brief history
Preface to the 3rd edition
Preface to the 2nd edition
Preface to the 1st edition

Chapter 1 What about our heart?

1.
Heart, the Source of Life 2
2.
Left heart and right heart 4
3.
Atria and ventricles 6
4.
Arteries of the Heart - Coronary Arteries 8
5.
Our Heart Beats on Its Own 10
6.
Sinus node 12, the tiny power plant in your heart
7.
Electricity flowing from the atrium to the ventricle 13
8.
Electrical Generation and Flow in the Heart, and the Electrocardiogram 15

Chapter 2: The Relationship Between Heart Disease and Arrhythmia

1.
Ischemic heart disease affecting the cardiovascular system 18
2.
Angina and Myocardial Infarction 19
3.
Heart valve disease 22
4.
Heart failure, a condition in which the heart muscle loses strength 23
5.
Hypertrophic cardiomyopathy, a condition in which the heart muscle thickens 24
6.
Inflammation of the pericardium, which surrounds the heart 25
7.
Several heart diseases are associated with arrhythmias 26

Chapter 3: What symptoms does arrhythmia exhibit?

1.
What is arrhythmia? 30
2.
If you differentiate arrhythmia, 31
3.
What Happens to Your Body When You Have an Arrhythmia 33
4.
Symptoms of Tachycardia, a rapid heartbeat, 34
5.
Does every pounding heartbeat indicate tachycardia? 36
6.
Symptoms of bradycardia, a slow heartbeat, 37
7.
If the symptoms are severe, does the illness also mean serious? 38
8.
There are other truly dangerous arrhythmia findings 39

Chapter 4: Arrhythmia: How to Diagnose It

1.
Electrocardiogram, 電圖, ECG, EKG 42
2.
Let's learn about the QRS, P, and T waves of the ECG waveform 43
3.
Electrocardiogram: Does it hurt? 44
4.
Electrocardiogram Record 45
5.
What Can an ECG Tell Your Doctor? 47
6.
Holter monitor worn all day long 49
7.
Rare Arrhythmias - Wearable Patch-Based ECG Monitoring 50
8.
Event Record ECG 51
9.
What is the role of exercise stress testing in arrhythmias? 53
10.
When you lose consciousness, do the sit-to-stand tilt test 54
11.
The advent of mobile electrocardiography 56
12.
Insertion loop recorder 59
13.
The End-All in Arrhythmia Diagnosis - Clinical Electrophysiology Testing 61
14.
Self-examination of arrhythmia 64

Chapter 5 Premature Ventricular Contractions

1.
What is extracorporeal shrinkage? 68
2.
70 Electrocardiograms of Premature Ventricular Contractions That Anyone Can Recognize at a Glance
3.
Premature ventricular contractions (PVT) are a much more common arrhythmia than you might think.
4.
Cause 72
5.
What are the symptoms? 73
6.
Are premature ventricular contractions dangerous? 74
7.
Premature ventricular contractions 78 that require special attention
8.
Frequent premature ventricular contractions impair cardiac function 80
9.
What is a dangerous premature ventricular contraction (R on T)? 82
10.
Diagnostic method 84
11.
Treatment for premature ventricular contractions varies depending on the situation. 85
12.
When to treat, when not to treat 87
13.
Treatment of premature ventricular contractions 89
14.
Treatment of Premature Ventricular Contractions - The Effect of Antiarrhythmic Drugs 92
15.
Why Do Antiarrhythmic Drugs Increase Mortality? 94
16.
Is it okay to take such a scary antiarrhythmic drug? 95
17.
What drugs are in Class Ic antiarrhythmic drugs? 96
18.
Treatment of Premature Ventricular Contractions - When Should I Perform Catheter Ablation? 98
19.
100% anxious due to premature ventricular contraction

Chapter 6 Ventricular Tachycardia

1.
There are two types of tachycardia: normal tachycardia and pathological tachycardia. 108
2.
What is ventricular tachycardia? 109
3.
Why does it happen? 110
4.
Various ventricular tachycardias 111
5.
Monomorphic ventricular tachycardia 112
6.
Idiopathic ventricular tachycardia 114
7.
Torsades de pointes ventricular tachycardia 116
8.
118 When Ventricular Tachycardia is Especially Dangerous
9.
Emergency treatment for tachycardia 119

