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Related Concept Videos

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...
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 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 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...
Dysrhythmias VII: Nursing Management of Dysrhythmias01:25

Dysrhythmias VII: Nursing Management of Dysrhythmias

Nursing management of dysrhythmias involves the following:AssessmentSubjective Assessment:The initial step involves gathering patient-reported symptoms such as dizziness, palpitations, and chest discomfort. It is crucial to collect a detailed history, including previous heart conditions, current medication use, and lifestyle factors like caffeine and alcohol consumption.Objective Assessment:This involves observing clinical signs such as jugular venous distention, cool and pale skin, and...
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...

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Programmed Electrical Stimulation in Mice
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Dyssynchrony parameter-guided interventricular delay programming.

Henryk Dreger1, Guido Antonow, Sebastian Spethmann

  • 1Medizinische Klinik für Kardiologie und Angiologie, Campus Mitte, Charité-Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany. henryk.dreger@charite.de

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|November 26, 2011
PubMed
Summary
This summary is machine-generated.

Optimizing interventricular (VV) delay in cardiac resynchronization therapy (CRT) is crucial. Left ventricular (LV) preactivation effectively reduces persistent interventricular dyssynchrony in CRT patients, offering a pragmatic approach to improve outcomes.

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06:57

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Published on: January 31, 2019

Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Cardiac resynchronization therapy (CRT) optimization is essential for patient outcomes.
  • Current guidelines recommend interventricular (VV) delay optimization, but a clinical gold standard is lacking.
  • Dyssynchrony parameter assessment may guide VV delay optimization.

Purpose of the Study:

  • To investigate if dyssynchrony parameter changes induced by sequential biventricular pacing follow a predictable pattern.
  • To assess the impact of left ventricular (LV) preactivation on interventricular dyssynchrony.

Main Methods:

  • Echocardiographic quantification of interventricular mechanical delay and septal-lateral time to peak systolic velocity delay in 80 CRT patients.
  • Assessment of dyssynchrony during simultaneous and sequential biventricular pacing with right ventricular (RV) or LV preactivation (40 ms).

Main Results:

  • Simultaneous biventricular pacing improved dyssynchrony parameters compared to baseline.
  • Sequential pacing induced high interindividual variance in dyssynchrony parameters, lacking a predictable pattern.
  • LV preactivation significantly reduced interventricular dyssynchrony by 80% in patients with persistent dyssynchrony.

Conclusions:

  • Left ventricular preactivation effectively ameliorates persistent interventricular dyssynchrony in nearly 20% of CRT patients.
  • Assessing interventricular dyssynchrony and programming LV preactivation is a pragmatic approach to improve CRT response.