MedWorm: Electrocardiogram

Electroencephalogram and electrocardiograph assessment of mental fatigue in a driving simulator.

Accident; Analysis and Prevention. — Wed, 08 Feb 2012 21:35:06 +0100

In this study, we measured mental fatigue in drivers using electroencephalogram (EEG) and electrocardiograph (ECG). Together, thirteen healthy subjects performed a continuous simulated driving task for 90min with simultaneous ECG and multi-channel EEG recording of each subject. Several important physiological parameters were investigated using preprocessed ECG and EEG signals. The results show that the EEG alpha and beta, the relative power, the amplitude of P300 wave of event-related potential (ERP), the approximated entropy of the ECG, and the lower and upper bands of power of heart rate variability (HRV) are significantly different before and after finishing the driving task (p<0.05). These metrics are possible indices for measuring simulated driving mental fatigue. PMID: 2226948...

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CardioComm enters mobile cardiac telemetry market

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

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

Shortening of Donepezil-induced QTc Prolongation with a Change in the Interacting Drug, after Electrocardiograph Monitoring by Community Pharmacists: A Case Report.

Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan — Mon, 06 Feb 2012 21:06:03 +0100

We report the case of a patient in whom the risk of drug-induced torsades de pointes (TdP) was lowered, after monitoring by community pharmacists. Case: An 80-year-old woman was under donepezil (5 mg/d) therapy for Alzheimer's disease and also taking other drugs that interact with donepezil, namely, benidipine (8 mg/d) and atorvastatin (10 mg/d). The patient was visited almost every month, and an electrocardiogram was usually obtained. QTc prolongation (avg. 470±9 ms) was observed in the first to third tests. Her doctor was informed about these results and the risk factors (advanced age, gender, and drugs interactions (benidipine and atorvastatin)) associated with TdP and asked to respond promptly since several cases of donepezil-induced TdP have been reported. As a result, benidipine was...

Hidradenitis suppurativa resulting in systemic amyloid A amyloidosis: A case report and review of the literature.

Dermatol Online J — Mon, 06 Feb 2012 12:54:18 +0100

We describe a 39-year-old man with a long history of recurrent, tender, erythematous nodules in the axillary and anogenital regions, resulting in abscesses, sinus tract formation, and large areas of scarring. After 21 years of cutaneous disease with concurrent elevated systemic inflammatory markers, the patient was noted to have significant proteinuria. A kidney biopsy and immunostaining revealed deposits of amyloid A. Echocardiogram and electrocardiogram showed ventricular and atrial wall thickening with an appearance consistent with cardiac amyloid deposition. Systemic amyloid A amyloidosis is a serious, but rare, complication of chronic inflammatory disorders, including hidradenitis suppurativa, with potential multi-organ involvement including renal and cardiac manifestations. Amyloid A...

Electroencephalogram and electrocardiograph assessment of mental fatigue in a driving simulator. - Zhao C, Zhao M, Liu J, Zheng C.

SafetyLit: All (Unduplicated) — Mon, 06 Feb 2012 11:54:53 +0100

Gender Differences in Cardiac Repolarization Following Intravenous Sotalol Administration

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

Conclusion: Females had greater QTc prolongation than males following sotalol administration. This enhanced response to drug action may explain the higher incidence of drug-induced TdP seen in females. (Source: Journal of Cardiovascular Pharmacology and Therapeutics)

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

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

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

Stimulation of gastric slow waves with manual acupuncture at acupuncture points ST36 and PC6 – A randomized single blind controlled trial

Neurogastroenterology and Motility — Mon, 06 Feb 2012 05:00:00 +0100

Conclusions & Inferences Our study suggests that manual stimulation of acupuncture needles at ST36 and PC6 affects gastric myoelectrical as well as cardiac activities in healthy volunteers. The effect of stimulation in acupuncture deserves further investigation. (Source: Neurogastroenterology and Motility)

Myocardial infarction secondary to unintentional ingestion of hydrogen peroxide.

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

Authors: Islamoglu Y, Cil H, Atilgan Z, Elbey MA, Tekbas E, Yazici M Abstract Ingestion of acid-containing household products, either accidentally or as a suicide attempt, is a common form of intoxication. A clear and odorless liquid, hydrogen peroxide is an oxidizing agent found in most households and many industrial environments. Cardiovascular manifestations of hydrogen peroxide ingestion are extremely rare. Here we report a 60 year-old woman with acute inferolateral myocardial infarction (MI) after hydrogen peroxide ingestion, who had no history of coronary artery disease. Physicians dealing with hydrogen peroxide ingestion in the emergency department should be aware of the probability of MI and obtain an electrocardiogram, even if the patient has no cardiac complaint. (Cardiol...

Tako-tsubo cardiomyopathy precipitated by alcohol withdrawal.

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

We report a case of TCM in a post-menopausal woman that was precipitated by alcohol withdrawal. (Cardiol J 2012; 19, 1: 81-85). PMID: 22298173 [PubMed - in process] (Source: Cardiology Journal)

Zolmitriptan-induced acute myocardial infarction.

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

We present the case of a 45 year-old woman with a history of migraine with visual aura since the age of 20. She had no history of diabetes mellitus, hypertension, smoking or any other risk factors for cardiovascular events before she was admitted to our emergency room with typical chest pain. An electrocardiogram revealed anterior myocardial infarction following her monthly dose of oral zolmitriptan. Catherization revealed a normal coronary arterial system. The laboratory indices for cardiac risk were within normal ranges. The patient was advised to avoid triptans permanently on being discharged. (Cardiol J 2012; 19, 1: 76-78). PMID: 22298171 [PubMed - in process] (Source: Cardiology Journal)

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ST-segment resolution after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction.

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

Conclusions: In patients with STEMI undergoing PPCI, ST-segment resolution in electrocardiograms recorded 90-120 min after initiation of PPCI did not predict long-term mortality. (Cardiol J 2012; 19, 1: 61-69). PMID: 22298169 [PubMed - in process] (Source: Cardiology Journal)

Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Objectives and Design

American Journal of Epidemiology — Fri, 03 Feb 2012 05:00:00 +0100

In this report, the authors delineate the study’s objectives, principal methodological features, and timeline. At baseline, ELSA-Brasil enrolled 15,105 civil servants from 5 universities and 1 research institute. The baseline examination (2008–2010) included detailed interviews, clinical and anthropometric examinations, an oral glucose tolerance test, overnight urine collection, a 12-lead resting electrocardiogram, measurement of carotid intima-media thickness, echocardiography, measurement of pulse wave velocity, hepatic ultrasonography, retinal fundus photography, and an analysis of heart rate variability. Long-term biologic sample storage will allow investigation of biomarkers that may predict cardiovascular diseases and diabetes. Annual telephone surveillance, initiated in ...

Growth differentiation factor-15, a novel biomarker related with disease severity in patients with hypertrophic cardiomyopathy.

European Journal of Internal Medicine — Fri, 03 Feb 2012 00:26:31 +0100

CONCLUSIONS: The present results show that higher levels of GDF-15 are associated to conditions of severe disease in HCM. Hence, GDF-15 is suggested as a novel marker related to the severity and could represent a further useful tool in monitoring functional capacity of HCM patients. PMID: 22284249 [PubMed - in process] (Source: European Journal of Internal Medicine)

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

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

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

Electrocardiogram in Left Ventricular Hypertrabeculation/Noncompaction

The American Journal of Cardiology — Thu, 02 Feb 2012 14:05:53 +0100

The report by Stöllberger et al in the October 1, 2011, issue of The American Journal of Cardiology on the frequency of stroke and embolism in 144 patients with left ventricular hypertrabeculation/noncompaction, a cardiac abnormality of unknown origin, was based on a retrograde analysis of baseline clinical, echocardiographic, and electrocardiographic data. In reference to electrocardiographic information, the investigators reported on the prevalence of normal findings, left bundle branch block, pathologic Q waves, and atrial fibrillation. Left ventricular hypertrabeculation/noncompaction is characterized by trabeculations in the inner core of myocardium and a thinner than usual external compact myocardial core. One wonders, given these anatomic peculiarities, about possible changes in th...

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Authors' Reply

The American Journal of Cardiology — Thu, 02 Feb 2012 14:05:53 +0100

Left ventricular hypertrabeculation/noncompaction (LVHT/NC) is characterized by trabeculations in the inner core of myocardium and a thinner than usual external compact myocardial core. Dr. Madias assumes changes in the depth distribution and/or extent of the Purkinje ventricular conduction network in patients with LVHT/NC and altered intraventricular conduction. He asks for data on QRS durations, QT and corrected QT (QTc) intervals, and PR intervals on the electrocardiograms of our patients with LVHT/NC. (Source: The American Journal of Cardiology)

Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient-Controlled Analgesia-Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

World Journal of Surgery — Thu, 02 Feb 2012 06:53:57 +0100

Conclusions Dexamethasone 5 mg with either haloperidol 2 mg or ondansetron 4 mg provides a better antiemetic effect than dexamethasone 5 mg alone in patients receiving postoperative morphine PCA. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-012-1446-yAuthors Po-Kai Wang, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CPei-Jiuan Tsay, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CChia-Chun Huang, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CHsien-Yong Lai, Department of Medical Education and Research, M...

The association of rate pressure product (RPP) and myocardial perfusion imaging (MPI) findings: a preliminary study.

Perfusion — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion. The study demonstrated that RPP is associated with MPI findings using gated SPECT imaging with dipyridamole stress. However, to confirm this preliminary result, further studies are mandatory. PMID: 22301391 [PubMed - as supplied by publisher] (Source: Perfusion)

Toluidine blue for the intraoperative staining of the ureters. Studies on the safe administration in rats

Langenbeck's Archives of Surgery — Wed, 01 Feb 2012 17:11:57 +0100

Conclusions In rats, intravenous injection of 0.4 mg TB/kg was sufficient for the intraoperative staining of the urinary tract without the risk of severe cardiovascular and hemodynamic side effects. Provided our results are transferable to humans, the administration of low TB doses could allow its safer clinical use for the intraoperative visualization of the ureters. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00423-012-0907-yAuthors Frank Petrat, Institut für Physiologische Chemie, Universitätsklinikum, Universität Duisburg-Essen, Hufelandstr. 55, 45122 Essen, GermanyMatthias Hartmann, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45122 Essen, GermanyErnst Schmidt, Dr. F...