Chapter 7 Atrial Premature Contractions and Atrial Tachycardia

1.
What is atrial fibrillation, when does it occur, and in whom? 122
2.
Electrocardiogram findings 123
3.
Symptom 125
4.
Are premature atrial contractions dangerous? 126
5.
Treatment 127
6.
What is atrial tachycardia? 128
7.
Symptoms and Treatment of Atrial Tachycardia 129

Chapter 8 Paroxysmal Supraventricular Tachycardia

1.
What is paroxysmal supraventricular tachycardia (PSVT)? 132
2. Emergency Treatment of PSVT 134
3. Pharmacological treatment of PSVT 137
4.
139 Arrhythmias That Can Be Cured with Electrode Catheter Ablation
5.
Case 141 Diagnosis Possible Using a Smartphone
6.
Is atrial tachycardia also paroxysmal supraventricular tachycardia? 142
7.
Sinus tachycardia and inappropriate sinus tachycardia 143

Chapter 9 WPW Syndrome

1. WPW syndrome and premature ventricular excitation syndrome? 146
2. Arrhythmias occurring in WPW syndrome 148
3.
Treatment 150

Chapter 10 Atrial Fibrillation

1.
What is atrial fibrillation? Who is prone to it? 153
2.
ECG pattern of atrial fibrillation 155
3.
Symptoms of Various Atrial Fibrillation 156
4.
Asymptomatic atrial fibrillation 157
5.
Four Patterns of Atrial Fibrillation 158
6.
New Classification of Atrial Fibrillation in 2023 160
7.
What problems does atrial fibrillation cause? 161
8.
Atrial Fibrillation and Stroke 162
(1) Stroke is particularly likely to occur in atrial fibrillation 162
(2) What is my stroke risk? 164
(3) Prevention of stroke 165
(4) Non-pharmacological stroke prevention - left atrial appendage occlusion and removal 168
(5) Drug treatment guidelines for stroke prevention 170
9.
Stroke prevention drug - NOAC 171
(1) New anticoagulants (NOACs), direct anticoagulants (DOACs) 171
(2) Comparison of NOACs and warfarin 173
(3) New anticoagulants are particularly good for Asians 174
(4) Are all NOACs the same? If you had to choose one, 177
10.
Stroke prevention drug - warfarin
The Action of Warfarin and Its Role in Stroke Prevention 178
11.
People taking anticoagulants should remember the following: 180
12.
Stroke prevention drug - aspirin
Aspirin is losing its place 182
13.
Two Strategies for Atrial Fibrillation Treatment: Rhythm Control vs. Rate Control 184
14.
Early Rhythm Control Strategies for Atrial Fibrillation 186
15.
Atrial Fibrillation Treatment - Electrode Catheter Ablation 188
16.
I'm curious.
How is catheter ablation performed for atrial fibrillation? 189
17.
When is catheter ablation performed for atrial fibrillation? 191
18.
The Effect of Catheter Ablation in Atrial Fibrillation 193
19.
What is Cryoballoon Ablation? 199
20.
The Effects of Cryoballoon Ablation 201
21.
Atrial fibrillation 203, which may return to normal on its own
22.
The Relationship Between Hyperthyroidism and Atrial Fibrillation 205
23.
Postoperative atrial fibrillation 207
24.
Living with Atrial Fibrillation - For Those First Diagnosed with Atrial Fibrillation 209
25.
Prevention of Atrial Fibrillation 211
26.
215 Foods Good for Atrial Fibrillation

Chapter 11 Atrial Fibrillation

1.
What is atrial flutter? 218
2.
What clinical implications does this have? 220
3.
Treatment 221
4.
Atrial Flap Pathogenesis and Electrode Catheter Ablation 223

Chapter 12: Bradycardia

1.
Bradycardia, a slow heartbeat arrhythmia 226
2.
Are all low heart rates pathological bradycardias? 227
3.
Symptom 228
4.
Diagnostic method 229
5.
When does bradycardia require emergency treatment? 232
6.
Emergency Care 233
7.
Patient Understanding and Treatment of Bradycardia 234

