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[Palpitations in competitive athletes. Risks from premature beats, nonsustained tachycardia and preexcitation].
Cardiovascular screening tests to prevent sudden cardiac death in athletes are discussed controversially, but they should include diligent patient history and physical examination as well as registration of an ECG. If palpitations or tachycardias are described or if preexcitation, supraventricular or ventricular arrhyt...
6,501
Echocardiographic assessment of left atrial size in patients with end-stage renal disease.
Cardiac disease is the most common cause of death in patients with end-stage renal disease. It is assumed that the high rate of cardiovascular mortality is related to accelerated atherosclerosis. Patients with chronic renal insufficiency have an increased prevalence of coronary artery disease, silent myocardial ischaem...
6,502
The role of chronic atrial stretch and atrial fibrillation on posterior left atrial wall conduction.
The posterior left atrium (LA) is involved in the initiation and maintenance of atrial fibrillation (AF).</AbstractText>The purpose of this study was to compare conduction patterns on the posterior LA in patients with mitral regurgitation (MR), with and without AF.</AbstractText>Epicardial mapping of the posterior LA w...
6,503
Profound myocardial ischemia associated to occlusion of the right coronary artery.
A 75-year-old man with hypertension, hypercholesterolemia and history of coronary artery disease was admitted to the hospital because of sudden loss of consciousness. The patient suffered an acute myocardial infarction seven years before this admission, which was treated with percutaneous transluminal coronary angiopla...
6,504
Combining antiplatelet and anticoagulant therapies.
Antiplatelet therapy is the cornerstone for both primary and secondary prevention therapies for ischemic events resulting from coronary atherosclerotic disease. Dual antiplatelet therapy (aspirin plus a thienopyridine, usually clopidogrel) has assumed a central role in the treatment of acute coronary syndromes and afte...
6,505
[Clinical characteristics of cardiac syncope in children].
To explore the clinical characteristics of cardiac syncope (CS) in children, and understand their significance in predicting the cardiac syncope.</AbstractText>Twenty-three patients were referred to our department for evaluation of syncope. The diagnosis of the above cases was cardiac syncope. Each patient was intervie...
6,506
Alcohol-induced electrical remodeling: effects of sustained short-term ethanol infusion on ion currents in rabbit atrium.
In some patients, above-average alcohol consumption before occurrence of atrial fibrillation (AF) in terms of a "holiday heart syndrome" (HHS) can be determined. There is evidence that long before development of apparent alcohol-induced cardiomyopathy, above-average alcohol consumption generates an arrhythmogenic subst...
6,507
Monomorphic ventricular tachycardia caused by electrocautery during pacemaker generator change in a patient with normal left ventricular function.
Pacemaker generator replacement is a simple procedure that is mostly done on outpatient basis. Electrocautery is almost universally used for bleeding control and tissue dissection. Ventricular fibrillation (VF) caused by electrocautery in these procedures is a very uncommon occurrence and an underappreciated possibilit...
6,508
Left ventricular mechanical assist devices and cardiac device interactions: an observational case series.
Nonpulsatile left ventricular assist devices (LVADs) are increasingly used for treatment of refractory heart failure. A majority of such patients have implanted cardiac devices, namely implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy-pacemaker (CRT-P) or cardiac resynchronization ther...
6,509
Sudden death: do cytokines and prothrombotic peptides contribute to the occurrence of ventricular fibrillation during acute myocardial infarction?
Sudden cardiac death (SCD) is frequently caused by ventricular fibrillation (VF) occurring in the course of acute myocardial infarction (AMI). It has not been investigated yet, to what extent markers of coagulation activation and inflammation differ between patients with and without VF in the acute phase of AMI.
6,510
A case of catecholaminergic polymorphic ventricular tachycardia.
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a familial cardiac arrhythmia that is related to RYR2 or CASQ2 gene mutation. It occurs in patients with structurally normal heart and causes exercise-emotion-triggered syncope and sudden cardiac death. We experienced a case of CPVT in an 11 year-old femal...
6,511
Myocardial perfusion imaging and cardiovascular outcomes in a cancer population.
Myocardial perfusion imaging can predict outcomes in cardiac patients. However, limited data exist regarding its prediction of cardiovascular outcomes in cancer patients. We sought to determine whether myocardial perfusion imaging predicts long-term cardiovascular outcomes in cancer patients.We performed a retrospectiv...
6,512
Chronic heart failure and the substrate for atrial fibrillation.
We sought to define the underlying mechanisms for atrial fibrillation (AF) during chronic heart failure (HF).</AbstractText>Preliminary studies showed that 4 months of HF resulted in irreversible systolic dysfunction (n = 9) and a substrate for sustained inducible AF (&gt;3 months, n = 3). We used a chronic (4-month) c...
