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Cardiac mapping

Pekka Jakkula, Ville Pettilä, Markus B Skrifvars, Johanna Hästbacka, Pekka Loisa, Marjaana Tiainen, Erika Wilkman, Jussi Toppila, Talvikki Koskue, Stepani Bendel, Thomas Birkelund, Raili Laru-Sompa, Miia Valkonen, Matti Reinikainen
PURPOSE: We aimed to determine the feasibility of targeting low-normal or high-normal mean arterial pressure (MAP) after out-of-hospital cardiac arrest (OHCA) and its effect on markers of neurological injury. METHODS: In the Carbon dioxide, Oxygen and Mean arterial pressure After Cardiac Arrest and REsuscitation (COMACARE) trial, we used a 23 factorial design to randomly assign patients after OHCA and resuscitation to low-normal or high-normal levels of arterial carbon dioxide tension, to normoxia or moderate hyperoxia, and to low-normal or high-normal MAP...
November 15, 2018: Intensive Care Medicine
Antonia E Curtin, Kevin V Burns, Alan J Bank, Theoden I Netoff
We developed an automated approach for QRS complex detection and QRS duration (QRSd) measurement that can effectively analyze multichannel electrocardiograms (MECGs) acquired during abnormal conduction and pacing in heart failure and cardiac resynchronization therapy (CRT) patients to enable the use of MECGs to characterize cardiac activation in such patients. The algorithms use MECGs acquired with a custom 53-electrode investigational body surface mapping system and were validated using previously collected data from 58 CRT patients...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Chris D Cantwell, Yumnah Mohamied, Konstantinos N Tzortzis, Stef Garasto, Charles Houston, Rasheda A Chowdhury, Fu Siong Ng, Anil A Bharath, Nicholas S Peters
We review some of the latest approaches to analysing cardiac electrophysiology data using machine learning and predictive modelling. Cardiac arrhythmias, particularly atrial fibrillation, are a major global healthcare challenge. Treatment is often through catheter ablation, which involves the targeted localised destruction of regions of the myocardium responsible for initiating or perpetuating the arrhythmia. Ablation targets are either anatomically defined, or identified based on their functional properties as determined through the analysis of contact intracardiac electrograms acquired with increasing spatial density by modern electroanatomic mapping systems...
October 18, 2018: Computers in Biology and Medicine
César Paz-Y-Miño, Jaime Guevara-Aguirre, Ariane Paz-Y-Miño, Francesca Velarde, Isaac Armendáriz-Castillo, Verónica Yumiceba, Jesús María Hernández, Juan Luis García, Paola E Leone
BACKGROUND: Ring chromosome 15 has been associated in previous studies with different clinical characteristic such as cardiac problems, digit and musculoskeletal abnormalities, and mental and motor problems among others. Only 97 clinical cases of ring chromosome 15 syndrome have been reported since 1966 and a common phenotype for these patients has not been established. CASE PRESENTATION: The present case report describes a 15-month-old girl from the Amazon region of Ecuador, of Mestizo ancestry, who after cytogenetic tests showed a 46,XX,r(15) karyotype in more than 70% of metaphases observed...
November 16, 2018: Journal of Medical Case Reports
Vasanth Ravikumar, Elizabeth M Annoni, Siva K Mulpuru, Henri Roukoz, Elena G Tolkacheva
Atrial Fibrillation (AF) is most common cardiac arrhythmia. It is associated with increased risk of stroke, heart failure and sudden cardiac death. Catheter ablation is a treatment used to control AF and has had suboptimal success for patients with persistent AF, which is primarily maintained by rotors outside of the pulmonary veins (PV) region. The pivot point (core) of the rotor is considered an efficient target for ablation. Currently available electro-anatomical mapping systems cannot accurately predict the exact location of the pivot point of rotors outside of the PV region, so there is a need for novel approaches to accurately identify and distinguish sites for ablation...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Mohammad Hassan Shariat, Damian P Redfearn
Catheter ablation therapy is an effective approach to treat different arrhythmias. Cardiac conduction velocity (Cv), extracted from intracardiac electrograms, shows the speed and direction of the wavefront propagation at different sites and is an insightful feature to guide ablation therapy. To create a propagation map, a small mapping catheter with a high density of electrodes is usually used to sequentially collect electrograms from different sites in a desired chamber of the heart. The CV and isochrone surface estimations are very challenging during complex arrhythmias such as atrial fibrillation, where multiple wavefronts simultaneously excite different cardiac sites...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Mina Nasr-Esfahani, Majid Mohrekesh, Mojtaba Akbari, S M Reza Soroushmehr, Ebrahim Nasr-Esfahani, Nader Karimi, Shadrokh Samavi, Kayvan Najarian
Medical image analysis, especially segmenting a specific organ, has an important role in developing clinical decision support systems. In cardiac magnetic resonance (MR) imaging, segmenting the left and right ventricles helps physicians diagnose different heart abnormalities. There are challenges for this task, including the intensity and shape similarity between the left ventricle and other organs, inaccurate boundaries, and presence of noise in most of the images. In this paper, we propose an automated method for segmenting the left ventricle in cardiac MR images...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Mark L Trew, Bryan J Caldwell, Bruce H Smaill
The arrangement of cardiac cells into strand and sheet-like structures within the heart wall, confers important electrical properties onto heart tissue. Unraveling cardiomyocyte architecture in both healthy and diseased hearts is fundamental to understanding the mechanisms generating normal rhythm and arrhythmia. We analyzed five extended volume serial image stacks of normal pig left ventricular tissue. Analysis included: (1) reconstruction of original tissue volume and shape with non-linear correction maps; (2) segmentation and higher-order descriptions, areas and orientations of laminar structures through the heart wall; (3)computation of fiber directions; (4) computation of tissue connectivity using a shell filter...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Patricia Rouet-Benzineb, Régine Merval, Evelyne Polidano
We investigated the potential adverse effects of hyperaldosteronism and/or hypoestrogenism on cardiac phenotype, and examined their combined effects in female mice overexpressing cardiac aldosterone synthase (AS). We focused on some signaling cascades challenging defensive responses to adapt and/or to survive in the face of double deleterious stresses, such as Ca2+ -homeostasis, pro/anti-hypertrophic, endoplasmic reticulum stress (ER stress), pro- or anti-apoptotic effectors, and MAP kinase activation, and redox signaling...
