Search

2024 OCT 19 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New research on supraventricular tachycardia is the subject of a new report. [...]

2024 MAR 16 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on supraventricular tachycardia have been presented. According to news reporting [...]

2022 NOV 5 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Fresh data on atrial fibrillation are presented in a new report. According [...]

2022 JUN 11 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on thrombotic microangiopathies is now available. According to news [...]

2020 DEC 19 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Research findings on Heart Disorders and Diseases - Supraventricular Tachycardia are discussed [...]

2020 AUG 1 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Heart Disorders and Diseases - Supraventricular Tachycardia have [...]

2020 JUL 4 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New research on tachycardia is the subject of a new report. According [...]

2018 JAN 27 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New research on Heart Disorders and Diseases - Atrioventricular Nodal Reentry Tachycardia [...]

Abstract Objectives To evaluate a system of prehospital thrombolysis, delivered by paramedics, in meeting the national service framework's targets for the management of acute myocardial infarction. Design Prospective observational cohort [...]

The management of supraventricular tachycardia (SVT) has changed considerably over the last 10 years, and some of the techniques that interventional electrophysiologists were using last year are now outdated. This [...]

Background: Radiofrequency ablation is an established but expensive treatment option for many forms of supraventricular tachycardia. Most cases of supraventricular tachycardia are not life-threatening; the goal of therapy is therefore to improve the patient's quality of life. Objective: To compare the cost-effectiveness of radiofrequency ablation with that of medical management of supraventricular tachycardia. Design: Markov model. Data Sources: Costs were estimated from a major academic hospital and the literature, and treatment efficacy was estimated from reports from clinical studies at major medical centers. Probabilities of clinical outcomes were estimated from the literature. To account for the effect of radiofrequency ablation on quality of life, assessments by patients who had undergone the procedure were used. Target Population: Cohort of symptomatic patients who experienced 4.6 unscheduled visits per year to an emergency department or a physician's office while receiving long-term drug therapy for supraventricular tachycardia. Time Horizon: Patient lifetime. Perspective: Societal. Interventions: Initial radiofrequency ablation, long-term antiarrhythmic drug therapy, and treatment of acute episodes of arrhythmia with antiarrhythmic drugs. Outcome Measures: Costs, quality-adjusted life-years, life-years, and marginal cost-effectiveness ratios. Results of Base-Case Analysis: Among patients who have monthly episodes of supraventricular tachycardia, mdiofrequency ablation was the most effective and least expensive therapy and therefore dominated the drug therapy options. Radiofrequency ablation improved quality-adjusted life expectancy by 3.10 quality-adjusted life-years and reduced lifetime medical expenditures by $27 900 compared with long-term drug therapy. Long-term drug therapy was more effective and had lower costs than episodic drug therapy. Results of Sensitivity Analysis: The findings were highly robust over substantial variations in assumptions about the efficacy and complication rate of radiofrequency ablation, including analyses in which the complication rate was tripled and efficacy was decreased substantially. Conclusions: Radiofrequency ablation substantially improves quality of life and reduces costs when it is used to treat highly symptomatic patients. Although the benefit of radiofrequency ablation has not been studied in less symptomatic patients, a small improvement in quality of life is sufficient to give preference to radiofrequency ablation over drug therapy.

Patients who choose to undergo radiofrequency catheter ablation must be prepared for an electrophysiological study prior to the ablation procedure. The first nursing responsibility is to inform the patient of the details and relevant data to the procedure. Puncture sites are then prepared and necessary equipment are attached to the patient. After the procedure, the patient is monitored and assessed for complications. Before the patient is discharged, the nurse informs her of possible after effects and instructs which is abnormal. The patient is also instructed on her medical regimen., This treatment can replace medication as first-line therapy for certain types of recurrent supraventricular tachycardia. Here's how to care for patients who choose this option. Renee Altman, 34 years old, [...]

