P6574Symptomatic palpitations causing anxiety in women, what are the underlying arrhythmias

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Insulander ◽  
C Carnlof ◽  
M Jensen-Urstad ◽  
K Schenck-Gustafsson
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Supraventricular Tachycardia ◽  
Sinus Tachycardia ◽  
Normal Sinus Rhythm ◽  
Sinus Bradycardia ◽  
Clinical Importance ◽  
Great Majority ◽  
Block Type ◽  
Digital Technique

Abstract Background Highly symptomatic palpitations are common, particularly in women, and may cause disturbing symptoms including anxiety, depression, and decreased health related quality of life. Palpitation in this context has been considered generally benign and caused by premature atrial or ventricular beats or stress-induced sinus tachycardia. However, how often arrhythmias of clinical importance such as atrial fibrillation and supraventricular or ventricular tachycardia is the cause is unknown. Purpose To evaluate to what extent symptomatic palpitation in women is caused by clinically important arrhythmias. Methods A new Swedish digital technique was used. The system uses a well-validated algorithm to analyze heart rhythm (both thumbs and chest recordings), is connected to the user's smartphone and provides immediate response to the user. The result is simultaneously available for the supervising physician. In cases of non-benign arrhythmias, the result was also analyzed manually. In all, 909 women (age 56±11 years) with palpitations causing anxiety were included. ECG was recorded twice a day and at symptoms for 60 days. Participants with known atrial fibrillation were excluded. Results In all, 6 861 ECG recordings were done due to symptomatic palpitation. Underlying heart rhythms were as follows: normal sinus rhythm (73%), sinus tachycardia (12%), premature atrial beats or ventricular beats (7%), atrial fibrillation (4%), benign sinus bradycardia and second-degree AV block type 1 (4%), and supraventricular tachycardia (1%). In 1% of recordings, quality was too poor for analysis. No ventricular tachycardia was recorded. In all, 19 women with previously undiagnosed atrial fibrillation and 12 women with undiagnosed supraventricular tachycardia were found. Conclusions In the great majority of episodes causing symptomatic palpitation in women, the underlying arrhythmia is benign. However, in 5% previously undiagnosed atrial fibrillation or supraventricular tachycardia were found.

2202Instant analysis of the ECG with a new digital technique during palpitations reduce symptoms, anxiety, depression, and increase HRQOL in women

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Carnlof ◽  
P Insulander ◽  
M Jensen-Urstad ◽  
K Schenck-Gustafsson
Keyword(s):  
Atrial Fibrillation ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Sinus Tachycardia ◽  
Normal Sinus Rhythm ◽  
Depression Scale ◽  
Heart Rhythm ◽  
Generalized Anxiety ◽  
Digital Technique ◽  
Anxiety Depression

Abstract Background Palpitation is common, particularly in women, and usually benign caused by premature atrial/ventricular beats or stress-induced sinus tachycardia. Palpitations may cause disturbing symptoms, anxiety, depression, and decreased health related quality of life (HRQOL). Uncommonly, arrhythmias of clinical importance such as atrial fibrillation or paroxysmal supraventricular or ventricular tachycardia may be the cause. Purposes To evaluate if instant analysis of underlying heart rhythm during palpitations reduce symptoms, anxiety, depression, and increase HRQOL. Methods In all, 913 women (age 56±11 years) with palpitations causing anxiety were recruited from social web sites. Coala Heart Monitor® was used by participants and ECG recorded twice a day and at symptoms for 60 days. The system uses a well-validated algorithm to analyze heart rhythm, is connected to the user's smartphone and provides immediate response to the user. In cases of non-benign arrhythmias, the result was also analyzed manually. Questionnaires addressing symptom (Symptom severity and frequency checklist (SCL), anxiety, depression Hospital anxiety and depression scale (HADS), Generalized Anxiety Disorder (GAD-7) and HRQOL (RAND-36)) were analyzed before and after two months. Exclusion criterium was known atrial fibrillation. Results Between June 2018 and November 2018, 280 474 recordings (both chest and thumbs) ECG recordings were automatically analyzed. Frequency and severity of symptoms decreased (frequency from 23.7±8.4 to 19.7±8.5 (p<0.001), severity from 22.7±4.9 to 21±4.4 (p<0.001)). Total anxiety measured by HADS decreased from 6.4±4.2 to 5.7±4.2 (p<0.001) and depression from 5.1±3.9 to 4.6±4.1 (p<0.001). Generalized anxiety disorder decreased from 5.6±4.8 to 4.7±4.6 (p<0.001) and HRQOL increased in all domains (p<0.001). In 83% of recordings during symptomatic palpitation, benign premature atrial or ventricular beats, sinus tachycardia, or normal sinus rhythm were found. Conclusions Instant analysis of the ECG with direct response to the user during palpitations reduce symptoms, anxiety, depression, and increase HRQOL in women.

