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Related Concept Videos

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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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

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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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 II: Classification of Tachyarrhythmias01:28

Dysrhythmias II: Classification of Tachyarrhythmias

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Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
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Disturbances in Heart Rhythm01:29

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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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Decreased pulse rate01:14

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Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
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Related Experiment Video

Updated: Jan 14, 2026

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
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Does a Pacemaker Make a Difference? Long-Term Outcomes Post-AF Ablation in Tachy-Brady Syndrome.

Kuan-Yu Lin1, Cassie Wang1, Benjamin Ho1

  • 1Northwell Cardiovascular Institute, Center for Arrhythmias, New York, USA.

Journal of Cardiovascular Electrophysiology
|October 17, 2025
PubMed
Summary

Tachy-brady syndrome (TBS) patients undergoing atrial fibrillation ablation had similar failure rates regardless of initial pacemaker status. However, delayed pacemaker implantation was linked to increased failure and hospitalizations, suggesting potential benefits of earlier intervention.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Tachy-brady syndrome (TBS) involves alternating slow and fast heart rhythms.
  • Catheter ablation (CA) for atrial fibrillation (AF) is common, but outcomes in TBS patients with pacemakers are less understood.
  • Permanent pacemaker (PPM) implantation is often used for bradycardia in TBS patients.

Purpose of the Study:

  • To evaluate long-term outcomes of AF ablation in TBS patients stratified by PPM status.
  • To compare AF recurrence, need for repeat procedures, and hospitalizations between TBS patients with and without a PPM at the time of ablation.
  • To investigate the impact of delayed PPM implantation on outcomes.

Main Methods:

  • Retrospective analysis of the ITHACA registry (2015-2021) including 111 TBS patients undergoing AF ablation.
  • Stratification of patients based on PPM status at the time of ablation.
  • Primary outcomes: composite failure (AF recurrence, cardioversion, repeat ablation) at 12 months and last follow-up, and all-cause hospitalization.

Main Results:

  • Overall composite failure rates at 12 months (42% vs. 40%) and last follow-up (44% vs. 47%) were similar between patients with and without an initial PPM.
  • Patients with an initial PPM had significantly higher all-cause hospitalization rates (85% vs. 62%).
  • Delayed PPM implantation was associated with higher failure rates at 12 months (65%) and last follow-up (73%) and numerically higher readmissions.

Conclusions:

  • Initial PPM status did not significantly impact AF ablation failure rates in TBS patients.
  • Higher hospitalization rates in the initial PPM group suggest a potentially sicker patient population.
  • Delayed PPM implantation was linked to worse outcomes, indicating potential benefit from earlier or concurrent PPM placement in selected TBS patients.