HF van Rijen

7 important questions on HF van Rijen

Most deaths class HF?

Class 3. Arrhythmias more in earlier stages

Circle of misery HF?

Myocyte dysfunction -> RAAS, ANS (baroreceptors) -> Cell remodeling -> Altered Ca-handling, fetal gene induction, apoptosis

Fetal gene reexpression HF?

SERCA 2 downregulation
bèta-adrenergic
Early transient K current
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Altered Ca handling HF?

SERCA downregulation -> Na-Ca-exchanger upregulation -> risk EAD

Determinants of impulse conduction?

Excitability (Na-current)
Electrical coupling (gap junction)
Fibrosis 

Gapjunction + fibrosis -> arrhythmogenicy

Trigger factors arrhythmia?

Fast impuls

T-wave vulnerable period?

Not every AP as long in heart. Heterogenicy -> unidirectional block -> Arrhythmogenicy. EAD -> T-wave is dangerous

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