Chapter 13: Atrioventricular block

1.
What is a heart block? 238
2.
Why does room-room blocking occur? 239
3.
Third-degree atrioventricular block (complete atrioventricular block) 240
4.
Symptoms of third-degree atrioventricular block 242
5.
Treatment of Third-Degree AV Block - Permanent Pacemaker 243
6.
What about second-degree heart block? 244
7.
Treatment of second-degree atrioventricular block 246
8.
Are Types I and II of Second-Degree AV Block the Same Prognosis? 247
9.
What is first-degree heart block? 248
10.
Causes of atrioventricular block in young people 250
11.
Congenital atrioventricular block 251
12.
Right-angle blocking, usually fine, but 255
13.
The much more important left-angle block 257

Chapter 14: Dysfunction of the Heart

1.
Various Syndromes of Dysfunction 260
2.
Why Does Dysfunction Syndrome Occur? 263
3.
Clinical features 264
4.
Severe sinus bradycardia - a manifestation of sinus dysfunction 265
5.
Tachycardia-Bradycardia Syndrome 267

Chapter 15 Pacemakers

1.
What is a pacemaker? 271
2.
There are also temporary pacemakers 272
3.
Components of a permanent pacemaker 273
4.
Types of electrode induction 275
5.
When is a permanent pacemaker used in patients with hypoventilation syndrome? 277
6.
When is a permanent pacemaker used in atrioventricular block? 279
7.
Current Status of Permanent Pacemaker Implants in Korea 281
8.
Four different types of permanent pacemakers 283
9.
Let's learn about the working mechanism of a permanent pacemaker 285
10.
Choosing a pacemaker 287
11.
Are permanent pacemakers permanent? 291
12.
How is permanent pacemaker surgery performed? 293
13.
Postoperative Patient Precautions 295
14.
Complications and Treatment of Permanent Pacemaker Implantation 299
15.
New permanent pacemaker - leadless pacemaker 301
16.
Future Pacemaker 303

Chapter 16 Fainting

1.
What is syncope? 306
2.
Is fainting dangerous? 307
3.
Syncope due to orthostatic hypotension 308
4.
Syncope due to arrhythmia - bradycardia 310
5.
Syncope due to arrhythmia - tachyarrhythmia 312
6.
Syncope due to structural heart disease other than arrhythmia 314
7.
Vasovagal Syncope 315
8.
Characteristic symptoms of vasovagal syncope 317
9.
Diagnosis of Vasovagal Syncope - Types of Positive Tilt-Up Test Reactions 319
10.
Treatment of Vasovagal Syncope 320

Chapter 17 Ventricular Fibrillation

1.
Ventricular fibrillation is a heart attack 324
2.
Idiopathic ventricular fibrillation 326
3.
Brugada syndrome 327
4.
Long QT syndrome 330

Chapter 18: Sudden Cardiac Arrest and CPR

1.
Sudden cardiac arrest 333
2.
Status of acute cardiac arrest in Korea 334
3.
Heart Attack and Cardiac Arrest 335
4.
Sudden cardiac death in a normal heart 337
5.
What happens to our bodies when cardiac arrest occurs? 338
6.
The Meaning of CPR 339
7.
What exactly is CPR? 340
8.
Basic CPR Course 342
9.
Hands-Only CPR - Forget Resuscitation 344
10.
What is an Automated External Defibrillator (AED)? 347
11. How to Use an AED 349
12.
How do chest compressions and the AED's role in CPR differ? 351
13.
Who Should Perform CPR in a Time-Constrained Circulation? 353
14.
If you take action within 4 minutes of cardiac arrest, your chances of survival are 354.
15.
What is Target Temperature Management? 357
16.
358 To prevent sudden cardiac arrest in adolescents
17.
360 Ridiculous "Self-Heart Attack Treatments"
18.
CPR and Rib Fractures 362
19.
Good Samaritan Law 363: Exemption from Liability for Injuries During CPR

Chapter 19 Implantable Cardioverter Defibrillators and Cardiac Resynchronization Therapy

1.
What is an implantable cardioverter defibrillator (ICD)? 366
2. Do ICDs prevent sudden cardiac arrest? 368
3. Secondary prevention of acute cardiac arrest with ICD 369
4. Primary Prevention of Acute Cardiac Arrest with ICD 371
5.
Korea's implantable cardioverter defibrillator certification standards 373
6.
A New Defibrillator - What is a Subcutaneous Implantable Cardioverter Defibrillator (S-ICD)? 376
7.
What is Cardiac Resynchronization Therapy (CRT)? 379
8. Does CRT reduce mortality in patients with heart failure? 380
9. What does CRT do? 381
10. For whom is CRT more effective? 383
11. What is CRT-D? 386

Chapter 20: Arrhythmias are common in women and the elderly.

