scholarly journals Preliminary Study of Coupling Intervals of Premature Ventricular Complexes in Dogs With Different Cardiac Diseases

2021 ◽  
Author(s):  
Liza Sally Koster ◽  
Jonathan Abbott
Keyword(s):  
Heart Disease ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Structural Heart Disease ◽  
Holter Monitoring ◽  
Antiarrhythmic Therapy ◽  
Premature Ventricular Complex ◽  
Coupling Interval ◽  
Familial Cardiomyopathy ◽  
Preliminary Study ◽  
Group 2

Abstract Coupling interval (CI), the time (ms) from the onset of a sinus QRS to the onset of the following premature ventricular complex (PVC), and their variability (CIV) might predict mortality and elucidate mechanisms of arrhythmogenesis. There has been limited investigation of CIV in dogs. Therefore, we determined CIV and prematurity index (PI) in three groups of dogs with ventricular arrhythmias that were subject to 24 hour ambulatory electrocardiographic (Holter) monitoring. Dogs in group 1 had presumptive arrhythmogenic right ventricular cardiomyopathy (ARVC), those in group 2 had structural heart disease in which patients with valvular heart disease predominated, and those in group 3 had a dilated cardiomyopathy (DCM) either phenotype or presumed familial cardiomyopathy. In this preliminary study, we did not find significant differences in indices of CIV between groups. Median PI was lower in dogs treated with antiarrhythmic therapy. Severity of cardiac remodeling, except for left atrial to aortic ratio, were not correlated with CIV. It was not possible to determine the mechanism of arrhythmias in ARVC, DCM phenotype or structural heart disease groups and re-entry, triggered activity, and abnormal automaticity are possible etiologies. The effect of antiarrhythmic therapy demonstrated potential drug effect on CIV. Risk for malignant arrhythmias and sudden cardiac death were not examined. A larger study would be needed to determine if differences exist; if present, this would give insight into possible mechanisms and optimal antiarrhythmic therapy.

scholarly journals P967 Profile of arrhythmia in pregnant women with different WHO class is similar

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Wisniowska-Smialek ◽  
A Lesniak-Sobelga ◽  
M Kostkiewicz ◽  
P Rubis ◽  
K Holcman ◽  
...  
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Structural Heart Disease ◽  
Holter Monitoring ◽  
Cardiac Complications ◽  
P Value ◽  
Conduction Disturbances ◽  
Foetal Mortality ◽  
Group 2 ◽  
D 20

Abstract Background Arrhythmia is the most common cardiac complications during pregnancy especially in women with structural heart disease. Methods: Since January 2015 till December 2018 the consecutive 150 pregnant women with different maternal cardiovascular risk according to WHO classification: 100 in WHO I and II (gr 1);50 in WHO II-III, III, IV were enrolled. Each woman had 24-hour Holter- ECG monitoring during at least 2 trimester. Results: Except mild ventricular arrhythmia i.e ventricular extrasystole > 1000 per 24 hour, which occured more often in group1, we did not observe any significant differences in arrhythmic profile of pregnant women with different WHO risk classification (table 1). Delivery: Caesarean section was more frequent in gr 2 (86% vs 62%) but rate of stillbirths were similar among groups. Maternal death did not occurred, there was 2 (4%) foetal mortality in gr 2. Mean duration of pregnancy, children length and birthweight were significantly higher in gr 1(table1).Conclusion: Arrhythmias during pregnancy occurred particularly on the substrate of structural heart disease. According to our observation pregnant women with potentially higher risk of maternal cardiovascular events did not reveal significant arrhythmia including conduction disturbances in comparison to women in WHO class I or II. Holter monitoring resultes Parameter Group 1; no 100 Group 2, no 50 P value Age 31(27-34) 31(28-33) 0,36 NYHA 1,34 1,32 0,76 SVE > 1000/d 2(2,15%) 2(5,88%) 0,28 VE > 1000/d 20(19,23%) 3(5,88%) 0,03 SVT 6(6,5%) 4(11,43%) 0,35 sVT 1(1%) 0 0,65 nsVT 8(8,79%) 3(8,57%) 0,96 AF/AT 0 2(4%) 0,54 AV I 5(5%) 3(6%) 0,32 AV II Mobitz I 1(1,1%) 1(2%) 0,53 AV III 0 1(2%) 0,41 Duration (weeks) 39(38-40) 37,1 0,017 Weight (grams) 3220+-641 2840+-767 g 0,02 Caesareon section 54(62%) 33(86%) 0,00 Stillbirths 22(21,57% 8(17,78%) 0,6

scholarly journals Monomorphic Ventricular Arrhythmias in Athletes

2019 ◽  
Vol 8 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Jeffrey J Hsu ◽  
Ali Nsair ◽  
Jamil A Aboulhosn ◽  
Tamara B Horwich ◽  
Ravi H Dave ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Arrhythmias ◽  
Comprehensive Evaluation ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Sports Participation ◽  
Structural Heart Disease ◽  
Competitive Sports ◽  
Ventricular Cardiomyopathy ◽  
Electrical Heart Disease ◽  
Increase Risk

