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Premature Junctional Contraction

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1. Premature Junctional Contraction

Premature Junctional Contraction Premature Junctional Contraction Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Premature Junctional (...) Contraction Premature Junctional Contraction Aka: Premature Junctional Contraction , PJC From Related Chapters II. Causes Same as for s III. Signs: EKG Findings Inverted (retrograde) if present Narrow complex if high nodal source Wide complex if lower nodal source Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Premature Junctional Contraction." Click on the image (or right click) to open the source website in a new browser window

2018 FP Notebook

2. A confused ECG with multiple rhythms caused by atrial premature contractions: A case report. (PubMed)

A confused ECG with multiple rhythms caused by atrial premature contractions: A case report. Atrial premature contractions (APCs) are commonly encountered in clinical practice. The APCs may influence heart conduction system and induce other arrhythmia. The disorder of atrioventricular conduction is related to electrophysiological phenomena, difficult to understand and diagnose.We presented a 15-year-old male patient whose baseline electrocardiogram (ECG) was confused with multiple rhythms (...) . Electrophysiological study results showed sinus rhythm with nonconducted APCs in bigeminal rhythm. Nonconducted APCs were blocked without H wave. Some APCs conducted to ventricle with longer AH interval and HV interval. When APCs were abolished by radiofrequency ablation, this patient was free from any arrhythmia during follow-up.We considered that the basic rhythm of the baseline ECG was sinus rhythm with atrial bigeminy rhythm and narrow QRS extrasystoles (junctional); some APCs were blocked and some APCs

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2017 Medicine

3. Electrocardiographic characteristics of idiopathic premature ventricular contractions originating from the junction of the right ventricular outflow tract and tricuspid annulus. (PubMed)

Electrocardiographic characteristics of idiopathic premature ventricular contractions originating from the junction of the right ventricular outflow tract and tricuspid annulus. The right ventricular outflow tract (RVOT) and tricuspid annulus (TA) are common origins for idiopathic PVCs from the right ventricle. We sought to clarify the characteristics of a subgroup of idiopathic PVCs originating from the RVOT-TA junction.Surface ECG and intra-cardiac electrophysiological characteristics were (...) analyzed in 101 patients with frequent PVCs who underwent successful RFCA in the right ventricle. Pacing was performed in the right ventricle in another 5 control subjects. The origin of PVCs determined by the successful ablation site was at the RVOT, the TA and the RVOT-TA junction in 78, 11 and 12 patients, respectively. The PVCs originating from RVOT-TA junction showed a monophasic R wave in leads I, II, III and aVF and a flat QRS complex in lead aVL. A flat QRS complex (rsr', qs, qr, rs or r

2015 International journal of cardiology

4. New electrocardiographic criteria for predicting successful ablation of premature ventricular contractions from the right coronary cusp. (PubMed)

New electrocardiographic criteria for predicting successful ablation of premature ventricular contractions from the right coronary cusp. ECG features for predicting successful ablation sites of outflow tract (OT) premature ventricular complex (PVCs) have been previously presented, but effective predictors of right coronary cusp (RCC) remain elusive.106 patients (59 males, 56±14years) who underwent successful PVC ablation were studied. Various ECG patterns and measurements were analyzed (...) to identify the unique features of RCC PVC origins. The R-wave duration index (RWDI) was calculated as a percentage by dividing the QRS complex duration by the longest R-wave duration in lead V1 or V2.Successful ablation sites were the RCC in 18 patients, the left coronary cusp (LCC) in 20, the RCC/LCC junction (RLJ) in 22, the AIV/GCV in 11 and the right ventricular outflow tract in 35. Forty-seven patients had dominantly positive forces in lead I. Among these 47 patients, 19 were ablated from the RCC

2016 International journal of cardiology

5. Radiofrequency ablation of ventricular premature contraction originating from a native coronary cusp after transcatheter aortic valve replacement (PubMed)

Radiofrequency ablation of ventricular premature contraction originating from a native coronary cusp after transcatheter aortic valve replacement We describe a case of radiofrequency ablation of ventricular premature contraction (VPC) originating from the left ventricular outflow tract after transcatheter aortic valve replacement. The VPC origin was the native aortic valve annulus between the left and right coronary cusps. Radiofrequency ablation was successfully performed by manipulating (...) the ablation catheter from the gap between the sinotubular junction and implanted valve.

