Atypical Ventricular Tachycardia in Combined Tetracyclic, Antidepressant, Neuroleptic and Anticholinergic Drugs Interaction

1983 ◽  
Vol 12 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Eran Leitersdorf ◽  
Ran Goshen ◽  
Arie Shefer
Keyword(s):  
Ventricular Tachycardia ◽  
Drug Interaction ◽  
Anticholinergic Drug ◽  
Pacemaker Implantation ◽  
Clinical Signs ◽  
Anticholinergic Drugs ◽  
Cardiac Arrythmias ◽  
Temporary Pacemaker ◽  
Tetracyclic Antidepressant ◽  
Drugs Interaction

A case of combined tetracyclic-neuroleptic and anticholinergic drug interaction is presented. Major clinical signs of intoxication were disturbed consciousness and severe cardiac arrythmias which required temporary pacemaker implantation. Possible pathogenetic mechanisms and drug interactions are discussed.

IDENTIFIKASI DRUG RELATED PROBLEMS PADA PASIEN AUTIS DI RUMAH SAKIT X KOTA YOGYAKARTA

2019 ◽  
pp. 30-40
Author(s):  
Ruri Renggani Sandra ◽  
Della Midi Wardhani ◽  
Woro Supadmi
Keyword(s):  
Autism Spectrum Disorders ◽  
Drug Interaction ◽  
Related Problem ◽  
Drug Information ◽  
Autism Spectrum ◽  
Drug Related Problems ◽  
Drug Reactions ◽  
Drug Related Problem ◽  
Spectrum Disorders ◽  
Drugs Interaction

   Autism spectrum disorders (ASD) adalah gangguan perkembangan saraf dengan penyebab yang kompleks dari banyak fakor Penggunaan obat pada pasien autis harus dimonitoring untuk mencegah terjadinya drug related problems. Intervensi farmasis dengan mengidentifikasi kejadian drug related problem adalah kegiatan pelayanan asuhan kefarmasian untuk meningkatkan keberhasilan terapi. Penelitian ini adalah observasional dengan pengumpulan data secara retrospektif berdasarkan data rekam medik. Evaluasi kejadian drug related problems meliputi indikasi yang tidak diterapi, terapi tanpa indikasi, pemilihan obat yang tidak tepat, overdosis, under dosis, adverse drug reactions dan interaksi obat. Literatur yang digunakan sebagai acuan adalah Drug Information Handbook, 18thed, Stockley Drug Interaction, Drugs Interaction Facts 2001, dan Pharmacotherapy A Pathophysiologic Approach 2005 dan jurnal yang relevan.   Hasil penelitian diperoleh pasien dengan jenis kelamin laki-laki 20 pasien (77%), perempuan 6 pasien (23%). Usia antara 6-11 tahun yaitu 15 pasien (58%), 1-5 tahun terdapat 9 pasien (34%), usia <1 tahun dan 12-17 tahun masing-masing sebanyak 1 pasien (4%). Penyakit penyerta ISPA merupakan kasus yang paling banyak terjadi, terbanyak kedua adalah epilepsi dan gastroenteritis akut (GEA). Kejadian DRPs Indikasi tidak diterapi 9%, Terapi tanpa indikasi 9%, Pemilihan obat tidak tepat 9%, Over dosis 31%, Under dosis 33% dan interaksi obat 9%.   Terdapat 24 pasien ( 92,3%) yang mengalami DRPs potensial dan 2 pasien (7,7%) yang tidak mengalami. Kriteria DRPs dengan persentase tertinggi adalah under dosis sebanyak 33% dan over dosis sebanyak 31%.

