How is it possible for both short and long QT syndrome to trigger VT ?
The stretch and strain experienced by the action potential’s left shoulder region is almost similar* in both long and short QT syndromes that trigger a VT.(* Hope this explanation makes some electrical sense !)
*Click over the image for high resolution
What is short QT interval ?
It is a range . Any thing less than 380 ms can be considered short.Generally It becomes important only at < 320ms.
Relationship between QTc and risk of VT . (Source: Dr.S.Venkatesan MD)
Source: Dr.S.Venkatesan MD - September 24, 2013 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Electrophysiology -Pacemaker Infrequently asked questions in cardiology (iFAQs) Long and Short QT syndromes how short qt syndrome induce vt Mechansim of VT in long and short QT syndrome Source Type: blogs
Delta wave on ECG
is seen in:
a) WPW syndrome
b) Lown Ganong Levine syndrome
c) Brugada syndrome
d) Long QT syndrome
Correct answer: a) WPW syndrome
Delta wave is the initial slurred wave at the beginning of the QRS seen in WPW syndrome due to pre-excitation of the ventricles. The PR interval is short in WPW syndrome and there is likely hood of recurrent atrioventricular re-entrant tachycardias. (Source: Cardiophile MD)
Source: Cardiophile MD - September 1, 2013 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Cigna to Require Genetic Counseling Prior to BRCA Testing
I have blogged previously about the use of companion diagnostics whereby a lab test is used to determine whether a patient is a suitable candidate for an expensive drug, usually an expensive chemotherapeutic agent (see: Companion Diagnostics Gains Wider Acceptance in FDA Despite Challenges; Some Interesting Insights into Companion Diagnostics). The underlying (reasonable) rationale is that a cancer drug should not be administered without a priori proof that it will be effective to treat the lesion. A similar concept is now being used in the lab world to determine whether the expensive BRCA test should be ordered for ...
Source: Lab Soft News - August 21, 2013 Category: Pathologists Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Healthcare Business Lab Processes and Procedures Laboratory Industry Trends Medical Consumerism Source Type: blogs
EuroPace 2013 wrap up — A major study on AF ablation and the limits of gene testing in Cardiology
I’m writing this from home. The travel back was uneventful and I actually got a little caught up in the office Friday. It was a fun trip but getting back to doctoring felt good.
Atrial Fibrillation ablation:
The Gap-AF trial was released as the lead late-breaker at EuroPace 2013. There were many remarkable (‘they-really-did-that’ sort of) features of this study. Born from a (Italian/German) debate on whether complete isolation of the pulmonary veins is needed, Gap-AF investigators swallowed hard and randomized German patients to two groups. The complete isolation group underwent AF ablation done in the currently acc...
Source: Dr John M - June 29, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
Athletes With Defibrillators Don’t Need To Quit Sports
Although the American College of Cardiology and the European Society of Cardiology now advise people with ICDs not to participate in vigorous sports, a new study offers strong support for people with ICDs who want to take part in sports. Although a large number of people with ICDs are elderly heart failure patients who are unlikely to want to participate in sports, ICDs are also implanted in young and otherwise healthy people with genetic diseases that leave them at high risk for lethal arrhythmias. Now findings from the ICD Sports Safety Registry, published in Circulation, provide vital new More… (Source: CardioBrief)
Source: CardioBrief - May 21, 2013 Category: Cardiology Authors: Larry Husten Tags: Heart Rhythms Policy & Ethics Prevention, Epidemiology & Outcomes Arrhythmogenic right ventricular dysplasia athletes Cardiac dysrhythmia Heart disease Hypertrophic cardiomyopathy ICDs Long QT syndrome sports Source Type: blogs
The LITFL Review 103
Welcome to the 103rd edition!
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
The Most Fair Dinkum Ripper Beaut of the Week
The Sono Cave
For those of you that love ultrasound or just learning – The Sono Cave is the ultimate EM blog fo...
Source: Life in the Fast Lane - May 7, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs
The LITFL Review 103
Welcome to the 103rd edition!
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
The Most Fair Dinkum Ripper Beaut of the Week
The Sono Cave
For those of you that love ultrasound or just learning – The Sono Cave is the ultimate EM blog fo...
Source: Life in the Fast Lane - May 7, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs
Azithromycin and long QT syndrome: Facts from a cardiologist
Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”
If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-pak). Quoting directly from the FDA warning:
[Azithromycin] can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.
Should we say this more clearly: that simple antibiotic you are taking for a minor inf...
Source: Kevin, M.D. - Medical Weblog - May 4, 2013 Category: Family Physicians Tags: Meds Cancer Medications Source Type: blogs
The Long QT Syndrome
The Long QT syndrome is an inherited disorder of the heart's electrical system that can cause sudden death, even in young, healthy individuals. Read about long QT syndrome, its causes and treatment, here. (Source: About.com Heart Disease)
Source: About.com Heart Disease - May 3, 2013 Category: Cardiology Source Type: blogs
How safe is a Z-pak?
Text message:
“John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”
If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-Pak). Quoting directly from the FDA warning:
[Azithromycin] can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.
Should we say this more clearly: that simple antibiotic you are taking for a minor i...
Source: Dr John M - March 27, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
Calmodulin gene mutation producing life threatening QT prolongation
Lia Crotti and colleagues along with Peter Schwartz [Calmodulin Mutations Associated With Recurrent Cardiac Arrest in Infants. Circulation. 2013; 127: 1009-1017.] , the pioneer in studies on congenital long QT syndrome, have described three denovo mutations in CALM1 and CALM2 mutations associated with QT prolongation and recurrent cardiac arrests in infants. The infants had life threatening ventricular arrhythmias, epilepsy and variable delay in neurodevelopment. There was a several fold decrease in the calcium binding efficacy of the mutant calmodulins. This will affect the calcium signaling in the membrane ion channels o...
Source: Cardiophile MD - March 24, 2013 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin Tags: General Source Type: blogs
