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MedWorm: Cardiac Arrhythmia 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 Cardiac Arrhythmia category.

Last Build Date: Tue, 22 Mar 2016 08:26:11 +0100


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...

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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...

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±...

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)

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)

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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)

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)

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...

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...

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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)

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)

What Your Tongue And Tonsils Could Tell You About Your Sleeping Habits

Wed, 09 Mar 2016 19:08:39 +0100

Your dentist might be able to tell if you're having trouble sleeping.  Yes. A new study published in the Saudi Medical Journal found that the size of a person's tonsils may indicate their risk for obstructive sleep apnea, a condition in which blocked upper airways cause breathing to stop and restart repeatedly during sleep. Tongue indentations, or teeth imprints on the tongue that suggest it's too big for the mouth, may also be a sign.  More than 18 million adults in the United States are affected by OSA. Since people with the condition are often suffering from interrupted and reduced sleep, it can lead to fatigue, irritability, and trouble concentrating. In severe cases, the disorder can lead to learning and memory difficulties, heart attack, congestive heart failure, card...

Surgery for Atrial Fibrillation

Wed, 09 Mar 2016 12:35:15 +0100

This article reviews the indications and preoperative planning for performing a Cox-Maze IV procedure. This article also reviews the literature describing the surgical results for both approaches including comparisons of the Cox-Maze IV to the previous cut-and-sew method. (Source: Heart Failure Clinics)

Mechanisms of Atrial Fibrillation

Wed, 09 Mar 2016 12:35:15 +0100

Atrial fibrillation (AF) is the most common cardiac arrhythmia; however, therapy is suboptimal. We review recent data on dynamics of wave propagation during AF and its mechanistic link to the substrate. Data show that the dominant frequency (DF) increase during transition to persistent AF may be explained by rotor acceleration. We discuss how translation of experimentally derived understanding of the rotors may find its way into the clinic, focusing on studies analyzing spatial distribution of DF in the atria of patients with paroxysmal versus persistent AF, and how that knowledge might contribute to improve the outcome of AF ablation procedures. (Source: Heart Failure Clinics)

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Effects of Insula Resection on Autonomic Nervous System Activity

Wed, 09 Mar 2016 12:07:22 +0100

Conclusions: These findings suggest that the right insula plays a critical role in parasympathetic autonomic modulation and subsequent cardiac arrhythmias. Additional research is needed to establish the long-term effects of right versus left insula resection as related to autonomic dysregulation and adverse brain-heart interactions, particularly in patients at risk of cardiac arrhythmias. (Source: Journal of Neurosurgical Anesthesiology)

Role of the dysfunctional ryanodine receptor - Na(+)-Ca(2+)exchanger axis in progression of cardiovascular diseases: what we can learn from pharmacological studies?

Wed, 09 Mar 2016 00:00:00 +0100

Authors: Acsai K, Ördög B, Varró A, Nánási PP Abstract Abnormal Ca(2+)homeostasis is often associated with chronic cardiovascular diseases, such as hypertension, heart failure or cardiac arrhythmias, and typically contributes to the basic ethiology of the disease. Pharmacological targeting of cardiac Ca(2+)handling has great therapeutic potential offering invaluable options for the prevention, slowing down the progression or suppression of the harmful outcomes like life threatening cardiac arrhythmias. In this review we outline the existing knowledge on the involvement of malfunction of the ryanodine receptor and the Na(+)-Ca(2+)exchanger in disturbances of Ca(2+)homeostasis and discuss important proof of concept pharmacological studies targeting these mechanisms in context of...

Cardiac Arrhythmias in Patients with Chronic Kidney Disease: Implications of Renal Failure for Antiarrhythmic Drug Therapy.

Tue, 08 Mar 2016 00:00:00 +0100

Authors: Potpara TS, Jokic V, Dagres N, Marin F, Prostran MS, Lundqvist CB, Lip GY Abstract The kidney has numerous complex interactions with the heart, including shared risk factors (e.g., hypertension, dyslipidemia, etc.) and mutual amplification of morbidity and mortality. Both cardiovascular diseases and chronic kidney disease (CKD) may cause various alterations in cardiovascular system, metabolic homeostasis and autonomic nervous system that may facilitate the occurrence of cardiac arrhythmias. Also, pre-existent or incident cardiac arrhythmias such as atrial fibrillation (AF) may accelerate the progression of CKD. Patients with CKD may experience various cardiac rhythm disturbances including sudden cardiac death. Contemporary management of cardiac arrhythmias includes the use...

0565: We are Charlie: emotional stress from “Charlie Hebdo attack” extensively relayed by media increases the risk of cardiac events

Mon, 07 Mar 2016 00:00:00 +0100

Publication date: January 2016 Source:Archives of Cardiovascular Diseases Supplements, Volume 8, Issue 1 Author(s): Francesco Della Rosa, Brubo Dongay, Jérôme Van Rothem, Bruno Farah, Atul Pathak The “Charlie Hebdo attack” in the morning of 7 January 2015 opened a 3 days series of terror attacks across Paris region. As France pays homage to victims, local media dedicated a too large part of their programming to a meticulouse coverage of the attacks. We retrospectively analized the activity of our Chest Pain Unit during January 2015 in Toulouse (France) hypothesizing that emotional stress could have triggered increased rate of cardiovascular–related admission. In January 2015 a total of 346 patients were referred to our Chest Pain Unit. Among them, 162 where hospitalized and ...

[Hypersensitivity reactions to implantable cardiac pacemakers and defibrillators].

Sun, 06 Mar 2016 11:00:02 +0100

Authors: Kreft B Abstract Nowadays, for modern electrotherapy of cardiac arrhythmias different pacemaker systems are used. Antibradycardia pacing systems (e. g. single-chamber, two-chamber, three-chamber systems, frequency-adapted pacemaker) can be distinguished from antitachycardia pacing systems like implantable or portable cardioverter defibrillators and combined antibradycardia/antitachycardia systems. Cutaneous reactions overlying a pacemaker or defibrillator are often termed "pacemaker dermatitis". In terms of the differential diagnostic workup, these cutaneous reactions can have various causes. After exclusion of infection by analyzing clinical and laboratory-chemical results, "pressure dermatitis" or the often clinically asymptomatic "reticular telangiectatic erythema" (...

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Common variation in atrial fibrillation: navigating the path from genetic association to mechanism

Fri, 04 Mar 2016 00:00:00 +0100

Atrial fibrillation (AF) is the most common cardiac arrhythmia with well-established clinical and genetic risk components. Genome-wide association studies (GWAS) have identified 17 independent susceptibility signals for AF at 14 genomic regions, but the mechanisms through which these loci confer risk to AF remain largely undefined. This problem is not unique to AF, as the field of functional genomics, which attempts to bridge this gap from genotype to phenotype, has only uncovered the mechanisms for a handful of GWAS loci. Recent functional genomic studies have made great strides towards translating genetic discoveries to an underlying mechanism, but the large-scale application of these techniques to AF has remain limited. These advances, as well as the continued unresolved challenges for ...

Cyclic AMP Sensor EPAC Proteins and Their Role in Cardiovascular Function and Disease.

Fri, 04 Mar 2016 00:00:00 +0100

Authors: Lezoualc'h F, Fazal L, Laudette M, Conte C Abstract cAMP is a universal second messenger that plays central roles in cardiovascular regulation influencing gene expression, cell morphology, and function. A crucial step toward a better understanding of cAMP signaling came 18 years ago with the discovery of the exchange protein directly activated by cAMP (EPAC). The 2 EPAC isoforms, EPAC1 and EPAC2, are guanine-nucleotide exchange factors for the Ras-like GTPases, Rap1 and Rap2, which they activate independently of the classical effector of cAMP, protein kinase A. With the development of EPAC pharmacological modulators, many reports in the literature have demonstrated the critical role of EPAC in the regulation of various cAMP-dependent cardiovascular functions, such as calci...

Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial

Thu, 03 Mar 2016 21:38:06 +0100

Conclusions This pilot study supports the feasibility of a large trial comparing lower versus higher MAP targets for shock. Further research may help delineate the reasons for vasopressor dosing in excess of prescribed targets and how individual patient characteristics modify the response to vasopressor therapy. (Source: Intensive Care Medicine)

Initial Egyptian extracorporeal membrane oxygenation experience

Thu, 03 Mar 2016 00:00:00 +0100

We describe our initial experience at the first ECMO center in Egypt. Methods Our adult ECMO program started January 2014. Since then we supported eleven patients on ECMO in respiratory failure patients 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 hypercapnoea with pH<7.2 with trial of prone positioning in 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. E...

Hypothesised mechanisms of swimming-related death: a systematic review.

Thu, 03 Mar 2016 00:00:00 +0100

CONCLUSIONS: The available evidence is limited but may suggest that cardiac arrhythmias are the most likely aetiology of swimming-related death. While symptoms of pulmonary edema may occur during swimming, current evidence does not support swimming-induced pulmonary edema as a frequent cause of swimming-related death, nor is there evidence to link hypothermia or hyperthermia as a causal mechanism. Further higher level studies are needed. PMID: 26941276 [PubMed - as supplied by publisher] (Source: British Journal of Sports Medicine)

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National, Heart, Lung, and Blood Institute Support of Cardiac Arrhythmia Research

Wed, 02 Mar 2016 00:00:00 +0100

(Source: Heart Rhythm)

Atorvastatin blocks increased l-type Ca2+ current and cell injury elicited by angiotensin II via inhibiting oxide stress.

Wed, 02 Mar 2016 00:00:00 +0100

Authors: Ma Y, Kong L, Qi S, Wang D Abstract The l-type Ca(2+) current (ICa,l) plays a crucial role in shaping action potential and is involved in cardiac arrhythmia. Statins have been demonstrated to contribute to anti-apoptotic and anti-arrhythmic effects in the heart. Here, we examined whether atorvastatin regulates the ICa,l and cell injury induced by angiotensin II (AngII) as well as the putative intracellular cascade responsible for the effects. Cultured neonatal rat ventricular myocytes were incubated with AngII for 24 h, and then cell injury and expression levels of Nox2/gp91(phox), p47(phox) , and Cav1.2 were analyzed. In addition, ICa,l was recorded using the whole-cell patch-clamp technique, and mechanisms of atorvastatin actions were also investigated. It was found that...

Atrial Fibrillation Increases the Risk of Peripheral Arterial Disease With Relative Complications and Mortality: A Population-Based Cohort Study

Tue, 01 Mar 2016 06:00:00 +0100

Abstract: Atrial fibrillation (AF), an increasing prevalent cardiac arrhythmia due to aging general population, has many common risk factors with peripheral arterial disease (PAD). However, it is unclear whether AF is associated with a risk of PAD. We investigated the prevalence of AF and PAD in the general population and the risk of PAD among the AF population. This longitudinal, nationwide, population-based cohort study was conducted using data from the Taiwan National Health Insurance Research Database recorded during 2000 to 2011. In total, 3814 and 15,364 patients were included in the AF and non-AF cohorts, respectively. Univariate and multivariate Cox proportional hazard regression models were used for examining the effects of AF on the risk of outcomes. The average follow-up perio...

Human Placental Extract Ameliorates Structural Lung Changes Iinduced by Amiodarone in Rats

Mon, 29 Feb 2016 19:30:00 +0100

Amiodarone is used in treatment of cardiac arrhythmias. Therapeutic use of amiodarone is limited by its side effects, including pulmonary toxicity. Human Placenta Extract (HPE) contains a variety of bio-active substances. Thus, the present study aimed to quantitatively evaluate the protective effects of HPE on the structural lung changes induced by amiodarone using stereological methods. Sprague-Dawley male rats were divided into four groups. The first, second, and third groups received no treatment, amiodarone (100 mg/kg, i.p.), and HPE (500µl/kg, i.p.), respectively. The fourth group was treated with amiodarone+HPE. The animals' lungs were removed after 10 days. The lung volume was estimated using the Cavalieri principle on the embedded and cut tissue and corrected for shrinkage. T...

Non-Cardiac Symptoms of Moderate to Severe Hypokalemia in a Patient with a Syncardia™ Total Artificial Heart.

Fri, 26 Feb 2016 21:39:02 +0100

Authors: Prasad A, Ghodsizad A, Pae W, Singbartl K, Boone J, Zeriouh M, Ruhparwar A, Loebe M, Khorrami GS, Koerner MM, Brehm C Abstract The Syncardia™ total artificial heart (TAH) is an option for patients as a bridge to transplant in those who are not candidates for left ventricular assist devices (LVAD) due to right ventricular failure. Postoperative course is highly dependent on volume status and aggressive diuresis is often necessary. One complication from aggressive diuresis is hypokalemia; however, in these patients we tolerate a lower potassium level because cardiac arrhythmias are not a concern.  However, in two separate instances non-cardiac symptoms related to severe hypokalemia occurred. These symptoms included nystagmus in one patient and agitation, tremors, and havi...

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N-Glycosylation of the Cardiac L-type Channel Complex [Protein Structure and Folding]

Fri, 26 Feb 2016 00:00:00 +0100

Alteration in the L-type current density is one aspect of the electrical remodeling observed in patients suffering from cardiac arrhythmias. Changes in channel function could result from variations in the protein biogenesis, stability, post-translational modification, and/or trafficking in any of the regulatory subunits forming cardiac L-type Ca2+ channel complexes. CaVα2δ1 is potentially the most heavily N-glycosylated subunit in the cardiac L-type CaV1.2 channel complex. Here, we show that enzymatic removal of N-glycans produced a 50-kDa shift in the mobility of cardiac and recombinant CaVα2δ1 proteins. This change was also observed upon simultaneous mutation of the 16 Asn sites. Nonetheless, the mutation of only 6/16 sites was sufficient to significantly 1) reduce the steady-state c...

Air particulate matter and cardiovascular disease: the epidemiological, biomedical and clinical evidence.

Thu, 25 Feb 2016 05:57:02 +0100

Authors: Du Y, Xu X, Chu M, Guo Y, Wang J Abstract Air pollution is now becoming an independent risk factor for cardiovascular morbidity and mortality. Numerous epidemiological, biomedical and clinical studies indicate that ambient particulate matter (PM) in air pollution is strongly associated with increased cardiovascular disease such as myocardial infarction (MI), cardiac arrhythmias, ischemic stroke, vascular dysfunction, hypertension and atherosclerosis. The molecular mechanisms for PM-caused cardiovascular disease include directly toxicity to cardiovascular system or indirectly injury by inducing systemic inflammation and oxidative stress in peripheral circulation. Here, we review the linking between PM exposure and the occurrence of cardiovascular disease and discussed the p...

Deletion of Kvβ1.1 subunit leads to electrical and haemodynamic changes causing cardiac hypertrophy in female murine hearts

Thu, 25 Feb 2016 00:00:00 +0100

New Findings What is the central question of this study? The goal of this study was to evaluate sex differences and the role of the potassium channel β1 (Kvβ1) subunit in the heart. What is the main finding and its importance? Genetic ablation of Kvβ1.1 in females led to cardiac hypertrophy characterized by increased heart size, prolonged monophasic action potentials, elevated blood pressure and increased myosin heavy chain α (MHCα) expression. In contrast, male mice showed only electrical changes. Kvβ1.1 binds the MHCα isoform at the protein level, and small interfering RNA targeted knockdown of Kvβ1.1 upregulated MHCα. Cardiovascular disease is the leading cause of death and debility in women in the USA, and cardiac arrhythmias are a major concern. Voltage‐gated potassium...

