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.

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.

scholarly journals The ‘Cauliflower Heart’: a case report of congenital bi-atrial aneurysms causing non-controllable arrhythmia

2020 ◽  
Author(s):  
Fabienne Stoller ◽  
Martin Glöckler ◽  
Alexander Kadner ◽  
Hannah Widenka
Keyword(s):  
Case Report ◽  
Drug Treatment ◽  
Sinus Rhythm ◽  
Medical Treatment ◽  
Atrial Tachycardia ◽  
High Probability ◽  
Frequency Control ◽  
Atrial Arrhythmia ◽  
Case Summary ◽  
Successful Termination

Abstract Background Congenital aneurysms of the atrium are very rare malformations. Known complications are therapy-resistant arrhythmias. Different treatments such as medical therapy, electrophysiological ablation, and surgery have been proposed. However, there are no guidelines on treatment. Case summary We describe the case of a neonate with bi-atrial aneurysms causing atrial arrhythmia. Arrhythmia was first observed in the 28th week of gestation. Maternal digoxin treatment did not show any effect. After birth, bi-atrial aneurysms were diagnosed and determined as the probable cause of the atrial tachycardia and later of atrial flutter. Antiarrhythmic drug treatment was initiated. However, only frequency control could be achieved. At the age of 7 months, the patient underwent surgical resection. Since surgery, sinus rhythm is present. Conclusion Atrial aneurysms are rare malformations, known complications are atrial arrhythmia. If medical treatment fails, surgery correction appears to be indicated going along with low operative risk and a high probability of successful termination of arrhythmia.

scholarly journals Mid-term outcomes of thoracoscopic and hybrid therapy of atrial fibrillation

2021 ◽  
Vol 28 (3) ◽  
pp. 5-12
Author(s):  
A. Sh. Revishvili ◽  
I. A. Taimasova ◽  
E. A. Artyukhina ◽  
E. S. Malishenko ◽  
M. V. Novikov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Atrial Tachycardia ◽  
Volume Index ◽  
Hybrid Techniques ◽  
Hybrid Approaches ◽  
Student’S T ◽  
Stable Sinus Rhythm

Aim. To evaluate the efficacy and safety of thoracoscopic and hybrid techniques in patients with various forms of atrial fibrillation (AF).Methods. The results of thoracoscopic ablation of 87 patients with AF were analyzed: 27 (31%) with paroxysmal form, 15 (17%) - with persistent, 45 (52%) - with long-term persistent form at follow-up 18.6±6.7 months. “Box-Lesion” treatments and amputation of left atrial appendage (LAA) were performed in 69 (79.3%) patients, “Box Lesion” without LAA amputation in 12 (13.7%). When atrial tachycardia was recorded for more than 30 seconds after a 3-month “blind” period, patients underwent hybrid catheter intervention.Results. Freedom from atrial arrhythmias in the group of paroxysmal AF was achieved in 84% of patients (21 of 25), in the group of persistent form - in 60% of patients (9 of 15), in the group of long-term persistent form - in 78% (32 of 41) at a given observation period. In the structure of postoperative atrial tachycardia, AF recurrence was 5 (6.25%), typical atrial flutter (AFL) - 3 (3.75%), atypical AFL - 10 (12.5%). The mean LA volume index in patients with stable sinus rhythm was 64.6±11.3 ml/m2 versus 74.65±15.4 ml/m2 in the atrial tachycardia group (Student’s t-test 0.53, p = 0.6). These patients underwent a hybrid intervention. At a follow-up period of 15.9±10.9 months, a stable sinus rhythm was maintained in 15 (83.3%) patients. The overall rate of intra- and postoperative complications of thoracoscopic ablation was 5.7%.Conclusion. Thoracoscopic and hybrid approaches are effective methods for various forms of AF treatment.

scholarly journals Small bowel obstruction due to retroperitoneal hernia following renal transplant: a case report

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Atta Nawabi ◽  
Adam C Kahle ◽  
Clay D King ◽  
Perwaiz Nawabi
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Common Type ◽  
Postoperative Phase ◽  
Oral Contrast ◽  
Large Defect ◽  
Retroperitoneal Dissection ◽  
Unclear Etiology

Abstract Para duodenal hernias, the most common type of retroperitoneal hernias, are thought to occur naturally from abnormal gut rotation because of fusion folds within the peritoneum. Retroperitoneal hernias are a rare postoperative complication and have not been described after renal transplantation via a retroperitoneal approach. This case report presents a 48-year-old male with intestinal obstruction after renal transplant due to herniation into the retroperitoneum via an incidentally created peritoneal defect. We suggest computed tomography with oral contrast be used in the early postoperative phase to assess for obstruction in patients with prolonged ileus of unclear etiology who have undergone retroperitoneal dissection. Small peritoneal defects should be closed during dissection. Larger, or multiple peritoneal defects should be extended to make a single, large defect to decrease the possibility of bowel herniating and becoming incarcerated.

