MedWorm: Arrhythmia

[Myocardial necrosis and severe biventricular dysfunction in the context of chronic ephedrine abuse.]

Adicciones — Sun, 21 Mar 2010 16:48:05 +0100

We present the case of a patient, with pre-existing psychiatric conditions, who developed congestive heart failure and pulmonary oedema in the context of severe biventricular dysfunction and myocardial necrosis secondary to longstanding ephedrine abuse. Secondary causes of dilated myocardiopathy such as alcohol abuse, autoimmunity, hemochromatosis, thyroid alterations, viral or bacterial myocarditis and coronary heart disease, were ruled out. Five years after total cessation of use of the drug containing ephedrine, the patient is symptom-free, with partial recovery of left ventricular ejection fraction. PMID: 20300711 [PubMed - in process] (Source: Adicciones)

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Surgical reverse remodelling of the left ventricle: 111 months of follow-up

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

CONCLUSION: EVSE' surgery is an effective option to treat this group of patients, with improvement of left ventricular function (from 32.3 to 46.4%) and patients' quality of life. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Role of the gap junction in ischemic preconditioning in the heart

AJP: Heart and Circulatory Physiology — Fri, 19 Mar 2010 17:01:45 +0100

The gap junction plays roles not only in electrical coupling of cardiomyocytes but also in intercellular transport of biologically active substances. Furthermore, the gap junction participates in decision making on cell survival versus cell death in various types of cells, and a part of reperfusion injury in the heart has been indicated to be gap junction mediated. The contribution of gap junction communication (GJC) and/or mitochondrial "hemichannels" to protective signaling during the trigger phase of ischemic preconditioning (IPC) is suggested by observations that IPC failed to protect the heart when GJC was blocked during IPC. Although ischemia suppresses both electrical and chemical GJC, chemical GJC persists for a considerable time after electrical GJC is lost. IPC facilitates the is...

Arrhythmias in systemic lupus erythematosus

Revista Brasileira de Reumatologia — Fri, 19 Mar 2010 16:37:09 +0100

Mais da metade dos pacientes com lúpus eritematoso sistêmico (LES) apresentam envolvimento cardíaco. Porém, não existem estudos de prevalência de eventos arrítmicos (EA) nesta doença, nem de correlações laboratoriais preditoras de sua ocorrência. É possível que o clássico segundo pico de mortalidade da doença esteja relacionado com a ocorrência da EA, sobretudo pela natureza súbita dos óbitos relatados. Processo autoimune, complicações ateroscleróticas e, até mesmo, efeito adverso do tratamento (cardiotoxicidade pela cloroquina) parecem ser os mecanismos fisiopatológicos mais prováveis para estes distúrbios. A participação direta de autoanticorpos, como o anti-Ro/SSA e o anti-RNP ainda é controversa.Todos os tipos de bloqueios atrioventriculares (BAV), distúrbi...

Reverse Remodeling of the Atria After Treatment of Chronic Stretch in Humans: Implications for the Atrial Fibrillation Substrate

Journal of the American College of Cardiology — Fri, 19 Mar 2010 14:00:30 +0100

Conclusions: The atrial electrophysiologic and electroanatomic abnormalities that result from chronic stretch due to MS reverses after MC. These observations suggest that the substrate predisposing to atrial arrhythmias might be reversed. (Source: Journal of the American College of Cardiology)

Cardiac arrest in the left lateral decubitus position and extracorporeal cardiopulmonary resuscitation during neurosurgery: a case report

Journal of Anesthesia — Fri, 19 Mar 2010 06:49:25 +0100

Abstract Cardiopulmonary resuscitation (CPR) in the lateral position during noncardiac surgery has been described in only a few reports in the past. Here, we report a case of cardiac arrest in a 61-year-old man undergoing microvascular decompression surgery for trigeminal neuralgia in the left lateral decubitus position. During the initial 5 min of CPR, chest compression was performed in this position by two rescuers; one from the chest and the other from the back, pushing simultaneously. Because ventricular arrhythmia was refractory to conventional CPR even after placing the patient back to the supine position, extracorporeal life support was introduced in the operating room by using the femoro–femoral approach (right atrio-femoral veno-arterial bypass). This alter...

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Assessment of cardiac injury in patients with blunt chest trauma

European Journal of Trauma and Emergency Surgery — Thu, 18 Mar 2010 14:11:39 +0100

Conclusion Indicators such as cardiac enzymes and ECG have low sensitivity and specificity when used alone. The reliability of ECG in the diagnosis of BCI decreases in the later hours of trauma. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00068-010-0005-1Authors Mucahit Emet, Ataturk University, School of Medicine Department of Emergency Medicine 25090 Erzurum TurkeyAyhan Akoz, Ataturk University, School of Medicine Department of Emergency Medicine 25090 Erzurum TurkeySahin Aslan, Ataturk University, School of Medicine Department of Emergency Medicine 25090 Erzurum TurkeyAyhan Saritas, Ataturk University, School of Medicine Department of Emergency Medicine 25090 Erzurum TurkeyZeynep Cakir, Ataturk University, School of Medicine Department of Eme...

Right Atrial Appendage: Forgotten Part of the Heart in Atrial Fibrillation

Clinical and Applied Thrombosis/Hemostasis — Thu, 18 Mar 2010 11:48:35 +0100

Atrial fibrillation (AF) is the most common clinically encountered arrhythmia in adults. Because it is associated with an increased risk of atrial thrombus formation and embolism, medical and/or electrical cardioversion is the preferred treatment method in the majority of clinics. Thrombus formation in the setting of AF most commonly occurs in the left atrial appendage (LAA), left atrium (LA), right atrial appendage (RAA), and right atrium in decreasing frequency. In routine transesophageal echocardiographic evaluation for AF, examination is generally limited to LA and LAA. Although relatively rare when compared with the left side, RAA thrombus has also the potential of embolism and should be screened. A case of RAA thrombus in which the LA and LAA were spared is described. The authors aim...

[How often is the Depersonalization-Derealization Disorder (ICD-10: F48.1) diagnosed in the outpatient health-care service?]

Zeitschrift fur Psychosomatische Medizin und Psychotherapie — Wed, 17 Mar 2010 22:12:02 +0100

Conclusions: According to epidemiological studies, the prevalence of depersonalization-derealization disorder is 1-2 %. We therefore conclude that F48.1 is severely underdiagnosed. Increased awareness for the detection of F48.1 and further health care research are urgently warranted. PMID: 20229493 [PubMed - as supplied by publisher] (Source: Zeitschrift fur Psychosomatische Medizin und Psychotherapie)

Interactions at Human ether-a-go-go-Related Gene Channels

Toxicological Sciences — Wed, 17 Mar 2010 00:49:58 +0100

In conclusion, terfenadine interacts with CnErg1 and chlorobutanol, but not with dofetilide or fluvoxamine, at hERG channels. It is shown that interactions between chlorobutanol and a hERG channel blocker binding inside the central cavity (terfenadine) produce synergistic effects on hERG currents. (Source: Toxicological Sciences)

Increased Sympathetic and Decreased Parasympathetic Activity Rather Than Changes in Hypothalamic-Pituitary-Adrenal Axis Activity Is Associated with Metabolic Abnormalities.

The Journal of Clinical Endocrinology and Metabolism — Wed, 17 Mar 2010 00:00:00 +0100

Conclusion: Our findings suggest that increased sympathetic and decreased parasympathetic nervous system activity is associated with metabolic syndrome, whereas HPA axis activity is not. PMID: 20237163 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

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CaV1.2 {beta}-subunit coordinates CaMKII-triggered cardiomyocyte death and afterdepolarizations [Biophysics_And_Computational_Biology]

Proceedings of the National Academy of Sciences — Tue, 16 Mar 2010 19:33:04 +0100

Excessive activation of calmodulin kinase II (CaMKII) causes arrhythmias and heart failure, but the cellular mechanisms for CaMKII-targeted proteins causing... (Source: Proceedings of the National Academy of Sciences)

Operational point of neural cardiovascular regulation in humans up to 6 months in space

Journal of Applied Physiology — Tue, 16 Mar 2010 14:01:59 +0100

Entering weightlessness affects central circulation in humans by enhancing venous return and cardiac output. We tested whether the operational point of neural cardiovascular regulation in space sets accordingly to adopt a level close to that found in the ground-based horizontal position. Heart rate (HR), finger blood and brachial blood pressure (BP), and respiratory frequency were collected in 11 astronauts from nine space missions. Recordings were made in supine and standing positions at least 10 days before launch and during spaceflight (days 5–19, 45–67, 77–116, 146–180). Cross-correlation analyses of HR and systolic BP were used to measure three complementary aspects of cardiac baroreflex modulation: 1) baroreflex sensitivity, 2) number of effective baroreflex e...

Medtronic CareLink(R) Network Remote Monitoring Significantly Reduced Time To Clinical Decision

Health News from Medical News Today — Tue, 16 Mar 2010 07:00:00 +0100

Medtronic, Inc. (NYSE: MDT) announced results from the CONNECT trial showing the median time to clinical decision was significantly reduced for cardiac resynchronization therapy-defibrillator (CRT-D) and implantable cardioverter-defibrillator (ICD) patients monitored remotely with the Medtronic CareLink® Network, compared to standard in-office follow-up. The trial showed the time from a patient's clinical event (arrhythmias, cardiovascular disease progression, and device issues) to the physician's clinical decision was 22 days for those monitored in-office, versus 4... (Source: Health News from Medical News Today)

Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus

British Journal of Haematology — Tue, 16 Mar 2010 00:00:00 +0100

Tumour lysis syndrome (TLS) is a life-threatening oncological emergency characterized by metabolic abnormalities including hyperuricaemia, hyperphosphataemia, hyperkalaemia and hypocalcaemia. These metabolic complications predispose the cancer patient to clinical toxicities including renal insufficiency, cardiac arrhythmias, seizures, neurological complications and potentially sudden death. With the increased availability of newer therapeutic targeted agents, such as rasburicase (recombinant urate oxidase), there are no published guidelines on the risk classification of TLS for individual patients at risk of developing this syndrome. We convened an international TLS expert consensus panel to develop guidelines for a medical decision tree to assign low, intermediate and high risk to patient...

Strict rate control in AF doesn't seem to have any advantages

NeLM - News — Tue, 16 Mar 2010 00:00:00 +0100

Source: N Engl J Med Area: News A controlled trial found that in patients with atrial fibrillation (AF), treatment to strict control of the heart rate was not associated with better outcomes over the study period (3 years) than more lenient control. AF is associated with unpleasant symptoms for the sufferer and increases the longer-term risk of stroke and heart failure: interventions to control the arrhythmia are therefore accepted practice. Studies indicate that controlling the heart rate (rate control) is as effective as rhythm control, thus rate control is the preferred option for most patients. Although the optimal level of heart rate control is unknown, guidelines recommend aiming for tight control on empirical grounds: this, however, has potential adverse effects. I...

