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https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#1
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28229310/diagnosis-and-treatment-of-non-24-h-sleep-wake-disorder-in-the-blind
#2
REVIEW
Jonathan S Emens, Charmane I Eastman
Non-24-h sleep-wake disorder (non-24) is a circadian rhythm disorder occurring in 55-70% of totally blind individuals (those lacking conscious light perception) in which the 24-h biological clock (central, hypothalamic, circadian pacemaker) is no longer synchronized, or entrained, to the 24-h day. Instead, the overt rhythms controlled by the biological clock gradually shift progressively earlier or later (free run) in accordance with the clock's near-24-h period, resulting in a recurrent pattern of daytime hypersomnolence and night-time insomnia...
February 22, 2017: Drugs
https://www.readbyqxmd.com/read/28229254/the-impact-of-post-procedural-complications-on-reimbursement-length-of-stay-and-mechanical-ventilation-among-patients-undergoing-transcatheter-aortic-valve-implantation-in-germany
#3
Klaus Kaier, Holger Reinecke, Huseyin Naci, Lutz Frankenstein, Martin Bode, Werner Vach, Philip Hehn, Andreas Zirlik, Manfred Zehender, Jochen Reinöhl
BACKGROUND: The impact of various post-procedural complications after transcatheter aortic valve implantation (TAVI) on resource use and their consequences in the German reimbursement system has still not been properly quantified. METHODS: In a retrospective observational study, we use data from the German DRG statistic on patient characteristics and in-hospital outcomes of all isolated TAVI procedures in 2013 (N = 9147). The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation was analyzed using both unadjusted and risk-adjusted linear and logistic regression analyses...
February 22, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28229109/interaction-between-circadian-rhythms-and-stress
#4
REVIEW
C E Koch, B Leinweber, B C Drengberg, C Blaum, H Oster
Life on earth has adapted to the day-night cycle by evolution of internal, so-called circadian clocks that adjust behavior and physiology to the recurring changes in environmental conditions. In mammals, a master pacemaker located in the suprachiasmatic nucleus (SCN) of the hypothalamus receives environmental light information and synchronizes peripheral tissues and central non-SCN clocks to geophysical time. Regulatory systems such as the hypothalamus-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), both being important for the regulation of stress responses, receive strong circadian input...
February 2017: Neurobiology of Stress
https://www.readbyqxmd.com/read/28228889/application-of-hong-s-technique-for-removal-of-stuck-hemodialysis-tunneled-catheter-to-pacemaker-leads
#5
Chaudhry Adeel Ebad, Stephen Davitt, Ramal Gnanasekaran, Amjad Khan, Anne-Marie Moran
The term "stuck catheter" refers to situations where a central venous catheter cannot be removed from the central veins or right atrium using standard technique, usually due to development of a fibrin sheath leading to adherence to SVC or right atrial wall. Endoluminal dilatation is an interventional radiology technique that has been previously reported in the removal of stuck hemodialysis catheters, and to the best of our knowledge, this case describes the first application of the technique to remove a hemodialysis catheter that was adherent to SVC wall and transvenous pacemaker leads...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228586/modeling-the-diversity-of-spontaneous-and-agonist-induced-electrical-activity-in-anterior-pituitary-corticotrophs
#6
Patrick Allen Fletcher, Hana Zemkova, Stanko S Stojilkovic, Arthur Sherman
Pituitary corticotrophs fire action potentials spontaneously and in response to stimulation with corticotropin-releasing hormone (CRH) and arginine vaspressin (AVP), and such electrical activity is critical for calcium signaling and calcium-dependent adrenocorticotropic hormone (ACTH) secretion. These cells typically fire tall sharp action potentials when spontaneously active, but a variety of other spontaneous patterns have also been reported, including various modes of bursting. There is variability in reports of the fraction of corticotrophs that are electrically active, as well as their patterns of activity, and the sources of this variation are not well understood...
