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MedWorm: Arrhythmia



MedWorm.com provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in the Arrhythmia category.



Last Build Date: Tue, 22 Mar 2016 08:28:25 +0100

 



A New Electrocardiographic Marker of Sudden Death in Brugada Syndrome The S-Wave in Lead I

Tue, 22 Mar 2016 05:43:04 +0100

ConclusionsThe presence of a wide and/or large S-wave in lead I was a powerful predictor of life-threatening ventricular arrhythmias in patients with BrS and no history of cardiac arrest at presentation. However, the prognostic value of a significant S-wave in lead I should be confirmed by larger studies and by an independent confirmation cohort of healthy subjects. (Source: Journal of the American College of Cardiology)

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Simultaneous esophagectomy and off‐pump coronary artery bypass grafting: a practicable approach with good survival

Tue, 22 Mar 2016 00:00:00 +0100

We reported, here, the first case series of esophageal cancer patients treated with simultaneous esophagectomy and off‐pump coronary artery bypass grafting (CABG). From August 2010 to August 2012, 2154 esophageal or esophageal gastric junction (EGJ) cancer patients underwent surgical treatment in Tangdu Hospital, Xi'an, China. Among them, six patients with esophageal or EGJ esophageal gastric junction cancer complicated with CAD were given simultaneous esophagectomy and off‐pump CABG, and were followed up until August 2014. Four patients were operated through left lateral thoracotomy and two patients were operated through median sternotomy plus upper midline laparotomy. All the patients survived the operation well and the postoperative morbidity rate was 67% (one anastomosis leakage, t...



[A comparative study between propofol and etomidate in patients under general anesthesia].

Mon, 21 Mar 2016 09:04:04 +0100

CONCLUSIONS: This study concludes that etomidate is a better agent for induction than propofol in view of hemodynamic stability and less pain on injection. PMID: 26993408 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Anestesiologia)



Perioperative optimal blood pressure as determined by ultrasound tagged near infrared spectroscopy and its association with postoperative acute kidney injury in cardiac surgery patients

Mon, 21 Mar 2016 00:00:00 +0100

CONCLUSIONS Optimal blood pressure during CPB and in the ICU was correlated. Excursions below optimal blood pressure (AUC < OptMAP mmHgXh) during perioperative period are associated with CSA-AKI. Individualized blood pressure management based on cerebral autoregulation monitoring during the perioperative period may help improve CSA-AKI-related outcomes. (Source: Interactive CardioVascular and Thoracic Surgery)



A meta-analysis of computerized tomography scan for reducing complications following repeat sternotomy for cardiac surgery

Mon, 21 Mar 2016 00:00:00 +0100

Cardiac reoperation carries additional risks compared with surgery in patients who are sternotomy-naïve. To identify if preoperative computerized tomography (CT) can reduce this risk, we performed a systematic review of the literature and meta-analysis. Literature search identified 178 studies of which 4 retrospective cohort studies incorporating 900 patients met inclusion criteria. There were no statistically significant differences in the risk of death, re-entry injury, renal failure or perfusion/ischaemic times. CT scan reduced the risk of stroke by 0.42 [95% confidence interval (CI): 0.19–0.93, P = 0.03] and a composite of major complications by 0.65 (95% CI: 0.47–0.88, P = 0.006). The use of preoperative cross-sectional imaging to reduce the risk of complications foll...



Is cardiac magnetic resonance imaging as accurate as echocardiography in the assessment of aortic valve stenosis?

Mon, 21 Mar 2016 00:00:00 +0100

A best evidence topic was written according to a structured protocol. The question addressed was: is cardiac magnetic resonance (CMR) imaging as accurate as echocardiography in the assessment of aortic valve stenosis? Altogether 239 papers were found using the reported search. Only 12 demonstrated the best evidence to answer the clinical question. Nine of these 12 papers found CMR to correlate well with transthoracic echocardiography (TTE) or transoesophageal echocardiography (TOE) in the evaluation of aortic valve stenosis. When aortic valve areas were measured with cardiac tomography (CT) or cardiac catheterization (CC), four papers found CMR to be more accurate than TTE. Eight of 12 papers found CMR to have excellent reliability and reproducibility, as demonstrated by the low inter- and...

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Dual atrioventricular nodal non-re-entrant tachycardia

Mon, 21 Mar 2016 00:00:00 +0100

(DAVNNT), also known as ‘double fire’, has recently received more attention since it was demonstrated to mimic more common arrhythmias such as atrial premature beats, atrial fibrillation, and ventricular tachycardia. This is important, since mistaken differential diagnoses and the resulting therapeutic decisions have severe consequences for affected patients. DAVNNT is characterized by conduction characteristics of the atrioventricular (AV) node that leads to a double antegrade conduction of one sinoatrial nodal activity via the slow and fast AV nodal pathways. As a result, the most significant hint from an electrocardiogram (ECG) is a P wave followed by two narrow QRS complexes. Although DAVNNT is rather a rare arrhythmia, it now appears to be more common than previously thou...



The impact of adjunctive complex fractionated atrial electrogram ablation and linear lesions on outcomes in persistent atrial fibrillation: a meta-analysis

Mon, 21 Mar 2016 00:00:00 +0100

Conclusion In PsAF, the addition of CFAE ablation or LALA, in comparison with PVI alone, offers no significant improvement in arrhythmia-free survival. Furthermore, they are associated with increases in both procedural and fluoroscopy times. The optimal ablation strategy for PsAF is currently unclear and needs further refinement. (Source: Europace)



Differences in predictors of implantable cardioverter-defibrillator therapies in patients with ischaemic and non-ischaemic cardiomyopathies

Mon, 21 Mar 2016 00:00:00 +0100

Conclusion The aetiology of cardiomyopathy should be taken into consideration for the therapy of ICD patients. The protective role of CRT devices should be pointed out in ischaemic cardiomyopathy (ICM) and a more rigorous antiarrhythmic treatment should be considered for ICM patients with secondary prevention or for dilated cardiomyopathy patients with AF. (Source: Europace)



Can we rely on machines? Device-detected atrial high rates correspond well with atrial arrhythmias in cardiac resynchronization recipients

Mon, 21 Mar 2016 00:00:00 +0100

Conclusion Nearly two-thirds of CRT-D patients had AHR episodes within 2.5 years after implantation. Almost 90% of AHRs were indeed AA. Misdetections were caused by far-field sensing or noise. A two-step diagnostic algorithm (>9% of time spent in AHRs and episode duration >36 s) allowed for proper detection of AA with a high hit-rate and specificity. (Source: Europace)



Prevalence of auricular thrombosis before atrial flutter cardioversion: a 17-year transoesophageal echocardiographic study

Mon, 21 Mar 2016 00:00:00 +0100

Conclusion Auricular thrombosis is not an infrequent finding in AFL before CV. Our study suggests the use of TEE screening in AFL, as well as in AF, when patients arrive to clinical attention after more than 48 h from arrhythmia onset. (Source: Europace)

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Differences in attitude, education, and knowledge about oral anticoagulation therapy among patients with atrial fibrillation in Europe: result of a self-assessment patient survey conducted by the European Heart Rhythm Association

Mon, 21 Mar 2016 00:00:00 +0100

The purpose of this patient survey was to analyse the knowledge about blood thinning medications relative to gender, age, education, and region of residence in patients with atrial fibrillation (AF). A total of 1147 patients with AF [mean age 66 ± 13 years, 529 (45%) women] from eight European countries responded to this survey. Most patients understood that the indication for anticoagulation therapy was to ‘thin the blood’, but 8.1% responded that the purpose of the medication was to treat the arrhythmia. Patients with college or university grades reported less frequent deviations from their target INR range compared with those without schooling (2.8% vs. 5.1%, P < 0.05). The awareness of anticoagulation-related risk of bleedings was lowest in patients without school...