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STOP-AF and CABANA: Trials Show Effectiveness of Ablation Over Drugs in AF

Medscape Today Headlines — Mon, 15 Mar 2010 22:09:02 +0100

In STOP-AF, patients with paroxysmal AF treated with a novel cryoablation technology were significantly more likely to be free of arrhythmia at one year compared with antiarrhythmic drug therapy. In addition, feasibility results of the CABANA pilot study were also presented. Heartwire (Source: Medscape Today Headlines)

STOP-AF and CABANA: Trials show effectiveness of ablation over drugs in AF

theHeart.org — Mon, 15 Mar 2010 19:45:27 +0100

In STOP-AF, patients with paroxysmal AF treated with a novel cryoablation technology were significantly more likely to be free of arrhythmia at one year compared with antiarrhythmic drug therapy. In... For complete story visit theheart.org. (Source: theHeart.org)

Innovations in drug treatment of atrial fibrillation

Clinical Research in Cardiology Supplements — Mon, 15 Mar 2010 17:59:58 +0100

Content Type Journal ArticleDOI 10.1007/s11789-010-0001-3Authors Nadina Stadler, St. Marienhospital Bonn Academic Hospital, University of Bonn Dept. of Internal Medicine, Heart, Vascular and Arrhythmia Center Rhineland-Bonn Robert-Koch-Str. 1 53115 Bonn GermanyThorsten Lewalter, St. Marienhospital Bonn Academic Hospital, University of Bonn Dept. of Internal Medicine, Heart, Vascular and Arrhythmia Center Rhineland-Bonn Robert-Koch-Str. 1 53115 Bonn Germany Journal Clinical Research in Cardiology SupplementsOnline ISSN 1861-0174Print ISSN 1861-0706 (Source: Clinical Research in Cardiology Supplements)

New concepts in understanding antiarrhythmic effects

Clinical Research in Cardiology Supplements — Mon, 15 Mar 2010 17:59:56 +0100

Abstract Radiofrequency catheter ablation (RFCA) has been established as a curative alternative to antiarrhythmic drug (AAD) therapy in patients with supraventricular arrhythmias other than atrial fibrillation (AF). Many currently used AAD have limited efficacy and cause cardiac and extracardiac adverse effects. There is a need for new AADs with high efficacy and a favorable safety profile in AF patients. Dronedarone and vernakalant are promising new agents with a low risk profile up to date. Effectively restoring sinus rhythm is a crucial aspect in heart failure (HF) patients with AF. RFCA, including pulmonary vein isolation and other left and right atrial ablation targets, offers the possibility of long-term suppressive or curative therapy of AF. New antiarrhythmic drug ...

Mortality risk score in primary prevention implantable cardioverter defibrillator recipients with non-ischaemic or ischaemic heart disease

European Heart Journal — Mon, 15 Mar 2010 16:45:23 +0100

Conclusion Utilization of an easily applicable baseline risk score can create an individual patient-tailored estimation on mortality risk to aid clinicians in daily practice. (Source: European Heart Journal)

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Tissue Doppler E/E' ratio is a powerful predictor of primary cardiac events in a hypertensive population: an ASCOT substudy

European Heart Journal — Mon, 15 Mar 2010 16:45:23 +0100

Conclusion Tissue Doppler E/E', a non-invasive estimate of left atrial filling pressure, independently predicts primary cardiac events in a hypertensive population and out-performed traditional echocardiographic measures in this moderately sized, well-treated hypertensive population. E/E' represents a simple, effective tool for assessing cardiac risk in a hypertensive population. (Source: European Heart Journal)

Cardiovascular disease in pregnancy

Obstetrics, Gynaecology and Reproductive Medicine — Mon, 15 Mar 2010 15:07:39 +0100

Abstract: Cardiac disease continues to be an important cause of maternal morbidity and mortality and is now the leading cause of maternal deaths in the United Kingdom. This is largely because of extensive haemodynamic changes which occur during pregnancy, namely the increase in blood volume, fluctuations in cardiac output, fall in systemic vascular resistance and hypercoagulable state. High risk periods include the end of the second trimester, during labour and the immediate postpartum period. Prognosis depends on the specific cardiac condition, the patient's functional class, presence of cyanosis, prior history of cardiac events or arrhythmia and the degree of systolic dysfunction. Conditions where pregnancy should be include Eisenmenger's syndrome, pulmonary hypertension, complex cyanoti...

Does Cholesterol Really Matter?

NaturalNews.com — Mon, 15 Mar 2010 07:00:00 +0100

(NaturalNews) I'd like to shine the spotlight on one of medicine's sacred cows- the belief that lowering cholesterol with drugs protects against heart attacks and premature death. Our obsession with cholesterol began in the 1950s when studies linked high consumption of animal fat with high rates of heart disease. This opened the door for clinical trials that laid the foundation of a new paradigm: the cholesterol theory of cardiovascular disease.This theory has had profound ramifications. It changed the way we eat (fats bad, carbohydrates good) and contributed to our problems with obesity and diabetes. It wormed its way into "clinical practice guidelines"- cholesterol management has become a "standard of care" that doctors are expected to follow. It spawned the invasive heart surgery indust...

Lead aVL P-Wave Polarity: Insight from Mapping and Ablation of Atrial Arrhythmia Initiated from Superior Vena Cava

Pacing and Clinical Electrophysiology : PACE — Mon, 15 Mar 2010 00:00:00 +0100

We report a case of focal atrial tachycardia (AT) originating from prior superior vena cava isolation line. The P-wave morphology in lead aVL during the AT differed from that during sinus rhythm although their foci were in close proximity to each other. We discuss the mechanism based on the activation maps of the right atrium. (PACE 2010; 1[ndash]2) (Source: Pacing and Clinical Electrophysiology : PACE)

The history of scientific cooperation in the field of cardiac pacing

Clinical Research in Cardiology Supplements — Sun, 14 Mar 2010 12:26:11 +0100

Abstract In this article, the development of the scientific cooperation of cardiologists with a focus on electrophysiology as well as the pharmacological and non-pharmacological treatment of arrhythmias is presented. This is achieved at the intercontinental level by the International Pacing and Electrophysiology Society, which is organized by the European Working Groups on Pacing and Arrhythmias who merged in 2003 and at the regional level by the Alpe Adria Cardiology Association in Central Europe. Content Type Journal ArticleDOI 10.1007/s11789-010-0005-zAuthors Konrad Steinbach, Österreichischer Herzfonds Türkenstraße 12/3 1090 Vienna Austria Journal Clinical Research in Cardiology SupplementsOnline ISSN 1861-0174Print ISSN 1861-0706 (Source: Clinical Resear...

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Transthoracic electrical bioimpedence cardiac output: comparison with multigated equillibrium radionuclide cardiography

Journal of Clinical Monitoring and Computing — Sun, 14 Mar 2010 11:28:42 +0100

Conclusions This study observed a moderate correlation between TEB and RNEC methods of CO measurement. Further studies are indicated to explore the relative utility of TEB in comparison with RNEC as well as other methods of CO measurement before considering its use in patients with ischemic heart disease. Content Type Journal ArticleDOI 10.1007/s10877-010-9225-5Authors Arunodaya R. Gujjar, National Institute of Mental Health and Neurosciences Bangalore 560029 IndiaK. Muralidhar, Narayana Hrudayalaya Institute of Cardiac Sciences Department of Anaesthesiology Bommasandra Industrial Area Anekal Taluk, Bangalore 560099 IndiaAbhijit Bhandopadhyaya, Narayana Hrudayalaya Institute of Cardiac Sciences Department of Anaesthesiology Bommasandra Industrial Area Anekal Taluk, ...

Development of various arrhythmias and conduction disturbances following corticosteroid therapy for systemic lupus erythematosus with antiphospholipid syndrome

Modern Rheumatology — Fri, 12 Mar 2010 06:51:26 +0100

Abstract A 45-year-old Chinese woman with active systemic lupus erythematosus, lupus anticoagulant positive, was admitted to our hospital. Electrocardiography on admission was normal. Though anti-Sjögren’s syndrome A (anti SS-A/Ro) antibodies were negative and ultrasound cardiographic findings were normal, she developed various arrhythmias/conduction disturbances shortly after starting corticosteroid. Nearly all were resolved with continuous corticosteroid and aspirin therapy before discharge. Vasculitis, the presence of antiphospholipid antibodies, and platelet aggregation due to corticosteroid were possible mechanisms underlying the arrhythmias/conduction disturbances. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10165-010-0283-9Authors Yu Kasama...

Total intravenous anesthesia and spontaneous respiration for airway endoscopy in children – a prospective evaluation

Pediatric Anesthesia — Fri, 12 Mar 2010 00:00:00 +0100

Conclusion: TIVA and spontaneous respiration is an effective technique to manage anesthesia for airway endoscopy and surgery in children. (Source: Pediatric Anesthesia)

Fatal Cardiac Arrhythmia and Long-QT Syndrome in a New Form of Congenital Generalized Lipodystrophy with Muscle Rippling (CGL4) Due to PTRF-CAVIN Mutations

PLoS Genetics — Fri, 12 Mar 2010 00:00:00 +0100

Author Summary Patients with generalized lipodystrophy have a marked lack of body fat. Several gene defects have been described that impede fat synthesis and maturation of fat cells. Here we report on mutations in a novel gene, called PTRF-CAVIN, causing congenital generalized lipodystrophy type 4 (CGL4) that is additionally associated with muscle disease. Patients' muscles are large but weak and show an involuntary, rolling contraction pattern called “rippling.” Further symptoms comprise life-threatening cardiac arrhythmias and a disorder of bone formation. We searched for shared segments in the genome of seven patients and found the responsible gene, called PTRF-CAVIN, on chromosome 17. This gene is crucial for caveolae (latin for “small caves”) formation. These small indentatio...

Influence of breathing frequency on the pattern of respiratory sinus arrhythmia and blood pressure: old questions revisited.

American Journal of Physiology. Heart and Circulatory Physiology — Fri, 12 Mar 2010 00:00:00 +0100

INFLUENCE OF BREATHING FREQUENCY ON THE PATTERN OF RESPIRATORY SINUS ARRHYTHMIA AND BLOOD PRESSURE: OLD QUESTIONS REVISITED. Am J Physiol Heart Circ Physiol. 2010 Mar 12; Authors: Sin PY, Galletly DC, Tzeng YC Respiratory sinus arrhythmia (RSA) is classically described as a vagally mediated increase and decrease in heart rate concurrent with inspiration and expiration respectively. However, although breathing frequency is known to alter this temporal relationship, the precise nature of this phase dependency and its relationship to blood pressure remains unclear. In 16 subjects we systematically examined the temporal relationships between respiration, RSA, and blood pressure by graphically portraying cardiac interval (R-R) and systolic blood pressure (SBP) variations as a functi...

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Mid-term Results of the Hancock II Valve and Carpentier-Edward Perimount Valve in the Pulmonary Portion in Congenital Heart Disease

Heart, Lung & Circulation — Thu, 11 Mar 2010 13:57:54 +0100

Conclusions: The overall survival rate associated with pulmonary valve bioprosthetic valve implantation was acceptable. However, the re-operation freedom rate was not satisfactory at mid-term for the Carpentier-Edward. (Source: Heart, Lung & Circulation)

Research Points To Way To Improve Heart Treatment

Health News from Medical News Today — Thu, 11 Mar 2010 11:00:00 +0100

Current drugs used to treat heart failure and arrhythmias (irregular heartbeat) have limited effectiveness and have side effects. New basic science findings from a University of Iowa study suggest a way that treatments could potentially be refined so that they work better and target only key heart-related mechanisms. The team, which included researchers from Vanderbilt University, showed in theory that it might be possible to use drugs that maintain the positive effects on heart function of a known enzyme called calmodulin kinase II (CaM kinase) while reducing its negative effects... (Source: Health News from Medical News Today)

Research Points To Way To Improve Heart Treatment

Cardiovascular / Cardiology News From Medical News Today — Thu, 11 Mar 2010 11:00:00 +0100

TNF-alpha and IL-1beta increase Ca(2+) leak from the sarcoplasmic reticulum and susceptibility to arrhythmia in rat ventricular myocytes.