February 22, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28227778/hybrid-automata-models-of-cardiac-ventricular-electrophysiology-for-real-time-computational-applications
#7
Sidharta Andalam, Harshavardhan Ramanna, Avinash Malik, Parthasarathi Roop, Nitish Patel, Mark L Trew, Sidharta Andalam, Harshavardhan Ramanna, Avinash Malik, Parthasarathi Roop, Nitish Patel, Mark L Trew, Nitish Patel, Avinash Malik, Parthasarathi Roop, Harshavardhan Ramanna, Mark L Trew, Sidharta Andalam
Virtual heart models have been proposed for closed loop validation of safety-critical embedded medical devices, such as pacemakers. These models must react in real-time to off-the-shelf medical devices. Real-time performance can be obtained by implementing models in computer hardware, and methods of compiling classes of Hybrid Automata (HA) onto FPGA have been developed. Models of ventricular cardiac cell electrophysiology have been described using HA which capture the complex nonlinear behavior of biological systems...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227158/interventional-placement-of-thin-coil-shaped-implants-powered-wirelessly-for-monitoring-vital-signals-and-controlling-abnormal-activities-by-electro-stimulation
#8
Hidetoshi Ohta, Masanobu Honda, Makoto Takamiya, Hidetoshi Ohta, Masanobu Honda, Makoto Takamiya, Masanobu Honda, Hidetoshi Ohta, Makoto Takamiya
Various types of implants are being commonly used for monitoring vital signals and controlling the critically ill patient's condition such as arrhythmia, sick sinus syndrome, etc. For implanting these medical devices under the skin, surgery is inevitable. These days many patients are more willing to accept interventional therapies that are less invasive, especially inserting a catheter into a blood vessel or endoscopy through a natural orifice. To be able to use interventional therapy for implanting medical devices, they will need to be small enough to fit them through a catheter or the forceps channel of an endoscope...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227090/amplitude-based-beat-detection-for-atrial-fibrillation-in-pacemaker
#9
Seung Hwan Lee, Hyoun Seok Myoung, Chang Hoon Kang, Eue Keun Choi, Kyoung Joung Lee, Seung Hwan Lee, Hyoun Seok Myoung, Chang Hoon Kang, Eue Keun Choi, Kyoung Joung Lee, Chang Hoon Kang, Eue Keun Choi, Seung Hwan Lee, Kyoung Joung Lee, Hyoun Seok Myoung
Bradycardia is defined as a sinus rhythm of less than 60 beats per minute and atrial tachyarrhythmia including atrial fibrillation (AF) is frequently associated with bradycardia. Pacemaker is the only effective treatment for symptomatic bradycardia and automatic mode switching (AMS) function is built in pacemaker to switch mode in the presence of atrial tachyarrhythmia. AMS algorithms consider appropriate mode switching in case of undersensing or oversensing and this consideration makes their onset time and resynchronization time late...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226994/high-dielectric-material-in-mri-numerical-assessment-of-the-reduction-of-the-induced-local-power-on-implanted-cardiac-leads
#10
Eugenio Mattei, Elena Lucano, Federica Censi, Leonardo M Angelone, Giovanni Calcagnini, Eugenio Mattei, Elena Lucano, Federica Censi, Leonardo M Angelone, Giovanni Calcagnini, Eugenio Mattei, Giovanni Calcagnini, Elena Lucano, Leonardo M Angelone, Federica Censi
High dielectric materials (HDM) have been proposed in magnetic resonance imaging (MRI) to increase the signal-to-noise ratio (SNR) of the images acquired while reducing the radiofrequency (RF) absorption in tissue. The aim of this study is to assess the potential merit of using HDM to reduce power induced at the tip of an endocardial lead in patients undergoing MRI. Numerical simulations were performed using a commercial finite-differences time-domain (FDTD) software to model the RF field generated by a birdcage body coil at 64 MHz on a human body model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226895/epoxy-casting-used-as-nonhermetic-encapsulation-technique-for-implantable-electronic-devices
#11
Fabian Boeser, Benjamin G Lang, Thomas Stieglitz, Dennis T T Plachta, Fabian Boeser, Benjamin G Lang, Thomas Stieglitz, Dennis T T Plachta, Benjamin G Lang, Fabian Boeser, Thomas Stieglitz, Dennis T T Plachta
