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6 years ago
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3 years ago
More than 100years have passed since the atrioventricular node (AVN) was first discovered by Sunao Tawara1 and described as a “Knoten” of tissue located at the proximal end of the Bundle of His (BoH).2 Despite the numerous advances in knowledge regarding the structure and function of the AVN, there are still several controversies that need to be addressed in both clinical and scientific settings…
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3 years ago
The concept of post-extrasystolic potentiation (PESP), which describes the phenomenon of increased contractility of the beat following an extrasystole, has intrigued physiologists and clinicians for more than 120 years. Since its first description in 1885 by Oskar Langendorff,1 PESP has become a widely debated concept, not only for its fundamental basis but also because of the potential…
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3 years ago
The incidence of ventricular arrhythmias is often related, within an individual, to the rate of their underlying sinus rhythm (heart rate). The direction of this relationship is generally considered to entail some prognostic significance: whereas ectopic activity suppressed by tachycardia is assumed to be benign, an arrhythmia enhanced by tachycardia is regarded with more concern. Is this…
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3 years ago
Optimal cardiac function depends on appropriate rate and force of contraction, with specific cardiac regions having developed particular beat-to-beat properties depending on their individual functions. For example, isovolumetric contraction time is shorter in the right ventricle (RV) than in the left ventricle (LV). At the cellular level, cardiac function is regulated by regional cardiomyocyte…
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3 years ago
Atrial fibrillation (AF) and heart failure (HF) are global epidemics that began more than a century ago, and their association with an ageing general population has brought about an increase in cardiovascular morbidity and rising healthcare costs.1,2 More than 50 % of patients with permanent AF have a concurrent diagnosis of HF and this proportion is expected to rise.3 It is well established that…
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3 years ago
Heart failure (HF) and AF are two conditions that are increasing in prevalence worldwide.1,2 They frequently co-exist and in recent years, the clinical and physiological intersection between arrhythmia and HF has become an area of renewed interest, particularly as interventional treatments for rhythm disorders have advanced and moved into the mainstream of cardiac management. In particular, AF,…
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3 years ago
Atrial fibrillation (AF) is the most common arrhythmia experienced in clinical practice, and is responsible for significant morbidity and mortality.1 It affects more than 6 million people in Europe.1 The lifetime risk of developing AF after the age of 40 is approximately 25 %.1 AF is a major public health burden as it is associated with an increased risk of stroke by fivefold, dementia by twofold…
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3 years ago
Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. The discovery that pulmonary veins (PV) play a prominent role in the pathogenesis of AF has revolutionised the management of AF. PV isolation has become the most widely used technique for treatment of paroxysmal AF. Since the initial discovery implicating PVs in AF pathogenesis, the mechanistic link between…
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3 years ago
Sudden cardiac death (SCD) is a major public health concern worldwide, accounting for 50 % of cardiovascular mortality.1 Reduced left ventricular ejection fraction (LVEF) is presently used to identify patients at high risk for primary prevention using implantable cardioverter defibrillator (ICD) therapy, but currently only a minority of patients meeting the criteria for prophylactic ICD receive…
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