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Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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...
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...
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...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...

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Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples
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Defibrillation thresholds in hypertrophic cardiomyopathy.

Ernest M Quin1, Frank A Cuoco, Matthew S Forcina

  • 1Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. emattquin@gmail.com

Journal of Cardiovascular Electrophysiology
|November 25, 2010
PubMed
Summary

Patients with hypertrophic cardiomyopathy (HCM) do not require higher defibrillation threshold (DFT) testing energy levels compared to other cardiomyopathy patients. This finding suggests routine high-energy devices are unnecessary for HCM patients needing implantable cardioverter-defibrillators.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Defibrillation threshold (DFT) testing ensures safety for terminating ventricular arrhythmias.
  • Left ventricular mass is a known predictor of high DFTs.
  • Hypertrophic cardiomyopathy (HCM) patients are presumed at risk for increased defibrillation energy needs, but data are limited.

Purpose of the Study:

  • To assess DFTs in patients with HCM.
  • To identify clinical predictors of elevated DFTs in HCM patients.

Main Methods:

  • A uniform modified step-down DFT testing protocol was used.
  • Eighty-nine HCM patients and 600 control cardiomyopathy patients were studied.
  • DFT was compared between groups, and predictors of elevated DFT were analyzed in the HCM cohort.

Main Results:

  • No significant difference in DFT was observed between HCM and control groups (10.4 ± 5.8 J vs 11.2 ± 5.6 J).
  • Clinical factors like ejection fraction, septal thickness, ventricular mass, and QRS duration did not predict elevated DFT in HCM patients.
  • Only 3.4% of HCM patients exhibited a DFT greater than 20 J.

Conclusions:

  • HCM patients do not demonstrate elevated DFTs compared to typical populations undergoing implantable cardioverter-defibrillator (ICD) implantation.
  • Routine use of high-energy ICD devices or complex lead systems is not typically required for HCM patients.
  • These findings support a standardized approach to ICD selection in HCM patients based on current evidence.