Displaying publications 1 - 20 of 31 in total

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  1. Pooled rates and demographics of POTS following SARS-CoV-2 infection versus COVID-19 vaccination: Systematic review and meta-analysis
    Yong SJ, Halim A, Liu S, Halim M, Alshehri AA, Alshahrani MA, et al.
    Auton Neurosci, 2023 Dec;250:103132.
    PMID: 38000119 DOI: 10.1016/j.autneu.2023.103132
    PURPOSE: To address recent concerns of postural orthostatic tachycardia syndrome (POTS) occurring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination.

    METHODS: We searched PubMed, Web of Science, and Scopus as of 1st June 2023. We performed a systematic review and meta-analysis of pooled POTS rate in SARS-CoV-2-infected and COVID-19-vaccinated groups from epidemiological studies, followed by subgroup analyses by characteristic. Meta-analysis of risk ratio was conducted to compare POTS rate in infected versus uninfected groups. Meta-analysis of demographics was also performed to compare cases of post-infection and post-vaccination POTS from case reports and series.

    RESULTS: We estimated the pooled POTS rate of 107.75 (95 % CI: 9.73 to 273.52) and 3.94 (95 % CI: 0 to 16.39) cases per 10,000 (i.e., 1.08 % and 0.039 %) in infected and vaccinated individuals based on 5 and 2 studies, respectively. Meta-regression revealed age as a significant variable influencing 86.2 % variance of the pooled POTS rate in infected population (P 

    Matched MeSH terms: Postural Orthostatic Tachycardia Syndrome*
  2. Intelligent classification of electrocardiogram (ECG) signal using extended Kalman Filter (EKF) based neuro fuzzy system
    Meau YP, Ibrahim F, Narainasamy SA, Omar R
    Comput Methods Programs Biomed, 2006 May;82(2):157-68.
    PMID: 16638620
    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.
    Matched MeSH terms: Tachycardia, Supraventricular/diagnosis; Tachycardia, Supraventricular/physiopathology
  3. Fulltext Belhassen ventricular tachycardia-a diagnostic challenge in emergency room: case report
    Syed Farid Almufazal Syed Salim, Shamsuriani Md Jamal
    Malaysian Journal of Emergency Medicine, 2018;3(1):0-0.
    MyJurnal
    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.
    Matched MeSH terms: Tachycardia; Tachycardia, Paroxysmal; Tachycardia, Supraventricular
  4. "Focal" ventricular tachycardia: insights from catheter ablation
    Mittal S
    Heart Rhythm, 2008 Jun;5(6 Suppl):S64-7.
    PMID: 18456205 DOI: 10.1016/j.hrthm.2008.03.023
    Catheter ablation has come to play an important therapeutic role in the management of some patients with ventricular arrhythmias. An important advance in catheter ablation of ventricular tachycardia (VT) has been the development of three-dimensional catheter-based mapping systems, which permit identification of the tachycardia circuit and facilitate a strategy for catheter ablation. As a result, patients who suffer from "focal" forms of VT have been identified. This can have implications with respect to underlying arrhythmia mechanism, patient prognosis, and therapeutic strategies. The article reviews some insights learned from catheter ablation of focal forms of VT.
    Matched MeSH terms: Tachycardia, Ventricular/physiopathology*; Tachycardia, Ventricular/surgery*
  5. Fulltext Intrauterine management of fetal supraventricular tachycardia (SVT) with cardiac failure
    Muniswaran G, Japaraj RP, Asri Ranga AR, Cheong HK
    Med J Malaysia, 2015 Dec;70(6):371-2.
    PMID: 26988216 MyJurnal
    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.
    Matched MeSH terms: Tachycardia; Tachycardia, Paroxysmal; Tachycardia, Supraventricular
  6. Fulltext Ventricular tachycardia storm: a case series and literature review
    Chia PL, Loh SY, Foo D
    Med J Malaysia, 2012 Dec;67(6):582-4.
    PMID: 23770949
    INTRODUCTION: Ventricular tachycardia (VT) storm is an uncommon but life-threatening condition. We describe the incidence, causes and management of VT storm among patients admitted to the coronary care unit of a large tertiary hospital.

    MATERIALS AND METHODS: Between 1 November 2009 and 30 April 2010, 198 patients were admitted to the coronary care unit and 7 (3.5%) presented with VT storm. A retrospective review of their records was conducted. The mean follow-up period was 268 (196 to 345) days.

