Another EKG video
Here is another video from my heart DVD series. Watch it and share your thoughts, then do a little research on other arrhythmias besides long QT syndrome: Wolff-Parkinson-White syndrome, tachycardia, atrial flutter, sick sinus syndrome and bradycardia. Remember to use your own words and write something new.
Previous students looked up Long Q-T Syndrome, Sudden Cardiac Arrest, or a technology mentioned in the video... but the comments have pretty much covered these now.
(Update 5/2/08) - comments full, video is being moved to a new location.
25 comments:
http://www.americanheart.org/presenter.jhtml?identifier=993
Long Q-T syndrome is a disorder of the electrical rhythm of the heart, which can be seen on an EKG when it takes an abnormally long time for the Q-T interval to occur. This disorder may not produce any symptoms, but it can produce fainting or arrythmias. This long gap between Q and T may occur during prolonged excercise, intense emotion, or when a person is suddenly scared. Because this condition can cause arrythmias, these irregular heartbeats may progress into heart failure and possible death, but usually the disroder is not life threatening. There are also many medications to treat this disoder, surgical procedures may be performed, and implanted difribrillators may be used.required
The long QT syndrome, also called LQTS, is a heart condition associated with prolongation of repolarization following depolarization of the cardiac ventricles. It is associated with syncope and sudden death due to ventricular arrhythmias. Arrhythmias in individuals with LQTS are often caused by exercise or excitement. The T wave of LQTS usually waits longer than normal rates. LQTS is associated with the rare, ventricular arrhythmia, which can deteriorate into ventricular fibrillation and ultimately death.
Honestly, it makes me shocked if people around me suddenly have heart arrest, and I might just don’t know what to do to save them. Kevin’s friends did a wonderful job; especially Jon brings the AED to shock the abnormal heart. I did some research on the treatment of LQTS. There are two treatment options in individuals with LQTS: arrhythmia prevention, and arrhythmia termination. The one mentioned in the video is arrhythmia termination. It involves stopping a life-threatening arrhythmia once it has already occurred. The only effective form of arrhythmia termination with LQTS is placement of an implantable cardioverter-defibrillator (ICD). It is commonly used in patients with syncopes, and in patients who have experienced a cardiac arrest.
http://en.wikipedia.org/wiki/Long_QT_syndrome
I am sure most of us are frightened after watching the video, since the occurrence of sudden cardiac arrest is so sporadic and most victims die within ten minutes (especially when the victim in the video is a normal college student that we can closely relate to). The complications of the human body scares and fascinates me at the same time, I appreciate having a healthy heart so much more after watching the victims struggling to grasp for air.
The implantable cardiovascular defibrillator mentioned in the video is a technology that helps pacing the heart and deliver electrical shocks when it detects irregular heartbeats. This article talks about this technology and how much it has revolutionized the medical field. It has helped numerous patients with life threatening heart deficiencies and as technology improves, the implanting surgery is now less complicated and the device is smaller than before. It is comforting to know that there are ways to fight the heart problems and victims can be saved.
http://www.emedicine.com/med/topic3386.htm
This video was really interesting and showed the advances that have been made to help any defects of the heart. Kevin is a perfect example of this. He faced a serious life-threatening problem and his friends were key in saving his life by CPR. The defibrillator in his chest is so advanced and basically saves his life if anything were to happen. It also keeps record of his irregular heart rhythms, and this allows the doctor to maintain and keep track of his heart beats.
Sudden Cardiac Arrest occurs when the heart suddenly stops beating, resulting in blood no longer flowing to the brain and other body parts. If not treated quickly, this can lead to death. This affects more people that have heart diseases already. Defibrillators are the main devices used to save anyone who is suffering from Sudden Cardiac Arrest. These send an electrical signal to the heart, which then can help the heart to beat at a normal level.
http://www.nhlbi.nih.gov/health/dci/Diseases/scda/scda_whatis.html
Sudden Cardiac Arrest is an instant loss of heart function where the heart experiences uncoordinated ventricle contraction, stopping blood flow, and depriving the body of oxygen. The heart's rapid and unorganized activity is known as Ventricular Fibrillation, and is usually seen in patients with underlying heart conditions. If left untreated, a person can be dead within ten minutes. About 310,000 deaths occur from SCA in American adults before receiving medical assistance.
