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Related Concept Videos

Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

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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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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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Electrocardiogram01:29

Electrocardiogram

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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.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
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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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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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Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

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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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Electrocardiographic Changes Associated With Ibrutinib Exposure.

Michael G Fradley1, Allan Welter-Frost1, Matthew Gliksman1

  • 1Cardio-Oncology Program, Division of Cardiovascular Medicine, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, FL, USA.

Cancer Control : Journal of the Moffitt Cancer Center
|June 5, 2020
PubMed
Summary

Ibrutinib treatment significantly shortens the QT interval and increases QT dispersion, potentially explaining associated arrhythmias. This study analyzed electrocardiograms (ECGs) before and after ibrutinib exposure in 21 patients.

Keywords:
QT intervalcardio-oncologycardiotoxicityelectrocardiogramibrutinib

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Area of Science:

  • Cardiology
  • Pharmacology
  • Electrophysiology

Background:

  • Ibrutinib is associated with cardiac arrhythmias.
  • Limited data exists on ibrutinib's impact on electrocardiographic parameters, especially the QT interval.

Purpose of the Study:

  • To investigate the effect of ibrutinib on the QT interval and QT dispersion.
  • To explore potential electrophysiologic mechanisms underlying ibrutinib-associated arrhythmias.

Main Methods:

  • Retrospective analysis of electrocardiograms (ECGs) from 21 patients treated with ibrutinib.
  • Manual measurement of traditional ECG parameters and QT dispersion by an electrophysiologist.
  • Comparison of pre- and post-ibrutinib exposure ECG data.

Main Results:

  • Significant shortening of the absolute QT interval (386 ms to 356 ms, P = .007).
  • Significant shortening of corrected QT intervals using Bazett's (446 ms to 437 ms, P = .04) and Fridericia's formulas (425 ms to 407 ms, P = .003).
  • Significant increase in QT dispersion (39.8 ms to 57.3 ms, P = .002).

Conclusions:

  • Ibrutinib exposure leads to significant QT interval shortening and increased QT dispersion.
  • These ECG changes may indicate a shared electrophysiologic mechanism for ibrutinib-induced arrhythmias.
  • Further research is warranted to elucidate the precise mechanisms.