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Electrocardiogram

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https://www.readbyqxmd.com/read/29786964/a-thorough-qt-qtc-study-with-laquinimod-a-novel-immunomodulator-in-development-for-multiple-sclerosis-and-huntington-disease
#1
Ofer Spiegelstein, Dorit Mimrod, Laura Rabinovich, Eli Eyal, Craig Sprenger, Anna Elgart, Emil Samara, Joel Morganroth
In this randomized double-blind study, 4 groups of healthy subjects (50 per arm) participated to evaluate the effect of laquinimod, an oral treatment in development for multiple sclerosis and Huntington disease, on the QTc interval. Subjects received a dose of either 0.6 or 1.2 mg/day laquinimod for 14 days, placebo for 14 days, or 13 days of placebo followed by a dose of 400 mg moxifloxacin on day 14. Continuous 12-lead electrocardiograms were recorded on day -1 (baseline) and days 14 to 17,  and quadruplicate electrocardiograms were extracted at predefined time points...
May 22, 2018: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/29786776/a-framework-for-image-based-modeling-of-acute-myocardial-ischemia-using-intramurally-recorded-extracellular-potentials
#2
Brett M Burton, Kedar K Aras, Wilson W Good, Jess D Tate, Brian Zenger, Rob S MacLeod
The biophysical basis for electrocardiographic evaluation of myocardial ischemia stems from the notion that ischemic tissues develop, with relative uniformity, along the endocardial aspects of the heart. These injured regions of subendocardial tissue give rise to intramural currents that lead to ST segment deflections within electrocardiogram (ECG) recordings. The concept of subendocardial ischemic regions is often used in clinical practice, providing a simple and intuitive description of ischemic injury; however, such a model grossly oversimplifies the presentation of ischemic disease-inadvertently leading to errors in ECG-based diagnoses...
May 21, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29784533/long-qt-syndrome-a-comprehensive-review-of-the-literature-and-current-evidence
#3
REVIEW
Syed Raza Shah, Ki Park
Long QT syndrome (LQT) represents a heterogeneous family of cardiac electrophysiologic disorders characterized by QT prolongation and T-wave abnormalities on the electrocardiogram. It is commonly associated with syncope, however, sudden cardiac death can occur due to torsades de pointes. LQT is a clinical diagnosis and should be suspected in individuals on the basis of clinical presentation, family history and electrocardiogram characteristics. Management is focused on the prevention of syncope and ultimately sudden death...
May 10, 2018: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29784492/electrocardiogram-and-imaging-an-integrated-approach-to-arrhythmogenic-cardiomyopathies
#4
REVIEW
Ketty Savino, Giuseppe Bagliani, Federico Crusco, Margherita Padeletti, Massimo Lombardi
Cardiovascular imaging has radically changed the management of patients with arrhythmogenic cardiomyopathies. This article focuses on the role of echocardiography and MRI in the diagnosis of these structural diseases. Cardiomyopathies with hypertrophic pattern (hypertrophic cardiomyopathy, restrictive cardiomyopathies, amyloidosis, Anderson-Fabry disease, and sarcoidosis), cardiomyopathies with dilated pattern, inflammatory cardiac diseases, and right ventricular arrhythmogenic cardiomyopathy are analyzed. Finally, anatomic predictors of arrhythmias and sudden cardiac death are discussed...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784491/neonatal-and-pediatric-arrhythmias-clinical-and-electrocardiographic-aspects
#5
REVIEW
Fabrizio Drago, Irma Battipaglia, Corrado Di Mambro
Arrhythmias have acquired a specific identity in pediatric cardiology, but for pediatric cardiologists it has always been difficult to recognize and treat them. Changes in anatomy and physiology result in electrocardiogram features that differ from the normal adult pattern and vary according to the age of the child. Sinus arrhythmia, ectopic atrial rhythm, "wandering pacemaker," and junctional rhythm can be normal characteristics in children (15%-25% of healthy children can have these rhythms on the electrocardiogram)...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784490/clinical-approach-to-patients-with-palpitations
#6
REVIEW
Franco Giada, Antonio Raviele
Palpitations are among the most common symptoms that prompt patients to consult a physician. In the diagnostic workup of patients with palpitations, the initial evaluation involves history, physical examination, and 12-lead electrocardiogram. These investigations yield a prognostic stratification of the patients, and a definitive suspected diagnosis of the cause of symptoms in a good proportion of cases. When the initial evaluation results are negative and the patient is suffering from heart disease, or if the palpitations are frequent or poorly tolerated and with a high probability of an arrhythmic origin, ambulatory electrocardiogram monitoring and/or electrophysiological study should be undertaken...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784488/j-wave-syndromes-electrocardiographic-and-clinical-aspects
#7
REVIEW
Silvia G Priori, Carlo Napolitano
Early repolarization, Brugada syndrome, and pathologic J waves have been described for decades, but only recently experimental and clinical data have allowed reconciliation of Brugada and Early Repolarization under the common definition of J-wave syndromes. The concept was derived from studies showing, in both conditions, the presence of transmural dispersion of repolarization, localized conduction abnormalities, and abnormal transition between QRS and ST segment on electrocardiogram. Although several clinical studies have addressed the clinical presentation and epidemiology of J-wave syndromes, relevant knowledge gaps exist...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784487/localization-of-ventricular-arrhythmias-for-catheter-ablation-the-role-of-surface-electrocardiogram
