A case of hypokalemia-induced bidirectional ventricular tachycardia

Background Bidirectional ventricular tachycardia (BVT) is a rare, but serious, arrhythmia. Hypokalemia is commonly found in clinical practice, but hypokalemia-induced BVT has rarely been reported. Case presentation A 74-year-old male patient with the symptoms of chest distress and palpitations was admitted owing to frequent discharge of his implantable cardioverter defibrillator (ICD) for 4 days. Before admission, the patient experienced diarrhea after intake of crabs, and felt frequent discharge of his ICD with a total of approximately 17 discharges in 4 days. He had no history of digitalis use. The serum potassium level after admission was 3.1 mmol/L and an electrocardiogram was consistent with BVT. The diagnosis was ventricular tachycardia, electrical storm, and hypokalemia. His ventricular tachycardia was completely relieved after correction of hypokalemia. Conclusions After correction of hypokalemia in this patient, the episode of BVT was terminated and no recurrence of BVT was observed during long-term follow-up. Our findings suggest the diagnosis of hypokalemia-induced BVT.

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Extramedullary Plasmacytoma of The Frontal Sinus: A Case Report

FACE ◽

10.1177/27325016211053640 ◽

2021 ◽

pp. 273250162110536

Author(s):

Joshua Harrison ◽

Samantha Marley ◽

Shawhin Shahriari ◽

Christian Bowers ◽

Anil Shetty

Keyword(s):

Frontal Sinus ◽

Surgical Excision ◽

Extramedullary Plasmacytoma ◽

High Rate ◽

Solitary Plasmacytoma ◽

Case Presentation ◽

Long Term Follow Up ◽

History Of

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.

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Small left ventricular size predicts implantable cardioverter defibrillator therapy in long-term observation of patients with left ventricular assist device for non-ischemic cardiomyopathy

EP Europace ◽

10.1093/europace/euab116.333 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

M Nakao ◽

M Watanabe ◽

T Koizumi ◽

T Kadosaka ◽

T Koya ◽

...

Keyword(s):

Heart Failure ◽

Implantable Cardioverter Defibrillator ◽

Ischemic Cardiomyopathy ◽

Left Ventricular ◽

Idiopathic Dilated Cardiomyopathy ◽

Electrical Storm ◽

Cardioverter Defibrillator ◽

Long Term Follow Up

Abstract Funding Acknowledgements Type of funding sources: None. Background The number of patients who received left ventricular assisted device (LVAD) implantation because of end-stage heart failure has been increasing. In those patients, ventricular arrhythmias (VAs) occur commonly, and electrical storm (ES) and shock therapies by implantable cardioverter-defibrillator (ICD) are considered to increase mortality. Although it is important to identify patients with higher risk of VA events, there have been limited data reporting the risk of VAs in LVAD patients during long-term follow up, especially in non-ischemic cardiomyopathy (NICM). Purpose We sought to clarify the predictors of ICD therapies in LVAD patients diagnosed as NICM during long-term follow up. Methods We retrospectively analyzed non-ischemic heart failure patients whom a continuous flow LVAD was implanted as a bridge to transplantation therapy from July 2011 to February 2019. ICD programming was generally set as follows; one zone setting (VF zone with maximum shocks) for primary prevention or two zone setting (VF with maximum shocks and VT with ATPs and shocks) for secondary prevention. ICD settings were generally unchanged after LVAD implantation. Clinical and echocardiographic data were collected before and 3 months after LVAD implantation. Device interrogation was performed every 4 - 6 months at out-patient clinic. Patients were followed until May 2019. Results A total of 25 patients were included in the study. The mean age was 49 years, 88% were men. They majority of patients (52%) were diagnosed as idiopathic dilated cardiomyopathy. During the median follow up duration of 889 days (IQR 546 – 2070), 27 appropriate shock events occurred in 7 patients and 154 appropriate ATP-only events in 10 patients. The group with appropriate ICD event (11 patients, 44%) had significantly smaller LVDd (65.2 ± 4.0 vs. 79.4 ± 3.5 mm; p = 0.01) and higher LVEF (26.2 ± 1.6 vs. 20.5 ± 1.4 %; p = 0.02) before LVAD implantation. When patients were divided into 2 groups based on the median value (70.0 mm) of LVDd before LVAD implantation (pre LVDd), patients with smaller pre LVDd (≤ 70mm) had significantly higher rate of appropriate ICD treatment than those with larger pre LVDd (> 70 mm) (Log-rank p < 0.01). In univariate cox regression analysis, pre LVDd was negatively associated with appropriate ICD therapy (hazard ratio 0.94, 95% confidence interval 0.88 - 0.99; p = 0.02). Conclusion Smaller LVDd before LVAD implantation might be a possible predictor of appropriate ICD treatment in patients with NICM. Abstract Figure.

