|
Medical Center Tower I 7950 Floyd Curl Drive Suite 803 San Antonio, TX 78229 tel: 210-615-9500 fax: 210-615-9600 email: office at cecst.com |
Specializing in the compassionate care of people who suffer from abnormalities of the electrical system of the heart |
Current Insurance Plans:
We accept most major commercial insurance plans. Please call for details. Medicare: We have opted out of Medicare, and are happy to care for Medicare beneficiaries on an affordable cash basis. Note: Federal law prohibits signing the Federally-mandated opt-out contract with a Medicare beneficiary who is in an emergency situation. No insurance? No problem! Consider our affordable Fee for service (direct pay). Home of the Original Personalized Medical Office SystemTM released April 5, 2013 |
| Table of Contents |
| Ventricular couplet | |
| Two ventricular premature complexes in a row. This can be a normal finding, but is more suggestive of electrical heart disease than are single ventricular premature complexes. | |
| Ventricular fibrillation | |
| This is a lethal rhythm, characterized by absence of both organized electrical and organized mechanical activity. This rhythm is equivalent to cardiac death. If you see this, you should initiate Cardiopulmonary Resuscitation immediately. | |
| Ventricular premature complex | |
| This is a wide QRS complex that occurs earlier than would be expected from the sinus rate, and that almost always has an abnormal morphology. It fails to conduct retrograde through the atrioventricular node in half of patients, in which case it results in a compensatory pause. That is, the next P wave occurs at the same time as would be expected had the VPC not occurred. When it does conduct through the atrioventricular node, the following P wave may occur either sooner or later than would be expected. Ventricular premature complexes are a normal finding in adults of all ages. They cause symptoms of palpitations or "skipping" in some people. Their frequency can be increased during stress, with ingestion of caffeine, and with sympathomimetic drugs such as some over-the-counter cold remedies. The frequency is also increased in patients with a tendency to develop ventricular tachycardia. | |
| Primary Ventricular standstill | |
| This is diagnosed when only ventricular escape complexes are present, and they occur very slowly. This is an agonal rhythm that is not consistent with life. "Primary" means that the condition arose on its own and is the immediate source of difficulty. If you see this, you should initiate Cardiopulmonary Resuscitation immediately. | |
| Secondary Ventricular standstill | |
| This is diagnosed when only ventricular escape complexes are present, and they occur very slowly. This is an agonal rhythm that is not consistent with life. "Secondary" means that the condition is caused by another factor, such as severely low oxygen levels, which must be fixed before the rhythm abnormality can be stabilized. If you see this, you should initiate Cardiopulmonary Resuscitation immediately. | |
| Ventricular tachycardia, General | |
| This rhythm is diagnosed when three or more premature ventricular complexes occur in a row at a rate of 100-120 beats per minute or faster. The major clinical distinctions are between hemodynamically unstable versus stable ventricular tachycardia and between sustained versus unsustained ventricular tachycardia. Hemodynamically unstable ventricular tachycardia is a life threatening emergency for which the ACLS protocol should be initiated immediately. Synchronized cardioversion is usually the treatment of choice. Awake patients should be sedated heavily before cardioversion if at all possible. Sustained ventricular tachycardia is defined as having a duration of 30 seconds or more, or being hemodynamically unstable. The immediate treatment is specified by the ACLS protocol. For long-term treatment, it is important to realize that these patients have a 20% to 40% sudden death mortality, when untreated, over the 12 months following initial presentation. Empiric treatment with antiarrhythmic drugs does not reduce this mortality. Effective treatment with drugs and/or an implantable cardioverter defibrillator reduces the sudden death mortality over the next 12 months to 0-2%. Therefore, consultation with a Cardiac Electrophysiologist is recommended during the initial hospital stay to ensure adequate evaluation and treatment before discharge from the hospital. | |
| Ventricular tachycardia, polymorphic | |
| This form of ventricular tachycardia is characterized by changing QRS morphology, sometimes accompanied by slight changes in the rate. It is a particularly malignant form of ventricular tachycardia that is thought to be intermediate between ordinary monomorphic ventricular tachycardia, and ventricular fibrillation. For etiology, think of proarrhythmia, as from type IA antiarrhythmic medications, ischemia, hypokalemia, hypomagnesemia, profound bradycardia, and idiopathic prolonged QT syndrome. | |
| Wandering atrial pacemaker | |
| This is a supraventricular rhythm resulting from multiple ectopic foci in the atria. It is characterized by three or more P wave morphologies and a rate less than 100 beats per minute. It itself is benign, but reflects electrical abnormalities in one or both atria that increase the likelihood of multifocal atrial tachycardia or other atrial arrhythmias. | |
| Wolff-Parkinson-White syndrome | |
| The term used to describe the presence of one or more accessory atrioventricular pathways that conduct in the antegrade direction, with or without retrograde conduction. Patients with this syndrome are susceptible to atrioventricular reentrant tachycardia and atrial fibrillation. | |
| For information, email webmaster@cecst.com | |
| We're Listed On The San Antonio Business List | |