scholarly journals Resistant Ventricular Arrhythmia and the Role of Overdrive Pacing in the Suppression of the Electrical Storm

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Mohamed Magdi ◽  
Mahmood Mubasher ◽  
Hakam Alzaeem ◽  
Tahir Hamid
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Arrhythmia ◽  
Ventricular Arrhythmias ◽  
Coronary Intervention ◽  
Electrical Storm ◽  
Electrical Instability ◽  
Percutaneous Coronary ◽  
Life Threatening ◽  
Overdrive Pacing ◽  
Antiarrhythmic Medications

Ventricular arrhythmia storm is a state of cardiac instability characterized by multiple ventricular arrhythmias or multiple ICD therapies within a 24-hour duration. Management of this life-threatening state depends on the reversal of the cause besides either electrical or medical management of the arrhythmia. We report a case of a 54-year-old male who underwent a percutaneous coronary intervention following massive acute myocardial infarction. Afterwards, he developed frequent life-threatening ventricular arrhythmias that required multiple shocks and antiarrhythmic medications. Despite all these interventions, it was very difficult to control the electrical instability, but after overdrive ventricular pacing, the storm subsided and within a few days the case was stabilized. Overdrive pacing is an easy temporary modality to control the resistant arrhythmia following myocardial infarction.

scholarly journals Effect of primary percutaneous coronary intervention on ventricular repolarization through evaluation of QT dispersion in patient with acute myocardial infarction

2018 ◽  
Vol 5 (2) ◽  
pp. 506
Author(s):  
Behzad Babapour ◽  
Bita Shahbazzadegan ◽  
Bahareh Khademi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Ventricular Arrhythmia ◽  
Primary Percutaneous Coronary Intervention ◽  
Qt Dispersion ◽  
Coronary Intervention ◽  
Ventricular Repolarization ◽  
Primary Pci ◽  
Percutaneous Coronary

Background: Cardiovascular disease is the most common cause of death around the world. QT dispersion is one of the parameters that used for evaluation of ventricular arrhythmia. Primary PCI increases probability of coronary artery and reperfusion of the ventricular arrhythmia. The aim of this study was to determine effect of primary percutaneous coronary intervention (PCI) on ventricular repolarization through evaluation of QT dispersion in patient with acute myocardial infarction. Methods: In this pre-post test study, 77 patients with acute ST with elevated myocardial infarction under primary PCI were investigated. The ECG and ST dispersion before PCI and 24 hours after PCI were determined and then the amount of QTd was calculated. The repeated measurement ANOVA was used to compare QTd of pre- PCI treatment and QTd in 24 hours after PCI. Data analysis was performed using statistical software SPSS ver.17. Results: From 77 participants, 60 were male and 17 were female. 43 (55.8%) had a MI position in ANT, PRE, and EXT, 33 (42.9%) had in the INF, and only one person (1.3%) had a MI position in LAT. The results showed that mean QT dispersion in ECG, 24h after primary PCI, for most of measured variables was deceased compare to before primary PCI, but the difference was not significant. Conclusions: The amount of QTd 24 hours after PCI decreased but its decline was not significant. With regards to lack of convenience data, more researches are recommended in this field. 

scholarly journals Impact of Late Ventricular Arrhythmias on Cardiac Mortality in Patients with Acute Myocardial Infarction

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Takuma Takada ◽  
Koki Shishido ◽  
Takahiro Hayashi ◽  
Shohei Yokota ◽  
Hirokazu Miyashita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ventricular Arrhythmias ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Cardiac Mortality ◽  
Killip Class ◽  
Percutaneous Coronary ◽  
The Relationship ◽  
Lower Ejection Fraction

