1/17. adenosine-induced atrial pro-arrhythmia in children.adenosine has become the preferred acute treatment for common types of supraventricular tachycardia because of its efficacy and safety. There have been a few reports of serious proarrhythmic events associated with its use, including the induction of atrial fibrillation in adult patients. Three instances of adenosine-induced atrial proarrhythmia (two atrial fibrillation and one atrial flutter) have been observed in children with manifest or concealed wolff-parkinson-white syndrome at the Hospital for Sick Children, Toronto, ontario since 1990, which indicates a previously unreported risk of atrial arrhythmia for children as well. Because adenosine may enhance antegrade bypass tract conduction, its use carries a risk of ventricular acceleration, including progression to ventricular fibrillation. Because of such rare and potentially life-threatening adverse effects, appropriate monitoring and precautions are required during the administration of the drug to children and adults.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/17. Neonatal intractable atrial flutter successfully treated with intravenous flecainide.We present a neonatal case with intractable atrial flutter that did not respond to digitalization and electrical cardioversion. Intravenous flecainide administration completely resolved the atrial flutter. Proarrhythmic effects were not induced by flecainide administration. Although the efficacy of flecainide for atrial flutter during the infantile or childhood period is low, intravenous flecainide is worth consideration as a treatment for atrial flutter, even in intractable cases as described here, during the neonatal period.- - - - - - - - - - ranking = 2keywords = administration (Clic here for more details about this article) |
3/17. Pseudo infarction ECG pattern occurring during intravenous treatment with flecainide acetate.A 79-year-old woman presented with atrial flutter and anginal complaints, which remitted on nitroglycerin but the flutter did not respond to digoxin and verapamil. flecainide acetate was given intravenously; administration was stopped because of development of a significant increase in the QRS duration, existence of prominent deep Q waves and marked ST elevation in leads V1 to V4. These abnormalities mimicked the ECG changes seen in myocardial infarction. However, the presence of an acute myocardial infarction could be ruled out. On a second admission intravenous flecainide acetate resulted in comparable marked ECG changes.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/17. Intraoperative infusion of epoprostenol sodium for patients with heparin-induced thrombocytopenia undergoing cardiac surgery.Prevention of catastrophic thromboembolic complications during surgery in patients with heparin-induced thrombocytopenia (HIT) remains a challenging problem during cardiac surgery. We infused an increasing dose of epoprostenol sodium, which is one of three anti-HIT regimens available in japan, ahead of administration of heparin and performed a mitral valve operation for a patient with type II HIT. The absence of thromboembolic events and platelet consumption during cardiopulmonary bypass, together with considerable reduction of platelet adhesion to the fibers of the membrane oxygenator, support the efficacy and safety of our strategy.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/17. Uncontrolled ventricular rate in atrial fibrillation. A manifestation of dissimilar atrial rhythms.A patient with coarse atrial fibrillation and a rapid ventricular response developed periods of high grade atrioventricular block interpersed with periods of rapid ventricular conduction after the administration of digitalis and propranolol. Intracardiac atrial recordings showed similar atrial rhythms of high right atrial flutter and left atrial fibrillation. The low right atrial recordings showed flutter during the periods of fast ventricular rates and fibrillation during periods of slower ventricular rates.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/17. Conversion of longstanding atrial flutter to sinus rhythm and transient complete A-V block following oral administration of verapamil. Report of a case.In a patient with ischaemic heart disease chronic atrial flutter reverted to sinus rhythm during treatment with oral verapamil, given at dosage of 240 mg once a day in order to prevent spontaneous angina. Such an unexpected event was accompanied by a remarkable sinus node depression and by a transient complete a-v block, that gradually subsides leaving a slight permanent a-v conduction delay. Either a higher bioavailability of the drug or an extremely increased sensitivity of the receptors can explain such a marked electrophysiological effect at a moderate drug dosage.- - - - - - - - - - ranking = 4keywords = administration (Clic here for more details about this article) |
7/17. atrial flutter in wolff-parkinson-white syndrome responding to intravenous disopyramide.atrial flutter occurring in patients with the wolff-parkinson-white syndrome is extremely uncommon. We describe a patient with this arrhythmia which converted to sinus rhythm and normal conduction following intravenous administration of disopyramide.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
8/17. A case showing atrial dissociation and other various kinds of arrhythmias.A case is reported in which atrial dissociation occurred after oral isoproterenol administration to increase the heart rate in the presence of complete atrioventricular block. Two types of P wave, one with small upward deflection and the other with deep downward spike-like deflection, were present. The latter wave appeared at a high rate of 300/min, suggesting the existence of atrial flutter in the left atrium alone.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
9/17. procainamide-induced polymorphous ventricular tachycardia.Seven cases of procainamide-induced polymorphous ventricular tachycardia are presented. In four patients, polymorphous ventricular tachycardia appeared after intravenous administration of 200 to 400 mg of procainamide for the treatment of sustained ventricular tachycardia. In the remaining three patients, procainamide was administered orally for treatment of chronic premature ventricular contractions or atrial flutter. These patients had Q-T prolongation and recurrent syncope due to polymorphous ventricular tachycardia. In four patients, the arrhythmia was rapidly diagnosed and treated with disappearance of further episodes of the arrhythmia. In two patients, the arrhythmia degenerated into irreversible ventricular fibrillation and both patients died. In the seventh patient, a permanent ventricular pacemaker was inserted and, despite continuation of procainamide therapy, polymorphous ventricular tachycardia did not reoccur. These seven cases demonstrate that procainamide can produce an acquired prolonged Q-T syndrome with polymorphous ventricular tachycardia.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
10/17. A hemodynamic complication of verapamil therapy in a neonate.The effectiveness and lack of undesirable side-effects has made verapamil the drug of choice in the treatment of paroxysmal supraventricular tachycardia in infants without underlying heart disease. The case described demonstrates the occasional severe negative inotropic effect of the drug, independent of its influence on heart rate and conduction. Severe heart failure and shock ensued after a therapeutic dose of i.v. verapamil in a newborn suffering from atrial flutter with no associated heart disease. Although the arrhythmia was promptly converted to sinus rhythm, the baby required two hours of cardiopulmonary resuscitation and inotropic support. Follow-up during the first year of life revealed a normal healthy baby. attention to the hemodynamic status in addition to continuous ECG monitoring is mandatory during i.v. verapamil administration also in patients without underlying heart disease.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
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