Diaphragm abnormalities in heart failure and aging: mechanisms and integration of cardiovascular and respiratory pathophysiology

Mon, 21 Mar 2016 00:00:00 +0100

Abstract Inspiratory function is essential for alveolar ventilation and expulsive behaviors that promote airway clearance (e.g., coughing and sneezing). Current evidence demonstrates that inspiratory dysfunction occurs during healthy aging and is accentuated by chronic heart failure (CHF). This inspiratory dysfunction contributes to key aspects of CHF and aging cardiovascular and pulmonary pathophysiology including: (1) impaired airway clearance and predisposition to pneumonia; (2) inability to sustain ventilation during physical activity; (3) shallow breathing pattern that limits alveolar ventilation and gas exchange; and (4) sympathetic activation that causes cardiac arrhythmias and tissue vasoconstriction. The diaphragm is the primary inspiratory muscle; hence, its neuromuscula...



Double twiddle trouble, a new variant of twiddler syndrome

Mon, 21 Mar 2016 00:00:00 +0100

We describe the first reported case of a dramatic pacemaker lead coiling with a double level of lead compromise, with one of them being intra-cardiac. This condition affected our treatment strategy, as the repositioning of the lead was unfeasible. (Source: Journal of Arrhythmia)



The Effect of Transcutaneous Electrıcal Nerve Stımulatıon on Post-Thoracotomy Paın.

Sat, 19 Mar 2016 10:26:02 +0100

CONCLUSIONS: Administering TENS in patients that have undergone posterolateral thoracotomy reduced postoperative pain and analgesic consumption. Thus, the use of TENS as an easy and reliable analgesic method in post-thoracotomy pain control can be recommended. PMID: 26986188 [PubMed - as supplied by publisher] (Source: Contemporary Nurse)



Adrenaline in anaphylaxis treatment. Balancing benefits and harms.

Sat, 19 Mar 2016 10:10:02 +0100

Authors: Cervellin G, Sanchis-Gomar F, Lippi G Abstract INTRODUCTION: Although anaphylaxis is a relatively common disorder, clinicians and scientists have debated on how to best define and manage this condition. Although the current recommendations are focused on the central role of adrenaline, evidence in support of this therapeutic approach is modest, mainly for the lack of well-designed trials. Conversely, serious adverse effects are commonly reported following adrenaline use, especially when given intravenously. These include hypertension, ventricular arrhythmias, myocardial infarction, pulmonary edema. Areas covered. Anaphylaxis treatment, with special focus on adrenaline utilization, both in pre-hospital and in-hospital settings. Aim is to examine in depth the balance between...

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Emergency Medical Services Utilization among Patients with ST-Segment Elevation Myocardial Infarction: Observations from the Singapore Myocardial Infarction Registry.

Sat, 19 Mar 2016 05:53:02 +0100

CONCLUSION: Less than half of STEMI patients utilized EMS and EMS patients had faster receipt of initial reperfusion therapies. Targeted public education to reduce time to treatment may improve the care of STEMI patients. PMID: 26986553 [PubMed - as supplied by publisher] (Source: Prehospital Emergency Care)



Neonatal atrial flutter after insertion of an intracardiac umbilical venous catheter

Sat, 19 Mar 2016 02:24:35 +0100

Abstract Objective: To describe a case of neonatal atrial flutter after the insertion of an intracardiac umbilical venous catheter, reporting the clinical presentation and reviewing the literature on this subject. Case description: A late-preterm newborn, born at 35 weeks of gestational age to a diabetic mother and large for gestational age, with respiratory distress and rule-out sepsis, required an umbilical venous access. After the insertion of the umbilical venous catheter, the patient presented with tachycardia. Chest radiography showed that the catheter was placed in the position that corresponds to the left atrium, and traction was applied. The patient persisted with tachycardia, and an electrocardiogram showed atrial flutter. As the patient was hemodynamically unstable, electric car...



Device-Detected Atrial Fibrillation—Perils and Pitfalls

Sat, 19 Mar 2016 00:00:00 +0100

This article reviews current literature on the risk of stroke with CIED-detected AHRE and raises questions that need further clarification. (Source: Cardiology Clinics)



Potassium Channel Remodeling in Heart Disease

Sat, 19 Mar 2016 00:00:00 +0100

Publication date: Available online 18 March 2016 Source:Cardiac Electrophysiology Clinics Author(s): Vincent Algalarrondo, Stanley NattelTeaser Heart disease produces substantial remodeling of K+ channels that in general promotes arrhythmia occurrence. In the case of ventricular arrhythmias, K+ channel remodeling contributes to the arrhythmic risk and increases vulnerability to torsades de pointes with K+ channel inhibiting drugs. Atrial K+ channel remodeling caused by atrial fibrillation promotes arrhythmia stability and presents opportunities for the development of new drugs targeting atrial inward rectifier K+ currents. A better understanding of K+ channel remodeling will help clinicians to appreciate arrhythmia mechanisms and determinants in a variety of clinical situations and to ...



New horizon for infection prevention technology and implantable device

Sat, 19 Mar 2016 00:00:00 +0100

Publication date: Available online 19 March 2016 Source:Journal of Arrhythmia Author(s): Yusuke Kondo, Marehiko Ueda, Yoshio Kobayashi, Joerg O. Schwab There has been a significant increase in the number of patients receiving cardiovascular implantable electronic devices (CIED) over the last two decades. CIED infection represents a serious complication after CIED implantation and is associated with significant morbidity and mortality. Recently, newly advanced technologies have offered attractive and suitable therapeutic alternatives. Notably, the leadless pacemaker and anti-bacterial envelope decrease the potential risk of CIED infection and the resulting mortality, when it does occur. A completely subcutaneous implantable cardioverter defibrillator is also an alternative to the tran...

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Human cerebral circuitry related to cardiac control: A neuroimaging meta‐analysis

Sat, 19 Mar 2016 00:00:00 +0100

This article is protected by copyright. All rights reserved. (Source: Annals of Neurology)



Cellular and Molecular Mechanisms of Arrhythmia by Oxidative Stress.

Fri, 18 Mar 2016 08:59:02 +0100

Authors: Sovari AA Abstract Current therapies for arrhythmia using ion channel blockade, catheter ablation, or an implantable cardioverter defibrillator have limitations, and it is important to search for new antiarrhythmic therapeutic targets. Both atrial fibrillation and heart failure, a condition with increased arrhythmic risk, are associated with excess amount of reactive oxygen species (ROS). There are several possible ways for ROS to induce arrhythmia. ROS can cause focal activity and reentry. ROS alter multiple cardiac ionic currents. ROS promote cardiac fibrosis and impair gap junction function, resulting in reduced myocyte coupling and facilitation of reentry. In order to design effective antioxidant drugs for treatment of arrhythmia, it is essential to explore the molecul...



Mechanisms and Clinical Management of Ventricular Arrhythmias following Blunt Chest Trauma.

