Key result
Cellular electrophysiologic mechanisms, including automaticity, triggered activity, and reentrant excitation, are responsible for abnormalities in impulse initiation and conduction causing arrhythmias.
Provides a review of the cellular electrophysiologic mechanisms underlying cardiac arrhythmias and their ECG manifestations.
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Guides arrhythmia ECG interpretation in practice; leaves open targeted therapies for specific cellular mechanisms.
Cardiac arrhythmias result from abnormalities in the initiation of impulses or in conduction of these impulses through the heart. 58, 60 Arrhythmias caused by abnormalities in impulse initiation may result from either automaticity or triggered activity. Arrhythmias caused by abnormalities in conduction are often the result of reentrant excitation. Such alterations in impulse initiation or conduction are readily apparent in recordings of extracellular signals from the heart in the form of either the electrocardiogram (ECG) or more direct electrographic recordings from the atria and ventricles. The recording of transmembrane electrical events of individual myocardial cells with microelectrodes, however, has provided the information necessary for understanding the mechanisms that are responsible for arrhythmias. Although arrhythmias may have many different pathologic causes, in the final analysis, all arrhythmias are the result of critical alterations in cellular electrophysiology. This article discusses the cellular mechanisms responsible for abnormalities in impulse initiation and how they are manifested on the ECG.
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Cabo et al. (1997) conducted a review in Cardiac arrhythmias. Cellular electrophysiologic mechanisms, including automaticity, triggered activity, and reentrant excitation, are responsible for abnormalities in impulse initiation and conduction causing arrhythmias.
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