scholarly journals Atypical response of class IC atrial flutter to adenosine

2015 ◽  
Vol 76 (3) ◽  
Author(s):  
Francesco Rotondi ◽  
Tonino Lanzillo ◽  
Fiore Manganelli ◽  
Francesca Lanni ◽  
Ferdinando Alfano ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Ventricular Rate ◽  
Qrs Complex ◽  
Intravenous Amiodarone ◽  
Adenosine Administration ◽  
Ventricular Conduction

We report the case of a 67-year-old female with a wide QRS complex tachycardia at 180 bpm. A diagnosis of class IC atrial flutter with aberrant ventricular conduction caused by flecainide therapy was formulated. Intravenous adenosine administration resulted in adequate slowing of the ventricular rate and normalization of QRS complexes. Restoration of sinus rhythm was achieved with intravenous amiodarone. The response to adenosine confirmed the diagnosis of supraventricular tachycardia with aberrant conduction, but the transition from arrhythmia onset to restoration of sinus rhythm showed interesting peculiarities.

Rapid control of foetal supraventricular tachycardia with digoxin and flecainide combination treatment

2011 ◽  
Vol 22 (4) ◽  
pp. 372-380 ◽  
Author(s):  
Orhan Uzun ◽  
Kadir Babaoglu ◽  
Anju Sinha ◽  
Spyridon Massias ◽  
Bryan Beattie
Keyword(s):  
Sinus Rhythm ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Combination Treatment ◽  
Serum Levels ◽  
Response To Treatment ◽  
Intrauterine Death ◽  
Tertiary Referral Centre ◽  
Rapid Control ◽  
Postnatal Outcome

AbstractObjectivesTo evaluate the efficacy of flecainide and digoxin combination in foetal supraventricular tachycardia.SettingThis study was carried out in a tertiary referral centre.MethodsWe conducted a retrospective review of 29 patients diagnosed with supraventricular foetal tachycardia between 2001 and 2009. Mode of presentation, foetal cardiac function, maternal anti-arrhythmic serum levels, drug tolerance, and maternal electrocardiogram recordings were assessed. The postnatal outcome of each infant was also evaluated for tachycardia recurrence.ResultsIn all, 27 foetuses were treated with digoxin and flecainide combination, and two foetuses were delivered without any treatment. Of the 27 foetuses, seven had atrial flutter and the remaining 22 had atrioventricular re-entry tachycardia. There were eight foetuses with hydrops (27%), of whom three had atrial flutter and five had atrioventricular re-entry tachycardia; 26 foetuses (96%) responded to flecainide and digoxin combination, with restoration of sinus rhythm in 22 (81.4%) and rate control in the other four. In one severely hydropic foetus, there was no response to treatment. In all, 26 treated infants were delivered alive, but one pregnancy was terminated for non-cardiac causes when the foetus was in sinus rhythm. There was no intrauterine death due to tachycardia. Although there were minor side effects to anti-arrhythmic medications, none of the pregnant women developed proarrhythmia.ConclusionFlecainide and digoxin combination treatment offers a safe and effective treatment for foetal supraventricular tachycardia with fast restoration of sinus rhythm.

scholarly journals Diagnostic use of Adenosine for Atrial Flutter with regular Tachycardia

2021 ◽  
Vol 02 ◽  
Author(s):  
Rajeev Lochan ◽  
Deepaali Arora ◽  
Hussain Al Rahma
Keyword(s):  
Emergency Room ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Diagnostic Value ◽  
Ventricular Rate ◽  
Male Smoker ◽  
P Waves ◽  
Case Presentation ◽  
Hemodynamic Compromise ◽  
Surface Ecg

Background: Supraventricular tachycardia is the commonest type of narrow complex regular tachycardia seen in an emergency room, which can easily be diagnosed by surface ECG and acutely managed by Adenosine injection. A 59 years old male smoker was presented with palpitation with a pulse rate of 220/min with mild hemodynamic compromise. ECG confirmed narrow complex regular tachycardia, and the initial working diagnosis was established as supraventricular tachycardia[SVT] in the emergency room. Case Presentation: As standard practice, adenosine was given, which failed in terminating the tachycardia but by creating a transient atrioventricular block, slowed down ventricular rate, and sawtooth-shaped P waves of atrial flutter were exposed. In contrast to the expectations, in this case of narrow complex regular tachycardia of supraventricular origin, adenosine could not establish the sinus rhythm but confirmed the diagnosis of atrial flutter with the regular rate with fixed A-V block. Conclusion: Instead of therapeutic use, adenosine has been proven to be of diagnostic value, which can be used when the diagnosis of narrow complex tachycardia is in doubt, however with some cautions.