Effect of caffeine on ventricular arrhythmia: a systematic review and meta-analysis of experimental and clinical studies

Thu, 25 Feb 2016 00:00:00 +0100

Conclusion Our meta-analysis demonstrates that data from human interventional studies do not show a significant effect of caffeine consumption on the occurrence of VBPs. The effects observed in animal studies are most probably the result of very high caffeine doses that are not regularly consumed in a daily basis by humans. (Source: Europace)

Slowing Down of Recovery as Generic Risk Marker for Acute Severity Transitions in Chronic Diseases

Wed, 24 Feb 2016 00:19:16 +0100

Conclusions: We hypothesize that in a range of chronic episodic diseases, indicators of critical slowing down, such as rising variance and temporal correlation, may be used to assess the risk of attacks, exacerbations, and even mortality. Identification of such early warning signals over a range of diseases will enhance the understanding of why, how, and when attacks and exacerbations will strike and may thus improve disease management in critical care medicine. (Source: Critical Care Medicine)

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Improved cardiac magnetic resonance thermometry and dosimetry for monitoring lesion formation during catheter ablation

Sun, 21 Feb 2016 00:00:00 +0100

ConclusionThis fully automated MR thermometry pipeline (five images/heartbeat) provides direct assessment of lesion formation in the heart during catheter‐based RFA, which may improve treatment of cardiac arrhythmia by ablation. Magn Reson Med, 2016. © 2016 Wiley Periodicals, Inc. (Source: Magnetic Resonance in Medicine)

Improved cardiac magnetic resonance thermometry and dosimetry for monitoring lesion formation during catheter ablation.

Sun, 21 Feb 2016 00:00:00 +0100

CONCLUSION: This fully automated MR thermometry pipeline (five images/heartbeat) provides direct assessment of lesion formation in the heart during catheter-based RFA, which may improve treatment of cardiac arrhythmia by ablation. Magn Reson Med, 2016. © 2016 Wiley Periodicals, Inc. PMID: 26899165 [PubMed - as supplied by publisher] (Source: Magnetic Resonance in Medicine)

Human placental extract ameliorates structural lung changes induced by amiodarone in rats ...

Sat, 20 Feb 2016 19:30:00 +0100

Amiodarone is used in treatment of cardiac arrhythmias. Therapeutic use of amiodarone is limited by its side effects, including pulmonary toxicity. Human Placenta Extract (HPE) contains a variety of bio-active substances. Thus, the present study aimed to quantitatively evaluate the protective effects of HPE on the structural lung changes induced by amiodarone using stereological methods. Sprague-Dawley male rats were divided into four groups. The first, second, and third groups received no treatment, amiodarone (100 mg/kg, i.p.), and HPE (500µl/kg, i.p.), respectively. The fourth group was treated with amiodarone+HPE. The animals' lungs were removed after 10 days. The lung volume was estimated using the Cavalieri principle on the embedded and cut tissue and corrected for shrinkage. T...

Drug-related mortality among inpatients: a retrospective observational study

Sat, 20 Feb 2016 00:00:00 +0100

Conclusions A high percentage of hospital deaths were suspected of being associated with ADRs, especially in patients with comorbidity and/or polypharmacy. Antithrombotics, psychotropics, and digoxin were the drugs most frequently associated with in-hospital drug-related deaths. (Source: European Journal of Clinical Pharmacology)

Lyme: The Infectious Disease Equivalent of Cancer, Says Top Duke Oncologist

Fri, 19 Feb 2016 16:50:57 +0100

Last week, I mentioned the case of Dr. Neil Spector, whose long-undiagnosed Lyme Disease resulted in irreversible heart failure and ultimately, a heart transplant. Dr. Spector, author of Gone in a Heartbeat: A Physician's Search for True Healing, is the Sandra Coates Associate Professor of Medicine and Associate Professor of Pharmacology and Cancer Biology at Duke University School of Medicine. As the Director of Developmental Therapeutics at the Duke Cancer Institute, he's a leader in applying translational research to the clinical development of molecularly targeted personalized cancer therapies. Here, Dr. Spector shares his story, explains what Lyme and cancer have in common (hint: a LOT), and encourages us with his vision for the future. Like so many of us, your Lyme was missed by mu...

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Circulating Glutamate and Taurine Levels Are Associated with the Generation of Reactive Oxygen Species in Paroxysmal Atrial Fibrillation.

Fri, 19 Feb 2016 15:16:02 +0100

Authors: Takano S, Fujibayashi K, Fujioka N, Ueno E, Wakasa M, Kawai Y, Kajinami K Abstract Atrial fibrillation (AF) is the most common cardiac arrhythmia, but its proarrhythmic mechanism remains to be elucidated. Glutamate (Glu) and taurine (Tau) are present in the myocardium at substantially higher concentrations than in the plasma, suggesting their active role in myocardium. Here, we tested the hypothesis that the metabolism of Glu and Tau is altered in association with the generation of reactive oxygen species (ROS) in patients with AF. Fifty patients with paroxysmal AF and 50 control subjects without a history of AF were consecutively enrolled. Circulating Glu and Tau levels were measured and correlations between Glu/Tau and ROS levels were examined. Glu/Tau content was signif...

Use of an Implantable Loop Recorder in a Chimpanzee (Pan troglodytes) to Monitor Cardiac Arrhythmias and Assess the Effects of Acupuncture and Laser Therapy.

Fri, 19 Feb 2016 04:50:01 +0100

Authors: Magden ER, Sleeper MM, Buchl SJ, Jones RA, Thiele EJ, Wilkerson GK Abstract Cardiovascular disease is a leading cause of death in captive chimpanzees and is often associated with myocardial fibrosis, which increases the risk of cardiac arrhythmias. In this case report, we present a 36-y-old male chimpanzee (Pan troglodytes) diagnosed with frequent ventricular premature complexes (VPC). We placed a subcutaneous implantable loop recorder for continual ECG monitoring to assess his arrhythmias without the confounding effects of anesthetics. During his initial treatment with the antiarrhythmia medication amiodarone, he developed thrombocytopenia, and the drug was discontinued. After reviewing other potential therapies for the treatment of cardiac arrhythmias, we elected to try ...

High risk of abnormal QT prolongation in the early morning in diabetic and non-diabetic patients with severe hypoglycemia.

Thu, 18 Feb 2016 06:09:02 +0100

CONCLUSIONS: The incidence of abnormal QT prolongation during severe hypoglycemia was significantly higher in the early morning than at all other times, independent of the cause of severe hypoglycemia. PMID: 25861830 [PubMed - indexed for MEDLINE] (Source: Annals of Medicine)

The effects of B0, B20, and B100 soy biodiesel exhaust on aconitine-induced cardiac arrhythmia in spontaneously hypertensive rats.

Thu, 18 Feb 2016 03:00:02 +0100

CONCLUSIONS: These data demonstrate that exposure to B20 causes less sensitivity to arrhythmia than B0 and B100. This diminished effect may be due to lower irritant components such as acrolein and nitrogen oxides. Thus, in terms of cardiac health, B20 may be a safer option than both of the pure forms. PMID: 26514783 [PubMed - in process] (Source: Inhalation Toxicology)

Feature-Based MRI Data Fusion for Cardiac Arrhythmia Studies

Thu, 18 Feb 2016 00:00:00 +0100

Current practices in studying cardiac arrhythmias primarily use electrical or optical surface recordings of a heart, spatially-limited transmural recordings, and mathematical models. However, given that such arrhythmias occur on a 3D myocardial tissue, information obtained from such practices lack in dimension, completeness, and are sometimes prone to oversimplification. The combination of complementary Magnetic-Resonance Imaging (MRI)-based techniques such as Current Density Imaging (CDI) and Diffusion Tensor Imaging (DTI) could provide more depth to current practices in assessing the cardiac arrhythmia dynamics in entire cross sections of myocardium. (Source: Computers in Biology and Medicine)

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Neutrophil to lymphocyte ratio (NLR) and cardiovascular diseases: an update.

