A form of heart block in which the electrical stimulation of HEART VENTRICLES is interrupted at either one of the branches of BUNDLE OF HIS thus preventing the simultaneous depolarization of the two ventricles.
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
Small band of specialized CARDIAC MUSCLE fibers that originates in the ATRIOVENTRICULAR NODE and extends into the membranous part of the interventricular septum. The bundle of His, consisting of the left and the right bundle branches, conducts the electrical impulses to the HEART VENTRICLES in generation of MYOCARDIAL CONTRACTION.
An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart.
Regulation of the rate of contraction of the heart muscles by an artificial pacemaker.
Impaired conduction of cardiac impulse that can occur anywhere along the conduction pathway, such as between the SINOATRIAL NODE and the right atrium (SA block) or between atria and ventricles (AV block). Heart blocks can be classified by the duration, frequency, or completeness of conduction block. Reversibility depends on the degree of structural or functional defects.
An alkaloid found in the root of RAUWOLFIA SERPENTINA, among other plant sources. It is a class Ia antiarrhythmic agent that apparently acts by changing the shape and threshold of cardiac action potentials.
The restoration of the sequential order of contraction and relaxation of the HEART ATRIA and HEART VENTRICLES by atrio-biventricular pacing.
Recording of the moment-to-moment electromotive forces of the heart on a plane of the body surface delineated as a vector function of time.
A device designed to stimulate, by electric impulses, contraction of the heart muscles. It may be temporary (external) or permanent (internal or internal-external).
This structure includes the thin muscular atrial septum between the two HEART ATRIA, and the thick muscular ventricular septum between the two HEART VENTRICLES.
An abnormally rapid ventricular rhythm usually in excess of 150 beats per minute. It is generated within the ventricle below the BUNDLE OF HIS, either as autonomic impulse formation or reentrant impulse conduction. Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide QRS complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (AV dissociation).
Impaired impulse conduction from HEART ATRIA to HEART VENTRICLES. AV block can mean delayed or completely blocked impulse conduction.
A form of CARDIAC MUSCLE disease that is characterized by ventricular dilation, VENTRICULAR DYSFUNCTION, and HEART FAILURE. Risk factors include SMOKING; ALCOHOL DRINKING; HYPERTENSION; INFECTION; PREGNANCY; and mutations in the LMNA gene encoding LAMIN TYPE A, a NUCLEAR LAMINA protein.
An autosomal dominant defect of cardiac conduction that is characterized by an abnormal ST-segment in leads V1-V3 on the ELECTROCARDIOGRAM resembling a right BUNDLE-BRANCH BLOCK; high risk of VENTRICULAR TACHYCARDIA; or VENTRICULAR FIBRILLATION; SYNCOPAL EPISODE; and possible sudden death. This syndrome is linked to mutations of gene encoding the cardiac SODIUM CHANNEL alpha subunit.
Abnormally rapid heartbeats caused by reentrant conduction over the accessory pathways between the HEART ATRIA and the HEART VENTRICLES. The impulse can also travel in the reverse direction, as in some cases, atrial impulses travel to the ventricles over the accessory pathways and back to the atria over the BUNDLE OF HIS and the ATRIOVENTRICULAR NODE.
Methods to induce and measure electrical activities at specific sites in the heart to diagnose and treat problems with the heart's electrical system.
A transient loss of consciousness and postural tone caused by diminished blood flow to the brain (i.e., BRAIN ISCHEMIA). Presyncope refers to the sensation of lightheadedness and loss of strength that precedes a syncopal event or accompanies an incomplete syncope. (From Adams et al., Principles of Neurology, 6th ed, pp367-9)
A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.
The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.
Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia.
A class Ia antiarrhythmic drug that is structurally-related to PROCAINE.
Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction.
A type of cardiac arrhythmia with premature contractions of the HEART VENTRICLES. It is characterized by the premature QRS complex on ECG that is of abnormal shape and great duration (generally >129 msec). It is the most common form of all cardiac arrhythmias. Premature ventricular complexes have no clinical significance except in concurrence with heart diseases.
Removal of tissue with electrical current delivered via electrodes positioned at the distal end of a catheter. Energy sources are commonly direct current (DC-shock) or alternating current at radiofrequencies (usually 750 kHz). The technique is used most often to ablate the AV junction and/or accessory pathways in order to interrupt AV conduction and produce AV block in the treatment of various tachyarrhythmias.
The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance.
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
Modified cardiac muscle fibers composing the terminal portion of the heart conduction system.
A condition in which HEART VENTRICLES exhibit impaired function.
Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells.
Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.
A group of diseases in which the dominant feature is the involvement of the CARDIAC MUSCLE itself. Cardiomyopathies are classified according to their predominant pathophysiological features (DILATED CARDIOMYOPATHY; HYPERTROPHIC CARDIOMYOPATHY; RESTRICTIVE CARDIOMYOPATHY) or their etiological/pathological factors (CARDIOMYOPATHY, ALCOHOLIC; ENDOCARDIAL FIBROELASTOSIS).
Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005)
Implantable devices which continuously monitor the electrical activity of the heart and automatically detect and terminate ventricular tachycardia (TACHYCARDIA, VENTRICULAR) and VENTRICULAR FIBRILLATION. They consist of an impulse generator, batteries, and electrodes.
Recording of regional electrophysiological information by analysis of surface potentials to give a complete picture of the effects of the currents from the heart on the body surface. It has been applied to the diagnosis of old inferior myocardial infarction, localization of the bypass pathway in Wolff-Parkinson-White syndrome, recognition of ventricular hypertrophy, estimation of the size of a myocardial infarct, and the effects of different interventions designed to reduce infarct size. The limiting factor at present is the complexity of the recording and analysis, which requires 100 or more electrodes, sophisticated instrumentation, and dedicated personnel. (Braunwald, Heart Disease, 4th ed)
A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart.
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
A characteristic symptom complex.
The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.
Method in which prolonged electrocardiographic recordings are made on a portable tape recorder (Holter-type system) or solid-state device ("real-time" system), while the patient undergoes normal daily activities. It is useful in the diagnosis and management of intermittent cardiac arrhythmias and transient myocardial ischemia.
A potentially lethal cardiac arrhythmia that is characterized by uncoordinated extremely rapid firing of electrical impulses (400-600/min) in HEART VENTRICLES. Such asynchronous ventricular quivering or fibrillation prevents any effective cardiac output and results in unconsciousness (SYNCOPE). It is one of the major electrocardiographic patterns seen with CARDIAC ARREST.
A generic expression for any tachycardia that originates above the BUNDLE OF HIS.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
Graphic registration of the heart sounds picked up as vibrations and transformed by a piezoelectric crystal microphone into a varying electrical output according to the stresses imposed by the sound waves. The electrical output is amplified by a stethograph amplifier and recorded by a device incorporated into the electrocardiograph or by a multichannel recording machine.
The joint that occurs between facets of the interior and superior articular processes of adjacent VERTEBRAE.
Unstable isotopes of thallium that decay or disintegrate emitting radiation. Tl atoms with atomic weights 198-202, 204, and 206-210 are thallium radioisotopes.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
Elements of limited time intervals, contributing to particular results or situations.
Agents used for the treatment or prevention of cardiac arrhythmias. They may affect the polarization-repolarization phase of the action potential, its excitability or refractoriness, or impulse conduction or membrane responsiveness within cardiac fibers. Anti-arrhythmia agents are often classed into four main groups according to their mechanism of action: sodium channel blockade, beta-adrenergic blockade, repolarization prolongation, or calcium channel blockade.
A voltage-gated sodium channel subtype that mediates the sodium ion PERMEABILITY of CARDIOMYOCYTES. Defects in the SCN5A gene, which codes for the alpha subunit of this sodium channel, are associated with a variety of CARDIAC DISEASES that result from loss of sodium channel function.
Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.
A form of ventricular pre-excitation characterized by a short PR interval and a long QRS interval with a delta wave. In this syndrome, atrial impulses are abnormally conducted to the HEART VENTRICLES via an ACCESSORY CONDUCTING PATHWAY that is located between the wall of the right or left atria and the ventricles, also known as a BUNDLE OF KENT. The inherited form can be caused by mutation of PRKAG2 gene encoding a gamma-2 regulatory subunit of AMP-activated protein kinase.
Types of artificial pacemakers with implantable leads to be placed at multiple intracardial sites. They are used to treat various cardiac conduction disturbances which interfere with the timing of contraction of the ventricles. They may or may not include defibrillating electrodes (IMPLANTABLE DEFIBRILLATORS) as well.
Abnormally rapid heartbeats caused by reentry of atrial impulse into the dual (fast and slow) pathways of ATRIOVENTRICULAR NODE. The common type involves a blocked atrial impulse in the slow pathway which reenters the fast pathway in a retrograde direction and simultaneously conducts to the atria and the ventricles leading to rapid HEART RATE of 150-250 beats per minute.
A method of computed tomography that uses radionuclides which emit a single photon of a given energy. The camera is rotated 180 or 360 degrees around the patient to capture images at multiple positions along the arc. The computer is then used to reconstruct the transaxial, sagittal, and coronal images from the 3-dimensional distribution of radionuclides in the organ. The advantages of SPECT are that it can be used to observe biochemical and physiological processes as well as size and volume of the organ. The disadvantage is that, unlike positron-emission tomography where the positron-electron annihilation results in the emission of 2 photons at 180 degrees from each other, SPECT requires physical collimation to line up the photons, which results in the loss of many available photons and hence degrades the image.
Theoretical representations that simulate the behavior or activity of the cardiovascular system, processes, or phenomena; includes the use of mathematical equations, computers and other electronic equipment.
The hollow, muscular organ that maintains the circulation of the blood.
Cardiac arrhythmias that are characterized by excessively slow HEART RATE, usually below 50 beats per minute in human adults. They can be classified broadly into SINOATRIAL NODE dysfunction and ATRIOVENTRICULAR BLOCK.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
A condition in which the RIGHT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE or MYOCARDIAL INFARCTION, and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the right ventricular wall.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
A combination of congenital heart defects consisting of four key features including VENTRICULAR SEPTAL DEFECTS; PULMONARY STENOSIS; RIGHT VENTRICULAR HYPERTROPHY; and a dextro-positioned AORTA. In this condition, blood from both ventricles (oxygen-rich and oxygen-poor) is pumped into the body often causing CYANOSIS.
Examinations used to diagnose and treat heart conditions.
An effective non-ionic, water-soluble contrast agent which is used in myelography, arthrography, nephroangiography, arteriography, and other radiographic procedures. Its low systemic toxicity is the combined result of low chemotoxicity and low osmolality.
Radiography of the vascular system of the heart muscle after injection of a contrast medium.
A technetium imaging agent used to reveal blood-starved cardiac tissue during a heart attack.
Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)
Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation.
Contractile activity of the MYOCARDIUM.
A phosphodiesterase inhibitor that blocks uptake and metabolism of adenosine by erythrocytes and vascular endothelial cells. Dipyridamole also potentiates the antiaggregating action of prostacyclin. (From AMA Drug Evaluations Annual, 1994, p752)
A congenital cardiomyopathy that is characterized by infiltration of adipose and fibrous tissue into the RIGHT VENTRICLE wall and loss of myocardial cells. Primary injuries usually are at the free wall of right ventricular and right atria resulting in ventricular and supraventricular arrhythmias.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.
Surgical insertion of synthetic material to repair injured or diseased heart valves.
Ion channels that specifically allow the passage of SODIUM ions. A variety of specific sodium channel subtypes are involved in serving specialized functions such as neuronal signaling, CARDIAC MUSCLE contraction, and KIDNEY function.
A form of CARDIAC MUSCLE disease, characterized by left and/or right ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR; HYPERTROPHY, RIGHT VENTRICULAR), frequent asymmetrical involvement of the HEART SEPTUM, and normal or reduced left ventricular volume. Risk factors include HYPERTENSION; AORTIC STENOSIS; and gene MUTATION; (FAMILIAL HYPERTROPHIC CARDIOMYOPATHY).
Developmental abnormalities in any portion of the VENTRICULAR SEPTUM resulting in abnormal communications between the two lower chambers of the heart. Classification of ventricular septal defects is based on location of the communication, such as perimembranous, inlet, outlet (infundibular), central muscular, marginal muscular, or apical muscular defect.
The chambers of the heart, to which the BLOOD returns from the circulation.
The geometric and structural changes that the HEART VENTRICLES undergo, usually following MYOCARDIAL INFARCTION. It comprises expansion of the infarct and dilatation of the healthy ventricle segments. While most prevalent in the left ventricle, it can also occur in the right ventricle.
A catecholamine derivative with specificity for BETA-1 ADRENERGIC RECEPTORS. It is commonly used as a cardiotonic agent after CARDIAC SURGERY and during DOBUTAMINE STRESS ECHOCARDIOGRAPHY.
A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material.
A method of recording heart motion and internal structures by combining ultrasonic imaging with exercise testing (EXERCISE TEST) or pharmacologic stress.
The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow.
The study of the generation and behavior of electrical charges in living organisms particularly the nervous system and the effects of electricity on living organisms.
The number of times the HEART VENTRICLES contract per unit of time, usually per minute.
Positive test results in subjects who do not possess the attribute for which the test is conducted. The labeling of healthy persons as diseased when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed)
Abnormally rapid heartbeats with sudden onset and cessation.
A calcium channel blocker that is a class IV anti-arrhythmia agent.
A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
Computer-assisted processing of electric, ultrasonic, or electronic signals to interpret function and activity.
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
The hemodynamic and electrophysiological action of the right HEART VENTRICLE.
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing MYOCARDIAL REPERFUSION INJURY.
The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material).
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
The circulation of blood through the CORONARY VESSELS of the HEART.
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
Period of contraction of the HEART, especially of the HEART VENTRICLES.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
Pathological conditions involving the HEART including its structural and functional abnormalities.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
The veins and arteries of the HEART.
The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.
Compounds that are used in medicine as sources of radiation for radiotherapy and for diagnostic purposes. They have numerous uses in research and industry. (Martindale, The Extra Pharmacopoeia, 30th ed, p1161)
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.
Research techniques that focus on study designs and data gathering methods in human and animal populations.
A form of ventricular pre-excitation characterized by a normal PR interval and a long QRS interval with an initial slow deflection (delta wave). In this syndrome, the atrial impulse travel to the ventricle via the MAHAIM FIBERS which connect ATRIOVENTRICULAR NODE directly to the right ventricle wall (NODOVENTRICULAR ACCESSORY PATHWAY) or to the RIGHT BUNDLE BRANCH OF HIS (nodofascicular accessory pathway).
A nucleoside that is composed of ADENINE and D-RIBOSE. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter.
Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation.
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.
A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
## I'm sorry for any confusion, but "Japan" is not a medical term or concept. It is a country located in Asia, known as Nihon-koku or Nippon-koku in Japanese, and is renowned for its unique culture, advanced technology, and rich history. If you have any questions related to medical topics, I would be happy to help answer them!
A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)
Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck.
An agent used as a substrate in assays for cholinesterases, especially to discriminate among enzyme types.
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
A complex group of fibers arising from the basal olfactory regions, the periamygdaloid region, and the septal nuclei, and passing to the lateral hypothalamus. Some fibers continue into the tegmentum.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
A glucocorticoid given orally, parenterally, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. Its lack of mineralocorticoid properties makes betamethasone particularly suitable for treating cerebral edema and congenital adrenal hyperplasia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p724)
Small sets of evidence-based interventions for a defined patient population and care setting.
The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included.
Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.
Persistent pain that is refractory to some or all forms of treatment.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.

Histopathology of conducting system in left anterior hemiblock. (1/664)

In 8 cases of left anterior hemiblock, combined with right bundle-branch block in 7, serial sections of the conducting system of the heart were examined histologically. In all cases there were pathological changes in the left bundle-branch but the anterior part of it was predominantly affected in only 2 cases. Acute changes were found in 6 cases of early myocardial infarction, and fibrosis in 2 cases of chronic heart disease. Reversible lesions may have a pathogenetic role in acute hemiblocks. The right bundle-branch was disrupted by fibrosis in 6 of the 7 cases with right bundle-branch block, and minor changes in the AV node were observed in 1. The widespread damage to the left bundle-branch in the majority of the present cases does not seem to be consistent with the limited clinicopathological correlation implied by the terms anterior fascicular block or hemiblock. Other cardiac lesions within the left bundle-branch and outside it may contribute to this electrocardiographic pattern.  (+info)

Incomplete right bundle branch block and vital capacity. (2/664)

Right bundle branch block (RBBB) is occasionally encountered in young persons who lack any other evidence of overt cardiac disease (Hiss and Lamb, 1962; Lancaster, Schechter, and Massing, 1972). The block may be complete or incomplete, the latter being more common. Right bundle branch block has been studied in relation to body weight, obesity, serum cholesterol and glucose levels, and blood pressure, but the results have been negative (Ostrander, 1964; Kannel et al., 1962). Data presented here suggest that incomplete RBBB is related to vital capacity.  (+info)

Phasic coronary flow pattern and flow reserve in patients with left bundle branch block and normal coronary arteries. (3/664)

OBJECTIVES: The purpose of this study was to determine whether scintigraphic myocardial perfusion defects in patients with left bundle branch block (LBBB) and normal coronary arteries are related to abnormalities in coronary flow velocity pattern and/or coronary flow reserve. BACKGROUND: Septal or anteroseptal defects on exercise myocardial perfusion scintigraphy are common in patients with LBBB and normal coronary arteries. METHODS: Thirteen patients (7 men, age 61+/-8 years) with LBBB and normal coronary arteries underwent stress thallium-201 scintigraphy and cardiac catheterization. In all patients and in 11 control subjects coronary blood flow parameters were calculated from Doppler measurements of flow velocity in the left anterior descending coronary artery (LAD) before and after adenosine administration. RESULTS: The time to maximum peak diastolic flow velocity was significantly longer both for the seven patients with (134+/-19 ms) and for the six without (136+/-7 ms) exercise perfusion defects than for controls (105+/-12 ms, p < 0.05), whereas the acceleration was slower (170+/-54, 186+/-42 and 279+/-96 cm/s2, respectively, p < 0.05). Coronary flow reserve in the patients with exercise perfusion defects (2.7+/-0.3) was significantly lower than in those without (3.7+/-0.5, p < 0.05) or in the control group (3.4+/-0.5, p < 0.05). CONCLUSIONS: Patients with LBBB have an impairment of early diastolic blood flow in the LAD due to an increase in early diastolic compressive resistance resulting from delayed ventricular relaxation. Furthermore, exercise scintigraphic perfusion defects in these patients are associated with a reduced coronary flow reserve, indicating abnormalities of microvascular function in the same vascular territory.  (+info)

Radiofrequency catheter ablation of coexistent atrioventricular reciprocating tachycardia and left ventricular tachycardia originating in the left anterior fascicle. (4/664)

Coexistence of supraventricular tachycardia and ventricular tachycardia is rare. A patient with no structural heart disease and wide QRS complex tachycardia with a right bundle block configuration and right-axis deviation underwent electrophysiological examination. A concealed left atrioventricular pathway (AP) was found, and atrioventricular reciprocating tachycardia (AVRT) and left ventricular tachycardia (VT) originating in or close to the anterior fascicle of the left ventricle were both induced. Radiofrequency (RF) catheter ablation of the concealed left AP was successfully performed. Ten months later, VT recurred and was successfully ablated using a local Purkinje potential as a guide. Coexistent AVRT and idiopathic VT originating from within or near the left anterior fascicle were successfully ablated.  (+info)

The circadian pattern of the development of ventricular fibrillation in patients with Brugada syndrome. (5/664)

AIMS: Brugada syndrome is considered to be a distinctive subgroup of idiopathic ventricular fibrillation. Identification of the circadian pattern of ventricular fibrillation would contribute to the elucidation of its underlying pathophysiology, but this pattern remains unknown in patients with Brugada syndrome. METHODS: and Results A total of 12 consecutive Brugada syndrome patients (46+/-14 years, all male) who underwent implantation of an implantable cardioverter defibrillator were studied. The distribution of the time of ventricular fibrillation detection was examined and classified into four 6-hour time periods of the day. The mean follow-up period following implantation was 777+/-535 days. In six out of the 12 patients, ventricular fibrillation occurred during follow-up. The data logs revealed that ventricular fibrillation was detected 30 times (range, 3-9). Ventricular fibrillation was observed more frequently at night ( 1800 h to 0600 h) than in the day (0600 h to 1800 h) (93.3% [28/30] vs 6.7%[2/30], P<0.001), and during sleep than while awake (86.7% [26/30] vs 13.3%[4/30], P<0.001). Ventricular fibrillation occurred most frequently between midnight and 0600 h in patients with ventricular fibrillation episodes during sleep (76.9% [20/26] vs 23.1%[6/26], P<0.01). CONCLUSION: These results suggest that increased nocturnal vagal activity and withdrawal sympathetic activity may play an important role in the arrhythmogenesis of the Brugada syndrome.  (+info)

Significance of late diastolic potential preceding Purkinje potential in verapamil-sensitive idiopathic left ventricular tachycardia. (6/664)

BACKGROUND: Verapamil-sensitive idiopathic left ventricular tachycardia (VT) is due to reentry with an excitable gap. A late diastolic potential (LDP) is recorded during endocardial mapping of this VT, but its relation to the reentry circuit and significance in radiofrequency (RF) ablation remain to be elucidated. METHODS AND RESULTS: Sixteen consecutive patients with this specific VT were studied (12 men and 4 women; mean age, 32 years). In all patients, sustained VT was induced and during left ventricular endocardial mapping, LDP preceding Purkinje potential (PP) was recorded at the basal (11 patients), middle (3 patients), or apical septum (2 patients). The area with LDP recording was confined to a small region (0.5 to 1.0 cm2) in each patient and was included in the area where PP was recorded (2 to 3 cm2). The relative activation times of LDP, PP, and local ventricular potential (V) at the LDP recording site to the onset of QRS complex were -50.4+/-18.9, -15.2+/-9.6, and 3.0+/-13.3 ms, respectively. The earliest ventricular activation site during VT was identified at the posteroapical septum and was more apical in the septum than the region with LDP in every patient. In 9 patients, VT entrainment was done by pacing from the right ventricular outflow tract while recording LDP. During entrainment, LDP was orthodromically captured, and as the pacing rate was increased, the LDP-to-PP interval was prolonged, whereas stimulus-to-LDP and PP-to-V interval were constant. In 3 patients, the pressure applied to the catheter tip at the LDP region resulted in conduction block between LDP and PP and in VT termination. RF energy application at the LDP recording site successfully eliminated VT. CONCLUSIONS: LDP was suggested to represent the excitation at the entrance to the specialized area with a conduction delay in response to the increase in the rate within the critical slow conduction zone participating in the reentry circuit of this VT. LDP can be a useful marker for successful RF ablation for this VT.  (+info)

