|
.htm_cmp_indust010_vbtn.gif)
| |
GLOSSARY
- A-Fib:
- Abbreviation for Atrial Fibrillation
- Ablation:
- The removal of heart tissue which causes A-Fib.
This tissue is physically destroyed by applications of RF, Cryo (freezing), laser, or ultrasound
energy.
-
Action Potential:
- When a heart cell goes from a negative resting value to a positive
value. See
http://library.thinkquest.org/C003758/Function/The Cardiac Action
Potential.htm
- Adrenergic A-Fib:
- See Vagal A-Fib.
- AF:
- Abbreviation for Atrial Fibrillation
- AFib:
- Abbreviation for Atrial Fibrillation
- Amiodarone:
- Brand name Cordarone. An antiarrhythmic drug
(Class 3). See Medications.
- Aneurysm:
- A ballooning out of a blood vessel or of a portion of the heart muscle. If
the aneurysm ruptures, it can be deadly.
- Angina Pectoris:
- Chest pain caused by reduced blood flow to the heart.
- Antiarrhythmic Medications:
- Drug therapy that attempts to stop A-Fib and
make the heart beat normally. See Medications.
- Anticoagulants:
- Medications such as aspirin (Plavix, Ticlid) and
warfarin
(Coumadin) which thin the blood helping to prevent blood clots and stroke.
See Medications.
- Arrhythmic:
- Having an abnormal heart beat (too fast
[Tachycardia], too slow [Bradycardia] or irregular [Fibrillation]).
-
ATP (Adenosine Triphosphate):
- A chemical used by cells as an energy carrier. It transports chemical
energy within cells for metabolism. See
http://en.wikipedia.org/wiki/Adenosine_triphosphatehttp://en.wikipedia.org/wiki/
-
Adenosine_triphosphate
- Atrial Fibrillation (A-Fib):
- A heart rhythm disorder in which the upper
chambers of the heart (the atria) contract (quiver) very rapidly and
irregularly as many as 300-600 times a minute, due to chaotic, uncoordinated
electrical activity.
- Atrial Flutter
(A-Flutter):
- A heart rhythm disorder in which the upper
chambers of the heart (the atria) contract faster than the lower chambers (the
ventricles) in an organized, predictable pattern. (In Atrial Fibrillation the
atria beat chaotically and irregularly.)
You can consider Atrial Flutter as a more regular variety of A-Fib.
A-Flutter often, though not always, originates in the right atrium, whereas
A-Fib usually comes from the left atrium. Here is an EKG of Atrial Flutter:
ECG 3 - atrial flutter
This ECG illustrated a heart
in atrial flutter. This has very distinct appearance. The "flutter waves"
that we expect to see in atrial flutter are noticeable throughout the ECG,
but are very easy to see in the rhythm strip. The rhythm is still regular,
although this is not always the case in AFL
130 (from
wolfminimaze.com)
-
Atrial-Esophageal Fistula:
- A hole that forms between the atrium and the esophagus, often resulting in
death. It is presumably caused by the use of high wattage catheters during
catheter ablation procedures to cure A-Fib.
-
Atrial Natriuretic Peptide (ANP):
- A powerful vasodilator and a hormone secreted by heart muscle cells in
the upper chambers (atria) of the heart. It reduces the water and sodium
loads on the circulatory system. It is released in response to atrial
stretch and other signals such as atrial fibrillation.
http://en.wikipedia.org/wiki/Atrial_natriuretic_peptide
-
Atrial Tachycardia:
- A rhythm disturbance in the atria of the heart. An electrical impulse
comes from somewhere in the atria other than from the
SA Node which is the normal pacemaker of the heart.
In A-Fib Ablation, Atrial Tachycardia can be considered a
milder form of Atrial Flutter. During an
ablation procedure, first A-Fib signals disappear, second A-Flutter signals,
then Atrial Tachycardia.
-
Atrioventricular (AV) Node:
- The AV Node is specialized conducting tissue
that acts as an electrical road or gate connecting the atria to the
ventricles. Normally the AV Node is the only electrical connection between
these heart chambers. See Overview.