6,513
Rosiglitazone-induced myocardial protection against ischaemia-reperfusion injury is mediated via a phosphatidylinositol 3-kinase/Akt-dependent pathway.
1. Rosiglitazone is widely used in the treatment of Type 2 diabetes. However, in recent years it has become evident that the therapeutic effects of peroxisome proliferator-activated receptor gamma ligands reach far beyond their use as insulin sensitizers. Recently, the ability of rosiglitazone pretreatment to induce ca...
6,514
Electrical storms and their prognostic implications.
The Agency for Healthcare Research and Quality (AHRQ) commissioned this report to review the evidence for the clinical effects and safety of radiofrequency catheter ablation (RFA) for the management of atrial fibrillation (AF). Over the past decade, RFA has rapidly evolved as a tool for managing AF in select patients. ...
6,515
Postoperative atrial fibrillation after cardiac surgery: who should receive chemoprophylaxis?
To evaluate arrhythmogenic risk factors associated with greater incidence of postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery (CABG and/or valvular surgery) in order to identify those more prone to the development of this arrhythmia for possible chemoprophylaxis. Sixty-six patients who un...
6,516
Elevated depression symptoms predict long-term cardiovascular mortality in patients with atrial fibrillation and heart failure.
Depression predicts prognosis in many cardiac conditions, including congestive heart failure (CHF). Despite heightened cardiac risk in patients with comorbid atrial fibrillation (AF) and CHF, depression has not been studied in this group. This substudy, from the AF-CHF Trial of rate- versus rhythm-control strategies, i...
6,517
Early and mid-term functional and survival benefits in ischaemic versus degenerative mitral valve repair using Duran flexible ring: a single surgeon series.
The late results of ischaemic mitral valve (MV) repair have been less than satisfying. We compared echocardiographically, the changes in LV function, mid-term durability and survival between MV repair caused by ischaemic cardiomyopathy (n=60) with degenerative MV disease (n=73) over a period of 15 years. The duration o...
6,518
Drug-induced QT interval shortening: potential harbinger of proarrhythmia and regulatory perspectives.
ATP-dependent potassium channel openers such as pinacidil and levcromakalim have long been known to shorten action potential duration and to be profibrillatory in non-clinical models, raising concerns on the clinical safety of drugs that shorten QT interval. Routine non-clinical evaluation of new drugs for their potent...
6,519
Sotalol and a broken heart.
An 82-year-old woman with persistent atrial fibrillation underwent successful electrical cardioversion and was begun on sotalol. After 3 days of in-hospital observation she had only mild lengthening of the QT interval. Two weeks later in clinic, the day after her husband's unexpected death, she was noted to have profou...
6,520
Coronary artery disease, left ventricular hypertrophy and diastolic dysfunction are associated with stroke in patients affected by persistent non-valvular atrial fibrillation: a case-control study.
Persistent non-valvular atrial fibrillation (NVAF) is associated with an increased risk of cardiovascular events such as stroke, and its rate is expected to rise because of the ageing population. The absolute rate of stroke depends on age and comorbidity. Risk stratification for stroke in patients with NVAF derives fro...
6,521
Ventricular arrhythmic disturbances and autonomic modulation after beating-heart revascularization in patients with pulmonary normotension.
De-novo ventricular arrhythmias are potentially life-threatening complications after beating-heart revascularization (off-pump CABG). Whether pulmonary hypertension can influence initiation of ventricular arrhythmias through increased sympathetic activity is controversial. In order to determine the influence of pulmona...
6,522
Use of the trendelenburg position in the porcine model improves carotid flow during cardiopulmonary resuscitation.
Cardiopulmonary resuscitation (CPR) is now widely used as a treatment for ventricular fibrillation, though numerous studies have shown the outcome of standard CPR to be dismal. Alternative methods of CPR, including interposed abdominal compression, constant aortic occlusion, and the use of intrathoracic pressure regula...
6,523
Targeting of cardiac autonomic plexus for modulation of intracardiac neural tone.
Ventricular rate control is considered as an initial choice of therapy in many patients with atrial fibrillation (AF). We could previously show that electrostimulation of the right inferior ganglionated plexus (RIGP), which supplies the AV node, instantly decreases ventricular rate during AF. This study describes the d...
6,524
Regional frequency variation during human ventricular fibrillation.
Quantifying the regional frequency variation in ventricular fibrillation (VF) may lead to focal strategies in treating human VF. We hypothesized that during human VF there are quantifiable regional frequency variations in the ventricles and they relate to underlying fixed myocardial substrate. In eight myopathic human ...
6,525
Incidence of ventricular arrhythmias in patients on long-term support with a continuous-flow assist device (HeartMate II).
The incidence of ventricular tachycardia (VT) or ventricular fibrillation (VF) in patients supported with a continuous-flow left ventricular assist device (LVAD) has not been investigated in detail. In 23 consecutive recipients of a HeartMate II, we analyzed the incidence of VT/VF during a total of 266 months of follow...