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2017 Journal of arrhythmia

6. Premature Junctional Beats Mimic 2nd Degree Block Mobitz Type II (contributed by K. Wang)

. The stress test was stopped for fear that it was induced by ischemia. This tracing was also recorded during the stress test: Figure 2. In this tracing, there are many premature junctional contractions ( PJC , premature narrow complex beats without any preceding P -wave). Note that they do not reset the sinus node, which marches out at the same rhythm on succeeding beats. Thus, these premature beats occur close to the sinus P-wave and are dissociated, as diagrammed here: Figure 3. The arrows point out (...) Premature Junctional Beats Mimic 2nd Degree Block Mobitz Type II (contributed by K. Wang) Dr. Smith's ECG Blog: Pseudo Type II Second Degree AV Block Induced by Concealed Premature Junctional Complexes (PJCs) (contributed by K. Wang) Monday, August 26, 2013 This patient is running on a treadmill: Figure 1. There are frequent apparently non-conducted p-waves. The PR interval is not lengthening, so this is not AV Wenckebach phenomenon. It appears to be 2nd degree AV block, Mobitz Type II

2013 Dr Smith's ECG Blog

7. Premature Junctional Contraction

Premature Junctional Contraction Premature Junctional Contraction Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Premature Junctional (...) Contraction Premature Junctional Contraction Aka: Premature Junctional Contraction , PJC From Related Chapters II. Causes Same as for s III. Signs: EKG Findings Inverted (retrograde) if present Narrow complex if high nodal source Wide complex if lower nodal source Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Premature Junctional Contraction." Click on the image (or right click) to open the source website in a new browser window

2015 FP Notebook

8. Evaluation of Symptomatic Esophagogastric Junction Outflow Obstruction. (PubMed)

with regurgitation (0% vs 41.2%, P = 0.05). Anatomical EGJOO had higher frequencies of premature contraction (50% vs 5.9%, P = 0.003) and lower mean values of distal latency (5.6 +/- 1.3 vs 6.7 +/- 1.2, P = 0.004). Computed tomography scans revealed 50% (3/6) of etiologies of anatomical EGJOO. Approximately, 73.5% (25/34) of patients with functional EGJOO had spontaneous resolution of their symptoms. One underwent pneumatic dilatation with symptom resolution while remaining eight with persistent symptoms were (...) Evaluation of Symptomatic Esophagogastric Junction Outflow Obstruction. Esophagogastric junction outflow obstruction (EGJOO) may be due to anatomical abnormalities, but it is unclear how to evaluate them after high-resolution manometry. We aimed to determine (i) clinical and high-resolution manometry parameters differentiating anatomical EGJOO from functional EGJOO, (ii) investigations chosen and yield for anatomical EGJOO, and (iii) clinical outcomes of functional EGJOO.Medical records

2018 Journal of gastroenterology and hepatology

9. Ablation of Nkx2-5 at mid-embryonic stage results in premature lethality and cardiac malformation. (PubMed)

Ablation of Nkx2-5 at mid-embryonic stage results in premature lethality and cardiac malformation. Human congenital heart disease linked to mutations in the homeobox transcription factor, NKX2-5, is characterized by cardiac anomalies, including atrial and ventricular septal defects as well as conduction and occasional defects in contractility. In the mouse, homozygous germline deletion of Nkx2-5 gene results in death around E10.5. It is, however, not established whether Nkx2-5 is necessary (...) results in embryonic death by E17.5. Analysis of mutant embryos at E16.5 shows arrhythmias, contraction defects, and cardiac malformations, including ASD. Quantitative measurements using serial section histology and three-dimensional reconstruction demonstrate growth retardation of the septum secundum and enlarged foramen ovale in Nkx2-5-ablated embryos. Functional cardiac defects may be attributed to abnormal expression of transcripts critical for conduction and contraction, including cardiac voltage

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2011 Cardiovascular Research

