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Related Concept Videos

Electrocardiogram Fundamentals01:28

Electrocardiogram Fundamentals

Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
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Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
Dysrhythmias I: Introduction01:15

Dysrhythmias I: Introduction

Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
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...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

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...
Electrophysiology of Normal Cardiac Rhythm01:19

Electrophysiology of Normal Cardiac Rhythm

The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase of...

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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Discrimination between His-bundle and the right bundle branch during electrophysiologic studies.

Yoshiaki Kaneko1, Tadashi Nakajima, Akihiro Saito

  • 1Department of Medicine and Biological Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan. kanekoy@showa.gunma-u.ac.jp

Pacing and Clinical Electrophysiology : PACE
|March 3, 2009
PubMed
Summary

Identifying the His-bundle (HB) and right bundle branch (RBB) using the V3 phenomenon is feasible. However, measuring the His-ventricular (H-V) interval can lead to misidentifying the RBB as the HB.

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Published on: January 31, 2019

Area of Science:

  • Electrophysiology
  • Cardiac conduction system

Background:

  • Accurate identification of the His-bundle (HB) and right bundle branch (RBB) is crucial in electrophysiologic studies.
  • Distinguishing between HB and RBB can be challenging, impacting diagnostic accuracy.

Purpose of the Study:

  • To identify the His-bundle (HB) versus right bundle branch (RBB) during electrophysiologic studies.
  • To utilize the V3 phenomenon for HB and RBB identification.
  • To compare the His-ventricular (H-V) interval timing for HB and RBB potentials.

Main Methods:

  • Electrophysiologic studies were performed on 16 patients without structural heart disease.
  • The V3 phenomenon was induced to record HB and RBB potentials using a multi-electrode catheter.
  • Specific recording sites were defined: HB branching portion (HBBP), proximal HB, and distal RBB.

Main Results:

  • The HBBP was successfully identified in all patients.
  • The H-V interval at the HB adjacent to the HBBP was ≥35 ms in most patients.
  • The H-V interval at the RBB adjacent to the HBBP was also ≥35 ms in 12 patients.

Conclusions:

  • Simultaneous recording of HB and RBB potentials during V3 phenomenon induction allows for feasible electrophysiologic identification.
  • Relying solely on H-V interval measurements for discrimination frequently leads to misidentification of the proximal RBB as the HB.