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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Pathophysiology of Heart Failure01:17

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Heart Failure I: Introduction01:27

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Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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Heart Failure VI: Adjunct Therapies01:22

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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
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Related Experiment Video

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Ventriculoatrial synchrony induced heart failure.

Stefan Andric1,2, Dragica Tesic1,2, Dalibor Somer1,2

  • 1a Faculty of Medicine , University of Novi Sad , Novi Sad , Serbia.

Acta Clinica Belgica
|February 23, 2018
PubMed
Summary

Pacemaker-mediated tachycardia, a form of ventriculoatrial (VA) synchrony, can cause severe heart failure. This case highlights how lead displacement can trigger VA synchrony and subsequent heart failure, which resolved after pacemaker reprogramming.

Keywords:
ECGHeart failurecomplicationlead displacementpacemaker

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Ventriculoatrial (VA) synchrony, including endless loop tachycardia and repetitive non-reentrant ventriculoatrial synchrony (RNRVAS), involves reverse impulse conduction.
  • While VA synchrony can theoretically worsen heart failure, severe clinical cases are infrequently reported.

Observation:

  • A 60-year-old patient developed severe heart failure with reduced left ventricular ejection fraction (LVEF) ten months post-pacemaker implantation for complete atrioventricular block.
  • Atrial lead displacement led to VA synchrony (RNRVAS-like), identified as the cause of heart failure.

Findings:

  • Reprogramming the pacemaker successfully resolved the VA synchrony and the induced heart failure.
  • Echocardiography confirmed improvement in LVEF following intervention.

Implications:

  • Ventriculoatrial conduction can persist despite complete atrioventricular block.
  • Atrial lead displacement is a potential trigger for VA synchrony and subsequent heart failure.
  • Permanent VA synchrony may precipitate or exacerbate heart failure, necessitating careful pacemaker management.