Mapping of regional myocardial strain and work during ventricular pacing: experimental study using magnetic resonance imaging tagging. (7/664)

OBJECTIVES: The purpose of this study was to determine the spatial distribution of myocardial function (myofiber shortening and work) within the left ventricular (LV) wall during ventricular pacing. BACKGROUND: Asynchronous electrical activation, as induced by ventricular pacing, causes various abnormalities in LV function, perfusion and structure. These derangements may be caused by abnormalities in regional contraction patterns. However, insight into these patterns during pacing is as yet limited. METHODS: In seven anesthetized dogs, high spatial and temporal resolution magnetic resonance-tagged images were acquired in three orthogonal planes. Three-dimensional deformation data and LV cavity pressure and volume were used to determine midwall circumferential strain and external and total mechanical work at 192 sites around the left ventricle. RESULTS: During ventricular pacing, systolic fiber strain and external work were approximately zero in regions near the pacing site, and gradually increased to more than twice the normal value in the most remote regions. Total mechanical work, normalized to the value during right atrial pacing, was 38 +/- 13% (right ventricular apex [RVapex] pacing) and 61 +/- 23% (left ventricular base [LVbase] pacing) close to the pacing site, and 125 +/- 48% and 171 +/- 60% in remote regions, respectively (p < 0.05 between RVapex and LVbase pacing). The number of regions with reduced work was significantly larger during RVapex than during LVbase pacing. This was associated with a reduction of global LV pump function during RVapex pacing. CONCLUSIONS: Ventricular pacing causes a threefold difference in myofiber work within the LV wall. This difference appears large enough to regard local myocardial function as an important determinant for abnormalities in perfusion, metabolism, structure and pump function during asynchronous electrical activation. Pacing at sites that cause more synchronous activation may limit the occurrence of such derangements.  (+info)

Partial cavotricuspid isthmus block before ablation in patients with typical atrial flutter. (8/664)

OBJECTIVES: The purpose of this study was to prospectively evaluate preexisting partial isthmus block in the context of an electrophysiologically directed linear ablation strategy for typical atrial flutter (AF). BACKGROUND: Double potentials (DPs) separated by an isoelectric interval have been recognized as markers of local block. However, the presence and significance of DPs in the cavotricuspid isthmus during AF before ablation have not been evaluated. METHODS: Thirty consecutive patients with AF (counterclockwise: 24, clockwise: 6) were studied during AF. Sequential withdrawal mapping was performed in the cavotricuspid isthmus from the tricuspid valve (TV) to the inferior vena cava (IVC) edge with electrograms coinciding with the center of the surface electrocardiographic plateau during counterclockwise AF or with the initial downslope of the positive flutter wave during clockwise AF. Atrial electrograms along this line were categorized as double, single or fractionated potentials (SPs or FPs). After demarcation of the zone of contiguous DPs, radiofrequency (RF) catheter ablation was performed during AF only at sites with SPs or FPs (other than DPs) on the mapped line. If isthmus conduction still persisted after AF termination, additional RF applications were delivered using the same electrophysiologic strategy of avoiding DPs with an isoelectric interval during low lateral right atrial pacing for filling in the gap of residual conduction. RESULTS: Before ablation, no DPs were recorded in the isthmus in 19 patients (63%); DPs were recorded only at the IVC edge in five patients, and only at the TV edge in one patient. A contiguous line of DPs extending through more than half the isthmus to the IVC edge was documented in five patients (17%: group DP). In group DP, AF was terminated with 1.4+/-0.5 applications (vs. 5.8+/-3.5 in the remaining patients: p < 0.01). Complete isthmus block was achieved with a total of 3.4+/-0.5 applications (vs. 12+/-6 in the remaining patients: p < 0.01). CONCLUSIONS: Seventeen percent of patients undergoing ablation of AF have preexisting partial isthmus block indicated by a large contiguous zone of DPs separated by an isoelectric interval. Electrophysiologically directed linear ablation avoiding confluent DPs can prevent unnecessary applications for effective cure of AF.  (+info)

Bundle-branch block (BBB) is a type of conduction delay or block in the heart's electrical system that affects the way electrical impulses travel through the ventricles (the lower chambers of the heart). In BBB, one of the two main bundle branches that conduct electrical impulses to the ventricles is partially or completely blocked, causing a delay in the contraction of one of the ventricles.

There are two types of bundle-branch block: right bundle-branch block (RBBB) and left bundle-branch block (LBBB). In RBBB, the right bundle branch is affected, while in LBBB, the left bundle branch is affected. The symptoms and severity of BBB can vary depending on the underlying cause and the presence of other heart conditions.

In some cases, BBB may not cause any noticeable symptoms and may only be detected during a routine electrocardiogram (ECG). However, if BBB occurs along with other heart conditions such as coronary artery disease, heart failure, or cardiomyopathy, it can increase the risk of serious complications such as arrhythmias, syncope, and even sudden cardiac death.

Treatment for bundle-branch block depends on the underlying cause and the severity of the condition. In some cases, no treatment may be necessary, while in others, medications, pacemakers, or other treatments may be recommended to manage symptoms and prevent complications.

Electrocardiography (ECG or EKG) is a medical procedure that records the electrical activity of the heart. It provides a graphic representation of the electrical changes that occur during each heartbeat. The resulting tracing, called an electrocardiogram, can reveal information about the heart's rate and rhythm, as well as any damage to its cells or abnormalities in its conduction system.

During an ECG, small electrodes are placed on the skin of the chest, arms, and legs. These electrodes detect the electrical signals produced by the heart and transmit them to a machine that amplifies and records them. The procedure is non-invasive, painless, and quick, usually taking only a few minutes.

ECGs are commonly used to diagnose and monitor various heart conditions, including arrhythmias, coronary artery disease, heart attacks, and electrolyte imbalances. They can also be used to evaluate the effectiveness of certain medications or treatments.

The Bundle of His is a bundle of specialized cardiac muscle fibers that conduct electrical impulses to the Purkinje fibers, which then stimulate contraction of the ventricles in the heart. It is named after Wilhelm His, Jr., who first described it in 1893.

The Bundle of His is a part of the electrical conduction system of the heart that helps coordinate the contraction of the atria and ventricles to ensure efficient pumping of blood. The bundle originates from the atrioventricular node, which receives electrical impulses from the sinoatrial node (the heart's natural pacemaker) and transmits them through the Bundle of His to the Purkinje fibers.

The Bundle of His is divided into two main branches, known as the right and left bundle branches, which further divide into smaller fascicles that spread throughout the ventricular myocardium. This ensures a coordinated contraction of the ventricles, allowing for efficient pumping of blood to the rest of the body.

The heart conduction system is a group of specialized cardiac muscle cells that generate and conduct electrical impulses to coordinate the contraction of the heart chambers. The main components of the heart conduction system include:

1. Sinoatrial (SA) node: Also known as the sinus node, it is located in the right atrium near the entrance of the superior vena cava and functions as the primary pacemaker of the heart. It sets the heart rate by generating electrical impulses at regular intervals.
2. Atrioventricular (AV) node: Located in the interatrial septum, near the opening of the coronary sinus, it serves as a relay station for electrical signals between the atria and ventricles. The AV node delays the transmission of impulses to allow the atria to contract before the ventricles.
3. Bundle of His: A bundle of specialized cardiac muscle fibers that conducts electrical impulses from the AV node to the ventricles. It divides into two main branches, the right and left bundle branches, which further divide into smaller Purkinje fibers.
4. Right and left bundle branches: These are extensions of the Bundle of His that transmit electrical impulses to the respective right and left ventricular myocardium. They consist of specialized conducting tissue with large diameters and minimal resistance, allowing for rapid conduction of electrical signals.
5. Purkinje fibers: Fine, branching fibers that arise from the bundle branches and spread throughout the ventricular myocardium. They are responsible for transmitting electrical impulses to the working cardiac muscle cells, triggering coordinated ventricular contraction.

In summary, the heart conduction system is a complex network of specialized muscle cells responsible for generating and conducting electrical signals that coordinate the contraction of the atria and ventricles, ensuring efficient blood flow throughout the body.

Artificial cardiac pacing is a medical procedure that involves the use of an artificial device to regulate and stimulate the contraction of the heart muscle. This is often necessary when the heart's natural pacemaker, the sinoatrial node, is not functioning properly and the heart is beating too slowly or irregularly.

The artificial pacemaker consists of a small generator that produces electrical impulses and leads that are positioned in the heart to transmit the impulses. The generator is typically implanted just under the skin in the chest, while the leads are inserted into the heart through a vein.

There are different types of artificial cardiac pacing systems, including single-chamber pacemakers, which stimulate either the right atrium or right ventricle, and dual-chamber pacemakers, which stimulate both chambers of the heart. Some pacemakers also have additional features that allow them to respond to changes in the body's needs, such as during exercise or sleep.

Artificial cardiac pacing is a safe and effective treatment for many people with abnormal heart rhythms, and it can significantly improve their quality of life and longevity.

Heart block is a cardiac condition characterized by the interruption of electrical impulse transmission from the atria (the upper chambers of the heart) to the ventricles (the lower chambers of the heart). This disruption can lead to abnormal heart rhythms, including bradycardia (a slower-than-normal heart rate), and in severe cases, can cause the heart to stop beating altogether. Heart block is typically caused by damage to the heart's electrical conduction system due to various factors such as aging, heart disease, or certain medications.

There are three types of heart block: first-degree, second-degree, and third-degree (also known as complete heart block). Each type has distinct electrocardiogram (ECG) findings and symptoms. Treatment for heart block depends on the severity of the condition and may include monitoring, medication, or implantation of a pacemaker to regulate the heart's electrical activity.

Ajmaline is a type of medication known as a Class I antiarrhythmic agent, which is used to treat certain types of abnormal heart rhythms. It works by blocking the sodium channels in the heart muscle, which helps to slow down the conduction of electrical signals within the heart and can help to restore a normal heart rhythm.

Ajmaline is typically administered intravenously (through a vein) in a hospital setting, as it acts quickly and its effects can be closely monitored by healthcare professionals. It may be used to diagnose certain types of heart rhythm disturbances or to treat acute episodes of arrhythmias that are not responding to other treatments.

Like all medications, ajmaline can have side effects, including dizziness, headache, nausea, and chest pain. It is important for patients to be closely monitored while taking this medication and to report any unusual symptoms to their healthcare provider. Ajmaline should only be used under the close supervision of a qualified healthcare professional.

Cardiac Resynchronization Therapy (CRT) is a medical treatment for heart failure that involves the use of a specialized device, called a biventricular pacemaker or a cardiac resynchronization therapy device, to help coordinate the timing of contractions between the left and right ventricles of the heart.

In a healthy heart, the ventricles contract in a coordinated manner, with the left ventricle contracting slightly before the right ventricle. However, in some people with heart failure, the electrical signals that control the contraction of the heart become disrupted, causing the ventricles to contract at different times. This is known as ventricular dyssynchrony and can lead to reduced pumping efficiency and further worsening of heart failure symptoms.

CRT works by delivering small electrical impulses to both ventricles simultaneously or in a coordinated manner, which helps restore normal synchrony and improve the efficiency of the heart's pumping function. This can lead to improved symptoms, reduced hospitalizations, and increased survival rates in some people with heart failure.

CRT is typically recommended for people with moderate to severe heart failure who have evidence of ventricular dyssynchrony and a wide QRS complex on an electrocardiogram (ECG). The procedure involves the implantation of a small device under the skin, usually in the upper chest area, which is connected to leads that are placed in the heart through veins.

While CRT can be an effective treatment for some people with heart failure, it is not without risks and potential complications, such as infection, bleeding, or damage to blood vessels or nerves. Therefore, careful consideration should be given to the potential benefits and risks of CRT before deciding whether it is appropriate for a particular individual.

Vectorcardiography (VCG) is a type of graphical recording that depicts the vector magnitude and direction of the electrical activity of the heart over time. It provides a three-dimensional view of the electrical activation pattern of the heart, as opposed to the one-dimensional view offered by a standard electrocardiogram (ECG).

In VCG, the electrical potentials are recorded using a special array of electrodes placed on the body surface. These potentials are then mathematically converted into vectors and plotted on a vector loop or a series of loops that represent different planes of the heart's electrical activity. The resulting tracing provides information about the magnitude, direction, and timing of the electrical activation of the heart, which can be helpful in diagnosing various cardiac arrhythmias, ischemic heart disease, and other cardiac conditions.

Overall, vectorcardiography offers a more detailed and comprehensive view of the heart's electrical activity than traditional ECG, making it a valuable tool in clinical cardiology.

An artificial pacemaker is a medical device that uses electrical impulses to regulate the beating of the heart. It is typically used when the heart's natural pacemaker, the sinoatrial node, is not functioning properly and the heart rate is too slow or irregular. The pacemaker consists of a small generator that contains a battery and electronic circuits, which are connected to one or more electrodes that are placed in the heart.

The generator sends electrical signals through the electrodes to stimulate the heart muscle and cause it to contract, thereby maintaining a regular heart rhythm. Artificial pacemakers can be programmed to deliver electrical impulses at a specific rate or in response to the body's needs. They are typically implanted in the chest during a surgical procedure and can last for many years before needing to be replaced.

Artificial pacemakers are an effective treatment for various types of bradycardia, which is a heart rhythm disorder characterized by a slow heart rate. Pacemakers can significantly improve symptoms associated with bradycardia, such as fatigue, dizziness, shortness of breath, and fainting spells.

The heart septum is the thick, muscular wall that divides the right and left sides of the heart. It consists of two main parts: the atrial septum, which separates the right and left atria (the upper chambers of the heart), and the ventricular septum, which separates the right and left ventricles (the lower chambers of the heart). A normal heart septum ensures that oxygen-rich blood from the lungs does not mix with oxygen-poor blood from the body. Any defect or abnormality in the heart septum is called a septal defect, which can lead to various congenital heart diseases.

Ventricular Tachycardia (VT) is a rapid heart rhythm that originates from the ventricles, the lower chambers of the heart. It is defined as three or more consecutive ventricular beats at a rate of 120 beats per minute or greater in a resting adult. This abnormal heart rhythm can cause the heart to pump less effectively, leading to inadequate blood flow to the body and potentially life-threatening conditions such as hypotension, shock, or cardiac arrest.

VT can be classified into three types based on its duration, hemodynamic stability, and response to treatment:

1. Non-sustained VT (NSVT): It lasts for less than 30 seconds and is usually well tolerated without causing significant symptoms or hemodynamic instability.
2. Sustained VT (SVT): It lasts for more than 30 seconds, causes symptoms such as palpitations, dizziness, shortness of breath, or chest pain, and may lead to hemodynamic instability.
3. Pulseless VT: It is a type of sustained VT that does not produce a pulse, blood pressure, or adequate cardiac output, requiring immediate electrical cardioversion or defibrillation to restore a normal heart rhythm.

VT can occur in people with various underlying heart conditions such as coronary artery disease, cardiomyopathy, valvular heart disease, congenital heart defects, and electrolyte imbalances. It can also be triggered by certain medications, substance abuse, or electrical abnormalities in the heart. Prompt diagnosis and treatment of VT are crucial to prevent complications and improve outcomes.

Atrioventricular (AV) block is a disorder of the electrical conduction system of the heart that causes a delay or interruption in the transmission of electrical signals from the atria (the upper chambers of the heart) to the ventricles (the lower chambers of the heart). This results in an abnormal heart rhythm, also known as an arrhythmia.

There are three degrees of AV block:

1. First-degree AV block: In this type of AV block, there is a delay in the conduction of electrical signals from the atria to the ventricles, but all signals are eventually conducted. This condition may not cause any symptoms and is often discovered during a routine electrocardiogram (ECG).
2. Second-degree AV block: In this type of AV block, some electrical signals from the atria are not conducted to the ventricles. There are two types of second-degree AV block: Mobitz type I and Mobitz type II. Mobitz type I is characterized by a progressive prolongation of the PR interval (the time between the electrical activation of the atria and ventricles) until a QRS complex (which represents the electrical activation of the ventricles) is dropped. Mobitz type II is characterized by a constant PR interval with occasional non-conducted P waves.
3. Third-degree AV block: In this type of AV block, no electrical signals are conducted from the atria to the ventricles. The atria and ventricles beat independently of each other, resulting in a slow heart rate (bradycardia) and an irregular rhythm. This condition can be life-threatening if not treated promptly.

The causes of AV block include aging, heart disease, medications, and certain medical conditions such as hypothyroidism and Lyme disease. Treatment depends on the severity of the condition and may include medication, a pacemaker, or surgery.

Dilated cardiomyopathy (DCM) is a type of cardiomyopathy characterized by the enlargement and weakened contraction of the heart's main pumping chamber (the left ventricle). This enlargement and weakness can lead to symptoms such as shortness of breath, fatigue, and fluid retention. DCM can be caused by various factors including genetics, viral infections, alcohol and drug abuse, and other medical conditions like high blood pressure and diabetes. It is important to note that this condition can lead to heart failure if left untreated.

Brugada Syndrome is a genetic disorder characterized by abnormal electrocardiogram (ECG) findings and an increased risk of sudden cardiac death. It is typically caused by a mutation in the SCN5A gene, which encodes for a sodium channel protein in the heart. This mutation can lead to abnormal ion transport in the heart cells, causing changes in the electrical activity of the heart that can trigger dangerous arrhythmias.

The ECG findings associated with Brugada Syndrome include a distinct pattern of ST-segment elevation in the right precordial leads (V1-V3), which can appear spontaneously or be induced by certain medications. The syndrome is often classified into two types based on the presence or absence of symptoms:

* Type 1 Brugada Syndrome: This type is characterized by a coved-type ST-segment elevation of at least 2 mm in height in at least one right precordial lead, with a negative T wave. This pattern must be present to make the diagnosis, and it should not be transient or induced by any medication or condition. Type 1 Brugada Syndrome is associated with a higher risk of sudden cardiac death.
* Type 2 Brugada Syndrome: This type is characterized by a saddleback-type ST-segment elevation of at least 2 mm in height in at least one right precordial lead, with a positive or biphasic T wave. The ST segment should return to the baseline level or below within 0.08 seconds after the J point (the junction between the QRS complex and the ST segment). Type 2 Brugada Syndrome is associated with a lower risk of sudden cardiac death compared to Type 1, but it can still pose a significant risk in some individuals.

Brugada Syndrome can affect people of any age, gender, or ethnicity, although it is more commonly diagnosed in middle-aged men of Asian descent. The syndrome can be inherited in an autosomal dominant manner, meaning that a child has a 50% chance of inheriting the mutation from a parent who carries the gene. However, not all individuals with the genetic mutation will develop symptoms or have abnormal ECG findings.

Treatment for Brugada Syndrome typically involves implanting a cardioverter-defibrillator (ICD) to prevent sudden cardiac death. Medications such as quinidine or isoproterenol may also be used to reduce the risk of arrhythmias. Lifestyle modifications, such as avoiding alcohol and certain medications that can trigger arrhythmias, may also be recommended.

Reciprocating tachycardia is a type of supraventricular tachycardia (SVT), which is a rapid heart rhythm originating in the atria or atrioventricular node. In reciprocating tachycardia, there are abnormal electrical connections between the atria and ventricles called "accessory pathways" that allow electrical impulses to bypass the normal conduction system.

In this type of tachycardia, an electrical impulse originates in one of the atria and travels down the normal conduction system to the ventricles, but then instead of following the normal route back up to the atria, it takes a shortcut through an accessory pathway. This creates a reentry circuit, where the electrical impulse continuously circulates between the atria and ventricles, causing a rapid heart rate.

Reciprocating tachycardia can be classified as either orthodromic or antidromic, depending on the direction of the electrical impulse through the accessory pathway. In orthodromic reciprocating tachycardia, the electrical impulse travels down the normal conduction system to the ventricles and then returns up the accessory pathway to the atria. This type of reciprocating tachycardia is more common than antidromic reciprocating tachycardia, which occurs when the electrical impulse travels down the accessory pathway to the ventricles and then returns up the normal conduction system to the atria.

Symptoms of reciprocating tachycardia may include palpitations, lightheadedness, shortness of breath, chest discomfort, or syncope (fainting). Treatment options for reciprocating tachycardia include medications, cardioversion, catheter ablation, and surgery.

Electrophysiologic techniques, cardiac, refer to medical procedures used to study the electrical activities and conduction systems of the heart. These techniques involve the insertion of electrode catheters into the heart through blood vessels under fluoroscopic guidance to record and stimulate electrical signals. The information obtained from these studies can help diagnose and evaluate various cardiac arrhythmias, determine the optimal treatment strategy, and assess the effectiveness of therapies such as ablation or implantable devices.

The electrophysiologic study (EPS) is a type of cardiac electrophysiologic technique that involves the measurement of electrical signals from different regions of the heart to evaluate its conduction system's function. The procedure can help identify the location of abnormal electrical pathways responsible for arrhythmias and determine the optimal treatment strategy, such as catheter ablation or medication therapy.

Cardiac electrophysiologic techniques are also used in device implantation procedures, such as pacemaker or defibrillator implantation, to ensure proper placement and function of the devices. These techniques can help program and test the devices to optimize their settings for each patient's needs.

In summary, cardiac electrophysiologic techniques are medical procedures used to study and manipulate the electrical activities of the heart, helping diagnose and treat various arrhythmias and other cardiac conditions.

Syncope is a medical term defined as a transient, temporary loss of consciousness and postural tone due to reduced blood flow to the brain. It's often caused by a drop in blood pressure, which can be brought on by various factors such as dehydration, emotional stress, prolonged standing, or certain medical conditions like heart diseases, arrhythmias, or neurological disorders.

During a syncope episode, an individual may experience warning signs such as lightheadedness, dizziness, blurred vision, or nausea before losing consciousness. These episodes usually last only a few minutes and are followed by a rapid, full recovery. However, if left untreated or undiagnosed, recurrent syncope can lead to severe injuries from falls or even life-threatening conditions related to the underlying cause.

Left ventricular dysfunction (LVD) is a condition characterized by the impaired ability of the left ventricle of the heart to pump blood efficiently during contraction. The left ventricle is one of the four chambers of the heart and is responsible for pumping oxygenated blood to the rest of the body.

