Document Detail


Adenosine-sensitive wide-complex tachycardia: an uncommon variant of idiopathic fascicular ventricular tachycardia--a case report.
MedLine Citation:
PMID:  12785032     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Most wide-complex tachycardias encountered in the emergency department (ED) are ventricular in origin, most commonly associated with structural heart disease. Ventricular tachyarrhythmias range in severity from life-threatening rhythms (eg, ventricular fibrillation and hemodynamically compromising ventricular tachycardia [VT]) to idiopathic forms of VT, which have a benign clinical course and a more favorable prognosis. The authors present the case of a 34-year-old woman who presented to the ED, with a wide-complex tachycardia with a right-bundle-branch block (RBBB) morphology and a right inferior axis, which was terminated with adenosine. The patient was previously misdiagnosed as suffering from a paroxysmal supraventricular tachycardia (SVT), which was unresponsive to beta-blocker therapy. Although the tachycardia responded to adenosine, suggestive of an SVT, the patient was referred to the arrhythmia service, where further work-up revealed an uncommon form of an idiopathic VT, originating from the left anterior fascicle. The authors discuss the unique electrocardiographic and electrophysiologic properties and useful diagnostic maneuvers required to properly identify this form of VT.
Authors:
John Kassotis; Todd Slesinger; Emir Festic; Louis Voigt; C V R Reddy
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Angiology     Volume:  54     ISSN:  0003-3197     ISO Abbreviation:  Angiology     Publication Date:    2003 May-Jun
Date Detail:
Created Date:  2003-06-04     Completed Date:  2003-07-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0203706     Medline TA:  Angiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  369-72     Citation Subset:  IM    
Affiliation:
Clinical Electrophysiologic Services, Division of Cardiology, Department of Medicine, New York Methodist Hospital, Brooklyn, NY 11215, USA. JTK747@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adenosine / therapeutic use
Adult
Anti-Arrhythmia Agents / therapeutic use
Diagnosis, Differential
Electrocardiography
Female
Humans
Tachycardia, Ventricular / diagnosis*,  drug therapy
Verapamil / therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 52-53-9/Verapamil; 58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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