Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Repetitive monomorphic ventricular tachycardia (RMVT) is defined by the presence of numerous monomorphic isolated, premature ventricular complexes, couplets, and runs of unsustained ventricular tachycardia having the same morphology in patients without structural heart disease. Patients with RMVT mostly demonstrate the typical left bundle branch block morphology with normal or rightward axis during tachycardia. At our institution, 20 patients with RMVT have been systematically studied: a syncope had occurred in 35% of our patients, in three cases a syncope was the first manifestation of the RMVT. Of our RMVT patients, 25% developed sustained episodes (> 3 min) of ventricular tachycardia as documented by Holter ECG. The salvos of ventricular tachycardia are generally short in RMVT. This behavior and the typical exercise dependence differentiates RMVT from paroxysmal sustained idiopathic ventricular tachycardia. Exercise testing is mandatory for correct diagnosis of RMVT. In our institution, 85-90% of RMVT patients demonstrated runs of ventricular tachycardia or sustained ventricular tachycardia while on a treadmill (exercise test) or during isoproterenol infusion. RMVT was inducible by programmed electrical right ventricular stimulation in only 13% of our patients. Therefore, in patients with suspected RMVT programmed electrophysiological stimulation is only useful to differentiate a ventricular tachycardia from a supraventricular tachycardia with bundle brunch block or in patients with unexplained syncope. The prognosis is considered generally good; in our patients no life threatening ventricular tachyarrhythmias were observed during a follow-up of up to 4 years. Verapamil and beta-adrenoceptor antagonists generally offer symptomatic improvement. In some cases treatment with a class III antiarrhythmic agent is necessary. While drug-refractory paroxysmal sustained idiopathic ventricular tachycardia can be abladed with both immediate and long-term success, catheter ablation of RMVT is only rarely indicated.
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PMID:[Repetitive monomorphic ventricular tachycardia (Gallavardin type): clinical and electrophysiological characteristics in 20 patients]. 965 50

A twenty year follow up of a selected, community population with complete right and left bundle branch block is reviewed by comparative mortality analysis. In this population, where cases and controls were free of hypertension and heart disease at entry, the presence of complete right bundle branch block does not have excess mortality. Complete left bundle branch block exhibits excess total and cardiac mortality.
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PMID:Mortality analysis of complete right and left bundle branch block in a selected community population. 1016 36

It has been reported that electrocardiographic abnormalities may be associated with acute pancreatitis. However, the data are lacking or sketchy. The aim of this study was to assess the frequency and type of electrocardiographic abnormalities present in patients with acute pancreatitis. Fifty-six consecutive patients with acute pancreatitis and without previous history of heart disease were studied. Eleven patients had arterial hypertension. Forty-one patients had mild pancreatitis and 15 had the severe form of the disease. On admission, all patients underwent a standard 12-leads electrocardiogram and a serum electrolyte determination. Nineteen healthy subjects were also studied as controls. Twenty-seven patients (48.2%) (10 with severe pancreatitis and 17 with mild pancreatitis) had a normal electrocardiogram. In the remaining 29 patients (51.8%), one patient with severe pancreatitis had atrial extrasystoles and eight had bradycardia (less than 60 beats/minute) (two with severe pancreatitis and six with mild pancreatitis); 14 patients had changes of the T-wave and/or the ST-segment (two with severe pancreatitis and 12 with mild pancreatitis); seven patients showed disturbances of the intraventricular conduction (one with severe pancreatitis and six with mild pancreatitis): four had left anterior hemiblock, two had complete left bundle branch block and one had left anterior hemiblock and incomplete right bundle branch block; one patient with mild pancreatitis had atrioventricular block (first degree). No differences in heart rate, RR interval, PR interval and QT interval were found when patients with acute pancreatitis were compared with healthy subjects, nor when patients with severe pancreatitis were compared with those having the mild form of the disease. Seventeen of the 29 patients with electrocardiographic abnormalities (52.6%) also had serum electrolyte alterations. More than 50% of the patients with acute pancreatitis had electrocardiographic abnormalities and electrolyte alterations were also present in about one-half of these.
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PMID:Electrocardiographic abnormalities in acute pancreatitis. 1034 Jul 31

We performed radiofrequency catheter ablation (RFCA) in 12 consecutive patients (17-77 years) with daily, symptomatic, monomorphic ventricular ectopy (VE) (12,096 +/- 3,326 on 24-hour Holter) resistant to antiarrhythmic drugs. Nine patients had no apparent structural heart disease, 1 patient had a mild dilated cardiomyopathy, 1 patient had a treated mitral stenosis, and 1 patient had arrhythmogenic ventricular dysplasia. VE morphology was LBBB with inferior axis in 9 patients, RBBB with inferior axis in 2 patients, RBBB with superior axis in 1 patient. None of the patients had spontaneous or inducible sustained ventricular tachycardia. The VE focus was targeted with RF energy at the earliest endocardial activation site and based on a matching 12-lead ECG pace map. The VE focus was localized in the right outflow tract in 9 patients and on the left ventricle in 3 patients. RFCA was delivered with a standard 4-mm tip electrode. The ablation was initially successful in 11 patients and unsuccessful in 1 patient. All successfully ablated patients were asymptomatic and discharged without antiarrhythmic drugs. During follow-up (25 +/- 8; 17-38 months), two patients had a recurrence of symptoms, which were controlled by a previously ineffective drug. At the end of follow-up, 1,329 +/- 3198 VE were observed on Holter monitoring (P < 0.001 compared with initial values). No short- and long-term complications were observed. RFCA is a safe and effective method for treating drug-resistant symptomatic monomorphic VE in carefully selected patients. A persistent benefit without complications was obtained over a 2-year follow-up.
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PMID:Radiofrequency catheter ablation of drug refractory symptomatic ventricular ectopy: short- and long-term results. 1035 39