Fri, 18 Mar 2016 08:59:02 +0100

Authors: Wolbrom DH, Rahman A, Tschabrunn CM Abstract Nonpenetrating, blunt chest trauma is a serious medical condition with varied clinical presentations and implications. This can be the result of a dense projectile during competitive and recreational sports but may also include other etiologies such as motor vehicle accidents or traumatic falls. In this setting, the manifestation of ventricular arrhythmias has been observed both acutely and chronically. This is based on two entirely separate mechanisms and etiologies requiring different treatments. Ventricular fibrillation can occur immediately after chest wall injury (commotio cordis) and requires rapid defibrillation. Monomorphic ventricular tachycardia can develop in the chronic stage due to underlying structural heart diseas...



Calmodulin kinase II inhibition limits the pro-arrhythmic Ca2+ waves induced by cAMP-phosphodiesterase inhibitors

Fri, 18 Mar 2016 00:00:00 +0100

Conclusion Our results show that PDE inhibitors exert inotropic effects via PKA but lead to SCWs via both PKA and CaMKII activation partly via Epac2, suggesting the potential use of CaMKII inhibitors as adjuncts to PDE inhibition to limit their pro-arrhythmic effects. (Source: Cardiovascular Research)



ST elevation without cardio-pulmonary symptoms

Fri, 18 Mar 2016 00:00:00 +0100

Publication date: Available online 17 March 2016 Source:Journal of Arrhythmia Author(s): Priyank Shah, Rahul Vasudev, Fayez Shamoon (Source: Journal of Arrhythmia)

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Effects of seasonal acclimatization on temperature-dependence of cardiac excitability in the roach, Rutilus rutilus [RESEARCH ARTICLE]

Fri, 18 Mar 2016 00:00:00 +0100

A. Badr, M.F. El-Sayed, and M. VornanenTemperature-sensitivity of electrical excitability is a potential limiting factor for performance level and thermal tolerance of excitable tissues in ectothermic animals. In order to test whether rate and rhythm of the heart acclimatize to seasonal temperature changes, thermal sensitivity of cardiac excitation in a eurythermal teleost, the roach (Rutilus rutilus), was examined. Excitability of the heart was determined from in vivo electrocardiograms and in vitro microelectrode recordings of action potentials (APs) from winter (WiR) and summer (SuR) roach acclimated to 4°C and 18°C, respectively. Under heat ramps (3°C/h), starting from the acclimatization temperatures of the fish, heart rate (HR) increased to the maximum value of 78±...



Strategies and Challenges to Myocardial Replacement Therapy

Fri, 18 Mar 2016 00:00:00 +0100

This article outlines the advantages and limitations of the cell injection and patch approaches to cardiac regenerative therapy. If the field is to move forward, some fundamental questions require answers, including the limitations to the use of animal models for human cell-transplantation studies; the best way to measure success in terms of functional improvements, histological integration, electrical coupling, and arrhythmias; and where the cells should be applied for maximal benefit—the epicardium or the myocardium. (Source: Stem Cells Translational Medicine)



Anti-arrhythmic effect of growth factors supplemented cardiac progenitor cells in chronic infarcted heart.

Fri, 18 Mar 2016 00:00:00 +0100

Authors: Savi M, Bocchi L, Rossi S, Frati C, Graiani G, Lagrasta C, Miragoli M, Di Pasquale E, Stirparo GG, Mastrototaro G, Urbanek K, De Angelis A, Macchi E, Stilli D, Quaini F, Musso E Abstract c-kit(pos) Cardiac Progenitor Cells (CPCs) represent a successful approach in healing the infarcted heart and rescuing its mechanical function while electrophysiological consequences are uncertain. CPC mobilization promoted by hepatocyte growth factor (HGF) and IGF-1 improved electrogenesis in myocardial infarction (MI). We hypothesized that locally delivered CPCs supplemented with HGF+IGF-1 (GFs) can concur in ameliorating electrical stability of the regenerated heart. One hundred and thirty-nine adult male Wistar rats with four-week old MI or sham operated were randomized to receive intr...



Left Ventricular Outflow Tract Arrhythmias: Clinical Characteristics and Site of Origin.

Thu, 17 Mar 2016 15:01:05 +0100

CONCLUSIONS: LVOT arrhythmias mostly originate from the LCC and are associated with LV dysfunction in 36% of patients. Knowledge regarding the prevalence of the anatomic origin of the LVOT arrhythmias may help achieve successful ablation. The use of cooled tip ablation catheters might have beneficial effects on the success rate of the procedure. PMID: 26979005 [PubMed - in process] (Source: The Israel Medical Association Journal)



Optimizing Heart Rate and Controlling Symptoms in Atrial Fibrillation

Thu, 17 Mar 2016 11:46:57 +0100

Atrial fibrillation (AF) is the most common pathologic clinical arrhythmia lasting more than 30 seconds, and its incidence and prevalence continue to increase. (Source: Radcliffe Cardiology)

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Involvement of Inflammatory Cytokines in Antiarrhythmic Effects of Clofibrate in Ouabain-Induced Arrhythmia in Isolated Rat Atria.

Thu, 17 Mar 2016 11:26:02 +0100

Authors: Moradi S, Nikoui V, Imran Khan M, Amiri S, Jazaeri F, Bakhtiarian A Abstract Considering the cardioprotective and anti-inflammatory properties of clofibrate, the aim of the present experiment was to investigate the involvement of local and systemic inflammatory cytokines in possible antiarrhythmic effects of clofibrate in ouabain-induced arrhythmia in rats. Rats were orally treated with clofibrate (300 mg/kg), and ouabain (0.56 mg/kg) was administered to animals intraperitoneally. After induction of anesthesia, the atria were isolated and the onset of arrhythmia and asystole was recorded. The levels of inflammatory cytokines in atria were also measured. Clofibrate significantly postponed the onset of arrhythmia and asystole when compared to control group (P ≤ 0.05 an...



Potentially fatal arrhythmias in two cases of adult Kawasaki disease

Thu, 17 Mar 2016 04:34:34 +0100

Brief Report Hirofumi Watanabe, Masataka Kato, Mamoru Ayusawa, Cardiology in the Young, Volume 26 Issue 03, pp 602-604Abstract (Source: Cardiology in the Young)



Analysis of cardiorespiratory phase coupling and cardiovascular autonomic responses during food ingestion

Thu, 17 Mar 2016 00:00:00 +0100

Publication date: 15 May 2016 Source:Physiology & Behavior, Volume 159 Author(s): Kyuichi Niizeki, Tadashi Saitoh The present study analyzed whether the phase coherency (λ) of respiratory sinus arrhythmia (RSA) is altered by food ingestion in healthy young subjects. After 5min of resting control, 13 healthy volunteers were asked to eat a solid meal with access to water at their own pace, followed by 5min of the postprandial state. The R-R interval (RRI), beat-to-beat blood pressure (BP), and respiratory activity were recorded using electrocardiography, a Finapres device, and inductance plethysmography, respectively. The stroke volume was calculated by the pulse-contour method from continuous BP measurement, and the cardiac output (CO) was obtained by multiplying the stroke vol...