6,526
Unexpected complications of transapical aortic valve implantation.
Recent series have reviewed the results of transapical aortic valve implantation (TAVI). However, specific problems of this new procedure are not well-described. Unexpected complications due to the procedure and their management are reported.</AbstractText>Eighteen patients underwent TAVI using the Edwards Sapien biopr...
6,527
Survival of cardiorespiratory arrest after coronary artery bypass grafting or aortic valve surgery.
Study objectives were to (1) report the clinical profile of and outcome for patients who experience a cardiorespiratory arrest after coronary artery bypass grafting or aortic valve replacement, and (2) identify factors associated with improved probability of survival.</AbstractText>We identified 108 consecutive patient...
6,528
Sinus rhythm restoration by catheter ablation in patients with long-lasting atrial fibrillation and congestive heart failure: impact of the left ventricular ejection fraction improvement on the implantable cardioverter defibrillator insertion indication.
In the setting of congestive heart failure (CHF), atrial fibrillation (AF) ablation can improve clinical status and the left ventricular ejection fraction (LVEF) value. However, the impact of AF ablation on the implantable cardioverter defibrillator (ICD) indication has never been specifically addressed.</AbstractText>...
6,529
Long-term follow-up free of ventricular fibrillation recurrence after resuscitated cardiac arrest in a myotonic dystrophy type 1 patient.
Cardiac involvement in myotonic dystrophy type 1 (DM1) is frequent with increased incidence of conduction disturbances and sudden cardiac death when compared with general population. We describe a 38-year-old man in whom the diagnosis of DM1 was made 8 years after occurrence of cardiac arrest owing to ventricular fibri...
6,530
Changes in plasma natriuretic peptide levels in patients with atrial fibrillation after cardioversion.
The aim of the study was to assess changes in plasma natriuretic peptide (NP) levels after spontaneous or electrical cardioversion (CV) in patients with paroxysmal or persistent atrial fibrillation (AF).</AbstractText>Patients with paroxysmal or persistent AF with normal left ventricular function and controlled heart r...
6,531
The potential beneficial effects of beta adrenergic blockade in the treatment of ventricular fibrillation.
Cardiac arrest remains a major medical emergency in Western societies, with ventricular fibrillation being the initial rhythm in a significant proportion of cases. Adrenaline is generally accepted to improve the resuscitation outcome, since it improves coronary and cerebral blood flow during cardiopulmonary resuscitati...
6,532
Successful resuscitation of a patient in asystole after a TASER injury using a hypothermia protocol.
New studies have shown the benefit of initiating a hypothermia protocol in the survivors of cardiac arrest. Although the data have shown an improved neurologic end point in patients initially in ventricular fibrillation or pulseless ventricular tachycardia, there is still debate about whether patients initially in othe...
6,533
Shortening of cardiopulmonary resuscitation time before the defibrillation worsens the outcome in out-of-hospital VF patients.
The purpose of the study is to investigate the influence of cardiopulmonary resuscitation (CPR) time before the first defibrillation.</AbstractText>The present study retrospectively analyzed the Utstein template records from April 1, 2002, to June 30, 2005. Patients who had out-of-hospital-witnessed cardiac arrest caus...
6,534
Prearrest signs of shock and respiratory insufficiency in out-of-hospital cardiac arrests witnessed by crew of the emergency medical service.
The objective of this study is to determine whether prearrest shock and respiratory insufficiency influence outcome in patients with emergency medical service-witnessed out-of-hospital cardiac arrest.</AbstractText>Analysis of data from a cardiac arrest database and data from the ambulance charts was performed. For the...
6,535
[In-hospital cardiopulmonary resuscitation at Landspitali University Hospital in Reykjavik].
Survival after in-hospital cardiac arrest has not been previously reported in Iceland and the purpose of this study was to examine the outcomes of in-hospital resuscitation over a two year period.</AbstractText>There are resuscitation teams on each of the two campuses of the University Hospital in Reykjavik. Since the ...
6,536
A meta-analysis of the prognostic significance of atrial fibrillation in chronic heart failure.
Atrial fibrillation (AF) is one of the commonest sustained arrhythmias in chronic heart failure (CHF), although the prognostic implications of the presence of AF in CHF remain controversial. We have therefore performed this meta-analysis to study the effects of the presence of AF on mortality in CHF patients.</Abstract...
6,537
Mitral regurgitation associated with mitral annular dilation in patients with lone atrial fibrillation: an echocardiographic study.
Whether and how lone atrial fibrillation (AF) is associated with functional mitral regurgitation (MR) remain unclear.</AbstractText>We studied 12 lone AF patients without left ventricular (LV) dysfunction and/or dilatation, who underwent mitral valve annuloplasty for functional mitral regurgitation (MR). Ten lone AF pa...
