• Title/Summary/Keyword: Lethal Arrhythmia

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QT-interval prolongation due to medication found in the preoperative evaluation

  • Seto, Mika;Koga, Sayo;Kita, Ryosuke;Kikuta, Toshihiro
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.323-327
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    • 2017
  • QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively. These cases were considered to have drug-induced QT prolongation. We reaffirmed that even drugs administered for conditions unrelated to cardiac diseases can have adverse side effect of QT prolongation. In conclusion, our cases indicate that dental surgeons should be aware of the dangerous and even potentially lethal side effects of QT prolongation. For safe oral and maxillofacial surgery, cooperation with medical departments in various fields is important.

Development of Multi-Channel Cardiac Mapping System Using Microcomputer (마이크로 컴퓨터를 이용한 다중 채널 심장 전기도 시스템 개발)

  • Chang, Byung-Chul;Kim, Won-Ky;Kim, Nam-Hyun;Jung, Sung-Hun
    • Proceedings of the KOSOMBE Conference
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    • v.1991 no.05
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    • pp.94-97
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    • 1991
  • It is well known that multipoint and computerized intraoperative mapping systems improve the results of surgery for Wolff-Parkinson-White syndrome and show tremendous potential for opening an entirely new era of surgical intervention for the more common and lethal types of supraventricular tachyarrhythmias such as atrial flutter and atrial fibrillation. In addition, the ability to map and ablate the sometimes fleeting automatic atrial tachycardia is greatly enhanced by computerized mapping systems. In this study, we have developed 16 channel computerized data analysis system using microcomputer for basic research of electrophysiology and electrical propagation. This system is expected to enable us to study pathophysiology of cardiac arrhythmia and to improve the results of diagnosis and surgical treatment for cardiac arrhythmia.

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A Case of Neonatal Atrial Flutter Treated by Propafenone after Fetal Echocardiographic Diagnosis (태아 심초음파 검사로 진단 된 뒤 출생 후 Propafenone으로 치유된 신생아 심방조동 1례)

  • Lee, Kyung Hwa;Ha, Chang Woo;Kim, Chul Ho;Song, Min Seob;Sung, Moon Su
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.928-932
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    • 2002
  • Perinatal atrial flutter is a potentially lethal arrhythmia. Management of this disorder is difficult and controversial. Fetal atrial flutter is a serious and life threatening rhythm disorder particulary when it causes hydrops; it may be associated with fetal death or neurological damage. Although the initial episode of flutter may be difficult to control, recurrence of atrial flutter after successful resolution of the arrhythmia seems highly unlikely and long-term prognosis is excellent. We experienced a case of a atrial flutter diagnosed in utero at $38^{+6}$ weeks' gestation by fetal cardiac echocardiography. He was treated with maternal digoxin, but he continued to have atrial flutter until delivery. Restoration of sinus rhythm occured with propafenone therapy in this patient after failure of initial digoxin therapy and direct current cardioversion.

64 channels computerized cardiac mapping system (64채널 심장전기도 시스템 구현에 관한 연구)

  • 장병철;김남현
    • Journal of Biomedical Engineering Research
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    • v.16 no.1
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    • pp.107-113
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    • 1995
  • It is well known that multipoint and computerized intraoperative mapping systems improve the results of surgery for Wolff-Parkinson-White syndrome and show tremendous potential for opening an entirely new era of surgical intervention for the more common and lethal types of supraventricular tachyarrhythmias such as atrial flutter and atrial fibrillation. In addition, the ability to map and ablate the sometimes fleeting automatic atrial tachycardia is greatly enhanced by computerized mapping systems. In this study, we have developed 64 channel computerized data analysis system using microcomputer (Macintosh ${II}_{x}$) for basic research of electrophysiology and electrical propagation. The bipolar electrogram information is acquired from 64 cardiac sites simultaneously at a sampling rate of 1 ksampls/sec with continuous and total data storage of up to 30 seconds. When the reference electrogram is selected and reference point is picked up, delay time from the reference point is displayed on two dimensional diagram of the heart. System design permits easy expansion to almost 256 simultaneous sites. this system is expected to enable us to study pathophysiology of cardiac arrhythmia and to improve the result of diagnosis and surgical treatment for cardiac arrhythmia.