Myocyte-fibroblast communication in cardiac fibrosis and arrhythmias: Mechanisms and model systems

Thu, 17 Mar 2016 00:00:00 +0100

Development of cardiac fibrosis and arrhythmias is controlled by the activity of and communication between cardiomyocytes and fibroblasts in the heart. Myocyte-fibroblast interactions occur via both direct and indirect means including paracrine mediators, extracellular matrix interactions, electrical modulators, mechanical junctions, and membrane nanotubes. In the diseased heart, cardiomyocyte and fibroblast ratios and activity, and thus myocyte-fibroblast interactions, change and are thought to contribute to the course of disease including development of fibrosis and arrhythmogenic activity. (Source: Journal of Molecular and Cellular Cardiology)



Adverse drug reactions in neonates: a prospective study

Thu, 17 Mar 2016 00:00:00 +0100

Conclusions There is a high incidence of ADRs in hospitalised newborns, which increases with the number of prescriptions. (Source: Archives of Disease in Childhood)

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InfoBionic wins 510(k) for next-gen MoMe Kardia cardiac monitor

Wed, 16 Mar 2016 19:19:43 +0100

Digital health startup InfoBionic said today it won FDA 510(k) clearance for its MoMe Kardia wireless cardiac remote monitoring system designed to aid in the diagnosis of cardiac arrhythmias. The next-generation MoMe Kardia is a 3-in-1 single piece device that acquires and stores ECG and motion data and transmits them through the company’s cloud-based MoMe Software system for analysis, the Lowell, Mass.-based company said. “We’re thrilled to announce FDA 510(k) clearance to market for MoMe Kardia, which supports our mission to create superior patient monitoring solutions for arrhythmia detection and chronic disease management. MoMe Kardia is a 3-in-1 device that seamlessly transitions between Holter, Event and MCT modes remotely, streamlining patient monitoring time wit...



FDA Clears MoMe Kardia Wearable EKG Cardiac Arrhythmia Monitor

Wed, 16 Mar 2016 14:16:44 +0100

InfoBionic, Inc. today announced that it received 510(k) clearance from the U.S. Food and Drug Administration ("FDA") for MoMeKardia, a wireless, remote monitoring system designed to aid physicians in their diagnosis of cardiac arrhythmias in patients with a demonstrated need for cardiac monitoring. (Source: Medical Design Online News)



AliveCor unveils EKG-equipped Kardia Band for Apple Watch

Wed, 16 Mar 2016 12:00:41 +0100

AliveCor said today it is premiering the Kardia Band EKG-equipped band for Apple‘s (NSDQ:AAPL) Apple Watch, designed to provide diagnostic-grade electrocardiogram readings through a smartphone-connected app, as well as a significant update to the company’s existing EKG-monitoring app. The Kardia Band is a thin wrist band designed specifically for the Apple watch that returns single-lead EKG readings and diagnostics that can be viewed through its app and sent to managing physicians, CEO Vic Gundotra told MassDevice.com in an interview. “We built an EKG machine so small it fits inside the band of a watch,” Gundotra said. “The form factor allows you to, in a very discrete way, to reach over, touch the band and do a single EKG. It’s kind of breathtaking.”...



Current and future treatment options for managing hyperkalemia

Wed, 16 Mar 2016 05:35:46 +0100

Hyperkalemia is associated with life-threatening cardiac arrhythmias and increased mortality. Hyperkalemia is most often observed in patients with chronic kidney disease and/or in those with congestive heart failure being treated with drugs that limit renal potassium excretion, especially drugs that inhibit the renin-angiotensin-aldosterone system. Treatment of hyperkalemia may be either acute, as needed during rapid changes in serum potassium, which are associated with cardiac arrhythmia, or chronic, which stabilizes serum potassium levels and limits the development of life-threatening arrhythmias. (Source: Kidney International Supplements)



Electrophysiological and clinical consequences of hyperkalemia

Wed, 16 Mar 2016 05:35:46 +0100

Despite the potentially life-threatening consequences of hyperkalemia, symptoms are often absent or mild. However, when hyperkalemia has been recognized, evaluation of vital signs is essential for determining hemodynamic stability and identifying the presence of cardiac arrhythmias related to the hyperkalemia. Quite commonly, and depending on the severity and rapidity of onset, hyperkalemia may be associated with substantial electrocardiographic (EKG) changes that can lead to death if proper interventions are not instituted. (Source: Kidney International Supplements)

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Epidemiology of hyperkalemia: an update

Wed, 16 Mar 2016 05:35:46 +0100

Hyperkalemia represents one of the most important acute electrolyte abnormalities, due to its potential for causing life-threatening arrhythmias. In individuals with normal kidney function hyperkalemia occurs relatively infrequently, but it can be much more common in patients who have certain predisposing conditions. Patients with chronic kidney disease are the most severely affected group, by virtue of their decreased ability to excrete potassium and because they commonly have additional predisposing conditions that often cluster within patients with chronic kidney disease. (Source: Kidney International Supplements)



Hyperkalemia: current concepts and emerging therapeutic options

Wed, 16 Mar 2016 05:35:46 +0100

Hyperkalemia has long constituted one of the electrolyte abnormalities of interest to clinicians and physiologists, and it represents one of the most important acute electrolyte abnormalities due to its potential for causing life-threatening arrhythmias. Hyperkalemia remains a vexing and challenging problem for clinicians, particularly in the management of patients with chronic kidney disease and cardiovascular disease, especially congestive heart failure. (Source: Kidney International Supplements)



The effect of verbal and imagery-based worry versus distraction on the emotional response to a stressful in-vivo situation

Wed, 16 Mar 2016 00:00:00 +0100

Conclusion By and large, our findings support the Contrast Avoidance Model of worry with regard to self-report measures and extend earlier findings by using an in-vivo stressor. The role of thinking style on the contrast avoidance effect as well as the contrast avoidance effect on physiological measures need to be explored in more detail. (Source: Journal of Behavior Therapy and Experimental Psychiatry)



Pre-procedural assessment of aortic annulus dimensions for transcatheter aortic valve replacement: comparison of a non-contrast 3D MRA protocol with contrast-enhanced cardiac dual-source CT angiography

Wed, 16 Mar 2016 00:00:00 +0100

Conclusion The employed non-contrast 3D-FLASH MRA protocol allows for reliable assessment of aortic annulus dimensions and calcifications even in the presence of arrhythmias in an all-comers pre-TAVR population. Implementation of this technique appears legitimate in patients at an increased risk for contrast-induced nephropathy. (Source: European Journal of Echocardiography)



Guidelines for Potassium Channel Blocker Use

Wed, 16 Mar 2016 00:00:00 +0100

This article summarizes recommendations for the clinical use of antiarrhythmic drugs for the treatment and prevention of atrial and ventricular arrhythmias based on current guideline and consensus documents. The choice of antiarrhythmic drug is based on the efficacy and safety profile and influenced by the presence or absence of structural heart disease. Because of its adverse side-effect profile, amiodarone is recommended for the management of atrial fibrillation only when other agents have failed or are contraindicated. For treatment of symptomatic ventricular arrhythmias in the setting of structural heart disease, amiodarone is generally the preferred agent. (Source: Cardiac Electrophysiology Clinics)

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The feasibility of a Box isolation strategy for non-paroxysmal atrial fibrillation in elderly patients

Wed, 16 Mar 2016 00:00:00 +0100

Conclusions Box isolation of non-PAF is effective and safe even in elderly patients. A prophylactic CTI ablation combined with Box isolation might be feasible to improve the long-term outcome. (Source: Journal of Arrhythmia)



Clinical and genetic features of Australian families with long QT syndrome: A registry-based study