November 2018: Physiological Reports
Greg Morley, Scott Bernstein, Laura Kuznekoff, Carolina Vasquez, Phil Saul, Dieter Haemmerich
OBJECTIVE: Cardiac catheter cryoablation is a safer alternative to radiofrequency ablation for arrhythmia treatment, but electrophysiological (EP) effects during and after freezing are not adequately characterized. The goal of this study was to determine transient and permanent temperature induced EP effects, during and after localized tissue freezing. METHODS: Conduction in right (RV) and left ventricles (LV) was studied by optical activation mapping during and after cryoablation in paced, isolated Langendorff-perfused porcine hearts...
November 9, 2018: IEEE Transactions on Bio-medical Engineering
Daniel Gensler, Tim Salinger, Markus Düring, Kristina Lorenz, Roland Jahns, Tobias Wech, Stefan Frantz, Georg Ertl, Peter M Jakob, Peter Nordbeck
PURPOSE: Cardiac T1 mapping has become an increasingly important imaging technique, contributing novel diagnostic options. However, currently utilized methods are often associated with accuracy problems because of heart rate variations and cardiac arrhythmia, limiting their value in clinical routine. This study aimed to introduce an improved arrhythmia-related robust T1 mapping sequence called RT-TRASSI (real-time Triggered RAdial Single-Shot Inversion recovery). METHODS: All measurements were performed on a 3...
November 12, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Jianxin Xue, Chengbo Han, Andrew Jackson, Chen Hu, Huan Yao, Weili Wang, James Hayman, Weijun Chen, Jianyue Jin, Gregory P Kalemkerian, Martha Matuzsak, Struti Jolly, Feng-Ming Spring Kong
BACKGROUND AND PURPOSE: Higher cardiac dose was associated with worse overall survival in the RTOG0617 study. Pericardial effusion (PCE) is a common cardiac complication of thoracic radiation therapy (RT). We investigated whether doses of radiation to the heart and pericardium are associated with PCE and overall survival in patients treated with thoracic radiation for non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: A total of 94 patients with medically inoperable/unresectable NSCLC treated with definitive RT in prospective studies were reviewed for this secondary analysis...
November 8, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Caroline H Roney, John Whitaker, Iain Sim, Louisa O'Neill, Rahul K Mukherjee, Orod Razeghi, Edward J Vigmond, Matthew Wright, Mark D O'Neill, Steven E Williams, Steven A Niederer
BACKGROUND: Cardiac conduction properties exhibit large variability, and affect patient-specific arrhythmia mechanisms. However, it is challenging to clinically measure conduction velocity (CV), anisotropy and fibre direction. Our aim is to develop a technique to estimate conduction anisotropy and fibre direction from clinically available electrical recordings. METHODS: We developed and validated automated algorithms for estimating cardiac CV anisotropy, from any distribution of recording locations on the atrial surface...
November 1, 2018: Computers in Biology and Medicine
Jean-Louis Vincent, Nathan D Nielsen, Nathan I Shapiro, Margaret E Gerbasi, Aaron Grossman, Robin Doroff, Feng Zeng, Paul J Young, James A Russell
BACKGROUND: Maintenance of mean arterial pressure (MAP) at levels sufficient to avoid tissue hypoperfusion is a key tenet in the management of distributive shock. We hypothesized that patients with distributive shock sometimes have a MAP below that typically recommended and that such hypotension is associated with increased mortality. METHODS: In this retrospective analysis of the Medical Information Mart for Intensive Care (MIMIC-III) database from Beth Israel Deaconess Medical Center, Boston, USA, we included all intensive care unit (ICU) admissions between 2001 and 2012 with distributive shock, defined as continuous vasopressor support for ≥ 6 h and no evidence of low cardiac output shock...
