Bradydysrhythmias

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EKG Teaching Rounds

Abstract

Bradydysrhythmias encompasses a variety of pathologic slow rhythms including sinus bradycardia, which receives sinus nodal input, as well as junctional and ventricular escape rhythms, which are intrinsically firing from a nidus other than the sinus node. Junctional rhythms are faster and have narrow QRS complexes while ventricular escape rhythms are slower and have wide QRS complexes. Bradycardia may also be secondary to other pathologies such as increased intracranial pressure, i.e., Cushing’s Triad, and digoxin toxicity, which each require their own specific treatment. This chapter concludes with a brief section on cardiac manifestations of digoxin toxicity and the effect that this drug has on an EKG.

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Suggested Readings

  • Bayer MJ. Recognition and management of digitalis intoxication: implications for emergency medicine. Am J Emerg Med. 1991;9:29–32.

    Article  CAS  Google Scholar 

  • ButtĂ  C, Tuttolomondo A, Casuccio A, Di Raimondo D, Miceli G, Cuttitta F, Roberto M, Pinto A. Heart rate variability in sick sinus syndrome: does it have a diagnostic role? Minerva Cardioangiol. 2019; https://doi.org/10.23736/s0026-4725.19.04972-7.

  • Clark BA, Prystowsky EN. Electrocardiography of atrioventricular block. Cardiac Electrophysiology Clinics. 2021;13:599–605.

    Article  Google Scholar 

  • Djohan AH, Sia CH, Singh D, Lin W, Kong WKF, Poh KK. A myriad of electrocardiographic findings associated with digoxin use. Singap Med J. 2020;61:9–14.

    Article  Google Scholar 

  • Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the heart rhythm society. Circulation. 2019; https://doi.org/10.1161/cir.0000000000000628.

  • Lien W-C, Huang C-H, Chen W-J. Bidirectional ventricular tachycardia resulting from digoxin and amiodarone treatment of rapid atrial fibrillation. Am J Emerg Med. 2004;22:235–6.

    Article  Google Scholar 

  • Limon G, Ersoy G, Oray NC, Bayram B, Limon O. Retrospective evaluation of patients with elevated digoxin levels at an emergency department. Turkish J Emergency Med. 2016;16:17–21.

    Article  Google Scholar 

  • Patocka J, Nepovimova E, Wu W, Kuca K. Digoxin: pharmacology and toxicology—a review. Environ Toxicol Pharmacol. 2020;79:103400.

    Article  CAS  Google Scholar 

  • Pejković B, Krajnc I, Anderhuber F, Košutić D. Anatomical aspects of the arterial blood supply to the sinoatrial and atrioventricular nodes of the human heart. J Int Med Res. 2008;36:691–8.

    Article  Google Scholar 

  • Richter S, Brugada P. Bidirectional ventricular tachycardia. J Am Coll Cardiol. 2009;22;54(13):1189. https://doi.org/10.1016/j.jacc.2009.03.086. PMID: 19761942

  • Sathnur N, Ebin E, Benditt DG. Sinus node dysfunction. Cardiac Electrophysiol Clinics. 2021;13:641–59.

    Article  Google Scholar 

  • Sidhu S, Marine JE. Evaluating and managing bradycardia. Trends Cardiovasc Med. 2020;30:265–72.

    Article  Google Scholar 

  • Wang K, Benditt DG. AV dissociation, an inevitable response. Ann Noninvasive Electrocardiol. 2011;16:227–31.

    Article  Google Scholar 

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Tannenbaum, L., Bridwell, R.E., Inman, B.L. (2022). Bradydysrhythmias. In: EKG Teaching Rounds. Springer, Cham. https://doi.org/10.1007/978-3-031-06028-1_4

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  • DOI: https://doi.org/10.1007/978-3-031-06028-1_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-06027-4

  • Online ISBN: 978-3-031-06028-1

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