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Self Introduction Malignant ventricular arrhythmia contributes to approximately half of the sudden cardiac deaths. In common practice, echocardiography is used to identify structural heart diseases that are the most frequent substrate of VA. Identification and prognostication of structural heart diseases are very important as they are the main determinant of poor prognosis of ventricular arrhythmia. Purpose : The objective of this study is to determine whether cardiac magnetic resonance (CMR) may identify structural heart disease (SHD) in patients with ventricular arrhythmia who had no pathology observed on echocardiography. Methods : A total of 864 consecutive patients were enrolled in this single-center prospective study with significant ventricular arrhythmia. VA was characterized as >1000 ventricular ectopic beats per 24 hours, non-sustained ventricular arrhythmia, sustained ventricular arrhythmia, and no pathological lesion on echocardiography. The primary endpoint was the detection of SHD with CMR. Secondary endpoints were a composite of CMR detection of SHD and abnormal findings not specific for a definite SHD diagnosis. Results : CMR studies were used to diagnose SHD in 212 patients (24.5%) and abnormal findings not specific for a definite SHD diagnosis in 153 patients (17.7%). Myocarditis (n = 84) was the more frequent disease, followed by arrhythmogenic cardiomyopathy (n = 51), ischemic heart disease (n = 32), dilated cardiomyopathy (n = 17), hypertrophic cardiomyopathy (n = 12), congenital cardiac disease (n = 08), left ventricle noncompaction (n = 5), and pericarditis (n = 3). The strongest univariate and multivariate predictors of SHD on CMR images were chest pain (odds ratios [OR]: 2.5 and 2.33, respectively) and sustained ventricular tachycardia (ORs: 2.62 and 2.21, respectively). Conclusion : Our study concludes that SHD was able to be identified on CMR imaging in a significant number of patients with malignant VA and completely normal echocardiography. Chest pain and sustained ventricular tachycardia were the two strongest predictors of positive CMR imaging results. Abstract Figure. Distribution of different SHD

scholarly journals Paediatric/young versus adult patients with long QT syndrome or catecholaminergic polymorphic ventricular tachycardia

2021 ◽  
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Kamalan Jeevaratnam ◽  
Wing Tak Wong ◽  
Ian Chi Kei Wong ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Long Qt Syndrome ◽  
Primary Outcome ◽  
Public Hospitals ◽  
Adult Patients ◽  
Polymorphic Ventricular Tachycardia ◽  
Qtc Interval ◽  
Long Qt ◽  
Old Patients ◽  
Qt Syndrome

AbstractIntroductionLong QT syndrome (LQTS) and catecholaminergic ventricular tachycardia (CPVT) are less prevalent cardiac ion channelopathies than Brugada syndrome in Asia. The present study compared paediatric/young and adult patients with these conditions.MethodsThis was a territory-wide retrospective cohort study of consecutive patients diagnosed with LQTS and CPVT attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).ResultsA total of 142 LQTS (mean onset age= 27±23 years old) and 16 CPVT (mean presentation age=11±4 years old) patients were included. For LQTS, arrhythmias other than VT/VF (HR=4.67, 95% confidence interval=[1.53-14.3], p=0.007), initial VT/VF (HR=3.25 [1.29-8.16], p=0.012) and Schwartz score (HR=1.90 [1.11-3.26], p=0.020) were predictive of the primary outcome for the overall cohort, whilst arrhythmias other than VT/VF (HR=5.41 [1.36-21.4], p=0.016) and Schwartz score (HR=4.67 [1.48-14.7], p=0.009) were predictive for the adult subgroup (>25 years old; n=58). All CPVT patients presented before the age of 25 but no significant predictors of VT/VF were identified. A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic, and arrhythmias other than VT/VF as the most important variables for risk prediction in LQTS, and initial VT/VF/sudden cardiac death, palpitations, QTc, initially symptomatic and heart rate in CPVT.ConclusionClinical and ECG presentation vary between the pediatric/young and adult LQTS population. All CPVT patients presented before the age of 25. Machine learning models achieved more accurate VT/VF prediction.

Left Stellate Ganglion Block for Refractory Ventricular Tachycardia: A Case Series

2021 ◽  
Vol 104 (3) ◽  
pp. 506-511
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmia ◽  
Stellate Ganglion ◽  
Case Series ◽  
Stellate Ganglion Block ◽  
Definitive Treatment ◽  
Ganglion Block ◽  
Cardiac Implantable Electronic Devices ◽  
Left Stellate Ganglion ◽  
Life Threatening

Ventricular arrhythmias are usually well controlled with medical management, cardiac implantable electronic devices, or catheter ablation. However, the refractory ventricular tachycardia or fibrillation (VT/VF) is life threatening and challenging. The authors reported a case series of left stellate ganglion blocks (LSGB) in patients with refractory VT/VF, who failed pharmacological treatment and multiple traditional cardiac interventions. Five patients underwent six LSGB. Four patients had significant decreased in ventricular arrhythmia burden. Among the responders, the LSGB suppressed significant VT/VF for three to seven days. Blocks did not only temporary suppress ventricular arrhythmia, but also stabilized the condition and served as a bridge to definitive treatment such as EP ablation or heart transplantation. There was no significant hemodynamic change or devastating side effects. The outcome from the present case series suggested that LSGB could be an effective treatment and a lifesaving intervention frintractable VT/VF. Keywords: Stellate ganglion block, Refractory ventricular tachycardia, Sympathectomy

Rhythm and Conduction Disturbances in Stress Testing

2018 ◽  
pp. 199-228
Author(s):  
Gregory S. Thomas ◽  
Maryam Balouch
Keyword(s):  
Ventricular Tachycardia ◽  
Stress Testing ◽  
Case Examples ◽  
Conduction Disturbances ◽  
Wide Complex Tachycardia ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Test Exercise ◽  
Artery Disease ◽  
Exercise Induced

The chapter Rhythm and Conduction Disturbances in Stress Testing reviews the frequency and significance of arrhythmias and conduction abnormalities precipitated by exercise. Case examples are provided. PVCs occurring prior to, during exercise, or during recovery all modestly increase the risk of all-cause mortality in patients with and without known coronary artery disease (CAD). Ventricular tachycardia and premature ventricular complexes are often not reproducible on a subsequent exercise test. Exercise induced left bundle branch block (LBBB) predicts increased risk of the presence of CAD, all cause mortality, and often permanent LBBB. Differentiating wide complex tachycardia during exercise testing between supraventricular tachycardia and ventricular tachycardia can be challenging. The Wellens, Brugada, and Vereckei algorithms to distinguish between these arrhythmias are detailed and compared.

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