Learning about Sudden Cardiac Arrest scared me. Anyone who experiences this by themselves is helpless and left to die. Heart disease is one of the biggest killers, and studying Ventricular Fibrillation makes me more motivated to find out if I or any of my family have any undetected heart conditions. I don't want to worry all the time, but I'd rather know and be preemptive, than to be caught off-guard and potentially doomed.
http://www.americanheart.org/presenter.jhtml?identifier=14
(the link with Melissa Chapman's post...whoops)
It’s unnerving to think that someone, such as Kevin, could go through their life participating in sports and living without heart problems to all of a sudden fall into cardiac arrest. Honestly, it makes me somewhat frightened that something like this could possibly happen to me In the future. What is more unnerving is that the people around Kevin had no idea what was happening as he abruptly fell to the floor. It is luck that the Paramedic grabbed the AED before ascending to the second floor. I remembering hearing in the news – if I remember correctly – that a 16 year old girl went into cardiac arrest while on California Adventure’s The Tower of Terror. This may sound silly, but even before I heard of this unfortunate incident I always felt chest pains after going on that ride.
The device implanted in Kevin, the ICD, captured my attention, especially with its advanced capability to monitor and create a record of irregular heartbeats on a tiny chip. I was interested in how the Implantable Cardioverter Defibrillator worked. It turns out, that it works like a pacemaker; it contains a battery and an electrical circuitry, which are connected to wires. When the ICD is placed under the skin near the shoulder, these insulated wires work as leads, and are threaded through different blood vessels, depending on the case, and attached to the muscle of the heart. Minor irregular heartbeats might induce a shock that the individual will be unconscious of, which is called cardioversion, or if the heart undergoes a serious ventricular fibrillation then a stronger shock will stop the heart. In the latter case the individual will surely experience the sensation of a shock.
http://www.fda.gov/hearthealth/treatments/medicaldevices/icd.html
From watching this video I learned much more about conditions that can affect the heart in a negative way. It was unnerving to learn about the long Q-T syndrome. At first I thought such ailments would only affect a person if they were not healthy and or in shape, but the video stated that this syndrome has the potential to severely hurt and possibly kill a person who plays sports and is physically fit.
One of the more interesting technological devices that I saw in the video was the automated electronic defibrillator that the EMT brought in to help Kevin Oill. Unlike how movies depict the device to be used, the two places where the electrodes are put are on different sides of the body so an electrical current can be made to reset the fibrillating heart. After the heart is shocked, the only thing that can be done is to wait until the heart begins to beat normally on its own again. The reason why the long Q-T syndrome is so deadly is because there are no symptoms that can be seen early on. Along with no symptoms, the window in which the person has to survive is under 10 minutes.
http://galenet.galegroup.com/servlet/HWRC/hits?r=d&origSearch=true&rlt=1&o=&bucket=ref&n=10&l=d&basicSearchOption=KE&items=0&tcit=1_1_0_1_1_1&c=1&docNum=A167019916&sgPhrase=true&locID=occc_main&secondary=false&t=RK&s=1&SU=cardiac+arrest
The device in which Kevin's friend used to save his life is an AED, otherwise know as an automated external defribillator. Through an electrical pulse the heart is able to re-organize itself with the shock of the AED. This device is external and because Kevin has a high risk of another cardiac arrest, he know has an internal defribillator, known as an ICD. Technology has allowed a small battery powered defribillator to be placed inside the body of a patient who may run risk of undergoing cardiac arrest so that when there is any arrythmia, this internal device will shock the heart back into a correct organization. ICD's are constantly monitoring the heart of the patient so that if something were to be off balance, it can do the job it needs to. It checks for rate, rhythm and morphology discrimination by comparing the rates and rhythms at which the chambers and ventricles NORMALLY contract. Most ICD's are implanted transvenously above the left pectoral. They are very similar to pacemakers and have been proven to work better in saving lives than drugs. ICD's weigh only 70 grams and as technology increases, ICD's will become smaller and more efficient.
This technology completely amazes me because what was once cause for death is now easily fixable. The minds at work creating these devices should be honored for their heroic efforts. The thing about cardiac arrest is that it can happen to anyone. It can even happen to athletes and those who are extremely physically active, which may seem like the healthier you are, the less likely you are at risk. Yet, everyone is at risk and I take comfort in knowing about this technology. Everyone should be aware!
