Susan Cheng, Michelle J Keyes, Martin G Larson, Elizabeth L McCabe, Christopher Newton-Cheh, Daniel Levy, Emelia J Benjamin, Ramachandran S Vasan, Thomas J Wang.Subjects with IVCD were older and predominantly males, had lower cholesterol values, and had a shorter JTc interval. The baseline characteristics of subjects with and without IVCD are shown in Table 1. Pseudo-pacemaker syndrome following inadvertent fast pathway ablation for atrioventricular nodal reentrant tachycardia. IVCD was present in 67 (0.6 of the total population) of the 147 subjects with prolonged QRSd. A nonspecific intraventricular conduction delay (IVCD) is a slowing of conduction through the myocardium, that does not meet the criteria of a right or left bundle branch block.
Y H Kim, S O’Nunain, T Trouton, G Sosa-Suarez, R A Levine, H Garan, J N Ruskin.Resting sinus heart rate and first degree AV block: modifiable risk predictors or epiphenomena?Indian Pacing Electrophysiol J. Rakesh Gopinathannair, Brian Olshansky.In this study, prolongation of PR interval was associated with increased risk of atrial fibrillation, pacemaker implantation and all cause mortality. In a long term follow up of 7575 person Framingham cohort, 124 had PR interval more than 200 milliseconds. Loss of atrial contribution to ventricular filling, shortening of diastolic filling time and diastolic mitral regurgitation may contribute to reduction of cardiac output. Marked first degree AV block can reduce cardiac output and may not be well tolerated, especially in patients with left ventricular dysfunction.
In that respect, moderate sinus bradycardia may be beneficial.įirst degree heart block though generally considered benign, marked prolongation with PR interval 300 ms or more can produce symptoms similar to those in pacemaker syndrome. Even small increments in heart rate over time was associated with worse prognosis. Higher resting heart rate is a predictor of cardiovascular risk. This combination is also often seen with acute inferior wall myocardial infarction. Pure sinus node inhibitors like ivabradine cannot produce this combination. The combination can occur in vagotonic states or in those on beta blockers or other drugs which suppress both the sinus node and the AV node. The most important life-threatening causes of QRS widening are: Hyperkalaemia Tricyclic antidepressant poisoning. Most commonly due to bundle branch block or left ventricular hypertrophy. PR interval is also prolonged at about 320 msec. Definition of QRS widening QRS duration > 100 ms in the presence of a supraventricular rhythm. Sinus bradycardia is evident from the long RR interval of 1280 ms, corresponding to a heart rate of 47 per minute. Sinus bradycardia with first degree AV block
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