6,538
Hypothermia after cardiac arrest: expanding the therapeutic scope.
Therapeutic hypothermia for 12 to 24 hrs following resuscitation from out-of-hospital cardiac arrest is now recommended by the American Heart Association for the treatment of neurological injury when the initial cardiac rhythm is ventricular fibrillation. However, the role of therapeutic hypothermia is uncertain when t...
6,539
Ventricular fibrillation frequency from implanted cardioverter defibrillator devices.
The dominant frequency (DF) of ventricular fibrillation (VF) provides a measure of cycle length that may relate to the underlying complexity of the arrhythmia. Dominant frequency analysis may therefore provide insights into VF mechanisms, and potentially guide future therapies. Dominant frequency analysis can be undert...
6,540
Defibrillation testing in patients with atrial fibrillation.
Implantable cardioverter defibrillator implantation in patients with atrial fibrillation (AF) is complicated by the need for anticoagulation during defibrillation testing. In this retrospective study, we evaluated the factors associated with successful cardioversion of AF during ventricular defibrillation testing and t...
6,541
Novel use of a vascular plug to anchor an azygous vein ICD lead.
We describe the case of a young patient with severe hypertrophic cardiomyopathy and marginal defibrillation thresholds (DFTs) at implant of a standard transvenous implantable cardioverter-defibrillator (ICD) system. The patient subsequently experienced multiple failed ICD shocks during a prolonged episode of spontaneou...
6,542
Nocturnal Arrhythmias across a spectrum of obstructive and central sleep-disordered breathing in older men: outcomes of sleep disorders in older men (MrOS sleep) study.
Rates of cardiac arrhythmias increase with age and may be associated with clinically significant morbidity. We studied the association between sleep-disordered breathing (SDB) with nocturnal atrial fibrillation or flutter (AF) and complex ventricular ectopy (CVE) in older men.</AbstractText>A total of 2911 participants...
6,543
Comparison of neurological outcomes following witnessed out-of-hospital ventricular fibrillation defibrillated with either biphasic or monophasic automated external defibrillators.
Biphasic waveform defibrillation results in higher rates of termination of fibrillation than monophasic waveform defibrillation but has not been shown to improve survival outcomes.</AbstractText>To compare the effectiveness of a biphasic automated external defibrillator (AED) with a monophasic AED for witnessed out-of-...
6,544
Update on medical management of atrial fibrillation in the modern era.
The management of atrial fibrillation involves control of the ventricular response rate, anticoagulation to reduce the risk of stroke and attempts to maintain sinus rhythm. The approach to patients with atrial fibrillation has become increasingly complex as therapeutic options have expanded. The ultimate reasons to tre...
6,545
Postshunt hemochromatosis leading to cardiogenic shock in a patient presenting for orthotopic liver transplant: a case report.
In this case report, we have presented a patient whose liver transplant course was greatly affected by a previously undiagnosed disease process that ultimately led to an unexpected perioperative death.</AbstractText>A 52-year-old woman with idiopathic hepatoportal sclerosis presented for liver transplantation 2 years p...
6,546
BNP/NT-proBNP and cardiac pacing: a review.
Natriuretic peptide (NP) levels (B-type natriuretic peptide [BNP] and N-terminal proBNP) are now widely used in clinical practice and cardiovascular research all over the world and have been incorporated into many cardiovascular guidelines for heart failure (HF). The roles of NP levels are evolving rapidly not only in ...
6,547
Ventricular arrhythmia inducibility predicts subsequent ICD activation in nonischemic cardiomyopathy patients: a DEFINITE substudy.
We evaluated whether electrophysiologic (EP) inducibility predicts the subsequent occurrence of spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) in the Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation (DEFINITE) trial.</AbstractText>Inducibility of ventricular arrhythmias has b...
6,548
The influence of left ventricle diastolic function on natriuretic peptides levels in patients with atrial fibrillation.
The diagnosis of the impaired left ventricle (LV) diastolic function during atrial fibrillation (AF) using traditional methods is very difficult. Natriuretic peptides seem to be useful for assessment of diastolic function in patients with AF.</AbstractText>To evaluate the influence of LV diastolic dysfunction on natriu...
6,549
QT interval disturbances in hospitalized elderly patients.
The QT interval reflects the total duration of ventricular myocardial repolarization. Its prolongation is associated with increased risk of polymorphic ventricular tachycardia, or torsade de pointes, which can be fatal.</AbstractText>To assess the prevalence of both prolonged and short QT interval in patients admitted ...
6,550
Arrhythmia and acute coronary syndrome suppression and cardiac resuscitation management with bretylium.
