scholarly journals Identification of R-peaks to Detect Ventricular Fibrillation, Ventricular Tachycardia and Atrial Fibrillation

2017 ◽  
Vol 6 (7) ◽  
pp. 1741-1745
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation

Abstract 269: Association of Atrial and Ventricular Arrhythmias with In-hospital Outcomes in Peripartum Cardiomyopathy

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Prakash Harikrishnan ◽  
Tanush Gupta ◽  
Dhaval Kolte ◽  
Chandrasekar Palaniswamy ◽  
Sahil Khera ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Atrial Flutter ◽  
Ventricular Arrhythmias ◽  
Peripartum Cardiomyopathy ◽  
Hospital Charges ◽  
Diagnostic Codes

Background: Arrhythmias are relatively common in patients with non-ischemic cardiomyopathies. There are limited data on the association of atrial and ventricular arrhythmias with outcomes in patients with peripartum cardiomyopathy (PPCM). Methods: We queried the 2003-2011 Nationwide Inpatient Sample databases using the ICD-9 diagnostic codes 674.50 to 674.55, to identify all women aged between 15-55 years admitted with a diagnosis of PPCM. The various arrhythmias were identified using appropriate ICD-9 diagnostic codes - atrial fibrillation (AF) (427.31), atrial flutter (427.32), supraventricular tachycardia (SVT) (427.0), ventricular tachycardia (VT) (427.1), ventricular fibrillation (VF) (427.41 and 427.42). Multivariable adjusted logistic regression was used to study the association of arrhythmias with in-hospital mortality and multivariable adjusted linear regression was used to study the association of arrhythmias with length of stay and hospital charges. Results: From 2003 to 2011, 34,944 patients were hospitalized with PPCM. The mean age was 30±7 years. Among these patients with PPCM, ventricular tachycardia (VT) (4.8%) was the most common arrhythmia followed by atrial fibrillation (AF) (2.2%), ventricular fibrillation (VF) (1.3%), atrial flutter (0.8%) and supraventricular tachycardia (SVT) (0.6%). The risk adjusted in-hospital mortality was higher in PPCM patients with AF (3.6% vs 1.2%, adjusted OR 2.38, 95% CI 1.50-3.78), VT (3.7% vs 1.1%, adjusted OR 1.8, 95% CI 1.30-2.48) and VF (14.2% vs 1.1%, adjusted OR 5.39, 95% CI 3.75-7.74) compared to those without arrhythmias. Among the study population, the average length of stay was longer in patients with AF (8 vs 5 days, p<0.001), atrial flutter (10 vs 5 days, p<0.001), SVT (10 vs 5 days, p<0.001), VT (9 vs 5 days, p<0.001) and VF (10 vs 5 days, p<0.001). The average hospital charges was also higher in patients with AF ($74,799 vs $40,974; p=0.004), atrial flutter ($129,692 vs $41,042; p<0.001), SVT ($133,223 vs $41,165; p<0.001), VT ($97,525 vs $38,929; p<0.001) and VF ($158,381 vs $40,194; p<0.001). Conclusions: In patients hospitalized with PPCM AF, VT and VF were independently associated with significantly higher in-hospital mortality. Also in these patients AF, atrial flutter, SVT, VT and VF were independently associated with higher hospital charges and longer length of stay.

scholarly journals Effect of Dexmedetomidine on Atrial Fibrillation-Based Tachyarrhythmia After Cardiac Surgery: A Systematic Review and Meta-Analysis 

2021 ◽  
Author(s):  
Wenzhu Wang ◽  
Jian Liu ◽  
Haibo Ye ◽  
Mingshan Wang ◽  
Tao Wang
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Supraventricular Tachycardia ◽  
Number Of Patients ◽  
Statistical Heterogeneity ◽  
Significant Difference

