Presentation
C as e presentation A 50-year-old female presented to the community hospital after several episo de s of loss of consciousness which were treated by her husband with resuscitative efforts and chest compressions. [yumpu.com]
The correlation between the type of clinical presentation and the timing of R on T was not statistically significant (P value 0.47). Interestingly, 6 patients from 7 who presented with VF degeneration had R on Tasc. [ncbi.nlm.nih.gov]
Presents a new chapter on recording and interpreting heart rhythms in patients with pacemakers. Includes new material on interpreting ECG findings associated with implantable cardioverter-defibrillators. [books.google.com]
Summary Presented in this paper were 3 cases of a special kind of polymorphic ventricular tachycardia (VT). The clinical manifestation was recurrent syncope without organic heart disease. [link.springer.com]
Entire Body System
- Collapse
Torsades de pointes Clinical Significance TdP is often short lived and self terminating, however can be associated with hemodynamic instability and collapse. TdP may also degenerate into ventricular fibrillation (VF). [lifeinthefastlane.com]
- Weakness
Drugs effects on ventricular repolarization: a critical evaluation of the strengths and weaknesses of current methodologies and regulatory practices. J Pharma Toxicolo Meth. 2005;52:12–21. [ncbi.nlm.nih.gov]
- Unconsciousness
Most individuals suffering from SCD become unconscious within seconds to minutes as a result of insufficient cerebral blood flow. There are usually no premonitory symptoms or signs. [omicsonline.org]
- Intravenous Administration
During acute amiodarone treatment, rapid intravenous administration blocks fast sodium channels in a use-dependent fashion that is, producing more channel blockade at faster heart rates. [omicsonline.org]
Cardiovascular
- Tachycardia
Yes: Dx is ventricular tachycardia! Step 4: No: Are there morphology criteria for VT present both in leads V1 and V6? Yes: Dx is ventricular tachycardia! NO: Diagnosis is supraventricular tachycardia with aberration! [ecg.utah.edu]
Summary Presented in this paper were 3 cases of a special kind of polymorphic ventricular tachycardia (VT). The clinical manifestation was recurrent syncope without organic heart disease. [link.springer.com]
Genetic testing to identify mutations responsible for long QT syndrome and catecholaminergic tachycardia was negative. [elsevier.pt]
Results in patients with inducible and noninducible ventricular tachycardia. Circulation 86:29–37 PubMed CrossRef 38. [springermedizin.de]
Viskin S et al. (2005) The “short-coupled” variant of right ventricular outflow ventricular tachycardia: a not-so-benign form of benign ventricular tachycardia. J Cardiovasc Electrophysiol 16 : 912–916 6. [nature.com]
- Heart Disease
Stay on top of the latest advances in molecular imaging, intravascular ultrasound, cardiovascular regeneration and tissue engineering, device therapy for advanced heart failure, atrial fibrillation management, structural heart disease, Chagasic heart [books.google.com]
METHODS AND RESULTS: We observed 14 patients aged 34.6 +/- 10 years (mean +/- SD) with no structural heart disease who presented with syncope related to a typical ECG aspect of torsade de pointes. [ncbi.nlm.nih.gov]
The clinical manifestation was recurrent syncope without organic heart disease. The electrocardiogram (ECG) was characterized by normal QT intervals with short-coupled variant of torsade de pointes. [link.springer.com]
disease was excluded, as well as significant coronary heart disease by cardiac catheterization. [elsevier.pt]
Workup
Rhythm
- Torsades De Pointes
Tan Short-coupled variant of torsade de pointes Neth Heart J, 16 (2008), pp. 246-249 [11] T. Shiga, M. Shoda, N. [elsevier.pt]
METHODS AND RESULTS: We observed 14 patients aged 34.6 +/- 10 years (mean +/- SD) with no structural heart disease who presented with syncope related to a typical ECG aspect of torsade de pointes. [ncbi.nlm.nih.gov]
The electrocardiogram (ECG) was characterized by normal QT intervals with short-coupled variant of torsade de pointes. [link.springer.com]
There has been much debate in the Circulation journal among French and American scientist whether one should write Torsades de Pointes or Torsade de Pointes. [en.ecgpedia.org]
Torsades de pointes or torsade de pointes ( TdP or simply torsade(s) ) ( French: [tɔʁsad də pwɛ̃t], translated as "twisting of the points"), is a specific type of abnormal heart rhythm that can lead to sudden cardiac death. [ipfs.io]
- Atrioventricular Dissociation
Retrospective analysis of the videotape showing fetal cardiac movement showed that atrioventricular dissociation was present prenatally and thus, that fetal tachyarrhythmia was due to ventricular tachycardia. [genome.jp]
