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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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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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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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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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Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

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Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
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Persistent Atrium Standstill Post Atrial Fibrillation Ablation Therapy.

Maya A Khatoun1, Houssein Toufayli1, Mary-Joe Touma1

  • 1Cardiology, University of Balamand, Beirut, LBN.

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|June 27, 2022
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Summary

Atrial standstill, a loss of atrial mechanical contraction, occurred post-ablation in a hypertrophic cardiomyopathy patient. Prompt imaging assessment after sinus rhythm restoration is crucial for managing potential complications.

Keywords:
ablation therapyatrial fibrillationatrial standstilldirect cardioversionenlarged left atrium

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Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Medical Imaging

Background:

  • Atrial standstill is a rare condition characterized by the absence of atrial mechanical contraction, potentially with preserved electrical conduction.
  • Hypertrophic cardiomyopathy (HCM) and persistent atrial fibrillation (AF) are significant cardiac conditions requiring advanced management.
  • Ablation therapy is a common intervention for refractory atrial fibrillation.

Observation:

  • A 64-year-old male with a history of HCM and persistent AF underwent successful ablation therapy, achieving sinus rhythm.
  • Post-procedure echocardiography revealed a complete absence of left atrial mechanical activity, indicating atrial standstill.
  • This observation highlights a potential complication following successful rhythm control interventions.

Findings:

  • The case demonstrates that atrial standstill can occur even after successful ablation and restoration of sinus rhythm.
  • Echocardiography is a vital tool for detecting the loss of atrial mechanical function.
  • Persistent AF and underlying conditions like HCM may predispose patients to such complications.

Implications:

  • Early detection of atrial standstill through routine post-procedure imaging is essential.
  • Prompt identification allows for timely management of potential thromboembolic or hemodynamic complications.
  • This case underscores the importance of comprehensive atrial assessment beyond electrical activity post-cardiac interventions.