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1.
Am J Case Rep ; 20: 1949-1955, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31879415

RESUMO

BACKGROUND Trazodone is widely used in the treatment of depression, anxiety, and insomnia. It is thought to have a safe cardiac profile due to the relative lack of anticholinergic effects. Publications about cardiac toxicities of trazodone are scant. CASE REPORT A 55-year-old woman presented with acute disorder of consciousness secondary to an intentional trazodone overdose. She was found to have seizure activity without cerebral edema. The initial electrocardiogram was unremarkable, with a normal QTc interval. She eventually developed QTc prolongation that evolved into ventricular tachycardia, and then into a transient right bundle-branch block, left anterior fascicular block, and variable degrees of atrioventricular nodal blocks at 12-24 h after ingestion. She then developed generalized tonic-clonic seizures, cardiogenic shock, and respiratory arrest. She was intubated and treated with antiepileptics, norepinephrine, and dopamine infusion. QTc interval prolongation gradually resolved and the various forms of heart block did not recur after at 24-36 h. She did not require transcutaneous pacing, and was successfully extubated with intact neurological function. CONCLUSIONS Fatal arrhythmias can occur in trazodone overdose. Close monitoring and supportive care are crucial for patient survival.


Assuntos
Ansiolíticos/efeitos adversos , Bloqueio de Ramo/induzido quimicamente , Overdose de Drogas/complicações , Síndrome do QT Longo/induzido quimicamente , Convulsões/induzido quimicamente , Taquicardia Ventricular/induzido quimicamente , Trazodona/efeitos adversos , Anticonvulsivantes/uso terapêutico , Bloqueio de Ramo/diagnóstico por imagem , Bloqueio de Ramo/tratamento farmacológico , Dopamina/uso terapêutico , Eletrocardiografia , Feminino , Humanos , Síndrome do QT Longo/diagnóstico por imagem , Síndrome do QT Longo/tratamento farmacológico , Pessoa de Meia-Idade , Norepinefrina/uso terapêutico , Taquicardia Ventricular/diagnóstico por imagem , Taquicardia Ventricular/tratamento farmacológico
2.
Expert Opin Pharmacother ; 20(17): 2101-2114, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31566420

RESUMO

Introduction: Ventricular arrhythmias are often seen in association with structural heart disease. However, approximately a tenth of affected patients have apparently normal hearts, where such arrhythmias typically occur in young patients, are sometimes inherited and can occasionally lead to sudden cardiac death (SCD). Over the past two decades, increased understanding of the underlying pathophysiology resulted in improved targeted pharmacological therapy.Areas covered: This article reviews current knowledge regarding drug therapy for inherited arrhythmia syndromes (Brugada, early repolarization, long QT and short QT syndromes, and catecholaminergic polymorphic ventricular tachycardia), and acquired arrhythmias (idiopathic ventricular fibrillation, short-coupled torsade de pointes, outflow tract ventricular tachycardia, idiopathic left, papillary muscle and annular ventricular tachycardias).Expert opinion: In inherited arrhythmia syndromes, appropriate clinical and genetic diagnoses followed by proper selection and dosing of antiarrhythmic drugs are of utmost importance to prevent SCD, most often without the need of implantable cardioverter-defibrillators. In acquired arrhythmias, appropriate pharmacotherapy in selected patients can also provide symptomatic relief and avoid the need for invasive therapy. Further research is needed to develop novel antiarrhythmic drugs or targeted therapy to increase efficacy and limit side effects.


Assuntos
Antiarrítmicos/uso terapêutico , Arritmias Cardíacas/tratamento farmacológico , Antagonistas Adrenérgicos beta/uso terapêutico , Arritmias Cardíacas/genética , Arritmias Cardíacas/patologia , Síndrome de Brugada/tratamento farmacológico , Síndrome de Brugada/patologia , Estudos de Associação Genética , Humanos , Síndrome do QT Longo/tratamento farmacológico , Síndrome do QT Longo/patologia , Quinidina/uso terapêutico , Taquicardia Ventricular/tratamento farmacológico , Taquicardia Ventricular/patologia
3.
Int Heart J ; 60(5): 1168-1175, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484876

