Skip to main content
SpringerLink
Log in

Cell-Based Tachyarrhythmias and Bradyarrhythmias

  • Chapter
  • First Online:
Book cover Heart of the Matter

Part of the book series: Learning Materials in Biosciences ((LMB))

  • 1012 Accesses

Abstract

Arrhythmias can have immediate clinical consequences because effective cardiac output is determined by efficient electromechanical coupling of the myocardium and coordination between and within cardiac chambers. This chapter will discuss specific bradyarrhythmias and tachyarrhythmias, providing an overview of their pathophysiology, clinical characteristics and treatment options. As the heart constitutes a functional syncytium, the cellular basis of arrhythmia will first be discussed before considering its effects across the larger myocardial mass as well as clinical manifestations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Konety SH, Koene RJ, Norby FL, Wilsdon T, Alonso A, Siscovick D et al (2016) Echocardiographic predictors of sudden cardiac death: the atherosclerosis risk in communities study and cardiovascular health study. Circ Cardiovasc Imaging 9(8):e004431

    Article  PubMed  Google Scholar 

  2. Goldberger JJ, Buxton AE, Cain M, Costantini O, Exner DV, Knight BP et al (2011) Risk stratification for arrhythmic sudden cardiac death: identifying the roadblocks. Circulation 123:2423

    Article  PubMed  Google Scholar 

  3. Waller AD (1887) A demonstration on man of electromotive changes accompanying the Heart’s beat. J Physiol 8:229

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Barold SS (2003) Willem Einthoven and the birth of clinical electrocardiography a hundred years ago. Card Electrophysiol Rev 7(1):99–104

    Article  PubMed  Google Scholar 

  5. Scherlag BJ, Lau SH, Helfant RH, Berkowitz WD, Stein E, Damato AN (1969) Catheter technique for recording his bundle activity in man. Circulation 39:13

    Article  CAS  PubMed  Google Scholar 

  6. Lüderitz B (2009) Historical perspectives of cardiac electrophysiology. Hell J Cardiol 50(1):3–16

    Google Scholar 

  7. Tse G (2016) Mechanisms of cardiac arrhythmias. J Arrhythmia 32:75

    Article  Google Scholar 

  8. Qu Z, Xie LH, Olcese R, Karagueuzian HS, Chen PS, Garfinkel A et al (2013) Early afterdepolarizations in cardiac myocytes: beyond reduced repolarization reserve. Cardiovasc Res 99:6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Liu GX, Choi BR, Ziv O, Li W, de Lange E, Qu Z et al (2012) Differential conditions for early after-depolarizations and triggered activity in cardiomyocytes derived from transgenic LQT1 and LQT2 rabbits. J Physiol 590:1171

    Article  PubMed  Google Scholar 

  10. Zeng J, Rudy Y (1995) Early afterdepolarizations in cardiac myocytes: mechanism and rate dependence. Biophys J 68:949

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Viswanathan PC, Rudy Y (1999) Pause induced early afterdepolarizations in the long QT syndrome: a simulation study. Cardiovasc Res 42:530

    Article  CAS  PubMed  Google Scholar 

  12. Xie JT, Lowell TK, Yuan CS (2000) Extracellular detection of delayed afterdepolarization of cardiac fibers using signal averaging technique. Acta Pharmacol Sin 21(11):977–985

    CAS  PubMed  Google Scholar 

  13. BOUTJDIR M, ASSADI M, El-SHERIF N (1995) Electrophysiologic effects of cocaine on subendocardial Purkinje fibers surviving 1 day of myocardial infarction. J Cardiovasc Electrophysiol 6:729

