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The heart beats rhythmically in a sequence called the cardiac cycle—a rapid coordination of contraction (systole) and relaxation (diastole).
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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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The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase...
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The cardiac cycle refers to the sequence of events that occur in the heart from the beginning of one heartbeat to the next. It's characterized by alternating periods of contraction (systole) and relaxation (diastole) of the heart muscles.
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Atrial activation sequence changes during ventricular overdrive pacing: What is the mechanism?

Takashi Nakashima1, Masaru Nagase2, Taro Shibahara2

  • 1Department of Cardiology, Central Japan International Medical Center, Gifu, Japan; Department of Cardiology, Graduate School of Medicine, Gifu University, Gifu, Japan..

Journal of Electrocardiology
|October 10, 2022
PubMed
Summary

Ventricular overdrive pacing altered atrial activation in a patient with a concealed left accessory pathway. This finding offers insights into accessory pathway mechanisms and electrophysiology.

Keywords:
Accessory pathwayAtrioventricular reciprocating tachycardiaConcealed conductionPeel backRefractory period

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Area of Science:

  • Electrophysiology
  • Cardiology
  • Cardiac Electrophysiology

Background:

  • Accessory pathways can cause supraventricular tachycardias.
  • Concealed accessory pathways are not associated with pre-excitation on the surface electrocardiogram.
  • Understanding accessory pathway function is crucial for managing arrhythmias.

Purpose of the Study:

  • To describe changes in atrial activation sequence during ventricular pacing.
  • To investigate the electrophysiological effects of ventricular overdrive pacing.
  • To elucidate the mechanism of a concealed left-sided accessory pathway.

Main Methods:

  • Utilized ventricular overdrive pacing in a patient.
  • Analyzed atrial activation sequences.
  • Correlated pacing effects with accessory pathway characteristics.

Main Results:

  • Observed distinct alterations in atrial activation patterns.
  • Demonstrated the impact of ventricular pacing on supraventricular conduction.
  • Provided evidence for concealed accessory pathway behavior.

Conclusions:

  • Ventricular overdrive pacing can unmask or alter accessory pathway conduction.
  • The findings contribute to understanding concealed accessory pathway electrophysiology.
  • This approach may aid in the diagnosis and management of related arrhythmias.