The prognostic meaning of the full spectrum of aVR ST-segment changes in acute myocardial infarction

European Heart Journal — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion There is a U-shaped relationship between 30-day mortality and aVR ST level in patients presenting with anterior but not inferior ST elevation MI. (Source: European Heart Journal)

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An artificial neural network to safely reduce the number of ambulance ECGs transmitted for physician assessment in a system with prehospital detection of ST elevation myocardial infarction

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Our ANN had an excellent ability to predict STEMI and the need of acute PCI in ambulance ECGs, and has a potential to safely reduce the number of ECG transmitted to the CCU by almost two thirds. (Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine)

Cardiac Screening Prior to Stimulant Treatment of ADHD: A Survey of US-Based Pediatricians

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: Variable pediatrician attitudes and cardiac screening practices reflect the limited evidence base and conflicting guidelines regarding cardiac screening. Barriers to identifying cardiac disorders influence practice. (Source: PEDIATRICS)

Midostaurin does not prolong cardiac repolarization defined in a thorough electrocardiogram trial in healthy volunteers

Cancer Chemotherapy and Pharmacology — Tue, 31 Jan 2012 16:48:29 +0100

Conclusion Midostaurin demonstrated a good safety profile in healthy volunteers, with no prolonged cardiac repolarization or other changes on the electrocardiogram. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00280-012-1825-yAuthors Adam del Corral, Novartis Oncology, East Hanover, NJ, USACatherine Dutreix, Novartis Oncology, Basel, SwitzerlandAlice Huntsman-Labed, Novartis Oncology, Basel, SwitzerlandSebastien Lorenzo, Novartis Oncology, Basel, SwitzerlandJoel Morganroth, ERT, East Bridgewater, NJ, USARobert Harrell, Osborne Research Center, LLC, Little Rock, AR, USAYanfeng Wang, Novartis Oncology, East Hanover, NJ, USA Journal Cancer Chemotherapy and PharmacologyOnline ISSN 1432-0843Print ISSN 0344-5704 (Source: Cancer Chemothe...

Spontaneous fluctuations in the peripheral photoplethysmographic waveform: roles of arterial pressure and muscle sympathetic nerve activity

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

This study addressed the contribution of arterial pressure and muscle sympathetic nerve activity (MSNA) in beat-to-beat PPG variability in resting humans under spontaneous breathing conditions. Peripheral PPG waveforms were measured from the fingertip, earlobe, and toe in young and healthy individuals (n = 13), together with the arterial pressure waveform, electrocardiogram, respiration, and direct measurement of MSNA by microneurography. Cross-spectral coherence analysis revealed that among the PPG waveforms, low-frequency fluctuations (0.04–0.15 Hz) in the ear PPG had the highest coherence with arterial pressure (0.71 ± 0.15) and MSNA (0.44 ± 0.18, with a peak of 0.71 ± 0.16 at 0.10 ± 0.03 Hz). The normalized midfrequency powers (0.08–0.15 Hz), wit...

Cardiac dysfunction in cirrhosis – does adrenal function play a role? A hypothesis

Liver International — Tue, 31 Jan 2012 05:00:00 +0100

AbstractCirrhotic cardiomyopathy (CCM), a condition of unknown pathogenesis, is characterized by suboptimal ventricular contractile response to stress, diastolic dysfunction and QT interval prolongation. It is most often found in patients with advanced cirrhosis. It is clinically relevant during stressful conditions, such as sepsis, bleeding and surgery. CCM reverses after liver transplantation and potentially has a role in the pathogenesis of hepatorenal syndrome. In adrenal insufficiency (AI), cardiac dysfunction is a feature with low ejection fraction, decreased left ventricular chamber size and electrocardiographic abnormalities, including QT interval prolongation. With optimal diagnostic tests, AI is present in approximately 10% of patients with cirrhosis, particularly in those with a...

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Preparticipation screening and prevention of sudden cardiac death in athletes: Implications for primary care

Journal of the American Academy of Nurse Practitioners — Mon, 30 Jan 2012 05:00:00 +0100

Conclusions: Although the American Heart Association guidelines do not include ECG testing for preparticipation screenings, the implementation of routine ECG testing for preparticipation sports physicals is effective in preventing SCD in athletes.Implications for practice: Primary care providers should be aware of current guidelines for screening patients for heart diseases that predispose them to SCD and their legal obligations to be sure these athletes are safe. The implementation of ECG testing will assist in the decision whether to disqualify an athlete from participation as a result of preexisting cardiac conditions, and ultimately preventing the untimely death of a young athlete. (Source: Journal of the American Academy of Nurse Practitioners)

Repeated supratherapeutic dosing of strontium ranelate 4g/d over 15 days does not prolong QTc interval in healthy volunteers

British Journal of Clinical Pharmacology — Sun, 29 Jan 2012 05:00:00 +0100

Conclusions: The findings of this study demonstrate that the administration of supratherapeutic repeated oral doses of strontium ranelate (4g/day for 15 days) does not lead to a prolongation of the QT/QTc interval above the threshold of regulatory concern.© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society (Source: British Journal of Clinical Pharmacology)

What may be happen after an organophosphate exposure: Acute myocardial infarction?

Journal of Forensic and Legal Medicine — Sat, 28 Jan 2012 08:18:44 +0100

Abstract: The increase in accidental organophosphate poisoning as well as the rise in the number of cases of suicide attempts with organophosphate compounds is due to primarily to the widespread use of these compounds in agriculture. Organophosphates are anti-acetycholinesterase agents and their toxicity affects many organs, including the pancreas, liver and heart. Cardiac complications often accompany poisoning with these compounds and may be serious and often fatal. However, little is known about the myocardial infarction risk associated with exposure to pesticides. Herein, a rare case of acute myocardial infarction due to acute exposure to organophosphate compound is documented with electrocardiogram, enzyme and clinical characteristics in this report. (Source: Journal of Forensic and L...

Interpretation of Electrocardiogram Images Sent Through the Mobile Phone Multimedia Messaging Service

Telemedicine and e-Health — Fri, 27 Jan 2012 14:41:19 +0100

Telemedicine and e-Health , Vol. 0, No. 0. (Source: Telemedicine and e-Health)

The risk of elevated resting heart rate on the development of type 2 diabetes in patients with clinically manifest vascular diseases.

European Journal of Endocrinology — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions. Increased RHR, a reflection of sympathetic nerve activity, is associated with an increased risk for T2DM in patients with manifest vascular diseases, particularly in middle-aged patients. PMID: 22285702 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

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ALTERED SINO-ATRIAL NODE FUNCTION AND INTRA-ATRIAL CONDUCTION IN MURINE GAIN-OF-FUNCTION Scn5a+/{Delta}KPQ HEARTS SUGGEST AN OVERLAP SYNDROME.

Am J Physiol Heart C... — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions:</BOLD> The gain-of-function LQT3 murine Scn5a+/ΔKPQ cardiac system, in overlap with corresponding features reported in loss-of-function Na(+) channel mutations, shows compromised SAN pacemaker and conduction function explicable in modeling studies through a combination of augmented tail and reduced peak Na(+) currents. PMID: 22287583 [PubMed - as supplied by publisher] (Source: Am J Physiol Heart C...)

Medicare cuts, ACOs to cause slowdown in diagnostic ECG device market

Healthcare IT News — Thu, 26 Jan 2012 16:04:34 +0100

A new report from Millennium Research Group shows that declining demand in private practices for diagnostic electrocardiography (ECG) devices will contribute to slow growth in the U.S. market – despite a growing number of older patients who require the devices. The study finds that reasons for declining private practice demand range from Medicare funding cuts to the impact of accountable care organizations. read more (Source: Healthcare IT News)

Multimodality Imaging of Left Ventricular Apical Pouch With Midventricular Cavity Obliteration: Rare Variant of Hypertrophic Cardiomyopathy

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

Transthoracic echocardiography (TTE) performed on a 52-year-old man for an abnormal electrocardiogram (A) demonstrated severe midventricular hypertrophy (30 mm) (Online Videos 1 and 2), a left ventricular apical pouch (B, pink arrow, Online Videos 3 and 4), and a midventricular systolic gradient of 40 mm Hg (C, white arrows). Characteristic diastolic velocity profile of the pouch was noted (C, white arrowheads), with mitral inflow and apical pouch flow colliding “head-on” in the midventricle, producing a vivid color display (D and inset, white arrows, Online Video 5). Strain analysis revealed decreased peak systolic strain limited to the apicolateral wall (E). Cardiac magnetic resonance imaging confirmed TTE findings (F, pink arrow) but did not reveal delayed hyperenhancement (Online V...

Silent Ischemia: Clinical Relevance

Journal of the American College of Cardiology — Thu, 26 Jan 2012 13:57:10 +0100

Myocardial ischemia can occur without overt symptoms. In fact, asymptomatic (or silent) ST-segment depression during ambulatory electrocardiogram monitoring occurs more often than symptomatic ST-segment depression in patients with coronary artery disease. Initial studies documented that silent ischemia provided independent prediction of adverse outcomes in patients with known and unknown coronary artery disease. The ACIP (Asymptomatic Cardiac Ischemia Pilot Study) enrolled patients in the 1990s and found that revascularization was better than medical therapy in reducing silent ischemic episodes and possibly cardiovascular (CV) events. However, the more recent COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial found similar CV event rates between pa...

Reversible Myocarditis after Black Widow Spider Envenomation

Journal of Oncology — Thu, 26 Jan 2012 13:25:09 +0100

We report a rare case of a 35-year-old man who developed an acute myocarditis with cardiogenic pulmonary edema requiring mechanical ventilation caused by black widow spider's envenomation. The patient was previously healthy. The clinical course was associated with systemic and cardiovascular complaints. His electrocardiogram revealed ST-segment elevation with T-wave amplitude. The plasma concentrations of cardiac enzymes were elevated. His first echocardiography showed hypokinesis of the left ventricle (left ventricle ejection fraction 48%). Magnetic resonance imaging showed also focal myocardial injury of the LV. There was progressive improvement in cardiac traces, biochemical and echocardiographical values (second left ventricle ejection fraction increased to 50%). Myocardial inv...

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Association of Plasma Phospholipid Long-Chain Omega-3 Fatty Acids with Incident Atrial Fibrillation in Older Adults: The Cardiovascular Health Study.

Circulation — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSIONS: In older adults, higher circulating total long-chain n-3 PUFA and DHA levels were associated with lower risk of incident AF. These results highlight the need to evaluate whether increased dietary intake of these fatty acids could be effective for primary prevention of AF. PMID: 22282329 [PubMed - as supplied by publisher] (Source: Circulation)

Mucopolysaccharidosis: Cardiologic features and effects of enzyme-replacement therapy in 24 children with MPS I, II and VI

Journal of Inherited Metabolic Disease — Wed, 25 Jan 2012 18:04:55 +0100

Abstract We determined the cardiologic features of children with MPS I, II and VI, and evaluated the effect of enzyme-replacement therapy (ERT) on cardiac disease. Twenty-four children aged 1-18 years with MPS I, II or VI were prospectively evaluated with echocardiogram and electrocardiogram from the start of enzyme-replacement therapy up to 6 years of treatment. At start of therapy, 66% had abnormal cardiac geometric features. Left-ventricular mass index (LVMI) was increased in half of the patients, due mainly to concentric hypertrophy in MPS I and II and to eccentric hypertrophy in MPS VI. Regurgitation was most severe in a subgroup of young MPS VI patients (<5 years) at the mitral valve. At baseline, all patients had abnormal valves. The ECG showed no ...

