Case conference-vt
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This case discusses a 23-year-old Mongolian woman who presented with recurrent syncope in the past 2 years. Tests revealed non-sustained ventricular tachycardia on Holter monitor and a prolonged QTc interval of 406 ms. Radiofrequency catheter ablation was performed and eliminated the daily attacks of non-sustained VT. However, spontaneous idiopathic ventricular fibrillation with near syncope occurred after ICD implantation, though it terminated spontaneously. The discussion notes that in 27 similar patients who underwent ablation of primary idiopathic ventricular fibrillation, 89% had no recurrence without drugs after ablation over 24 months on average.
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ECG: Wide QRS Tachycardia
A 46-year-old woman presented with palpitations and breathlessness. Her ECG showed a wide QRS tachycardia at 300 beats per minute with a changing QRS morphology. This is consistent with polymorphic ventricular tachycardia. Intravenous magnesium is the drug of choice for polymorphic VT related to digitalis toxicity or hypomagnesemia. For stable monomorphic VT, intravenous beta blockers are preferred as the initial treatment. Refractory VT may require additional treatments such as amiodarone, overdrive pacing, or an intra-aortic balloon pump.
Papillary muscle-vt
The document describes a case study of a 59-year-old man with a history of hypertension and smoking who presented with recurrent ventricular tachycardia originating from the left anterior papillary muscle. Through catheter mapping and ablation, the source of the arrhythmia was identified as late potentials near the left anterior papillary muscle, and no further arrhythmias occurred following radiofrequency ablation at this site. The presentation also reviews characteristics of papillary muscle ventricular arrhythmias compared to fascicular arrhythmias.
Idiopathic ventricular tachycardia
Idiopathic VT refers to VT occurring in structurally normal hearts in the absence of myocardial scarring. Classification of monomorphic idiopathic VT includes outflow tract VT, fascicular VT, papillary muscle VT,annular VT, and miscellaneous (VT from the body of the RV and crux of
the heart). It is commonly seen in young patients and usually has a benign course. The 12-lead lectrocardiogram is critical in distinguishing the specific form and locations of idiopathic VT. Treatment options include medical therapy specific to the underlying mechanism of VT or catheter
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Case report_manifest WPW syndrome
This 23-year-old woman presented with palpitations when carrying heavy materials and was found to have paroxysmal supraventricular tachycardia. She received adenosine and verapamil which terminated the arrhythmia. An electrophysiology study found atrioventricular reentrant tachycardia using an accessory pathway. Radiofrequency catheter ablation was performed and successfully eliminated conduction over the left posteroseptal and left lateral accessory pathways. She was diagnosed with manifest Wolff-Parkinson-White syndrome status post successful ablation.
Ventricular tachycardia
Ventricular tachycardia (VT) is an arrhythmia originating in the ventricles with a heart rate over 100 beats per minute and wide QRS complexes of at least 120 ms. VT can be either idiopathic or structural, sustained or non-sustained, and monomorphic or polymorphic. The ECG can diagnose VT based on the wide QRS complexes. VT has subtypes including bundle branch reentry VT and idiopathic monomorphic VT. Treatment options include medical therapies like amiodarone, implantable cardioverter defibrillators based on major trials, and catheter ablation.
Ventricular tachycardia_lecture
1. Outflow tract VT is the most common type of idiopathic VT, accounting for over 60% of cases in the study.
2. Pace mapping alone may not accurately locate ablation sites, especially for VT associated with scar tissue. Activation mapping and substrate identification are important complementary mapping techniques.
3. Successful ablation of substrate-based VT requires targeting abnormal electrograms within scar regions like late potentials or fractionated signals at the critical isthmus.
VT in structurally normal heart
Ventricular tachycardia are difficult to understand. it is classified in to two types. 1. VT in structurally normal heart, 2. VT in heart with structural diseases. I have tried to simplify the VT in structurally normal heart, which may be helpful to many students and learners.
