TAILIEUCHUNG - Antiarrhythmic Drugs A practical guide – Part 2

Vì lý do này, đoạn ST và sóng T (các phần của điện tâm đồ bề mặt phản ánh tái cực tâm thất) cung cấp rất ít thông tin định hướng, và bất thường trong các phân đoạn ST và sóng T thường xuyên nhất (và khá đúng) giải thích như là không đặc hiệu . | 12 Chapter 1 occurring simultaneously. For this reason the ST segment and the T wave the portions of the surface ECG that reflect ventricular repolarization give very little directional information and abnormalities in the ST segments and T waves are most often and quite properly interpreted as being nonspecific. The QT interval represents the time from the beginning of depolarization the beginning of the QRS complex to the end of repolarization the end of the T wave of the ventricular myocardium and thus reflects the average action potential duration of ventricular muscle. Mechanisms of cardiac tachyarrhythmias Most rapid cardiac arrhythmias are thought to be due to one of two general mechanisms abnormal automaticity or reentry. In recent years however a third general mechanism the channelopathy has been recognized as the cause of several relatively unusual varieties of cardiac arrhythmias. Automaticity As already noted automaticity is an important feature of the normal electrical system the pacemaker function of the heart depends upon it. Under some circumstances however abnormal automaticity can occur. When an abnormal acceleration of phase 4 activity occurs at some location within the heart an automatic tachyarrhythmia is the result. Such an automatic focus can arise in the atria the AV junction or the ventricles and can lead to automatic atrial tachycardia automatic junctional tachycardia or automatic ventricular tachycardia. Automatic tachyarrhythmias are not particularly common they probably account for less than 10 of all tachyarrhythmias. Further automatic tachyarrhythmias are usually recognizable by their characteristics and the clinical settings in which they occur. Consideration of some of the features of sinus tachycardia which is the only normal variety of automatic tachycardia may be helpful in this regard. Sinus tachycardia usually occurs as a result of appropriately increased sympathetic tone . in response to exercise . When sinus tachycardia .

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