LVD can be caused by various underlying conditions, such as coronary artery disease, cardiomyopathy, valvular heart disease, or hypertension. These conditions can lead to structural changes in the left ventricle, including remodeling, hypertrophy, and dilation, which ultimately impair its contractile function.

The severity of LVD is often assessed by measuring the ejection fraction (EF), which is the percentage of blood that is pumped out of the left ventricle during each contraction. A normal EF ranges from 55% to 70%, while an EF below 40% is indicative of LVD.

LVD can lead to various symptoms, such as shortness of breath, fatigue, fluid retention, and decreased exercise tolerance. It can also increase the risk of complications, such as heart failure, arrhythmias, and cardiac arrest. Treatment for LVD typically involves managing the underlying cause, along with medications to improve contractility, reduce fluid buildup, and control heart rate. In severe cases, devices such as implantable cardioverter-defibrillators (ICDs) or left ventricular assist devices (LVADs) may be required.

The heart ventricles are the two lower chambers of the heart that receive blood from the atria and pump it to the lungs or the rest of the body. The right ventricle pumps deoxygenated blood to the lungs, while the left ventricle pumps oxygenated blood to the rest of the body. Both ventricles have thick, muscular walls to generate the pressure necessary to pump blood through the circulatory system.

Tachycardia is a medical term that refers to an abnormally rapid heart rate, often defined as a heart rate greater than 100 beats per minute in adults. It can occur in either the atria (upper chambers) or ventricles (lower chambers) of the heart. Different types of tachycardia include supraventricular tachycardia (SVT), atrial fibrillation, atrial flutter, and ventricular tachycardia.

Tachycardia can cause various symptoms such as palpitations, shortness of breath, dizziness, lightheadedness, chest discomfort, or syncope (fainting). In some cases, tachycardia may not cause any symptoms and may only be detected during a routine physical examination or medical test.

The underlying causes of tachycardia can vary widely, including heart disease, electrolyte imbalances, medications, illicit drug use, alcohol abuse, smoking, stress, anxiety, and other medical conditions. In some cases, the cause may be unknown. Treatment for tachycardia depends on the underlying cause, type, severity, and duration of the arrhythmia.

Procainamide is an antiarrhythmic medication used to treat various types of irregular heart rhythms (arrhythmias), such as atrial fibrillation, atrial flutter, and ventricular tachycardia. It works by prolonging the duration of the cardiac action potential and decreasing the slope of the phase 0 depolarization, which helps to stabilize the heart's electrical activity and restore a normal rhythm.

Procainamide is classified as a Class Ia antiarrhythmic drug, according to the Vaughan Williams classification system. It primarily affects the fast sodium channels in the heart muscle cells, reducing their availability during depolarization. This results in a decreased rate of impulse generation and conduction velocity, which can help to suppress abnormal rhythms.

The medication is available as an oral formulation (procainamide hydrochloride) and as an injectable solution for intravenous use. Common side effects of procainamide include nausea, vomiting, diarrhea, headache, and dizziness. Procainamide can also cause a lupus-like syndrome, characterized by joint pain, skin rashes, and other autoimmune symptoms, in some patients who take the medication for an extended period.

It is essential to monitor procainamide levels in the blood during treatment to ensure that the drug is within the therapeutic range and to minimize the risk of adverse effects. Healthcare providers should also regularly assess patients' renal function, as procainamide and its active metabolite, N-acetylprocainamide (NAPA), are primarily excreted by the kidneys.

Cardiac arrhythmias are abnormal heart rhythms that result from disturbances in the electrical conduction system of the heart. The heart's normal rhythm is controlled by an electrical signal that originates in the sinoatrial (SA) node, located in the right atrium. This signal travels through the atrioventricular (AV) node and into the ventricles, causing them to contract and pump blood throughout the body.

An arrhythmia occurs when there is a disruption in this electrical pathway or when the heart's natural pacemaker produces an abnormal rhythm. This can cause the heart to beat too fast (tachycardia), too slow (bradycardia), or irregularly.

There are several types of cardiac arrhythmias, including:

1. Atrial fibrillation: A rapid and irregular heartbeat that starts in the atria (the upper chambers of the heart).
2. Atrial flutter: A rapid but regular heartbeat that starts in the atria.
3. Supraventricular tachycardia (SVT): A rapid heartbeat that starts above the ventricles, usually in the atria or AV node.
4. Ventricular tachycardia: A rapid and potentially life-threatening heart rhythm that originates in the ventricles.
5. Ventricular fibrillation: A chaotic and disorganized electrical activity in the ventricles, which can be fatal if not treated immediately.
6. Heart block: A delay or interruption in the conduction of electrical signals from the atria to the ventricles.

Cardiac arrhythmias can cause various symptoms, such as palpitations, dizziness, shortness of breath, chest pain, and fatigue. In some cases, they may not cause any symptoms and go unnoticed. However, if left untreated, certain types of arrhythmias can lead to serious complications, including stroke, heart failure, or even sudden cardiac death.

Treatment for cardiac arrhythmias depends on the type, severity, and underlying causes. Options may include lifestyle changes, medications, cardioversion (electrical shock therapy), catheter ablation, implantable devices such as pacemakers or defibrillators, and surgery. It is essential to consult a healthcare professional for proper evaluation and management of cardiac arrhythmias.

Ventricular Premature Complexes (VPCs), also known as Ventricular Extrasystoles or Premature Ventricular Contractions (PVCs), are extra heartbeats that originate in the ventricles, the lower chambers of the heart. These premature beats disrupt the normal sequence of electrical impulses in the heart and cause the ventricles to contract earlier than they should.

VPCs can result in a noticeable "skipped" or "extra" beat sensation, often followed by a stronger beat as the heart returns to its regular rhythm. They may occur occasionally in healthy individuals with no underlying heart condition, but frequent VPCs could indicate an underlying issue such as heart disease, electrolyte imbalance, or digitalis toxicity. In some cases, VPCs can be harmless and require no treatment; however, if they are frequent or associated with structural heart problems, further evaluation and management may be necessary to prevent potential complications like reduced cardiac output or heart failure.

Catheter ablation is a medical procedure in which specific areas of heart tissue that are causing arrhythmias (irregular heartbeats) are destroyed or ablated using heat energy (radiofrequency ablation), cold energy (cryoablation), or other methods. The procedure involves threading one or more catheters through the blood vessels to the heart, where the tip of the catheter can be used to selectively destroy the problematic tissue. Catheter ablation is often used to treat atrial fibrillation, atrial flutter, and other types of arrhythmias that originate in the heart's upper chambers (atria). It may also be used to treat certain types of arrhythmias that originate in the heart's lower chambers (ventricles), such as ventricular tachycardia.

The goal of catheter ablation is to eliminate or reduce the frequency and severity of arrhythmias, thereby improving symptoms and quality of life. In some cases, it may also help to reduce the risk of stroke and other complications associated with arrhythmias. Catheter ablation is typically performed by a specialist in heart rhythm disorders (electrophysiologist) in a hospital or outpatient setting under local anesthesia and sedation. The procedure can take several hours to complete, depending on the complexity of the arrhythmia being treated.

It's important to note that while catheter ablation is generally safe and effective, it does carry some risks, such as bleeding, infection, damage to nearby structures, and the possibility of recurrent arrhythmias. Patients should discuss the potential benefits and risks of the procedure with their healthcare provider before making a decision about treatment.

Left ventricular function refers to the ability of the left ventricle (the heart's lower-left chamber) to contract and relax, thereby filling with and ejecting blood. The left ventricle is responsible for pumping oxygenated blood to the rest of the body. Its function is evaluated by measuring several parameters, including:

1. Ejection fraction (EF): This is the percentage of blood that is pumped out of the left ventricle with each heartbeat. A normal ejection fraction ranges from 55% to 70%.
2. Stroke volume (SV): The amount of blood pumped by the left ventricle in one contraction. A typical SV is about 70 mL/beat.
3. Cardiac output (CO): The total volume of blood that the left ventricle pumps per minute, calculated as the product of stroke volume and heart rate. Normal CO ranges from 4 to 8 L/minute.

Assessment of left ventricular function is crucial in diagnosing and monitoring various cardiovascular conditions such as heart failure, coronary artery disease, valvular heart diseases, and cardiomyopathies.

Heart failure is a pathophysiological state in which the heart is unable to pump sufficient blood to meet the metabolic demands of the body or do so only at the expense of elevated filling pressures. It can be caused by various cardiac disorders, including coronary artery disease, hypertension, valvular heart disease, cardiomyopathy, and arrhythmias. Symptoms may include shortness of breath, fatigue, and fluid retention. Heart failure is often classified based on the ejection fraction (EF), which is the percentage of blood that is pumped out of the left ventricle during each contraction. A reduced EF (less than 40%) is indicative of heart failure with reduced ejection fraction (HFrEF), while a preserved EF (greater than or equal to 50%) is indicative of heart failure with preserved ejection fraction (HFpEF). There is also a category of heart failure with mid-range ejection fraction (HFmrEF) for those with an EF between 40-49%.

Echocardiography is a medical procedure that uses sound waves to produce detailed images of the heart's structure, function, and motion. It is a non-invasive test that can help diagnose various heart conditions, such as valve problems, heart muscle damage, blood clots, and congenital heart defects.

During an echocardiogram, a transducer (a device that sends and receives sound waves) is placed on the chest or passed through the esophagus to obtain images of the heart. The sound waves produced by the transducer bounce off the heart structures and return to the transducer, which then converts them into electrical signals that are processed to create images of the heart.

There are several types of echocardiograms, including:

* Transthoracic echocardiography (TTE): This is the most common type of echocardiogram and involves placing the transducer on the chest.
* Transesophageal echocardiography (TEE): This type of echocardiogram involves passing a specialized transducer through the esophagus to obtain images of the heart from a closer proximity.
* Stress echocardiography: This type of echocardiogram is performed during exercise or medication-induced stress to assess how the heart functions under stress.
* Doppler echocardiography: This type of echocardiogram uses sound waves to measure blood flow and velocity in the heart and blood vessels.

Echocardiography is a valuable tool for diagnosing and managing various heart conditions, as it provides detailed information about the structure and function of the heart. It is generally safe, non-invasive, and painless, making it a popular choice for doctors and patients alike.

Purkinje fibers are specialized cardiac muscle fibers that are located in the subendocardial region of the inner ventricular walls of the heart. They play a crucial role in the electrical conduction system of the heart, transmitting electrical impulses from the bundle branches to the ventricular myocardium, which enables the coordinated contraction of the ventricles during each heartbeat.

These fibers have a unique structure that allows for rapid and efficient conduction of electrical signals. They are larger in diameter than regular cardiac muscle fibers, have fewer branching points, and possess more numerous mitochondria and a richer blood supply. These features enable Purkinje fibers to conduct electrical impulses at faster speeds, ensuring that the ventricles contract simultaneously and forcefully, promoting efficient pumping of blood throughout the body.

Ventricular dysfunction is a term that refers to the impaired ability of the ventricles, which are the lower chambers of the heart, to fill with blood or pump it efficiently to the rest of the body. This condition can lead to reduced cardiac output and may cause symptoms such as shortness of breath, fatigue, and fluid retention.

There are two types of ventricular dysfunction:

1. Systolic dysfunction: This occurs when the ventricles cannot contract forcefully enough to eject an adequate amount of blood out of the heart during each beat. This is often due to damage to the heart muscle, such as that caused by a heart attack or cardiomyopathy.
2. Diastolic dysfunction: This happens when the ventricles are unable to relax and fill properly with blood between beats. This can be caused by stiffening of the heart muscle, often due to aging, high blood pressure, or diabetes.

Both types of ventricular dysfunction can lead to heart failure, a serious condition in which the heart is unable to pump blood effectively to meet the body's needs. Treatment for ventricular dysfunction may include medications, lifestyle changes, and in some cases, medical procedures or surgery.

Doppler echocardiography is a type of ultrasound test that uses high-frequency sound waves to produce detailed images of the heart and its blood vessels. It measures the direction and speed of blood flow in the heart and major blood vessels leading to and from the heart. This helps to evaluate various conditions such as valve problems, congenital heart defects, and heart muscle diseases.

In Doppler echocardiography, a small handheld device called a transducer is placed on the chest, which emits sound waves that bounce off the heart and blood vessels. The transducer then picks up the returning echoes, which are processed by a computer to create moving images of the heart.

The Doppler effect is used to measure the speed and direction of blood flow. This occurs when the frequency of the sound waves changes as they bounce off moving objects, such as red blood cells. By analyzing these changes, the ultrasound machine can calculate the velocity and direction of blood flow in different parts of the heart.

Doppler echocardiography is a non-invasive test that does not require any needles or dyes. It is generally safe and painless, although patients may experience some discomfort from the pressure applied by the transducer on the chest. The test usually takes about 30 to 60 minutes to complete.

A nerve block is a medical procedure in which an anesthetic or neurolytic agent is injected near a specific nerve or bundle of nerves to block the transmission of pain signals from that area to the brain. This technique can be used for both diagnostic and therapeutic purposes, such as identifying the source of pain, providing temporary or prolonged relief, or facilitating surgical procedures in the affected region.

The injection typically contains a local anesthetic like lidocaine or bupivacaine, which numbs the nerve, preventing it from transmitting pain signals. In some cases, steroids may also be added to reduce inflammation and provide longer-lasting relief. Depending on the type of nerve block and its intended use, the injection might be administered close to the spine (neuraxial blocks), at peripheral nerves (peripheral nerve blocks), or around the sympathetic nervous system (sympathetic nerve blocks).

While nerve blocks are generally safe, they can have side effects such as infection, bleeding, nerve damage, or in rare cases, systemic toxicity from the anesthetic agent. It is essential to consult with a qualified medical professional before undergoing this procedure to ensure proper evaluation, technique, and post-procedure care.

Cardiomyopathies are a group of diseases that affect the heart muscle, leading to mechanical and/or electrical dysfunction. The American Heart Association (AHA) defines cardiomyopathies as "a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually (but not always) exhibit inappropriate ventricular hypertrophy or dilatation and frequently lead to heart failure."

There are several types of cardiomyopathies, including:

1. Dilated cardiomyopathy (DCM): This is the most common type of cardiomyopathy, characterized by an enlarged left ventricle and impaired systolic function, leading to heart failure.
2. Hypertrophic cardiomyopathy (HCM): In this type, there is abnormal thickening of the heart muscle, particularly in the septum between the two ventricles, which can obstruct blood flow and increase the risk of arrhythmias.
3. Restrictive cardiomyopathy (RCM): This is a rare form of cardiomyopathy characterized by stiffness of the heart muscle, impaired relaxation, and diastolic dysfunction, leading to reduced filling of the ventricles and heart failure.
4. Arrhythmogenic right ventricular cardiomyopathy (ARVC): In this type, there is replacement of the normal heart muscle with fatty or fibrous tissue, primarily affecting the right ventricle, which can lead to arrhythmias and sudden cardiac death.
5. Unclassified cardiomyopathies: These are conditions that do not fit into any of the above categories but still significantly affect the heart muscle and function.

Cardiomyopathies can be caused by genetic factors, acquired conditions (e.g., infections, toxins, or autoimmune disorders), or a combination of both. The diagnosis typically involves a comprehensive evaluation, including medical history, physical examination, electrocardiogram (ECG), echocardiography, cardiac magnetic resonance imaging (MRI), and sometimes genetic testing. Treatment depends on the type and severity of the condition but may include medications, lifestyle modifications, implantable devices, or even heart transplantation in severe cases.

Sudden cardiac death (SCD) is a sudden, unexpected natural death caused by the cessation of cardiac activity. It is often caused by cardiac arrhythmias, particularly ventricular fibrillation, and is often associated with underlying heart disease, although it can occur in people with no known heart condition. SCD is typically defined as a natural death due to cardiac causes that occurs within one hour of the onset of symptoms, or if the individual was last seen alive in a normal state of health, it can be defined as occurring within 24 hours.

It's important to note that sudden cardiac arrest (SCA) is different from SCD, although they are related. SCA refers to the sudden cessation of cardiac activity, which if not treated immediately can lead to SCD.

An implantable defibrillator is a medical device that is surgically placed inside the chest to continuously monitor the heart's rhythm and deliver electrical shocks to restore a normal heartbeat when it detects a life-threatening arrhythmia, such as ventricular fibrillation or ventricular tachycardia.

The device consists of a small generator that is implanted in the upper chest, along with one or more electrode leads that are threaded through veins and positioned in the heart's chambers. The generator contains a battery and a microcomputer that constantly monitors the heart's electrical activity and detects any abnormal rhythms.

When an arrhythmia is detected, the defibrillator delivers an electrical shock to the heart to restore a normal rhythm. This can be done automatically by the device or manually by a healthcare provider using an external programmer.

Implantable defibrillators are typically recommended for people who have a high risk of sudden cardiac death due to a history of heart attacks, heart failure, or inherited heart conditions that affect the heart's electrical system. They can significantly reduce the risk of sudden cardiac death and improve quality of life for those at risk.

Body Surface Potential Mapping (BSPM) is a non-invasive medical technique used to record and analyze the electrical activity of the heart from the surface of the body. It involves placing multiple electrodes on the skin of the chest, back, and limbs to measure the potential differences between these points during each heartbeat. This information is then used to create a detailed, visual representation of the electrical activation pattern of the heart, which can help in the diagnosis and evaluation of various cardiac disorders such as arrhythmias, myocardial infarction, and ventricular hypertrophy.

The BSPM technique provides high-resolution spatial and temporal information about the cardiac electrical activity, making it a valuable tool for both clinical and research purposes. It can help identify the origin and spread of abnormal electrical signals in the heart, which is crucial for determining appropriate treatment strategies. Overall, Body Surface Potential Mapping is an important diagnostic modality that offers unique insights into the electrical functioning of the heart.

The atrioventricular (AV) node is a critical part of the electrical conduction system of the heart. It is a small cluster of specialized cardiac muscle cells located in the lower interatrial septum, near the opening of the coronary sinus. The AV node receives electrical impulses from the sinoatrial node (the heart's natural pacemaker) via the internodal pathways and delays their transmission for a brief period before transmitting them to the bundle of His and then to the ventricles. This delay allows the atria to contract and empty their contents into the ventricles before the ventricles themselves contract, ensuring efficient pumping of blood throughout the body.

The AV node plays an essential role in maintaining a normal heart rhythm, as it can also function as a backup pacemaker if the sinoatrial node fails to generate impulses. However, certain heart conditions or medications can affect the AV node's function and lead to abnormal heart rhythms, such as atrioventricular block or atrial tachycardia.

Myocardial infarction (MI), also known as a heart attack, is a medical condition characterized by the death of a segment of heart muscle (myocardium) due to the interruption of its blood supply. This interruption is most commonly caused by the blockage of a coronary artery by a blood clot formed on the top of an atherosclerotic plaque, which is a buildup of cholesterol and other substances in the inner lining of the artery.

The lack of oxygen and nutrients supply to the heart muscle tissue results in damage or death of the cardiac cells, causing the affected area to become necrotic. The extent and severity of the MI depend on the size of the affected area, the duration of the occlusion, and the presence of collateral circulation.

Symptoms of a myocardial infarction may include chest pain or discomfort, shortness of breath, nausea, lightheadedness, and sweating. Immediate medical attention is necessary to restore blood flow to the affected area and prevent further damage to the heart muscle. Treatment options for MI include medications, such as thrombolytics, antiplatelet agents, and pain relievers, as well as procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

A syndrome, in medical terms, is a set of symptoms that collectively indicate or characterize a disease, disorder, or underlying pathological process. It's essentially a collection of signs and/or symptoms that frequently occur together and can suggest a particular cause or condition, even though the exact physiological mechanisms might not be fully understood.

For example, Down syndrome is characterized by specific physical features, cognitive delays, and other developmental issues resulting from an extra copy of chromosome 21. Similarly, metabolic syndromes like diabetes mellitus type 2 involve a group of risk factors such as obesity, high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that collectively increase the risk of heart disease, stroke, and diabetes.

It's important to note that a syndrome is not a specific diagnosis; rather, it's a pattern of symptoms that can help guide further diagnostic evaluation and management.

Stroke volume is a term used in cardiovascular physiology and medicine. It refers to the amount of blood that is pumped out of the left ventricle of the heart during each contraction (systole). Specifically, it is the difference between the volume of blood in the left ventricle at the end of diastole (when the ventricle is filled with blood) and the volume at the end of systole (when the ventricle has contracted and ejected its contents into the aorta).

Stroke volume is an important measure of heart function, as it reflects the ability of the heart to pump blood effectively to the rest of the body. A low stroke volume may indicate that the heart is not pumping efficiently, while a high stroke volume may suggest that the heart is working too hard. Stroke volume can be affected by various factors, including heart disease, high blood pressure, and physical fitness level.

The formula for calculating stroke volume is:

Stroke Volume = End-Diastolic Volume - End-Systolic Volume

Where end-diastolic volume (EDV) is the volume of blood in the left ventricle at the end of diastole, and end-systolic volume (ESV) is the volume of blood in the left ventricle at the end of systole.

Ambulatory electrocardiography, also known as ambulatory ECG or Holter monitoring, is a non-invasive method of recording the electrical activity of the heart over an extended period of time (typically 24 hours or more) while the patient goes about their daily activities. The device used to record the ECG is called a Holter monitor, which consists of a small, portable recorder that is attached to the patient's chest with electrodes.

The recorded data provides information on any abnormalities in the heart's rhythm or electrical activity during different stages of activity and rest, allowing healthcare providers to diagnose and evaluate various cardiac conditions such as arrhythmias, ischemia, and infarction. The ability to monitor the heart's activity over an extended period while the patient performs their normal activities provides valuable information that may not be captured during a standard ECG, which only records the heart's electrical activity for a few seconds.

In summary, ambulatory electrocardiography is a diagnostic tool used to evaluate the electrical activity of the heart over an extended period, allowing healthcare providers to diagnose and manage various cardiac conditions.

Ventricular Fibrillation (VF) is a type of cardiac arrhythmia, which is an abnormal heart rhythm. In VF, the ventricles, which are the lower chambers of the heart, beat in a rapid and unorganized manner. This results in the heart being unable to pump blood effectively to the rest of the body, leading to immediate circulatory collapse and cardiac arrest if not treated promptly. It is often caused by underlying heart conditions such as coronary artery disease, structural heart problems, or electrolyte imbalances. VF is a medical emergency that requires immediate defibrillation to restore a normal heart rhythm.

