Surviving Ventricular Standstill for 111 Seconds during Holter Monitoring

Sidhu, Maninder Singh; Singh, Harinder; Kapila, Deepak; Sidhu, Stanley

doi:10.1111/j.1542-474x.2011.00482.x

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…3,9 Ventricular standstill usually occurs in patients with structural heart disease ( Table 1) but it has also been reported in patients with normal heart structure. 10,11 Ventricular standstill should be considered amongst the differential diagnoses of recurrent episodes of collapse. Cardiac or Holter monitoring should be utilised in accordance with clinical suspicion.…”

Section: Discussionmentioning

confidence: 99%

“Be still my beating heart”: Ventricular standstill occurring in different age groups

Lynch

Ballesty

Maicoo

2014

African Journal of Emergency Medicine

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Introduction: Ventricular standstill is an uncommon yet potentially fatal arrhythmia, which requires urgent recognition and treatment. As the name suggests, the ventricles come to a standstill with an almost immediate cessation of cardiac output. If this persists for more than a few seconds the patient will lose consciousness and no pulse will be palpable. Recommended treatment includes prompt initiation of cardiopulmonary resuscitation, and if return of circulation is achieved, pacemaker insertion is usually required. Case report: Four case reports are presented which highlight the ECG features of ventricular standstill and that this arrhythmia can occur across a wide range of ages. Conclusion: Ventricular standstill can occur at any age. It can be difficult to diagnose with many cases only evident on pre-hospital ECG recordings. It may present as recurring episodes of loss of consciousness yet the patient may be well in the intervening period. During episodes of ventricular standstill failure to palpate the pulse and/or over reliance on cardiac monitoring and automated ECG analysis programmes to determine the heart rate, may result in dramatic overestimation of the heart rate and may lead to delays in initiation of cardiopulmonary resuscitation and pacing if required.Introduction: La pause ventriculaire est une arythmie peu courante, mais potentiellement mortelle, qui ne´cessite un diagnostic et un traitement urgent. Comme son nom l'indique, les ventricules se mettent en pause, avec un arreˆt quasi-imme´diat du de´bit cardiaque. Si cette pause persiste pendant plus de quelques secondes, le patient perdra conscience et le pouls ne sera plus palpable. Le traitement recommande´consiste a`pratiquer rapidement une re´animation cardio-pulmonaire, et si le coeur repart, l'insertion d'un pacemaker est ge´ne´ralement ne´cessaire. Etudes de cas: Quatre e´tudes de cas sont pre´sente´es, qui soulignent les caracte´ristiques a`l'ECG de la pause ventriculaire; elles re´ve`lent e´galement que cette arythmie peut survenir sur une large fourchette d'aˆge. Conclusion: La pause ventriculaire peut survenir a`tout aˆge. Elle peut eˆtre difficile a`identifier, de nombreux cas n'apparaissant qu'a`l'ECG re´alise´avant l'arrive´e al 'hoˆpital. Elle peut se pre´senter sous forme d'e´pisodes de perte de conscience re´currents, mais le patient peut e´galement se sentir bien lorsqu'elle se produit. Lors des e´pisodes de pause ventriculaire, l'absence de prise de pouls et/ou le recours excessif a`l'e´lectrocardioscope et aux programmes d'analyse automatique des ECG pour de´terminer la fre´quence cardiaque peuvent re´sulter sur une surestimation conside´rable de la fre´quence cardiaque et retarder l'initiation de la re´animation cardiopulmonaire ainsi que la stimulation cardiaque si celle-ci s'ave`re ne´cessaire.

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Section: Discussionmentioning

confidence: 99%

“Be still my beating heart”: Ventricular standstill occurring in different age groups

Lynch

Ballesty

Maicoo

2014

African Journal of Emergency Medicine

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“…[3] This is because the level of block is usually in the His-Purkinge system or below, and patients are at a risk of profound bradycardia or asystole. Patients may present with syncope or sudden death and require cardiopulmonary resuscitation (CPR).…”

Section: Discussionmentioning

confidence: 99%

“…AV block of high degree is well described in literature and is considered an indication for permanent pacemaker implantation irrespective of symptoms. [ 3 ] This is because the level of block is usually in the His-Purkinge system or below, and patients are at a risk of profound bradycardia or asystole. Patients may present with syncope or sudden death and require cardiopulmonary resuscitation (CPR).…”

Section: Discussionmentioning

confidence: 99%

Ventricular standstill: An uncommon electrophysiological abnormality caused by profound vagal tone

2014

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Context:Ventricular standstill (VS) is an uncommon electrophysiological phenomenon and usually manifests as syncope. Rarely has a case been reported where the patient has been totally asymptomatic, and it has resolved spontaneously.Case Report:We report a case of complete VS and high-degree atrioventricular (AV) block in a 50-year-old female, who was admitted for nausea, vomiting, and chest pain. The patient never had a syncopal episode, even though she was in VS for more than 10 s.Conclusion:Such degree of conduction abnormality without any syncope has not been reported so far. Her electrophysiological abnormality was attributed to profound vagotonic effect and was treated with a permanent pacemaker.

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“…As a result, patients typically present with repeated episodes of syncope, although dizziness, sudden cardiac death and even seizures have been described. [3][4][5] In comparison to VF, the underlying mechanism is quite different. In VF, there is a lack of coordinated contractions causing the ventricles to quiver.…”

Section: Introductionmentioning

confidence: 99%

Paroxysmal Ventricular Standstill – A Case Report of all Ps and no QRS in Ventricular Asystole

Ehsani-Nia¹,

Bryczkowski²

2020

Journal of Education and Teaching in Emergency Medicine

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Surviving Ventricular Standstill for 111 Seconds during Holter Monitoring

Abstract: Holter electrocardiogram recording revealed symptomatic prolonged ventricular standstill lasting for about two minutes which terminated without any external cardiopulmonary resuscitation.

Cited by 7 publications

References 4 publications

“Be still my beating heart”: Ventricular standstill occurring in different age groups

“Be still my beating heart”: Ventricular standstill occurring in different age groups

Ventricular standstill: An uncommon electrophysiological abnormality caused by profound vagal tone

Paroxysmal Ventricular Standstill – A Case Report of all Ps and no QRS in Ventricular Asystole

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