Physiological Parameter Monitoring from Optical Recordings With a Mobile Phone

IEEE Transactions on Biomedical Engineering — Wed, 25 Jan 2012 14:46:07 +0100

We show that a mobile phone can serve as an accurate monitor for several physiological variables, based on its ability to record and analyze the varying color signals of a fingertip placed in contact with its optical sensor. We confirm the accuracy of measurements of breathing rate, cardiac R-R intervals, and blood oxygen saturation, by comparisons to standard methods for making such measurements (respiration belts, ECGs, and pulse-oximeters, respectively). Measurement of respiratory rate uses a previously reported algorithm developed for use with a pulse-oximeter, based on amplitude and frequency modulation sequences within the light signal. We note that this technology can also be used with recently developed algorithms for detection of atrial fibrillation or blood loss. (Source: IEEE Tr...

Electrocardiographic findings in children with different degrees of pulmonary regurgitation following surgical correction of tetralogy of Fallot.

Kardiologia Polska — Wed, 25 Jan 2012 06:54:02 +0100

Conclusions: In children with severe PR after TOF correction, no physiological shortening of QRS duration and QT interval during exertion is seen. The QT dispersion in resting ECG is higher in children with severe PR than in children with mild/moderate PR. Kardiol Pol 2012; 70, 1: 38-43. PMID: 22267423 [PubMed - in process] (Source: Kardiologia Polska)

Nifedipine Blocks Ondansetron Electrophysiological Effects in Rabbit Purkinje Fibers and Decreases Early Afterdepolarization Incidence.

Current Clinical Pharmacology — Wed, 25 Jan 2012 05:00:00 +0100

Authors: Rouet R, Worou ME, Puddu PE, Lemoine S, Plaud B, Sallé L, Gérard JL, Hanouz JL Abstract We hypothesized that a high concentration of nifedipine (1 µM), known to inhibit at least 75% of L-type Ca++ current, might counteract proarrhythmic dose-dependent effects of ondansetron (0.1 to 10 µM) in rabbit Purkinje fibers. Ondansetron is a 5-HT3 receptor antagonist commonly prescribed to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, and surgery but may increase the risk of developing prolongation of the QT interval of the electrocardiogram, which can lead to an abnormal and potentially fatal heart rhythm and recently raised FDA concerns and warnings. Neostigmine, a quaternary nitrogen agent was also used clinically concomitant to antiemetics aft...

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ECG Findings Associated With Cocaine Use in HumansECG Findings Associated With Cocaine Use in Humans

Medscape Today Headlines — Wed, 25 Jan 2012 04:00:00 +0100

What clues can ECGs provide in diagnosing and managing patients who are using cocaine? Expert Review of Cardiovascular Therapy (Source: Medscape Today Headlines)

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

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

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

Pulsatile Distention of the Nondiseased and Stenotic Aortic Valve Annulus: Analysis With Electrocardiogram-Gated Computed Tomography [ORIGINAL ARTICLES: ADULT CARDIAC]

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

Conclusions With the use of CT and postprocessing software, significant area and radius changes during the cardiac cycle were demonstrated in both the nondiseased annulus and the stenotic annulus. This finding may help selection of the optimal size in patients undergoing AV implantation and also aid in prosthesis design. (Source: The Annals of Thoracic Surgery)

Refractory Spasm of Coronary Arteries and Grafted Conduits After Isolated Coronary Artery Bypass Surgery [ORIGINAL ARTICLES: ADULT CARDIAC]

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

Conclusions Diffuse RVS after CABG is a rare but lethal condition. Our experience, although limited, indicates that in such cases an aggressive treatment, that is, prompt extracorporeal membrane oxygenation institution and controlled cardiocirculatory assistance, represents the preferred solution to face such a dramatic event and may save patient lives. (Source: The Annals of Thoracic Surgery)

Rhabdomyolysis: Not a Textbook Case

The American Journal of Medicine — Mon, 23 Jan 2012 23:45:01 +0100

A 21-year-old gravida 2, para 1, woman at 34 weeks' gestation with a history of iron deficiency anemia presented to the hospital with lower-extremity numbness, tingling, and weakness, resulting in falls. Vital signs were unremarkable, with the physical examination significant for diminished lower-extremity strength and intact sensation. Laboratory assessment was notable for hemoglobin of 9.5 g/dL, potassium of 2.2 mmol/L, magnesium of 1.81 mg/dL, phosphorus of 3.0 mg/dL, calcium of 8.2 mg/dL, glucose of 91 mg/dL, creatine kinase of 11,089 U/L, albumin of 1.1 g/dL, and thyroid-stimulating hormone of 2.5 mIU/L. Further laboratory evaluation revealed a mild respiratory alkalosis (pH 7.43, PaCO2 34 mm Hg, and bicarbonate 23 mmol/L), serum osmolality of 279 mOsm/kg, urine pH of 7.0, urine osmol...

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Isorhythmic Atrioventricular Dissociation in Labrador Retrievers

Journal of Veterinary Internal Medicine — Mon, 23 Jan 2012 05:00:00 +0100

Conclusion and Clinical ImportanceIAVD with type I synchronization is more common than IAVD with type II synchronization in Labrador Retrievers, and a correlation between IAVD and FJT can be hypothesized. (Source: Journal of Veterinary Internal Medicine)

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

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

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

Heart Rate Variability Response to Standing in Men and Women Receiving D,L-Sotalol Following Coronary Artery Bypass Graft Surgery

Biological Research For Nursing — Mon, 23 Jan 2012 05:00:00 +0100

In this study, the HRV response to standing 4 days following CABG surgery in men and women prescribed d,l-sotalol was measured to examine the influence of d,l-sotalol on previously reported HRV responses, taking age and gender into consideration. Participants included 28 men and 10 women who completed testing in supine and standing postures; all had received low-dose d,l-sotalol daily since the first postoperative day. Data included continuous electrocardiograph recording of R-R interval for 10 min in each posture. Participants showed significant effects of standing on the autonomic modulation of HR, as seen by a decrease in parasympathetic indices and R-R interval and an increase in BP. In men, standing decreased parasympathetic modulation and increased the sympathetic nervous system indi...

An approach to determine myocardial ischemia by hidden Markov models.

Computer Methods in Biomechanics and Biomedical Engineering — Mon, 23 Jan 2012 05:00:00 +0100

Authors: Tang X, Xia L, Liu W, Peng Y, Gao T, Zeng Y Abstract A hidden Markov model (HMM) of electrocardiogram (ECG) signal is presented for detection of myocardial ischemia. The time domain signals that are recorded by the ECG before and during the episode of local ischemia were pre-processed to produce input sequences, which is needed for the model training. The model is also verified by test data, and the results show that the models have certain function for the detection of myocardial ischemia. The algorithm based on HMM provides a possible approach for the timely, rapid and automatic diagnosis of myocardial ischemia, and also can be used in portable medical diagnostic equipment in the future. PMID: 22263753 [PubMed - as supplied by publisher] (Source: Computer Methods in ...

Clinical cardiac safety profile of nilotinib.

Haematologica — Sun, 22 Jan 2012 05:00:00 +0100

Conclusions. Whereas new electrocardiographic abnormalities were recorded in twenty percent of all patients and some of them developed severe or even life-threatening coronary artery disease, QT prolongation, changes in left ventricular ejection fraction, and clinical cardiac adverse events were uncommon in patients treated with nilotinib. PMID: 22271904 [PubMed - as supplied by publisher] (Source: Haematologica)

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Bayesian tracking of intracranial pressure signal morphology

Artificial Intelligence in Medicine — Sun, 22 Jan 2012 03:06:39 +0100

Conclusion: The proposed tracking algorithm sucessfuly increases the temporal resolution of detecting ICP pulse morphological changes from the minute-level to the beat-level. (Source: Artificial Intelligence in Medicine)

A characterization of electrocardiogram signals through optimal allocation of information granularity

Artificial Intelligence in Medicine — Sun, 22 Jan 2012 03:06:39 +0100

Conclusions: A complete algorithm of the construction of granular prototypes is presented. Treating the granular prototype as a template of a given class of electrocardiogram (ECG) signals, a matching process is facilitated and used as a basis for the design of signal classification algorithms. Various realizations of granular prototypes can be completed with the use of fuzzy sets or rough sets. (Source: Artificial Intelligence in Medicine)

Time frequency power profile of QRS complex obtained with wavelet transform in spontaneously hypertensive rats

Computers in Biology and Medicine — Sun, 22 Jan 2012 03:06:38 +0100

Abstract: We evaluated whether frequency analysis could detect the development of interstitial fibrosis in rats. SHR/Izm and age-matched WKY/Izm were used. Limb lead II electrocardiograms were recorded. Continuous wavelet transform (CWT) was applied for the time–frequency analysis. The integrated time–frequency power (ITFP) between QRS complexes was measured and compared between groups. The ITFP at low-frequency bands (≤125Hz) was significantly higher in SHR/Izm. The percent change of ITFP showed the different patterns between groups. Prominent interstitial fibrosis with an increase in TIMP-1 mRNA expression was also observed in SHR/Izm. These results were partly reproduced in a computer simulation. (Source: Computers in Biology and Medicine)

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

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

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

Response to Alemtuzumab in FIP1L1/PDGFRA-Negative Hypereosinophilic Myocarditis on Serial Cardiac Magnetic Resonance Imaging

Journal of the American College of Cardiology — Fri, 20 Jan 2012 13:57:13 +0100

A 48-year-old Caucasian woman presented with 2 weeks of myalgias, arthralgias, headache, and neck stiffness. Total peripheral leukocyte count was 80.2 × 109/l with 72% eosinophils. A diagnosis of FIP1L1/PDGFRA-negative hypereosinophilic syndrome was made. The 12-lead electrocardiogram demonstrated inferolateral repolarization abnormalities (A). Serum troponin T was 0.25 ng/ml. Electrocardiography-gated cardiac magnetic resonance imaging demonstrated anterior, anterolateral, inferolateral, and inferior left ventricular (LV) wall thickening, with corresponding abnormal subendocardial T2 signal (C, white arrows) and delayed gadolinium enhancement (E, white arrows). The posterior mitral valve leaflet was tethered. The LV wall motion, right ventricle, and pericardium were normal. Subcutaneous ...