Idiopathic ventricular tachycardias (VTs) are generally divided into those arising from the right ventricle and those arising from the left ventricle. There has been few reports of two morphologically distinct VT occurring in patients with no apparent structural heart disease. We report a patient with verapamil-sensitive left VT with a right bundle branch block pattern that spontaneously changed to VT with a left bundle branch block pattern. Ventricular fibrillation was induced by the application of programmed stimulation. Although it is unclear if our patient with pleomorphic VT has ventricular vulnerability, it is necessary to investigate further and follow him carefully.
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PMID:Idiopathic verapamil-sensitive left ventricular tachycardia complicated by right ventricular outflow tract ventricular tachycardia and ventricular fibrillation. 1036 10

We studied a 48 years old woman, with chronic Chagasic cardiopathy, manifested with cardiomegaly, heart failure and syncope, due to a sustained ventricular tachycardia (SVT) of two different configurations (left bundle branch block and right bundle branch block). During electrophysiological testing, both types of ventricular tachycardia were reproduced. Successful ablation therapy of the right branch of His was performed due to suspicion of the bundle branch reentrant tachycardia, with a left bundle branch block. The patient continued to show SVT episodes, now with right bundle branch block pattern. Cardioverter Defibrillator was implanted. We report this case due to the rare frequency of Chagas' disease, where it could be a cause of heart disease, since the existence of the parasite (trypanosoma cruzi) and its vector (Triatoma) has been identified in some rural and suburban zones in the state of Aguascalientes, Mexico.
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PMID:[Automatic, implantible cardioverter-defibrillator in a patient with chronic Chagas cardiopathy and sustained ventricular tachycardia]. 1036 35

A case of neonatal catecholaminergic ventricular tachycardia is reported. Episodes of fetal tachycardia were detected in a female baby and just after birth, sustained monomorphic ventricular tachycardia of complete left bundle branch block pattern and inferior axis were recorded, suggesting a right ventricular outflow origin. Routine examination did not reveal overt heart disease. Ventricular tachycardia was induced by crying or sucking, elicited by isoproterenol infusion, and was suppressed by intravenous injection of ATP or propranolol. The baby's arrhythmia was controlled with oral propranolol. The ventricular tachycardia seemed to be caused by triggered activity.
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PMID:Neonatal catecholaminergic ventricular tachycardia--a case report. 1049 91

Repetitive monomorphic ventricular tachycardia with a morphology of inferior axis and left bundle branch block pattern in patients without structural heart disease commonly originates from the right ventricular outflow tract. We report the case of a 22-year-old man with an incessant, monomorphic ventricular tachycardia with a similar morphology originating from the left coronary cusp, which was confirmed by perfect pace mapping, local ventricular activation preceding the onset of QRS by 25 mse, and eliminated by a single delivery of low-energy (11 W) radiofrequency currents.
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PMID:Repetitive monomorphic ventricular tachycardia of left coronary cusp origin. 1058 61

OBJECTIVES: To determine risk factors for cardiac complications in patients with myotonic dystrophy, and to determine whether permanent cardiac pacemakers may be beneficial in the treatment of myotonic dystrophy heart disease. BACKGROUND: Myotonic dystrophy affects the cardiac conduction system. Cardiac pacemakers are easily implanted and can be life-saving in patients with severe or complete heart block. METHODS: A total of 94 patients with myotonic dystrophy were examined; 46 were followed for a mean of 6.4 (+/- 3.5 SD) years to determine predictors of the end point events of sudden death, Stokes-Adams attacks, or onset of atrial fibrillation. The end points were chosen to determine when cardiac pacemakers should be implanted (Fig. 1). RESULTS: Four out of 5 patients (and all 4 patients >60 years of age) with PR intervals longer than 275 msec had sudden death (n=1), Stokes-Adams attacks (n=1), or onset of atrial fibrillation (n=2). Conversely, only 1 of 89 patients with a PR interval shorter than 275 msec had end point events; 1 patient, aged 63 years, developed left bundle branch block and palpitations accompanied by dyspnea, which responded to a pacemaker. CONCLUSIONS: We recommend that patients with myotonic dystrophy and any indication or a family history of myotonic heart disease have at least a yearly electrocardiogram, particularly if they have a prolonged baseline or progressively increasing PR interval, or symptoms suggestive of heart block.
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PMID:Indications for Cardiac Pacemaker Implantation in Myotonic Dystrophy. 1110 7

A 56-year-old woman without structural heart disease had an ECG typical of Brugada syndrome. Syncope occurred due to monomorphic VT with left bundle branch block (LBBB) morphology. At electrophysiological study, VT with the same morphology was inducible.
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PMID:Brugada syndrome: a case report of monomorphic ventricular tachycardia. 1122 55


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