Cell Calcium — Thu, 11 Mar 2010 00:00:00 +0100

Authors: Duncan DJ, Yang Z, Hopkins PM, Steele DS, Harrison SM Sepsis is associated with ventricular dysfunction and increased incidence of atrial and ventricular arrhythmia however the underlying pro-arrhythmic mechanisms are unknown. Serum levels of tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) are elevated during sepsis and affect Ca(2+) regulation. We investigated whether pro-inflammatory cytokines disrupt cellular Ca(2+) cycling leading to reduced contractility, but also increase the probability of pro-arrhythmic spontaneous Ca(2+) release from the sarcoplasmic reticulum (SR). Isolated rat ventricular myocytes were exposed to TNF-alpha (0.05ngml(-1)) and IL-1beta (2ngml(-1)) for 3 hr and then loaded with fura-2 or fluo-3 to record the intracellular Ca(2...

Classification of Arrhythmia Using Hybrid Networks

Journal of Medical Systems — Wed, 10 Mar 2010 16:14:06 +0100

Abstract Reliable detection of arrhythmias based on digital processing of Electrocardiogram (ECG) signals is vital in providing suitable and timely treatment to a cardiac patient. Due to corruption of ECG signals with multiple frequency noise and presence of multiple arrhythmic events in a cardiac rhythm, computerized interpretation of abnormal ECG rhythms is a challenging task. This paper focuses a Fuzzy C- Mean (FCM) clustered Probabilistic Neural Network (PNN) and Multi Layered Feed Forward Network (MLFFN) for the discrimination of eight types of ECG beats. Parameters such as fourth order Auto Regressive (AR) coefficients along with Spectral Entropy (SE) are extracted from each ECG beat and feature reduction has been carried out using FCM clustering. The cluster centers...

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Catheter ablation of atrial fibrillation with a novel, duty-cycled ablation system

Clinical Research in Cardiology Supplements — Wed, 10 Mar 2010 15:43:50 +0100

This study investigates whether a novel multielectrode catheter, delivering duty-cycled bipolar/unipolar RF energy, is feasible and safe. Therefore, 81 consecutive patients with paroxysmal or persistent AF has been analyzed. Pulmonary vein isolation with the pulmonary vein ablation catheter was safe with short fluoroscopy/procedural time and good clinical efficacy at 6 months (stable sinus rhythm in 78% of patients). Content Type Journal ArticleDOI 10.1007/s11789-010-0011-1Authors Stefan G. Spitzer, Akademische Lehrpraxisklinik der TU Dresden PRAXISKLINIK HERZ UND GEFÄSSE Forststraße 3 01099 Dresden GermanyLaszlo Karolyi, Akademische Lehrpraxisklinik der TU Dresden PRAXISKLINIK HERZ UND GEFÄSSE Forststraße 3 01099 Dresden Germany Journal Clinical Research in Cardi...

The burden of atrial fibrillation

Clinical Research in Cardiology Supplements — Wed, 10 Mar 2010 15:43:46 +0100

This article provides a brief overview of the patients and physicians, such as epidemiologic and socioeconomic burden. Content Type Journal ArticleDOI 10.1007/s11789-010-0002-2Authors Britta Weidtmann, Universitätsklinikum Schleswig-Holstein Klinik für Innere Medizin III, Campus Kiel Schittenhelmstr. 12 24105 Kiel GermanyThomas Demming, Universitätsklinikum Schleswig-Holstein Klinik für Innere Medizin III, Campus Kiel Schittenhelmstr. 12 24105 Kiel GermanyHendrik Bonnemeier, Universitätsklinikum Schleswig-Holstein Klinik für Innere Medizin III, Campus Kiel Schittenhelmstr. 12 24105 Kiel Germany Journal Clinical Research in Cardiology SupplementsOnline ISSN 1861-0174Print ISSN 1861-0706 (Source: Clinical Research in Cardiology Supplements)

Tachycardia due to atrial flutter with rapid 1:1 conduction following treatment of atrial fibrillation with flecainide

BMJ Online First — Wed, 10 Mar 2010 15:42:30 +0100

Flecainide can "organise" atrial fibrillation into atrial flutter with 1:1 conduction, leading to cardiovascular compromise. (Source: BMJ Online First)

A 34-year-old man with cardiac arrhythmias and lymphadenopathy

Clinical Research in Cardiology — Wed, 10 Mar 2010 15:28:04 +0100

Content Type Journal ArticleCategory Clinical CorrespondenceDOI 10.1007/s00392-010-0135-9Authors Nico Abegunewardene, Johannes Gutenberg-University Mainz 2nd Medical Clinic Mainz GermanyTommaso Gori, Johannes Gutenberg-University Mainz 2nd Medical Clinic Mainz GermanyMarkus Vosseler, Johannes Gutenberg-University Mainz 2nd Medical Clinic Mainz GermanyKai-Helge Schmidt, Johannes Gutenberg-University Mainz 2nd Medical Clinic Mainz GermanyChristian Taube, Johannes Gutenberg-University Mainz 3rd Medical Clinic Mainz GermanyFelix Post, Johannes Gutenberg-University Mainz 2nd Medical Clinic Mainz GermanyChristoph Düber, Johannes Gutenberg-University Mainz Department of Radiology Mainz GermanyKarl-Friedrich Kreitner, Johannes Gutenberg-University Mainz Department of Radiology Mainz GermanyTh...

Coffee associated with lower risk of arrhythmias

theHeart.org — Wed, 10 Mar 2010 14:26:51 +0100

Drinking four or more cups of java per day is associated with an 18% lower risk of hospitalization for arrhythmias, new research shows. While the data are observational and researchers don't advocate... For complete story visit theheart.org. (Source: theHeart.org)

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Electrocardiographic effects of dexmedetomidine in patients with congenital heart disease

Intensive Care Medicine — Wed, 10 Mar 2010 12:54:33 +0100

Conclusions Use of dexmedetomidine in patients with CHD and patients following cardiothoracic surgery is not associated with any significant ECG interval abnormalities other than a trend towards lower HR. Content Type Journal ArticleCategory Pediatric OriginalDOI 10.1007/s00134-010-1782-zAuthors Constantinos Chrysostomou, Children’s Hospital of Pittsburgh of UPMC Department of Pediatric Cardiology, Division of Cardiac Intensive Care 45th and Penn Avenue Pittsburgh PA 15201 USARukmini Komarlu, Children’s Hospital of Pittsburgh of UPMC Department of Pediatric Cardiology, Division of Cardiac Intensive Care 45th and Penn Avenue Pittsburgh PA 15201 USASteven Lichtenstein, Children’s Hospital of Pittsburgh of UPMC Department of Anesthesiology 45th and Penn Avenue Pit...

Author's reply

BMJ Online First — Wed, 10 Mar 2010 12:12:58 +0100

(Source: BMJ Online First)

Antitachycardia pacing associated with better survival versus shock treatment

MedWire News - Cardiology — Wed, 10 Mar 2010 00:00:00 +0100

Shock treatment of ventricular arrhythmia episodes in patients with implantable cardioverter defibrillators is associated with poorer survival than antitachycardia pacing termination, indicates a meta-analysis of four trials. (Source: MedWire News - Cardiology)

A Novel Approach to Transplanting Bone Marrow Stem Cells to Repair Human Myocardial Infarction: Delivery via a Noninfarct-relative Artery

Cardiovascular Therapeutics — Wed, 10 Mar 2010 00:00:00 +0100

The objective of the present study was to evaluate the safety and feasibility of autologous bone marrow mesenchymal stem cell transplantation via such an approach in patients with acute myocardial infarction (AMI). Sixteen patients with anterior AMI who had successfully undergone percutaneous coronary intervention (PCI) were enrolled in this pilot, randomized study. Three weeks after PCI, cultured bone marrow mesenchymal stem cells were injected into the myocardium via either the infarct-relative artery (left anterior descending branch artery, LAD) or a noninfarct-relative artery (right coronary artery, RCA). The safety and feasibility of the cell infusion were evaluated during the procedure and during 6 months of follow-up. In addition, 2D echocardiography, technetium-99m methoxyisobutyli...

Coffee Associated With Lower Risk of Arrhythmias

Medscape Today Headlines — Tue, 09 Mar 2010 23:09:19 +0100

Drinking four or more cups of java per day is associated with an 18% lower risk of hospitalization for arrhythmias, new research shows. While the data are observational and researchers don't advocate for greater consumption, they say it is good news that coffee doesn't appear to be harmful to the heart's electrical system. Heartwire (Source: Medscape Today Headlines)

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Cor triatriatum and lipomatous hypertrophy of the interatrial septum in the elderly: a case report

BioMed Central — Tue, 09 Mar 2010 00:00:00 +0100

We report the case of a 75-year-old woman with a previously undescribed association of the above stated abnormalities detected by both transthoracic and transeosophageal echocardiography. Diagnosis was confirmed by means of computed tomography. The singular physiologic and anatomic factors underlying survival until such a late age are described. The diagnostic, therapeutic and surgical management is discussed and a short review of the literature performed. (Source: BioMed Central)

Is Mechanical Dispersion a Raven of Ventricular Arrhythmias?

Journal of the American College of Cardiology: Cardiovascular Imaging — Mon, 08 Mar 2010 22:00:50 +0100

(Source: Journal of the American College of Cardiology: Cardiovascular Imaging)

Mechanical Dispersion Assessed by Myocardial Strain in Patients After Myocardial Infarction for Risk Prediction of Ventricular Arrhythmia

Journal of the American College of Cardiology: Cardiovascular Imaging — Mon, 08 Mar 2010 22:00:49 +0100

Conclusions Mechanical dispersion was more pronounced in post-MI patients with recurrent arrhythmias. Global strain was a marker of arrhythmias in post-MI patients with relatively preserved ventricular function. These novel parameters assessed by myocardial strain may add important information about susceptibility for ventricular arrhythmias after MI. (Source: Journal of the American College of Cardiology: Cardiovascular Imaging)

Coronary Venous Aneurysm in Patients Without Cardiac Arrhythmia as Detected by MDCT: An Anatomic Variant or a Pathologic Entity

Journal of the American College of Cardiology: Cardiovascular Imaging — Mon, 08 Mar 2010 22:00:49 +0100

Conclusions Coronary vein aneurysms (especially the fusiform type) were seen in up to 10% of patients with no history of cardiac arrhythmia and can be well visualized on computed tomography angiograms. (Source: Journal of the American College of Cardiology: Cardiovascular Imaging)

Assessment of Radiofrequency Ablation Lesions by CMR Imaging After Ablation of Idiopathic Ventricular Arrhythmias

Journal of the American College of Cardiology: Cardiovascular Imaging — Mon, 08 Mar 2010 22:00:49 +0100

Conclusions RF ablation lesions can be detected long term after an ablation procedure targeting ventricular arrhythmias in patients without previous infarction. Lesion size correlates with the amount of RF energy delivered and is largest when a targeted arrhythmia originates in a papillary muscle. (Source: Journal of the American College of Cardiology: Cardiovascular Imaging)

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Moderate caffeine may not hurt heart

Health News - UPI.com — Mon, 08 Mar 2010 19:02:44 +0100

SAN FRANCISCO, March 8 (UPI) -- U.S. researchers say it is unlikely moderate caffeine increases heart arrhythmia risks. (Source: Health News - UPI.com)

Testing an Exercise Intervention to Improve Aerobic Conditioning and Autonomic Function after an Implantable Cardioverter Defibrillator (ICD)

Pacing and Clinical Electrophysiology : PACE — Mon, 08 Mar 2010 00:00:00 +0100

Conclusion: The exercise after ICD trial is one of the first clinical trials to test the effects of aerobic exercise on cardiopulmonary outcomes after receiving an ICD for primary or secondary prevention of sudden cardiac arrest. (PACE 2010; 1[ndash]8) (Source: Pacing and Clinical Electrophysiology : PACE)

HCN-related channelopathies.

