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Ventricular escape rhythm

MedGen UID:
65423
Concept ID:
C0232216
Pathologic Function
Synonym: Ventricular escape rhythms
SNOMED CT: Ventricular escape rhythm (81898007)
 
HPO: HP:0005155

Definition

A ventricular escape rhythm occurs whenever higher-lever pacemakers in AV junction or sinus node fail to control ventricular activation. Escape rate is usually 20-40 bpm, often associated with broad QRS complexes (at least 120 ms). [from HPO]

Term Hierarchy

Conditions with this feature

Sick sinus syndrome 1
MedGen UID:
325270
Concept ID:
C1837845
Disease or Syndrome
The term 'sick sinus syndrome' encompasses a variety of conditions caused by sinus node dysfunction. The most common clinical manifestations are syncope, presyncope, dizziness, and fatigue. Electrocardiogram typically shows sinus bradycardia, sinus arrest, and/or sinoatrial block. Episodes of atrial tachycardias coexisting with sinus bradycardia ('tachycardia-bradycardia syndrome') are also common in this disorder. SSS occurs most often in the elderly associated with underlying heart disease or previous cardiac surgery, but can also occur in the fetus, infant, or child without heart disease or other contributing factors, in which case it is considered to be a congenital disorder (Benson et al., 2003). Genetic Heterogeneity of Sick Sinus Syndrome Sick sinus syndrome-2 (SSS2; 163800) is caused by mutation in the HCN4 gene (605206). Susceptibility to sick sinus syndrome-3 (SSS3; 614090) is influenced by variation in the MYH6 gene (160710). Sick sinus syndrome-4 (SSS4; 619464) is caused by mutation in the GNB2 gene (139390).
Chronic atrial and intestinal dysrhythmia
MedGen UID:
863911
Concept ID:
C4015474
Disease or Syndrome
Syndrome with characteristics of sick sinus syndrome and intestinal pseudo-obstruction. The heart and digestive issues develop at the same time, usually by age 20. The syndrome is caused by mutations in the SGO1 gene. This gene provides instructions for making part of a protein complex cohesin. This protein complex helps control the placement of chromosomes during cell division. Research suggests that SGO1 gene mutations may result in a cohesin complex that is less able to hold sister chromatids together, resulting in decreased chromosomal stability during cell division. This instability is thought to cause senescence of cells in the intestinal muscle and in the sinoatrial node, resulting in problems maintaining proper rhythmic movements of the heart and intestines.
Atrial standstill 1
MedGen UID:
1646392
Concept ID:
C4551959
Disease or Syndrome
Atrial standstill (AS) is a rare condition characterized by the absence of electrical and mechanical activity in the atria. On surface ECG, AS is distinguished by bradycardia, junctional (usually narrow complex) escape rhythm, and absence of the P wave. Nearly 50% of patients with AS experience syncope. AS can be persistent or transient, and diffuse or partial (summary by Fazelifar et al., 2005).

Professional guidelines

PubMed

Kim YG, Nam GB, Cho MS, Park GM, Kim M, Lee JH, Hwang KW, Kim J, Choi KJ, Kim YH
J Electrocardiol 2019 Jul-Aug;55:34-40. Epub 2019 Apr 7 doi: 10.1016/j.jelectrocard.2019.04.002. PMID: 31078106

Recent clinical studies

Etiology

Yanagihara C, Kumagi T, Tasaka T, Watanabe Y, Kono T, Ohshima K, Ogimoto A
Intern Med 2022 Jun 1;61(11):1721-1725. Epub 2021 Nov 6 doi: 10.2169/internalmedicine.8479-21. PMID: 34744114Free PMC Article
Lee W, Tay A, Walker BD, Kuchar DL, Hayward CS, Spratt P, Subbiah RN
Europace 2016 Dec;18(12):1837-1841. Epub 2016 Feb 3 doi: 10.1093/europace/euv433. PMID: 26847073
Teng R, Butler K
Int J Clin Pharmacol Ther 2013 Oct;51(10):795-806. doi: 10.5414/CP201903. PMID: 24040849
Jones P, Dauger S, Denjoy I, Pinto da Costa N, Alberti C, Boulkedid R, Peters MJ
Pediatr Crit Care Med 2013 Jul;14(6):e289-97. doi: 10.1097/PCC.0b013e31828a8624. PMID: 23689705
Feigl D, Ashkenazy J, Kishon Y
J Am Coll Cardiol 1984 Jul;4(1):35-8. doi: 10.1016/s0735-1097(84)80315-0. PMID: 6736451

