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Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
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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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Dynamic atrioventricular delay programming improves ventricular electrical synchronization as evaluated by 3D

Elien B Engels1, Bernard Thibault2, Jan Mangual3

  • 1Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands; Department of Medicine, University of Western Ontario, London, Ontario, Canada.

Journal of Electrocardiology
|November 3, 2019
PubMed
Summary
This summary is machine-generated.

Optimizing atrioventricular delay with SyncAV™ in cardiac resynchronization therapy (CRT) significantly reduced electrical dyssynchrony. This patient-specific approach improved synchrony beyond conventional CRT pacing.

Keywords:
Cardiac resynchronization therapyElectrical optimizationVectorcardiography

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Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Cardiac resynchronization therapy (CRT) aims to improve synchrony in heart failure patients.
  • Optimal atrioventricular (AV) delay is crucial for effective CRT.
  • Electrical dyssynchrony impacts heart failure management.

Purpose of the Study:

  • To evaluate the impact of SyncAV™ on electrical synchrony during bi-ventricular (BiV) pacing.
  • To assess SyncAV™'s effect on vectorcardiography (VCG) derived QRS metrics.
  • To determine if patient-specific AV delay optimization enhances synchrony.

Main Methods:

  • One hundred CRT patients with quadripolar LV leads were studied.
  • 12-lead ECGs were recorded during intrinsic conduction, BiV Nominal pacing, and BiV + SyncAV Opt pacing.
  • Vectorcardiography (VCG) metrics, including QRS duration (QRSd) and area, were analyzed by blinded observers.

Main Results:

  • BiV + SyncAV Opt significantly narrowed QRS duration (122 ± 22 ms) compared to BiV Nominal (137 ± 23 ms) and intrinsic conduction (166 ± 25 ms).
  • 3D QRS area was significantly reduced with BiV + SyncAV Opt (53 ± 30 mV*ms) compared to BiV Nominal (65 ± 39 mV*ms) and intrinsic conduction (90 ± 42 mV*ms).
  • Pacing with SyncAV™ optimization resulted in progressively reduced electrical dyssynchrony.

Conclusions:

  • Patient-specific optimization of the programmable AV offset using SyncAV™ effectively reduced electrical dyssynchrony.
  • SyncAV™ demonstrated superior improvement in electrical synchrony compared to conventional CRT pacing.
  • VCG-derived QRS metrics are valuable for assessing CRT optimization.