Cases reported "Tachycardia"

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1/260. acebutolol-induced ventricular tachycardia reversed with sodium bicarbonate.

    BACKGROUND: acebutolol is a unique beta blocker that possesses cardioselectivity, partial agonist activity, and membrane stabilizing activity. sodium bicarbonate is used to reverse the cardiotoxic effects of other drugs with membrane stabilizing activity. There have been no reported cases of acebutolol-induced ventricular dysrhythmias treated successfully with bolus sodium bicarbonate. CASE PRESENTATION: A 48-year-old man ingested approximately 6.4 g of acebutolol with ethanol (blood ethanol 61 mmol/L). There were no other coingestants identified. One hour after presentation, the patient had a cardiac arrest with the monitor showing ventricular tachycardia. sodium bicarbonate 50 mEq intravenous push converted the patient to sinus rhythm and the blood pressure improved to 129/90 mm Hg. CONCLUSION: This case demonstrates a temporal relationship between bolus sodium bicarbonate administration and the termination of acebutolol-induced ventricular tachycardia.
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keywords = block
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2/260. Use of multisite electroanatomic mapping to facilitate ablation of intra-atrial reentry following the Mustard procedure.

    Ablation of intra-atrial reentrant tachycardia following Mustard or Senning procedures has low success rates. The Biosense Carto system was used to map intra-atrial reentry in a 22-year-old woman who had undergone a Mustard procedure. A line of block was created connecting a Mustard baffle suture line to the tricuspid valve annulus, which terminated the arrhythmia and prevented its reinitiation. Multisite electroanatomic mapping was invaluable in defining atrial anatomy and the intra-atrial reentrant pathway, and in creating a contiguous line of block. This mapping may improve ablation success rates in patients following the Mustard or Senning repair.
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keywords = block
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3/260. Use of atrial and bifocal cardiac pacemakers for treating resistant dysrhythmias.

    Several permanent cardiac pacing techniques have been utilized to control resistant cardiac arrhythmias. SA block, sinus arrest and intermittent ventricular tachycardia was controlled by the use of an atrial 'J' catheter and a rate programmable demand pacemaker. When these arrhythmias were associated with AV conduction delay they were managed with an AV sequential pacemaker with the additional insertion of a ventricular pacing lead. Appropriate adjustment of the AV sequential interval inhibited reciprocal AV or VA reentry thus controlling reciprocal tachycardia. Frequent ventricular premature systoles or intermittent ventricular tachycardia with in appropriately delayed sinus or subsidiary escape cycle lengths appear best managed by an AV sequential pacemaker by adjusting the atrial return cycle. Intractable atrial reentry tachycardias appear best managed by paired or rapid atrial stimulating pacemakers. Development of variable atrial rate, AV sequential and atrial return cycle activating pacemakers offer an effective control of resistant cardiac arrhythmias.
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keywords = block
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4/260. Interatrial conduction of atrial tachycardia in heart transplant recipients: potential pathophysiology.

    Surgical suture lines formed at the site of anastamosis have been considered to be electrically inert and thus present a line of block to conduction. However, a number of reports have suggested that conduction is occasionally possible across suture lines. Most of these cases have reported conduction between donor and recipient atria following cardiac transplantation. We report an illustrative case successfully treated with radiofrequency ablation, and present pathology findings that may give insight into the pathophysiology.
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keywords = block
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5/260. Sustained accelerated idioventricular rhythm.

    A 73-year-old white man became easily fatigued and hypotensive six weeks after a documented acute inferior myocardial infarction. Continuous ECG monitoring showed a sustained tachycardia with a right bundle branch block pattern. A His bundle electrogram showed no His deflection prior to ventricular activation. The patient was successfully treated with intravenous procaine amide resulting in reversion to sinus rhythm, loss of symptoms, and return of blood pressure to normal levels. The unique aspects of this case and therapeutic considerations in the management of this problem are discussed.
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ranking = 1
keywords = block
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6/260. Concealed accessory pathway with long conduction times and incremental properties: a case report.