11. Guidelines on Supraventricular Tachycardia (for the management of patients with)

isthmus-dependent macro-re-entrant atrial tachycardia 27 11.1.4.2.1 Right atrium macro-re-entrant atrial tachycardia 27 11.1.4.2.2 Left atrium macro-re-entrant atrial tachycardia 28 11.2 Atrioventricular junctional arrhythmias 29 11.2.1 Atrioventricular nodal re-entrant tachycardia 29 11.2.1.1 Diagnosis 29 11.2.1.1.1 12 lead electrocardiogram during tachycardia 29 11.2.1.1.2 Electrophysiology study 30 11.2.1.1.3 Typical atrioventricular nodal re-entrant tachycardia 30 11.2.1.1.4 Atypical (...) atrioventricular nodal re-entrant tachycardia 30 11.2.1.2 Therapy 30 11.2.1.2.1 Acute therapy 31 11.2.1.2.2 Catheter ablation 31 11.2.1.2.3 Chronic therapy 31 11.2.2 Non-re-entrant junctional tachycardias 32 11.3 Atrioventricular arrhythmias 32 11.3.1 Accessory pathways 32 11.3.2 Wolff Parkinson White syndrome 33 11.3.3 Orthodromic atrioventricular re-entrant tachycardia 33 11.3.4 Antidromic atrioventricular re-entrant tachycardia 34 11.3.5 Accessory pathway as a bystander 34 11.3.6 Pre-excited atrial

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2019 European Society of Cardiology

13. Male Sexual Dysfunction

and health among older adults in the United States. N Engl J Med, 2007. 357: 762. 2. Rosenberg, M.T., et al. Identification and diagnosis of premature ejaculation. Int J Clin Pract, 2007. 61: 903. 3. Tekgül, S., et al. European Association of Urology guidelines on Paediatric Urology. Edn. presented at the EAU Annual Congress London, 2017. 4. Montague, D.K., et al. American Urological Association guideline on the management of priapism. J Urol, 2003. 170: 1318. 5. Eland, I.A., et al. Incidence of priapism (...) on Male Sexual Dysfunction. EAU Guidelines on Male Sexual Dysfunction (Erectile Dysfunction and premature ejaculation). Edn. presented at the EAU Annual congress Stockholm. 2009: Arnhem, The Netherlands. 13. Hatzimouratidis, K., et al., EAU Guidelines Panel on Male Sexual Dysfunction. EAU guidelines on Penile Curvature. Edn. presented at the EAU Annual Congress Paris. 2012: Arnhem, The Netherlands. 14. Salonia, A., et al., EAU Guidelines Panel on Male Sexual Dysfunction. EAU guidelines on priapism

2019 European Association of Urology

14. Oesophageal manometry and oesophageal reflux monitoring

been recognised that the previous defini- tion of simultaneous waves (contractile front velocity of distal peristaltic wave >8 cm/s) presenting in >20% of water swal- lows with amplitude >30 mm Hg, 83 is not specific for DOS. 10 84 Premature contractions, defined as a distal latency 180 mm Hg. 41 Originally, HRM DCI >5000 mm Hg. s. cm was taken to indicate hypertensive peristalsis, with a subgroup with DCI >8000 mm Hg. s. cm and repetitive contractions termed ‘spastic nutcracker’, invariably (...) Integrated relaxation pressure The integrated relaxation pressure (IRP) is calculated as the lowest mean deglutitive oesophago-gastric junction (OGJ) pressure referenced to gastric pressure for 4 continuous or non-contin- uous seconds during a 10 s window after the onset of swallowing, measured from the start of upper oesophageal sphincter (UOS) opening. This provides information on the degree of OGJ relax- ation during swallowing. 11 12 Distal contractile integer The distal contractile integer (DCI

2019 British Society of Gastroenterology

15. CRACKCast E152 – Cardiovascular Drugs

: decreased resting potential, resulting in slowed phase 0 depolarization and conduction velocity ; (2) decreased action potential duration, which increases sensitivity of muscle fibers to electrical stimuli; and (3) enhanced automaticity resulting from increased rate of phase 4 repolarization and delayed after-depolarizations. These mechanisms account for an increase in premature ventricular contractions, which is the most common electrocardiographic manifestation of digoxin toxicity. At extremes (...) action potentials, a larger amount of calcium is released into the cell, causing a more powerful contraction and thus increased cardiac output. ) Increase in intracellular Na+ and Calcium Decreases SA and AV nodal conduction At toxic concentrations, digoxin can directly block the generation of impulses in the SA node, depress conduction through the AV node, and increase the sensitivity of the SA and AV nodes to catecholamines In toxicity gives tachy-brady/AV block syndromes Purkinje effects

