scholarly journals Diagnostic Difficulties in a Case of Fetal Ventricular Tachycardia Associated with Neonatal COVID Infection: Case Report

2021 ◽  
Vol 18 (23) ◽  
pp. 12796
Author(s):  
Liliana Gozar ◽  
Carmen Corina Șuteu ◽  
Dorottya Gabor-Miklosi ◽  
Andreea Cerghit-Paler ◽  
Amalia Făgărășan
Keyword(s):  
Ventricular Tachycardia ◽  
Myocardial Injury ◽  
Clinical Course ◽  
Myocardial Dysfunction ◽  
Pediatric Population ◽  
Left Ventricular ◽  
Rapid Progression ◽  
First Case ◽  
Diagnostic Difficulties ◽  
Fetal Tachyarrhythmia

The clinical course of COVID in the pediatric population is considered to be much milder when compared to adults; however, the occurrence of severe and fatal forms of the disease in children is non-negligible, especially in patients with comorbidities such as prematurity or cardiac disease. We report a case of a newborn with sotalol-controlled fetal ventricular tachycardia, who was postnatally diagnosed with COVID infection. The myocardial injury was sustained on the basis of pericardial effusion, left ventricular dysfunction, rapid progression to coronary artery dilation, and an arrhythmic storm. We believe that, in our case, there is a significant overlap between fetal ventricular tachycardia, associated with impaired left ventricular function, and COVID infection, diagnosed after birth; both factors contribute to the myocardial dysfunction with a fulminant clinical evolution. To our knowledge, this is the first case describing neonatal myocardial dysfunction associated with SARS-CoV infection complicating the clinical course of rare fetal tachyarrhythmia.

scholarly journals Sustained ventricular tachycardia of left, right or both bundle branch block morphology in patients with Arrhythmogenic Cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Milman ◽  
M Laredo ◽  
R Roudijk ◽  
G Peretto ◽  
A Andorin ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Right Bundle Branch Block ◽  
Left Bundle Branch Block ◽  
Clinical Course ◽  
Left Ventricular ◽  
Funding Source ◽  
Arrhythmogenic Cardiomyopathy ◽  
Icd Implantation ◽  
Bundle Branch Block ◽  
Group 3

Abstract Aims In arrhythmogenic cardiomyopathy (ACM) sustained monomorphic ventricular tachycardia (VT) typically displays left bundle branch block (LBBB) morphology. Sustained VT with right bundle branch block (RBBB) morphology is very rare despite the frequent left ventricular involvement. The present study sought to assess the prevalence of spontaneous sustained LBBB-VT, RBBB-VT or both as well as clinical and genetic differences associated with these VT types. Methods and results Twenty-six centers from 11 European countries provided information on 952 patients with ACM and >1 episode of sustained VT observed during the patients' clinical course. VT was classified as: LBBB-VT; RBBB-VT or LBBB+RBBB-VT. Among 952 patients, 881 (92.5%) had LBBB-VT alone, 71 (7.5%) had RBBB-VT [alone in 42 (4.4%) patients or with LBBB-VT in 29 (3.0%) patients]. Male prevalence was 90.5%, 79.2% and 55.9% in the RBBB-VT, LBBB-VT and LBBB+RBBB-VT groups, respectively (P=0.001). Patients' age at first VT did not differ amongst the 3 VT groups. ICD implantation was more frequent for the RBBB-VT and the LBBB+RBBB groups (≈90% each) vs. 67.9% for the LBBB-VT group (P=0.001). Death incidence (9.5%–17.2%) was not significantly different between the 3 groups (P=0.425). Plakophylin-2 mutations predominated in the LBBB-VT and LBBB-VT+RBBB-VT groups (47.2% and 27.3%, respectively) and Desmoplakin mutations in the RBBB-VT group (36.7%). Conclusion This large European survey demonstrates: 1) Sustained RBBB-VT is documented in 7.5% patients with ACM; 2) Males markedly predominate in the RBBB-VT and LBBB-VT groups but not in the LBBB+RBBB VT group; 3) Distribution of desmosomal mutations appears to be different in the 3 VT groups. Funding Acknowledgement Type of funding source: None

scholarly journals Left anterior descending coronary artery dissection during ventricular tachycardia ablation – case report

