RT Book, Section
A1 Vijayaraman, Pugazhendhi
A1 Arkles, Jeffrey
A1 Koneru, Jayanthi N.
A1 Callans,  David J.
A2 Fuster, Valentin
A2 Narula, Jagat
A2 Vaishnava, Prashant
A2 Leon, Martin B.
A2 Callans, David J.
A2 Rumsfeld, John S.
A2 Poppas, Athena
SR Print(0)
ID 1202447686
T1 Conduction System Disturbances and Bradyarrhythmias
T2 Fuster and Hurst's The Heart, 15e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264257560
LK accesscardiology.mhmedical.com/content.aspx?aid=1202447686
RD 2024/04/24
AB Chapter  SummaryThis  chapter  examines  the  pathophysiology  of  various  clinical  forms  of  conduction  system  disturbances  and  sinus  node  dysfunction  (SND)  (see  Fuster  and  Hurst’s  Central  Illustration).  The  conduction  system  serves  as  the  “translator”  between  the  autonomic  nervous  system’s  various  demands  for  heart  rate  and  coordinates  electrical  activation  to  provide  efficient  excitation–contraction  coupling.  Dysfunction  can  occur  at  any  level  of  the  electrical  system,  sinus  node,  atrioventricular  (AV)  conduction  axis  (AV  node/His  bundle),  and  intraventricular  conduction  (right  and  left  bundle  branches),  with  variable  clinical  effects.  Many  disease  processes  affect  the  electrical  system,  but  the  most  prominent  are  aging  and  concomitant  structural  heart  disease.  Genetic  disorders,  although  rare,  are  important  to  discover  because  they  may  be  syndromic  and  can  affect  other  family  members.  AV  block  caused  by  surgical  trauma,  particularly  during  transcatheter  aortic  valve  procedures,  is  increasing  in  incidence  and  often  requires  complex  decision  making.  Treatment  primarily  involves  pacemaker  implantation  when  appropriate,  and  the  indications  for  pacing  are  reviewed.  Novel  technologies,  including  leadless  pacing,  conduction  system  pacing,  and  the  promise  of  biological  pacing,  are  also  discussed.