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Related Concept Videos

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 III: Characteristics of Dysrhythmias01:29

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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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Dysrhythmias II: Classification of Tachyarrhythmias01:28

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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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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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Dysrhythmias VI: Management of Dysrhythmias01:25

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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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Acute Coronary Syndrome III: Diagnostic Studies01:30

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Ventricular Tachycardia Ablation Clinical Trials.

Jackson J Liang1, Daniele Muser1, Pasquale Santangeli1

  • 1Electrophysiology Section, Division of Cardiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.

Cardiac Electrophysiology Clinics
|February 8, 2017
PubMed
Summary

Catheter ablation for ventricular tachycardia (VT) in structural heart disease is promising but needs more randomized trials. This review summarizes current studies and discusses challenges for future research.

Keywords:
Catheter ablationClinical trialOutcomeVentricular tachycardia

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Catheter ablation is a growing treatment for ventricular tachycardia (VT) in patients with structural heart disease.
  • Existing data primarily come from retrospective and nonrandomized observational studies.
  • There is a scarcity of randomized controlled trials (RCTs) comparing VT ablation to antiarrhythmic drugs.

Purpose of the Study:

  • To review major studies on the efficacy of VT ablation in patients with structural heart disease.
  • To identify and discuss barriers to enrollment and completion of RCTs in this field.
  • To propose future research directions for VT ablation in structural heart disease.

Main Methods:

  • Literature review of published studies on catheter ablation for VT in structural heart disease.
  • Analysis of existing data from retrospective, observational, and limited randomized trials.
  • Discussion of challenges and barriers encountered in conducting RCTs.

Main Results:

  • Extensive data exist from non-randomized studies, suggesting efficacy.
  • Limited high-quality randomized data are available, particularly in comparison to antiarrhythmic drugs.
  • Barriers to RCTs include patient selection, study design, and funding.

Conclusions:

  • Catheter ablation is a significant option for VT in structural heart disease, but robust evidence from RCTs is lacking.
  • Overcoming barriers in RCTs is crucial for establishing definitive treatment guidelines.
  • Future research should focus on well-designed randomized trials to compare ablation with medical therapy.