7.Complete Atrioventricular Block-Induced Torsade de Pointes, Manifested by Epilepsy.
Jun Han JEON ; Sung Ho HER ; Jung Yeon CHIN ; Ki Hoon PARK ; Hee Jeong YOON ; Jong Min LEE ; Seung Won JIN
The Korean Journal of Internal Medicine 2011;26(1):99-102
Complete atrioventricular (AV) block is frequently regarded as a cause of informed syncopal attacks, even though the escape rhythm is maintained. Torsade de pointes (TdP) may be a significant complication of AV block associated with QT prolongation. Here, we report the case of a 42-year-old female who was referred to our hospital due to recurrent seizure-like attacks while taking anti-convulsant drugs at a psychiatric hospital. TdP with a long QT interval (corrected QT = 0.591 seconds) was observed on an electrocardiogram (ECG) taken in the emergency department. The patient's drug history revealed olanzapine as the suspicious agent. Even after the medication was stopped, however, the QT interval remained within an abnormal range and multiple episodes of TdP and related seizure-like symptoms were found via ECG monitoring. A permanent pacemaker was thus implanted, and the ventricular rate was set at over 80 beats/min. There was no recurrence of tachyarrhythmia or other symptoms.
Adult
;
Atrioventricular Block/*complications
;
Benzodiazepines/adverse effects
;
Electrocardiography
;
Epilepsy/*etiology
;
Female
;
Humans
;
Pacemaker, Artificial
;
Torsades de Pointes/*etiology/therapy
8.Late recurrent high degree atrioventricular block after percutaneous closure of a perimembranous ventricular septal defect.
Rong YANG ; Yan-Hui SHENG ; Ke-Jiang CAO ; Jiang-Gang ZOU ; Hao ZHANG ; Xiao-Feng HOU ; Di XU ; Yong-Hong YONG ; Lei ZHOU ; Xiang-Qing KONG
Chinese Medical Journal 2011;124(19):3198-3200
High degree atrioventricular block (HDAVB) is a serious complication of transcatheter closure of a perimembranous ventricular septal defect (PMVSD). We report one patient who developed transient HDAVB seven days after transcathter closure of PMVSD and had recurrent HDAVB 42 months after the procedure.
Atrioventricular Block
;
etiology
;
Heart Septal Defects, Ventricular
;
surgery
;
Humans
;
Male
;
Middle Aged
;
Postoperative Complications
;
Recurrence
;
Septal Occluder Device
9.Cardiac conductive disease with atrial fibrillation in a Chinese pedigree and evaluation of the treatments.
Fuqiang LIU ; Yan LI ; Yong XIE ; Donghua ZHAO ; Zhongbo XIAO ; Guifang ZHOU ; Jian PENG
Journal of Southern Medical University 2012;32(1):128-130
OBJECTIVETo investigate the clinical characteristics of a Chinese pedigree with cardiac conductive disease complicated by atrial fibrillation and the therapeutic effect of the treatments.
METHODSAll the family members including the proband were screened with routine examination, electrocardiography, echocardiograpy, Holter recording, chest X-ray, blood biochemistry tests and autoantibody test. The proband received dual chamber pacemaker implantation combined with oral amiodarone treatment for 3 months. The patient was monitored for thyreoid function and chest X-ray during the treatments, and was followed up for another 3 months.
RESULTSClinical evidence of organic heart disease was found in none of the family members. The proband showed recurrent dizziness and chest distress, which exacerbated after exercise, and ECG showed atrial fibrillation and severe A-V block. The proband's uncle was found to have atrial fibrillation and III degree A-V block after a syncope episode at the age of 30, and received a pacemaker treatment. Her grandpa died from a heart attack without detailed clinical documentations. No other family members showed abnormal ECG or a history of any heart events. The proband's condition was improved by treatments, after which ECG and Holter recording showed pace rhythm without atrial fibrillation.
CONCLUSIONCardiac conductive disease with atrial fibrillation can present in one family, and can be managed effectively and safely with implantation of dual chamber pacemaker combined with oral amiodarone.
Asian Continental Ancestry Group ; Atrial Fibrillation ; complications ; genetics ; therapy ; Atrioventricular Block ; complications ; genetics ; therapy ; Cardiac Resynchronization Therapy ; Female ; Heart Conduction System ; abnormalities ; Humans ; Pedigree ; Young Adult
10.Complete atrioventricular block complicating acute anterior myocardial infarction can be reversed with acute coronary angioplasty.
Kay Woon HO ; Tian Hai KOH ; Philip WONG ; Sung Lung WONG ; Yen Teak LIM ; Soo Teik LIM ; Li Fern HSU
Annals of the Academy of Medicine, Singapore 2010;39(3):254-257
INTRODUCTIONA retrospective case series of acute anterior myocardial infarction (MI) patients complicated by complete atrioventricular block (AVB) treated with acute percutaneous transluminal coronary angioplasty (PTCA).
CLINICAL PICTUREEight patients with anterior MI and complete AVB underwent acute PTCA between 2000 and 2005. Mean onset of complete AVB was 16.6 +/- 16.9 hours from chest pain onset.
TREATMENTAll patients underwent successful PTCA to the left anterior descending artery.
OUTCOMEComplete AVB resolved with PTCA in 88%; mean time of resolution was 89 +/- 144 minutes after revascularisation. One patient had permanent pacemaker implanted at Day 12 after developing an 8-second ventricular standstill during hospitalisation but not pacing-dependent on follow-up. The rhythm on discharge for the other surviving patients was normal sinus rhythm.
CONCLUSIONThis case series suggests that complete AVB complicating anterior MI is reversible with acute PTCA and survivors are not at increased risk of recurrent AVB. Nevertheless, this condition is associated with extensive myocardial damage and high mortality during the acute hospitalisation was not improved with correction of AVB with temporary pacing.
Adult ; Aged ; Angioplasty, Balloon, Coronary ; Anterior Wall Myocardial Infarction ; complications ; therapy ; Atrioventricular Block ; complications ; therapy ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Retrospective Studies