a-pacing
A slang term used to denote use of a pacemaker that electrically stimulates
the atrium (top chamber) of the heart to contract
ablation
A non-surgical procedure that destroys heart tissue by directing energy
(direct current or radio frequency) through a catheter
accessory
pathway
An extra pathway that bypasses the normal route of electrical conduction,
allowing electrical impulses to travel directly from the atria to the
ventricles
adrenergic
AF
A form of atrial fibrillation that is associated with excessive adrenaline
that comes from the sympathetic response ("fight or flight") of the nervous
system
amiodarone
A potent medication that is used primarily to suppress ventricular
arrhythmias, but may also be useful in the medical management of atrial
fibrillation
antiarrhythmic
A type of medication that is used to control (or to convert) heart rhythm
by altering the electrophysiology of cardiac cells
anticoagulant
A medication that is used to alter the normal clotting mechanism (Coumadin
and Heparin are the most commonly prescribed anticoagulants)
arrhythmia
A generalized term used to denote disturbances in heart
rhythm
asynchrony
A term describing a loss of coordination or timing between the atria
and the ventricles
atria
The two upper chambers of the heart (atrium is the singular
term)
atrial defibrillator
An experimental device (implanted into the chest) capable of delivering
small electrical shocks directly to the heart to terminate atrial
arrhythmias
atrial dilatation
A term used to describe enlargement of the atria
atrial fibrillation (AF)
A complex atrial arrhythmia that has no definitive cause, characterized
as a storm of electrical energy that travels in spinning "wavelets" throughout
the atria, causing the upper chambers to quiver or to
fibrillate
atrial flutter
Atrial flutter is a less complex dysrhythmia, characterized by one or
two macroreentrant circuits spinning within the atria as well as a slower
atrial and ventricular rate. This rhythm has a distinctive "sawtooth pattern"
that can be readily identified on an EKG
atrial
kick
A term used to describe the atrial contribution (pumping action) to the
cardiac cycle
atrial
mapping
A detailed study of the atrial electrical system
atrial pacemaker
A type of pacemaker that stimulates the atria to contract
atrial tachycardia
A type of atrial arrhythmia that comes from one or two sites and is typically
sudden in onset with a rapid rate (150-200 beats per minute)
atrial thrombus
A blood clot that forms in the atrium
AV nodal ablation
A procedure performed with a specialized catheter placed near the AV
node that is capable of delivering electrical energy to interrupt or stop
the flow of electrical impulses from the top to the bottom of the heart.
A pacemaker will be inserted to maintain a regular ventricular beat
with this procedure
AV
node
The site (located between the atria and the ventricles) where electrical
impulses traveling from the top to the bottom of the heart briefly slow down
to allow time for the atria to contract
beta
blocker
A group of medications that reduce heart rate by blocking the sympathetic
("fight or flight") response
bradyarrhythmia
A slow and irregular heart rhythm
bradycardia
A heart rate that is less than 60 beats per minute
bundle
branch
A portion of the conduction system that is located in the lower chambers
of the heart
calcium channel blocker
A group of medications that decrease the rate and the workload of the
heart
capture
A term used to describe appropriate muscular response to the electrical
stimulation of a pacemaker
cardiac catheterization
A specialized study that uses catheters and the injection of dye to visualize
the coronary arteries that supply blood to the heart
cardiac rehabilitation program
A supervised exercise program that may be recommended following a heart
attack or open heart surgery to assist in the recovery process
cardiomyopathy
A general term that describes a group of conditions that involve heart
muscle dysfunction, often with no identifiable cause
cardioversion, electrical
A procedure that uses an electrical charge applied over the heart to
momentarily discharge all the cardiac cells, allowing the primary pacemaker
the SA node to take control of the rhythm
cardioversion, pharmacological
Use of an antiarrhythmic medication to convert an abnormal heart rhythm
back to normal
cath
film
The x-ray film of the coronary arteries that is taken when dye is injected
during a catheterization procedure
catheter ablation
A procedure that utilizes a specialized catheter to deliver electrical
energy in order to destroy heart tissue that is causing an
arrhythmia
cerebral
vascular accident (CVA)
The medical term used to describe a stroke
chronic
AF
A continual form of atrial fibrillation that acts as the heart's primary
rhythm
congestive
heart failure (CHF)
Ineffective or poor pumping function of the the heart that results in
symptoms such as fatigue, shortness of breath, or swelling of
extremities
coronary
artery bypass procedure (CABG)
A surgical procedure that restores blood flow around a blocked coronary
artery using another artery or vein to supply the blood to the heart
muscle
defibrillation
See cardioversion,
electrical
depolarization
The neutralization of electrical polarity via a decrease in ion
potential across the cell membranes of the myocardium - a kind of electrical
"discharge" of the heart's muscle cells during the course of a heart beat.