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Wolff-Parkinson-White Syndrome and Concentric Left Ventricular Hypertrophy in a Teenager: Danon Disease

Journal of the American College of Cardiology — Fri, 20 Jan 2012 13:57:13 +0100

A 14-year-old boy complained of intermittent palpitations and syncope. He also had mild mental retardation. His electrocardiogram showed type B Wolff-Parkinson-White (WPW) syndrome and left ventricular hypertrophy (LVH) (A). He underwent successful ablation, and his echocardiography (B, Online Videos 1, 3, and 4) and cardiovascular magnetic resonance imaging (C, Online Video 2) confirmed the concentric LVH; the thickness of the left ventricular posterior wall and septum were 15 mm and 14 mm, respectively. Serum creatine kinase was 2,301 U/l (normal range (Source: Journal of the American College of Cardiology)

Electrocardiographic findings in sickle cell cardiovascular autonomic neuropathy

Clinical Autonomic Research — Fri, 20 Jan 2012 07:05:34 +0100

Conclusion Electrocardiographic features consistent with atrio-ventricular and ventricular repolarization abnormalities are associated with CAN in sickle cell anaemia. Further studies are required to evaluate the prognostic implications of these findings in sickle cell patients with cardiovascular autonomic dysfunction. Content Type Journal ArticleCategory Research ArticlePages 1-9DOI 10.1007/s10286-011-0156-0Authors N. I. Oguanobi, Department of Medicine, University of Nigeria Teaching Hospital, Enugu, NigeriaE. C. Ejim, Department of Medicine, University of Nigeria Teaching Hospital, Enugu, NigeriaB. C. Anisiuba, Department of Medicine, University of Nigeria Teaching Hospital, Enugu, NigeriaB. J. C. Onwubere, Department of Medicine, University of Nigeria Teaching ...

Divergent Electrocardiographic Responses to Whole and Particle-Free Diesel Exhaust Inhalation in Spontaneously Hypertensive Rats

Toxicological Sciences — Fri, 20 Jan 2012 05:00:00 +0100

Diesel exhaust (DE) is a major contributor to traffic-related fine particulate matter (PM)2.5. Although inroads have been made in understanding the mechanisms of PM-related health effects, DE’s complex mixture of PM, gases, and volatile organics makes it difficult to determine how the constituents contribute to DE’s effects. We hypothesized that exposure to particle-filtered DE (fDE; gases alone) will elicit less cardiac effects than whole DE (wDE; particles plus gases). In addition, we hypothesized that spontaneously hypertensive (SH) rats will be more sensitive to the electrocardiographic effects of DE exposure than Wistar Kyoto rats (WKY; background strain with normal blood pressure). SH and WKY rats, implanted with telemeters to monitor electrocardiogram and heart rate (HR)...

Simplified electrocardiogram sampling maintains high diagnostic capability for atrial fibrillation: implications for opportunistic atrial fibrillation screening in primary care

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

Conclusions Despite inferior electrocardiographic quality a 6-lead frontal plane ECG acquired by a simple prototype hand-held electrode assembly allowed reliable differentiation of AF from SR compared with standard 12-lead ECG. (Source: Europace)

Focal atrial tachycardia originating from the distal portion of the left atrial appendage: characteristics and long-term outcomes of radiofrequency ablation

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

Conclusion The LAAd is an uncommon site of origin for focal AT (2.1% incidence). In this case series, focal ATs originating from the LAAd had typical electrophysiological and electrocardiographic characteristics. Focal ablation yielded high acute success rate with low rate of recurrence during follow-up. (Source: Europace)

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Women, but not men, have prolonged QT interval if depressed after an acute coronary syndrome

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

Conclusions In this ACS sample, prolongation of the QT interval was associated with depressive symptoms in women, but not in men. Further investigation of the mechanism of the relationship between depression and abnormal cardiac repolarization, particularly in women, is warranted to develop treatment strategies. (Source: Europace)

T-wave alternans in apparently healthy subjects and in different subsets of patients with ischaemic heart disease

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

Conclusions In healthy people, TWA_tot and TWA_prec were ≤75 and ≤65 µV, respectively, in 95% of subjects. In IHD patients TWA values were higher compared with healthy individuals; a history of AMI was independently associated with abnormal TWA values. (Source: Europace)

Competing cardiovascular outcomes associated with electrocardiographic left ventricular hypertrophy: the Atherosclerosis Risk in Communities Study

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

Conclusions Among middle-aged individuals with ECG LVH, the most likely first events are CHD in men and heart failure in women; these results may have implications for preventive approaches. (Source: Heart)

Heart rate variability after heart transplantation: A 10-year longitudinal follow-up study.

Journal of Cardiology — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSIONS: The observed changes in HRV during long-term follow-up after HTx are compatible with partial re-innervation of the cardiac sinus node, as has been suggested by cross-sectional studies. PMID: 22266458 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

Arterial Stiffness Is the Independent Factor of Left Ventricular Hypertrophy Determined by Electrocardiogram.

The American Journal of the Medical Sciences — Fri, 20 Jan 2012 05:00:00 +0100

CONCLUSION: Aortic stiffness may be related to electrocardiographically determined LVH in patients with hypertension. Thus, stiffening of large arteries, together with increased systolic blood pressure, seems to significantly contribute to the pathogenesis of LVH. Quantification of LVH by ECG can also predict the degree of aortic stiffness. PMID: 22270392 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

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Cardiac autonomic dysfunction in anabolic steroid users

Scandinavian Journal of Medicine and Science in Sports — Wed, 18 Jan 2012 05:00:00 +0100

This study aimed to evaluate if androgenic‐anabolic steroids (AAS) abuse may induce cardiac autonomic dysfunction in recreational trained subjects. Twenty‐two men were volunteered for the study. The AAS group (n = 11) utilized AAS at mean dosage of 410 ± 78.6 mg/week. All of them were submitted to submaximal exercise testing using an Astrand–Rhyming protocol. Electrocardiogram (ECG) and respired gas analysis were monitored at rest, during, and post‐effort. Mean values of VO2, VCO2, and VE were higher in AAS group only at rest. The heart rate variability variables were calculated from ECG using MATLAB‐based algorithms. At rest, AAS group showed lower values of the standard deviation of R‐R intervals, the proportion of adjacent R‐R intervals differing by more than 50...

Self-rated Health Compared With Objectively Measured Health Status as a Tool for Mortality Risk Screening in Older Adults: 10-Year Follow-up of the Bambui Cohort Study of Aging

American Journal of Epidemiology — Wed, 18 Jan 2012 05:00:00 +0100

Interest in self-rated health (SRH) as a tool for use in disease and mortality risk screening is increasing. The authors assessed the discriminatory ability of baseline SRH to predict 10-year mortality rates compared with objectively measured health status. Principal component analysis was used to create a health score that included systolic blood pressure, presence of diabetes mellitus, body mass index, electrocardiographic parameters, B-type natriuretic peptide, and other biochemical and hematologic measures. From 1997 to 2007, a total of 474 of the 1,388 baseline participants died and 81 were lost to follow-up, yielding 11,833 person-years of observation. The adjusted hazard ratio for death was 1.74 (95% confidence interval (CI): 1.32, 2.29) for persons reporting poor health versus thos...

Partial anomalous pulmonary venous connection to the superior vena cava: the outcome after the Warden procedure [CONGENITAL]

European Journal of Cardio-Thoracic Surgery — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSIONS The Warden procedure is a safe and effective surgical option for repair of PAPVC to the SVC in terms of preserving the sinus node function and non-obstructive pulmonary venous pathway. However, more attention must be paid to the reconstruction of non-obstructive systemic venous pathway, especially in younger and smaller children. Patch augmentation could be considered and effectively performed, if there is any doubt regarding tension-free anastomosis. (Source: European Journal of Cardio-Thoracic Surgery)

An unusual fatal penetrating coronary artery injury with effective perioperative management [CASE REPORTS]

European Journal of Cardio-Thoracic Surgery — Wed, 18 Jan 2012 05:00:00 +0100

We report here an uncommon anterior chest trauma with an unusual fatal penetrating coronary artery injury by pneumatic nail gun with effective perioperative management. While doing upholstery, a 32-year-old male patient accidentally stabbed by a pneumatic nail gun with injury to the anterior chest was brought to the emergency room of our hospital. Persistent chest pain with unstable vital signs and no external injury except for a faint ecchymosis on anterior chest were noted at arrival. Sixty-four-slice computed tomography (CT) scan revealed a foreign body completely embedded in the chest wall penetrating the left ventricle, with the coronary artery also suspected of being involved because of ST-T changes of V2 to V6 on electrocardiography. Three-dimensional reconstructive CT scans showed ...

Contrast-enhanced sonography of malignant pediatric abdominal and pelvic solid tumors: preliminary safety and feasibility data

Pediatric Radiology — Tue, 17 Jan 2012 07:09:16 +0100

Conclusions Although our sample size is small, perflutren contrast agents appear to be safe and well tolerated in children. Contrast-enhanced sonography of pediatric abdominal and pelvic tumors is feasible, but larger studies are needed to define their safety and efficacy in children. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00247-011-2338-2Authors M. Beth McCarville, Department of Radiological Sciences, Mail Stop 220, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USASue C. Kaste, Department of Radiological Sciences, Mail Stop 220, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USAFredric A. Hoffer, Department of Radiological Sciences, Mail Stop 220, St. Jud...

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Safety and efficacy of exercise testing with atropine in patients with recent uncomplicated ST elevation acute myocardial infarction

Central European Journal of Medicine — Tue, 17 Jan 2012 07:07:14 +0100

Conclusion Atropine added to ET in patients who cannot achieve their 85% age-related HR is safe and well-tolerated, and improves the prognostic accuracy in patients with recent uncomplicated STEMI. The combination with atropine increases the utility and the cost-effectiveness of ET. Content Type Journal ArticleCategory Research ArticlePages 1-7DOI 10.2478/s11536-012-0001-4Authors Filippo M. Sarullo, Division of Cardiology, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, ItalyLuigi Americo, Division of Cardiology, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, ItalySalvatore Milia, Division of Cardiology, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, ItalyIgnazio Brusca, Division of Cardiology, Buccheri La Ferla Fatebenefratelli Hospital, Palermo...