Wed, 17 Feb 2016 15:49:03 +0100

Authors: Afari ME, Bhat T Abstract As we know, inflammatory and oxidative stresses have a role in the pathogenesis of cardiovascular disease. This knowledge has triggered many investigations targeted to inflammatory markers. One such example, the neutrophil to lymphocyte ratio (NLR), is an inexpensive and easily accessible inflammatory marker whose role in cardiovascular disease has been studied extensively in the past few years. The neutrophil lymphocyte ratio has been shown to predict cardiac arrhythmias as well as short- and long-term mortality in patients with acute coronary syndromes (ACS). It has correlated well with ACS risk prediction models such as the GRACE and SYNTAX scores. A higher NLR has also been associated with frequent congestive heart failure decompensation and l...

Cardiomyocyte Ca(2+) dynamics: clinical perspectives.

Wed, 17 Feb 2016 15:42:02 +0100

Authors: Aronsen JM, Louch WE, Sjaastad I Abstract In the heart, Ca(2+) signals regulate a variety of biological functions ranging from contractility to gene expression, cellular hypertrophy and death. In this review, we summarize the role of local Ca(2+) homeostasis in these processes in healthy cardiac muscle cells, and highlight how mismanaged Ca(2+) handling contributes to the pathophysiology of conditions such as cardiac arrhythmia, ischemic heart disease, cardiac hypertrophy and heart failure. Aiming to provide an introduction to the field with a clinical perspective, we also indicate how current and future therapies may modulate cardiomyocytes Ca(2+) handling for the treatment of patients. PMID: 26729487 [PubMed - as supplied by publisher] (Source: Scandinavian Cardiovas...

Application of a novel liquid chromatography/tandem mass spectrometry method for the determination of antazoline in human plasma: Result of ELEPHANT-I [ELEctrophysiological, pharmacokinetic and hemodynamic effects of PHenazolinum (ANTazoline mesylate)] human pharmacokinetic study

Wed, 17 Feb 2016 00:00:00 +0100

In conclusion, the proposed new LC–MS/MS method was successfully used for the first time for the determination of antazoline in human plasma. Graphical abstract (Source: Journal of Pharmaceutical and Biomedical Analysis)

Clinical and echocardiographic findings in an 8 year old Brown Swiss cow with myocardial abscess

Tue, 16 Feb 2016 00:00:00 +0100

Publication date: Available online 16 February 2016 Source:Journal of Veterinary Cardiology Author(s): C. Gerspach, C.C. Schwarzwald, M. Hilbe, S. Buczinski Intramyocardial abscesses are rare in cattle and may lead to unspecific clinical signs. This case report describes the clinical and echocardiographic findings in an 8 year old Brown Swiss cow presented with an intramural myocardial abscess. The main clinical findings were anorexia, drop in milk yield, fever, tachycardia, and hyperfibrinogenemia. Neither heart murmurs nor cardiac arrhythmias were present on auscultation. Transthoracic echocardiographic examination revealed a prominent intramural mass embedded in the left ventricular free wall and bulging into the lumen of the left ventricle. Diagnosis was confirmed at necropsy. A ...

[Cardiac arrhythmias: Diagnosis and management].

Mon, 15 Feb 2016 12:02:01 +0100

Authors: Waldmann V, Marijon E Abstract Cardiac arrhythmias, with, on top of the list, atrial fibrillation, are frequent conditions and any physician might have to get involved at any stage of patient care (from diagnosis to treatment), without always having the opportunity to immediately refer to the cardiologist. The aim of this review is to present a summary of pathophysiology, clinical and electrocardiographic presentations, as well as diagnostic and therapeutic strategies for the main cardiac arrhythmias. Supra-ventricular tachycardias (atrial fibrillation and flutter, atrioventricular reciprocating tachycardias) and ventricular tachycardias will be consecutively presented and discussed. PMID: 26872434 [PubMed - as supplied by publisher] (Source: Revue de Medecine Interne)

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Id4 functions downstream of Bmp signaling to restrict TCF function in endocardial cells during atrioventricular valve development.

Mon, 15 Feb 2016 00:00:00 +0100

Authors: Ahuja S, Dogra D, Stainier DY, Reischauer S Abstract The atrioventricular canal (AVC) connects the atrial and ventricular chambers of the heart and its formation is critical for the development of the cardiac valves, chamber septation and formation of the cardiac conduction system. Consequently, problems in AVC formation can lead to congenital defects ranging from cardiac arrhythmia to incomplete cardiac septation. While our knowledge about early heart tube formation is relatively comprehensive, much remains to be investigated about the genes that regulate AVC formation. Here we identify a new role for the basic helix-loop-helix factor Id4 in zebrafish AVC valve development and function. id4 is first expressed in the AVC endocardium and later becomes more highly expressed ...

A Novel Approach to Improve Time to First Shock in Prehospital STEMI Complicated by Ventricular Fibrillation.

Sun, 14 Feb 2016 14:58:02 +0100

Authors: Osei-Ampofo M, Cheskes S, Byers A, Drennan IR, Buick JE, Verbeek PR Abstract Lethal cardiac arrhythmias such as ventricular fibrillation and pulseless ventricular tachycardia (VF/pVT) complicate up to 6% of all out-of-hospital STEMIs. Typically, paramedics respond to this by applying defibrillation pads and delivering a shock as soon as possible. A recently introduced "pads-on" protocol directed paramedics to apply defibrillation pads to all STEMI patients (regardless of clinical stability) with the aim of decreasing time to first shock. In this article we present two cases of prehospital STEMI complicated by VF to illustrate times to first shock for the two different protocols. One case each of a STEMI complicated by VF before implementation of the pads-on protocol and af...

Optimizing the solution conditions to solve the structure of the Connexin43 carboxyl terminus attached to the 4(th) transmembrane domain in detergent micelles.

Sat, 13 Feb 2016 21:19:02 +0100

Authors: Grosely R, Kieken F, Sorgen PL Abstract pH-mediated gating of Cx43 channels following an ischemic event is believed to contribute to the development of lethal cardiac arrhythmias. Studies using a soluble version of the Cx43 carboxyl-terminal domain (Cx43CT; S255-I382) have established the central role it plays in channel regulation; however, research in the authors' laboratory suggests that this construct may not be the ideal model system. Therefore, we have developed a more 'native-like' construct (Cx43CT attached to the 4th transmembrane domain [TM4-Cx43CT; G178-I382]) than the soluble Cx43CT to further investigate the mechanism(s) governing this regulation. Here, we utilize circular dichroism and nuclear magnetic resonance (NMR) were used to validate the TM4-Cx43CT for ...

Fetal and Neonatal Arrhythmias

Fri, 12 Feb 2016 09:07:10 +0100

Cardiac arrhythmias are an important aspect of fetal and neonatal medicine. Premature complexes of atrial or ventricular origin are the main cause of an irregular heart rhythm. The finding is typically unrelated to an identifiable cause and no treatment is required. Tachyarrhythmia most commonly relates to supraventricular reentrant tachycardia, atrial flutter, and sinus tachycardia. Several antiarrhythmic agents are available for the perinatal treatment of tachyarrhythmias. Enduring bradycardia may result from sinus node dysfunction, complete heart block and nonconducted atrial bigeminy as the main arrhythmia mechanisms. The management and outcome of bradycardia depend on the underlying mechanism. (Source: Clinics in Perinatology)

Sudden infant death syndrome caused by cardiac arrhythmias: only a matter of genes encoding ion channels?