It is well known that electric shock can both initiate and terminate ventricular fibrillation. Refractory ventricular fibrillation (RVF) may often be an iatrogenic paradoxical result of early, frequent, excessive salvos of DC current countershocks and inappropriate off-label drug use, particularly aggressive epinephrin...
6,551
Pathological remodeling of cardiac gap junction connexin 43-With special reference to arrhythmogenesis.
A dysfunction of the cardiac gap junction, which contributes to electrical cell-to-cell coupling is one of essential factors known to generate arrhythmias. The function of the gap junction depends on the regulation of connexin which composes the gap junction channel. A dysfunction of the gap junction is possibly caused...
6,552
Atrial fibrillation and quality of life after pacemaker implantation for sick sinus syndrome: data from the Mode Selection Trial (MOST).
In the Mode Selection Trial (MOST) of 2,010 patients with sinus node dysfunction, dual-chamber-paced patients had less atrial fibrillation (AF) and heart failure and had slightly improved health-related quality of life (QOL) compared with rate modulated right ventricular-paced patients. Our objective was to assess the ...
6,553
Improvement of P wave dispersion after cardiac resynchronization therapy for heart failure.
The purpose of this study is to investigate the effect of cardiac resynchronization therapy (CRT) on P wave maximum duration (PWM) and P wave dispersion (PWD) in patients with advanced heart failure.</AbstractText>Forty-six patients (33 men; mean age, 60 +/- 11 years) with CRT were enrolled in the present study. PWM an...
6,554
Effect of biventricular pacing during a ventricular sensed event.
Loss of biventricular (BiV) pacing occurs during ventricular sensed events such as frequent ventricular ectopy, nonsustained ventricular tachycardia, and intrinsic atrioventricular nodal conduction, such as in atrial fibrillation. Ventricular sense response (VSR) pacing, a novel cardiac resynchronization therapy pacing...
6,555
Re-expression of alpha skeletal actin as a marker for dedifferentiation in cardiac pathologies.
Differentiation of foetal cardiomyocytes is accompanied by sequential actin isoform expression, i.e. down-regulation of the 'embryonic' alpha smooth muscle actin, followed by an up-regulation of alpha skeletal actin (alphaSKA) and a final predominant expression of alpha cardiac actin (alphaCA). Our objective was to det...
6,556
Postoperative atrial fibrillation - what do we really know?
Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, occurring in 20% to 60% of patients. Advanced age, history of atrial fibrillation (AF), heart failure, peripheral arterial disease and chronic obstructive pulmonary disease are predictors of POAF. The pathogenesis of AF seems t...
6,557
Early and comprehensive management of atrial fibrillation: executive summary of the proceedings from the 2nd AFNET-EHRA consensus conference 'research perspectives in AF'.
Atrial fibrillation (AF) causes important mortality and morbidity on a population-level. So far, we do not have the means to prevent AF or AF-related complications adequately. Therefore, over 70 experts on atrial fibrillation convened for the 2nd AFNET/EHRA consensus conference to suggest directions for research to imp...
6,558
Noninvasive risk stratification after myocardial infarction: rationale, current evidence and the need for definitive trials.
Despite advances in therapies for myocardial infarction (MI), death attributed to a cardiac arrest from ventricular tachycardia (VT) or ventricular fibrillation (VF) remains an important problem. The implantable cardioverter defibrillator (ICD) is effective in preventing death from VT/VF, but reliably identifying which...
6,559
CPR degradation diagram.
During untreated ventricular fibrillation (VF), before CPR is applied, different bodily systems deteriorate at different rates. This paper describes the times when the EEG disappears, when respiratory arrest occurs, and when PD-PEA occurs. It also describes the frequency of VF waves over a 7-min period and how the freq...
6,560
[Takotsubo syndrome from original description up to now].
Stress-induced cardiomyopathy, also known as takotsubo syndrome, imitates an acute ST elevation myocardial infarction or an acute coronary syndrome, but without concomitant coronary artery disease. It mainly affects postmenopausal women, but no established epidemiologic data of this syndrome are available to date. Furt...
6,561
Management of left ventricular diastolic heart failure: is it only blood pressure control?
Diastolic heart failure (DHF) is the most common form of heart failure (HF) seen by clinicians today in practice. With the increasing prevalence of DHF, the need for greater spectrum of proven therapies in this condition is clear.</AbstractText>There are few data available to guide the therapy of these patients, and no...
6,562
Significance of early onset and progressive increase of activation delay during premature stimulation in Brugada syndrome.
The relationship between the activation delay during programmed stimulation and the inducibility of ventricular fibrillation (VF) and filtered QRS duration on signal-averaged ECG (SAECG) were assessed in patients with Brugada syndrome (BS).</AbstractText>The activation delay was assessed using the interval between the ...
6,563
Antiarrhythmic activity of phytoadaptogens in short-term ischemia-reperfusion of the heart and postinfarction cardiosclerosis.