Also, see refractory period and
repolarization
diastole
The resting phase of the cardiac cycle when the atria and ventricles
fill with blood
digitalis
A medication that increases the force of heart contraction and slows
down the rate
diltiazem
Also known as Cardizem. See calcium
channel blocker
disopyramide
An antiarrhythmic medication that suppresses ventricular arrhythmias
by altering the electrophysiology of cardiac cells. It may also be useful
in decreasing atrial arrhythmias
dual-lead pacemaker
A sophisticated pacemaker system with one lead in the top (atrium) and
another in the bottom (ventricle) of the heart that is capable of sensing
one's own rhythm, or pacing both chambers in synchrony
echocardiogram
An ultrasound study of the heart that aids the physician in the evaluation
of the structure and function of the heart
electrolyte imbalances
An alteration in the normal balance of essential elements such as potassium,
magnesium, and calcium
electrophysiologist (EP)
A cardiologist with expertise in diagnosing and treating heart rhythm
disturbances, using specialized studies to direct them
electrophysiology (EP) studies
Specialized tests that are performed with the aid of catheters that are
placed in the heart to ascertain and gain information about rhythm
disturbances
embolic
stroke
A stroke that is caused by a blood clot that lodges in a vessel in the
brain and stops the flow of blood to that area
embolism
A foreign body or blood clot that lodges in a blood vessel
etiology
The cause of an illness or condition
familial
AF
A rare type of atrial fibrillation that is linked with a chromosomal
defect
flecainide
An antiarrhythmic agent used to treat ventricular rhythm disturbances
primarily, but may also be used to suppress atrial arrhythmias (also known
as Tambacor)
heart
block
An alteration in the electrical conduction of the heart that causes the
top and the bottom of the heart to beat out of synchrony
heparin
A commonly used anticoagulant that alters the normal clotting mechanism.
His
bundle
A part of the atrioventricular node that connects to the interventricular
septum and carries electrical impulses from the AV node to the
ventricle
Holter
monitor
A portable monitor that records and stores heart rhythms for extended
periods of time (usually 24 hours) It is useful in diagnosing rhythm disturbances
because the patient is active while wearing this type of
monitor
hypotension
Low blood pressure that may or may not cause symptoms
hyperthyroidism
A metabolic condition that occurs as a result of an overactive thyroid
gland and is characterized by symptoms such as nervousness, weight loss,
rapid heart rate and atrial fibrillation (also known as Grave's
disease)
hypertrophic cardiomyopathy (HOCM)
A type of cardiomyopathy with no known cause, characterized by hypertrophy
or disproportionate increase in size of the left ventricle (the main pumping
chamber of the heart)
hypertrophy
Increased size of an organ or cell
interatrial septum
A ridge of tissue between the two atria or top chambers of the
heart
International Normalized Ratio (INR)
A standardized blood test that is used to determine the level of
anticoagulation from medications such as Coumadin
interventional cardiologist
A cardiologist who specializes in interventional technologies such as
cardiac cathertization, angioplasty, and pacemaker insertion
junctional rhythm
A backup heart rhythm that is initiated in the AV node usually at a rate
of 50-70 beats per minute (this is generally a secondary pacemaker for the
heart in the event of SA node failure)
lone
AF
Atrial fibrillation with no identifiable cause or underlying structural
heart problem
macro reentrant circuits
A term used to describe relatively large circular electrical patterns
or wavelets that are typical of rhythm disturbances such as atrial flutter
and atrial fibrillation
Maze
procedure
A surgical procedure that cures atrial fibrillation by interrupting the
circular wavelets of electrical energy that are typical of this arrhythmia.