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 Prescribing Trends of Anticholinergic Drugs Between 1989 and 2017: A UK Biobank Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 209-209
Author(s):  
Jure Mur ◽  
Simon Cox ◽  
Riccardo Marioni ◽  
Tom Russ ◽  
Graciela Muniz Terrera
Keyword(s):  
Prescription Drugs ◽  
Anticholinergic Drug ◽  
Later Life ◽  
Anticholinergic Drugs ◽  
Uk Biobank ◽  
Linear Estimate ◽  
Cross Sectional ◽  
Increased Risk ◽  
Prescribing Trends ◽  
Anticholinergic Burden

Abstract Prescription drugs with anticholinergic properties are commonly prescribed and negatively impact physical performance, cognitive function, and increase the risk of falls and dementia. The prevalence of anticholinergic drugs is high in later life, when there is an increased risk of adverse drug effects. Recent, in-depth longitudinal analyses of specifically anticholinergic prescribing in Europe is lacking. Prescriptions for the UK-Biobank participants (n=222,122) were ascertained from primary care electronic patient records. We assigned anticholinergic activity to each drug by using a composite score. We used linear regression to study the association between current anticholinergic burden and time period, explore secular trends in anticholinergic use, and various demographic factors. We further explored the results in the context of different classes of prescriptions drugs. 74 distinct drugs in the sample (1.1%) had anticholinergic effects. An individual’s overall anticholinergic burden increased nonlinearly (linear estimate=0.474, quadratic estimate = 0.094, both p&lt;2.2x10-16) between 1989 (mean=0.09, σ=0.009) and 2000 (mean=0.22, σ=0.006) and increased nonlinearly (linear estimate=0.282, quadratic estimate=0.074, both p&lt;2.2x10-16) from 2000 to 2016 (mean=0.27, σ=0.009). The proportion of patients prescribed at least one anticholinergic drug per month increased from 6.1% to 16.7% from 1989 to 2000 and increased to 18.6% by 2016. When adjusted for sex and polypharmacy, age was negatively associated with recent cross-sectional anticholinergic burden (estimate=-0.042, p&lt;2.2x10-16). Our results demonstrate an increase in prescribing of anticholinergic drugs over the past 30 years and indicate contemporary deprescribing of anticholinergic drugs in the later decades of life.

scholarly journals Case Report: Complete heart block as a manifestation of cardiac metastasis of oral cancer

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1243
Author(s):  
Andrianto Andrianto ◽  
Eka Prasetya Budi Mulia ◽  
Denny Suwanto ◽  
Dita Aulia Rachmi ◽  
Mohammad Yogiarto
Keyword(s):  
Pericardial Effusion ◽  
Heart Block ◽  
Complete Heart Block ◽  
Tongue Cancer ◽  
Pacemaker Implantation ◽  
Metastatic Tumor ◽  
Variable Number ◽  
Permanent Pacemaker ◽  
Cardiac Metastasis ◽  
Temporary Pacemaker

Metastatic tumors of the heart presenting with complete heart block (CHB) is an extremely uncommon case. There are no available guidelines in managing CHB in terminal cancer. Permanent pacemaker implantation in such cases is a challenge in terms of clinical utility and palliative care. We report a case of a 24-year-old man suffering from tongue cancer presenting with CHB. An intracardiac mass and moderate pericardial effusion were present, presumed as the metastatic tumor of tongue cancer. We implanted a temporary pacemaker for his symptomatic heart block and cardiogenic shock, and pericardiocentesis for his massive pericardial effusion. We decided that a permanent pacemaker would not be implanted based on the low survival rate and significant comorbidities. Multiple studies report a variable number of cardiac metastasis incidence ranging from 2.3% to 18.3%. It is rare for such malignancies to present with CHB. The decision to implant a permanent pacemaker is highly specific based on the risks and benefits of each patient. It needs to be tailored to the patient’s functional status, comorbid diseases, prognosis, and response to conservative management.

scholarly journals Anticholinergic drugs and risk of dementia: case-control study

BMJ ◽  
2018 ◽  
pp. k1315 ◽  
Author(s):  
Kathryn Richardson ◽  
Chris Fox ◽  
Ian Maidment ◽  
Nicholas Steel ◽  
Yoon K Loke ◽  
...  
Keyword(s):  
Case Control Study ◽  
Anticholinergic Drug ◽  
Specific Effect ◽  
Case Control ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Anticholinergic Drugs ◽  
Incident Dementia ◽  
Diagnosis Of Dementia ◽  
Control Study