ECG: Fascicular VT
This ECG is from a 13-year-old boy who presented with loose stools and dizziness. The ECG shows a regular wide-complex tachycardia with a right bundle branch block pattern and left axis deviation. Based on the ECG findings and characteristics of fascicular ventricular tachycardia, the diagnosis is a fascicular ventricular tachycardia originating from the left posterior fascicle. Fascicular VT can be treated effectively with verapamil or catheter ablation.
Recommended
ECG: Wide QRS Tachycardia
A 46-year-old woman presented with palpitations and breathlessness. Her ECG showed a wide QRS tachycardia at 300 beats per minute with a changing QRS morphology. This is consistent with polymorphic ventricular tachycardia. Intravenous magnesium is the drug of choice for polymorphic VT related to digitalis toxicity or hypomagnesemia. For stable monomorphic VT, intravenous beta blockers are preferred as the initial treatment. Refractory VT may require additional treatments such as amiodarone, overdrive pacing, or an intra-aortic balloon pump.
Papillary muscle-vt
The document describes a case study of a 59-year-old man with a history of hypertension and smoking who presented with recurrent ventricular tachycardia originating from the left anterior papillary muscle. Through catheter mapping and ablation, the source of the arrhythmia was identified as late potentials near the left anterior papillary muscle, and no further arrhythmias occurred following radiofrequency ablation at this site. The presentation also reviews characteristics of papillary muscle ventricular arrhythmias compared to fascicular arrhythmias.
Idiopathic ventricular tachycardia
Idiopathic VT refers to VT occurring in structurally normal hearts in the absence of myocardial scarring. Classification of monomorphic idiopathic VT includes outflow tract VT, fascicular VT, papillary muscle VT,annular VT, and miscellaneous (VT from the body of the RV and crux of
the heart). It is commonly seen in young patients and usually has a benign course. The 12-lead lectrocardiogram is critical in distinguishing the specific form and locations of idiopathic VT. Treatment options include medical therapy specific to the underlying mechanism of VT or catheter
ablation.
Case report_manifest WPW syndrome
This 23-year-old woman presented with palpitations when carrying heavy materials and was found to have paroxysmal supraventricular tachycardia. She received adenosine and verapamil which terminated the arrhythmia. An electrophysiology study found atrioventricular reentrant tachycardia using an accessory pathway. Radiofrequency catheter ablation was performed and successfully eliminated conduction over the left posteroseptal and left lateral accessory pathways. She was diagnosed with manifest Wolff-Parkinson-White syndrome status post successful ablation.
Ventricular tachycardia
Ventricular tachycardia (VT) is an arrhythmia originating in the ventricles with a heart rate over 100 beats per minute and wide QRS complexes of at least 120 ms. VT can be either idiopathic or structural, sustained or non-sustained, and monomorphic or polymorphic. The ECG can diagnose VT based on the wide QRS complexes. VT has subtypes including bundle branch reentry VT and idiopathic monomorphic VT. Treatment options include medical therapies like amiodarone, implantable cardioverter defibrillators based on major trials, and catheter ablation.
Ventricular tachycardia_lecture
1. Outflow tract VT is the most common type of idiopathic VT, accounting for over 60% of cases in the study.
2. Pace mapping alone may not accurately locate ablation sites, especially for VT associated with scar tissue. Activation mapping and substrate identification are important complementary mapping techniques.
3. Successful ablation of substrate-based VT requires targeting abnormal electrograms within scar regions like late potentials or fractionated signals at the critical isthmus.
VT in structurally normal heart
Ventricular tachycardia are difficult to understand. it is classified in to two types. 1. VT in structurally normal heart, 2. VT in heart with structural diseases. I have tried to simplify the VT in structurally normal heart, which may be helpful to many students and learners.
ECG: Fascicular VT
This ECG is from a 13-year-old boy who presented with loose stools and dizziness. The ECG shows a regular wide-complex tachycardia with a right bundle branch block pattern and left axis deviation. Based on the ECG findings and characteristics of fascicular ventricular tachycardia, the diagnosis is a fascicular ventricular tachycardia originating from the left posterior fascicle. Fascicular VT can be treated effectively with verapamil or catheter ablation.
