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Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
Aortic Regurgitation III: Medical Management01:25

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...

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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Cardiorespiratory interactions in patients with atrial flutter.

Michela Masè1, Marcello Disertori, Flavia Ravelli

  • 1Dept. of Physics, Univ. of Trento, Via Sommarive 14, 38050 Povo-Trento, Italy.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|November 22, 2008
PubMed
Summary

Respiratory sinus arrhythmia (RSA) during atrial flutter (AFL) shows unique patterns distinct from normal RSA. These cardiorespiratory interactions involve coupled atrial and ventricular rhythms, influenced by atrioventricular conduction, and may result from respiration

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Area of Science:

  • Cardiology
  • Physiology
  • Medical Technology

Background:

  • Respiratory sinus arrhythmia (RSA) describes breathing-synchronized heart rate variations, typically studied during normal sinus rhythm.
  • Little is known about cardiorespiratory interactions during reentrant arrhythmias like atrial flutter (AFL).

Purpose of the Study:

  • To investigate cardiorespiratory interactions at atrial and ventricular levels during atrial flutter (AFL).
  • To characterize the nature of these interactions and compare them to normal RSA.

Main Methods:

  • Cross-spectral analysis and computer modeling were used in 20 patients with typical AFL and AV block.
  • Respiration and atrial/ventricular interval series coherence and phase were estimated.
  • Ventricular patterns were analyzed based on fixed vs. variable AV conduction.

Main Results:

  • Atrial intervals showed strong, in-phase coupling with respiration, independent of frequency.
  • Ventricular patterns varied with AV conduction type: strongly coupled in fixed conduction, less coupled in variable conduction (Wenckebach).
  • Computer modeling suggested ventricular patterns arise from modulated atrial input and AV node properties.

Conclusions:

  • Atrial flutter exhibits paradoxical, frequency-independent respiratory modulation of atrial intervals with short delays.
  • Ventricular rhythm complexity during AFL differentiates it from normal RSA.
  • Direct mechanical effects of respiration on the AFL reentrant circuit may explain these findings.