-
Atrioventricular (AV) Nodal Reentry Tachycardia (AVNRT):
- The AV Node develops two pathways instead of one, allowing a signal to go
down one pathway, then back up the other pathway to the atrium (reentrant
circuit) resulting in
Supraventricular Tachycardia (speeding up the heart beat).
- Atrium (plural Atria):
- Either one of the two upper chambers of the
heart in which blood collects before being pumped into the lower chambers
(ventricles). See Overview.
- AV Node:
- See
Atrioventricular Node.
- AVNRT:
- See Atrioventricular (AV) Nodal Reentry
Tachycardia.
- Beta Blocker:
- A medication that slows down conduction through
the heart and makes the AV Node less sensitive to A-Fib impulses. See
Medications.
- Betapace:
- See Sotalol.
- Bradycardia:
- A heart rhythm problem in which the heart beats
slower than normal. Bradycardia may be caused by the SA Node not working
properly or by the electrical pathway in the heart being blocked (heart
block).
- Calcium Channel Blocker:
- A medication that prevents or slows the flow of
calcium ions into smooth muscle cells such as the heart. This impedes muscle
cell contraction, thereby allowing blood vessels to expand and carry more
blood and oxygen to tissues. See Medications.
- Cardiac Arrest:
- When the heart quits pumping effectively.
- Cardiologist:
- A doctor who specializes in the diagnosis and
treatment of heart disease.
- Cardiomyopathy:
- A heart condition or disease in which the heart muscle is weakened and the
heart's ability to pump blood is impaired. For example, fibrous tissue may
partially replace the heart muscle, disabling the heart so that it no longer
functions properly, and blood no longer moves efficiently. Cardiomyopathy is often accompanied by atrial
fibrillation.
- Dilated Cardiomyopathy: The lower chambers of the heart
become enlarged and cannot pump efficiently.
- Hypertrophic Cardiomyopathy: The walls of the heart become
thickened and stiff, and are unable to properly fill and pump blood
efficiently. This disorder often runs in families.
- Restrictive Cardiomyopathy: The heart chambers are unable
to expand and fill with blood between contractions.
(See
http://www.hrspatients.org/patients/the_normal_heart/
structural_defects.asp)
(The World Health Organization recognizes Cardiomyopathy
as a "selenium deficiency.")134
- Cardiologist:
- A heart doctor.
- Cardioversion:
- Converting the heart from A-Fib to normal rhythm by using medications
and/or electrical shock.
-
Carotid Sinus Stimulus (Massage):
- Doctors partially block or slow down the flow of
blood through the carotid sinus.
It is used to tell the difference
between different types of arrhythmias, and "rarely, may also terminate the
arrhythmias and reestablish sinus rhythm."212
- CARTO Mapping:
- An A-Fib mapping system that uses a special catheter to generate 3-D maps
of the heart.
- Catheter:
- A soft, thin, flexible tube with an electrode at
the tip.
- Catheter Ablation:
- A procedure in which a catheter (a soft, thin,
flexible tube with an electrode at the end) is inserted through a vein or
artery in the groin or neck and moved into the heart. Through the electrode,
RF, laser, Cryo (freezing) or ultrasound energy is applied to eliminate or physically destroy
specific heart tissue.
- CAT Scan:
- Short for Computed Axial Tomography---a method of producing 3-D images by
recording the passage of waves of energy through structures.
- Caviotricuspid Isthmus:
- In the Right Atrium this is the space between the Inferior Vena Cava and
the Tricuspid Valve. In ablation for Right Atrial Flutter, a Caviotricuspid
Isthmus ablation line is often made to prevent Atrial Flutter.
- CHADS2:
- CHADS2 refers to risk factors for stroke. If you have one of the risk
factors, you have a risk score of 1. However, if you’ve had a stroke
already, that counts as a risk score of 2 ("S2"):
 | "C" Congestive Heart Failure Score = 1 |
| "H" Hypertension
Score = 1 |
| "A" Age over 75
Score = 1 |
| "D" Diabetes
Score = 1 |
| "S2" Previous Stroke or TIA Score = 2 |
For example, someone with a risk factor of 1 not receiving
any anticoagulant therapy would have 1.9%-2.8% chance of having a stroke within
a year, whereas someone with a score of 6 would have an 18.2% chance of having a
stroke.