Wide complex tachycardia
This document discusses wide complex tachycardias and how to differentiate them based on electrocardiogram (ECG) findings. It provides details on what makes a complex narrow or wide, types of wide complex tachycardias including ventricular tachycardia and supraventricular tachycardia, and ECG criteria to help determine the source and mechanism such as the presence or absence of RS complexes and their intervals. Morphologic criteria on the ECG and algorithms like the ACC algorithm are presented to aid in differential diagnosis.
Wide complex tachycardia
This document discusses wide complex tachycardia (WCT), which is ventricular in origin 80% of the time. In patients with structural heart disease, 95% of WCT is ventricular tachycardia (VT). VT can be life-threatening and cause sudden death or tachycardia-induced cardiomyopathy. The document describes types of VT based on morphology and duration, symptoms of VT, features that appear on ECGs during VT like abnormal wide QRS complexes and AV dissociation, and examples of patients presenting with potential VT.
ECG: Wolff-Parkinson-White syndrome
This ECG shows signs of Wolff-Parkinson-White syndrome with a likely accessory right posteroseptal pathway. Key features include a frontal QRS axis around -30 degrees, frontal delta wave axis between -30 to -60 degrees, and dominant negative QRS deflection in lead V1 with isoelectric or negative delta wave. The patient presented with palpitations since childhood and exam was unremarkable other than tachycardia.
Out Flow tract VT, Diagnostic Tools and Ablation Weapons
Lecture presented by Dr Sherif Hamed at the Egyptian Critical care Summit , the leading critical care event and medical exhibition in Egypt
WIDE QRS TACHYCARDIA
1) The document defines wide complex tachycardia as a rhythm with a QRS duration ≥120ms and heart rate >100 bpm.
2) The main causes listed are ventricular tachycardia (80% of cases) and supraventricular tachycardia with aberrancy.
3) Key features that can help differentiate the underlying rhythm include QRS duration, axis, morphology, and the presence or absence of AV dissociation on electrocardiogram.
Ecg tracings teaching
The document describes 10 cases of arrhythmias with electrocardiogram (ECG) findings. Case 1 involves paroxysmal supraventricular tachycardia (PSVT) with right bundle branch block (RBBB) and cycle length alternans due to dual atrioventricular node (AVN) physiology, consistent with orthodromic atrioventricular reentrant tachycardia (AVRT). Case 2 involves a narrow P wave indicating simultaneous right and left atrial depolarization, consistent with slow-fast AVNRT with 2:1 atrioventricular block. Case 3 demonstrates initiation of supraventricular tachycardia from normal sinus rhythm with preexcitation due to a retrograde
Idiopathic Ventricular Tachycardia (VT)
Case scenario of a patient with idiopathic ventricular Tachycardia (VT), followed by a topic review including diagnosis and management guidelines. It is defined as Monomorphic VT in patients without any structural heart disease or coronary disease”. Classified on the basis of site of origin broadly into three different categories i.e Outflow Tract VT, Annular VT, Fascicular VT
Ventricular tachycardia
The document discusses various types of ventricular arrhythmias including premature ventricular contractions, ventricular couplets, ventricular tachycardia, idioventricular rhythm, non-sustained and sustained ventricular tachycardia, monomorphic and polymorphic ventricular tachycardia, and ventricular fibrillation. It notes potential symptoms of these arrhythmias can include palpitations, dizziness, lightheadedness, syncope, and sudden cardiac arrest. Treatment options discussed include direct current cardioversion for hemodynamically unstable patients and intravenous amiodarone for stable patients.
Wide Complex Tachycardia
This document discusses the differential diagnosis and evaluation of wide complex tachycardia. It lists the main differential diagnoses as ventricular tachycardia, supraventricular tachycardia with pre-existing conduction abnormalities, supraventricular tachycardia with aberrant conduction, electrolyte abnormalities, or conduction over an accessory pathway. When in doubt, it is safest to assume it is ventricular tachycardia, especially in patients with cardiovascular disease. The document outlines criteria to consider in the history and examination and ECG features that can help differentiate ventricular tachycardia from supraventricular tachycardia.