RESUMO

The aims of the present study were to investigate the effects of angiotensin receptor neprilysin inhibitors (ARNi) on the susceptibility of ventricular arrhythmias (VAs) in rats with myocardial infarction (MI) and to explore the related mechanisms.A total of 32 adult male Sprague-Dawley rats were divided into 3 groups: a control group, MI group, and MI+ARNi group. MI was generated by ligation of the left anterior descending coronary artery. ARNi was given at 68 mg/kg/day for 4 weeks after MI surgery. At 4 weeks after MI, electrical programmed stimulation (EPS) was performed in all groups for the evaluation of VAs, and echocardiography was used to evaluate cardiac function. Indicators of sympathetic neural remodeling and cardiac remodeling were detected to further explore the related mechanisms.Four weeks after MI, rats in the ARNi group exhibited low susceptibility of VAs in comparison with that in the MI group, which was coincident with the attenuation of sympathetic nerve remodeling, amelioration of cardiac fibrosis, and regulation of Cx43 expression.ARNi is effective in reducing VAs in rats with ischemic cardiomyopathy, which is associated with attenuating sympathetic nerve remodeling and myocardial fibrosis.


Assuntos
Conexina 43/metabolismo , Infarto do Miocárdio/tratamento farmacológico , Neprilisina/farmacologia , Taquicardia Ventricular/tratamento farmacológico , Remodelação Ventricular/efeitos dos fármacos , Animais , Biópsia por Agulha , China , Modelos Animais de Doenças , Ecocardiografia/métodos , Imuno-Histoquímica , Masculino , Contração Miocárdica/efeitos dos fármacos , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/patologia , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Fatores de Risco , Taxa de Sobrevida , Sistema Nervoso Simpático/efeitos dos fármacos , Taquicardia Ventricular/diagnóstico por imagem
4.
Medicine (Baltimore) ; 98(34): e16961, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441899

RESUMO

BACKGROUND: Owing to reports of recurrent cardiac events in some catecholaminergic polymorphic ventricular tachycardia (CPVT) patients using ß-blockers, safer alternatives are being investigated. Flecainide is an alternative adjunctive anti-arrhythmic agent known to provide incomplete protection to CPVT patients. METHODS: To investigate the efficacy and tolerability of flecainide, we searched 4 databases for retrospective cohort studies (RCs) and randomized controlled trials (RCTs) investigating the efficacy and safety of flecainide for CPVT patients. Data were extracted and analyzed (risk ratio [RR] or mean difference [MD]) using RevMan software. Seven RCs and 1 RCT (333 CPVT patients; 152 patients treated with flecainide) were identified. RESULTS: Flecainide monotherapy was superior to standard therapy in alleviating the risk of arrhythmic events (RR = 0.46, confidence interval [CI] = [0.38, 0.56], P < .00001) and exercise-induced arrhythmia scores (MD = -0.39, CI = [-0.74, -0.05], P = .03). Combination therapy of flecainide and ß-blockers was superior to ß-blocker monotherapy in reducing the risk of arrhythmic and symptomatic events (RR = 0.29, CI = [0.13, 0.69], P = .005; RR = 0.36, CI = [0.20, 0.62], P = .0003, respectively), peak heart rate (MD = -16.81, CI = [-28.21, -5.41], P = .004), and exercise-induced arrhythmia scores (MD = -1.87, CI = [-2.71, 1.04], P < .0001). Flecainide did not increase the risk of all side effects (RR = 0.76, CI = [0.42, 1.40], P = .38) compared to that with ß-blockers alone. No deaths were reported among patients treated with flecainide. CONCLUSIONS: Flecainide is an effective and safe anti-arrhythmic agent, and its use as a monotherapy might be a good alternative for CPVT patients with ß-blocker intolerance. Combination therapy was superior to ß-blocker monotherapy. More randomized clinical trials are required to explore the long-term efficacy and safety of flecainide in these patients.


