Paramedic use of IV amiodarone to terminate supraventricular tachycardia

2020 ◽  
Vol 12 (12) ◽  
pp. 487-494
Author(s):  
Ashley Hanson
Keyword(s):  
Supraventricular Tachycardia ◽  
Cardiac Patients ◽  
Definitive Treatment ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Training And Education ◽  
Pharmacological Management ◽  
Specialist Services ◽  
Life Threatening ◽  
First Time

The introduction of specialist services within the hospital network has increased conveyance times for many patients, as paramedics look to deliver them to the most appropriate hospital first time. Patients with potentially life-threatening arrhythmias can decompensate quickly, increasing the need for pharmacological management of these conditions en route. Amiodarone is carried as part of the existing paramedic formulary and is used to terminate paroxysmal supraventricular tachycardia (PSVT), resistant to cardioversion, in the hospital. With appropriate training and education, paramedics could safely deliver amiodarone to this sub-group of cardiac patients, while en route to hospital for definitive treatment.

scholarly journals Adenosine-induced ventricular fibrillation in a patient with supraventricular tachycardia

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Shu Yu Lee ◽  
Sohil Pothiawala ◽  
Chong Meng Seet
Keyword(s):  
Ventricular Fibrillation ◽  
Supraventricular Tachycardia ◽  
Accessory Pathway ◽  
Structural Heart Disease ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Frequent Use ◽  
First Case ◽  
Raising Awareness ◽  
Life Threatening ◽  
Prolonged Qt Syndrome

Adenosine is frequently used for paroxysmal supraventricular tachycardia (PSVT) treatment in the emergency department (ED). Atrial and ventricular pro-arrhythmic effects of adenosine were described in the literature, but ventricular fibrillation (VF) secondary to adenosine administration was rarely reported (with an incidence of < 1%). Reported herein is the first case of a 72-year-old female patient who developed VF hemodynamic collapse after an intravenous administration of adenosine for PSVT treatment. She had no known pre-excitation or accessory pathway, nor any underlying structural heart disease or prolonged QT syndrome. Raising awareness of this potential life-threatening pro-arrhythmic effect of adenosine is important, given its frequent use for PSVT treatment in the ED.

scholarly journals Supraventricular Tachycardia in Pregnancy

2021 ◽  
Vol 8 (3) ◽  
pp. 88-90
Author(s):  
Gauri Prabhu ◽  
Shubha SR ◽  
M.B. Bellad ◽  
Shridevi Metugud
Keyword(s):  
Heart Rate ◽  
Supraventricular Tachycardia ◽  
Treatment Options ◽  
Tertiary Care ◽  
Electrical Cardioversion ◽  
Reproductive Age ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Tertiary Care Centre ◽  
Intravenous Amiodarone ◽  
Life Threatening

The commonest arrhythmia in women of reproductive age, is paroxysmal supraventricular tachycardia (SVT). We present a rare case of SVT who presented for the first time during pregnancy, who failed to respond to Electrical cardioversion(ECV), but reverted back to sinus rhythm by secondline pharmacotherapy. PROCEDURE: A 22 year old primigravidapresented at 37weeks in labour with complaints of breathlessness and severe palpitations when she was diagnosed to have supraventricular tachycardia(SVT) on ECG and was referred to a tertiary care centre for further management.Pharmacological cardioversion was attempted with intravenous diltiazem, but in vain. Decision was taken for electrical cardioversion with synchronized DC shocks of 50 joules and 100 joules successively, but was not successful too. As a last resort, bolus of intravenous Amiodarone 150 mg was given over 10 minutes followed by infusion at the rate of 24 mg per hour(2ml/hr), which finally brought down the heart rate to 98bpm. In view of non-reassuring fetal heart rate observed on CTG, patient was taken up for an emergency caesarean section under epidural anaesthesia with grave risk consent and shifted to ICCU post-operatively. RESULT: Patient delivered a male baby of birth weight 2.35kg. Patient tolerated the surgery well and did not experience any episodes of PSVT throughout the intra-operative period. Postoperatively patient was managed in consultation with cardiologist. Amiodarone infusion was continued for 24 hours at 24mg/ hour. Post-operative period was uneventful, patient was started on oral anti arrhythmic medications and discharged on the same. CONCLUSION : Accurate diagnosis, regular follow up and multidisciplinary approach during acute episode and during delivery can prevent life threatening risks that might be posed to the mother and fetus in a case of PSVT. Treatment options include nonpharmacological therapy, followed by adenosine and other drugs if required, and lastly electrical cardioversion

Resveratrol: A new potential therapeutic agent for melanoma?

2019 ◽  
Vol 26 ◽  
Author(s):  
Mohamad Hossein Pourhanifeh ◽  
Kazem Abbaszadeh-Goudarzi ◽  
Mohammad Goodarzi ◽  
Sara G.M. Piccirillo ◽  
Alimohammad Shafiee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Therapeutic Agent ◽  
Current Knowledge ◽  
Treatment Resistance ◽  
Anti Cancer ◽  
Apoptosis Inducer ◽  
Life Threatening ◽  
First Time

: Melanoma is the most life-threatening and aggressive class of skin malignancies. The incidence of melanoma has steadily increased. Metastatic melanoma is greatly resistant to standard anti-melanomatreatments such as chemotherapy, and 5-year survival rate of cases with melanoma who have metastatic form of disease is less than 10%. The contributing role of apoptosis, angiogenesis and autophagy in the pathophysiology of melanoma has been previously demonstrated. Thus, it is extremely urgent to search for complementary therapeutic approachesthat couldenhance the quality of life of subjects and reduce treatment resistance and adverse effects. Resveratrol, known as a polyphenol component present in grapes and some plants, has anti-cancer properties due to its function as an apoptosis inducer in tumor cells, and anti-angiogenic agent to prevent metastasis. However, more clinical trials should be conducted to prove resveratrol efficacy. : Herein, for first time, we summarize current knowledge of anti-cancerous activities of resveratrol in melanoma.

A case of linear epidermal naevus presenting as genital warts – a cautionary tale

2005 ◽  
Vol 16 (3) ◽  
pp. 267-269
Author(s):  
M Mahto ◽  
J Ashworth ◽  
D M Vickers
Keyword(s):  
Unusual Case ◽  
Adult Life ◽  
Genital Warts ◽  
Definitive Treatment ◽  
Cautionary Tale ◽  
Surgical Ablation ◽  
Genital Area ◽  
Organ Systems ◽  
First Time ◽  
Epidermal Naevus Syndrome

Linear epidermal naevus (LEN) in the genital area is quite rare. It may present at birth or appear later on in life, in infancy or childhood and occasionally for the first time in adult life. There are several variants of epidermal naevi (EN), which, to the less experienced, can be mistaken for warts. When extensive, it can be associated with abnormalities in other organ systems (epidermal naevus syndrome). The definitive treatment of LEN is surgical ablation with excision of underlying dermis, but this frequently leads to scarring. Laser therapy is an alternative treatment modality and good results have been shown. We report an unusual case of LEN in the genital area in a 60-year-old man presenting as genital warts.

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