Byline: SH Lim, V Anantharaman, WS Teo, PP Goh, ATH Tan Abstract: Study objective: To compare the efficacy of the Valsalva maneuver with that of carotid sinus massage (CSM) in terminating paroxysmal supraventricular tachycardia (SVT) in the ED. Methods: This prospective, randomized case study was performed in the ED of a tertiary care institution. Patients were at least 10 years of age with regular narrow complex tachycardia and had an ECG diagnosis of SVT. Patients with regular narrow complex tachycardia were randomly assigned to undergo either the Valsalva maneuver or CSM. If the tachycardia was not terminated by the method chosen by randomization, then the alternative method of vagal maneuver was used. If the tachycardia was not converted by both methods of vagal stimulation, patients would undergo either synchronized electrical cardioversion or a pharmacologic method of conversion at the discretion of the treating physician, depending on the patient's hemodynamic status. Results: One hundred forty-eight instances of SVT were studied. Sixty-two patients underwent Valsalva maneuver first with conversion in 12 (success rate of 19.4%). Eighty-six underwent CSM first with conversion in 9 (success rate 10.5%). Carotid sinus massage was used in the 50 cases of SVT in which conversion was not achieved with the Valsalva maneuver. Conversion occurred in 7 cases (success rate 14.0%). For the 77 cases of SVT in which initial CSM did not achieve conversion, conversion occurred in 13 with the Valsalva maneuver (success rate 16.9%). The Valsalva maneuver and CSM achieved conversion in a total of 41 instances of SVT (success rate 27.7%). Conclusion: Vagal maneuvers are efficacious in terminating about one quarter of spontaneous SVT cases. There is no detectable difference in efficacy between the Valsalva maneuver and CSM. [Lim SH, Anantharaman V, Teo WS, Goh PP, Tan ATH: Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage. Ann Emerg Med January 1998;31:30-35.] Article History: Received 19 August 1996; Revised 3 March 1997; Revised 1 August 1997; Accepted 22 August 1997 Article Note: (footnote) [star] From the Departments of Emergency Medicine* and Cardiology,a and the Singapore Heart Center, Singapore General Hospital, Singapore.As. , [star][star] Address for reprints: Swee Han Lim, FRCS (A&E) (Edin), Department of Emergency Medicine, Singapore General Hospital, Outram Road, Singapore 169608, 65-3214100, Fax 65-2260294, a 47/1/87281

Byline: Laszlo Littmann, Marvin M McCall Abstract: We present the cases of three patients with preexisting bundle-branch block in whom wide-complex tachycardias were considered to be of supraventricular origin because QRS morphologies were essentially unchanged from those during normal sinus rhythm. The patients experienced adverse effects from medications for supraventricular tachycardia. Ventricular tachycardia eventually was diagnosed in all three by means of invasive electrophysiologic studies. Ventricular tachycardia may masquerade as supraventricular tachycardia in patients with fixed intraventricular conduction disturbance. Emergency therapy based solely on the QRS identity criteria may result in poor clinical outcome. [Littmann L, McCall MM: Ventricular tachycardia may masquerade as supraventricular tachycardia in patients with preexisting bundle-branch block: Ann Emerg Med July 1995:26:98-101.] Article History: Received 26 August 1994; Revised 19 January 1995; Accepted 19 January 1995 Article Note: (footnote) [star] From the Department of Internal Medicine, Carolinas Medical Center, Charlotte, North Carolina., [star][star] Address for reprints: Laszlo Littmann, MD, Department of Internal Medicine, Carolinas Medical Center, PO Box 32861, Charlotte, North Carolina 28232, 704-355-3165, Fax 704-355-7626, a Reprint no. 47/1/65121

