Abstract
Wide complex tachycardia (WCT) presents on an ECG with a rate higher than 100 beats per minute and the QRS complex width of over 120ms. The usual classification of wide complex tachycardia includes ventricular tachycardia and supraventricular tachycardia with aberration, but they can also be the result of the effects of metabolic and/or toxic agents. A xenobiotic is a chemical substance that is present in an organism but is not produced within the organism or expected to be there. That also includes substances that are present within the organism in much higher concentrations than usual. For people, various drugs are also considered to be xenobiotics. One type of irregularity caused by xenobiotic poisoning is based on cardiomyocyte sodium channel blockade, responsible for the phase 0 rapid depolarization of action potentials. Certain groups of drugs can cause the WCT as a result of a repolarization disorder and prolonging of the QTc interval. Treating WCT as a result of xenobiotic poisoning depends primarily on the type of tachycardia and the disorder that caused it. Early recognition and adequate treatment are of the utmost importance for a favourable outcome.
Highlights
Pored standarnih mera održavanja i stabilizacije vitalnih parametara i nespecifične i suportativne terapije, u lečenju Wide complex tachycardia (WCT) uzrokovanih intoksikacijama koriste se i infuzije bikarbonata i u novije vreme intravenske lipidne emulzije (ILE)
Relative role of alkalosis and sodium ions in reversal of class I antiarrhythmic drug-induced sodium channel blockade by sodium bicarbonate
Summary
Tahikardije širokih kompleksa predstavljaju elektrokardiografski zapis srčanog ritma frekvence preko 100/minutu, a širine QRS kompleksa preko 120ms. Klasična podela tahikardija širokih kompleksa podrazumeva ventrikularne tahikardije i supraventrikularne aberantno sprovedene, ali one mogu nastati i kao posledica uticaja metaboličkih i/ili toksičnih agenasa. Pojedine grupe lekova mogu da izazivaju WCT kao posledicu poremećene repolarizacije i produžavanja QTc intervala. „wide complex tachycardia“) predstavljaju elektrokardiografski zapis srčanog ritma frekvence preko 100/minutu, a širine QRS kompleksa preko 120ms [2]. Pojedine grupe lekova mogu da izazivaju WCT kao posledicu poremećene repolarizacije i produžavanja QTc intervala [14] (antiaritmici IA klase: kinidin, prokainamid i III klase: amjodaron i sotalol [15]; fenotiazini, TCA, litijum, haloperidol, nesedativni antihistaminici terfenadin/astimazol, neki antimikrobni lekovi: claritromicin/eritromicin, hlorokvin, ketokonazol/flukonazol). Rano prepoznavanje i rano započinjanje adekvatne terapije su od neprocenjivog značaja za povoljan ishod pacijenta [24]
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