    Article  CAS  PubMed  Google Scholar 

  14. Nattel S, Carlsson L (2006) Innovative approaches to anti-arrhythmic drug therapy. Nat Rev Drug Discov 5:1034

    Article  CAS  PubMed  Google Scholar 

  15. Quan W, Rudy Y (1990) Unidirectional block and reentry of cardiac excitation: a model study. Circ Res 66:367

    Article  CAS  PubMed  Google Scholar 

  16. MacLeod K (2014) An essential introduction to cardiac electrophysiology [internet]. Imperial College Press, [cited 2019 Jan 3]

    Google Scholar 

  17. Spodick DH, Raju P, Bishop RL, Rifkin RD (1992) Operational definition of normal sinus heart rate. Am J Cardiol 69:1245

    Article  CAS  PubMed  Google Scholar 

  18. Fagard R (2002) Athlete’s heart. Heart 89(12):1455–1461

    Article  Google Scholar 

  19. Jensen PN, Gronroos NN, Chen LY, Folsom AR, Defilippi C, Heckbert SR et al (2014) Incidence of and risk factors for sick sinus syndrome in the general population. J Am Coll Cardiol 64:531

    Article  PubMed  PubMed Central  Google Scholar 

  20. Marcum ZA, Amuan ME, Hanlon JT, Aspinall SL, Handler SM, Ruby CM et al (2012) Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans. J Am Geriatr Soc 60:34

    Article  PubMed  Google Scholar 

  21. Dakkak W, Rhythm DR (2017) Sick sinus syndrome. StatPearls, Treasure Island

    Google Scholar 

  22. Prystowsky EN (1988) The effects of slow channel blockers and beta blockers on atrioventricular nodal conduction. J Clin Pharmacol 28:6

    Article  CAS  PubMed  Google Scholar 

  23. Abraham S, Reddy S, Abboud J, Jonnalagadda K, Ghanta SK, Kondamudi V (2010) Brief, recurrent, and spontaneous episodes of loss of consciousness in a healthy young male. Int Med Case Rep J 3:71–76

    Article  PubMed  PubMed Central  Google Scholar 

  24. Barold SS, Hayes DL (2001) Second-degree atrioventricular block: a reappraisal. Mayo Clin Proc 76:44

    Article  CAS  PubMed  Google Scholar 

  25. Jones WM, Rhythm NL (2018) Atrioventricular block, second-degree. StatPearls, Treasure Island

    Google Scholar 

  26. Adams MG, Pelter MM (2003) Ventricular escape rhythms. Am J Crit Care 12(5):477–478

    PubMed  Google Scholar 

  27. SCHER AM, RODRIGUEZ MI, LIIKANE J, YOUNG AC (1959) The mechanism of atrioventricular conduction. Circ Res 7:54

    Article  CAS  PubMed  Google Scholar 

  28. Narula OS, Scherlag BJ, Samet P, Javier RP (1971) Atrioventricular block. Localization and classification by his bundle recordings. Am J Med 50(2):146–165

    Article  CAS  PubMed  Google Scholar 

  29. Palatini P (1999) Need for a revision of the normal limits of resting heart rate. Hypertension 33:622

    Article  CAS  PubMed  Google Scholar 

  30. Whinnett Z, Sohaib SA, Davies DW (2012) Diagnosis and management of supraventricular tachycardia. Br Med J 345:e7769

    Article  CAS  Google Scholar 

  31. Kannel W, Wolf P, Benjamin E, Levy D (1998) Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates 11Reprints are not available. Am J Cardiol 82:2N

    Article  CAS  PubMed  Google Scholar 

  32. Nattel S, Dobrev D (2016) Electrophysiological and molecular mechanisms of paroxysmal atrial fibrillation. Nat Rev Cardiol 13:575

    Article  CAS  PubMed  Google Scholar 

  33. Wijffels MCEF, Kirchhof CJHJ, Dorland R, Allessie MA (1995) Atrial fibrillation begets atrial fibrillation: a study in awake chronically instrumented goats. Circulation 92:1954

    Article  CAS  PubMed  Google Scholar 

  34. Patel P, Pandya J, Goldberg M (2017) NOACs vs. Warfarin for stroke prevention in Nonvalvular atrial fibrillation. Cureus 9(6):e1395

