MedWorm: Arrhythmia

Three day course on Cardiac Pacing, ICD and Cardiac Resynchronisation

European Society of Cardiology — Tue, 07 Feb 2012 14:26:54 +0100

There are still seats available for those who would like to attend this three day EHRA course in Vienna, Austria from 8-10 March. Participants should have some experience with device follow-up to attend this course. The information provided will serve as a structured basis for the preparation of the EHRA certification examination. Topics: Arrhythmias (Source: European Society of Cardiology)

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CardioComm enters mobile cardiac telemetry market

mobihealthnews — Tue, 07 Feb 2012 11:01:07 +0100

CardioComm Solutions and TZ Medical inked a device integration and distribution deal that brings the pair into the the mobile cardiac telemetry (MCT) electrocardiographic (ECG) and arrhythmia management market. CardioComm will integrate TZM’s Aera CT MCT monitor into its GEMS software to create a new offering called GEMS Aera CT. It will be an extension [...] (Source: mobihealthnews)

Double Potentials of Coronary Sinus During the Mitral Isthmus Ablation

Journal of Cardiovascular Electrophysiology — Tue, 07 Feb 2012 05:00:00 +0100

(Source: Journal of Cardiovascular Electrophysiology)

Healthy People Co. Dietary Supplements: Recall - Undeclared Drug Ingredient

FDA MedWatch — Mon, 06 Feb 2012 15:00:00 +0100

Recalled products pose significant risk to patients with a history of coronary artery disease, congestive heart failure, arrhythmias, or stroke. (Source: FDA MedWatch)

Arrhythmias

About.com Eating Disorders — Mon, 06 Feb 2012 05:00:00 +0100

Encyclopedia Home Diseases A-Z Images Heart, section t... Heart, front vie... Atrioventricular... Normal (Source: About.com Eating Disorders)

Tizanidine (Zanaflex): A Muscle Relaxant That May Prolong the QT Interval by Blocking IKr

Journal of Cardiovascular Pharmacology and Therapeutics — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion: Tizanidine prolongs the QT interval by blocking IKr. Patients could be at risk of cardiac proarrhythmia during impaired drug elimination, such as in case of CYP1A2 inhibition during drug interactions. (Source: Journal of Cardiovascular Pharmacology and Therapeutics)

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Long-Term Efficacy of Deferasirox in Preventing Cardiovascular Complications in the Iron-Overloaded Gerbil

Journal of Cardiovascular Pharmacology and Therapeutics — Mon, 06 Feb 2012 05:00:00 +0100

Iron-induced cardiovascular disease is the leading cause of death in iron-overloaded patients. Deferasirox is a novel tridentate oral chelator that exhibits a half-life suitable for once-daily dosing; however, little is known regarding the effectiveness of this agent in preventing iron-induced cardiovascular disease. Adult male Mongolian gerbils were randomly divided into 3 groups: control, iron overload, and iron overload followed by deferasirox treatment. Iron-overloaded animals received iron dextran 100 mg/kg intraperitoneally (ip)/5 days for 10 weeks, while deferasirox was given 100 mg/kg per d orally (po) for 9 months post iron loading. Cardiac and aortic iron levels were determined by inductively coupled plasma atomic emission spectrometry. Gerbil electro- and echocardiograms were ob...

Evaluation of a direct access cardiac arrhythmia monitoring service.

Cardiology Journal — Mon, 06 Feb 2012 00:36:02 +0100

Conclusions: Direct access for cardiac arrhythmia monitoring seems to provide an effective mechanism for diverting inappropriate or non-essential referrals away from the cardiology clinic. (Cardiol J 2012; 19, 1: 70-75). PMID: 22298170 [PubMed - in process] (Source: Cardiology Journal)

Amiodarone/grapefruit interaction: Bradycardia and ventricular arrhythmia in an elderly patient: case report

Reactions — Sun, 05 Feb 2012 18:29:54 +0100

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Single-heartbeat electromechanical wave imaging with optimal strain estimation using temporally unequispaced acquisition sequences.

Physics in Medicine and Biology — Sat, 04 Feb 2012 04:37:06 +0100

Authors: Provost J, Thiébaut S, Luo J, Konofagou EE Abstract Electromechanical Wave Imaging (EWI) is a non-invasive, ultrasound-based imaging method capable of mapping the electromechanical wave (EW) in vivo, i.e. the transient deformations occurring in response to the electrical activation of the heart. Optimal imaging frame rates, in terms of the elastographic signal-to-noise ratio, to capture the EW cannot be achieved due to the limitations of conventional imaging sequences, in which the frame rate is low and tied to the imaging parameters. To achieve higher frame rates, EWI is typically performed by combining sectors acquired during separate heartbeats, which are then combined into a single view. However, the frame rates achieved remain potentially sub-optimal and this approac...

The Molecular Autopsy: Should the Evaluation Continue After the Funeral?

Pediatric Cardiology — Fri, 03 Feb 2012 17:51:30 +0100

Abstract Sudden cardiac death (SCD) is one of the most common causes of death in developed countries, with most SCDs involving the elderly, and structural heart disease evident at autopsy. Each year, however, thousands of sudden deaths involving individuals younger than 35 years of age remain unexplained after a comprehensive medicolegal investigation that includes an autopsy. In fact, several epidemiologic studies have estimated that at least 3% and up to 53% of sudden deaths involving previously healthy children, adolescents, and young adults show no morphologic abnormalities identifiable at autopsy. Cardiac channelopathies associated with structurally normal hearts such as long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and Br...

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Endobronchial Lipomatous Hamartoma: An Incidental Finding in a Patient with Atrial Fibrillation—A Case Report

Advances in Pharmacological Sciences — Thu, 02 Feb 2012 18:35:24 +0100

Conclusion. Endobronchial tumors such as endobronchial lipoma or hamartoma should be considered as potential causes of exertional dyspnea and thus as differential diagnosis of atrial fibrillation. Although endobronchial hamartomas are benign, resection is recommended to prevent postobstructive lung damage. (Source: Advances in Pharmacological Sciences)

Propofol-induced coved-type electrocardiogram during catheter ablation of paroxysmal atrial fibrillation

Herzschrittmachertherapie und Elektrophysiologie — Thu, 02 Feb 2012 18:14:28 +0100

We report a case of a young man with paroxysmal atrial fibrillation, in whom a characteristic coved-type Brugada pattern developed during catheter ablation performed under sedation with propofol. After immediate discontinuation of the propofol infusion, coved-type ST-segment elevation gradually resolved and no ventricular arrhythmias occurred. An ajmaline challenge failed to unmask a coved-type electrocardiogram and genetic testing was negative for ion channel mutations related to Brugada syndrome. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s00399-011-0156-8Authors S. Richter, Department of Electrophysiology, Heart Center, University of Leipzig, Strümpellstr. 39, 04289 Leipzig, GermanyP. Brugada, The Heart Rhythm Management Centre, Cardiovascular Centre...

“From Bench to Practice”, ESC Congress set for Munich this summer

European Society of Cardiology — Thu, 02 Feb 2012 16:43:01 +0100

In response to feedback from delegates, this year’s congress will kick off on Saturday with a fuller day of scientific sessions. The grand finale on Wednesday will be a two-hour highlight session in which world leading experts summarise all the new and exciting developments in basic, clinical and population sciences presented at the congress. Read more about this year's event.... Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Basic Science, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of th...

Mediastinal goiter presenting with ventricular tachycardia

Head and Neck — Thu, 02 Feb 2012 05:00:00 +0100

ConclusionTo our knowledge, this case represents the first documented presentation of ventricular tachycardia as a unique and sole feature of mediastinal goiter. © 2012 Wiley Periodicals, Inc. Head Neck, 2012 (Source: Head and Neck)

Omega-3 fatty acids tied to lower heart arrhythmia risk

Reuters: Health — Thu, 02 Feb 2012 02:14:44 +0100

(Reuters) - Older adults who had the highest blood levels of omega-3 fatty acids, most commonly found in fish, were 30 percent less likely to later develop an irregular heartbeat than peers with the lowest blood levels of omega-3s, according to a U.S. study. (Source: Reuters: Health)

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Omega-3s tied to lower risk of heart arrhythmia

Reuters: Health — Wed, 01 Feb 2012 18:17:41 +0100

NEW YORK (Reuters Health) - In a new study of some 3,000 older adults, those with the highest levels of omega-3 fatty acids in their blood were 30 percent less likely to develop an irregular heartbeat over the next 14 years than peers with the lowest blood levels of omega-3s. (Source: Reuters: Health)

Attention-Deficit/Hyperactivity Disorder, Stimulant Therapy, and the Patient with Congenital Heart Disease: Evidence and Reason

Pediatric Cardiology — Wed, 01 Feb 2012 17:13:49 +0100

Abstract Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood, and congenital heart disease (CHD) is the most common form of birth defect. Children with CHD are at increased risk for neurodevelopmental disorders such as ADHD. Stimulant medications, specifically methylphenidates and amphetamines, are frequently prescribed and effective in reducing the symptoms of ADHD. Despite their efficacy and long history of use, the safety of these medications has recently come into question due to isolated reports describing sudden unexplained death of children undergoing treatment. This review summarizes the current literature on the cardiovascular risks associated with the use of pharmacologic therapy for ADHD, with an emphasis on p...

ESC Webinar - Arrhythmia highlights ESC Congress 2011: Relevance for general cardiologists

European Society of Cardiology — Wed, 01 Feb 2012 11:04:18 +0100

Join our experts, Prof. Hein Heidbuchel & Dr. Maurizio Lunati, in the ESC Webinar on Arrhythmia highlights ESC Congress 2011: Relevance for general cardiologists in daily practice on 15 February from 17:00 to 18:00. Topics: Arrhythmias (Source: European Society of Cardiology)

MS Drug Prevented Fatal Heart Condition In Lab Study

Health News from Medical News Today — Wed, 01 Feb 2012 08:00:00 +0100

A drug used to treat multiple sclerosis may also be effective at preventing and reversing the leading cause of heart attack, a new study has found. Scientists found that Gilenya, a drug recently approved in the US for treating MS, was effective at reversing the symptoms of ventricular hypertrophy in mice. Ventricular hypertrophy is a fatal cardiac disorder that can result in an abnormal heart rhythm (arrhythmia) and cardiac arrest... (Source: Health News from Medical News Today)

Guidelines for the diagnosis and management of Catecholaminergic Polymorphic Ventricular Tachycardia

Heart, Lung and Circulation — Wed, 01 Feb 2012 05:00:00 +0100

Background: Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) is an inherited arrhythmia syndrome, characterised by polymorphic ventricular tachycardia induced by adrenergic stress. CPVT can be caused by mutations the cardiac ryanodine receptor gene (RYR2) or mutations in the cardiac calsequestrin gene CASQ2. Structural heart disease is usually absent and the baseline ECG is usually normal. Patients with CPVT often present with exercise- or emotion induced syncope, the first presentation can also be sudden cardiac death.Management: Besides removal of triggers treatment with beta blockers is currently a class I indication in clinically diagnosed patients. Beta blockage should be titrated up to an effective level. The addition of flecainide seems to be a promising approach in pati...