Treatment
Long-term treatment is required for patients with a congenital long QT-interval syndrome. Treatment choices include beta-blockers, permanent pacing, implantable cardioverter-defibrillator (ICD), or a combination. [merckmanuals.com]
The efficacy of treatment with class I,I,I antiarrhythmic drugs was not apparent but verapamil had an excellent therapeutic effect for it. [link.springer.com]
Integrate the latest scientific understanding of arrhythmias with the newest clinical applications, to select the right treatment and management options for each patient. [books.google.com]
Isoproterenol as temporary treatment in patients with recurrent pause-dependent TdP who do not have congenital long QT syndrome. [en.ecgpedia.org]
Prognosis
[…] implanted in all t Page 20 and 21: An ICD should be implanted in all t Page 22 and 23: Asymptomatic Brugada SyndromeProbab Page 24 and 25: An ICD should be implanted in all t Page 26 and 27: Brugada SyndromeProbability of SD o Page 28 and 29: Long-term prognosis [yumpu.com]
Prognosis and therapeutic management in IVF Among survivors of SCD due to IVF, the reported rate of recurrent VF ranges between 22 and 37 percent at two to four years. [omicsonline.org]
In 16 from the 26 SD cases occurred ultra-short SC-PVC (61.5%), which enables to state that the low-er coupling intlow-erval, the worse prognosis. [1library.co]
Etiology
There are some interesting findings that shed some light into the understanding of the mechanism and etiology of IVF. At almost 8 decades after the original description of IVF [ 1 ], the etiology of this disorder still remains a mystery. [omicsonline.org]
After rhythm stability was achieved, the etiological study was completed by performing cardiac magnetic resonance imaging, which was normal ( Figure 3 ). [elsevier.pt]
October 2013: Intensive Care Medicine # 11 Giulio Conte, Lucia Coppini, Maria Antonietta Demola, Diego Ardissino Short-coupled variant of torsade de pointes (TdP) is an uncommon variant of polymorphic ventricular tachycardia with unknown etiology. [readbyqxmd.com]
The authors stated that this is a good example of the power of genetic diagnosis to direct the selection of appropriate therapy for patients with diseases of heterogeneous genetic etiology. [genome.jp]
Etiology, warning signs and therapy of Torsade de Pointes. A study of 10 patients Circulation 1981 ; 64 : 1167 -1174. [3], Plumb VJ, Arciniegas JG, et al. [academic.oup.com]
Pathophysiology
[…] polymorphic ventricular tachycardia which displays on the electrocardiogram (ECG) as a characteristic feature of beat-to-beat varying QRS morphology prone to revert spontaneously. 1,2 Prolongation of the QT interval as a consequence of congenital or acquired pathophysiological [yumpu.com]
Further review of the causes of QT prolongation Pathophysiology of TdP A prolonged QT reflects prolonged myocyte repolarisation due to ion channel malfunction. [lifeinthefastlane.com]
[…] medical citation needed ] Hypokalemia (low blood potassium) Hypomagnesemia (low blood magnesium) Hypocalcemia (low blood calcium) Bradycardia (slow heartbeat) Heart failure Left ventricular hypertrophy Hypothermia Subarachnoid hemorrhage Hypothyroidism Pathophysiology [en.wikipedia.org]
The pathophysiological basis of long-QT syndrome (LQTS) is prolongation of cardiac ventricular repolarization by acquired factors such as drug exposure or genetic variation in the proteins controlling transmembrane ion-concentration gradients ( 8, 9 ) [pnas.org]
The QT interval, a global index of ventricular repolarization, varies among individuals and is influenced by diverse physiologic and pathophysiologic stimuli such as gender, age, heart rate, electrolyte concentrations, concomitant cardiac disease, and [pubfacts.com]
Prevention
Prevention of torsade de pointes in the congenital long QT syndrome: use of a pause prevention pacing algorithm. Heart 1998; 79:417–419. Viskin S, Glikson M, Fish R, et al. Rate smoothing with cardiac pacing for preventing torsade de pointes. [innovationsincrm.com]
Overdrive ventricular pacing could not prevent malignant TdP, but exposed a pause-related TdP initiation pattern. [yumpu.com]
Unlike the other types of antiarrhythmic agents including beta-blockers and amiodarone, verapamil is in our experience the only drug apparently active on the arrhythmias; however, it does not prevent sudden death. [ncbi.nlm.nih.gov]
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]
ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death--executive summary: A report of the American College of Cardiology/American Heart Association Task Force and the European Society [en.ecgpedia.org]