scholarly journals Pre-excitation pattern associated with accessory pathway related tachycardia: Case report

2010 ◽  
Vol 138 (9-10) ◽  
pp. 639-642
Author(s):  
Mirko Burazor ◽  
Ivana Burazor ◽  
Nebojsa Mujovic
Keyword(s):  
Ventricular Tachycardia ◽  
Diagnostic Tests ◽  
Accessory Pathway ◽  
Accurate Assessment ◽  
Wpw Syndrome ◽  
Conduction Pathway ◽  
Difficulty Breathing ◽  
Life Threatening ◽  
Mapping Techniques ◽  
Excitation Pattern

Introduction. Pre-excitation is based on an accessory conduction pathway between the atrium and ventricle. The term Wolff- Parkinson-White (WPW) syndrome is used for patients with the pre-excitation/WPW pattern associated with AP-related tachycardia. Case Outline. We present a 52-year-old man with severe palpitation, fatigue, lightheadedness and difficulty breathing. The initial ECG showed tachyarrhythmia with heart rate between 240 and 300/min. He was treated with antiarrhythmics (Digitalis, Verapamil, Lidocaine) with no response. Then, the patient was treated with electrical cardioversion and was referred to our Clinic for further evaluation with the diagnosis: ?Ventricular tachycardia?. During in-hospital stay, the previously undiagnosed WPW pattern had been seen. Additional diagnostic tests confirmed permanent pre-excitacion pattern (ECG Holter recording, exercises test). The patient was referred to an electrophysiologist for further evaluation. Mapping techniques provided an accurate assessment of the position of the accessory pathway which was left lateral. The elimination of the accessory pathway by radiofrequent catheter ablation is highly effective in termination and elimination of tacchyarrhythmias. Conclusion. Symptomatic, life-threatening arrhythmia, first considered as ventricular tachycardia, reflected atrial fibrillation with ventricular pre-excitation over an accessory pathway in a patient with previously undiagnosed WPW syndrome.

scholarly journals Clinical and Demographic Characteristics of WPW Syndrome Attending Arrhythmia Clinic of NICVD

2014 ◽  
Vol 41 (2) ◽  
pp. 50-53
Author(s):  
MM Rahman ◽  
MMR Khan ◽  
N Kamal ◽  
AK Shamim ◽  
MS Akter ◽  
...  
Keyword(s):  
Antiarrhythmic Drugs ◽  
Demographic Data ◽  
Accessory Pathway ◽  
Atrioventricular Reentrant Tachycardia ◽  
Wpw Syndrome ◽  
Ventricular Response ◽  
Life Threatening ◽  
Study Population ◽  
Left And Right ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White syndrome is a disorder characterized by presence of an accessory pathway which predisposes patients to tachyarrhythmias and sudden death. Among patients with WPW syndrome, atrioventricular reentrant tachycardia (AVRT) is the most common arrhythmia, accounting for 95% of re-entrant tachycardias. It has been estimated that one-third of patients with WPW syndrome have atrial fibrillation (AF). AF is a potentially life-threatening arrhythmia. If an accessory pathway has a short anterograde refractory period, then rapid repetitive conduction to the ventricles during AF can result in a rapid ventricular response with subsequent degeneration to ventricular fibrillation (VF). The study population included a total of 255 patients in whom 175 (68.62%) were men and 80 (31.38%) were women. Demographic data and clinical characteristics are depicted in Table 1. Left and right WPW syndrome were existing in 70.59% and 29.41% of patients respectively. Documented narrow QRS SVT was present in 96.86%, broad QRS SVT was in 2.75% and AF was in 3.14% of patients. Antiarrhythmic drugs most frequently used were Digitalis, Metoprolol, Sotalol, Amiodarone and Verapamil DOI: http://dx.doi.org/10.3329/bmj.v41i2.18809 Bangladesh Medical Journal 2012 Vol. 41 No. 2: 50-53

scholarly journals Enteric Fever Diagnosis: Current Challenges and Future Directions

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 410
Author(s):  
Durga P. Neupane ◽  
Hari P. Dulal ◽  
Jeongmin Song
Keyword(s):  
Diagnostic Tests ◽  
Enteric Fever ◽  
Asymptomatic Carrier ◽  
Diagnostic Methods ◽  
Effective Control ◽  
Future Directions ◽  
Clinical Presentations ◽  
Global Spread ◽  
Life Threatening ◽  
Pros And Cons