Supraventricular tachycardia (SVT) is a rapid heart rhythm that originates above the ventricles (the lower chambers of the heart). This type of tachycardia includes atrial tachycardia, atrioventricular nodal reentrant tachycardia (AVNRT), and atrioventricular reentrant tachycardia (AVRT). SVT usually causes a rapid heartbeat that starts and stops suddenly, and may not cause any other symptoms. However, some people may experience palpitations, shortness of breath, chest discomfort, dizziness, or fainting. SVT is typically diagnosed through an electrocardiogram (ECG) or Holter monitor, and can be treated with medications, cardioversion, or catheter ablation.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

The Predictive Value of Tests, specifically the Positive Predictive Value (PPV) and Negative Predictive Value (NPV), are measures used in diagnostic tests to determine the probability that a positive or negative test result is correct.

Positive Predictive Value (PPV) is the proportion of patients with a positive test result who actually have the disease. It is calculated as the number of true positives divided by the total number of positive results (true positives + false positives). A higher PPV indicates that a positive test result is more likely to be a true positive, and therefore the disease is more likely to be present.

Negative Predictive Value (NPV) is the proportion of patients with a negative test result who do not have the disease. It is calculated as the number of true negatives divided by the total number of negative results (true negatives + false negatives). A higher NPV indicates that a negative test result is more likely to be a true negative, and therefore the disease is less likely to be present.

The predictive value of tests depends on the prevalence of the disease in the population being tested, as well as the sensitivity and specificity of the test. A test with high sensitivity and specificity will generally have higher predictive values than a test with low sensitivity and specificity. However, even a highly sensitive and specific test can have low predictive values if the prevalence of the disease is low in the population being tested.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

Phonocardiography is a non-invasive medical procedure that involves the graphical representation and analysis of sounds produced by the heart. It uses a device called a phonocardiograph to record these sounds, which are then displayed as waveforms on a screen. The procedure is often used in conjunction with other diagnostic techniques, such as electrocardiography (ECG), to help diagnose various heart conditions, including valvular heart disease and heart murmurs.

During the procedure, a specialized microphone called a phonendoscope is placed on the chest wall over the area of the heart. The microphone picks up the sounds generated by the heart's movements, such as the closing and opening of the heart valves, and transmits them to the phonocardiograph. The phonocardiograph then converts these sounds into a visual representation, which can be analyzed for any abnormalities or irregularities in the heart's function.

Phonocardiography is a valuable tool for healthcare professionals, as it can provide important insights into the health and functioning of the heart. By analyzing the waveforms produced during phonocardiography, doctors can identify any potential issues with the heart's valves or other structures, which may require further investigation or treatment. Overall, phonocardiography is an essential component of modern cardiac diagnostics, helping to ensure that patients receive accurate and timely diagnoses for their heart conditions.

A zygapophyseal joint, also known as a facet joint, is a type of synovial joint that connects the articulating processes of adjacent vertebrae in the spine. These joints are formed by the superior and inferior articular processes of the vertebral bodies and are covered with hyaline cartilage. They allow for smooth movement between the vertebrae, providing stability and limiting excessive motion while allowing flexibility in the spine. The zygapophyseal joints are supported by a capsule and ligaments that help to maintain their alignment and restrict abnormal movements. These joints can become sources of pain and discomfort when they become inflamed or damaged due to conditions such as arthritis, degenerative disc disease, or injury.

Thallium radioisotopes are radioactive isotopes or variants of the element thallium (Tl), which decays and emits radiation. Thallium has several radioisotopes, with the most commonly used being thallium-201 (^201Tl). This radioisotope is used in medical imaging, specifically in myocardial perfusion scintigraphy, to evaluate blood flow to the heart muscle. It decays by electron capture and emits gamma radiation with a half-life of 73 hours, making it suitable for diagnostic procedures.

It's important to note that handling and using radioisotopes require proper training and safety measures due to their ionizing radiation properties.

Cardiac catheterization is a medical procedure used to diagnose and treat cardiovascular conditions. In this procedure, a thin, flexible tube called a catheter is inserted into a blood vessel in the arm or leg and threaded up to the heart. The catheter can be used to perform various diagnostic tests, such as measuring the pressure inside the heart chambers and assessing the function of the heart valves.

Cardiac catheterization can also be used to treat certain cardiovascular conditions, such as narrowed or blocked arteries. In these cases, a balloon or stent may be inserted through the catheter to open up the blood vessel and improve blood flow. This procedure is known as angioplasty or percutaneous coronary intervention (PCI).

Cardiac catheterization is typically performed in a hospital cardiac catheterization laboratory by a team of healthcare professionals, including cardiologists, radiologists, and nurses. The procedure may be done under local anesthesia with sedation or general anesthesia, depending on the individual patient's needs and preferences.

Overall, cardiac catheterization is a valuable tool in the diagnosis and treatment of various heart conditions, and it can help improve symptoms, reduce complications, and prolong life for many patients.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

Anti-arrhythmia agents are a class of medications used to treat abnormal heart rhythms or arrhythmias. These drugs work by modifying the electrical activity of the heart to restore and maintain a normal heart rhythm. There are several types of anti-arrhythmia agents, including:

1. Sodium channel blockers: These drugs slow down the conduction of electrical signals in the heart, which helps to reduce rapid or irregular heartbeats. Examples include flecainide, propafenone, and quinidine.
2. Beta-blockers: These medications work by blocking the effects of adrenaline on the heart, which helps to slow down the heart rate and reduce the force of heart contractions. Examples include metoprolol, atenolol, and esmolol.
3. Calcium channel blockers: These drugs block the entry of calcium into heart muscle cells, which helps to slow down the heart rate and reduce the force of heart contractions. Examples include verapamil and diltiazem.
4. Potassium channel blockers: These medications work by prolonging the duration of the heart's electrical cycle, which helps to prevent abnormal rhythms. Examples include amiodarone and sotalol.
5. Digoxin: This drug increases the force of heart contractions and slows down the heart rate, which can help to restore a normal rhythm in certain types of arrhythmias.

It's important to note that anti-arrhythmia agents can have significant side effects and should only be prescribed by a healthcare professional who has experience in managing arrhythmias. Close monitoring is necessary to ensure the medication is working effectively and not causing any adverse effects.

NAV1.5, also known as SCN5A, is a specific type of voltage-gated sodium channel found in the heart muscle cells (cardiomyocytes). These channels play a crucial role in the generation and transmission of electrical signals that coordinate the contraction of the heart.

More specifically, NAV1.5 channels are responsible for the rapid influx of sodium ions into cardiomyocytes during the initial phase of the action potential, which is the electrical excitation of the cell. This rapid influx of sodium ions helps to initiate and propagate the action potential throughout the heart muscle, allowing for coordinated contraction and proper heart function.

Mutations in the SCN5A gene, which encodes the NAV1.5 channel, have been associated with various cardiac arrhythmias, including long QT syndrome, Brugada syndrome, and familial atrial fibrillation, among others. These genetic disorders can lead to abnormal heart rhythms, syncope, and in some cases, sudden cardiac death.

An exercise test, also known as a stress test or an exercise stress test, is a medical procedure used to evaluate the heart's function and response to physical exertion. It typically involves walking on a treadmill or pedaling a stationary bike while being monitored for changes in heart rate, blood pressure, electrocardiogram (ECG), and sometimes other variables such as oxygen consumption or gas exchange.

During the test, the patient's symptoms, such as chest pain or shortness of breath, are also closely monitored. The exercise test can help diagnose coronary artery disease, assess the severity of heart-related symptoms, and evaluate the effectiveness of treatments for heart conditions. It may also be used to determine a person's safe level of physical activity and fitness.

There are different types of exercise tests, including treadmill stress testing, stationary bike stress testing, nuclear stress testing, and stress echocardiography. The specific type of test used depends on the patient's medical history, symptoms, and overall health status.

Wolff-Parkinson-White (WPW) Syndrome is a heart condition characterized by the presence of an accessory pathway or abnormal electrical connection between the atria (the upper chambers of the heart) and ventricles (the lower chambers of the heart). This accessory pathway allows electrical impulses to bypass the normal conduction system, leading to a shorter PR interval and a "delta wave" on the electrocardiogram (ECG), which is the hallmark of WPW Syndrome.

Individuals with WPW Syndrome may experience no symptoms or may have palpitations, rapid heartbeat (tachycardia), or episodes of atrial fibrillation. In some cases, WPW Syndrome can lead to more serious heart rhythm disturbances and may require treatment, such as medication, catheter ablation, or in rare cases, surgery.

It is important to note that not all individuals with WPW Syndrome will experience symptoms or complications, and many people with this condition can lead normal, active lives with appropriate monitoring and management.

Cardiac resynchronization therapy (CRT) devices are medical implants used to treat heart failure by helping the heart's lower chambers (ventricles) contract more efficiently and in a coordinated manner. These devices combine the functions of a pacemaker and an implantable cardioverter-defibrillator (ICD).

A CRT device has three leads: one that is placed in the right atrium, another in the right ventricle, and a third in the left ventricle through the coronary sinus vein. This configuration allows for simultaneous or near-simultaneous electrical activation of both ventricles, which can improve the heart's pumping efficiency and reduce symptoms associated with heart failure.

There are two main types of CRT devices:

1. Cardiac Resynchronization Therapy-Pacemaker (CRT-P): This device is primarily used to coordinate the contractions of both ventricles through electrical stimulation, using pacing therapy. It is appropriate for patients who do not require defibrillation therapy.
2. Cardiac Resynchronization Therapy-Defibrillator (CRT-D): This device combines the functions of a CRT-P and an ICD, providing both coordinated electrical stimulation and protection against life-threatening ventricular arrhythmias that can lead to sudden cardiac death.

The selection of a CRT device depends on the individual patient's needs and medical history. The primary goal of CRT devices is to improve heart function, reduce symptoms, enhance quality of life, and potentially increase survival in select patients with heart failure.

Atrioventricular (AV) nodal reentrant tachycardia (AVNRT) is a type of supraventricular tachycardia (SVT), which is a rapid heart rhythm originating at or above the atrioventricular node. In AVNRT, an abnormal electrical circuit in or near the AV node creates a reentry pathway that allows for rapid heart rates, typically greater than 150-250 beats per minute.

In normal conduction, the electrical impulse travels from the atria to the ventricles through the AV node and then continues down the bundle branches to the Purkinje fibers, resulting in a coordinated contraction of the heart. In AVNRT, an extra electrical pathway exists that allows for the reentry of the electrical impulse back into the atria, creating a rapid and abnormal circuit.

AVNRT is classified based on the direction of the reentry circuit:

1. Typical or common AVNRT: The most common form, accounting for 90% of cases. In this type, the reentry circuit involves an "anterior" and a "posterior" loop in or near the AV node. The anterior loop has slower conduction velocity than the posterior loop, creating a "short" reentry circuit that is responsible for the rapid heart rate.
2. Atypical AVNRT: Less common, accounting for 10% of cases. In this type, the reentry circuit involves an "outer" and an "inner" loop around the AV node. The outer loop has slower conduction velocity than the inner loop, creating a "long" reentry circuit that is responsible for the rapid heart rate.

AVNRT can present with symptoms such as palpitations, dizziness, lightheadedness, shortness of breath, chest discomfort, or syncope (fainting). Treatment options include observation, vagal maneuvers, medications, and catheter ablation. Catheter ablation is a curative treatment that involves the destruction of the abnormal electrical pathway using radiofrequency energy or cryotherapy.

Emission-Computed Tomography, Single-Photon (SPECT) is a type of nuclear medicine imaging procedure that generates detailed, three-dimensional images of the distribution of radioactive pharmaceuticals within the body. It uses gamma rays emitted by a radiopharmaceutical that is introduced into the patient's body, and a specialized gamma camera to detect these gamma rays and create tomographic images. The data obtained from the SPECT imaging can be used to diagnose various medical conditions, evaluate organ function, and guide treatment decisions. It is commonly used to image the heart, brain, and bones, among other organs and systems.

Cardiovascular models are simplified representations or simulations of the human cardiovascular system used in medical research, education, and training. These models can be physical, computational, or mathematical and are designed to replicate various aspects of the heart, blood vessels, and blood flow. They can help researchers study the structure and function of the cardiovascular system, test new treatments and interventions, and train healthcare professionals in diagnostic and therapeutic techniques.

Physical cardiovascular models may include artificial hearts, blood vessels, or circulation systems made from materials such as plastic, rubber, or silicone. These models can be used to study the mechanics of heart valves, the effects of different surgical procedures, or the impact of various medical devices on blood flow.

Computational and mathematical cardiovascular models use algorithms and equations to simulate the behavior of the cardiovascular system. These models may range from simple representations of a single heart chamber to complex simulations of the entire circulatory system. They can be used to study the electrical activity of the heart, the biomechanics of blood flow, or the distribution of drugs in the body.

Overall, cardiovascular models play an essential role in advancing our understanding of the human body and improving patient care.

In medical terms, the heart is a muscular organ located in the thoracic cavity that functions as a pump to circulate blood throughout the body. It's responsible for delivering oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. The human heart is divided into four chambers: two atria on the top and two ventricles on the bottom. The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs, while the left side receives oxygenated blood from the lungs and pumps it out to the rest of the body. The heart's rhythmic contractions and relaxations are regulated by a complex electrical conduction system.

Bradycardia is a medical term that refers to an abnormally slow heart rate, typically defined as a resting heart rate of less than 60 beats per minute in adults. While some people, particularly well-trained athletes, may have a naturally low resting heart rate, bradycardia can also be a sign of an underlying health problem.

There are several potential causes of bradycardia, including:

* Damage to the heart's electrical conduction system, such as from heart disease or aging
* Certain medications, including beta blockers, calcium channel blockers, and digoxin
* Hypothyroidism (underactive thyroid gland)
* Sleep apnea
* Infection of the heart (endocarditis or myocarditis)
* Infiltrative diseases such as amyloidosis or sarcoidosis

Symptoms of bradycardia can vary depending on the severity and underlying cause. Some people with bradycardia may not experience any symptoms, while others may feel weak, fatigued, dizzy, or short of breath. In severe cases, bradycardia can lead to fainting, confusion, or even cardiac arrest.

Treatment for bradycardia depends on the underlying cause. If a medication is causing the slow heart rate, adjusting the dosage or switching to a different medication may help. In other cases, a pacemaker may be necessary to regulate the heart's rhythm. It is important to seek medical attention if you experience symptoms of bradycardia, as it can be a sign of a serious underlying condition.

Prognosis is a medical term that refers to the prediction of the likely outcome or course of a disease, including the chances of recovery or recurrence, based on the patient's symptoms, medical history, physical examination, and diagnostic tests. It is an important aspect of clinical decision-making and patient communication, as it helps doctors and patients make informed decisions about treatment options, set realistic expectations, and plan for future care.

Prognosis can be expressed in various ways, such as percentages, categories (e.g., good, fair, poor), or survival rates, depending on the nature of the disease and the available evidence. However, it is important to note that prognosis is not an exact science and may vary depending on individual factors, such as age, overall health status, and response to treatment. Therefore, it should be used as a guide rather than a definitive forecast.

Right ventricular dysfunction is a condition characterized by the impaired ability of the right ventricle (one of the two pumping chambers in the heart) to fill with blood during the diastolic phase or eject blood during the systolic phase. This results in reduced cardiac output from the right ventricle, which can lead to various complications such as fluid accumulation in the body, particularly in the abdomen and lower extremities, and ultimately congestive heart failure if left untreated.

Right ventricular dysfunction can be caused by various factors, including damage to the heart muscle due to a heart attack, high blood pressure in the lungs (pulmonary hypertension), chronic lung diseases, congenital heart defects, viral infections, and certain medications. Symptoms of right ventricular dysfunction may include shortness of breath, fatigue, swelling in the legs, ankles, or abdomen, and a decreased tolerance for physical activity.

Diagnosis of right ventricular dysfunction typically involves a combination of medical history, physical examination, imaging tests such as echocardiography, cardiac MRI, or CT scan, and other diagnostic procedures such as electrocardiogram (ECG) or cardiac catheterization. Treatment options depend on the underlying cause but may include medications to reduce fluid buildup, improve heart function, and manage symptoms, as well as lifestyle modifications such as reducing salt intake and increasing physical activity levels. In severe cases, more invasive treatments such as surgery or implantable devices like pacemakers or ventricular assist devices may be necessary.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

Tetralogy of Fallot is a congenital heart defect that consists of four components: ventricular septal defect (a hole between the lower chambers of the heart), pulmonary stenosis (narrowing of the pulmonary valve and outflow tract), overriding aorta (the aorta lies directly over the ventricular septal defect), and right ventricular hypertrophy (thickening of the right ventricular muscle). This condition results in insufficient oxygenation of the blood, leading to cyanosis (bluish discoloration of the skin and mucous membranes) and other symptoms such as shortness of breath, fatigue, and poor growth. Treatment typically involves surgical repair, which is usually performed during infancy or early childhood.

Heart function tests are a group of diagnostic exams that are used to evaluate the structure and functioning of the heart. These tests help doctors assess the pumping efficiency of the heart, the flow of blood through the heart, the presence of any heart damage, and the overall effectiveness of the heart in delivering oxygenated blood to the rest of the body.

Some common heart function tests include:

1. Echocardiogram (Echo): This test uses sound waves to create detailed images of the heart's structure and functioning. It can help detect any damage to the heart muscle, valves, or sac surrounding the heart.
2. Nuclear Stress Test: This test involves injecting a small amount of radioactive substance into the patient's bloodstream and taking images of the heart while it is at rest and during exercise. The test helps evaluate blood flow to the heart and detect any areas of reduced blood flow, which could indicate coronary artery disease.
3. Cardiac Magnetic Resonance Imaging (MRI): This test uses magnetic fields and radio waves to create detailed images of the heart's structure and function. It can help detect any damage to the heart muscle, valves, or other structures of the heart.
4. Electrocardiogram (ECG): This test measures the electrical activity of the heart and helps detect any abnormalities in the heart's rhythm or conduction system.
5. Exercise Stress Test: This test involves walking on a treadmill or riding a stationary bike while being monitored for changes in heart rate, blood pressure, and ECG readings. It helps evaluate exercise capacity and detect any signs of coronary artery disease.
6. Cardiac Catheterization: This is an invasive procedure that involves inserting a catheter into the heart to measure pressures and take samples of blood from different parts of the heart. It can help diagnose various heart conditions, including heart valve problems, congenital heart defects, and coronary artery disease.

Overall, heart function tests play an essential role in diagnosing and managing various heart conditions, helping doctors provide appropriate treatment and improve patient outcomes.

Iohexol is a non-ionic, water-soluble contrast medium primarily used in radiographic imaging procedures such as computed tomography (CT) scans and angiography. It belongs to a class of medications known as radiocontrast agents. Iohexol works by increasing the X-ray absorption of body tissues, making them more visible on X-ray images. This helps healthcare professionals to better diagnose and assess various medical conditions, including injuries, tumors, and vascular diseases.

The chemical structure of iohexol consists of an iodine atom surrounded by organic molecules, which makes it safe for intravenous administration. It is eliminatted from the body primarily through urinary excretion. Iohexol has a low risk of allergic reactions compared to ionic contrast media and is generally well-tolerated in patients with normal renal function. However, its use should be avoided or closely monitored in individuals with impaired kidney function, as it may increase the risk of nephrotoxicity.

Coronary angiography is a medical procedure that uses X-ray imaging to visualize the coronary arteries, which supply blood to the heart muscle. During the procedure, a thin, flexible catheter is inserted into an artery in the arm or groin and threaded through the blood vessels to the heart. A contrast dye is then injected through the catheter, and X-ray images are taken as the dye flows through the coronary arteries. These images can help doctors diagnose and treat various heart conditions, such as blockages or narrowing of the arteries, that can lead to chest pain or heart attacks. It is also known as coronary arteriography or cardiac catheterization.

Technetium Tc 99m Sestamibi is a radiopharmaceutical compound used in medical imaging, specifically in myocardial perfusion scintigraphy. It is a technetium-labeled isonitrile chelate that is taken up by mitochondria in cells with high metabolic activity, such as cardiomyocytes (heart muscle cells).

Once injected into the patient's body, Technetium Tc 99m Sestamibi emits gamma rays, which can be detected by a gamma camera. This allows for the creation of images that reflect the distribution and function of the radiopharmaceutical within the heart muscle. The images can help identify areas of reduced blood flow or ischemia, which may indicate coronary artery disease.

The uptake of Technetium Tc 99m Sestamibi in other organs, such as the breast and thyroid, can also be used for imaging purposes, although its primary use remains in cardiac imaging.

Sensitivity and specificity are statistical measures used to describe the performance of a diagnostic test or screening tool in identifying true positive and true negative results.

* Sensitivity refers to the proportion of people who have a particular condition (true positives) who are correctly identified by the test. It is also known as the "true positive rate" or "recall." A highly sensitive test will identify most or all of the people with the condition, but may also produce more false positives.
* Specificity refers to the proportion of people who do not have a particular condition (true negatives) who are correctly identified by the test. It is also known as the "true negative rate." A highly specific test will identify most or all of the people without the condition, but may also produce more false negatives.

In medical testing, both sensitivity and specificity are important considerations when evaluating a diagnostic test. High sensitivity is desirable for screening tests that aim to identify as many cases of a condition as possible, while high specificity is desirable for confirmatory tests that aim to rule out the condition in people who do not have it.

It's worth noting that sensitivity and specificity are often influenced by factors such as the prevalence of the condition in the population being tested, the threshold used to define a positive result, and the reliability and validity of the test itself. Therefore, it's important to consider these factors when interpreting the results of a diagnostic test.

Mitral valve insufficiency, also known as mitral regurgitation, is a cardiac condition in which the mitral valve located between the left atrium and left ventricle of the heart does not close properly, causing blood to flow backward into the atrium during contraction of the ventricle. This leads to an increased volume load on the left heart chamber and can result in symptoms such as shortness of breath, fatigue, and fluid retention. The condition can be caused by various factors including valve damage due to degenerative changes, infective endocarditis, rheumatic heart disease, or trauma. Treatment options include medication, mitral valve repair, or replacement surgery depending on the severity and underlying cause of the insufficiency.

Myocardial contraction refers to the rhythmic and forceful shortening of heart muscle cells (myocytes) in the myocardium, which is the muscular wall of the heart. This process is initiated by electrical signals generated by the sinoatrial node, causing a wave of depolarization that spreads throughout the heart.