2018 ◽  
Vol 56 (1) ◽  
pp. 63-66
Author(s):  
Kresimir Kordic ◽  
Sime Manola ◽  
Ivan Zeljkovic ◽  
Ivica Benko ◽  
Nikola Pavlovic
Keyword(s):  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Left Ventricular ◽  
Artery Dissection ◽  
Complication Rates ◽  
Left Main ◽  
Coronary Artery Dissection ◽  
Ventricular Tachycardia Ablation ◽  
First Case

Abstract Fascicular left ventricular tachycardia (VT) is the second most frequent idiopathic left VT in the setting of a structurally normal heart. Catheter ablation is curative in most patients with low complication rates. We report a case of ostial left anterior descending coronary artery (LAD) occlusion during fascicular ventricular tachycardia ablation. Dissection was the most likely cause of LAD obstruction. To the authors’ best knowledge, this is the first case reporting selective LAD dissection during electrophysiology study with no left main coronary artery (LMCA) affection.

Interleukin-27 attenuates myocardial injury after ischemia-reperfusion through down-regulation of inflammatory response

2021 ◽  
Vol 9 (1) ◽  
pp. 62-75
Author(s):  
Mai HN ◽  
Lee YS
Keyword(s):  
Inflammatory Response ◽  
Ventricular Function ◽  
Myocardial Injury ◽  
Myocardial Dysfunction ◽  
Ischemia Reperfusion ◽  
Cardiac Injury ◽  
Left Ventricular ◽  
Mice Model ◽  
Down Regulation ◽  
Stat Pathway

The proinflammatory cytokines may mediate myocardial dysfunction associated with myocardial injury and inflammatory response is an important process during the pathogenesis of myocardial I/R injury. IL-27, this cytokine is mainly produced by cells of myeloid origin such as monocytes, macrophages, dendritic cells, and microglial cells, in response to stimuli acting through Toll-like receptors. The objective of present study is to assess whether IL-27 can improve ventricular function after myocardial ischemia by down-regulation of inflammatory response. The results demonstrated that the IL-27 markedly attenuated Left Ventricular Function (LVF) in mice model, and reduced plasma level of cTn-I as marker of cardiac injury. Moreover, the IL-27 was associated with up-regulation in both chemokine and cytokines expression following I/R, through down-regulation of activation of JAK/STAT pathway.

scholarly journals Spontaneous Remission in an Older Patient with RelapsedFLT3ITD Mutant AML

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Pankit Vachhani ◽  
Jason H. Mendler ◽  
Andrew Evans ◽  
George Deeb ◽  
Petr Starostik ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Tandem Duplication ◽  
Clinical Course ◽  
Spontaneous Remission ◽  
Rapid Progression ◽  
Older Patient ◽  
Internal Tandem Duplication ◽  
First Case ◽  
Short Overall Survival ◽  
Aggressive Clinical Course

Spontaneous remission (SR) of acute myeloid leukemia (AML) is a very rare phenomenon. AML characterized byFLT3internal tandem duplication (FLT3ITD) is typically associated with an aggressive clinical course with rapid progression, relapse, and short overall survival in the absence of transplantation. We report here the first case of SR ofFLT3ITD mutant AML in the literature. Our patient was an elderly woman with relapsedNPM1andFLT3ITD mutant AML whose disease underwent SR for a brief duration without precipitating cause. We review the potential immune mechanisms underlying SR in AML and discuss the implications for novel immunotherapeutic approaches forFLT3mutant AML.

scholarly journals Diagnosing Cardiac Amyloidosis: From Heart Failure to Electrical Storm

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Adithya T. Mathews ◽  
Abu-Sayeef Mirza ◽  
Chandrashekar Bohra ◽  
Akshay G. Mathews ◽  
Philip Ritucci-Chinni ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Left Ventricular Hypertrophy ◽  
Cardiac Amyloidosis ◽  
Ventricular Hypertrophy ◽  
Diastolic Heart Failure ◽  
Diuretic Therapy ◽  
Left Ventricular ◽  
Electrical Storm ◽  
Rapid Progression

