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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In women with heart disease, sustained arrhythmias can result in an increased risk to the mother and fetus. The purpose of this study was to determine the recurrence rates of arrhythmias during pregnancy in women with cardiac rhythm disorders and examine the impact on fetal and neonatal outcomes. Women with tachyarrhythmias before pregnancy who underwent obstetric care at the Toronto General and Mount Sinai Hospitals from 1990 to 2002 were included. The recurrence rates of arrhythmias were calculated. A multivariate logistic model was used to identify predictors of fetal complications. Seventy-three women had 87 pregnancies; 36 pregnancies were in women with a history of paroxysmal supraventricular tachycardia, 23 with paroxysmal atrial fibrillation or atrial flutter (AF/Afl), 6 with persistent AF/Afl, and 22 with ventricular tachycardia. In the women in sinus rhythm at baseline, 44% (36 of 81 pregnancies) developed recurrences of tachyarrhythmias during pregnancy or in the early postpartum period. The specific recurrence rates during pregnancy in women with a history of supraventricular tachycardia, paroxysmal AF/Afl, and ventricular tachycardia were 50%, 52%, and 27%, respectively. The 6 women in AF/Afl at baseline remained in this rhythm throughout their pregnancy. Adverse fetal events occurred in 17 of the 87 pregnancies (20%). Adverse fetal events occurred more commonly in women who developed antepartum arrhythmias (RR 3.4, 95% confidence interval 1.0 to 11.0, p = 0.045) compared with those who did not. In conclusion, in women with preexisting cardiac rhythm disorders, exacerbation of arrhythmia during pregnancy is common. Recurrence of arrhythmia during the antepartum period increases the risk of adverse fetal complications, independent of other maternal and fetal risk factors.
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PMID:Recurrence rates of arrhythmias during pregnancy in women with previous tachyarrhythmia and impact on fetal and neonatal outcomes. 1661 27

A 2.5-year-old patient with complex congenital heart disease involving dextrocardia, atrioventricular and ventriculoarterial discordance, pulmonary stenosis, ventricular septal defect (VSD), atrial septal defect (ASD), and paroxysmal supraventricular tachycardia (SVT) underwent electrophysiological study. The tachycardia mechanism was diagnosed with cryomapping. The ability of cryomapping to have transient and reversible effect on the tissue, unlike radiofrequency (RF) ablation, helped in the establishment of diagnosis in this toddler with typical atrioventricular nodal reentrant tachycardia. Cryomapping can be an additional safe diagnostic utility in young patients with complex congenital heart disease.
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PMID:Diagnosis of tachycardia mechanism with cryomapping in a toddler with complex congenital heart disease. 1701 79

Cardiac arrhythmias can develop during pregnancy. The risk of arrhythmias is relatively higher during labor and delivery. Potential factors that can promote arrhythmias in pregnancy or during labor and delivery, include the direct cardiac electrophysiological effects of hormones, changes in autonomic tone, hemodynamic perturbations, hypokalemia, and underlying heart disease. In this review, the basis for treatment of supraventricular and ventricular tachycardias are described. No drug therapy is usually needed for the management of supraventricular or ventricular premature beats, but potential stimulants, such as smoking, caffeine, and alcohol should be eliminated. In paroxysmal supraventricular tachycardia, vagal stimulation maneuvers should be attempted first. In pregnant women with atrial fibrillation, the goal of treatment is conversion to sinus rhythm by electrical cardioversion. Rate control can be achieved by a cardioselective beta-adrenergic blocker drug and/ or digoxin. Ventricular arrhythmias may occur in the pregnant women, specially when cardiomyopathy, congenital heart disease, valvular heart disease, or mitral valve prolapse exists. Electrical cardioversion or treatment with sotalol may be used (amiodarone is not safe for the fetus). Finally, in women with congenital long QT syndrome, beta-blocker therapy must be continued during pregnancy and postpartum period.
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PMID:[Arrhythmias in pregnancy. How and when to treat?]. 1797 73

Paroxysmal supraventricular tachycardia (SVT) may have a variety of hemodynamic effects depending on rate, patient volume status, and presence of structural heart disease or left bundle branch block. We report a case of a patient with atrial tachycardia and dual atrioventricular (AV) nodal physiology who developed profound hypotension during transition from fast to slow AV nodal pathway conduction, despite similar tachycardia cycle length. This case illustrates the potential importance of AV timing in determining the hemodynamic effect of SVT.
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PMID:Profound hypotension due to slow atrioventricular nodal pathway conduction during atrial tachycardia. 1917 Sep 23