Ventricular tachycardia
This document discusses ventricular tachycardia (VT), providing definitions and key characteristics. VT can be nonsustained (<30 seconds) or sustained (>30 seconds). ECG patterns include right bundle branch block (RBBB), left bundle branch block (LBBB), and various axis deviations. Idiopathic VT originates from the outflow tracts, mitral/tricuspid annuli, or fascicles. Specific VT types like bidirectional VT and torsades de pointes are also outlined. The document provides visual examples and differentiates VT from similar rhythms.
Wide complex tachycardia drneeraj
This document discusses criteria for differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) using electrocardiograms (ECGs) of patients presenting with wide complex tachycardia. It outlines definitions of VT and SVT, as well as diagnostic criteria including Brugada criteria, the lead aVR algorithm, and the RWPT (R wave to peak time) criterion. The document then analyzes ECGs of two case studies, concluding that the first is VT and the second is SVT with aberrant conduction based on application of the discussed criteria. It recognizes Prevost and Batelli for inventing defibrillation in 1899 by discovering electric shocks could
Are pv cs in patients without structural heart disease really safe samir rafla
Are pv cs in patients without structural heart disease really safe samir raflaAlexandria University, Egypt
1) Ventricular arrhythmias can occur in patients without structural heart disease and account for around 10% of ventricular tachycardias. Common types include outflow tract tachycardia originating from the right or left ventricular outflow tract.
2) Electrocardiogram morphology can provide clues about the site of origin of ventricular arrhythmias. The amplitude of the R-wave in lead V1 increases as the site of origin moves from right to left.
3) Treatment options for ventricular arrhythmias without structural heart disease include medications like beta-blockers and calcium channel blockers as well as catheter ablation which has good outcomes, especially for outflow tract arrhythmias.EP diagnosis of WIDE COMPLEX TACHYCARDIA
The document discusses wide complex tachycardia, providing definitions and discussing the differential diagnosis, ECG diagnosis, and electrophysiological approach. It notes that wide complex tachycardia can be ventricular tachycardia or supraventricular tachycardia with aberrancy or preexcitation. The ECG is important for diagnosis but often inconclusive. An electrophysiology study can help determine the site of origin through evaluating AV dissociation, measuring HV intervals, and inducing arrhythmias.
Basic of Pre-excitation syndrome
This document discusses pre-excitation syndrome, specifically Wolff-Parkinson-White (WPW) syndrome and Lown-Ganong-Levine (LGL) syndrome. It defines pre-excitation syndrome as having a short PR interval and usually an abnormal QRS complex due to an accessory pathway in the cardiac conduction system. Accessory pathways can connect different parts of the heart and have faster conduction velocities than the atrioventricular node. WPW syndrome is the most common type, affecting about 1.5 per 1000 people. Common symptoms include palpitations and chest discomfort due to paroxysmal tachyarrhythmias like atrioventricular reentrant tachycardia. Management involves catheter ablation
Case 3
This 73-year-old man presented with chest tightness and respiratory distress. He has a history of heart disease including prior heart attack and pacemaker implantation. Electrocardiogram showed paced rhythms, conduction abnormalities, and ST elevation suggestive of heart attack. Imaging showed enlarged heart and pulmonary congestion. Coronary angiography revealed multiple severe blockages. Due to cardiogenic shock, he was placed on devices including IABP and ECMO and started on inotropic medications and dialysis. His condition indicated emergency revascularization was needed.
Wpw case presentation by dr adeel
A 35-year-old female presented with a history of palpitations and shortness of breath for the past 6 hours. She has a history of hypertension for the past 3 months and is on medication. On examination, her blood pressure was elevated and heart rate was rapid. An ECG showed Wolff-Parkinson-White syndrome. WPW is a condition where there is an extra pathway between the atria and ventricles that can cause rapid heart rates. Treatment options include medications, cardioversion, catheter ablation to destroy the extra pathway, or surgery.