#8
REVIEW
Domenico Giovanni Della Rocca, Carola Gianni, Sanghamitra Mohanty, Chintan Trivedi, Luigi Di Biase, Andrea Natale
The surface ECG is a valuable mapping tool in patients with idiopathic and scar-related ventricular arrhythmias (VAs). A detailed analysis of 12-lead ECG can provide useful information in localizing the VA site of origin. This might help tailoring the ablation strategy to optimize procedural duration, increase the probability of success, and prevent complications. The aim of this article is to review the ECG features of both idiopathic and scar-related VAs and discuss their potential implications for optimizing the ablation strategy...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784486/peculiar-electrocardiographic-aspects-of-wide-qrs-complex-tachycardia-when-differential-diagnosis-is-difficult
#9
REVIEW
Roberto De Ponti, Jacopo Marazzato, Giuseppe Bagliani, Alessandra Tondini, Stefano Donzelli, Luigi Padeletti
Wide complex tachycardia may represent a challenge for correct interpretation of standard electrocardiogram, which is crucial for proper patient management. For this reason, algorithms based on electrocardiographic criteria have been developed to guide interpretation in a step-by-step approach. Despite their greater accuracy, some cases of wide QRS complex tachycardia are a challenge. Some peculiar forms of ventricular tachycardia, and complex supraventricular substrate or particular clinical condition, may originate a challenging electrocardiographic pattern...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784485/p-wave-analysis-in-the-era-of-atrial-fibrillation-ablation
#10
REVIEW
Fabio M Leonelli, Emanuela T Locati, Giuseppe Bagliani, Roberto De Ponti, Luigi Padeletti, Laura Cipolletta, Alessandro Capucci
The common arrhythmia atrial fibrillation (AF) is incompletely understood. The mechanism of initiation and the perpetuation of AF remain speculative. This article summarizes current knowledge of the complex relationship between arrhythmias triggering AF and their long-term effects on atrial tissue, leading to perpetuation of tachycardia. It focuses on the role of the electrocardiogram (ECG) from AF diagnosis to identification of sinus P wave abnormalities predicting future occurrences. The role of ambulatory ECG recordings in managing AF and the use of frequency analysis determining degree of organization and identification of AF triggers are discussed...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784484/advanced-concepts-of-atrioventricular-nodal-electrophysiology-observations-on-the-mechanisms-of-atrioventricular-nodal-reciprocating-tachycardias
#11
REVIEW
Giuseppe Bagliani, Fabio M Leonelli, Roberto De Ponti, Luigi Padeletti
Atrioventricular node reentrant tachycardia (AVNRT) is a supraventricular arrhythmia easily diagnosed by 12-lead electrocardiogram. What is far more challenging, is the understanding of the reentrant circuit in its typical and atypical presentations. The function of the atrioventricular node is still incomplete and this knowledge gap is reflected in the reconstruction of the pathways used by AVNRT in its multiform presentations. This article illustrates the heterogeneous electrocardiographic manifestations of AVNRT...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784482/role-of-surface-electrocardiograms-in-patients-with-cardiac-implantable-electronic-devices
#12
REVIEW
Emanuela T Locati, Giuseppe Bagliani, Alessio Testoni, Maurizio Lunati, Luigi Padeletti
Surface electrocardiograms, both resting 12-lead electrocardiographs and ambulatory electrocardiograph monitoring, play an essential role in establishing indications for cardiac implantable electronic devices (pacemakers, cardiac implantable defibrillators, and cardiac resynchronization therapies), and in the evaluation of patients already implanted. Current devices have prolonged memory capabilities (defined as Holter functions) and remote monitoring functions, to evaluate the electrical properties and the automatic detection of arrhythmias...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784480/atrioventricular-nodal-conduction-disease
#13
REVIEW
Giuseppe Bagliani, Fabio M Leonelli, Roberto De Ponti, Ezio Mesolella, Luigi Padeletti
This article describes the different anatomic structures involved in normal atrioventricular conduction and their pathologic states. It defines their effects on the electrocardiogram, and describes how to localize the level and evaluate the severity of conduction disease by electrocardiographic analysis. It illustrates the relevance of intracavitary recordings in the diagnosis of level of block.
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29784479/sick-sinus-syndrome
#14
REVIEW
Roberto De Ponti, Jacopo Marazzato, Giuseppe Bagliani, Fabio M Leonelli, Luigi Padeletti
The sick sinus syndrome includes symptoms and signs related to sinus node dysfunction. This can be caused by intrinsic abnormal impulse formation and/or propagation from the sinus node or, in some cases, by extrinsic reversible causes. Careful evaluation of symptoms and of the electrocardiogram is of crucial importance, because diagnosis is mainly based on these 2 elements. In some cases, the pathophysiologic mechanism that induces sinus node dysfunction also favors the onset of atrial arrhythmias, which results in a more complex clinical condition, known as "bradycardia-tachycardia syndrome...
