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Related Concept Videos

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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Cardiomyopathy II: Dilated Cardiomyopathy01:30

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

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Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
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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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Cardiomyopathy V: Interprofessional Care01:29

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Related Experiment Video

Updated: Nov 21, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Cardiac resynchronization therapy and ventricular tachyarrhythmia burden.

Sinan Tankut1, Ilan Goldenberg1, Valentina Kutyifa1

  • 1Clinical Cardiovascular Research Center, University of Rochester, Rochester, New York.

Heart Rhythm
|January 13, 2021
PubMed
Summary

Cardiac resynchronization therapy-defibrillator (CRT-D) significantly lowers ventricular tachyarrhythmia (VTA) burden in heart failure patients with left bundle branch block (LBBB). Early CRT-D intervention also reduces mortality and appropriate ICD shocks.

Keywords:
Cardiac resynchronization therapyHeart failureLeft bundle branch blockVentricular fibrillationVentricular tachycardia arrhythmia

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Heart failure (HF) patients with left bundle branch block (LBBB) are at increased risk of ventricular tachyarrhythmia (VTA).
  • Cardiac resynchronization therapy-defibrillator (CRT-D) is a device that can help manage these patients.

Purpose of the Study:

  • To assess the impact of CRT-D on VTA burden in patients with LBBB.

Main Methods:

  • Analysis of 1281 LBBB patients from the MADIT-CRT trial.
  • VTA defined as sustained ventricular tachycardia (VT ≥180 bpm) or ventricular fibrillation (VF).
  • Life-threatening VTA defined as VT ≥200 bpm or VF.

Main Results:

  • CRT-D significantly reduced VTA rate (20 vs 34 per 100 person-years) compared to ICD alone.
  • CRT-D was associated with a 32% risk reduction for VTA recurrence.
  • CRT-D reduced recurrent life-threatening VTA by 57% and appropriate ICD shocks by 54%.

Conclusions:

  • Early CRT-D intervention in LBBB and HF patients reduces mortality and VTA burden.
  • VTA burden is a significant predictor of subsequent mortality.
  • CRT-D is effective in reducing VTA burden and appropriate ICD shocks in this patient population.