Cardiac amyloidosis is a condition when amyloid fibers are deposited in the extracellular space of the heart causing tachyarrhythmias, heart failure, or sudden cardiac death. We present a 71-year-old woman presenting with dyspnea on admission. Echocardiogram revealed diastolic heart failure and left ventricular hypertrophy with strain pattern concerning for an infiltrative process. She was discharged with diuretic therapy and scheduled for a cardiac magnetic resonance imaging. One week after discharge, she was readmitted with progressive shortness of breath and syncope. She was found to be in shock and had multiple episodes of cardiac arrest with both ventricular tachycardia and pulseless electrical activity. She developed electrical storm and eventually passed within 24 hours. Autopsy revealed gross cardiomegaly and left ventricular hypertrophy with Congo red staining revealing amyloid fibrils with apple-green birefringence. This case demonstrates the rapid progression of cardiac amyloidosis from acute-onset diastolic heart failure to uncontrollable ventricular tachycardia, and eventually death. We review the literature regarding multiple diagnostic modalities that facilitate the confirmation of cardiac amyloidosis.

scholarly journals Spectrum of cardiovascular diseases in children during high peak COVID-19 period infection in Northern Italy: is there a link?

2020 ◽  
Author(s):  
Marianna Fabi ◽  
Emanuele Filice ◽  
Laura Andreozzi ◽  
Francesca Conti ◽  
Liliana Gabrielli ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Clinical Course ◽  
Myocardial Dysfunction ◽  
Parvovirus B19 ◽  
Northern Italy ◽  
Myocardial Depression ◽  
Positive Serology ◽  
Cross Sectional ◽  
Aggressive Form ◽  
Inflammatory Syndrome

Abstract Background Children with COVID-19 have a milder clinical course than adults. We describe the spectrum of cardiovascular manifestations during a COVID-19 outbreak in Emilia-Romagna, Italy. Methods Cross-sectional multicenter study including all diagnosis of KD, myocarditis and multisystem inflammatory syndrome in children (MIS-C) from February to April,2020. KD patients were compared to those diagnosed before the epidemic. Results KD: 8 patients (6/8 boys, all negative for SARS-CoV-2); complete presentation in 5/8; 7/8 IVIG-responders; 3/8 showed transient coronary lesions (CALs). Myocarditis one 5-year-old girl negative for SARS-CoV-2, positive for Parvovirus B19. She responded to IVIG. MIS-C 4 SARS-CoV-2 positive boys (3 patients with positive swab and serology, 1 patient with negative swab and positive serology). Three presented myocardial dysfunction and pericardial effusion, one developed multicoronary aneurysms and hyperinflammation; all responded to treatment. The fourth boy had mitral and aortic regurgitation that rapidly regressed after steroids. Conclusions KD, myocarditis and MIS-C were distinguishable cardiovascular manifestations. KD did not show a more aggressive form compared to previous years: coronary involvement was frequent, but always transient. MIS-C and myocarditis rapidly responded to treatment without cardiac sequelae despite high markers of myocardial injury at onset suggesting a myocardial depression due to systemic inflammation rather than focal necrosis. Evidence of actual or previous SARS-CoV-2 infection was documented only in patients with MIS-C.

Limiting sarcolemmal Na+entry during resuscitation from ventricular fibrillation prevents excess mitochondrial Ca2+accumulation and attenuates myocardial injury

2007 ◽  
Vol 103 (1) ◽  
pp. 55-65 ◽  
Author(s):  
Sufen Wang ◽  
Jeejabai Radhakrishnan ◽  
Iyad M. Ayoub ◽  
Julieta D. Kolarova ◽  
Domenico M. Taglieri ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Chest Compression ◽  
Myocardial Injury ◽  
Troponin I ◽  
Myocardial Dysfunction ◽  
Aortic Pressure ◽  
Left Ventricular ◽  
Ischemia And Reperfusion ◽  
Reverse Mode ◽  
Ventricular Compliance

