This study presents the development of a hybrid system consisting of an ensemble of Extended Kalman Filter (EKF) based Multi Layer Perceptron Network (MLPN) and a one-pass learning Fuzzy Inference System using Look-up Table Scheme for the recognition of electrocardiogram (ECG) signals. This system can distinguish various types of abnormal ECG signals such as Ventricular Premature Cycle (VPC), T wave inversion (TINV), ST segment depression (STDP), and Supraventricular Tachycardia (SVT) from normal sinus rhythm (NSR) ECG signal.
Hydroxyzine is a first generation antihistamine widely used in the paediatric population for a variety of conditions. A nine-year-old girl presented with supraventricular tachycardia while on clinical doses of hydroxyzine for pruritus. On arrival at the hospital, she was diaphoretic, with cool peripheries, poor peripheral pulses and a heart rate of 250/minute. There was a history of three palpitation episodes with chest tightness during the five months she was taking hydroxyzine. The supraventricular tachycardia eventually reverted to sinus rhythm with intravenous verapamil. Relevant cardiac examination and investigations had not shown any cardiac abnormalities. After discontinuing hydroxyzine, she had no further episodes of supraventricular tachycardia. To our knowledge, this is the first report of hydroxyzine induced-supraventricular tachycardia in the medical literature.
Thyroid disease is common and can have various systemic manifestations including cardiac diseases. Hypothyroidism is commonly associated with sinus bradycardia, low QRS complexes, prolonged QT interval and conduction blocks but rarely may cause arrhythmias. We present a patient who presented with presyncope and supraventricular tachycardia with severe hypothyroidism. Patient responded well to thyroxine replacement with biochemical improvement, the disappearance of arrhythmia after restoration of euthyroidism suggests that hypothyroidism might be the cause of supraventricular tachycardia. The aim of this report is to underline the possible aetiological link between supraventricular tachycardia and hypothyroidism, although supraventricular arrhythmias are ordinary features of hyperthyroidism.
A gravid patient with fetal supraventricular tachycardia is presented. A review of this rare condition and the present recommended mode of therapy are discussed.
FascicularVentricular Tachycardia (VT) is a uniqueclinical syndrome, rarelyencountered by physicians.It isalso known as BelhassenSyndrome, named after a physician who reported the case in 1981. The condition,accounts for 10-15% of total idiopathic VTand the rhythm is sensitive tocalcium channel blocker. First described in 1979, the diagnosis of thissyndromeremains challenging,as the electrocardiogram (ECG) changes may be incorrectly diagnosed as Supraventricular Tachycardia (SVT) with aberrant conductions. We describeda patient whopresented to Emergency Department with palpitation. The difficulty in diagnosis and management is illustrated in the reportas he was initially misdiagnosed as SVT with resistance to initial standard treatment.This case report alsodescribedwide complex tachycardia algorithms to assist physician in daily clinicalpractice. Therapeutic options inmanaging this rare syndrome werealso discussed.
Nine children, aged 2.5 months to 16 years, presenting with tachyarrhythmias were treated with intravenous (i.v.) flecainide, a type 1C antiarrhythmic drug. There were four boys and five girls; seven were supraventricular and two ventricular tachycardias and three had structural cardiac abnormalities. The i.v. dose required to terminate the arrhythmias ranged from 1.0 to 2.4 mg/kg (mean 1.55 mg/kg) although a mean of 1.94 mg/kg per dose was required to maintain sustained sinus rhythm after a single i.v. dose. Eight of the patients--six supraventricular and two ventricular tachyarrhythmias, required maintenance oral flecainide. Oral dosages of 6.7-9.5 mg/kg per day (mean of 7.97 mg/kg per day in three divided doses) were required to effectively prevent the tachyarrhythmias. Intravenous and oral flecainide are safe and effective in terminating supraventricular and ventricular tachyarrhythmias. No evidence of proarrhythmia was found in the patients during follow up of between 5 and 9 months. The present limitation of performing radiofrequency ablation on infants and small children justifies the important place of medical therapy for re-entrant supraventricular tachyarrhythmias.
Fetal arrhythmias are not uncommon in pregnancy. The diagnosis can be established on routine ultrasound scan. Fetal supraventricular tachycardia (SVT) is the most common cause of fetal tachycardia. If left undiagnosed and untreated, these fetuses may develop cardiac failure, hydrops fetalis and eventually death. We report two fetuses diagnosed antenatally to have fetal SVT. Both fetuses were in cardiac failure and were successfully treated with maternal administration of antiarrhythmic medications. Digoxin, and in severe instances, a combination with flecanaide significantly improved fetal outcomes and prevented fetal mortality. The long term prognosis of such patients are good.
Anaphylactic reaction towards antibiotics is common during anaesthesia. It may present as bronchospasm, hypotension, desaturation, or urticarial. However it is uncommon for anaphylaxis reaction to present only as supraventricular tachycardia (SVT). This is a rare interesting case report on a 23-year-old healthy man whose anaesthetic categorization is American Society of Anaesthesiologist (ASA) 1, developed supraventricular tachycardia (SVT) towards intravenous cefuroxime, peri operatively. His condition resolved with carotid sinus massage. No pharmacological interventions were used. His skin prick intradermal tests showed allergies towards cefuroxime, cefazoline and cefoperazone. The patient subsequently underwent.