Diagnosis

Umapathi KK, Schmidt H, Salazar N, Sosnowski C, Wilkerson MK, Logan LK
Pediatrics 2021 May;147(5) Epub 2021 Apr 13 doi: 10.1542/peds.2020-017624. PMID: 33850027
Kim YG, Nam GB, Cho MS, Park GM, Kim M, Lee JH, Hwang KW, Kim J, Choi KJ, Kim YH
J Electrocardiol 2019 Jul-Aug;55:34-40. Epub 2019 Apr 7 doi: 10.1016/j.jelectrocard.2019.04.002. PMID: 31078106
Sanders KH, Martin CA, Virdee M
Heart 2019 Apr;105(8):657-659. Epub 2018 Dec 4 doi: 10.1136/heartjnl-2018-314118. PMID: 30514728
Tripathy RK, Sharma LN, Dandapat S
J Med Syst 2016 Apr;40(4):79. Epub 2016 Jan 21 doi: 10.1007/s10916-016-0441-5. PMID: 26798076
Rein AJ, Simcha A, Ludomirsky A, Appelbaum A, Uretzky G, Tamir I
J Pediatr 1985 Nov;107(5):724-7. doi: 10.1016/s0022-3476(85)80400-5. PMID: 4056971

Therapy

Umapathi KK, Schmidt H, Salazar N, Sosnowski C, Wilkerson MK, Logan LK
Pediatrics 2021 May;147(5) Epub 2021 Apr 13 doi: 10.1542/peds.2020-017624. PMID: 33850027
Sanders KH, Martin CA, Virdee M
Heart 2019 Apr;105(8):657-659. Epub 2018 Dec 4 doi: 10.1136/heartjnl-2018-314118. PMID: 30514728
Lee W, Tay A, Walker BD, Kuchar DL, Hayward CS, Spratt P, Subbiah RN
Europace 2016 Dec;18(12):1837-1841. Epub 2016 Feb 3 doi: 10.1093/europace/euv433. PMID: 26847073
Tripathy RK, Sharma LN, Dandapat S
J Med Syst 2016 Apr;40(4):79. Epub 2016 Jan 21 doi: 10.1007/s10916-016-0441-5. PMID: 26798076
Teng R, Butler K
Int J Clin Pharmacol Ther 2013 Oct;51(10):795-806. doi: 10.5414/CP201903. PMID: 24040849

Prognosis

Olson PC, Cinelli M, Kurtovic E, Barsoum E, Spagnola J, Lafferty J
Heart Lung 2020 Mar-Apr;49(2):198-201. Epub 2019 Jun 24 doi: 10.1016/j.hrtlng.2019.06.002. PMID: 31248624
Lee W, Tay A, Walker BD, Kuchar DL, Hayward CS, Spratt P, Subbiah RN
Europace 2016 Dec;18(12):1837-1841. Epub 2016 Feb 3 doi: 10.1093/europace/euv433. PMID: 26847073
Pieper CC, Weis V, Fimmers R, Rajab I, Linhart M, Schild HH, Nähle CP
Rofo 2015 Nov;187(11):1029-35. Epub 2015 Jul 22 doi: 10.1055/s-0035-1553351. PMID: 26200569
Chin JY, Yi JE, Youn HJ
Echocardiography 2013 Oct;30(9):E269-73. Epub 2013 Jul 30 doi: 10.1111/echo.12314. PMID: 23895503
van der Boon RM, Van Mieghem NM, Theuns DA, Nuis RJ, Nauta ST, Serruys PW, Jordaens L, van Domburg RT, de Jaegere PP
Int J Cardiol 2013 Sep 30;168(2):1269-73. Epub 2013 Jan 5 doi: 10.1016/j.ijcard.2012.11.115. PMID: 23295037

Clinical prediction guides

Olson PC, Cinelli M, Kurtovic E, Barsoum E, Spagnola J, Lafferty J
Heart Lung 2020 Mar-Apr;49(2):198-201. Epub 2019 Jun 24 doi: 10.1016/j.hrtlng.2019.06.002. PMID: 31248624
Pieper CC, Weis V, Fimmers R, Rajab I, Linhart M, Schild HH, Nähle CP
Rofo 2015 Nov;187(11):1029-35. Epub 2015 Jul 22 doi: 10.1055/s-0035-1553351. PMID: 26200569
Teng R, Butler K
Int J Clin Pharmacol Ther 2013 Oct;51(10):795-806. doi: 10.5414/CP201903. PMID: 24040849
Jones P, Dauger S, Denjoy I, Pinto da Costa N, Alberti C, Boulkedid R, Peters MJ
Pediatr Crit Care Med 2013 Jul;14(6):e289-97. doi: 10.1097/PCC.0b013e31828a8624. PMID: 23689705
Schmidinger H, Probst P, Schneider B, Weber H, Kaliman J
Circulation 1988 Oct;78(4):893-8. doi: 10.1161/01.cir.78.4.893. PMID: 3168198

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