    Concealed AP with Slow and Incremental Conduction. We report a peculiar form of permanent junctional reciprocating tachycardia that occurs only during daytime and physical activity. ECG obtained during tachycardia showed an unusual progressive shortening of the ventriculoatrial (VA) interval that was maximal at the first complex and shortest at the last one before block occurred, always at the accessory pathway level. This phenomenon has not been previously described and appears to be a reverse type of Wenckebach block. It was observed during salvos of spontaneous tachycardia and could be reproduced by right ventricular pacing. The accessory pathway was ablated successfully at the right posteroseptal region, close to the coronary sinus ostium. After ablation, there was no VA conduction, and tachycardia did not recur during a 9-month follow-up period.
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ranking = 2
keywords = block
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7/260. Electrocardiographic observations in bradycardia and tachycardia-dependent atrioventricular block. Relationship to supernormal phase of intraventricular conduction.

    This report describes the clinical course of a patient with bradycardia and tachycardia-dependent atrioventricular block. bradycardia dependent A-V block (phase 4 block) was transient and precipitated by spontaneous slowing of the sinus rate, atrial and ventricular extrasystoles; The degree of slowing (critical RP interval) required to induce A-V block increased progressively over a three-day period. bradycardia-dependent A-V block was terminated mostly by critically times spontaneous or paced ventricular escape beats, but normally conducted atrial impulses also appeared to restore A-V conduction on several occasions. The tachycardia-dependent component was manifested by an unusual fatigue phenomenon in the His-Purkinje system seen only at an atrial pacing rate of 150 per minute. These observations document the presence of both bradycardia and tachycardia-dependent A-V block in the presence of a normal H-V time and also illustrate the dynamic nature of both phase 4 block and the period of "supernormal" intraventricular conduction.
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ranking = 11
keywords = block
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8/260. syncope in patients with atrial flutter during treatment with class Ic antiarrhythmic drugs.

    We describe 2 atrial flutter (AFL) patients with syncope during treatment with class Ic antiarrhythmic drugs. During the syncope, 1:1 atrioventricular (AV) conduction during AFL preceded a wide QRS tachycardia. The class Ic drugs, flecainide and pilsicainide, slowed the atrial rate, resulting in AFL with 1:1 AV conduction, and the width of the QRS complexes became wider during the tachycardia. syncope was abolished after successful radiofrequency catheter ablation of the AFL. These potential proarrhythmic effects of the class Ic drugs should be taken into account in AFL patients, and concomitant use of beta-blocking agents would be critical to prevent proarrhythmias.
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ranking = 1
keywords = block
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9/260. Extensive myocardial stunning showing transient regression of prolonged T wave inversion and prolonged sympathetic denervation.

    A 69-year-old woman was admitted to the hospital with palpitations. Although left ventriculography showed extensive akinesis except in the basal hyperkinetic segment, coronary angiography showed normal coronary arteries. 123I-metaiodobenzylguanidine (MIBG) accumulation was obviously reduced in the anteroseptal, apical and inferior areas. Inverted T waves developed on day 3 and disappeared on day 104 after transient regression. echocardiography showed normal left ventricular motion two weeks later. ergonovine provocation test showed no vasospasm and thallium-201 showed no perfusion defect on day 46. electrocardiography and MIBG returned to normal on day 216. These findings suggest prolonged sympathetic nerve injury in extensive myocardial stunning.
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ranking = 0.00012821099101635
keywords = nerve
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10/260. Spontaneous regression over a 16-year period of tachyarrhythmias to sick sinus syndrome and complete atrioventricular block in a young patient with Ebstein's anomaly.

    A 25-year-old man with Ebstein's anomaly showed spontaneous regression of tachyarrhythmias to sick sinus syndrome and complete atrioventricular block over a 16-year period. This is the first clinical report supporting the hypothesis that abnormal cell death might contribute to the disturbance of the heart conduction system in Ebstein's anomaly.
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ranking = 5
keywords = block
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