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Related Concept Videos

Conduction System of the Heart01:19

Conduction System of the Heart

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Autorhythmicity is a term that refers to the heart's inherent ability to generate electrical signals and instigate muscle contractions. This self-regulating conduction system within the heart consists of two key components: the pacemaker cells and specialized conducting cells.
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
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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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Electrophysiology of Normal Cardiac Rhythm01:19

Electrophysiology of Normal Cardiac Rhythm

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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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Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

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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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Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
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The Cardiac Cycle01:13

The Cardiac Cycle

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The heart beats rhythmically in a sequence called the cardiac cycle—a rapid coordination of contraction (systole) and relaxation (diastole).
The Process
Electrical signals—sent from the sinoatrial (SA) node in the right atrial wall to the atrioventricular (AV) node between the right atrium and right ventricle—cause both atria to simultaneously contract. When the signal reaches the AV node, it pauses for approximately a tenth of a second, allowing the atria to contract and...
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Articles linked to this work by shared authors, journal, and citation graph.

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Insulin-treated type 2 diabetes is associated with increased mortality after transvenous lead extraction for device infection: the IN2DEEP study.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology·2026
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" Real-world procedural outcomes on adoption of a novel stylet-driven, fixed-helix lead for left bundle branch area pacing: Insights from the Conduction-System pacing Italian Network Group (C-SING)".

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Edoxaban versus Apixaban Outcomes Differences in 8,444 Patients with Atrial Fibrillation from Italy: A Real-World Use Comparison.

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Baseline characteristics of patients enrolled in the AZIMUTH trial: an e-health-integrated, smartphone app-based model of care for heart failure patients.

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Sedation Strategies, Drugs, and Protocols Used in Catheter Ablation of Atrial Fibrillation: A Focused Review.

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Related Experiment Video

Updated: Jun 27, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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"Ablate and Pace" with Conduction System Pacing: Concomitant versus Delayed Atrioventricular Junction Ablation.

Pietro Palmisano1, Matteo Ziacchi2, Gabriele Dell'Era3

  • 1Cardiology Unit, "Card. G. Panico" Hospital, 73039 Tricase, Italy.

Journal of Clinical Medicine
|April 27, 2024
PubMed
Summary
This summary is machine-generated.

Conduction system pacing with concomitant atrioventricular junction ablation is as safe as a delayed procedure. This combined approach reduces hospitalizations and healthcare resource utilization for atrial fibrillation patients.

Keywords:
AV junction ablationHis bundle pacingablate and paceatrial fibrillationcatheter ablationconduction system pacingleft bundle branch area pacing

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Last Updated: Jun 27, 2025

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Symptomatic, refractory atrial fibrillation (AF) poses significant clinical challenges.
  • Conduction system pacing (CSP) and atrioventricular junction ablation (AVJA) are established treatments for AF.
  • The optimal timing for AVJA relative to CSP implantation (concomitant vs. delayed) remains unclear.

Purpose of the Study:

  • To compare the safety and healthcare resource utilization of concomitant AVJA versus delayed AVJA following CSP implantation.
  • To evaluate long-term outcomes in patients undergoing these two strategies.

Main Methods:

  • A prospective, multicentre, observational study.
  • 147 patients with symptomatic, refractory AF were enrolled.
  • Patients underwent either simultaneous CSP implantation and AVJA (concomitant group, n=105) or staged procedures with AVJA performed weeks after CSP implantation (delayed group, n=42).

Main Results:

  • Procedure-related complication rates were similar between concomitant (3.8%) and delayed (2.4%) AVJA groups (p=0.666).
  • The concomitant AVJA group showed significantly fewer procedure-related hospitalizations per patient (1.0 vs. 2.0, p<0.001).
  • Concomitant AVJA also resulted in fewer hospital treatment days per patient (4.7 vs. 7.4, p<0.001).

Conclusions:

  • Concomitant AVJA is a safe alternative to delayed AVJA in patients undergoing CSP.
  • Performing AVJA simultaneously with CSP implantation reduces healthcare resource utilization.
  • This strategy offers potential benefits in managing patients with refractory atrial fibrillation.