Potential dangers of the Valsalva maneuver and adenosine in paroxysmal supraventricular tachycardia--beware preexcitation.

نویسندگان

  • R Nagappan
  • S Arora
  • C Winter
چکیده

Paroxysmal supraventricular tachycardia (PSVT) is a common clinical problem. Valsalva maneuver and adenosine are effective therapies for many patients with PSVT, although any conversion to an irregular or wide complex tachycardia should prompt consideration of a preexcitation syndrome. We report a case where the Valsalva maneuver and adenosine, in a patient with PSVT and previously undiagnosed Wolff-Parkinson-White syndrome, caused atrial fibrillation and led to a haemodynamically unstable wide complex tachycardia and ventricular fibrillation. In PSVT, where preexcitation has not been excluded, the Valsalva maneuver and adenosine can be potentially dangerous.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Electrophysiological mechanisms and determinants of vagal maneuvers for termination of paroxysmal supraventricular tachycardia.

BACKGROUND The vagal maneuvers used for termination of paroxysmal supraventricular reentrant tachycardia (PSVT) appear to involve more complex mechanisms than we have known, and further study should be done to explore the possible mechanisms. METHODS AND RESULTS In this study, 133 patients with PSVT and 30 age- and sex-matched control subjects were included. We assessed the effects of differe...

متن کامل

Valsalva maneuver using a Handmade Device in Supraventricular Tachycardia Reversion; a Quasi Experimental Study

Introduction The use of vagal nerve stimulation is identified as a proper treatment option in patients with stable supraventricular tachycardia (SVT). This study aimed to assess the success of Valsalva maneuver via a handmade device in reversion of SVT. Methods In this quasi experimental study, using a handmade device, vagus nerve stimulation was performed for SVT patients presenting to emerg...

متن کامل

Congenitally corrected transposition of great vessels with infundibular pulmonary stenosis with ventricular septal defect, presenting with atypical atrioventricular nodal reentrant tachycardia: a rare association

Congenitally corrected transposition of great vessels (CCTGV) is a rare congenital heart disease (CHD) accounting for <1% of CHDs. CCTGV with infundibular pulmonary stenosis (PS) with ventricular septal defect (VSD) is part of Fallot's physiology. It is known to be associated with bradyarrhythmias like atrioventricular (AV) blocks, and acquired complete AV block occurs at a rate of 2% per year....

متن کامل

Modified Valsalva Maneuver vs. Standard Valsalva Maneuver on Emergency Department Patients Presenting with Supraventricular Tachycardia

Background: Supraventricular tachycardia (SVT) is a relatively common dysrhythmia among the general population and a common dysrhythmia presenting to the emergency department. Generally speaking, it is assumed the provider should attempt a vagal maneuver as first-line treatment for SVT, and the most common vagal maneuver used is the Valsalva. Current resources describing the method to perform t...

متن کامل

Paroxysmal Supraventricular Tachycardias and the Preexcitation Syndromes

Paroxysmal supraventricular tachycardia (PSVT) has been a well-recognized clinical syndrome and an electrocardiographically defined arrhythmia since the early days of electrocardiography. The clinical syndrome was defined in European literature in the 19th century. In 1867, Cotton reported on an “unusually rapid action of the heart,” and this was followed by further observations by French and G...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine

دوره 4 2  شماره 

صفحات  -

تاریخ انتشار 2002