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Related Concept Videos

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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Heart Failure I: Introduction01:27

Heart Failure I: Introduction

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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 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

Pathophysiology of Heart Failure

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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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Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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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.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
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Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
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Heart failure as a substrate and trigger for ventricular tachycardia.

Chikezie K Alvarez1, Edmond Cronin2, William L Baker3

  • 1Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. chalvarez@montefiore.org.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|October 11, 2019
PubMed
Summary

Heart failure patients frequently experience ventricular arrhythmias. While some treatments reduce mortality, others like implantable cardioverter-defibrillators may increase it. Understanding these complex mechanisms is key.

Keywords:
Beta blockerCalcium homeostasisCardiac resynchronization therapyEarly after depolarizationsHeart failureICDLate after depolarizationsVentricular tachycardia

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Heart failure (HF) affects millions, increasing morbidity and mortality.
  • Ventricular tachyarrhythmias (VAs) are common complications of HF.
  • HF pathophysiology involves complex changes predisposing to arrhythmias.

Purpose of the Study:

  • To review mechanisms of arrhythmogenesis in HF.
  • To examine the impact of HF therapies on VAs.
  • To discuss telemonitoring and LVAD effects on VAs.

Main Methods:

  • Literature review of HF pathophysiology and arrhythmia mechanisms.
  • Analysis of clinical trial data on HF medications and devices.
  • Review of studies on cardiac resynchronization therapy (CRT) and LVADs.

Main Results:

  • HF-related changes like hypertrophy, fibrosis, and calcium handling promote VAs.
  • Beta-blockers and sacubitril/valsartan reduce mortality and sudden cardiac death (SCD).
  • ICDs reduce SCD but may increase overall mortality if shocks occur; prophylactic ICDs have nuanced effects.

Conclusions:

  • HF therapies have varied impacts on VAs and overall mortality.
  • CRT, telemonitoring, and LVADs play roles in managing VAs in HF.
  • Further research is needed to optimize VA prevention and management in HF.