1/26. Escape capture bigeminy: a manifestation of sinoatrial conduction block.sinoatrial block (SAB) is often difficult to identify in the presence of bradycardic rhythms. This study demonstrates several manifestations of so-called escape capture bigeminy in 14 patients. Although periods of 1:1 sinoatrial conduction can aid in the analysis of SAB, the electrocardiographic pattern of bigeminal rhythm may be the only electrocardiographic clue of SAB. In one case, both sinoatrial entrance and exit block were identified. In eight instances, digitalis or digitalis plus a beta or calcium blocking agent could be partially implicated as the cause of SAB. In 6 of 14 patients, a permanent pacemaker was required to correct the bradycardia, in spite of discontinuation of aggravating antiarrhythmic agents or electrolyte derangement.- - - - - - - - - - ranking = 1keywords = rhythm (Clic here for more details about this article) |
2/26. Sinus escape-capture bigeminy and sinus extrasystolic bigeminy.Blocking conduction between the sinus node and the atria (SA block) can be responsible for symptomatic rhythm problems. However, in atrial escape-capture bigeminy with SA block, when atrial escape P waves originate in a site within or close to the sinus node, the diagnosis of SA block is not easy. Electrocardiograms were selected from 7 people with atrial bigeminy because (1) all atrial deflections (P waves) were almost the same in shape and in length of PR intervals, (2) comparatively long PP intervals alternated with comparatively short PP intervals, and (3) occasionally the atrial bigeminy changed to normal regular sinus rhythm in which 2 or more sinus P waves were found in succession. An attempt is made to clarify the mechanism for these cases. When regular sinus rhythm changed to bigeminal rhythm, the long PP interval introduced the bigeminy in 3 cases, indicating the presence of "sinus" escape-capture bigeminy; whereas the short PP interval introduced the bigeminy in the other 4 cases, indicating the presence of "sinus" extrasystolic bigeminy. In cases of sinus escape-capture bigeminy associated with SA block, the cases may occasionally be diagnosed wrongly as ordinary sinus arrhythmia not associated with SA block. Therefore, it seems that sinus escape-capture bigeminy is not so rare as is generally believed. patients with SA block often require implantation of the artificial pacemaker. Thus, the authors believe that differentiation of sinus escape-capture bigeminy from other forms of "sinus" bigeminy is clinically important.- - - - - - - - - - ranking = 1.6666666666667keywords = rhythm (Clic here for more details about this article) |
3/26. Evidence of sinoatrial block as a curative mechanism in radiofrequency current ablation of inappropriate sinus tachycardia.Inappropriate sinus tachycardia is a nonparoxysmal tachycardia characterized by high resting heart rates and a disproportionate response to activity. Sinus node modification with radiofrequency current has been used successfully as treatment for this arrhythmia. However, the electrophysiologic mechanisms leading to successful modification are not yet fully elucidated. We report a case of a patient with drug-resistant inappropriate sinus tachycardia in whom successful treatment of the arrhythmia was achieved by documented sinoatrial exit block induced by radiofrequency current applications.- - - - - - - - - - ranking = 0.66666666666667keywords = rhythm (Clic here for more details about this article) |
4/26. Viral encephalitis associated with reversible asystole due to sinoatrial arrest.We report a case of sinoatrial node block associated with syncopal episodes that required a temporary pacemaker. magnetic resonance imaging (MRI) of the brain showed lesions of both temporal lobes consistent with viral encephalitis, presumably due to herpes simplex virus (HSV). The patient quickly recovered with intravenous acyclovir (Zovirax) therapy. patients with presumed encephalitis might benefit from cardiac monitoring for possible associated cardiac arrhythmia. A permanent pacemaker is rarely required, since recovery is spontaneous in the majority of these cases.- - - - - - - - - - ranking = 0.33333333333333keywords = rhythm (Clic here for more details about this article) |
