scholarly journals Efficacy of Adenosine versus Verapamil for Management of Supraventricular Tachycardia Post- Coronary Artery Bypass Grafting: A Randomized Trial

2021 ◽  
Author(s):  
Hoda Shokri ◽  
Ihab Ali
Keyword(s):  
Blood Pressure ◽  
Adverse Events ◽  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Normal Sinus Rhythm ◽  
Artery Bypass ◽  
Study Groups ◽  
Normal Sinus ◽  
Arterial Blood ◽  
Significant Difference

Abstract Background The aim is to compare the use of adenosine and verapamil for management of postoperative supraventricular tachycardia in terms of time of conversion of SVT to normal sinus rhythm, success rate, hospital stay length and adverse eventsMethods Patients (54–65 years old) received adenosine or verapamil groups. In the adenosine group, patients received IV adenosine 6 mg bolus then wait 2 minutes, if it failed another 12 mg IV of adenosine was administered. In the verapamil group, patients received IV verapamil 5mg bolus slowly over 2 minutes followed by a second IV bolus of 10 mg, 30 minutes after the initial dose in persistent supraventricular tachycardia (SVT). If SVT persisted, the patient was shifted to adenosine. Results Patients were followed up regarding the efficacy of drug, blood pressure, mean time of conversion of SVT (time elapsed from effective dose of the study drug till conversion of SVT to sinus rhythm) and incidence of adverse events were recorded. The efficacy of adenosine was significantly higher than verapamil (P <0.001). The time of conversion of SVT to sinus rhythm was significantly shorter in adenosine group compared with verapamil group (P < 0.001). The incidence of hypotension was comparable between the study groups. The mean arterial blood pressure and the incidence of complications were comparable.Conclusions Intravenous administration of adenosine effectively treat SVT in terms of higher efficacy and shorter time of conversion of SVT to normal sinus rhythm compared with verapamil without any significant difference regarding the incidence of side effects between the study groups.Trial registrationThis study was approved by Medical ethics committee of Ain Shams University approval number FMASU R 62/ 2019). and the protocol was prospectively registered at ClinicalTrials.gov : NCT 04203368 on December 16, 2019.

Management of Supraventricular Tachycardia in Pregnancy

Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 426-428
Author(s):  
Ashley A Peterson ◽  
Katherine W Arendt ◽  
Emily E Sharpe
Keyword(s):  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Normal Sinus Rhythm ◽  
Catecholamine Release ◽  
Labor And Delivery ◽  
Neuraxial Analgesia ◽  
Normal Sinus ◽  
In Pregnancy

Abstract Supraventricular tachycardia is a common arrhythmia in pregnancy. During labor and delivery, neuraxial analgesia is important to prevent arrhythmia recurrence. We present the case of a 27-year-old gravida 2 para 1 woman at 35 weeks’ gestation presenting with supraventricular tachycardia that converted to normal sinus rhythm with adenosine. To prevent recurrence of the arrhythmia, an early epidural was provided during labor to minimize catecholamine release.

Robust correlation dimension estimator for heart rate variability

2020 ◽  
Vol 15 (16) ◽  
pp. 62-68
Author(s):  
A.V. Martynenko ◽  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Sinus Rhythm ◽  
Correlation Dimension ◽  
Normal Sinus Rhythm ◽  
Robust Estimator ◽  
Normal Sinus ◽  
Significant Difference ◽  
Limited Length

