Volume : 09, Issue : 10, October – 2022
76.A SYSTEMATIC REVIEW OF THE OCCURRENCE OF PATHOLOGICAL ARRHYTHMIA IN INDIVIDUALS WHO CAME TO THE EMERGENCY ROOM WITH THE DIAGNOSIS OF CARDIAC ARRHYTHMIA
Dr Kaleem Ullah, Dr. Rida Amir Hassan, Dr Kausar Noor
Aim: A systematic review of the occurrence of pathological arrhythmia in individuals who came to the emergency room with the diagnosis of cardiac arrhythmia. Although myocardial fibrosis is often seen in HCM, its medical importance is unknown.
Methods: In 178 HCM individuals (age 42 + 17 years; 96% normal or minimally asymptomatic), researchers investigated the incidence in addition incidence of tachyarrhythmias on 24-h ambulatory Holter electrocardiogram in relation to deferred enhancement on contrast-enhanced CMR.
Results: Individuals having DE had the higher rate of premature ventricular contractions, couplets, including non-sustained ventricular tachycardia (PVCs: 87% vs. 71%; couplets: 42% vs. 18%; NSVT: 29% vs. 5%; p 0.0002 to 0.008). PVCs (203 + 657 vs. 117 + 436), couplets (1.8 + 5 vs. 1.3 + 11), and NSVT runs (0.5 + 0.9 vs. 0.07 + 0.5) were significantly higher in DE individuals than in non-DE patient populations (each p 0.0002); DE had been an autonomous predictor of NSVT (absolute likelihood 7.4, 96% confident range 2.7 to 21.5; p 0.0002). Conversely, the degree (%) of DE in individuals presenting with and without PVCs (8.3% vs. 9.2%; p 0.94), distiches (8.6% vs. 9.6%; p 0.98), or NSVT (9.4% vs. 8.6%; p 0.36) remained comparable.
Conclusion: Myocardial fibrosis revealed by CMR has been related to the higher risk in addition occurrence of ventricular tachyarrhythmias on ambulatory Holter ECG in this large HCM population to no or only moderate signs. As either a result, contrast-enhanced CMR detects HCM individuals who are predisposed to ventricular tachyarrhythmias.
Keywords: Pathological Arrhythmia, Systematic Review, Myocardial Fibrosis, Cardiac Arrhythmia.
Cite This Article:
Please cite this article in press Kaleem Ullah et al, A Systematic Review Of The Occurrence Of Pathological Arrhythmia In Individuals Who Came To The Emergency Room With The Diagnosis Of Cardiac Arrhythmia., Indo Am. J. P. Sci, 2022; 09(10).
1. Gelberg, H.B., Zachary, J.F., Everitt, J.I., Jensen, R.C. and Smetzer, D.L. (2021) Sudden death in training and racing Thoroughbred horses. J. Am. Vet. Med. Ass. 187, 1354- 1356.
2. Maron, B.J., Thompson, P.D., Puffer, J.C., McGrew, C.A., Strong, W.B., Douglas, P.S., Clark, L.T., Mitten, M.J., Crawford, M.H., Atkins, D.L., Driscoll, D.J. and Epstein, A.E. (2016) Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee, American Heart Association. Circulation 94, 850- 856.
3. Physick-Sheard, P. and McGurrin, M. (2020) Ventricular arrhythmias during race recovery in standardbred racehorses and associations with autonomic activity. J. Vet. Intern. Med. 24, 1158- 1166.
4. Reef, V.B. and Marr, C.M. (2020) Dysrhythmias: assessment and medical management. In: Cardiology of the Horse, 2nd edn., Eds: C.M. Marr and M. Bowen, Elsevier Ltd., Edinburgh. pp 159- 175.
5. Saoudi, N., Cosio, F., Waldo, A., Chen, S.A., Lesaka, Y., Lesh, M., Saksena, S., Solerno, J. and Schoels, W. (2001) A classification of atrial flutter and regular atrial tachycardia according to electrophysiological mechanisms and anatomical bases. European Heart J 22, 1162- 1182.