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CD36 overexpression predisposes to arrhythmias but reduces infarct size in spontaneously hypertensive rats: gene expression profile analysis

Physiological Genomics — Wed, 01 Feb 2012 05:00:00 +0100

CD36 fatty acid translocase plays a key role in supplying heart with its major energy substrate, long-chain fatty acids (FA). Previously, we found that the spontaneously hypertensive rat (SHR) harbors a deletion variant of Cd36 gene that results in reduced transport of long-chain FA into cardiomyocytes and predisposes the SHR to cardiac hypertrophy. In the current study, we analyzed the effects of mutant Cd36 on susceptibility to ischemic ventricular arrhythmias and myocardial infarction in adult SHR-Cd36 transgenic rats with wild-type Cd36 compared with age-matched SHR controls. Using an open-chest model of coronary artery occlusion, we found that SHR-Cd36 transgenic rats showed profound arrhythmogenesis resulting in significantly increased duration of tachyarrhythmias (207 ± 48 s ...

Prinzmetal angina in the differential diagnosis of syncope.

Acute Cardiac Care — Wed, 01 Feb 2012 05:00:00 +0100

We present 2 patients with syncope where vasospastic angina and severe ventricular arrhythmias were found to be responsible for the syncopal episodes. PMID: 22296564 [PubMed - as supplied by publisher] (Source: Acute Cardiac Care)

Histological and ultrastructural abnormalities in murine desmoglein 2-mutant hearts

Cell and Tissue Research — Tue, 31 Jan 2012 16:45:33 +0100

Abstract Mice carrying a deletion of the adhesive extracellular domain of the desmosomal cadherin desmoglein 2 develop an arrhythmogenic right ventricular cardiomyopathy-like phenotype with ventricular dilation, fibrosis and arrhythmia. To unravel the sequence of myocardial alterations and to identify potential pathomechanisms, histological analyses were performed on mutant hearts from the juvenile to the adult state, i.e., between 2 and 13 weeks. At an age of 2 weeks 30% of mutants presented lesions, which were visible as white plaques on the heart surface or in the septum. From 4 weeks onwards, all mutants displayed a cardiac phenotype. Dying cardiomyocytes with calcification were found in lesions of all ages. But lesions of young mutant animals contained ...

Implantable Cardioverter-Defibrillators and the Young Athlete: Can the Two Coexist?

Pediatric Cardiology — Tue, 31 Jan 2012 07:04:41 +0100

Abstract Since the incorporation of implantable cardioverter-defibrillators (ICDs) into the management of life-threatening arrhythmias in the 1980s, tremendous advances in device and lead technology have allowed the implantation of ICD systems in younger and smaller patients. The majority of these young patients with “electrical” cardiac disease and a significant number of those with other indications for ICD placement have near normal to normal cardiac function, which has resulted in a large population of young ICD patients with minimal to no symptoms. This population has pushed the boundaries of published guidelines on activity restrictions for the disease state and the presence of an ICD, creating a dilemma for the patient, the family, and the health care team with ...

Respiratory variations in pulmonary and systemic blood flow in healthy humans

Acta Physiologica — Tue, 31 Jan 2012 05:00:00 +0100

ConclusionThe amplitude of respiratory variations in l‐CO is significantly smaller than in r‐CO. Respiratory variations in HR and in l‐SV are in inverse phase, thus RSA buffers respiratory variations in l‐SV. RSA plays an important role in reducing oscillations in systemic blood flow resulting from respiratory changes in venous return. (Source: Acta Physiologica)

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Pericardiocentesis: A clinical anatomy review

Clinical Anatomy — Tue, 31 Jan 2012 05:00:00 +0100

AbstractThe safe and successful performance of pericardiocentesis demands a working and specific knowledge of anatomy. Misunderstanding of anatomy may result in failure or serious complications. This review attempts to aid understanding of the anatomical framework, pitfalls, and complications of pericardiocentesis. Pericardiocentesis is carried out for aspiration of blood from the pericardial cavity in cases of cardiac tamponade and symptomatic pericardial effusion. In addition, this technique may be used for the diagnosis of neoplastic effusions, purulent pericarditis, and introduction of cytotoxic agents into the pericardial space. Most complications of the procedure are due to the needle penetrating the heart and surrounding structures such a coronary arteries, lungs, stomach, colon, an...

Constitutive overexpression of phosphomimetic phospholemman S68E mutant results in arrhythmias, early mortality, and heart failure: potential involvement of Na+/Ca2+ exchanger

AJP: Heart and Circulatory Physiology — Tue, 31 Jan 2012 05:00:00 +0100

Expression and activity of cardiac Na+/Ca2+ exchanger (NCX1) are altered in many disease states. We engineered mice in which the phosphomimetic phospholemman S68E mutant (inhibits NCX1 but not Na+-K+-ATPase) was constitutively overexpressed in a cardiac-specific manner (conS68E). At 4–6 wk, conS68E mice exhibited severe bradycardia, ventricular arrhythmias, increased left ventricular (LV) mass, decreased cardiac output (CO), and ~50% mortality compared with wild-type (WT) littermates. Protein levels of NCX1, calsequestrin, ryanodine receptor, and α1- and α2-subunits of Na+-K+-ATPase were similar, but sarco(endo)plasmic reticulum Ca2+-ATPase was lower, whereas L-type Ca2+ channels were higher in conS68E hearts. Resting membrane potential and action potential amplitude were...

Ca2+ signaling amplification by oligomerization of L-type Cav1.2 channels [Physiology]

Proceedings of the National Academy of Sciences — Tue, 31 Jan 2012 05:00:00 +0100

Ca2+ influx via L-type Cav1.2 channels is essential for multiple physiological processes, including gene expression, excitability, and contraction. Amplification of the Ca2+ signals produced by the opening of these channels is a hallmark of many intracellular signaling cascades, including excitation-contraction coupling in heart. Using optogenetic approaches, we discovered that Cav1.2 channels form clusters of varied sizes in ventricular myocytes. Physical interaction between these channels via their C-tails renders them capable of coordinating their gating, thereby amplifying Ca2+ influx and excitation-contraction coupling. Light-induced fusion of WT Cav1.2 channels with Cav1.2 channels carrying a gain-of-function mutation that causes arrhythmias and autism in humans with Timothy syndrome...

Left Atrial Myxoma Complicated with an Acute Upper Extremity Embolism.

Annals of Thoracic and Cardiovascular Surgery — Tue, 31 Jan 2012 05:00:00 +0100

Authors: Chiba K, Abe H, Kitanaka Y, Makuuchi H Abstract Atrial myxoma is the most common benign tumor of the heart. Patients who have atrial myxoma usually present with cardiac obstruction, arrhythmia, or peripheral embolization. We encountered an unusual case of acute upper extremity ischemia due to a massive atrial myxoma in a young man. A 38-year-old man was admitted to our hospital with an acute onset of severe, right upper extremity pain and paralysis while working. Neurologic examination yielded normal results, but the patient showed no palpable right radial or ulnar artery. Routine sonographic evaluation revealed acute aortic embolism in his right brachial artery. Because of his young age and otherwise healthy condition, we decided to perform transthoracic echocardiography,...

Evaluating the physiological significance of respiratory sinus arrhythmia: looking beyond ventilation-perfusion efficiency.

The Journal of Physiology — Mon, 30 Jan 2012 05:00:00 +0100

Authors: Ben-Tal A, Shamailov SS, Paton JF Abstract We conducted a theoretical study of the physiological significance of respiratory sinus arrhythmia (RSA), a phenomenon used as an index of cardiac vagal tone and wellbeing, whereby the heart rate (HR) increases during inspiration and decreases during expiration. We first tested the hypothesis that RSA improves gas exchange efficiency but found that although gas exchange efficiency improved with slow and deep breathing and with increased mean heart rate, this was unrelated to RSA. We then formulated and tested a new hypothesis: that RSA minimizes the work done by the heart while maintaining physiological levels of arterial carbon dioxide (CO2). We tested the new hypothesis using two methods. First, the HR for which the work is mini...

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Managing Arrhythmias before and after Aortic Valve Surgery in Children

American Journal of Cardiovascular Drugs — Sun, 29 Jan 2012 14:03:56 +0100

(Source: American Journal of Cardiovascular Drugs)

Lethality and osteomuscular and cardiovascular complications in tetanus

Revista Brasileira de Terapia Intensiva — Fri, 27 Jan 2012 15:57:11 +0100

CONCLUSION: The present study demonstrates the failure of primary medical care in vaccination and post-traumatic tetanus prophylaxis. Despite improvements in intensive care support, cardiovascular complications are still frequent in these patients. Individuals exhibiting high APACHE II scores and severe clinical forms of tetanus should be monitored closely due to a risk of death and cardiovascular complications. (Source: Revista Brasileira de Terapia Intensiva)

Risk Factors for Malignant Ventricular Arrhythmias in Lamin A/C Mutation Carriers: A European Cohort Study

Journal of the American College of Cardiology — Thu, 26 Jan 2012 13:57:11 +0100

Objectives: The purpose of this study was to determine risk factors that predict malignant ventricular arrhythmias (MVA) in Lamin A/C (LMNA) mutation carriers. Background: LMNA mutations cause a variety of clinical phenotypes, including dilated cardiomyopathy and conduction disease. Many LMNA mutation carriers have a poor prognosis, because of a high frequency of MVA and progression to end-stage heart failure. However, it is unclear how to identify mutation carriers that are at risk for MVA. Methods: In this multicenter cohort of 269 LMNA mutation carriers, we evaluated risk factors for MVA, defined as sudden cardiac death, resuscitation, and appropriate implantable cardioverter-defibrillator (ICD) treatment. Results: In a median follow-up period of 43 months (interquartile range: 1...

Right intra‐atrial catheter placement for hemodialysis in patients with multiple venous failure

Hemodialysis International — Thu, 26 Jan 2012 05:00:00 +0100

AbstractThe purpose of this study is to evaluate the efficacy and safety of direct right atrial catheter insertion for hemodialysis in patients with multiple venous access failure. We retrospectively evaluated the charts of 27 patients with multiple venous access failure who had intra‐atrial dialysis catheter placement between October 2005 and October 2010 in our clinic. Permanent right atrial dialysis catheters were placed through a right anterior mini‐thoracotomy under intratracheal general anesthesia in all patients. Demographics of the cases, the patency rates of hemodialysis via atrial catheterization, existence of any catheter thrombosis, and catheter‐related infections were documented and used in statistical analysis. Seventeen women (63%) and 10 men (37%) with the mean age of...

Cardio‐Selective Beta‐Blocker: Pharmacological Evidence and Their Influence on Exercise Capacity

Cardiovascular Therapeutics — Thu, 26 Jan 2012 05:00:00 +0100

SUMMARY For the past 40 years, beta‐blockers have been widely used in cardiovascular medicine, reducing morbidity as well as mortality. Beta‐blockers are currently used in a number of cardiovascular conditions such as systolic heart failure, postmyocardial infarction, and in prevention and treatment of arrhythmias. They are not recommended as the first line antihypertensive therapy, particularly in the elderly, unless there are specific indications. Despite the benefits of beta‐blockers, tolerability concerns in patients with co‐morbidities have limited their use. Some of these problems were overcome with the discovery of cardioselective beta‐blockers. The third generation beta‐blockers have additional properties of vasodilatation and advantages in terms of minimizing the ad...

