Prenatal diagnosis and management of junctional ectopic tachycardia

Slides:

Advertisements

Similar presentations

Flecainide-induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff- Parkinson-White syndrome: Uneven depression of accessory pathway.

Advertisements

Dual-Chamber Pacing for Cardiomyopathies: A 1996 Clinical Perspective

Jeffrey P. Moak, MD, Marco A. Mercader, MD, Dingchao He, MD, TK

Incessant bundle branch reentrant ventricular tachycardia in a patient with corrected transposition of the great arteries Ken Kato, MD, Daigo Yagishita,

His-bundle pacing in a patient with dextrocardia, severe systolic dysfunction, and complete atrioventricular block Manuel Molina-Lerma, MD, Juan Jiménez-Jáimez,

Isolated left bundle branch block progressing to complete heart block and asystole: A novel presentation of a desmin mutation Addison S. Gearhart, MD,

Inappropriate shock from delayed T-wave oversensing by a subcutaneous implantable cardioverter-defibrillator after septal myectomy for hypertrophic cardiomyopathy

Premature ventricular contractions with two QRS morphologies originate from one focus in great cardiac vein Juan Ma, MD, Ke-Xiang Wu, MD, Yu-Bin Wang,

Paradoxical reflex bradycardia after epinephrine infusion for arrhythmia induction in the electrophysiology laboratory Timothy R. Larsen, DO, Karoly.

Nicholas M. Cundiff, DO, Jeffrey A. Robinson, MD, Bryan C

Prakash G. Suryanarayana, MD, David S. Frankel, MD, FHRS, Francis E

Successful catheter ablation of recipient left ventricular tachycardia 26 years after heterotopic heart transplantation Mikael Laredo, MD, Shaida Varnous,

Is it bradycardia or something else causing symptoms?

Novel CALM3 mutations in pediatric long QT syndrome patients support a CALM3- specific calmodulinopathy Marie-A. Chaix, MD, MSc, Tamara T. Koopmann, PhD,

Ruchit Shah, MD, Vineet Kumar, MD, FHRS HeartRhythm Case Reports

Use of topical lidocaine in eliminating mechanically stimulated ventricular fibrillation in a patient with short QT syndrome Maria J. Farag, BS, Joseph.

Santiago O. Valdés, MD, Andrew P. Landstrom, MD, PhD, Andrew E

Successful prenatal management of ventricular tachycardia and second-degree atrioventricular block in fetal long QT syndrome Akira Miyake, MD, Heima.

Resolution of the functional retrograde right bundle branch block during antidromic atrioventricular reciprocating tachycardia Keiko Takahashi, MD, PhD,

Swallow-induced syncope: A case report of atrial tachycardia originating from the SVC Tiffany Y. Hu, BS, Suraj Kapa, MD, FHRS, Yong-Mei Cha, MD, FHRS,

Limitations of 12-lead electrocardiogram wide complex tachycardia algorithms in a patient with left atrial flutter and large myocardial infarction Carlos.

Use of intravenous sotalol in newborns with supraventricular tachycardia Hannah Kim, MD, Jennifer Wolff, PharmD, BCPPS, Aarti Dalal, DO, George F. Van.

Atrioventricular block and pause-dependent torsade de pointes

Jonathan T. Jaffe, MD, Lee-Gardie Jean, MD, Richard J. Murray, MD

Unusual mechanism of complete atrioventricular block following atrial flutter ablation Frederic Georger, MD, Luc De Roy, MD, Camelia Sorea, Jean-Paul.

Successful demonstration of the detailed connection between the twin atrioventricular nodes and sling in a patient with asplenia syndrome Hitoshi Mori,

Bradley D. Brochu, MD, Ahmed Abdi-Ali, MD, Jeffrey Shaw, MD, F

Swallowing-induced atrial tachycardia arising from superior vena cava: Significant involvement of parasympathetic nerve activity Koji Higuchi, MD, PhD,

Elisa Ebrille, MD, Fernando M. Contreras-Valdes, MD, Peter J

Volume 11, Issue 1, Pages (January 2014)

An unusual atrioventricular accessory pathway with an oblique course

Fetal paroxysmal atrial fibrillation during transplacental therapy for supraventricular tachycardia Takekazu Miyoshi, MD, PhD, Heima Sakaguchi, MD, PhD,

Reduced combined ventricular output and increased oxygen extraction fraction in a fetus with complete heart block demonstrated by MRI Meng Yuan Zhu,

Cardiac arrest in an adolescent with Uhl’s anomaly: Two unusual cardiac arrhythmia mechanisms Jeffrey P. Moak, MD, Gail D. Pearson, MD, ScD, Bradley.