Chronic Atrial Fibrillation:
In chronic A-Fib the heart remains in A-Fib all
the time, as contrasted with "paroxysmal" A-Fib where the heart has occasional
attacks of A-Fib.
Circumferential Catheter Ablation:
A Catheter Ablation technique that utilizes a circular catheter to make
circular lesions around the Pulmonary Vein openings, thereby isolating the
Pulmonary Veins from the rest of the heart. This prevents A-Fib pulses
produced in the Pulmonary Veins from spreading through the rest of the heart.
A type of Pulmonary Vein Ablation.
Class 1 Medications:
Sodium Channel Blocker medications which
decrease the speed of electrical conduction in the heart muscle. See
Medications.
Class 2 Medications:
Beta-Adrenergic or Beta-Blocker medications
which slow down conduction through the heart and make the AV Node less
sensitive to A-Fib impulses. See Medications.
Class 3 Medications:
Potassium Channel Blockers which slow nerve
impulses in the heart. See Medications.
Class 4 Medications:
Calcium Channel Blockers which prevent or slow
the flow of calcium ions into smooth muscle cells such as the heart. This
calcium blocking impedes muscle cell contraction, thereby allowing blood
vessels to expand and carry more blood and oxygen to tissues. See
Medications.
Complex Fractionated Atrial Electrograms:
A low voltage A-Fib signal with many deflections and irregular spiking and
often with a very short cycle length. Discovered by
Dr. Nademanee they are used to identify sources of A-Fib in the heart.
Congestive Heart Failure:
The heart is unable to pump adequate amounts of blood, often as a result
of a heart attack.
Cordarone:
Coronary Artery Disease (CAD):
Plaque accumulates in the coronary arteries limiting the flow
of blood to the heart. CAD sometimes results in a blood clot that causes a
heart attack.
See Amiodarone.
Coumadin:
An anticoagulant whose generic name is
"Warfarin." See Medications.
C-Reactive Protein (CRP):
A marker or sign of inflammation, often found in patients with A-Fib.82
Cryoablation:
An ablation technique that freezes the focal sources of A-Fib rather than
ablating them with RF energy. Currently still in the experimental and trial
stages for A-Fib.
Defibrillator:
An electrical device that delivers a shock in
order to restore the heart to normal rhythm. It is used primarily in life
threatening conditions to stop very rapid and irregular heart beats.
DHA:
Docosahexaenoic Acid, a fish oil/omega-3 fatty acid that plays a crucial
role in brain function, as well as in normal growth and development.
Diastolic
Blood Pressure:
The optimal blood pressure reading currently is 115/75.59
The "75", the second number, is the Diastolic Blood Pressure---the amount of
pressure in your arteries when your heart is at rest between beats. See
Systolic Blood Pressure.
Digoxin:
A rate-control medication that is a Digitalis
compound, brand name Lanoxin. Digoxin slows down and controls the heart rate
by blocking the electrical conduction between the atria and ventricles. See
Medications.
Ditiazem:
A rate-control calcium-channel blocker
medication. See Medications.
Disopyramide:
Brand name Norpace. An antiarrhythmic drug
(Class 1A). See Medications.
Dofetilide:
Brand name Tikosyn. An antiarrhythmic drug
(Class 3). See Medications.
Top of Page
ECG:
See Electrocardiogram.
Ectopic Beats:
Beats that come from any region of the heart
that ordinarily should not produce heart beat signals. Normal heart beats come
from the Sinus Node, not from areas like the Pulmonary Vein openings where
most A-Fib signals originate. See Overview.