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A new collaboration between EHRA and the ESC Working Group on e-Cardiology

European Society of Cardiology — Wed, 25 Jan 2012 16:16:47 +0100

This decision comes after a recent meeting of the Working Group nucleus with the president of the EHRA, Angelo Auricchio....Read the agreement between EHRA and the Working Group on e-Cardioogy. Topics: Arrhythmias (Source: European Society of Cardiology)

Outcome of Pregnancy and Effects on the Right Heart in Women With Repaired Tetralogy of Fallot.

Circulation Journal — Wed, 25 Jan 2012 05:00:00 +0100

Conclusions: Many of the pregnancies in women with repaired TOF were successful. However, careful management is required for some patients and the BNP level may be a useful marker to identify these patients. Because the right heart tended to be enlarged in the late postpartum period, pregnancy may also affect the long-term prognosis of patients with repaired TOF. PMID: 22277318 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Feature extraction for ECG heartbeats using higher order statistics of WPD coefficients

Computer Methods and Programs in Biomedicine — Wed, 25 Jan 2012 04:50:49 +0100

Abstract: This paper describes feature extraction methods using higher order statistics (HOS) of wavelet packet decomposition (WPD) coefficients for the purpose of automatic heartbeat recognition. The method consists of three stages. First, the wavelet package coefficients (WPC) are calculated for each different type of ECG beat. Then, higher order statistics of WPC are derived. Finally, the obtained feature set is used as input to a classifier, which is based on k-NN algorithm. The MIT-BIH arrhythmia database is used to obtain the ECG records used in this study. All heartbeats in the arrhythmia database are grouped into five main heartbeat classes. The classification accuracy of the proposed system is measured by average sensitivity of 90%, average selectivity of 92% and average specifici...

QT interval variability in familial Mediterranean fever: a study in colchicine-responsive and colchicine-resistant patients

Clinical Rheumatology — Tue, 24 Jan 2012 07:54:07 +0100

In conclusion, patients with FMF who are continuously treated with colchicine and have not developed amyloidosis, regardless of their clinical response, have normal QT variability parameters, indicating normal repolarization dynamics and suggesting no increased risk of repolarization-associated cardiac arrhythmias. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s10067-011-1926-8Authors Udi Nussinovitch, Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel 31080Keren Kaminer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelMoshe Nussinovitch, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelBenjamin Volovitz, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelMerav Lidar, Sackler Faculty of Me...

Estimating the time scale and anatomical location of atrial fibrillation spontaneous termination in a biophysical model

Medical and Biological Engineering and Computing — Tue, 24 Jan 2012 07:19:28 +0100

This study contributes to the interpretation of previous clinical observations, and illustrates how computer modeling provides a complementary approach to study the mechanisms of cardiac arrhythmias. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s11517-011-0859-3Authors Laurent Uldry, Applied Signal Processing Group, Swiss Federal Institute of Technology, EPFL-STI-SCI-JMV, Bâtiment ELD, Station 11, 1015 Lausanne, SwitzerlandVincent Jacquemet, Department of Physiology, Université de Montréal, Montréal, CanadaNathalie Virag, Medtronic Europe, Tolochenaz, SwitzerlandLukas Kappenberger, University of Lausanne, Lausanne, SwitzerlandJean-Marc Vesin, Applied Signal Processing Group, Swiss Federal Institute of Technology, EPFL-STI-SCI-JMV, Bâtiment ELD, Sta...

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Metabolic Syndrome Affects Midterm Outcome After Coronary Artery Bypass Grafting [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions The main finding of our study was the association between MetS and mortality both early and late after coronary artery bypass grafting. Thus, MetS should be recognized as an independent preoperative variable that can lead to the identification of high-risk patients and as a risk factor to correct with lifestyle modifications and pharmacologic therapy. (Source: The Annals of Thoracic Surgery)

Permanent Epicardial Pacing in Pediatric Patients: 12-Year Experience at a Single Center [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Lead longevity was sufficiently long and did not vary significantly according to type of lead. Generator longevity was not affected by lead type, generator mode, or patient age at the time of pacemaker implantation. (Source: The Annals of Thoracic Surgery)

Invited Commentary [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

(Source: The Annals of Thoracic Surgery)

Determinants of recourse to hospital treatment in the elderly

The European Journal of Public Health — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions: Elderly account for a high proportion of hospitalizations, mainly determined by critical health conditions, advanced age and functional dependence. Poor health conditions (high comorbidity and presence of chronic multi-organ diseases), functional dependence but not critical social factors were the main determinants of multiple hospital admissions. (Source: The European Journal of Public Health)

Indapamide: Hypokalaemia-induced arrhythmia in an elderly patient: case report

Reactions — Mon, 23 Jan 2012 18:35:21 +0100

(Source: Reactions)

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Supraventricular Tachycardia: What Is the Mechanism?

Journal of Cardiovascular Electrophysiology — Mon, 23 Jan 2012 05:00:00 +0100

(Source: Journal of Cardiovascular Electrophysiology)

Atrial Electrical and Structural Remodeling Associated with Longstanding Pulmonary Hypertension and Right Ventricular Hypertrophy in Humans

Journal of Cardiovascular Electrophysiology — Mon, 23 Jan 2012 05:00:00 +0100

Conclusion: Idiopathic PH is associated with RA remodeling characterized by: generalized conduction slowing with marked regional abnormalities; reduced tissue voltage; and regions of electrical silence. These changes provide important insights into the isolated effects of PH fundamental to a range of clinical conditions associated with AF. (J Cardiovasc Electrophysiol, Vol. pp. 1–7) (Source: Journal of Cardiovascular Electrophysiology)

Blood Pressure Variability as Sign of Autonomic Imbalance in Patients with Idiopathic Dilated Cardiomyopathy

Pacing and Clinical Electrophysiology : PACE — Mon, 23 Jan 2012 05:00:00 +0100

Conclusion:Diastolic BPV indexes, especially those from symbolic dynamics, appear to be useful for risk stratification of sudden death in patients with IDC. (PACE 2011;1–9) (Source: Pacing and Clinical Electrophysiology : PACE)

Drugs of abuse (amfetamines, BZP, cannabis, cocaine, GHB, LSD)

Medicine — Sat, 21 Jan 2012 13:58:54 +0100

Abstract: The features of amfetamine poisoning are related predominantly to stimulation of central and peripheral adrenergic receptors, and in severe cases, excitability, agitation, paranoid delusions, hallucinations with violent behaviour, hypertonia and hyperreflexia develop. Convulsions, rhabdomyolysis, hyperthermia, intracerebral haemorrhage and cardiac arrhythmias are less common. In addition, hyperthermia and hyponatraemia are features of severe MDMA toxicity.Benzylpiperazine (BZP) has stimulant and amfetamine-like properties. Those severely poisoned may develop seizures, collapse, hyperthermia, myoclonic jerks, extrapyramidal features and respiratory failure.Features of cannabis use include euphoria, distorted and heightened images, colours and sounds, altered tactile sensations, im...

Antidepressants

Medicine — Sat, 21 Jan 2012 13:58:54 +0100

Abstract: Antidepressant drugs differ in their relative toxicities. The most hazardous are tricyclics, citalopram, venlafaxine and the rarely used monamine oxidase inhibitors. Features include arrhythmias, convulsions and cardiovascular effects. Management should be as active as necessary to reduce arrhythmia risk by aggressive correction of acidosis and use of sodium bicarbonate to shorten QRS duration if prolonged. (Source: Medicine)

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Can A Middle-Aged Neophyte Make It to Carnegie Hall?

Scientific American - Official RSS Feed — Sat, 21 Jan 2012 12:00:00 +0100

Gary Marcus suffers from what a friend jokingly describes as congenital arrhythmia--the inability, despite many hours of his youth spent practicing and taking lessons, to learn to play a musical instrument. A few years ago Marcus, a cognitive psychologist at New York University, decided at 38 to make one last try when he took up guitar. No surprise: He did not succeed in becoming the next Jimi Hendrix, but managed to acquire a modicum of skill--and went on to describe his experience in Guitar Zero: The New Musician and the Science of Learning . [More] (Source: Scientific American - Official RSS Feed)

[Review] Cardiovascular and neurological causes of sudden death after ischaemic stroke

Lancet Neurology — Sat, 21 Jan 2012 01:16:39 +0100

SummarySudden death is an important but widely under-recognised consequence of stroke. Acute stroke can disturb central autonomic control, resulting in myocardial injury, electrocardiographic abnormalities, cardiac arrhythmias, and ultimately sudden death. Experimental and clinical evidence suggests that autonomic imbalance is more frequent after infarcts involving the insular cortex, a crucial region for the control of sympathetic and parasympathetic autonomic functions. Cardiovascular comorbidities increase the risk of cardiac morbidity and mortality after stroke. (Source: Lancet Neurology)

Mitral valve prolapse.

Annual Review of Medicine — Fri, 20 Jan 2012 09:00:47 +0100

Authors: Guy TS, Hill AC Abstract Mitral valve prolapse is defined as abnormal bulging of the mitral valve leaflets into the left atrium during ventricular systole. Mitral valve prolapse is a common condition that is a risk factor for mitral regurgitation, congestive heart failure, arrhythmia, and endocarditis. Myxomatous degeneration is the most common cause of mitral prolapse in the United States and Europe, and progression of myxomatous mitral prolapse is the most common cause of mitral regurgitation that requires surgical treatment. Myxomatous degeneration appears to have genetic etiology. The genetics of myxomatous degeneration is complex and not fully worked out; it appears to be heterogeneous with multi-gene, multi-chromosomal autosomal dominance with incomplete penetrance. ...

Post-operative atrial fibrillation: a maze of mechanisms

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Post-operative atrial fibrillation (POAF) is one of the most frequent complications of cardiac surgery and an important predictor of patient morbidity as well as of prolonged hospitalization. It significantly increases costs for hospitalization. Insights into the pathophysiological factors causing POAF have been provided by both experimental and clinical investigations and show that POAF is ‘multi-factorial’. Facilitating factors in the mechanism of the arrhythmia can be classified as acute factors caused by the surgical intervention and chronic factors related to structural heart disease and ageing of the heart. Furthermore, some proarrhythmic mechanisms specifically occur in the setting of POAF. For example, inflammation and beta-adrenergic activation have been shown to play ...

Therapeutic approach for patients with catecholaminergic polymorphic ventricular tachycardia: state of the art and future developments

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited arrhythmia syndrome characterized by bidirectional or polymorphic ventricular arrhythmias under conditions of increased sympathetic activity in young patients with structurally normal hearts. Patients with CPVT are at high risk of developing life-threatening ventricular arrhythmias when untreated. A wide variety of arrhythmic event rates on conventional therapy, with β-blockers as the cornerstone, has been reported. Here, we systematically review all available studies describing the efficacy of β-blocker therapy for prevention of arrhythmic events in CPVT. Because of heterogeneity between the studies, a random-effects meta-analysis model was used to assess the efficacy of β-blocker therapy in preven...