scholarly journals 829 Perioperative Surgical Patients and The Availability and Utilisation Of ECGs Machines Pre- And Post-Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Wareing ◽  
H Sandhar ◽  
A Howitt ◽  
M Yiasemidou ◽  
D Craske
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Patient Outcomes ◽  
Sinus Tachycardia ◽  
Normal Sinus Rhythm ◽  
Cardiac Pathology ◽  
Normal Sinus ◽  
The Impact ◽  
Operative Monitoring

Abstract Introduction ECGs are a NICE recommended pre-operative investigation and an integral part of post-operative monitoring. Delay in recognition of cardiac pathology can be catastrophic. Therefore, ECG machines should be readily available. Here, we report the results of an audit assessing the availability of ECG machines in surgical wards. Method In 2018 and then 2020, a bespoke, nine-item audit proforma was disseminated to all foundation doctors. Results In 2018, 17/32 wards had a ward based, readily available machine, 6/32 shared with another ward and 15/32 did not have a ward-based machine. The same was noted in 2020. In 2018 and 2020, the average time to obtain an ECG machine was 27 and 23 respectively. When no ECG was available, a doctor would obtain the machine 24% in 2018 compare to 52% in 2020. The diagnoses of the patients who had ECGs in 2018 were: normal sinus rhythm, atrial fibrillation, bradycardia, supraventricular tachycardia, sinus tachycardia and STEMI. In 2020 were: normal sinus rhythm, atrial fibrillation, supraventricular tachycardia, sinus tachycardia, atrial flutter, bradycardia, prolonged QTc, hyperkalaemia, STEMI and NSTEMI. The average time for NSTEMI patients to have an ECG was 35mins while for STEMI patients was 11.6mins. Conclusions Whilst our audit has highlighted the importance of ECG machine availability, the time to obtain one remained static between the two cycles. A study investigating the impact on patient outcomes may highlight the necessity for available ECG machines further.

Atrial Fibrillation and Other Cardiac Arrhythmias (DRAFT)

2018 ◽  
Author(s):  
Antoine Schneider ◽  
Rinaldo Bellomo
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Cardiac Arrhythmias ◽  
Older Patients ◽  
Hospital Setting ◽  
Rapid Response Team ◽  
Hospitalized Patients ◽  
Response Team

Cardiac arrhythmias are common in hospitalized patients, with their incidence increasing in older patients and those with comorbidities. Cardiac arrhythmias represent a trigger for approximately 10% of rapid response team (RRT) activations. Of those, atrial fibrillation (AF) is the most commonly observed. Other common cardiac arrhythmias in the in-hospital setting include supraventricular tachycardia, atrial flutter, ventricular tachycardia, and bradycardias. Members of the RRT should be skilled in the diagnosis and management of these common arrhythmias. This chapter presents an overview of cardiac arrhythmias that RRT members are likely to encounter, discussing their incidence and significance, as well as their immediate management.

scholarly journals Hypertrophic Cardiomyopathy and Wolff-Parkinson-White Syndrome in a Young African Soldier with Recurrent Syncope

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Mohammed Abdullahi Talle ◽  
Faruk Buba ◽  
Aimé Bonny ◽  
Musa Mohammed Baba
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Hypertrophic Cardiomyopathy ◽  
General Population ◽  
Supraventricular Tachycardia ◽  
White Syndrome ◽  
Wpw Syndrome ◽  
The Individual ◽  
Common Manifestation ◽  
Wolff Parkinson White Syndrome

Syncope is a common manifestation of both hypertrophic cardiomyopathy (HCM) and Wolff-Parkinson-White (WPW) syndrome. The most common arrhythmia in HCM is ventricular tachycardia (VT) and atrial fibrillation (AF). While preexcitation provides the substrate for reentry and supraventricular tachycardia (SVT), AF is more common in patients with preexcitation than the general population. Concurrence of HCM and WPW has been reported in many cases, but whether the prognosis or severity of arrhythmia is different compared to the individual disorders remains unsettled. We report a case of HCM and Wolff-Parkinson-White (WPW) syndrome in a 28-year-old male Nigerian soldier presenting with recurrent syncope and lichen planus.

