…often not true in other circumstances (e.g. pulmonary embolism, trauma, respiratory causes, drug overdoses, etc.). Among victims in whom the cardiac arrest was caused…

…On the other hand, sinus bradycardia developing during physical exercise is considered abnormal, because heart rate must increase during exercise. Mechanisms of cardiac arrhythmias The…

Arrhythmias and arrhythmology Cardiology Definition and pathophysiology Cardiac implantable electronic devices (CIEDs) include permanent pacemakers, implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices…

…complex or T wave can be seen. This is pathognomonic (unique) to ventricular fibrillation and must not be confused with any other arrhythmia. Figure 1…

…and location. Tumors can reduce cardiac output by causing obstruction or valve dysfunction. Tumors that grow invasively in the myocardium can cause arrhythmias, which in…

…ventricular fibrillation (VF). Clinical presentation Confusion Abdominal pain Hypotension Arrhythmias and ECG changes Cardiac arrest Treatment Furosemide 1 mg/kg IV. Hydrocortisone 300 mg IV…

…93%) for myocardial infarction. Moreover, fragmented QRS is associated with an increased risk of sudden cardiac death and ventricular arrhythmias. Figure 2. Fragmented QRS complex…

…cessation of tissue perfusion as a result of cardiac or vascular condition. May reverse spontaneously (e.g., vasovagal syncope) or with treatment (e.g., arrhythmias)…

…ischemia result in cardiac arrest. In order for an infarction or ischemic episode to result in ventricular arrhythmia, it must coincide with other pro arrhythmogenic…

…sudden cardiac arrest. The constraint does not lie in therapy: implantable cardioverter defibrillators (ICDs) are highly effective, terminating well over 99% of the ventricular arrhythmias…

…arrhythmias, shockable rhythm indicates that the duration of cardiac arrest is relatively short (or there is high quality CPR). The longer the duration of cardiac…

…However, most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy…

…separate from those in Brugada syndrome and the risk of ventricular arrhythmias and sudden cardiac death is considerably lower than the risk among patients with…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and Pathophysiology Adenosine is an endogenous nucleoside present throughout the body that interacts with G protein coupled A1 receptors…

…the arrhythmia itself. It may cause symptoms and impaired quality of life, contribute to heart failure, and increase the risk of stroke and other thromboembolic…

Arrhythmias and arrhythmology ECG Sinus bradycardia: ECG, causes & management Definition of sinus bradycardia Sinus bradycardia fulfills the criteria for sinus rhythm but the heart rate…

…slow rate. Acute treatment is generally unnecessary unless the cardiac output is inadequate, hypotension is present, or secondary arrhythmias result from the slow rate. In…

…the arrhythmia may result in symptoms indicative of reduced cardiac output, such as pre syncope or syncope. Definition of Paroxysmal Supraventricular Tachyarrhythmia (PSVT) The arrhythmias…

Arrhythmias and arrhythmology ECG Atrial rhythms: ectopic atrial rhythm, atrial tachycardia and multifocal atrial tachycardia Ectopic atrial tachycardia (EAT, or atrial tachycardia) arises when an…

Arrhythmias and arrhythmology ECG Premature ventricular contractions (premature ventricular complex, premature ventricular beats): ECG and clinical implications Premature ventricular complexes are also referred to as…

…the ventricles, which results in reduced stroke volume and reduced cardiac output. Most patients experience presyncope or syncope if the arrhythmia is sustained. In its…

Arrhythmias and arrhythmology ECG Ventricular rhythm and accelerated ventricular rhythm (idioventricular rhythm) This article provides an overview of ventricular rhythm and accelerated ventricular rhythm, the…

…when other therapeutic options cannot be pursued. Patients receiving digoxin may present with symptoms of digitalis toxicity, which manifests across multiple organ systems. Non cardiac…

…or extrapolation from other fields (e.g. sepsis research) or physiological reasoning. Cardiac arrest care is advanced and should preferably only be conducted in specialized…

…fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of a coronary artery from…

…hemodynamic deterioration, cardiogenic shock, malignant ventricular arrhythmias, or sudden cardiac death. The resulting extensive ischemia causes immediate myocardial stunning (akinesia) and electrical instability. Fewer than…

…is generally related to an atherothrombotic event, whereas Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial…

…fraction. Enlargement of the left ventricle predisposes to atrial and ventricular arrhythmias. In advanced alcohol related cardiomyopathy, dilation may involve all four cardiac chambers. Associated…

…0.07 Arrhythmias 0.38 Vascular complications 0.43 Contrast agent reaction 0.37 Haemodynamic complications 0.26 Cardiac chamber perforation 0.03 Other complications…