Introduction. Non-linear methods of analysis have found widespread use in the Heart Rate Variability (HRV) technology, when the long-term HRV records are available. Using one of the effective nonlinear methods of analysis of HRV correlation dimension D2 for the standard 5-min HRV records is suppressed by unsatisfactory accuracy of available methods in case of short records (usually, doctors have about 500 RRs during standard 5-min HRV record), as well as complexity and ambiguity of choosing additional parameters for known methods of calculating D2. The purpose of the work. Building a robust estimator for calculating correlation dimension D2 with high accuracy for limited se-ries of RR-intervals observed in a standard 5-minute HRV record, i. e. with N  500. As well as demonstrating the capabilities of the D2 formula on a well known attractors (Lorenz, Duffing, Hennon and etc.) and in applications for Normal Sinus Rhythm (NSR), Congestive Heart Failure (CHF) and Atrial Fibrillation (AF). Materials and Methods. We used MIT-BIH long-term HRV records for normal sinus rhythm, congestive heart failure and atrial fibrillation. In order to analyze the accuracy of new robust estimator for D2, we used the known theoretical values for some famous attractors (Lorenz, Duffing, Hennon and etc.) and the most popular Grassberger-Procaccia (G-P) algorithm for D2. The results of the study. We have shown the effectiveness of the developed D2 formula for time series of limited length (N = 500–1000) by some famous attractors (Lorenz, Duffing, Hennon and etc.) and with the most popular Grassberger-Procaccia (G-P) algorithm for D2. It was demonstrated statistically significant difference of D2 for normal sinus rhythm and congestive heart failure by standard 5 min HRV segments from MIT-BIH database. The promised technology for early prediction of atrial fibrillation episodes by current D2 algorithm was shown for standard 5 min HRV segments from MIT-BIH Atrial Fibrillation database. Conclusion. Robust correlation dimension D2 estimator suggested in the article allows for time series of limited length (N ≈ 500) to calculate D2 value that differs at mean from a precise one by 5 ± 4%, as demonstrated for various well known attractors (Lorenz, Duffing, Hennon and etc.). We have shown on the standard 5-min segments from MIT-BIH database of HRV records: - the statistically significant difference of D2 for cases of normal sinus rhythm and congestive heart failure; - D2 drop significantly for the about 30 min. before of AF and D2 growth drastically under AF there was shown for HRV records with Atrial Fibrillation (AF) episodes. The suggested robust correlation dimension D2 estimator is perfect suitable for real time HRV monitoring as accurate, fast and non-consuming for computing resources. Key words: Hearth rate variability; Correlation dimension; Congestive heart failure; Atrial fibrillation.

scholarly journals Conversion of supraventricular tachycardia to normal sinus rhythm by dexmedetomidine treatment

2013 ◽  
Vol 65 (6 Suppl) ◽  
pp. S123
Author(s):  
Cheol Lee ◽  
Yeon-Dong Kim ◽  
Dong-Hyuk Seo ◽  
Jae-Hun Lee ◽  
Yoon-Kang Song
Keyword(s):  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Normal Sinus Rhythm ◽  
Normal Sinus

scholarly journals Artificial intelligence to diagnose paroxysmal supraventricular tachycardia using electrocardiography during normal sinus rhythm

2021 ◽  
Author(s):  
Yong-Yeon Jo ◽  
Joon-myoung Kwon ◽  
Ki-Hyun Jeon ◽  
Yong-Hyeon Cho ◽  
Jae-Hyun Shin ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Predictive Value ◽  
High Performance ◽  
Normal Sinus Rhythm ◽  
Point Of Care ◽  
Characteristic Curve ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Normal Sinus ◽  
Accuracy Test

Abstract Aims Paroxysmal supraventricular tachycardia (PSVT) is not detected owing to its paroxysmal nature, but it is associated with the risk of cardiovascular disease and worsens the patient quality of life. A deep learning model (DLM) was developed and validated to identify patients with PSVT during normal sinus rhythm in this multicenter retrospective study. Methods and Results This study included 12,955 patients with normal sinus rhythm, confirmed by a cardiologist. A DLM was developed using 31,147 ECGs of 9,069 patients from one hospital. We conducted an accuracy test with 13,753 ECGs of 3,886 patients from another hospital. The DLM was developed based on residual neural network. Digitally stored ECG were used as predictor variables and the outcome of the study was ability of the DLM to identify patients with PSVT using an ECG during sinus rhythm. We employed a sensitivity map method to identify an ECG region that had a significant effect on developing PSVT. During accuracy test, the area under the receiver operating characteristic curve of an DLM using a 12-lead ECG for identifying PSVT patients during sinus rhythm was 0.966 (0.948–0.984). The, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of DLM were 0.970, 0.868, 0.972, 0.255, and 0.998, respectively. The DLM showed delta wave and QT interval were important to identify the PSVT. Conclusion The proposed DLM demonstrated a high performance in identifying PSVT during normal sinus rhythm. Thus, it can be used as a rapid, inexpensive, point-of-care means of identifying PSVT in patients.

scholarly journals Differences in brand versus generic esmolol in the treatment of perioperative supraventricular tachycardia and hypertension: A pilot study

2020 ◽  
Vol 8 ◽  
pp. 205031212096233
Author(s):  
Diamanto Aretha ◽  
Panagiotis Kiekkas ◽  
Nektarios Sioulas ◽  
Fotini Fligou
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Pilot Study ◽  
Adverse Events ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Supraventricular Tachycardia ◽  
Brand Name ◽  
Significant Difference