Fri, 12 Feb 2016 00:00:00 +0100

Abstract Sudden infant death syndrome is the unexpected demise of a child younger than 1 year of age which remains unexplained after a complete autopsy investigation. Usually, it occurs during sleep, in males, and during the first 12 weeks of life. The pathophysiological mechanism underlying the death is unknown, and the lethal episode is considered multifactorial. However, in cases without a conclusive post-mortem diagnosis, suspicious of cardiac arrhythmias may also be considered as a cause of death, especially in families suffering from any cardiac disease associated with sudden cardiac death. Here, we review current understanding of sudden infant death, focusing on genetic causes leading to lethal cardiac arrhythmias, considering both genes encoding ion channels as well as s...

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Classification of persistent and long-standing persistent atrial fibrillation by means of surface electrocardiograms.

Thu, 11 Feb 2016 16:39:02 +0100

Authors: Ortigosa N, Fernández C, Galbis A, Cano Ó Abstract Atrial fibrillation, which is the most common cardiac arrhythmia, is typically classified into four clinical subtypes: paroxysmal, persistent, long-standing persistent and permanent. The ability to distinguish between them is of crucial significance in choosing the most suitable therapy for each patient. Nevertheless, classification is currently established once the natural history of the arrhythmia has been disclosed as it is not possible to make an early differentiation. This paper presents a novel method to discriminate persistent and long-standing atrial fibrillation patients by means of a time-frequency analysis of the surface electrocardiogram. Classification results provide approximately 75% accuracy when evaluati...

Some heart drugs and antibiotics show effective in fighting cancer

Tue, 09 Feb 2016 09:00:00 +0100

North American researchers have identified drugs that showed promising perspectives in treating cancers, according to a recent study published in Cancer Research. These drugs are normally used to treat other diseases, such as heart failure, cardiac arrhythmia, and infections. (Source: World Pharma News)

MY Approach to Arial Fibrillation Patients With a Bleeding Risk

Fri, 05 Feb 2016 00:00:00 +0100

Atrial fibrillation is the most common significant cardiac arrhythmia. The most feared complication is cardioembolic stroke. The risk of both atrial fibrillation and stroke increases as people age. Alone, atrial fibrillation increases stroke risk approximately fivefold; of concern is the fact that these specific strokes tend to be larger with higher associated morbidity and mortality with greater disability and an increased rate of recurrence. In the setting of nonvalvular atrial fibrillation, the predominant (90%) source of emboli is the left atrial appendage. (Source: Trends in Cardiovascular Medicine)

Association Between Particulate Air Pollution and QT Interval Duration in an Elderly Cohort

Tue, 02 Feb 2016 21:34:18 +0100

Conclusions: PM2.5 was associated with increased corrected QT duration in an elderly cohort. While most previous studies focused on short-term air pollution exposures, our results suggest that longer-term exposures are associated with cardiac repolarization. (Source: Epidemiology)

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Exome‐based analysis of cardiac arrhythmia, respiratory control, and epilepsy genes in sudden unexpected death in epilepsy

Tue, 02 Feb 2016 00:00:00 +0100

ObjectiveThe leading cause of epilepsy‐related premature mortality is sudden unexpected death in epilepsy (SUDEP). The cause of SUDEP remains unknown. To search for genetic risk factors in SUDEP cases, we performed an exome‐based analysis of rare variants. MethodsDemographic and clinical information of 61 SUDEP cases were collected. Exome sequencing and rare variant collapsing analysis with 2,936 control exomes were performed to test for genes enriched with damaging variants. Additionally, cardiac arrhythmia, respiratory control, and epilepsy genes were screened for variants with frequency of <0.1% and predicted to be pathogenic with multiple in silico tools. ResultsThe 61 SUDEP cases were categorized as definite SUDEP (n = 54), probable SUDEP (n = 5), and definite SUDEP plus (n = 2...

Arsenic Trioxide as a Radiation Sensitizer for 131I-Metaiodobenzylguanidine Therapy: Results of a Phase II Study

Mon, 01 Feb 2016 00:00:00 +0100

Conclusion: 131I-MIBG plus arsenic trioxide was well tolerated, with an adverse event profile similar to that of 131I-MIBG therapy alone. The addition of arsenic trioxide to 131I-MIBG did not significantly improve response rates when compared with historical data with 131I-MIBG alone. (Source: Journal of Nuclear Medicine)

Electrophysiology Catheter Detection and Reconstruction From Two Views in Fluoroscopic Images

Mon, 01 Feb 2016 00:00:00 +0100

We present a novel image-based approach for automatic detection and 3-D reconstruction of EP catheters where the physician marks the catheter to be reconstructed by a single click in each image. The result can be used to provide 3-D information for enhanced navigation throughout EP procedures. Our approach involves two X-ray projections acquired from different angles, and it is based on two steps: First, we detect the catheter in each view after manual initialization using a graph-search method. Then, the detection results are used to reconstruct a full 3-D model of the catheter based on automatically determined point pairs for triangulation. An evaluation on 176 different clinical fluoroscopic images yielded a detection rate of 83.4%. For measuring the error, we used the coupling distance...

Carnitine transport and fatty acid oxidation

Sat, 30 Jan 2016 00:00:00 +0100

Publication date: Available online 29 January 2016 Source:Biochimica et Biophysica Acta (BBA) - Molecular Cell Research Author(s): Nicola Longo, Marta Frigeni, Marzia Pasquali Carnitine is essential for the transfer of long-chain fatty acids across the inner mitochondrial membrane for subsequent β-oxidation. It can be synthesized by the body or assumed with the diet from meat and dairy products. Defects in carnitine biosynthesis do not routinely result in low plasma carnitine levels. Carnitine is accumulated by the cells and retained by kidneys using OCTN2, a high affinity organic cation transporter specific for carnitine. Defects in the OCTN2 carnitine transporter results in autosomal recessive primary carnitine deficiency characterized by decreased intracellular carnitine accumulat...

Carnitine transport and fatty acid oxidation.

Fri, 29 Jan 2016 00:00:00 +0100

Authors: Longo N, Frigeni M, Pasquali M Abstract Carnitine is essential for the transfer of long-chain fatty acids across the inner mitochondrial membrane for subsequent β-oxidation. It can be synthesized by the body or assumed with the diet from meat and dairy products. Defects in carnitine biosynthesis do not routinely result in low plasma carnitine levels. Carnitine is accumulated by the cells and retained by kidneys using OCTN2, a high affinity organic cation transporter specific for carnitine. Defects in the OCTN2 carnitine transporter results in autosomal recessive primary carnitine deficiency characterized by decreased intracellular carnitine accumulation, increased losses of carnitine in the urine, and low serum carnitine levels. Patients can present early in life with hyp...

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Arrhythmias in 2015: Advances in drug, ablation, and device therapy for cardiac arrhythmias

Fri, 29 Jan 2016 00:00:00 +0100

Nature Reviews Cardiology 13, 179 (2016). doi:10.1038/nrcardio.2016.11 Author: Laurent Macle & Stanley Nattel Arrhythmias in 2015 (Source: Nature Reviews Cardiology)

Here's Some Good News About Coffee And Your Heart

Wed, 27 Jan 2016 21:27:57 +0100

Sip your coffee with peace of mind: A new study published in the Journal of the American Heart Association has found that caffeine doesn't cause heartbeat irregularities, despite what we've heard in the past. Researchers at the University of California San Fransisco assessed the coffee, tea and chocolate intake of 1,388 healthy men and women over a year-long period. During this time, participants also wore a portable device that monitored their heart rhythm 24 hours a day.  Sixty-one percent of participants reported drinking or eating more than one caffeinated item every day, yet the heartbeat monitors did not detect extra heartbeats in those who ingested higher amounts of caffeine. This led researchers to conclude that caffeine intake has little effect on heartbeat. Why is this impo...

