Multifocal atrial tachycardia

Article Abstract:

Multifocal atrial tachycardia is a term applied to a rare disorder (present on less than 0.35 percent of electrocardiograms in general hospitals), characterized by irregularity and alterations in the P wave, a component of the electrocardiogram. Its incidence, clinical picture, characteristics, treatment, and prognosis, are discussed. This arrhythmia, or abnormal heart rhythm, is most common in people 70 years of age, or older, and many patients (60 percent) have pulmonary (lung) disease. Cardiac disease, especially disease of the coronary arteries (the arteries that supply blood to the heart), is also common among patients with multifocal atrial tachycardia. In one study, 24 percent of 118 patients with multifocal atrial tachycardia also had diabetes. Children with this arrythmia have a lower incidence of other cardiac and pulmonary diseases, and their prognosis is favorable. Because the condition is diagnosed on the basis of electrocardiography, modern methods and computerized diagnostic approaches can still fall prey to the difficulties of interpreting P-wave abnormalities. The mechanism by which multifocal atrial tachycardia arises is not known. Generally, therapy is provided by treating the associated pulmonary, cardiac, and other conditions. The actions of calcium-channel blockers (drugs that act on the heart by reducing the effects of calcium) and beta-blockers (drugs that reduce the effects of the sympathetic nervous system) on multifocal atrial tachycardia are discussed. Digitalis (used to improve cardiac output) does not help this condition, but need not be withheld if it is needed to treat other problems. However, patients with multifocal atrial tachycardia can quickly develop digitalis intoxication. In one study of adults with multifocal atrial tachycardia, 43 percent of the patients died in the hospital when they were diagnosed, but usually due to diseases other than the arrhythmia. The prognosis for patients with multifocal atrial tachycardia who leave the hospital is not known. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Heart diseases, Electrocardiography

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Wide QRS tachycardia in the conscious adult: ventricular tachycardia is the most frequent cause

Article Abstract:

Ventricular tachycardia (VT), rapid heart rate produced by pathology of the ventricle, is a serious problem that is often associated with improper filling of the heart chambers and severely impaired hemodynamic (blood flow patterns) functioning. One irregularity that is seen clinically is wide QRS tachycardia, which may be associated with a stable hemodynamic situation. Wide QRS refers to a relatively increased length of electrical activity (greater than 0.14 seconds) in the phase identified on an electrocardiogram as the QRS complex, which reflects the muscular contraction of the ventricle. A generally held misconception, which in turn has led to misdiagnosis, is that VT must lead to circulatory collapse. To examine the association of hemodynamic stability in patients with wide QRS tachycardia, 20 consecutive patients were examined. Eighty-five percent of patients were found to have VT. As a result of this study, until proven otherwise, patients with wide QRS tachycardia should be regarded as being in VT and appropriate therapy for this condition should be instituted. Failure by physicians to understand that a wide QRS tachycardia is associated with ventricular difficulties may lead to improper treatment that can severely and adversely affect a patient's condition. Electrophysiologic testing has been shown to be of particular value in establishing this diagnosis.

Case studies, Dosage and administration, Verapamil

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Clinical consequences of electrocardiographic artifact mimicking ventricular tachycardia

Article Abstract:

Electrocardiographic artifact can mimic a serious heart arrhythmia called ventricular tachycardia. This artifact occurs when a person is having an ECG and the test mistakenly shows that the patient is having an arrhythmia. In reality, these artifacts are usually caused by the patient moving or by a poor contact between the skin and the electrode. Researchers describe 12 cases of patients who received aggressive treatment for suspected ventricular tachycardia when all they had was an electrocardiographic artifact. Some even received a pacemaker or an implantable defibrillator. Even several cardiologists missed the true cause of the arrhythmia.

Causes of

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