Here is more info about ICD's:
http://www.fda.gov/hearthealth/treatments/medicaldevices/icd.html
ICDs have been around saving lives since the 1980s. Today, only patients that have serious life-threatening arrhythmias can have an ICD. Although ICDs are highly successful in detecting arrhythmias, sometimes the devices cannot determine one type of heart rhythm from another. In the video, the doctor noticed some irregular EKG waves, but had to ask Kevin if he exercised at any point during the week. Similarly, the ICDs can have trouble considering factors such as exercising when analyzing the EKG waves. I found it interesting that programming the ICDs for each individual patient in order to take into consideration factors such as exercise decreases the amount of inappropriate shocks to the heart. It also prevents the ICD from inappropriately pacing the heart. Now, it is ideal for an ICD to have a dual-chamber so that detecting arrhythmias is more precise.
http://www.aafp.org/afp/980115ap/groh.html
This video was really fascinating to me. The heart is the single most important muscle in the body and if something goes wrong with it, the effects are quite clear. In the case of the student in the video, his heart went into sudden cardiac arrest. His heart starting beating incorrectly and had difficulty getting the blood to where his body needed it. Obviously if the misfiring heart wasn't treated, death could have easily occurred. The thing I find to be really ironic is that the students heart malfunctioned while he was with his friends. As already stated in the video, had he been alone somewhere by himself, there would have been zero chance of him knowing what to do in order to treat himself properly.
After the incident, Oill had an implantable cardiovascular defibrillator put into his body. The generator is placed under the skin in the upper chest. This implanted defibrillator can be the difference between life and death if ever another heart problem occurs. The machine monitors the heart and decides the appropriate treatment to assist the heart. The machine looks for Anti-tachycardia Pacing (when the heart beats too fast a small shock is released to reset the heart), Cardioversion (a low energy shock is given to the heart to reset it to a normal beating pattern), Defibrillation (when the heart beats too fast, a high energy shock is given to restore it back to normal, and Bradycardia pacing (when the heart is working too slow , electrical charges are sent to it to stimulate a faster pace. You never know when a sudden cardiac arrest may occur, its nice to know that there is technology like this that can help potentially save your life.
http://www.clevelandclinic.org/heartcenter/pub/guide/tests/procedures/icd.htm
Nearly everyone has already adddressed the QT Syndrome, EMT, AED, ICD, Sudden Cardiac Arrest, and Ventricular Fibrillation. So, I've decided to research more
on the Oill story and add on new things to what others have said.
An interesting part that they don't add in the video is that the Doctors at Rochester's Strong Memorial Hospital had to immediately put Oill into a coma as soon as he arrived.
I've learned that putting a patient deliberately into a coma reduces the total amount of blood in the brain in order to function--thus preventing brain
damage. In addition, the doctors were forced to use painkillers and drugs in Oill's fragile state which also followed a side-effect of short term memory.
Like how Oill describes: "When I woke up on Jan 23, my first reaction was utter disbelief. The last thing that I remember was New Year's Day; to be told that it was almost a month later[...] it was impossible to believe."
I don't believe anyone has yet to address that Oill's condition of LQTS is one of actually several sudden arrhythmia death sydromes called SADS. Regardless to health condition and age, SADS causes sudden death in hundreds of U.S. citizens each year. SADS include LQTS, Hypertrophic Cardiomyopathy(HCM), and Brugada Syndrome. In addition, I've found that there is a certain surgery performed for people with LQTS called a Cervical Sympathectomy. The surgery aims to limite the amount of adrenaline (and by-products) that are being produced and taken through the nerves, the left cervical ganglia,and to the heart. The surgery focuses on removing and blocking the nerves through the left neck(these are not essential to fucntion normally).
For more information:
http://media.www.thelamron.com/media/storage/paper1150/news/2007/02/08/News/Pbs-Documentary.On.Human.Heart.Features.Geneseo.Student-2706933.shtml
http://www.sads.org/index.php?option=com_content&task=view&id=3&Itemid=12
http://www.sads.org.uk/technical_terms.htm
The long QT syndrome is very alarming to me. It seems as though there isn't really a cause to the disease, which is perhaps the most frightning thing about it. Like Kevin, I too would never expect anything like that to happen to me. For the most part, I am a pretty healthy kid, and I would say I have a pretty healthy heart. The worst part about long QT syndrome is that it is so unpredictable.