Enteric fever is a life-threatening systemic febrile disease caused by Salmonella enterica serovars Typhi and Paratyphi (S. Typhi and S. Paratyphi). Unfortunately, the burden of the disease remains high primarily due to the global spread of various drug-resistant Salmonella strains despite continuous advancement in the field. An accurate diagnosis is critical for effective control of the disease. However, enteric fever diagnosis based on clinical presentations is challenging due to overlapping symptoms with other febrile illnesses that are also prevalent in endemic areas. Current laboratory tests display suboptimal sensitivity and specificity, and no diagnostic methods are available for identifying asymptomatic carriers. Several research programs have employed systemic approaches to identify more specific biomarkers for early detection and asymptomatic carrier detection. This review discusses the pros and cons of currently available diagnostic tests for enteric fever, the advancement of research toward improved diagnostic tests, and the challenges of discovering new ideal biomarkers and tests.

scholarly journals Accessory pathway analysis using a multimodal deep learning model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Nishimori ◽  
Kunihiko Kiuchi ◽  
Kunihiro Nishimura ◽  
Kengo Kusano ◽  
Akihiro Yoshida ◽  
...  
Keyword(s):  
Deep Learning ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Learning Model ◽  
X Rays ◽  
X Ray ◽  
Wpw Syndrome ◽  
Chest X Ray ◽  
Deep Learning Model ◽  
Ecg Data

AbstractCardiac accessory pathways (APs) in Wolff–Parkinson–White (WPW) syndrome are conventionally diagnosed with decision tree algorithms; however, there are problems with clinical usage. We assessed the efficacy of the artificial intelligence model using electrocardiography (ECG) and chest X-rays to identify the location of APs. We retrospectively used ECG and chest X-rays to analyse 206 patients with WPW syndrome. Each AP location was defined by an electrophysiological study and divided into four classifications. We developed a deep learning model to classify AP locations and compared the accuracy with that of conventional algorithms. Moreover, 1519 chest X-ray samples from other datasets were used for prior learning, and the combined chest X-ray image and ECG data were put into the previous model to evaluate whether the accuracy improved. The convolutional neural network (CNN) model using ECG data was significantly more accurate than the conventional tree algorithm. In the multimodal model, which implemented input from the combined ECG and chest X-ray data, the accuracy was significantly improved. Deep learning with a combination of ECG and chest X-ray data could effectively identify the AP location, which may be a novel deep learning model for a multimodal model.

Approach to the Cardiovascular Patient

2013 ◽  
Author(s):  
Catherine M. Otto ◽  
David M Shavelle
Keyword(s):  
Physical Examination ◽  
Diagnostic Tests ◽  
Clinical Status ◽  
Correct Diagnosis ◽  
Complete Evaluation ◽  
Treatment Expectations ◽  
Cardiovascular Patient ◽  
Life Threatening ◽  
Background History ◽  
Cardiac Testing

The complete evaluation of the cardiovascular patient begins with a thorough history and a detailed physical examination. These two initial steps will often lead to the correct diagnosis and assist in excluding life-threatening conditions. The history and physical examination findings should be assessed in the overall clinical status of the patient, including the patient's specific complaints, lifestyle, comorbidities, and treatment expectations. This chapter discusses the cardiovascular conditions that frequently require evaluation: chest pain, dyspnea, palpitations, syncope, claudication, and cardiac murmurs; and reviews the background, history and physical examination, and diagnostic tests available for each. Diagnostic algorithms are provided, and the appropriate use of invasive and noninvasive cardiac testing for each condition is discussed. This review contains 8 highly rendered figures, 12 tables, and 52 references.