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Isolating the pulmonary veins as first-line therapy in patients with lone paroxysmal atrial fibrillation using the Cryoballoon

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion Cryoballoon ablation in patients with lone paroxysmal AF yields a high acute efficacy rate with a great chance of being free of symptomatic AF recurrence without antiarrhythmic drugs on a mid-term follow-up period, when offered as a first-line treatment. (Source: Europace)

Ventricular tachycardia or ventricular fibrillation occurs less often in patients with left bundle branch block and combined resynchronization and defibrillators than in patients with narrow QRS and conventional defibrillators

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions Chronic heart failure patients with LBBB treated with CRT–ICD, experience less and delayed VT/VF episodes compared with matched controls without LBBB receiving conventional ICD. In the long-term, CRT appears to exert antiarrhythmic effects and to attenuate the particularly high arrhythmia-related risk of CHF patients with LBBB. The incremental benefit of adding the ICD option to CRT pacing in LBBB patients appears questionable. (Source: Europace)

Detection of atrial high-rate events by continuous Home Monitoring: clinical significance in the heart failure-cardiac resynchronization therapy population

Europace — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion In a high-risk cohort of HF patients, device-detected atrial arrhythmias are associated with an increased incidence of TE events. A cut-off point of 3.8 h over 24 h was associated with significant increase in the event rate. Routine assessment of AHRE should be considered with other data when assessing stroke risk and considering anti-coagulation initiation and should also prompt the optimization of cardioprotective HF therapy in CRT patients. (Source: Europace)

Outpatient evaluation and management of patients with ventricular premature beats or non-sustained ventricular tachycardia

Europace — Fri, 20 Jan 2012 05:00:00 +0100

In this survey, European physicians who deal with arrhythmia patients gave their opinions about diagnostic work up when they see patients with ventricular premature beats (VPBs) or non-sustained ventricular tachycardia (NSVT). In general, similar work-up regimens were used for these two arrhythmias except for coronary angiography, which was considered by one in four physicians when dealing with NSVT but by almost none for VPBs. The majority of physicians believe that it is acceptable to abstain from pharmacological therapy in an asymptomatic patient with VPBs. When considering second-line therapy almost half of the respondents would consider amiodarone in patients with NSVT whereas almost none would when dealing with VPBs. When the effect of therapy was evaluated, its influence on symptoms...

Development, maturation, and transdifferentiation of cardiac sympathetic nerves.

Circulation Research — Fri, 20 Jan 2012 05:00:00 +0100

We reported that cardiac sympathetic rejuvenation occurs in cardiac hypertrophy and, moreover, interleukin-6 cytokines secreted from the failing myocardium induce cholinergic transdifferentiation of the cardiac sympathetic system via a gp130 signaling pathway, affecting cardiac performance and prognosis. In this review, we summarize the molecular mechanisms involved in sympathetic development, maturation, and transdifferentiation, and propose their investigation as new therapeutic targets for heart disease. PMID: 22267838 [PubMed - in process] (Source: Circulation Research)

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Researchers Identify Triggering Conditions And Direct Link To Sex Hormones In Sudden Cardiac Death

Health News from Medical News Today — Thu, 19 Jan 2012 09:00:00 +0100

Researchers in Rhode Island Hospital's Cardiovascular Research Center have published two new studies focusing on the causes of arrhythmia and sudden cardiac death (SCD) when a genetic disorder is present. The studies use a first-ever genetic animal model the researchers developed in 2008 to further their understanding of a genetic disorder known as Long QT Syndrome (LQTS)... (Source: Health News from Medical News Today)

Identification of Recurring Patterns in Fractionated Atrial Electrograms using New Transform Coefficients

BioMedical Engineering OnLine — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions: Transform coefficients computed from ensemble averages can be used to succinctly quantify synchronized patterns present in AF data. The technique can is useful to automatically detect recurrent patterns in CFAE that are embedded in interference without user bias. This quantitation can be implemented in real-time to map the AF substrate prior to and during catheter ablation. (Source: BioMedical Engineering OnLine)

Republished article: Arrhythmias in chronic kidney disease

Postgraduate Medical Journal — Wed, 18 Jan 2012 05:00:00 +0100

Chronic kidney disease (CKD) is defined as evidence of kidney damage or a glomerular filtration rate (GFR) ≤60 ml/min/1.73 m2 (table 1). The most common causes of CKD are hypertension and diabetes mellitus. The many causes of CKD are associated with different varying prognoses. Patients with adult polycystic kidney disease have a 50% lifetime risk of needing dialysis compared with 25% for type 1 diabetes and <5% for type 2 diabetes. Dialysis is usually considered when GFR falls below 10 ml/min/1.73 m2 but the exact timing will often be dictated by clinical circumstances. This may be refractory oedema, hyperkalaemia and acidosis, uraemia or unacceptable symptoms. Dialysis only partially replaces the excretory function of the kidneys and so the morbidity and mortali...

Human Embryonic and Induced Pluripotent Stem Cells-Derived Cardiomyocytes Exhibit Beat Rate Variability and Power-Law Behavior.

Circulation — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSIONS: Collectively, this is the first study demonstrating that hESC-CMs and iPSC-CMs exhibit BRV andpower law behavior as in humans, thus supporting the potential capability of these cell sources to serve as biological pacemakers.Our ability to generate sinoatrial-compatible spontaneous cardiomyocytes from the patient's own hair (via keratinocytes-derived iPSC), thus eliminating the critical need for immunosuppression, renders these myocytes an attractive cell source as biological pacemakers. PMID: 22261196 [PubMed - as supplied by publisher] (Source: Circulation)

Rhode Island Hospital studies uncover keys in sudden cardiac death

EurekAlert! - Medicine and Health — Tue, 17 Jan 2012 05:00:00 +0100

(Lifespan) Researchers from Rhode Island Hospital Cardiovascular Research Center have published two new studies focusing on the causes of arrhythmia and sudden cardiac death (SCD) when a genetic disorder, Long QT Syndrome, is present. The first study identified differential conditions and cellular mechanisms that can trigger SCD when LQTS is a factor, and the second study, for the first time, directly links sex hormones and the incidence of arrhythmia and SCD. (Source: EurekAlert! - Medicine and Health)

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Lethal arrhythmias in Tbx3-deficient mice reveal extreme dosage sensitivity of cardiac conduction system function and homeostasis [Medical Sciences]

Proceedings of the National Academy of Sciences — Tue, 17 Jan 2012 05:00:00 +0100

In conclusion, Tbx3 is required for the functional development, maturation, and homeostasis of the conduction system in a highly dosage-sensitive manner. TBX3 and its regulatory targets merit investigation as candidates for human arrhythmias. (Source: Proceedings of the National Academy of Sciences)

Arrhythmogenic consequences of myofibroblast-myocyte coupling

Cardiovascular Research — Mon, 16 Jan 2012 05:00:00 +0100

Conclusion Coupling of myocytes to myofibroblasts promotes EAD formation as a result of a mismatch in early vs. late repolarization reserve caused by the Ito-like component of the gap junction current. These cellular and ionic mechanisms may contribute to the pro-arrhythmic risk in fibrotic hearts. (Source: Cardiovascular Research)

Enhanced cardiac PI3K{alpha} signalling mitigates arrhythmogenic electrical remodelling in pathological hypertrophy and heart failure

Cardiovascular Research — Mon, 16 Jan 2012 05:00:00 +0100

Conclusion In the setting of pathological hypertrophy or heart failure, enhanced PI3Kα signalling results in the up-regulation of K+ channel subunits, normalization of K+ current densities and preserved ventricular function. Augmentation of PI3Kα signalling, therefore, may be a useful and unique strategy to protect against the increased risk of ventricular arrhythmias and sudden death associated with cardiomyopathy. (Source: Cardiovascular Research)

Pitx2 confers left morphological, molecular, and functional identity to the sinus venosus myocardium

Cardiovascular Research — Mon, 16 Jan 2012 05:00:00 +0100

Conclusion Pitx2 drives left/right patterning of the SV myocardium through multiple developmental steps. Overall, Pitx2 plays a crucial functional role by negatively modulating a nodal-type programme in the left SV myocardium. (Source: Cardiovascular Research)

Cytomegalovirus associated corneal endotheliitis after penetrating keratoplasty in a patient with Fuchs corneal endothelial dystrophy

British Journal of Ophthalmology — Mon, 16 Jan 2012 05:00:00 +0100

Corneal endotheliitis, a specific inflammation targeted primarily to the corneal endothelium, is characterised by cornea oedema, keratic precipitates (KPs) and a mild anterior chamber reaction.1–3 Several viruses, including herpes simplex virus (HSV), varicella zoster virus (VZV), mumps and cytomegatovirus (CMV), have been implicated in the aetiology of the disease.1–3 Based on its definition, allograft endothelial rejection after keratoplasty can be included in the corneal endotheliitis. Here, we report a patient with corneal endotheliitis occurring after penetrating keratoplasty for Fuchs corneal endothelial dystrophy. Case report A 65-year-old Taiwanese female without previous ocular illness but arrhythmias and mitral valve prolapse history presented with progressive corneal...

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The involvement of gap junctions in the delayed phase of the protection induced by cardiac pacing in dogs

Clinical Science — Mon, 16 Jan 2012 05:00:00 +0100

This study has examined the role of gap junctions in the delayed anti-arrhythmic effect of cardiac pacing, with particular reference to the time-course changes in connexin43 (Cx43) expression both after pacing (4x5 min, at a rate of 240 beats min-1) and 24h later, when the dogs were subjected to a 25 min occlusion and reperfusion of the left anterior descending coronary artery. Compared to the sham-paced controls (n=20), in dogs paced 24h previously (n=16) there were reductions in arrhythmia severity (e.g. number of ventricular premature beats during occlusion 294±78 vs. 63±25; survival from the combined ischaemia/reperfusion insult 20% vs. 78%), and in other ischaemic changes (epicardial ST-segment, total activation time, tissue impedance). Pacing also prevented the ischaemi...

Energy drinks: health risks and toxicity.

Med J Aust — Mon, 16 Jan 2012 05:00:00 +0100

CONCLUSIONS: Reports of caffeine toxicity from energy drink consumption are increasing, particularly among adolescents, warranting review and regulation of the labelling and sale of these drinks. Educating adolescents and increasing the community's awareness of the hazards from energy drinks is of paramount importance. PMID: 22256934 [PubMed - in process] (Source: Med J Aust)

Modeling Anesthetic Times. Predictors and Implications for Short Term Outcomes

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:42 +0100

Introduction: Little is known about predictors of anesthetic times, and the impact of anesthetic and operative times on patient outcomes. Methods: We documented operative case length (OCL) - defined as the time from incision to time of dressing placement -, and anesthetic time length (ATL) - defined as the sum of anesthetic induction time length (time from the patient's entrance in the operating room to the time of skin incision) and anesthetic recovery time length (time from dressing placement to time of patient's exit from the operating room), in 1771consecutive patients who underwent elective vascular surgical interventions. We recorded patient and procedure-related characteristics that might influence the anesthetic time length, including a variable for possible July-effect. Forward st...