Electrocardiographic and haemodynamic alterations caused by three different test solutions of local anaesthetics to detect accidental intravascular injection in children

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

Conclusions ECG and haemodynamic alterations after i.v. injection of a local anaesthetic test dose were significantly influenced by epinephrine. T-wave elevation, increase in AP, and changes in HR are highly reliable variables, particularly when age is taken into account. (Source: British Journal of Anaesthesia)

Optimized method for correct left-sided central venous catheter placement under electrocardiographic guidance

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

(Source: British Journal of Anaesthesia)

Teaching NeuroImages: Somatic muscle fasciculations detected by electrocardiography

Neurology — Mon, 16 Jan 2012 05:00:00 +0100

(Source: Neurology)

D.C. Cardiologist Develops Mobile App to Speed Diagnosis of Heart Attacks

RWJF News Digest - Quality/Equality — Mon, 16 Jan 2012 05:00:00 +0100

In theory, the concept seems like a no-brainer for quickly determining if someone is having a heart attack: Use a smartphone, tablet or other device equipped with a camera to take video of the patient's electrocardiogram, or ECG, which is typically used to diagnose heart attacks. (Source: RWJF News Digest - Quality/Equality)

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Unusually High Association of Hypertrophic Cardiomyopathy and Complex Heart Defects in Children with Fasciculoventricular Pathways

Pacing and Clinical Electrophysiology : PACE — Fri, 13 Jan 2012 05:00:00 +0100

Conclusions:In this largest reported series of FVP in children, there is an unusually high association of FVP with complex CHDs, chromosomal anomalies, and hypertrophic cardiomyopathy. Any patient with such disorders and manifest preexcitation should be evaluated with a high index of suspicion for a FVP. (PACE 2012;1–6) (Source: Pacing and Clinical Electrophysiology : PACE)

Cardiac effects of granisetron in a prospective crossover randomized dose comparison trial

Supportive Care in Cancer — Thu, 12 Jan 2012 16:45:52 +0100

Conclusions As the first study that has studied cardiac side effects of granisetron in patients that are not using cardiotoxic chemotherapeutics, we conclude that granisetron at 40 μg kg−1 dose−1 causes bradycardia only. We have also demonstrated that granisetron does not cause any clinically cardiac side effects either at 10 or 40 μg kg−1 dose−1. However, our results should be supported by prospective randomized studies with larger samples of patient groups. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00520-011-1376-5Authors F. B. Cakir, Department of Pediatric Hematology–Oncology, Bezmialem University Medical Center, Istanbul, TurkeyO. Yapar, Department of Pediatrics, Marmara University Medical Center, Istanbul, TurkeyC. ...

The Efficacy and Safety of the Novel Long-Acting β2 Agonist Vilanterol in COPD Patients: a Randomized Placebo-Controlled Trial.

Chest — Thu, 12 Jan 2012 05:00:00 +0100

CONCLUSIONS:VI 25 and 50μg once daily provided both statistically and clinically relevant 24-h improvements in lung function in patients with COPD compared with placebo. All doses of VI had a safety and tolerability profile similar to placebo. PMID: 22241764 [PubMed - as supplied by publisher] (Source: Chest)

A Case of Caffeine-Induced Coronary Artery Vasospasm of a 17-Year-Old Male.

Cardiovascular Toxicology — Wed, 11 Jan 2012 05:00:00 +0100

We report on a case of a 17-year-old male who presented with angina and an abnormal electrocardiogram (ECG) concerning for ST elevation myocardial infarct. He was found to have diffuse ECG changes and markedly elevated cardiac enzymes. A transthoracic echocardiogram revealed a reduced left ventricular (LV) systolic function as well as segmental wall motion abnormalities consistent with an ischemic insult. The patient admitted to consuming near lethal doses of caffeine immediately preceding his angina. He was diagnosed with coronary vasospasms as a result of stimulant use. During hospitalization, ECG changes resolved, cardiac enzymes started trending downward, and LV systolic function returned to normal, all consistent with stunned myocardium that fully recovered. This case strongly suggest...

The use of a 4-step algorithm in the electrocardiographic diagnosis of ST-segment elevation myocardial infarction by novice interpreters.

Pain Physician — Wed, 11 Jan 2012 05:00:00 +0100

Authors: Hartman SM, Barros AJ, Brady WJ Abstract The electrocardiographic (ECG) diagnosis of ST-segment elevation myocardial infarction (STEMI) represents a challenge to all health care providers, particularly so for the novice ECG interpreter. We have developed-and present in this article-a 4-step algorithm that will detect STEMI in most instances in the prehospital and other nonemergency department (ED) settings. The algorithm should be used in adult patients with chest pain or equivalent presentation who are suspected of STEMI. It inquires as to the presence of ST-segment elevation as well as the presence of STEMI confounding/mimicking patterns; the algorithm also makes use of reciprocal ST-segment depression as an adjunct in the ECG diagnosis of STEMI. If STEMI is detected by ...

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

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

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

N-terminal pro-brain natriuretic peptide could be a marker of subclinical atherosclerosis in patients with type 2 diabetes

Heart and Vessels — Tue, 10 Jan 2012 16:57:36 +0100

In conclusion, NT-proBNP could be a marker of subclinical atherosclerosis in patients with type 2 diabetes. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00380-011-0227-0Authors Takafumi Senmaru, Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 JapanMichiaki Fukui, Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 JapanMuhei Tanaka, Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hiro...

An Unusual Cardiomyopathy after Physical Stress in a Child

Congenital Heart Disease — Tue, 10 Jan 2012 05:00:00 +0100

We described a celiac 4‐year‐old girl, following a gluten‐free diet, who developed features of cardiac failure few days after episodes of acute diarrhea with fever. The patient was treated with oral anticongestive therapy and intravenous immunoglobulins, and she had a dramatic and rapid improvement; echocardiographic features normalized in 48 hours. (Source: Congenital Heart Disease)

Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Objectives and Design.

Am J Epidemiol — Tue, 10 Jan 2012 05:00:00 +0100

In this report, the authors delineate the study's objectives, principal methodological features, and timeline. At baseline, ELSA-Brasil enrolled 15,105 civil servants from 5 universities and 1 research institute. The baseline examination (2008-2010) included detailed interviews, clinical and anthropometric examinations, an oral glucose tolerance test, overnight urine collection, a 12-lead resting electrocardiogram, measurement of carotid intima-media thickness, echocardiography, measurement of pulse wave velocity, hepatic ultrasonography, retinal fundus photography, and an analysis of heart rate variability. Long-term biologic sample storage will allow investigation of biomarkers that may predict cardiovascular diseases and diabetes. Annual telephone surveillance, initiated in 2009, will c...

Heart-attack Patients in US More Likely to be Readmitted to Hospital

Medical Headlines From Ivanhoe.com — Mon, 09 Jan 2012 05:00:00 +0100

(Ivanhoe Newswire) -- In an analysis of data from more than 15 countries that included the U.S., Canada, Australia, and many European nations, patients in the U.S. who experienced a ST-segment elevation myocardial infarction (STEMI; a certain pattern on an electrocardiogram following a heart attack) were more likely to be readmitted to the hospital at 30 days after the heart attack than patients in other countries. (Source: Medical Headlines From Ivanhoe.com)

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Imaging for Planning of Cardiac Resynchronization Therapy

Journal of the American College of Cardiology: Cardiovascular Imaging — Mon, 09 Jan 2012 05:00:00 +0100

Cardiac resynchronization therapy (CRT) is a novel therapy for patients with refractory heart failure (HF). Large clinical trials evaluating CRT have demonstrated significant improvements in cardiac survival, decreases in recurrent HF hospitalization, and improvements in indexes of quality of life. Although numerous mechanisms are involved in CRT's therapeutic effects, correction of both interventricular and intraventricular mechanical dyssynchrony has been postulated as the key mechanism. To date, most large randomized controlled trials evaluating CRT have identified dyssynchronous patients on the basis of prolongation of the QRS complex from the baseline electrocardiogram. Concerns have been raised regarding the use of this measure for patient selection, stemming from a significant 30% t...

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

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

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

Objective assessment of internal stress in children during dental treatment by analysis of autonomic nervous activity

International Journal of Paediatric Dentistry — Sun, 08 Jan 2012 05:00:00 +0100

Conclusion. The present results suggest that the measurement of autonomic nervous activity, especially sympathetic nervous activity, is quite useful in assessing the internal stress of children, even when no expressed sign of unease are present during dental treatment. (Source: International Journal of Paediatric Dentistry)

Heart rate variability, sleep and sleep disorders

Sleep Medicine Reviews — Sat, 07 Jan 2012 14:46:21 +0100

Summary: Heart rate (HR) is modulated by the combined effects of the sympathetic and parasympathetic nervous systems. Therefore, measurement of changes in HR over time (heart rate variability or HRV) provides information about autonomic functioning. HRV has been used to identify high risk people, understand the autonomic components of different disorders and to evaluate the effect of different interventions, etc. Since the signal required to measure HRV is already being collected on the electrocardiogram (ECG) channel of the polysomnogram (PSG), collecting data for research on HRV and sleep is straightforward, but applications have been limited. As reviewed here, HRV has been applied to understand autonomic changes during different sleep stages. It has also been applied to understand the e...

Effects of Domperidone on QTc Interval in Infants

Acta Paediatrica — Sat, 07 Jan 2012 05:00:00 +0100

Conclusion: Overall, the group‐analysis showed no statistical significant difference in QTc duration induced by domperidone. However, 2/45 (4.4%) infants had a prolonged QTc interval (>460 msec) induced by domperidone. As a consequence, QTc measurement should be recommended in routine in infants when domperidone is started (Source: Acta Paediatrica)

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Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death proven fact or wishful thinking? - Steinvil A, Chundadze T, Zeltser D, Rogowski O, Halkin A, Galily Y, Perluk H, Viskin S.

SafetyLit: All (Unduplicated) — Fri, 06 Jan 2012 15:21:09 +0100

OBJECTIVES: The purpose of this study was to determine if pre-participation screening of athletes with a strategy including resting and exercise electrocardiography (ECG) reduces their risk for sudden death. BACKGROUND: An increasing number of countries ma... (Source: SafetyLit: All (Unduplicated))

Preparticipation electrocardiographic screening for the prevention of sudden death in sports medicine. - Corrado D, Migliore F, Zorzi A, Siciliano M, Basso C, Schiavon M, Thiene G.

