scholarly journals ОСОБЛИВОСТІ ДІАГНОСТИЧНОГО ТА МЕДИКАМЕНТОЗНО-ІНВАЗИВНОГО МЕНЕДЖМЕНТУ ЧАСТО РЕЦИДИВУЮЧОЇ ПОЛІМОРФНОЇ, ПОЛІТОПНОЇ ШЛУНОЧКОВОЇ ТАХІКАРДІЇ

2021 ◽  
Vol 25 (1-2) ◽  
pp. 72-78
Author(s):  
Т.В. Дубровінська ◽  
Ю.А. Остапчук ◽  
К.Е. Вакуленко ◽  
Б.Б. Кравчук ◽  
Н.О. Люлька ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Ventricular Arrhythmias ◽  
Electrophysiological Study ◽  
Antiarrhythmic Therapy ◽  
Polymorphic Ventricular Tachycardia ◽  
Long Term Follow Up ◽  
Life Threatening ◽  
Complicated Course

In today's conditions, given the difficult economic situation in the country and the low adherence of patients to treatment, a difficult and relevant issue is the treatment of post-myocardial infarction patients, especially in the complicated course of the disease. The main reason for the occurrence of complex cardiac arrhythmias is the formation of a focus of ectopic activity in the myocardium or the appearance of a re-entry wave. In case of recurrence of life-threatening tachycardias, despite antiarrhythmic therapy, the choice must be between escalating drug therapy and radiofrequency catheter ablation (RFA). Purpose: a detailed description of the clinical case of the disease in a patient with low compliance to medical treatment, who suffered an acute myocardial infarction and was subsequently hospitalized several times in a specialized cardiac hospital for the development of complex ventricular arrhythmias. The article describes in detail modern approaches to the diagnosis and treatment of life-threatening tachycardias, including emergency care, comparison of escalation of antiarrhythmic therapy with RFA in a patient with post-infarction cardiosclerosis and frequent attacks of recurrent polymorphic ventricular tachycardia, treatment of modern defibrillator, electrophysiological study, RFA. Conclusions: Long-term follow-up of a patient with low compliance to the treatment of complex ventricular arrhythmias showed that ablation of the ventricular tachycardia substrate was more effective than escalation of antiarrhythmic therapy, which led to the remodulation of the heart cavities, improving the quality of life of the patient and preventing the progression of cardiovascular events.

scholarly journals Long-Term Follow-Up of Patients with Catecholaminergic Polymorphic Ventricular Arrhythmia

2020 ◽  
Vol 9 (4) ◽  
pp. 903
Author(s):  
Michael Veith ◽  
Ibrahim El-Battrawy ◽  
Gretje Roterberg ◽  
Laura Raschwitz ◽  
Siegfried Lang ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Beta Blockers ◽  
Polymorphic Ventricular Tachycardia ◽  
Cardiac Events ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up ◽  
Life Threatening

Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited disorder causing life-threatening arrhythmias. Long-term outcome studies of the channelopathy are limited. Objective: The aim of the present study was to summarize our knowledge on CPVT patients, including the clinical profile treatment approach and long-term outcome. Methods: In this single center study, we retrospectively and prospectively collected data from nine CPVT patients and analyzed them. Results: We reviewed nine patients with CPVT in seven families (22% male), with a median follow-up time of 8.6 years. Mean age at diagnosis was 26.4 ± 12 years. Symptoms at admission were syncope (four patients) and aborted cardiac arrest (four patients). Family history of sudden cardiac death was screened in five patients. In genetic analyses, we found five patients with ryanodine type 2 receptor (RYR2) mutations. Seven patients were treated with beta-blockers, and if symptoms persisted flecainide was added (four patients). Despite beta-blocker treatment, three patients suffered from seven adverse cardiac events. An implantable cardioverter defibrillator was implanted in seven patients (one primary, six secondary prevention). Over the follow-up period, three patients suffered from ventricular tachycardia (ten times) and five patients from ventricular fibrillation (nine times). No one died during follow-up. Conclusion: Our CPVT cohort showed a high risk of cardiac events. Family screening, optimal medical therapy and individualized treatment are necessary in affected patients in referral centers.