The Influence of Nitrogen Dioxide on Arrhythmias in Spain and Its Relationship with Atmospheric Circulation.

Wed, 27 Jan 2016 00:00:00 +0100

Authors: Santurtún A, Sanchez-Lorenzo A, Villar A, Riancho JA, Zarrabeitia MT Abstract Epidemiological studies suggest that increased ambient NO2 concentrations are associated with cardiovascular disease. However, none of them have examined the association between ambient air pollution and cardiac arrhythmias in the general population in Spain. This paper assesses the short-term association between the aforementioned air pollutant and hospital admissions for arrhythmia in nine different regions of Spain during a 6-year period (2005-2010), and the possible season-specific effects of the compound on this pathology, by performing a time-series analysis based on Poisson regression models. The results show statistically significant positive relationship increases between arrhythmia adm...

Cardiac arrhythmias in the critically ill

Tue, 26 Jan 2016 00:00:00 +0100

Publication date: Available online 25 January 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): James Gray, Paul Haydock, Adrian Wong, J M Tom Pierce Arrhythmias are a common problem in the critically ill and they can have significant effects on patient outcome. They often require immediate and swift action and it is, therefore, essential that clinicians have a structured approach to the recognition and management of arrhythmias. Here, we provide a framework for the appropriate management of the more frequently encountered cardiac arrhythmias in critical care. We include the algorithms from the 2010 Resuscitation Council Guidelines for reference. (Source: Anaesthesia and intensive care medicine)

Surgical perspectives in the management of atrial fibrillation.

Tue, 26 Jan 2016 00:00:00 +0100

Authors: Kyprianou K, Pericleous A, Stavrou A, Dimitrakaki IA, Challoumas D, Dimitrakakis G Abstract Atrial fibrillation (AF) is the most common cardiac arrhythmia and a huge public health burden associated with significant morbidity and mortality. For decades an increasing number of patients have undergone surgical treatment of AF, mainly during concomitant cardiac surgery. This has sparked a drive for conducting further studies and researching this field. With the cornerstone Cox-Maze III "cut and sew" procedure being technically challenging, the focus in current literature has turned towards less invasive techniques. The introduction of ablative devices has revolutionised the surgical management of AF, moving away from the traditional surgical lesions. The hybrid procedure, a co...

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Effect of Remote Ischaemic Conditioning in Oncology Patients Undergoing Chemotherapy: Rationale and Design of the ERIC‐ONC Study—A Single‐Center, Blinded, Randomized Controlled Trial

Mon, 25 Jan 2016 00:00:00 +0100

ABSTRACT Cancer survival continues to improve, and thus cardiovascular consequences of chemotherapy are increasingly important determinants of long‐term morbidity and mortality. Conventional strategies to protect the heart from chemotherapy have important hemodynamic or myelosuppressive side effects. Remote ischemic conditioning (RIC) using intermittent limb ischemia‐reperfusion reduces myocardial injury in the setting of percutaneous coronary intervention. Anthracycline cardiotoxicity and ischemia‐reperfusion injury share common biochemical pathways in cardiomyocytes. The potential for RIC as a novel treatment to reduce subclinical myocyte injury in chemotherapy has never been explored and will be investigated in the Effect of Remote Ischaemic Conditioning in Oncology (ERIC‐ONC) t...

An Integrated Management Approach to Atrial Fibrillation [Arrhythmia and Electrophysiology]

Mon, 25 Jan 2016 00:00:00 +0100

Conclusions Adoption of this integrated management approach for the burgeoning population of AF may provide an overall benefit to cardiovascular morbidity and mortality. (Source: JAHA:Journal of the American Heart Association)

Combined 1,25-Dihydroxy-vitamin D and Resveratrol: A Novel Therapeutic Approach to Ameliorate Ischemia Reperfusion-Induced Myocardial Injury.

Thu, 21 Jan 2016 00:57:02 +0100

Authors: Safari F, Zarei F, Shekarforoush S, Fekri A, Klishadi MS, Hekmatimoghaddam S Abstract The aim of this study was to assess the effect of combined 1,25-dihydroxyvitamin D (1,25 D) and resveratrol on cardiac arrhythmias, infarct size, and transcription of catalase, thioredoxin-1 and B-cell lymphoma 2 (Bcl-2), following myocardial ischemia-reperfusion (IR) in male rats. Ligation of coronary artery was performed in rats (n = 6 per group) without any treatment (IR group), pretreated with 0.1 μg/kg/day of 1,25 D (1,25 D + IR), 1 mg/kg/day of resveratrol (Res + IR) or a combination (1,25 D + Res + IR) for 14 days. Arrhythmias were analyzed according to the Lambeth conventions, and infarct size was measured by 2,3,5-triphenyl-2H-tetrazolium chloride staining. Expression of prosurv...

Recurrent Muscle Weakness with Rhabdomyolysis, Metabolic Crises, and Cardiac Arrhythmia due to Bi-allelic Mutations

Thu, 21 Jan 2016 00:00:00 +0100

The underlying genetic etiology of rhabdomyolysis remains elusive in a significant fraction of individuals presenting with recurrent metabolic crises and muscle weakness. Using exome sequencing, we identified bi-allelic mutations in TANGO2 encoding transport and Golgi organization 2 homolog (Drosophila) in 12 subjects with episodic rhabdomyolysis, hypoglycemia, hyperammonemia, and susceptibility to life-threatening cardiac tachyarrhythmias. A recurrent homozygous c.460G>A (p.Gly154Arg) mutation was found in four unrelated individuals of Hispanic/Latino origin, and a homozygous ∼34 kb deletion affecting exons 3–9 was observed in two families of European ancestry. (Source: The American Journal of Human Genetics)

Reconstructing three-dimensional reentrant cardiac electrical wave dynamics using data assimilation

Wed, 20 Jan 2016 13:51:57 +0100

For many years, reentrant scroll waves have been predicted and studied as an underlying mechanism for cardiac arrhythmias using numerical techniques, and high-resolution mapping studies using fluorescence recordings from the surfaces of cardiac tissue preparations have confirmed the presence of visible spiral waves. However, assessing the three-dimensional dynamics of these reentrant waves using experimental techniques has been limited to verifying stable scroll-wave dynamics in relatively thin preparations. We propose a different approach to recovering the three-dimensional dynamics of reentrant waves in the heart. By applying techniques commonly used in weather forecasting, we combine dual-surface observations from a particular experiment with predictions from a numerical model to recons...

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Choice of Health Options In prevention of Cardiovascular Events for people with Atrial Fibrillation (CHOICE-AF): A pilot study

Wed, 20 Jan 2016 00:00:00 +0100

Conclusions: Participation in the CHOICE-AF pilot study did not improve BMI or waist circumference: however, it was associated with significant improvement in reported symptom severity. Further research is required to determine the most appropriate model of care for addressing risk factor management for people with AF. (Source: European Journal of Cardiovascular Nursing)

Central Sympathetic Inhibition: a Neglected Approach for Treatment of Cardiac Arrhythmias?