BCG/bisoprolol/rifampicin: BCG-induced tuberculosis, and bisoprolol/rifampicin interaction leading to hypertension and arrhythmia, in an elderly patient: case report

Reactions — Fri, 13 Jan 2012 23:22:43 +0100

(Source: Reactions)

Cardiac Transplantation in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

Journal of the American College of Cardiology — Fri, 13 Jan 2012 13:52:06 +0100

Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is an inherited cardiomyopathy characterized by fibrofatty replacement of the ventricular myocardium, right ventricular (RV) dysfunction, and ventricular arrhythmias. The Johns Hopkins ARVD Program Registry, which was established in 1995 to provide clinical care for patients with ARVD/C and to study this disease, currently consists of over 1,000 patients, family members, and borderline phenotypes. From this registry, we sought to define the clinical characteristics, pre-transplant course, and indications for and outcomes of those who underwent cardiac transplantation. (Source: Journal of the American College of Cardiology)

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Stroke Risk Increased By Atrial Arrhythmias

Health News from Medical News Today — Fri, 13 Jan 2012 08:00:00 +0100

An irregular heartbeat that you don't even feel but can be picked up by a pacemaker is associated with a significantly increased risk of stroke, says a new McMaster University study. The report, published in the New England Journal of Medicine, says that of nearly 2,600 patients without a history of atrial fibrillation but with a recently implanted pacemaker, more than one-third had episodes when the heartbeat would become rapid and irregular for more than six minutes... (Source: Health News from Medical News Today)

Predictors of the development of myocarditis or acute renal failure in patients with leptospirosis: An observational study

BMC Infectious Diseases — Fri, 13 Jan 2012 05:00:00 +0100

Conclusions: This study shows that out of clinical and laboratory variables, only oliguria, jaundice and arrhythmia are strong predictors of development of acute renal failure or myocarditis in patients with leptospirosis presented to Teaching Hospital of Kandy, Sri Lanka. (Source: BMC Infectious Diseases)

Silent heart irregularity also raises risk of stroke

Health Facts and Fears — Fri, 13 Jan 2012 05:00:00 +0100

Affecting over 2 million people in the U.S., atrial fibrillation (AF) is the most common cardiac arrhythmia (irregular heart beat) and can be associated with palpitations, chest pains, fainting, and congestive heart failure. (Source: Health Facts and Fears)

A new drug for heat stroke? Implications for malignant hyperthermia

ScienceDaily Headlines — Thu, 12 Jan 2012 21:24:24 +0100

Malignant hyperthermia (MH) is a life-threatening genetic muscle disorder, most commonly triggered in those at risk by certain types of drugs used during anesthesia. Heat stroke, on the other hand, most commonly occurs in individuals in response to physical exertion in hot/humid environments. While their common triggers may differ, the signs associated with MH and heat stroke are remarkably similar – uncontrolled muscle contractions, dangerous increases in body temperature, and muscle breakdown leading to the release of toxins in the blood which may cause cardiac arrhythmias and death. A new medication may be effective in preventing certain forms of heat stroke. (Source: ScienceDaily Headlines)

Webinar on Mechanisms of Arrhythmia and its Clinical Implications

European Society of Cardiology — Thu, 12 Jan 2012 10:16:13 +0100

Organised by the European Heart Rhythm Association (EHRA), this webinar includes a presentation and selected practical clinical cases. During the live session, you will be invited to participate in a live assessment using an online voting system. The results (anonymous) will be commented by M. Antz in interaction with L. Mont who will share their experience with you. Register until 18 January to join them on 20 January! Topics: Arrhythmias (Source: European Society of Cardiology)

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[Low-dose droperidol in children : Rescue therapy for persistent postoperative nausea and vomiting.]

Der Anaesthesist — Thu, 12 Jan 2012 05:00:00 +0100

CONCLUSIONS: Low-dose droperidol (10 µg/kgBW) was found to be effective as rescue medication in pediatric patients experiencing PONV despite various prophylactic antiemetic regimens. No neurological or cardiopulmonary side effects were recorded after this low dosage. PMID: 22234576 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)

In patients with an enlarged left atrium does left atrial size reduction improve maze surgery success?

Interactive CardioVascular and Thoracic Surgery — Thu, 12 Jan 2012 05:00:00 +0100

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: In [adults undergoing a maze procedure for Atrial Fibrillation (AF)], [does Left Atrial size reduction] compared to [maze surgery alone] improve [maze surgery success]? A total of 58 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Four out of eight papers compared a volume reduction technique as an adjunct to the maze procedure to a maze procedure alone – all four papers reported that atrial volume reduction significantly increased restorat...

Is it safe to stop anticoagulants after successful surgery for atrial fibrillation?

Interactive CardioVascular and Thoracic Surgery — Thu, 12 Jan 2012 05:00:00 +0100

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: is it safe to stop anticoagulants after successful surgery for atrial fibrillation? Altogether, 177 papers were found using the reported search, of which 14 were selected that represented the best evidence to answer the clinical question. Selection criteria included study relevance, primary outcome, size of study population and length of follow-up. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The weight of evidence, including over 10,000 patient–years of follow-up, supports the discontinuation of warfarin following atrial fibrillation correction procedures a...

A New Era of Antithrombotic Therapy in Patients With Atrial Fibrillation.

The American Journal of the Medical Sciences — Thu, 12 Jan 2012 05:00:00 +0100

This article will review 3 new antithrombotic medications that may potentially become the mainstay for treatment of patients with atrial fibrillation in the near future. PMID: 22245946 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

Serum Potassium Targets in Acute MI Need RethinkSerum Potassium Targets in Acute MI Need Rethink

Medscape Today Headlines — Wed, 11 Jan 2012 17:01:28 +0100

Recommendations to routinely raise serum potassium levels when ventricular arrhythmias are a concern may be based on outmoded data, according to authors of one of the largest analyses of its kind. Heartwire (Source: Medscape Today Headlines)

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Automatic filtering of outliers in RR intervals before analysis of heart rate variability in Holter recordings: a comparison with carefully edited data

BioMedical Engineering OnLine — Wed, 11 Jan 2012 05:00:00 +0100

Conclusions: The study showed that it might not be necessary to perform the time-consuming careful editing of all detected heartbeats before HRV is analysed in Holter recordings. In most subjects, it is sufficient to perform the regular editing needed for valid arrhythmia analyses, and then remove undetected ectopic beats and artefacts by age-based filtration of the series of RR intervals, particularly in subjects older than 30 years. (Source: BioMedical Engineering OnLine)

Question 3 Does a higher initial dose of adenosine improve cardioversion rates in supraventricular tachycardia?

Archives of Disease in Childhood — Wed, 11 Jan 2012 05:00:00 +0100

Scenario An 8-year-old girl attends the accident and emergency department complaining of palpitations and breathlessness for 1 h. An ECG confirms a diagnosis of supraventricular tachycardia (SVT). The patient is haemodynamically stable and vagal manoeuvres are ineffective. Intravenous access is obtained and a 100 µg/kg dose of adenosine is administered with persistence of SVT. A further higher dose of 200 µg/kg is administered with successful restoration of sinus rhythm. The case is discussed with colleagues, who indicate similar initial failures with lower doses of adenosine. You wonder if choosing the higher dose initially would be more effective at re-establishing sinus rhythm? Structured clinical question In children with supraventricular tachycardia [patient], does high do...

Hemodialysis-Induced P-Wave Signal-Averaged Electrocardiogram Alterations Are Indicative of Vulnerability to Atrial Arrhythmias.

Circulation Journal — Wed, 11 Jan 2012 05:00:00 +0100

Conclusions: HD resulted in prolongation of PWD and reduction of RMS20, indicating the vulnerability of HD patients to AF. These P-SAECG changes correlated with HD duration and the rate of removal of the body fluid. These findings underline the importance of the control of dialysis variables in the prevention of atrial arrhythmias following HD. PMID: 22240596 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Serum potassium targets in acute MI need rethink, analysis suggests

theHeart.org — Tue, 10 Jan 2012 21:00:00 +0100

Effects of a novel amiodarone-like compound SAR114646A on the pig atrium and susceptibility to ventricular fibrillation in dogs and pigs

Naunyn-Schmiedeberg's Archives of Pharmacology — Tue, 10 Jan 2012 16:59:48 +0100

This study evaluated the antiarrhythmic efficacy of this drug in vivo. In porcine studies, atrial effective refractory period (AERP) was measured in pentobarbital-anesthetized thoracotomized pigs and atrial fibrillation (AF) was induced by a premature beat. Ventricular fibrillation (VF) was induced via either burst pacing or programmed electrical stimulation (a series of progressively shorter beats, S1–S5). In canine studies, VF was induced by a 2-min occlusion of the left circumflex coronary artery during the last minute of exercise in dogs with healed myocardial infarctions (n = 8). One week later, this test was repeated after pretreatment with SAR114646A (3.0 mg/kg, i.v., slow bolus). SAR114646A produced a significant dose-dependent prolongation of AERP, inhibited AF induced ...

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NEW OFFER in General Cardiology - ESC Webinar package

European Society of Cardiology — Tue, 10 Jan 2012 14:29:03 +0100

Access the next 10 ESC Webinars in General Cardiology for only 100€. That’s a saving of 200€ off the standard registration price. Take advantage of our money saving offer to benefit from interactive learning delivered by Europe's leading cardiologists. Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Basic Science, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of the Aorta and Trauma to the Aorta and Heart, Echocardiography (Non-invasive imaging), Genetics, Heart Failure (HF), Hypertension...

Feasibility and efficacy of minimally invasive stand-alone surgical ablation of atrial fibrillation. A single-center experience

Journal of Interventional Cardiac Electrophysiology — Tue, 10 Jan 2012 06:41:59 +0100

Conclusions Our results show that minimally invasive surgical ablation was feasible and gave satisfactory results at long-term term follow-up in patients with AF. Content Type Journal ArticlePages 1-9DOI 10.1007/s10840-011-9650-5Authors Massimo Santini, Department of Cardiology, S. Filippo Neri Hospital, Via Martinotti 20, 00135 Rome, ItalyVincenzo Loiaconi, Department of Cardiology, S. Filippo Neri Hospital, Via Martinotti 20, 00135 Rome, ItalyMaria Pia Tocco, Department of Cardiology, S. Filippo Neri Hospital, Via Martinotti 20, 00135 Rome, ItalyFrancesco Mele, Department of Cardiology, S. Filippo Neri Hospital, Via Martinotti 20, 00135 Rome, ItalyClaudio Pandozi, Department of Cardiology, S. Filippo Neri Hospital, Via Martinotti 20, 00135 Rome, Italy Journa...

Serum Potassium Levels and Mortality in Acute Myocardial Infarction [Original Contribution]

JAMA — Tue, 10 Jan 2012 05:00:00 +0100

Conclusion Among inpatients with AMI, the lowest mortality was observed in those with postadmission serum potassium levels between 3.5 and <4.5 mEq/L compared with those who had higher or lower potassium levels. (Source: JAMA)

Potassium Concentration and Repletion in Patients With Acute Myocardial Infarction [Editorial]

JAMA — Tue, 10 Jan 2012 05:00:00 +0100

(Source: JAMA)

Incorrect/Omitted Reference in: Antiplatelet and Anticoagulant Therapy in Patients With Gastrointestinal Bleeding: An 86-Year-Old Woman With Peptic Ulcer Disease [Correction]

JAMA — Tue, 10 Jan 2012 05:00:00 +0100

(Source: JAMA)

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Heart Q&A: Answers from the Experts

DukeHealth.org: Duke Health Features — Mon, 09 Jan 2012 05:57:39 +0100

Cardiology experts Camille Frazier-Mills, MD; Bimal Shah, MD; Jason Koontz, MD; and Jonathan Piccini Sr, MD, answer commonly asked questions related to atrial fibrillation, echocardiograms, heart attack, and pacemakers. What are the dangers of having untreated atrial fibrillation? Camille Frazier-Mills, MDFrazier-Mills: Atrial fibrillation (AFib) occurs when the upper chambers of the heart beat fast and irregularly. Most people with AFib will also have fatigue, chest pain, shortness of breath, or dizziness. People who have AFib are at a much higher risk of stroke than people who don’t, but the stroke risk can be lessened with blood thinners. Also, AFib could lead to heart failure if not treated. But virtually all AFib patients can be treated successfully. What causes atrial fibrillatio...