Quinidine-responsive out-of-hospital polymorphic ventricular tachycardia in patients with coronary heart disease

EP Europace ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 265-273 ◽  
Author(s):  
Sami Viskin ◽  
Aviram Hochstadt ◽  
Ehud Chorin ◽  
Dana Viskin ◽  
Ofer Havakuk ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Coronary Event ◽  
Antiarrhythmic Therapy ◽  
Polymorphic Ventricular Tachycardia ◽  
Precipitating Factors ◽  
Acute Ischaemia ◽  
Coupling Interval ◽  
Long Term Follow Up ◽  
Healing Phase

Abstract Aims We recently reported that patients with coronary artery disease (CAD) who develop polymorphic ventricular tachycardia (VT) during the healing phase of an acute coronary event, generally fail to respond to revascularization or standard antiarrhythmic therapy but respond immediately to quinidine therapy. Here, we describe that CAD patients presenting with out-of-hospital polymorphic VT without a recent coronary event or an obvious precipitating factor, also respond uniquely to quinidine therapy. Methods and results Retrospective study of patients with unheralded, mainly out-of-hospital, polymorphic VT related to CAD but without evidence of acute myocardial ischaemia. We identified 20 patients who developed polymorphic VT without precipitating factors. The polymorphic VT events were triggered by extrasystoles with short (376 ± 49 ms) coupling interval. Arrhythmic storms occurred in 70% patients. These arrhythmic storms were generally refractory to conventional antiarrhythmic therapy but invariably responded to quinidine therapy. Revascularization was antiarrhythmic in 3 patients despite the absent clinical or ECG signs of ischaemia. During long-term follow-up (range 2 months to 11 years), 3 (15%) of patients not receiving quinidine developed recurrent polymorphic VT. There were no recurrent arrhythmias during long-term quinidine therapy. Conclusions Patients with CAD may develop polymorphic VT in the absence of obvious acute ischaemia or apparent precipitating factors, presenting as out-of-hospital polymorphic VT with high risk of arrhythmic storms that respond uniquely to quinidine therapy.

scholarly journals Impact of ventricular arrhythmias on survival in patients after myocardial infarction

2014 ◽  
Vol 1 (1) ◽  
pp. 21 ◽  
Author(s):  
Katarzyna Anna Mitręga ◽  
Agnieszka Kolczyńska ◽  
Joanna Hanzel ◽  
Sylwia Cebula ◽  
Stanisław Morawski ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Factor ◽  
Ventricular Arrhythmias ◽  
Independent Risk Factor ◽  
Premature Ventricular Beats ◽  
Large Numbers ◽  
Ventricular Extrasystoles ◽  
Long Term Follow Up

Introduction: Despite the continuous development of new methods of pharmacological and invasive treatment for patients with acute myocardial infarction (MI) the prognosis of long-term survival is still uncertain. Therefore, there is still need to look for new noninvasive predictors of death in patients after MI. Aim: To analyze the prognostic value of ventricular arrhythmias in predicting mortality following MI in long-term follow-up. Methods: We analyzed 390 consecutive patients (114 females and 276 males, aged 63.9 ± 11.15 years, mean EF: 43.8 ± 7.9%) with MI treated invasively.  On the 5th day after MI 24-hour digital Holter recording was performed to assess the number of premature ventricular beats (VPB) and their sustained forms such as: salvos and nonsustained ventricular tachycardia (nsVT <  30 s). The large numbers of ventricular extrasystoles: ≥ 10 VPB / hour were considered as abnormal. In echocardiography the size of heart cavities and cardiac contractile function were evaluated. Within 30.1 ± 15.1 months of follow-up 38 patients died. Results: In the group of patients with MI the mean value of ventricular ectopy during the day was: 318.8 ± 1447.6. Large numbers of ventricular extrasystoles were observed in 75% patients, while nsVT in 6% patients. Significant differences in the incidence of death after MI were observed in patients with nsVT and ventricular salvos. In the group of patients who died in comparison to the group of patients who survived in long-term follow-up, a significantly less ventricular ectopic incidence was noted (9.83% vs 90.17%, p < 0.01). In patients who died after MI more premature ventricular beats (≥ 10 VPB / h) and a greater nsVT incidence were observed; however not significant. Moreover, in patients with MI the systolic and diastolic LV dimension, decreased values of hemoglobin, salvos and nsVT incidence are the independent risk factors of death. The strongest independent risk factor of death after MI is salvos (HR: 1.32, P < 0.01). Conclusions: In long term follow-up the largest differences in death were observed in patients with ventricular salvos and nsVT. Furthermore, ventricular salvos are the strongest independent risk factor of death in patients with AMI. 

