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Parasystole

MedGen UID:
60067
•Concept ID:
C0206068
•
Pathologic Function
Synonym: Parasystoles
SNOMED CT: Parasystole (10164001); Parasystolic beat (10164001)

Definition

A cardiac arrhythmia that is caused by interaction of two independently initiated cardiac impulses of different rates from two separate foci. Generally one focus is the SINOATRIAL NODE, the normal pacemaker. The ectopic focus is usually in the HEART VENTRICLE but can be in the HEART ATRIUM or the ATRIOVENTRICULAR NODE. Modulation of the parasystolic rhythm by the sinus rhythm depends on the completeness of entrance block surrounding the parasystolic focus. [from MeSH]

Professional guidelines

PubMed

The diagnostic criteria for classic parasystole.
Ren Z, Zhou J, Xu G, Xian T, Xie L, Zhuang Y
Chin Med J (Engl) 1999 Nov;112(11):992-4. PMID: 11721482
Long-term ventricular pacing in treatment of sinoatrial block.
Bayley TJ
Br Med J 1971 Aug;3(5772):456-8. doi: 10.1136/bmj.3.5772.456. PMID: 5567769Free PMC Article

Recent clinical studies

Etiology

Ventricular Parasystole in Cardiomyopathy Patients: A Link Between His-Purkinje System Damage and Ventricular Fibrillation.
Do DH, O'Meara K, Lee J, Meyer S, Hanna P, Mori S, Fishbein MC, Boyle NG, Elizari MV, Bradfield JS, Shivkumar K
JACC Clin Electrophysiol 2023 Jul;9(7 Pt 1):936-948. Epub 2023 Feb 22 doi: 10.1016/j.jacep.2022.11.014. PMID: 37438043
Ventricular arrhythmias in children with attention deficit disorder--a symptom of autonomic imbalance?
Buchhorn R, Christian W
Cardiol Young 2014 Feb;24(1):120-5. Epub 2013 Feb 12 doi: 10.1017/S104795111200234X. PMID: 23402394
Thalidomide causes sinus bradycardia in ALS.
Meyer T, Maier A, Borisow N, Dullinger JS, Splettstösser G, Ohlraun S, Münch C, Linke P
J Neurol 2008 Apr;255(4):587-91. Epub 2008 Apr 21 doi: 10.1007/s00415-008-0756-3. PMID: 18425621
Ventricular ectopic activity and its relevance to aircrew licensing.
Campbell RW
Eur Heart J 1984 Mar;5 Suppl A:95-8. doi: 10.1093/eurheartj/5.suppl_a.95. PMID: 6373292
Electronic pacemaker models of parasystole. With special reference to artificial intermittent parasystole with phase 3 and phase 4 protection and to parasystolic modulation.
Castellanos A, Castillo CA, Medina-Ravell V, Moleiro F, Berkovits BV, Myerburg RJ
Pacing Clin Electrophysiol 1982 Jul;5(4):537-45. doi: 10.1111/j.1540-8159.1982.tb02275.x. PMID: 6180396

Diagnosis

New Heart…New Rhythm.
Yadlapati A, Kim SS, Knight BP
Pacing Clin Electrophysiol 2017 Jan;40(1):67-68. Epub 2016 Dec 22 doi: 10.1111/pace.12980. PMID: 27868219
Atrial parasystole.
Johnson CD
Bol Asoc Med P R 1996 Jul-Sep;88(7-9):73-81. PMID: 8962529
Sinus parasystole.
Satullo G, Oreto G, Luzza F, Consolo A, Donato A
Am Heart J 1991 May;121(5):1507-12. doi: 10.1016/0002-8703(91)90159-f. PMID: 1708199
Parasystole and its variants.
Pick A, Langendorf R
Med Clin North Am 1976 Jan;60(1):125-47. doi: 10.1016/s0025-7125(16)31923-x. PMID: 1246166
Measuring ventricular extrasystoles.
Talbot S
J Electrocardiol 1975;8(4):325-31. doi: 10.1016/s0022-0736(75)80005-7. PMID: 51895

