Arrhythmia
Lauren A. Plante in Expecting Trouble, 2018
Premature atrial contractions (PACs) are frequently encountered in pregnancy. In one study of pregnant women with symptoms versus those with isolated murmur, PACs were seen in 56% of pregnant women with symptoms and 58% of those with an isolated murmur during 24-hour Holter monitoring. The investigators found a significant reduction postpartum (3). Most women with PAC tend to be asymptomatic, and therapy is recommended only in the presence of intolerable symptoms. Cardioselective beta-blockers, such as metoprolol, can safely be used. Prior to initiating treatment, all potential precipitators such as caffeine, tobacco, or other stimulants must be discontinued (24) (Table 5.3).
Arrhythmias in Pregnancy
Afshan B. Hameed, Diana S. Wolfe in Cardio-Obstetrics, 2020
PVCs and premature atrial contractions (PACs) are common in pregnancy [3,4] and typically run a benign course. The exception may be very frequent PVCs. Rhythm monitoring is indicated to establish the burden of arrhythmia to help guide therapy. PACs are quite common in both symptomatic (59%) and asymptomatic pregnant patients (50%) [3]. However, treatment is only recommended if symptoms are intolerable. Symptoms typically improve or resolve in the postpartum period.
Supraventricular rhythms
Andrew R Houghton, David Gray in Making Sense of the ECG, 2014
Ectopic beats appear earlier than expected and can arise from any region of the heart (usually being classified into atrial, AV junctional and ventricular ectopics). Atrial ectopic beats are also called atrial extrasystoles, atrial premature complexes (APCs), atrial premature beats (APBs) or premature atrial contractions (PACs).
Can local infiltration of lidocaine reduce the postoperative atrial fibrillation rate in patients undergoing lobectomy for lung cancer?
Published in Acta Chirurgica Belgica, 2020
Murat Akkuş, Ender Öner
This study indicated that pericardial infiltration of lidocaine around the pulmonary veins after lung cancer resection decreased the POAF rate. The etiology of POAF is multifactorial, and the underlying pathomechanisms are unclear. Therefore, no single drug or intervention targeting a single pathway can effectively prevent POAF in all cases. Patients undergoing pulmonary lobectomy are at a high risk for POAF, and the administration of diltiazem or amiodarone is recommended in these patients to prevent POAF [9]. Additionally, intraoperative mechanical manipulation can cause local tissue injury, and the consequent activation of repair mechanisms results in the onset of premature beats, thereby triggering paroxysmal AF [10,11]. The mechanisms that initiate and sustain AF, including POAF, require a vulnerable atrial substrate [12], as well as a trigger to initiate the AF. Several triggers located in the pulmonary veins and other atrial sites are known to initiate AF [13]. Sorensen et al. [8] applied a direct standardized surgical stimulus around the pericardium and the lung hilum during thoracic surgery. This manipulation triggered premature atrial contractions and nodal rhythm. The hypothesis of the present study was that local infiltration of lidocaine around the pulmonary veins produces both, local anesthetic and antiarrhythmic effects, which might successfully attenuate the undesirable consequences of mechanical manipulation and reduce the incidence of POAF after thoracic surgery.
Supraventricular tachycardia with the use of phentermine: case report and review of literature
Published in Postgraduate Medicine, 2021
Sundeep Kumar, Akhil Mogalapalli, Ruthvik Srinivasamurthy, Sayed T. Hussain, Philip L. Mar
AV nodal reentrant tachycardia (AVNRT) is a type of SVT originating from above the bundle of His. It results from a reentry circuit in or around the AV node, produced by two distinct pathways, designated as a slow and fast pathway. The slow-fast or typical AVNRT is the most common form of this arrhythmia. The circuit consists of anterograde conduction down the slow pathway with retrograde conduction up the fast pathway. Under normal circumstances (sinus rhythm), the impulse progresses down both pathways, but the impulse propagating down the fast pathway will reach the end of the AV node first, rendering the end of the slow pathway refractory before progressing into the bundle of His. AVNRT can occur because of differences in the rate of recovery for each pathway (refractory period). While the slow pathway conducts slower than the fast pathway, it ‘recharges’ or repolarizes faster than the fast pathway. Thus, this arrhythmia can be initiated if a critically timed premature atrial contraction sends an impulse down the slow pathway while the fast pathway is still refractory. In this scenario, when the impulse conducts down the slow pathway only, it can conduct retrogradely up the fast pathway once it reaches the end of the AV node if the fast pathway has recovered, setting up a reentry loop back down the slow pathway, all within the AV node, until something perturbs the cycle, such as carotid massage, Valsalva maneuvers, or IV adenosine [21].
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
According to the American Heart Association statistics, cardiovascular diseases (CVDs) have become the primary cause of death in the world [1]. Due to irregular and unhealthy lifestyles, patients with CVDs tend to become younger. The early symptoms of most CVDs are irregular heartbeats, also known as arrhythmia. Arrhythmia is generated by the disordered electrical activity of the heart, and some arrhythmia such as ventricular tachycardia (VT) and ventricular fibrillation (VF) can be life-threatening [2]. In addition, atrial fibrillation (AF), atrial flutter (AFL), premature ventricular contraction (PVC), premature atrial contraction (PAC), paroxysmal supraventricular tachycardia (PSVT), and bradycardia are also common types of arrhythmia [3]. Therefore, rapid detection and accurate diagnosis of cardiac arrhythmia are particularly essential.
Related Knowledge Centers
- Arrhythmia
- Beta Blocker
- Psychological Stress
- Sinus Rhythm
- Hypertension
- Atrium
- Sinoatrial Node
- Ectopic Beat
- Asymptomatic
- Holter Monitor