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Related Concept Videos

Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

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.
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...
Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

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 heart...
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

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...
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

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...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

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

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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Electrophysiological Assessment of Murine Atria with High-Resolution Optical Mapping
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Adenosine-induced atrial arrhythmia: a prospective analysis

S A Strickberger1, K C Man, E G Daoud

  • 1University of Michigan Medical Center, Ann Arbor, USA.

Annals of Internal Medicine
|October 6, 1997
PubMed
Summary

Adenosine effectively treats paroxysmal supraventricular tachycardia (PSVT) but can trigger atrial fibrillation in 12% of patients. This arrhythmia is linked to a specific "long-short" atrial sequence, warranting caution during administration.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Adenosine is a first-line treatment for paroxysmal supraventricular tachycardia (PSVT).
  • Anecdotal evidence suggests adenosine may induce atrial arrhythmias.
  • The precise incidence and mechanism of adenosine-induced atrial arrhythmias require further investigation.

Purpose of the Study:

  • To investigate the frequency of adenosine-induced atrial arrhythmias.
  • To elucidate the underlying mechanisms of these arrhythmias.
  • To assess the clinical implications of adenosine administration in PSVT patients.

Main Methods:

  • A prospective observational study was conducted in a university medical center's electrophysiology laboratory.
  • 200 consecutive patients with PSVT received a 12 mg central intravenous dose of adenosine.
  • Frequency of adenosine-induced atrial fibrillation and associated electrophysiological parameters were recorded.

Main Results:

  • Adenosine successfully terminated PSVT in 99% of patients.
  • Atrial fibrillation or atrial flutter occurred in 12% of patients following adenosine administration.
  • Adenosine-induced atrial arrhythmias were associated with premature atrial complexes and a "long-short" atrial sequence.

Conclusions:

  • The incidence of adenosine-induced atrial fibrillation is approximately 12%.
  • A "long-short" atrial sequence appears to be a mechanism contributing to adenosine-induced atrial fibrillation.
  • Caution is advised when administering adenosine for PSVT, particularly in patients with potential Wolff-Parkinson-White syndrome, necessitating emergency equipment availability.