I did some research on sick sinus syndrome and found that it is a name for a group of heart rhytm problems in which the sinus node does not work properly. Normally the sinus node produces a steady pace of regular electrical impulses, but in sick sinus syndrome, the sinus node beats abnormally causing bradycardia (slow heart rate), tachycardia (rapid heart rate), or the alternation between the two.
http://www.mayoclinic.com/health/sick-sinus-syndrome/DS00930
Long QT syndrome (LQTS) patients frequently have no symptoms or warning signs. When diagnosed the one treatment option is the use of beta blockers to lessen the number of nerve impulses. The reduced heart rate helps mitigate the dangerously fast beat that can occur in times of stress, free or exertion. This type of treatment is effective in preventing syncope in about 75-90 percent of LQTS patients.
The use of an implantable cardioverter defibrillator (ICD)is used in extremely difficult to treat cases. There is also a surgical procedure called left cardiac sympathetic denervation which reduces the incidence of dangerous arrhythmias. Apparently, this type of surgery is performed more frequently in countries outside of the United States.
http://yourtotalhealth.ivillage.com/long-qt-syndrome.html?pageNum=4
It was really shock because of the fact that most victims die within 10 minutes since the occurrence of sudden cardiac arrest is so sporadic. Actually, I got even scared because there is a chance that I might happen to me later in the future.
When you have Wolff-Parkinson-White syndrome you have an extra conduction pathway called accessory pathway. With extra conduction pathways, they may conduct impulses faster than normal. People with WPW may have dizziness, chest palpitations, fainting or, rarely, cardiac arrest. people with WPW who are experiencing a tachydysrhythmia may require electrical cardioversion if their condition is critical, or, if more stable, medical treatment may be used.
http://www.americanheart.org/presenter.jhtml?identifier=993
http://www.americanheart.org/presenter.jhtml?identifier=4785
http://www.emedicinehealth.com/atrial_flutter/page2_em.htm
This video clip was very interesting. I am very glad that Kelvin is alive. This video reminded me one more time the importance of electrical signals, and what arrhythmias can do to the heart. I watched many medical dramas and did not know why the doctors ‘shock’ the patients’ heart. But, after watching this clip and learn about the heart helped me understand the reason why the doctors shock patients’ hearts. I did some research Atrial flutter. This is also a heart defect (kinds of arrhythmia: related to electrical impulse).
Ventricular tachycardia is a difficult clinical problem for most doctors because it often occurs in life-threatening situations that dictate rapid diagnosis and treatment. Ventricular tachycardia is usually when the heart has three or more beats at a rate greater than 100 beats/minute. Thus, the QRS complex looks very abnormal.
Generally, ventricular tachycardia affects the diseased heart, although it has been described in patients with apparently normal hearts. It is usually associated with coronary artery disease. However, patients who have ventricular tachycardia in the absence of coronary artery disease have other cardiac abnormalities like mitral valve prolapse, valvular heart disease, which are all malfunctions that we've learned thus far in class.
Ventricular tachycardia is treated with lidocaine, procainamide or bretylium, which are all complex medicines.
http://www.americanheart.org/presenter.jhtml?identifier=64
http://www.advocatehealth.com/system/info/library/articles/heartcare/common/wpwsynd.html
Wolff-Parkinson-White Syndrome is a type of arrhythmias in which an extra electrical pathway between the atria and ventricles encourages a rapid heart rhythm. This extra pathway can pick up an extra electrical impulse in the ventricles and send it upwards into the atria, whereas normally the heart beat begins at the SA node and travels down toward the ventricles. The result of this is a rapid heart rate.
I found the video really interesting because I always wondered why hospitals always shock patients who are rushed into the E.R., and I learned that it's to shock the heart to stop the irregular heart beat and allow it to return to normal. I didn't know ventricular fibrillation could be so serious and that 90% of people die from it. It's scary that it must be treated within the first ten minutes of the victim can die.
After watching this video, I now know what Q-T syndrome is. Kyle was a lucky man because his friend was there when his cardiac arrest happened, otherwise he probably won't be alive right now. I did not really think that there were these kinds of arrests in the world, but now that I think about it, any missed timings with the P-Wave, QRS Complex, or T-Wave can be deadly.
