Pulseless ventricular tachycardia other diagnostic studies: Difference between revisions

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{{Pulseless ventricular tachycardia}}
{{Pulseless ventricular tachycardia}}
{{CMG}}; {{AE}}{{Aisha}}
{{CMG}}; {{AE}}{{Aisha}}
==Overview==
2017 guidelines from the AHA/ACC/HRS state that [[MRI]], [[cardiac computed tomography]] (CT), or [[radionuclide angiography]] can be useful in detecting and characterizing underlying [[heart disease]] when [[echocardiography]] fails to provide an accurate evaluation of LV or RV function and/or assessment of structural changes. [[Electrophysiologic (EP) testing]] can be useful when an uncertain diagnosis of [[sustained monomorphic ventricular tachycardia]]. An [[electrophysiological study]] is especially useful for assessing the risk of [[ventricular tachycardia]] in patients with [[ischemic cardiomyopathy]], [[non-ischemic cardiomyopathy]], or adult [[congenital heart disease]] who have [[syncope]] or other [[ventricular arrhythmia]] symptoms and who do not meet indications for a primary prevention [[implantable cardioverter-defibrillator]].
==Other Diagnostic Studies==


*2017 guidelines from the AHA/ACC/HRS state that [[MRI]], [[cardiac computed tomography]] (CT), or [[radionuclide angiography]] can be useful in detecting and characterizing underlying [[heart disease]] when [[echocardiography]] fails to provide an accurate evaluation of LV or RV function and/or assessment of structural changes. 
*[[Coronary angiography]] is used in the diagnostic evaluation of ventricular tachycardia in survivors of [[sudden cardiac death]] and life-threatening ventricular tachycardia. 
*[[Coronary angiography]] is used to rule out the presence of [[coronary artery disease]] in these patients.<ref name="pmid16935995">{{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=Circulation | year= 2006 | volume= 114 | issue= 10 | pages= e385-484 | pmid=16935995 | doi=10.1161/CIRCULATIONAHA.106.178233 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16935995}}</ref>
*Electrophysiologic (EP) testing can be useful when an uncertain diagnosis of sustained monomorphic ventricular tachycardia.
*An electrophysiological study is especially useful for assessing the risk of ventricular tachycardia in patients with certain conditions who have syncope or other ventricular arrhythmia symptoms and who do not meet indications for a primary prevention implantable cardioverter-defibrillator. These conditions include;
**Ischemic cardiomyopathy,
**Non-ischemic cardiomyopathy,
**Adult congenital heart disease.
==2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death<ref name="urlwww.onlinejacc.org">{{cite web |url=https://www.onlinejacc.org/content/72/14/e91.full.pdf |title=www.onlinejacc.org |format= |work= |accessdate=}}</ref>==
=== Left Ventricular Function and Imaging (DO NOT EDIT)<ref name="urlwww.onlinejacc.org">{{cite web |url=https://www.onlinejacc.org/content/72/14/e91.full.pdf |title=www.onlinejacc.org |format= |work= |accessdate=}}</ref> ===
{| class="wikitable"
|-
| Colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| Bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''In patients who have recovered from unexplained sudden cardiac arrythmis, [['''CT''']] or invasive [['''coronary angiography''']] is useful to confirm the presence or absence of [[ischemic heart disease]] and guide decisions for myocardial [[revascularization]].'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>''
|}
=== Recommendations for Electrophysiological study (DO NOT EDIT)<ref name="urlwww.onlinejacc.org">{{cite web |url=https://www.onlinejacc.org/content/72/14/e91.full.pdf |title=www.onlinejacc.org |format= |work= |accessdate=}}</ref> ===
{| class="wikitable"
|-
| Colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''In patients with [[ischemic cardiomyopathy]], [[non-ischemic cardiomyopathy]], or adult[[ congenital heart disease]] who have [[syncope]] or other [[ventricular arrhythmia]] symptoms and who do not meet indications for a primary prevention [[implantable cardioverter-defibrillator]], an [[electrophysiological study]] can be useful for assessing the risk of [[sustained ventricular tachycardia]]'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>''
|}
{| class="wikitable"
|-
| Colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]
|-
| Bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' In patients who meet criteria for  [[implantable cardioverter-defibrillator]] implantation, an [[electrophysiological study]] for the sole reason of inducing [[ventricular arrhythmia]] is not indicated for risk stratification'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>''
|-
| Bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.'''A [[Electrophysiologic Testing or Electrophysiologic Studies for diagnosis of atrial fibrillation|electrophysiological study]] is not recommended for risk stratification for [[ventricular arrhythmia]] in the setting of [[long QT syndrome]], [[catecholaminergic polymorphic ventricular tachycardia]], [[short QT syndrome]], or [[Early repolarization syndrome|early repolarization syndromes]] ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>''
|}
==References==
{{Reflist|2}}


