1/171. Significant complications can occur with ischemic heart disease and tilt table testing.We present an elderly patient who had syncope, with known coronary artery disease and a conduction abnormality. Because of a possible vasovagal reaction, the patient underwent a tilt table test prior to evaluation of ischemia or her LV function. During the tilt table test on isoproterenol, the patient developed ventricular fibrillation which was corrected immediately by cardioversion. Subsequently, the patient was found to have significant coronary artery disease which was treated with stenting and angioplasty. After treatment, there were no inducible arrhythmias on full dose isoproterenol. This case reports a significant complication that may occur when tilt table testing with isoproterenol and ischemia.- - - - - - - - - - ranking = 1keywords = heart (Clic here for more details about this article) |
2/171. Idiopathic verapamil-sensitive left ventricular tachycardia complicated by right ventricular outflow tract ventricular tachycardia and ventricular fibrillation.Idiopathic ventricular tachycardias (VTs) are generally divided into those arising from the right ventricle and those arising from the left ventricle. There has been few reports of two morphologically distinct VT occurring in patients with no apparent structural heart disease. We report a patient with verapamil-sensitive left VT with a right bundle branch block pattern that spontaneously changed to VT with a left bundle branch block pattern. Ventricular fibrillation was induced by the application of programmed stimulation. Although it is unclear if our patient with pleomorphic VT has ventricular vulnerability, it is necessary to investigate further and follow him carefully.- - - - - - - - - - ranking = 0.25keywords = heart (Clic here for more details about this article) |
3/171. Early proarrhythmia during intravenous amiodarone treatment.We present a case of early (within the first 24 hours) development of malignant torsades de pointes (TdP) associated with intravenous amiodarone therapy. After correction of predisposing factors (heart failure, hypokalemia, digoxin) amiodarone again resulted in torsades. This observation suggests that in patients who have experienced amiodarone-induced proarrhythmia, amiodarone administration under different, more stable clinical conditions may still be hazardous.- - - - - - - - - - ranking = 0.25keywords = heart (Clic here for more details about this article) |
4/171. Transient local changes in right ventricular monophasic action potentials due to ajmaline in a patient with brugada syndrome.A 48-year-old patient with recurrent episodes of palpitations and syncope presented with transient ST segment elevation in the right precordial ECG leads. Structural heart disease was excluded. No arrhythmias were inducible by programmed ventricular stimulation. Parallel to ST elevation after intravenous ajmaline, a gradual and reversible delay in the upstroke of right ventricular (RV) monophasic action potentials (maps) occurred that was most marked in the RV outflow tract and nearly absent at right free-wall recordings. ajmaline led to a cycle length-dependent increase in RV dispersion of repolarization. Thus, right endocardial maps may demonstrate regionally different action potential changes that may contribute to the ECG changes in brugada syndrome.- - - - - - - - - - ranking = 0.25keywords = heart (Clic here for more details about this article) |
5/171. syncope and inducible ventricular fibrillation in a woman with hemochromatosis.BACKGROUND: hemochromatosis has been associated with atrial tachyarrhythmias and congestive heart failure as a consequence of dilated or restrictive cardiomyopathy. Inducible ventricular fibrillation has not been previously described.methods AND RESULTS: An electrophysiologic study was conducted in a woman after two episodes of syncope. Polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF) were induced with ventricular programmed stimulation. magnetic resonance imaging demonstrated signal loss in the liver consistent with hemochromatosis, but normal cardiac size and function. Hematologic studies supported a diagnosis of hemochromatosis.CONCLUSION: Cardiac hemochromatosis may be associated with serious ventricular arrhythmias.- - - - - - - - - - ranking = 0.25keywords = heart (Clic here for more details about this article) |
6/171. Emergency extracorporeal membrane oxygenation (ECMO)-supported percutaneous coronary interventions in the fibrillating heart.We describe two cases of refractory ventricular fibrillation complicating transcatheter interventional procedures. extracorporeal membrane oxygenation was used in each to support percutaneous coronary revascularization in the fibrillating heart as a means of facilitating successful restoration of sinus rhythm. Cathet. Cardiovasc. Intervent. 48:402-405, 1999.- - - - - - - - - - ranking = 1.25keywords = heart (Clic here for more details about this article) |
7/171. ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiographic leads: a brugada syndrome variant?Recurrent ventricular fibrillation was observed in a 29-year-old Vietnamese man who did not exhibit structural heart disease. The patient's ECG showed prominent J (Osborn) waves and ST segment elevation in the inferior leads that were not associated with hypothermia, serum electrolyte disturbance, or myocardial ischemia. Rate-dependent change in the amplitude of J waves and ST segment elevation also were observed. An implantable cardioverter defibrillator (ICD) was implanted. Adjunctive treatment with amiodarone reduced J wave amplitude, preventing ventricular fibrillation and ICD shocks. Prominent J waves and ST segment elevation in the inferior leads may serve as an important diagnostic sign to detect high-risk individuals with a history of unexplained syncope. ICD implantation plus amiodarone is the treatment of choice.- - - - - - - - - - ranking = 0.25keywords = heart (Clic here for more details about this article) |
8/171. Spontaneous sustained monomorphic ventricular tachycardia after administration of ajmaline in a patient with brugada syndrome.We present the case of a 13-year-old boy with an episode of aborted sudden death, absence of structural heart disease, and a characteristic ECG pattern of right bundle branch block with persistent ST-segment elevation in the right precordial leads, in whom a monomorphic sustained ventricular tachycardia developed spontaneously after the administration of ajmaline. This effect may be related to an increased inhomogeneity of repolarization mediated by the drug and demonstrates the arrhythmogenic potential of Class I antiarrhythmic drugs in patients with brugada syndrome.- - - - - - - - - - ranking = 0.25keywords = heart (Clic here for more details about this article) |
9/171. Unmasking effect of propafenone on the concealed form of the Brugada phenomenon.A case report of a patient with frequent ventricular premature beats but with an otherwise normal ECG and no structural heart disease. propafenone in therapeutical doses unmasked the ECG picture of the Brugada phenomenon.- - - - - - - - - - ranking = 0.25keywords = heart (Clic here for more details about this article) |
10/171. Switch from a BIVAD to a LVAD in a boy with Kawasaki disease.A 9-year-old boy with Kawasaki disease survived after two severe myocardial infarctions. Thereafter pharmacologically untreatable ventricular arrhythmia and rapidly deteriorating heart failure developed in the patient. After 19 days of biventricular and a further 27 days of left univentricular mechanical circulatory support with the berlin Heart (Cardiotechnica, berlin, germany) assist device the boy successfully underwent heart transplantation. At a follow-up of 54 months, the boy is leading an active and unrestricted life.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
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