Strategic placement of multiple incisions in both atria stops the formation
of errant electrical impulses and channels the normal electrical impulses
in one direction from the top of the heart to the bottom
mitral stenosis
A disorder of the mitral valve that is characterized by leaflet adhesions
or scarring that causes the valve opening to be narrowed. A surgical repair
or replacement may be necessary. Some patients with mitral stenosis can have
a procedure called valvuloplasty where balloons are used to dilate the valve
opening. Patients may experience symptoms of shortness of breath, fatigue,and
heart failure with mitral valve stenosis.
mitral valve disease
A generalized term used to describe dysfunction of the mitral valve.
There are two major problems that can occur with the mitral valve. The valve
either does not open properly and is said to be stenotic (causing obstruction
of the blood flow through the valve), or the valve does not close properly
and is said to be regurgitant or insufficient (allowing the backflow of blood
into the left atrium).
mitral valve prolapse
A condition often caused by degenerative changes in the leaflets of the
mitral valve. When the leaflets of the valve close, the edges normally meet.
In the case of prolapse one of the two leaflets slips out of place and the
valve does not close completely. Mitral valve prolapse is associated with
congenital conditions, connective tissue disorders, cardiomyopathy, and Marfan's
syndrome. It occurs more often in women than in men.
nerve
block
A type of local anesthetic that is used to relieve pain following minimally
invasive surgery.
neurogenic
AF
A term used to describe a form of atrial fibrillation that results from
an imbalance in the nervous system regulation of the heart. For a further
description of neurogenic AF, see A-Fib
101
normal sinus rhythm (NSR)
The normal cycle of electrial stimulation of the heart that begins in
the sinoatrial node (SA node), traveling to the left atrium and down to the
atrioventricular node (AV node) where is slows briefly. It then continues
to travel down a common pathway where it splits into two branches in the
ventricle. The electrical stimulation of the heart is necessary to produce
the muscluar contraction that is responsible for the pumping action of the
heart.
p-wave
A small rounded wave on an electrocardiogram (ECG) that indicates atrial
contraction has occurred
pacemaker
A device that provides the electrical stimulation needed to cause the
heart muscle to contract. A pacemaker has many different modes of operation
and can be programed to function as the primary stimulis for the heart, or
it can be used in a backup mode. Pacemakers can be either temporary or permanent
depending upon the need of the patient.
palpitation
An unusually forceful or strong heartbeat (may be fast or irregular)
that one becomes aware of. Palpitations may occur in response to emotional
or stressful events, in response to medication, or as a result of many heart
disorders.
parasympathetic tone
Also known as vagotonus - an abnormal increase in the activity
of the vagus nerve, a major part of the autonomic nervous system. Can cause
bradycardia (a slowing-down of the heart) with resulting dizziness and/or
fainting. This response (known as a vagovagal reflex) can sometimes
occur as a result of irritation or pressure to the larynx (back of
throat/voicebox) or trachea (windpipe).
paroxysmal
AF
An intermittent form of atrial fibrillation that is characterized by
a sudden onset and abrupt cessation of arrhythmia
permanent pacing
Describes the long-term use of an internal (versus external, as
in temporary pacing) pacemaker as the primary (or back-up) electrical stimulus
for the heart
platelet
A small blood cell that is essential for blood coagulation
(clotting).