Pflugers Archiv : European Journal of Physiology — Mon, 08 Mar 2010 00:00:00 +0100

Authors: Baruscotti M, Bottelli G, Milanesi R, Difrancesco JC, Difrancesco D HCN channels are the molecular subunits of native funny (f-) channels of cardiac pacemaker cells and neurons. Although funny channels were first functionally described in cardiac cells in the late 1970s, cloning of HCN channels, of which four subunits are known today (HCN1-4), had to wait some 20 years to be accomplished, which delayed the investigation of HCN-related channelopathies. In cardiac pacemaker cells, the main function of f-channels is to contribute substantially to the generation of spontaneous activity of pacemaker cells and control of heart rate. Given this role in cardiac rhythm, it is natural to expect that defective f-channels (or their molecular correlates HCN4 channels) might be responsible ...

Hearts and minds: Coordination of neurocognitive and cardiovascular regulation in children and adolescents.

Biological Psychology — Mon, 08 Mar 2010 00:00:00 +0100

Authors: Chapman HA, Woltering S, Lamm C, Lewis MD Emotional reactions involve changes in both cognitive and bodily processes. Therefore, effective emotion regulation may also involve modulation of responses in both of these systems. The present study investigated the relationship between regulation of cognition and regulation of the heart in children and adolescents, using a go/nogo task in combination with the induction of negative emotions. Behavioral, temperamental and event-related brain potential (ERP) indicators of inhibitory cognitive control were collected, as was a measure of parasympathetic control of the heart (respiratory sinus arrhythmia, RSA). Independently of age, RSA was correlated with nogo N2 magnitudes during the emotion-induction procedure. RSA during the task was ...

Risk of arrhythmia and domestic low-voltage electrical injury. - Claudet I, Marechal C, Debuisson C, Salanne S.

SafetyLit: All (Unduplicated) — Sun, 07 Mar 2010 15:34:45 +0100

AIM: Analysis of domestic low-voltage (220-240V) electrical injury in children admitted to a pediatric emergency department to illustrate the low risk of initial or delayed risk of arrhythmia. MATERIAL AND METHODS: Retrospective study between 2001 and 2008... (Source: SafetyLit: All (Unduplicated))

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Ebstein's anomaly in pregnancy: Maternal and neonatal outcomes

Journal of Obstetrics and Gynaecology Research — Sun, 07 Mar 2010 00:00:00 +0100

Conclusion: When a woman with Ebstein's anomaly reaches childbearing age, fertility is not affected, even in cyanotic women. Under close supervision by the woman's obstetrician and cardiologist, the pregnancy outcome is usually favorable. (Source: Journal of Obstetrics and Gynaecology Research)

Left-Sided Atrial Flutter Originating in the Coronary Sinus after Radiofrequency Ablation of Atrial Fibrillation

Pacing and Clinical Electrophysiology : PACE — Sat, 06 Mar 2010 00:00:00 +0100

We describe a case of atypical atrial flutter presenting 1 year after radiofrequency ablation for atrial fibrillation (AF). Electrophysiologic study showed a reentry circuit involving the inferolateral aspect of the mitral annulus and the coronary sinus (CS); however, a mitral isthmus line did not terminate the arrhythmia. Participation of the proximal CS musculature in the circuit suggested a possible target for ablation. Radiofrequency energy applications from within the CS terminated the tachycardia. Mapping and ablation within the CS should be considered in patients with post-AF ablation arrhythmias, particularly when the mitral annulus appears to be involved in the tachycardia circuit. (PACE 2010; e1[ndash]e4) (Source: Pacing and Clinical Electrophysiology : PACE)

Clinical profile of acute paraphenylenediamine intoxication in Egypt

Toxicology and Industrial Health current issue — Fri, 05 Mar 2010 11:44:46 +0100

In conclusion, PPD causes serious multisystem toxicity and its selling to the public should be officially restricted. (Source: Toxicology and Industrial Health current issue)

Beta Blocker Therapy Underused In Heart Failure Patients

Health News from Medical News Today — Fri, 05 Mar 2010 08:00:00 +0100

New Saint Louis University research has found that beta blockers, a class of drugs used to prevent the progression of heart failure and manage arrhythmias (irregular heart beat) and hypertension (high blood pressure), are underused in heart failure patients who receive implantable cardiac devices. Failure to take beta blockers prior to implanting a cardiac device can affect the patient's overall outcome and survival rate, says Paul Hauptman, M.D., SLUCare cardiologist and professor of internal medicine at Saint Louis University School of Medicine and lead author of the study... (Source: Health News from Medical News Today)

Beta Blocker Therapy Underused In Heart Failure Patients

Cardiovascular / Cardiology News From Medical News Today — Fri, 05 Mar 2010 08:00:00 +0100

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Air Travel Could Raise Risk for Heartbeat Irregularities

MedlinePlus Health News — Fri, 05 Mar 2010 00:00:00 +0100

Older people with heart disease most susceptible to potential problems, small study suggests Source: HealthDay Related MedlinePlus Pages: Arrhythmia, Traveler's Health (Source: MedlinePlus Health News)

Diminished Cardiac Fibrosis in Heart Failure is Associated with Altered Ventricular Arrhythmia Phenotype

Journal of Cardiovascular Electrophysiology — Fri, 05 Mar 2010 00:00:00 +0100

Conclusion: Attenuated ventricular fibrosis is associated with reduced VT inducibility, increased VT duration, and significantly longer arrhythmia cycle length. (J Cardiovasc Electrophysiol, Vol. pp. 1[ndash]7) (Source: Journal of Cardiovascular Electrophysiology)

A Couplet of PVCs with Different QRS Morphologies Arising from a Single Origin in the Left Ventricular Outflow Tract

Pacing and Clinical Electrophysiology : PACE — Fri, 05 Mar 2010 00:00:00 +0100

A 59-year-old man with two different premature ventricular contractions (PVCs) forming a couplet underwent electrophysiological testing. Although pacing from the aorto-mitral continuity (AMC) produced an excellent pace map of one type of PVCs, a radiofrequency application within the right coronary cusp (RCC) eliminated all the PVCs. This case demonstrates that a single origin with two breakout sites in the left ventricular ostium (LVos) may result in a couplet consisting of different PVCs and preferential conduction from the RCC to AMC may also occur. These possibilities should be kept in our mind when predicting sites of origin of LVos ventricular arrhythmias. (PACE 2010; e1[ndash]e5) (Source: Pacing and Clinical Electrophysiology : PACE)

Radiofrequency Catheter Ablation of Parasystole Originating from the Inferior Vena Cava

Pacing and Clinical Electrophysiology : PACE — Fri, 05 Mar 2010 00:00:00 +0100

A 76-year-old man with a history of atrial septal defect repair underwent radiofrequency (RF) ablation of typical atrial flutter. During electrophysiological study, incessant sharp potentials were recorded, originating from the ostium of the inferior vena cava (IVC), and dissociated from atrial activity. During sinus rhythm, these potentials propagated to the atria and caused premature complexes when falling beyond the atrial refractory period. Electro-anatomical mapping revealed the presence of the earliest potential in the postero-lateral ostium of the IVC, propagating to the septal region. After RF isolation of the IVC, the patient has remained arrhythmia-free over a 5-year follow-up. (PACE 2010; e1[ndash]e4) (Source: Pacing and Clinical Electrophysiology : PACE)

Cryoablation with an 8-mm Tip Catheter for Pediatric Atrioventricular Nodal Reentrant Tachycardia Is Safe and Efficacious with a Low Incidence of Recurrence

Pacing and Clinical Electrophysiology : PACE — Fri, 05 Mar 2010 00:00:00 +0100

Conclusion: Cryoablation with an 8-mm tip ablation catheter is both safe and effective with a low risk of recurrence for the treatment of AVNRT in pediatric patients. (PACE 2010; 1[ndash]6) (Source: Pacing and Clinical Electrophysiology : PACE)

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Review: Arrhythmias and sport practice

NeLM - News — Fri, 05 Mar 2010 00:00:00 +0100

Conclusions (Source: NeLM - News)

Sudden Arrhythmia Death Syndromes Young Investigator Award in Cardiac Channelopathies

ScanGrants feed — Fri, 05 Mar 2010 00:00:00 +0100

The Sudden Arrhythmia Death Syndromes (SADS) Foundation would like to encourage the next generation of researchers in SADS conditions. Therefore, we are announcing the 2nd Annual SADS Foundation Young Investigator Award in Cardiac Channelopathies. The Award will be administered by the Pediatric and Congenital EP Society (PACES), and will be presented at the annual PACES evening meeting at HRS in Boston.To encourage the next generation of researchers in SADS conditions, the Sudden Arrhythmia Death Syndromes (SADS) Foundation is announcing the Second Annual SADS Foundation Young Investigator Award in Cardiac Channelopathies. The Award will be administered by the Pediatric and Congenital EP Society (PACES), and will be presented at the annual PACES evening meeting, Wednesday May 13th at the ...

Asymptotics of Conduction Velocity Restitution in Models of Electrical Excitation in the Heart.

Bulletin of Mathematical Biology — Fri, 05 Mar 2010 00:00:00 +0100

Authors: Simitev RD, Biktashev VN We extend a non-Tikhonov asymptotic embedding, proposed earlier, for calculation of conduction velocity restitution curves in ionic models of cardiac excitability. Conduction velocity restitution is the simplest non-trivial spatially extended problem in excitable media, and in the case of cardiac tissue it is an important tool for prediction of cardiac arrhythmias and fibrillation. An idealized conduction velocity restitution curve requires solving a non-linear eigenvalue problem with periodic boundary conditions, which in the cardiac case is very stiff and calls for the use of asymptotic methods. We compare asymptotics of restitution curves in four examples, two generic excitable media models, and two ionic cardiac models. The generic models include t...

Biological therapies for cardiac arrhythmias: can genes and cells replace drugs and devices?

Circulation Research — Fri, 05 Mar 2010 00:00:00 +0100

This article reviews the present state of the art in gene- and cell-based therapies to correct cardiac rhythm disturbances. We begin with the rationale for such approaches, briefly discuss efforts to address aspects of tachyarrhythmia, and review advances in creating a biological pacemaker to cure bradyarrhythmia. Insights gained bring the field closer to a paradigm shift away from devices and drugs, and toward biologics, in the treatment of rhythm disorders. PMID: 20203316 [PubMed - in process] (Source: Circulation Research)

Mechanisms of ventricular rate adaptation as a predictor of arrhythmic risk.

American Journal of Physiology. Heart and Circulatory Physiology — Fri, 05 Mar 2010 00:00:00 +0100

Conclusions: This study suggests that protracted QTI adaptation could be an indicator of altered [Na(+)]i dynamics following INaK inhibition as it occurs in patients with ischemia or heart failure. Increased risk of cardiac arrhythmias in patients with protracted rate adaptation may be due to increased risk of EAD formation. Key words: action potentials, ventricles, ion channels, arrhythmia. PMID: 20207815 [PubMed - as supplied by publisher] (Source: American Journal of Physiology. Heart and Circulatory Physiology)

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Simulated urban carbon monoxide air pollution exacerbates rat hearts ischemia-reperfusion injury.