Introduction to the Electrophysiology Manual: Fluoroscopic Views, Electrograms, and Relevant Anatomy

2013 ◽  
pp. 3-64
Author(s):  
Samuel J. Asirvatham
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Catheter Position ◽  
Display Format ◽  
The Common

The purpose of this chapter is to familiarize the reader with the typical fluoroscopic views and electrograms used throughout this book. First, the rationale for the particular views used and the standard electrogram display format are introduced. The discussion then continues to the important fluoroscopic landmarks relevant to the arrhythmias encountered in the electrophysiology laboratory. These landmarks are discussed in the context of the electrograms obtained from mapping these sites and their importance from an anatomic and ablation standpoint. The first topics are the common fluoroscopic and anatomic principles relevant to the electrophysiology laboratory; then the specific differences in catheter use and electrograms obtained from the standard fluoroscopic catheter position in supraventricular tachycardia, atrial flutter, atrial fibrillation, and ventricular tachycardia; and finally some unusual positions and congenital variants.

Some effects of breath holding and apneic underwater diving on cardiac rhythm in man

1962 ◽  
Vol 17 (3) ◽  
pp. 461-466 ◽  
Author(s):  
C. Robert Olsen ◽  
Darrell D. Fanestil ◽  
Per F. Scholander
Keyword(s):  
Cardiac Arrhythmias ◽  
Cardiac Rhythm ◽  
Sinus Tachycardia ◽  
Normal Sinus Rhythm ◽  
Sinus Bradycardia ◽  
Breath Holding ◽  
Sinus Arrest ◽  
Sinus Arrhythmia ◽  
Normal Sinus ◽  
Idioventricular Rhythm

Man's bradycardic response to simple breath holding was augmented by submersion in water of 27 C and was not prevented by muscular exercise. Cardiac arrhythmias occurred with 45 of 64 periods of apnea in 16 subjects and were more frequent during the dives than during breath holding. These arrhythmias, with the exception of atrial, nodal, and ventricular premature contractions, were inhibitory in type and included sinus bradycardia and arrhythmia, sinus arrest followed by either nodal escape or ventricular escape, A-V block, A-V nodal rhythm, and idioventricular rhythm. T waves frequently became tall and peaked during both breath holding and dives. Prompt return to normal sinus rhythm was the rule with the first breath after surfacing. Sinus tachycardia, sinus arrhythmia, and atrial, nodal, or ventricular premature contractions were seen during recovery. Submitted on October 9, 1961

scholarly journals The Pattern of Cardiac Arrhythmias in Acute ST Elevated Myocardial Infarction and their in-hospital Outcome

2020 ◽  
Vol 16 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Mohammad Khurshadul Alam ◽  
Manzoor Mahmood ◽  
Dipal Krishna Adhikary ◽  
Fakhrul Islam Khaled ◽  
Msi Tipu Chowdhury ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Sinus Tachycardia ◽  
Sinus Bradycardia ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Av Block ◽  
Acute Stemi ◽  
Hospital Outcome

Background: Acute myocardial infarction (AMI) is a major cause of death worldwide with arrhythmia being the most common determinant in the post-infarction period. Identification and management of arrhythmias at an early period of acute MI has both short term and long term significance. Objective: The aim of the study is to evaluate the pattern of arrhythmias in acute STEMI in the first 48 hours of hospitalization and their inhospital outcome. Methods: A total of 50 patients with acute STEMI were included in the study after considering the inclusion and exclusion criteria. The patients were observed for the first 48 hours of hospitalization for detection of arrhythmia with baseline ECG at admission and continuous cardiac monitoring in the CCU. The pattern of the arrhythmias during this period & their in-hospital outcome were recorded in predesigned structured data collection sheet. Result: The mean age was 53.38 ± 10.22 years ranging from 29 to 70 years. Most of the patients were male 42(84%). Majority of the patients had anterior wall ( anterior, antero-septal & extensive anterior) myocardial infarction (54%). Sinus tachycardia in isolation was the most common arrhythmia observed in 36.8% of patients followed by sinus bradycardia (22.8%), ventricular tachycardia (19.3%), ventricular ectopic (12.3%),first degree AV block (5.3%), complete heart block and atrial ectopic 1.7% each. Tachyarrhythmias were more common in anterior wall myocardial infarction, whereas bradyarrhythmias were more common in inferior wall myocardial infarction. Among studied patients, 72% had favourable outcome , followed by acute left ventricular failure 10%, cardiogenic shock & lengthening of hospital stay 8% each and death 2%. Conclusion: The commonest arrhythmias encountered were sinus tachycardia followed by sinus bradycardia, ventricular tachycardia, ventricular ectopic, AV block and atrial ectopic. The incidence of mortality was 2%. University Heart Journal Vol. 16, No. 1, Jan 2020; 16-21

Perioperative Outcomes and Safety of Atrial Fibrillation Catheter Ablation in Octogenarians: A Retrospective Study and Review of the Benefits of Rhythm Control