    RESULTS: The mean age was 67 years and 4 patients were male. One patient had a previous myocardial infarction. All had abnormal left ventricular ejection fraction, median of 30%. Acute myocardial infarction (4 patients) was the most common trigger, followed by decompensated heart failure (1), systemic inflammatory response syndrome on a background of non-ischemic dilated cardiomyopathy (1) and bradycardia-induced polymorphic VT (1). Three patients had polymorphic VT and the rest had monomorphic VT. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful in arrhythmia control. Three patients underwent coronary revascularization, 3 patients received implantable cardioverter-defibrillators, 1 had a permanent cardiac pacemaker, 1 died during the acute episode. Five out of the 6 survivors were prescribed oral beta-blockers upon discharge. On follow-up, none of the patients had a recurrence of the tachyarrhythmia.

    CONCLUSION: Acute myocardial infarction was the main trigger of VT storm in our patients. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful at suppressing VT storm.
    Matched MeSH terms: Tachycardia, Ventricular*
  7. Fulltext Bizarre ECG in head injury mimicking ventricular tachycardia
    Loke YK, Lai VM, Tan MH, Gunn A
    Singapore Med J, 1997 Apr;38(4):166-8.
    PMID: 9269397
    Bizarre electrocardiographic (ECG) changes were found in an 18-year-old girl who had a subdural haematoma following head trauma. The initial diagnosis was of ventricular tachycardia (VT) and she was treated with intravenous anti-arrhythmic drugs and electrical cardioversion, but to no effect. It was later concluded that the ECG appearances were not of a ventricular arrhythmia but were the result of the intracranial pathology. ECG abnormalities related to head injuries have been reported on many occasions, and our case report illustrates how this can create difficulties for the attending clinicians.
    Matched MeSH terms: Tachycardia, Ventricular/diagnosis*
  8. Incessant ectopic atrial tachycardia and tachycardia-related cardiomyopathy: therapeutic options and potential for cure
    Shah RP, Kam RM, Teo WS
    Ann Acad Med Singap, 1999 Nov;28(6):871-4.
    PMID: 10672407
    Incessant ectopic atrial tachycardia (IEAT) is a rare cause of cardiomyopathy. Cardiomyopathy is reversible by curative ablation using surgery or radiofrequency current. We report our experience with 5 patients with IEAT. Three patients presented with palpitations and were diagnosed to have paroxysmal supraventricular tachycardia (2 patients) and atrial flutter with 1:1 conduction (1 patient), but 2 presented insidiously with congestive cardiac failure. All the initial echocardiograms showed left ventricular dysfunction. The patients underwent electrophysiological studies which confirmed the diagnosis of IEAT. The first patient had surgical cryoablation and the other patients had successful radiofrequency catheter ablation. Follow-up for 2 to 7 years has shown no recurrences. All patients had significant improvement in left ventricular function on echocardiography. In conclusion, curative ablation by surgery or radiofrequency current is safe and effective. Because of its low morbidity, radiofrequency catheter ablation should be the treatment of choice for IEAT, especially if complicated by tachycardia-related cardiomyopathy.
    Matched MeSH terms: Tachycardia, Ectopic Atrial/complications; Tachycardia, Ectopic Atrial/diagnosis; Tachycardia, Ectopic Atrial/surgery*
  9. Treatment with flecainide for symptomatic and refractory tachyarrhythmias in children
    Ismail Z, Alwi M, Lim MK, Murtazam HA, Jamaluddin A
    Acta Paediatr Jpn, 1994 Feb;36(1):44-8.
    PMID: 8165907
    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.
    Matched MeSH terms: Tachycardia, Supraventricular/drug therapy*; Tachycardia, Ventricular/drug therapy*
  10. Fulltext Markers of ventricular tachyarrythmias in patients with acromegaly
    Mohamed AL, Yusoff K, Muttalif AR, Khalid BAk
    Med J Malaysia, 1999 Sep;54(3):338-45.
    PMID: 11045060
    Sudden cardiac death is a known complication of acromegaly. Little is known of the exact mechanism leading to sudden cardiac death in these patients. Ventricular tachyarrhythmias may be an important cause. If this is so, clinical markers of ventricular tachyarrhythmias may be more common in this group of patients. The presence of these markers allow better risk stratification among acromegalic patients.
    Matched MeSH terms: Tachycardia, Ventricular/blood; Tachycardia, Ventricular/etiology*; Tachycardia, Ventricular/pathology; Tachycardia, Ventricular/physiopathology*
  11. Fulltext Hydroxyzine-induced supraventricular tachycardia in a nine-year-old child
    Wong AR, Rasool AH
    Singapore Med J, 2004 Feb;45(2):90-2.
    PMID: 14985850
    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.
    Matched MeSH terms: Tachycardia, Supraventricular/chemically induced*
  12. Severe hypothyroidism presenting with supraventricular tachycardia
    Mak WW, Raja Nurazni RA, Mohamed Badrulnizam LB
    Med J Malaysia, 2018 10;73(5):349-350.
    PMID: 30350825 MyJurnal
    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.
    Matched MeSH terms: Tachycardia, Supraventricular
  13. Fulltext Properties of Foamed Mortar Prepared with Granulated Blast-Furnace Slag
    Zhao X, Lim SK, Tan CS, Li B, Ling TC, Huang R, et al.
    Materials (Basel), 2015 Jan 30;8(2):462-473.
    PMID: 28787950 DOI: 10.3390/ma8020462
    Foamed mortar with a density of 1300 kg/m³ was prepared. In the initial laboratory trials, water-to-cement (w/c) ratios ranging from 0.54 to 0.64 were tested to determine the optimal value for foamed mortar corresponding to the highest compressive strength without compromising its fresh state properties. With the obtained optimal w/c ratio of 0.56, two types of foamed mortar were prepared, namely cement-foamed mortar (CFM) and slag-foamed mortar (SFM, 50% cement was replaced by slag weight). Four different curing conditions were adopted for both types of foamed mortar to assess their compressive strength, ultrasonic pulse velocity (UPV) and thermal insulation performance. The test results indicated that utilizing 50% of slag as cement replacement in the production of foamed mortar improved the compressive strength, UPV and thermal insulation properties. Additionally, the initial water curing of seven days gained higher compressive strength and increased UPV values as compared to the air cured and natural weather curing samples. However, this positive effect was more pronounced in the case of compressive strength than in the UPV and thermal conductivity of foamed mortar.
