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https://www.readbyqxmd.com/read/28482353/haemodynamic-findings-in-obstructive-hypertrophic-cardiomyopathy-pulsus-bisferiens-and-brockenbrough-braunwald-morrow-sign
#1
Andrea Barison, Annamaria Del Franco, Giancarlo Todiere
: A 55-year-old gentleman with hypertrophic obstructive cardiomyopathy and heart failure symptoms underwent cardiac catheterization, which confirmed a significant pressure drop (60 mmHg) across the left ventricular outflow tract, a double-peaked pulse (pulsus bisferiens) and an absent postextrasystolic potentiation (Brockenbrough-Braunwald-Morrow sign) in the left ventricular outflow tract and the aorta. He was treated with medical therapy optimization and intracardiac defibrillator implantation. Cardiac catheterization may provide characteristic clues not only to diagnose obstructive hypertrophic cardiomyopathy, but also to understand its pathophysiological correlates...
December 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28411139/the-quidam-study-hydroquinidine-therapy-in-the-management-of-brugada-syndrome-patients-at-high-arrhythmic-risk
#2
Antoine Andorin, Jean-Baptiste Gourraud, Jacques Mansourati, Swanny Fouchard, Hervé le Marec, Philippe Maury, Philippe Mabo, Jean-Sylvain Hermida, Jean-Claude Deharo, Beatrice Delasalle, Simon Esnault, Nicolas Sadoul, Jean-Marc Davy, Antoine Leenhardt, Didier Klug, Pascal Defaye, Dominique Babuty, Frédéric Sacher, Vincent Probst
BACKGROUND: Although the implantable cardiac defibrillator (ICD) remains the main therapy in Brugada syndrome (BrS), it does not reduce life-threatening ventricular arrhythmia. Based on pathophysiological mechanisms, hydroquinidine (HQ) has been suggested for the effective prevention of arrhythmia. OBJECTIVE: To provide evidence-based data supporting HQ use to prevent life threatening ventricular arrhythmia in high-risk patients with BrS. METHODS: We performed a prospective multicentre randomised (HQ vs...
April 11, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28373784/left-ventricular-noncompaction-a-rare-form-of-cardiomyopathy-revelation-modes-and-predictors-of-mortality-in-adults-through-23-cases
#3
Iliyasse Asfalou, Sanae Boulaamayl, Maha Raissouni, Najat Mouine, Mohamed Sabry, Jamal Kheyi, Nawal Doghmi, Aatif Benyass
OBJECTIVES: To describe modes of clinical presentation and echocardiographic, angiographic, and rhythmic features, and prognostic characteristics of left ventricular noncompaction cardiomyopathy (LVNC) in North African adults, through one of the first series in Morocco. BACKGROUND: LVNC is a rare congenital disorder, described for the first time by Engberding in 1984. The suspected diagnosis in thromboembolic, hemodynamic, or rhythm events requires both echocardiography and cardiovascular magnetic resonance (CMR)...
April 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28267474/results-of-a-curtailed-randomized-controlled-trial-evaluating-the-efficacy-and-safety-of-azimilide-in-patients-with-implantable-cardioverter-defibrillators-the-shield-2-trial
#4
Victoria M Robinson, David B Bharucha, Kenneth W Mahaffey, Paul Dorian, Peter R Kowey
BACKGROUND: Frequent hospital attendances in patients with implantable cardioverter-defibrillators (ICDs) result in significant morbidity and health care costs. Current drugs to reduce ICD shocks and hospital visits have limited efficacy and considerable toxicity. We evaluated the efficacy and safety of azimilide, a novel oral class III antiarrhythmic, for use in ICD patients. METHODS: A total of 240 patients were enrolled in a prospective, randomized, double-blind, placebo-controlled trial to evaluate the effect of oral azimilide 75 mg daily in ICD patients with previously documented ventricular tachycardia or ventricular fibrillation, and a left ventricular ejection fraction ≤40%...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28098197/dantrolene-versus-amiodarone-for-cardiopulmonary-resuscitation-a-randomized-double-blinded-experimental-study
#5
Thomas Wiesmann, Dennik Freitag, Wolfgang Dersch, Daphne Eschbach, Marc Irqsusi, Thorsten Steinfeldt, Hinnerk Wulf, Carsten Feldmann
Dantrolene was introduced for treatment of malignant hyperthermia. It also has antiarrhythmic properties and may thus be an alternative to amiodarone for the treatment of ventricular fibrillation (VF). Aim of this study was to compare the return of spontaneous circulation (ROSC) with dantrolene and amiodarone in a pig model of cardiac arrest. VF was induced in anesthetized pigs. After 8 min of untreated VF, chest compressions and ventilation were started and one of the drugs (amiodarone 5 mg kg(-1), dantrolene 2...