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A Case Report of Cardiac Fibroma (심장 섬유종 -1례 보고-)

  • Jang, Jae-Han;Kim, Min-Ho;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.99-102
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    • 1996
  • Cardiac fibroma is a rare benign tumor of the heart that occurs primarily in infants and children. Prognosis depends on size, extent and site of tumor. Cardiac fibroma may invade the conduction system, papillary muscle and outflw of inflow tract of ventricle. In these situations, its clinical course is very poor Although operative mortality is high, surgical resection is treatment of choice because lethal arrhythmia and sudden death can be developed by the fibroma. A cardiac fibroma was successfully resected from the left ventricular myocardium of a 8 years old male patient in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital.

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A study on the development of 64 channels computerized cardiac mapping system (64채널 심장전기도 시스템 구현에 관한 연구)

  • Chang, Byung-Chul;Kim, Nam-Hyun;Jung, Sung-Hun;Ra, Sang-Weon;Cho, Bum-Koo
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.88-91
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    • 1994
  • It is well known that multipoint and computerized intraoperative mapping systems improve the results of surgery for Wolff-Parkinson-White syndrome and show tremendous potential for opening an entirely new era of surgical intervention for the more common and lethal types of supraventricular tachyarrhythmias such as atrial flutter and atrial fibrillation. In addition, the ability to map and ablate the sometimes fleeting automatic atrial tachycardia is greatly enhanced by computerized mapping systems. In this study, we have developed 64 channel computerized data analysis system using microcomputer (Macintosh IIx) for basic research of electrophysiology and electrical propagation. The bipolar electrogram information is acquired from 64 cardiac sites simultaneously at a sampling rate of 1ksamples/sec with continuous and total data storage of up to 30 seconds. When the reference electrogram is selected and reference point is picked up, delay time from the reference point in displayed on two dimensional diagram of the heart. System design permits easy expansion to almost 256 simultaneous sites, This system is expected to enable us to study pathophysiology of cardiac arrhythmia and to improve the results of diagnosis and surgical treatment for cardiac arrhythmia.

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Pre-clinical QT Risk Assessment in Pharmaceutical Companies - Issues of Current QT Risk Assessment -

  • Takasuna, Kiyoshi; Katsuyoshi, Chiba;Manabe, Sunao
    • Biomolecules & Therapeutics
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    • v.17 no.1
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    • pp.1-11
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    • 2009
  • Since the Committee for Proprietary Medicinal Products (CPMP) of the European Union issued in 1997 a "points to consider" document for the assessment of the potential for QT interval prolongation by non-cardiovascular agents to predict drug-induced torsades de pointes (TdP), the QT liability has become the critical safety issue in the development of pharmaceuticals. As TdP is usually linked to delayed cardiac repolarization, international guideline (ICH S7B) has advocated the standard repolarization assays such as in vitro IKr (hERG current) and in vivo QT interval, or in vitro APD (as a follow up) as the best biomarkers for predicting the TdP risk. However, the recent increasing evidence suggests that the currently used above biomarkers and/or assays are not fully predictive for TdP, but also does not address potential new druginduced TdP due to the selective disruption of hERG protein trafficking to the cell membrane or VT and/or VF with QT shortening. There is, therefore, an urgent need for other surrogate markers or assays that can predict the proarrhythmic potential of drug candidate. In this review, we provide an ideal pre-clinical strategy to predict the potentials of QT liability and lethal arrhythmia of the drug candidates with recent issues in this field in mind, not at the expense of discarding therapeutically innovative drugs.