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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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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 III: Characteristics of Dysrhythmias01:29

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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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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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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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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.
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Spontaneous right bundle branch block during narrow complex tachycardia.

Sudipta Mondal1, Nadeem Afroz Muslim1

  • 1Department of Cardiology, The Mission Hospital, Durgapur, West Bengal, India 713212.

Journal of Electrocardiology
|March 20, 2026
PubMed
Summary

Recurrent narrow complex tachycardia (NCT) in a patient likely resulted from an atrioventricular nodal reentrant tachycardia. The tachycardia spontaneously transitioned to right bundle branch block during an electrophysiological study.

Keywords:
Coumel'sRBBBRight sided pathwayRight-sided

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Arrhythmias

Background:

  • Narrow complex tachycardia (NCT) is a common arrhythmia requiring accurate diagnosis.
  • Identifying the specific mechanism of NCT is crucial for effective treatment.
  • Preexcitation syndromes are a known cause of tachycardia, but baseline ECG was normal.

Purpose of the Study:

  • To determine the underlying mechanism of recurrent narrow complex tachycardia (NCT) in a patient.
  • To investigate the electrophysiological properties during induced tachycardia.
  • To correlate ECG findings with intracardiac electrograms during an electrophysiological study.

Main Methods:

  • Electrophysiological (EP) study was performed in a 40-year-old male with recurrent NCT.
  • Spontaneous induction of tachycardia was achieved during catheter manipulation.
  • Electrocardiogram (ECG) and intracardiac recordings were analyzed during the tachycardia.
  • The transition to right bundle branch block during tachycardia was specifically observed.

Main Results:

  • Narrow complex tachycardia (NCT) was spontaneously induced during the EP study.
  • During the tachycardia, a spontaneous transition to right bundle branch block was observed on ECG.
  • No manifest preexcitation was evident on the baseline ECG.

Conclusions:

  • The observed findings suggest a diagnosis of atrioventricular nodal reentrant tachycardia (AVNRT).
  • The transition to right bundle branch block during AVNRT is likely due to rate-related aberration.
  • Further investigation and management should be guided by this likely diagnosis.