presyncope
Dizziness caused by cerebral near-hypoxia (low levels of oxygen in the
blood supply to the brain)
primary
AF
See lone AF
proarrhythmic
Having a tendency to cause cardiac arrhythmia. Potentially, any
antiarrhythmic drug can have a proarrhythmic effect on the
heart
procainamide
A drug used to prolong the heart's refractory period and thus alter the
electrophysiology of cardiac cells and convert the heart back to normal sinus
rhythm
propranolol
A beta blocker commonly used to decrease the heart's rate and force of
contraction
QRS
complex
A graphic representation of part of the cardiac cycle, specifically the
heart's electrical impulse as it passes through the ventricles as seen on
an electrocardiogram (EKG)
QT
interval
An EKG measurement that focuses on the rate of ventricular depolarization
and repolarization over time. Among other things, it is often used for monitoring
the effects of anti-arrhythmic drugs on the heart's refractory
period
quinidine
Another class 1A drug used to prolong the heart's refractory period and
thus alters the electrophysiology of cardiac cells and suppresses or converts
arrythmias
R
- R interval
An interval that is measured from the peak of one QRS complex to the
next. Used as an indicator of regularity when evaluating the heart's rhythm
during an electrocardiogram
refractory period
A null period following the depolarization (discharge) of the heart's
muscle cells during which time the cells cannot respond to a second
stimulus until repolarization (recharging) has been completed
repolarization
The restoration of electrical polarity via an increase in ion
differential between the cell membranes of the myocardium - a kind of electrical
"recharging" of the heart's muscle cells in preparation for the next heart
beat
rheumatic heart disease
Residual damage to the heart muscle and valves caused by rheumatic
fever
SA
node
Short for sinoatrial node, a cluster of special muscle fibers located
in the right atrial wall of the heart. Normally generates regular electrical
impulses that cause the heart muscle to contract. Considered to be the primary
pacemaker of the heart
sick sinus syndrome
Rhythm disturbance characterized by disruptions of SA nodal impulse formation
or conduction. EKG characteristics include sinus bradycardia, pauses, AF,
supraventricular tachycardia (SVT), and sinus node arrest. The SA node can
be partially or totally destroyed via inflammatory and/or degenerative processes,
which in turn, cause fatty or fibrotic changes. Treatment usually requires
a permanent pacemaker
single-lead pacemaker
A type of pacemaker that can only pace one-half of the heart (either
the atria or the ventricles). Seldom used today
sinus bradycardia
A form of bradycardia (heart rate of less than 60 beats per minute) that
originates in the SA node
sinus
rhythm
See normal sinus rhythm
(NSR)
sinus tachycardia
A type of tachycardia (heart rate greater than 100 beats per minute)
that originates in the SA node
slick
AV node
Description of an atrioventricular condition that is characterized by
a shorter-than-normal conduction delay in the AV node, allowing the electrical
impulses to travel on to the ventricles before the atria have fully
contracted
sotalol
A beta blocker used to decrease overall heart rate
supraventricular tachycardia (SVT)
General term used to describe a fast and regular rhythm (greater than
100 beats per minute) that is initiated above the ventricles
syncope
Brief loss of consciousness (fainting) due to a lack of oxygen to the
brain
systole
The "contractive" phase of the cardiac cycle - when blood is ejected
from the ventricles and into the aorta and pulmonary artery
tachycardia
Any heart rate that is greater than 100 beats per minute
thromboembolism
Describes a condition by which a vessel becomes blocked by an embolus
via the bloodstream from a remote clot formation
thrombus
A blood clot that becomes attached to the wall of a vein or
artery
transient
AF
See paroxysmal AF
transient ischemic attacks (TIA's)
Brief cerebrovascular incidents during which dizziness, vision disturbances,
numbness and/or unconsciousness can occur as a result of partial occlusion
of an artery due to plaque deposits or an embolism
v-pacing
Short for ventricular pacing
vagal
tone
See parasympathetic
tone
vagal
AF
A form of atrial fibrillation thought to be triggered indirectly by
vagotonus, an abnormal increase in the activity of the vagus nerve. The vagovagal
reflex causes bradycardia, a slowing of the heart rate, and is believed to
set the stage for macro reentrant circuit activity (a hallmark of AF). Also,
see parasympathetic tone
vagus
nerve
The vagus nerve comprises part of the body's longest pair of cranial
nerves, and is responsible for many important functions, including speech,
swallowing and digestion
ventricular pacemaker
A type of pacemaker used to provide the primary (or back-up) electrical
stimulus to the heart's ventricles
verapamil
A calcium channel blocker used in the treatment of SVT and some types
of atrial arrythmias by lowering the heart's ventricular response, and thus
its rate
warfarin
Commonly known under the trademark Coumadin, a drug used as an
anticoagulant
wavelet
A circular electrical pattern originating in the atria that is typically
seen in rhythm disturbances, such as atrial flutter and atrial
fibrillation
Wolff- Parkinson- White (WPW) syndrome
An atrioventricular conduction disorder, characterized by two separate
AV conduction pathways. Can be identified by the presence of a hallmark "delta"
wave during EKG testing
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