1/9. Profound sinus bradycardia after intravenous nicardipine.IMPLICATIONS: nicardipine-induced bradycardia has been reported in experimental animals but not in clinical patients. We report a clinical case of unexpected bradycardia caused by nicardipine. The mechanism of this bradycardia was not clear, and depression of sympathetic tone by epidural anesthesia, hypothermia, and paroxysmal atrial fibrillation might have been contributory.- - - - - - - - - - ranking = 1keywords = fibrillation, atrial fibrillation (Clic here for more details about this article) |
2/9. Intermittent pacemaker syndrome: revision of VVI pacemaker to a new cardiac pacing mode for tachy-brady syndrome.A patient with tachy-brady syndrome manifested by paroxysmal atrial fibrillation and symptomatic sinus bradycardia and treated by VVI pacing developed pacemaker syndrome during episodes of ventricular pacing. His cardiac pacemaker was revised to a dual chamber system utilizing the new AV sequential DDI pacing mode which eliminated pacemaker-related tachycardias and totally abolished the pacemaker syndrome symptoms. There have been no further episodes of atrial fibrillation, possibly due to elimination of temporal dispersion of refractory periods during bradycardia. The propensity for atrial fibrillation has also been minimized by excluding competitive atrial stimulation during DVI pacing. The DDI mode provides the clinician increased utility and flexibility in the use of AV sequential pacing therapy.- - - - - - - - - - ranking = 3keywords = fibrillation, atrial fibrillation (Clic here for more details about this article) |
3/9. amsacrine treatment of patients with supraventricular arrhythmias and acute leukemia.Three patients with a history of supraventricular arrhythmia presented with relapse of acute leukemia. Two of the three patients were in sinus rhythm, receiving digoxin and/or verapamil daily. The third patient was in atrial fibrillation, but her heart rate was controlled with daily digoxin. All three patients received amsacrine without the occurrence of cardiac events. Although amsacrine may cause ventricular arrhythmias in the setting of hypokalemia, correction of the electrolyte abnormality permits its use in patients with a history of supraventricular arrhythmias.- - - - - - - - - - ranking = 1keywords = fibrillation, atrial fibrillation (Clic here for more details about this article) |
4/9. Transient atrial fibrillation in a patient with acute ureterolithiasis.A 34-year-old woman with symptoms associated with a confirmed ureteral calculus was found to be in atrial fibrillation on arrival at the emergency department. When her symptoms had improved, it was noted that the atrial fibrillation had reverted spontaneously to a sinus rhythm. Subsequent evaluation did not reveal a common etiology of the atrial fibrillation. Transient atrial fibrillation has been associated with many diverse conditions. It has not been previously reported in association with acute ureterolithiasis.- - - - - - - - - - ranking = 8keywords = fibrillation, atrial fibrillation (Clic here for more details about this article) |
5/9. Autonomic sinus node dysfunction and its treatment.The clinical, electrocardiographic, pharmacologic, electrophysiologic and Holter monitoring findings are described in four patients with autonomic sinus node dysfunction and one patient with autonomic binodal disease. All showed cerebral symptoms, and had attacks of dizziness, weakness, near-syncope or syncope. After a pharmacologic autonomic blockade with propranolol and atropine, all patients had normal intrinsic heart rates. Electrophysiological studies revealed normal corrected intrinsic node recovery time (less than or equal to 240 msec) a gradual return to the basic cycle length in the secondary postpacing cycles after autonomic blockade, and no intrinsic paroxysmal atrioventricular block. Continuous ECG monitoring (1-3 X 24 hours) revealed severe sinus bradycardia, SA-block, severe sinus arrest, cardiac standstill, atrial fibrillation and in two patients associated AV-block. Autonomic blockade with electrophysiological studies exclude the intrinsic involvement of the sinoatrial and atrioventricular node. Holter monitoring is the best method for assessing the autonomic neurovegetative component of dysrhythmias. Therapy regarding isolated autonomic sinus node dysfunction depended on the pathomechanisms of rhythm disorders: two patients received permanent pacemakers, antiarrhythmic drugs were applied in the case of two patients, and etiological treatment in the case of one. During the follow-up, all patients became symptom-free.- - - - - - - - - - ranking = 1keywords = fibrillation, atrial fibrillation (Clic here for more details about this article) |
6/9. Changing P waves after mitral valve replacement.A 55-year-old man is convalescing from mitral valve replacement five days earlier. He had severe calcific mitral stenosis and moderately severe hypertension, with repeated attacks of acute pulmonary edema. He had always been in normal sinus rhythm, except for a single episode of atrial fibrillation associated with one of his episodes of acute pulmonary edema. He had been taking digoxin (0.25 mg daily) but this was stopped the day before the operation. The cardiac rhythm has been mostly regular since the operation, but occasional irregularities have been noted. An ECG on the fifth postoperative day is shown.- - - - - - - - - - ranking = 1keywords = fibrillation, atrial fibrillation (Clic here for more details about this article) |
7/9. Familial atrioventricular heart block of adult onset: electrocardiogram and HLA typing analysis.A family was investigated because of heart block and sinus arrhythmia. The electrical characteristics were: (1) adult onset in all members; (2) complete heart block with atrial fibrillation in 2, and first- or second-degree heart block in 7 members; and (3) sinus arrhythmia in 3 members. Human leukocyte antigen (HLA) typing was performed. HLA A2, B39, Cw7, and DR12 were positive in 4 of 5 members in the heart block group. In the sinus arrhythmia group, HLA DR12 was positive in all members. In the normal group, none of these HLA typings was positive except one. These findings indicate a tighter relationship between heart block and the HLA locus than previously thought.- - - - - - - - - - ranking = 1keywords = fibrillation, atrial fibrillation (Clic here for more details about this article) |
8/9. Pacing induced ventricular fibrillation in internal cardioverter defibrillator patients: a new form of proarrhythmia.Current model internal cardioverter defibrillators (ICDs) have cardioversion, defibrillation, pacemaker, and telemetry function. telemetry documents arrhythmia and facilitates therapeutic adjustments. We report two cases of pacing induced VF terminated by the defibrillator, with the device responsible for both initiation and correction of the arrhythmia.- - - - - - - - - - ranking = 2.5461447516841keywords = fibrillation (Clic here for more details about this article) |
9/9. Unexpected recurrence of sinus rhythm in chronic atrial fibrillation due to sick sinus disease.A 60-years old patient with symptomatic sick sinus disease was implanted a dual-chamber pacemaker that did well during the following 13 years. Thereafter, the pacemaker had to be explanted because of a systemic infection, with the patient in constant chronic atrial fibrillation in the meantime. After another asymptomatic year, 6 arrhythmogenic syncopes occurred, apparently due to pre-automatic pauses prior to spontaneous conversions to sinus rhythm. Subsequently, the patient was implanted a VVI pacemaker, whereupon he did well henceforth. This case demonstrates the possibility of recurrence of sinus rhythm even after long-standing chronic atrial fibrillation.- - - - - - - - - - ranking = 6keywords = fibrillation, atrial fibrillation (Clic here for more details about this article) |