Therapy

Pseudo-Atrial Parasystoles After Open Heart Surgery and Catheter Ablation.
Nakamura K, Sasaki T, Minami K, Sasaki W, Kimura K, Take Y, Naito S
JACC Clin Electrophysiol 2021 Mar;7(3):431-432. doi: 10.1016/j.jacep.2020.12.022. PMID: 33736762
New Heart…New Rhythm.
Yadlapati A, Kim SS, Knight BP
Pacing Clin Electrophysiol 2017 Jan;40(1):67-68. Epub 2016 Dec 22 doi: 10.1111/pace.12980. PMID: 27868219
Ventricular arrhythmias in children with attention deficit disorder--a symptom of autonomic imbalance?
Buchhorn R, Christian W
Cardiol Young 2014 Feb;24(1):120-5. Epub 2013 Feb 12 doi: 10.1017/S104795111200234X. PMID: 23402394
Thalidomide causes sinus bradycardia in ALS.
Meyer T, Maier A, Borisow N, Dullinger JS, Splettstösser G, Ohlraun S, Münch C, Linke P
J Neurol 2008 Apr;255(4):587-91. Epub 2008 Apr 21 doi: 10.1007/s00415-008-0756-3. PMID: 18425621
Parasystole.
Chung EK
Prog Cardiovasc Dis 1968 Jul;11(1):64-81. doi: 10.1016/s0033-0620(68)80012-x. PMID: 4172854

Prognosis

Ventricular Parasystole in Cardiomyopathy Patients: A Link Between His-Purkinje System Damage and Ventricular Fibrillation.
Do DH, O'Meara K, Lee J, Meyer S, Hanna P, Mori S, Fishbein MC, Boyle NG, Elizari MV, Bradfield JS, Shivkumar K
JACC Clin Electrophysiol 2023 Jul;9(7 Pt 1):936-948. Epub 2023 Feb 22 doi: 10.1016/j.jacep.2022.11.014. PMID: 37438043
Premature ventricular contractions originating from the left ventricular septum: results of radiofrequency catheter ablation in twenty patients.
Jia L, Yue-Chun L, Kang-Ting J, Na-Dan Z, Jia-Xuan L, Wen-Wu Z, Peng-Lin Y, Ji-Fei T, Jia-Feng L
BMC Cardiovasc Disord 2011 Jun 2;11:27. doi: 10.1186/1471-2261-11-27. PMID: 21635765Free PMC Article
Dynamics of pure parasystole.
Glass L, Goldberger AL, Bélair J
Am J Physiol 1986 Oct;251(4 Pt 2):H841-7. doi: 10.1152/ajpheart.1986.251.4.H841. PMID: 3766761
Ventricular ectopic activity and its relevance to aircrew licensing.
Campbell RW
Eur Heart J 1984 Mar;5 Suppl A:95-8. doi: 10.1093/eurheartj/5.suppl_a.95. PMID: 6373292
Parasystole.
Chung EK
Prog Cardiovasc Dis 1968 Jul;11(1):64-81. doi: 10.1016/s0033-0620(68)80012-x. PMID: 4172854

Clinical prediction guides

Timed RR-interval Scatter Plots and Reverse Technology.
Xiang JT
Curr Med Sci 2020 Dec;40(6):1191-1202. Epub 2021 Jan 11 doi: 10.1007/s11596-020-2308-8. PMID: 33428149
Dynamics of pure parasystole.
Glass L, Goldberger AL, Bélair J
Am J Physiol 1986 Oct;251(4 Pt 2):H841-7. doi: 10.1152/ajpheart.1986.251.4.H841. PMID: 3766761
Ventricular ectopic activity and its relevance to aircrew licensing.
Campbell RW
Eur Heart J 1984 Mar;5 Suppl A:95-8. doi: 10.1093/eurheartj/5.suppl_a.95. PMID: 6373292
Coexistence of ventricular parasystole and ventricular couplets: mechanism and clinical significance.
Kuo CS, Surawicz B
Am J Cardiol 1979 Sep;44(3):435-41. doi: 10.1016/0002-9149(79)90393-x. PMID: 474422
Mechanisms of ventricular parasystole.
Kinoshita S
Circulation 1978 Oct;58(4):715-22. doi: 10.1161/01.cir.58.4.715. PMID: 80290

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