Wide complex tachycardia
This document provides an overview of the approach to evaluating and diagnosing wide complex tachycardias. It begins with definitions of terms like wide complex tachycardia, ventricular tachycardia, and supraventricular tachycardia. It then discusses the importance of making an accurate diagnosis to avoid inappropriate treatment. Various ECG criteria are presented to help distinguish ventricular from supraventricular rhythms based on features like AV dissociation, QRS morphology, axis, and precordial patterns. Specific criteria for right bundle branch block and left bundle branch block morphologies are also outlined. The document emphasizes taking a stepwise approach and considering clinical history in narrowing the differential diagnosis of wide complex tachycardias.
Wide complex tacycardia
Wide QRS tachycardia requires differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrancy. The document outlines the following approach:
1. Obtain history, physical exam, and 12-lead electrocardiogram (ECG) findings to help determine VT vs SVT. Features like AV dissociation or axis deviation favor VT.
2. Use criteria/algorithms like Wellens, Brugada, Vereckei (incorporating lead aVR) to analyze ECG morphology. A majority of criteria must be met to diagnose VT.
3. Consider electrophysiological testing like measuring His-ventricular intervals
ECG: WPW Syndrome
A 45-year-old female presented with difficulty breathing, palpitations, and sweating for 4 hours. An ECG showed Wolff-Parkinson-White (WPW) syndrome, characterized by a short PR interval, delta wave, and widened QRS complex. WPW is a congenital condition involving an accessory pathway that allows supraventricular impulses to bypass the AV node and activate the ventricles early. Treatment options include antiarrhythmic drugs or radiofrequency ablation to destroy the accessory pathway.
ECG: Wide Complex Tachycardia
A 22-year-old male presented with acute onset breathlessness, palpitations, and profuse sweating. His ECG showed tachycardia at a rate of 200 bpm with a right bundle branch block pattern. This wide complex tachycardia was determined to be ventricular tachycardia based on Brugada criteria and AVR criteria, including the absence of an RS complex in leads V1-V6, a QRS duration greater than 100 ms, and a ventricular activation-velocity ratio greater than 1. The patient was diagnosed with ventricular tachycardia based on the ECG findings and treated accordingly.
2012-10-06 APHRS 2012
The document provides dates for an event held in Taipei, Taiwan from October 3-6, 2012. It lists the location as Taipei, Taiwan and includes the date October 6. No other details are included in the document.
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Wide complex tachycardia
This document discusses wide complex tachycardias and how to differentiate them based on electrocardiogram (ECG) findings. It provides details on what makes a complex narrow or wide, types of wide complex tachycardias including ventricular tachycardia and supraventricular tachycardia, and ECG criteria to help determine the source and mechanism such as the presence or absence of RS complexes and their intervals. Morphologic criteria on the ECG and algorithms like the ACC algorithm are presented to aid in differential diagnosis.
Wide complex tachycardia
This document discusses wide complex tachycardia (WCT), which is ventricular in origin 80% of the time. In patients with structural heart disease, 95% of WCT is ventricular tachycardia (VT). VT can be life-threatening and cause sudden death or tachycardia-induced cardiomyopathy. The document describes types of VT based on morphology and duration, symptoms of VT, features that appear on ECGs during VT like abnormal wide QRS complexes and AV dissociation, and examples of patients presenting with potential VT.
ECG: Wolff-Parkinson-White syndrome
This ECG shows signs of Wolff-Parkinson-White syndrome with a likely accessory right posteroseptal pathway. Key features include a frontal QRS axis around -30 degrees, frontal delta wave axis between -30 to -60 degrees, and dominant negative QRS deflection in lead V1 with isoelectric or negative delta wave. The patient presented with palpitations since childhood and exam was unremarkable other than tachycardia.
Out Flow tract VT, Diagnostic Tools and Ablation Weapons
Lecture presented by Dr Sherif Hamed at the Egyptian Critical care Summit , the leading critical care event and medical exhibition in Egypt
WIDE QRS TACHYCARDIA
1) The document defines wide complex tachycardia as a rhythm with a QRS duration ≥120ms and heart rate >100 bpm.