Wed, 16 Mar 2016 00:00:00 +0100

Conclusions This is the first clinical and genetic study in a large cohort of Australian families with LQTS. Findings from this study suggest that the clinical and genetic features in this population are not dissimilar to those described in North American, European, and Asian cohorts. Global-scale information about families with LQTS is an important initiative to ensure diagnostic and management approaches are applicable to different populations and ethnicities. (Source: Journal of Arrhythmia)



Resolution of a warfarin and dabigatran-resistant left atrial appendage thrombus with apixaban

Wed, 16 Mar 2016 00:00:00 +0100

Publication date: Available online 15 March 2016 Source:Journal of Arrhythmia Author(s): Yosuke Miwa, Toshinori Minamishima, Toshiaki Sato, Konomi Sakata, Hideaki Yoshino, Kyoko Soejima The majority of embolisms associated with atrial fibrillation (AF) are from the left atrial appendage (LAA). To treat the existing thrombus, warfarin and novel anticoagulants have been used. However, there has been no clinical information regarding the difference of the effects of congealing the fibrinogenolysis system among these oral anticoagulants. Here, we report a case of persistent AF, in whom apixaban, factor Xa inhibitor resolved an LAA clot refractory to warfarin and direct thrombin inhibition. Factor Xa inhibitor, apixaban, could resolve the left appendage thrombosis refractory to warfarin...



ECG risk markers for atrial fibrillation and sudden cardiac death in minimally symptomatic obstructive sleep apnoea: the MOSAIC randomised trial

Wed, 16 Mar 2016 00:00:00 +0100

Conclusions There seems to be no effect of CPAP on ECG measures of arrhythmia risk in patients with minimally symptomatic OSA. Trial registration number ISRCTN34164388; Post-results. (Source: BMJ Open)



Current controversies in determining the main mechanisms of atrial fibrillation

Wed, 16 Mar 2016 00:00:00 +0100

Abstract Despite considerable basic research into the mechanisms of atrial fibrillation (AF), not much progress has been made in the prognosis of patients with AF. With the exception of anticoagulant therapy, current treatments for AF still do not improve major cardiovascular outcomes. This may be due partly to the diverse aetiology of AF with increasingly more factors found to contribute to the arrhythmia. In addition, a strong increase has been seen in the technological complexity of the methods used to quantify the main pathophysiological alterations underlying the initiation and progression of AF. Because of the lack of standardization of the technological approaches currently used, the perception of basic mechanisms of AF varies widely in the scientific community. Areas of debate incl...

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Pulmonary vein triggers, focal sources, rotors and atrial cardiomyopathy: implications for the choice of the most effective ablation therapy

Wed, 16 Mar 2016 00:00:00 +0100

Abstract Understanding of the pathophysiological mechanism(s) underlying atrial fibrillation (AF) is the foundation on which current ablation strategies are built. In the vast majority of patients with paroxysmal AF, the ablation procedure should target the pulmonary veins. In patients with nonparoxysmal AF, however, pulmonary vein isolation alone seems to be insufficient to prevent the arrhythmia. Several recent clinical trials have investigated the concept that rotors (re‐entry based on a meandering central core from which spiral waves emanate) might be the mechanism responsible for sustaining AF. Ablation of these localized AF sources is an important step towards substrate‐driven procedures in persistent AF. Hybrid AF ablation procedures, based on the integration of endocardial tran...



Surgical ventricular restoration plus mitral valve repair in patients with ischaemic heart failure: risk factors for early and mid-term outcomes [ADULT CARDIAC]

Wed, 16 Mar 2016 00:00:00 +0100

CONCLUSIONS MV repair combined with SVR is a complex and challenging procedure that can be performed with acceptable early and mid-term results. Interestingly, angina features predict both early and late outcome, with unstable angina at the time of surgery being a predictor of poor early outcome and the absence of angina at surgery, a predictor of favourable outcome at mid-term follow-up. (Source: European Journal of Cardio-Thoracic Surgery)



Thoracoscopic surgical ablation versus catheter ablation for atrial fibrillation [REVIEWS]

Wed, 16 Mar 2016 00:00:00 +0100

For patients with atrial fibrillation (AF) who are refractory to anti-arrhythmic drugs (AADs), minimally invasive video-assisted thoracoscopic surgical ablation (SA) and catheter ablation (CA) are potential alternative treatment options. The recent FAST randomized study suggested that thoracoscopic SA was superior to CA in achieving freedom of AF in patients who have failed at least one prior AAD. To assess the relative merits and risks of SA versus CA, a systematic review and meta-analysis was conducted. Electronic searches were performed using six databases from their inception to December 2014. Relevant studies comparing thoracoscopic SA and CA were identified; data were extracted and analysed according to predefined clinical endpoints. Relative risk (RR) and weighted mean difference we...



Numerical analysis of the 3-dimensional aortic root morphology during the cardiac cycle [EXPERIMENTAL]

Wed, 16 Mar 2016 00:00:00 +0100

CONCLUSIONS Aortic root geometry demonstrates precise 3D changes of tilt and rotation angle. Reduction of angles during ejection results in a straight cylinder with low shear stress that facilitates the ejection; the increase during diastole results in a tilted frustum with elevated shear stress. Findings can be used for comparative analysis of native and synthetic structures with individual compliance. (Source: European Journal of Cardio-Thoracic Surgery)



An unexpected case of a hydatid cyst on the mitral valve mimicking infective endocarditis [IMAGES IN CARDIO-THORACIC SURGERY]

Wed, 16 Mar 2016 00:00:00 +0100

(Source: European Journal of Cardio-Thoracic Surgery)

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Congenital left atrial appendage herniation [IMAGES IN CARDIO-THORACIC SURGERY]

Wed, 16 Mar 2016 00:00:00 +0100

(Source: European Journal of Cardio-Thoracic Surgery)



Right ventricular function in patients undergoing surgical or transcatheter aortic valve replacement [LETTERS TO THE EDITOR]

Wed, 16 Mar 2016 00:00:00 +0100

(Source: European Journal of Cardio-Thoracic Surgery)



Reply to Demirkol et al. [LETTERS TO THE EDITOR]

Wed, 16 Mar 2016 00:00:00 +0100

(Source: European Journal of Cardio-Thoracic Surgery)



Intermittent accelerated idioventricular rhythm: a novel arrhythmia in lupus erythematosus.

Wed, 16 Mar 2016 00:00:00 +0100

Authors: Panagiota V, König T, Bauersachs J, Veltmann C, Napp LC PMID: 26989168 [PubMed - as supplied by publisher] (Source: Lupus)



Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology

Tue, 15 Mar 2016 00:00:00 +0100

Acute right ventricular (RV) failure is a complex clinical syndrome that results from many causes. Research efforts have disproportionately focused on the failing left ventricle, but recently the need has been recognized to achieve a more comprehensive understanding of RV anatomy, physiology, and pathophysiology, and of management approaches. Right ventricular mechanics and function are altered in the setting of either pressure overload or volume overload. Failure may also result from a primary reduction of myocardial contractility owing to ischaemia, cardiomyopathy, or arrhythmia. Dysfunction leads to impaired RV filling and increased right atrial pressures. As dysfunction progresses to overt RV failure, the RV chamber becomes more spherical and tricuspid regurgitation is aggravated, a ca...