[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Cardiovascular diseases]]
[[Category:Cardiovascular diseases]]
[[Category:Inflammations]]
[[Category:Arrythmia]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Disease]]
[[Category:Disease]]

Latest revision as of 10:12, 9 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

2017 guidelines from the AHA/ACC/HRS state that MRI, cardiac computed tomography (CT), or radionuclide angiography can be useful in detecting and characterizing underlying heart disease when echocardiography fails to provide an accurate evaluation of LV or RV function and/or assessment of structural changes. Electrophysiologic (EP) testing can be useful when an uncertain diagnosis of sustained monomorphic ventricular tachycardia. An electrophysiological study is especially useful for assessing the risk of ventricular tachycardia in patients with ischemic cardiomyopathy, non-ischemic cardiomyopathy, or adult congenital heart disease who have syncope or other ventricular arrhythmia symptoms and who do not meet indications for a primary prevention implantable cardioverter-defibrillator.

Other Diagnostic Studies

  • 2017 guidelines from the AHA/ACC/HRS state that MRI, cardiac computed tomography (CT), or radionuclide angiography can be useful in detecting and characterizing underlying heart disease when echocardiography fails to provide an accurate evaluation of LV or RV function and/or assessment of structural changes.
  • Coronary angiography is used in the diagnostic evaluation of ventricular tachycardia in survivors of sudden cardiac death and life-threatening ventricular tachycardia.
  • Coronary angiography is used to rule out the presence of coronary artery disease in these patients.[1]
  • Electrophysiologic (EP) testing can be useful when an uncertain diagnosis of sustained monomorphic ventricular tachycardia.
  • An electrophysiological study is especially useful for assessing the risk of ventricular tachycardia in patients with certain conditions who have syncope or other ventricular arrhythmia symptoms and who do not meet indications for a primary prevention implantable cardioverter-defibrillator. These conditions include;
    • Ischemic cardiomyopathy,
    • Non-ischemic cardiomyopathy,
    • Adult congenital heart disease.

2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death[2]

Left Ventricular Function and Imaging (DO NOT EDIT)[2]

Class I
"1.In patients who have recovered from unexplained sudden cardiac arrythmis, '''CT''' or invasive '''coronary angiography''' is useful to confirm the presence or absence of ischemic heart disease and guide decisions for myocardial revascularization. (Level of Evidence B)"

Recommendations for Electrophysiological study (DO NOT EDIT)[2]

Class IIa
"1.In patients with ischemic cardiomyopathy, non-ischemic cardiomyopathy, or adultcongenital heart disease who have syncope or other ventricular arrhythmia symptoms and who do not meet indications for a primary prevention implantable cardioverter-defibrillator, an electrophysiological study can be useful for assessing the risk of sustained ventricular tachycardia (Level of Evidence B)"
Class III
"1. In patients who meet criteria for implantable cardioverter-defibrillator implantation, an electrophysiological study for the sole reason of inducing ventricular arrhythmia is not indicated for risk stratification (Level of Evidence B)"
"2.A electrophysiological study is not recommended for risk stratification for ventricular arrhythmia in the setting of long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, short QT syndrome, or early repolarization syndromes (Level of Evidence B)"

References

  1. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M; et al. (2006). "ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation. 114 (10): e385–484. doi:10.1161/CIRCULATIONAHA.106.178233. PMID 16935995.
  2. 2.0 2.1 2.2 "www.onlinejacc.org" (PDF).


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