Effective Refractory Period (ERP):
Effective Refractory Period (ERP) refers to the period
of time a cell can not be activated by a new action potential. The ERP acts as
a protective mechanism in the heart by preventing multiple, compounded action
potentials from occurring (i.e., it limits the frequency of depolarization and
therefore heart rate). This is important because at very high heart rates, the
heart would be unable to adequately fill with blood and therefore ventricular
ejection would be reduced.
Many antiarrhythmic drugs alter the ERP, thereby altering
cellular excitability. For example, drugs that block potassium channels (e.g.,
amiodarone, a Class III antiarrhythmic) delay phase 3 repolarization and
increases the ERP. Drugs that increase the ERP can be particularly effective
in abolishing reentry currents that lead to arrhythmias. [Based on
"Cardiovascular Physiology Concepts by Richard E. Klabunde.]103
Ejection Fraction:
The ratio of the volume of blood the heart pumps out during contraction to
the volume of blood in the heart when it fills up with blood. It is expressed
as a percentage normally between 56 and 78 percent.
EKG:
See Electrocardiogram.
Electrical Cardioversion:
Delivering an electrical shock to the heart in
order to convert it from A-Fib to normal rhythm.
Electrogram (EGM):
A picture of the electrical activity of the heart as sensed by an ICD or
pacemaker implanted in the heart, or produced by catheter mapping devices
inside the heart. (This is different from an Electrocardiogram
which senses the heart's electrical activity from the surface of the skin.)
Electrocardiogram (ECG or EKG):
A graphical representation of the electrical
activity of the heart. 12 sensors placed on different parts of the body record
electrical activity from 12 different areas of the heart. These signals are
listed as I, II III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6. An
Electrocardiogram is used as an examination tool to determine if you have
A-Fib, and can sometimes show a doctor where in your heart an arrhythmia signal is
coming from. It is also used during an ablation procedure to determine if an
A-Fib signal source has been ablated/isolated.
Electrophysiologist:
A Cardiologist who specializes in the electrical
activity of the heart and in the diagnosis and treatment of heart rhythm
disorders. (It is usually an Electrophysiologist who performs Pulmonary Vein
Ablations.)
Electrophysiology Study (EP)
(EPS):
A test which uses a catheter inserted through
the veins into the heart to determine which areas in the atria give rise to
Atrial Fibrillation or Flutter.
EPA:
Eicosapentaenoic Acid, a fish oil/omega 3 essential fatty acid
Esmolol:
A rate control beta-blocker medication. See
Medications.
Esophageal Fistula
A hole that forms in the esophagus. See
Atrio-Esophageal Fistula.
Event (Loop) Recorder:
A patient-triggered monitor/recorder. When you feel an episode of A-Fib,
you press a button to record several minutes of the A-Fib episode.
Fibrillation:
Rapid, uncoordinated contractions of individual
heart muscle fibers.
Fibrosis:
A condition occurring in A-Fib where the heart develops fiber-like
characteristics in place of the normal smooth walls of the heart. A-Fib
seems to cause
Fibrosis in the heart.
Flecainide:
Brand name Tambocor. An antiarrhythmic drug
(Class 1C). See Medications.
Fluoroscopy:
A special type of x-ray that allows the heart to
be visualized.
Flutter:
Rapid contractions of individual heart muscle
fibers.
Focal
Circuit:
A-Fib coming from a particular spot in the heart. (See also
Reentrant Circuit.)
Focal Point Catheter Ablation:
A procedure in which a catheter (a soft, thin,
flexible tube with an electrode at the tip) is inserted through a vein or
artery in the groin or neck and moved into the heart. This catheter is
directed to the exact point(s) in the heart that are producing the A-Fib.
These points are burned off or isolated from the heart. See
Focal Point Catheter Ablation.
GLA:
Gamma-Linolenic Acid, an omega-6 fatty acid
Heart
Attack (Myocardial Infarction):
A total blockage of blood flow and oxygen to a portion of the heart. This
damages the heart's muscle cells.
Holter Monitor:
A small, portable monitor that continually
records the heart's rhythm for 24-72 hours.
Hypertension:
High blood pressure.
Hypertrophic Cardiomyopathy:
See Cardiomyopathy.
