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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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Dysrhythmias VI: Management of Dysrhythmias01:25

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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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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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Dysrhythmias II: Classification of Tachyarrhythmias01:28

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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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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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Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

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Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Stepwise Approach to Ventricular Tachycardia Ablation in Structural Heart Disease.

Juan Mundisugih1, Ashwin Bhaskaran2, Kaimin Huang2

  • 1Department of Cardiology, Westmead Hospital, Westmead, NSW, Australia; Westmead Applied Research Centre, Westmead, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. Electronic address: https://x.com/Westmead_EP.

Heart, Lung & Circulation
|December 6, 2025
PubMed
Summary

Catheter ablation is a key treatment for scar-related ventricular tachycardia (VT) in structural heart disease (SHD). A systematic approach improves success rates for this complex procedure.

Keywords:
Catheter ablationStructural heart diseaseVentricular tachycardia

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Technology

Background:

  • Scar-related ventricular tachycardia (VT) is a significant challenge in patients with structural heart disease (SHD).
  • Catheter ablation is a primary therapeutic option for managing drug-refractory VT in these patients.
  • The complexity of VT circuits and underlying structural abnormalities complicates ablation procedures.

Purpose of the Study:

  • To present a systematic approach for catheter ablation of VT in patients with SHD.
  • To detail preprocedural assessment, procedural techniques, and postprocedural care strategies.
  • To highlight the role of technological advancements in improving ablation outcomes.

Main Methods:

  • Review of systematic approaches to VT ablation in SHD.
  • Focus on preprocedural imaging and electrophysiological mapping.
  • Discussion of ablation techniques and post-ablation management.

Main Results:

  • A systematic approach is crucial for successful VT ablation in SHD.
  • Leveraging advanced technologies enhances procedural efficacy.
  • Careful preprocedural assessment and postprocedural management are vital.

Conclusions:

  • Catheter ablation is an effective strategy for scar-related VT in SHD.
  • A systematic, technology-assisted approach optimizes outcomes.
  • Successful management requires comprehensive procedural planning and execution.