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Ventricular flutter

MedGen UID:
56266
Concept ID:
C0152173
Disease or Syndrome; Finding
Synonyms: Ventricular Flutter; Ventricular Flutters
SNOMED CT: Ventricular flutter (111288001)
 
HPO: HP:0011841

Definition

A potentially lethal cardiac arrhythmia characterized by an extremely rapid, hemodynamically unstable ventricular tachycardia (150-300 beats/min) with a large oscillating sine-wave appearance. [from HPO]

Conditions with this feature

Long QT syndrome 3
MedGen UID:
349087
Concept ID:
C1859062
Disease or Syndrome
Long QT syndrome (LQTS) is a cardiac electrophysiologic disorder, characterized by QT prolongation and T-wave abnormalities on the EKG that are associated with tachyarrhythmias, typically the ventricular tachycardia torsade de pointes (TdP). TdP is usually self-terminating, thus causing a syncopal event, the most common symptom in individuals with LQTS. Such cardiac events typically occur during exercise and emotional stress, less frequently during sleep, and usually without warning. In some instances, TdP degenerates to ventricular fibrillation and causes aborted cardiac arrest (if the individual is defibrillated) or sudden death. Approximately 50% of untreated individuals with a pathogenic variant in one of the genes associated with LQTS have symptoms, usually one to a few syncopal events. While cardiac events may occur from infancy through middle age, they are most common from the preteen years through the 20s. Some types of LQTS are associated with a phenotype extending beyond cardiac arrhythmia. In addition to the prolonged QT interval, associations include muscle weakness and facial dysmorphism in Andersen-Tawil syndrome (LQTS type 7); hand/foot, facial, and neurodevelopmental features in Timothy syndrome (LQTS type 8); and profound sensorineural hearing loss in Jervell and Lange-Nielson syndrome.

Professional guidelines

PubMed

Khan MZ, Sulaiman S, Agrawal P, Osman M, Khan MU, Khan SU, Balla S, Munir MB
Am Heart J 2020 Jul;225:129-137. Epub 2020 May 3 doi: 10.1016/j.ahj.2020.04.023. PMID: 32485327Free PMC Article
Link MS, Bockstall K, Weinstock J, Alsheikh-Ali AA, Semsarian C, Estes NAM 3rd, Spirito P, Haas TS, Rowin EJ, Maron MS, Maron BJ
J Cardiovasc Electrophysiol 2017 May;28(5):531-537. Epub 2017 Mar 31 doi: 10.1111/jce.13194. PMID: 28240435
Brembilla-Perrot B, Huttin O, Azman B, Sellal JM, Schwartz J, Olivier A, Blangy H, Sadoul N
Isr Med Assoc J 2014 Jun;16(6):352-7. PMID: 25058996

Recent clinical studies

Etiology

Sun L, Han B, Wang Y, Zhu W, Jiang J, Zou A, Chi B, Mao L, Ji Y, Wang Q, Tang L
Clin Interv Aging 2023;18:283-292. Epub 2023 Feb 21 doi: 10.2147/CIA.S395121. PMID: 36851975Free PMC Article
Tang Y, Tertulien T, Bhonsale A, Kancharla K, Estes NAM 3rd, Jain SK, Saba S
Am J Cardiol 2021 Dec 1;160:1-7. Epub 2021 Sep 25 doi: 10.1016/j.amjcard.2021.08.034. PMID: 34583813
Scott PA, Barry J, Roberts PR, Morgan JM
Eur J Heart Fail 2009 Oct;11(10):958-66. doi: 10.1093/eurjhf/hfp123. PMID: 19789399
Masrani K, Cowley C, Bekheit S, el-Sherif N
Chest 1994 Nov;106(5):1601-3. doi: 10.1378/chest.106.5.1601. PMID: 7956430
McComb JM, Logan KR, Khan MM, Geddes JS, Adgey AA
Eur J Cardiol 1980;11(5):381-5. PMID: 7398728