American Journal of Physiology. Heart and Circulatory Physiology — Fri, 05 Mar 2010 00:00:00 +0100

In conclusion, our results are consistent with the idea that chronic CO pollution dramatically increases the severity of myocardial IR injuries. Key words: Environmental pollution, myocardial infarction, carbon monoxide, ischemia reperfusion. PMID: 20207812 [PubMed - as supplied by publisher] (Source: American Journal of Physiology. Heart and Circulatory Physiology)

New Approaches to Arrhythmia Detection and Treatment (SBIR [R43/R44])

Grants.gov — Thu, 04 Mar 2010 16:15:30 +0100

Funding Opportunity Number: PA-10-117 Opportunity Category: DiscretionaryFunding Instrument Type: GrantCategory of Funding Activity: HealthCFDA Number: 93.837Eligible Applicants Small businessesAgency Name HHS-NIH11 (Source: Grants.gov)

New Approaches to Arrhythmia Detection and Treatment (STTR [R41/R42])

Grants.gov — Thu, 04 Mar 2010 16:15:30 +0100

Funding Opportunity Number: PA-10-118 Opportunity Category: DiscretionaryFunding Instrument Type: GrantCategory of Funding Activity: HealthCFDA Number: 93.837Eligible Applicants Small businessesAgency Name HHS-NIH11 (Source: Grants.gov)

Test Of Implantable Cardioverter Defibrillator Linked To Cognitive Problems

Health News from Medical News Today — Thu, 04 Mar 2010 08:00:00 +0100

A standard test of the implantable cardioverter defibrillator (ICD) is linked to significant thought-processing problems that improve for most patients within a year after the device is inserted, according to research reported in Circulation: Arrhythmia and Electrophysiology, a journal of the American Heart Association. An ICD is a small electronic device that monitors and regulates heartbeat (somewhat similar to a pacemaker). It's inserted into the patient's chest or abdomen and connected to the heart... (Source: Health News from Medical News Today)

Test Of Implantable Cardioverter Defibrillator Linked To Cognitive Problems

Cardiovascular / Cardiology News From Medical News Today — Thu, 04 Mar 2010 08:00:00 +0100

A standard test of the implantable cardioverter defibrillator (ICD) is linked to significant thought-processing problems that improve for most patients within a year after the device is inserted, according to research reported in Circulation: Arrhythmia and Electrophysiology, a journal of the American Heart Association... (Source: Cardiovascular / Cardiology News From Medical News Today)

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Remission of paroxysmal atrial fibrillation with iron reduction in haemophilia A

Haemophilia — Thu, 04 Mar 2010 00:00:00 +0100

Summary. Two male first cousins with mild haemophilia A had baseline factor VIII levels of 12[ndash]15% and experienced bleeding requiring coagulation factor infusion therapy with trauma and surgical procedures. Both the patients with haemophilia A also had electrocardiographically documented symptomatic paroxysmal atrial fibrillation (PAF) for several years that had become resistant to pharmacological suppression. Radiofrequency ablation was considered in both the cases but deferred considering refusal of consent by the patients to undergo the procedure. Remission of arrhythmias has been reported in patients with iron-overload syndromes. Body iron stores assessed by serum ferritin levels were elevated in both men but neither had the C282Y or H63D genes for haemochromatosis. Calibrated red...

Decreased respiratory sinus arrhythmia in individuals with deceptive intent

Psychophysiology — Thu, 04 Mar 2010 00:00:00 +0100

In detecting deception, the Cognitive Load hypothesis states that lying requires more cognitive resources compared to truth telling. Further, increases in cognitive load are predicted to decrease respiratory sinus arrhythmia (RSA). We evaluated the impact of cognitive tasks and the intent to deceive on RSA in 40 male, native Arabic-speaking participants quasi-randomized into truthful (n=14) or deceptive (n=26) groups. Participants donned an ambulatory physiologic recording device and completed cognitive testing after receiving translated instructions about their role in an impending mock crime. The results show that a decrease in RSA recorded during the cognitive testing was greater in individuals who were about to commit a deceptive act. (Source: Psychophysiology)

Cocaine causes atrial purkinje fiber damage.

Ultrastructural Pathology — Wed, 03 Mar 2010 18:16:34 +0100

Authors: Gilloteaux J, Ekwedike NN Comparisons of atrial tissues from Syrian hamster offspring born from cocaine-treated mothers during the last days of pregnancy with sham-treated ones demonstrate irreversible focal ischemic damage in the Purkinje myofibers and minor endocardial damages as well as minute cardiomyocyte vacuolization. These defects are consistent with the pharmacotoxicity of cocaine or its metabolites. The damaged Purkinje myocytes apparently remain in contact with adjacent cardiomyocytes but undergo autolytic process similar to that found in autoschizic cell death. Adjacent cell type(s) appear to segregate or engulf the injured cells. Data collected in this report demonstrate why clinical bradyarrhythmias, arrhythmias, or sudden death as cardiac arrest can be found in ...

New Approaches to Arrhythmia Detection and Treatment (SBIR [R43/R44])

NIH Funding Opportunities (Notices, PA, RFA) — Wed, 03 Mar 2010 17:00:00 +0100

Program Announcement from the NIH Guide for Grants and Contracts (Source: NIH Funding Opportunities (Notices, PA, RFA))

New Approaches to Arrhythmia Detection and Treatment (STTR [R41/R42])

NIH Funding Opportunities (Notices, PA, RFA) — Wed, 03 Mar 2010 17:00:00 +0100

Program Announcement from the NIH Guide for Grants and Contracts (Source: NIH Funding Opportunities (Notices, PA, RFA))

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Reduced Risk of Hospitalization for Heart Rhythm Disturbances from Coffee

Disabled World — Wed, 03 Mar 2010 13:55:16 +0100

Coffee associated with reduced risk of hospitalization for heart rhythm disturbances - While it is not proven that coffee is protective, it is unlikely that moderate caffeine intake increases arrhythmia risk, Kaiser Permanente study finds... (Source: Disabled World)

CCDEP: Coffee Not Linked to Serious Arrhythmias (CME/CE, with audio)

MedPage Today Cardiovascular — Wed, 03 Mar 2010 12:43:01 +0100

SAN FRANCISCO (MedPage Today) -- Contrary to conventional thinking, drinking lots of coffee appears to be associated with a lower risk of hospitalization for an arrhythmia, researchers found. (Source: MedPage Today Cardiovascular)

Chiari’s network: review of the literature

Surgical and Radiologic Anatomy — Wed, 03 Mar 2010 08:50:07 +0100

Abstract The Chiari network, present in approximately 2% of the population, and is a reticulated network of fibers originating from the Eustachian connecting to different parts of the right atrium. Its presence results from incomplete reabsorption of the right valve of the sinus venosus. Chiari’s network is often clinically insignificant. However, it has been reported to be involved in the pathogenesis of thromboembolic disease, endocarditis, arrhythmias, and entrapment of catheters upon percutaneous intervention. While initially discovered and researched using autopsy dissections, Chiari’s network is often found as an incidental finding on diagnostic imaging studies, thus providing new methods for studying its incidence and clinical significance. Content Type Jour...

Emerging therapies for atrial fibrillation: is the paradigm shifting?

Journal of Interventional Cardiac Electrophysiology — Wed, 03 Mar 2010 08:09:53 +0100

Content Type Journal ArticleCategory EditorialDOI 10.1007/s10840-010-9472-xAuthors Ann C. Garlitski, Tufts University School of Medicine Tufts New England Cardiac Arrhythmia Center, The CardioVascular Center, Division of Cardiology, Department of Medicine, Tufts Medical Center 860 Washington Street Boston MA 02111 USAN. A. Mark Estes, Tufts University School of Medicine Tufts New England Cardiac Arrhythmia Center, The CardioVascular Center, Division of Cardiology, Department of Medicine, Tufts Medical Center 860 Washington Street Boston MA 02111 USA Journal Journal of Interventional Cardiac ElectrophysiologyOnline ISSN 1572-8595Print ISSN 1383-875X (Source: Journal of Interventional Cardiac Electrophysiology)

Same morphology of ventricular premature complexes triggering repeated ventricular fibrillation

Journal of Interventional Cardiac Electrophysiology — Wed, 03 Mar 2010 08:09:29 +0100

Conclusion VPCs triggering VF that occur at different times in the same patient have similar morphologies suggesting similar sites of origin for the initial VPC of VF in each patient. Content Type Journal ArticleDOI 10.1007/s10840-010-9471-yAuthors Juan José Sánchez-Muñoz, University Hospital Virgen de la Arrixaca, Murcia Arrhythmia Unit Ctra. Madrid-Cartagena 30120 El Palmar Murcia SpainArcadio García-Alberola, University Hospital Virgen de la Arrixaca, Murcia Arrhythmia Unit Ctra. Madrid-Cartagena 30120 El Palmar Murcia SpainJuan Martínez-Sánchez, University Hospital Virgen de la Arrixaca, Murcia Arrhythmia Unit Ctra. Madrid-Cartagena 30120 El Palmar Murcia SpainPablo Peñafiel-Verdú, University Hospital Virgen de la Arrixaca, Murcia Arrhythmia Unit Ctra. Ma...

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Impact of left ventricular lead position on the incidence of ventricular arrhythmia and clinical outcome in patients with cardiac resynchronization therapy

Journal of Interventional Cardiac Electrophysiology — Wed, 03 Mar 2010 08:09:29 +0100

Conclusions Thus, biventricular pacing with an anterior LV lead seems to have no impact on the incidence of ventricular arrhythmia but may be associated with an increased mortality rate due to worsening heart failure. Content Type Journal ArticleDOI 10.1007/s10840-010-9470-zAuthors Thomas Kleemann, Cardiac Arrhythmia Center at the Heart Center of Ludwigshafen Bremserstraße 79 67063 Ludwigshafen GermanyTorsten Becker, Cardiac Arrhythmia Center at the Heart Center of Ludwigshafen Bremserstraße 79 67063 Ludwigshafen GermanyMargit Strauss, Cardiac Arrhythmia Center at the Heart Center of Ludwigshafen Bremserstraße 79 67063 Ludwigshafen GermanyNgoc Dyck, Cardiac Arrhythmia Center at the Heart Center of Ludwigshafen Bremserstraße 79 67063 Ludwigshafen GermanySteffen Sc...

In vitro and in vivo evaluation of buccal bioadhesive films containing salbutamol sulphate.

Chemical and Pharmaceutical Bulletin — Wed, 03 Mar 2010 05:56:03 +0100

Authors: Singh S, Soni R, Rawat MK, Jain A, Deshpande SB, Singh SK, Muthu MS The aim of present study was to prepare and evaluate buccal bioadhesive films of salbutamol sulphate (SS) for the treatment of asthma. The films were designed to release the drug for a prolonged period of time so as to reduce the frequency of administration of the available conventional dosage forms of SS. The different proportions of sodium carboxymethylcellulose (SCMC) and Carbopol 940P (CP 940P) were used for the preparation of films. Carbopol was used to incorporate the desired bioadhesiveness in the films. The films were prepared by solvent casting method and evaluated for bioadhesion, in vitro drug release and anti asthmatic effect (bronchoprotection) in histamine induced bronchospasm of guinea pigs. In ...

