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Interpreting AV (Heart) Blocks: Breaking Down the Mystery
Interpreting AV (Heart) Blocks: Breaking Down the Mystery

... of the node do not conduct impulses as fast as the other cardiac electrical tissues. This means that the wave of depolarization will take a longer time to get through the AV node. On the ECG this is represented by a short period of electrical inactivity called the PR interval. The PR interval extend ...
EKG Powerpoint
EKG Powerpoint

... Electrophysiology of the Heart ...
Management of atrial fibrillation-Review
Management of atrial fibrillation-Review

... cover.10–12,22 Use of low-molecular-weight heparin could simplify the treatment regimen, and allow early hospital discharge after cardioversion.23 When the left atrial appendage cannot be adequately seen, cardioversion should be done after 3 weeks of therapeutic anticoagulation. Anticoagulation with ...
The Role of BNP in Atrial Fibrillation
The Role of BNP in Atrial Fibrillation

... score based on hitherto known clinical risk factors.[8] ...
Interventional Cardiology
Interventional Cardiology

... sufficient conduction following ablation. Abnormal ventricular looping seen in L-transposition of the great arteries may also result in congenital or postnatal AV block, accessory AV node tissue and abnormal course of the bundle branches [10] . The location of the AV node and bundle of His are deter ...
Electrical Cardioversion
Electrical Cardioversion

... dysfunction (low left ventricular ejection fraction), valvular heart disease or permanent AF were excluded from the study. Twenty-four of the patients had been taking ACE inhibitors [enalapril (11), lisinopril (8), and captopril (5)] for at least 6 months before inclusion and continued to do so for ...
Sinus Rhythms
Sinus Rhythms

... Anemia; pump failure; hyperthyroidism Rate: 101-150 per minute (may go up to 180) Rhythm: Regular P waves (pacemaker site SA node) a. Normal and upright b. One to one relationship with each QRS P-R interval: 0.12 - 0.20 seconds QRS complex: 0.04 - 0.10 seconds (narrow or normal unless IVCD present) ...
Bradycardia and Heart Block
Bradycardia and Heart Block

... physiological finding due to enhanced vagal tone (e.g. in well-conditioned subjects), be the result of medications that suppress SA node activity (e.g. beta blockers) or reflect intrinsic disease of the SA node. The rhythm is typically regular (equal spacing between P waves) but slight phasic variat ...
Accepted Manuscript
Accepted Manuscript

... evidence-based methodologies developed by the Task Force (1). The Classification of Recommendation (COR) is an estimate of the size of the treatment effect, with consideration given to risks versus benefits, as well as evidence and/or agreement that a given treatment or procedure is or is not useful ...
Vagally Induced Second Degree AV Block Mobitz
Vagally Induced Second Degree AV Block Mobitz

... It can be seen that the sinus rate remains ...
This presentation will deal with the basics of ECG description as well
This presentation will deal with the basics of ECG description as well

... further propagated into atrioventricular node. Here the electrical impulse is slowed down in order to let the ventricles fill with blood due to atria contraction, and further transmitted to His bundle and left and right bundle branches, where the later one speeds up the electrical impulse again, so ...
Transposition of the great arteries with atrial switch versus arterial
Transposition of the great arteries with atrial switch versus arterial

... a = class of recommendation. b = level of evidence. AV = atrioventricular; L-R shunt = left-to-right shunt; LV = Left ventricle; LVOTO = left ventricular outflow tract obstruction; PM = pacemaker; RVEF = right ventricular ejection fraction; TR = tricuspid regurgitation. ...
12 EKG
12 EKG

... tracing represents electrical activity moving toward the active lead (the green lead in this experiment). Five components of a single beat are traditionally recognized and labeled P, Q, R, S, and T. The P wave represents the start of the electrical journey as the impulse spreads from the sinoatrial ...
Accuracy of pulse oximeters in estimating heart rate
Accuracy of pulse oximeters in estimating heart rate

... by linear regression revealed that all three oximeter probe readings correlated well with ECG tracings at all work rates (Table 1). A comparison of mean heart rate at all work rates showed that oximeter readings were not significantly different from those of ECG. However, comparison of heart rate at ...
Flip and See ECG
Flip and See ECG

... Obtaining a Patient History A complete and accurate picture of the patient can be obtained when you use an organized approach to patient history and physical examination. Experienced clinicians start their assessment with how the patient looks. They ask if there is a past cardiac history. There are ...
Acute Electrophysiologic Effects of Inhaled Salbutamol in Humans*
Acute Electrophysiologic Effects of Inhaled Salbutamol in Humans*

... severe arrhythmias. The patients were clinically stable during the 4 weeks preceding the intervention, with no upper or lower respiratory tract infections. Oral and inhaled corticosteroids and oral bronchodilators were discontinued for at least 1 month prior to the study. Inhaled short- and long-act ...
Rosenberg (BIDMC) PACE Article 2012
Rosenberg (BIDMC) PACE Article 2012