January 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27996097/prevention-of-cardiac-implantable-electronic-device-infections-single-operator-technique-with-use-of-povidone-iodine-double-gloving-meticulous-aseptic-antiseptic-measures-and-antibiotic-prophylaxis
#6
Antonis S Manolis, Helen Melita
BACKGROUND: Cardiac implantable electronic device (CIED) implantation is complicated by infection still at a worrisome rate of 2-5%. Since early on during device implantation procedures, we have adopted an infection-preventive technique which has hitherto resulted in effective prevention of infections. Herein we present our results of applying this technique by a single operator in a prospective series of 762 consecutive patients undergoing device implantation. METHODS: A meticulous search for and treatment of active, occult, or smoldering infection was undertaken preoperatively...
January 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27881566/association-of-bystander-cardiopulmonary-resuscitation-and-survival-according-to-ambulance-response-times-after-out-of-hospital-cardiac-arrest
#7
Shahzleen Rajan, Mads Wissenberg, Fredrik Folke, Steen Møller Hansen, Thomas A Gerds, Kristian Kragholm, Carolina Malta Hansen, Lena Karlsson, Freddy K Lippert, Lars Køber, Gunnar H Gislason, Christian Torp-Pedersen
BACKGROUND: Bystander-initiated cardiopulmonary resuscitation (CPR) increases patient survival after out-of-hospital cardiac arrest, but it is unknown to what degree bystander CPR remains positively associated with survival with increasing time to potential defibrillation. The main objective was to examine the association of bystander CPR with survival as time to advanced treatment increases. METHODS: We studied 7623 out-of-hospital cardiac arrest patients between 2005 and 2011, identified through the nationwide Danish Cardiac Arrest Registry...
December 20, 2016: Circulation
https://www.readbyqxmd.com/read/27865189/screening-entire-healthcare-system-ecg-database-association-of-deep-terminal-negativity-of-p-wave-in-lead-v1-and-ecg-referral-with-mortality
#8
Allison Junell, Jason Thomas, Lauren Hawkins, Jiri Sklenar, Trevor Feldman, Charles A Henrikson, Larisa G Tereshchenko
BACKGROUND: Each encounter of asymptomatic individuals with the healthcare system presents an opportunity for improvement of cardiovascular disease (CVD) awareness and sudden cardiac death (SCD) risk assessment. ECG sign deep terminal negativity of the P wave in V1 (DTNPV1) was shown to be associated with an increased risk of SCD in the general population. OBJECTIVE: To evaluate association of DTNPV1 with all-cause mortality and newly diagnosed atrial fibrillation (AFib) in the large tertiary healthcare system patient population...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27863358/temporal-trends-and-long-term-follow-up-of-implantable-cardioverter-defibrillator-therapy-for-secondary-prevention-a-15-year-single-centre-experience
#9
Maria Luce Caputo, François Regoli, Giulio Conte, Boris Adjibodou, Stefano Svab, Alessandro Del Bufalo, Tiziano Moccetti, Moreno Curti, Catherine Klersy, Angelo Auricchio
BACKGROUND: The aim of this study was to determine overall and aetiology-related incidence of secondary prevention ICD implantation over the last 15years in Canton Ticino and to assess clinical outcome according to time period of implantation. METHODS AND RESULTS: Consecutive patients treated by implantation of an ICD for secondary prevention from 2000 to 2015 were included in the current study and compared between 5-year cohorts (2000/2004; 2005/2009; 2010/2015)...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27836874/assessment-of-cardiac-resynchronisation-therapy-in-patients-with-wide-qrs-and-non-specific-intraventricular-conduction-delay-rationale-and-design-of-the-multicentre-randomised-nicd-crt-study
#10
Romain Eschalier, Sylvain Ploux, Bruno Pereira, Nicolas Clémenty, Antoine Da Costa, Pascal Defaye, Stéphane Garrigue, Jean-Baptiste Gourraud, Daniel Gras, Benoît Guy-Moyat, Christophe Leclercq, Pierre Mondoly, Pierre Bordachar