Assuntos
Antiarrítmicos/administração & dosagem , Flecainida/administração & dosagem , Taquicardia Ventricular/tratamento farmacológico , Antagonistas Adrenérgicos beta/administração & dosagem , Antagonistas Adrenérgicos beta/efeitos adversos , Antiarrítmicos/efeitos adversos , Feminino , Flecainida/efeitos adversos , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos
5.
Int Heart J ; 60(5): 1189-1191, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31447465

RESUMO

The first onset of cardiac event of long QT syndrome (LQTS) was at young age and caused by emotional or physical triggers. We presented a 64-year-old woman who experienced recurrent ventricular arrhythmia after hemodialysis initiation because of end-stage renal disease. Persistent prolonged QTc interval and diagnosis of inherited LQT2 were missed at her first 3 years of hemodialysis. The patient was beta-blocker nonresponder for ventricular arrhythmias suppression and experienced multiple ICD discharge. We reported an inherited LQT2 case with uncommon clinical manifestations and the successful experience of mexiletine use in such a patient.


Assuntos
Falência Renal Crônica/terapia , Síndrome do QT Longo/genética , Mexiletina/uso terapêutico , Diálise Renal/efeitos adversos , Taquicardia Ventricular/tratamento farmacológico , Taquicardia Ventricular/etiologia , Antiarrítmicos/uso terapêutico , Eletrocardiografia/métodos , Feminino , Seguimentos , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/diagnóstico , Síndrome do QT Longo/diagnóstico , Pessoa de Meia-Idade , Doenças Raras , Recidiva , Diálise Renal/métodos , Medição de Risco , Taquicardia Ventricular/diagnóstico , Resultado do Tratamento
6.
Lipids Health Dis ; 18(1): 119, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31122256

RESUMO

OBJECTIVES: The study sought to assess the impact of statin therapy on survival in patients presenting with ventricular tachyarrhythmias. BACKGROUND: Data regarding the outcome of patients with statin therapy presenting with ventricular tachyarrhythmias is limited. METHODS: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2016. Patients with statin were compared to patients without statin therapy (non-statin). The primary prognostic endpoint was long-term all-cause death at 3 years. Uni- and multivariable Cox regression analyses were applied in propensity-score matched cohorts. RESULTS: A total of 424 matched patients was included. The rates of VT and VF were similar in both groups (VT: statin 71% vs. non-statin 68%; VF: statin 29% vs. 32%; p = 0.460). Statin therapy was associated with lower all-cause mortality at long-term follow-up (mortality rates 16% versus 33%; log rank, p = 0.001; HR = 0.438; 95% CI 0.290-0.663; p = 0.001), irrespective of the underlying type of ventricular tachyarrhythmia (VT/VF), left ventricular ejection fraction (LVEF) > 35%, presence of an activated implantable cardioverter defibrillator (ICD), cardiogenic shock or cardiopulmonary resuscitation (CPR). CONCLUSION: Statin therapy is independently associated with lower long-term mortality in patients presenting with ventricular tachyarrhythmias on admission. TRIAL REGISTRATION: Clinicaltrials.gov, NCT02982473 , 11/29/2016, Retrospectively registered.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Taquicardia Ventricular/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Pontuação de Propensão , Modelos de Riscos Proporcionais , Análise de Sobrevida , Taquicardia Ventricular/mortalidade , Adulto Jovem
10.
Int J Cardiol ; 279: 64-71, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30642646

RESUMO

BACKGROUND: It is reported interleukin (IL)-17A, a classical proinflammatory cytokine, is implicated in neuroimmune-associated remodeling in neural plasticity and pathological conditions. However, the effect of IL-17A on left stellate ganglion (LSG) remodeling remains unclear. OBJECTIVE: This study was performed to determine whether exogenous IL-17A promotes LSG remodeling and destabilize ventricular electrophysiological properties (EPs) in normal canines. METHODS: 24 beagles were randomly allocated into three groups. In the first group, animals were subjected to 0.1 ml phosphate buffer saline (PBS) microinjection of into LSG (n = 8), an equivalent IL-17A was administrated in the second group (n = 8), and an equivalent anti-IL-17A mAb plus IL-17A was administrated in the third group (n = 8). The ventricular EPs, neural function and activity of the LSG were determined at baseline and 30 min after administration. In the end, LSG tissues were collected. RESULTS: Compared with the control group, the experimental group had a significantly shorter effective refractory period (ERP) and action potential duration (APD)90, an increased ERP, APD90, Smax dispersion, and APD alternans cycle length; and steepened APD restitution curves. In addition, IL-17A enhanced the neural function and activity of the LSG, upregulated the expressions of neuropeptides and proinflammatory cytokines and cells. And all these effects were attenuated by anti-IL-17A mAb. Importantly, IL-17 receptor A (IL-17R-A) was detected in sympathetic neurons in the LSG. CONCLUSION: IL-17A promoted LSG remodeling by regulating the neural inflammation response. It did so by binding to IL-17R-A, resulting in unstable ventricular electrophysiology in normal structural hearts.


