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Related Concept Videos

Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

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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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The cardiac conduction system produces and transmits electrical impulses that prompt myocardial contraction, ensuring efficient heart function. This intricate system ensures that the heart beats in a coordinated and efficient manner, beginning with the atria and then the ventricles. The conduction system optimizes cardiac output by maintaining this precise sequence, which is crucial for adequate blood circulation.
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Autorhythmicity is a term that refers to the heart's inherent ability to generate electrical signals and instigate muscle contractions. This self-regulating conduction system within the heart consists of two key components: the pacemaker cells and specialized conducting cells.
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Mechanism of Cardiac Arrhythmias01:28

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Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
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Disturbances in Heart Rhythm01:29

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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.
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Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
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Simultaneous Accessory Pathway and AV Node Mechanical Block.

Daniel Garofalo1, Alfonso Gomez Gallanti, David Filgueiras Rama

  • 1Unidad de Electrofisiología y Arritmias, Hospital Universitario "La Paz", Madrid, Spain.

Indian Pacing and Electrophysiology Journal
|October 17, 2013
PubMed
Summary
This summary is machine-generated.

This case study details a 22-year-old female with palpitations and preexcitation. Cryoablation of a right superior paraseptal accessory pathway (AP) resulted in transient atrioventricular block, halting ablation.

Keywords:
Accessory pathwayAtrioventricular nodeBlockCryoablationOrthodromic reciprocating tachycardia

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Case Reports

Background:

  • Preexcitation syndromes, often caused by accessory pathways (AP), can lead to tachyarrhythmias.
  • Accessory pathways near the His bundle pose unique ablation challenges.
  • Cryoablation is an alternative energy source for catheter ablation of cardiac arrhythmias.

Purpose of the Study:

  • To report a clinical case of accessory pathway ablation using cryoenergy.
  • To describe the occurrence of transient supra-hisian atrioventricular block during cryoablation.
  • To highlight the rarity of simultaneous AP and AV node block with cryothermal energy.

Main Methods:

  • Electrophysiological study (EPS) to localize a right superior paraseptal accessory pathway (AP).
  • Cryo-mapping and attempted cryoablation of the AP.
  • Induction and termination of orthodromic reciprocating tachycardia (ORT).

Main Results:

  • A right superior paraseptal AP was identified near the His recordings.
  • Initial cryo-mapping failed to terminate ORT.
  • A posterior cryoablation attempt caused mechanical block of the AP, rendering ORT non-inducible.
  • Further catheter manipulation resulted in transient, reproducible Wenckebach type supra-hisian atrioventricular block.
  • No ablation was performed due to the risk of AV block.

Conclusions:

  • Simultaneous block of an accessory pathway and the atrioventricular node is a rare complication during ablation.
  • This phenomenon has not been previously reported in large series using cryo-thermal energy.
  • Careful catheter manipulation and energy application are crucial in challenging accessory pathway ablations.