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3 years ago
Ventricular fibrillation (VF) is a complex arrhythmia that leads invariably to cardiac arrest. Its mechanisms remain largely unclear. Similar to atrial fibrillation, the mother rotor hypothesis is one plausible alternative.1,2 In larger animals, some authors reported that the dominant frequency of VF could be recorded at a junction of the left ventricular posterior wall and the septum.3-6 Others…
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3 years ago
Premature ventricular contractions (PVCs) are very common cardiac arrhythmias, detected on up to 75% of Holter monitors of ambulatory patients.1 Although PVCs in the setting of advanced structural heart disease have independent negative prognostic implications,2 the majority of PVCs are quite benign, associated with neither symptoms nor signals of future harm. For an important minority, PVCs…
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3 years ago
Early repolarisation pattern is defined electrocardiographically by a distinct J wave or J-point elevation that is either a notch or a slur of the terminal part of the QRS entirely above the baseline, with or without ST-segment elevation. The peak of the notch or slur (Jp) should be ≥0.1 mV in two or more contiguous leads, excluding leads V1 to V2 (see Figure 1).1,2 Early repolarisation syndromes…
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3 years ago
Premature ventricular complexes (PVCs) are the most common ventricular arrhythmia. Their prognostic significance cannot be interpreted without considering the presence or absence of any associated underlying cardiac condition. In the absence of structural heart disease, PVCs were generally considered to be benign.1,2 In the 1970s and 1980s, it was postulated that frequent PVCs could be a trigger…
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3 years ago
Experimental and clinical studies have demonstrated that enhanced sympathetic autonomic nervous system (SANS) activity can destabilise myocardial repolarisation,1–4 increasing vulnerability to developing fatal cardiac arrhythmias.5–8 Accordingly, assessment of SANS activity has always been a major goal for cardiac risk stratification methods. Various non-invasive methods including assessment of…
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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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3 years ago
Cardiac arrhythmias during pregnancy pose a serious threat to the health of both mother and foetus. Women with established tachyarrhythmias, congenital heart defects or channelopathies have the highest risk for development of arrhythmias.1,2 They also develop de novo or occur in women without apparent heart diseases. Tachyarrhythmias, including both supraventricular and ventricular tachycardias,…
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Mahaim Revisited
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1 year ago
Article
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3 years ago
HCN4 (hyperpolarisation-activated, cyclic nucleotide gated 4) channels, the pore-forming α–subunits of ‘funny’ channels originally described in pacemaker cells of the sinoatrial node (SAN),1 are responsible for the early phase of diastolic depolarisation in these cells and are key determinants of pacemaker generation and control of heart rate.2–5 HCN4 channels are selectively expressed in the SAN…
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3 years ago
An estimated 180,000–300,000 sudden cardiac deaths (SCD) occur in the US annually.1,2 Worldwide, sudden and unexpected cardiac death is the most common cause of death,2 accounting for 17 million deaths every year with SCD accounting for 25% of these. The accepted definition of SCD is death that occurs within one hour of onset of symptoms in witnessed cases, and within 24 hours of last being seen…
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