Complete congenital heart block: A case of multilevel block

Srinath C. Yeshwant, MD, Mitchell H. Tsai, MD, MMM, Bradley R

His bundle capture proximal to the site of bundle branch block: A novel pitfall of the para-Hisian pacing maneuver Marek Jastrzebski, MD, PhD, Piotr.

Cyclical sinus bradycardia and atrioventricular block induced by ticagrelor Victor Waldmann, MD, MPH, Mikael Laredo, MD, Anil Nigam, MD, MSc, Paul Khairy,

An inferior myocardial infarction with conduction abnormalities

Expanding the electrical phenotype of NKX2-5 mutations: Ventricular tachycardia, atrial fibrillation, and complete heart block within one family Simone.

Dual intraventricular response after cardiac resynchronization

QRS normalization during atrial pacing in a patient with complete left bundle branch block: What is your diagnosis? Oholi Tovia-Brodie, MD, Yoav Michowitz,

Volume 13, Issue 1, Pages (January 2016)

Bundle branch reentry: A novel mechanism for sustained ventricular tachycardia in Chagas heart disease Alvaro V. Sarabanda, MD, PhD, Wagner L. Gali,

Mapping of a postinfarction left ventricular aneurysm–dependent macroreentrant ventricular tachycardia Elad Anter, MD, Jianqing Li, MD, Cory M. Tschabrunn,

Polymorphic ventricular tachycardia due to change in pacemaker programming Ihab Elsokkari, MBBCh, MMed, FRACP, Amir Abdelwahab, MBBCh, MSc, MD, Ratika.

Haseeb Jafri, MD, Alan Cheng, MD, FHRS HeartRhythm Case Reports

Hiroko Asakai, MD, Laura Fenwick, BSc, Robert M. Hamilton, MD, FRCP(C)

Circular mapping recordings in a persistent left superior vena cava during atrial tachycardia: Was isolation achieved? Sandrine Venier, MD, Jason G.

Successful treatment of tachycardia-induced cardiomyopathy secondary to dual atrioventricular nodal nonreentrant tachycardia using cryoablation Harold.

Benjamin A. Blais, MD, Gary Satou, MD, Mark S

An unusual cause of HV prolongation

Different rate-dependent responses between J waves and the notches on an epicardial local electrogram in a patient with idiopathic ventricular fibrillation

Slow pathway modification for treatment of pseudo-pacemaker syndrome due to first- degree atrioventricular block with dual atrioventricular nodal physiology

Catheter ablation of the slow pathway as a treatment for severe sinus node dysfunction in a patient with incessant atrioventricular nodal reentry tachycardia

Colin Yeo, MBBS, Martin Green, MD, Robert Lemery, MD, FHRS

Radiofrequency catheter ablation for treatment of premature ventricular contractions triggering ventricular fibrillation from the right ventricular outflow.

Annika Winbo, MD, PhD, Annika Rydberg, MD, PhD

Dana B. Gal, MD, Julianne Wojciak, MS, Jennifer Perera, MD, Ronn E

Majid Husain, MD, Anthony McCanta, MD, FHRS, Anjan S

Mahaim pathway tachycardia versus bystander ventricular tachycardia: A distinction without a difference Michael S. Wu, MD, James E. Ip, MD, FHRS, George.

Analysis of variable conduction ratios into the atrioventricular node during atrial flutter: Multilevel block theory Kazushi Tanaka, MD, PhD, FACC, Osamu.

HeartRhythm Case Reports

Successful catheter ablation of focal ventricular tachycardia originating from right bundle branch without making right bundle branch block, using pharmacologic.