Abstract Objectives To estimate the association between the duration and level of exposure to different classes of anticholinergic drugs and subsequent incident dementia. Design Case-control study. Setting General practices in the UK contributing to the Clinical Practice Research Datalink. Participants 40 770 patients aged 65-99 with a diagnosis of dementia between April 2006 and July 2015, and 283 933 controls without dementia. Interventions Daily defined doses of anticholinergic drugs coded using the Anticholinergic Cognitive Burden (ACB) scale, in total and grouped by subclass, prescribed 4-20 years before a diagnosis of dementia. Main outcome measures Odds ratios for incident dementia, adjusted for a range of demographic and health related covariates. Results 14 453 (35%) cases and 86 403 (30%) controls were prescribed at least one anticholinergic drug with an ACB score of 3 (definite anticholinergic activity) during the exposure period. The adjusted odds ratio for any anticholinergic drug with an ACB score of 3 was 1.11 (95% confidence interval 1.08 to 1.14). Dementia was associated with an increasing average ACB score. When considered by drug class, gastrointestinal drugs with an ACB score of 3 were not distinctively linked to dementia. The risk of dementia increased with greater exposure for antidepressant, urological, and antiparkinson drugs with an ACB score of 3. This result was also observed for exposure 15-20 years before a diagnosis. Conclusions A robust association between some classes of anticholinergic drugs and future dementia incidence was observed. This could be caused by a class specific effect, or by drugs being used for very early symptoms of dementia. Future research should examine anticholinergic drug classes as opposed to anticholinergic effects intrinsically or summing scales for anticholinergic exposure. Trial registration Registered to the European Union electronic Register of Post-Authorisation Studies EUPAS8705.

Abstract 16235: Rhythmic Disturbances in Patients With Cardiac Amyloidosis: Analysis From Cedars-Sinai Amyloidosis Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jae Hyung Cho ◽  
Natasha Cuk ◽  
Derek Leong ◽  
Ashkan Ehdaie ◽  
Eugenio Cingolani ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Secondary Prevention ◽  
Cardiac Arrhythmias ◽  
Cardiac Amyloidosis ◽  
Electronic Devices ◽  
Pacemaker Implantation ◽  
Ambulatory Monitoring ◽  
Al Amyloidosis ◽  
Cardioverter Defibrillator ◽  
Large Patient

Introduction: Cardiac arrhythmias are frequent complications of patients with cardiac amyloidosis. The burden and nature of cardiac arrhythmias in patients with cardiac amyloidosis have not been investigated in a large patient population. Hypothesis: Cardiac amyloidosis is a highly arrhythmogenic disorder requiring implantation of cardiac electronic devices. Methods: Cedars-Sinai amyloidosis registry was analyzed to investigate the prevalence and nature of cardiac arrhythmias in patients with cardiac amyloidosis. Ambulatory ECG monitoring data, implantable cardioverter-defibrillator or pacemaker implantation, and interrogation data were reviewed to study the burden of cardiac arrhythmias in patients with cardiac amyloidosis. Results: A total of 156 patients were analyzed in the registry: 51 patients (32.7%) with AL amyloidosis, 101 patients (64.7%) with ATTR amyloidosis, and 4 patients with AA amyloidosis (2.6%). Thirty-seven patients (23.7%) were implanted with cardioverter-defibrillator; 23 patients (14.7%) for primary prevention, 11 patients (7.1%) for secondary prevention of ventricular tachycardia, and 3 patients (1.9%) for secondary prevention of ventricular fibrillation. Twenty-two patients (12.1%) needed pacemaker implantation; 9 patients (5.8%) for high-grade or complete heart block, and 13 patients (8.3%) due to sick sinus syndrome. The most common arrhythmias were atrial fibrillation occurring in 80 patients (51.3%) followed by first-degree AV block in 31 patients (19.9%). Sustained ventricular tachycardia occurred in 14 patients (8.9%) during hospitalization, device interrogation or ambulatory monitoring. Conclusions: Both atrial and ventricular arrhythmias are common manifestations of cardiac amyloidosis, frequently necessitating implantation of cardiac electronic devices.

