TACHYCARDIA Edited by Takumi Yamada Tachycardia Edited by Takumi Yamada Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Molly Kaliman Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Tachycardia, Edited by Takumi Yamada p. cm. ISBN 978-953-51-0413-1 Contents Preface IX Chapter 1 Accurate Detection of Paediatric Ventricular Tachycardia in AED 1 U. Irusta, E. Aramendi, J. Ruiz and S. Ruiz de Gauna Chapter 2 Surgical Maze Procedures for Atrial Arrhythmias in Univentricular Hearts, from Maze History to Conversion–Fontan 25 Charles Kik and Ad J.J.C. Bogers Chapter 3 Definition, Diagnosis and Treatment of Tachycardia 41 Anand Deshmukh Chapter 4 Ryanodine Receptor Channelopathies: The New Kid in the Arrhythmia Neighborhood 65 María Fernández-Velasco, Ana María Gómez, Jean-Pierre Benitah and Patricia Neco Chapter 5 The Effects of Lidocaine on Reperfusion Ventricular Fibrillation During Coronary Artery – Bypass Graft Surgery 89 Ahmet Mahli and Demet Coskun Chapter 6 Tachycardia as “Shadow Play” 97 Andrey Moskalenko Chapter 7 Metabolic Modulators to Treat Cardiac Arrhythmias Induced by Ischemia and Reperfusion 123 Moslem Najafi and Tahereh Eteraf-Oskouei Chapter 8 Mechanisms of Ca 2+ –Triggered Arrhythmias 159 Simon Sedej and Burkert Pieske VI Contents Chapter 9 Heart Rate Variability: An Index of the Brain–Heart Interaction 187 Ingrid Tonhajzerova, Igor Ondrejka, Zuzana Turianikova, Kamil Javorka, Andrea Calkovska and Michal Javorka Preface Tachycardia is defined as a faster heart rhythm than normal sinus rhythm (with a rate of greater than 100 beats per minute in humans). Tachycardias can occur from different clinical backgrounds including congenital or acquired heart diseases, electrophysiological mechanisms and origins. The diagnosis of tachycardias is made by surface electrocardiograms and electrophysiological testing. The management and treatment of tachycardias including pharmacological and non-pharmacological approaches are determined based on these factors. These concerns have been studied and the details have been increasingly recognized. In this book, internationally renowned authors have contributed chapters detailing these concerns of tachycardias from basic and clinical points of view and the chapters will lead to a further understanding and improvement in the clinical outcomes of tachycardias. Dr. Takumi Yamada Distinguished Professor of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, USA [...]... in both adults and children, and it could safely be incorporated into 1 The latest version of the guidelines was released in 2010 (Biarent et al., 2010) 3 3 Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED SAA Section 5 discusses the main conclusions of this work and analyzes what issues need to be addressed when using adult... rhythms include supraventricular tachycardia (SVT), atrial fibrillation, premature ventricular contractions, heart blocks, sinus bradycardia and idioventricular rhythms The 90 % one-sided confidence intervals (CI) are computed for the observed performance goals no.=number; NSR=normal sinus rhythm; Sens=sensitivity; Spec=specificity; VF=ventricular fibrillation; VT=ventricular tachycardia Currently, there exists... s for the shockable records The adult database was compiled following the AHA statement; hence, all records within a rhythm type come from different patients Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED 5 5 The adult records were obtained from three sources Two hundred fifty-one nonshockable and 63 shockable records were... with disagreements in diagnosis (heart rate 210 bpm) 0.70 0 −1.50 0 2 4 6 8 10 (d) Paediatric VT with disagreements in diagnosis (heart rate 255 bpm) Fig 1 Paediatric supraventricular tachycardia (SVT) and ventricular tachycardia( VT) records that required a forced consensus between cardiologists for the rhythm classification For an accurate SVT/VT diagnosis, attention should be paid to the differences... increases and contributes more significantly to overall cardiac output The duration of the QRS complex is shorter in children than in adults because of the smaller Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED 7 7 cardiac muscle mass in children (Chan et al., 2008), while the QT interval is similar in children and adults The... with an accessory atrioventricular pathway in neonates and young children In adolescents and adults, the most common cause of SVT is an atrioventricular nodal reentry tachycardia (Chan et al., 2008) Although SVT is more common in children, tachycardias of ventricular origin do occur in paediatric patients (Chan et al., 2008) As the normal QRS complex is of shorter duration in children than in adults,... were excluded from the analysis because VF is an irregular ventricular rhythm characterized by the absence of QRS complexes and a well-defined heart rate 9 9 Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED 0.024 0.015 0.016 0.010 0.008 0.005 0 100 150 200 250 HR (bpm) 300 0 350 (a) HR distribution of the adult SVT and VT... frequency is the cardiac frequency: f c ( Hz) = 1 RR (s) (3) The harmonics are located at the integer multiples of the cardiac frequency: fk = k · fc (4) 11 11 Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED Although SVT and VT distribute their power around the harmonic frequencies, f k , the relative power content of each... frequencies, as expected from the HR analysis described in section 2.3 The relative difference between the dominant and the cardiac frequency is smaller 13 13 Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED in the paediatric population because paediatric SVT with heart rates above 240 bpm are frequent in our database, and... ) Fig 6 Computation of the power content of the harmonics, for the examples shown in Fig.4 6 Harmonics that contribute at least 5 % of the total power 15 15 Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED paediatric SVT Pk k k k k k =1 =2 =3 =4 =5 k≥6 28 19 16 12 8 VT (6 − 56) 83 (71 − 92) (8 − 31) 10 (3 − 18) (8 − 23) . TACHYCARDIA Edited by Takumi Yamada Tachycardia Edited by Takumi Yamada Published by InTech Janeza. orders@intechopen.com Tachycardia, Edited by Takumi Yamada p. cm. ISBN 978-953-51-0413-1 Contents Preface IX Chapter 1 Accurate Detection of Paediatric Ventricular Tachycardia. Chapter 5 The Effects of Lidocaine on Reperfusion Ventricular Fibrillation During Coronary Artery – Bypass Graft Surgery 89 Ahmet Mahli and Demet Coskun Chapter 6 Tachycardia as “Shadow Play”