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Related Concept Videos

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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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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, 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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Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

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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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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 refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
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Updated: Oct 26, 2025

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Recurrent Atrial Flutter Requiring Multiple Cardioversions in a Preterm Infant.

Jesus C Jaile1, Manoj K Gupta2

  • 1Department of Pediatrics, Harlem Hospital Center, Affiliate of Columbia University, New York, New York, USA.

JACC. Case Reports
|July 28, 2021
PubMed
Summary

This study details the first preterm infant experiencing atrial flutter needing repeated cardioversion. Even after successful treatment, a second episode of atrial flutter occurred, highlighting treatment challenges.

Keywords:
AFL, atrial flutterAV, atrioventricularDOL, day of lifeECG, electrocardiogramNICU, neonatal intensive care unitarrhythmiaatrial fluttercardioversionpreterm infantrecurrent

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Area of Science:

  • Pediatric Cardiology
  • Neonatal Medicine
  • Cardiac Electrophysiology

Background:

  • Atrial flutter is a rare but serious condition in preterm infants.
  • Direct current cardioversion is a standard treatment with a high initial success rate.
  • Recurrent arrhythmias can pose significant management challenges in neonates.

Purpose of the Study:

  • To report the first case of recurrent atrial flutter in a preterm infant requiring multiple cardioversions.
  • To illustrate the electrocardiographic findings associated with recurrent atrial flutter post-cardioversion.
  • To discuss the clinical implications of managing refractory atrial flutter in neonates.

Main Methods:

  • Case report of a preterm infant diagnosed with atrial flutter.
  • Electrocardiogram (ECG) analysis to confirm atrial flutter and assess response to treatment.
  • Multiple direct current cardioversion procedures performed.

Main Results:

  • The infant experienced atrial flutter requiring multiple direct current cardioversions.
  • A second episode of atrial flutter was documented after an initially successful cardioversion.
  • Electrocardiograms confirmed the recurrence of the arrhythmia.

Conclusions:

  • Recurrent atrial flutter can occur in preterm infants even after successful cardioversion.
  • Management of refractory atrial flutter in neonates may require further investigation and tailored approaches.
  • This case highlights the complexity of managing cardiac arrhythmias in extremely vulnerable populations.