Implantable medical applications experienced a rapid growth since starting in the late 1950s with the first pacemakers. However, there are only two main packaging strategies available to protect the implanted electronics from the body environment. While hermetic packaging oftentimes seems to be more feasible, nonhermetic encapsulation can be an alternative under certain conditions. Previous studies using commercially available USB flash drives (UFD) pointed out the feasibility of using epoxy resins as encapsulant material...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226475/a-telemonitoring-platform-for-the-investigation-of-blood-pressure-profiles-in-pacemaker-patients
#12
G Calcagnini, E Mattei, R Quaglione, E De Ruvo, G Biancalana, G Pavone, A Gargaro, L Calo, F Ammirati, F Censi, G Calcagnini, E Mattei, R Quaglione, E De Ruvo, G Biancalana, G Pavone, A Gargaro, L Calo, F Ammirati, F Censi, A Gargaro, F Ammirati, R Quaglione, L Calo, G Pavone, F Censi, E Mattei, G Calcagnini, E De Ruvo, G Biancalana
Rate responsive pacemakers (PM) use different strategies to adapt the patient paced rate, with the aim of having the best hemodynamic performance in response to internal or external conditions. Closed-loop stimulation (CLS) uses intracardiac impedance as a sensor principle. The evaluation of impact of different pacing modalities and technologies on the blood pressure (BP) profiles is mainly investigated in short-term laboratory settings, mainly due to the need of reliable daily-based BP values. The impact of CLS pacing on systemic blood pressure (BP) has been studied on short term basis, but data on long term effects are scarse...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226464/modulation-of-cardiac-pacemaker-inter-beat-intervals-by-sinoatrial-fibroblasts-a-numerical-study
#13
Ariel Greisas, Sharon Zlochiver, Ariel Greisas, Sharon Zlochiver, Ariel Greisas, Sharon Zlochiver
The potential effect of sinoatrial fibroblasts on beat rate and variability of the cardiac pacemakers is not yet fully understood. Heterocellular coupling formation and fibroblast proliferation during diseased conditions may further signify the impact of those cells on sinoatrial node function. In this study we numerically modeled the impact of varying numbers of fibroblasts that are electrically coupled to a single pacemaker cell on several electrophysiological parameters. We employed cellular kinetics of the rabbit sinoatrial myocyte, and employed a range of potential gap junctional coupling between fibroblasts and myocytes...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225684/assessing-the-risks-associated-with-mri-in-patients-with-a-pacemaker-or-defibrillator
#14
Robert J Russo, Heather S Costa, Patricia D Silva, Jeffrey L Anderson, Aysha Arshad, Robert W W Biederman, Noel G Boyle, Jennifer V Frabizzio, Ulrika Birgersdotter-Green, Steven L Higgins, Rachel Lampert, Christian E Machado, Edward T Martin, Andrew L Rivard, Jason C Rubenstein, Raymond H M Schaerf, Jennifer D Schwartz, Dipan J Shah, Gery F Tomassoni, Gail T Tominaga, Allison E Tonkin, Seth Uretsky, Steven D Wolff
Background The presence of a cardiovascular implantable electronic device has long been a contraindication for the performance of magnetic resonance imaging (MRI). We established a prospective registry to determine the risks associated with MRI at a magnetic field strength of 1.5 tesla for patients who had a pacemaker or implantable cardioverter-defibrillator (ICD) that was "non-MRI-conditional" (i.e., not approved by the Food and Drug Administration for MRI scanning). Methods Patients in the registry were referred for clinically indicated nonthoracic MRI at a field strength of 1...
23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28224629/clinical-performance-of-magnetic-resonance-imaging-conditional-and-non-conditional-cardiac-implantable-electronic-devices
#15
Anand D Shah, Adarsh U Patel, Andrea Knezevic, Michael H Hoskins, David S Hirsh, Faisal M Merchant, Mikhael F El Chami, David B Delurgio, Anshul M Patel, Angel R Leon, Jonathan J Langberg, Michael S Lloyd
OBJECTIVES: This study compared risks associated with magnetic resonance imaging (MRI) in patients with non-MRI conditional and MRI conditional pacing and defibrillator systems with particular attention to clinically actionable outcomes. BACKGROUND: While recipients of new MRI conditional pacemaker and defibrillator systems may undergo MRI scanning with very low risk, safety and regulatory concerns persist regarding such scanning in recipients of non- MRI conditional systems...