2018 CandiEM

16. Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease

prematurity and genetic syndrome. 18–21 Neonates with single-ventricle physiology have an increased risk of cardiac arrest as the result of (1) in- creased myocardial work as a consequence of volume overload, (2) imbalances in relative systemic and PBF, and (3) potential shunt occlusion. 3,4,22–24 The risk of car- diac arrest remains high until the superior CPA is creat- ed. 25–27 For patients with HLHS, the frequency of in-hos- pital cardiac arrest after stage 1 Norwood palliation is lower after

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2018 American Heart Association

17. Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association

the shared annulus of the aortic and mitral valves, the crista supraventricularis is a muscle bridge that is unique to the RV and separates the RV inflow (tricuspid annulus) from the outflow tract (pulmonic annulus). The crista supraventricularis shares muscle fibers with the interventricular septum and the RV free wall and serves to contract the orifice of the tricuspid valve (TV) while pulling the RV free wall toward the interventricular septum during systole. , Figure 2. Right ventricular (RV (...) (PV) loop, which lacks isovolumic phases of contraction and relaxation during systole and diastole, has a lower peak systolic pressure, and exists at a higher steady-state volume compared with the LV. In contrast to the LV, peak RV pressure occurs before the end of systolic ejection, which leads to a more trapezoid-appearing RV PV loop ( ). Figure 3. Right ventricular (RV) pressure-volume (PV) loops. RV PV loops obtained by a conductance catheter. White solid lines reflect the end-systolic PV

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2018 American Heart Association

18. Induced Pluripotent Stem Cells for Cardiovascular Disease Modeling and Precision Medicine: A Scientific Statement From the American Heart Association

affecting the left ventricle, with increased risk of SCD. The most commonly mutated genes in ARVC cases are components of a structure involved in cell-to-cell adhesion called desmosome: PKP2 (plakophilin 2), DSG2 (desmoglein 2), DSP (desmoplakin), DSC2 (desmocollin 2), and JUP (junction plakoglobin). The most intensively studied ARVC iPSC lines to date were derived from 2 unrelated individuals, one homozygous for a mutation in PKP2 that causes a splicing defect and the other heterozygous (...) with iPSC-based models to date, in particular the long-QT syndromes (LQTS). LQTS is marked by delayed repolarization of the heart after contraction, which manifests as an increased QT interval on the ECG and predisposes patients to ventricular arrhythmias and SCD. LQTS is usually inherited in an autosomal dominant manner, although there are a few forms that are inherited in an autosomal recessive manner. Mutations in at least 15 genes have been linked to LQTS, typically affecting the function

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2018 American Heart Association

19. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency

are brought to prompt medical attention. Third, premature, sick, or stressed infants have higher levels of 17OHP than do term infants, generating many false positives. For example, in 26 years of operation of the Swedish screening program, the positive predictive value was 25% for full-term infants but only 1.4% for preterm infants, and the predictive value correlated very strongly with gestational age ( ). Finally, immunoassays may lack specificity. There are no universally accepted standards (...) -pregnenolone sulfate ( ). Immunoassay specificity may be improved with organic extraction to remove cross-reacting substances, such as steroid sulfates. The dissociation-enhanced lanthanide fluoroimmunoassay was reformulated in late 2009 to reduce its sensitivity to cross-reacting compounds in premature infants ( ). This change improved the positive predictive value from 0.4% to 3.7% for the first screen alone ( ). Finally, antenatal corticosteroids may reduce 17OHP levels, potentially increasing

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2018 The Endocrine Society

20. Evaluation and Management of Right-Sided Heart Failure

tract (pulmonic annulus). The crista supraventricularis shares muscle fibers with the interventricular septum and the RV free wall and serves to contract the orifice of the tricuspid valve (TV) while pulling the RV free wall toward the interventricular septum during systole. , Figure 2. Right ventricular (RV) geometry in health and disease. Three-dimensional reconstructions of the RV illustrating its complex shape in a normal subject ( A ). RV remodeling in diseased hearts can result in profound (...) of the RV free wall and interventricular septum. Generating RV output requires one sixth the energy expenditure of the LV because much of RV stroke work maintains forward momentum of blood flow into a highly compliant, low-resistance pulmonic circulation. This difference is exemplified by the RV pressure-volume (PV) loop, which lacks isovolumic phases of contraction and relaxation during systole and diastole, has a lower peak systolic pressure, and exists at a higher steady-state volume compared

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2018 International Society for Heart and Lung Transplantation

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