A course of treatment (16 mg/kg orally during 5 days) by Aralia mandshurica or Rhodiola rosea extracts reduced the incidence of ischemic and reperfusion ventricular arrhythmias during 10-min ischemia and 10-min reperfusion. Extracts of Eleutherococcus senticosus, Leuzea carthamoides, and Panax ginseng did not change th...
6,564
Assessment of the ion channel-blocking profile of the novel combined ion channel blocker AZD1305 and its proarrhythmic potential versus dofetilide in the methoxamine-sensitized rabbit in vivo.
AZD1305 is a novel antiarrhythmic agent under clinical evaluation for management of atrial fibrillation. This study assessed its ion channel-blocking potency by the whole cell patch-clamp technique in vitro and its proarrhythmic liability in anesthetized methoxamine-sensitized rabbits in comparison with dofetilide. AZD...
6,565
Brugada syndrome whose ST-segment changes were enhanced by antihistamines and antiallergenic drugs.
We describe a case of Brugada syndrome, in which a coved type ST-segment elevation was enhanced by antihistamines and antiallergenic drugs. The patient had been treated with four kinds of antihistamines and antiallergenic drugs. The twelve-lead ECG exhibited a coved type ST-segment elevation in leads V(1) and V(2), and...
6,566
Bench study of the accuracy of a commercial AED arrhythmia analysis algorithm in the presence of electromagnetic interferences.
This paper presents a bench study on a commercial automated external defibrillator (AED). The objective was to evaluate the performance of the defibrillation advisory system and its robustness against electromagnetic interferences (EMI) with central frequencies of 16.7, 50 and 60 Hz. The shock advisory system uses two ...
6,567
Which factors influence spontaneous state transitions during resuscitation?
The clinical state (i.e. ventricular fibrillation/tachycardia: VF/VT, asystole: ASY, pulseless electrical activity: PEA, or return of spontaneous circulation, ROSC) during cardiopulmonary resuscitation determines patient management. We investigate how spontaneous transitions (i.e. not forced by DC shock) between these ...
6,568
Factors associated with a change in functional outcome between one month and six months after cardiac arrest: a retrospective cohort study.
The appropriate time point of evaluation of functional outcome in cardiac arrest survivors remains a matter of debate. In this cohort study we posed the hypothesis that there are no significant changes in Cerebral Performance Categories (CPC) between one month and six months after out-of hospital cardiac arrest. If cha...
6,569
Association of intramyocardial high energy phosphate concentrations with quantitative measures of the ventricular fibrillation electrocardiogram waveform.
Quantitative measures of the ventricular fibrillation (VF) electrocardiogram (ECG) have been correlated with the success of rescue shocks, making them ideal measures for guiding resuscitative interventions. Correlation of intramyocardial energy stores with the change in quantitative VF ECG measures would provide mechan...
6,570
Surface ECG organization analysis to predict paroxysmal atrial fibrillation termination.
The aim of this work is to predict non-invasively if an AF episode terminates spontaneously or not by analyzing the increase of atrial activity organization prior to paroxysmal atrial fibrillation (PAF) termination. Sample entropy was selected as non-linear organization index. Synthetic PAF signals were used to evaluat...
6,571
Technical and practical aspects of remote monitoring of implantable cardioverter-defibrillator patients in Poland - preliminary results.
The aim of remote monitoring of implantable cardioverter-defibrillators (ICD) is to increase the patient's safety by early detection of technical or medical malfunctions and decrease the number of follow-up visits.</AbstractText>To evaluate the feasibility and reliability of internet-based home monitoring of ICD recipi...
6,572
Cognitive disorders in elderly patients with permanent atrial fibrillation.
Atrial fibrillation (AF) is a risk factor for development of thromboembolic events with an annual stroke rate of 4.5%. In subjects over 80 years AF is the single leading cause of major stroke. Moreover, about 25% of patients with AF in the absence of neurological deficits have tomographic signs of one or more silent ce...
6,573
Ventricular reverse remodeling early after mitral valve repair for severe chronic mitral regurgitation with atrial fibrillation.
Chronic mitral regurgitation (MR) results in volume overload followed by left ventricular (LV) and left atrial remodeling. The aim of this study was to investigate the relation of clinical, echocardiographic findings and N-terminal B-type natriuretic peptide (NT-proBNP) to LV reverse remodeling (LVRR) early after valve...
6,574
Predictors of stroke in patients with severe systolic dysfunction in sinus rhythm: role of echocardiography.
Congestive heart failure in sinus rhythm ranks second after atrial fibrillation (AF) among cardiogenic risk-factors for stroke. Clinical and echocardiographic predictors of stroke in this high-risk population remain poorly defined.</AbstractText>Retrospective screening of 1886 consecutive patients with severe systolic ...