    Matched MeSH terms: Tachycardia
  14. Fulltext Torsade de pointes and syncopal attacks in a 26-year old woman with congenital complete heart block and prolonged QT interval
    Quek DK, Ong SB
    Singapore Med J, 1990 Apr;31(2):185-8.
    PMID: 2371586
    A 26-year old woman with congenital complete heart block and prolonged QT interval presented for the first time with syncopal attacks associated with torsade de pointes in adulthood. Cardioversion followed by overdrive pacing was needed to finally control the unstable rhythm. During episodes of non-capture, paraoxysms of torsade de pointes leading to ventricular flutter were recorded by a 24-hour ambulatory electrocardiographic monitoring. Beta-blockade and permanent ventricular pacing finally abolished both the syncopal attacks and the torsade phenomena. The prognosis of congenital complete heart block associated with QT prolongation resembles that of the Romano-Ward syndrome. Recognition of this variant would facilitate earlier treatment of this rare but potentially lethal disorder.
    Matched MeSH terms: Tachycardia/diagnosis; Tachycardia/etiology*
  15. Fulltext Fetal supraventricular tachycardia--a case report
    Soh EBS, Raman S, Chia PMK
    Med J Malaysia, 1998 Sep;53(3):280-3.
    PMID: 10968167
    A gravid patient with fetal supraventricular tachycardia is presented. A review of this rare condition and the present recommended mode of therapy are discussed.
    Matched MeSH terms: Tachycardia, Supraventricular/diagnosis*; Tachycardia, Supraventricular/drug therapy*
  16. Hepatotoxicity of amiodarone
    Jeyamalar R, Pathmanathan R, Wong D, Kannan P
    Ann Acad Med Singap, 1992 Nov;21(6):838-40.
    PMID: 1295429
    Amiodarone, a commonly used antiarrhythmic agent, has numerous adverse effects. The purpose of this case report is to highlight its hepatotoxicity, an unusual complication of long term amiodarone therapy. Our patient is a 76-year-old man with underlying ischaemic heart disease and recurrent ventricular tachycardia. Eleven months after commencing amiodarone, he developed asymptomatic raised aminotransferases which resolved following drug withdrawal. Amiodarone was then reintroduced and four years later, the patient developed hepatomegaly, worsening liver biochemistry and histopathological changes consistent with early cirrhosis. His symptoms improved following discontinuation of amiodarone. However, hepatomegaly and a low serum albumin still persist four years later.
    Matched MeSH terms: Tachycardia, Ventricular/drug therapy*; Tachycardia, Ventricular/pathology
  17. Fulltext A Combination of Tachycardia-Mediated Heart Failure and Coronary Artery Vasospasm-Induced Silent Myocardial Infarction in a Patient with Severe Thyrotoxicosis
    Khoo SSK, Chu CM, Fung YK
    Case Rep Cardiol, 2018;2018:4827907.
    PMID: 29713551 DOI: 10.1155/2018/4827907
    Severe thyrotoxicosis can present with a myriad of cardiovascular complications. It may be mild features such as palpitations, tachycardia, and exertional dyspnea or may progress to life-threatening consequences such as atrial fibrillation, tachyarrhythmias, heart failure, myocardial infarction, and shock. In rare cases, they may present with myocardial ischemia secondary to coronary artery vasospasm. We report a case of a 59-year-old Malay gentleman who presented with fast atrial fibrillation and tachycardia-mediated heart failure that evolved to a silent myocardial infarction secondary to severe coronary artery vasospasm with undiagnosed severe thyrotoxicosis. He had complete resolution of heart failure and no further recurrence of coronary artery vasospasm once treatment for thyrotoxicosis was initiated and euthyroidism achieved. This life-threatening consequence has an excellent prognosis if recognised early and treated promptly.
    Matched MeSH terms: Tachycardia
  18. Fulltext Marked junctional bradycardia, prolonged QT interval and torsade de pointes in acute phenothiazine intoxication in a schizophrenic patient. A case report
    Quek DK, Ong SB, Chan PY
    Med J Malaysia, 1988 Jun;43(2):173-7.
    PMID: 2907093
    Matched MeSH terms: Tachycardia/chemically induced
  19. Fulltext Torsade de pointes and sudden death associated with diabetic autonomic diarrhoea--a case report
    Quek DK, H'ng PK
    Singapore Med J, 1993 Jun;34(3):266-70.
    PMID: 8266190
    A 68-year-old diabetic and hypertensive woman presented with chronic autonomic diarrhoea, syncope and palpitations which were associated with QT prolongation and recurrent episodes of torsade de pointes. She was on glibenclamide, indapamide and probucol (for type V hyperlipidaemia). Despite intravenous infusions of potassium, lignocaine and amiodarone, the unstable rhythm persisted. However, intravenous magnesium sulphate with small doses of intravenous propranolol terminated the torsade de pointes. She was stabilised but following discharge she relapsed, and upon re-admission, succumbed to intractable ventricular fibrillation. Early recognition and aggressive treatment of this condition is emphasised. Multiple aggravating factors ie autonomic diarrhoea resulting in severe potassium and magnesium depletion, kaliuretic effect of indapamide, probable QT prolongation associated with diabetic autonomic neuropathy and probucol; probable underlying coronary artery disease and heightened emotional and sympathetic discharge could have contributed to this very unstable ventricular arrhythmia and sudden death.
    Matched MeSH terms: Tachycardia, Ventricular/complications
  20. Fulltext Utilization of implantable cardioverter-defibrillators for the prevention of sudden cardiac death in emerging countries: Improve SCA clinical trial
    Zhang S, Ching CK, Huang D, Liu YB, Rodriguez-Guerrero DA, Hussin A, et al.
    Heart Rhythm, 2020 03;17(3):468-475.
    PMID: 31561030 DOI: 10.1016/j.hrthm.2019.09.023
    BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are underutilized in Asia, Latin America, Eastern Europe, the Middle East, and Africa. The Improve SCA Study is the largest prospective study to evaluate the benefit of ICD therapy in underrepresented geographies. This analysis reports the primary objective of the study.