SafetyLit: All (Unduplicated) — Fri, 06 Jan 2012 15:21:09 +0100

Both the American Heart Association and the European Society of Cardiology consensus panel recommendations agree that cardiovascular screening for young competitive athletes is justifiable and compelling on ethical, legal, and medical grounds. However, the... (Source: SafetyLit: All (Unduplicated))

Heart Attack Hospital Re-Admission Rates Higher In The USA Than Abroad

Health News from Medical News Today — Fri, 06 Jan 2012 15:00:00 +0100

A study published in the January 4 issue of JAMA shows that U.S. patients who experienced a ST-segment elevation myocardial infarction (STEMI), a certain pattern on an electrocardiogram after a heart attack, were more likely to be readmitted to the hospital at 30 days after the heart attack compared with patients in other countries. The findings were discovered during a data analysis from over 15 countries, including the U.S., Canada, Australia, and many European nations. Approximately 29 to 38% of all heart attacks are due to ST-segment elevation... (Source: Health News from Medical News Today)

Letter: Skin irritation because of electrocardiograph lead in patients in intensive care unit

International Wound Journal — Fri, 06 Jan 2012 05:00:00 +0100

(Source: International Wound Journal)

Canagliflozin Improves Glycemic Control Over 28 Days in Subjects With Type 2 Diabetes Not Optimally Controlled on Insulin

Diabetes, Obesity and Metabolism — Fri, 06 Jan 2012 05:00:00 +0100

Conclusion: In subjects receiving insulin and oral antihyperglycemic therapy, canagliflozin was well tolerated without evidence for glucose malabsorption, had pharmacokinetic characteristics consistent with once‐daily dosing, and improved glycemic control. (Source: Diabetes, Obesity and Metabolism)

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Cardiac mechanoreceptor function implicated during premature ventricular contraction.

Autonomic Neuroscience — Fri, 06 Jan 2012 05:00:00 +0100

Authors: Zamir M, Kimmerly DS, Shoemaker JK Abstract In a premature ventricular contraction (PVC), a systolic blood pressure peak is missing during the affected cardiac cycle, leading to a prolonged reduction in blood pressure which is then followed by a large burst of sympathetic outflow. In a normal ventricular contraction, it is generally believed that peak carotid and aortic distensions associated with systolic pressure is the neural feedback that terminates sympathetic outflow through a baroreflex mechanism. Yet, the characteristically large sympathetic burst following a PVC is terminated without a systolic pressure and evidently without this mechanism. To address this anomaly, we examined the possible role of cardiac receptors in providing an alternative mechanism for the ter...

Cardiac CT Imaging: Precocious Maturity?

Cardiology Clinics — Fri, 06 Jan 2012 05:00:00 +0100

It is not very frequently that an entirely new diagnostic modality is created to offer new possibilities and opportunities to clinicians in a short span of time. Computed tomography (CT) made its way into the cardiovascular arena approximately 10 years ago, when the first multidetector CT systems were introduced. Engineers then devised methods for synchronizing data acquisition and data reconstruction with the electrocardiograms. Much effort has focused on using CT imaging to visualize the coronary vessels, and coronary CT angiography has matured rapidly to find its way into clinical practice and a few official guidelines for selected patients. Although the emergence of coronary angiography has been the most noticeable development in the field of CT, many other innovations deserve our atte...

Canagliflozin improves glycaemic control over 28 days in subjects with type 2 diabetes not optimally controlled on insulin

Diabetes, Obesity and Metabolism — Fri, 06 Jan 2012 05:00:00 +0100

Conclusion: In subjects receiving insulin and oral antihyperglycaemic therapy, canagliflozin was well tolerated without evidence for glucose malabsorption, had pharmacokinetic characteristics consistent with once‐daily dosing, and improved glycaemic control. (Source: Diabetes, Obesity and Metabolism)

Development and Validation of a Smartphone Heart Rate Acquisition Application for Health Promotion and Wellness Telehealth Applications

Advances in Pharmacological Sciences — Thu, 05 Jan 2012 14:27:20 +0100

Conclusion. The Android application provides valid HRs at varying levels of movement free mental/perceptual motor exertion. Lack of electrode patches or wireless sensor telemetric straps make it advantageous for use in mobile-cell-phone-delivered health promotion and wellness programs. Further validation is needed to determine its applicability while engaging in physical movement-related activities. (Source: Advances in Pharmacological Sciences)

Efficacy and safety of the long‐acting muscarinic antagonist, GSK233705, delivered once‐daily in patients with COPD

The Clinical Respiratory Journal — Thu, 05 Jan 2012 05:00:00 +0100

Conclusion: All doses of GSK233705 demonstrated bronchodilatory activity and were well tolerated. Although the onset of bronchodilation was rapid, it was not sustained over 24 hours making it unsuitable for once‐daily dosing. (Source: The Clinical Respiratory Journal)

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

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

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

Association between C-reactive protein, carotid intima-media thickness and P-wave dispersion in obese premenopausal women: an observational study.

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

CONCLUSION: We found that increased PWD values in obese patients are correlated positively with hsCRP, CIMT and abdominal obesity. However, independent and significant association was found only between LAD and PWD. PMID: 22214742 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

Amount of ST wave resolution in patients with and without spontaneous coronary reperfusion in the infarct -related artery after primary PCI: an observational study.

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

CONCLUSION: Mean ST wave resolution was lower in patients with spontaneous coronary reperfusion who were treated with primary PCI compared to their counterparts who did not have spontaneous coronary reperfusion on initial coronary angiography. PMID: 22214740 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

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

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

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

Penile block for paediatric urological surgery: A comparative evaluation with general anaesthesia

Indian Journal of Urology — Wed, 04 Jan 2012 05:00:00 +0100

Conclusions: Penile block is very effective when used along with light sedation for distal penile surgeries of less than 2 hours duration as compared to standard GA as reflected by more stable haemodynamics in peri-operative period, excellent pain relief extending up to 6-8 hrs postoperatively and absence of any significant complications or side effects. (Source: Indian Journal of Urology)

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Is Nurse Interpretation of the ECG QRS Width Reliable?

Journal of Medical Toxicology — Wed, 04 Jan 2012 05:00:00 +0100

Authors: Zimmerman T, Beuhler MC, Kerns W Abstract Electrocardiogram (ECG) data are critical in formulating management strategies following sodium channel antagonist overdose. Poison centers frequently rely on verbal reports of the ECG obtained from bedside nurses. No previous study has addressed the quality of ECG data obtained in this manner. Therefore, we sought to test the ability of nurses to recognize and measure a widened QRS complex, the hallmark of myocardial sodium channel toxicity. Thirty-six emergency department and critical care nurses employed at a tertiary care hospital participated in this prospective study. The study subjects were divided into three groups and asked to interpret 12 ECGs (five normal and seven wide QRS). For each ECG, participants (1) determined if ...

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

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

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

Reducing Personal Exposure To Particulate Air Pollution Improves Cardiovascular Health In Patients With Coronary Heart Disease

EHP-in-Press — Tue, 03 Jan 2012 05:00:00 +0100

Conclusions. Reducing personal exposure to air pollution using a highly efficient facemask appeared to reduce symptoms and improve a range of cardiovascular health measures in patients with coronary heart disease. Such interventions to reduce personal exposure to particulate air pollution have the potential to reduce the incidence of cardiovascular events in this highly susceptible population. (Source: EHP-in-Press)

Cardiac Resynchronization Devices: Q&A with Kevin Jackson, MD

DukeHealth.org: Duke Health Features — Mon, 02 Jan 2012 19:07:05 +0100

Duke cardiologist Kevin Jackson, MD, answers questions about cardiac resynchronization devices. How does a cardiac resynchronization therapy device help heart failure patients? Kevin Jackson, MDSome heart failure patients need specialized care for hearts that pump with too little force. Such patients might benefit from an implantable device called an implantable cardioverter defibrillator (ICD). Between one-third and one-half of ICD candidates may benefit from a type of ICD called a cardiac resynchronization therapy (CRT) device. The CRT device is recommended for many heart failure patients who have both low ejection fractions (EF) and electrocardiograms (ECG) that show delayed and disorganized electrical activation of the heart, which can worsen the mechanical pumping problem. What does a...

Electrocardiogram-Based Sleep Spectrogram Measures of Sleep Stability and Glucose Disposal in Sleep Disordered Breathing

Sleep — Mon, 02 Jan 2012 13:58:37 +0100

Conclusions:ECG-derived sleep-spectrogram measures of sleep quality are associated with alterations in glucose-insulin homeostasis. This alternate mode of estimating sleep quality could improve our understanding of sleep and sleep-breathing effects on glucose metabolism.Citation:Pogach MS; Punjabi NM; Thomas N; Thomas RJ. Electrocardiogram-based sleep spectrogram measures of sleep stability and glucose disposal in sleep disordered breathing. SLEEP 2012;35(1):139-148. (Source: Sleep)

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Primary angioplasty in acute myocardial infarction with right bundle branch block: should new onset right bundle branch block be added to future guidelines as an indication for reperfusion therapy?

European Heart Journal — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion Acute myocardial infarction with RBBB is frequently caused by the complete occlusion of the infarct-related artery and is more frequently treated with primary PCI when compared with AMI + LBBB. In-hospital mortality of patients with AMI and RBBB is highest from all ECG presentations of AMI. Restoration of coronary flow by primary PCI may lead to resolution of the conduction delay on the discharge ECG. Right bundle branch block should strongly be considered for listing in future guidelines as a standard indication for reperfusion therapy, in the same way as LBBB. (Source: European Heart Journal)

Magnetic mini-mover procedure for pectus excavatum III: safety and efficacy in a Food and Drug Administration-sponsored clinical trial

Journal of Pediatric Surgery — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: The 3MP is a safe, cost-effective, outpatient alternative treatment for pectus excavatum that achieves good results for patients in early and midpuberty stages. (Source: Journal of Pediatric Surgery)

The effect of a high-fat breakfast on the pharmacokinetics of moxidectin in healthy male subjects: a randomized phase I trial.

The American Journal of Tropical Medicine and Hygiene — Sun, 01 Jan 2012 05:00:00 +0100

The objective of this study was to assess the effect of a high-fat meal on the pharmacokinetics of moxidectin. Healthy male subjects were randomized to receive single oral 8 mg doses of moxidectin after an overnight fast or high-fat breakfast. In fasted subjects (N = 27), mean [SD] parameters were C(max): 58.9 [12.5] ng/mL; t(max): 3.7 [1.5] h; area under concentration-time curve (AUC): 3,387 [1,328] ng/h/mL; Vλ(z)/F: 2,829 [1,267] L; CL/F: 2.76 [1.28] L/h; and t(½): 784 [347] h. Compared with fasted subjects, fed subjects (N = 27) exhibited a 34% increase in C(max), delay in t(max) to 5.3 [2.1] h, 44% increase in AUC, 40% decrease in Vλ(z)/F, and a 35% decrease in CL/F. There was no significant change in t(½). The changes are consistent with an increase in moxidect...

Artifactual electrocardiographic ST segment depression: Less likely due to electrocautery.