A total of 8 patients with junctional tachycardia (JT) were included for study. Patients with JT had a supraventricular arrhythmia that was initiated by a junctional complex without PR prolongation and episodes of atrioventricular (AV) dissociation. JT could not be initiated by pacing and occurred either spontaneously (3 patients) or with isoproterenol (5 patients). Tachycardia could be consistently terminated by either carotid sinus massage (1 patient), intravenous adenosine (2 patients), or critically timed ventricular premature complexes (3 patients). In 6 of the 8 other patients, tachycardia foci (atrial or ventricular) or mechanisms (AV node reentry) were found. Two patients underwent complete AV junctional ablation and 2 had termination of tachycardia without change in the AV conduction by perinodal application of radiofrequency lesions. AVJT appears to be due to abnormal automaticity and may be successfully ablated by application of radiofrequency energy to perinodal areas. (Am J Cardiol 1994;74:565-572)

* Purpose: To review the radiofrequency ablation method, describe the technique, and discuss the indications, results, and limitations of its use in patients with cardiac tachyarrhythmias. * Data Sources: Peer-reviewed reports in the literature by clinical investigators who use radiofrequency catheter ablation as identified by a MEDLINE search and our own experience with this intervention in 214 patients with cardiac tachyarrhythmias. * Study Selection: All articles reporting results of radiofrequency ablation for cardiac tachyarrhythmias and articles describing the ablation technique or comparing it with direct-current or surgical methods. * Results of Data Synthesis: Percutaneous catheter ablation of cardiac arrhythmias using high-voltage, direct current was limited by a high complication rate and a need for general anesthesia. This method was recently replaced by a new safe and efficacious technique using low-voltage, high-frequency (radiofrequency) alternating current. Nonsurgical cure of many supraventricular arrhythmias is now feasible with radiofrequency ablation, especially in patients with accessory pathways or atrioventricular nodal reentrant tachycardia. For these arrhythmias, success rates are greater than 90%. The indications for ablation include preexcitation syndromes, atrioventricular nodal reentrant tachycardia, and other selected atrial and ventricular tachyarrhythmias refractory to antiarrhythmic drug therapy. The efficacy and safety profile of this technique has made it feasible for children as well as adults. * Conclusions: Percutaneous radiofrequency catheter ablation has evolved as a safe and effective method for managing and curing the two most common forms of supraventricular tachycardia: those associated with preexcitation syndromes and atrioventricular nodal reentrant tachycardia. Further studies are needed to determine the efficacy of this method or to evaluate alternative transcatheter techniques in patients with atrial tachycardias and, more importantly, in the large population of patients with ischemic ventricular tachycardia., Radiofrequency catheter ablation appears to be an effective treatment for cardiac tachyarrhythmias such as supraventricular tachycardia. A cardiac tachyarrhthmia is an irregular and excessively rapid heart beat. Supraventricular tachycardia means that the rapid beat originates above the chambers called ventricles. Radiofrequency catheter ablation alters the electric conduction pathway responsible for the defective heart beat by means of a low-voltage radiofrequency current applied to the heart tissue by an electrode catheter. A review of medical literature and experience with radiofrequency ablation in 214 patients with tachyarrhythmias led researchers to conclude that this nonsurgical procedure has an excellent success rate and a low complication rate. Future research should include long-term follow-up and comparison of radiofrequency ablation with drug therapy.

This report describes the use of programmed atrial stimulation via the esophagus to predict the clinical efficacy of various management strategies for supraventricular arrhythmias in infants and children. A total of 203 transesophageal electrophysiologic studies were performed in 132 patients. Therapies evaluated included medications from each antiarrhythmic class, the Valsalva maneuver, follow-up of radiofrequency ablation, and no therapy. The transesophageal technique appeared to be adequate for inducing tachycardia, yielding a low false-negative rate. Overall, the predictive value of a negative study was high (89%), and increased to 96% when stimulation was performed in the presence of isoproterenol. However, the positive predictive value was significantly lower both with (72%, p (Am J Cardiol 1994;74:353-356)

Premature ventricular complexes (PVCs), atrial fibrillation (AF), and supraventricular tachyarrhythmias are three of the commonest heart rhythm abnormalities (see Figure 1, page 146). Each can represent a benign variation in [...]

