scholarly journals A Case of Wide-Complex Tachycardia Due to Atrial Tachycardia Diagnosed by Non-Invasive Programmed Stimulation

2021 ◽  
Vol 05 (01) ◽  
Author(s):  
Daniel Sohinki ◽  
Phi Wiegn ◽  
Owen A. Obel
Keyword(s):  
Atrial Tachycardia ◽  
Non Invasive ◽  
Programmed Stimulation ◽  
Wide Complex Tachycardia

scholarly journals Incessant Automatic Atrial Tachycardia in a Neonate Successfully Treated with Nadolol and Closely Spaced Doses of Flecainide: A Case Report

2020 ◽  
Vol 12 (3) ◽  
pp. 108-113
Author(s):  
Gilda Belli ◽  
Mattia Giovannini ◽  
Giulio Porcedda ◽  
Marco Moroni ◽  
Giancarlo la Marca ◽  
...  
Keyword(s):  
Case Report ◽  
Sinus Rhythm ◽  
Atrial Tachycardia ◽  
Electrophysiological Study ◽  
Common Type ◽  
Supraventricular Tachyarrhythmia ◽  
Risk Of Mortality ◽  
Wide Complex Tachycardia ◽  
Stable Sinus Rhythm ◽  
Narrow Complex Tachycardia

Supraventricular tachyarrhythmia (SVT) is the most common type of arrhythmia in childhood. Management can be challenging with an associated risk of mortality. A female neonate was diagnosed with episodes of SVT, controlled antenatally with digoxin. Flecainide was commenced prophylactically at birth. Despite treatment, the infant developed a narrow complex tachycardia at 5 days of age. The electrocardiogram features were suggestive of either re-entry tachycardia or of automatic atrial tachycardia (AAT). Following several unsuccessful treatments, a wide complex tachycardia developed. A transesophageal electrophysiological study led to a diagnosis of AAT. Stable sinus rhythm was finally achieved through increasing daily administrations of flecainide up to six times a day, in association with nadolol. The shortening of intervals to this extent has never been reported before and supports the evidence of a personal, age-specific variability in pharmacokinetics of flecainide. Larger studies are needed to better define the appropriate dose and timing of administration.

Incessant Automatic Atrial Tachycardia in a Neonate Successfully Treated with Nadolol and Closely Spaced Doses of Flecainide: A Case Report

2020 ◽  
Vol 12 (3) ◽  
pp. 1-6
Author(s):  
Gilda Belli ◽  
Mattia Giovannini ◽  
Giulio Porcedda ◽  
Marco Moroni ◽  
Giancarlo la Marca ◽  
...  
Keyword(s):  
Case Report ◽  
Sinus Rhythm ◽  
Atrial Tachycardia ◽  
Electrophysiological Study ◽  
Common Type ◽  
Supraventricular Tachyarrhythmia ◽  
Risk Of Mortality ◽  
Wide Complex Tachycardia ◽  
Stable Sinus Rhythm ◽  
Narrow Complex Tachycardia

Supraventricular tachyarrhythmia (SVT) is the most common type of arrhythmia in childhood. Management can be challenging with an associated risk of mortality. A female neonate was diagnosed with episodes of SVT, controlled antenatally with digoxin. Flecainide was commenced prophylactically at birth. Despite treatment, the infant developed a narrow complex tachycardia at 5 days of age. The electrocardiogram features were suggestive of either re-entry tachycardia or of automatic atrial tachycardia (AAT). Following several unsuccessful treatments, a wide complex tachycardia developed. A transesophageal electrophysiological study led to a diagnosis of AAT. Stable sinus rhythm was finally achieved through increasing daily administrations of flecainide up to six times a day, in association with nadolol. The shortening of intervals to this extent has never been reported before and supports the evidence of a personal, age-specific variability in pharmacokinetics of flecainide. Larger studies are needed to better define the appropriate dose and timing of administration.

Atrial tachycardias: focal and multifocal atrial tachycardias

ESC CardioMed ◽  
2018 ◽  
pp. 2070-2075
Author(s):  
Pierre Jaïs ◽  
Nicolas Derval
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Atrial Tachycardia ◽  
New Technologies ◽  
Atrial Fibrillation Ablation ◽  
Practical Approach ◽  
Density Mapping ◽  
Non Invasive ◽  
Mapping System ◽  
Surface Electrocardiogram

Atrial tachycardia (AT) is increasingly observed in patients, particularly in the context of atrial fibrillation ablation. The exact electrophysiological mechanisms are not easy to establish but a practical approach consists in distinguishing macroreentries from focal ATs as this is crucial for the ablation strategy. In centrifugal arrhythmias (such as focal AT and localized reentry), the activation originates from a source and spreads centrifugally to the rest of the atria, while in macroreentries, it follows a large path around a central obstacle and reenters. The analysis of the surface electrocardiogram is of limited value to predict the macroreentrant or focal nature of the arrhythmia. Antiarrhythmic drugs are usually tried first and in case of failure, catheter ablation is considered, with or without the support of a localization/mapping system. The most challenging cases are those with multifocal AT as they are poorly responsive to drugs, difficult to ablate, and arise in patients in poor medical conditions. New technologies such as high-density mapping and non-invasive mapping may facilitate the identification of mechanisms and target(s) for catheter ablation.

scholarly journals Use of aVR and Jastrzębski algorithms in the classification of wide complex tachycardia in dogs – a preliminary study

2018 ◽  
Vol 62 (3) ◽  
pp. 365-369
Author(s):  
Marcin Michałek ◽  
Piotr Frydrychowski ◽  
Jakub Adamowicz ◽  
Agnieszka Sławuta ◽  
Urszula Pasławska ◽  
...  
Keyword(s):  
Veterinary Medicine ◽  
Retrospective Analysis ◽  
Cardiac Electrophysiology ◽  
Electrophysiological Study ◽  
Qrs Complex ◽  
Algorithmic Approach ◽  
Non Invasive ◽  
Wide Complex Tachycardia ◽  
Common Criterion

AbstractIntroductionVentricular rhythm disturbances are a common pathology in human and veterinary medicine. In humans, the algorithmic approach is used to differentiate wide QRS complex tachycardia. The most commonly used are the aVR and Brugada algorithms as well as the ventricular tachycardia (VT) score developed by Jastrzębski and coworkers. In veterinary medicine, no such algorithms are available and the only parameter used to describe VT abnormalities is the duration of the QRS complexes. The aim of this analysis was determining whether human medicine algorithms for VT are applicable in veterinary medicine to differentiate wide QRS complex tachycardia in dogs.Material and MethodsA retrospective analysis was performed on 11 dogs of both sexes and various breeds and age diagnosed with VT. The diagnosis was based on ambulatory ECG, further established based on the reaction to lidocaine or adenosine or an invasive electrophysiological study.ResultsOf the 11 tracings passed through the aVR algorithm, 10 met the VT criteria. The most common criterion was the Vi/Vt ratio (8 out of 11 tracings). Based on the VT score, seven out of eight dogs had a high probability of VT.ConclusionRetrospective analysis of ECGs by aVR and VT score indicates that the applied algorithms may be useful in differentiating wide QRS complex tachycardia as a quick, easy, and non-invasive alternative to cardiac electrophysiology.

Sign in / Sign up

Export Citation Format

Share Document