RESUMO
A 10-year-old girl with genetically confirmed Jervell-Lange-Nielsen syndrome treated with beta-blocker and developed electrical storm after changing propranolol syrup to tablets. Jervell-Lange-Nielsen is characterised by long QT and congenital sensorineural deafness, with high risk of malignant arrhythmias at early ages. Gastric involvement and achlorhydria may be present, with subsequent alteration of medication bioavailability which can trigger severe arrhythmic complications.
Assuntos
Síndrome de Jervell-Lange Nielsen , Síndrome do QT Longo , Antagonistas Adrenérgicos beta , Arritmias Cardíacas/tratamento farmacológico , Criança , Feminino , Humanos , Síndrome de Jervell-Lange Nielsen/diagnóstico , Síndrome de Jervell-Lange Nielsen/tratamento farmacológico , Síndrome do QT Longo/induzido quimicamente , Síndrome do QT Longo/diagnóstico , Propranolol , ComprimidosRESUMO
A 74-year-old man underwent an electrophysiological study because of Mobitz type II second-degree atrioventricular (AV) block with narrow QRS and frequent junctional extrasystoles. During the study, there were very frequent single His bundle depolarizations with multiple coupling intervals that reproduce the ECG findings. In this case, some His bundle extrasystoles result in retrograde concealed conduction and prolonged local refractoriness in the AV node that manifest as block of the next atrial impulse.
Assuntos
Bloqueio Atrioventricular/complicações , Complexos Cardíacos Prematuros/etiologia , Eletrocardiografia , Idoso , Bloqueio Atrioventricular/fisiopatologia , Fascículo Atrioventricular/fisiopatologia , Complexos Cardíacos Prematuros/fisiopatologia , Humanos , MasculinoRESUMO
Atrial fibrillation is the most common sustained arrhythmia. Because of its potentially serious clinical consequences (heart failure, stroke, and cognitive impairment), atrial fibrillation has important socioeconomic and health implications. This article reviews the major studies on the epidemiology of atrial fibrillation in Spain. Recent data suggest that in people older than 40 years, the prevalence of atrial fibrillation may be more than 4%. Given the current Spanish demography, these data would imply that more than 1 million people in Spain have atrial fibrillation.