Article

Potential danger of ocular compression in paroxysmal supraventricular tachycardia in patients with latent preexcitation.

Cardiology Department, University Hospital Hedi Chaker, Sfax, Tunisia.
Journal of electrocardiology (impact factor: 1.08). 09/2009; 42(6):645-7. DOI:10.1016/j.jelectrocard.2009.07.001 pp.645-7
Source: PubMed

ABSTRACT The vagal maneuver is the first line of therapeutic available for patients with paroxysmal supraventricular tachycardia. It increases vagal tone and includes the traditional ocular compression, carotid sinus massage, and Valsalva maneuver. A 40-year-old man was admitted because of 180 beats/min regular narrow QRS-complex tachycardia. The physician in the emergency department had performed an ocular compression, and at its ending, the tachycardia degenerated into unstable hemodynamically high ventricular rate atrial fibrillation. It was reverted to sinus rhythm by electrical shock. The electrophysiologic study documented a latent posterolateral bypass tract, with an anterograde refractory period of 210 milliseconds, which was successfully ablated.

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Keywords

180 beats/min regular narrow QRS-complex tachycardia
 
40-year-old man
 
ablated
 
anterograde refractory period
 
carotid sinus massage
 
electrical shock
 
first line
 
latent posterolateral bypass tract
 
physician
 
vagal maneuver
 
Valsalva maneuver