We present the case of an unconscious 81 year-old woman admitted to the Emergency Department with fever and significant tachycardia up to 210 bpm. The patient was referred by the general physician to the neurology department with suspected stroke. Atrial fibrillation (AF) with rapid ventricular rate was found. The causes of significant tachycardia, in this case, were complex and associated with dehydration, fever, infection and thyroid storm. It could be assumed that the deterioration of the patient's general condition and a decreased fluid intake had caused hypertonic dehydration which could have led to further acceleration of the heart rhythm and loss of consciousness. Thyroid function tests are indicated in all cases of paroxysmal AF. In the presented case, the suspicion of thyroid storm was based on the results of analysis and it was confirmed later by the results of free traction of thyroid hormones' levels. The very fast ventricular rate was related to metabolic disorders and the influence of thyroid hormones on the electrophysiological properties of the atrioventricular junction. In order to stabilise the condition of the patient, passive oxygen therapy, an antipyretic drug, the correction of water and electrolyte disturbances, and digoxin were administered. This treatment improved the patient's general condition and state of consciousness, resulting in slowing heart rate and respiratory rate.
Background: Atrioventricular nodal reentry tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia. The relatively ineffective antiarrhythmic drugs and the predominant young age makes the catheter ablation the therapy of choice in many patients. This results in predominance of this arrhythmia in electrophysiological labs. The aim of the study was to analyze the gender-related differences among patients undergoing the radiofrequency catheter ablation of slow pathway entrance to the atrioventricular node. Material and methods: The study group comprised of 147 consecutive patients with diagnosed atrioventricular nodal reentry tachycardia, who underwent the radiofrequency catheter ablation (RFCA) of slow pathway. Patients have been divided into 2 groups, based on sex. Results: The overall 97.3% of effectiveness of RFCA was observed. Women were significantly younger than men (53.7 +/-17.2 vs. 57.7 +/-9.8 years) with lower radiation dose (2383.5 +/-1993.2 vs. 2891.6 +/-2377.1 cGyxcm2). Conclusions: Younger age of women in comparison to men during RFCA of AVNRT reflects earlier onset of symptoms in women. Gender does not affect the time of fluoroscopy, but the higher rate of inducible tachycardia after RFCA in women may suggest the existence of anatomical difficulties or the operator's apprehensions. Sex-related difference in radiation dose that we have observed may result from the greater volume of the men's chest.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.