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Related Concept Videos

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.
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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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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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Dysrhythmias II: Classification of Tachyarrhythmias01:28

Dysrhythmias II: Classification of Tachyarrhythmias

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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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Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

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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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Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

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Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
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Postablation Atrial Flutters.

Aman Chugh1

  • 1Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.

Cardiac Electrophysiology Clinics
|March 5, 2016
PubMed
Summary
This summary is machine-generated.

Mapping and ablating atrial tachycardia (AT) after atrial fibrillation (AF) ablation is complex. While 90% of post-ablation ATs are successfully ablated, recurrence is common, necessitating improved prevention strategies.

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Area of Science:

  • Electrophysiology
  • Cardiology
  • Cardiac Arrhythmias

Background:

  • Atrial fibrillation (AF) ablation can lead to the development of atrial tachycardia (AT).
  • These post-ablation ATs present diagnostic and therapeutic challenges due to varied mechanisms and origins (atrial or coronary sinus).
  • Accurate diagnosis is crucial as the procedural endpoint relies on identifying the specific tachycardia mechanism.

Purpose of the Study:

  • To review the challenges and outcomes associated with mapping and ablating post-AF ablation atrial tachycardias.
  • To emphasize the importance of precise mechanism definition for successful ablation.
  • To discuss strategies for reducing AT incidence post-AF ablation and managing persistent AF.

Main Methods:

  • Electrophysiologic study (EPS) for mapping tachycardia circuits.
  • Radiofrequency catheter ablation targeting specific arrhythmogenic substrates.
  • Review of procedural success rates and recurrence data for post-ablation AT.

Main Results:

  • Successful ablation of post-ablation ATs is achieved in approximately 90% of patients.
  • Recurrence of AT remains a significant issue despite adherence to rigorous procedural endpoints.
  • The origin of AT can be diverse, including left atrium, right atrium, and coronary sinus.

Conclusions:

  • Post-ablation AT ablation is highly successful but recurrence highlights the need for improved techniques and patient selection.
  • Focus should shift towards preventing AT development after AF ablation.
  • Identifying patients who may benefit from adjunctive linear ablation during persistent AF procedures is essential.