Bigeminy

Atrioventricular (AV) nodal conduction disorders occur when the AV conduction pathway is refractory due to functional or organic reasons, resulting in a delay or complete blockage of atrial impulses to the ventricles. One of the causes of nodal dysfunction includes chronic alcohol abuse and excessive binge drinking. We are presenting a case where a chronic alcoholic was binge drinking due to a loss of a close friend, which resulted in nodal dysfunction and multiple cardiac rhythms, including supraventricular bigeminy, sinus bradycardia, significant sinus pauses, and complete heart block...

Lacosamide is a newer antiepileptic medication used in refractory neonatal seizures with limited safety and efficacy data. This case series spans 4 years and includes 38 neonates cared for in the neonatal, pediatric, and cardiovascular intensive care units, who received lacosamide for refractory seizures. Because lacosamide affects atrioventricular node function in adults, among other metrics, electrocardiogram (ECG) changes were monitored closely in these neonates. Within this cohort, 2 neonates were found to have atrial bigeminy on ECG and telemetry...

Smart watches, which are a rapidly developing technology that can record and store personal health data such as heart rate, oxygen saturation, ECG, and sports activities. We presented a patient who applied to the emergency department due to palpitation and he recorded an ECG output with a smart watch before admission. In this case, we emphasized that the use of smart watches in the prehospital period can help the diagnosis process of dysrhythmias in the hospital setting.

Syncope or "blackout" (BO) in breath-hold diving (freediving) is generally considered to be caused by hypoxia. However, it has been suggested that cardiac arrhythmias affecting the pumping effectivity could contribute to BO. BO is fairly common in competitive freediving, where athletes aim for maximal performance. We recorded heart rate (HR) during a static apnea (STA) competition, to reveal if arrhythmias occur. Four male freedivers with STA personal best (PB) of 349±43s, volunteered during national championships, where they performed STA floating face down in a shallow indoor pool...

INTRODUCTION: Physiological heart adaptations may lead to increased susceptibility to arrhythmia in athletes. Furthermore, vigorous training and method like rapid weight loss (RWL) in combat sports could pose additional risks. This case represents how routine cardiovascular screening during high-risk methods like RWL and high-intensity training (HIT) reveal abrupt ventricular arrhythmias in a young athlete. CASE REPORT: We report a case of a 20-year-old male wrestler athlete who developed disrupting arrhythmia during RWL and HIT...

Catecholaminergic polymorphic ventricular tachycardia (CPVT) can cause fatal tachyarrhythmias brought on by physical or emotional stress. Previously published cases deny the association between CPVT with dilated cardiomyopathy (DCM). However, rare cases show a possible association between CPVT and DCM development. Our case is one of them; we describe the development of dilated cardiomyopathy in a young woman who, six years earlier, went through bilateral cardiac sympathetic denervation (CSD) because of symptomatic catecholaminergic polymorphic ventricular tachycardia...

Although PVCs commonly lead to degraded cine cardiac MRI (CMR), patients with PVCs may have relatively sharp cine images of both normal and ectopic beats ("double beats") when the rhythm during CMR is ventricular bigeminy, and only one beat of the pair is detected for gating. MRI methods for directly imaging premature ventricular contractions (PVCs) are not yet widely available. Localization of PVC site of origin with images may be helpful in planning ablations. The contraction pattern of the PVCs in bigeminy provides a "natural experiment" for investigating the potential utility of PVC imaging for localization...

AIM: To characterize ventricular bigeminy from 24-h Holter recordings of Andersen-Tawil syndrome (ATS) patients, a first comparison with a large database of post-myocardial infarction (post-MI) patients with frequent premature ventricular complexes (PVC) was performed. METHODS: Baseline Holter recordings from 6 ATS1 patients and 618 post-MI patients were analyzed to assess total number of PVC, quantification of coupling intervals (CI), total number of bigeminy episodes, and percentage of PVC in bigeminy...

A 69-year-old man presented bradycardia with a constant blocked atrial bigeminy and heart failure. Successful catheter ablation of blocked atrial bigeminy with bradycardia resulted in myocardial reverse remodeling and restoration of the normal sinus rhythm from the ectopic atrial rhythm.

BACKGROUND: Aluminum phosphide (ALP) intoxication either accidentally or intentionally, is one of the major health concerns in developing countries. Its poisoning causes severe damage to organs including the heart and liver. OBJECTIVES: This study aimed to investigate the hepato- and cardioprotective effects of quercetin (QCN) on the acute/subacute toxicity of ALP in rodent models. METHODS: Acute (single dose, 12.5 mg/kg, orally) and subacute (2 mg/kg, orally and 7 days) intoxication of ALP were induced in rats and the protective effects of QCN on altered hepatic/cardiac functional enzyme concentrations, myeloperoxidase activity, oxidative stress biomarkers, and histopathological changes were studied at three doses of 10, 50 and 100 mg/kg BW...

