Cases reported "Tachycardia"

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11/155. 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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12/155. Giant negative T waves during interferon therapy in a patient with chronic hepatitis c.

    interferon-alpha (IFN-alpha) has been widely used for treatment of chronic hepatitis c in japan. In general, cardiovascular adverse reactions are rare in association with IFN-alpha therapy. Here, a 64-year-old man with chronic active hepatitis c complained of fatigue, palpitation and depression, and developed atrial fibrillation with prominent negative T waves during IFN-alpha therapy. Echocardiogram showed septal and apical hypertrophy. Three days after discontinuation of IFN-alpha, subjective symptoms and atrial fibrillation subsided. It is unclear whether or not IFN-alpha induced the giant negative T waves with apical hypertrophy. We might observe the developing course of hepatitis c virus (HCV)-related myocardial hypertrophy by chance. Cardiovascular toxicity should be carefully monitored during IFN-alpha therapy even in patients with minor cardiac disease, such as premature ventricular contracture (PVC) and mild hypertension.
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ranking = 397.39158530287
keywords = wave
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13/155. 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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keywords = wave
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14/155. Pacemaker-mediated tachycardia in a biventricular pacing system.

    A 63-year-old man with chronic atrial fibrillation and heart failure had a biventricular pacing system implanted. The pulse generator was a standard DDDR pacemaker, using the atrial channel for the right ventricular lead and the ventricular channel for the left ventricular lead. During final adjustment of the pacing parameters, a pacemaker tachycardia triggered by T wave oversensing from the right ventricular lead was recorded.
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ranking = 66.231930883812
keywords = wave
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15/155. Cross-ventricular endless loop tachycardia during biventricular pacing.

    This report describes the development of an unusual pacemaker tachycardia in a patient with a conventional dual chamber pacemaker used for biventricular pacing in the VVIR mode. The atrial channel was connected to the left ventricle and the ventricular channel to the right ventricle. The tachycardia was sustained by sensing of the T wave by the "atrial channel" which triggered pacing by the "ventricular channel. " This "cross-ventricular" endless loop tachycardia is a reentrant pacemaker tachycardia like classic endless loop tachycardia and can be prevented by appropriate programming of the pacemaker.
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ranking = 66.231930883812
keywords = wave
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16/155. Dissimilar atrial rhythms: coexistence of reentrant atrial tachycardia, atrioventricular nodal reentrant tachycardia and interatrial conduction block.

    We report a patient in whom mapping of the right atrium with multipolar catheters and electroanatomic mapping revealed the presence of three dissimilar rhythms: a reentrant atrial tachycardia in the antero-lateral wall of the right atrium and an atrioventricular nodal reentrant tachycardia (AVNRT) isolated from each other and a conduction disturbance at the interatrial septum resulting in a rate-related interatrial block and a slow left atrial rhythm. The AVNRT was stopped with intravenous adenosine (6 mg) and induced repeatedly by atrial extrastimuli associated with a critical atrioventricular delay and dual atrioventricular nodal pathways. Electroanatomic mapping disclosed extensive fibrosis isolating viable myocardium of the antero-lateral wall from the rest of the right atrium. The viable myocardium in the antero-lateral wall was activated by a reentrant rhythm circulating around an islet of fibrosis located in the middle of the viable tissue. The AVNRT was ablated by a standard approach and the reentrant atrial tachycardia by producing a linear lesion bridging the central islet of fibrosis with the anterior tricuspid annulus. This case highlights the complicated nature of some dissimilar atrial rhythms and the power of electroanatomic mapping tools to reveal the exact mechanism and guide radiofrequency ablation.
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17/155. Permanent left atrial tachycardia: radiofrequency catheter ablation through the coronary sinus.

    The case of a 13-year-old child with an unusually localized "focal" permanent atrial tachycardia is reported. Electrophysiologic study showed that the earliest atrial activation occurred in the distal coronary sinus and preceded the atrial depolarization recorded along the endocardial side of the lateral part of the mitral annulus. Distal coronary sinus mapping revealed a fragmented, polyphasic atrial electrogram. Radiofrequency current delivery to the site permanently stopped the tachycardia.
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18/155. Atrial tachycardia with recipient-to-donor atrioatrial conduction and isthmus-dependent donor atrial flutter in a patient after orthotopic heart transplantation. Successful treatment by radiofrequency catheter ablation.

    Atrial arrhythmias are common after orthotopic heart transplantation. We report an unusual case of a patient after heart transplantation with 2 types of atrial arrhythmias: one was a macro-reentrant, incisional, recipient-atrial tachycardia conducted to the donor atrium, and the other was a common-type, isthmus-dependent atrial flutter in the donor atrium. These 2 arrhythmias were successfully treated with selective radiofrequency catheter ablation.
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keywords = frequency
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19/155. Antitachycardia pacing therapies and arrhythmia monitoring diagnostics for the treatment of atrial fibrillation.

    The case of a patient with frequent episodes of atrial fibrillation that organizes into atrial flutter following implantation of a dual chamber, rate adaptive pacemaker is reported. The atrial flutter was effectively pace-terminated following activation of the atrial antitachycardia pacing therapies in the pacemaker. This resulted in a decrease in atrial fibrillation burden over time. The present case also illustrates the value of diagnostic data retrieved from pacemakers for monitoring atrial fibrillation frequency over time and evaluating the efficacy of pacing and drug therapy.
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keywords = frequency
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20/155. De Subitaneis mortibus. XVI. Intractable tachycardia in infancy.

    Intractable tachycardia in a boy proved fatal at the age of one year. A cousin still living has the same problem. Special electrocardiographic studies in the boy demonstrated a consistent abnormality which included complete atrioventricular dissociation with a normal atrial rate but a ventricular rate usually about 240 beats/minute; a His bundle comples preceded each QRS and all QRS complexes were narrow and uniform in configuration without a delta wave. At postmortem examination there were changes due to congestive failure and the heart was enlarged but otherwise normal except for the His bundle. In its midportion the His bundle was split into several thin and irregular longitudinally oriented strands, within which there were many areas of focal degeneration. There was no myocarditis and no focal degeneration elsewhere in the heart. Although the etiology of this process is uncertain, some possibilities are discussed.
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ranking = 66.231930883812
keywords = wave
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