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Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

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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.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
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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...
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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...
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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...
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Updated: May 5, 2026

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Phased RF ablation in persistent atrial fibrillation.

John Hummel1, Gregory Michaud2, Robert Hoyt3

  • 1The Ohio State University, Columbus, Ohio.

Heart Rhythm
|November 19, 2013
PubMed
Summary

Phased RF catheter ablation significantly improved effectiveness for persistent atrial fibrillation (AF) compared to medical management. While acute safety events occurred, long-term safety did not differ between groups, suggesting ablation is a viable treatment option.

Keywords:
AADACEAFAMAblationAtrial fibrillationCFAEComplex Fractionated Atrial ElectrogramDCCVFDAFood and Drug AdministrationINRITTInternational normalized ratioLALMWHLVEFMAACMASCMMOATPVPVACPersistentPhased RFRFSRTEETTOPTTOP-AFTailored Treatment of Persistent Atrial Fibrillationablation managementantiarrhythmic drugasymptomatic cerebral embolusatrial fibrillationdirect current cardioversionintention to treatleft atrialleft ventricular ejection fractionlow-molecular weight heparinmedical managementmultiarray ablation cathetermultiarray septal catheteroral anticoagulation therapypulmonary veinpulmonary vein ablation catheterradiofrequencysinus rhythmtransesophageal echocardiography

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Robotic Ablation of Atrial Fibrillation
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Last Updated: May 5, 2026

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Persistent and long-standing persistent atrial fibrillation (AF) often necessitate complex or repeat radiofrequency (RF) ablation procedures.
  • Current treatment paradigms may require extensive interventions for effective management.

Purpose of the Study:

  • To evaluate the effectiveness and safety of a phased RF ablation system.
  • To compare phased RF ablation against medical therapy for persistent AF in the Tailored Treatment of Persistent Atrial Fibrillation (TTOP-AF) study.

Main Methods:

  • Patients failing antiarrhythmic drugs were randomized (2:1) to ablation management (AM) or medical management (MM).
  • Ablation procedures included pulmonary vein isolation and complex fractionated atrial electrogram ablation, with up to two procedures allowed.
  • Medical management involved antiarrhythmic drug adjustments and/or cardioversion.

Main Results:

  • At 6 months, 55.8% of ablation patients achieved effectiveness off antiarrhythmic drugs versus 26.4% in the medical management group (P < .0001).
  • Acute procedure success was 92.8%, with a 12.3% rate of serious adverse events.
  • The study did not meet its predefined acute safety endpoint, but chronic safety event rates were similar between groups.

Conclusions:

  • Catheter ablation using the phased RF system demonstrates effectiveness in reducing persistent/long-standing persistent AF compared to medical management.
  • Strategies to mitigate risks like stroke and pulmonary vein stenosis include optimized anticoagulation and precise catheter placement.