Tue, 19 Jan 2016 00:00:00 +0100

Abstract Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Overactivation of the sympathetic nervous system (SNS) plays an important role in the pathogenesis of comorbidities related to AF such as hypertension, congestive heart failure, obesity, insulin resistance, and obstructive sleep apnea. Methods that reduce sympathetic drive, such as centrally acting sympatho-inhibitory agents, have been shown to reduce the incidence of spontaneous or induced atrial arrhythmias, suggesting that neuromodulation may be helpful in controlling AF. Moxonidine acts centrally to reduce activity of the SNS, and clinical trials indicate that this is associated with a decreased AF burden in hypertensive patients with paroxysmal AF and reduced post-ablation recurrence of AF in ...

Fragmentation of the QRS complex in patients with acute coronary syndrome treated invasively.

Mon, 18 Jan 2016 00:00:00 +0100

CONCLUSIONS: In the patients with ACS, who underwent successful revascularization (TIMI=3) the presence of f-QRS is not correlated to a higher incidence of arrhythmias compared to patients without f-QRS in a short-term follow up. PMID: 26779847 [PubMed - as supplied by publisher] (Source: Polish Heart Journal)

Cardiac Arrhythmias and Pacing 2015: A Selection of Topical Issues

Sat, 16 Jan 2016 00:00:00 +0100

Publication date: Available online 15 January 2016 Source:Revista Española de Cardiología (English Edition) Author(s): Rafael Peinado, Francisco Ruiz-Mateas, Maite Izquierdo, Eduardo Arana, Maria Robledo, Miguel Angel Arias, Juan Jiménez-Jáimez, Moisés Rodríguez-Mañero, Javier Chimeno (Source: Revista Espanola de Cardiologia)

Cardioversion in Non-Valvular Atrial Fibrillation.

Fri, 15 Jan 2016 17:10:04 +0100

CONCLUSION: The main risks of cardioversion-thrombo - embolism and clinically significant hemorrhage-occur in 1% of cases or less (in the first 30 days after treatment) if the procedure is carried out as recommended in therapeutic guidelines. Serious complications still occur, but they are rare. PMID: 26763380 [PubMed - in process] (Source: Deutsches Arzteblatt International)

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Different Impacts of Atrial Fibrillation and Cardiac Premature Contractions on the Health-Related Quality of Life in Elderly People: The Yilan Study.

Thu, 14 Jan 2016 23:50:02 +0100

Authors: Hsu NW, Tsao HM, Chen HC, Lo SS, Chen SA, Chou P Abstract Atrial fibrillation (AF) is currently recognized as one of the most common cardiac arrhythmias worldwide, with the increasing prevalence that has been estimated to be as high as 9% among the elderly. Health-related quality of life (HRQoL) has become an important patient-centered health outcome measurement, but the impacts created by AF and other arrhythmias with similar symptoms, such as frequent atrial and ventricular premature contractions (APCs and VPCs, defined as ≥ 3 beats/5 minutes), have not been extensively evaluated. The Yilan Study is a population-based community health survey, which in part aims to evaluate the prevalence and impacts of these arrhythmias on the HRQoL in a community dwelling elderly popu...

Apical hypertrophic cardiomyopathy with hemodynamically unstable ventricular arrhythmia – Atypical presentation

Thu, 14 Jan 2016 00:00:00 +0100

We present a patient with asymptomatic apical hypertrophic cardiomyopathy (AHCM) who recently developed cardiac arrhythmias, and shortly discuss the diagnostic modalities, differential diagnosis, and treatment strategy for this condition. AHCM is a rare form of hypertrophic cardiomyopathy, which usually involves the apex of the left ventricle. AHCM can occur with varied presentations such as chest pain, palpitations, dyspnea, syncope, atrial fibrillation, myocardial infarction, embolic events, ventricular fibrillation, and congestive heart failure. The most peculiar electrocardiogram findings are giant T-waves inversion in the precordial leads with left ventricular (LV) hypertrophy. A transthoracic echocardiogram is the initial diagnostic modality in the evaluation of AHCM and shows hypert...

Arrhythmia and Sudden Death in Hemodialysis Patients: Protocol and Baseline Characteristics of the Monitoring in Dialysis Study.

Wed, 13 Jan 2016 00:00:00 +0100

CONCLUSIONS: Cardiac arrhythmia is an important contributor to cardiovascular morbidity and mortality in dialysis patients, but available technology has previously limited the ability to estimate its true burden and triggers and to define terminal rhythms in sudden death. Use of implantable technology in observational studies raises complex issues but may greatly expand understanding of dialysis physiology. The use of implantable loop recorders in MiD is among the first examples of such a trial, and the results are expected to provide novel insights into the nature of arrhythmia in hemodialysis patients. PMID: 26763255 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

The contribution of pathways initiated via the Gq\11 G-protein family to atrial fibrillation

Tue, 12 Jan 2016 00:00:00 +0100

Publication date: Available online 7 January 2016 Source:Pharmacological Research Author(s): Andrew Tinker, Malcom Finlay, Muriel Nobles, Aaisha Opel Atrial fibrillation is the commonest cardiac arrhythmia and leads to significant clinical morbidity and mortality. It has a complex pathophysiology but is often initiated by atrial ectopic beats and because of atrial remodelling once it occurs it can become established. Thus therapeutic interventions designed to prevent the initial occurrence of the arrhythmia are particularly needed. At the cellular level, these ectopic beats arise because of abnormal calcium release events from the sarcoplasmic reticulum leading to an inward current mediated by the sodium-calcium exchanger. There has been considerable interest in this over the last fe...

Preoperative prediction of potentially preventable morbidity after fast-track hip and knee arthroplasty: a detailed descriptive cohort study

Tue, 12 Jan 2016 00:00:00 +0100

Conclusions Preoperative identification of patients at high risk of preventable ‘medical’, but not ‘surgical’, complications is statistically possible. However, clinical relevance is limited. Future risk indices should differ between ‘medical’ and ‘surgical’ complications, and also consider ‘preventability’ of these. Trial registration number NCT01515670. (Source: BMJ Open)

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Dominant Negative Consequences of a hERG 1b-Specific Mutation Associated with Intrauterine Fetal Death

Mon, 11 Jan 2016 00:00:00 +0100

Publication date: Available online 6 January 2016 Source:Progress in Biophysics and Molecular Biology Author(s): David K. Jones, Fang Liu, Natasha Dombrowski, Sunita Joshi, Gail A. Robertson The human ether-a-go-go related gene (hERG) encodes two subunits, hERG 1a and hERG 1b, that combine in vivo to conduct the rapid delayed rectifier potassium current (IKr). Reduced IKr slows cardiac action potential (AP) repolarization and is an underlying cause of cardiac arrhythmias associated with long QT syndrome (LQTS). Although the physiological importance of hERG 1b has been elucidated, the effects of hERG 1b disease mutations on cardiac IKr and AP behavior have not been described. To explore the disease mechanism of a 1b-specific mutation associated with a case of intrauterine fetal death...

Cardiac arrhythmia alarm from optical interferometric signals during resting or sleeping for early intervention

Mon, 11 Jan 2016 00:00:00 +0100

Publication date: Available online 4 January 2016 Source:Biocybernetics and Biomedical Engineering Author(s): Imre Cikajlo, Sebastijan Šprager, Tatjana Erjavec, Damjan Zazula Diagnostics of cardiac arrhythmias and frequent interventions may contribute to early detection of diseases or even prevent sudden death. Generally electrocardiograph with several on body electrodes at outpatient clinic is applied and the procedure requires a medical expert. We propose cardiac arrhythmia estimation on the basis of heartbeat detection with optical fibers integrated in the bedding. The modified Michelson's interferometer with error detection was used to measure and maximum a-posteriori probability was used to estimate the beat-to-beat intervals. The consistency of heartbeat intervals was examined...