June 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29783947/preexcitation-syndrome-experimental-study-on-the-electrocardiogram-of-antegradely-conducting-accessory-pathway
#15
Zhaolong Xu, Renguang Liu, Qinghua Chang, Changjun Li
BACKGROUND: Preexcitation syndrome is characterized by a dominant delta wave on the baseline electrocardiogram (ECG), resulting from the change in QRS initial vector by the accessory pathway (AP). This study is to explore the effect of ventricular preexcitation on the QRS initial, maximal and terminal vector in an experimental rabbit with preexcitation syndrome induced by programmed electrical stimulation. METHODS: Rabbits (n = 10) were randomized for the experimental model of ventricular preexcitation...
May 21, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29782862/evaluation-of-cardiac-arrhythmic-risks-using-a-rabbit-model-of-left-ventricular-systolic-dysfunction
#16
Bianca Hemmeryckx, Yuanbo Feng, Liesbeth Frederix, Marleen Lox, Sander Trenson, Rob Vreeken, Hua Rong Lu, David Gallacher, Yicheng Ni, H Roger Lijnen
Patients with heart disease have a higher risk to develop cardiac arrhythmias, either spontaneously or drug-induced. In this study, we have used a rabbit model of myocardial infarction (MI) with severe left ventricular systolic dysfunction (LVSD) to study potential drug-induced cardiac risks with N-(piperidin-2-ylmethyl)-2,5-bis(2,2,2-trifluoroethoxy)benzamide (flecainide). Upon ligation of the left circumflex arteries, male New Zealand White rabbits developed a large MI and moderate or severe LVSD 7 weeks after surgery, in comparison to SHAM-operated animals...
May 18, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29782639/sudden-cardiac-death-in-athletes-and-the-value-of-cardiovascular-magnetic-resonance
#17
REVIEW
Sophie I Mavrogeni, Flora Bacopoulou, Despoina Apostolaki, George P Chrousos
Sudden cardiac death (SCD) is the non-traumatic death, due to loss of heart function that occurs suddenly and unexpectedly within 6 hours of a previously normal state of health. It is related to intense competitive sports promoting ventricular tachycardia (VT)/ventricular fibrillation (VF) in the presence of underlying abnormal substrate. A serial evaluation of cardiac physiologic changes taking place during training will allow the better understanding of athlete's heart and will facilitate its discrimination from other gray-zone cardiomyopathies...
May 21, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29781518/an-interesting-case-of-wide-qrs-tachycardia-with-right-bundle-branch-block-morphology-what-is-the-mechanism
#18
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Hiren Kevadiya, Ajitkumar Valaparambil
A 30 year old gentleman with no structural heart disease has been evaluated for paroxysmal palpitation with documented regular wide QRS tachycardia that has not responded to IV adenosine. Surface electrocardiogram has not shown any pre-excitation. He has been taken for an EP study after informed consent. Diagnostic catheters were placed at coronary sinus (CS), His bundle region and right ventricle (RV). During catheter manipulation a regular wide QRS tachycardia with right bundle branch block morphology (RBBB) with a tachycardia cycle length (TCL) of 400 ms and normal QRS axis similar to the clinical tachycardia got induced (Fig:1)...
May 21, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29781516/cardiac-autonomic-modulation-and-long-term-use-of-amiodarone-in-patients-with-chronic-chagasic-cardiopathy
#19
Henriette Elana Fortes Silva, Renan Sandoval de Almeida, Danilo Batista Silveira, Maurício Llaguno, Luiz Antônio Pertili Rodrigues Resende, Valdo José Dias da Silva, Dalmo Correia
BACKGROUND: Patients with chronic Chagas cardiopathy (CCC), which may be associated with cardiac arrhythmias, frequently use amiodarone, an anti-arrhythmic drug that, experimentally, appears to modulate the cardiac autonomic function. OBJECTIVE: The present cross-sectional observational study aimed to evaluate autonomic cardiac modulation in patients with CCC undergoing chronic amiodarone therapy. METHODS: Three groups were investigated: Group 1 included patients with CCC not treated with amiodarone (n = 27); Group 2 included patients with CCC with prolonged use (at least 6 months) of amiodarone (n = 16); and Group 3 including non-chagasic control patients (n = 23)...
May 21, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29780109/a-case-of-cardiogenic-shock-due-to-pulseless-electrical-activity-arrest-associated-with-severe-coronary-artery-spasm
#20
Shozo Sueda, Kaori Fujimoto, Yasuhiro Sasaki, Hirokazu Habara, Hiroaki Kohno
A 75-year-old man was admitted to our hospital for follow-up coronary angiography. Just after starting coronary angiography, his electrocardiogram showed ST-segment elevation in the V1-6, I, II, and aVF leads, and he fell into catastrophic cardiogenic shock. His left coronary arteriogram showed proximal total obstruction in the left anterior descending artery and proximal subtotal occlusion in the left circumflex artery. Because pulseless electrical activity arrest was recognized, cardiopulmonary support was started...
May 18, 2018: Internal Medicine
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