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Cardiac Arrythmias
Published in Charles Theisler, Adjuvant Medical Care, 2023
An arrythmia refers to any change from the normal sequence of electrical impulses that affects either the rate or rhythm of the heartbeat. Irregular heartbeats such as atrial fibrillation, bradycardia, tachycardia, conduction disorders, rhythm disorders, ventricular fibrillation, and premature contractions are arrythmias, also known as dysrhythmias. Palpitations are disturbances in the rhythm that can be felt and can make the heart feel like it is beating too hard or too fast, skipping a beat, or fluttering. Symptoms and signs of arrhythmia often include chest pain, dizziness, breathlessness, palpitations, fainting, chest fluttering, tachycardia or bradycardia, and shortness of breath. Arrythmia is the most common cause of sudden cardiac arrest. There are a wide variety of causes for arrythmias, such as myocardial infarction, coronary heart disease (CAD), hypertension (HTN), thyroid problems, drug abuse, diabetes, certain medications, etc. Smoking and excessive alcohol or caffeine use also increase the risk of an arrythmia.
Anesthesia Monitoring and Management
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Use of an ECG is requisite for definitive diagnosis of arrhythmias. AV block is normal in horses and may be observed while under anesthesia, especially in the presence of alpha-2 agonists (Figure 7.8). The most common pathologic arrhythmia observed in horses is atrial fibrillation and is commonly identified peri-anesthetically.Ventricular premature complexes (VPCs) are sometimes seen in systemically ill patients.Supraventricular premature complexes are occasionally seen in anesthetized horses, and they may precede atrial fibrillation.Foals with uroabdomen suffering from hyperkalemia may exhibit bradycardia, VPCs, sinus arrest, asystole, and/or ventricular fibrillation.
Coronary Artery Disease
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Atherosclerosis in CAD often has distribution in different vessels that is highly irregular. It occurs most at vessel bifurcations or other areas of turbulence. With growth of atheromatous plaques, the arterial lumen becomes progressively narrowed, and ischemia develops. This often causes angina pectoris. The amount of stenosis that will cause ischemia is different with varying oxygen demands. Sometimes an atheromatous plaque splits or ruptures, likely due to morphology, calcium content, or plaque softening because of an inflammatory condition. An acute thrombus is formed, interrupting coronary blood flow. Acute coronary syndromes, including acute ischemia, are based on the degree of obstruction and its location. A transmural infarction can occur. Additional complications include conduction defects, ventricular arrhythmias, heart failure, and sudden death.
A review of arrhythmia detection based on electrocardiogram with artificial intelligence
Published in Expert Review of Medical Devices, 2022
Jinlei Liu, Zhiyuan Li, Yanrui Jin, Yunqing Liu, Chengliang Liu, Liqun Zhao, Xiaojun Chen
Electrocardiogram (ECG) is one of the recommended techniques for detecting arrhythmia. The complete ECG heartbeat contains three key waves: P-wave, QRS-wave, and T-wave, as shown in Figure 1. Different types of arrhythmia correspond to various wave shapes and periods [4], and an experienced cardiologist can quickly make a diagnosis based on the ECG. The widespread application of various ECG devices, especially wearable ECG monitors, has resulted in a large number of ECGs waiting to be diagnosed. However, it is a time-consuming and challenging task to perform arrhythmia analysis on ECG manually. The rapid application of artificial intelligence (AI) technology provides new opportunities for automatic detection of arrhythmia and assists physicians in accurately diagnosing cardiac diseases. Meanwhile, AI methods have also been applied to other physiological signals, such as Electromyogram (EMG), Electroencephalogram (EEG), and Electrooculogram (EOG) [5]. It is comparatively convenient to obtain ECG and the theory of ECG diagnosis of cardiac disease is relatively well established. Aiming at thousands of ECG data, AI methods can automatically learn the inherent patterns between features to achieve rapid and reliable disease classification [6]. Hence, the investigation and application of arrhythmia detection based on AI are of great importance.
Gene therapy to terminate tachyarrhythmias
Published in Expert Review of Cardiovascular Therapy, 2022
Kohei Kawajiri, Kensuke Ihara, Tetsuo Sasano
Gene therapy targeting cardiac arrhythmias has been studied for many years, but few clinical applications have been made. Currently, the most commonly used treatments for cardiac arrhythmia are antiarrhythmic drugs, ablative therapy, and implantable devices. Antiarrhythmic drugs, which have been studied for a long time, have shown some efficacy in treating tachyarrhythmias [1]. Ablative therapy is making progress and is particularly effective in treating paroxysmal and early stage of supraventricular arrhythmias [2]. Implantable devices are used to prevent sudden death [3,4]. However, it is difficult to treat all arrhythmias effectively with these therapies [5]. In particular, persistent atrial fibrillation (AF), which is often encountered in daily practice, is difficult to treat using the methods listed above [6], and the treatment of catheter ablation or antiarrhythmic drugs may lead to iatrogenic arrhythmias [7–9]. Once implanted, Implantable Cardioverter-Defibrillators (ICDs) are effective in preventing sudden death from ventricular tachycardia (VT) and ventricular fibrillation (VF), but it is difficult to treat the arrhythmia itself and suppress its onset. It can also cause device infections in the long term [10].
Clinical electrophysiology of the aging heart
Published in Expert Review of Cardiovascular Therapy, 2022
Kyle Murray, Muizz Wahid, Kannayiram Alagiakrishnan, Janek Senaratne
Palpitations are a heightened or uncomfortable awareness of heartbeat and are a common reason for elderly patients to present to a clinic or hospital [34]. Palpitations are divided into cardiac and noncardiac causes. Noncardiac causes are further subclassified into psychosomatic, medical illness, and pharmacologic mediated. Cardiac causes are secondary to arrhythmias (e.g. tachyarrhythmia, bradyarrhythmia, and extrasystoles) and structural heart disease (e.g. valvular disease, heart failure, and hypertrophic cardiomyopathy). In adults presenting to emergency with palpitations, 47% of cases are a cardiac cause [35]. Patients who are elderly, male, have irregular palpitations, palpitations lasting >5 minutes, and history of coronary artery disease (CAD) have a high likelihood of a cardiac cause [24].