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Related Concept Videos

Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

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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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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.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

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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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Heart Valves01:16

Heart Valves

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The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
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Aortic Regurgitation I: Introduction01:15

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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How to define valvular atrial fibrillation?

Laurent Fauchier1, Raphael Philippart1, Nicolas Clementy1

  • 1Service de cardiologie, faculté de médecine, université François-Rabelais, CHU Trousseau, Tours, France.

Archives of Cardiovascular Diseases
|July 18, 2015
PubMed
Summary

The classification of atrial fibrillation (AF) as "valvular" or "non-valvular" impacts stroke risk and anticoagulant choice. Patients with mitral stenosis or artificial valves require vitamin K antagonists, while others may benefit from non-vitamin K antagonist oral anticoagulants.

Keywords:
Accident vasculaire cérébralAtrial fibrillationFibrillation atrialeStrokeValve diseaseValvulopathie

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Atrial fibrillation (AF) significantly increases stroke risk.
  • Current guidelines distinguish between "valvular" and "non-valvular" AF for anticoagulant selection.
  • The definition and implications of "valvular AF" remain debated, particularly concerning specific valvular heart diseases.

Purpose of the Study:

  • To clarify the distinction between "valvular" and "non-valvular" atrial fibrillation.
  • To evaluate the appropriateness of non-vitamin K antagonist oral anticoagulants (NOACs) in various forms of AF.
  • To guide antithrombotic strategies based on thromboembolic risk associated with different valvular conditions.

Main Methods:

  • Review of recent clinical trials comparing vitamin K antagonists (VKAs) with NOACs in AF patients.
  • Analysis of post-hoc data concerning thromboembolic risk in AF with specific valvular heart diseases.
  • Examination of the pathogenesis of thrombosis in relation to prosthetic heart valves.

Main Results:

  • "Valvular AF" is currently defined by mitral stenosis or artificial heart valves, necessitating VKAs.
  • Other valvular heart diseases (e.g., mitral regurgitation, aortic stenosis) do not appear to increase AF-related thromboembolic risk or reduce NOAC responsiveness.
  • Thrombosis pathogenesis differs with mechanical prosthetic valves, where warfarin showed better efficacy and safety than dabigatran.

Conclusions:

  • The classification of AF should focus on thromboembolic risk and antithrombotic strategy, not just arrhythmia etiology.
  • Patients with AF and certain valvular heart diseases, excluding mitral stenosis or artificial valves, may be candidates for NOAC therapy.
  • "Non-valvular AF" does not preclude NOAC use in patients with some types of valvular heart disease.