Ventricular tachycardia as default diagnosis in broad complex tachycardia

Griffith, Michael; Mounsey, Patrick; Camm, A. John; Garratt, Clifford J.

doi:10.1016/s0140-6736(94)91223-8

Cited by 104 publications

(65 citation statements)

References 11 publications

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“…Study end points were: (1) pharmacological VT termination rates within 20 min and 1 h of the start of amiodarone administration and (2) rate of emergency direct current cardioversion (DCCV) within 1 h due to haemodynamic deterioration. The diagnosis of VT was based on standard electrocardiographic criteria8 and, when administered, the response to intravenous adenosine. The modified Wald method was used to compute the 95% confidence interval of a proportion to permit comparisons between trial data.…”

Section: Methodsmentioning

confidence: 99%

Intravenous amiodarone for the pharmacological termination of haemodynamically-tolerated sustained ventricular tachycardia: is bolus dose amiodarone an appropriate first-line treatment?

Tomlinson

Cherian

Betts

et al. 2008

Emergency Medicine Journal

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Although advocated by advanced life support guidelines, bolus dose intravenous amiodarone was relatively ineffective for acutely terminating haemodynamically-tolerated sustained monomorphic VT with a significant incidence of haemodynamic destabilisation requiring emergency DCCV. Previous studies in the identical clinical setting suggest that alternative antiarrhythmic agents, particularly intravenous procainamide and sotalol, may be superior. A prospective randomised trial is required to determine the optimal drug treatment for stable sustained monomorphic VT in the emergency setting.

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Section: Methodsmentioning

confidence: 99%

Intravenous amiodarone for the pharmacological termination of haemodynamically-tolerated sustained ventricular tachycardia: is bolus dose amiodarone an appropriate first-line treatment?

Tomlinson

Cherian

Betts

et al. 2008

Emergency Medicine Journal

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“…These features are consistent with initial ventricular activation via the His-Purkinje system. [25][26][27] The ventricular activation is faster than and dissociated with atrial activation. Although cardiac orientation has impact on the ECG morphology, the other important reason contributing to the slight morphological difference of the RBB-AIVR/VT among the study patients is its proximal or distal origin.…”

Section: Clinical Manifestations and Potential Risksmentioning

confidence: 99%

Idiopathic Accelerated Idioventricular Rhythm or Ventricular Tachycardia Originating From the Right Bundle Branch

Chen

Yang

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Background— Accelerated idioventricular rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arrhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arrhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arrhythmias, which demonstrated chronotropic variability, were often isorhythmic with sinus rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arrhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arrhythmia with subsequent RBB block morphology during sinus rhythm. During follow-up, patients’ symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. Conclusions— RBB-AIVR/VT is an unusual type of ventricular arrhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation.

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“…As emphasized by Griffith et al, if a typical pattern of aberrant conduction is not observed, the wide complex tachycardia should be considered to be VT [18].…”

Section: Precordial Qrs Complex Morphologymentioning

confidence: 99%

Life-Threatening Arrhythmias in the Intensive Care Unit

Reising

Kusumoto

Goldschlager

2007

J Intensive Care Med

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Symptomatic arrhythmias are frequently observed in the intensive care unit and often lead to significant hemodynamic compromise because of the presence of multisystem disease. In particular, prompt evaluation of patients with tachycardia is critical because treatment depends on the accurate diagnosis of the arrhythmia mechanism. The electrocardiogram remains the most important diagnostic tool for the evaluation of both wide complex and narrow complex tachycardia. For wide complex tachycardia, evaluation of the atrioventricular relationship and QRS morphology are critical, and for narrow QRS complex tachycardias, evaluation focuses on identification of the location and morphology of P waves. Bradycardia can arise from sinus node dysfunction or atrioventricular conduction block.

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Ventricular tachycardia as default diagnosis in broad complex tachycardia

Cited by 104 publications

References 11 publications

Intravenous amiodarone for the pharmacological termination of haemodynamically-tolerated sustained ventricular tachycardia: is bolus dose amiodarone an appropriate first-line treatment?

Intravenous amiodarone for the pharmacological termination of haemodynamically-tolerated sustained ventricular tachycardia: is bolus dose amiodarone an appropriate first-line treatment?

Idiopathic Accelerated Idioventricular Rhythm or Ventricular Tachycardia Originating From the Right Bundle Branch

Life-Threatening Arrhythmias in the Intensive Care Unit

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