What causes Fascicular ventricular tachycardia?
Causes. Usually occurs in young healthy patients (15-40 years of age; 60-80% male). Most episodes occur at rest but may be triggered by exercise, stress and beta agonists. The mechanism is re-entrant tachycardia due to an ectopic focus within the left ventricle.
What is Fascicular VT?
Idiopathic fascicular left ventricular tachycardia is the most common idiopathic ventricular tachycardia of the left ventricle. It is a reentrant tachycardia typical of young patients without structural heart disease. For the acute management, verapamil is the first line treatment.
What is Belhassen ventricular tachycardia?
Commonly referred to as fascicular or intrafascicular tachycardia, verapamil sensitive VT or Belhassen VT, it is characterized by a right bundle branch block pattern and left axis deviation. 3. Patients are typically young and healthy with their first episode often occurring in adolescence.
What’s the difference between VT and SVT?
Supraventricular tachycardia (SVT) begins in the upper portion of the heart, usually the atria. Ventricular tachycardia (VT) begins in the heart’s lower chambers, the ventricles.
Can you use adenosine for ventricular tachycardia?
Adenosine is safe and effective for differentiating wide-complex supraventricular tachycardia from ventricular tachycardia.
Why is verapamil contraindicated in Vermont?
The use of intravenous diltiazem or verapamil is contraindicated in patients with ventricular tachycardia. IV administration of a calcium channel blocker can precipitate cardiac arrest in such patients.
Can VT be narrow complex?
Our patient had relatively narrow complexes during sustained ventricular tachycardia, likely because the His-Purkinje system constituted a portion of his VT circuit. The relatively narrow QRS complexes led to an initial misdiagnosis of supraventricular tachycardia.
Do you do CPR for torsades?
Consider magnesium for torsades de pointes associated with a long QT interval (see below). You should administer the drug during CPR, as soon as possible after rhythm analysis.
How rare is torsades de pointes?
The prevalence of torsade de pointes is unknown. Torsade is a life-threatening arrhythmia and may present as sudden cardiac death in patients with structurally normal hearts. In the United States, 300,000 sudden cardiac deaths occur per year. Torsade probably accounts for fewer than 5%.
Can You masquerade left anterior fascicular block ( LAFB )?
Consequent high-grade left anterior fascicular block ( LAFB), often associated left ventricular enlargement, manifests as a complete LBBB. This is partially masqueraded by concurrent RBBB Patients have a higher risk of progression to complete AV block than typical bifascicular block
Is there a LV strain pattern in LAFB?
In LAFB, the QRS voltage in lead aVL may meet voltage criteria for LVH (R wave height > 11 mm), but there will be no LV strain pattern. Wiesbauer F, Kühn P. ECG Yellow Belt online course: Become an ECG expert. Medmastery Wiesbauer F, Kühn P. ECG Blue Belt online course: Learn to diagnose any rhythm problem. Medmastery Smith SW. Dr Smith’s ECG blog.
Which is VT arises near the left posterior fascicle?
Posterior fascicular VT (90-95% of cases): RBBB morphology + left axis deviation; arises close to the left posterior fascicle. Anterior fascicular VT (5-10% of cases): RBBB morphology + right axis deviation; arises close to the left anterior fascicle.
Is there such a thing as Upper septal fascicular VT?
Upper septal fascicular VT (rare): atypical morphology – usually RBBB but may resemble LBBB instead; cases with narrow QRS and normal axis have also been reported. Arises from the region of the upper septum.