Ibutilide:
An antiarrhythmic drug (Class 3). See
Medications.
ICD:
Abbreviation for Implantable (Cardioverter) Defibrillator
ICE:
Short for Intracardiac Ultrasound (Echo) which uses Ultrasound to image
within the heart in real time.
Implantable (Cardioverter)
Defibrillator [ICD]:
An implanted electronic device which delivers a
shock to the heart any time it senses the heart going into A-Fib. It is also
used in patients who have V-Tach (Ventricular Tachycardia).
ABLATION FOR V-TACH (VENTRICULAR
TACHYCARDIA) AT MASS. GENERAL BY DR. VIVEK REDDY
See
Implanted Defibrillator.
INR (International Normalized
Ratio):
A measurement of the amount of blood thinner in
the blood stream.
To be effective warfarin must be maintained at a certain level in the blood (INR---International Normalized Ratio between 2.0 and 3.0).
Above 4.0 you run the risk of having a hemorrhagic (bleeding) stroke. Below
2.0 you are more in danger of having an ischemic (clotting) stroke, the kind
that most often occurs in A-Fib
Intracardiac Ultrasound (Echo) (ICE):
Using Ultrasound to image within the heart in real time.
Top of Page
Isolation:
A catheter ablation technique that creates
lesions (cuts or scars) around a source of A-Fib to keep it from transmitting
A-Fib signals into the rest of the heart. If a source of A-Fib area is
"isolated," it is still producing A-Fib signals, but they aren't spreading to
the rest of the heart. See Focal Point
Catheter Ablation.
Isoproterenol:
A drug used to stimulate the heart into A-Fib during a Pulmonary Vein
Ablation procedure.
Left Atrial Appendage:
Most strokes come from the Left Atrial Appendage (91%)87
which is located at the top of the Left Atrium. It is a very complicated structure with often more than
one lobe. In A-Fib
the flow of blood from the Left Atrial Appendage is particularly poor. Clots
can easily form. Then when the heart beats, these clots can dislodge and cause
stroke.
Lesions:
In Focal Point Catheter Ablation of A-Fib,
lesions are electronically created cuts or scars.
Ligament of Marshall:
A vestige of a vein that was required during fetal development, but is no
longer needed.
Lone (Idiopathic) Atrial
Fibrillation:
A-Fib without any accompanying or triggering
heart disease or other illness.
Loop (Event) Recorder:
A patient-triggered monitor/recorder. When you feel an episode of A-Fib,
you press a button to record several minutes of an A-Fib episode.
Maze Surgical Operation:
An open heart operation in which the surgeon
makes numerous incisions in the atria. This "maze" of incisions divides the
atria into electronically isolated segments, thereby blocking the electrical
impulses that cause A-Fib from spreading throughout the heart. The atria
continue to be activated by a regular signal from the Sinus Node. See
Maze Surgical Operation.
Metoprolol:
A rate control beta-blocker medication. See
Medications.
Millisievert (mSv):
A measurement of radiation dose used for measuring the effects of
various types or radiation. 1 Sievert equals 1.0 joule/killogram or 100 rem.
A Sievert is defined as producing the same biological effect in a specific
tissue as 1 gray of high-energy x-rays.
Mitochondria:
The part of a cell responsible for the production of energy in the form
of ATP.
mSv:
See Millisievert.
Myocardial Infarction:
The medical term for a Heart Attack. See Heart
Attack.
Normal Heart Rhythm (also called
"Sinus Rhythm"):
The normal beating of the heart (60-80 beats per
minute). See Overview.
Norpace:
See Disopyramide.
Off-Label:
Outside of
licensed indication---the clinical application of prescribed drugs for
indications other than those approved by the FDA. Off-label uses are legal
and may be in the best interests of patients. But they have not received the
same degree of independent scrutiny through randomized clinical trials as
have approved indications. One can not advertise or market a drug for
something other than what has been approved by the FDA.
Operating Room (O.R.) Report:
A very technical, detailed
report by your ablation doctor describing step by step the procedures and
results of an particular ablation. (Because it is very technical and
difficult for patients to read, it isn't normally given to patients unless
they ask for it.)