During myocardial contraction, calcium ions flow into the myocytes, triggering the interaction between actin and myosin filaments, which are the contractile proteins in the muscle cells. This interaction causes the myofilaments to slide past each other, resulting in the shortening of the sarcomeres (the functional units of muscle contraction) and ultimately leading to the contraction of the heart muscle.

Myocardial contraction is essential for pumping blood throughout the body and maintaining adequate circulation to vital organs. Any impairment in myocardial contractility can lead to various cardiac disorders, such as heart failure, cardiomyopathy, and arrhythmias.

Dipyridamole is a medication that belongs to a class of drugs called antiplatelet agents. It works by preventing platelets in your blood from sticking together to form clots. Dipyridamole is often used in combination with aspirin to prevent stroke and other complications in people who have had a heart valve replacement or a type of irregular heartbeat called atrial fibrillation.

Dipyridamole can also be used as a stress agent in myocardial perfusion imaging studies, which are tests used to evaluate blood flow to the heart. When used for this purpose, dipyridamole is given intravenously and works by dilating the blood vessels in the heart, allowing more blood to flow through them and making it easier to detect areas of reduced blood flow.

The most common side effects of dipyridamole include headache, dizziness, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting. In rare cases, dipyridamole can cause more serious side effects, such as allergic reactions, abnormal heart rhythms, or low blood pressure. It is important to take dipyridamole exactly as directed by your healthcare provider and to report any unusual symptoms or side effects promptly.

Arrhythmogenic Right Ventricular Dysplasia (ARVD) is a rare cardiac condition characterized by the replacement of the normal heart muscle tissue in the right ventricle with fatty and fibrous tissues. This can lead to abnormal heart rhythms (arrhythmias), particularly during exercise or emotional stress.

The condition can be inherited and is often associated with genetic mutations that affect the desmosomes, which are protein structures that help connect heart muscle cells together. These mutations can weaken the heart muscle and make it more prone to arrhythmias and heart failure over time.

Symptoms of ARVD may include palpitations, chest pain, shortness of breath, dizziness, or fainting, especially during exercise. In some cases, the condition may not cause any symptoms and may only be discovered during a routine medical exam or evaluation for another condition.

Diagnosis of ARVD typically involves a combination of clinical evaluation, imaging tests such as echocardiography or magnetic resonance imaging (MRI), and electrophysiological testing to assess heart rhythm abnormalities. Treatment may include medications to control arrhythmias, implantable devices such as pacemakers or defibrillators, and lifestyle modifications such as avoiding strenuous exercise. In severe cases, a heart transplant may be necessary.

I believe there might be a misunderstanding in your question. "Dogs" is not a medical term or condition. It is the common name for a domesticated carnivore of the family Canidae, specifically the genus Canis, which includes wolves, foxes, and other extant and extinct species of mammals. Dogs are often kept as pets and companions, and they have been bred in a wide variety of forms and sizes for different purposes, such as hunting, herding, guarding, assisting police and military forces, and providing companionship and emotional support.

If you meant to ask about a specific medical condition or term related to dogs, please provide more context so I can give you an accurate answer.

Thrombolytic therapy, also known as thrombolysis, is a medical treatment that uses medications called thrombolytics or fibrinolytics to dissolve or break down blood clots (thrombi) in blood vessels. These clots can obstruct the flow of blood to vital organs such as the heart, lungs, or brain, leading to serious conditions like myocardial infarction (heart attack), pulmonary embolism, or ischemic stroke.

The goal of thrombolytic therapy is to restore blood flow as quickly and efficiently as possible to prevent further damage to the affected organ and potentially save lives. Commonly used thrombolytic drugs include alteplase (tPA), reteplase, and tenecteplase. It's essential to administer these medications as soon as possible after the onset of symptoms for optimal treatment outcomes. However, there are risks associated with thrombolytic therapy, such as an increased chance of bleeding complications, which must be carefully weighed against its benefits in each individual case.

Heart valve prosthesis implantation is a surgical procedure where an artificial heart valve is inserted to replace a damaged or malfunctioning native heart valve. This can be necessary for patients with valvular heart disease, including stenosis (narrowing) or regurgitation (leaking), who do not respond to medical management and are at risk of heart failure or other complications.

There are two main types of artificial heart valves used in prosthesis implantation: mechanical valves and biological valves. Mechanical valves are made of synthetic materials, such as carbon and metal, and can last a long time but require lifelong anticoagulation therapy to prevent blood clots from forming. Biological valves, on the other hand, are made from animal or human tissue and typically do not require anticoagulation therapy but may have a limited lifespan and may need to be replaced in the future.

The decision to undergo heart valve prosthesis implantation is based on several factors, including the patient's age, overall health, type and severity of valvular disease, and personal preferences. The procedure can be performed through traditional open-heart surgery or minimally invasive techniques, such as robotic-assisted surgery or transcatheter aortic valve replacement (TAVR). Recovery time varies depending on the approach used and individual patient factors.

Sodium channels are specialized protein structures that are embedded in the membranes of excitable cells, such as nerve and muscle cells. They play a crucial role in the generation and transmission of electrical signals in these cells. Sodium channels are responsible for the rapid influx of sodium ions into the cell during the initial phase of an action potential, which is the electrical signal that travels along the membrane of a neuron or muscle fiber. This sudden influx of sodium ions causes the membrane potential to rapidly reverse, leading to the depolarization of the cell. After the action potential, the sodium channels close and become inactivated, preventing further entry of sodium ions and helping to restore the resting membrane potential.

Sodium channels are composed of a large alpha subunit and one or two smaller beta subunits. The alpha subunit forms the ion-conducting pore, while the beta subunits play a role in modulating the function and stability of the channel. Mutations in sodium channel genes have been associated with various inherited diseases, including certain forms of epilepsy, cardiac arrhythmias, and muscle disorders.

Hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by the thickening of the heart muscle, specifically the ventricles (the lower chambers of the heart that pump blood out to the body). This thickening can make it harder for the heart to pump blood effectively, which can lead to symptoms such as shortness of breath, chest pain, and fatigue. In some cases, HCM can also cause abnormal heart rhythms (arrhythmias) and may increase the risk of sudden cardiac death.

The thickening of the heart muscle in HCM is caused by an overgrowth of the cells that make up the heart muscle, known as cardiomyocytes. This overgrowth can be caused by mutations in any one of several genes that encode proteins involved in the structure and function of the heart muscle. These genetic mutations are usually inherited from a parent, but they can also occur spontaneously in an individual with no family history of the disorder.

HCM is typically diagnosed using echocardiography (a type of ultrasound that uses sound waves to create images of the heart) and other diagnostic tests such as electrocardiogram (ECG) and cardiac magnetic resonance imaging (MRI). Treatment for HCM may include medications to help manage symptoms, lifestyle modifications, and in some cases, surgical procedures or implantable devices to help prevent or treat arrhythmias.

A ventricular septal defect (VSD) is a type of congenital heart defect that involves a hole in the wall separating the two lower chambers of the heart, the ventricles. This defect allows oxygenated blood from the left ventricle to mix with deoxygenated blood in the right ventricle, leading to inefficient oxygenation of the body's tissues. The size and location of the hole can vary, and symptoms may range from none to severe, depending on the size of the defect and the amount of blood that is able to shunt between the ventricles. Small VSDs may close on their own over time, while larger defects usually require medical intervention, such as medication or surgery, to prevent complications like pulmonary hypertension and heart failure.

The heart atria are the upper chambers of the heart that receive blood from the veins and deliver it to the lower chambers, or ventricles. There are two atria in the heart: the right atrium receives oxygen-poor blood from the body and pumps it into the right ventricle, which then sends it to the lungs to be oxygenated; and the left atrium receives oxygen-rich blood from the lungs and pumps it into the left ventricle, which then sends it out to the rest of the body. The atria contract before the ventricles during each heartbeat, helping to fill the ventricles with blood and prepare them for contraction.

Ventricular remodeling is a structural adaptation process of the heart in response to stress or injury, such as myocardial infarction (heart attack) or pressure overload. This process involves changes in size, shape, and function of the ventricles (the lower chambers of the heart).

In ventricular remodeling, the heart muscle may thicken, enlarge, or become more stiff, leading to alterations in the pumping ability of the heart. These changes can ultimately result in cardiac dysfunction, heart failure, and an increased risk of arrhythmias (irregular heart rhythms).

Ventricular remodeling is often classified into two types:

1. Concentric remodeling: This occurs when the ventricular wall thickens (hypertrophy) without a significant increase in chamber size, leading to a decrease in the cavity volume and an increase in the thickness of the ventricular wall.
2. Eccentric remodeling: This involves an increase in both the ventricular chamber size and wall thickness due to the addition of new muscle cells (hyperplasia) or enlargement of existing muscle cells (hypertrophy). As a result, the overall shape of the ventricle becomes more spherical and less elliptical.

Both types of remodeling can negatively impact heart function and contribute to the development of heart failure. Close monitoring and appropriate treatment are essential for managing ventricular remodeling and preventing further complications.

Dobutamine is a synthetic catecholamine used in medical treatment, specifically as a positive inotrope and vasodilator. It works by stimulating the beta-1 adrenergic receptors of the heart, thereby increasing its contractility and stroke volume. This results in an improved cardiac output, making dobutamine beneficial in treating heart failure, cardiogenic shock, and other conditions where heart function is compromised.

It's important to note that dobutamine should be administered under strict medical supervision due to its potential to cause adverse effects such as arrhythmias, hypotension, or hypertension. The dosage, frequency, and duration of administration are determined by the patient's specific condition and response to treatment.

A heart valve prosthesis is a medical device that is implanted in the heart to replace a damaged or malfunctioning heart valve. The prosthetic valve can be made of biological tissue (such as from a pig or cow) or artificial materials (such as carbon or polyester). Its function is to allow for the proper directional flow of blood through the heart, opening and closing with each heartbeat to prevent backflow of blood.

There are several types of heart valve prostheses, including:

1. Mechanical valves: These are made entirely of artificial materials and have a longer lifespan than biological valves. However, they require the patient to take blood-thinning medication for the rest of their life to prevent blood clots from forming on the valve.
2. Bioprosthetic valves: These are made of biological tissue and typically last 10-15 years before needing replacement. They do not require the patient to take blood-thinning medication, but there is a higher risk of reoperation due to degeneration of the tissue over time.
3. Homografts or allografts: These are human heart valves that have been donated and preserved for transplantation. They have similar longevity to bioprosthetic valves and do not require blood-thinning medication.
4. Autografts: In this case, the patient's own pulmonary valve is removed and used to replace the damaged aortic valve. This procedure is called the Ross procedure and has excellent long-term results, but it requires advanced surgical skills and is not widely available.

The choice of heart valve prosthesis depends on various factors, including the patient's age, overall health, lifestyle, and personal preferences.

Stress echocardiography is a medical test that uses ultrasound imaging to assess how well your heart muscles are pumping blood and how well they respond to stress. It can help diagnose and evaluate coronary artery disease, valvular heart disease, and other cardiac conditions.

During the test, you will be asked to exercise on a treadmill or stationary bike while your heart rate and blood pressure are monitored. At peak exercise, a healthcare professional will take ultrasound images of your heart to evaluate its structure and function. If you are unable to exercise, medication may be given to simulate the effects of exercise on your heart.

The test can help identify areas of your heart that aren't receiving enough oxygen-rich blood due to blocked or narrowed arteries. It can also assess how well your heart valves are functioning and whether there are any structural abnormalities in your heart. Your healthcare provider will use the results of the test to develop a treatment plan tailored to your individual needs.

The myocardium is the middle layer of the heart wall, composed of specialized cardiac muscle cells that are responsible for pumping blood throughout the body. It forms the thickest part of the heart wall and is divided into two sections: the left ventricle, which pumps oxygenated blood to the rest of the body, and the right ventricle, which pumps deoxygenated blood to the lungs.

The myocardium contains several types of cells, including cardiac muscle fibers, connective tissue, nerves, and blood vessels. The muscle fibers are arranged in a highly organized pattern that allows them to contract in a coordinated manner, generating the force necessary to pump blood through the heart and circulatory system.

Damage to the myocardium can occur due to various factors such as ischemia (reduced blood flow), infection, inflammation, or genetic disorders. This damage can lead to several cardiac conditions, including heart failure, arrhythmias, and cardiomyopathy.

Electrophysiology is a branch of medicine that deals with the electrical activities of the body, particularly the heart. In a medical context, electrophysiology studies (EPS) are performed to assess abnormal heart rhythms (arrhythmias) and to evaluate the effectiveness of certain treatments, such as medication or pacemakers.

During an EPS, electrode catheters are inserted into the heart through blood vessels in the groin or neck. These catheters can record the electrical activity of the heart and stimulate it to help identify the source of the arrhythmia. The information gathered during the study can help doctors determine the best course of treatment for each patient.

In addition to cardiac electrophysiology, there are also other subspecialties within electrophysiology, such as neuromuscular electrophysiology, which deals with the electrical activity of the nervous system and muscles.

Heart rate is the number of heartbeats per unit of time, often expressed as beats per minute (bpm). It can vary significantly depending on factors such as age, physical fitness, emotions, and overall health status. A resting heart rate between 60-100 bpm is generally considered normal for adults, but athletes and individuals with high levels of physical fitness may have a resting heart rate below 60 bpm due to their enhanced cardiovascular efficiency. Monitoring heart rate can provide valuable insights into an individual's health status, exercise intensity, and response to various treatments or interventions.

A "false positive reaction" in medical testing refers to a situation where a diagnostic test incorrectly indicates the presence of a specific condition or disease in an individual who does not actually have it. This occurs when the test results give a positive outcome, while the true health status of the person is negative or free from the condition being tested for.

False positive reactions can be caused by various factors including:

1. Presence of unrelated substances that interfere with the test result (e.g., cross-reactivity between similar molecules).
2. Low specificity of the test, which means it may detect other conditions or irrelevant factors as positive.
3. Contamination during sample collection, storage, or analysis.
4. Human errors in performing or interpreting the test results.

False positive reactions can have significant consequences, such as unnecessary treatments, anxiety, and increased healthcare costs. Therefore, it is essential to confirm any positive test result with additional tests or clinical evaluations before making a definitive diagnosis.

Paroxysmal Tachycardia is a type of arrhythmia (abnormal heart rhythm) characterized by rapid and abrupt onset and offset of episodes of tachycardia, which are faster than normal heart rates. The term "paroxysmal" refers to the sudden and recurring nature of these episodes.

Paroxysmal Tachycardia can occur in various parts of the heart, including the atria (small upper chambers) or ventricles (larger lower chambers). The two most common types are Atrial Paroxysmal Tachycardia (APT) and Ventricular Paroxysmal Tachycardia (VPT).

APT is more common and typically results in a rapid heart rate of 100-250 beats per minute. It usually begins and ends suddenly, lasting for seconds to hours. APT can cause symptoms such as palpitations, lightheadedness, shortness of breath, chest discomfort, or anxiety.

VPT is less common but more serious because it involves the ventricles, which are responsible for pumping blood to the rest of the body. VPT can lead to decreased cardiac output and potentially life-threatening conditions such as syncope (fainting) or even cardiac arrest.

Treatment options for Paroxysmal Tachycardia depend on the underlying cause, severity, and frequency of symptoms. These may include lifestyle modifications, medications, cardioversion (electrical shock to restore normal rhythm), catheter ablation (destroying problematic heart tissue), or implantable devices such as pacemakers or defibrillators.

Verapamil is a calcium channel blocker medication that is primarily used to treat hypertension (high blood pressure), angina (chest pain), and certain types of cardiac arrhythmias (irregular heart rhyats). It works by relaxing the smooth muscle cells in the walls of blood vessels, which causes them to dilate or widen, reducing the resistance to blood flow and thereby lowering blood pressure. Verapamil also slows down the conduction of electrical signals within the heart, which can help to regulate the heart rate and rhythm.

In addition to its cardiovascular effects, verapamil is sometimes used off-label for the treatment of other conditions such as migraine headaches, Raynaud's phenomenon, and certain types of tremors. It is available in various forms, including immediate-release tablets, extended-release capsules, and intravenous (IV) injection.

It is important to note that verapamil can interact with other medications, so it is essential to inform your healthcare provider about all the drugs you are taking before starting this medication. Additionally, verapamil should be used with caution in people with certain medical conditions, such as heart failure, liver disease, and low blood pressure.

Aortic valve stenosis is a cardiac condition characterized by the narrowing or stiffening of the aortic valve, which separates the left ventricle (the heart's main pumping chamber) from the aorta (the large artery that carries oxygen-rich blood to the rest of the body). This narrowing or stiffening prevents the aortic valve from opening fully, resulting in reduced blood flow from the left ventricle to the aorta and the rest of the body.

The narrowing can be caused by several factors, including congenital heart defects, calcification (hardening) of the aortic valve due to aging, or scarring of the valve due to rheumatic fever or other inflammatory conditions. As a result, the left ventricle must work harder to pump blood through the narrowed valve, which can lead to thickening and enlargement of the left ventricular muscle (left ventricular hypertrophy).

Symptoms of aortic valve stenosis may include chest pain or tightness, shortness of breath, fatigue, dizziness or fainting, and heart palpitations. Severe aortic valve stenosis can lead to serious complications such as heart failure, arrhythmias, or even sudden cardiac death. Treatment options may include medications to manage symptoms, lifestyle changes, or surgical intervention such as aortic valve replacement.

Computer-assisted signal processing is a medical term that refers to the use of computer algorithms and software to analyze, interpret, and extract meaningful information from biological signals. These signals can include physiological data such as electrocardiogram (ECG) waves, electromyography (EMG) signals, electroencephalography (EEG) readings, or medical images.

The goal of computer-assisted signal processing is to automate the analysis of these complex signals and extract relevant features that can be used for diagnostic, monitoring, or therapeutic purposes. This process typically involves several steps, including:

1. Signal acquisition: Collecting raw data from sensors or medical devices.
2. Preprocessing: Cleaning and filtering the data to remove noise and artifacts.
3. Feature extraction: Identifying and quantifying relevant features in the signal, such as peaks, troughs, or patterns.
4. Analysis: Applying statistical or machine learning algorithms to interpret the extracted features and make predictions about the underlying physiological state.
5. Visualization: Presenting the results in a clear and intuitive way for clinicians to review and use.

Computer-assisted signal processing has numerous applications in healthcare, including:

* Diagnosing and monitoring cardiac arrhythmias or other heart conditions using ECG signals.
* Assessing muscle activity and function using EMG signals.
* Monitoring brain activity and diagnosing neurological disorders using EEG readings.
* Analyzing medical images to detect abnormalities, such as tumors or fractures.

Overall, computer-assisted signal processing is a powerful tool for improving the accuracy and efficiency of medical diagnosis and monitoring, enabling clinicians to make more informed decisions about patient care.

Coronary artery disease, often simply referred to as coronary disease, is a condition in which the blood vessels that supply oxygen-rich blood to the heart become narrowed or blocked due to the buildup of fatty deposits called plaques. This can lead to chest pain (angina), shortness of breath, or in severe cases, a heart attack.

The medical definition of coronary artery disease is:

A condition characterized by the accumulation of atheromatous plaques in the walls of the coronary arteries, leading to decreased blood flow and oxygen supply to the myocardium (heart muscle). This can result in symptoms such as angina pectoris, shortness of breath, or arrhythmias, and may ultimately lead to myocardial infarction (heart attack) or heart failure.

Risk factors for coronary artery disease include age, smoking, high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, and a family history of the condition. Lifestyle changes such as quitting smoking, exercising regularly, eating a healthy diet, and managing stress can help reduce the risk of developing coronary artery disease. Medical treatments may include medications to control blood pressure, cholesterol levels, or irregular heart rhythms, as well as procedures such as angioplasty or bypass surgery to improve blood flow to the heart.

Right Ventricular Function refers to the ability of the right ventricle (RV) of the heart to receive and eject blood during the cardiac cycle. The right ventricle is one of the four chambers of the heart and is responsible for pumping deoxygenated blood from the body to the lungs for re-oxygenation.

Right ventricular function can be assessed by measuring various parameters such as:

1. Right Ventricular Ejection Fraction (RVEF): It is the percentage of blood that is ejected from the right ventricle during each heartbeat. A normal RVEF ranges from 45-75%.
2. Right Ventricular Systolic Function: It refers to the ability of the right ventricle to contract and eject blood during systole (contraction phase). This can be assessed by measuring the tricuspid annular plane systolic excursion (TAPSE) or tissue Doppler imaging.
3. Right Ventricular Diastolic Function: It refers to the ability of the right ventricle to relax and fill with blood during diastole (relaxation phase). This can be assessed by measuring the right ventricular inflow pattern, tricuspid valve E/A ratio, or deceleration time.
4. Right Ventricular Afterload: It refers to the pressure that the right ventricle must overcome to eject blood into the pulmonary artery. Increased afterload can impair right ventricular function.

Abnormalities in right ventricular function can lead to various cardiovascular conditions such as pulmonary hypertension, heart failure, and arrhythmias.

Myocardial ischemia is a condition in which the blood supply to the heart muscle (myocardium) is reduced or blocked, leading to insufficient oxygen delivery and potential damage to the heart tissue. This reduction in blood flow typically results from the buildup of fatty deposits, called plaques, in the coronary arteries that supply the heart with oxygen-rich blood. The plaques can rupture or become unstable, causing the formation of blood clots that obstruct the artery and limit blood flow.

Myocardial ischemia may manifest as chest pain (angina pectoris), shortness of breath, fatigue, or irregular heartbeats (arrhythmias). In severe cases, it can lead to myocardial infarction (heart attack) if the oxygen supply is significantly reduced or cut off completely, causing permanent damage or death of the heart muscle. Early diagnosis and treatment of myocardial ischemia are crucial for preventing further complications and improving patient outcomes.

Myocardial reperfusion is the restoration of blood flow to the heart muscle (myocardium), usually after a period of ischemia or reduced oxygen supply, such as during a myocardial infarction (heart attack). This can be achieved through various medical interventions, including thrombolytic therapy, percutaneous coronary intervention (PCI), or coronary artery bypass surgery (CABG). The goal of myocardial reperfusion is to salvage the jeopardized myocardium, preserve cardiac function, and reduce the risk of complications like heart failure or arrhythmias. However, it's important to note that while reperfusion is crucial for treating ischemic heart disease, it can also lead to additional injury to the heart muscle, known as reperfusion injury.

Observer variation, also known as inter-observer variability or measurement agreement, refers to the difference in observations or measurements made by different observers or raters when evaluating the same subject or phenomenon. It is a common issue in various fields such as medicine, research, and quality control, where subjective assessments are involved.