Coffee Prevents Heart Arrhythmia?

Medical Headlines From Ivanhoe.com — Wed, 03 Mar 2010 05:00:00 +0100

(Ivanhoe Newswire) -- Good news for Starbucks denizens -- a few cups of coffee each day may actually prevent you from being hospitalized for heart rhythm disturbances. (Source: Medical Headlines From Ivanhoe.com)

Beta blocker therapy underused in heart failure patients

EurekAlert! - Medicine and Health — Wed, 03 Mar 2010 05:00:00 +0100

(Saint Louis University) New Saint Louis University research has found that beta blockers, a class of drugs used to prevent the progression of heart failure and manage arrhythmias (irregular heart beat) and hypertension (high blood pressure), are underused in heart failure patients who receive implantable cardiac devices. Failure to take beta blockers prior to implanting a cardiac device can affect the patient's overall outcome and survival rate. (Source: EurekAlert! - Medicine and Health)

Cocaine and Brugada Syndrome

The Poison Review — Wed, 03 Mar 2010 02:45:22 +0100

2.5 out of 5 stars Hyperkalemia and cocaine induced dynamic Brugada-type electrocardiogram. Irani F et al. Eur J Emerg Med April 2010;17:113-115. Abstract The Brugada syndrome is an EKG abnormality that can be genetic or acquired. The syndrome — especially if acquired through mutation of a gene that codes for a component of the cardiac sodium channel — is associated with ventricular arrhythmias, syncope, and even sudden death. EKG changes in Type I Brugada syndrome include coved ST elevation of 2 mm or more in the right precordial leads (V1 and V2) followed by T wave inversion. Acquired forms of Brugada syndrome are associated with electrolyte abnormalities such as hyperkalemia or drugs with sodium-channel blocking properties, including Type I antiarrhtymics, lithium, coc...

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Comparison of Dopamine and Norepinephrine in the Treatment of Shock

New England Journal of Medicine — Wed, 03 Mar 2010 00:00:00 +0100

In this comparative-effectiveness trial, there was no significant difference in the overall survival rate between patients with shock who were treated with dopamine and those who were treated with norepinephrine. However, dopamine was associated with more cardiac arrhythmias and with a higher mortality rate among patients with cardiogenic shock. (Source: New England Journal of Medicine)

Patients with heart arrhythmia can still drink coffee: study

CTV Health — Tue, 02 Mar 2010 23:00:43 +0100

Good news for those who can't get their day started without a morning cup of joe -- a new study says coffee drinkers are less likely to be hospitalized for heart rhythm disturbances. (Source: CTV Health)

Aldosterone Antagonists in Patients With Heart Failure [Letters]

JAMA — Tue, 02 Mar 2010 20:50:35 +0100

(Source: JAMA)

Aldosterone Antagonists in Patients With Heart Failure [Letters]

JAMA — Tue, 02 Mar 2010 20:50:35 +0100

(Source: JAMA)

Aldosterone Antagonists in Patients With Heart Failure--Reply [Letters]

JAMA — Tue, 02 Mar 2010 20:50:35 +0100

(Source: JAMA)

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Short- and long-term outcomes of acute upper extremity arterial thromboembolism.

Annals of Thoracic and Cardiovascular Surgery — Tue, 02 Mar 2010 19:36:31 +0100

Conclusion: Because of the high recurrence rates of thromboembolism, it seems necessary to severe anticoagulant therapy. Upper extremity thromboembolism should also be considered as one manifestation of a systemic embolism. (Ann Thorac Cardiovasc Surg 2010; 16: 31-34). PMID: 20190707 [PubMed - in process] (Source: Annals of Thoracic and Cardiovascular Surgery)

Circulation: ICD ventricular defibrillation testing affects cognitive function

Cardiovascular Business News — Tue, 02 Mar 2010 17:43:00 +0100

A standard test of implantable cardioverter-defibrillator (ICDs) is linked to significant thought-processing problems that improve for most patients within a year after the device is inserted, according to a study published in the March 2 issue of Circulation: Arrhythmia and Electrophysiology. (Source: Cardiovascular Business News)

Arrhythmias and sport practice

Heart — Tue, 02 Mar 2010 14:19:59 +0100

(Source: Heart)

Cardioversion of atrial fibrillation: the use of antiarrhythmic drugs

Heart — Tue, 02 Mar 2010 14:19:57 +0100

Atrial fibrillation (AF) is the commonest atrial arrhythmia and represents a large burden on modern health services. Large multicentre randomised trials have demonstrated that a rhythm control strategy (using antiarrhythmic drugs and direct current (DC) cardioversion) has no morbidity or mortality advantage over rate control. Therefore, for most patients, attempts to cardiovert AF to sinus rhythm (SR) should be reserved for those patients who are symptomatic despite adequate rate control. For recent-onset AF (<24 h) the use of agents like flecainide can be highly successful to pharmacologically cardiovert AF, although caution should be exercised in patients who have the potential for structural or coronary artery disease because of the risk of proarrhythmia. If there any is doubt a...

Decreased cardiac parasympathetic nerve activity of pregnant women during foot baths

Japan Journal of Nursing Science — Tue, 02 Mar 2010 00:00:00 +0100

Conclusion: A foot bath, used as part of midwives' daily nursing care, is able to decrease the cardiac parasympathetic outflow of pregnant women. (Source: Japan Journal of Nursing Science)

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Cardiac Conduction Disturbance Due To Prallethrin (Pyrethroid) Poisoning.

Journal of Medical Toxicology — Tue, 02 Mar 2010 00:00:00 +0100

We report a case of cardiac conduction disturbance due to a pyrethroid, prallethrin. A 28-year-old female presented after a suicidal consumption of prallethrin. Her clinical and laboratory parameters were normal during the first 24 h of hospital stay. On the second hospital day, she developed metabolic acidosis and sinus arrest with escape junctional rhythm. Despite correction of metabolic acidosis, the sinus arrest persisted for 3 days. She reverted back to sinus rhythm with bradycardia after this period and was discharged on the seventh hospital day. Her follow-up was uneventful. Pyrethroid poisoning can affect the gastrointestinal, respiratory, and nervous system. Most serious effects of the toxin in humans are seizures and coma. Mechanism of pyrethroid neurotoxicity is believed to be d...

Chronic stable coronary artery disease: drugs vs. revascularization

European Heart Journal — Mon, 01 Mar 2010 08:05:56 +0100

Coronary artery disease remains the leading cause of mortality in most industrialized countries, although age-standardized mortality related to coronary artery disease (CAD) has decreased by more than 40% during the last two decades. Coronary atherosclerosis may cause angina pectoris, myocardial infarction, heart failure, arrhythmia, and sudden death. Medical management of atherosclerosis and its manifestation aims at retardation of progression of plaque formation, prevention of plaque rupture, and subsequent events and treatment of symptoms, when these occur as well as treatment of the sequelae of the disease. Revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) is performed as treatment of flow-limiting coronary stenosis to reduce ...

Imaging and atrial fibrillation: the role of multimodality imaging in patient evaluation and management of atrial fibrillation

European Heart Journal — Mon, 01 Mar 2010 08:05:56 +0100

Atrial fibrillation (AF) is the most common cardiac arrhythmia, and is associated with an increased risk of cardiac morbidity and mortality. In this review, the role of multimodality imaging in the evaluation and treatment of AF is discussed in two main parts. First, an overview of the initial assessment of an AF patient is provided, including the role of different imaging techniques. Conditions that are associated with AF (coronary artery disease, heart failure, valvular heart disease, and left ventricular hypertrophy), and the assessment with various imaging modalities, will be reviewed. Furthermore, left atrial size assessment and the screening for thrombus formation are addressed. Secondly, the role of imaging in the invasive treatment of AF with catheter ablation is reviewed. Issues t...

Sevoflurane Causes Greater QTc Interval Prolongation in Elderly Patients than in Younger Patients.

Anesthesia and Analgesia — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: Sevoflurane causes greater QTc interval prolongation in elderly patients than in younger patients. Although sevoflurane does not affect the transmural dispersion of repolarization and sevoflurane-induced QTc prolongation does not advance with time and by droperidol administration, QT interval prolongation and its associated arrhythmias should be carefully monitored during sevoflurane anesthesia in elderly patients. PMID: 20185656 [PubMed - in process] (Source: Anesthesia and Analgesia)

Adenosine during arrhythmia.

American Journal of Critical Care — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Pelter MM, Carey MG, Kasmani R, Irani F PMID: 20194616 [PubMed - in process] (Source: American Journal of Critical Care)

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Cardiac Surgical Nurses' Use of Atrial Electrograms to Improve Diagnosis of Arrhythmia.

American Journal of Critical Care — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions Nurses' use of atrial electrograms improves diagnoses of cardiac arrhythmias. PMID: 20194609 [PubMed - as supplied by publisher] (Source: American Journal of Critical Care)

Role of spiral wave pinning in inhomogeneous active media in the termination of atrial fibrillation by electrical cardioversion

Computers in Biology and Medicine — Mon, 01 Mar 2010 00:00:00 +0100

Abstract: Atrial fibrillation is the most common type of arrhythmia to affect humans. One of the treatment modalities for atrial fibrillation is an electrical cardioversion. Electrical cardioversion can result in one of three outcomes: an immediate termination of arrhythmic activity, a delayed termination or unsuccessful termination. The mechanism of delayed termination is unknown. Here we present a model of an atrial fibrillation as a coexistence of several spiral waves pinned to the inhomogeneities in active media. We show that in inhomogeneous system delayed termination can be explained as the unpinning of a spiral wave from inhomogeneities and its termination after collision with the edge of the system. (Source: Computers in Biology and Medicine)

Rivaroxaban—Once daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation: Rationale and Design of the ROCKET AF study

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: The ROCKET AF study will determine the efficacy and safety of rivaroxaban as an alternative to warfarin for the prevention of thromboembolism in patients with AF. (Source: American Heart Journal)

Catheter Ablation Mortality Is Volume Dependent

Cardiology News — Mon, 01 Mar 2010 00:00:00 +0100

SNOWMASS, COLO. — In-hospital mortality owing to left atrial catheter ablation for atrial fibrillation is markedly increased at lower-volume centers, according to a recent analysis of all patients in the Medicare database undergoing the increasingly popular procedure. (Source: Cardiology News)

Ablation Bests Drug Therapy for Refractory Paroxysmal AF

Cardiology News — Mon, 01 Mar 2010 00:00:00 +0100

Major Finding: At 9 months, 66% of paroxysmal atrial fibrillation patients who received radiofrequency catheter ablation were free from treatment failure, compared with 16% of patients who received drug therapy. (Source: Cardiology News)

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Trial of Catheter Ablation for AF Is Underway: CABANA could resolve the question of which type of control is better for atrial fib: rate or rhythm.

Cardiology News — Mon, 01 Mar 2010 00:00:00 +0100

SNOWMASS, COLO. — The large multicenter CABANA trial, which is now in the process of recruiting patients, may be the last and best chance to learn if maintaining sinus rhythm confers a survival advantage over rate control in patients with atrial fibrillation. (Source: Cardiology News)

Capsule Endoscopies Do Not Interfere With Cardiac Devices

Cardiology News — Mon, 01 Mar 2010 00:00:00 +0100

SAN DIEGO — The largest study to date of performing capsule endoscopy in patients with implanted cardiac devices suggests that neither type of device interferes with the other. (Source: Cardiology News)

Statin Cut ICD Shocks 54% In Heart Failure Patients

Cardiology News — Mon, 01 Mar 2010 00:00:00 +0100

SAN DIEGO — Statin therapy slashed appropriate implantable cardioverter-defibrillator shocks by 54% and all-cause mortality by 95% in a nonrandomized observational study of patients who had advanced heart failure and were undergoing combined ICD and cardiac resynchronization therapy. (Source: Cardiology News)

Sleep apnea and ventricular arrhythmias: Clinical outcome, electrophysiologic characteristics, and follow-up after catheter ablation.

