We present the case of a previously healthy 42-year-old man who attended the emergency department due to a sudden onset of rapid and regular palpitations. The variation of QRS complex duration between LBBB pattern in SR and AVRT could be useful for early diagnosis of an ipsilateral AP on surface ECG. In these patients, it is unlikely to control the arrhythmia pharmacologically, catheter ablation being the best therapeutic option. During 6-months follow-up the patient presented no more episodes of tachycardia or heart failure and the LVEF remained normal.ĪVRT is rarely associated with intrinsic LBBB, being a potential cause of TIC. One week after the ablation the patient had no signs of heart failure and the LVEF normalized to 55%. Catheter ablation was successfully performed at the level of the lateral mitral ring. The electrophysiological study revealed a left lateral accessory pathway. Considering the patient's clinical picture, TIC was suspected. Echocardiography showed global hypokinesia with 25% left ventricular ejection fraction (LVEF). The patient had a wide QRS tachycardia, with LBBB morphology and a heart rate of 160/minute. The coexistence of left bundle branch block (LBBB) in patients with AVRT may cause difficulties in the early diagnosis and management of tachycardia because of the wide complex morphology, making it harder to localize the accessory pathway (AP).Ī 60-year-old woman, presented incessant episodes of palpitations and shortness of breath due to a LBBB tachycardia leading to hemodynamic instability. In its incessant form, it is unlikely to be controlled by pharmacological treatment, catheter ablation being the principal therapeutic option. Atrioventricular reentrant tachycardia (AVRT) is one of the most frequent causes of TIC. Tachycardia-induced cardiomyopathy (TIC) is defined as systolic and/or diastolic dysfunction of the left ventricle resulting from prolonged elevated heart rates, completely reversible upon control of the arrhythmia.
#SUPRAVENTRICULAR TACHYCARDIA WITH IVCD FREE#
The most experienced parachutists recorded the highest HR at the moment of landing and the least experienced at the moment of free fall.
Skydiving triggers an acute adaptive cardiovascular response which is reflected in the increase in the HR, between the moment of boarding the plane and the moment at which the parachute opens, thereafter decreasing until contact with the ground. With regard to experience, the identified differences were not statistically significant. Statistically significant differences were found at the different moments of the jump, regarding HR (Max: p < 0.001, ƞ2p = 0.820 Min: p < 0.001, ƞ2p = 0.821 AVG: p < 0.001, ƞ2p = 0.834) Level of experience with jumping moment interaction, we only verified differences related to HR Min (p = 0.007, ƞ2p = 0.056). Comparing the variable, we found that the less experienced had higher HR than the more experienced at all moments during the jump. HR increases from the value recorded at rest until the moment of jumping from the plane and opening the parachute, reaching the highest average at that moment, then decreasing until contact with the ground. The results showed that average HR in this group of skydivers was 130 bpm, in the different moments of the jump. The effect size was evaluated with partial eta squared. Bonferroni multiple comparisons were performed to study the importance of the differences observed in HR at the different moments. A repeated measures analysis of variance was used to analyse HR at different moments in the jump and its relation with the variables level of experience. The instrument used to record the heart rate of the skydivers at the different moments of their first jump of the day was the WIMU PRO. Thirty-one Portuguese skydivers, 28 men and 3 women, aged between 19 and 62, participated in the study, 12 had A and B licenses (less experienced) and 19 had C and D licences (more experienced). The general objective of this study was to identify the variation in heart rate (HR) of Portuguese skydivers during 6 moments in their first jump of the day, bearing in mind the variable level of experience.
0 kommentar(er)
