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Related Concept Videos

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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Dysrhythmias VII: Nursing Management of Dysrhythmias01:25

Dysrhythmias VII: Nursing Management of Dysrhythmias

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Nursing management of dysrhythmias involves the following:AssessmentSubjective Assessment:The initial step involves gathering patient-reported symptoms such as dizziness, palpitations, and chest discomfort. It is crucial to collect a detailed history, including previous heart conditions, current medication use, and lifestyle factors like caffeine and alcohol consumption.Objective Assessment:This involves observing clinical signs such as jugular venous distention, cool and pale skin, and...
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Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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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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Cardiomyopathy VI: Nursing Management01:29

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Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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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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Related Experiment Video

Updated: Oct 26, 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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A Clinical Challenge Overcome by His Bundle Pacing.

Alison Zimmerman1, Hena Patel2, Annabelle Volgman2

  • 1Department of Medicine, Rush University Medical Center, Chicago, Illinois.

JACC. Case Reports
|July 28, 2021
PubMed
Summary

Radiation therapy can cause severe atrioventricular block, leading to shortness of breath. Permanent His bundle pacing effectively treated these symptoms in a challenging case.

Keywords:
AV, atrioventricularECG, electrocardiographyHB, His bundleHBP, His bundle pacingRBBB, right bundle branch blockRV, right ventricularcardiac pacemakercardiac resynchronization therapyelectroanatomic mappingelectrocardiographyelectrophysiologyshortness of breath

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Radiation Oncology

Background:

  • Radiation therapy is a crucial cancer treatment but can cause cardiac complications.
  • Atrioventricular block (AV block) is a known, albeit uncommon, side effect of thoracic radiation.
  • Severe AV block can lead to significant symptoms like dyspnea on exertion, impacting quality of life.

Observation:

  • A patient presented with exertional dyspnea attributed to severe first-degree atrioventricular block.
  • The atrioventricular block was diagnosed as a complication following radiation therapy.
  • Standard treatments were considered but His bundle pacing was identified as a potential solution.

Findings:

  • Severe first-degree atrioventricular block was confirmed as the cause of the patient's dyspnea.
  • Permanent His bundle pacing was successfully implemented in this patient.
  • The His bundle pacing effectively resolved the patient's exertional dyspnea.

Implications:

  • This case demonstrates the utility of His bundle pacing in managing radiation-induced cardiac complications.
  • His bundle pacing offers a potentially effective therapeutic option for patients with specific types of AV block.
  • Highlights the importance of considering cardiac side effects in patients undergoing radiation therapy and exploring advanced pacing solutions.