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Related Concept Videos

Dysrhythmias I: Introduction01:15

Dysrhythmias I: Introduction

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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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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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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 V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

153
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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Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

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Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
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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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Removal of tine-based leadless pacemakers - Insights from a large multicenter experience.

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·2026
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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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Micra-AV leadless pacemaker and atrioventricular (dys)synchrony: A stepwise process.

Gianfranco Mitacchione1, Marco Schiavone1, Alessio Gasperetti1

  • 1Cardiology Unit, ASST-Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy.

Pacing and Clinical Electrophysiology : PACE
|August 31, 2021
PubMed
Summary

Leadless pacemakers like Micra-AV offer an alternative to traditional devices, but atrioventricular (AV) synchrony can be overestimated. Early detection of AV dyssynchrony using Holter-ECG and exercise tests is crucial for proper management.

Keywords:
atrioventricular synchronous leadless pacemakeratrioventricular synchronyleadless pacemakermicra-AV

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Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Leadless pacemakers, such as the Micra-AV, are emerging as a significant advancement for treating bradyarrhythmia, offering an alternative to transvenous pacing systems.
  • Despite their advantages, the safety and long-term efficacy of leadless pacemakers, particularly their ability to ensure atrioventricular (AV) synchrony, remain incompletely understood.

Observation:

  • A case study involving a 57-year-old patient who experienced pacemaker syndrome due to significant Micra-AV dyssynchrony is presented.
  • This syndrome arose from an overestimation of the leadless pacemaker's capacity to maintain AV synchrony.

Findings:

  • The case highlights that the atrioventricular (AV) synchrony provided by leadless pacemakers may be overestimated.
  • A systematic, stepwise approach to device reprogramming is necessary for achieving adequate AV synchrony.

Implications:

  • Holter-ECG monitoring and exercise testing are valuable tools for the early identification of inadequate AV synchrony.
  • These diagnostic methods complement device-specific reports, aiding in comprehensive patient management.