…bundle of His). Abnormal depolarization will consequently lead to abnormal repolarization. This explains the secondary ST T changes seen on premature ventricular complexes; the ST…

…most cases, the premature atrial impulse is conducted to the ventricles, which results in ventricular depolarization and the appearance of a QRS complex. Because the…

…These situations are as follows: Premature ventricular depolarization: As exemplified in Figure 1, if the atrial impulse reaches the ventricular His Purkinje system too early…

…voltage. Patients with ARVC display frequent premature ventricular contractions (PVC), which may advance to monomorphic ventricular tachycardia (VT). Ventricular tachycardia in ARVC has LBBB morphology…

…figure is 500 ms. The QT interval represents the time between the onset of ventricular depolarization and the end of ventricular repolarization. It reflects the…

…and anxiety. As the tachyarrhythmia originates above the ventricles, ventricular depolarization proceeds normally via the His Purkinje system, and in most cases, there is no…

…interval is <0.12 seconds. Delta wave : depolarization of ventricular myocardium will start where the accessory pathway inserts into the ventricle, and the impulse will…

…actually a J wave. The term “early repolarization” was used to describe what appeared to be a premature repolarization on the ECG. As seen in…

…of the QRS complex. It reflects the time interval from start of atrial activation (depolarization) to start of ventricular activation (depolarization). The PR interval reflects…

…The fifth beat is a ventricular premature beat. A ventricular tachycardia (VT) emerges. As evident, ventricular tachycardia may appear more polymorphic in one lead (the…

…by Gopinnathair et al. All tachyarrhythmias can cause cardiomyopathy. This also applies to frequent premature ventricular contractions (PVC). As a rule, 20000 PVCs/day is…

…involves prolonged ventricular repolarisation, which allows for the recovery of time dependent inward currents. This process creates early afterdepolarisations (EADs) that generate premature ventricular contractions…

…Intermittent bradycardia The following conditions may cause intermittent bradycardia: Extrasystoles (premature ventricular beats or premature atrial supraventricular beats) can cause transient AV blocks by affecting…

…zoom. Figure 2. Sinus bradycardia, two premature ventricular contractions, incomplete right bundle branch block and ST segment depressions in V2 V6. Click to zoom. Figure…

…have structural heart disease or reduced left ventricular function. Persistent or non persistent ventricular tachycardia or frequent premature ventricular contractions that cause pronounced symptoms and…

…of hypertension. Hypertension becomes more prevalent in women than men after approximately 65 years of age. Hypertension related left ventricular hypertrophy, concentric remodelling, reduced longitudinal…

…first line therapies. Digoxin is also used frequently in the emergency setting to control ventricular rate during supraventricular tachycardias (e.g.atrial fibrillation). Because digoxin…

…wp less cardiac rhythm irregularities mild Oxytocin OXYTOCIN OXYTOCIN Arrhythmia ar less Premature ventricular contractions mild Penicillin G Sodium PENICILLIN G SODIUM PENICILLIN G SODIUM…

…resuscitation is not started immediately. Ventricular fibrillation is the result of numerous re entry circuits , causing rapid and chaotic ventricular depolarizations, rendering the left ventricle…

…IVR; Figures 1 and 2). When the ventricular pressure is less than the left atrial pressure, the mitral valve opens and the cycle is repeated…

…the ventricular conduction system, and thus the ventricular depolarization is slow (yielding a wide QRS complex). Because the ventricular depolarization is abnormal, the repolarization will…

Cardiology Introduction Ventricular tachycardia (VT) represents a complex and potentially lethal spectrum of cardiac arrhythmias that remains a formidable challenge in contemporary cardiovascular medicine. As…

…or syncope if the arrhythmia is sustained. In its fulminant course, VT degenerates to ventricular fibrillation, which then degenerates into asystole and cardiac arrest. Importantly…

…Left ventricular mass and geometry Women Men Reference Mildy abnormal Moderately abnormal Severely abnormal Reference Mildly abnormal Moderately abnormal Severely abnormal LINEAR METHOD LV mass…

Echocardiography Myocardial ischemia and infarction Definition and pathophysiology Left ventricular (LV) thrombus is an intracavitary clot attached to the LV endocardium, typically overlying an akinetic…

…by the failing right ventricle. Clinical presentation and symptoms Clinically important RVI is characterized by manifestations of severe right ventricular failure. Typical findings include: Jugular…

…may appear as a simple and passive process, it is actually a complicated and fundamental aspect of ventricular function. Impaired diastolic function (i.e diastolic…

…pulmonary, renal and neurohormonal factors. These factors, which influence cardiac function primarily by affecting ventricular function, include blood pressure, venous return, pulmonary gas exchange efficiency…

…however, an important parameter in the assessment of ventricular hypertrophy and cardiomyopathy. Numerous formulas have been developed to approximate ventricular mass. Most formulas are simple…

…and clinical applications of these modalities, the definitions of cardiac planes, ventricular segments, and coronary arterial territories evolved differently. This resulted in difficulties when comparing…

