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3 years ago
Introduction
Premature ventricular complexes (PVCs) in the absence of underlying structural heart disease have long been viewed as benign. Early studies with small population sizes and limited cardiac testing suggested that long-term prognosis in patients with idiopathic PVCs is similar to those in patients without other cardiac disease, and treatment was consequently limited to provide…
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3 years ago
In 1885, Oscar Langendorff was the first person to describe the increase in contractility (‘Pulsverstärkung‘) that follows an extrasystole.1Langendorff experimented with spontaneously beating isolated frog hearts. He recorded the heartbeats by using a lever that transferred the contractile movements of the heart to a rotating drum. Electrical stimulation resulted in premature contractions that…
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3 years ago
Premature ventricular complexes (PVCs) are the most common ventricular arrhythmia. Their prognostic significance cannot be interpreted without considering the presence or absence of any associated underlying cardiac condition. In the absence of structural heart disease, PVCs were generally considered to be benign.1,2 In the 1970s and 1980s, it was postulated that frequent PVCs could be a trigger…
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3 years ago
The origin of idiopathic ventricular tachycardia (VT) or symptomatic premature ventricular contractions (PVCs) from papillary muscle (PM) was first described in 2008 as a distinct clinical syndrome by a group from Birmingham, Alabama, US.1 Out of 290 patients ablated for idiopathic VT or symptomatic PVCs, seven patients were recognised who had the ablation site at the base of the posteromedial PM…
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3 years ago
An estimated 180,000–300,000 sudden cardiac deaths (SCD) occur in the US annually.1,2 Worldwide, sudden and unexpected cardiac death is the most common cause of death,2 accounting for 17 million deaths every year with SCD accounting for 25% of these. The accepted definition of SCD is death that occurs within one hour of onset of symptoms in witnessed cases, and within 24 hours of last being seen…
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2 years ago
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3 years ago
Premature ventricular contractions (PVCs) are very common cardiac arrhythmias, detected on up to 75% of Holter monitors of ambulatory patients.1 Although PVCs in the setting of advanced structural heart disease have independent negative prognostic implications,2 the majority of PVCs are quite benign, associated with neither symptoms nor signals of future harm. For an important minority, PVCs…
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3 years ago
Ventricular arrhythmias are designated idiopathic when demonstrable structural heart disease, significant coronary disease including coronary spasm or genetic arrhythmia syndromes are absent.1 These arrhythmias may be benign but are also a recognised cause of sudden cardiac death. The common form of idiopathic ventricular tachycardia (VT) originates in the ventricular outflow tracts, manifest…
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3 years ago
Ventricular fibrillation (VF) is a complex arrhythmia that leads invariably to cardiac arrest. Its mechanisms remain largely unclear. Similar to atrial fibrillation, the mother rotor hypothesis is one plausible alternative.1,2 In larger animals, some authors reported that the dominant frequency of VF could be recorded at a junction of the left ventricular posterior wall and the septum.3-6 Others…
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3 years ago
Monomorphic ventricular arrhythmias (MMVA) are not uncommon in athletes,1,2 yet their presence appropriately raises concern among practitioners for possible increased risk of sudden cardiac death (SCD) during sports activity and competition. While all MMVA detected in athletes warrant further evaluation,1 a majority of MMVA in this population are likely to be benign. In some instances of so…
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