Journal of Cardiology — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSIONS: Ventricular arrhythmia patients with sleep apnea have a high recurrence of arrhythmias after successful catheter ablation. Patients with ventricular arrhythmias should be systematically assessed for sleep apnea owing to the potential detrimental effects of sleep apnea in the follow-up period. PMID: 20206074 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

Factors contributing to left atrial enlargement in adults with normal left ventricular systolic function.

Journal of Cardiology — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: Increased LV wall thickness and decreased hemoglobin concentration might contribute to LA enlargement in patients with normal LV systolic function irrespective of gender. PMID: 20206072 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

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Desmin myopathy with severe cardiomyopathy in a Uruguayan family due to a codon deletion in a new location within the desmin 1A rod domain

Neuromuscular Disorders — Mon, 01 Mar 2010 00:00:00 +0100

We report a five generation Uruguayan family with severe cardiomyopathy and skeletal myopathy. Its most striking features are: atrial dilation, arrhythmia, conduction block and sudden death due to conduction impairment. Affected skeletal muscle shows alteration of mitochondria with paracrystallin inclusions and granulofilamentous material scattered in the muscle fibres. This family carries an unusual deletion p.E114del within the 1A rod domain of desmin. Transfected cells expressing the mutated desmin show punctuated and speckled cytoplasmic aggregates. The mutation causes a local conformational change in heptads a/d residues and charge positions. These findings lead to the hypothesis that coiled-coil interactions may be impaired, resulting in severe alterations in the desmin network. This...

Toward a Personal Health Society in Cardiology

Information Technology in Biomedicine, IEEE Transactions on - new TOC — Mon, 01 Mar 2010 00:00:00 +0100

In this paper, we present a new generation of health services that has emerged due to the development of advanced information and communication technology (ICT) solutions, like the Enhanced Personal, Intelligent, and Mobile system for Early Detection and Interpretation of Cardiac Syndromes (EPI-MEDICS). It is a personal self-care system that allows any citizen to self-record high-quality ECGs on demand with a smart portable device, which is endowed with powerful ICT capabilities: self-adaptive embedded intelligence, mobile health record management support on SmartMedia card, embedded Web server, and wireless communication. The EPI-MEDICS solution design also provides ambient, intelligent, and pervasive computing services offering any citizen a ubiquitous, reliable, and efficient management...

Atrial Arrhythmia Strikes 13% After Lung Cancer Surgery

Hospitalist News — Mon, 01 Mar 2010 00:00:00 +0100

FORT LAUDERDALE, FLA. — Patients undergoing lung resection for non–small cell lung cancer had a 13% risk for developing a new atrial arrhythmia in a review of nearly 14,000 patients in a nationwide database involving 111 centers. (Source: Hospitalist News)

Results of the modified Fontan procedure are not related to age at operation [Original articles]

European Journal of Cardio-Thoracic Surgery — Fri, 26 Feb 2010 22:01:57 +0100

Conclusions: The modified Fontan operation can be performed safely in older patients without affecting operative and medium-term follow-up results. Postponing the extracardiac Fontan operation may have the advantage of the use of a larger conduit. (Source: European Journal of Cardio-Thoracic Surgery)

Measuring the Pediatric Nurses' Knowledge, Perception, and Behaviors Concerning Clinical Alarms

Journal of Pediatric Nursing — Fri, 26 Feb 2010 14:57:47 +0100

Clinical monitoring is a key tool for patient safety as it alerts clinicians to patient deviations from a predetermined “normal” status. However, when alerted excessively for clinically insignificant events, clinicians may ignore or silence the alarms. Results from an online survey for hospitals and clinicians, sponsored by the American College of Clinical Engineers, found that 77% of respondents felt that clinical alarms to disrupt patient care and 78% reported that the frequency of alarms can reduce trust in alarms and cause clinicians to disable them. Preliminary data collection at our organization in August 2007 indicated that a total of 8732 alarms occurred over a 10 day period; 51.25% of these alarms were heart rate alarms, 17.58% were pulse oximetry alarms, and 31.17% were arrhy...

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Prevalence and Prognostic Significance of Exercise-Induced Right Bundle Branch Block

The American Journal of Cardiology — Fri, 26 Feb 2010 13:53:28 +0100

Exercise-induced (EI) right bundle branch block (RBBB) is an infrequent electrocardiographic phenomenon, and controversy exists regarding its association with cardiovascular disease. We compared the prevalence and prognostic significance of RBBB, abnormal ST depression, and normal electrocardiographic findings in response to exercise testing in 9,623 consecutive veterans who underwent exercise testing from 1987 to 2007. EI RBBB, EI ST depression, and a normal exercise electrocardiographic response occurred in 0.24%, 15.2%, and 71.9% veterans, respectively. After appropriate exclusions, of the 8,047 patients analyzed, 6 patients in the EI RBBB subgroup died. Of these 6 deaths, 3 were cardiovascular deaths during the 9 years of follow-up. The annual death rate was 7.3% (1.4% cardiac deaths),...

Association of the Long QT Syndrome With Goiter and Deafness

The American Journal of Cardiology — Fri, 26 Feb 2010 13:53:28 +0100

We report on the long QT syndrome occurring in conjunction with nontoxic multinodular goiter and sensorineural deafness in several siblings of a large family. Autosomal and X-linked recessive and dominant modes of inheritance are possible for the different phenotypes. The affected family members had various phenotype combinations, suggesting variable expressivity and incomplete penetrance. (Source: The American Journal of Cardiology)

Inflammatory myofibroblastic tumour at the pacemaker site [Case report - Thoracic oncologic]

Interactive CardioVascular and Thoracic Surgery — Fri, 26 Feb 2010 01:18:44 +0100

We report an unusual case of IMT which had undergone malignant transformation in the chest wall at the pacemaker site. A 64-year-old male presented with a history of high fever, loss of appetite and weight loss of three months duration. He had a dual chamber pacemaker reinserted in the left infraclavicular region in the previous year. This was followed by a gradually enlarging hard swelling at the insertion site. The CT-scan showed a soft tissue mass encasing the pacing box, without intrathoracic extension. The trucut biopsy was suspicious of soft tissue sarcoma. A well encapsulated hard mass, with pacemaker embedded within it was resected en-bloc ensuring wide resection margins. Histology revealed fascicles of spindle cell proliferation with prominent inflammatory component, occasional sp...

[Seminar] Dilated cardiomyopathy

LANCET — Fri, 26 Feb 2010 00:00:00 +0100

Dilated cardiomyopathy is characterised by left ventricular dilation that is associated with systolic dysfunction. Diastolic dysfunction and impaired right ventricular function can develop. Affected individuals are at risk of left or right ventricular failure, or both. Heart failure symptoms can be exercise-induced or persistent at rest. Many patients are asymptomatic. Chronically treated patients sometimes present acutely with decompensated heart failure. Other life-threatening risks are ventricular arrhythmias and atrioventricular block, syncope, and sudden death. Genetic inheritance arises in 30–48% of patients, and inflammatory disorders such as myocarditis or toxic effects from medications, alcohol, or illicit drugs also result in dilated cardiomyopathy. Genes that cause dilated car...

Possible mechanisms of sudden cardiac death in top athletes: a basic cardiac electrophysiological point of view.

Pflugers Archiv : European Journal of Physiology — Fri, 26 Feb 2010 00:00:00 +0100

Authors: Varró A, Baczkó I Sudden death among athletes is very rare (1:50,000-1:100,000 annually) but it is still 2-4 times more frequent than in the age-matched control population and attracts significant media attention. We propose a mechanism underlying sudden cardiac death in athletes that does not relate to myocardial ischemia but is based on repolarization abnormalities due to potassium channel downregulation and can also be best explained by the concurrent presence of several factors such as cardiac hypertrophy (athlete's heart), and/or hypertrophic cardiomyopathy, increased sympathetic tone, genetic defects, drugs, doping agents, food, or dietary ingredients. These factors together can increase the repolarization inhomogeneity of the heart ("substrate") and an otherwi...

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[Risk of arrhythmia and domestic low-voltage electrical injury.]

Archives de Pediatrie — Fri, 26 Feb 2010 00:00:00 +0100

CONCLUSION: After a low-voltage electrical injury, initial arrhythmia is not frequent, with often a nonspecific and transitory EKG expression; delayed arrhythmia is very rare. Children presenting to the emergency department after such an electrical accident, who are asymptomatic, without any risk factors for arrhythmia (wet skin, tetany, vertical pathway of the current, preexistent cardiological conditions, loss of consciousness) and with a normal initial EKG do not require cardiac monitoring. PMID: 20189784 [PubMed - as supplied by publisher] (Source: Archives de Pediatrie)

Heterogeneous ventricular sympathetic innervation, altered {beta} adrenergic receptor expression, and rhythm instability in mice lacking p75 neurotrophin receptor.

American Journal of Physiology. Heart and Circulatory Physiology — Fri, 26 Feb 2010 00:00:00 +0100

We examined the innervation of adult p75(NTR)-/- ventricles and discovered that the subendocardium of the p75(NTR)-/- left ventricle was essentially devoid of sympathetic nerve fibers, while the innervation density of the subepicardium was normal. This phenotype is similar to that seen in mice over-expressing semaphorin3a, and we found that sympathetic axons lacking p75(NTR) are more sensitive to semaphorin3a in vitro than control neurons. The lack of subendocardial innervation was associated with decreased dP/dt, altered cardiac beta1 adrenergic receptor (beta1AR) expression and sensitivity, and a significant increase in spontaneous ventricular arrhythmias. The lack of p75(NTR) also resulted in increased tyrosine hydroxylase content in cardiac sympathetic neurons and elevated norepinephri...

Increased Late Sodium Current in Left Atrial Myocytes of Rabbits with Left Ventricular Hypertrophy : Its Role in the Genesis of Atrial Arrhythmias.

American Journal of Physiology. Heart and Circulatory Physiology — Fri, 26 Feb 2010 00:00:00 +0100

Authors: Guo D, Young LH, Wu Y, Belardinelli L, Kowey PR, Yan GX Left ventricular hypertrophy (LVH) is frequently associated with clinical atrial arrhythmias, but little is known about how it causes those arrhythmias. Our previous studies have shown that LVH increases the late sodium current (INa-L) that plays an important role in genesis of ventricular arrhythmias. We hypothesize that LVH may also induce an up-regulation of the INa-L in atrial myocytes, leading to atrial electrical abnormalities. The renovascular hypertension model was used to induce LVH in rabbits. Action potential and membrane current recordings were performed in single myocytes. At a pacing cycle length of 2000 ms, spontaneous phase-2 early afterdepolarizations (EADs) could be recorded from the left atrial myocytes...