Background: Once a patent expires, generic analogue drugs are alternatives to brand name drugs. Because bioequivalence/biodistribution problems have been reported for many generic analogue drugs, we prospectively evaluated 31 patients to reveal the differences in the doses used and the efficacy and adverse events of two different intravenous esmolol formulations. Methods: This was a prospective observational pilot study. Our aim was to reveal the possible differences in the required doses between two different formulations (brand name drug vs generic analogue drug) of intravenous esmolol in beats per minute, systolic blood pressure, diastolic blood pressure and mean arterial pressure in intra- and postoperative patients with supraventricular tachycardia and hypertension. The patients were categorised into two groups according to the medication they received (brand name drug or generic analogue drug). Results: Esmolol was given to 31 patients (16 generic analogue drug and 15 brand name drug). Although there was a statistically significant difference in bolus (mg/kg) and continued (mg/kg/h) drug dose used (brand name drug/generic analogue drug, mean (standard deviation), 0.3 (0.1) vs 0.38 (0.1), p = 0.03 for bolus dose, and 0.22 (0.09) vs 0.29 (0.08) for continued dose at 10 min (p = 0.03), 0.19 (0.06) vs 0.24 (0.05) at 20 min (p = 0.01) and 0.14 (0.05) vs 0.18 (0.05) at 30 min (p = 0.02)), there were no time-related statistical significant differences in the reduction rates of the two drugs (p = 0.47). There were no time-related statistically significant differences between the two groups in systolic blood pressure, diastolic blood pressure, mean arterial pressure and beats per minute, nor in their adverse events. Conclusion: In this pilot study, smaller doses were given for controlling the patient’s haemodynamics when a brand name drug was used. Because there were no significant time-related differences in the reduction rates of the two drugs nor in any haemodynamic differences between the two groups, optimal titration of the drug used could effectively control the patient’s haemodynamics. The adverse events were also similar in both groups.

scholarly journals COMPARATIVE EFFECTIVENESS OF RADIOFREQUENCY PULMONARY VEIN ISOLATION PLUS AMIODARONE THERAPY IN PREVENTING POST-CORONARY ARTERY BYPASS GRAFTING ATRIAL FIBRILLATION

2020 ◽  
Vol 26 (3) ◽  
pp. 29-36
Author(s):  
A. Sh. Revishvili ◽  
V. A. Popov ◽  
G. P. Plotnikov ◽  
A. N. Korostelev ◽  
E. S. Malyshenko ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Pulmonary Vein ◽  
Artery Bypass ◽  
Randomized Study ◽  
Study Groups ◽  
Wound Complications ◽  
Amiodarone Therapy ◽  
Mechanical Lung Ventilation ◽  
Significant Difference

Objective. To evaluate the effectiveness of epicardial bipolar radiofrequency ablation (RFA) of pulmonary vein ostia (PV) in comparison with its being combined with amiodarone administration for post-CABG atrial fibrillation (AF) prevention.Methods. A single-centre, prospective randomized study (PULVAB), including 96 CAD patients with no history of AF, was conducted between January 2015 and December 2018. Group 1 (control; n=34) had standard CABG alone. Group 2 (n=29) received RFA of PV as an adjunct to CABG for prevention of postoperative AF (POAF). Group 3 patients (n=33) had RFA at the time of CABG and were given amiodarone. Allocation was concealed using sequentiallynumbered opaque envelopes. The efficacy and safety of RFA concomitant with CABG were assessed, as both performed independently and combined with amiodarone administration, as well as intra-and postoperative course.Results. No differences were seen in operation length (p=0.937), cardiopulmonary bypass (CPB) or the aorta clamping times (р=0.377 and p=0.072, respectively). The study groups (CABG, CABG-RFA, CABG-RFA-amiodarone) did not differ statistically in the number of shunts placed - 3.17±0.61, 3.10±0.51 and 2.94±0,6 (p=0,121). No significant difference was noted in RFA duration between Groups 2 and 3 - 11.7±3.7 and 11.4±6.3 min, respectively (p=0,834).AF was found to occur most commonly at postoperative days two or four. The isolated CABG surgery group patients developed POAF most often of all (32,4%). The incidence of POAF was lower after RFA concomitant to CABG - 20.7% (р=0,29). A significant difference was identified in POAF incidence between Groups 1 and 3- 32.4% and 6.1%, respectively (p = 0.0065). Differences between Groups 2 and 3 proved not to be statistically significant (р= 0,086). Sinus rhythm in most of those who had developed arrhythmias was restored by pharmacological cardioversion except for three patients (one in each group). At discharge, 97.1% , 96.7% and 97% of the subjects in Groups 1, 2 and 3, respectively, exhibited sinus rhythm (p>0,05).There was no in-hospital mortality in any of the groups. Neither were there any wound complications, reoperations, perioperative myocardial infarction or cerebral circulatory disorders observed. No difference was revealed in the severity and frequency of renal or respiratory failure. The mechanical lung ventilation time and duration of stay in the ICU in the isolated CABG group were shown to be increased as compared with the CABG-RFA and CABG-RFA-amiodarone groups (p<0.05).Conclusion. The evidence from the pilot study (PULVAB) suggests that bipolar ablation of PV does not significantly complicate CABG, while being combined with amiodarone administration for prevention of rhythm disorders it significantly reduces the incidence of POAF. The in-hospital incidence of POAF tended to decrease, which was not statistically significant, though. Evaluating the efficacy of RFA concomitant with CABG, as performed independently, invites further investigation with more data analysis.

