Where to begin: from the electrocardiogram or the symptoms?
Yükleniyor...
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Elsevier Ireland Ltd
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Dear Editor,
We have read the article published by Brembilla-Perrot et al. [1] with great interest. In their study, they have aimed to search the symptom
characteristics in patients suspected of supraventricular tachycardiam (SVT) in which the SVT cannot be documented noninvasively. Briefly, they have analyzed 2650 patients, age ranging from 6 to 97, and ran- domized them according to their electrophysiological study (EPS) re- sults whether SVT was inducible during EPS or not. In their study, they have found that among patients whom suspected of SVT but not docu-mented noninvasively, chest pain and/or syncope and age b 40 years is associated with negative EPS results. They have concluded that, in this patient group in the absence of documented SVT, EPS is not indicated [1]. Although, there are several take home messages that might be gath-ered from these results, we believe that symptomatology of SVT pa-tients needs to be discussed in the light of this study.
The main and most common types of symptoms in SVT are palpita-tion, pulsation in the neck, chest discomfort, dyspnea, hyperventilation,
lightheadedness and anxiety. Chest pain, nausea and syncope are less frequent symptoms in this patient group. Sometimes, these patients can survive asymptomatic [2]. In non-documented tachycardia attacks, symptoms of the patients can be misleading because of the short dura- tion and atypical presentation of the episodes. Due to the elevation of troponin levels and chest pain or chest discomfort, these patients are
diagnosed as acute coronary syndrome occasionally and sometimes coronary angiography is performed [3]. Although it is not the aim of this study, it would be nice to know whether coronary angiography was performed in these patients. And their biomarker levels might be suggestive of myocardial ischemia, especially in the older patient group. Moreover possible cross-talk through the cardiac plexus, cervi-cal, thoracic plexus, and cranial nerves has been supposed to be the mechanism of extraordinary symptoms of SVT such as burping, tinnitus, and cough attacks.
Açıklama
Anahtar Kelimeler
Supraventricular Tachycardia, Electrophysiology, Radio-Frequency Ablation, Cross-Talk, Syncope, Arrhythmia
Kaynak
International Journal Of Cardiology
WoS Q Değeri
Q1
Scopus Q Değeri
Q1
Cilt
216