Ostium (plural Ostia):
The opening from a pulmonary vein into the left
atrium.
PAC:
Abbreviation for Premature Atrial Contraction. A common and generally
benign arrhythmia that occurs even in people with normal heart rhythm. A PAC
is a heartbeat that comes from some other area than the sinus node. It feels
like a skipped or extra heart beat.
Pacemaker:
A small, implantable device that provides an
electrical stimulus to the heart when the natural electrical signal is absent
or too slow to provide sufficient pumping action.
Paroxysmal Atrial Fibrillation:
Occasional attacks of A-Fib, as contrasted with
"chronic" A-Fib where the heart remains in A-Fib all the time.
Pericarditis:
Inflammation of the pericardium, the sac that surrounds your heart.
Persistent Atrial Fibrillation:
A-Fib that lasts over 24 hours but that is
amenable to cardioversion.
Polar Heart Rate Monitor:
A device for monitoring your heart rate in
A-Fib. Designed primarily for runners it consists of a band around your chest
which transmits a signal to a wrist watch. You can set the wrist watch to set
off an alarm if your pulse rate goes too high. Available in sporting goods
stores.
Premature Atrial Contraction
(PAC):
A common and generally benign arrhythmia that occurs even in people with
normal heart rhythm. A PAC is a heartbeat that comes from some other area than
the sinus node. It feels like a skipped or extra heart beat.
Proarrhythmic:
A medication is "proarrhythmic" if it worsens
your heart rhythm rather than making it more regular.
Procainamide:
Brand names Procan SR, Promine, Pronestyl,
Procanbid. An Antiarrhythmic drug (Class 1C). See
Medications.
Procan SR:
See Procainamide.
Procanbid:
See Procainamide.
Promine:
See Procainamide.
Pronestyl:
See Procainamide.
Top of Page
Propafenone:
Brand name Rythmol. An antiarrhythmic drug
(Class 1C). See Medications.
Propranolol:
A rate control beta-blocker medication. See
Medications.
Pulmonary Vein:
The four Pulmonary Veins bring oxygenated blood
from the lungs into the left atrium. (The openings from these Pulmonary Veins
into the left atrium are the source of most Focal Point A-Fib).
Pulmonary Vein Ablation:
A term used to refer to both Segmental and Circumferential Catheter
Ablation. It is replacing the term "Focal" or "Focal Point Catheter Ablation."
PVC:
Premature Ventricular Contraction. A type of irregular heart beat in which
the ventricle contracts prematurely. also known as VPB (Ventricular
Premature Beat,) extrasystole, "skipped beat," or palpitations.
Pulmonary Vein (PV) Potentials:
An electrical charge or energy (potential) in
the Pulmonary Vein openings that can cause A-Fib. A PV Potential can be
measured and pinpointed even if you aren't in A-Fib at the time. See
Focal Point Catheter Ablation.
PV Stenosis:
Swelling of the Pulmonary Vein opening that may
occur after Catheter Ablation. This swelling can restrict blood flow from the
lungs into the heart. See Questions For Doctors.
Quinaglute:
See Quinidine.
Quinidex:
See Quinidine.
Quinidine:
Brand names Quiniglute, Quinidex, Quinidine
Glaconate. An antiarrhythmic (Class 1A) drug. See
Medications.
Quinidine Glaconate:
See Quinidine.
The QT Interval:
In an EKG signal the QT interval represents the time the ventricles are
pumping and at rest. See The EKG Signal.
The QTc Interval:
In an EKG signal the QTc Interval represents the time the ventricles are
pumping and at rest corrected or adjusted for movement of the heart when
beating. See The EKG Signal.
Radio Frequency (RF):
High frequency electrical energy used in
Catheter Ablation.
Rate Control Medications:
Drug therapy that attempts to control your heart
rate (ventricular beats), but leave the upper chambers (atria) of your heart
in A-Fib. See Medications.