INTRODUCTION: Cardiac resynchronisation therapy (CRT) was initially developed to treat patients with left bundle branch block (LBBB). However, many patients with heart failure have a widened QRS but neither left-BBB nor right-BBB; this is called non-specific intraventricular conduction delay (NICD). It is unclear whether CRT is effective in this subgroup of patients. METHODS AND ANALYSIS: The NICD-CRT study is a prospective, double-blind, randomised (1:1), parallel-arm, multicentre trial comparing the effects of CRT in patients with heart failure, a reduced left ventricular ejection fraction (LVEF <35%) and NICD, who have been implanted with a device (CRT-pacemaker or CRT-defibrillator) that has or has not been activated...
November 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27791428/cpr-induced-consciousness-during-out-of-hospital-cardiac-arrest-a-case-report-on-an-emerging-phenomenon
#11
Joshua Pound, P Richard Verbeek, Sheldon Cheskes
BACKGROUND: High quality cardiopulmonary resuscitation (CPR) has produced a relatively new phenomenon of consciousness in patients with vital signs absent. Further research is necessary to produce a viable treatment strategy during and post resuscitation. OBJECTIVE: To provide a case study done by paramedics in the field illustrating the need for sedation in a patient whose presentation was consistent with CPR induced consciousness. Resuscitative challenges are provided as well as potential future treatment options to minimize harm to both patients and prehospital providers...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27749954/short-term-effects-of-high-dose-caffeine-on-cardiac-arrhythmias-in-patients-with-heart-failure-a-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Priccila Zuchinali, Gabriela C Souza, Maurício Pimentel, Diego Chemello, André Zimerman, Vanessa Giaretta, Joyce Salamoni, Bianca Fracasso, Leandro I Zimerman, Luis E Rohde
Importance: The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. Objective: To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Design, Setting, and Participants: Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital...
December 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27716706/double-valve-replacement-in-a-patient-with-implantable-cardioverter-defibrillator-with-severe-left-ventricular-dysfunction
#13
Girish Manjunath, Prakash Rao, Nagendra Prakash, B K Shivaram
Recent data from landmark trials suggest that the indications for cardiac pacing and implantable cardioverter defibrillators (ICDs) are set to expand to include heart failure, sleep-disordered breathing, and possibly routine implantation in patients with myocardial infarction and poor ventricular function.[1] This will inevitably result in more patients with cardiac devices undergoing surgeries. Perioperative electromagnetic interference and their potential effects on ICDs pose considerable challenges to the anesthesiologists...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27521470/use-of-double-sequential-external-defibrillation-for-refractory-ventricular-fibrillation-during-out-of-hospital-cardiac-arrest
#14
Eric Cortez, William Krebs, James Davis, David P Keseg, Ashish R Panchal
INTRODUCTION: Survival from out of hospital cardiac arrest (OHCA) is highest in victims with shockable rhythms when early CPR and rapid defibrillation are provided. However, a subset of individuals present with ventricular fibrillation (VF) that does not respond to defibrillation (refractory VF). One intervention that may be a possible option in refractory VF is double sequential external defibrillation (DSD). The objective of this case series was to describe the outcome of prehospital victims with refractory VF treated with DSD in the out-of-hospital setting...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/27468928/geographic-and-temporal-variation-in-cardiac-implanted-electric-devices-to-treat-heart-failure
#15
Laura A Hatfield, Daniel B Kramer, Rita Volya, Matthew R Reynolds, Sharon-Lise T Normand
BACKGROUND: Cardiac implantable electric devices are commonly used to treat heart failure. Little is known about temporal and geographic variation in use of cardiac resynchronization therapy (CRT) devices in usual care settings. METHODS AND RESULTS: We identified new CRT with pacemaker (CRT-P) or defibrillator generators (CRT-D) implanted between 2008 and 2013 in the United States from a commercial claims database. For each implant, we characterized prior medication use, comorbidities, and geography...