Ventricular arrhythmias are challenging to manage in athletes with concern for an elevated risk of sudden cardiac death (SCD) during sports competition. Monomorphic ventricular arrhythmias (MMVA), while often benign in athletes with a structurally normal heart, are also associated with a unique subset of idiopathic and malignant substrates that must be clearly defined. A comprehensive evaluation for structural and/or electrical heart disease is required in order to exclude cardiac conditions that increase risk of SCD with exercise, such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy. Unique issues for physicians who manage this population include navigating athletes through the decision of whether they can safely continue their chosen sport. In the absence of structural heart disease, therapies such as radiofrequency catheter ablation are very effective for certain arrhythmias and may allow for return to competitive sports participation. In this comprehensive review, we summarise the recommendations for evaluating and managing athletes with MMVA.

Sustained and non-sustained ventricular tachycardia and no associated heart disease (idiopathic ventricular tachycardia)

ESC CardioMed ◽  
2018 ◽  
pp. 2288-2293
Author(s):  
Victor Bazan ◽  
Enrique Rodriguez-Font ◽  
Francis E. Marchlinski
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Drug Therapy ◽  
Catheter Ablation ◽  
Beta Blockers ◽  
Young Patients ◽  
Structural Heart Disease ◽  
Holter Monitoring ◽  
Severe Arrhythmia ◽  
The Right

Around 10% of ventricular arrhythmias (VA) occur in the absence of underlying structural heart disease. These so-called ‘idiopathic’ VAs usually have a benign clinical course. Only rarely do these “benign” arrhythmias trigger polymorphic ventricular tachycardia (PVT) and idiopathic ventricular fibrillation (VF). Due to their focal origin and to the absence of underlying myocardial scar, the 12-lead ECG very precisely establishes the right (RV) or left (LV) ventricular site of origin of the arrhythmia and can help regionalizing the origin of VT for ablation. A 12-lead ECG obtained during the baseline rhythm and 24-hour ECG Holter monitoring are indicated in order to identify structural or electrical disorders leading to PVT/VF and to determine the VA burden. The most frequent origin of idiopathic VAs is the RV outflow tract (OT). Other origins include the LVOT, the LV fascicles (fascicular VTs), the LV and RV papillary muscles, the crux cordis, the mitral and tricuspid annuli and the RV moderator band. Recognizing the typical anatomic sites of origin combined with a 12 lead ECG assessment facilitates localization.  Antiarrhythmic drug therapy (including use of beta-blockers) or catheter ablation may be indicated to suppress or eliminate idiopathic VAs, particularly upon severe arrhythmia-related symptoms or if the arrhythmia burden is high and ‘tachycardia’-induced cardiomyopathy is suspected. Catheter ablation is frequently preferred to prevent lifelong drug therapy in young patients.

scholarly journals Premature Ventricular Complex Causing Ice-Pick Headache

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Selcuk Ozturk ◽  
Ertan Yetkin
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Premature Ventricular Contraction ◽  
Headache Disorder ◽  
Structural Heart Disease ◽  
Ventricular Myocardium ◽  
Benign Disease ◽  
Premature Ventricular Complex ◽  
Ventricular Contraction ◽  
Premature Ventricular Contractions

Ice pick headache is a momentary, transient, repetitive headache disorder and manifests with the stabbing pains and jolts. The exact mechanism causing this disease is unknown. Premature ventricular contractions are early depolarization of the ventricular myocardium and in the absence of a structural heart disease, it is considered to be a benign disease. In this report, we describe a male patient presenting with the symptom of momentary headache attacks accompanied with instant chest pain which is associated with premature ventricular contraction.

scholarly journals Presence of dysfunction and myocardial remodeling in patients with premature ventricular complex-induced cardiomyopathy - a cardiovascular MR study

