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All AV nodal blocking medications (e.g., adenosine, calciumchannel blockers, beta blockers) should be used with caution in these patients when treating an irregular or widecomplex SVT. Rarely, do patients with unusual hypertrophy patterns or repaired congenital heart disease have bizarre, wide QRS patterns during sinus rhythm SVT in these. It is concluded that this easily swallowed esophageal electrode provides an excellent-quality short-term ECG and often permits proper arrhythmia diagnosis in selected patients with arrhythmias. The SVT may appear as a narrow or widecomplex QRS, depending on AV node involvement and the direction of the reentry circuit.
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Of 27 patients in the ambulatory ECG group, 19 (70%) had fairly good to excellent-quality 24-hour esophageal pill tracings, with the esophageal ECG contributing to correct arrhythmia diagnosis in 11 patients (41%). This study evaluates the clinical use of an easily swallowed bipolar electrode for recording an esophageal electrocardiogram (ECG). 3 In patients with suspected coronary artery disease.
SVT WITH IVCD PLUS
1,2 For patients with coronary artery disease plus depressed ventricular function and nonsustained ventricular tachycardia, QRS prolongation resulting from LBBB or IVCD has been associated with a 50 increase in the risk of both arrhythmic and total mortality. Abnormalities of local myocardial activation can further alter the specific pattern of venticular activation. In most patients with systolic left ventricular dysfunction, QRS prolongation presents as LBBB, 14 and in these patients, increased QRSd is associated with a worse prognosis. However, the low specificity (0.63) for the second criterion (R-to-S interval >100 ms) and the low consecutive specificity (0.57) could potentially limit the diagnostic efficiency of the proposed algorithm in a patient with IVCD should he or she develop SVT. A second group of 27 non-selected patients scheduled for routine 24-hour ambulatory electrocardiographic recordings (ambulatory ECG group) had an esophageal ECG recorded as the “third channel.” All 14 patients (100%) in the ECG group had excellent-quality tracings, and the esophageal ECG was diagnostic in 12 cases (86%). An IVCD is the result of abnormal activation of the ventricles caused by conduction delay or block in one or more parts of the specialized conduction system (bundle of His, bundle branch or purkinje conduction system) resulting in widening of QRS complex. Fourteen patients were selected for bedside diagnosis (ECG group) because of arrhythmias difficult to evaluate using a standard 12-lead ECG. This study evaluates the clinical use of an easily swallowed bipolar electrode for recording an esophageal electrocardiogram (ECG).