Classification of Paroxysmal Atrial Fibrillation using Second Order System

2014 ◽  
Vol 67 (3) ◽  
Author(s):  
Nurul Ashikin Abdul-Kadir ◽  
Norlaili Mat Safri ◽  
Mohd Afzan Othman
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Atrial Fibrillation Patient ◽  
Heart Rhythm ◽  
Second Order ◽  
Order System ◽  
Normal Sinus ◽  
Specificity And Sensitivity ◽  
Significant Difference

In this paper, we monitored and analyzed the characteristics of atrial fibrillation in patient using second order approach. Atrial fibrillation is a type of atria arrhythmias, disturbing the normal heart rhythm between the atria and lower ventricles of the heart. Heart disease and hypertension increase risk of stroke from atrial fibrillation. This study used electrocardiogram (ECG) signals from Physiobank, namely MIT-BIH Atrial Fibrillation Dataset and MIT-BIH Normal Sinus Rhythm Dataset. In total, 865 episodes for each type of ECG signal were classified, specifically normal sinus rhythm (NSR) of human without arrhythmia, normal sinus rhythm of atrial fibrillation patient (N) and atrial fibrillation (AF). Extracted parameters (forcing input, natural frequency and damping coefficient) from second order system were characterized and analyzed. Their ratios, time derivatives, and differential derivatives were also observed. Altogether, 12 parameters were extracted and analysed from the approach. The results show significant difference between the three ECGs of forcing input, and derivative of forcing input. Overall system performance gives specificity and sensitivity of 84.9 % and 85.5 %, respectively.

Rapid Ventricular Pacing for Flow Arrest During Cerebrovascular Surgery: Revival of an Old Concept

2011 ◽  
Vol 70 (suppl_2) ◽  
pp. ons270-ons275 ◽  
Author(s):  
Vera Saldien ◽  
Tomas Menovsky ◽  
Margo Rommens ◽  
Gregory Van der Steen ◽  
Katrin Van Loock ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Normal Sinus Rhythm ◽  
Interventional Cardiology ◽  
Ventricular Pacing ◽  
Normal Sinus ◽  
Arterial Blood ◽  
Rapid Ventricular Pacing ◽  
Cerebrovascular Surgery ◽  
Intraoperative Rupture ◽  
Produce Flow

ABSTRACT BACKGROUND: Intraoperative rupture of a cerebral aneurysm can be a devastating event that increases operative morbidity and mortality. Rapid ventricular pacing (RVP) is a technique used in interventional cardiology to obtain flow arrest for short periods of time. OBJECTIVE: To present our experience using RVP for flow arrest during cerebrovascular surgery. METHODS: We used RVP to produce flow arrest for periods of 40 seconds in 12 patients who underwent craniotomy for a cerebrovascular disorder (11 aneurysms and 1 arteriovenous malformation). RESULTS: During RVP, there was an immediate and significant reduction of blood pressure in each patient. The maximum degree of hypotension was obtained 3.2 ± 0.7 seconds (mean ± SD) after the start of RVP. When RVP was terminated, normal sinus rhythm returned instantaneously, along with recovery of indexes of hemodynamic function. Subjectively, the decrease in blood pressures facilitated dissection, and during clipping, the aneurysm sac felt softer and was easier to manipulate. No complications related to RVP occurred. CONCLUSION: Rapid ventricular pacing during cerebrovascular surgery is an effective method for lowering the arterial blood pressure in a controlled and directly reversible manner. Advances in cardiology now make RVP a promising and safe technique that can facilitate complex cerebrovascular surgery.

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