Abstract Background: The incidence of tachyarrhythmia with atrial fibrillation as the main manifestation increases after adult cardiac surgery, which leads to an increase in adverse events. Dexmedetomidine has been widely used in the perioperative period, but the effect of dexmedetomidine on tachyarrhythmia after cardiac surgery in adults remains controversial.Objective: To evaluate the effect of perioperative use of dexmedetomidine on tachyarrhythmia with atrial fibrillation as the main manifestation after cardiac surgery.Methods: We searched six databases, including Embase, PubMed, Cochrane, CNKI, Wanfang, and Sinomed, for literature published up to November 2020, without restrictions on language. The primary endpoint was the number of patients with atrial fibrillation after cardiac surgery. The secondary endpoints included: the number of patients with supraventricular tachycardia, the number of patients with ventricular tachycardia, the number of patients with ventricular fibrillation, the number of patients with myocardial infarction, the number of dead patients, mechanical ventilation duration, and the length of ICU stay and hospitalization. We used Stata (Version 12.0) and Review Manager (Version 5.3) provided by Cochrane Collaboration for data analysis. If the included studies have high statistical heterogeneity (P≤0.1, I2>50%), we will use a random-effects model. Otherwise, a fixed-effects model will be used for calculation.Results: Among the 1388 studies retrieved, a total of 18 studies met our inclusion criteria (N=3171 participants). The use of dexmedetomidine reduced the incidence of atrial fibrillation by 17% (RR=0.83, 95% CI 0.73-0.93; Z=3.06, P=0.002), reduced the incidence of supraventricular tachycardia by about 70% (RR=0.29, 95% CI 0.11-0.77; Z=2.47, P=0.01), reduced the incidence of ventricular tachycardia by about 80% (RR=0.23, 95% CI 0.08-0.63; Z=2.85, P=0.004), but had no effect on the incidence of ventricular fibrillation (RR=1.02, 95% CI 0.14-7.31; Z=0.02, P=0.99）.There was no significant difference in the incidence of myocardial infarction between the two groups (RR = 0.90, 95% CI 0.37-2.18; Z = 0.24, P = 0.81). There was no significant difference in mortality between the two groups (RR = 0.86, 95% CI 0.31-2.44; Z = 0.28, P = 0.78). Dexmedetomidine group can reduce the time of patients in ICU (SMD = - 0.35, 95% CI -0.69 to -0.02; Z = 2.07, P = 0.04), but the heterogeneity between studies is high (I2 = 93%). There was no effect on duration of mechanical ventilation (SMD = -0.10, 95% CI -0.25 to 0.06; Z = 1.18, P = 0.24) and length of hospitalization (SMD = -0.46, 95% CI -1.08 to 0.16; Z = 1.46, P = 0.14).Conclusion: Dexmedetomidine can reduce the incidence of atrial fibrillation, supraventricular tachycardia, and ventricular tachycardia after cardiac surgery in adults but does not affect the occurrence of ventricular fibrillation.Trial registration: CRD42021233613; Registration: Jan 2021

scholarly journals Unsynchronised Cardioversion as a Cause of Ventricular Tachycardia in a Patient with Atrial Fibrillation

2020 ◽  
Author(s):  
Dmitry Pshezhetskiy ◽  
Tanveer Alam ◽  
Heba Alshaker
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Sinus Rhythm ◽  
Electric Current ◽  
Cardiac Cycle ◽  
Left Ventricular ◽  
Electrical Shock ◽  
Case Presentation

Background: Synchronised cardioversion (SC) is used to terminate tachycardic arrhythmia by applying electric current to the thorax. SC is synchronised to the R wave of the cardiac cycle and ventricular tachycardia (VT) or ventricular fibrillation (VF) can occur if an electrical shock is provided in a nonsynchronised way. Case Presentation: Here we present a case of a 66-year-old man who had elective cardioversion for atrial fibrillation worsened by severe left ventricular impairment. A manual defibrillator was used for the cardioversion, which, after the first synchronised shock, reverted to defibrillator mode. An unsynchronised shock was administered and induced VT, which was reverted to sinus rhythm with a defibrillation shock. Conclusion: When using manual defibrillator for SC, the machine needs to be set to a synchronised mode. The synchronisation to the R wave needs to be checked before every shock.

scholarly journals Artifacts in electrocardiogram interpreted as cardiac arrhythmias: Reports of clinical cases

2021 ◽  
Vol 62 (4) ◽  
pp. 104-109
Author(s):  
AMAR Talib AL-HAMDI
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Clinical Practice ◽  
Ventricular Fibrillation ◽  
Atrial Flutter ◽  
Cardiac Arrhythmias ◽  
Private Practice ◽  
High Grade ◽  
Ecg Artifacts ◽  
Practicing Physicians

Background: Artifact waves in the ECG and Holter recording are not rare in clinical practice and can be mistaken for tachyarrhythmia. Objective: To orient the practicing physicians to differentiate these artifacts from cardiac arrhythmias. Patients and Methods: Thirteen patients with incorrectly diagnosed cardiac arrhythmias by ECG or Holter recording then distinguished to be ECG artifacts were included in this study. The patients were collected from the author’s private practice in the northern Iraqi governorate of Sulaimanya during the period from June 2015 to August 2020. The differentiation of the artifact waves from the arrhythmias were made by careful inspection of the ECG, identification of the R waves within the artifact waves and correlating the artifact waves with the patient’s symptoms. Results: The artifacts were mistaken for ventricular fibrillation in two patients, ventricular tachycardia in four, atrial fibrillation in two, atrial flutter in four, and in one patient bradycardia of high grade atrio-ventricular block. Conclusion: Distinguishing artifact in ECG and differentiating them from cardiac arrhythmia is important to avoid mismanagement.