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
N Kirchgaessner ◽  
J Salatzki ◽  
P Lugenbiel ◽  
A Ochs ◽  
H Hund ◽  
...  
Keyword(s):  
Heart Disease ◽  
Myocardial Fibrosis ◽  
Cardiac Dysfunction ◽  
Feature Tracking ◽  
Structural Heart Disease ◽  
Holter Ecg ◽  
Z Scores ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements Type of funding sources: None. Background Premature ventricular complexes (PVCs) in the absence of underlying structural heart disease are considered to be benign. However, cardiac dysfunction has been observed in patients with a high PVC burden. The characterization of a PVC-induced cardiomyopathy with structural remodeling including myocardial fibrosis and the determination of a specific PVC burden leading to subclinical cardiac dysfunction remains to be determined. Objectives We aimed to evaluate cardiac function, remodeling and myocardial fibrosis patterns in patients with PVCs using cardiac magnetic resonance imaging (CMR). Additionally, we aimed to determine a PVC cut-off value leading to subclinical cardiac dysfunction. Methods Patients who underwent CMR and 24-hour, 12-lead ECG monitoring (Holter ECG) within six months were retrospectively studied. Patients with evidence of structural heart disease were excluded. The cohort was subdivided based on the number of PVCs in Holter ECG; Group-1 = 0-100, Group-2 = 100-5000 and Group-3 > 5000 PVCs. CMR parameters were extracted from our local databank. Myocardial strain was measured using feature tracking. For quantification of myocardial fibrosis, T1 mapping and late gadolinium enhancement (LGE) were investigated. Z-scores were calculated in order to combine T1 values from a 1.5 and 3Tesla CMR vendor. Results 443 patients (52 ± 20 years, 45% females) were included in the study. Compared to Group-1, Group-3 revealed a significantly reduced LV-EF, an increased indexed LV-EDV and increased indexed LV-ESV, indicating cardiac dysfunction and LV enlargement. PVCs frequency was inversely correlated with LV-EF (r=-0.23, p < 0.001) and positively correlated with indexed LV-EDV (r = 0.13; p < 0.01). Feature tracking showed significantly higher global circumferential strain (GCS) indicating subclinical dysfunction. Global T1 times were significantly prolonged in Group-3. Elevated global T1 Z-scores were found in Group-2 and Group-3 compared to Group-1. Significantly more intramural LGE was present in Group-2. The PVC cut-off value characterized by reduced GCS was defined by 216 PVCs (AUC = 0.61, p = 0.02).  Conclusion CMR revealed cardiac dysfunction, left ventricular enlargement and diffuse myocardial fibrosis in patients with PVC in the absence of structural heart disease. These changes indicate the development of a PVC-induced cardiomyopathy depending on the PVC burden. Interestingly, subclinical myocardial dysfunction was determined at already low PVC frequencies. Further investigations are necessary in order to examine the influence of different origins of PVCs and the development of structural remodeling.

Ventricular arrhythmias

2019 ◽  
pp. 221-240
Author(s):  
Martin Borggrefe ◽  
Erol Tülümen ◽  
Josep Brugada
Keyword(s):  
Heart Disease ◽  
Ventricular Arrhythmias ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Atrioventricular Node ◽  
Structural Heart Disease ◽  
Polymorphic Ventricular Tachycardia ◽  
European Society Of Cardiology ◽  
Ventricular Tachycardias ◽  
Current Guidelines

Ventricular arrhythmias are abnormal rhythms that originate from below the atrioventricular node. They include premature ventricular complexes, ventricular tachycardias, and ventricular fibrillation. Ventricular arrhythmias may occur in patients with structural heart disease (ischaemic heart disease, cardiomyopathies such as dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, etc.) or in patients with a structurally normal heart (genetic arrhythmia syndromes such as long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, or as idiopathic ventricular tachycardias). Symptoms depend on the frequency, duration, and haemodynamic effects of the arrhythmia. They may be asymptomatic or may cause symptoms, such as palpitations, shortness of breath, chest discomfort, dizziness, or syncope, or may present with cardiac arrest. This chapter is focused on the role of antiarrhythmic drugs in the management of ventricular arrhythmias. The recommendations are based on the current guidelines of the European Society of Cardiology for the management of patients with ventricular arrhythmias.

scholarly journals Irrigated Needle Ablation Compared to Other Advanced Ablation Techniques for Failed Endocardial Ventricular Arrhythmia Ablation

2021 ◽  
Author(s):  
Ryohsuke Narui ◽  
Shinichi Tanigawa ◽  
Ikutaro Nakajima ◽  
Kenichi Tokutake ◽  
Tomofumi Nakamura ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Arrhythmia ◽  
Right Ventricular ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Structural Heart Disease ◽  
Mortality Rates ◽  
Ablation Techniques ◽  
Ventricular Cardiomyopathy ◽  
Epicardial Ablation ◽  
Major Complications

Background - Options when endocardial ventricular arrhythmia (VA) ablation fails include epicardial, simultaneous two site unipolar radiofrequency (SURF) and transcoronary ethanol (TCE) ablation. Recently, investigational needle ablation has also been used, but how it compares to other advanced methods is not clear. This study sought to compare outcomes and complications for needle ablation versus other advanced ablation techniques in patients with structural heart disease, VA, and failed endocardial ablation. Methods - We retrospectively reviewed 136 procedures in 119 consecutive patients with structural heart disease (excluding arrhythmogenic right ventricular cardiomyopathy) who failed endocardial ablation and underwent ablation with either an investigational needle catheter (27 gauge, single end hole) or with other advanced techniques including epicardial, SURF or TCE ablation. Results - Of 136 procedures, needle ablation was performed in 58 procedures. In the remaining 78 procedures, 65 were epicardial ablation including 10 with SURF ablation from endocardial and epicardial sites, seven with SURF from both sides of the septum, one SURF and TCE ablation, and five TCE ablation procedures. Acute outcomes, 6-month VA recurrence, and mortality rates were not different between the two groups (49% vs 55%, P=0.54, 45% vs 46%, P=1.00, and 4% vs 3%, P=1.00, respectively). There were 22 major complications observed in 22 procedures with pericardial bleeding occurring less frequently with needle ablation (1.7% vs 12.8%, P=0.02). Conclusions - Ablation with an irrigated needle catheter compares favorably to other advanced ablation techniques.

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