Patients with non-ischemic systolic heart failure (HF) have increased risk of sudden cardiovascular death (SCD). The initiation and substrate for ventricular arrhythmias remains poorly understood. Our purpose was to describe the relationship between cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) and Holter recorded ventricular arrhythmic activity. Patients from the DANISH trial underwent a Holter-recording and a CMR-scan. The presence of non-sustained ventricular tachycardia (NSVT) and premature ventricular contractions (PVC) were examined in relation to presence and amount of LGE...

BACKGROUND: The trigeminocardiac reflex (TCR) is usually caused by an increased parasympathetic tone when pressure or traction is applied to the surrounding tissue of the trigeminal nerve. However, the inexperienced anesthesiologists may have challenges on the management of TCR patients. CASE SUMMARY: This is the case of an 18-year-old woman diagnosed with hemangioma of the upper lip. During the operation, about 1 h after surgery started, a constant 1:1 premature ventricular complex was detected, and blood pressure was decreased when approaching the deeper part with more strong traction for exposure of the part...

Background: The utility of an implantable loop recorder (ILR) in the evaluation of unexplained syncope or palpitations in young patients in the absence of structural heart disease or ventricular dysfunction is limited. To compare the diagnostic yield of ILR with conventional extended Holter evaluation in the detection of arrhythmias among young patients with a structurally normal heart presenting with unexplained palpitations or syncope. Methods: Open-label randomised control trial was conducted in a tertiary cardiac care centre among young patients with recurrent unexplained palpitations (≥3 episodes/year) or syncope (≥2 episodes) with normal electrocardiogram and echocardiography, after excluding non-cardiac causes...

Chemotherapy-associated cardiotoxicity is a common adverse event. Immune checkpoint inhibitors (ICI) - a new class of monoclonal antibodies - have revolutionized the management of various diseases. Their use is expected to increase in the near future and their cardiac side effects have been increasingly recognized. Clinical case: We describe a case of a 67-year-old female patient with urothelial carcinoma undergoing treatment with pembrolizumab who presented to the emergency department with progressive fatigue, retrosternal pain and palpitations for three days...

A 58-year-old female patient presented at cardiology outpatient clinic with palpitation. The 12-lead electrocardiography on admission revealed monomorphic bigeminy premature ventricular contractions (PVCs) showed a left bundle-branch block configuration, monophasic R wave in lead I and aVL and precordial transition in V3 lead. Cardiac electrophysiological study was performed to patient. Activation mapping guided by three-dimensional electroanatomic system was done. The earliest ventricular activation was observed in the para-hisian region with the largest His potential (0...

Background: Strain imaging has been suggested as a tool to detect early left ventricular (LV) dysfunction due to frequent premature ventricular contractions (PVCs) in patients with preserved LV ejection fraction (EF). However, the progression of intraventricular dyssynchrony (IVD), radial, and circumferential strain (RS, CS) in PVC-cardiomyopathy (CM) are unknown. The aim of this study was to elucidate the progression patterns of CS, IVD, and electro-mechanical latency (EML) in PVC-CM...

Background: Hepatocellular carcinoma (HCC) is a highly malignant disease with poor prognosis, and most cases were already considered unresectable at the time of presentation. Conversion therapy, as an emerging treatment, is designed to provide patients with initially unresectable hepatocellular carcinoma (uHCC) the opportunity to undergo radical resection. At present, conversion therapy for patients with uHCC remains controversial. Transarterial chemoembolization (TACE) is currently the most widely selected treatment for uHCC, but its efficacy as a conversion therapy remains controversial...

Atrial fibrillation (AF) is an irregular heart rhythm, characterised by chaotic atrial activation, which is promoted by remodelling. Once initiated, AF can also propagate the progression of itself in the so-called ''AF begets AF''. Several lines of investigation have shown that signalling molecules, including reactive oxygen species, angiotensin II, and phosphoinositide 3-kinases (PI3Ks), in presence or absence of cardiovascular disease risk factors, stabilise and promote AF maintenance. In particular, reduced cardiac-specific PI3K activity that is not associated with oncology is cardiotoxic and increases susceptibility to AF...

Objective: To provide evidence that fetal atrial flutter (AF) caused by atrial septal aneurysm (ASA) can be completely cured by delivery. Methods: Cases series of three fetuses with ASA complicated by AF in late gestation, including hydrops fetalis in one case, were collected and completely followed up. Results: AF in all cases completely disappeared shortly after birth. New insights gained from this study are as follows: (1) PACs or bigeminy associated with ASA can progressively change to AF. (2) AF associated with ASA can cause hydrops fetalis and intrauterine treatment is needed; however, delivery is the definitive treatment...

BACKGROUND Myocarditis is cardiac muscle inflammation caused by infectious or noninfectious agents. Rarely, clozapine, an atypical antipsychotic drug used to treat resistant schizophrenia, has been reported to cause myocarditis, as we report in this case. CASE REPORT A 29-year-old man, who was known to have schizophrenia and was on olanzapine therapy, presented in our Emergency Department with active psychosis, and was subsequently admitted to the psychiatric ward for refractory schizophrenia. He was started on clozapine, which was cross-titrated with olanzapine...