Background: intracellular Na+accumulation during ischemia and reperfusion leads to cytosolic Ca2+overload through reverse-mode operation of the sarcolemmal Na+-Ca2+exchanger. Cytosolic Ca2+accumulation promotes mitochondrial Ca2+(Ca2+m) overload, leading to mitochondrial injury. We investigated whether limiting sarcolemmal Na+entry during resuscitation from ventricular fibrillation (VF) attenuates Ca2+moverload and lessens myocardial dysfunction in a rat model of VF and closed-chest resuscitation. Methods: hearts were harvested from 10 groups of 6 rats each representing baseline, 15 min of untreated VF, 15 min of VF with chest compression given for the last 5 min (VF/CC), and 60 min postresuscitation (PR). VF/CC and PR included four groups each randomized to receive before starting chest compression the new NHE-1 inhibitor AVE4454B (1.0 mg/kg), the Na+channel blocker lidocaine (5.0 mg/kg), their combination, or vehicle control. The left ventricle was processed for intracellular Na+and Ca2+mmeasurements. Results: limiting sarcolemmal Na+entry attenuated cytosolic Na+increase during VF/CC and the PR phase and prevented Ca2+moverload yielding levels that corresponded to 77% and 71% of control hearts at VF/CC and PR, without differences among specific Na+-limiting interventions. Limiting sarcolemmal Na+entry attenuated reductions in left ventricular compliance during VF and prompted higher mean aortic pressure (110 ± 7 vs. 95 ± 11 mmHg, P < 0.001) and higher cardiac work index (159 ± 34 vs. 126 ± 29 g·m·min−1·kg−1, P < 0.05) with lesser increases in circulating cardiac troponin I at 60 min PR. Conclusions: Na+-limiting interventions prevented excess Ca2+maccumulation induced by ischemia and reperfusion and ameliorated myocardial injury and dysfunction.

First Case of Left Posterior Fascicle in a Bystander Circuit of Idiopathic Left Ventricular Tachycardia

2014 ◽  
Vol 30 (11) ◽  
pp. 1460.e11-1460.e13 ◽  
Author(s):  
Shingo Maeda ◽  
Yasuhiro Yokoyama ◽  
Akihiko Nogami ◽  
William W. Chik ◽  
Kenzo Hirao
Keyword(s):  
Ventricular Tachycardia ◽  
Left Ventricular ◽  
Idiopathic Left Ventricular Tachycardia ◽  
First Case ◽  
Left Posterior ◽  
Left Posterior Fascicle

scholarly journals Is narrow qrs complex tachyarrythmia always from supraventricular?

2019 ◽  
Vol 43 (1) ◽  
pp. 38
Author(s):  
Tiya Setiadi ◽  
Hauda El Rasyid
Keyword(s):  
Ventricular Tachycardia ◽  
Young Patients ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Qrs Complex ◽  
Bundle Branch Block ◽  
Idiopathic Left Ventricular Tachycardia ◽  
Narrow Qrs ◽  
First Case ◽  
Narrow Qrs Complex

Idiopathic left ventricular tachycardia (previously known as fascicular VT) is characterized by right bundle branch block (RBBB) left axis ventricular tachycardia (VT) with a relatively narrow QRS (120–140 ms) in young patients and sensitive to verapamil. Objective: To remind that not all tachyarrhythmias with relatively narrow QRS are derived from supraventricular. Cases: First case of 23 years old man with chief complain palpitation and presyncope with narrow QRS ventricular tachycardia electrocardiography (ECG). Second case of 16 years old man with chief complain palpitation with narrow QRS ventricular tachycardia ECG, both of them are getting better after administration of diltiazem and verapamil. Conclusions: Idiopathic left ventricular tachycardia is associated with presyncope, palpitation and was successfully terminated with verapamil. Medical management is variable in its outcomes and given the age of the population affected. Narrow QRS complex tachycardia not always from supraventricular, we should think about ventricular tachycardia especially ILVT if there is no structural heart disease.

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