In medical terms, observer variation can occur in various contexts, including:

1. Diagnostic tests: Different radiologists may interpret the same X-ray or MRI scan differently, leading to variations in diagnosis.
2. Clinical trials: Different researchers may have different interpretations of clinical outcomes or adverse events, affecting the consistency and reliability of trial results.
3. Medical records: Different healthcare providers may document medical histories, physical examinations, or treatment plans differently, leading to inconsistencies in patient care.
4. Pathology: Different pathologists may have varying interpretations of tissue samples or laboratory tests, affecting diagnostic accuracy.

Observer variation can be minimized through various methods, such as standardized assessment tools, training and calibration of observers, and statistical analysis of inter-rater reliability.

Medical Definition:

"Risk factors" are any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. They can be divided into modifiable and non-modifiable risk factors. Modifiable risk factors are those that can be changed through lifestyle choices or medical treatment, while non-modifiable risk factors are inherent traits such as age, gender, or genetic predisposition. Examples of modifiable risk factors include smoking, alcohol consumption, physical inactivity, and unhealthy diet, while non-modifiable risk factors include age, sex, and family history. It is important to note that having a risk factor does not guarantee that a person will develop the disease, but rather indicates an increased susceptibility.

In epidemiology, the incidence of a disease is defined as the number of new cases of that disease within a specific population over a certain period of time. It is typically expressed as a rate, with the number of new cases in the numerator and the size of the population at risk in the denominator. Incidence provides information about the risk of developing a disease during a given time period and can be used to compare disease rates between different populations or to monitor trends in disease occurrence over time.

Multivariate analysis is a statistical method used to examine the relationship between multiple independent variables and a dependent variable. It allows for the simultaneous examination of the effects of two or more independent variables on an outcome, while controlling for the effects of other variables in the model. This technique can be used to identify patterns, associations, and interactions among multiple variables, and is commonly used in medical research to understand complex health outcomes and disease processes. Examples of multivariate analysis methods include multiple regression, factor analysis, cluster analysis, and discriminant analysis.

Coronary circulation refers to the circulation of blood in the coronary vessels, which supply oxygenated blood to the heart muscle (myocardium) and drain deoxygenated blood from it. The coronary circulation system includes two main coronary arteries - the left main coronary artery and the right coronary artery - that branch off from the aorta just above the aortic valve. These arteries further divide into smaller branches, which supply blood to different regions of the heart muscle.

The left main coronary artery divides into two branches: the left anterior descending (LAD) artery and the left circumflex (LCx) artery. The LAD supplies blood to the front and sides of the heart, while the LCx supplies blood to the back and sides of the heart. The right coronary artery supplies blood to the lower part of the heart, including the right ventricle and the bottom portion of the left ventricle.

The veins that drain the heart muscle include the great cardiac vein, the middle cardiac vein, and the small cardiac vein, which merge to form the coronary sinus. The coronary sinus empties into the right atrium, allowing deoxygenated blood to enter the right side of the heart and be pumped to the lungs for oxygenation.

Coronary circulation is essential for maintaining the health and function of the heart muscle, as it provides the necessary oxygen and nutrients required for proper contraction and relaxation of the myocardium. Any disruption or blockage in the coronary circulation system can lead to serious consequences, such as angina, heart attack, or even death.

Reproducibility of results in a medical context refers to the ability to obtain consistent and comparable findings when a particular experiment or study is repeated, either by the same researcher or by different researchers, following the same experimental protocol. It is an essential principle in scientific research that helps to ensure the validity and reliability of research findings.

In medical research, reproducibility of results is crucial for establishing the effectiveness and safety of new treatments, interventions, or diagnostic tools. It involves conducting well-designed studies with adequate sample sizes, appropriate statistical analyses, and transparent reporting of methods and findings to allow other researchers to replicate the study and confirm or refute the results.

The lack of reproducibility in medical research has become a significant concern in recent years, as several high-profile studies have failed to produce consistent findings when replicated by other researchers. This has led to increased scrutiny of research practices and a call for greater transparency, rigor, and standardization in the conduct and reporting of medical research.

Systole is the phase of the cardiac cycle during which the heart muscle contracts to pump blood out of the heart. Specifically, it refers to the contraction of the ventricles, the lower chambers of the heart. This is driven by the action of the electrical conduction system of the heart, starting with the sinoatrial node and passing through the atrioventricular node and bundle branches to the Purkinje fibers.

During systole, the pressure within the ventricles increases as they contract, causing the aortic and pulmonary valves to open and allowing blood to be ejected into the systemic and pulmonary circulations, respectively. The duration of systole is typically shorter than that of diastole, the phase during which the heart muscle relaxes and the chambers fill with blood.

In clinical settings, the terms "systolic" and "diastolic" are often used to describe blood pressure measurements, with the former referring to the pressure exerted on the artery walls when the ventricles contract and eject blood, and the latter referring to the pressure when the ventricles are relaxed and filling with blood.

Hemodynamics is the study of how blood flows through the cardiovascular system, including the heart and the vascular network. It examines various factors that affect blood flow, such as blood volume, viscosity, vessel length and diameter, and pressure differences between different parts of the circulatory system. Hemodynamics also considers the impact of various physiological and pathological conditions on these variables, and how they in turn influence the function of vital organs and systems in the body. It is a critical area of study in fields such as cardiology, anesthesiology, and critical care medicine.

Heart disease is a broad term for a class of diseases that involve the heart or blood vessels. It's often used to refer to conditions that include:

1. Coronary artery disease (CAD): This is the most common type of heart disease. It occurs when the arteries that supply blood to the heart become hardened and narrowed due to the buildup of cholesterol and other substances, which can lead to chest pain (angina), shortness of breath, or a heart attack.

2. Heart failure: This condition occurs when the heart is unable to pump blood efficiently to meet the body's needs. It can be caused by various conditions, including coronary artery disease, high blood pressure, and cardiomyopathy.

3. Arrhythmias: These are abnormal heart rhythms, which can be too fast, too slow, or irregular. They can lead to symptoms such as palpitations, dizziness, and fainting.

4. Valvular heart disease: This involves damage to one or more of the heart's four valves, which control blood flow through the heart. Damage can be caused by various conditions, including infection, rheumatic fever, and aging.

5. Cardiomyopathy: This is a disease of the heart muscle that makes it harder for the heart to pump blood efficiently. It can be caused by various factors, including genetics, viral infections, and drug abuse.

6. Pericardial disease: This involves inflammation or other problems with the sac surrounding the heart (pericardium). It can cause chest pain and other symptoms.

7. Congenital heart defects: These are heart conditions that are present at birth, such as a hole in the heart or abnormal blood vessels. They can range from mild to severe and may require medical intervention.

8. Heart infections: The heart can become infected by bacteria, viruses, or parasites, leading to various symptoms and complications.

It's important to note that many factors can contribute to the development of heart disease, including genetics, lifestyle choices, and certain medical conditions. Regular check-ups and a healthy lifestyle can help reduce the risk of developing heart disease.

Risk assessment in the medical context refers to the process of identifying, evaluating, and prioritizing risks to patients, healthcare workers, or the community related to healthcare delivery. It involves determining the likelihood and potential impact of adverse events or hazards, such as infectious diseases, medication errors, or medical devices failures, and implementing measures to mitigate or manage those risks. The goal of risk assessment is to promote safe and high-quality care by identifying areas for improvement and taking action to minimize harm.

Coronary vessels refer to the network of blood vessels that supply oxygenated blood and nutrients to the heart muscle, also known as the myocardium. The two main coronary arteries are the left main coronary artery and the right coronary artery.

The left main coronary artery branches off into the left anterior descending artery (LAD) and the left circumflex artery (LCx). The LAD supplies blood to the front of the heart, while the LCx supplies blood to the side and back of the heart.

The right coronary artery supplies blood to the right lower part of the heart, including the right atrium and ventricle, as well as the back of the heart.

Coronary vessel disease (CVD) occurs when these vessels become narrowed or blocked due to the buildup of plaque, leading to reduced blood flow to the heart muscle. This can result in chest pain, shortness of breath, or a heart attack.

The aortic valve is the valve located between the left ventricle (the lower left chamber of the heart) and the aorta (the largest artery in the body, which carries oxygenated blood from the heart to the rest of the body). It is made up of three thin flaps or leaflets that open and close to regulate blood flow. During a heartbeat, the aortic valve opens to allow blood to be pumped out of the left ventricle into the aorta, and then closes to prevent blood from flowing back into the ventricle when it relaxes. Any abnormality or damage to this valve can lead to various cardiovascular conditions such as aortic stenosis, aortic regurgitation, or infective endocarditis.

Radiopharmaceuticals are defined as pharmaceutical preparations that contain radioactive isotopes and are used for diagnosis or therapy in nuclear medicine. These compounds are designed to interact specifically with certain biological targets, such as cells, tissues, or organs, and emit radiation that can be detected and measured to provide diagnostic information or used to destroy abnormal cells or tissue in therapeutic applications.

The radioactive isotopes used in radiopharmaceuticals have carefully controlled half-lives, which determine how long they remain radioactive and how long the pharmaceutical preparation remains effective. The choice of radioisotope depends on the intended use of the radiopharmaceutical, as well as factors such as its energy, range of emission, and chemical properties.

Radiopharmaceuticals are used in a wide range of medical applications, including imaging, cancer therapy, and treatment of other diseases and conditions. Examples of radiopharmaceuticals include technetium-99m for imaging the heart, lungs, and bones; iodine-131 for treating thyroid cancer; and samarium-153 for palliative treatment of bone metastases.

The use of radiopharmaceuticals requires specialized training and expertise in nuclear medicine, as well as strict adherence to safety protocols to minimize radiation exposure to patients and healthcare workers.

Survival analysis is a branch of statistics that deals with the analysis of time to event data. It is used to estimate the time it takes for a certain event of interest to occur, such as death, disease recurrence, or treatment failure. The event of interest is called the "failure" event, and survival analysis estimates the probability of not experiencing the failure event until a certain point in time, also known as the "survival" probability.

Survival analysis can provide important information about the effectiveness of treatments, the prognosis of patients, and the identification of risk factors associated with the event of interest. It can handle censored data, which is common in medical research where some participants may drop out or be lost to follow-up before the event of interest occurs.

Survival analysis typically involves estimating the survival function, which describes the probability of surviving beyond a certain time point, as well as hazard functions, which describe the instantaneous rate of failure at a given time point. Other important concepts in survival analysis include median survival times, restricted mean survival times, and various statistical tests to compare survival curves between groups.

Epidemiologic methods are systematic approaches used to investigate and understand the distribution, determinants, and outcomes of health-related events or diseases in a population. These methods are applied to study the patterns of disease occurrence and transmission, identify risk factors and causes, and evaluate interventions for prevention and control. The core components of epidemiologic methods include:

1. Descriptive Epidemiology: This involves the systematic collection and analysis of data on the who, what, when, and where of health events to describe their distribution in a population. It includes measures such as incidence, prevalence, mortality, and morbidity rates, as well as geographic and temporal patterns.

2. Analytical Epidemiology: This involves the use of statistical methods to examine associations between potential risk factors and health outcomes. It includes observational studies (cohort, case-control, cross-sectional) and experimental studies (randomized controlled trials). The goal is to identify causal relationships and quantify the strength of associations.

3. Experimental Epidemiology: This involves the design and implementation of interventions or experiments to test hypotheses about disease prevention and control. It includes randomized controlled trials, community trials, and other experimental study designs.

4. Surveillance and Monitoring: This involves ongoing systematic collection, analysis, and interpretation of health-related data for early detection, tracking, and response to health events or diseases.

5. Ethical Considerations: Epidemiologic studies must adhere to ethical principles such as respect for autonomy, beneficence, non-maleficence, and justice. This includes obtaining informed consent, ensuring confidentiality, and minimizing harm to study participants.

Overall, epidemiologic methods provide a framework for investigating and understanding the complex interplay between host, agent, and environmental factors that contribute to the occurrence of health-related events or diseases in populations.

"Pre-excitation, Mahaim-type" is a medical term used to describe a specific electrical conduction pattern in the heart that can lead to an abnormal heart rhythm (arrhythmia). This condition involves an accessory pathway, also known as a "Mahaim fiber," which connects the atria (the upper chambers of the heart) to the ventricles (the lower chambers) in a way that bypasses the normal conduction system.

In this type of pre-excitation, the electrical impulses travel through the accessory pathway and reach the ventricles earlier than they would via the normal conduction system, resulting in a characteristic pattern on an electrocardiogram (ECG) known as a "delta wave." This pre-excitation can lead to tachyarrhythmias such as atrioventricular reentrant tachycardia (AVRT), which can cause symptoms like palpitations, dizziness, or even syncope (fainting).

It's important to note that not all individuals with Mahaim-type pre-excitation will develop arrhythmias, but some may require treatment if they experience symptoms or have a high risk of complications. Treatment options include medications, catheter ablation, or surgical intervention.

Adenosine is a purine nucleoside that is composed of a sugar (ribose) and the base adenine. It plays several important roles in the body, including serving as a precursor for the synthesis of other molecules such as ATP, NAD+, and RNA.

In the medical context, adenosine is perhaps best known for its use as a pharmaceutical agent to treat certain cardiac arrhythmias. When administered intravenously, it can help restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT) by slowing conduction through the atrioventricular node and interrupting the reentry circuit responsible for the arrhythmia.

Adenosine can also be used as a diagnostic tool to help differentiate between narrow-complex tachycardias of supraventricular origin and those that originate from below the ventricles (such as ventricular tachycardia). This is because adenosine will typically terminate PSVT but not affect the rhythm of VT.

It's worth noting that adenosine has a very short half-life, lasting only a few seconds in the bloodstream. This means that its effects are rapidly reversible and generally well-tolerated, although some patients may experience transient symptoms such as flushing, chest pain, or shortness of breath.

Atrial fibrillation (A-tre-al fi-bru-la'shun) is a type of abnormal heart rhythm characterized by rapid and irregular beating of the atria, the upper chambers of the heart. In this condition, the electrical signals that coordinate heartbeats don't function properly, causing the atria to quiver instead of contracting effectively. As a result, blood may not be pumped efficiently into the ventricles, which can lead to blood clots, stroke, and other complications. Atrial fibrillation is a common type of arrhythmia and can cause symptoms such as palpitations, shortness of breath, fatigue, and dizziness. It can be caused by various factors, including heart disease, high blood pressure, age, and genetics. Treatment options include medications, electrical cardioversion, and surgical procedures to restore normal heart rhythm.

The Chi-square distribution is a continuous probability distribution that is often used in statistical hypothesis testing. It is the distribution of a sum of squares of k independent standard normal random variables. The resulting quantity follows a chi-square distribution with k degrees of freedom, denoted as χ²(k).

The probability density function (pdf) of the Chi-square distribution with k degrees of freedom is given by:

f(x; k) = (1/ (2^(k/2) * Γ(k/2))) \* x^((k/2)-1) \* e^(-x/2), for x > 0 and 0, otherwise.

Where Γ(k/2) is the gamma function evaluated at k/2. The mean and variance of a Chi-square distribution with k degrees of freedom are k and 2k, respectively.

The Chi-square distribution has various applications in statistical inference, including testing goodness-of-fit, homogeneity of variances, and independence in contingency tables.

Patient selection, in the context of medical treatment or clinical research, refers to the process of identifying and choosing appropriate individuals who are most likely to benefit from a particular medical intervention or who meet specific criteria to participate in a study. This decision is based on various factors such as the patient's diagnosis, stage of disease, overall health status, potential risks, and expected benefits. The goal of patient selection is to ensure that the selected individuals will receive the most effective and safe care possible while also contributing to meaningful research outcomes.

Prevalence, in medical terms, refers to the total number of people in a given population who have a particular disease or condition at a specific point in time, or over a specified period. It is typically expressed as a percentage or a ratio of the number of cases to the size of the population. Prevalence differs from incidence, which measures the number of new cases that develop during a certain period.

Hospital mortality is a term used to describe the number or rate of deaths that occur in a hospital setting during a specific period. It is often used as a measure of the quality of healthcare provided by a hospital, as a higher hospital mortality rate may indicate poorer care or more complex cases being treated. However, it's important to note that hospital mortality rates can be influenced by many factors, including the severity of illness of the patients being treated, patient demographics, and the availability of resources and specialized care. Therefore, hospital mortality rates should be interpreted with caution and in the context of other quality metrics.

A case-control study is an observational research design used to identify risk factors or causes of a disease or health outcome. In this type of study, individuals with the disease or condition (cases) are compared with similar individuals who do not have the disease or condition (controls). The exposure history or other characteristics of interest are then compared between the two groups to determine if there is an association between the exposure and the disease.

Case-control studies are often used when it is not feasible or ethical to conduct a randomized controlled trial, as they can provide valuable insights into potential causes of diseases or health outcomes in a relatively short period of time and at a lower cost than other study designs. However, because case-control studies rely on retrospective data collection, they are subject to biases such as recall bias and selection bias, which can affect the validity of the results. Therefore, it is important to carefully design and conduct case-control studies to minimize these potential sources of bias.

I'm sorry for any confusion, but "Japan" is not a medical term. Japan is the name of a country, officially known as Nippon-koku or Nihon-koku in Japanese, and is located in East Asia. It is an island nation in the Pacific Ocean with a population of about 126 million people.

If you have any medical questions or terms that you would like me to define, please let me know!

The Kaplan-Meier estimate is a statistical method used to calculate the survival probability over time in a population. It is commonly used in medical research to analyze time-to-event data, such as the time until a patient experiences a specific event like disease progression or death. The Kaplan-Meier estimate takes into account censored data, which occurs when some individuals are lost to follow-up before experiencing the event of interest.

The method involves constructing a survival curve that shows the proportion of subjects still surviving at different time points. At each time point, the survival probability is calculated as the product of the conditional probabilities of surviving from one time point to the next. The Kaplan-Meier estimate provides an unbiased and consistent estimator of the survival function, even when censoring is present.

In summary, the Kaplan-Meier estimate is a crucial tool in medical research for analyzing time-to-event data and estimating survival probabilities over time while accounting for censored observations.

Neck pain is discomfort or soreness in the neck region, which can extend from the base of the skull to the upper part of the shoulder blades, caused by injury, irritation, or inflammation of the muscles, ligaments, or nerves in the cervical spine. The pain may worsen with movement and can be accompanied by stiffness, numbness, tingling, or weakness in the neck, arms, or hands. In some cases, headaches can also occur as a result of neck pain.

Acetylthiocholine is a synthetic chemical compound that is widely used in scientific research, particularly in the field of neuroscience. It is the acetylated form of thiocholine, which is a choline ester. Acetylthiocholine is often used as a substrate for enzymes called cholinesterases, including acetylcholinesterase (AChE) and butyrylcholinesterase (BChE).

When Acetylthiocholine is hydrolyzed by AChE, it produces choline and thioacetic acid. This reaction is important because it terminates the signal transduction of the neurotransmitter acetylcholine at the synapse between neurons. Inhibition of AChE can lead to an accumulation of Acetylthiocholine and acetylcholine, which can have various effects on the nervous system, depending on the dose and duration of inhibition.

Acetylthiocholine is also used as a reagent in the Ellman's assay, a colorimetric method for measuring AChE activity. In this assay, Acetylthiocholine is hydrolyzed by AChE, releasing thiocholine, which then reacts with dithiobisnitrobenzoic acid (DTNB) to produce a yellow color. The intensity of the color is proportional to the amount of thiocholine produced and can be used to quantify AChE activity.

A Severity of Illness Index is a measurement tool used in healthcare to assess the severity of a patient's condition and the risk of mortality or other adverse outcomes. These indices typically take into account various physiological and clinical variables, such as vital signs, laboratory values, and co-morbidities, to generate a score that reflects the patient's overall illness severity.

Examples of Severity of Illness Indices include the Acute Physiology and Chronic Health Evaluation (APACHE) system, the Simplified Acute Physiology Score (SAPS), and the Mortality Probability Model (MPM). These indices are often used in critical care settings to guide clinical decision-making, inform prognosis, and compare outcomes across different patient populations.

It is important to note that while these indices can provide valuable information about a patient's condition, they should not be used as the sole basis for clinical decision-making. Rather, they should be considered in conjunction with other factors, such as the patient's overall clinical presentation, treatment preferences, and goals of care.

The medial forebrain bundle (MFB) is a group of fiber tracts in the brain that carries various neurotransmitters, including dopamine, serotonin, and norepinephrine. It plays a crucial role in reward processing, motivation, and reinforcement, as well as regulation of motor function, cognition, and emotion.

The MFB is located in the ventral part of the forebrain and extends from the ventral tegmental area (VTA) in the midbrain to the prefrontal cortex, nucleus accumbens, amygdala, and other limbic structures in the basal forebrain.

Damage to the MFB can result in various neurological and psychiatric symptoms, such as motor impairment, mood disorders, and addiction. Stimulation of the MFB has been shown to produce rewarding effects and is implicated in the reinforcing properties of drugs of abuse.

"Age factors" refer to the effects, changes, or differences that age can have on various aspects of health, disease, and medical care. These factors can encompass a wide range of issues, including:

1. Physiological changes: As people age, their bodies undergo numerous physical changes that can affect how they respond to medications, illnesses, and medical procedures. For example, older adults may be more sensitive to certain drugs or have weaker immune systems, making them more susceptible to infections.
2. Chronic conditions: Age is a significant risk factor for many chronic diseases, such as heart disease, diabetes, cancer, and arthritis. As a result, age-related medical issues are common and can impact treatment decisions and outcomes.
3. Cognitive decline: Aging can also lead to cognitive changes, including memory loss and decreased decision-making abilities. These changes can affect a person's ability to understand and comply with medical instructions, leading to potential complications in their care.
4. Functional limitations: Older adults may experience physical limitations that impact their mobility, strength, and balance, increasing the risk of falls and other injuries. These limitations can also make it more challenging for them to perform daily activities, such as bathing, dressing, or cooking.
5. Social determinants: Age-related factors, such as social isolation, poverty, and lack of access to transportation, can impact a person's ability to obtain necessary medical care and affect their overall health outcomes.

Understanding age factors is critical for healthcare providers to deliver high-quality, patient-centered care that addresses the unique needs and challenges of older adults. By taking these factors into account, healthcare providers can develop personalized treatment plans that consider a person's age, physical condition, cognitive abilities, and social circumstances.

Betamethasone is a type of corticosteroid medication that is used to treat various medical conditions. It works by reducing inflammation and suppressing the activity of the immune system. Betamethasone is available in several forms, including creams, ointments, lotions, gels, solutions, tablets, and injectable preparations.