Assuntos
Interleucina-17/administração & dosagem , Neuroimunomodulação/efeitos dos fármacos , Gânglio Estrelado/efeitos dos fármacos , Remodelação Vascular/efeitos dos fármacos , Animais , Cães , Interleucina-17/metabolismo , Microinjeções/métodos , Neuroimunomodulação/fisiologia , Gânglio Estrelado/imunologia , Gânglio Estrelado/metabolismo , Taquicardia Ventricular/tratamento farmacológico , Taquicardia Ventricular/imunologia , Taquicardia Ventricular/metabolismo , Remodelação Vascular/fisiologia
12.
Am J Emerg Med ; 37(2): 376.e3-376.e7, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30415983

RESUMO

BACKGROUND: Brugada pattern is a well-known pathological finding on electrocardiogram (ECG) which increases the likelihood of cardiac arrest due to ventricular arrhythmia. These cases generally present in younger patients without evidence of an electrolyte abnormality, structural heart disease, or cardiac ischemia. In many instances, this pattern is either hidden on initial presentation or presents as an incidental finding on an EKG. Often times the Brugada syndrome leads to sudden cardiac death or more rarely can be unmasked with a class 1A or 1C anti-arrhythmic agent. Here, we present a distinctive case in which the pattern was exposed by amiodarone during the emergent treatment of Ventricular Tachycardia (VT). CASE REPORT: A 34-year-old female, without significant cardiac history, presented to the Emergency Department after multiple near syncopal episodes at home. Initial ECG showed VT vs. SVT. After a failed trial of adenosine, the patient was treated with 150 mg amiodarone and became hypotensive needing an electrical cardioversion. After becoming bradycardic, the amiodarone drip was discontinued and she was admitted to the MICU. An echocardiogram and left heart catheterization showed no evidence of coronary artery disease or decreased ejection fraction. The patient's ECG now showed a subtle Brugada Type 3 pattern and she received a dual chamber AICD upon discharge. CONCLUSION: This case emphasizes the awareness needed to seek out this pattern on subsequent ECG's. With the high lethality of Brugada, the emergency physician must recognize that multiple drugs can evoke this pattern after initial presentation.


Assuntos
Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Síndrome de Brugada/diagnóstico , Síndrome de Brugada/terapia , Desfibriladores Implantáveis , Taquicardia Ventricular/tratamento farmacológico , Adulto , Síndrome de Brugada/fisiopatologia , Eletrocardiografia , Serviço Hospitalar de Emergência , Feminino , Humanos , Taquicardia Ventricular/fisiopatologia
13.
Heart Lung Circ ; 28(1): 49-56, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30392983

RESUMO

While implantable cardioverter defibrillators decrease mortality in high risk groups of patients who have ventricular arrhythmias, antiarrhythmic drugs are still required to reduce the burden of both benign and life-threatening arrhythmias. This review will address the available medical therapy for ventricular arrhythmias in Australia and their use in different clinical situations.