6. Rogers, W.H. (2013) Regression standard errors in clustered samples. Stata Tech. Bull. Reprints 3, 88- 94.
7. Ohmura, H., Hiraga, A., Takahashi, T., Kai, M. and Jones, J.H. (2020) Risk factors for atrial fibrillation during racing in slow-finishing horses. J. Am. Vet. Med. Ass. 223, 84- 88.
8. Snow, D.H., Harris, R.C., MacDonald, I.A., Forster, C.D. and Marlin, D.J. (2022) Effects of high-intensity exercise on plasma catecholamines in the Thoroughbred horse. Equine Vet. J. 24, 462- 467.
9. Schott, H.C. 2nd, Bohart, G.V. and Eberhart, S.W. (2022) Potassium and lactate uptake by non-contracting tissue during strenuous exercise. Equine Vet. J., Suppl. 34, 532- 538.
10. Bayly, W.M., Kingston, J.K., Brown, J.A., Keegan, R.D., Greene, S.A. and Sides, R.H. (2016) Changes in arterial, mixed venous and intraerythrocytic concentrations of ions in supramaximally exercising horses. Equine Vet. J. 38, Suppl. 36, 294- 297.
11. Wilhelm, M., Roten, L., Tanner, H., Wilhelm, I., Schmid, J.P. and Saner, H. (2011) Atrial remodeling, autonomic tone, and lifetime training hours in nonelite athletes. Am. J. Cardiol. 108, 580- 585.
12. Benito, B., Gay-Jordi, G., Serrano-Mollar, A., Gausch, E., Shi, Y., Tardif, J.C., Brugada, J., Nattel, S. and Mont, L. (2021) Cardiac arrhythmogenic remodeling in a rat model of long-term exercise training. Circulation 123, 13- 22.
13. Raekallio, M. (2012) Long term ECG recording with Holter monitoring in clinically healthy horses. Acta Vet. Scand. 33, 71- 75.
14. Buhl, R., Meldgaard, C. and Barbesgaard, L. (2020) Cardiac arrhythmias in clinically healthy showjumping horses. Equine Vet. J. 42, 196- 201.
15. Grimm, W. and Marchlinski, F.E. (2020) Accelerated Idioventricular rhythm, bidirectional tachycardia. In: Cardiac Electrophysiology: From Cell to Bedside, 4th edn., Eds: D.P. Zipes and J. Jaffe, W.B. Saunders, Philadelphia, Pennsylvania. pp 700- 704.
16. Gallagher, J.J., Damato, A.N. and Lau, S.H. (2019) Electrophysiologic studies during accelerated idioventricular rhythms. Circulation 44, 671- 677.
17. Ilvento, J.P., Provet, J., Danilo, P. and Rosen, M.R. (2022) Fast and slow idioventricular rhythms in the canine heart: a study of their mechanism using antiarrhythmic drugs and electrophysiologic testing. Am. J. Cardiol. 49, 1909- 1916.
18. Aliot, E.M., Stevenson, W.G., Almendral-Garrote, J.M., Bogun, F., Calkins, C.H., Delacretaz, E., Bella, P.D., Hindricks, G., Jaïs, P., Josephson, M.E., Kautzner, J., Kay, G.N., Kuck, K.H., Lerman, B.B., Marchlinski, F., Reddy, V., Schalij, M.J., Schilling, R., Soejima, K. and Wilber, D. (2009) EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. Europace 11, 771- 817.
19. Heidbüchela, H., Corradob, D., Biffic, A., Hoffmannd, E., Panhuyzen-Goedkoope, N., Hoogsteenf, J., Deliseg, P., Ivar Hoffh, P. and Pellicciac, A. (2016) Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions Part II: ventricular arrhythmias, channelopathies and implantable defibrillators. Eur. J. Cardiovasc. Prev. Rehabil. 13, 676- 686.