Limits...
Idiopathic left ventricular aneurysm causing ventricular tachycardia with 1:1 ventriculoatrial conduction and intermittent wenckebach block.

Paraskevaidis S, Stavropoulos G, Vassilikos V, Chatzizisis YS, Polymeropoulos K, Ziakas A, Dakos G, Parcharidis GE - Open Cardiovasc Med J (2009)

View Article: PubMed Central - PubMed

Affiliation: 1 Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece. stparask@otenet.gr

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Left ventricular aneurysms (LVAs) can be congenital or acquired... Other causes include hypertrophic cardiomyopathy, arrythmogenic right ventricular cardiomyopathy, myocarditis, chest trauma, sarcoidosis or Chagas disease... The patient was started on amiodarone per os and after two weeks an electrophysiology study was performed... The programmed ventricular stimulation in the right ventricular apex with 500/230-240 msec basic drive cycle and two extrastimuli reproducibly induced sustained monomorphic VT of 160 bpm associated with hemodynamic instability... These aneurysms can be either congenital or acquired... The most frequent cardiac cause of LVAs is myocardial infarction or coronary artery fistula but they can also occur in hypertrophic cardiomyopathy, myocarditis, arrhythmogenic right ventricular cardiomyopathy, blunt chest trauma and surgery... Patients with LVAs may be either asymptomatic or manifest with recurrent arterial emboli, angina, congestive heart failure, ventricular tachyarrhythmias and sudden cardiac death... As a result, LVAs represent an uncommon but important cause of sudden death, especially in young adults... In most of the cases, VT associated with LVAs present with RBBB morphology due to the left ventricular origin... The ventricular tachyarrhythmias can be treated by antiarrhythmic drugs, VT ablation, or by an ICD implantation as in our case... Aneurysmectomy can also be an option especially if conservative approaches are not effective... Prognosis of idiopathic LVAs depends on their size, location, degree of valvular involvement, functional class of congestive heart failure and the presence of ventricular tachyarrhythmias... In our case, the implantation of ICD complemented with amiodarone per os was a quite effective treatment strategy, as no arrhythmia was reported in the following six months.

No MeSH data available.


Related in: MedlinePlus

ECG on admission showing the ventriculat tachycardia (VT) with RBBB morphology, (B). Restoration of VT to sinus rhythm with electrical cardioversion, (C). Induced VT with LBBB morphology during the electrophysiology study, (D). Electrogram during the electrophysiology study showing a 1:1 ventriculoatrial conduction with intermittent Wenckebach block.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2743851&req=5

Figure 1: ECG on admission showing the ventriculat tachycardia (VT) with RBBB morphology, (B). Restoration of VT to sinus rhythm with electrical cardioversion, (C). Induced VT with LBBB morphology during the electrophysiology study, (D). Electrogram during the electrophysiology study showing a 1:1 ventriculoatrial conduction with intermittent Wenckebach block.

Mentions: A 72-year old woman was admitted to our hospital with palpitations, dizziness and fatigue from a few hours ago. The patient had a history of heart failure (NYHA II) from three years ago and also an episode of paroxysmal atrial flutter two years ago. She was free of angina and had no cardiovascular disease risk factors. The family history was unremarkable with respect to cardiac arrest, unexplained syncope, ventricular tachyarrhythmias, or cardiomyopathy. At the time of presentation to the emergency department the patient was receiving carvedilol, valsartan, and furosemide. The baseline 12-lead ECG revealed a sustained monomorphic VT with RBBB morphology and left axis deviation (Fig. 1A). Since tachycardia was poorly tolerated with systolic blood pressure of 80 mmHg an electrical cardioversion was applied and the rhythm was restored to sinus (Fig. 1B). The ΕCG, physical examination and laboratory tests after the cardioversion were unremarkable.


Idiopathic left ventricular aneurysm causing ventricular tachycardia with 1:1 ventriculoatrial conduction and intermittent wenckebach block.

Paraskevaidis S, Stavropoulos G, Vassilikos V, Chatzizisis YS, Polymeropoulos K, Ziakas A, Dakos G, Parcharidis GE - Open Cardiovasc Med J (2009)

ECG on admission showing the ventriculat tachycardia (VT) with RBBB morphology, (B). Restoration of VT to sinus rhythm with electrical cardioversion, (C). Induced VT with LBBB morphology during the electrophysiology study, (D). Electrogram during the electrophysiology study showing a 1:1 ventriculoatrial conduction with intermittent Wenckebach block.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2743851&req=5

Figure 1: ECG on admission showing the ventriculat tachycardia (VT) with RBBB morphology, (B). Restoration of VT to sinus rhythm with electrical cardioversion, (C). Induced VT with LBBB morphology during the electrophysiology study, (D). Electrogram during the electrophysiology study showing a 1:1 ventriculoatrial conduction with intermittent Wenckebach block.
Mentions: A 72-year old woman was admitted to our hospital with palpitations, dizziness and fatigue from a few hours ago. The patient had a history of heart failure (NYHA II) from three years ago and also an episode of paroxysmal atrial flutter two years ago. She was free of angina and had no cardiovascular disease risk factors. The family history was unremarkable with respect to cardiac arrest, unexplained syncope, ventricular tachyarrhythmias, or cardiomyopathy. At the time of presentation to the emergency department the patient was receiving carvedilol, valsartan, and furosemide. The baseline 12-lead ECG revealed a sustained monomorphic VT with RBBB morphology and left axis deviation (Fig. 1A). Since tachycardia was poorly tolerated with systolic blood pressure of 80 mmHg an electrical cardioversion was applied and the rhythm was restored to sinus (Fig. 1B). The ΕCG, physical examination and laboratory tests after the cardioversion were unremarkable.

View Article: PubMed Central - PubMed

Affiliation: 1 Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece. stparask@otenet.gr

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Left ventricular aneurysms (LVAs) can be congenital or acquired... Other causes include hypertrophic cardiomyopathy, arrythmogenic right ventricular cardiomyopathy, myocarditis, chest trauma, sarcoidosis or Chagas disease... The patient was started on amiodarone per os and after two weeks an electrophysiology study was performed... The programmed ventricular stimulation in the right ventricular apex with 500/230-240 msec basic drive cycle and two extrastimuli reproducibly induced sustained monomorphic VT of 160 bpm associated with hemodynamic instability... These aneurysms can be either congenital or acquired... The most frequent cardiac cause of LVAs is myocardial infarction or coronary artery fistula but they can also occur in hypertrophic cardiomyopathy, myocarditis, arrhythmogenic right ventricular cardiomyopathy, blunt chest trauma and surgery... Patients with LVAs may be either asymptomatic or manifest with recurrent arterial emboli, angina, congestive heart failure, ventricular tachyarrhythmias and sudden cardiac death... As a result, LVAs represent an uncommon but important cause of sudden death, especially in young adults... In most of the cases, VT associated with LVAs present with RBBB morphology due to the left ventricular origin... The ventricular tachyarrhythmias can be treated by antiarrhythmic drugs, VT ablation, or by an ICD implantation as in our case... Aneurysmectomy can also be an option especially if conservative approaches are not effective... Prognosis of idiopathic LVAs depends on their size, location, degree of valvular involvement, functional class of congestive heart failure and the presence of ventricular tachyarrhythmias... In our case, the implantation of ICD complemented with amiodarone per os was a quite effective treatment strategy, as no arrhythmia was reported in the following six months.

No MeSH data available.


Related in: MedlinePlus