Assuntos
Antiarrítmicos/uso terapêutico , Frequência Cardíaca/efeitos dos fármacos , Taquicardia Ventricular/tratamento farmacológico , Humanos , Taquicardia Ventricular/fisiopatologia
14.
Int J Cardiol ; 277: 118-124, 2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30473333

RESUMO

OBJECTIVE: The study sought to assess the prognostic impact of treatment with beta-blocker (BB) compared to combined BB plus amiodarone (BB-AMIO) on long-term survival in patients surviving ventricular tachyarrhythmias on admission. BACKGROUND: Data regarding the prognostic outcome of patients presenting with ventricular tachyarrhythmias treated with BB and BB-AMIO is limited. METHODS: A large retrospective registry was used including consecutive patients surviving index episodes of ventricular tachyarrhythmias from 2002 to 2016. Patients treated with BB were compared to patients with BB-AMIO. The primary prognostic endpoint was long-term all-cause death at 3 years. Kaplan-Meier, multivariable Cox regression and propensity score matching analyses were applied. RESULTS: A total of 1354 patients was included, 85% treated with BB, 15% with BB-AMIO. Within the unmatched real-life cohort, uni- and multivariable Cox regression models revealed BB associated with improved long-term survival compared to BB-AMIO (univariable: HR = 0.550; p = 0.001, multivariable: HR = 0.712; statistical trend, p = 0.052). After propensity-score matching (n = 186 matched pairs), BB therapy was still associated with improved survival compared to BB-AMIO (mortality rate 18% versus 26%; log rank p = 0.042; HR = 0.634; 95% CI = 0.407-0.988; p = 0.044). Prognostic superiority of BB was mainly observed in patients with LVEF ≥ 35% (HR = 0.463; 95% CI = 0.215-0.997; p = 0.049) and in those without atrial fibrillation (non-AF) (HR = 0.415; 95% CI = 0.202-0.852; p = 0.017). CONCLUSION: BB therapy is associated with improved secondary long-term prognosis compared to BB-AMIO in patients surviving index episodes of ventricular tachyarrhythmias.


Assuntos
Antagonistas Adrenérgicos beta/administração & dosagem , Amiodarona/administração & dosagem , Antiarrítmicos/administração & dosagem , Taquicardia Ventricular/diagnóstico por imagem , Taquicardia Ventricular/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Taquicardia Ventricular/mortalidade , Adulto Jovem
15.
Intern Med ; 58(8): 1111-1118, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30568130

RESUMO

A 47-year-old man with ulcerative colitis was transferred to our hospital due to progressive dyspnea. Electrocardiography on admission showed ST elevation in leads II, III, aVF, and V5-V6. Coronary angiography revealed no remarkable coronary stenosis, and left ventriculography showed a depressed left ventricular ejection fraction (EF) of 23%. Although the patient received percutaneous cardiopulmonary support, his EF progressively decreased (7-15%), and both ventricular tachycardia (VT) and high-degree atrial-ventricular block occurred. An endomyocardial biopsy showed eosinophilic infiltration in the myocardium. Steroid therapy improved the patient's EF. However, his severe inferior wall hypokinesis and non-sustained VT remained after the abovementioned treatment.


Assuntos
Colite Ulcerativa/complicações , Colite Ulcerativa/tratamento farmacológico , Miocardite/tratamento farmacológico , Intervenção Coronária Percutânea/métodos , Esteroides/uso terapêutico , Taquicardia Ventricular/tratamento farmacológico , Taquicardia Ventricular/etiologia , Eosinofilia/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Miocardite/patologia , Resultado do Tratamento , Função Ventricular Esquerda/efeitos dos fármacos
17.
Turk Kardiyol Dern Ars ; 46(8): 718-722, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30516532

RESUMO

Andersen-Tawil syndrome (ATS) is a disorder that causes episodes of muscle weakness (periodic paralysis), changes in heart rhythm, and developmental abnormalities. QT prolongation and ventricular arrhythmias, including bidirectional ventricular tachycardia (VT) and polymorphic VT, may occur. About 60% of all cases of the disorder arecaused by mutations in the KCNJ2 gene. A 13-year-old female patient was referred for frequent premature ventricular contractions. Suspicion of ATS due to dysmorphic findings, electrocardiogram changes, and periodic muscle weakness was genetically confirmed. Beta-blocker therapy was initiated as a first-line treatment for bidirectional VT and frequent polymorphic premature ventricular contractions. Despite proper treatment, the VT attacks were not brought under control. Flecainide was added to the treatment regime. The number of premature ventricular contractions was dramatically reduced with flecainide and the VT attacks completely disappeared. This patient is a rare example of ATS in our country. This article provides a description of successful management of rhythm disturbance in a patient with ATS.