The medical definition of betamethasone is:

A synthetic corticosteroid with anti-inflammatory, immunosuppressive, and vasoconstrictive properties. It is used to treat a variety of conditions such as skin disorders, allergies, asthma, arthritis, and autoimmune diseases. Betamethasone is available in various formulations including topical (creams, ointments, lotions, gels), oral (tablets), and injectable preparations. It acts by binding to specific receptors in cells, which leads to the inhibition of the production of inflammatory mediators and the suppression of immune responses.

It is important to note that betamethasone should be used under the guidance of a healthcare professional, as it can have significant side effects if not used properly.

Patient care bundles are a collection of evidence-based practices that, when implemented together, result in significantly better outcomes for patients than when the practices are implemented individually. These bundles typically include a few critical steps or interventions that, when consistently followed, have been shown to improve patient safety and reduce the risk of complications. The practices included in a bundle may involve both clinical care (such as specific treatments or medications) and non-clinical care (such as communication strategies or patient education). By standardizing care through the use of bundles, healthcare providers can ensure that all patients receive the most effective and safe care possible.

Spinal nerves are the bundles of nerve fibers that transmit signals between the spinal cord and the rest of the body. There are 31 pairs of spinal nerves in the human body, which can be divided into five regions: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. Each spinal nerve carries both sensory information (such as touch, temperature, and pain) from the periphery to the spinal cord, and motor information (such as muscle control) from the spinal cord to the muscles and other structures in the body. Spinal nerves also contain autonomic fibers that regulate involuntary functions such as heart rate, digestion, and blood pressure.

Local anesthetics are a type of medication that is used to block the sensation of pain in a specific area of the body. They work by temporarily numbing the nerves in that area, preventing them from transmitting pain signals to the brain. Local anesthetics can be administered through various routes, including topical application (such as creams or gels), injection (such as into the skin or tissues), or regional nerve blocks (such as epidural or spinal anesthesia).

Some common examples of local anesthetics include lidocaine, prilocaine, bupivacaine, and ropivacaine. These medications can be used for a variety of medical procedures, ranging from minor surgeries (such as dental work or skin biopsies) to more major surgeries (such as joint replacements or hernia repairs).

Local anesthetics are generally considered safe when used appropriately, but they can have side effects and potential complications. These may include allergic reactions, toxicity (if too much is administered), and nerve damage (if the medication is injected into a nerve). It's important to follow your healthcare provider's instructions carefully when using local anesthetics, and to report any unusual symptoms or side effects promptly.

In medicine, "intractable pain" is a term used to describe pain that is difficult to manage, control or relieve with standard treatments. It's a type of chronic pain that continues for an extended period, often months or even years, and does not respond to conventional therapies such as medications, physical therapy, or surgery. Intractable pain can significantly affect a person's quality of life, causing emotional distress, sleep disturbances, and reduced mobility. It is essential to distinguish intractable pain from acute pain, which is typically sharp and short-lived, resulting from tissue damage or inflammation.

Intractable pain may be classified as:

1. Refractory pain: Pain that persists despite optimal treatment with various modalities, including medications, interventions, and multidisciplinary care.
2. Incurable pain: Pain caused by a progressive or incurable disease, such as cancer, for which no curative treatment is available.
3. Functional pain: Pain without an identifiable organic cause that does not respond to standard treatments.

Managing intractable pain often requires a multidisciplinary approach involving healthcare professionals from various fields, including pain specialists, neurologists, psychiatrists, psychologists, and physical therapists. Treatment options may include:

1. Adjuvant medications: Medications that are not primarily analgesics but have been found to help with pain relief, such as antidepressants, anticonvulsants, and muscle relaxants.
2. Interventional procedures: Minimally invasive techniques like nerve blocks, spinal cord stimulation, or intrathecal drug delivery systems that target specific nerves or areas of the body to reduce pain signals.
3. Psychological interventions: Techniques such as cognitive-behavioral therapy (CBT), mindfulness meditation, and relaxation training can help patients cope with chronic pain and improve their overall well-being.
4. Physical therapy and rehabilitation: Exercise programs, massage, acupuncture, and other physical therapies may provide relief for some types of intractable pain.
5. Complementary and alternative medicine (CAM): Techniques like yoga, tai chi, hypnosis, or biofeedback can be helpful in managing chronic pain.
6. Lifestyle modifications: Dietary changes, stress management, and quitting smoking may also contribute to improved pain management.

A cohort study is a type of observational study in which a group of individuals who share a common characteristic or exposure are followed up over time to determine the incidence of a specific outcome or outcomes. The cohort, or group, is defined based on the exposure status (e.g., exposed vs. unexposed) and then monitored prospectively to assess for the development of new health events or conditions.

Cohort studies can be either prospective or retrospective in design. In a prospective cohort study, participants are enrolled and followed forward in time from the beginning of the study. In contrast, in a retrospective cohort study, researchers identify a cohort that has already been assembled through medical records, insurance claims, or other sources and then look back in time to assess exposure status and health outcomes.

Cohort studies are useful for establishing causality between an exposure and an outcome because they allow researchers to observe the temporal relationship between the two. They can also provide information on the incidence of a disease or condition in different populations, which can be used to inform public health policy and interventions. However, cohort studies can be expensive and time-consuming to conduct, and they may be subject to bias if participants are not representative of the population or if there is loss to follow-up.