Reentrant
Circuit (Macro Reentrant Circuit):
Circular, random electrical patterns or wavelets found in the Atria of
patients with A-Fib and A-Flutter.
Remodeling:
In A-Fib over a period of time, the fast,
abnormal heart rhythm in the atria causes electrical changes and enlarges the
atria.
Rythmol:
See Propafenone.
Segmental Catheter Ablation:
A Catheter Ablation technique that uses Pulmonary Vein Potentials to
identify and ablate (destroy) focal points or areas of the heart producing
A-Fib signals. A type of Pulmonary Vein Ablation.
Sinoatrial (SA) Node:
See Sinus Node.
Sinus Node:
(Also called "Sinoatrial [SA] Node.") The Sinus
Node is a specialized group of cells in the heart which generates an
electrical signal that travels down a single electrical road (the AV Node)
connecting the atria to the ventricles. The Sinus Node is called the heart's
"natural pacemaker," because it maintains a regular heart beat and makes
adjustments to increase the heart rate during exercise and to slow it during
rest. See Overview.
Sinus Rhythm:
The normal beating of the heart (60-80 beats per
minute). Also called "Normal Heart Rhythm." See
Overview.
Top of Page
Sotalol:
Brand name Betapace. A rate control beta-blocker
medication. (Class 3 drug.) See Medications.
Spline:
A spline has a series of
projections on a shaft that fit into slots on a corresponding shaft. A spline
is used on a catheter to insert the Watchman device.
Stenosis:
A swelling, constriction or narrowing of a duct or passage. See
PV
Stenosis.
Structural Heart Disease:
This term can refer to several different structural defects in the heart:
1. Heart muscle disease (Cardiomyopathy)
2. Heart valve disease
3. Congenital heart disease (patients born with abnormalities
of the heart valves or chambers)
4. Heart damage caused by infection, such as Paricarditis
Sudden Cardiac Death:
Also called "cardiac arrest." Occurs when the electrical
impulses in the heart become rapid (ventricular tachycardia) or chaotic
(ventricular fibrillation) or both. This irregular heart rhythm causes the
heart to suddenly stop beating. (This heart problem has received much less
publicity than a Heart Attack.)
Supraventricular Tachycardia (SVT):
An arrhythmia similar to A-Fib in which the heart beats fast (100 to 240
beats per minute). SVT usually begins and ends suddenly. SVT often begins in
childhood or adolescence. It is commonly caused by a variation in the
electrical system of the heart. It is usually not dangerous, but can cause a
drop in blood pressure and lightheadedness.
"Supraventricular Tachycardia" in clinical practice commonly
refers to atrial tachycardia, atrioventricular nodal reentrant tachycardia
(AVNRT), and atrioventricular reciprocating tachycardia (AVRT), an entity
that includes Wolff-Parkinson-White syndrome. While Atrial Fibrillation is a
distinct entity classified separately.
The term "Supraventricular Arrhythmia" most often is used to
refer to Supraventricular Tachycardias and Atrial Flutter.
In practice, Supraventricular Tachycardia is often used to
include all arrhythmias in the Atria, including A-Fib.
SVT:
See Supraventricular
Tachycardia.
Systolic Blood
Pressure:
The optimal blood pressure reading currently is 115/75.59
The "115", the first number, is the Systolic Blood Pressure---the pressure
your heart generates when pumping blood through your arteries. See
Diastolic Blood Pressure.
Tachycardia:
A heart rhythm problem in which the heart beats
faster than normal.
Tambocor:
See Flecainide.
TEE:
See Transesophageal Echocardiogram
Tikosyn:
See Dofetilide.
TIA:
Transient Ischemic Attack, a temporary "mini-stroke"
Toprol-XL:
A rate control beta-blocker medication.
See Medications.
Transmurality:
Passing through the wall of the heart or involving the whole thickness of
the heart wall.
Transesophageal Echocardiogram:
In this procedure used to test for the presence of blood clots in the
heart, a tube is run down your Esophagus next to your heart. The
Echocardiogram uses high-frequency ultrasonic waves to visualize structural and functional
abnormalities of the heart from behind it within the esophagus.
