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Related Concept Videos

Electrocardiogram01:29

Electrocardiogram

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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
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Electrocardiogram Fundamentals01:28

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Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
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Correlation between ECG and Cardiac Cycle01:25

Correlation between ECG and Cardiac Cycle

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The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
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Electrodes: Overview01:17

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 Electrochemical measurements are conducted in an electrochemical cell composed of various components that control and measure the current and potential. One fundamental component is electrodes, conductive materials that enable electron transfer reactions at their surfaces.
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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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Disturbances in Heart Rhythm01:28

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...
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Crochetage, the Forgotten Electrocardiographic Sign.

Carol Fernandez Hazim1, Mohammed Shaban2, Dessiree Cordero2

  • 1Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA.

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|November 6, 2023
PubMed
Summary

A rare case of complete heart block in a teen was linked to a patent foramen ovale (PFO). PFO closure and a pacemaker resolved symptoms, highlighting the connection between these conditions.

Keywords:
crochetage signpacemaker placementpatent foramen ovale closurepediatric cardiologythird-degree atrioventricular block

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Electrophysiology

Background:

  • Acquired complete heart block is a severe arrhythmia with diverse causes.
  • Atrial septal defect (ASD) is a common congenital defect; larger defects may cause symptoms.
  • The incidence of high-grade atrioventricular block in conjunction with ASD is not well-established.

Observation:

  • A 15-year-old male presented with acute dizziness and complete heart block on EKG, notable for a Crochetage sign.
  • Transthoracic and transesophageal echocardiograms confirmed a coexisting patent foramen ovale (PFO).

Findings:

  • The patient underwent successful patent foramen ovale (PFO) closure and permanent pacemaker implantation.
  • Following the interventions, complete resolution of symptoms and disappearance of the Crochetage sign were observed.

Implications:

  • This case underscores the potential association between patent foramen ovale and acquired complete heart block in adolescents.
  • Interventional closure of PFO combined with pacemaker insertion can effectively manage such complex cardiac conditions.
  • Further research is warranted to establish the precise incidence and underlying mechanisms of heart block in patients with PFO.