    PubMed  PubMed Central  Google Scholar 

  35. Katritsis DG, Josephson ME (2016) Classification, electrophysiological features and therapy of atrioventricular nodal reentrant tachycardia. Arrhythmia Electrophysiol Rev 5:130

    Article  Google Scholar 

  36. Schluter M, Geiger M, Siebels J, Duckeck W, Kuck KH (1991) Catheter ablation using radiofrequency current to cure symptomatic patients with tachyarrhythmias related to an accessory atrioventricular pathway. Circulation 84:1644

    Article  CAS  PubMed  Google Scholar 

  37. Keating L, Morris FP (2003) Electrocardiographic features of Wolff-Parkinson-white syndrome. Emerg Med J 20:491

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Sohinki D, Obel OA (2014) Current trends in supraventricular tachycardia management. Ochsner J 14(4):586–595

    PubMed  PubMed Central  Google Scholar 

  39. Benito B, Guasch E, Rivard L, Nattel S (2010) Clinical and mechanistic issues in early repolarization: of normal variants and lethal arrhythmia syndromes. J Am Coll Cardiol 56:1177

    Article  PubMed  Google Scholar 

  40. de Luna AB, Coumel P, Leclercq JF (1989) Ambulatory sudden cardiac death: mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J 117(1):151–159

    Article  Google Scholar 

  41. Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al (1991) Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The cardiac arrhythmia suppression trial. N Engl J Med 324:781

    Article  CAS  PubMed  Google Scholar 

  42. Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB et al (2018) AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. J Am Coll Cardiol 15(10):e190–e252

    Google Scholar 

  43. Muser D, Santangeli P, Castro SA, Pathak RK, Liang JJ, Hayashi T et al (2016) Long-term outcome after catheter ablation of ventricular tachycardia in patients with nonischemic dilated cardiomyopathy. Circ Arrhythmia Electrophysiol 9(10):e004328

    Article  CAS  Google Scholar 

  44. van Herendael H, Dorian P (2010) Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia. Vasc Health Risk Manag 6:465–472

    PubMed  PubMed Central  Google Scholar 

  45. Guan Yap Y, John Camm A, Yap YG, Camm AJ (2012) Drug induced QT prolongation and torsades de pointes. Heart 2003;89:1363–1372.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M, Gregoratos G et al (2006) 2006 ACC/AHA/ESC guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. J Am Coll Cardiol 114:e385–e484

    Google Scholar 

  47. Moe GK, Abildskov JA (1959) Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge. Am Heart J 58:59

    Article  CAS  PubMed  Google Scholar 

  48. Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, et al (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339(10):659–666 [Internet]. Available from: http://www.nejm.org/doi/abs/10.1056/NEJM199809033391003.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hull York Medical School, York, UK

    Rohin K. Reddy

  2. Imperial College London, London, UK

    Rohin K. Reddy & Ben N. Cullen

  3. National Heart and Lung Institute, Imperial College London, London, UK

    Ahran D. Arnold & Zachary I. Whinnett

Authors
  1. Rohin K. Reddy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ben N. Cullen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahran D. Arnold
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zachary I. Whinnett
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahran D. Arnold .

Editor information

Editors and Affiliations

  1. National Heart & Lung Institute, Imperial College London, London, UK

    Cesare Terracciano

  2. Imperial College London & St George’s Medical School, London, UK

    Samuel Guymer

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Reddy, R.K., Cullen, B.N., Arnold, A.D., Whinnett, Z.I. (2019). Cell-Based Tachyarrhythmias and Bradyarrhythmias. In: Terracciano, C., Guymer, S. (eds) Heart of the Matter. Learning Materials in Biosciences. Springer, Cham. https://doi.org/10.1007/978-3-030-24219-0_8

Download citation

Publish with us

Policies and ethics

Search

Navigation