... study, was shown to be superior to a 24-Holter monitor for detection of AF episodes and other significant cardiac arrhythmias. Although larger studies are needed to make broad generalizations about the nature of AF detection and characteristics of AF in specific populations, several observations fro ...
Atrial Septal Defect and Atrial Fibrillation: The Known and Unknown
Atrial Septal Defect and Atrial Fibrillation: The Known and Unknown

... cells, hence the propagation velocity in the CT is approximately 10 times greater in the longitudinal than in the transverse direction leading to anisotropic conduction preferentially along the anatomic LoB.58 The increase in atrial refractoriness observed with atrial dilatation is unequally distrib ...
Cardio-vascular Physiology 3
Cardio-vascular Physiology 3

... cardiac function, showing rapid depolarization and then repolarization Electrocardiogram trace recorded simultaneously. ...
Cardiac Memory and Review
Cardiac Memory and Review

... within 2 hours.7 Although this tends to increase with increases in pacing rate7 or duration of pacing, its accumulation is masked by the concomitant occurrence of atrial arrhythmias whose P wave is similar to that of the sinus P wave and that compete with both the sinus and paced rhythms.8 The net r ...
A or V
A or V

... – Class I: There is general agreement that permanent pacemakers should be implanted.  Bifasicular block with intermittent complete heart block associated with symptomatic bradycardia  Bifasicular or Trifasicular block with intermittent type ll second degree A/V block without symptoms attributable ...
The Anatomical Substrates of Wolff-Parkinson-White
The Anatomical Substrates of Wolff-Parkinson-White

... Patient 2. A 19-year-old man was first seen because of syncopal attacks. The site of the anticipated accessory atrioventricular connection was predicted to be left sided and posterior, close to the crux of the heart (fig. 2). The patient died suddenly at home. There were no abnormal findings during ...
Prevention of atrial fibrillation following cardiac surgery: Basis for a
Prevention of atrial fibrillation following cardiac surgery: Basis for a

... idiopathic lone AF (Thamilarasan & Klein, 1999; Sitges et al., 2007). In addition, left atrial size reduction improves sinus rhythm conversion rate after radiofrequency ablation for ...
Chapter 91 - Extras Springer
Chapter 91 - Extras Springer

... behavior of this arrhythmia during programmed electrical stimulation of the heart and its response to different antiarrhythmic drugs suggest that paroxysmal atrial tachycardia is based either on reentry or on triggered activity. Triggered activity is an arrhythmogenic mechanism resulting from delaye ...
Typical atrioventricular nodal reentrant and orthodromic
Typical atrioventricular nodal reentrant and orthodromic

... Atrial pacing with extra stimuli at progressively shorter coupling intervals is used for the electrophysiological study for diagnosis of double nodal pathway. There is a prolongation of at least 50 ms at A-H interval (interval between the atrial electrogram and His bundle) in response to the shorten ...
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Atrial fibrillation



Atrial fibrillation (AF or A-fib) is an abnormal heart rhythm characterized by rapid and irregular beating. Often it starts as brief periods of abnormal beating which become longer and possibly constant over time. Most episodes have no symptoms. Occasionally there may be heart palpitations, fainting, shortness of breath, or chest pain. The disease increases the risk of heart failure, dementia, and stroke.Hypertension and valvular heart disease are the most common alterable risk factors for AF. Other heart-related risk factors include heart failure, coronary artery disease, cardiomyopathy, and congenital heart disease. In the developing world valvular heart disease often occurs as a result of rheumatic fever. Lung-related risk factors include COPD, obesity, and sleep apnea. Other factors include excess alcohol intake, diabetes mellitus, and thyrotoxicosis. However, half of cases are not associated with one of these risks. A diagnosis is made by feeling the pulse and may be confirmed using an electrocardiogram (ECG). The typical ECG shows no P waves and an irregular ventricular rate.AF is often treated with medications to slow the heart rate to a near normal range (known as rate control) or to convert the rhythm to normal sinus rhythm (known as rhythm control). Electrical cardioversion can also be used to convert AF to a normal sinus rhythm and is often used emergently if the person is unstable. Ablation may prevent recurrence in some people. Depending on the risk of stroke either aspirin or anti-clotting medications such as warfarin or a novel oral anticoagulant may be recommended. While these medications reduce this risk, they increase rates of major bleeding.Atrial fibrillation is the most common serious abnormal heart rhythm. In Europe and North America, as of 2014, it affects about 2% to 3% of the population. This is an increase from 0.4 to 1% of the population around 2005. In the developing world about 0.6% of males and 0.4% of females are affected. The percentage of people with AF increases with age with 0.14% under 50 years old, 4% between 60 and 70 years old, and 14% over 80 years old being affected. A-fib and atrial flutter resulted in 112,000 deaths in 2013, up from 29,000 in 1990. The first known report of an irregular pulse was by John Baptist Senac in 1749. This was first documented by ECG in 1909 by Thomas Lewis.
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