…Right ventricular hypertrophy causes large R waves in right sided chest leads and deeper S waves in left sided leads. Right ventricular hypertrophy (RVH) During…

Echocardiography Right ventricular strain When assessing the right half of the heart, it is important to familiarize yourself with the principles of hemodynamics and conditions…

…QT prolongation. Ventricular flutter Monomorphic VT at a rate ~300 bpm (cycle length 200 ms). Ventricular fibrillation Irregular, rapid ( 300 bpm) ventricular depolarizations, with very…

…complication. Clinical deterioration may be abrupt or progressive, and cardiogenic shock may develop rapidly. Ventricular septal rupture VSR typically causes: Recurrent chest pain. Dyspnoea. Hypotension…

…QT prolongation. Ventricular flutter Monomorphic VT at a rate ~300 bpm (cycle length 200 ms). Ventricular fibrillation Irregular, rapid ( 300 bpm) ventricular depolarizations, with very…

Echocardiography Methods for assessing systolic function (contractile function) Several echocardiographic measurements are available to assess left ventricular systolic function. These methods elucidate slightly different aspects…

…right ventricular hypertrophy, and to the left in left ventricular hypertrophy). ST T segment Significant hypertrophy may result in abnormal depolarization of the ventricular myocardium…

…left ventricle): ≥45 milliseconds 1 Romhilt Este's score system ECG changes in left ventricular hypertrophy (LVH) Large R waves in left sided leads (V5…

Info Brugada's algorithm is the most used algorithm for distinguishing ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with wide QRS complex. The algorithm entails…

…and arrhythmology ECG Diagnosis and management of narrow and wide complex tachycardia All clinically significant supraventricular and ventricular tachyarrhythmias have been reviewed in previous sections…

…fraction <55%. This implies that left ventricular pumping capacity is reduced and it is synonymous with heart failure with reduced ejection fraction (HFREF ). Average ejection…

…originate from the atria but the QRS complexes become wide due to abnormal ventricular depolarization (e.g sinus tachycardia with simultaneous left bundle branch block)…

…Threatening Ventricular Arrhythmias [calc_123lqts] Long QT Syndrome (LQTS) is an inherited cardiac channelopathy characterized by prolonged ventricular repolarization, which predisposes individuals to malignant ventricular…

…is derived by measuring flow velocities across the mitral valve using pulsed Doppler. Estimating left ventricular filling pressure via e' . Measurement of deceleration time (DT) …

Echocardiography Myocardial relaxation and left ventricular diastolic function Diastolic function is determined by the efficiency of myocardial relaxation. The degree and velocity of relaxation are…

…interrupted by ventricular tachycardia (VT). ECG 2 . Spontaneous termination of ventricular tachycardia (VT). ECG 3 . A single ventricular beat, followed by a three ventricular beats…

Esmolol Drug Esmolol Brand names Brevibloc ® Indications Short term control of ventricular rate (including perioperative tachycardia) and hypertension (including hypertensive emergency, perioperative hypertension). Mechanism…

…of which waves are visible, the wave(s) that reflect ventricular depolarization is always referred to as the QRS complex . Naming of the waves in…

…long QT syndrome (LQTS) & ventricular arrhythmias (torsade de pointes) due to prolonged QT interval The QT interval is the time interval from the beginning of…

…lines the greater vessels connected to the heart. The epicardium The outermost layer of the ventricular wall is the epicardium , which contains fibroelastic connective tissue…

Echocardiography Echocardiographic assessment of regional contractile function Systolic ventricular function is one of the strongest predictors of total and cardiovascular mortality. Previous chapters have discussed…

[calc_123lqts] Long QT Syndrome (LQTS) is an inherited cardiac channelopathy characterized by prolonged ventricular repolarization, which predisposes individuals to malignant ventricular arrhythmias, notably torsade…

…syncope, etc.). The results were as follows: 73% were caused by ventricular tachyarrhythmias, of which 45% were VT degenerating into VF. 27% were caused by…

…speckle tracking As previously discussed, the left ventricular wall can be subdivided into three layers: the inner lining ( endocardium ), a thick muscle layer ( myocardium ) and…

…spontaneous termination of ventricular tachycardia. ECG 5 . Polymorphic ventricular tachycardia, self terminating. ECG 6 . Repeated runs of ventricular tachycardia. ECG 7 . Continued ventricular ectopy and…

[calc_hcmrisk] Predicting Sudden Cardiac Death in Hypertrophic Cardiomyopathy (HCM) Hypertrophic Cardiomyopathy (HCM) is a genetic cardiomyopathy characterized by left ventricular hypertrophy. It is the…

…PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury. This classification is central to determining the…

…coronary anatomy, myocardial ischaemia, ventricular function and the anticipated benefit–risk balance of revascularization. Coronary angiography remains primarily an anatomical examination, whereas contemporary decision making…

…25% Normal FS, 2D measurement 18% Advantages of fractional shortening If ventricular geometry is normal and there are no regional wall motion abnormalities, then fractional…