scholarly journals Runaway pacemaker

2019 ◽  
Vol 12 (3) ◽  
pp. e225411
Author(s):  
Ambreen Gul ◽  
Muhammad Asad Sheikh ◽  
Atif Rao
Keyword(s):  
Heart Rate ◽  
Ventricular Tachycardia ◽  
Cardiac Cycle ◽  
Pulse Generator ◽  
Epigastric Pain ◽  
Pacemaker Implantation ◽  
Shortness Of Breath ◽  
Ventricular Pacing ◽  
Cardiac Impulse ◽  
History Of

Runaway pacemaker is phenomenon in which pacemaker induces ventricular tachycardia as a result of some malfunction in the device. This entity is not very common in clinical practice. Normally, the pacemaker perceives the inherent cardiac impulse and hence averting the delivery of pacemaker stimulus in susceptible period of cardiac cycle. This is a case of a pacemaker-induced tachycardia (named as runaway pacemaker) in a patient with a history of Single Chamber Ventricular (VVI) pacemaker. A 75-year-old man was admitted with 3 days history of fluttering in the chest, shortness of breath, central chest and epigastric pain which radiated to the back. His medical history includes pacemaker implantation in 1996 with lead complication following which he was managed with VVI pacemaker, and the last procedure was generator change 4 years ago with no complication. Examination revealed ventricular tachycardia with ECG showing paced rhythm with ventricular pacing at the rate of 200–150/min. His pacemaker-induced ventricular tachycardia was immediately aborted after putting magnet on the device which restored his baseline rhythm with heart rate of 60/min. Pacemaker was explanted urgently with replacement of new pulse generator. The patient was discharged home with VVI pacemaker showing excellent parameters.

scholarly journals 16-48: Does drug discontinuation in patients treated with temporary pacemaker reduce permanent pacemaker implantation?

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i12-i12
Author(s):  
Joao Bicho Augusto ◽  
Joana Urzal ◽  
Miguel Santos ◽  
Mariana Faustino ◽  
Francisco Madeira ◽  
...  
Keyword(s):  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Drug Discontinuation ◽  
Permanent Pacemaker Implantation ◽  
Temporary Pacemaker

scholarly journals Inter/Intra‐Atrial Dissociation in Patients With Maze Procedure and Its Clinical Implications: Pseudo‐Block and Pseudo‐Ventricular Tachycardia

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Ungjeong Do ◽  
Gi‐Byoung Nam ◽  
Minsoo Kim ◽  
Min Soo Cho ◽  
Jun Kim ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Left Atrium ◽  
Atrioventricular Block ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Maze Procedure ◽  
Conduction Delay ◽  
Electrophysiologic Study ◽  
Valvular Surgery ◽  
Complete Atrioventricular

Background Severe conduction delay and inter/intra‐atrial dissociation may occur in patients who undergo an extensive catheter ablation or a maze procedure for atrial tachyarrhythmia. We report a series of patients with inter/intra‐atrial dissociation that mimicked complete atrioventricular block or ventricular tachycardia. Methods and Results We retrospectively reviewed the medical records of 7 patients who were referred for the evaluation of atrioventricular block (patients 1–6) or ventricular tachycardia (patient 7) that occurred after biatrial maze procedure and valvular surgery. During the electrophysiologic study, slow atrial or junctional escape rhythm dissociated from isolated atrial activity mimicked complete atrioventricular blocks. Intra‐atrial dissociation of the right atrium or left atrium was observed. Atrioventricular nodal conduction from the nondissociated atrium to the ventricle was preserved in all patients, while the conduction from the dissociated atrium was blocked. In patient 7, the pacing of the ventricle by tracking of atrial tachycardia from the nondissociated left atrium/coronary sinus mimicked ventricular tachycardia during pacemaker interrogation. A total of 5 patients received new permanent pacemaker implantations during the index hospitalization for the surgery (n=2) or as a deferred procedure (n=3) according to the treatment for sick sinus syndrome. Conclusions Pseudo‐atrioventricular block or pseudo‐ventricular tachycardia may occur because of inter/intra‐atrial dissociation after a maze procedure. The selection of patients for permanent pacemaker implantation should be determined based on the patient’s symptoms and the status of the escape pacemaker and not on the apparent atrioventricular block. Proper diagnosis is important to avoid unnecessary implantation of a pacemaker or a defibrillator.

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