Sinus Bradycardia is a heart disease defined as the resting heart rate being at 60 beats per minute. This is normally an unusually slow heart beat due to the disease, a reaction to medication or even could be a normal cause such as excellent fitness. Some types of bradycardia don’t show any symptoms, but some do. A couple are: Fainting, weakness, mild fatigue, palpitations, and chest pain.
It is shocking to hear that people so young can experience sudden cardiac death. I found an article that talks about research on how endurance sports are related to changes in the heart. It says that endurance athletes who have ventricular arrhythmia, usually have dysfunctional right ventricles. In past research, arrhythmia in endurance athletes often originates in the right ventricle and is associated with arrhythmogenic right ventricular cardiomyopathy. About half of those who have this condition will have a family history of it. For anyone, not just endurance athletes, who are aware that they have a family history of arrhythmia or any other heart problems should see a doctor and learn ways to help maintain a normal heart function.
http://www.healthcentral.com/heart-disease/news-29677-29.html
This video was very interesting, and actually shed light on a personal experience of mine. The Valedictorian from my high school (from the graduating class one year older than me) died just this year of a pre-existing heart condition. He was not one of the lucky ones like Mr. Oil, and until I saw this video and understood more about what can go wrong in the heart I really didn't understand what could have caused such a great and healthy young person to die so suddenly. I also had no idea that it affected so many people every year. That was quite shocking too me, but I am glad that they are making advances and gaining understanding about Arrhythmias so that it might help others in the future.
I also decided to look up what tachycardia and bradycaria were since I don't think I saw that on the other comments yet. Arrhythmias are simply abnormal heart beats that may be too fast (a Tachycardia) or too slow (a bradycardia).
http://yourtotalhealth.ivillage.com/arrhythmia.html
I was fascinated by the implanted defibrillator. This is a wonderful example of how technology can sustain lives that would otherwise be lost. Without this device, people diagnosed with long QT would be forced to always have another individual around them. That isn't feasible for most people. It's amazing that we have been able to implant this device, so this is no longer necessary.
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The most prevalent arrhythmia is atrial fibrillation. Individuals with the disorder do not always show clear signs or symptoms. They may notice discomfort in their chest, irregular heartbeats, weakness/faintness, or shortness of breath.
There are three main problems that occur with atrial fibrillation. They are: abnormal atrial contractions, increased ventricular rate, and a decrease in the flow time of the coronary arteries. Myocardial ischemia may result from the decrease in flow of the coronary arteries. In addition, cardiac output may reduce by 25-30% due to the loss of atrial systole. For those who have heart disorders and already have a low output, this problem is especially dangerous.
Treatment of the disorder is pursued in three ways. Physicians attempt to control ventricular rate ,restore sinus rhythm, and finally ,decrease risk of a cerebrovascular accident. There is a disagreement on whether or not atrial fibrillation should be attacked aggressively or be allowed to persist while drug therapy is controlling ventricular rates.
Bradford Schwarz. Atrial fibrillation: Controlling the most common arrhythmia. JAAPA 1999;10:36
I'll be honest... I believe I enjoyed watching this partly because I felt smart for understanding it...
Other than that, it's quite shocking that such cases don't only happen in dramas. It's scary to think that 90% of those who are hit with cardiac arrest die. Not to mention that the two examples given were active people; exercise and youth were not the big issues.
A type of arrhythmia that occurs due to a slow pumping hard is called Bradyarrhythmias. It is caused when the bundle branch is either blocked or causes delay in signals. But it seems that those who are physically fit are quite safe from this type of arrhythmia. The website
http://www.nhlbi.nih.gov/health/dci/Diseases/arr/arr_types.html
says that it usually hits cardiac arrest victims who have survived, and the old. In other words, those who are not high on terms of good physical condition either due to age, medications, or a previous stroke.
Sudden cardiac arrest is caused by electical problems in the heart that prevent it from beating properly. This can hapen at any time and can only be resolved with "paddles" to shock the heart. If not addressed in the first ten minutes, the patient could die. Half of all heart disease deaths are caused by sudden cardiac arrest. The risk factors are the same as heart disease; high blood pressure, high cholesterol, inactivity ect. This video scared me because it could happen at any time with no warning.
http://www.hrspatients.org/patients/heart_disorders/cardiac_arrest/scd_basic_facts.asp
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