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Rapport coût/efficacité des traitements médicamenteux et interventionnels dans la fibrillation atriale

Tue, 15 Mar 2016 00:00:00 +0100

Publication date: February 2016 Source:Archives of Cardiovascular Diseases Supplements, Volume 8, Issue 2 Author(s): A. Cohen, C. Leclercq Résumé La fibrillation atriale (FA) est le trouble du rythme le plus fréquent touchant l'adulte âgé et est associée à une augmentation du risque de décès, d'accident ischémique cérébral (AIC), d'insuffisance cardiaque ainsi qu'à une réduction de la qualité de la vie. La charge de cette pathologie sur le patient, les soignants, et donc le retentissement sociétal, est importante. La FA est une maladie chronique augmentant de façon significative le coût de la prise en charge qui peut être lié aux modalités initiales de prise en charge, au traitement des complications, ainsi qu'à la baisse d'activité professionnelle. Cependant, le...



Systolic MOLLI T1 mapping with heart-rate-dependent pulse sequence sampling scheme is feasible in patients with atrial fibrillation

Tue, 15 Mar 2016 00:00:00 +0100

T1 mapping enables assessment of myocardial characteristics. As the most common type of arrhythmia, atrial fibrillation (AF) is often accompanied by a variety of cardiac pathologies, whereby the irregular and ... (Source: Journal of Cardiovascular Magnetic Resonance)



Correlation between indexes of autonomic maneuvers and heart rate variability in hemodialysis patients

Tue, 15 Mar 2016 00:00:00 +0100

Conclusion The autonomic maneuvers, especially RSA, are useful methods to evaluate cardiac autonomic function in hemodialysis patients. The acquisition of the RSA index by independent cycles should not be used in this population. (Source: Clinical Autonomic Research)



[AFNET. A translational research network develops into an academic research organization].

Tue, 15 Mar 2016 00:00:00 +0100

Authors: Kirchhof P, Goette A, Näbauer M, Schotten U Abstract "The whole is greater than the sum of its parts" (Aristotle).Atrial fibrillation (AF) is the most common sustained arrhythmia and affects 1-2 % of the population in developed countries, especially the elderly. We expect that the prevalence of AF will double in the next few decades. The last decades have seen important improvements in the management of atrial fibrillation, but many questions remain regarding the optimal diagnosis and management of the condition. The German Atrial Fibrillation NETwork (AFNET) was one of three cardiovascular competence networks in medicine funded by the German Ministry of Education and Research between 2003-2014. AFNET has contributed to the understanding of atrial fibrillation, and AFNE...



Yale team screens cardiac drugs that also attack cancer

Mon, 14 Mar 2016 12:19:00 +0100

Several drugs now being used to treat heart failure and atrial arrhythmia also show promise as DNA disruptors in cancer cells and could be readily repurposed as anticancer agents, according to a new study by Yale researchers. (Source: Yale Science and Health News)

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Energy metabolic alterations in the progression of atrial fibrillation: Potential role of AMP-activated protein kinase as a critical regulator

Mon, 14 Mar 2016 00:00:00 +0100

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia associated with increased risk of heart failure and stroke [1]. Accumulating studies have revealed that a series of striking alterations in atrial electrical, structural, and autonomic properties is critical to most acquired forms of AF [2–3]. However, the impact of cardiac energy metabolism upon the initiation or persistence of AF is incompletely understood. Metabolomic and proteomic analyses have indicated a close relationship between metabolic dysfunction and AF development [4]. (Source: International Journal of Cardiology)



Prognostic significance of periodic leg movements during sleep in heart failure patients

Mon, 14 Mar 2016 00:00:00 +0100

Heart failure (HF) is the major cause of death among the elderly in many countries. Periodic limb movements during sleep (PLMS) consist of recurring muscular activations of legs which occur repetitively in the sleeping period [1–3]. Although there is a physiological plausibility to argument that PLMS increase the risk of cardiovascular disease by increasing sympathetic nervous activity resulting in hypertension, left ventricular hypertrophy [4], arrhythmia [5], the clinical significance of PLMS and its relationship to cardiovascular disease and HF still remains controversial [1,4–6]. (Source: International Journal of Cardiology)



Efficacy of atrial substrate modification based on dominant frequency of paroxysmal atrial fibrillation

Mon, 14 Mar 2016 00:00:00 +0100

Conclusions Atrial substrate ablation may improve the clinical outcome after ablation in patients after PVI with residual arrhythmia inducibility. (Source: Journal of Arrhythmia)



Altered Cardiomyocyte Function and Trypanosoma cruzi Persistence in Chagas Disease.

Mon, 14 Mar 2016 00:00:00 +0100

Authors: Cruz JS, Santos-Miranda A, Sales PA, Monti-Rocha R, Campos PP, Machado FS, Campos DR Abstract Chagas disease, caused by the triatominae Trypanosoma cruzi, is one of the leading causes of heart malfunctioning in Latin America. The cardiac phenotype is observed in 20-30% of infected people 10-40 years after their primary infection. The cardiac complications during Chagas disease range from cardiac arrhythmias to heart failure, with important involvement of the right ventricle. Interestingly, no studies have evaluated the electrical properties of right ventricle myocytes during Chagas disease and correlated them to parasite persistence. Taking advantage of a murine model of Chagas disease, we studied the histological and electrical properties of right ventricle in acute (30 d...



A Practical Approach for Management of QT Prolongation Induced by Anticancer Drugs.

Mon, 14 Mar 2016 00:00:00 +0100

Authors: Maurea N, Coppola C, Piscopo G, Galletta F, Riccio G, De Lorenzo C Abstract : The U.S. National Cancer Institute estimates that at least 13.7 million cancer survivors were alive in the United States in 2012 and that this number will approach 18 million by 2022. The progress in cancer therapy and the increase in number of long-term survivors reveal the cardiovascular side effects of anticancer drugs. In a National Health and Nutrition Examination survey of 1,807 cancer survivors followed for 7 years, 33% died of heart diseases and 51% died of cancer. Thus, cardiotoxicity is becoming a relevant issue, and the risk for cardiac adverse events induced by systemic drugs in patients receiving anticancer therapy needs to be carefully examined. Potential cardiovascular toxicities r...

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The VALVAFRIC study: A registry of rheumatic heart disease in Western and Central Africa.

Mon, 14 Mar 2016 00:00:00 +0100

CONCLUSIONS: Patients with RHD hospitalized in sub-Saharan Africa are young, socially disadvantaged, with a high mortality rate and extremely low access to surgery. Poverty, as quantified by GDP and educational level, affects RHD-related severity, NYHA class and left ventricular dysfunction. PMID: 26988837 [PubMed - as supplied by publisher] (Source: Archives of Cardiovascular Diseases)



Utilization and Predictors of Electrical Cardioversion in Patients Hospitalized for Atrial Fibrillation.

Sun, 13 Mar 2016 21:11:02 +0100

Authors: Rochlani YM, Shah NN, Pothineni NV, Paydak H Abstract Atrial fibrillation (AF) is a common arrhythmia in adults associated with thromboembolic complications. External electrical cardioversion (DCCV) is a safe procedure used to convert AF to normal sinus rhythm. We sought to study factors that affect utilization of DCCV in hospitalized patients with AF. The study sample was drawn from the Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project in the United States. Patients with a primary discharge diagnosis of AF that received DCCV during hospitalization in the years 2000-2010 were included. An estimated 2,810,530 patients with a primary diagnosis of AF were hospitalized between 2001 and 2010, of which 1,19,840 (4.26%) received DCCV. The likelihood...