November 8, 2018: Annals of Intensive Care
Margarita Gorodezky, Pedro F Ferreira, Sonia Nielles-Vallespin, Peter D Gatehouse, Dudley J Pennell, Andrew D Scott, David N Firmin
PURPOSE: Diffusion tensor cardiovascular magnetic resonance (DT-CMR) has a limited spatial resolution. The purpose of this study was to demonstrate high-resolution DT-CMR using a segmented variable density spiral sequence with correction for motion, off-resonance, and T2*-related blurring. METHODS: A single-shot stimulated echo acquisition mode (STEAM) echo-planar-imaging (EPI) DT-CMR sequence at 2.8 × 2.8 × 8 mm3 and 1.8 × 1.8 × 8 mm3 was compared to a single-shot spiral at 2...
November 8, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Izzy Jayasinghe, Alexander H Clowsley, Oscar de Langen, Sonali S Sali, David J Crossman, Christian Soeller
Remodelling of the membranes and protein clustering patterns during the pathogenesis of cardiomyopathies has renewed the interest in spatial visualisation of these structures in cardiomyocytes. Coincidental emergence of single molecule (super-resolution) imaging and tomographic electron microscopy tools in the last decade have led to a number of new observations on the structural features of the couplons, the primary sites of excitation-contraction coupling in the heart. In particular, super-resolution and tomographic electron micrographs have revised and refined the classical views of the nanoscale geometries of couplons, t-tubules and the organisation of the principal calcium handling proteins in both healthy and failing hearts...
2018: Frontiers in Physiology
Sophie I Mavrogeni, Petros P Sfikakis, George Markousis-Mavrogenis, Vasiliki-Kalliopi Bournia, George Poulos, Loukia Koutsogeorgopoulou, Georgia Karabela, Efthymios Stavropoulos, Gikas Katsifis, Kyriaki Boki, Vasiliki Vartela, Genovefa Kolovou, George Theodorakis, George D Kitas
BACKGROUND: Ventricular tachycardia/fibrillation (VT/VF) may occur in autoimmune rheumatic diseases (ARDs). We hypothesized that cardiovascular magnetic resonance (CMR) can identify arrhythmogenic substrates in ARD patients. PATIENTS - METHODS: Using a 1.5 T system, we evaluated 61 consecutive patients with various types of ARDs and normal left ventricular ejection fraction (LVEF) on echocardiography. A comparison of patients with recent VT/VF and those that never experienced VT/VF was performed...
October 25, 2018: International Journal of Cardiology
Thomas M Roston, Omid Haji-Ghassemi, Martin J LaPage, Anjan S Batra, Yaniv Bar-Cohen, Chris Anderson, Yung R Lau, Kathleen Maginot, Roman A Gebauer, Susan P Etheridge, James E Potts, Filip Van Petegem, Shubhayan Sanatani
BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is often a life-threatening arrhythmia disorder with variable penetrance and expressivity. Little is known about the incidence or outcomes of CPVT patients with ≥2 variants. METHODS: The phenotypes, genotypes and outcomes of patients in the Pediatric and Congenital Electrophysiology Society CPVT Registry with ≥2 variants in genes linked to CPVT were ascertained. The American College of Medical Genetics & Genomics (ACMG) criteria and structural mapping were used to predict the pathogenicity of variants (3D model of pig RyR2 in open-state)...
2018: PloS One
Giacomo Tarroni, Ozan Oktay, Wenjia Bai, Andreas Schuh, Hideaki Suzuki, Jonathan Passerat-Palmbach, Antonio de Marvao, Declan P O'Regan, Stuart Cook, Ben Glocker, Paul M Matthews, Daniel Rueckert
The effectiveness of a cardiovascular magnetic resonance (CMR) scan depends on the ability of the operator to correctly tune the acquisition parameters to the subject being scanned and on the potential occurrence of imaging artefacts such as cardiac and respiratory motion. In the clinical practice, a quality control step is performed by visual assessment of the acquired images: however, this procedure is strongly operatordependent, cumbersome and sometimes incompatible with the time constraints in clinical settings and large-scale studies...
November 1, 2018: IEEE Transactions on Medical Imaging
Cedric Klein, Julie Brunereau, Dominique Lacroix, Sandro Ninni, François Brigadeau, Didier Klug, Benjamin Longere, David Montaigne, François Pontana, Augustin Coisne
OBJECTIVE: To evaluate whether the epicardial adipose tissue (EAT) phenotype is associated with the electrophysiological properties of adjacent atrial myocardium in patients with atrial fibrillation (AF). METHODS: Between January and May 2017, 30 consecutive patients referred for a first AF catheter ablation were prospectively included. For each patient, a pre-procedural computed tomography scan was performed to assess total and left atrial (LA) EAT amount and radiodensity...
November 6, 2018: European Radiology
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