13 research outputs found
ECG Approach to Narrow QRS Complex Supraventricular Tachycardia
Supraventricular tachycardia (SVT) is an irregular heart rhythm in which the focus of impulse lies above the bundle of His, i.e., the sinus node, the atria, and the atrioventricular node (AVN). There are two types of SVT: Narrow QRS complex tachycardia and wide QRS complex tachycardia. Narrow QRS complexe tachycardias can further be divided as regular or irregular based on R鈥揜 intervals. There is further classification that can be made in regular rhythms in terms of RP interval. The most common tachycardias that are characterized by a long RP interval include sinus tachycardia, atrial tachycardia, and atrioventricular reentrant tachycardia. Short RP interval tachycardias mainly Atrioventricular nodal reentrant tachycardia (AVNRT), junctional tachycardia (JT) and permanent junctional reciprocating tachycardia (PJRT). On the other hand, irregular SVTs usually include atrial fibrillation, atrial flutter, and multifocal atrial tachycardia
Practical Approach to Chest Pain Related to Cardiac Implantable Electronic Device Implantation
In this review article, we described the common causes and approach for chest pain that happens after cardiac device implantation surgeries. We also describe the clinical features and appropriate treatment for them
Corrected QT interval as a predictor of mortality in elderly patients with syncope
Background: Prolonged corrected QT interval (QTc) holds independent prognostic importance
in predicting mortality in patients with coronary artery disease, diabetes mellitus and
congestive heart failure. However, its association with all cause or cardiac mortality in the
general population remains unclear. We evaluated the relationship between prolonged QTc
and total mortality among patients with syncope.
Methods: This was a retrospective study of 348 patients presenting to the emergency department
with syncope of any etiology over a period of one year. All patients with atrial fibrillation,
left bundle branch block and cardiac devices (pacemaker/defibrillator) were excluded. Prolonged
QTc interval was defined as QTc interval ≥ 440 ms. The primary end point for this
study was total mortality in patients presenting with syncope.
Results: There were 58 (16%) deaths in this population during a mean follow-up of 30 months.
Patients with prolonged QTc interval had significantly higher mortality when compared to
those with normal QTc interval (22% vs 11%; p = 0.004). This significance was not retained
after adjustment for covariates in the Cox regression model, where we found that age ≥ 65 years
(hazard ratio [HR] 7.9; 95% confidence interval [CI] 1.9–32.9; p = 0.004) and QTc interval
≥ 500 ms (HR 3.5; 95% CI 1.56–8.12; p = 0.002) were predictors of increased mortality
among patients with syncope.
Conclusions: In elderly patients presenting to the emergency department with syncope, QTc
interval ≥ 500 ms helps identify patients at higher risk of adverse outcomes. (Cardiol J 2011;
18, 4: 395–400
Skorygowany odst臋p QT jako czynnik prognostyczny zgonu w grupie os贸b w podesz艂ym wieku z omdleniem w wywiadzie
Wst臋p: Wyd艂u偶ony odst臋p QT (QTc) jest niezale偶nym czynnikiem prognostycznym wzmo偶onej
艣miertelno艣ci w grupie os贸b obci膮偶onych chorob膮 wie艅cow膮, cukrzyc膮 i zastoinow膮 niewydolno艣ci膮
serca. Jego zwi膮zek z mechanizmami wszystkich zgon贸w z przyczyn sercowo-naczyniowych
w populacji og贸lnej pozostaje niejasny. W niniejszej pracy wykazano zale偶no艣膰 mi臋dzy
wyd艂u偶onym odst臋pem QT a ca艂kowit膮 艣miertelno艣ci膮 w grupie os贸b z omdleniami.
Metody: Badaniem retrospektywnie obj臋to grup臋 348 pacjent贸w, kt贸rzy zg艂osili si臋 na oddzia艂
ratunkowy z powodu omdlenia z jakiejkolwiek przyczyny w ci膮gu ostatniego roku. Wykluczono
osoby z migotaniem przedsionk贸w, blokiem lewej odnogi p臋czka Hisa oraz pacjent贸w z implantowanymi
urz膮dzeniami, jak stymulator/kardiowerter-defibrylator. Wyd艂u偶ony odst臋p QT zdefiniowano
jako trwaj膮cy co najmniej 440 ms. Pierwszorz臋dowy punkt ko艅cowy w badanej
grupie os贸b z omdleniami stanowi艂 zgon.
Wyniki: W obserwacji 30-miesi臋cznej odnotowano 58 zgon贸w (16%). W grupie pacjent贸w
z wyd艂u偶onym odst臋pem QT odsetek zgon贸w by艂 znacznie wy偶szy ni偶 w grupie z prawid艂owym
odst臋pem (22% v. 11%; p = 0,004). Ta istotno艣膰 nie zosta艂a podtrzymana po dodaniu kowariancji
w modelu regresji Coxa, gdzie wiek 65 lat i wi臋cej [hazard wzgl臋dny (HR) 7,9;
95-procentowy przedzia艂 ufno艣ci (CI) 1,9–32,9; p = 0,004] i odst臋p QTc wynosz膮cy co najmniej
500 ms (HR 3,5; 95% CI 1,56–8,12; p = 0,002) 艂膮cznie by艂y wska藕nikami prognostycznymi
zgonu w grupie pacjent贸w z omdleniami.
Wnioski: W grupie starszych os贸b zg艂aszaj膮cych si臋 na oddzia艂 ratunkowy z powodu omdlenia
odst臋p QT ≥ 500 ms pozwala pom贸c zidentyfikowa膰 pacjent贸w z grupy ryzyka wyst膮pienia
nag艂ego incydentu sercowego.
(Folia Cardiologica Excerpta 2011; 6, 4: 211–216
Echocardiography in Heart Failure and Cardiac Electrophysiology
The world of echocardiography continues to be full of exciting new technological developments with an ultimate goal of better patient care. In this book, titled ""Echocardiography in Heart Failure and Cardiac Electrophysiology"", authors from various parts of the world contributed to the advancement of the field. We have included various chapters about the use of echocardiography and modalities of imaging in various common clinical scenarios - ranging from evaluation of commonly ignored right ventricle, imaging in congestive heart failure, to echocardiographic evaluation of critically ill patients. We have also included topics describing the use of echocardiography in cardiac electrophysiology with special interest to cardiac resynchronization therapy and atrial fibrillation ablation. These topics would be of great interest to the clinicians whether they are trainees, physicians, advanced care providers, or anyone involved in the patient care
Cardiac Arrhythmias
This book is a comprehensive and practical updated review about the various aspects of cardiac arrhythmias. It covers a variety of aspects of both atrial and nonatrial arrhythmias, including genetics, clinical aspects, ECG manifestations, and practical approaches to complex cardiac arrhythmia management - office, hospital, intensive care unit, electrophysiology laboratory, and operating room. This book also presents comprehensive ECG reviews of cardiac arrhythmias like atrial flutter, Brugada pattern, Breijo ECG pattern, and PVCs. Practical aspects of preventing and managing arrhythmias - central venous catheter-induced, atrial flutter, and drug-induced cardiac arrhythmias - are described. Experts have demonstrated the approach for mapping and ablation of complex arrhythmias like atrial flutter, idiopathic ventricular tachycardia, and Brugada syndrome