2) The main causes listed are ventricular tachycardia (80% of cases) and supraventricular tachycardia with aberrancy.
3) Key features that can help differentiate the underlying rhythm include QRS duration, axis, morphology, and the presence or absence of AV dissociation on electrocardiogram.
Ecg tracings teaching
The document describes 10 cases of arrhythmias with electrocardiogram (ECG) findings. Case 1 involves paroxysmal supraventricular tachycardia (PSVT) with right bundle branch block (RBBB) and cycle length alternans due to dual atrioventricular node (AVN) physiology, consistent with orthodromic atrioventricular reentrant tachycardia (AVRT). Case 2 involves a narrow P wave indicating simultaneous right and left atrial depolarization, consistent with slow-fast AVNRT with 2:1 atrioventricular block. Case 3 demonstrates initiation of supraventricular tachycardia from normal sinus rhythm with preexcitation due to a retrograde
Idiopathic Ventricular Tachycardia (VT)
Case scenario of a patient with idiopathic ventricular Tachycardia (VT), followed by a topic review including diagnosis and management guidelines. It is defined as Monomorphic VT in patients without any structural heart disease or coronary disease”. Classified on the basis of site of origin broadly into three different categories i.e Outflow Tract VT, Annular VT, Fascicular VT
Ventricular tachycardia
The document discusses various types of ventricular arrhythmias including premature ventricular contractions, ventricular couplets, ventricular tachycardia, idioventricular rhythm, non-sustained and sustained ventricular tachycardia, monomorphic and polymorphic ventricular tachycardia, and ventricular fibrillation. It notes potential symptoms of these arrhythmias can include palpitations, dizziness, lightheadedness, syncope, and sudden cardiac arrest. Treatment options discussed include direct current cardioversion for hemodynamically unstable patients and intravenous amiodarone for stable patients.
Wide Complex Tachycardia
This document discusses the differential diagnosis and evaluation of wide complex tachycardia. It lists the main differential diagnoses as ventricular tachycardia, supraventricular tachycardia with pre-existing conduction abnormalities, supraventricular tachycardia with aberrant conduction, electrolyte abnormalities, or conduction over an accessory pathway. When in doubt, it is safest to assume it is ventricular tachycardia, especially in patients with cardiovascular disease. The document outlines criteria to consider in the history and examination and ECG features that can help differentiate ventricular tachycardia from supraventricular tachycardia.
Ventricular tachycardia
This document discusses ventricular tachycardia (VT), providing definitions and key characteristics. VT can be nonsustained (<30 seconds) or sustained (>30 seconds). ECG patterns include right bundle branch block (RBBB), left bundle branch block (LBBB), and various axis deviations. Idiopathic VT originates from the outflow tracts, mitral/tricuspid annuli, or fascicles. Specific VT types like bidirectional VT and torsades de pointes are also outlined. The document provides visual examples and differentiates VT from similar rhythms.
Wide complex tachycardia drneeraj
This document discusses criteria for differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) using electrocardiograms (ECGs) of patients presenting with wide complex tachycardia. It outlines definitions of VT and SVT, as well as diagnostic criteria including Brugada criteria, the lead aVR algorithm, and the RWPT (R wave to peak time) criterion. The document then analyzes ECGs of two case studies, concluding that the first is VT and the second is SVT with aberrant conduction based on application of the discussed criteria. It recognizes Prevost and Batelli for inventing defibrillation in 1899 by discovering electric shocks could
Are pv cs in patients without structural heart disease really safe samir rafla
Are pv cs in patients without structural heart disease really safe samir raflaAlexandria University, Egypt
1) Ventricular arrhythmias can occur in patients without structural heart disease and account for around 10% of ventricular tachycardias. Common types include outflow tract tachycardia originating from the right or left ventricular outflow tract.
2) Electrocardiogram morphology can provide clues about the site of origin of ventricular arrhythmias. The amplitude of the R-wave in lead V1 increases as the site of origin moves from right to left.