Initial Egyptian ECMO experience

Sun, 13 Mar 2016 00:00:00 +0100

We describe our initial experience at the first ECMO center in Egypt. Methods Our adult ECMO program started in January 2014. Since then we supported eleven respiratory failure patients on ECMO indicated according to ELSO guidelines and one case of ECMO CPR. Respiratory failure patients were subjected to VV ECMO when lung injury score (LIS) was above 3 and PaO2/FiO2 <100 on protective lung strategy mechanical ventilation according to ARDS net protocol and or severe hypercapnia with pH<7.2 with trial of prone positioning in the indicated cases. Percutaneous cannulation was done in all patients using single lumen cannulae, additional cannula was added when needed. Cardiohelp (Maquet, Germany) and Rotaflow (Maquet, Germany) ECMO consoles were used with centrifugal pump. ECMO ci...



Drug-drug interactions and QT prolongation as a commonly assessed cardiac effect - comprehensive overview of clinical trials.

Sat, 12 Mar 2016 14:55:01 +0100

CONCLUSIONS: DDIs can play significant roles in drugs' cardiac safety, as evidenced by the provided examples. Assessment of the pharmacodynamic effects of the drug interactions is more challenging as compared to the pharmacokinetic due to the significant diversity in the endpoints which should be analyzed specifically for various clinical effects. Nevertheless, PD components of DDIs should be accounted for as PK changes alone do not allow to fully explain the electrophysiological effects in clinic situations. PMID: 26960809 [PubMed - in process] (Source: BMC Pharmacology and Toxicology)

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Left atrial posterior wall isolation reduces the recurrence of atrial fibrillation: a meta-analysis

Sat, 12 Mar 2016 00:00:00 +0100

Conclusions This meta-analysis shows that with comparable procedure-related complications and procedural time, ablation with PWI reduces AF recurrence. (Source: Journal of Interventional Cardiac Electrophysiology)



Current views on the diagnosis and management of hypokalaemia in children

Sat, 12 Mar 2016 00:00:00 +0100

ConclusionUnderstanding the pathophysiology of hypokalaemic states, along with a detailed medical history, physical examination and specific laboratory tests, are required for proper diagnosis and appropriate treatment.This article is protected by copyright. All rights reserved. (Source: Acta Paediatrica)



Relationship between B-type natriuretic peptide and short-term prognosis in non-diabetic patients with ST-segment elevation myocardial infarction.

Fri, 11 Mar 2016 11:56:03 +0100

CONCLUSIONS: BNP levels can be used as a clinical indicator to predict short-term prognosis in STEMI patients. PMID: 26957276 [PubMed - in process] (Source: European Review for Medical and Pharmacological Sciences)



Closure of Long-Tunnel PFOs With the Coherex Flatstent EF - A Tailored Approach.

Fri, 11 Mar 2016 00:32:02 +0100

CONCLUSION: In long-tunnel PFOs, the Flatstent device was quicker to deploy, was at least as equally efficacious as umbrella devices, and reduced the incidence of symptomatic arrhythmias following PFO closure. PMID: 26332883 [PubMed - in process] (Source: The Journal of Invasive Cardiology)



Inflammatory biomarkers in atrial fibrillation: are they linked to future outcomes?

Fri, 11 Mar 2016 00:00:00 +0100

Atrial fibrillation (AF), the most common arrhythmia in the elderly, is an independent risk factor for stroke and death. There is increasing evidence that inflammation contributes to the pathogenesis of AF. Association between high-sensitivity C-reactive protein (hs-CRP) and AF has been well described, both experimentally and clinically, and studies have shown that hs-CRP and interleukin 6 (IL-6) levels are higher in patients with AF than in control patients.1–3 Incremental elevation of hs-CRP has been observed in both paroxysmal and persistent AF.1–3 Furthermore, levels of both inflammatory CRP and IL-6 have been associated with the future development and progression of AF.1–3 Of important clinical interest is the relationship between the prothrombotic state and AF. Virc...

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Biomarkers of inflammation and risk of cardiovascular events in anticoagulated patients with atrial fibrillation

Fri, 11 Mar 2016 00:00:00 +0100

Conclusions In patients with AF on anticoagulation, after accounting for clinical risk factors and other biomarkers, biomarkers of inflammation were significantly associated with an increased risk of mortality. However, there were no associations with the risk of stroke or major bleeding. Trial registration number ClinicalTrials.gov identifier: NCT00412984 post-results. (Source: Heart)



A cohort study of women with a Fontan circulation undergoing preconception counselling

Fri, 11 Mar 2016 00:00:00 +0100

Conclusions Most women accept PCC and decided to pursue pregnancy; in some cases, this was despite being advised of a poor prognosis. Pregnancy outcome was related to baseline hypoxia and CARPREG scores. (Source: Heart)



Special program and abstract issue of the 12 th Annual Congress of the European Cardiac Arrhythmia Society (ECAS)

Fri, 11 Mar 2016 00:00:00 +0100

(Source: Journal of Interventional Cardiac Electrophysiology)



Percolation as a Mechanism to Explain Atrial Fractionated Electrograms and Reentry in a Fibrosis Model Based on Imaging Data

Fri, 11 Mar 2016 00:00:00 +0100

Complex fractionated atrial electrograms (CFAEs) have long been associated with proarrhythmic alterations in atrial structure or electrophysiology. Structural alterations disrupt and slow smoothly propagating wavefronts, leading to wavebreaks and electrogram (EGM) fractionation, but the exact nature and characteristics for arrhythmia remain unknown. Clinically, in AF patients, increases in frequency, whether by pacing or fibrillation, increase EGM fractionation and duration, and reentry can occur in relation with the conduction disturbance. (Source: Heart Rhythm)



An Atypical Presentation of a Typical Arrhythmia

Fri, 11 Mar 2016 00:00:00 +0100

This article is protected by copyright. All rights reserved (Source: Pacing and Clinical Electrophysiology : PACE)

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Catheter Ablation Of Ventricular Tachycardia in the Presence of an Old Endocavitary Thrombus Guided by Intracardiac Echocardiography

Fri, 11 Mar 2016 00:00:00 +0100

ConclusionsICE seems to be more sensitive for the detection of LV thrombi compared to transthoracic echocardiography and is helpful in real‐time navigation of mapping/ablation catheter. Besides potential thromboembolic risk, large thrombus may prevent accessibility to the „critical“ portion of arrhythmia circuit and epicardial ablation is required in selected cases.This article is protected by copyright. All rights reserved (Source: Pacing and Clinical Electrophysiology : PACE)



Anti-arrhythmic medications increase non-cardiac mortality – A meta-analysis of randomized control trials

Fri, 11 Mar 2016 00:00:00 +0100

Conclusion AAMs are associated with an increased risk of non-cardiac and all-cause mortality. The effect of AAMs, especially amiodarone, on non-cardiac mortality requires further evaluation. (Source: Journal of Arrhythmia)



Drug-Induced QT/QTc Interval Shortening: Lessons from Drug-Induced QT/QTc Prolongation

Fri, 11 Mar 2016 00:00:00 +0100

Abstract The review discusses safety implications of drugs found to shorten the QT/QTc interval. It uses parallels with drug-induced QT/QTc prolongation. It summarizes the evidence that increases in repolarization heterogeneity are likely more important for arrhythmia induction and maintenance than the absolute changes in the QT/QTc duration. The review further compares the direct evidence of proarrhythmia caused by QT-prolonging and -shortening drugs. At present, there is little proof of QT-shortening drugs causing ventricular fibrillation in more than rare isolated instances. Comparisons of the incidence of the congenital syndromes show that short QT syndrome is much rarer than long QT syndrome, similar to the findings of short QT intervals compared with long QT intervals in the...



