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.

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.

Abstract 269: Association of Atrial and Ventricular Arrhythmias with In-hospital Outcomes in Peripartum Cardiomyopathy

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Prakash Harikrishnan ◽  
Tanush Gupta ◽  
Dhaval Kolte ◽  
Chandrasekar Palaniswamy ◽  
Sahil Khera ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Atrial Flutter ◽  
Ventricular Arrhythmias ◽  
Peripartum Cardiomyopathy ◽  
Hospital Charges ◽  
Diagnostic Codes

Background: Arrhythmias are relatively common in patients with non-ischemic cardiomyopathies. There are limited data on the association of atrial and ventricular arrhythmias with outcomes in patients with peripartum cardiomyopathy (PPCM). Methods: We queried the 2003-2011 Nationwide Inpatient Sample databases using the ICD-9 diagnostic codes 674.50 to 674.55, to identify all women aged between 15-55 years admitted with a diagnosis of PPCM. The various arrhythmias were identified using appropriate ICD-9 diagnostic codes - atrial fibrillation (AF) (427.31), atrial flutter (427.32), supraventricular tachycardia (SVT) (427.0), ventricular tachycardia (VT) (427.1), ventricular fibrillation (VF) (427.41 and 427.42). Multivariable adjusted logistic regression was used to study the association of arrhythmias with in-hospital mortality and multivariable adjusted linear regression was used to study the association of arrhythmias with length of stay and hospital charges. Results: From 2003 to 2011, 34,944 patients were hospitalized with PPCM. The mean age was 30±7 years. Among these patients with PPCM, ventricular tachycardia (VT) (4.8%) was the most common arrhythmia followed by atrial fibrillation (AF) (2.2%), ventricular fibrillation (VF) (1.3%), atrial flutter (0.8%) and supraventricular tachycardia (SVT) (0.6%). The risk adjusted in-hospital mortality was higher in PPCM patients with AF (3.6% vs 1.2%, adjusted OR 2.38, 95% CI 1.50-3.78), VT (3.7% vs 1.1%, adjusted OR 1.8, 95% CI 1.30-2.48) and VF (14.2% vs 1.1%, adjusted OR 5.39, 95% CI 3.75-7.74) compared to those without arrhythmias. Among the study population, the average length of stay was longer in patients with AF (8 vs 5 days, p<0.001), atrial flutter (10 vs 5 days, p<0.001), SVT (10 vs 5 days, p<0.001), VT (9 vs 5 days, p<0.001) and VF (10 vs 5 days, p<0.001). The average hospital charges was also higher in patients with AF ($74,799 vs $40,974; p=0.004), atrial flutter ($129,692 vs $41,042; p<0.001), SVT ($133,223 vs $41,165; p<0.001), VT ($97,525 vs $38,929; p<0.001) and VF ($158,381 vs $40,194; p<0.001). Conclusions: In patients hospitalized with PPCM AF, VT and VF were independently associated with significantly higher in-hospital mortality. Also in these patients AF, atrial flutter, SVT, VT and VF were independently associated with higher hospital charges and longer length of stay.

Epidemiology of supraventricular tachycardias

ESC CardioMed ◽  
2018 ◽  
pp. 2050-2050
Author(s):  
Gregory Y. H Lip
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Published Data ◽  
Supraventricular Arrhythmias ◽  
Precise Description ◽  
Specific Focus ◽  
Poor Differentiation ◽  
Supraventricular Tachycardias

The precise description of the epidemiology of supraventricular tachycardias is difficult as the published data often has poor differentiation between atrial fibrillation, atrial flutter, and other supraventricular arrhythmias. In contrast to the extensive epidemiology on atrial fibrillation, a specific focus on supraventricular tachycardia population epidemiology is sparse, especially in the general population (rather than observational cohorts from specialized centres).

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.

scholarly journals Six-months success of radiofrequency ablation in cardiac arrhythmias treatment: Experience of our centre

2019 ◽  
Vol 76 (4) ◽  
pp. 398-403
Author(s):  
Ruzica Jurcevic-Mudric ◽  
Lazar Angelkov ◽  
Milosav Tomovic ◽  
Dejan Kojic ◽  
Predrag Milojevic
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Radiofrequency Ablation ◽  
Atrial Flutter ◽  
Cardiac Arrhythmias ◽  
Paroxysmal Atrial Fibrillation ◽  
Atrial Tachycardia ◽  
Pulmonary Veins ◽  
Av Node

Background/Aim. Numerous trials have shown a high success of radiofrequency ablation (RFA) in the treatment of the patients with cardiac arrhythmias. We aimed to examine the RFA initial success in treatment of different cardiac arrhythmias and the RFA success after 6 months of followup. Second aim was to evaluate influence of all clinical and echocardiography parameters on initial and 6-month success and failure of RFA. Methods. The present study included 320 consecutive patients with atrial and ventricular arrhythmias in which RFA was performed during 2014 in the Institute for Cardiovascular Diseases ?Dedinje?, Belgrade, Serbia. We evaluated the initial RFA success and success of this procedure after 6-month follow-up. We also investigated the prognostic role of clinical and echocardiography parameters on initial and 6-month success and failure of RFA. Results. The RFA initial success for RFA of atrioventriculas (AV) node and AV nodal reentrant tachycardia (AVNRT) was 100%, RFA of pulmonary veins 99%, RFA of atrial flutter 92%, RFA of premature ventricular complexes (PVC) and the Wolf-Parkinson-White (WPW) syndrome 87%, RFA of ventricular tachycardia 85% and RFA of atrial tachycardia 78%. The success of RFA after 6 months of follow-up for RFA of the AV node was 100%, RFA of AVNRT 94%, RFA of atrial flutter 90%, RFA of WPW syndrome 86%, RFA of pulmonary veins 79% (paroxysmal atrial fibrillation 88% and persistent atrial fibrillation 63% with a significant difference p < 0.05), RFA of PVC 78%, RFA of ventricular tachycardia 77% and RFA of atrial tachycardia 67%. Conclusion. This study proved a very high RFA initial success in treatment of cardiac arrhythmias and a satisfactory RFA success after 6 months of follow-up. Only the prognostic value had the type of atrial fibrillation in the group with catheter ablated pulmonary veins: after 6-month follow-up, the patients with paroxysmal atrial fibrillation had a significantly better outcome than those with persistent form.

Pseudo–Ventricular Tachycardia Mimicking Malignant Arrhythmia in a Patient with Rapid Atrial Fibrillation

2014 ◽  
Vol 23 (3) ◽  
pp. 270-272 ◽  
Author(s):  
Walid Barake ◽  
Adrian Baranchuk ◽  
Arnold Pinter
Keyword(s):  
Atrial Fibrillation ◽  
Critical Care ◽  
Ventricular Tachycardia ◽  
Atrial Flutter ◽  
Newly Diagnosed ◽  
Critical Care Units ◽  
Malignant Arrhythmia ◽  
Special Challenge

Artifacts can simulate arrhythmias such as atrial flutter, atrial fibrillation, and ventricular tachycardia. A case of pseudo-ventricular tachycardia is outlined in a patient with newly diagnosed atrial fibrillation, which made the diagnosis a special challenge. Characteristic signs of pseudo–ventricular tachycardia are described. This case reinforces the importance of recognizing artifacts to avoid unnecessary interventions, especially in the telemetry and critical care units. (American Journal of Critical Care. 2014;23:270–272)

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