Effect of Amiodarone on Dispersion of Ventricular Repolarization in a Canine Congestive Heart Failure Model.

Clinical and Experimental Pharmacology and Physiology — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Zhou SX, Fang C, Zheng SX, Zhang YL, Lei J, Wang JF Abstract 1. The effects of amiodarone on ventricular electrophysiological parameters, especially the dispersion of ventricular repolarization, were investigated in a canine model of congestive heart failure (CHF). 2. Dogs were randomized to either a control, amiodarone, CHF, or CHF + amiodarone group. Dogs in the CHF and CHF + amiodarone groups underwent 4-5 weeks of rapid ventricular pacing; dogs in the control and amiodarone groups underwent only a sham operation. Amiodarone 20mg/kg/day was administered orally beginning on day 1 post-operatively in the treatment groups, and ventricular electrophysiological variables were evaluated 4-5 weeks after rapid pacing or sham operation. 3. In CHF dogs, the transmural dispe...

[Original Articles] Association of Baseline Anxiety With Depression Persistence at 6 Months in Patients With Acute Cardiac Illness

Psychosomatic Medicine — Mon, 09 Jan 2012 05:00:00 +0100

Conclusions Among a cohort of depressed cardiac patients, higher baseline anxiety score was linked with lesser improvement in depressive symptoms and increased likelihood of depression persistence at 6 months, independent of multiple relevant covariates. Trial Registration: clinicaltrials.gov Identifier: NCT00847132. (Source: Psychosomatic Medicine)

Respiratory control when measuring respiratory sinus arrhythmia during a talking task.

Biological Psychology — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Tininenko JR, Measelle JR, Ablow JC, High R Abstract The current study explored the effects of talking on respiratory sinus arrhythmia (RSA) during a semi-structured emotional interview (Adult Attachment Interview) using 76 female undergraduates. The effectiveness of 2 different methodological approaches (i.e. talking baseline or transfer function) was explored as respiratory control during talking tasks. RSA was collected during resting baseline, talking baseline, and interview conditions. Subjective reports of distress were higher in the interview than in the other 2 conditions. Mean RSA levels were significantly lower in the 2 talking tasks than in the resting baseline. After applying a transfer function for respiratory control, there were no significant differences bet...

Making Decisions About Screening Mammography in Older Women: Comment on "Older Patient Experiences in the Mammography Decision-Making Process" [Editor's Note]

Archives of Internal Medicine — Mon, 09 Jan 2012 05:00:00 +0100

(Source: Archives of Internal Medicine)

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Optimal Medical Therapy Use Among Patients Receiving Implantable Cardioverter/Defibrillators: Insights From the National Cardiovascular Data Registry [Research Letters]

Archives of Internal Medicine — Mon, 09 Jan 2012 05:00:00 +0100

(Source: Archives of Internal Medicine)

Implantable Cardioverter/Defibrillators in the Primary Prevention of Sudden Death: We Know What to Do but Are We Doing It?: Comment on: "Optimal Medical Therapy Use Among Patients Receiving Implantable Cardioverter-Defibrillators" [Invited Commentary]

Archives of Internal Medicine — Mon, 09 Jan 2012 05:00:00 +0100

(Source: Archives of Internal Medicine)

Assessment of the cardiac safety of prucalopride in healthy volunteers: a randomized, double‐blind, placebo‐ and positive‐controlled thorough QT study

British Journal of Clinical Pharmacology — Sun, 08 Jan 2012 18:02:27 +0100

CONCLUSION Prucalopride at both therapeutic and supra therapeutic doses has no clinically significant effects on cardiac repolarisation in healthy volunteers. (Source: British Journal of Clinical Pharmacology)

Activation of cardiac M(3) muscarinic acetylcholine receptors has cardioprotective effects against ischaemia-induced arrhythmias.

Clinical and Experimental Pharmacology and Physiology — Sat, 07 Jan 2012 05:00:00 +0100

Activation of cardiac M(3) muscarinic acetylcholine receptors has cardioprotective effects against ischaemia-induced arrhythmias. Clin Exp Pharmacol Physiol. 2012 Jan 7; Authors: Wang S, Han HM, Jiang YN, Wang C, Song HX, Pan ZY, Fan K, Du J, Fan YH, Du ZM, Liu Y Abstract 1. Increasing evidence indicates the important roles of M(3) muscarinic acetylcholine receptors (M(3) mAChR) in the regulation and maintenance of cardiac function and heart disease. In the present study, we investigated whether M(3) mAChR mediates the cardioprotection against ischaemia-induced arrhythmias and the mechanisms involved. 2. Myocardial ischaemia was established in Wistar rats by occlusion of the left anterior descending coronary artery. Rats were treated with choline (choline chloride; an M...

Cardiac involvement in patients with lamin A/C gene mutations: A cohort observation

Muscle and Nerve — Fri, 06 Jan 2012 05:00:00 +0100

DISCUSSION:Cardiac involvement represents a very common phenotypic expression of LMNA gene mutation. Subjects sharing common genetic background seem to suffer from analogue pattern of cardiac manifestation. © 2012 Wiley‐Liss, Inc. (Source: Muscle and Nerve)

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Membrane dysfunction in Andersen‐Tawil syndrome assessed by velocity recovery cycles

Muscle and Nerve — Fri, 06 Jan 2012 05:00:00 +0100

This study was undertaken to determine whether sarcolemmal dysfunction could be identified with muscle velocity recovery cycles (MVRCs).Methods:Eleven genetically confirmed ATS patients and 20 normal controls were studied. MVRCs were recorded with 1, 2 and 5 conditioning stimuli and with single conditioning stimuli during intermittent repetitive stimulation at 20 Hz, in addition to the long exercise test.Results:ATS patients had longer relative refractory periods (P<0.0001) and less early supernormality, consistent with membrane depolarization. Patients had reduced enhancement of late supernormality with 5 conditioning stimuli (P<0.0001), and less latency reduction during repetitive stimulation (P<0.001). Patients were separated completely from controls by combining MVRC and repet...

Total Occlusions Predict Arrhythmias in ICD Patients (CME/CE)

MedPage Today State Required CME — Thu, 05 Jan 2012 16:43:11 +0100

(MedPage Today) -- Chronic total coronary occlusions (CTO) independently predicted the occurrence of ventricular arrhythmias in ischemic heart disease patients with implantable cardioverter defibrillators according to a study. (Source: MedPage Today State Required CME)

A systematic review and meta‐analysis of heart rate variability in epilepsy and antiepileptic drugs

Epilepsia — Thu, 05 Jan 2012 05:00:00 +0100

SummaryPurpose: Epilepsy is associated with near‐fatal and fatal arrhythmias, and sudden unexpected death in epilepsy (SUDEP) is partly related to cardiac events. Dysfunction of the autonomous nervous system causes arrhythmias and, although previous studies have investigated the effects of epilepsy on the autonomic control of the heart, the results are still mixed regarding whether imbalance of sympathetic, vagal, or both systems is present in epilepsy, and also the importance of anticonvulsant treatment on the autonomic system. Therefore, we aimed to investigate epilepsy and its treatment impact on heart rate variability (HRV), assessed by sympathetic and parasympathetic activity expressed as low‐frequency (LF) and high‐frequency (HF) power spectrum, respectively.Method: We pe...

Ischemia-modified albumin use as a prognostic factor in coronary bypass surgery

Journal of Cardiothoracic Surgery — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: IMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases. (Source: Journal of Cardiothoracic Surgery)

Drug‐like actions of autoantibodies against receptors of the autonomous nervous system and their impact on human heart function

British Journal of Pharmacology — Thu, 05 Jan 2012 05:00:00 +0100

In conclusion, such autoantibodies seem to cause or promote chronic human left ventricular dysfunction by acting on their receptor targets in a drug‐like fashion. However, the pharmacology of this interaction is poorly understood. It is unclear how the autoantibodies trigger changes in receptor activity and second messenger coupling and how that is related to the pathogenesis and severity of the associated diseases. Here, we summarise the available evidence regarding these issues and discuss these findings in the light of recent knowledge about the conformational activation of the human β2‐adrenergic receptor and the properties of bona fide cardio‐pathogenic autoantibodies derived from immune‐adsorption therapy of DCM patients. These considerations might contribute to the concepti...

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Shortened Ca2+ Signaling Refractoriness Underlies Cellular Arrhythmogenesis in a Postinfarction Model of Sudden Cardiac Death.

Circulation Research — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions:The attainment of a certain threshold [Ca(2+)](SR) is not sufficient for the generation of DCWs. Postrelease Ca(2+) signaling refractoriness critically influences the occurrence of spontaneous Ca(2+) waves in the diastolic period. Shortened Ca(2+) signaling refractoriness due to RyR2 phosphorylation and oxidation is responsible for the increased rate of DCWs observed in VF myocytes. PMID: 22223353 [PubMed - as supplied by publisher] (Source: Circulation Research)

Usability of QTc dispersion for the prediction of orthostatic intolerance syndromes.

European Journal of Paediatric Neurology — Thu, 05 Jan 2012 05:00:00 +0100

CONCLUSIONS: These results revealed that we can use QTc dispersion measurement as a noninvasive electrocardiographic test to evaluate OIS for predicting positive result before performing HUTT. PMID: 22226850 [PubMed - as supplied by publisher] (Source: European Journal of Paediatric Neurology)

Procedural Complications, Rehospitalizations, and Repeat Procedures After Catheter Ablation for Atrial Fibrillation

Journal of the American College of Cardiology — Wed, 04 Jan 2012 18:27:39 +0100

Conclusions: Periprocedural complications occurred in 1 of 20 patients undergoing AF ablation, and all-cause and arrhythmia-related rehospitalizations were common. Older age, female sex, prior AF hospitalizations, and recent hospital procedure experience were associated with a higher risk of complications and/or 30-day readmission after AF ablation. (Source: Journal of the American College of Cardiology)

Atrial Fibrillation Ablation in the Real World⁎

Journal of the American College of Cardiology — Wed, 04 Jan 2012 18:27:39 +0100

Atrial fibrillation (AF) ablation has offered the promise to free patients of symptoms of palpitations, dyspnea, and fatigue, as well as eliminate the need for use of chronic drug therapy with agents that sometimes have significant risks, cost, and inconvenience for the patient. The belief among many is that elimination of symptomatic AF with ablative procedures will also restore patients to the AF-free natural history curve, with reduction in stroke and mortality long term. These advantages are compelling, and they explain the wide adoption of a procedure that is technically challenging and has results that can be characterized as mediocre at best. Despite the fact that reports have claimed procedural success rates of 76% to 91% (), carefully monitored clinical trials performed by experie...