5/26. Chronic binodal block with Wenckebach phenomenon.Coexistent sino-atrial and atrioventricular block with Wenckebach phenomenon is an extremely unusual cardiac arrhythmia. Observations on the natural history of sinus node dysfunction are rare. For over six years our elderly patient has been followed without symptoms but with increasing severity of atrio-ventricular block.- - - - - - - - - - ranking = 0.33333333333333keywords = rhythm (Clic here for more details about this article) |
6/26. sinoatrial block during lithium treatment.lithium is known to produce T wave changes in the ECG, whereas effect upon the conducting system of the heart has not been described. In our patient lithium produced sinoauricular block and possibly tachycardia. The correlation between lithium treatment and tachyarrhythmias is discussed. When during lithium treatment block is found, the treatment should preferably be stopped, but if this is not possible it is important to realize that digitalis should not be used as a prophylactic drug against tachycardia, as it worsens the block and therefore increases the frequency of arrhythmia, even leading to Adams-Stokes attacks.- - - - - - - - - - ranking = 0.66666666666667keywords = rhythm (Clic here for more details about this article) |
7/26. Sinoventricular conduction in atrial standstill.Sinoventricular rhythm implies preserved sinus node function with conduction of impulses to the A-V junction without generalized atrial excitation. Impulse propagation in such cases is presumably via specialized internodal tracts. In this present case, synchronized but localized activation from an area of the right atrium preceded each QRS, without generalized atrial depolarization. These recordings are offered as further evidence for the clinical occurrence of sinoventricular rhythm in humans.- - - - - - - - - - ranking = 0.66666666666667keywords = rhythm (Clic here for more details about this article) |
8/26. sinoatrial block complicating legionnaire's disease.A 59 year old woman presented with acute onset of fever, chills, diaphoresis, vague chest discomfort, and was found to be hypotensive and tachypnoeic. An electrocardiogram demonstrated sinoatrial block with a junctional rhythm between 50 and 80 beats/min. All cultures were negative and imaging studies unrevealing. Her urine tested positive for legionella pneumophila antigen serotype 1 and she improved with antibiotic therapy.- - - - - - - - - - ranking = 0.33333333333333keywords = rhythm (Clic here for more details about this article) |
9/26. Atrial escape-capture bigeminy in dominant atrial rhythm with 2:1 exit block.A 27-year-old woman with atrial bigeminy is reported in whom long PP intervals alternate with short PP intervals. All P waves are negative in lead II and all PR intervals measure 0.12 s. In the 12-lead electrocardiogram, however, these P waves were definitely different in configuration from each other, and were divided into two groups. Namely, these negative P waves are divided into those of dominant atrial rhythm J1 with 2:1 exit block, and those of atrial escape J2. Long J1-J2 intervals alternate with short J2-J1 intervals. These electrocardiographic findings show the presence of atrial escape-capture bigeminy. Such atrial escape-capture bigeminy in dominant atrial rhythm with 2:1 exit block has never been reported before.- - - - - - - - - - ranking = 2keywords = rhythm (Clic here for more details about this article) |
10/26. Familial progressive sinoatrial and atrioventricular conduction disease of adult onset with sudden death, dilated cardiomyopathy, and brachydactyly. A new type of heart-hand syndrome?We identified a family with 10 affected members in four generations suffering from adult-onset progressive sinoatrial and atrioventricular conduction disease, sudden death due to ventricular tachyarrhythmia, dilated cardiomyopathy, and a unique type of brachydactyly with mild hand involvement (short distal, middle, proximal phalanges and clinodactyly) and more severe foot involvement (short distal, proximal phalanges and metatarsal bones, short or absent middle phalanges, terminal symphalangism, duplication of the bases of the second metatarsals, extra ossicles, and syndactyly). The phenotype differences from other reported genetic abnormalities and linkage exclusion of Holt-Oram syndrome, ulnar-mammary syndrome, brachydactyly type B or Robinow syndrome, and cardiac conduction disease or brugada syndrome loci suggest that we report on a new hereditary heart-hand syndrome.- - - - - - - - - - ranking = 0.33333333333333keywords = rhythm (Clic here for more details about this article) |
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