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Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

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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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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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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.
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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, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
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Related Experiment Video

Updated: Feb 26, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Comparative Left Bundle Branch Block Correction With Physiological Pacing-An Intrapatient Electrocardiographic Study.

Catalin Pestrea1, Ecaterina Cicala1, Sever Risca1

  • 1Department of Interventional Cardiology, Brasov County Clinical Emergency Hospital, Brasov, Romania.

Pacing and Clinical Electrophysiology : PACE
|February 24, 2026
PubMed
Summary
This summary is machine-generated.

His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) offer similar electrocardiographic improvements for patients with left bundle branch block. Both pacing methods effectively reduced depolarization and repolarization abnormalities, aiding cardiac resynchronization therapy.

Keywords:
His bundle pacingdepolarization parametersleft bundle branch area pacingleft bundle branch blockrepolarization parameters

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Pacing

Background:

  • Left bundle branch block (LBBB) and reduced left ventricular ejection fraction (LVEF) often necessitate cardiac resynchronization therapy (CRT).
  • His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) are emerging CRT techniques with varying effects on cardiac depolarization and repolarization.
  • Direct comparisons of intraprocedural electrocardiographic changes between HBP and LBBAP in the same LBBB patient are limited.

Purpose of the Study:

  • To compare acute intraprocedural depolarization and repolarization electrocardiographic changes between corrective His bundle pacing (HBP) and left bundle branch area pacing (LBBAP).
  • To evaluate these changes in patients with baseline left bundle branch block and reduced left ventricular ejection fraction undergoing CRT.

Main Methods:

  • Retrospective review of 36 patients who underwent successful corrective LBBAP for CRT, with demonstrated feasibility of corrective HBP.
  • Measurement of QRS duration (QRSd), QRS and T wave axes, left ventricular activation time (LVAT), corrected QT (QTc) and JT (JTc) intervals, QT dispersion (QTd), and corrected T wave peak-to-end interval (Tpec) for both pacing methods.

Main Results:

  • Both HBP and LBBAP significantly narrowed QRS duration compared to baseline, with no significant difference between the two pacing methods.
  • LBBAP resulted in significantly shorter left ventricular activation times (LVAT) compared to both baseline and HBP.
  • Both pacing techniques similarly reduced QTc, JTc, and Tpec intervals, indicating improved repolarization.

Conclusions:

  • In patients with LBBB and an indication for CRT, both HBP and LBBAP yield comparable significant improvements in electrocardiographic depolarization and repolarization parameters.
  • LBBAP demonstrated a trend towards faster LVAT compared to HBP.
  • The choice between HBP and LBBAP may depend on specific patient factors and procedural goals for CRT optimization.