[The effect of levosimendan and dobutamine treatment on QT dispersion in patients with decompensated heart failure: a prospective study.]

Anadolu Kardiyol Der... — Wed, 04 Jan 2012 05:00:00 +0100

CONCLUSION: Our results suggest that, therapeutic doses of levosimendan infusion do not have a significant effect on QT parameters - the predictors of arrhythmias-, in patients with decompensated heart failure when compared with dobutamine infusion. PMID: 22214738 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

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ICD's near end of life: Risk Versus Benefit- A Review.

The American Journal of Hospice and Palliative Care — Wed, 04 Jan 2012 05:00:00 +0100

Authors: Singh B, Singh J Abstract The number of annual implantable cardioverter defibrillator (ICD) implants has substantially increased over the last 5 years and is expected to grow rapidly. Implantable cardioverter defibrillators have a proven mortality benefit by terminating the life-threatening arrhythmias, even near end of life. In patients with moderate/severe symptomatic heart failure, enough clinical literature representing mortality benefits has been published, but limited numbers of studies have reviewed the dwindling risk-benefit profile near end of life, studying quality of life (QoL)/psychosocial impact. Criteria outlining either continued use or deactivation policy/procedures near end of life have not been clearly defined and/or largely implemented, which in turn req...

A Neonate with Long QT Syndrome, Refractory Ventricular Arrhythmias, and Lidocaine Toxicity.

Anesthesia and Analgesia — Wed, 04 Jan 2012 05:00:00 +0100

This report discusses the implications and challenges of management of a neonate with compound long mutations. PMID: 22218697 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

Arrhythmia Driven By TBX3 Gene Mutation

Health News from Medical News Today — Tue, 03 Jan 2012 17:00:00 +0100

Arrhythmia, a potentially life-threatening disorder whereby the rate or rhythm of the heartbeat causes it to beat too fast, slow or irregularly, affects millions of people worldwide. The rhythm and rate of the heart is regulated by the cardiac conduction system (CCS), a group of specialized cells in the walls of the heart that send electrical signals from the sinoatrial node in the heart's right atrium or upper chamber to the ventricles or lower chambers, causing them to contract and pump blood... (Source: Health News from Medical News Today)

Effect of meal content on heart rate variability and cardiovascular reactivity to mental stress

Psychophysiology — Tue, 03 Jan 2012 05:00:00 +0100

AbstractLittle is known about transient effects of foods and nutrients on reactivity to mental stress. In a randomized crossover study of healthy adults (n = 20), we measured heart rate variability (respiratory sinus arrhythmia), blood pressure, and other hemodynamic variables after three test meals varying in type and amount of fat. Measurements were collected at rest and during speech and cold pressor tasks. There were significant postmeal changes in resting diastolic blood pressure (−4%), cardiac output (+18%), total peripheral resistance (−17%), and interleukin‐6 (−27%). Heart rate variability and hemodynamic reactivity to stress was not affected by meal content. We recommend that future studies control for time since last meal and continue to examine effects of meal conten...

Letter by Ravensbergen et al Regarding Article, "Long-Term Recording of Cardiac Arrhythmias With an Implantable Cardiac Monitor in Patients With Reduced Ejection Fraction After Acute Myocardial Infarction: The Cardiac Arrhythmias and Risk Stratification After Acute Myocardial Infarction (CARISMA) Study".

Circulation — Tue, 03 Jan 2012 05:00:00 +0100

Letter by Ravensbergen et al Regarding Article, "Long-Term Recording of Cardiac Arrhythmias With an Implantable Cardiac Monitor in Patients With Reduced Ejection Fraction After Acute Myocardial Infarction: The Cardiac Arrhythmias and Risk Stratification After Acute Myocardial Infarction (CARISMA) Study". Circulation. 2012 Jan 3;125(1):e239 Authors: Ravensbergen NJ, Verhagen HJ, De Melis M PMID: 22215899 [PubMed - in process] (Source: Circulation)

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Risk of Malignant Arrhythmias in Initially Symptomatic Patients with WPW Syndrome: Results of a Prospective Long-Term Electrophysiological Follow-Up Study.

Circulation — Tue, 03 Jan 2012 05:00:00 +0100

CONCLUSIONS: Symptomatic patients with WPW syndrome generally have a good outcome and predictors of malignant arrhythmias are similar to those reported for asymptomatic patients with ventricular preexcitation. PMID: 22215859 [PubMed - as supplied by publisher] (Source: Circulation)

The Big Chill: Accidental Hypothermia

AJN — Sun, 01 Jan 2012 06:00:00 +0100

Overview: A potential cause of such emergent issues as cardiac arrhythmias, hypotension, and fluid and electrolyte shifts, accidental hypothermia can be deadly, is common among trauma patients, and is often difficult to recognize. The author discusses predisposing conditions, the classic presentation, and the effects on normal thermoregulatory processes; explains how to conduct a systems assessment of the hypothermic patient; and describes crucial management strategies. (Source: AJN)

Ondansetron (Zofran) Warning Strengthened

AJN — Sun, 01 Jan 2012 06:00:00 +0100

* The antiemetic ondansetron (Zofran) has undergone a label revision to emphasize the risk of cardiac arrhythmias such as QT-interval prolongation and torsade de pointes. * Patients with congenital long QT syndrome shouldn't receive ondansetron. * Cardiac monitoring should be conducted in patients taking ondansetron who have electrolyte imbalances, congestive heart failure, bradyarrythmias, or a history of taking other drugs that prolong the QT interval. (Source: AJN)

Effect of Pranayama (Breathing Exercise) on Arrhythmias in the Human Heart

Explore — Sun, 01 Jan 2012 05:00:00 +0100

Background: Cardiac arrhythmias, especially ventricular tachyarrhythmias are an important public health problem. QT dispersion (QTd), defined as the difference between maximal and minimal QT intervals, reflects the regional inhomogeneity of ventricular repolarization dispersion and may mark the presence of malignant ventricular arrhythmias. Purpose: To determine the effects of Pranayama (breathing exercise) on QTd in patients with arrhythmia. Patients: Fifteen patients with arrhythmia and ejection fractions (Source: Explore)

Cardiac-Gated Bright Blood MR Imaging to Determine Retrieval Feasibility of a Chronic Foreign Body

Journal of Vascular and Interventional Radiology : JVIR — Sun, 01 Jan 2012 05:00:00 +0100

When identified acutely, fractured central venous catheters are usually removed to prevent complications including perifragment thrombosis, infection, or potentially fatal arrhythmias. However, some clinicians are hesitant to consider retrieval when the fragment has migrated to the pulmonary artery, thinking that this scenario is not a risk to patient safety and that a fragment quickly becomes endothelialized and unretrievable. We used magnetic resonance (MR) imaging to estimate feasibility of retrieval, and report here the successful retrieval of a fragment that had been in vivo for 16 years. Letters of this nature do not require review by our institutional review board. (Source: Journal of Vascular and Interventional Radiology : JVIR)

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Expanding the Benefits of Implantable Cardioverter-Defibrillator Therapy: “Is Less More”?

Progress in Cardiovascular Diseases — Sun, 01 Jan 2012 05:00:00 +0100

Abstract: Implantable cardioverter-defibrillator (ICD) therapy improves survival in patients with significant left ventricular systolic dysfunction. Although this lifesaving therapy has many benefits, inappropriate ICD shocks may increase morbidity and mortality. With rates of inappropriate therapy quoted as high as 35% at 3 years after device implantation, numerous strategies have been evaluated to decrease the overall incidence of inappropriate therapy. Changes in programming algorithms, which allow for longer detection windows for rhythm analysis, extended the use of antitachycardia pacing, and improved supraventricular tachycardia discriminators, hold promise for decreasing inappropriate ICD therapy. In this review, we discuss the data summarizing the adverse effects of ICD shocks on o...

Anaesthetic management of transcatheter aortic valve implantation.

Annals of Cardiac Anaesthesia — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Franco A, Gerli C, Ruggeri L, Monaco F Abstract Transcatheter aortic valve implantation (TAVI) is an emergent technique for high-risk patients with aortic stenosis. TAVI poses significant challenges about its management because of the procedure itself and the population who undergo the implantation. Two devices are currently available and marketed in Europe and several other technologies are being developed. The retrograde transfemoral approach is the most popular procedure; nevertheless, it may not be feasible in patients with signiﬁcant aortic or ileo-femoral arterial disease. Alternatives include a transaxillary approach, transapical approach, open surgical access to the retroperitoneal iliac artery and the ascending aorta. A complementary approach using both devices ...

Earthing defect: A cause for unstable hemodynamics.

Annals of Cardiac Anaesthesia — Sun, 01 Jan 2012 05:00:00 +0100

We report a rare event of IABP failure due to ECG artifact, which appeared on placement of the transthoracic echocardiography probe over the chest. Subsequent evaluation revealed potential current leakage from echocardiography machine secondary to earthing defect in the machine. PMID: 22234022 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)

Atrial Burst Pacing with Biphasic and Monophasic Waveforms for Atrial Fibrillation

Annals of Noninvasive Electrocardiology — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: Rapid atrial pacing using a variety of waveforms at the cycle length and output used in the current study was found to be safe. There was a single success in converting a chronic AF to sinus rhythm.Ann Noninvasive Electrocardiol 2012;17(1):22–27 (Source: Annals of Noninvasive Electrocardiology)

A systematic review of validated methods for identifying ventricular arrhythmias using administrative and claims data

Pharmacoepidemiology and Drug Safety — Sun, 01 Jan 2012 05:00:00 +0100

ConclusionsThe use of ICD‐9 codes 427.x, alone or in combination with code 798.x, in the principal position is appropriate for the identification of ventricular arrhythmias in administrative and claims databases. Copyright © 2012 John Wiley & Sons, Ltd. (Source: Pharmacoepidemiology and Drug Safety)

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Late Gadolinium Enhancement CMR in Patients with Tachycardia‐Induced Cardiomyopathy Caused by Idiopathic Ventricular Arrhythmias

Pacing and Clinical Electrophysiology : PACE — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions:LGE is a rare finding in patients with TICMP caused by idiopathic ventricular arrhythmias. LGE‐CMR can be used in the diagnostic work‐up of patients with TICMP. Further prospective studies are required to determine the role of LGE‐CMR in predicting the recovery of left ventricular systolic dysfunction in patients with presumptive TICMP.(PACE 2012;1–6) (Source: Pacing and Clinical Electrophysiology : PACE)

Sleep deprivation, sleep apnea and cardiovascular diseases.

Atherosclerosis — Fri, 30 Dec 2011 21:26:15 +0100

Authors: Levy P, Tamisier R, Arnaud C, Monneret D, Baguet JP, Stanke-Labesque F, Dematteis M, Godin-Ribuot D, Ribuot C, Pepin JL Abstract Sleep dramatically influences cardiovascular regulation. Changes in sleep duration or quality as seen in sleep disorders may prevent blood pressure to fall during sleep as expected in human physiology. This supports the increased prevalence of hypertension and drug-resistant hypertension in those with sleep loss. Other cardiovascular outcomes i.e. coronary lesions seem to be associated with sleep duration. Systemic inflammation, oxidative stress and endothelial dysfunction seem to be associated with both sleep loss and sleep disorders. The most critical example is Obstructive Sleep Apnea (OSA). Sympathetic activation, oxidative stress and systemi...