Clinical management of supraventricular tachycardia with adenosine

1993 ◽  
Vol 2 (1) ◽  
pp. 41-47 ◽  
Author(s):  
C Chronister
Keyword(s):  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Clinical Management ◽  
Research Articles ◽  
Original Research ◽  
Qrs Complex

Adenosine is a reliable agent to convert supraventricular tachycardia to regular sinus rhythm with few complications. Also, adenosine may be useful in the diagnosis of narrow and wide QRS complex tachycardias. Original research articles published predominantly in the last 10 years were reviewed. These articles examined the therapeutic and electrophysiologic effects of adenosine compounds and compared their actions to other antiarrhythmics.

Myotonic dystrophy presenting as atrial flutter in childhood

2004 ◽  
Vol 14 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Kenji Suda ◽  
Masahiko Matsumura ◽  
Yuji Hayashi
Keyword(s):  
Cardiac Function ◽  
Sinus Rhythm ◽  
Atrial Flutter ◽  
Myotonic Dystrophy ◽  
Left Ventricular ◽  
Ventricular Rate ◽  
Cardiac Complications ◽  
Ventricular Dilation ◽  
Left Ventricular Dilation ◽  
Normal Cardiac Function

A 12-year-old boy presented with tachycardia and cardiomegaly. An electrocardiogram showed atrial flutter with a ventricular rate of 170 beats/min. The echocardiogram showed left ventricular dilation, with decreased contractility. Electromyography confirmed the diagnosis of myotonic dystrophy. The atrial flutter was converted to sinus rhythm by electroversion, leading to restoration of normal cardiac function. Our case illustrates that atrial flutter can be an early sign of the cardiac complications of myotonic dystrophy in childhood.

scholarly journals Fetal supraventricular tachycardia at 12 weeks of gestation: diagnosis and follow up. A case report

2019 ◽  
Vol 21 (1) ◽  
pp. 93 ◽  
Author(s):  
Nathalie Jeanne Bravo-Valenzuela ◽  
Alberto Borges Peixoto ◽  
Edward Araujo Júnior ◽  
Gabriele Tonni
Keyword(s):  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Fetal Heart ◽  
First Trimester ◽  
Ventricular Rate ◽  
Healthy Male ◽  
Fetal Hydrops ◽  
Male Baby ◽  
Digoxin Therapy

This report describes a case of fetal supraventricular tachycardia (SVT) diagnosed at 12 weeks of gestation in a pregnant woman with diabetes mellitus. Transplacental digoxin therapy administered orally to the mother was unsuccessful. Subsequently, sotalol was added to digoxin to achieve fetal heart rate (HR) control and the conversion to sinus rhythm was achieved. The fetal HR remained stable until term, and a healthy male baby was born. The newborn electrocardiogram showed sinus rhythm with normal PR and QTc intervals. When the newborn was stable, he was discharged with propanolol. Sustained SVT is extremely rare during the first trimester. The goal of treatment in utero is the conversion to sinus rhythm or reduction of the ventricular rate to tolerable levels, preventing or even reversing fetal hydrops.

scholarly journals Atrial Flutter as the First Manifestation of Progressive Cardiac Conduction Disease in a Young Apparently Healthy Patient: А Case Report

2019 ◽  
Vol 2 (4) ◽  
pp. 139-142
Author(s):  
I. Stepanenko ◽  
D. Frolov ◽  
V. Salukhov ◽  
M. Didenko ◽  
V. Kitsyshin ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Atrial Flutter ◽  
Sinus Node ◽  
Atrioventricular Conduction ◽  
Cardiac Conduction ◽  
Ventricular Rate ◽  
Av Block ◽  
Ecg Monitoring ◽  
Ambulatory Ecg ◽  
Ambulatory Ecg Monitoring