Mechanisms of cardiac arrhythmias

Mon, 11 Jan 2016 00:00:00 +0100

Publication date: Available online 17 December 2015 Source:Journal of Arrhythmia Author(s): Gary Tse Blood circulation is the result of the beating of the heart, which provides the mechanical force to pump oxygenated blood to, and deoxygenated blood away from, the peripheral tissues. This depends critically on the preceding electrical activation. Disruptions in the orderly pattern of this propagating cardiac excitation wave can lead to arrhythmias. Understanding of the mechanisms underlying their generation and maintenance requires knowledge of the ionic contributions to the cardiac action potential, which is discussed in the first part of this review. A brief outline of the different classification systems for arrhythmogenesis is then provided, followed by a detailed discussion for eac...

Denervação simpática renal em pacientes com cardiodesfibrilador implantável e tempestade elétrica

Mon, 11 Jan 2016 00:00:00 +0100

Conclusions In patients with ICDs and electrical storm refractory to optimal medical treatment, renal sympathetic denervation significantly reduced arrhythmia load and, consequently, antitachycardia pacing and shocks. Randomized clinical trials in the context of renal sympathetic denervation to control refractory cardiac arrhythmias are needed to further support these findings. (Source: Revista Brasileira de Cardiologia Invasiva)

Clinical Pearls in Using Antiarrhythmic Drugs in the Outpatient Setting

Mon, 11 Jan 2016 00:00:00 +0100

A role for oral antiarrhythmic drugs (AADs) remains in clinical practice for patients with atrial and ventricular arrhythmias in spite of advances in nonpharmacologic therapy. Pharmacists play a vital role in the appropriate use of AAD dosing, administration, adverse effects, interactions, and monitoring. Pharmacists who are involved in providing care to patients with cardiac arrhythmias must remain updated regarding the efficacy and safety of the most commonly used AADs. This review will address key issues for appropriate initiation and maintenance of commonly selected Vaughan-Williams Class Ic and III agents in the outpatient setting. (Source: Journal of Pharmacy Practice)

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A review on dronedarone: Pharmacological, pharmacodynamic and pharmacokinetic profile

Sat, 09 Jan 2016 00:00:00 +0100

This article briefly highlights the important pharmacological, pharmacodynamic and pharmacokinetic properties of dronedarone. (Source: Journal of Acute Disease)

Ankle-Brachial Index and cardiovascular events in atrial fibrillation. The ARAPACIS Study.

Thu, 07 Jan 2016 00:00:00 +0100

In conclusion, low ABI is useful to predict MI and vascular death in NVAF patients and may independently facilitate cardiovascular risk assessment in NVAF patients. PMID: 26740316 [PubMed - as supplied by publisher] (Source: Thrombosis and Haemostasis)

Effects of probucol on left atrial remodeling in patients with paroxysmal atrial fibrillation

Tue, 05 Jan 2016 00:00:00 +0100

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and increases the risk of stroke and death. An increasing body of evidence indicate the role of inflammation and oxidative stress in the development and perpetuation of AF. Indeed, inflammation and oxidative stress are involved in electrophysiological and structural remodeling of the atria [1–3]. Probucol is a lipid-lowering drug that has potent antioxidant effects. Specifically, it attenuates the production of oxygen free radicals and also acts as a direct superoxide anion scavenger [4]. (Source: International Journal of Cardiology)

Atrial Fibrillation and Arterial Hypertension:

Tue, 05 Jan 2016 00:00:00 +0100

Atrial fibrillation (AF), as it represents the most common sustained cardiac arrhythmia, affects 1%–2% of the general population and up to 15% of people over 80years. High blood pressure, due to its high prevalence in the general population, is by far the most common condition associated with AF, although a variety of diseases, including valvular, coronary heart and metabolic diseases, are held to create the substrate favouring AF. Due to the concomitance of these conditions, it is quite often challenging to dissect the precise role of high blood pressure in triggering/causing AF. (Source: International Journal of Cardiology)

Arrhythmias in 2015: Advances in drug, ablation, and device therapy for cardiac arrhythmias

Mon, 04 Jan 2016 00:00:00 +0100

Nature Reviews Cardiology 13, 67 (2016). doi:10.1038/nrcardio.2015.196 Authors: Laurent Macle & Stanley Nattel Cardiac arrhythmias produce considerable morbidity and mortality, and are challenging to treat. Advances reported in 2015 will help to guide physicians in the use of therapeutic approaches ranging from established pharmaceutical agents through ablation of arrhythmic sources to novel uses of implanted devices for life-threatening bradyarrhythmias and tachyarrhythmias. (Source: Nature Reviews Cardiology)

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The Role of Pharmacogenetics in Atrial Fibrillation Therapeutics: Is Personalized Therapy in Sight?

Fri, 01 Jan 2016 06:00:00 +0100

Abstract: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide requiring therapy. Despite recent advances in catheter-based and surgical therapy, antiarrhythmic drugs (AADs) remain the mainstay of treatment for symptomatic AF. However, response in individual patients is highly variable with over half the patients treated with rhythm control therapy experiencing recurrence of AF within a year. Contemporary AADs used to suppress AF are incompletely and unpredictably effective and associated with significant risks of proarrhythmia and noncardiac toxicities. Furthermore, this “one-size” fits all strategy for selecting antiarrhythmics is based largely on minimizing risk of adverse effects rather than on the likelihood of suppressing AF. The limited success of r...

Etiology of Syncope in Patients Hospitalized With Syncope and Predictors of Mortality and Readmission for Syncope at 17-Month Follow-Up: A Prospective Study

Fri, 01 Jan 2016 06:00:00 +0100

We investigated the etiologies of syncope and risk factors for mortality and rehospitalization for syncope at 17-month follow-up in a prospective study of 242 consecutive patients, mean age 69 years, hospitalized for syncope. The etiologies of syncope included the following: vasovagal syncope in 49 patients (20%), volume depletion in 39 patients (16%), orthostatic hypotension in 13 patients (5%), primary cardiac arrhythmias in 25 patients (10.3%), structural cardiac disease in 6 patients (2%), and drug overdose in 5 patients (2%). The etiology of syncope could not be determined in 84 patients (35%). Of the 242 patients, 6 (2%) were rehospitalized for syncope and 12 (5%) died. Stepwise logistic regression analysis showed that the significant independent prognostic factors for rehospitalizat...

Recent Advances in the Pharmacological Management of Atrial Fibrillation

Fri, 01 Jan 2016 06:00:00 +0100

This article provides an overview of the current pharmacological therapies for the management of AF, with particular emphasis on the emerging agents. (Source: American Journal of Therapeutics)

Syncope: Approaches to Diagnosis and Management

Fri, 01 Jan 2016 06:00:00 +0100

Syncope is defined as a transient loss of consciousness due to cerebral hypoperfusion followed by spontaneous recovery. Common causes of syncope include vasovagal syncope, situational syncope, orthostatic hypotension, carotid sinus hypersensitivity, left- and right-sided obstructive cardiac lesions, and cardiac arrhythmias. History and physical examination often provide valuable clues about the underlying etiology of syncope. Admission decisions in the emergency department can be guided by various risk prediction scores. Evaluation of a patient with syncope involves a large battery of diagnostic tests that include a 12-lead electrocardiogram, Holter monitoring, echocardiogram, tilt table testing, ischemia evaluation, electrophysiologic studies, and other imaging tests. Despite the availabi...

Deletion of Kvβ1.1 subunit leads to electrical and hemodynamic changes causing cardiac hypertrophy in female murine hearts

Fri, 01 Jan 2016 00:00:00 +0100

This article is protected by copyright. All rights reserved (Source: Experimental Physiology)

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