Diagnosis

Lescot B, Pathak A, Boveda S, Honton B
Eur Heart J 2018 Jun 1;39(21):2015. doi: 10.1093/eurheartj/ehy095. PMID: 29529175
Jacobson JT, Iwai S, Aronow W
Postgrad Med 2015 Jun;127(5):549-59. Epub 2015 May 13 doi: 10.1080/00325481.2015.1045816. PMID: 25971427
DiMauro J, Carter S, Folk JB, Kashdan TB
J Anxiety Disord 2014 Dec;28(8):774-86. Epub 2014 Sep 16 doi: 10.1016/j.janxdis.2014.09.002. PMID: 25261838
Scott PA, Barry J, Roberts PR, Morgan JM
Eur J Heart Fail 2009 Oct;11(10):958-66. doi: 10.1093/eurjhf/hfp123. PMID: 19789399
McComb JM, Logan KR, Khan MM, Geddes JS, Adgey AA
Eur J Cardiol 1980;11(5):381-5. PMID: 7398728

Therapy

Lescot B, Pathak A, Boveda S, Honton B
Eur Heart J 2018 Jun 1;39(21):2015. doi: 10.1093/eurheartj/ehy095. PMID: 29529175
Antink CH, Leonhardt S, Walter M
Physiol Meas 2016 Aug;37(8):1233-52. Epub 2016 Jul 25 doi: 10.1088/0967-3334/37/8/1233. PMID: 27454256
Jacobson JT, Iwai S, Aronow W
Postgrad Med 2015 Jun;127(5):549-59. Epub 2015 May 13 doi: 10.1080/00325481.2015.1045816. PMID: 25971427
McComb JM, Logan KR, Khan MM, Geddes JS, Adgey AA
Eur J Cardiol 1980;11(5):381-5. PMID: 7398728
Sliwiński M, Rydlewska-Sadowska W, Hoffmann M, Soczek-Michalska J, Holdrowicz M, Falencik M, Kamiński P, Biederman A
Anaesth Resusc Intensive Ther 1975 Oct-Dec;3(4):315-24. PMID: 1229913

Prognosis

Sun L, Han B, Wang Y, Zhu W, Jiang J, Zou A, Chi B, Mao L, Ji Y, Wang Q, Tang L
Clin Interv Aging 2023;18:283-292. Epub 2023 Feb 21 doi: 10.2147/CIA.S395121. PMID: 36851975Free PMC Article
Gu Y, Xue P, Chen HL, Zou G, Ni Y, Li L, Lu L, Chen H, Zheng A
BMC Pediatr 2022 Feb 16;22(1):95. doi: 10.1186/s12887-022-03158-9. PMID: 35172767Free PMC Article
Liu Y, Narayanan K, Zhang Z, Li G, Liu T
Int J Cardiol 2016 Jul 1;214:406-7. Epub 2016 Apr 6 doi: 10.1016/j.ijcard.2016.03.216. PMID: 27085657
Scott PA, Barry J, Roberts PR, Morgan JM
Eur J Heart Fail 2009 Oct;11(10):958-66. doi: 10.1093/eurjhf/hfp123. PMID: 19789399
Lanzino G, Kongable GL, Kassell NF
J Neurosurg Anesthesiol 1994 Jul;6(3):156-62. doi: 10.1097/00008506-199407000-00002. PMID: 8081095

Clinical prediction guides

Wu CS, Tsai YT, Hsiung CA, Tsai HJ
J Clin Psychopharmacol 2017 Feb;37(1):32-39. doi: 10.1097/JCP.0000000000000631. PMID: 27941418
Antink CH, Leonhardt S, Walter M
Physiol Meas 2016 Aug;37(8):1233-52. Epub 2016 Jul 25 doi: 10.1088/0967-3334/37/8/1233. PMID: 27454256
Jánosi A, Lászik A, Bárczi G, Keller E
J Electrocardiol 2004 Jul;37(3):227-30. doi: 10.1016/j.jelectrocard.2004.02.001. PMID: 15286936
Lanzino G, Kongable GL, Kassell NF
J Neurosurg Anesthesiol 1994 Jul;6(3):156-62. doi: 10.1097/00008506-199407000-00002. PMID: 8081095
Sliwiński M, Rydlewska-Sadowska W, Hoffmann M, Soczek-Michalska J, Holdrowicz M, Falencik M, Kamiński P, Biederman A
Anaesth Resusc Intensive Ther 1975 Oct-Dec;3(4):315-24. PMID: 1229913

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