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Paroxysmal Atrial Tachycardia with Atrioventricular Block — A Five Year Experience in Singapore
Author(s) -
Lim C. H.,
Toh C. C. S.,
Low L. P.,
Chia B. L.
Publication year - 1974
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1974.tb03178.x
Subject(s) - medicine , digitalis , cardiology , digoxin , atrioventricular block , heart disease , tachycardia , atrial tachycardia , ventricular tachycardia , incidence (geometry) , heart failure , anesthesia , atrial fibrillation , catheter ablation , physics , optics
Summary: A prospective analysis of 17 cases of paroxysmal atrial tachycardia with block was carried out over a five‐year period from June 1968 to June 1973 in a medical unit in Singapore. Seventy‐six percent had prior digitalis therapy, and all except one were more than 50 years old. Of the 17 cases, eight patients (46%) with chronic obstructive lung disease and cor pulmonale developed this arrhythmia after digitalis administration, five had severe chronic ischaemic heart disease, two chronic renal failure, one hypertensive heart disease and one had no apparent organic disease. Digitalis was stopped in all those patients who had received digitalis as it was assumed to be one of the contributing factors which precipitated the arrhythmia. Intravenous potassium chloride was used successfully in nine out of 10 patients. The use of potassium and its dangers are discussed. Intravenous diphenylhydantoin and propanolol were used in three and two patients respectively. Sixteen patients had their arrhythmia terminated but the mortality rate remained high (59%) reflecting the severity of the underlying disease. The incidence of this arrhythmia (1: 2,000 ECGs per annum) in our department was low compared to other series.