3) Treatment options for ventricular arrhythmias without structural heart disease include medications like beta-blockers and calcium channel blockers as well as catheter ablation which has good outcomes, especially for outflow tract arrhythmias.EP diagnosis of WIDE COMPLEX TACHYCARDIA
The document discusses wide complex tachycardia, providing definitions and discussing the differential diagnosis, ECG diagnosis, and electrophysiological approach. It notes that wide complex tachycardia can be ventricular tachycardia or supraventricular tachycardia with aberrancy or preexcitation. The ECG is important for diagnosis but often inconclusive. An electrophysiology study can help determine the site of origin through evaluating AV dissociation, measuring HV intervals, and inducing arrhythmias.
Basic of Pre-excitation syndrome
This document discusses pre-excitation syndrome, specifically Wolff-Parkinson-White (WPW) syndrome and Lown-Ganong-Levine (LGL) syndrome. It defines pre-excitation syndrome as having a short PR interval and usually an abnormal QRS complex due to an accessory pathway in the cardiac conduction system. Accessory pathways can connect different parts of the heart and have faster conduction velocities than the atrioventricular node. WPW syndrome is the most common type, affecting about 1.5 per 1000 people. Common symptoms include palpitations and chest discomfort due to paroxysmal tachyarrhythmias like atrioventricular reentrant tachycardia. Management involves catheter ablation
Case 3
This 73-year-old man presented with chest tightness and respiratory distress. He has a history of heart disease including prior heart attack and pacemaker implantation. Electrocardiogram showed paced rhythms, conduction abnormalities, and ST elevation suggestive of heart attack. Imaging showed enlarged heart and pulmonary congestion. Coronary angiography revealed multiple severe blockages. Due to cardiogenic shock, he was placed on devices including IABP and ECMO and started on inotropic medications and dialysis. His condition indicated emergency revascularization was needed.
Wpw case presentation by dr adeel
A 35-year-old female presented with a history of palpitations and shortness of breath for the past 6 hours. She has a history of hypertension for the past 3 months and is on medication. On examination, her blood pressure was elevated and heart rate was rapid. An ECG showed Wolff-Parkinson-White syndrome. WPW is a condition where there is an extra pathway between the atria and ventricles that can cause rapid heart rates. Treatment options include medications, cardioversion, catheter ablation to destroy the extra pathway, or surgery.
Wide complex tachycardia
This document provides an overview of the approach to evaluating and diagnosing wide complex tachycardias. It begins with definitions of terms like wide complex tachycardia, ventricular tachycardia, and supraventricular tachycardia. It then discusses the importance of making an accurate diagnosis to avoid inappropriate treatment. Various ECG criteria are presented to help distinguish ventricular from supraventricular rhythms based on features like AV dissociation, QRS morphology, axis, and precordial patterns. Specific criteria for right bundle branch block and left bundle branch block morphologies are also outlined. The document emphasizes taking a stepwise approach and considering clinical history in narrowing the differential diagnosis of wide complex tachycardias.
Wide complex tacycardia
Wide QRS tachycardia requires differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrancy. The document outlines the following approach:
1. Obtain history, physical exam, and 12-lead electrocardiogram (ECG) findings to help determine VT vs SVT. Features like AV dissociation or axis deviation favor VT.
2. Use criteria/algorithms like Wellens, Brugada, Vereckei (incorporating lead aVR) to analyze ECG morphology. A majority of criteria must be met to diagnose VT.
3. Consider electrophysiological testing like measuring His-ventricular intervals
ECG: WPW Syndrome
A 45-year-old female presented with difficulty breathing, palpitations, and sweating for 4 hours. An ECG showed Wolff-Parkinson-White (WPW) syndrome, characterized by a short PR interval, delta wave, and widened QRS complex. WPW is a congenital condition involving an accessory pathway that allows supraventricular impulses to bypass the AV node and activate the ventricles early. Treatment options include antiarrhythmic drugs or radiofrequency ablation to destroy the accessory pathway.
