Heart & Cardiology/Couple heart questions?


Hi Dr Richardson,

Once when i went to ER for palpitations, i remember the MD saying in effect "We don't see V-fib in people w/structurally normal hearts"...

1. Would it be rare to have cardiac event if one has a NORMAL echo and/or cardiac MRI?.

2. Is it safe to stay in junctional rhythms if heart is structurally normal for extended periods?...My understanding of junctional rhythm is that a different area is controlling the heartbeats instead of the SA node (if i have it correctly)?...


1. It's extremely rare to have a ventricular arrhythmia if one has a normal echo or MRI, though neither test will keep you from having atrial fib or a heart attack.

2. Junctional rhythm is safe forever.  You're correct, the junction is the area between atria and ventricles, well below the SA node, which is in the upper right atrium.

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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