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Related Concept Videos

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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Dysrhythmias VI: Management of Dysrhythmias01:25

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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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Pulse rhythm01:30

Pulse rhythm

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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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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Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

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Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
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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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Related Experiment Video

Updated: Oct 8, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Rate Control Versus Rhythm Control in Patients with Left Ventricular Assist Devices and Atrial Fibrillation.

Jasen L Gilge1, Asim Ahmed1, Bradley A Clark1

  • 1All authors are from Ascension St Vincent, 8333 Naab Road, #400, Indianapolis, IN 46260.

Journal of Atrial Fibrillation
|December 24, 2021
PubMed
Summary

Managing atrial fibrillation (AF) in left ventricular assist device (LVAD) patients showed no difference between rate or rhythm control strategies. Maintaining sinus rhythm may not be essential for all LVAD recipients.

Keywords:
Atrial FibrillationLVADRhythm Control

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) is a frequent comorbidity in patients with left ventricular assist devices (LVAD).
  • Current guidelines lack a defined strategy for managing AF in LVAD patients, specifically regarding rate versus rhythm control.
  • This study addresses the need for evidence-based treatment approaches in this population.

Purpose of the Study:

  • To compare the clinical outcomes of rate control versus rhythm control for atrial fibrillation in patients with LVAD.
  • To evaluate the impact of different AF management strategies on major adverse events in LVAD recipients.

Main Methods:

  • Retrospective analysis of consecutive LVAD patients implanted between January 2015 and December 2017.
  • Patients with post-LVAD implantation AF were categorized into rate control or rhythm control groups.
  • Primary outcome: composite of death, heart failure admission, GI bleed, VT, stroke, hemolysis, and pump thrombosis.

Main Results:

  • Of 201 LVAD patients, 81 had AF. Median follow-up was 384 days.
  • No significant difference in composite outcomes between rate control (61%) and rhythm control (59%) groups (p=0.83).
  • Individual adverse events also showed no significant differences between the groups. Electrical cardioversion achieved 71% success but had a 60% recurrence rate.

Conclusions:

  • Rate and rhythm control strategies for AF in LVAD patients yield similar primary outcomes.
  • These findings suggest that maintaining sinus rhythm is not universally required for all LVAD recipients.
  • Further research may clarify optimal AF management in LVAD patients.