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Related Concept Videos

Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.
Dysrhythmias II: Classification of Tachyarrhythmias01:28

Dysrhythmias II: Classification of Tachyarrhythmias

Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
Correlation between ECG and Cardiac Cycle01:25

Correlation between ECG and Cardiac Cycle

The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
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...
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...
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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Variability in postpacing intervals predicts global ventricular activation pattern during tachycardia.

Ilyas K Colombowala1, Ali Massumi, Abdi Rasekh

  • 1Texas Heart Institute, St. Luke's Episcopal Hospital, Houston, TX 77060, USA.

Pacing and Clinical Electrophysiology : PACE
|November 26, 2009
PubMed
Summary

Assessing postpacing interval variability (PPIV) rapidly and accurately determines ventricular activation patterns during ventricular tachycardia (VT). This method differentiates centrifugal from circuitous VT, aiding ablation procedures.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Accurate assessment of ventricular activation patterns is crucial for successful ventricular tachycardia (VT) ablation.
  • Previous research established postpacing interval variability (PPIV) for atrial activation patterns, showing minimal PPIV in circuitous and high variability in centrifugal tachycardias.
  • This study aimed to apply PPIV for determining ventricular global activation patterns during VT.

Purpose of the Study:

  • To evaluate the utility of postpacing interval variability (PPIV) in defining global ventricular activation patterns during ventricular tachycardia (VT).
  • To differentiate between centrifugal and circuitous VT based on PPIV measurements.
  • To assess the potential of PPIV as a rapid and accurate tool for VT mapping and ablation.

Main Methods:

  • Included patients with mappable VT.
  • Defined global ventricular activation as centrifugal or circuitous using electroanatomic mapping.
  • Calculated PPIV using right ventricular apical overdrive pacing at cycle lengths 10 ms and 30 ms shorter than VT cycle length.
  • Studied 23 VTs (11 centrifugal, 12 circuitous) in 20 patients.

Main Results:

  • Mean PPIV was significantly different between centrifugal (45 ± 16 ms) and circuitous VT (6.7 ± 4.1 ms).
  • Rank sum analysis confirmed a statistically significant difference (P < 0.05) in PPIV between the two VT activation patterns.
  • The findings indicate PPIV effectively distinguishes between centrifugal and circuitous ventricular activation.

Conclusions:

  • Postpacing interval variability (PPIV) can rapidly and accurately define global ventricular activation patterns during VT.
  • This technique facilitates VT mapping and ablation by enabling quick confirmation of tachycardia activation.
  • PPIV is a valuable tool for improving the success rates of VT ablation procedures.