Radiofrequency catheter ablation of the concealed atrioventricular (AV) accessory pathway was performed during entrainment of the AV reciprocating tachycardia. Right ventricular pacing at a rate 5 to 15 beats/min faster than the tachycardia rate was performed during the tachycardia, which resulted in transient entrainment. In 2 patients with a right-sided accessory pathway, constant fusion of the QRS complex was observed during entrainment, whereas in 2 with a left-sided pathway, no fusion beat was noted (concealed entrainment). Radiofrequency energy was applied to the accessory pathway while entraining the tachycardia. One to 4.5 seconds after initiation of energy delivery, ventriculoatrial conduction block occurred (i.e., the accessory pathway was ablated). This was associated with a change in the left ventricular activation sequence from orthodromic capture through the normal AV conduction system to antidromic capture through the right ventricle and with a change in the QRS morphology in patients with a right-sided accessory pathway. The left ventricular activation sequence and QRS morphology remained unchanged in patients with concealed entrainment. Radiofrequency energy was effectively delivered for 30 seconds with a stable ablation catheter position, and termination of rapid pacing resulted in sinus rhythm. Thus, radiofrequency ablation of the reentry circuit component during manifest entrainment fulfilled the third entrainment criterion defined previously. The results suggest that tachycardia entrainment can be used for continuous application of radiofrequency energy during tachycardia in selected patients, because it provides a constant ventricular rate during the procedure and thus maintains the catheter in a stable position. (Am J Cardiol 1993;72:188-193)

Medical therapy for the treatment of supraventricular tachycardias is frequently ineffective and associated with significant side effects, whereas curative surgical approaches have generally been limited by their considerable morbidity and cost. Greater understanding of the mechanisms underlying supraventricular tachycardias has improved our ability to precisely map endocardial areas critical to arrhythmogenesis. Advances in catheter ablation techniques and particularly the use of radiofrequency current to generate thermal energy for ablation have resulted in dramatic success rates for curative catheter ablation. This review examines the physics of radiofrequency current ablation and its application to the treatment of atrial fibrillation, atrial flutter, AV nodal reentrant tachycardia, and arrhythmias associated with the Wolff-Parkinson-White syndrome. The limitations, risks, and cost-effectiveness of this technique relative to medical and surgical approaches are also evaluated.

A predischarge electrophysiologic study was performed in 113 patients with the Wolff-Parkinson-White (WPW) syndrome who had undergone surgical ablation of the accessory pathway. The study was performed 5 to 20 (mean 10 [+ or -] 3) days after surgery. There were 82 male and 31 female patients (aged 4 to 58 years, mean 36 [+ or -] 13. Sixty-one patients (54%) had manifest, 52 (46%) had concealed and 12 (11%) had multiple accessory pathways. All but 1 patient had atrioventricular reentrant tachycardia incorporating single or multiple accessory pathways during the control electrophysiologic study. The accessory pathways were located in the left ventricular free wall in 60% of cases, right ventricular free wall in 22%, posteroseptum in 13%, and anteroseptum in 5%. The predischarge electrophysiologic study showed that the accessory pathway was capable of anterograde and retrograde conductions in 4 patients (all with manifest WPW syndrome). Four patients showed induction of supraventricular tachycardia, including 2 with atrioventricular reentrant tachycardia, and 2 with atrioventricular nodal reentrant tachycardia. Recurrence of supraventricular tachycardia was noted in 5 patients during a follow-up of 28 [+ or -] 26 months. Of these 5 patients, 2 had inducible and 3 had no inducible supraventricular tachycardia during the predischarge electrophysiologic study. Thus, the predischarge electrophysiologic study could predict late outcome with recurrence of preexcitation or supraventricular tachycardia in patients who had undergone surgical ablation of the accessory pathway with an overall predictive accuracy of 95% (107 of 113 patients), negative predictive value of 96% (103 of 107), and positive predictive value of 67% (4 of 6).