Abstract We reported a case of a twenty-one-year-old man with an atrial flutter as the first manifestation of progressive cardiac conduction disease. The patient was admitted to the cardiology department due to complaints of shortness of breath and a decrease in exercise tolerance, which had happened after physical exercises (running). During ambulatory ECG monitoring persistent AFL was observed with atrial rate 262-297 bpm and ventricular rate 26-136 bpm (average 56 bpm). AV conduction was very variable – 4:1-14:1. The results of ambulatory ECG monitoring during the whole period of recording indicated signs of atrioventricular conduction disturbances. After cardioversion sinus rhythm was restored additional rhythm and conduction disorders were revealed. Ambulatory ECG monitoring was performed two weeks after the initial one, and throughout this recording were registered sinus rhythm on the background of first-degree AV block; transient Mobitz I AV block; and type 2 second-degree sinoatrial block. Trans-esophageal electrophysiology study was performed. During pharmacological denervation of the heart, signs of slowing of the atrioventricular conduction and sinus node recovery time persisted. These changes along with right bundle branch block were regarded as a progressive cardiac conduction disease with an apparently hereditary cause.

scholarly journals A Case Report of Neonatal Supraventricular Tachycardia Resolved with Single-Syringe Adenosine

2020 ◽  
Vol 4 (4) ◽  
pp. 617-619
Author(s):  
Marc McDowell ◽  
Tasneem Ahmed ◽  
Bill Schroeder ◽  
Shannon Staley
Keyword(s):  
Case Report ◽  
Sodium Chloride ◽  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Emergency Care ◽  
Normal Sinus Rhythm ◽  
The Novel ◽  
Normal Sinus ◽  
Administration Method ◽  
Adenosine Administration

Introduction: Supraventricular tachycardia (SVT) is a condition requiring emergency care in neonates. Case Report: We describe a successfully treated case of neonatal SVT in a four-week-old neonate using the novel adenosine administration method. This technique is potentially easier to facilitate and does not require equipment such as a stopcock. Adenosine 0.2 milligrams per kilogram was drawn up into a syringe containing 0.9% sodium chloride to a total volume of 3 milliliters. Once administered, the patient had near-immediate return to normal sinus rhythm without sequelae. Conclusion: This case demonstrates that the single-syringe method appears potentially safe and effective in neonates.

scholarly journals Atrial Flutter in a Newborn: a Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 67-71
Author(s):  
Andreea Paler Cerghit ◽  
Amalia Făgărășan ◽  
Iolanda Muntean ◽  
Sorina Pasc ◽  
Dorottya Miklósi ◽  
...  
Keyword(s):  
Heart Rate ◽  
Sinus Rhythm ◽  
Atrial Flutter ◽  
Good Condition ◽  
Late Pregnancy ◽  
Electrical Cardioversion ◽  
Ventricular Rate ◽  
Ventricular Extrasystoles ◽  
Surface Ecg ◽  
Structural Disease

AbstractIntroduction: The incidence of cardiac arrhythmia is approximately 1% in the neonatal period and 1–3% in late pregnancy. Atrial flutter (AF), a rhythm disorder based on the mechanism of reentry, represents approximately 32% of all neonatal cardiac arrhythmias. In the majority of cases, the flutter is converted to sinus rhythm using antiarrhythmic drugs, transesophageal overdrive pacing, or synchronized electrical cardioversion.Case presentation: We present a case of a born on term, female infant who was noted to be tachycardic on the fetal monitor. Clinical examination revealed tachypnea and tachycardia with dysrhythmia, at a heart rate of 250 bpm. Electrocardiography showed AF with 2–3 : 1 atrioventricular conduction (atrial and ventricular rates were 350 bpm and 250–275 bpm, respectively). Echocardiography revealed no relevant structural disease. Therapy with amiodarone and prophylactic anticoagulant was initiated. As no control of ventricular rate was obtained and a succession of three ventricular extrasystoles was noted on the surface ECG, propranolol therapy was initiated, without success. Therefore, synchronized electrical cardioversion was applied, with conversion to sinus rhythm at a heart rate of 136 bpm. The neonate was discharged in good condition.Conclusions: AF is one of the most common high ventricular rate arrhythmias during fetal age. Uncontrolled AF may precipitate heart failure, and prompt restoration to sinus rhythm may require electrical cardioversion in cases refractory to anti-arrhythmic drugs, in order to prevent possible complications.

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