Association between the use of renin-angiotensin system blockers and development of in-hospital atrial fibrillation in patients with ST-segment elevation myocardial infarction

Fri, 11 Mar 2016 00:00:00 +0100

Conclusions Previous therapy with RAS blockers does not reduce the incidence of AF in STEMI. Administration of RAS blockers at the hospital may decrease the AF rate in STEMI. (Source: Medicina)



A Computational Framework for Personalized Blood Flow Analysis in the Human Left Atrium.

Fri, 11 Mar 2016 00:00:00 +0100

In this study, our aim was to develop a clinically feasible methodology to perform personalized blood flow analysis within the heart. We propose an alternative computational approach to perform personalized blood flow analysis by providing the three-dimensional LA endocardial surface motion estimated from patient-specific cardiac CT images. In two patients (case 1 and 2), a four-dimensional displacement vector field was estimated using nonrigid registration. The LA blood outflow across the mitral valve (MV) was calculated from the LV volume, and the flow field within the LA was derived from the incompressible Navier-Stokes equation. The CFD results successfully captured characteristic features of LA blood flow observed clinically by transesophageal echocardiogram. The LA global flow charac...

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Structural heart: Nobles Medical, HeartStitch tout cardiac suture procedures

Thu, 10 Mar 2016 21:45:04 +0100

Structural heart focused HeartStitch and Nobles Medical today touted separate procedures utilizing cardiac sutures with the company’s Hearstitch ST and Noblestitch EL devices. Nobles Medical Tech said that the NobleStitch EL device was used in the 1st percutaneous ASD closure and ASA repair and remodeling without the use of an implantable device. The NobleStitch EL device closes the hole through a minimally invasive cardiovascular suturing procedure, the company said, with a routine cardiac catheterization procedure to secure the closure. “This was the 1st time we used the NobleStitch cardiovascular suturing device in this way. We suspected that the patient, apart from the PFO, also had a small ASD, which was verified during intervention. We started by attempting to cross the ...



Aurora Health Care touts role in clearance of cardiac mapping system

Thu, 10 Mar 2016 18:47:53 +0100

Aurora Health Care Systems today touted the FDA Clearance of APN Health‘s Navik 3D Cardiac mapping system, originally developed by Aurora Health cardiac electrophysiologist Dr. Jasbir Sra at Aurora St. Luke’s Medical Center and the Aurora Research Institute. The system from Pleasanton, Calif.-based APN Health is designed to give operating electrophysiologists or cardiologists real-time 3D catheter locations using 2D fluoroscopic images correlated with the electrical activation of the heart to create 3D maps. “Aurora Health Care and the Aurora Research Institute are proud to support the work of Dr. Sra and his talented team in the development of this leading-edge technology that will ultimately better treat patients with heart irregularities. Dr. Sra is a pioneer in his u...



Glioblastoma following treatment with fingolimod for relapsing-remitting multiple sclerosis

Thu, 10 Mar 2016 00:00:00 +0100

We report a 50-year-old woman diagnosed with glioblastoma within threeyears of induction of fingolimod therapy for relapsing-remitting multiple sclerosis. Fingolimod, an immunomodulating agent used in the treatment of relapsing-remitting multiple sclerosis, has also been suggested to impart a cardioprotective role in heart failure and arrhythmia via activation of P21-activated kinase-1 (Pak1). In the brain, Pak1 activation has been shown to correlate with decreased survival time amongst patients with glioblastoma. A molecular mechanism underlying a link between fingolimod use and glioblastoma development may involve activation of Pak1. To our knowledge, this is the first report of a potential association between fingolimod use and glioblastoma development. (Source: Journal of Clinical Neur...



Remote Magnetic Navigation: A Focus on Catheter Ablation of Ventricular Arrhythmias

Thu, 10 Mar 2016 00:00:00 +0100

A Focus on Catheter Ablation of Ventricular Arrhythmias VT ablation is based on percutaneous catheter insertion under fluoroscopic guidance to selectively destroy (i.e., ablate) myocardial tissue regions responsible for the initiation or propagation of ventricular arrhythmias. Although the last decade has witnessed a rapid evolution of ablation equipment and techniques, the control over catheter movement during manual ablation has remained largely unchanged. Moreover, the procedures are long, and require ergonomically unfavorable positions, which can lead to operator fatigue. In an attempt to overcome these constraints, several technical advancements, including remote magnetic navigation (RMN), have been developed. RMN utilizes a magnetic field to remotely manipulate specially designed sof...



Remote Magnetic Navigation for Catheter Ablation in Patients With Congenital Heart Disease: A Review

Thu, 10 Mar 2016 00:00:00 +0100

Review on Remote Magnetic Navigation in Congenital Heart Disease In patients with congenital heart disease, challenges to catheter‐based arrhythmia interventions are unique and numerous given the complexity of the underlying defects, anatomic and surgical intervention variants including baffles, conduits, patches, and/or shunts. Remote magnetic navigation offers significant advantages in these cases that may present with limited vascular access or difficult access to the target cardiac chambers implicated by the previous surgical interventions. We reviewed the data available on the safety, feasibility, and effectiveness of magnetic navigation for the treatment of arrhythmia in congenital heart disease and discussed the specific challenges related to various congenital defects and repair ...

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Examining the “Killer K” of Diabetic Ketoacidosis at a Tertiary Care Hospital: An Exploratory Study

Thu, 10 Mar 2016 00:00:00 +0100

Conclusions Hypokalemia occurs frequently during acute DKA management and is often preventable. Our findings suggest that interventions targeted at enhancing awareness of guidelines may reduce hypokalemia rates. (Source: Canadian Journal of Diabetes)



HCV false positive immunoassays in patients with LVAD: a potential trap!

Thu, 10 Mar 2016 00:00:00 +0100

Over the last decades, left ventricular assist device (LVAD) has become the therapeutic choice for patients with advanced heart failure [1]. Patients benefit from a LVAD in different situations: as a bridge to cardiac transplantation or to recover a better heart function, or as a destination therapy [2]. The outcome of patients with LVAD has improved but it requires a close monitoring to avoid complications as bleeding, stroke, malignant arrhythmias, pump thrombosis and infection. (Source: Journal of Clinical Virology)



Ablation of Persistent Atrial Fibrillation Targeting Low-Voltage Areas With Selective Activation Characteristics [Original Articles]

Thu, 10 Mar 2016 00:00:00 +0100

Conclusions— Ablation of sites with distinct activation characteristics within/at borderzones of LVA in addition to PVI is more effective than conventional PVI-only strategy for persistent AF. PVI only seems to be sufficient to treat patients with left atrial low voltage <10%. (Source: Circulation: Arrhythmia and Electrophysiology)



Association Between Left Atrial Stiffness Index and Atrial Fibrillation Recurrence in Patients Undergoing Left Atrial Ablation [Original Articles]

Thu, 10 Mar 2016 00:00:00 +0100

Conclusions— LA stiffness index, a novel measure to assess LA diastolic function, increases with age and is higher in persistent AF and in the setting of repeat AF ablation. Greater LA stiffness index was independently associated with recurrence of AF after LA ablation. (Source: Circulation: Arrhythmia and Electrophysiology)