ECG: Wide Complex Tachycardia
A 22-year-old male presented with acute onset breathlessness, palpitations, and profuse sweating. His ECG showed tachycardia at a rate of 200 bpm with a right bundle branch block pattern. This wide complex tachycardia was determined to be ventricular tachycardia based on Brugada criteria and AVR criteria, including the absence of an RS complex in leads V1-V6, a QRS duration greater than 100 ms, and a ventricular activation-velocity ratio greater than 1. The patient was diagnosed with ventricular tachycardia based on the ECG findings and treated accordingly.
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2014 12-21 current and future directions anticoagulation management in non-va...
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A medical conference was held on December 21, 2014 at Taipei's Liu Fu Palace. The conference discussed current and future directions for anticoagulation management in non-valvular atrial fibrillation. Management of anticoagulation therapy for patients with non-valvular atrial fibrillation was the topic.2011 thrs 年會 Agenda
The document outlines the schedule for the First Annual Scientific Meeting of Taiwan Heart Rhythm Society to be held on December 3-4, 2011 at the Hsinchu Sheraton Hotel, including various sessions on device therapy, ablation, ECG interpretation, and lectures in different meeting rooms over the two day period.
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A meeting was held on April 15, 2012 at the 12th floor of the Taipei International Hotel. The location of the meeting was described as being "outside on the floor" which likely means an outdoor terrace or balcony area on the 12th floor. Few other details were provided in the short text.
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Case conference-vt
- 1. Case Conference Recurrent syncope in a 23-year-old Mongolian woman 吳宏彬醫師 中國醫藥大學附設醫院心臟科
- 2. History 23-year-old Mongolian woman presented with recurrent syncope in recent 2 years. Syncope preceded with short of breath and palpitation Witnessed trismus and seizure before fainting Mother died suddenly at her twenties CMUH
- 3. Holter 24 hr monitor ECG: Non-sustained VT Brain CT: negative EEG: equivocal abnormality CMUH
- 4. QTc : 406 ms CMUH
- 5. CMUH
- 6. Daily attacks of non-sustained VT 101/03/18 101/03/21 101/03/19 101/03/22 101/03/20 CMUH
- 7. Three Different QRS morphologies of the Triggering VPC CMUH
- 8. Treadmill exercise test Negativefor ischemia No VT or VF was induced during TET CMUH
- 9. CMUH
- 10. Sudden Cardiac Death in Young Coronary artery anomalies, LAD bridge, CAD Primary electrical diseases: WPW Long QT syndrome Catecholaminergic polymorphic VT Brugada syndrome Short QT syndrome Idiopathic VF Neurologic problems CMUH
- 11. CMUH
- 12. Basic intervals Sinus CL 857 ms QRS 87 ms AH 99 ms HV 43 ms SNRT 600=1103 ms 500=1000 ms CL-1:1 AV 420 ms conduction CL-AVB 410 ms AEST-CL 500 ms ERP-AVN 370 ms CL-1:1Ret FP No VA CMUH
- 13. LV Inferior-apico-septal location Spontaneous VPC Pace mapping CMUH
- 14. Purkinje potential CMUH
- 15. Endocardial electrograms of VPC CMUH
- 16. No more daily VT post RFCA 101/03/24 ICD implantation was performed due to only one of three morphologic VPCs ablation CMUH
- 17. After ICD implantation Spontaneous idiopathic VF with near syncope was noted. Aborted ICD shock due to spontaneous termination. CMUH
- 18. Disscussion
- 19. After ablation, 24 ± 28 months, 24 patients (89%) in 27 patients had no recurrence of ventricular fibrillation without drug. CMUH
- 20. Characteristics of Patients Twenty-seven consecutive patients underwent attempted ablation of primary idiopathic VF in 6 centers CMUH
- 21. CMUH
- 22. VPC Patient number morphology RVOT 4 RBBB 10 LBBB 13 Both 4 CMUH
- 23. CMUH
- 24. CMUH
- 25. CMUH
- 26. CMUH
- 27. CMUH
- 28. CMUH
- 29. CMUH
- 30. CMUH
- 31. Thank you for your attention!