scholarly journals Ventricular tachycardia triggered by pregnancy in left-ventricular non-compaction cardiomyopathy: a controversial indication to automated defibrillator implantation

2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Elisa Gherbesi ◽  
Carla Bonanomi ◽  
Vera Bottari ◽  
Gian Battista Danzi
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Ventricular Arrhythmias ◽  
Clinical Presentation ◽  
Left Ventricular ◽  
Rare Form ◽  
Long Term Follow Up ◽  
Malignant Arrhythmias

Left-ventricular non-compaction (LVNC) is a rare form of cardiomyopathy. Its clinical presentation is highly variable and during pregnancy is frequently associated with heart failure, embolic events, and arrhythmias. Herein we report a case of a woman with left ventricular non-compaction who had an automated defibrillator implantation for recurrent ventricular arrhythmias during pregnancy. During pregnancy and at long-term follow-up no interventions of the device were documented. In conclusion, the management of malignant arrhythmias during pregnancy is one of the concerns for patients with LVNC and requires a careful approach in third-level centers.

Abstract 15884: Life-threatening Arrhythmias With Autosomal Recessive TECRL Variants

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Gregory Webster ◽  
Elhadi H Aburawi ◽  
Marie Chaix ◽  
Stephanie Chandler ◽  
Roger Foo ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Sudden Death ◽  
Long Qt Syndrome ◽  
Catecholaminergic Polymorphic Ventricular Tachycardia ◽  
Polymorphic Ventricular Tachycardia ◽  
Long Qt ◽  
Long Term Follow Up ◽  
Qt Syndrome

Introduction: Sudden death and aborted sudden death have been observed in patients with biallelic variants in TECRL . Phenotypes have only begun to be described and no data are available on medical therapy after long-term follow-up. Methods: An international, multicenter retrospective review was conducted. We report new cases associated with TECRL variants and long-term follow-up from previously published cases. Results: We present 10 cases and 37 asymptomatic heterozygous carriers. Median age at onset of cardiac symptoms was 8 years (range 1-22 years) and cases were followed for an average of 10.3 years (SD 8.3), right censored by death in 3 cases. All patients on metoprolol, bisoprolol or atenolol were transitioned to nadolol or propranolol due to failure of therapy. Phenotypes typical of both long QT syndrome and catecholaminergic polymorphic ventricular tachycardia were observed. We also observed divergent phenotypes in some cases despite identical homozygous variants. None of 37 heterozygous family members had a cardiac phenotype. Conclusions: Patients with biallelic pathogenic TECRL variants present with variable cardiac arrhythmia phenotypes, including those typical of long QT syndrome and catecholaminergic polymorphic ventricular tachycardia. Nadolol and propranolol may be superior beta-blockers in this setting. No cardiac disease or sudden death was present in patients with a heterozygous genotype.

Long-term follow-up after sustained monomorphic ventricular tachycardia: Causes, pump failure, and empiric antiarrhythmic therapy that modify survival

1991 ◽  
Vol 121 (6) ◽  
pp. 1685-1692 ◽  
Author(s):  
Jean-Frangois Leclercq ◽  
Philippe Coumel ◽  
Isabelle Denjoy ◽  
Pierre Maisonblanche ◽  
Bruno Cauchemez ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Antiarrhythmic Therapy ◽  
Pump Failure ◽  
Monomorphic Ventricular Tachycardia ◽  
Long Term Follow Up
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