1.
Arrhythmia 388 common in women
2.
Pregnancy and Arrhythmia 390
3.
Treatment of Arrhythmia During Pregnancy 393
4.
Pediatric Arrhythmias 394
5.
Cardiovascular disease in the elderly 395

Chapter 21: Daily Life and Arrhythmia

1. Foods that are good for arrhythmia? 402
2. 'Holiday Heart': Alcohol and Atrial Fibrillation 404
3. Smoking and Arrhythmia 406
4. Coffee and Arrhythmia 407
5. Coffee and the Risk of Cardiovascular Disease 410
6. Can patients with arrhythmia drink coffee or alcohol? 412
7. Stress 414
8. Anger increases the risk of heart attack by five times. 417
9. The Effects of Meditation 418
10. Strengthen your heart by exercising like this 419
11. How often and at what intensity should I jog? 420
12. Benefits of Regular Exercise 422
13. How does sexual activity affect the cardiovascular system? 424
14. Sexuality, Ventricular Arrhythmia, and Sudden Death 425
15. Recommendations Regarding Sexuality for Patients with Arrhythmias, Including Permanent Pacemakers and ICDs 426
16. Heart Medications and Sexual Dysfunction 428

Preface to the 3rd edition

Arrhythmia is a discipline that developed relatively late in cardiology, so its development is very fast.
If you neglect it even for a moment, even experts will have a hard time keeping up.
In particular, atrial fibrillation, which is showing an explosive increase worldwide, is showing new contents as new medical knowledge is accumulated and treatment guidelines in the United States and Europe are competing to present new contents.
Moreover, as advances in science and technology have a significant impact on all fields of medicine, the paradigm of traditional medicine is showing signs of change.
Remote patient monitoring will bring about a major change in cardiology.
Electrocardiogram, the basis for diagnosing arrhythmia, has already moved beyond hospitals and is evolving into a new form.
Various forms of mobile electrocardiograms, such as wearable patch electrocardiograms, event recording electrocardiograms, watch electrocardiograms, and ring-type electrocardiogram monitors, are being developed, facilitating the early diagnosis of arrhythmia beyond space.
CPR guidelines are also updated every five years.
The need to quickly introduce and reflect these academic and practical changes led to the hasty publication of the third edition.

"Dr. Noh's Easy-to-Understand Arrhythmia" is a book prepared for two different groups of readers.
First of all, they are medical professionals who do not treat arrhythmia as their main area of ​​treatment.
This includes not only doctors, but also nurses, medical technicians, students, and those working in related medical industries.
Even if you have excellent knowledge and experience in your field, it is difficult to fully understand new arrhythmias every day.
"Dr. Noh's Easy-to-Understand Arrhythmia" aims to provide these people with the latest knowledge along with Dr. Noh's clinical experience.
The following are non-medical professionals with a keen interest in arrhythmias.
These are people who have been diagnosed with a specific arrhythmia, or whose family members or acquaintances want to know more about the arrhythmia and get help in deciding on a treatment plan or preventing it.
Even for doctors, arrhythmia is a truly insurmountable mountain for non-medical professionals.
『Dr. Noh's Easy-to-Understand Arrhythmia』 strives to convey the content in an easy-to-understand manner so that even those without extensive medical knowledge can understand it.
In addition, I am confident that it will be of great help as I am continuously updating and sharing new content that was not included in the book through my YouTube channel and Naver blog.

April 2024
Professor Emeritus, Catholic University of Korea College of Medicine
Noh Tae-ho Paulo Internal Medicine, Heart & Arrhythmia Clinic
Noh Tae-ho