No abstract available.
Arrhythmias, Cardiac ; Atrial Flutter ; Lymphoma ; Tachycardia, Ventricular

Amiodarone ; therapeutic use ; Combined Modality Therapy ; Electric Countershock ; Humans ; Infant ; Male ; Myocarditis ; therapy ; Ventricular Flutter ; therapy

We report a case of young male referred for evaluation of recent onset recurrent syncope. Inhospital electrocardiogram revealed an episode of ventricular flutter which reverted spontaneously to sinus rhythm. Transthoracic echocardiogram showed hyperechoic mass in the left ventricle. For further tissue characterization a cardiac magnetic resonance imaging was done which revealed a left ventricular mass with predominant fat content. The tumor was surgically resected. Histopathological examination confirmed the diagnosis of cardiac fibrolipoma. The patient recovered and is currently asymptomatic.
Arrhythmias, Cardiac* ; Diagnosis ; Electrocardiography ; Heart Neoplasms ; Heart Ventricles* ; Humans ; Magnetic Resonance Imaging ; Male ; Syncope ; Ventricular Flutter

There are a few case reports describing conversion to normal sinus rhythm after a propofol injection in tachyarrhythmic patients. We managed two cases of 52 year old males complaining of chest pain and dyspnea. We diagnosed them with atrial flutter and idiopathic ventricular tachycardia respectively. Initially they were treated with antiarrhythmic drugs but conversion to normal sinus rhythm was not achieved. Therefore, we decided to use electrical cardioversion. For sedation during electrical cardioversion, we injected propofol 2 mg/kg and 2% lidocaine 1 mg/kg. A few seconds later, conversion to normal sinus rhythm was achieved without electrical cardioversion in both cases. Thereafter normal sinus rhythm continued on the ECG and they were discharged.
Anti-Arrhythmia Agents ; Atrial Flutter* ; Chest Pain ; Dyspnea ; Electric Countershock* ; Electrocardiography ; Humans ; Lidocaine ; Male ; Middle Aged ; Propofol* ; Tachycardia, Ventricular

This is a report of a biatrial cardiac myxoma in a young man with a 10-month history of exertional dyspnea and palpitation. The echocardiogram revealed biatrial myxoma prolapsing through the mitral and tricuspid valves during diastole. All cardiac chambers were enlarged and dysfunctional. The electrocardiogram revealed a rapid ventricular response with atrial flutter rhythm. The masses were resected and diagnosed as myxoma by a histological examination. The follow-up echocardiogram revealed significant improvement in ventricular function and reduction in the cardiac chambers' volume. There was no evidence of myxoma recurrence. The most probable cause of the patient's heart failure was considered to be tachycardia-induced cardiomyopathy.
Atrial Flutter ; Cardiomyopathies ; Diastole ; Dyspnea ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Myxoma* ; Recurrence ; Tricuspid Valve ; Ventricular Function

The excitatory influence on heart rate is generally considered by beta-adrenergic neuroreceptors of Ahlquist's classificantion. Blockade of the beta adrenergic system would therefore be expected to alter heart rate and consequently to have an effect of patients with a variety of cardiac arrhythmias. In 1964 a clinically useable agent was produced by the name of propranolol which would effectively block beta action of adrenergic system and safe from side effects. The purpose of this study is to determine and estimate the immediate therapeutic effects of propranolol on 29 cases with various cardiac arrhythmias, administered intravenously. The following results were obtained: 1. It is apparent that propranolol by the intravenous route offers a rapid means of inducing A-V block and hence a reduction of the ventricular response in atrial fibrillation and atrial flutter. 2. Propranolol may be of value in improving digitalis-resistant atrial tachyarrhythmias with the therapeutic supplement. 3. Propranolol diminishes the automaticity of ectopic pacemakers because this is evident in the slowing of atrial rate or conversion of paroxysmal atrial tachycardia to sinus rhythm and the abolition or diminution of ventricular extrasystoles. 4. Digitalis-induced ventricular arrhythmias respond to propranolol well, and propranolol may well be the drug of choice in treating digitalis-induced ventricular arrhythmias. 5. Ventricular arrhythmias not related to digitalis were not satisfactorily treated with propranolol in our series. 6. Side effects associated with propranolol treatment were not remarkable except for development of transient hypertension in 2 cases.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Flutter ; Digitalis ; Heart Rate ; Humans ; Hypertension ; Propranolol* ; Sensory Receptor Cells ; Tachycardia ; Ventricular Premature Complexes