6,575
Robotic magnetic navigation for ablation of human arrhythmias: initial experience.
Magnetic navigation system (MNS) (Niobe, Stereotaxis, Saint-Louis, Missouri, USA) allows remote control of a radiofrequency ablation catheter using a steerable magnetic field and a catheter advancement system.</AbstractText>We report our initial experience of ablation of human arrhythmias using the MNS.</AbstractText>E...
6,576
Effectiveness of cardiac resynchronization therapy in heart failure patients with valvular heart disease: comparison with patients affected by ischaemic heart disease or dilated cardiomyopathy. The InSync/InSync ICD Italian Registry.
To analyse the effectiveness of cardiac resynchronization therapy (CRT) in patients with valvular heart disease (a subset not specifically investigated in randomized controlled trials) in comparison with ischaemic heart disease or dilated cardiomyopathy patients.</AbstractText>Patients enrolled in a national registry w...
6,577
Application of constrained independent component analysis algorithms in electrocardiogram arrhythmias.
The extraction of the atrial activity in atrial fibrillation episodes is a must for clinical purposes. During atrial fibrillation arrhythmia, the independent atrial and ventricular signals are superposed in the electrocardiogram, fulfilling the independent component analysis (ICA) model. We propose three new algorithms...
6,578
Brugada-like EKG pattern and myocardial effects in a chronic propofol abuser.
Cases of death are reported due to medical use of propofol, whereas deaths due to recreational purpose are unusual.</AbstractText>A 26-year-old Caucasian man, physician trainee in anesthesiology, was referred to an intensive care unit. The man was found unconscious in his bed with a butterfly-needle canalized into the ...
6,579
Aconite poisoning.
Aconitine and related alkaloids found in the Aconitum species are highly toxic cardiotoxins and neurotoxins. The wild plant (especially the roots and root tubers) is extremely toxic. Severe aconite poisoning can occur after accidental ingestion of the wild plant or consumption of an herbal decoction made from aconite r...
6,580
ONTARGET, TRANSCEND, and PRoFESS: new-onset diabetes, atrial fibrillation, and left ventricular hypertrophy.
Prevention of diabetes represents an important therapeutic goal in current cardiovascular risk reduction strategies. Blockade of the renin-angiotensin system has been shown to markedly reduce the incidence of new-onset diabetes in different patient populations. Recent results from three large clinical endpoint trials w...
6,581
Right ventricular rapid pacing in catheter ablation of atrial fibrillation: a novel application for cryoballoon pulmonary vein isolation.
Cryoballoon ablation (Arctic Front, Cryocath) represents a novel technology for pulmonary vein isolation (PVI). The initial phase of a freeze is crucial for cryolesion formation which is determined by local temperature depending on blood flow. We investigated the impact of right ventricular rapid pacing (RVRP) on tempe...
6,582
The effect of myocardial revascularization on malignant ventricular arrhythmias in coronary artery disease.
Malignant ventricular arrhythmia in coronary artery disease (CAD) is a severe life-threatening disease and a risk factor for sudden cardiac death. Myocardial revascularization influences the arrhythmogenic substrate of the malignant ventricular arrhythmia in the secondary prevention of sudden cardiac death. Its effecti...
6,583
Therapeutic hypothermia after out-of-hospital cardiac arrest with the target temperature 34-35 degrees C.
The objective of this study was to evaluate the impact of mild hypothermia (34-35 degrees C) on the final neurological outcome in patients after resuscitation from out-of-hospital cardiac arrest.</AbstractText>Forty three patients, admitted at University Hospital Brno after the out-of-hospital cardiac arrest, were incl...
6,584
Predictors of appropriate implantable cardioverter-defibrillator therapy during long-term follow-up of patients with coronary artery disease.
Indications for implantable cardioverter defibrillators (ICDs) are expanding. Defining long-term predictors of ICD therapies might help to identify those patients who will benefit most from implantation of an ICD. The objective of this study was to examine long-term predictors of appropriate ICD therapy among patients ...
6,585
Torsade de pointes associated with recurrent ampulla cardiomyopathy in a patient with idiopathic ACTH deficiency.
We describe here a patient with torsade de pointes associated with recurrent ampulla cardiomyopathy, who was later proven to suffer from idiopathic AC TH deficiency. A 70-year-old man was admitted to our hospital for bacterial pneumonia. A cardiac examination performed on admission revealed ampulla cardiomyopathy, whic...
6,586
Relation of disease pathogenesis and risk factors to heart failure with preserved or reduced ejection fraction: insights from the framingham heart study of the national heart, lung, and blood institute.
The contributions of risk factors and disease pathogenesis to heart failure with preserved ejection fraction (HFPEF) versus heart failure with reduced ejection fraction (HFREF) have not been fully explored.</AbstractText>We examined clinical characteristics and risk factors at time of heart failure onset and long-term ...
