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Related Concept Videos

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

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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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Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

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Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
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Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

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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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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Device Therapy for Rate Control: Pacing, Resynchronisation and AV Node Ablation.

Dennis H Lau1, Anand Thiyagarajah1, Stephan Willems2

  • 1Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia.

Heart, Lung & Circulation
|July 9, 2017
PubMed
Summary
This summary is machine-generated.

Atrioventricular node ablation (AVNA) offers a valuable treatment for refractory atrial fibrillation (AF), particularly when tachycardia-induced cardiomyopathy is suspected. This approach, often resulting in pacemaker dependence, is being explored for its mortality benefits in heart failure patients.

Keywords:
Atrial fibrillationAtrioventricular nodal ablationCardiac resynchronisation therapyDevice therapy

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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Atrioventricular node ablation (AVNA) is a treatment option for atrial fibrillation (AF) refractory to other therapies.
  • Patients undergoing AVNA often become pacemaker dependent.
  • AVNA may be beneficial in cases of suspected tachycardia-induced cardiomyopathy.

Purpose of the Study:

  • To evaluate the role and outcomes of AVNA in specific patient populations.
  • To explore the evolving use of AVNA in conjunction with cardiac resynchronization therapy (CRT) for heart failure.
  • To assess the potential mortality benefits of AVNA compared to pharmacotherapy.

Main Methods:

  • Review of historical "ablate and pace" strategies involving AVNA and ventricular pacing.
  • Investigation into the integration of AVNA with CRT in patients with systolic heart failure.
  • Analysis of observational studies demonstrating mortality benefits.

Main Results:

  • AVNA is a viable option for refractory AF, especially with suspected tachycardia-induced cardiomyopathy.
  • Observational studies suggest a mortality benefit of AVNA over pharmacotherapy.
  • Ongoing multi-center randomized controlled trials are further investigating these findings.

Conclusions:

  • AVNA is a significant therapeutic option for select patients with refractory AF and heart failure.
  • The combination of AVNA and CRT is an evolving area of treatment.
  • Further research through randomized trials is crucial to confirm the mortality benefits of AVNA.