Puzzle 2004 2 73, A fainting lady with some extrasystoles - Answer: Difference between revisions

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there are four important differences from what is
there are four important differences from what is
usually referred to as TdP.
usually referred to as TdP.
<cite>Leenhardt</cite><cite>Haissaguerre</cite>) There is no long QT interval and the arrhythmia
is not preceded by a pause; TdP is a polymorphic
#There is no long QT interval and  
#the arrhythmia is not preceded by a pause; TdP is a polymorphic
ventricular arrhythmia almost exclusively
ventricular arrhythmia almost exclusively
encountered in the setting of prolongation of
encountered in the setting of prolongation of
the QT interval and preceded by a pause.
the QT interval and preceded by a pause.
3) The rate is very high (up to 300 beats/min);
#The rate is very high (up to 300 beats/min);
typically, TdP has a rate of 220 beats/min.
typically, TdP has a rate of 220 beats/min.
4) The coupling interval of the initiating beat is
#The coupling interval of the initiating beat is
extremely short; TdP in the setting of a
extremely short; TdP in the setting of a
prolonged QT interval is always initiated by a
prolonged QT interval is always initiated by a
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intervals are otherwise only ever seen in acute
intervals are otherwise only ever seen in acute
myocardial ischaemia.
myocardial ischaemia.
Recently, it has been suggested that the arrhythmia
Recently, it has been suggested that the arrhythmia
may be cured by radiofrequency catheter ablation.2
may be cured by radiofrequency catheter ablation.2
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arrhythmia recurrence). Long-term follow-up has to
arrhythmia recurrence). Long-term follow-up has to
be awaited before the patient can be discharged without
be awaited before the patient can be discharged without
an ICD.
an ICD.<cite>Leenhardt</cite><cite>Haissaguerre</cite>
==References==
==References==
<biblio>
<biblio>