    OBJECTIVES: The objectives of this study was to determine whether patients with primary prevention (PP) indications with specific risk factors (1.5PP: syncope, nonsustained ventricular tachycardia, premature ventricular contractions >10/h, and low ventricular ejection fraction <25%) are at a similar risk of life-threatening arrhythmias as patients with secondary prevention (SP) indications and to evaluate all-cause mortality rates in 1.5PP patients with and without devices.

    METHODS: A total of 3889 patients were included in the analysis to evaluate ventricular tachycardia or fibrillation therapy and mortality rates. Patients were stratified as SP (n = 1193) and patients with PP indications. The PP cohort was divided into 1.5PP patients (n = 1913) and those without any 1.5PP criteria (n = 783). The decision to undergo ICD implantation was left to the patient and/or physician. The Cox proportional hazards model was used to compute hazard ratios.

    RESULTS: Patients had predominantly nonischemic cardiomyopathy. The rate of ventricular tachycardia or fibrillation in 1.5PP patients was not equivalent (within 30%) to that in patients with SP indications (hazard ratio 0.47; 95% confidence interval 0.38-0.57) but was higher than that in PP patients without any 1.5PP criteria (hazard ratio 0.67; 95% confidence interval 0.46-0.97) (P = .03). There was a 49% relative risk reduction in all-cause mortality in ICD implanted 1.5PP patients. In addition, the number needed to treat to save 1 life over 3 years was 10.0 in the 1.5PP cohort vs 40.0 in PP patients without any 1.5PP criteria.

    CONCLUSION: These data corroborate the mortality benefit of ICD therapy and support extension to a selected PP population from underrepresented geographies.

    Matched MeSH terms: Tachycardia, Ventricular/complications; Tachycardia, Ventricular/therapy*
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