Cardiology ◽  
2017 ◽  
Vol 137 (3) ◽  
pp. 173-178
Author(s):  
Stephanie Hakimian ◽  
Juan C. Camacho ◽  
Edwin Grajeda Silvestri ◽  
Farid AbdelMalak ◽  
Elie Donath ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Normal Sinus Rhythm ◽  
Therapeutic Option ◽  
Sinus Bradycardia ◽  
Age Groups ◽  
Coronary Intervention ◽  
Rhythm Control ◽  
Perioperative Outcomes ◽  
Normal Sinus

Objectives: Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control. Methods: Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified. The primary outcome was normal sinus rhythm (NSR) on electrocardiogram at discharge. Secondary outcomes were periprocedural complications and markers and risks of reablation compared to younger cohorts. Results: An NSR on discharge occurred in 83 patients. Three patients required pacing for symptomatic sinus bradycardia, complete heart block, and symptomatic junctional bradycardia, respectively. Reablation for recurrent AF occurred in 23 octogenarians. Using the octogenarians as reference, the relative risk (RR) of 1 reablation was not significantly different among the age groups 70-79, 60-69, and <60 years. The RR of 2 reablations was greater in the octogenarian group (RR 0.26 [95% CI 0.09-0.71, p = 0.008], 0.42 [95% CI 0.17-1.04, p = 0.06], and 0.27 [95% CI 0.1-0.75, p = 0.01], respectively). Coronary artery disease (OR 0.14, 95% CI 0.02-0.68, p = 0.026) and percutaneous coronary intervention (OR 0.13, 95% CI 0.02-0.63, p = 0.021) were markers for reablation. Conclusion: AF catheter ablation achieved an NSR with minimal periprocedural complications. The benefits of rhythm control should be considered in treatment.

VP27 Countrywide Screening Of Cardiovascular Diseases Through Telemedicine

2019 ◽  
Vol 35 (S1) ◽  
pp. 82-82
Author(s):  
Pedro Galvan ◽  
Jose Ortellado ◽  
Ronald Rivas ◽  
Juan Portillo ◽  
Julio Mazzoleni ◽  
...  
Keyword(s):  
Public Health ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Prevention Program ◽  
Ventricular Hypertrophy ◽  
Sinus Tachycardia ◽  
Sinus Bradycardia ◽  
Left Ventricular ◽  
Bundle Branch Block

IntroductionThrough telemedicine, advantageous telediagnostic systems can be developed to improve the health care of populations that do not have access to specialists. However, evidence on how such innovation technology can enhance the countrywide electrocardiographic (EKG) screening to support a prevention program for cardiovascular diseases is limited. The usability of telemedicine to improve the countrywide detection of heart diseases according to the national cardiovascular disease prevention program in Paraguay was investigated.MethodsThis cross-sectional survey included adults (≥19 and ≤ 80 years) and children (≥1 and ≤ 18 years) with medical prescription. The study was carried out by the Telemedicine Unit of the Ministry of Public Health and Social Welfare (MSPBS) in collaboration with the Department of Biomedical Engineering and Imaging of the Health Science Research Institute (IICS-UNA) to evaluate the utility of a telediagnostic net for detection and prevention program of cardiovascular disease in public health. For this purpose, the results obtained by the EKG telediagnosis net implemented in sixty countrywide public hospitals were analyzed and verified the adherence to the cardiovascular prevention program.ResultsA total of 246,217 remote EKG diagnoses were performed between January 2014 and August 2018. Of the total, 80.6 percent (198,494) corresponded to adults and 19.4 percent (47,723) to children. The adult diagnoses were mainly normal (66.3 percent), sinus bradycardia (11.2 percent), right bundle branch block (4.8 percent), left ventricular hypertrophy (4.7 percent), ventricles repolarization disorder (4.4 percent), sinus tachycardia (4,4 percent), ischemia (1.7 percent), atrial fibrillation (1.1 percent), left bundle branch block (0.7 percent), and unspecified arrhythmias (0.6 percent). The children's diagnoses were mainly normal (79.4 percent), sinus bradycardia (10.6 percent), sinus tachycardia (3,2 percent), unspecified arrhythmias (2.8 percent), right bundle branch block (1.9 percent), left ventricular hypertrophy (1.0 percent), left bundle branch block (0.4 percent), ventricles repolarization disorder (0.3 percent), and atrial fibrillation (0.2 percent). The mean adherence rate to the prevention program was 2.3 between 2014 and 2018 for each thousand diagnosis performed.ConclusionsThe results show that the telemedicine can enhance significantly the EKG screening to support a prevention program for cardiovascular diseases and health programs. However, before carrying out its systematic implementation, a contextualization with the regional epidemiological profile must be performed.

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