Assuntos
Síndrome de Andersen , Antiarrítmicos/uso terapêutico , Flecainida/uso terapêutico , Taquicardia Ventricular , Adolescente , Síndrome de Andersen/complicações , Síndrome de Andersen/tratamento farmacológico , Criança , Feminino , Humanos , Taquicardia Ventricular/tratamento farmacológico , Taquicardia Ventricular/etiologia , Taquicardia Ventricular/prevenção & controle
18.
Pacing Clin Electrophysiol ; 41(11): 1454-1460, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30221382

RESUMO

BACKGROUND: Many patients undergoing ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation receive antithrombotic medications.  Their uninterrupted use has the potential to affect complication rates. We assessed the incidence of complications in a large cohort of patients undergoing these procedures, according to antithrombotic medication use. METHODS: From June 2014 to June 2016, 201 VT and PVC ablations were performed at a single center. We allocated patients to three groups: (A) anticoagulation group (international normalized ratio ≥ 1.5 or non-vitamin K anticoagulant or full-dose low-molecular-weight (LMW) heparin on day of procedure); (B) antithrombotic group (antiplatelet therapy and/or prophylactic LMW heparin on day of procedure); and (C) no antithrombotics group.  We assessed periprocedural complication rates in each group.  Multivariable analysis was performed. RESULTS: Group A (47 patients) had 8.5% procedural complication rate: one stroke, one pseudoaneurysm, one femoral artery occlusion, and one access site hematoma. In this group, 37 patients had femoral arterial and 18 had epicardial access. In Group B (46 patients), the complication rate was 6.5%: two cardiac tamponades and one pericardial effusion without compromise. Group C (108 patients) had a 5.6% complication rate: three cardiac tamponades (with one periprocedural death and one concomitant gastric vessel injury), one pericardial effusion without compromise, one stomach perforation, and two access site hematomas. Multivariable analysis did not show any significant predictors of complications, though age approached significance. CONCLUSIONS: Complication rates were not significantly different between groups. These findings suggest that VT and PVC ablation can be performed safely in patients with uninterrupted antithrombotic medications.


Assuntos
Anticoagulantes/administração & dosagem , Ablação por Cateter/métodos , Complicações Pós-Operatórias/epidemiologia , Taquicardia Ventricular/tratamento farmacológico , Taquicardia Ventricular/cirurgia , Complexos Ventriculares Prematuros/tratamento farmacológico , Complexos Ventriculares Prematuros/cirurgia , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco
19.
Am J Case Rep ; 19: 1078-1082, 2018 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-30201947

RESUMO

BACKGROUND Following catheter ablation of atrial fibrillation, increased incidence of ventricular arrhythmia has been observed. We report a case of sustained ventricular arrhythmia in a patient who underwent cryoballoon-based pulmonary vein isolation for symptomatic persistent atrial fibrillation. CASE REPORT A 57-year-old patient with dilated cardiomyopathy underwent CB-based pulmonary vein isolation for symptomatic persistent AF. On the day following an uneventful procedure, the patient for the first time experienced a sustained ventricular tachycardia that exacerbated into VT storm. Each arrhythmia was terminated by the ICD that had been implanted for primary prevention. Antiarrhythmic treatment with amiodarone was initiated immediately. The patient remained free from sustained ventricular arrhythmia during follow-up. CONCLUSIONS After pulmonary vein isolation, physicians should be vigilant for ventricular arrhythmia. The influence of atrial autonomic innervation on ventricular electrophysiology is largely unknown.


Assuntos
Fibrilação Atrial/terapia , Criocirurgia/efeitos adversos , Veias Pulmonares/cirurgia , Taquicardia Ventricular/tratamento farmacológico , Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Desfibriladores Implantáveis , Humanos , Pessoa de Meia-Idade , Recidiva , Taquicardia Ventricular/etiologia
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