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Investigation of Sudden Cardiac Death
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
There are anomalous pathways which can activate the ventricle, leading to the term pre-excitation or Wolff–Parkinson–White syndrome. Sudden death is a risk with these pathways. Identification of accessory pathways associated with pre-excitation syndromes is totally impractical and the clinical history is important to indicate that this is the likely cause of death with a morphologically normal heart. Electrophysiologists are experts at localizing the abnormal pathway between the atrium and ventricle and will usually ablate this if clinically indicated. Sudden death can occur even after successful ablation.66
Investigations
Published in Gregory YH Lip, Atrial Fibrillation in Practice, 2020
Rapid AF with a rapid ventricular response may be mistaken for other supraventricular arrhythmias (for example, atrial flutter or supraventricular tachycardias) or if a bundle branch block is present, ventricular tachycardia. Subtle variations in the relative risk (RR) interval are the important clues. The ECG may also provide a clue to the aetiology or electrophysiological features that may have caused the AF. For example, the presence of prior myocardial infarction, left ventricular hypertrophy or pre-excitation syndromes (such as the delta wave in Wolff-Parkinson-White syndrome) may be seen on the 12-lead ECG.
Cardiac tests and procedures
Published in Clive Handler, Gerry Coghlan, Nick Brown, Management of Cardiac Problems in Primary Care, 2018
Clive Handler, Gerry Coghlan, Nick Brown
It has a lower predictive accuracy in women, although the reason for this is not clear. The ST response to exercise is the objective hallmark of myocardial ischaemia, but this cannot be interpreted in patients with an abnormal ST segment at rest. This includes patients with bundle branch block and pre-excitation syndromes. Nevertheless, exercise tolerance, vulnerability to exercise-induced arrhythmia and symptoms can be evaluated.
Prognostic value of myocardial injury-related findings on resting electrocardiography for cardiovascular risk in the asymptomatic general population: the 12-year follow-up report from the Ansan-Ansung cohort
Published in Annals of Medicine, 2020
Jinho Shin, Yonggu Lee, Jin-Kyu Park, Jeong-Hun Shin, Young-Hyo Lim, Heo Ran, Hyun-Jin Kim, Hwan-Cheol Park
Participants who had a prior history of CV diseases, including myocardial infarction (MI), non-MI CADs, congestive heart failure and haemorrhagic/ischaemic stroke, were excluded from the study. These CV diseases were identified through the interviews conducted during the baseline evaluations. Previous diagnoses made by physicians were used as the definitions of these CV diseases. Non-MI CADs were identified through a binary question for the presence of physician-diagnosed angina pectoris without MI. Participants with any angina-related symptoms were also excluded. Participants with pre-excitation syndrome (Minnesota code 6-4-1), left or right bundle branch block (Minnesota code 7-1-1 and 7-2-1, respectively) or tachycardia ≥120 bpm were also excluded because of the STAs accompanying these conditions.
Etripamil nasal spray: an investigational agent for the rapid termination of paroxysmal supraventricular tachycardia (SVT)
Published in Expert Opinion on Investigational Drugs, 2020
Anthony H. Kashou, Peter A. Noseworthy
While etripamil nasal spray has the potential to alter acute management of SVT, it is important to remain cautious of the existing unknowns. A major concern involves unidentified adverse events (e.g. complete AV block, sinus pause, ventricular arrhythmias), especially in elderly patients, those on other anti-arrhythmic or AV nodal blocking medications (e.g. digoxin, beta-blockers, calcium-channel blocks), and those with undiagnosed pre-excitation syndrome. Prior to prescribing patients with a new medication to administer at home away from medical personnel, it will be crucial to ensure adverse events are clarified and that safety measures are in place for patients.
Is kratom (Mitragyna speciosa Korth.) use associated with ECG abnormalities? Electrocardiogram comparisons between regular kratom users and controls
Published in Clinical Toxicology, 2021
Mohammad Farris Iman Leong Abdullah, Kok Leng Tan, Suresh Narayanan, Novline Yuvashnee, Nelson Jeng Yeou Chear, Darshan Singh, Oliver Grundmann, Jack E. Henningfield
None of the following ECG abnormalities were detected among the kratom users and controls: torsades de pointes, ST-segment abnormalities, acute myocardial infarction, complete RBBB, left bundle branch block, second- and third-degree atrioventricular block, bifascicular block, trifascicular block, second-degree left or right atrial hypertrophy, right ventricular hypertrophy, ventricular premature beat, atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, pre-excitation syndrome, Wolff–Parkinson–White syndrome, pathological Q wave, pathological U wave, and pacemaker ECG.