Double heart beat
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Understanding Double Heart Beat: Causes and Mechanisms
Double or Multiple Impulse Apex Beat
A double or multiple impulse apex beat can be attributed to several distinct cardiac phenomena. These include an atrial thrust, a bifid systolic impulse, and a palpable diastolic bulge, all of which contribute to the sensation of multiple pulsations at the cardiac apex. The mechanisms behind these abnormalities are complex and involve various cardiac structures and functions. Diagnostic tools such as electrocardiograms (ECG), arterial and venous pulse tracings, apex cardiograms, and phonocardiograms play a crucial role in identifying and understanding these cardiac signs.
Double Rhythm in Heterotopic Heart Transplantation
In cases of heterotopic heart transplantation, a double rhythm can occur due to the presence of two separate heartbeats originating from the donor and native hearts. This phenomenon was observed in a patient with sinus rhythm from the donor heart and ventricular fibrillation in the native heart. The double rhythm was effectively detected using surface ECG and transthoracic echocardiogram, highlighting the importance of these diagnostic tools in managing such complex cases. Treatment with direct current shock successfully restored synchronization in the native heart, alleviating the patient's symptoms.
Electrical Rhythmic Activity in Embryonic Double Hearts
Research on embryonic chick models has provided insights into the development of electrical rhythmic activity in double hearts. In these studies, double-hearted embryos were created by microsurgical intervention at early developmental stages. Optical recordings of spontaneous electrical action potentials and contractions from both halves of the heart revealed that regular rhythmic activity was more common than irregular rhythms. Notably, the heart rate in the left half-heart was generally faster than in the right half-heart, indicating intrinsic differences in pacemaking activity between the two halves.
Pacemaking Activity in Congenital Double Hearts
Further studies on congenital double-hearted chick embryos have shown that both the right and left half-hearts exhibit spontaneous rhythmical action potentials and beating. These findings suggest that intrinsic pacemaking activity is present in both halves of the heart, with observable differences in their rhythms. The research also noted action potentials in malformed hearts formed by partial fusion of cardiac primordia, providing valuable insights into the genesis of pacemaking activity and the spatial gradient of rhythmicity during early cardiogenesis.
Conclusion
The phenomenon of a double heartbeat can arise from various conditions, including abnormalities in the apex beat, heterotopic heart transplantation, and congenital double hearts. Diagnostic tools such as ECG, echocardiograms, and optical recordings are essential for detecting and understanding these complex cardiac rhythms. Research on embryonic models continues to shed light on the developmental aspects of double heartbeats, offering potential pathways for future clinical applications.
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