Flecainide is a drug used to manage supraventricular and ventricular arrhythmias. It is also effective in the treatment of fetal tachyarrhythmia through administration to the mother. However, flecainide toxicity may cause serious complications, including cardiac conduction disturbance, ventricular arrhythmia, resulting in syncope and sudden death. We describe here a 27-year-old woman at 31 weeks of gestation who experienced ventricular tachycardia, leading a perimortem cesarean section. On her past medication history, she has taken overdose of oral flecainide for the treatment of fetal atrial flutter. Just after neonatal delivery, her ventricular tachycardia was successfully reverted to a sinus rhythm through administration of intravenous lidocaine and hemodynamics were stabilized. According to her clinical signs and symptoms, we presume the ventricular tachycardia was likely induced by flecainide toxicity, although serum flecainide concentration could not be measured in our institution.
Adult ; Arrhythmias, Cardiac ; Atrial Flutter ; Cesarean Section ; Death, Sudden ; Female ; Flecainide ; Hemodynamics ; Humans ; Lidocaine ; Mothers ; Pregnancy ; Pregnant Women ; Syncope ; Tachycardia ; Tachycardia, Ventricular

A patient with non-ischaemic cardiomyopathy, and pre-existing atypical atrial flutter and left bundle branch block, developed broad complex tachycardia. In this unique and uncommon case of double tachycardia, we discuss the diagnostic approach of ventricular tachycardia in patients with broad complex tachycardia, and the use of different contemporary algorithms to help diagnose ventricular tachycardia and differentiate it from supraventricular tachycardia with aberrant conduction.
Algorithms ; Atrial Flutter ; complications ; diagnosis ; Bundle-Branch Block ; physiopathology ; Cardiomyopathies ; complications ; diagnosis ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Humans ; Male ; Middle Aged ; Tachycardia, Supraventricular ; diagnosis ; physiopathology ; Tachycardia, Ventricular ; diagnosis ; physiopathology

BACKGROUND: We analyzed our experience of arrhythmia surgery in patients with congenital heart disease. MATERIAL AND METHOD: A retrospective review was performed on 43 consecutive patients with congenital heart disease, who underwent arrhythmia surgery between June 1998 and June 2006. RESULT: The median age at surgery was 52 years (4~75 years). The most frequent cardiac anomaly was an atrial septal defect (23/43, 53.5%). The types of arrhythmias were atrial flutter-fibrillation, intermittent non-sustainable ventricular tachycardia and others in 37, 2 and 4, respectively. Arrhythmia surgery consisted of a bi-atrial maze operation in 18 patients (modified cox maze III procedure in 5 patients, and a right side maze plus pulmonary vein cryo-isolation in 13), right side maze operation in 18 patients, cavo-tricuspid isthmus cryoablation for benign atrial flutter in 4 patients, right ventricular endocardial cryoablation in 2 patients and extranodal cryoablation for atrioventricular node re-entry tachycardia in 1 patient. The median follow-up was 23.8 months (1~95.2 months). There was no early mortality, and one late non-cardiac related death. The overall rates of restored sinus rhythm before discharge and 3~6 months after surgery were 79% and 81%, respectively (bi-atrial maze group: 72% and 83%, right-side maze group: 77%, 77%). CONCLUSION: Arrhythmias associated with congenital heart disease can be safely treated surgically with an excellent intermediate-term outcome.
Arrhythmias, Cardiac* ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Node ; Cryosurgery ; Follow-Up Studies ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial ; Humans ; Mortality ; Pulmonary Veins ; Retrospective Studies ; Tachycardia ; Tachycardia, Ventricular

BACKGROUND AND OBJECTIVES: The mechanisms of supraventricular tachycardia (SVT) in children are known to have age-dependent distributions. However, the distribution of the mechanisms of tachyarrhythmia, as a whole, is not known in infants and children. The aim of this study was to evaluate the mechanisms of tachyarrhythmia in infants with a structurally normal heart. SUBJECTS AND METHODS: We retrospectively reviewed the mechanisms of tachycardia in 56 children with structurally normal hearts, who had had a tachyarrhythmia in infancy. The mechanisms of tachycardia were confirmed in surface electrocardiogram and by transesophageal, or transvenous, electrophysiological study. RESULTS: The majority of tachycardia during infancy were SVT, in 50 of the 56 (89%). In the infants with SVT, 29 (58%) had atrioventricular reentrant tachycardia using an accessory pathway, With a manifested accessory pathway were in 13 of the 29. Primary atrial tachycardia was found in 19 (38%: a chaotic atrial tachycardia in 10, an atrial flutter in 5 and an atrial ectopic tachycardia in 4). 6 (11%) had a ventricular tachycardia, and of these 5 had a verapamil-sensitive idiopathic left ventricular tachycardia. The most infrequent tachycardia during infancy was an atrioventricular nodal reentrant tachycardia, which occurred in only 2 (4%). 39% of the tachycardia during infancy occurred in the neonatal period. Atrioventricular nodal reentrant and ventricular tachycardia were not found during the neonatal period. CONCLUSION: The most frequent mechanism of tachycardia during infancy was SVT related, with an accessory pathway. Primary atrial and ventricular tachycardia were also found in nearly half the infants, and these were sometimes difficult to manage without understanding their precise mechanism.
Atrial Flutter ; Child ; Electrocardiography ; Heart* ; Humans ; Infant* ; Retrospective Studies ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ectopic Atrial ; Tachycardia, Supraventricular ; Tachycardia, Ventricular