Objectives. This study investigated the relationship between the timing of ventricular tachycardia or ventricular fibrillation (VT or VF) and prognosis in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Background. It is unknown whether the timing of VT/VF occurrence affects the prognosis of patients with AMI. Methods. From January 2004 to December 2014, 1004 patients with AMI underwent primary PCI. Of these patients, 888 did not have VT/VF (non-VT/VF group) and 116 had sustained VT/VF during prehospitalization or hospitalization. Patients with VT/VF were divided into two groups: early VT/VF (VT/VF occurrence before and within 2 days of admission, 92 patients) and late VT/VF (VT/VF occurrence >2 days after admission; 24 patients) groups. Results. The frequency of VT/VF occurrence was high between the day of admission and the 2nd day and between days 6 and 10 of hospitalization. The late VT/VF group had a significantly longer onset-to-balloon time, lower ejection fraction, poorer renal function, and higher creatine phosphokinase (CK)-MB level on admission (p< 0.001). They also had a lower 30-day cardiac survival rate than the early VT/VF and non-VT/VF groups (42% vs. 76% vs. 96%, p < 0.001). Moreover, independent predictors of in-hospital cardiac mortality among patients with AMI who had sustained VT/VF were higher peak CK-MB [Odds ratio (OR: 1.001, 95%confidence interval (CI): 1.000-1.002, p= 0.03)], higher Killip class (OR: 1.484, 95%CI 1.017-2.165, p= 0.04), and late VT/VF (OR: 3.436, 95%CI 1.115-10.59, p= 0.03). Conclusions. The timing of VT/VF occurrences had a bimodal peak. Although late VT/VF occurrence after primary PCI was less frequent than early VT/VF occurrence, patients with late VT/VF had a very poor prognosis.

scholarly journals Ventricular fibrillation storm after revascularization of chronic total occlusion of the left anterior descending artery: is this reperfusion arrhythmia?

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199761
Author(s):  
Xingji Liu ◽  
Binay Kumar Adhikari ◽  
Tianlong Chen ◽  
Yonggang Wang ◽  
Quan Liu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Ventricular Fibrillation ◽  
Collateral Circulation ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Electrical Storm ◽  
Total Occlusion ◽  
Reperfusion Arrhythmia ◽  
Percutaneous Coronary ◽  
Life Threatening

Electrical storm is a life-threatening emergency condition defined as three or more episodes of ventricular tachycardia or ventricular fibrillation (VF) within 24 hours requiring anti-tachycardia therapy, electrical cardioversion, or defibrillation. However, studies of the incidence of electrical storm after chronic total occlusion-percutaneous coronary intervention (CTO-PCI) are limited, 7 and post-procedural VF after revascularization of CTO has not been described. The purpose of this article was to present a case of post-operative VF electrical storm after revascularization of CTO of the left anterior descending (LAD) artery to determine whether the electrical storm was caused by reperfusion arrhythmia or compromise of either branch vessels or the collateral circulation during intervention.

scholarly journals Surgical Cardiac Sympathetic Denervation for Ventricular Arrhythmias: A Systematic Review

2021 ◽  
pp. 24-35
Author(s):  
Ray K Chihara ◽  
Edward Y Chan ◽  
Leonora M Meisenbach ◽  
Min P` KIM
Keyword(s):  
Systematic Review ◽  
Ventricular Arrhythmia ◽  
Ventricular Arrhythmias ◽  
Treatment Guidelines ◽  
Adult Population ◽  
Sympathetic Denervation ◽  
Cardiac Events ◽  
Life Threatening ◽  
Antiarrhythmic Medications ◽  
Cardiac Sympathetic Denervation

Ventricular arrhythmias are potentially life-threatening disorders that are commonly treated with medications, catheter ablation and implantable cardioverter defibrillator (ICD). Adult patients who continue to be symptomatic, with frequent ventricular arrhythmia cardiac events or defibrillation from ICD despite medical treatment, are a challenging subgroup to manage. Surgical cardiac sympathetic denervation has emerged as a possible treatment option for people refractory to less invasive medical options. Recent treatment guidelines have recommended cardiac sympathectomy for ventricular tachycardia (VT) or VT/fibrillation storm refractory to antiarrhythmic medications, long QT syndrome, and catecholaminergic polymorphic VT, with much of the data pertaining to pediatric literature. However, for the adult population, the disease indications, complications, and risks of cardiac sympathectomy are less understood, as are the most effective surgical cardiac denervation techniques for this patient demographic. This systematic review navigates available literature evaluating surgical denervation disease state indications, techniques, and sympathectomy risks for medically refractory ventricular arrhythmia in the adult patient population.

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