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A Case of Hypokalemia-induced Bidirectional Ventricular Tachycardia

10.21203/rs.3.rs-16321/v1 ◽

2020 ◽

Author(s):

Yanan Xie ◽

Jingzhe Han ◽

Jinming Liu ◽

Jie Hao ◽

Xiuguang Zu ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Clinical Practice ◽

Male Patient ◽

Serum Potassium ◽

Electrical Storm ◽

Case Presentation ◽

History Of

Abstract Background: Bidirectional ventricular tachycardia (BVT) is a rare but serious arrhythmia. Hypokalemia is commonly seen in clinical practice, but hypokalemia-induced BVT has rarely been reported. Case presentation: A 74-year-old male patient with the symptom of chest distress and palpitation was admitted due to frequent discharge of ICD for 4 days. Before admission, the patient experienced diarrhea after intake of crabs, and felt frequent discharge of ICD with a total of about 17 discharges in 4 days. He had no history of digitalis use. Serum potassium after admission was 3.1 mmol/L and the ECG was consistent with BVT. The diagnosis was ventricular tachycardia, electrical storm and hypokalemia, and ventricular tachycardia was completely relieved after the correction of hypokalemia. Conclusions: After correction of hypokalemia in this patient, the episode of BVT was terminated and no recurrence of BVT was noted during long-term follow-ups, confirming the diagnosis of hypokalemia-induced BVT.

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245 Long-term follow-up of pacing and sensing parameters in right ventricular dysplasia patients with implantable cardioverter defibrillator

EP Europace ◽

10.1016/s1099-5129(05)80154-0 ◽

2005 ◽

Vol 7 ◽

pp. 52-52

Keyword(s):

Right Ventricular ◽

Implantable Cardioverter Defibrillator ◽

Cardioverter Defibrillator ◽

Right Ventricular Dysplasia ◽

Long Term Follow Up

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The natural history of pituitary apoplexy: long term follow-up study

Endocrine Abstracts ◽

10.1530/endoabs.65.p301 ◽

2019 ◽

Author(s):

Ayesha Shaikh ◽

Natasha Shrikrishnapalasuriyar ◽

Giselle Sharaf ◽

David Price ◽

Maneesh Udiawar ◽

...

Keyword(s):

Natural History ◽

Pituitary Apoplexy ◽

Follow Up Study ◽

Long Term Follow Up ◽

History Of

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Faculty Opinions recommendation of Natural history of imatinib-naive GISTs: a retrospective analysis of 929 cases with long-term follow-up and development of a survival nomogram based on mitotic index and size as continuous variables.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13356067.14726207 ◽

2011 ◽

Author(s):

Richard Riedel

Keyword(s):

Natural History ◽

Retrospective Analysis ◽

Mitotic Index ◽

Continuous Variables ◽

Long Term Follow Up ◽

History Of

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Faculty Opinions recommendation of Long-Term Follow-Up of Patients with Tetralogy of Fallot and Implantable Cardioverter Defibrillator: The DAI-T4F (Implantable Cardioverter Defibrillator-Tetralogy of Fallot) Nationwide Registry.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.738783850.793579822 ◽

2020 ◽

Author(s):

Marlon Rosenbaum

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Tetralogy Of Fallot ◽

Cardioverter Defibrillator ◽

Nationwide Registry ◽

Long Term Follow Up

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Fibromuscular dysplasia with recurrence after “long-term” following percutaneous transcatheter renal angioplasty: two case reports with a review of 26 patients

BMC Nephrology ◽

10.1186/s12882-021-02342-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Shuntaro Oribe ◽

Takafumi Toyohara ◽

Eikan Mishima ◽

Takehiro Suzuki ◽

Koichi Kikuchi ◽

...

Keyword(s):

Fibromuscular Dysplasia ◽

Age Of Onset ◽

Case Reports ◽

Case Presentation ◽

Renal Angioplasty ◽

Long Term Follow Up ◽

Percutaneous Transluminal Renal Angioplasty ◽

The Difference

Abstract Background Fibromuscular dysplasia (FMD) often causes renal artery stenosis with renovascular hypertension. Recent clinical outcomes encourage percutaneous transluminal renal angioplasty (PTRA) to treat FMD; however, the necessary follow-up period remains unclear. Moreover, previous studies have not revealed the difference in the period until recurrence between two major types of FMD—multifocal and focal. Case presentation We describe two patients with multifocal FMD who developed hypertension during their teenage years and had recurrence of FMD > 10 years after PTRA. We further examined the types of FMD and age of onset in 26 patients who underwent PTRA. The period until recurrence of multifocal FMD was longer than that of focal FMD. Moreover, patients with early-onset multifocal FMD are likely to have a delayed recurrence after PTRA compared to other types. Conclusions Our report suggests that patients with multifocal FMD, especially those with onset at an early age, may need long-term follow-up for at least ≥ 10 years.

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