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At least 217 records · Page 12Linked to original sources
PubMed2005

[1/1 nodo-ventricular conduction atrial flutter with amiodarone].

1/1 atrial flutter is a regularly described complication of class I anti-arrhythmics. It is, however, very rarely encountered with class III anti-arrhythmics because prolongation of the atrio-ventricular node refractory period prevents 1/1 nodo-ventricular conduction. There have only been seven cases of 1/1 atrial flutter with amiodarone reported in the literature. Here we describe a new case of 1/1 atrial flutter with amiodarone. Our case clearly illustrates not only the different pro-arrhythmic effects of amiodarone (prolongation of the flutter cycle, and infra-Hissian block) but also the pathophysiological mechanisms possible with 1/1 conduction (prolongation of the flutter cycle, considerable permeability of the AV node). It demonstrates the difficulties of diagnosing such a rhythm disturbance, and that it is sometimes poorly tolerated, as well as underlining the importance of early diagnosis (in this case by oesophageal recording). Preventive treatment of 1/1 flutter can include amiodarone, digitalis, a betablocker or a bradycardic calcium inhibitor.

Aged↗
PubMed1992

Autodecremental pacing for the interruption of ventricular tachycardia and atrial flutter.

The efficacy and safety of autodecremental pacing (ADP) to interrupt ventricular tachycardia (VT) and atrial flutter was examined. Once tachycardia was recognized, ADP was initiated using a short train of stimuli with gradual shortening (3%) of the interstimulus interval. ADP was applied to 13 consecutive patients during 75 episodes of VT (mostly following induction by ventricular stimulation). Successful interruption of VT occurred in 88% of the episodes. In 6 episodes (8%), ADP resulted in ventricular fibrillation and in 3 episodes VT was unaffected by ADP. The only significant discriminator between the failure or success of ADP was the rate of VT. ADP was also applied to 17 consecutive patients with an atrial flutter that was resistant to conventional antiarrhythmic agents. Successful conversion of atrial flutter to sinus was seen in only 8 patients (47%). A temporary acceleration to atrial fibrillation appeared in 3 patients (18%), and in 6 patients atrial flutter was unaffected by ADP. ADP was successful in 70% (7/10) of patients with type 1 (< 300 beats/min) atrial flutter. The authors conclude that ADP is beneficial in the interruption of VT and atrial flutter in a selected group of patients, especially with a slower rate of tachyarrhythmia (atrial rate during atrial flutter < 300 beats/min and ventricular tachycardia < 180 beats/min).

Adult↗
PubMed1983

Delayed repolarization syndrome.

The electrocardiograms of 18 patients with atypical ventricular tachycardia manifested as torsade de pointes, ventricular fibrillo-flutter, polymorphous ventricular tachycardia, and uniform ventricular tachycardia were analyzed. The patients were divided into two groups: The first group included 10 patients with prolonged Q-T intervals or abnormal U waves (delayed repolarization) and the second group included eight patients with normal ventricular repolarization. All of the electrocardiographic manifestations of atypical ventricular tachycardia were seen in both groups, regardless of the duration of the Q-T interval or the presence of an abnormal U wave. It is suggested that QRS morphology during the tachycardia is not sufficient to distinguish between delayed repolarization and other causes of atypical ventricular tachycardia. Finally, because the electrocardiogram may vary among different patients and from one episode to the next in a single patient due to abnormal repolarization, it is recommended that the term delayed repolarization syndrome be used to identify the arrhythmia.

Adult↗