Ventricular tachycardia converts to sinus rhythm after administration of propofol: A case report

2021 ◽  
Author(s):  
Krysta Shannon ◽  
Daniel Saltzman ◽  
Irene Li ◽  
Robert Mokszycki ◽  
Gayle Galletta
Keyword(s):  
Ventricular Tachycardia ◽  
Case Report ◽  
Sinus Rhythm

scholarly journals Atrial standstill in the newborn: a case report

2021 ◽  
Vol 26 (7) ◽  
pp. 4419
Author(s):  
O. Yu. Dzhaffarova ◽  
I. V. Plotnikova ◽  
L. I. Svintsova
Keyword(s):  
Heart Rate ◽  
Anticoagulant Therapy ◽  
Contractile Function ◽  
Electrophysiological Study ◽  
Left Ventricular ◽  
Atrial Pacing ◽  
Wide Complex Tachycardia ◽  
Ventricular Lead ◽  
Idioventricular Rhythm ◽  
Atrial Enlargement

Introduction. Persistent atrial standstill is a rare syndrome characterized by absence of mechanical and electrical atrial activity. The article presents a unique case of atrial standstill in the newborn patient with tachyarrhythmia.Brief description. The first manifestation of atrial standstill in the patient was heart failure (HF) manifestations and wide-complex tachycardia according to electrocardiography, which was identified as ventricular tachycardia. At the local outpatient clinic, the child was prescribed with antiarrhythmic therapy (AAT), which decreased heart rate. Three months later, a transesophageal electrophysiological study was carried out in our center in order to determine the arrhythmia origin. A multiform idioventricular rhythm with a heart rate of 46-119 beats per min was diagnosed, atrial pacing spike (A waves) was not recorded. Given bradyarrhythmia, hemodynamic abnormalities on echocardiography (significant atrial enlargement, decreased contractility), the patient, in order to prevent the risk of sudden cardiac death, underwent implantation of single chamber pacemaker in VVIR mode and bipolar ventricular lead. Anticoagulant therapy was prescribed. After 6-month follow-up, relief of HF symptoms and an increase in left ventricular contractile function was noted.Discussion. Timely diagnosis and implantation of pacemakers allowed avoiding AAT and minimizing the HF symptoms. Continuous ventricular pacing and anticoagulant therapy are important in HF prevention.

scholarly journals Management of complicated crown root fracture using pizeo surgery, fiber post and fragment reattachment: A case report

2021 ◽  
Vol 6 (3) ◽  
pp. 160-165
Author(s):  
Sheena S Raj ◽  
A. Devadathan ◽  
Baby James ◽  
Minimol K Johny ◽  
Emil George ◽  
...  
Keyword(s):  
Case Report ◽  
Common Type ◽  
Fiber Post ◽  
Root Fracture ◽  
Crown Root ◽  
Anterior Teeth ◽  
Psychological Reaction ◽  
Difficult Procedure ◽  
Improved Function ◽  
Type Of Fracture

A common type of fracture involving tooth is complicated crown root fracture of anterior teeth. The reattachment of the coronal fragment to the remaining tooth will provide better and long-lasting aesthetics, improved function and a positive psychological reaction. It is a simple and less difficult procedure if the original tooth fragments are retained after fracture. This paper reports about a case of complicated crown root fracture that was treated successfully using broken fragment adhesive reattachment and post placement.

High-dose adenosine for refractory supraventricular tachycardia: a case report and literature review

2016 ◽  
Vol 27 (5) ◽  
pp. 981-984 ◽  
Author(s):  
Gal Dadi ◽  
Daniel Fink ◽  
Giora Weiser
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Literature Review ◽  
Cardiogenic Shock ◽  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Electrical Cardioversion ◽  
High Dose ◽  
Prompt Treatment ◽  
Unstable Patient

AbstractSupraventricular tachycardia is the most common significant arrhythmia in children. If prolonged, it may cause heart failure and progress to cardiogenic shock warranting prompt treatment. The recommended interventions following vagal manoeuvres are intravenous adenosine and in the unstable patient electrical cardioversion. We present an infant with an unstable supraventricular tachycardia that was resistant to electrical cardioversion and recommended doses of adenosine. He reverted to sinus rhythm with a higher dose of adenosine, suggesting that such doses may be required in refractory supraventricular tachycardia.

ASCENDING AORTIC ANEURYSM – A CASE REPORT

2020 ◽  
Vol 1 (3) ◽  
pp. 54-55
Author(s):  
Prathap Kumar. J.
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Aortic Aneurysm ◽  
Ascending Aorta ◽  
Leg Pain ◽  
Ultrasound Screening ◽  
Ascending Aortic Aneurysm ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Life Threatening

An aortic aneurysm is an abnormal dilation of the aorta to greater than 1.5 times its normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be symptoms like abdominal, back, or leg pain. They are most commonly located in the abdominal aorta, but can also be located in the thoracic aorta, rarely in arch of aorta. Abdominal aortic aneurysm is more common in men, a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. It can be easily diagnosed by an ultrasound screening, and if the aneurysm is > 5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Aneurysm of the ascending aorta is rare but can be easily diagnosed by echocardiogram.

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