Cardiophile MD Archive

Elective cardioversion for atrial fibrillation / flutter is often done in conditions in which the atrial booster function is needed as in hypertrophic cardiomyopathy. Sometimes it is performed after balloon mitral valvotomy as well. In situations in which it is likely to recur, anti arrhythmic therapy may be continued after the procedure. Sometimes when the [...]

Atrial fibrillation with WPW syndrome (Click on the image for an enlarged view) Atrial fibrillation with WPW syndrome (pre-excitation) is a potentially life threatening arrhythmia. Since it is a wide QRS tachycardia, it is often mistaken for ventricular tachycardia. Due to very fast rates, they often present with hemodynamic compromise requiring cardioversion. In the current [...]

Which of the following rhythms is taken as a marker of successful ablation of atrioventricular nodal re-entrant tachycardia (AVNRT)? A. Ventricular tachycardia B. Sinus rhythm C. Junctional rhythm D. Atrial fibrillation Answer: C Usually a short run of accelerated junctional rhythm occurs during successful radiofrequency catheter ablation of AVNRT. Non inducibility of tachycardia is an [...]

Apical ballooning syndrome is known by the following eponyms except: A. Takotsubo cardiomyopathy B. Broken heart syndrome C. Tachycardiomyopathy D. Stress cardiomyopathy Answer: C All the others are eponyms for apical ballooning syndrome. Tachycardiomyopathy is secondary to long standing tachycardia as in atrial fibrillation or permanent junctional tachycardia.

Click on the image for a larger view ECG of pacing through lateral cardiac vein. Pacing through lateral cardiac vein was done because of prior triple valve replacement (mitral, tricuspid and aortic) which precluded trans venous right ventricular pacing. The basic rhythm is atrial fibrillation and the fifth and last beats are paced. The tall [...]