The importance of managing fetal arrhythmia has increased over the past three decades. Although most fetal arrhythmias are benign, some types cause fetal hydrops and can lead to fetal death. With the aim of improving the outcome in such cases, various studies for prenatal diagnosis and perinatal management have been published. Detailed analysis of the type of arrhythmia in utero is possible using M-mode and Doppler echocardiography. In particular, a simultaneous record of Doppler waveform at the superior venous cava and the ascending aorta has become an important and useful method of assessing the interval between atrial and ventricular contractions. Common causes of fetal tachycardia (ventricular heart rate faster than 180 bpm), are paroxysmal supraventricular tachycardia (SVT) with 1:1 atrioventricular (AV) relation and atrial flutter with 2:1 AV relation. Of fetal SVT, short ventriculo-atrial (VA) interval tachycardia due to atrioventricular reentrant tachycardia is more common than long VA interval. Most fetuses with tachycardia are successfully treated in utero by transplacental administration of antiarrhythmic drugs. Digoxin is widely accepted as a first-line antiarrhythmic drug. Sotalol, flecainide and amiodarone are used as second-line drugs when digoxin fails to achieve conversion to sinus rhythm. Fetal bradycardia is diagnosed when the fetal ventricular heart rate is slower than 100 bpm, mainly due to AV block. Approximately half of all cases are caused by associated congenital heart disease, and the remaining cases that have normal cardiac structure are often caused by maternal SS-A antibody. The efficacy of prenatal treatment for fetal AV block is limited compared with treatment for fetal tachycardia. Beta stimulants and steroids have been reported as effective transplacental treatments for fetal AV block. Perinatal management based on prospective clinical study protocol rather than individual experience is crucial for further improvement of outcome in fetuses with tachycardia and bradycardia.
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PMID:Fetal arrhythmia: prenatal diagnosis and perinatal management. 1975 19

Paroxysmal supraventricular tachycardia (SVT) is a common arrhythmia in the parturient and can occur with or without an underlying organic heart disease. A woman of 35 weeks' gestation, who had a paroxysmal SVT that was resistant to antiarrhythmic drugs and electric cardioversion, required emergency Cesarean delivery. The Cesarean delivery was performed under spinal anesthesia and a healthy baby was delivered uneventfully. SVT spontaneously converted to normal sinus rhythm right after delivery of the baby.
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PMID:Emergency cesarean delivery in a parturient who had an intractable paroxysmal supraventricular tachycardia -A case report-. 2311 91

Pregnancy may predispose to paroxysmal supraventricular tachycardia (SVT), in subjects with or without identifiable heart disease. Many physiological conditions such as autonomic nervous system changes, altered systemic hemodynamics, etc. can contribute to the onset of arrhythmias during pregnancy. Some cases reported the occurrence of arrhythmias in relation to systemic fluid variations. We report the case of a pregnant woman who experienced SVT due to fluid depletion, detected by bioimpedance vector analysis (BIVA), which was successfully treated by water repletion under tight BIVA monitoring. Emergency physicians can overcome dangerous drug administration by considering historical examination and using fast and reproducible techniques such as BIVA.
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PMID:Supraventricular tachycardia, pregnancy, and water: A new insight in lifesaving treatment of rhythm disorders. 2883 59

Congenitally corrected transposition of great vessels (CCTGV) is a rare congenital heart disease (CHD) accounting for <1% of CHDs. CCTGV with infundibular pulmonary stenosis (PS) with ventricular septal defect (VSD) is part of Fallot's physiology. It is known to be associated with bradyarrhythmias like atrioventricular (AV) blocks, and acquired complete AV block occurs at a rate of 2% per year. Patients can have left-sided accessory pathways, which may cause atrioventricular reentrant tachycardia (AVRT). Tachyarrhythmias like atrioventricular nodal reentrant tachycardia (AVNRT) are very rare in such patients. A 30-year-old woman, a known case of CCTGV with PS with VSD, not corrected surgically and not on any drugs, presented with the syndrome of paroxysmal supraventricular tachycardia without hemodynamic compromise. Electrocardiogram showed atypical AVNRT. She was pharmacologically cardioverted to normal sinus rhythm with adenosine. CTGV with PS with VSD known to be associated with AV blocks, and preexcitation can sometimes present with atypical AVNRT.
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PMID:Congenitally corrected transposition of great vessels with infundibular pulmonary stenosis with ventricular septal defect, presenting with atypical atrioventricular nodal reentrant tachycardia: a rare association. 2898 87

In general practice palpitations are reported in around 8 per 1,000 persons per year. The differential diagnosis includes cardiac and psychiatric causes, as well as numerous others e.g. anaemia, hyperthyroidism, prescribed medication, caffeine and recreational drugs. Factors that point towards a cardiac aetiology are male sex, irregular heartbeat, history of heart disease, event duration > 5 minutes, frequent palpitations, and palpitations which occur at work or disturb sleep. Other clues suggesting a cardiac origin are abrupt onset and termination of palpitations, positional palpitations, and accompanying symptoms such as dizziness and presyncope. Cardiac arrhythmias are the result of enhanced automaticity, triggered activity or re-entry. The latter mechanism is responsible for the majority of clinically relevant arrhythmias, such as atrial fibrillation and supraventricular tachycardias. The prevalence of supraventricular tachycardia in the general population is around 2-3 per 1,000 persons. AV nodal re-entry tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia, accounting for nearly two-thirds of all cases. The typical clinical presentation of AVNRT is a sudden onset of palpitations (98%) and/or dizziness (78%). Patients may present at any age and are more frequently female than male.
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PMID:Palpitations: when you hear hoof beats don't forget to think zebras. 2902 Jul 30

This report presents the case of a 48-year-old male with acute congestive heart failure caused by paroxysmal supraventricular tachycardia. The patient showed no structural heart disease with normal echocardiography parameters of the left ventricle. The pulmonary capillary wedge pressure (PCWP) was continuously monitored during the electrophysiological study. The PCWP and the plasma B-type natriuretic peptide increased from the normal range during ongoing tachycardia. The tachycardia was diagnosed as orthodromic atrioventricular reciprocating tachycardia and it was successfully eliminated by radiofrequency catheter ablation.
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PMID:Acute progression of congestive heart failure during paroxysmal supraventricular tachycardia in a patient without structural heart disease. 3061 52


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