Heart rhythm disturbances

LECTURE IN INTERNAL MEDICINE FOR V COURSE STUDENT

Heart Arrhythmias

LECTURE IN INTERNAL MEDICINE FOR V COURSE STUDENT

Heart arrhythmias

LECTURE IN INTERNAL MEDICINE FOR V COURSE STUDENT

Guías colombianas de electrofisiología no invasiva

Los métodos diagnósticos no invasivos son el pilar inicial del estudio de cualquier paciente con una patología en particular, de ahí que sean los exámenes más solicitados y constituyan una importante carga en costos para un sistema de salud.Q4Guías1-12

Cardiac development in relation to clinical supraventricular arrhythmias : focus on structure-function relations

Supraventricular tachycardias (SVTs) are amongst the most commonly encountered cardiac arrhythmias in clinical practice in both children and adults. The causative mechanisms underlying the appearance of most of these SVTs have however still remained as intriguing as they are unexplained. In this thesis, cardiac development is analyzed in relation to the etiology of clinical supraventricular arrhythmias with a special focus on structure-function relations. Firstly, in PART I of this thesis, both the (patho) physiological development of the annulus fibrosus cordis and the etiological origin of clinical accessory AV pathway (AP) mediated AVRT in children and adults is analyzed in experimental animal models and human sections. Secondly, in PART II of this thesis a review of the different ontogenic theories on the embryonic development of the AV Node (AVN) in literature is followed by an experimental study postulating a new concept on the developmental origin of the AVN in relation to the etiology of AV Nodal Reentrant Tachycardia (AVNRT). As a general introduction to both these basic research (I & II) and the clinical (III) parts of this thesis, structural cardiac development in avians (with references to equivalent mouse and human developmental timelines) (Figure 1) will first be described since the development of the cardiac conduction system (CCS) and structural cardiogenesis are intimately related. Next, the developmental transitions in impulse propagation and the construction of the individual components of the specialized CCS and the AVN in particular will be shortly outlined. Following a description of the changes in electrocardiograms (ECGs) during cardiogenesis, current concepts on the transitions in ventricular activation sequences during embryogenesis will be discussed. Thereafter, contemporary knowledge on the development of the isolating annulus fibrosis, the key structure involved in AP persistence, in relation to general CCS development will be reviewed. Subsequently, relevant genera l characteristics of the different animal models and the immunohistochemical markers used in this thesis are briefly discussed. Following the description of the structural basics of cardiogenesis, attention will be focused on current knowledge of clinical SVTs in neonates and children and the treatment of these arrhythmias. These therapeutic clinical issues will be further outlined in PART III of this thesis.UBL - phd migration 201