... , especially left bundle branch block, can lead to cardiac dyssynchrony. The simultaneous occurrence of left ... A (V1) QRS segment deflected down indicates left bundle branch block, while a deflection up indicates right bundle branch block ... Left bundle branch block, incomplete (iLBBB) or complete (cLBBB) The left bundle branch block can be further sub classified ... A bundle branch block is a defect in one of the bundle branches in the electrical conduction system of the heart. The heart's ...
... first degree AV block RBBB with associated tachycardia RBBB Intraventricular block Bundle branch block Left bundle branch block ... A right bundle branch block (RBBB) is a heart block in the right bundle branch of the electrical conduction system. During a ... Incomplete right bundle branch block (IRBBB) is an conduction abnormality in the right bundle branch block. While a complete ... "Right Bundle Branch Block". Symptoma. Retrieved 2015-08-13. Harkness WT, Hicks M (2022). "Right Bundle Branch Block". ...
Bundle branch block Right bundle branch block Sgarbossa's criteria "Conduction Blocks". Department of Physiology. Kansas City ... There are also partial blocks of the left bundle branch: "left anterior fascicular block" (LAFB) and a "left posterior ... Left bundle branch block (LBBB) is a conduction abnormality in the heart that can be seen on an electrocardiogram (ECG). In ... "Bundle branch block: Symptoms and causes". Mayo Clinic. Retrieved 6 April 2021. Foster DB (2007). Twelve-lead ...
This is referred to as a bundle branch block and is seen clinically as rate-dependent bundle branch block, right bundle branch ... can cause a BBB known as a rate-dependent bundle branch block (RDBBB). This manifests in a similar fashion to a regular bundle ... branch block, but occurs only under conditions that affect contractile rate. Tachycardia-dependent bundle branch block (TDBBB) ... A tachycardia-dependent bundle branch block is a defect in the conduction system of the heart, and is distinct from typical ...
This condition is known as a bundle branch block. The bundle branches were separately described by Retzer and Braeunig as early ... There are two branches of the bundle of His: the left bundle branch and the right bundle branch, both of which are located ... The bundle branches, or Tawara branches, are offshoots of the bundle of His in the heart's ventricle. They play an integral ... Rothberger showed that cutting off both branches to induce a bilateral bundle branch block results in a complete heart block. ...
"Left bundle branch block". Circulation: Arrhythmia and Electrophysiology. 13 (4): e008239. doi:10.1161/circep.119.008239. ISSN ... Atrioventricular block (AV block) is a type of heart block that occurs when the electrical signal traveling from the atria, or ... Third-degree AV block is the most severe of the AV blocks. Persons with third-degree AV block need emergency treatment ... the electrical signal travels through Bundle of His and divides into the right bundle and left bundle, which are located within ...
Conduction defects such as left bundle branch block or left anterior fascicular block can cause LAD on the ECG. Pre-excitation ... If a conduction defect such as left bundle branch block is the cause of LAD, there may not be any symptoms unless the ... "Left Bundle Branch Block". Cedars-Sinai. Retrieved 2021-07-26. "Left ventricular hypertrophy - Diagnosis and treatment - Mayo ... if it is combined with another borderline feature such as right bundle branch block, requires further investigation in view of ...
... (February 1945). "Diagnoisis and Prognosis of Bundle-Branch Block". Journal of the Indiana State Medical ... "Diagnoisis and Prognosis of Bundle-Branch Block", Journal of the Indiana State Medical Association (February 1945) " ... and took a leading role in fundraising for a new branch, which opened on Fall Creek Parkway in 1959. Middleton was chairman of ...
RBBB with fascicular block) Right bundle branch block (RBBB) Left bundle branch block (LBBB) Intraventricular conduction delays ... An example is a right bundle branch block, right fascicular block, bifascicular block, trifascicular block. Types of ... "Intraventricular Blocks". empendium.com. Retrieved 2021-10-17. "Intraventricular conduction delay: bundle branch blocks & ... intraventricular blocks are Fascicular block Left anterior fascicular block Left posterior fascicular block Trifascicular block ...
Transient, Recurrent, Complete Bundle-branch Block: Report of a Case. American Heart Journal. 1934;10(2):248-252. Goldsmith, G. ... Special Consideration of Bundle Branch Block with Concordant Graphs and with Discordant Graphs. Arch Intern Med (Chic). 1941;67 ... General Considerations of Bundle Branch Block with Concordant and with Discordant Graphs and the Wide S-Wave Pattern, Based on ... Chronic heart-block. Am J Med Sci 1917;154:585-592 Blackford, J.M., F.A. Willius and S.B. Haines. Operative Risk in Cardiac ...
Left bundle branch block Left anterior fascicular block Kevin J. Koop; et al., eds. (2010). "23". Atlas of emergency medicine ( ... The wave-front instead moves more quickly through the left anterior fascicle and right bundle branch, leading to a right axis ... A left posterior fascicular block (LPFB), also known as left posterior hemiblock (LPH), is a condition where the left posterior ... Rokey, R.; Chahine, R. A. (June 1984). "Isolated left posterior fascicular block associated with acquired ventricular septal ...
HBP in some cases can also correct bundle branch block patterns. A major step forward in pacemaker function has been to attempt ... His bundle pacing (HBP) leads to a more natural or perfectly natural ventricular activation and has generated strong research ... Eich C, Bleckmann A, Paul T (October 2005). "Percussion pacing in a three-year-old girl with complete heart block during ... Weirich WL, Gott VL, Lillehei CW (1957). "The treatment of complete heart block by the combined use of a myocardial electrode ...
How he did that, I'll ask him about some day." In 2016 he was diagnosed with asymptomatic left bundle branch block. In April ... In a 1992 article for the monthly Indiana Policy Review, Pence likened Bayh's and Coats's attempt at blocking out-of-state ... In 2013, Pence signed a law blocking local governments in Indiana from requiring businesses to offer higher wages or benefits ... Smith, Mitch; Eckholm, Erik (June 30, 2016). "Federal Judge Blocks Indiana Abortion Law". The New York Times. Archived from the ...
Right ventriculotomy often causes right bundle branch block if it is extensive. Modern congenital surgery techniques have ...
Common electrical disturbances include premature ventricular contraction and transient bundle branch blocks. It is important ... Complications for BCI are rare but can include delayed rupture of the heart, complete AV block, heart failure, pericardial ...
When left bundle-branch block (LBBB) is accompanied by right axis deviation (RAD), the rare combination is considered to be ... Childers R, Lupovich S, Sochanski M, Konarzewska H (2000). "Left bundle branch block and right axis deviation: a report of 36 ... Nikolic G, Marriott HJ (October 1985). "Left bundle branch block with right axis deviation: a marker of congestive ...
Electrocardiographic conduction abnormalities: Generally observed on an electrocardiograph as a bundle branch block. Ocular ...
Netanyahu has been suffering from Right bundle branch block (RBBB) since around 2003. On 22 July 2023, a pacemaker was ... "Israel: Asylum Seekers Blocked at Border". Human Rights Watch. 8 October 2012. Retrieved 16 September 2014. "Israel: New ... Although it is a small unit, it influences all branches of the military ... My service in the unit strengthened my ... The first months of Netanyahu's sixth term were centered around reforms in the judicial branch, which drew widespread criticism ...
... left bundle branch block (LBBB). It is caused by only the left anterior fascicle - one half of the left bundle branch being ... Bundle branch block Rebuzzi AG, Loperfido F, Biasucci LM (July 1985). "Transient Q waves followed by left anterior fascicular ... Normal activation of the left ventricle (LV) proceeds down the left bundle branch, which consist of three fascicles, the left ... Left anterior fascicular block (LAFB) is an abnormal condition of the left ventricle of the heart, related to, but ...
E. B. Sgarbossa (2000). "Value of the ECG in suspected acute myocardial infarction with left bundle branch block". Journal of ... F. J. Wackers (August 1987). "The diagnosis of myocardial infarction in the presence of left bundle branch block". Cardiology ... 2006). "Unraveling the spectrum of left bundle branch block in acute myocardial infarction: Insights from the Assessment of the ... "Diagnosis of ST-Elevation Myocardial Infarction in the Presence of Left Bundle Branch Block With the ST-Elevation to S-Wave ...
Lenegre J (1964). "Etiology and pathology of bilateral bundle branch block in relation to complete heart block". Prog ... Heart block Schott JJ, Alshinawi C, Kyndt F, et al. (1999). "Cardiac conduction defects associate with mutations in SCN5A". Nat ... Lev's disease is an acquired complete heart block due to idiopathic fibrosis and calcification of the electrical conduction ... Lev M (1964). "Anatomic basis for atrioventricular block". Am J Med. 37 (5): 742-8. doi:10.1016/0002-9343(64)90022-1. PMID ...
Sayin MR, Karabag T, Dogan SM, Akpinar I, Aydin M (April 2012). "Transient ST segment elevation and left bundle branch block ... electrocardiographic changes of bundle branch block and/or ST-segment elevations as seen in ischemic myocardial threat, and ... a branch of the autonomic nervous system) and innervates various organs including the lungs, stomach, kidney and heart. In one ... and partial or complete atrioventricular block. Other early-onset symptoms may include diplopia and blurred vision, dizziness, ...
Others include: QT prolongation, bundle branch block, first-degree atrioventricular block, and even sinus tachycardia. It may ...
... bundle branch block, and AV block are common, as is atrial fibrillation.[citation needed] Although not based on a human ... or heart block. Unfortunately, echocardiographic findings are indistinguishable from those seen in AL amyloidosis, and include ...
... incomplete left bundle-branch block". Cardiovascular Journal of Africa. 20 (1): 28-9. PMC 4200562. PMID 19287812. Publications ...
Bifascicular block is a combination of right bundle branch block and either left anterior fascicular block or left posterior ... They produce QRS complexes of relatively short durations with a right bundle branch block pattern. Tachycardias originating in ... Fascicular tachycardia usually arises from the posterior fascicle of the left bundle branch. ... The lateral wall of the left ventricle is supplied by branches of the left anterior descending (LAD) and left circumflex (LCx) ...
In bundle branch block, there can be an abnormal second upward deflection within the QRS complex. In this case, such a second ... but it may also be caused by left bundle branch block, Wolff-Parkinson-White syndrome, right and left ventricular hypertrophy, ... Depolarization of the heart ventricles occurs almost simultaneously, via the bundle of His and Purkinje fibers. If they are ...
In the presence of bundle branch block or ventricular hypertrophy, the depolarization impulse takes a longer than normal period ... This prolongation or delay is an important criterion for diagnosing bundle branch block or ventricular hypertrophy. Time of ...
"Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachyardia." American Heart Journal, St ...
Also in regional asynchrony, as in bundle branch block, there is regional heterogeneity of systolic function. By strain rate ... 2007 Mar 13;115(10):1252-9 Dillon JC, Chang S, Feigenbaum H. Echocardiographic manifestations of left bundle branch block. ... In Left bundle branch block (LBBB), the asynchronous activation of the left ventricle gives asynchronous contraction as well. ...
A left bundle branch block is a type of disruption of the hearts electrical impulses that can signal an underlying heart ... Left bundle branch block (LBBB) is a type heart block. It results from a problem with the electrical conduction system that ... Bundle branch blocks occur when there is blockage or disruption in the hearts electrical impulses. They cause those impulses ... This can help regulate the heart rhythm, as a bundle branch block can cause bradycardia and the heart to become fragile. ...
Bundle branch block, especially left bundle branch block, can lead to cardiac dyssynchrony. The simultaneous occurrence of left ... A (V1) QRS segment deflected down indicates left bundle branch block, while a deflection up indicates right bundle branch block ... Left bundle branch block, incomplete (iLBBB) or complete (cLBBB) The left bundle branch block can be further sub classified ... A bundle branch block is a defect in one of the bundle branches in the electrical conduction system of the heart. The hearts ...
... electrical impulse is delayed or fails to be conducted along the rapidly conducting fibers of the main left bundle branch or in ... Left bundle branch block (LBBB) occurs when transmission of the cardiac ... Left bundle branch block. Left bundle branch (LBB) block (LBBB) is not a benign entity; risk factors include the following:. * ... encoded search term (Pediatric Left Bundle Branch Block) and Pediatric Left Bundle Branch Block What to Read Next on Medscape ...
Left bundle branch block natural history, complications and prognosis ‎ (← links). *Left bundle branch block electrocardiogram ... Pages that link to "Left bundle branch block". ← Left bundle branch block ... Retrieved from "https://www.wikidoc.org/index.php/Special:WhatLinksHere/Left_bundle_branch_block" ... Third degree AV block echocardiography and ultrasound ‎ (← links). *Pulseless ventricular tachycardia differential diagnosis ‎ ...
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Centers RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.. ...
The definition of left bundle branch block and non-specific intraventricular conduction delay influences long-term mortality in ...
Left bundle branch block- new paradigm brewing- echo plus ekg Left bundle branch block (LBB) has been defined by various EKG ... Left Bundle Branch Block (LBBB) is not just a EKG finding, it is a really big deal ... The EKG pattern of left bundle branch block (LBBB) has been known for decades and that pattern was considered an indication of ... Left Bundle Branch Block (LBBB) is not just a EKG finding, it is a really big deal ...
... 2019-09-10T13:36:03-07:00. Aug 29, 2013 , Cardiovascular, ECG, Expert Peer Reviewed (Clinical) ... Hopefully, this helps simplify bundle branch blocks and how to read them on ECGs. Just remember:. S wave = depolarization away ... to help them understand bundle branch blocks. This is different than some of my usual posts because it is meant to be more ... If there is a delay or block in the left or right bundle, depolarization will take longer to occur. Therefore we get a widened ...
Bundle Branch Block and Fascicular Block - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the MSD ... Right bundle branch block (RBBB-see figure Right bundle branch block Right bundle branch block ) can occur in people with no ... Left bundle branch block (LBBB-see figure Left bundle branch block Left bundle branch block ) is associated with a structural ... Bundle branch block is partial or complete interruption of impulse conduction in a bundle branch; fascicular block is similar ...
Current concepts relating coronary flow, myocardial perfusion and metabolism in left bundle branch block and cardiac ... myocardial perfusion and metabolism in left bundle branch block and cardiac resynchronisation therapy. Together they form a ...
left bundle branch block, functional left bundle branch block, conduction abnormality, AF ... Syncope, left bundle branch block and second-degree atrioventricular block type 1. ... Home » ECG » left bundle branch block. Find a tracing. Library / Pathology - Any -. Atrioventricular block. Extrasystoles. ... myocardial infarction, left bundle branch block, ST-segment elevation, ST-segment depression, Q-wave ...
"Bundle-Branch Block" by people in this website by year, and whether "Bundle-Branch Block" was a major or minor topic of these ... "Bundle-Branch Block" is a descriptor in the National Library of Medicines controlled vocabulary thesaurus, MeSH (Medical ... Right Bundle-Branch Block*Right Bundle-Branch Block. *Block, Right Bundle-Branch ... Left Bundle-Branch Block*Left Bundle-Branch Block. *Block, Left Bundle-Branch ...
... lifeinthefastlane.com/ecg-library/basics/left-bundle-branch-block/. *Bundle Branch Block. (n.d.). Retrieved July 27, 2016, from ... A left bundle branch block occurs when the normal direction of septal depolarization is reversed (becomes right to left), as ... www.verywell.com/left-bundle-branch-block-lbbb-1745784. *MIT-BIH Arrhythmia Database. (1980). Retrieved June, 2016, from https ... Fogoros, R. N. (n.d.). What Does It Mean to Have a Left Bundle Branch Block? Retrieved August 08, 2016, from https:// ...
arrhythmia, atrial fibrillation, bradycardia, bundle branch block, extra heart beats, PACs, PVCs, tachycardia ...
Right Bundle Branch Block (RBBB) ByDr. Nur Karim. Jun 20, 2022 ... Left Bundle Branch Block (LBBB) * Right Bundle Branch Block ( ... The full terms of RBBB is Right Bundle Branch Block. ECG Criteria. • RSR-in V1 and V2 (M pattern).. • QRS-wide, ,0.12 second (3 ... Fascicular Block (Hemiblock). Left bundle divides into anterior and posterior fascicles.. • Anterior fascicle spreads in ... Fascicular block is diagnosed by looking at the axis deviation.. Fascicular block are of two types:. • RBBB with left anterior ...
Robert A. Shor of Virginia Heart know there is more to the story.,/div> ,div> ,/div> ,div>Bob has a bundle branch block in ... Bobs Story - Bundle Branch Block Because of careful monitoring of his left bundle branch block by Dr. Robert Shor, Bob Weber ... Bob has a bundle branch block in his hearts left ventricle. This is a delay in the electrical impulses and could be a sign of ...
Differentiating Right bundle branch block from other Diseases. Right bundle branch block should be differentiated from the ... "pseudo right bundle branch block" as electrocardiographically right bundle branch block is not actually present. Aprolongation ... Type 1 Brugada pattern is characterized by ST elevations in leads V1-V3 with a right bundle branch block (RBBB) like pattern, ... The criteria to diagnose a left bundle branch block on an electrocardiogram includes the following: *The heart rhythm must be ...
Bundle Branch - left and right block. Bundle Branch - An organization of NERVE fibers along the hearts ventricular septum that ... intensify as they travel along the bundle branches. The bundle branches, as the name implies, branch out into smaller and ... The right bundle branch extends to the right ventricle and the left bundle branch to the left ventricle. The electrical ... For further discussion of the bundle branches within the context of cardiovascular structure and function, please see the ...
ECG shows Second Degree Block and Right Bundle Branch Block - See the Clinical Interpretation and Management of this patient. ... This patient has second degree block and right bundle branch block, so he clearly has extensive conduction tissue disease. ...
LBB = left bundle branch. LBBB = left bundle branch block. LBBP = left bundle branch pacing. LV = left ventricular. LVAT= left ... RBB = right bundle branch. RBBB = right bundle branch block. RV = right ventricular. RVP = right ventricular pacing. SA = ... Cardiac resynchronization therapy by left bundle branch area pacing in patients with heart failure and left bundle branch block ... This article summarizes the current status of left bundle branch pacing. Keywords: His bundle pacing, left bundle branch pacing ...
The ICD code I451 is used to code Right bundle branch block A right bundle branch block (RBBB) is a heart block in the ... Other right bundle-branch block BILLABLE Billable Code Billable codes are sufficient justification for admission to an acute ... I45.19 is a billable ICD code used to specify a diagnosis of other right bundle-branch block. A billable code is detailed ... ICD-10-CM Alphabetical Index References for I45.19 - Other right bundle-branch block The ICD-10-CM Alphabetical Index links ...
Right Ventricular Septal Pacing in Patients With Right Bundle Branch Block and Heart Failure, a Pilot Clinical Trial ... This group has a unique electrical conduction problem (Right Bundle Branch Block) that did not respond well to the current ... Right Ventricular Septal Pacing in Patients With Right Bundle Branch Block and Heart Failure (The SPARK Trial). ...
Complete right bundle branch block (CRBBB) occurs in 0.2% to 1.3% of the general population, but its prognostic significance in ... Complete right bundle branch block positive; CRBBB(-), Complete right bundle branch block negative. ... Figure 3. Prevalence of complete right bundle branch block by gender and age. *P. P. ... Those with left bundle branch block, old MI, pacing rhythm, lung diseases, or poor image quality on ECG were excluded from this ...
Bundle branch block is the term for the condition when the heart cannot beat normally due to a delay or obstruction in the ... Types of Bundle Branch Blocks Bundle branch bricks come in two varieties:. *Right bundle branch block (RBBB): The disorder ... Severe bundle branching block.. Risk Factors of The Bundle Branch Block. Risk factors for bundle branch block include the ... Diagnosis Of The Bundle Branch Block. If you have the right bundle branch block and are in good general health, you might not ...
Is Left atrial enlargement and a Right Bundle Branch Block Dangerous?. Dr. T. January 10, 2011. Ask Doctor T Leave a Comment ... Note that with both kinds of bundle branch block, the QRS is wide and misshapen. The characteristic shapes of the QRS complex ... From: The Significance of Bundle Branch Block, Richard N. Fogoros, M.D, 2003) ... allow doctors to determine whether the right or the left bundle branch is blocked. Why does the QRS complex change in BBB? The ...
What to Expect When Purchasing Life Insurance with Bundle Branch Block. *Purchasing Other Types of Insurance with Bundle Branch ... How Bundle Branch Block and Heart Block Impact Life Insurance Coverage. The most common cause of BBB, about 50 percent of all ... How Bundle Branch Block and Heart Block Impact Life Insurance Coverage. * ... If your bundle branch block is mild, head on over to our instant rate form and select "regular to see a selection of instant ...
1) Bundle branch block (BBB). Partial right BBB (RBBB pattern but QRS,120ms) is commonly found in trained athletes but care is ... 2) Right bundle branch block: prevalence, risk factors, and outcome in the general population: results from the Copenhagen City ... Criteria for Discriminating Between Brugada Types 2 and 3 Patterns and Incomplete Right Bundle Branch Block. Stéphane ... dyskinesia or aneurysm and non-sustained or sustained ventricular tachycardia of left bundle-branch morphology on Holter ...
ECG Interpretation Review #33 (Bundle Branch Block - PACs - Blocked - Aberrant Conduction - RBBB) ... in the form of a complete right bundle branch block pattern). This makes sense because the coupling interval of the PAC ... Whether blocked PACs also occur and are hidden within the ST-T wave of beats #4 and 8 can not be determined with certainty from ... Some of these PACs are blocked, while others are manifest varying degrees of aberrant conduction. The importance of being ...
Long-term cardiovascular outcomes in patients with angina pectoris presenting with bundle branch block. In: American Journal of ... Long-term cardiovascular outcomes in patients with angina pectoris presenting with bundle branch block. American Journal of ... Long-term outcomes of unselected patients with angina pectoris and bundle branch block (BBB) on initial electrocardiogram are ... Long-term cardiovascular outcomes in patients with angina pectoris presenting with bundle branch block. / Bansilal, Sameer; ...
  • This is a combination of right bundle branch block (RBBB) and either left anterior fascicular block (LAFB) or left posterior fascicular block (LPFB) Trifascicular block. (wikipedia.org)
  • Trifascicular block refers to RBBB with alternating left anterior and left posterior hemiblock or alternating LBBB and RBBB. (msdmanuals.com)
  • RBBB with left anterior hemiblock (block in anterior fascicle). (easymbbs.com)
  • Type 1 Brugada pattern is characterized by ST elevations in leads V 1 -V 3 with a right bundle branch block ( RBBB ) like pattern, although it is actually a cause of "pseudo right bundle branch block" as electrocardiographically right bundle branch block is not actually present. (wikidoc.org)
  • As the lead is advanced, the paced QRS morphology changes from a LBB pattern to a right bundle branch block (RBBB) pattern in lead V1 (qR or rsR´)11. (romanianjournalcardiology.ro)
  • The disorder known as right bundle branch block (RBBB) is caused by a break in the electrical pathway that connects your right ventricle to the external environment. (prepladder.com)
  • Conduction in RBBB: With a blockage in the right bundle branch (red), the left ventricle is excited in time (purple), while the excitation of the right ventricle takes a detour via the left bundle branch (blue arrows). (cardiachealth.org)
  • QUEBEC, QC - A new study shows that patients who harbor preexisting right bundle branch block (RBBB) face a significantly higher risk of death 2 years after transcatheter aortic- valve replacement (TAVR) [ 1 ] . (medscape.com)
  • Most (63%) had isolated RBBB, but 34% and 2.7% had associated left anterior and posterior fascicular blocks, respectively. (medscape.com)
  • At his institution, Waksman said patients with RBBB or left bundle branch block undergo electrophysiological testing before discharge, which may slow the race to early TAVR discharge but helps to delineate who does and doesn't need a pacemaker. (medscape.com)
  • BACKGROUND - Patients with an acute anterior ST-segment elevation myocardial infarction and right bundle-branch block (RBBB) have a high mortality risk, which may be stratified by early ECG changes. (sahmri.org.au)
  • The right bundle branch contains one fascicle. (wikipedia.org)
  • The left bundle branch subdivides into two fascicles: the left anterior fascicle, and the left posterior fascicle. (wikipedia.org)
  • Other sources divide the left bundle branch into three fascicles: the left anterior, the left posterior, and the left septal fascicle. (wikipedia.org)
  • citation needed] When a bundle branch or fascicle becomes injured (by underlying heart disease, myocardial infarction, or cardiac surgery), it may cease to conduct electrical impulses appropriately. (wikipedia.org)
  • In this case only the anterior half of the left bundle branch (fascicle) is involved Left posterior fascicular block. (wikipedia.org)
  • The left bundle actually has an anterior and a posterior fascicle. (aliem.com)
  • If the left anterior fascicle is blocked, then depolarization in the left ventricle will go toward the lateral leads (I and aVL) and away from the inferior leads (II, III, and aVF). (aliem.com)
  • Fascicular block involves the anterior or posterior fascicle of the left bundle branch. (msdmanuals.com)
  • Depending on the anatomical location of the defect which leads to a bundle branch block, the blocks are further classified into: Right bundle branch block, incomplete (IRBBB) or complete (CRBBB) Left bundle branch block, incomplete (iLBBB) or complete (cLBBB) The left bundle branch block can be further sub classified into: Left anterior fascicular block. (wikipedia.org)
  • This is a combination of right bundle branch block with either left anterior fascicular block or left posterior fascicular block together with a first degree AV block. (wikipedia.org)
  • fascicular block is similar interruption in a hemifascicle of the left bundle. (msdmanuals.com)
  • Fascicular block is diagnosed by looking at the axis deviation. (easymbbs.com)
  • Histopathologic correlates of left posterior fascicular block. (medscape.com)
  • Long-term outcomes of unselected patients with angina pectoris and bundle branch block (BBB) on initial electrocardiogram are not well established. (elsevierpure.com)
  • Kasmani R, Okoli K, Mohan G, Casey K, Ledrick D. Transient left bundle branch block: an unusual electrocardiogram in acute pulmonary embolism. (medscape.com)
  • Bundle branch block is a significant abnormality that is typically discovered on an abnormal ECG (electrocardiogram) and should be further evaluated b. (healthtap.com)
  • SIGNIFICANT VENTRICULAR DYSSYNCHRONY manifested by left bundle-branch block (LBBB) and wide QRS complex is demonstrated on an electrocardiogram (ECG) in 30% of patients with heart failure. (amrita.edu)
  • Chien SJ, Liang CD, Lin IC, Lin YJ, Huang CF. Myocarditis complicated by complete atrioventricular block: nine years' experience in a medical center. (medscape.com)
  • Electrocardiographic and electrophysiological predictors of atrioventricular block after transcatheter aortic valve replacement. (medscape.com)
  • Transient left bundle branch block - A sheep in wolf 's clothing! (gjmpbu.org)
  • Except for the use of atropine in selected cases of transient AV block, permanent cardiac pacing has replaced medical interventions in the treatment of patients with symptomatic, otherwise untreatable, AV block. (medscape.com)
  • Transient high-degree right bundle branch block masking the type 1 Brugada ECG pattern associated with possible transient early repolarization syndrome. (bvsalud.org)
  • Biventricular pacing, sometimes referred to as cardiac resynchronization therapy, may be necessary if you have a bundle branch block and poor heart pumping capacity. (prepladder.com)
  • Cardiac resynchronization therapy in patients with intrinsic and right ventricular pacing-induced left bundle branch block pattern. (medscape.com)
  • Background: Patients with heart failure and left bundle branch block (LBBB) may receive cardiac resynchronization therapy (CRT), but current selection criteria are imprecise, and many patients have limited treatment response. (lu.se)
  • Left bundle branch (LBB) block (LBBB) occurs when transmission of the cardiac electrical impulse is delayed or fails to be conducted along the rapidly conducting fibers of the main LBB or in both left anterior and posterior fascicles. (medscape.com)
  • Left bundle divides into anterior and posterior fascicles. (easymbbs.com)
  • The catheter and pacing lead are placed into the His bundle area in 30° right anterior oblique fluoroscopic view and the His bundle potential is recorded8,9. (romanianjournalcardiology.ro)
  • Where this is clinically relevant is the fact that anterior hemi-blocks make patients four times more likely to arrest when they also have acute coronary syndrome findings, and can also hide proximal left anterior descending (LAD) coronary artery occlusion. (ems1.com)
  • I45.19 is a billable ICD code used to specify a diagnosis of other right bundle-branch block. (icd.codes)
  • Bifascicular block. (wikipedia.org)
  • Presence of bifascicular or trifascicular block after myocardial infarction implies extensive cardiac damage. (msdmanuals.com)
  • Bifascicular blocks require no direct treatment unless intermittent 2nd- or third-degree AV block is present. (msdmanuals.com)
  • Bifascicular block or LBBB in young individuals should prompt screening of siblings and consideration of genetic testing to exclude a genetically determined progressive conduction abnormality (e.g. (escardio.org)
  • Bundle branch blocks occur when there is blockage or disruption in the heart's electrical impulses. (medicalnewstoday.com)
  • If there is a delay or block in the left or right bundle, depolarization will take longer to occur. (aliem.com)
  • In patients with LBBB, it is recommended to have ventricular backup pacing because complete AV block may occur due to RBB injury8. (romanianjournalcardiology.ro)
  • Whether blocked PACs also occur and are hidden within the ST-T wave of beats #4 and 8 can not be determined with certainty from Figure-2 - but the slight 'blip' near the beginning of the ST segment of beat #4 suggests that this may be the case. (blogspot.com)
  • Evaluation of left bundle branch block as a reversible cause of non-ischaemic dilated cardiomyopathy with severe heart failure. (medscape.com)
  • However, if a person has alternating right and left bundle branch blocks, a doctor may also recommend a pacemaker. (medicalnewstoday.com)
  • From the AV node the electrical impulse travels down the bundle of His and divides into the right and left bundle branches. (wikipedia.org)
  • Calabro MP, Cerrito M, Luzza F, Oreto G. Alternating right and left bundle branch block aberration during atrial tachycardia. (medscape.com)
  • Complete right bundle branch block (CRBBB) occurs in 0.2% to 1.3% of the general population, but its prognostic significance in the geriatric population is unknown. (aging-us.com)
  • Disruption of normal electrical activity in the cardiac conduction system and delayed depolarization of the right ventricle consequently result in complete right bundle branch block (CRBBB). (aging-us.com)
  • For example, a pacemaker may be an option for people who develop a heart block while having a heart attack. (medicalnewstoday.com)
  • citation needed] Cardiac pacemaker Heart block First degree AV block Second degree AV block Third degree AV block Cecil Textbook of Medicine. (wikipedia.org)
  • QRS complex will be wide and can have the appearance of a right bundle branch block, if the dominant rhythm originates from a pacemaker in the ventricle. (wikidoc.org)
  • However the presence of pacemaker spikes at the beginning of the QRS complexes can differentiate a paced rhythm from a right bundle branch complex. (wikidoc.org)
  • Your doctor might recommend a pacemaker if you have a bundle branch block and a history of fainting. (prepladder.com)
  • Some institutions recommend insertion of a transvenous pacemaker for all new Mobitz type II blocks, although this practice varies greatly from institution to institution. (medscape.com)
  • Dual chamber modes are specifically indicated for treatment of conduction disorders that require restoration of both rate and AV synchrony, which include various degrees of AV block to maintain the atrial contribution to cardiac output and VVI intolerance (e.g., pacemaker syndrome) in the presence of persistent sinus rhythm. (medtronic.com)
  • A left bundle branch block occurs when 'the normal direction of septal depolarization is reversed (becomes right to left), as the impulse spreads first to the RV via the right bundle branch and then to the LV via the septum. (umich.edu)
  • When it occurs, treating the underlying medical condition such as heart disease that led to the bundle branch block is the main course of treatment. (prepladder.com)
  • These electrocardiograms show a normal sinus rhythm and a sinus rhythm with a left bundle branch block. (medscape.com)
  • Utilizing a 12-lead ECG can help you interpret the difference between true VT and another tachycardia with some sort of aberrancy, like a bundle branch block. (ems1.com)
  • The impulse then travels down the bundle of His (4), which divides into the right bundle branch for the right ventricle (5) and the left bundle branch for the left ventricle (5). (msdmanuals.com)
  • Background: The present study and for the first time hypothesizes that the patients with left bundle branch block (LBBB) suffer considerably from metabolic syndrome (MetS) and this metabolic phenomenon can be associated with cardiac dysfunction status such as ventricular dilation and reduced left ventricular ejection fraction (LVEF) in these patients. (mattioli1885journals.com)
  • Gharipour M, Hashemi Jazi M, Nilforoush P, Batvandi A, Mohammadi R, Najafi R. Metabolic syndrome and its association with left ventricular dysfunction in patients with left bundle branch block. (mattioli1885journals.com)
  • An ECG can record the heart's rhythm and indicate the type of heart block a person has. (medicalnewstoday.com)
  • An ECG measures the heart's electrical impulses at rest or during exercise and can indicate the type of heart block present. (medicalnewstoday.com)
  • citation needed] A bundle branch block can be diagnosed when the duration of the QRS complex on the ECG exceeds 120 ms. A right bundle branch block typically causes prolongation of the last part of the QRS complex and may shift the heart's electrical axis slightly to the right. (wikipedia.org)
  • The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the left. (wikipedia.org)
  • The heart's electrical wiring system is designed so that the impulses that cause muscle contraction spread out more or less simultaneously from the two bundle branches. (blogspot.com)
  • Bob has a bundle branch block in his heart's left ventricle. (virginiaheart.com)
  • Bundle Branch - An organization of NERVE fibers along the heart's ventricular septum that conveys electrical impulses to the ventricles to cause them to contract, also called the BUNDLE OF HIS . (beltina.org)
  • Tachycardia-dependent bundle branch block A simple way to quickly differentiate between the two types is to note the deflection of the QRS complex in the V1 lead. (wikipedia.org)
  • A (V1) QRS segment deflected down indicates left bundle branch block, while a deflection up indicates right bundle branch block. (wikipedia.org)
  • Looking at V 1 , viewing the angle of deflection before the J-point can help you determine which bundle branch is blocked. (ems1.com)
  • In a wide-complex rhythm, upward deflection before the J-point indicates a right bundle branch block, while downward deflection indicates the left. (ems1.com)
  • Ventricular tachycardia and accelerated idioventricular rhythm can give rise to EKG patterns that mimic right bundle branch block. (wikidoc.org)
  • Pathological variants in TRPM4 gene have been linked to several cardiac phenotypes such as complete heart block (CHB), ventricular tachycardia, and Brugada syndrome (BrS). (frontiersin.org)
  • A form of heart block in which the electrical stimulation of HEART VENTRICLES is interrupted at either one of the branches of BUNDLE OF HIS thus preventing the simultaneous depolarization of the two ventricles. (sdsu.edu)
  • However the technique is limited by difficult implantation, long fluoroscopic exposure time, high capture threshold and fails to provide adequate pacing in patients with infrahisian block or proximal left bundle branch block4. (romanianjournalcardiology.ro)
  • The acute or new onset of a left bundle branch block can also be an indicator of ischemic activity. (ems1.com)
  • Most people who have bundle branch blocks are asymptomatic and do not need medical care. (prepladder.com)
  • Second-degree atrioventricular (AV) block in the asymptomatic patient does not require any specific therapy in the prehospital setting. (medscape.com)
  • Transcutaneous pacing pads should be applied to all patients with Mobitz II second-degree AV block, including those who are asymptomatic patients, because such patients have a propensity to progress to complete heart block. (medscape.com)
  • Urgent cardiology consult is indicated for patients who have symptomatic type II block and for those asymptomatic patients who are unable to achieve capture with transcutaneous pacing. (medscape.com)
  • A bundle branch block is a defect in one of the bundle branches in the electrical conduction system of the heart. (wikipedia.org)
  • Knowledge of the anatomy and electrophysiology of the cardiac conduction system from the atrioventricular (AV) junction to the distal Purkinje fibers is essential to understanding the pathophysiology of left bundle branch (LBB) block (LBBB). (medscape.com)
  • Using (HBP) the native conduction system, His bundle pacing has been proved to be the most physiologic form of ventricular pacing, than can correct wide QRSd, ensure the ventricular electrical activation synchrony and improves the clinical outcomes in heart failure patients1-3. (romanianjournalcardiology.ro)
  • In children, left bundle branch block (LBBB) is not a benign entity, and it is associated with anatomic malformations and abnormalities of the conduction system. (medscape.com)
  • The electrical impulses, which originate with the SINOATRIAL (SA) NODE, intensify as they travel along the bundle branches. (beltina.org)
  • The bundle branches, as the name implies, branch out into smaller and smaller fibers culminating in the Purkinje fibers, which disperse the electrical impulses to the myocardial cells throughout the ventricles. (beltina.org)
  • The pathway that electrical impulses follow as they travel to the left or right ventricles of the heart could stop or get blocked. (prepladder.com)
  • If either of these branch bundles is damaged for example, following a heart attack the electrical impulses could get blocked. (prepladder.com)
  • Blood supply to the AV node is derived from the AV nodal artery, which is a branch of the right coronary artery in 85%-90% of individuals and a branch of the left circumflex coronary artery in 10%-15% of individuals. (medscape.com)
  • 1st-degree block is usually AV nodal in origin). (msdmanuals.com)
  • As with Mobitz I block, AV nodal agents should be avoided, and an anti-ischemic regimen should be instituted if ischemia is suspected. (medscape.com)
  • Since the electrical impulse can no longer use the preferred pathway across the bundle branch, it may move instead through muscle fibers in a way that both slows the electrical movement and changes the directional propagation of the impulses. (wikipedia.org)
  • A break in the electrical signaling pathway that supplies your left ventricle causes a left bundle branch block (LBBB). (prepladder.com)
  • Hemi-blocks, or hemi-fascicular blocks, are electrical conduction pathway abnormalities involving one of the two branches off the left bundle branch. (ems1.com)
  • In this syndrome, atrial impulses are abnormally conducted to the HEART VENTRICLES via an ACCESSORY CONDUCTING PATHWAY that is located between the wall of the right or left atria and the ventricles, also known as a BUNDLE OF KENT. (bvsalud.org)
  • Left bundle branch block (LBBB) has been shown to increase morbidity and mortality in heart failure patients due to ventricular dyssynchrony. (romanianjournalcardiology.ro)
  • Is Left atrial enlargement and a Right Bundle Branch Block Dangerous? (cardiachealth.org)
  • This can help regulate the heart rhythm, as a bundle branch block can cause bradycardia and the heart to become fragile. (medicalnewstoday.com)
  • Bundle branch block, especially left bundle branch block, can lead to cardiac dyssynchrony. (wikipedia.org)
  • A bundle branch block may not exhibit any symptoms at all. (prepladder.com)
  • Drugs to reduce blood pressure or decrease heart failure symptoms are possible treatments for cardiac problems caused by bundle branch blocks. (prepladder.com)
  • This patient has second degree block and right bundle branch block, so he clearly has extensive conduction tissue disease. (rishacademy.com)
  • No specific therapy is required in the emergency department (ED) for Mobitz I (Wenckebach) second-degree AV block, unless the patient is symptomatic. (medscape.com)
  • In cases where there is a 2:1 block and one is unable to determine if there is a Mobitz I block or Mobitz II block, the patient should be admitted and cardiology consultation should be obtained. (medscape.com)
  • METHODS AND RESULTS: Original patient-level data from eight randomized trials exploring the effects of CRT versus no CRT were pooled (BLOCK-HF, MIRACLE, MIRACLE-ICD, MIRACLE-ICD II, RAFT, COMPANION, MADIT-CRT and REVERSE). (bvsalud.org)