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Keyword
AfterdepolarizationOutflow tract tachycardia
Prolonged QT
Triggered activity
Ventricular tachycardia
Journal title
The American journal of emergency medicineDate Published
2020-11-07Publication Volume
44Publication Begin page
480.e5Publication End page
480.e7
Metadata
Show full item recordAbstract
One of the less frequent underlying mechanisms of ventricular tachycardia (VT) is triggered activity. Triggered activity refers to an extrasystole due to a premature depolarization that occurs when the amplitude of an early or delayed afterdepolarization brings the cardiac membrane to its threshold potential. Hydrochlorothiazide and hydroxyzine can prolong repolarization and QT interval and are associated with early afterdepolarizations. Cyclic AMP-mediated, delayed afterdepolarizations can occur as a result of catecholaminergic surge. Delayed afterdepolarization is classically associated with outflow tract (OT) tachycardia, a type of VT that is uniquely defined by its termination with adenosine. We present a case of triggered OT tachycardia for which intravenous amiodarone through its antiadrenergic effect may have been effective. Infusions of magnesium and a cardioselective, β-receptor antagonist that does not prolong repolarization may have been more appropriate given the concurrent, acquired prolonged QT syndrome. After initial stabilization, considering the underlying VT mechanism may prompt the clinician to select the most appropriate, further treatment.Citation
Riggins J Jr, Douglas T, deSouza IS. Ventricular tachycardia as a consequence of triggered activity. Am J Emerg Med. 2021 Jun;44:480.e5-480.e7. doi: 10.1016/j.ajem.2020.11.008. Epub 2020 Nov 7. PMID: 33221113.DOI
10.1016/j.ajem.2020.11.008ae974a485f413a2113503eed53cd6c53
10.1016/j.ajem.2020.11.008
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Except where otherwise noted, this item's license is described as Copyright © 2020 Elsevier Inc. All rights reserved.
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