Value of carnitine therapy in kidney dialysis patients and effects on cardiac function from human and animal studies.

Current Drug Targets — Thu, 29 Dec 2011 05:00:00 +0100

Authors: Molyneux R, Seymour AM, Bhandari S Abstract Cardiovascular complications are the leading cause of mortality, accounting for 50% of all deaths among patients with end-stage renal disease (ESRD). The majority of these deaths are from cardiac causes. The mechanisms underlying the enhanced susceptibility to myocardial ischaemia and subsequent morbidity in ESRD remain ill-defined. Numerous metabolic derangements accompany myocardial ischaemia and reperfusion and play a pivotal role in the development of concurrent myocardial dysfunction. Carnitine plays a critical role in myocardial energy metabolism, as the transporter of long chain fatty acyl intermediates across the inner mitochondrial membrane for β oxidation and as a central regulator of carbohydrate metabolism. Myocardia...

Functional Reentry and Circus Movement Arrhythmias in the Small Intestine of Normal and Abnormal Diabetic Rats.

Am J Physiol Gastroi... — Thu, 29 Dec 2011 05:00:00 +0100

Conclusions: This is the first demonstration of a reentrant arrhythmia in the small intestine of control and diabetic rats. Calculations of the size of the circuit indicate that they are small enough to fit inside the intestinal wall. Extrapolation based on measured velocities and rates indicate that reentrant arrhythmias are also possible in the distal small intestine of larger animals including humans. PMID: 22207580 [PubMed - as supplied by publisher] (Source: Am J Physiol Gastroi...)

Differential susceptibility and the early development of aggression: Interactive effects of respiratory sinus arrhythmia and environmental quality. - Eisenberg N, Sulik MJ, Spinrad TL, Edwards A, Eggum ND, Liew J, Sallquist J, Popp TK, Smith CL, Hart D.

SafetyLit: All (Unduplicated) — Thu, 29 Dec 2011 04:51:29 +0100

The purpose of the current study was to predict the development of aggressive behavior from young children's respiratory sinus arrhythmia (RSA) and environmental quality. In a longitudinal sample of 213 children, baseline RSA, RSA suppression in response t... (Source: SafetyLit: All (Unduplicated))

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Mutation In TBX3 Gene Linked To Arrhythmia

Health News from Medical News Today — Wed, 28 Dec 2011 08:00:00 +0100

Arrhythmia is a potentially life-threatening problem with the rate or rhythm of the heartbeat, causing it to go too fast, too slow or to beat irregularly. Arrhythmia affects millions of people worldwide. The cardiac conduction system (CCS) regulates the rate and rhythm of the heart. It is a group of specialized cells in the walls of the heart. These cells control the heart rate by sending electrical signals from the sinoatrial node in the heart's right atrium (upper chamber) to the ventricles (lower chambers), causing them to contract and pump blood... (Source: Health News from Medical News Today)

Biomarkers for Predicting Serious Cardiac Outcomes at 72 Hours in Patients Presenting Early after Chest Pain Onset with Symptoms of Acute Coronary Syndromes [Brief Communications]

Clinical Chemistry — Wed, 28 Dec 2011 05:00:00 +0100

CONCLUSIONS: The optimal cutoffs for predicting serious cardiac outcomes in this low-risk population are different from the published 99th percentiles. Larger studies are required to verify these findings. (Source: Clinical Chemistry)

Intraoperative device closure of perimembranous ventricular septal defects in the young children under transthoracic echocardiographic guidance; initial experience

Journal of Cardiothoracic Surgery — Wed, 28 Dec 2011 05:00:00 +0100

Conclusions: Minimally invasive transthoracic device closure of perimembranous VSDs is safe and feasible, using a domestically made device under transthoracic echocardiographic guidance, without the need for cardiopulmonary bypass. This technique should be considered an acceptable alternative to surgery or device closure guided by transesophageal echocardiography in selected young children. However, a long-term evaluation of outcomes is necessary. (Source: Journal of Cardiothoracic Surgery)

Mutation in gene that's critical for human development linked to arrhythmia

ScienceDaily Headlines — Tue, 27 Dec 2011 19:25:25 +0100

The biologic and genetic mechanisms controlling the formation and function of the cardiac conduction system (CCS) are not well understood, but new research with mice shows that altered function of a gene called Tbx3 interferes with the development of the CCS and causes lethal arrhythmias. (Source: ScienceDaily Headlines)

A double‐blind, randomized, placebo‐controlled, phase 2 study of maintenance enzastaurin with 5‐fluorouracil/leucovorin plus bevacizumab after first‐line therapy for metastatic colorectal cancer

Cancer — Tue, 27 Dec 2011 05:00:00 +0100

CONCLUSIONS:Enzastaurin combined with bevacizumab‐based therapy is tolerable, but does not improve PFS during maintenance therapy in patients with MCRC compared with bevacizumab‐based therapy alone. Cancer 2011. © 2011 American Cancer Society. (Source: Cancer)

Respiratory sinus arrhythmia: A marker for positive social functioning and receptive language skills in children with autism spectrum disorders

Developmental Psychobiology — Tue, 27 Dec 2011 05:00:00 +0100

AbstractThe current study builds on the emerging autism spectrum disorder (ASD) literature that associates autonomic nervous system activity with social function, and examines the link between respiratory sinus arrhythmia (RSA) and both social behavior and cognitive function. The RSA response pattern was assessed in 23 4‐ to 7‐year‐old children diagnosed with an ASD. Higher baseline RSA amplitudes were associated with better social behavior (i.e., more conventional gestures, more instances of joint attention) and receptive language abilities. Similar to reports of typically developing children, ASD children with higher RSA amplitude at baseline showed greater RSA and HP reactivity during an attention‐demanding task. These results highlight the importance of studying RSA as a marker...

The association between urinary cadmium and frontal T wave axis deviation in the US adults.

International Journal of Hygiene and Environmental health — Tue, 27 Dec 2011 05:00:00 +0100

This study documents a positive graded relationship between environmental cadmium exposure and the risk for frontal T-wave axis deviation. Screening individuals with large body burden of cadmium to identify frontal T-wave axis deviation is warranted. PMID: 22206735 [PubMed - as supplied by publisher] (Source: International Journal of Hygiene and Environmental health)

The effects of a bidirectional cavo-tricuspid isthmus block in persistent atrial fibrillation.

Yonsei Medical Journal — Tue, 27 Dec 2011 03:58:20 +0100

Conclusion: Despite favorable outcome during 12 month, the CTI block with AADs showed outcomes similar to AAD therapy after electrical cardioversion over a 12 month follow up period. Minimal substrate modification with AADs might be an alternative treatment for persistent AF with minimal atrial remodeling. PMID: 22187235 [PubMed - in process] (Source: Yonsei Medical Journal)

Treating Cardiac Arrhythmias Detected With an Implantable Cardiac Monitor in Patients After an Acute Myocardial Infarction

Current Treatment Options in Cardiovascular Medicine — Mon, 26 Dec 2011 16:45:58 +0100

Opinion statement Using an implantable cardiac monitor (ICM) in patients with acute myocardial infarction (MI) allows continuous electrocardiogram monitoring and provides a much more detailed picture of the incidence of brady- and tachyarrhythmias than conventional follow-up. The CARISMA study was the first to use the ICM in post-MI patients with moderate to severe left ventricular systolic dysfunction. Atrial fibrillation (AF) events lasting longer than 30 s were associated with an almost threefold increase in the risk of major cardiac events. This confirms the current definition of clinically significant AF episodes, as patients with episodes of shorter duration were not at increased risk. The association of AF to progressive heart failure, reinfarction, and cardiova...

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Tissue engineered myoblast sheets improved cardiac function sufficiently to discontinue LVAS in a patient with DCM: report of a case

Surgery Today — Mon, 26 Dec 2011 16:45:45 +0100

Abstract Dilated cardiomyopathy (DCM) is a heart muscle disease characterized by progressive heart failure, and is a leading cause of mortality and morbidity. Recently, cellular therapy for end-stage heart failure has been emerging. We herein report a 56-year-old male who received a transplant of autologous myoblast sheets manufactured in temperature-responsive culture dishes. His clinical condition improved markedly, leaving him without any arrhythmia and able to discontinue using a left ventricular assist system and avoid cardiac transplantation. These findings suggest that cellular therapy using myoblast sheets is a promising new strategy for treating patients with end-stage DCM. This method might be an effective alternative to heart transplantation in the near future. ...

Hemodynamic response, arrhythmic risk, and overall safety of Regadenoson as a pharmacologic stress agent for myocardial perfusion imaging in chronic obstructive pulmonary disease and bronchial asthma patients

The International Journal of Cardiovascular Imaging — Mon, 26 Dec 2011 16:45:12 +0100

Abstract Regadenoson (REG) is a A2a receptor selective pharmacologic SPECT imaging agent. Its safety in unselected chronic obstructive pulmonary disease (COPD) or asthma (AM) undergoing SPECT imaging has not been well evaluated. We retrospectively identified 228 patients (COPD n = 126 and AM n = 102, Grp 1) undergoing REG SPECT from Jan to Nov 2009 and compared to 1,142 patients without COPD and AM (control, Grp 2). A standard 400 μg REG bolus was used and gated Tc-99 m tetrofosmin SPECT done. Patient demographics, REG SPECT data, side effects, arrhythmia occurrences, and any exacerbation of COPD or AM leading to treatment, hospitalization or death were evaluated. The side effect profile of Grp 1 was also compared to a historical cohort who un...

EP News: Basic and Translational

Heart Rhythm — Mon, 26 Dec 2011 05:00:00 +0100

During the American Heart Association Annual Meeting, Rizzo et al (Circulation 2011:124:A13059) reported pathological characteristics of stellate ganglia resected from 5 long QT syndrome (LQTS) and 5 catecholaminergic polymorphic ventricular tachycardia (CPVT) patients. Control stellate ganglia were obtained from 4 accidently deceased patients. Sections were immunostained with antibodies against various lymphocyte markers. The authors found that stellate ganglia of all 10 LQTS/CVPT patients had mild but distinct inflammatory infiltrates composed of T-lymphocytes and macrophages. These cells were diffusely spread, but also clustered in small foci or even inside ganglion cells. These findings are interpreted as T cell-mediated ganglionitis. The authors conclude that a low grade cytotoxic T c...

Respiratory and non-respiratory sinus arrhythmia: implications for heart rate variability

Journal of Clinical Monitoring and Computing — Sat, 24 Dec 2011 16:42:26 +0100

This study investigated with the same recordings whether heart period oscillations or spectral heart rate variability measures could function as estimators of breathing frequency. Continuous 270 s cardiovascular recordings were obtained from 22 healthy adult volunteers in the supine and upright postures. Breathing was recorded simultaneously. Breathing frequency and heart period oscillation frequency were calculated manually, while heart rate variability spectral maximums were obtained using heart rate variability software. These estimates were compared to the breathing frequency using the Bland–Altman agreement procedure. Estimates were required to be <±10% (95% levels of agreement). The 95% levels of agreement measures for the heart period oscillation frequency (supine: ...