Pulseless ventricular tachycardia and ventricular fibrillation complicating severe traumatic brain injury in pediatrics

2019 ◽  
Vol 85 (12) ◽  
Author(s):  
Marco Piastra ◽  
Luca Tortorolo ◽  
Orazio Genovese ◽  
Tony C. Morena ◽  
Enzo Picconi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Ventricular Tachycardia ◽  
Brain Injury ◽  
Ventricular Fibrillation ◽  
Severe Traumatic Brain Injury

scholarly journals POSTERS (2)96CONTINUOUS VERSUS INTERMITTENT MONITORING FOR DETECTION OF SUBCLINICAL ATRIAL FIBRILLATION IN HIGH-RISK PATIENTS97HIGH DAY-TO-DAY INTRA-INDIVIDUAL REPRODUCIBILITY OF THE HEART RATE RESPONSE TO EXERCISE IN THE UK BIOBANK DATA98USE OF NOVEL GLOBAL ULTRASOUND IMAGING AND CONTINUEOUS DIPOLE DENSITY MAPPING TO GUIDE ABLATION IN MACRO-REENTRANT TACHYCARDIAS99ANTICOAGULATION AND THE RISK OF COMPLICATIONS IN PATIENTS UNDERGOING VT AND PVC ABLATION100NON-SUSTAINED VENTRICULAR TACHYCARDIA FREQUENTLY PRECEDES CARDIAC ARREST IN PATIENTS WITH BRUGADA SYNDROME101USING HIGH PRECISION HAEMODYNAMIC MEASUREMENTS TO ASSESS DIFFERENCES IN AV OPTIMUM BETWEEN DIFFERENT LEFT VENTRICULAR LEAD POSITIONS IN BIVENTRICULAR PACING102CAN WE PREDICT MEDIUM TERM MORTALITY FROM TRANSVENOUS LEAD EXTRACTION PRE-OPERATIVELY?103PREVENTION OF UNECESSARY ADMISSIONS IN ATRIAL FIBRILLATION104EPICARDIAL CATHETER ABLATION FOR VENTRICULAR TACHYCARDIA ON UNINTERRUPTED WARFARIN: A SAFE APPROACH?105HOW WELL DOES THE NATIONAL INSTITUTE OF CLINICAL EXCELLENCE (NICE) GUIDENCE ON TRANSIENT LOSS OF CONSCIOUSNESS (T-LoC) WORK IN A REAL WORLD? AN AUDIT OF THE SECOND STAGE SPECIALIST CARDIOVASCULAT ASSESSMENT AND DIAGNOSIS106DETECTION OF ATRIAL FIBRILLATION IN COMMUNITY LOCATIONS USING NOVEL TECHNOLOGY'S AS A METHOD OF STROKE PREVENTION IN THE OVER 65'S ASYMPTOMATIC POPULATION - SHOULD IT BECOME STANDARD PRACTISE?107HIGH-DOSE ISOPRENALINE INFUSION AS A METHOD OF INDUCTION OF ATRIAL FIBRILLATION: A MULTI-CENTRE, PLACEBO CONTROLLED CLINICAL TRIAL IN PATIENTS WITH VARYING ARRHYTHMIC RISK108PACEMAKER COMPLICATIONS IN A DISTRICT GENERAL HOSPITAL109CARDIAC RESYNCHRONISATION THERAPY: A TRADE-OFF BETWEEN LEFT VENTRICULAR VOLTAGE OUTPUT AND EJECTION FRACTION?110RAPID DETERIORATION IN LEFT VENTRICULAR FUNCTION AND ACUTE HEART FAILURE AFTER DUAL CHAMBER PACEMAKER INSERTION WITH RESOLUTION FOLLOWING BIVENTRICULAR PACING111LOCALLY PERSONALISED ATRIAL ELECTROPHYSIOLOGY MODELS FROM PENTARAY CATHETER MEASUREMENTS112EVALUATION OF SUBCUTANEOUS ICD VERSUS TRANSVENOUS ICD- A PROPENSITY MATCHED COST-EFFICACY ANALYSIS OF COMPLICATIONS & OUTCOMES113LOCALISING DRIVERS USING ORGANISATIONAL INDEX IN CONTACT MAPPING OF HUMAN PERSISTENT ATRIAL FIBRILLATION114RISK FACTORS FOR SUDDEN CARDIAC DEATH IN PAEDIATRIC HYPERTROPHIC CARDIOMYOPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS115EFFECT OF CATHETER STABILITY AND CONTACT FORCE ON VISITAG DENSITY DURING PULMONARY VEIN ISOLATION116HEPATIC CAPSULE ENHANCEMENT IS COMMONLY SEEN DURING MR-GUIDED ABLATION OF ATRIAL FLUTTER: A MECHANISTIC INSIGHT INTO PROCEDURAL PAIN117DOES HIGHER CONTACT FORCE IMPAIR LESION FORMATION AT THE CAVOTRICUSPID ISTHMUS? INSIGHTS FROM MR-GUIDED ABLATION OF ATRIAL FLUTTER118CLINICAL CHARACTERISATION OF A MALIGNANT SCN5A MUTATION IN CHILDHOOD119RADIOFREQUENCY ASSOCIATED VENTRICULAR FIBRILLATION120CONTRACTILE RESERVE EXPRESSED AS SYSTOLIC VELOCITY DOES NOT PREDICT RESPONSE TO CRT121DAY-CASE DEVICES - A RETROSPECTIVE STUDY USING PATIENT CODING DATA122PATIENTS UNDERGOING SVT ABLATION HAVE A HIGH INCIDENCE OF SECONDARY ARRHYTHMIA ON FOLLOW UP: IMPLICATIONS FOR PRE-PROCEDURE COUNSELLING123PROGNOSTIC ROLE OF HAEMOGLOBINN AND RED BLOOD CELL DITRIBUTION WIDTH IN PATIENTS WITH HEART FAILURE UNDERGOING CARDIAC RESYNCHRONIZATION THERAPY124REMOTE MONITORING AND FOLLOW UP DEVICES125A 20-YEAR, SINGLE-CENTRE EXPERIENCE OF IMPLANTABLE CARDIOVERTER DEFIBRILLATORS (ICD) IN CHILDREN: TIME TO CONSIDER THE SUBCUTANEOUS ICD?126EXPERIENCE OF MAGNETIC REASONANCE IMAGING (MEI) IN PATIENTS WITH MRI CONDITIONAL DEVICES127THE SINUS BRADYCARDIA SEEN IN ATHLETES IS NOT CAUSED BY ENHANCED VAGAL TONE BUT INSTEAD REFLECTS INTRINSIC CHANGES IN THE SINUS NODE REVEALED BY I (F) BLOCKADE128SUCCESSFUL DAY-CASE PACEMAKER IMPLANTATION - AN EIGHT YEAR SINGLE-CENTRE EXPERIENCE129LEFT VENTRICULAR INDEX MASS ASSOCIATED WITH ESC HYPERTROPHIC CARDIOMYOPATHY RISK SCORE IN PATIENTS WITH ICDs: A TERTIARY CENTRE HCM REGISTRY130A DGH EXPERIENCE OF DAY-CASE CARDIAC PACEMAKER IMPLANTATION131IS PRE-PROCEDURAL FASTING A NECESSITY FOR SAFE PACEMAKER IMPLANTATION?