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

Authors: Patel S PMID: 22234030 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)

Earthing defect: A cause for unstable hemodynamics.

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

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

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[Systematic review and meta-analysis of randomized controlled trials comparing Chinese patent medicines Compound Danshen Dripping Pills and Di'ao Xinxuekang in treating angina pectoris].

Zhong xi yi jie he xue bao : Journal of Chinese Integrative Medicine. — Sun, 01 Jan 2012 05:00:00 +0100

CONCLUSION: DSP was consistently more effective than DXK according to meta-analysis, which was verified by subgroup analysis and sensitivity analysis. However, more RCTs of higher quality are needed for further confirmation. PMID: 22237271 [PubMed - in process] (Source: Zhong xi yi jie he xue bao : Journal of Chinese Integrative Medicine.)

Willem Einthoven (1860-1927): Father of electrocardiography.

Singapore Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Merritt C, Tan SY PMID: 22252177 [PubMed - in process] (Source: Singapore Medical Journal)

High-definition computed tomography for coronary artery stent imaging: a phantom study.

Korean J Radiol — Sun, 01 Jan 2012 05:00:00 +0100

CONCLUSION: High-definition CT helps improve measurement accuracy for imaging coronary stents compared to SDCT. HDCT with 100 kVp and the prospective ECG-triggered axial technique, with a lower radiation dose than 120 kVp application, may be advantageous in evaluating coronary stents with smaller calibers (≤ 3 mm). PMID: 22247632 [PubMed - in process] (Source: Korean J Radiol)

Electrocardiogram from a Young Trained Athlete

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

Ann Noninvasive Electrocardiol 2012;17(1):57 (Source: Annals of Noninvasive Electrocardiology)

Surviving Ventricular Standstill for 111 Seconds during Holter Monitoring

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

Holter electrocardiogram recording revealed symptomatic prolonged ventricular standstill lasting for about two minutes which terminated without any external cardiopulmonary resuscitation.Ann Noninvasive Electrocardiol 2012;17(1):61–62 (Source: Annals of Noninvasive Electrocardiology)

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Key findings on ECGs - level of agreement between GPs and cardiologists.

Australian Family Physician — Sun, 01 Jan 2012 05:00:00 +0100

This study aimed to retrospectively assess the level of agreement between GPs and cardiologists of key findings on ECGs. Methods A retrospective study of all patient referrals from GPs sent to a cardiology clinic at a medium sized public hospital over a 3 year period. The ECG diagnosis of the GP and the interpretive function of the ECG was compared with the ECG diagnosis of the cardiologist. Results A total of 2143 referrals were received from 292 GPs from 111 different practices. The level of agreement between the GPs and the cardiologists key findings was 58.9%. In comparison, the level of agreement between the key findings of the interpretive function on the GPs' ECG machines and of the cardiologists was 44.4%. Discussion The GPs' ability to accurately diagnose key findings on the ECG w...

A Smart Health Monitoring Chair for Nonintrusive Measurement of Biological Signals

Information Technology in Biomedicine, IEEE Transactions on - new TOC — Sun, 01 Jan 2012 05:00:00 +0100

This study demonstrates the feasibility of our method and device for biological signal monitoring through clothing for unconstrained long-term daily health monitoring that does not require user awareness and is not limited by physical activity. (Source: Information Technology in Biomedicine, IEEE Transactions on - new TOC)

Population pharmacokinetic and exposure-response analysis of nilotinib in patients with newly diagnosed Ph+ chronic myeloid leukemia in chronic phase

European Journal of Clinical Pharmacology — Fri, 30 Dec 2011 07:09:47 +0100

Conclusions There is a less than proportional dose-exposure relationship between nilotinib 300 mg and 400 mg twice-daily doses. Blood level testing is unlikely to play an important role in the general management of patients with newly diagnosed CML treated with nilotinib. Content Type Journal ArticleCategory Pharmacokinetics and DispositionPages 1-11DOI 10.1007/s00228-011-1200-7Authors Richard A. Larson, University of Chicago, Chicago, IL, USAOphelia Q. P. Yin, Novartis Pharmaceuticals Corporation, Florham Park, NJ, USAAndreas Hochhaus, Universitätsklinikum Jena, Jena, GermanyGiuseppe Saglio, University of Turin, Orbassano, ItalyRichard E. Clark, Royal Liverpool University Hospital, Liverpool, UKHirohisa Nakamae, Osaka City University, Osaka, JapanNeil J....

Impact of 64-slice coronary CT on the management of patients presenting with acute chest pain: results of a prospective two-centre study

European Radiology — Fri, 30 Dec 2011 07:08:08 +0100

Conclusion Our study confirms 64-slice CCT utility to rule out significant coronary artery stenosis in 8/10 patients admitted in ED with ACP or ACS with low-to-intermediate risk score. Early discharge with a negative 64-slice CCT is associated with very low risk of cardiac events at 6 months. Key Points • 64-slice coronary computed tomography (CCT) offers a critical role in acute chest pain. • 64-slice CCT allows differentiation between significant and non-significant coronary artery stenosis. • Normal 64-slice CCT allows rapid discharge of patients with ACP. • 64-slice CCT helps make appropriate therapeutic decision in patients with ACP. Content Type Journal ArticleCategory CardiacPages 1-9DOI 10.1007/s003...

Adding ST analysis to fetal ECG monitoring improves some delivery outcomes

Modern Medicine — Fri, 30 Dec 2011 05:00:00 +0100

NEW YORK (Reuters Health) - Analyzing the ST segment on the fetal electrocardiogram along with conventional cardiotocography during labor reduces operative vaginal deliveries but doesn't seem to have any neonatal benefit, say the authors of a new meta-analysis. (Source: Modern Medicine)

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Heart rate increment in the diagnosis of obstructive sleep apnoea in an older population

Sleep Medicine — Fri, 30 Dec 2011 03:41:21 +0100

Abstract: Objective: To evaluate the ability of the heart rate power spectral density of the very low frequency component expressed as a percentage of the total power spectral band (%VLFI) to diagnose obstructive sleep apnoea (OSA) in the elderly.Patients and methods: Eight hundred and thirty-two subjects aged 68.5±0.8years were selected from the participants of a 7-year cross-sectional study on the association between OSA and vascular morbidity–mortality. All subjects underwent electrocardiogram Holter monitoring and an at-home polysomnogram to measure the apnoea/hypopnoea index (AHI). OSA was assessed as an AHI>15.Results: The very low, the low frequency powers, and the %VLFI increased in subjects with OSA and were correlated with the autonomic arousal index and AHI (p (Source: Sleep ...

Cardiovascular Events With ADHD MedicationsCardiovascular Events With ADHD Medications

Medscape Today Headlines — Thu, 29 Dec 2011 16:37:46 +0100

Do the data support the recommendation to perform baseline ECGs before starting ADHD medications in children? Medscape Pediatrics (Source: Medscape Today Headlines)

Unstable Angina and Non-ST Elevation Myocardial Infarction.

American Journal of Respiratory and Critical Care Medicine — Wed, 28 Dec 2011 05:00:00 +0100

Authors: Braunwald E Abstract Non ST elevation acute coronary syndromes (NSTE-ACS) are responsible for approximately 1 million admissions to U.S. hospitals and twice as many to European hospitals each year. Thus, it is one of the most common serious illnesses in adults, and it is associated with an in-hospital mortality of approximately 5%. The most common cause is rupture of an atherosclerotic coronary plaque, resulting in subtotal coronary occlusion. Diagnosis is based on the clinical picture of retrosternal chest pain, aided by electrocardiographic findings of ST segment deviations and biomarker abnormalities (elevation of troponin and natriuretic peptides) and cardiac imaging (myocardial scans showing perfusion defects). Treatment involves anti-ischemic agents (nitrates and bet...

Serum copeptin/NT-proBNP ratio: A more reliable index of absolute endogenous stress and prognosis during the course of Tako-tsubo cardiomyopathy?

International Journal of Cardiology — Wed, 28 Dec 2011 05:00:00 +0100

Diagnostic approaches for the non-invasive differentiation of Tako-tsubo cardiomyopathy (TTC) and acute coronary syndromes (ACS) have drawn particular attention in the recent years.These approaches are generally based on a variety of suggested initial electrocardiographic (ECG) findings and non-invasive imaging modalities. However, serum levels of a variety of biomarkers including copeptin (C-terminal provasopressin) (CP) and the ratios of serum N-terminal pro-brain natriuretic peptide (NT-proBNP)/myocardial enzymes (myoglobin and troponin T) have also been recently suggested for the differentiation of these two entities. Notwithstanding the recent progress in the non-invasive diagnosis of TTC, clinical tools for the risk stratification (serum markers, etc.) that may potentially serve as p...

Marked lipomatous hypertrophy of the right ventricular wall: A distinct clinicopathological entity from arrhythmogenic right ventricular cardiomyopathy?

International Journal of Cardiology — Wed, 28 Dec 2011 05:00:00 +0100

A 21-year-old male was referred to our hospital because of palpitations due to sustained ventricular tachycardia (VT) (A) after hitting his chest hard while snow-boarding. Since the VT was resistant to antiarrhythmic drugs, it was converted to sinus rhythm by cardioversion. His 12-lead electrocardiogram (ECG) during sinus rhythm showed conduction abnormalities, with a complete right bundle branch block morphology, right axis deviation, and first degree atrioventricular block, accompanied by inverted T waves in leads V1-3 (B). Although he had remained asymptomatic by that time, he was diagnosed with a cardiac tumor of unknown pathogenesis in his right ventricle (RV) when he was three years old. Annual checkups with non-invasive imagings in a pediatrics department had demonstrated no remarka...

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Takotsubo-pericarditis association

The American Journal of Emergency Medicine — Wed, 28 Dec 2011 05:00:00 +0100

I have read the interesting article by Jimmy and Foo in a recent issue of the journal and congratulate them for their observation. The article clearly exemplified that Takotsubo cardiomyopathy (TC) can present with electrocardiographic (ECG) features of pericarditis. In the presented ECG, the widespread concave upwards ST-segment elevation and PR-segment depression (except in aVR and V1) and the absence of reciprocal ST-segment depression is a clear ECG evidence of acute pericarditis. TC with ECG criteria of acute pericarditis is known in the literature and has been previously reported. demonstrates all previously published cases taking into account the sequence of events, outcome, and possible explanations provided by the authors for this association. Regarding the sequence of both pathol...

