or auditory neuropathy: Understanding the pathophysiology and exploring methods of treatment.
, also known as auditory neuropathy, is a condition where transmission of sound impulses including speech sounds is not in proportion or synchronous from the inner ear to the brain thus leading to interrupted sound signals leading to understanding problems in the individual.
Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony
sup] VPCs generally causes dyssynchrony
with reduced ventricular contraction, leading to adverse ventricular remodeling and is detrimental to ventricular systolic function.
The presence of reversible perfusion defect may or may not alter the indices of mechanical dyssynchrony
by phase analysis17.
It was initially named Auditory Neuropathy (AN) or Auditory Dyssynchrony
(AD)  due to its association to direct impairment of the cochlear nerve.
Prevention and management of AV blocks and bradyarrhythmia are very important, because they cause AV dyssynchrony
leading to loss of atrial contribution to ventricular filling further jeopardising already decreased cardiac output.
Electrical and mechanical components of dyssynchrony
in heart failure patients with normal QRS duration and left bundle-branch block impact of left and biventricular pacing.
Score Term Despcription +4 Combative Overtly combative or violent; immediate danger to staff +3 Very agitated Pulls on or removes tube(s) or Catheter(s) or has aggressive behavior toward staff +2 Agitated Frequent non-purposeful movement or patient-ventilator dyssynchrony
+1 Restless Anxious or apprehensive but movements not aggressive or vigorous 0 Alert and calm -1 Drowsy Not fully alert, but has sustained (more than 10 seconds) awakening, with eye contact to voice -2 Light sedation Briefly (less than 10 seconds) awakens with eye contact to voice -3 Moderate sedation Any movement (but no eye contact) to voice -4 Deep sedation No response to voice, but any movement to physical stimulation -5 Unarousable No response to voice or physical stimulation 1.
The pacemaker stimulation from right ventricular outflow tract (RVOT) provides stimulus conduction that enables the chamber activation from the septum to the rest of the myocardium which in turn gives less dyssynchrony
and shorter QRS duration [2-4].
This may be because muscle relaxation provides superior transferring conditions, with less risk of patient-ventilator dyssynchrony
and airway complications.
Cardiac resynchronization therapy (CRT) is widely used to treat chronic heart failure patients with electromechanical dyssynchrony
and a deteriorating functional status .