6,587
Hypertension to heart failure: a pathophysiological spectrum relating blood pressure, drug treatments and stroke.
Hypertension is a leading cause of major adverse cardiovascular outcomes, including heart attacks and stroke. The most visible manifestation of target organ damage related to hypertension is left ventricular hypertrophy (LVH). LVH eventually predisposes to systolic and diastolic heart failure, and is associated with an...
6,588
Antipsychotic-induced sudden cardiac death: examination of an atypical reaction.
Following the publication of a recent study, which linked antipsychotics to sudden cardiac death, the safety of both typical and atypical antipsychotics has once again been questioned. Sudden cardiac death resulting from ventricular arrhythmias remains a significant public health concern, with over 300,000 deaths per y...
6,589
[Phytoadaptogens-induced phenomenon similar to ischemic preconditioning].
The course administration (16 mg/kg per os for 5 days) of extracts of Panax ginseng or Rhodiola rosea induced a decrease in the infarction size/the area at risk (IS AAR) ratio during a 45-min local ischemia and a 2-hr reperfusion in artificially ventilated chloralose-anaesthetized rats. Single administration of ginseng...
6,590
Reduction in myocardial infarct size at 48 hours after brief intravenous infusion of ATL-146e, a highly selective adenosine A2A receptor agonist.
This study was undertaken to determine whether the myocardial infarct-sparing effect of ATL-146e, a selective adenosine A(2A) receptor agonist, persists without a rebound effect for at least 48 h and to determine the optimal duration of ATL-146e treatment in anesthetized dogs. Reperfusion injury after myocardial infarc...
6,591
Sample entropy of the main atrial wave predicts spontaneous termination of paroxysmal atrial fibrillation.
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. In the first stages of the disease, AF may terminate spontaneously and it is referred as paroxysmal atrial fibrillation (PAF). In this respect, the prediction of PAF termination or maintenance could avoid unnecessary therapy and contribute to ...
6,592
Arrhythmia detection in single- and dual-chamber implantable cardioverter defibrillators: the more leads, the better?
The implantable cardioverter defibrillator (ICD) offers life-saving therapies for primary and secondary prevention of sudden cardiac death in high-risk patients. However, ICD detection algorithms consistently misclassify a substantial proportion of supraventricular rhythms, thus carrying the risk for inappropriate ther...
6,593
Fluconazole-induced recurrent ventricular fibrillation leading to multiple cardiac arrests.
This case report describes the successful management of a patient with diabetic ketoacidosis, who developed torsades de pointes leading to nine cardiac arrests secondary to intravenous fluconazole administration on a background of hypokalaemia and hypocalcaemia.
6,594
Prehospital resuscitated cardiac arrest patients: role for induced hypothermia.
This article is a support paper for the National Association of EMS Physicians' position paper on induced therapeutic hypothermia in resuscitated cardiac arrest patients. Induced hypothermia is one of the newest treatments aimed at increasing the dismal neurologically intact survival rate for out-of-hospital cardiac ar...
6,595
The effect of paramedic experience on survival from cardiac arrest.
We hypothesized that paramedics with more experience would be more successful at treating patients in ventricular fibrillation (VF) cardiac arrest than those with less experience. We conducted a study examining the relationship between the years of experience of paramedics and survival from out-of-hospital cardiac arre...
6,596
Prompt advanced life support improves survival from ventricular fibrillation.
To determine whether the interval between the arrival of basic life support (BLS) providers and the arrival of advanced life support (ALS) providers is associated with patient outcome after cardiac arrest.</AbstractText>We conducted a retrospective cohort study of all witnessed, out-of-hospital ventricular fibrillation...
6,597
The relative role of refractoriness and source-sink relationship in reentry generation during simulated acute ischemia.
During acute myocardial ischemia, reentrant episodes may lead to ventricular fibrillation (VF), giving rise to potentially mortal arrhythmias. VF has been traditionally related to dispersion of refractoriness and more recently to the source-sink relationship. Our goal is to theoretically investigate the relative role o...
6,598
Amiodarone for pediatric resuscitation: a word of caution.
Intravenous administration of amiodarone has recently been recommended for use during pediatric resuscitation of pediatric patients with ventricular fibrillation or pulseless ventricular tachycardia. We present two pediatric patients who received amiodarone for polymorphic ventricular tachycardia, although they were ul...
6,599
Giant coronary aneurysm in adult Kawasaki disease: angiographic, 64-slice coronary MDCT and cardiac MRI appearances.
Kawasaki disease is a small-to-medium-vessel vasculitis that preferentially affects infants and young children. This condition is rare in adults, and therefore the diagnosis can easily be missed in a patient presenting to a primary care clinic. We report an unusual case of a patient who presented with ventricular fibri...