February 22, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28224227/-exceptional-pacemaker-complication-in-still-s-disease
#16
Salma Haj Kheder, Thomas Hummel, Heike Majewski, Rafael Jimènez, Alexander Wutzler
CASE REPORT: A 49-year-old man with Still's disease presented with a rash above his pacemaker scar. In 2012, there was a replacement of the generator in which the position was changed from subpectoral to subcutaneous. A revision operation was performed after the local finding became worse, turning from a granuloma to a macula. THERAPY: During surgery, a superficial position of the leads was revealed. Both leads and generator were removed with great effort from the granulation tissue...
February 21, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28220944/magnetic-resonance-examination-of-patients-with-implanted-pacemakers-an-evaluation-of-magnetic-field-gradients-slew-rate
#17
Diego Trevisan, Gloria Miori, Armando Correale, Davide Libralon
Performing safe magnetic resonance imaging of patients with "MR conditional" pacemakers needs to meet some specific restrictions. One of these is related to the slew rate (SR) parameter, defined as the speed of magnetic field gradients rising up to their required strengths. Unfortunately, SR values cannot be easily checked at the tomograph console. The present work provides an accurate evaluation of the maximum SR for a set of widely used clinical MR sequences. The experimental approach is based on indirect measurement of time-varying spatial magnetic field gradients...
February 21, 2017: Bioelectromagnetics
https://www.readbyqxmd.com/read/28219978/a-mutation-in-the-g-protein-gene-gnb2-causes-familial-sinus-node-and-atrioventricular-conduction-dysfunction
#18
Birgit Stallmeyer, Johanna Kuß, Stefan Kotthoff, Sven Zumhagen, Kirsty S Vowinkel, Susanne Rinne, Lina A Matschke, Corinna Friedrich, Ellen Schulze-Bahr, Stephan Rust, Guiscard Seebohm, Niels Decher, Eric Schulze-Bahr
Rationale: Familial sinus node and atrioventricular (AV) conduction dysfunction is a rare disorder that leads to paroxysmal dizziness, fatigue and syncope due to a temporarily or permanent reduced heart rate. To date, only a few genes for familial sinus and/or AV conduction dysfunction are known and the majority of cases remain etiologically unresolved. Objective: We aim to identify the disease gene in a large three-generation family (n=25) with autosomal dominant sinus node dysfunction (SND) and AV block (AVB) and to characterise the mutation-related pathomechanisms in familial SND+AVB...
February 20, 2017: Circulation Research
https://www.readbyqxmd.com/read/28219898/sk4-k-channels-are-therapeutic-targets-for-the-treatment-of-cardiac-arrhythmias
#19
Shiraz Haron-Khun, David Weisbrod, Hanna Bueno, Dor Yadin, Joachim Behar, Asher Peretz, Ofer Binah, Edith Hochhauser, Michael Eldar, Yael Yaniv, Michael Arad, Bernard Attali
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a stress-provoked ventricular arrhythmia, which also manifests sinoatrial node (SAN) dysfunction. We recently showed that SK4 calcium-activated potassium channels are important for automaticity of cardiomyocytes derived from human embryonic stem cells. Here SK4 channels were identified in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from healthy and CPVT2 patients bearing a mutation in calsequestrin 2 (CASQ2-D307H) and in SAN cells from WT and CASQ2-D307H knock-in (KI) mice...
February 20, 2017: EMBO Molecular Medicine
https://www.readbyqxmd.com/read/28219665/comparison-of-hospital-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-diabetes-mellitus-from-the-nationwide-inpatient-sample
#20
Tomo Ando, Emmanuel Akintoye, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, David P Slovut, Theodore Schreiber, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in diabetes mellitus (DM) patients are scarce. We aimed to assess and compare the outcomes of TAVR versus SAVR in DM patients using the Nationwide Inpatient Sample database from 2011 to 2013. A complete case analysis was performed for the multivariate analysis and cases with missing data were excluded. The primary end point was in-patient all-cause mortality and secondary outcomes were perioperative complications...
January 25, 2017: American Journal of Cardiology
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