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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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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.
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Dysrhythmias V: Evaluating Dysrhythmias01:30

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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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Heart Failure IV: Classification and Diagnostic Evaluation01:30

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Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
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Dysrhythmias II: Classification of Tachyarrhythmias01:28

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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...
357
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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Related Experiment Video

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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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A simple and practical criterion for determining a failed His-bundle pacing.

Yanchun Liang1, Na Wang1, Haibo Yu1

  • 1Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, People's Republic of China.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|October 21, 2020
PubMed
Summary
This summary is machine-generated.

A simple criterion, stimulus to QRS end interval greater than His-bundle potential to QRS end interval (S-QRSend > H-QRSend), reliably identifies failed His-bundle pacing (HBP). This method accurately detects failed HBP in over 30% of pacing tests.

Keywords:
Effective refractory periodCycle lengthHis-Purkinje conductionHis-bundle pacingPacing thresholdRight ventricular pacing

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Area of Science:

  • Electrophysiology
  • Cardiology
  • Medical Devices

Background:

  • His-bundle pacing (HBP) is an advanced pacing technique aiming to achieve physiological ventricular activation.
  • Accurate assessment of HBP success is crucial for optimal patient outcomes.
  • Current methods for determining HBP failure can be complex and time-consuming.

Purpose of the Study:

  • To establish a straightforward and reliable criterion for identifying failed His-bundle pacing (HBP).
  • To validate a new criterion based on the relationship between stimulus-to-QRS end interval and His-bundle potential-to-QRS end interval (S-QRSend > H-QRSend).

Main Methods:

  • Retrospective analysis of 737 HBP tests in 241 patients and prospective analysis of 400 HBP tests in 123 patients.
  • Defined successful HBP as capture of the His-bundle, with or without adjacent ventricular myocardium capture.
  • Utilized output and effective refractory period criteria as gold standards for HBP success validation.

Main Results:

  • In retrospective analysis, the S-QRSend > H-QRSend criterion identified failed HBP in 31% of tests with 100% specificity.
  • Prospective analysis confirmed failed HBP with 100% accuracy in 33% of pacing tests using the simple criterion.
  • The criterion demonstrated suitability for patients with and without His-Purkinje conduction disease.

Conclusions:

  • The criterion 'S-QRSend > H-QRSend' provides a simple and reliable method for determining failed His-bundle pacing.
  • This simple criterion can be applied in over 30% of pacing tests, enhancing diagnostic efficiency.
  • The findings support the clinical utility of this criterion in routine electrophysiology practice.