Parsing a perplexing paroxysmal pathway

Ablation of a symptomatic spontaneous automatic focus arising from an atriofascicular fiber Sandrine Venier, MD, Paul Khairy, MD, PhD, Bernard Thibault,

HeartRhythm Case Reports

Resolution of new left bundle branch block and ventricular tachycardia with immunosuppressive therapy in a patient with cardiac sarcoidosis Aatish Garg,

Jeffrey Munro, DO, Win-Kuang Shen, MD, FHRS, Komandoor Srivathsan, MD

Flecainide-induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff- Parkinson-White syndrome: Uneven depression of accessory pathway.

Presentation transcript:

Prenatal diagnosis and management of junctional ectopic tachycardia S. Javed Zaidi, MD, Saad Siddiqui, MD, Bettina F. Cuneo, MD, Janette F. Strasburger, MD, Robert McDuffie, MD, Ronald T. Wakai, PhD HeartRhythm Case Reports Volume 3, Issue 11, Pages 503-508 (November 2017) DOI: 10.1016/j.hrcr.2017.07.022 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Case 1: Fetal magnetocardiography (fMCG) recordings during and after junctional ectopic tachycardia (JET). A: MCG fetal heart rate (FHR) trend recording over 10 minutes at 20 weeks gestational age (GA) during incessant JET (181 beats per minute). Low FHR variability is seen, except during ventriculoatrial (VA) dissociation with resultant sinus capture (horizontal arrows). Periods of VA dissociation are associated with increased beat-to-beat heart rate variability and spikes in FHR owing to shortened R-R intervals from conducted beats. B: fMCG rhythm tracing at 20 weeks GA during JET. The sinus P waves are indicated by upward arrows. Retrograde P waves are indicated by downward arrows. The 2 early beats (asterisks) are preceded by a P wave and have different QRS morphology, consistent with conducted sinus capture beats. These support that antegrade atrioventricular node conduction is still present. C: Signal-averaged butterfly (20 weeks GA) showing retrograde bifid P waves occurring within the lower-amplitude T waves. QTc is prolonged. Cardiac intervals are as follows: R-R = 333 ms, VA = 77 ms, QRS = 33 ms, and QTc = 513 ms. D: Signal-averaged butterfly plot at 25 weeks GA during sinus rhythm showing tall P waves and P-R prolongation. HeartRhythm Case Reports 2017 3, 503-508DOI: (10.1016/j.hrcr.2017.07.022) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Cases 1 and 2 postnatal electrocardiograms (ECGs) (leads II and V1). Case 1: At age < 1 day (A–C) and age 2 days (D). A: Second-degree atrioventricular (AV) block, left bundle branch block (LBBB). B: Sinus rhythm with first-degree AV block, LBBB. C: Junctional ectopic tachycardia (JET) demonstrating probable drug-related LBBB. D: Sinus rhythm; the LBBB has resolved. Case 2: At age < 1 day (E, F) and age 6 and 9 days (G, H). All ECGs are recorded at an amplitude of 0.1 mV/mm and at 25 mm/s. E: JET, 1:1 retrograde ventriculoatrial (VA) conduction. F: JET, VA dissociation possibly secondary to flecainide. G: JET with VA dissociation, the sinus capture beat in V1 suggests intact AV conduction. HeartRhythm Case Reports 2017 3, 503-508DOI: (10.1016/j.hrcr.2017.07.022) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 Case 2. Spectral Doppler images of junctional ectopic tachycardia (JET). A: Ascending aorta (Ao) and superior vena cava (SVC) waveforms. Atrial systole (seen as retrograde SVC flow velocities [arrows]) occurs simultaneously with ventricular systole (antegrade Ao flow velocity). B: A sinus capture beat (arrow) is seen from simultaneous mitral E inflow (MV) and Ao outflow. C: Increased retrograde flow during atrial systole (atrial wave [a] below baseline) is seen in the ductus venosus. Flow toward the heart is biphasic (S and D waves). HeartRhythm Case Reports 2017 3, 503-508DOI: (10.1016/j.hrcr.2017.07.022) Copyright © 2017 Heart Rhythm Society Terms and Conditions