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Related Concept Videos

Overview of the Heart01:07

Overview of the Heart

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The heart, a muscular organ located in the chest, functions as the body's pump, circulating blood through the vascular system. It has four chambers: two atria on top and two ventricles below. The right atrium receives deoxygenated blood from the body and passes it to the right ventricle, which pumps it to the lungs for oxygenation. The left atrium receives oxygenated blood from the lungs and transfers it to the left ventricle, which pumps it to the rest of the body.
The heart's...
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Chambers of the Heart01:16

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The human heart is a complex organ made up of four chambers: the right and left atria and the right and left ventricles. These internal chambers are separated by partitions known as the interatrial and interventricular septa. The exterior of the heart features a groove known as the coronary sulcus that demarcates the atria from the ventricles, while the anterior and posterior interventricular sulci distinguish between the two ventricles.
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Disturbances in Heart Rhythm01:28

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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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Electrophysiology of Normal Cardiac Rhythm01:19

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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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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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Conduction System of the Heart01:20

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The cardiac conduction system produces and transmits electrical impulses that prompt myocardial contraction, ensuring efficient heart function. This intricate system ensures that the heart beats in a coordinated and efficient manner, beginning with the atria and then the ventricles. The conduction system optimizes cardiac output by maintaining this precise sequence, which is crucial for adequate blood circulation.
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Robotic Ablation of Atrial Fibrillation
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Right Heart Structure and Function after Electrical Cardioversion for Atrial Fibrillation.

Xiaohan Yan1, Pascal B Meyre1,2, Stefanie Aeschbacher1,2

  • 1Division of Cardiology, University Hospital and University of Basel, Basel, Switzerland.

Cardiology
|June 27, 2023
PubMed
Summary

Electrical cardioversion (ECV) improves right ventricular (RV) function in atrial fibrillation (AF) patients. RV function shows immediate and sustained improvement after restoring sinus rhythm, with significant gains in TAPSE and FAC.

Keywords:
Atrial fibrillationCardioversionEchocardiographyRight ventricular functionTachycardia-induced cardiomyopathy

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Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Echocardiography

Background:

  • Atrial fibrillation (AF) negatively affects right heart structure and function.
  • Limited data exist on right ventricular (RV) and right atrial (RA) changes post-electrical cardioversion (ECV).
  • Understanding immediate and short-term effects of ECV on right cardiac chambers is crucial.

Purpose of the Study:

  • To evaluate immediate and short-term changes in right cardiac chamber dimensions and RV function after ECV in persistent AF patients.
  • To assess the impact of heart rate and rhythm status on these changes.
  • To investigate the association between rhythm restoration and RV/RA remodeling.

Main Methods:

  • Transthoracic echocardiography was used to measure right cardiac dimensions and RV function in 64 AF patients.
  • Measurements were taken 1-2 hours before, immediately after, and 4-6 weeks after ECV.
  • Linear regression models analyzed associations between cardiac measures and follow-up rhythm status.

Main Results:

  • In patients maintaining sinus rhythm post-ECV (n=48), RV function improved significantly (p<0.01) for Fractional Area Change (FAC) and Tricuspid Annular Plane Systolic Excursion (TAPSE).
  • RV end-systolic area and RA volume index decreased significantly at 4-6 weeks post-ECV (p<0.01).
  • Improved TAPSE and FAC were associated with sustained sinus rhythm (p=0.027 and p=0.053, respectively).

Conclusions:

  • Electrical cardioversion improves RV function in AF patients who achieve sinus rhythm.
  • RV function demonstrates immediate improvement post-ECV with further enhancement at 4-6 weeks.
  • Sustained sinus rhythm is linked to improved RV systolic function after ECV.