…Atrial arrhythmias Pericardial disease, including constriction Right ventricular dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac…

…may also present without prominent discomfort through heart failure, arrhythmias, silent myocardial ischaemia or sudden cardiac death. Important clinical features suggesting UA include a prolonged…

…patients who develop serious arrhythmias during spontaneous episodes represent a higher risk subgroup. Evaluation and physical examination The cardiac examination is usually normal when the…

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…

…in life and a family history of heart failure, ventricular arrhythmias or sudden cardiac arrest is common. The following cardiomyopathies lead to dilation of the…

…and significant arrhythmias. Absolute contraindications Acute myocardial infarction (MI) within 48 hours Ongoing unstable angina Uncontrolled cardiac arrhythmia with hemodynamic compromise Active endocarditis Symptomatic severe…

…and physical examination. It is also reasonable to analyze cardiac troponins if there is any probability of myocardial ischemia as the underlying cause. Holter ECG…

…from ongoing myocardial ischaemia Haemodynamic instability or cardiogenic shock Life threatening arrhythmias or cardiac arrest after presentation Mechanical complications of myocardial infarction Recurrent dynamic ECG…

…heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The…

…syndromes HF across the spectrum of left ventricular ejection fraction AF and other arrhythmias Ischaemic stroke PAD CKD with associated cardiovascular complications Symptoms are determined…

…pectoris). Yet, exercise stress testing provides a fundamental parameter that cannot be obtained by other imaging methods, namely exercise capacity (and VO2 max , see below…

…age. Exercise, or any other activity causing adrenergic stimulation, increase the risk of syncope, ventricular arrhythmias and sudden cardiac arrest. ARVC can cause ventricular tachycardia…

…and other emergency instruments. Personnel conducting the test must be formally trained to assess cardiovascular response, symptoms, and ECG changes. Although the risk of cardiac…

…some arrhythmias) it is not always necessary to analyze all leads, as the diagnosis can often be established by examining fewer leads. On the other…

…intraventricular conduction delays were at particularly high risk of death due to arrhythmias. Note that other causes of wide QRS complex must always be considered…

…considerable risk of developing life threatening ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation) and subsequently cardiac arrest. Although ventricular arrhythmias may occur any time after coronary…

Arrhythmias and arrhythmology ECG Genetic and miscellaneous conditions The early repolarization pattern and syndrome: from ECG criteria to management Although the early repolarization pattern has…

…Atrial Fibrillation and Atrial Thromboembolism Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality…

Drugs and electrolyte imbalance ECG ECG changes due to electrolyte imbalance (electrolyte disorder) The normal cardiac action potential may be altered by electrolyte imbalance, owing…

…syndrome (BrS) has evolved from an obscure electrocardiographic curiosity into a major focus of contemporary cardiac electrophysiology [1] . Recognized as a primary inherited arrhythmia syndrome…

…Focal chest pain or unilaterally reduced breath sounds Consider pneumothorax New arrhythmia or ischaemic ECG changes Concomitant cardiac disease Oxygen targets Patient Initial target saturation : …

…active chest pain or other evidence of ongoing ischaemia Symptoms suggesting haemodynamic compromise, such as near syncope or poor perfusion Known arrhythmia or electrical instability…

…suggesting acute coronary occlusion. Most patients with this working diagnosis subsequently develop myocardial necrosis and cardiac troponin elevation, although not every patient with an initial…

…left ventricular dysfunction, peripheral vascular disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures…

…breathlessness. Other less common presentations, with or without pain, include sudden loss of consciousness, a confusional state, profound weakness, the appearance of an arrhythmia, evidence…

…trigger: consider vestibular migraine, Ménière's disease, TIA and arrhythmia, among others. Acute severe balance disturbance without nystagmus: HINTS does not apply. Assess gait and…

…by insufficient ventilation, leading to hypoxia. Etiologies of hypoxic cardiac arrest : Trauma and injuries : Direct trauma can cause airway injuries, resulting in obstruction. Central nervous…

…the maternal cardiac arrest. Within the context of pregnancy, hypovolemia and other etiologies of hypotension remain the predominant causes of cardiac arrest. Should cardiac arrest…

…showed no recent disease in coronary arteries or in heart muscle. In other words, the heart today is anatomically the same as it was yesterday…

…ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI…

…associations include: Idiopathic or viral pericarditis Malignant pericardial disease Tuberculosis Purulent or bacterial pericarditis Trauma Cardiac surgery and other iatrogenic cardiovascular procedures Acute aortic disease…