Noninvasive Electrocardiomapping Facilitates Previously Failed Ablation of Right Appendage Diverticulum Associated Life-Threatening Accessory Pathway

2012 ◽  
Vol 24 (5) ◽  
pp. 583-585 ◽  
Author(s):  
MÉLÈZE HOCINI ◽  
ASHOK J. SHAH ◽  
HUBERT COCHET ◽  
PHILIPPE MAURY ◽  
ARNAUD DENIS ◽  
...  
Keyword(s):  
Accessory Pathway ◽  
Life Threatening

Detection of Accessory Pathway in Patients with WPW Syndrome by Means of The Isomagnetic Map and MRI

1989 ◽  
pp. 373-376 ◽  
Author(s):  
Masahiro Nomura ◽  
Yutaka Nakaya ◽  
Katsusuke Watanebe ◽  
Mariko Katayama ◽  
Akemi Takeuchi ◽  
...  
Keyword(s):  
Accessory Pathway ◽  
Wpw Syndrome

Approach to the Cardiovascular Patient

2018 ◽  
Author(s):  
Catherine M. Otto ◽  
David M Shavelle
Keyword(s):  
Physical Examination ◽  
Diagnostic Tests ◽  
Clinical Status ◽  
Correct Diagnosis ◽  
Complete Evaluation ◽  
Treatment Expectations ◽  
Cardiovascular Patient ◽  
Life Threatening ◽  
Background History ◽  
Cardiac Testing

The complete evaluation of the cardiovascular patient begins with a thorough history and a detailed physical examination. These two initial steps will often lead to the correct diagnosis and assist in excluding life-threatening conditions. The history and physical examination findings should be assessed in the overall clinical status of the patient, including the patient's specific complaints, lifestyle, comorbidities, and treatment expectations. This chapter discusses the cardiovascular conditions that frequently require evaluation: chest pain, dyspnea, palpitations, syncope, claudication, and cardiac murmurs; and reviews the background, history and physical examination, and diagnostic tests available for each. Diagnostic algorithms are provided, and the appropriate use of invasive and noninvasive cardiac testing for each condition is discussed. This review contains 8 highly rendered figures, 12 tables, and 52 references.

UNEXPLAINED DELIRIUM : THINK OF THYROID STORM

2021 ◽  
pp. 23-25
Author(s):  
Soni Namita ◽  
Shruti A ◽  
Soni Anand ◽  
Nikalje A ◽  
Bharadwaj M
Keyword(s):  
Ventricular Tachycardia ◽  
Thyroid Storm ◽  
Rare Entity ◽  
Thyroid Medication ◽  
Malignant Arrhythmia ◽  
Life Threatening ◽  
Systemic Condition ◽  
Very High ◽  
Serum Tsh

Background: Thyroid storm is a life-threatening Endocrine emergency with an incidence rate of 1% to 2% all over the world. It is a systemic condition leading to increased production of Thyroid Hormone and its release leading to Thermoregulatory, Adrenergic, Neuropsychiatric, Cardiovascular, and Abdominal Manifestations. Thyroid storm with Malignant Arrhythmia and delirium both together is rare entity, but the mortality rate is very high. The presentation of Malignant Arrhythmias and delirium together in the initial phase of the disease is much less common with only a few isolated cases described in the scientic literature. Objective: To present a case in which a patient had two simultaneous complication of thyroid storm i.e. delirium and ventricular tachycardia. Case Study: We report a 65 years-year-old man who came with complaints of Diarrhea, Fever, Breathlessness and psychosis. His serum tsh was <0.015 and anti tpo antibodies was 83. He was diagnosed to be in Thyroid storm and later had complications including Ventricular Tachycardia and delirium in an undiagnosed case of Hyperthyroidism. He was started on anti thyroid medication and slowly as his condition improved he was discharged. Conclusion: Patients with Thyrotoxicosis need to be closely monitored for complications since its early diagnosis and treatment may save lives.

Extreme hyperthermia-induced arrhythmogenesis

2021 ◽  
pp. 1-4
Author(s):  
Tripat Kaur ◽  
Chenni S. Sriram ◽  
Utkarsh Kohli
Keyword(s):  
Ventricular Tachycardia ◽  
Body Temperature ◽  
Cardiovascular Effects ◽  
Regulatory Mechanisms ◽  
Normal Heart ◽  
Normal Range ◽  
Organ Systems ◽  
Life Threatening ◽  
Elevated Body Temperature

Abstract Hyperthermia is defined as an elevated body temperature above the normal range due to a failure of heat regulatory mechanisms. In addition to its effects on other organ systems, hyperthermia is associated with profound cardiovascular effects. We report the sentinel case of a 6-year-old girl with structurally and electrically normal heart, who presented with life-threatening hyperpyrexia-induced ventricular tachycardia, which was refractory to cardioversion and anti-arrhythmics but responded promptly to cooling. We emphasise the lifesaving role of immediate and aggressive cooling in such patients.

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