EP Europace ◽  
2016 ◽  
Vol 18 (suppl 2) ◽  
pp. ii36-ii47
Author(s):  
T. Philippsen ◽  
M. Orini ◽  
C.A. Martin ◽  
E. Volkova ◽  
J.O.M. Ormerod ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Hypertrophic Cardiomyopathy ◽  
Pacemaker Implantation ◽  
Left Ventricular ◽  
Day Case ◽  
Single Centre ◽  
Subcutaneous Icd

scholarly journals Flecainide How and When: A Practical Guide in Supraventricular Arrhythmias

2021 ◽  
Vol 10 (7) ◽  
pp. 1456
Author(s):  
Carlo Lavalle ◽  
Michele Magnocavallo ◽  
Martina Straito ◽  
Luca Santini ◽  
Giovanni Battista Forleo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Drug Treatment ◽  
Sinus Rhythm ◽  
Antiarrhythmic Drug ◽  
Safety Profile ◽  
Patient Management ◽  
Clinical Use ◽  
Supraventricular Arrhythmias ◽  
Sinus Rhythm Maintenance

Transcatheter ablation was increasingly and successfully used to treat symptomatic drug refractory patients affected by supraventricular arrhythmias. Antiarrhythmic drug treatment still plays a major role in patient management, alone or combined with non-pharmacological therapies. Flecainide is an IC antiarrhythmic drug approved in 1984 from the Food and Drug Administration for the suppression of sustained ventricular tachycardia and later for acute cardioversion of atrial fibrillation and for sinus rhythm maintenance. Currently, flecainide is mostly used for sinus rhythm maintenance in atrial fibrillation (AF) patients without structural cardiomyopathy although recent studies enrolling different patient populations have demonstrated a good effectiveness and safety profile. How should we interpret the results of the CAST after the latest evidence? Is it possible to expand the indications of flecainide, and therefore, its use? This review aims to highlight the main characteristics of flecainide, as well as its optimal clinical use, delineating drug indications and contraindications and appropriate monitoring, based on the most recent evidence.

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