Ventricular arrhythmias due to ARVD and right ventricular outflow tract arrhythmia (RVOTA) share the same left bundle branch block pattern with inferior axis on the ECG. The former has a more malignant course while the latter has a better prognosis and is more amenable to radiofrequency catheter ablation. Hence differentiating them is of utmost clinical importance in the management of these pat...

OBJECTIVE To examine autonomic function as assessed by heart rate variability in patients 10 or more years after repair of tetralogy of Fallot, and to relate this to cardiac structure, function, and electrocardiographic indices. METHODS Heart rate variability was measured by standard time domain techniques on a 24 hour Holter ECG in 28 patients, aged 12 to 34 years (mean 19.5), who had underg...

BACKGROUND Cardiac resynchronization therapy using bi-ventricular pacing is proven effective in the management of heart failure (HF) with a wide QRS-complex. In the absence of QRS prolongation, however, device-based resynchronization is reported unsuitable. As an alternative, the present study tests a regenerative cell-based approach in the setting of narrow QRS-complex HF. METHODS AND RESULT...

Since the introduction of our local manufacturing of terfenadine, we have observed and expressed our concern about a small but increasing number of serious ventricular arrhythmias associated with the use of this non sedating antihistamine. In January 1997 a case of torsade de pointes ventricular tachycardia was detected in a previously healthy woman taking terfenadine with erythromycin. El...

Alkalinization of the blood by administration of sodium bicarbonate or hyperventilation is widely recommended for treatment of cardiac toxicity due to tricyclic antidepressant overdose, yet its efficacy and mechanism of action are poorly defined. We studied the effects and possible mechanism of action of 1 M NaHCO3 on desipramine (DMI) toxicity in anesthetized, paralyzed rats. Administration of...

In imipramine and amitriptyline poisoning the electrocardiographic abnormalities comprise arrhythmias, widening of the QRS complex, and marked changes in die S-T segment. These features were found to be of value in the differential diagnosis of unknown poisoning. The unusual configuration of qR with raised S-T segment in V1, simulating myocardial infarction, was seen in one of our patients and ...

Widening of the electrocardiographic (ECG) spatial QRS-T angle has been predictive of cardiovascular disease (CVD) events in the general population. However, its prognostic significance in human immunodeficiency virus (HIV)-infected patients remains unknown. The spatial QRS-T angle was derived from the baseline resting 12-lead electrocardiogram of 4,453 HIV-infected patients aged 43.5 ± 9.3 yea...

The opiate analgesic propoxyphene produces cardiac toxicity when taken in overdose. We recently observed a patient with propoxyphene overdose in whom marked QRS widening was reversed by lidocaine. The reversal is apparently paradoxical as both agents block the inward sodium current (INa). We examined possible mechanisms of the reversal by measuring INa in rabbit atrial myocytes during exposure ...

A12-lead ECG was obtained from a 72-year-old man with a core body temperature of 85°F (Figure 1). The ECG shows severe sinus bradycardia with prolonged PR, prolonged QRS complex, prolonged QT interval, and an extra deflection at the end of the QRS complex (Osborn waves) (arrows). A second 12-lead ECG obtained 24 hours later, after the patient had been rewarmed to 98°F, was normal (Figure 2). Hy...