Prognostic Importance of Atrial Fibrillation in Implantable Cardioverter-Defibrillator Patients

Journal of the American College of Cardiology — Thu, 25 Feb 2010 13:51:48 +0100

Conclusions: In the population currently receiving ICD treatment outside the setting of clinical trials, a large portion has either a history of AF or permanent AF. Both types of AF have prognostic implications for mortality and appropriate as well as inappropriate device discharge. (Source: Journal of the American College of Cardiology)

The anti-protozoal drug pentamidine blocks KIR2.x-mediated inward rectifier current by entering the cytoplasmic pore region of the channel

British Journal of Pharmacology — Thu, 25 Feb 2010 00:00:00 +0100

Conclusions and implications: Pentamidine inhibits cardiac IK1 by interacting with three negatively charged amino acids in the cytoplasmic pore region. Our findings may provide new insights for development of specific IK1 blocking compounds. (Source: British Journal of Pharmacology)

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Ostial plication: a rarely reported cause of sudden death

Diagnostic Pathology — Thu, 25 Feb 2010 00:00:00 +0100

We report a rare case of ostial plication as a potential cause of sudden death. Very few reports and images are available in the specialized literature regarding this anomaly. Ostial plication may be a source of sudden death or cause of death when no other significant autopsy findings are present.Ostial plication is a congenital severe obstruction/occlusion of the right or left ostium. Plication of the aortic wall leads to a "valve-like" ridge that can act as a door blocking inflow during diastolic filling, with consequent ischemia and a potentially life-threatening arrhythmia. The true incidence of this condition and its relationship to sudden death have not been reported in the literature.We believe that this case will be useful to autopsy pathologists in detecting this infrequent anomal...

Carotid Artery Stenting in Octogenarians. Periprocedural Stroke Risk Predictor Analysis From the Multicenter Carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events (CAPTURE 2) Clinical Trial.

Stroke — Thu, 25 Feb 2010 00:00:00 +0100

CONCLUSIONS: Patients >/=80 years old have higher periprocedural event rates than nonoctogenarians. Age, symptomatic status, and lesion length should be considered when identifying appropriate candidates for the procedure. PMID: 20185789 [PubMed - as supplied by publisher] (Source: Stroke)

Antibodies to Platelet Factor 4-Heparin Complex and Outcome in Hemodialysis Patients with Diabetes.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 25 Feb 2010 00:00:00 +0100

CONCLUSIONS: In hemodialysis patients who have type 2 diabetes and are treated with acetylsalicylic acid, PF4-H-ABs are associated with sudden and all-cause death. Further studies are needed to elucidate this association. PMID: 20185595 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

Wt1 and Retinoic Acid Signaling in the Subcoelomic Mesenchyme Control the Development of the Pleuropericardial Membranes and the Sinus Horns.

Circulation Research — Thu, 25 Feb 2010 00:00:00 +0100

Conclusions: Pericardium and sinus horn formation are coupled and depend on the expansion and correct temporal release of pleuropericardial membranes from the underlying subcoelomic mesenchyme. Wt1 and downstream Raldh2/retinoic acid signaling are crucial regulators of this process. Thus, our results provide novel insight into the genetic and cellular pathways regulating the posterior extension of the mammalian heart and the formation of its coelomic lining. PMID: 20185795 [PubMed - as supplied by publisher] (Source: Circulation Research)

Year-long upregulation of connexin43 in rabbit hearts by heavy ion irradiation

AJP: Heart and Circulatory Physiology — Wed, 24 Feb 2010 22:23:38 +0100

This study investigated the time- and dose-dependent effects of THIR (5–15 Gy) on Cx43 expression in normal rabbit hearts (n = 45). Five rabbits without THIR were used as controls. A significant upregulation of Cx43 protein and mRNA in the ventricular myocardium was recognized by immunohistochemistry, Western blotting, and real-time PCR from 2 wk up to 1 yr after a single THIR at 15 Gy. THIR ≥10 Gy caused a significant dose-dependent increase of Cx43 protein and mRNA 2 wk after THIR. Anterior, lateral, and posterior free wall of the left ventricle, interventricular septum, and right ventricular free wall were affected similarly by THIR in terms of Cx43 upregulation. The radiation-induced increase of immunolabeled Cx43 was observed not only at the intercalated disk region but also ...

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Gap junction heterogeneity as mechanism for electrophysiologically distinct properties across the ventricular wall

AJP: Heart and Circulatory Physiology — Wed, 24 Feb 2010 22:23:37 +0100

Gap junctions are critical to maintaining synchronized impulse propagation and repolarization. Heterogeneous expression of the principal ventricular gap junction protein connexin43 (Cx43) is associated with action potential duration (APD) dispersion across the anterior ventricular wall. Little is known about Cx43 expression patterns and their disparate impact on regional electrophysiology throughout the heart. We aimed to determine whether the anterior and posterior regions of the heart are electrophysiologically distinct. Multisegment, high-resolution optical mapping was performed in canine wedge preparations harvested separately from the anterior left ventricle (aLV; n = 8) and posterior left ventricle (pLV; n = 8). Transmural APD dispersion was significantly greater on the aLV than the ...

FDA: Combining HIV drugs could cause life-threatening heart arrhythmias

Cardiovascular Business News — Wed, 24 Feb 2010 14:50:39 +0100

The FDA has warned physicians to exude caution when administering saquinavir (Invirase, Roche) with a boost of ritonavir (Norvir, Abbott) as a treatment for HIV infection, after a clinical trial found that the combination could potentially cause abnormal heart rhythms. (Source: Cardiovascular Business News)

Transseptal versus transaortic approach for radiofrequency ablation in patients with cardioverter–defibrillator and electrical storm

Journal of Interventional Cardiac Electrophysiology — Wed, 24 Feb 2010 06:52:01 +0100

Conclusions Transseptal approach is an accurate, safe, feasible, and effective method of RF ablation in patients with malignant, recurrent ventricular arrhythmias. However, limited access to the septal regions with the use of this method has to be remembered. Transseptal approach may be considered as an alternative to the transaortic route in patients with contraindication to the latter. Content Type Journal ArticleDOI 10.1007/s10840-009-9464-xAuthors Slawomir Pluta, Silesian Medical University, Silesian Center of Heart Diseases 1st Department of Cardiology Ul. Szpitalna 2 41-800 Zabrze PolandRadoslaw Lenarczyk, Silesian Medical University, Silesian Center of Heart Diseases 1st Department of Cardiology Ul. Szpitalna 2 41-800 Zabrze PolandPatrycja Pruszkowska-Skrzep,...

Flecainide for cardioversion in patients at elevated cardiovascular risk and persistent atrial fibrillation: a prospective observational study

Clinical Research in Cardiology — Wed, 24 Feb 2010 06:48:13 +0100

Conclusions When monitored properly, flecainide is safe and useful for cardioversion in patients at elevated cardiovascular risk. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00392-010-0129-7Authors Fikret Er, Heart Center of the University of Cologne Department of Internal Medicine III Kerpener Str. 62 50937 Cologne GermanyOrhan Aslan, Heart Center of the University of Cologne Department of Internal Medicine III Kerpener Str. 62 50937 Cologne GermanyEvren Caglayan, Heart Center of the University of Cologne Department of Internal Medicine III Kerpener Str. 62 50937 Cologne GermanyNatig Gassanov, Heart Center of the University of Cologne Department of Internal Medicine III Kerpener Str. 62 50937 Cologne GermanyAmir M. Nia, Heart Center of the Universit...

Use of the Wearable External Cardiac Defibrillator in Children

Pacing and Clinical Electrophysiology : PACE — Wed, 24 Feb 2010 00:00:00 +0100

Conclusions: The WCD is an option for children of appropriate size who are at increased risk for sudden cardiac death, but in whom the risk of ICD implantation outweighs the benefit. Careful patient selection and education is important to ensure safety, as noncompliance with wear was common in this series of children. (PACE 2010; 1[ndash]5) (Source: Pacing and Clinical Electrophysiology : PACE)

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SCHILLER Provides the World's First Zoom Function for the Easy Detection of Atrial Fibrillation

Hospital Management — Wed, 24 Feb 2010 00:00:00 +0100

SCHILLER is proud to introduce a new and revolutionary medical tool called AF Toolbox, which allows the early and fast detection of atrial fibrillation based on regular resting ECGs. It is the result of a joint development project between EPFL (Swiss Federal Institute of Technology) Lausanne and SCHILLER medical technology engineers*. Highly efficient and time-saving Atrial fibrillation is the most common cardiac arrhythmia but in most patients it is difficult to detect. Thanks to this unique AF Toolbox (Atrial Fibrillation Toolbox), atrial fibrillations – which are the most ... Read More Related Links: SCHILLER to Exhibit its Cardiopulmonary Diagnostics Products at ECR 2010 and ACC 2010The Next Generation - SCHILLERmedilog Holter Recor...

SCHILLER Provides the World's First Zoom Function for the Easy Detection of Atrial Fibrillation

Hospital Management — Wed, 24 Feb 2010 00:00:00 +0100

Thyroid Function and Cardiac Surgery: What Should We Measure, and When? [CORRESPONDENCE]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:26 +0100

(Source: The Annals of Thoracic Surgery)

Reply [CORRESPONDENCE]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:26 +0100

(Source: The Annals of Thoracic Surgery)

Chronic Atrial Fibrillation Is Associated With Reduced Survival After Aortic and Double Valve Replacement [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions Chronic AF negatively affects survival after AVR with or without CABG and DVR with a mechanical prosthesis. Prospective randomized evaluation of AF ablation is suggested for these patients. (Source: The Annals of Thoracic Surgery)

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Venlafaxine Not Linked to Sudden Cardiac Death

Medscape Medical News Headlines — Tue, 23 Feb 2010 17:32:11 +0100

The antidepressant venlafaxine is not linked to an excess risk of sudden cardiac death or to life-threatening arrhythmias compared with other common antidepressants, according to a nested case-control study reported online in BMJ on February 10th. Reuters Health Information (Source: Medscape Medical News Headlines)

When The Heart Gets Out Of Step Newly Identified Gene May Open Route To Innovative Treatments For Atrial Fibrillation

Health News from Medical News Today — Tue, 23 Feb 2010 09:00:00 +0100

Atrial fibrillation is a cardiac arrhythmia a chronic irregularity of heartbeat which affects an estimated 1 million people in Germany. Although the condition is not acutely life-threatening, it does increase the risk of developing more serious illnesses, such as cardiac insufficiency, stroke and dementia. In the third of a series of genomewide asssociation studies, an international team of researchers, led by LMU physician PD Dr. Stefan KÃ¤Ã¤b, now reports the identification of a new gene locus that has a significant influence on risk for atrial fibrillation... (Source: Health News from Medical News Today)

When The Heart Gets Out Of Step Newly Identified Gene May Open Route To Innovative Treatments For Atrial Fibrillation

Cardiovascular / Cardiology News From Medical News Today — Tue, 23 Feb 2010 09:00:00 +0100

Ventricular arrhythmias in patients treated with methadone for opioid dependence

Journal of Interventional Cardiac Electrophysiology — Tue, 23 Feb 2010 07:51:19 +0100

Conclusion Ventricular arrhythmias in patients on methadone are an uncommon but important problem. Buprenorphine, a partial µ-opiate–receptor agonist and a κ-opiate–receptor antagonist does not cause QTP or TdP. Buprenorphine is a useful and effective alternative to methadone in a select group of patients, including those with documented ventricular arrhythmias on methadone. Pacemakers or defibrillators should be reserved for patients who have failed buprenorphine or a reduced methadone dose. Content Type Journal ArticleDOI 10.1007/s10840-009-9465-9Authors Sam Hanon, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine Division of Cardiology New York NY USARandy M. Seewald, University Hospital and Ma...