Effect of Long-Term Music Therapy Intervention on Autonomic Function in Anthracycline-Treated Breast Cancer Patients

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

This study aimed to determine whether music therapy intervention improves autonomic function in anthracycline-treated breast cancer patients, and if so, whether such improvements persist after cessation of the intervention. Participants were 12 women with breast cancer who had undergone mastectomy or breast-conserving treatment and adjuvant chemotherapy; they attended 8 weekly music therapy sessions, each lasting 2 hours. Electrocardiogram traces (5 minutes) for HRV analysis were recorded 4 times: prior to the first music session, T1; after the fourth music session, T2; after the eighth music session, T3; and 4 weeks after the completion of music therapy, T4. HRV parameters were subjected to a nonparametric Friedman test on the differences between T1 and T2, T3, and T4. The standard deviat...

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

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

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

Pharmacokinetics of Vandetanib: Three Phase I Studies in Healthy Subjects.

Clinical Therapeutics — Tue, 27 Dec 2011 05:00:00 +0100

CONCLUSIONS: The pharmacokinetics of vandetanib after single oral doses to healthy subjects were defined and the metabolic pathway was proposed. Vandetanib was absorbed and eliminated slowly with a t(½) of ∼10 days after single oral doses. The extent of absorption was not significantly affected by the presence of food. Approximately two thirds of the dose was recovered in feces (44%) and urine (25%) over 21 days. Unchanged vandetanib and N-desmethyl and N-oxide metabolites were detected in plasma, urine, and feces. Vandetanib appeared to be was well tolerated in the populations studied. PMID: 22206795 [PubMed - as supplied by publisher] (Source: Clinical Therapeutics)

Clinical Pharmacokinetics of Gabapentin After Administration of Gabapentin Enacarbil Extended-Release Tablets in Patients With Varying Degrees of Renal Function Using Data From an Open-Label, Single-Dose Pharmacokinetic Study.

Clinical Therapeutics — Tue, 27 Dec 2011 05:00:00 +0100

CONCLUSIONS: The data suggest that dosage adjustment for gabapentin enacarbil is necessary in patients with impaired renal function. Gabapentin enacarbil, 600 mg, seemed to be well tolerated in this small selected population. PMID: 22206794 [PubMed - as supplied by publisher] (Source: Clinical Therapeutics)

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[Three recurrent episodes of Tako-Tsubo cardiomyopathy precipitated by an emotional stressful event: A case report.]

Annales de Cardiologie et d'Angeiologie — Tue, 27 Dec 2011 05:00:00 +0100

Authors: Montassier E, Segard J, Martinage A, Goffinet N, Piriou N, Le Conte P, Potel G, Gueffet JP Abstract Tako-Tsubo cardiomyopathy, first described in 1990 by Sato in Japan, has recently gained increasing consideration when reported in non-Japanese patients, including the United States and Europe. Typical presentation mimics acute coronary syndrome, with acute chest pain and/or dyspnoea, associated to electrocardiographic changes and moderate cardiac biomarkers release, but in which coronary angiography reveals no coronary arteries lesions and echocardiography or left ventriculography shows a reversible left ventricle systolic dysfunction. Prognosis is good, in contrast to acute coronary syndrome, provided that the patients survive the possible life-threatening acute presentati...

[A cause of dilated cardiomyopathy in child: Primary carnitine deficiency.]

Annales de Cardiologie et d'Angeiologie — Tue, 27 Dec 2011 05:00:00 +0100

CONCLUSION: Primary carnitine deficiency is a cause of dilated cardiomyopathy in child. It must systematically be suspected when a child presents a primitive cardiomyopathy. The treatment with oral carnitine for live is simple, with excellent prognosis. PMID: 22260907 [PubMed - as supplied by publisher] (Source: Annales de Cardiologie et d'Angeiologie)

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

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

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

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

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

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

ST Analysis of the Fetal Electrocardiogram in Intrapartum Fetal Monitoring: A Meta-Analysis.

Obstetrics and Gynecology — Mon, 26 Dec 2011 10:51:04 +0100

CONCLUSION:: The additional use of ST analysis for intrapartum monitoring reduced the incidence of operative vaginal deliveries and the need for fetal blood sampling but did not reduce the incidence of metabolic acidosis at birth. PMID: 22183222 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)

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Intracoronary electrocardiogram ST segment shift evaluation during intravenous adenosine infusion: A comparison with fractional flow reserve.

Cardiology Journal — Sat, 24 Dec 2011 18:12:03 +0100

Conclusions: Intracoronary ST segment shift evaluation during adenosine infusion may be of value in assessing the functional significance of a borderline stenosis. The presence of IST during adenosine infusion could obviate the need for additional FFR evaluation. (Cardiol J 2011; 18, 6: 662-667). PMID: 22113754 [PubMed - in process] (Source: Cardiology Journal)

Electrocardiography and prognosis of patients with acute pulmonary embolism.

Cardiology Journal — Sat, 24 Dec 2011 18:12:03 +0100

Conclusions: In our population of APE patients, the sum of negative T waves, the number of leads with negative T waves and the ST segment elevation in lead V1 were independent predictors of death during hospitalization. In turn, the sum of negative T waves, the number of leads with negative T waves, and RBBB and ST segment elevation in leads V1 and aVR were independent predictors of complications during hospitalization. We conclude that ECG analysis may be a useful noninvasive method for risk stratification of patients with APE. (Cardiol J 2011; 18, 6: 648-653). PMID: 22113752 [PubMed - in process] (Source: Cardiology Journal)

Usefulness of the 12-lead electrocardiogram in the follow-up of patients with cardiac resynchronization devices. Part II.

Cardiology Journal — Sat, 24 Dec 2011 18:12:03 +0100

Authors: Barold SS, Herweg B Abstract The interval from the pacemaker stimulus to the onset of the earliest paced QRS complex (latency) may be prolonged during left ventricular (LV) pacing. Marked latency is more common with LV than right ventricular (RV) pacing because of indirect stimulation through a coronary vein and higher incidence of LV pathology including scars. During simultaneous biventricular (BiV) pacing a prolonged latency interval may give rise to an ECG dominated by the pattern of RV pacing with a left bundle branch block configuration and commonly a QS complex in lead V1. With marked latency programming the V-V interval (LV before RV) often restore the dominant R wave in lead V1 representing the visible contribution of the LV to overall myocardial depolarization. W...

ECG signal analysis for the assessment of sleep-disordered breathing and sleep pattern

Medical and Biological Engineering and Computing — Fri, 23 Dec 2011 06:49:18 +0100

Abstract The diagnosis of sleep-disordered breathing (SDB) usually relies on the analysis of complex polysomnographic measurements performed in specialized sleep centers. Automatic signal analysis is a promising approach to reduce the diagnostic effort. This paper addresses SDB and sleep assessment solely based on the analysis of a single-channel ECG recorded overnight by a set of signal analysis modules. The methodology of QRS detection, SDB analysis, calculation of ECG-derived respiration curves, and estimation of a sleep pattern is described in detail. SDB analysis detects specific cyclical variations of the heart rate by correlation analysis of a signal pattern and the heart rate curve. It was tested with 35 SDB-annotated ECGs from the Apnea-ECG Database, and achieved a...

Accuracy of algorithms to predict accessory pathway location in children with Wolff-Parkinson-White syndrome

Heart — Fri, 23 Dec 2011 05:00:00 +0100

Conclusions All algorithms were less accurate in our hands than in other authors' own assessment. None performed well in identifying midseptal or right anteroseptal accessory pathway locations. (Source: Heart)

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Incoherent oscillations of respiratory sinus arrhythmia during acute mental stress in humans

AJP: Heart and Circulatory Physiology — Fri, 23 Dec 2011 05:00:00 +0100

Respiratory sinus arrhythmia (RSA) has been widely used as a measure of the cardiac vagal control in response to stress. However, RSA seems not to be a generalized indicator because of its dependency on respiratory parameter and individual variations of RSA amplitude (ARSA). We hypothesized that phase-lag variations between RSA and respiration may serve as a normalized index of the degree of mental stress. Twenty healthy volunteers performed mental arithmetic task (ART) after 5 min of resting control followed by 5 min of recovery. Breathing pattern, beat-to-beat R-R intervals, and blood pressure (BP) were determined using inductance plethysmography, electrocardiography, and a Finapres device, respectively. The analytic signals of breathing and RSA were obtained by Hilbert transform and the...

Successful Surgical Repair of a Giant Calcified Left Ventricular Aneurysm: A Report of a Case.

Annals of Thoracic and Cardiovascular Surgery — Thu, 22 Dec 2011 05:00:00 +0100

Authors: Sugimura Y, Toyama M, Katoh M, Kotani M, Kato Y, Hisamoto K Abstract A 68-year-old man presented at the outpatient clinic with epigastric discomfort. He had suffered a myocardial infarction 10 years previously. Chest radiography and computed tomography showed a giant calcified aneurysm in the left ventricle. Electrocardiography indicated atrial fibrillation. Echocardiography showed moderate mitral regurgitation and enlarged left atrium. End-diastolic volume and ejection fraction were 164 ml and 31%, respectively. Coronary angiography revealed total occlusion of the left anterior descending artery and diffuse stenosis of the right coronary artery. Aneurysmectomy, mitral annuloplasty, maze procedure, and coronary artery bypass were performed. The patient was discharged 16 da...

Clinical Implications of Electrocardiograms for Patients With Anterior Wall ST-Segment Elevation Acute Myocardial Infarction in the Interventional Era.

Circulation Journal — Thu, 22 Dec 2011 05:00:00 +0100

Authors: Kosuge M, Kimura K Abstract Reperfusion therapy has become an established treatment for ST-segment elevation acute myocardial infarction (STEMI), increasing the need for early diagnosis and early treatment. Despite the development of diagnostic strategies, the electrocardiogram (ECG) plays a central role in the diagnostic pathway for STEMI because it is inexpensive, readily available, and noninvasive. Moreover, in the acute phase of STEMI, the ECG can provide useful information about the extent of area at risk, the degree of myocardial damage, reperfusion injury, and myocardial reperfusion, all of which influence infarct size. This review explores the clinical importance of the ECG for patients with anterior wall STEMI in the current interventional era. (Circ J 2012; 76: 3...

Early cardiac arrest in patients hospitalized with pneumonia: a report from the American Heart Association's Get With the Guidelines - Resuscitation Program.

Chest — Thu, 22 Dec 2011 05:00:00 +0100

CONCLUSIONS:In patients with pre-existing pneumonia, cardiac arrest may occur in the absence of preceding shock or respiratory failure. Clinicians should be alert to the possibility of abrupt cardiopulmonary collapse, and future studies should address this possibility. The mechanism may involve myocardial ischemia, a maladaptive response to hypoxia, sepsis-related cardiomyopathy, or other phenomena. PMID: 22194592 [PubMed - as supplied by publisher] (Source: Chest)