Ultrasound:
High-frequency sound vibrations used in some
types of Catheter Ablation.
Vagal A-Fib:
The Adrenal (Adrenergic) Glands sit above the kidneys and produce the
hormone epinephrine (adrenaline) in response to stress, which causes an
increase in heart rate and blood pressure. This adrenaline stimulates what is
called the Sympathetic Nervous System to speed up the heart and constrict the
blood vessels. The Vagus Nerve, in contrast, controls the abdomen and is part
of the Parasympathetic Nervous System that tends to slow the heart and dilate
blood vessels.
Adrenergic and Vagotonic forms of paroxysmal A-Fib are
uncommon.43
"The majority of patients with paroxysmal A-Fib do not have a clear autonomic
pattern."110
However, if your A-Fib is normally triggered by exercise, stress, stimulants,
exertion, etc., then you may have "Adrenergically-Mediated" A-Fib. People with
structural heart disease seem more prone to Adrenergic A-Fib44.
But if your A-Fib occurs at night, after a meal, when resting after
exercising, or when you have digestive problems, then you may have
"Vagally-Mediated" A-Fib. People with Lone A-Fib seem more prone to Vagal A-Fib44. (Many people have a mix of both Adrenergic and Vagal A-Fib.)
(Perhaps A-Fib begins as a nervous system problem, then becomes a heart
problem after the arrhythmia is established.)
It might
be helpful to determine if you have one or the other so
that you can better identify what triggers your A-Fib, and because the
treatments are often different for each. For example, beta-blockers usually
don't work well with Vagal A-Fib.86
Of the antiarrhythmic 1c meds, flecainide seems to work better for Vagal A-Fib
than propafenone.111 (Though it's difficult to generalize
about A-Fib treatments, because each person reacts so individually.) For a
more in depth look at Vagal A-Fib, go to
http://www.vagalafibinfo.fsnet.co.uk
(This
site seems to have disappeared from the Internet as of October, 2006).
See also in the FAQs section
"What is the difference between
"Adrenergic" and "Vagal" Atrial Fibrillation. How can I tell which one I have?
Does it really matter? Does Pulmonary Vein Ablation (Isolation)
work for Adrenergic and/or Vagal A-Fib?"
Ventricles:
The lower chambers of the heart. See
Overview.
Ventricular Tachycardia:
A fast heart rhythm that originates in one of the ventricles. It is a
potentially life-threatening arrhythmia, because it may lead to Ventricular
Fibrillation---very rapid uncoordinated fluttering contractions of the
ventricles resulting in loss of synchronization between heartbeat and pulse
beat. Unlike A-Fib, it can be very dangerous and result in sudden death.
Verapamil:
A rate control calcium-channel blocker
medication. See Medications.
Vitamin K Antagonist (VKA):
A technical description of how VKAs work is the following: "they prevent
the y-carboxylation of the vitamin K-dependent coagulation factor prothrombin
and Factors VII, IX, and X."115
In layman’s terms warfarin works by affecting several steps in the
anticoagulation pathway to prevent clotting.
VKA:
See Vitamin K Antagonist
V-Tach (VT):
Short for Ventricular Tachycardia. A fast heart rhythm that
originates in one of the ventricles. It is a potentially life-threatening
arrhythmia, because it may lead to Ventricular Fibrillation---very rapid
uncoordinated fluttering contractions of the ventricles resulting in loss of
synchronization between heartbeat and pulse beat. Unlike A-Fib, it can be very
dangerous and result in sudden death.
Warfarin:
The generic name of an anticoagulant whose
product name is "Coumadin." See Medications.
Watchman Device:
See
Watchman device.
Wolff-Parkinson-White syndrome
(WPW):
A form of Supraventricular Tachycardia, WPW occurs when electrical signals fail to
pause in the AV Node because an extra pathway allows the impulse to "bypass"
the normal pathway. Patients with WPW may develop A-Fib and are at increased
risk of developing a dangerous ventricular arrhythmia.
Back To Top (Last
updated 2/13/10)
|