August 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27445024/the-prevalence-of-superior-vena-cava-anomalies-as-detected-in-cardiac-implantable-electronic-device-recipients-at-a-tertiary-cardiology-centre-over-a-12-year-period
#16
Roman Steckiewicz, Dariusz A Kosior, Marek Rosiak, Elżbieta Świętoń, Przemysław Stolarz, Marcin Grabowski
INTRODUCTION: The vast majority of cardiac implantable electronic device (CIED) recipients require transvenous lead insertion, which may be hindered by the presence of venous anomalies. The aim of this study was to determine the prevalence and variations of persistent left superior vena cava (PLSVC) and to conduct subsequent outpatient follow-up in terms of device function and the clinical condition of the recipients using data from CIED placement procedures conducted over a 12-year period...
March 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27411097/clinical-course-after-cardioverter-defibrillator-implantation-chagasic-versus-ischemic-patients
#17
Francisca Tatiana Moreira Pereira, Eduardo Arrais Rocha, Marcelo de Paula Martins Monteiro, Neiberg de Alcantara Lima, Carlos Roberto Martins Rodrigues Sobrinho, Roberto da Justa Pires Neto
BACKGROUND: The outcome of Chagas disease patients after receiving implantable cardioverter defibrillator (ICD) is still controversial. OBJECTIVE: To compare clinical outcomes after ICD implantation in patients with chronic Chagas cardiomyopathy (CCC) and ischemic heart disease (IHD). METHODS: Prospective study of a population of 153 patients receiving ICD (65 with CCC and 88 with IHD). The devices were implanted between 2003 and 2011. Survival rates and event-free survival were compared...
August 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/27301098/an-electrical-hail-mary
#18
David Neubert
Double sequential defibrillation is currently being employed in a number of EMS systems across the United States, including Wake County, N.C.; Fort Worth, Texas; and New Orleans. Even though there isn't a large body of literature surrounding this technique, it's been demonstrated successful in the electrophysiology lab, ED and prehospital settings. Since access to procainamide--another treatment for refractory v fib--is limited, this may be the only available option when faced with a patient who's failed standard ACLS defibrillation and medication administration...
May 2016: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/27077941/double-sequential-external-defibrillation-and-survival-from-out-of-hospital-cardiac-arrest-a-case-report
#19
Martin Johnston, Sheldon Cheskes, Garry Ross, P Richard Verbeek
BACKGROUND: Patients who present in ventricular fibrillation are typically treated with cardiopulmonary resuscitation (CPR), epinephrine, antiarrhythmic medications, and defibrillation. Although these therapies have shown to be effective, some patients remain in a shockable rhythm. Double sequential external defibrillation has been described as a viable option for patients in refractory ventricular fibrillation. OBJECTIVE: To describe the innovative use of two defibrillators used to deliver double sequential external defibrillation by paramedics in a case of refractory ventricular fibrillation resulting in prehospital return of spontaneous circulation and survival to hospital discharge with good neurologic function...
September 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27059887/ixmyelocel-t-for-patients-with-ischaemic-heart-failure-a-prospective-randomised-double-blind-trial
#20
RANDOMIZED CONTROLLED TRIAL
Amit N Patel, Timothy D Henry, Arshed A Quyyumi, Gary L Schaer, R David Anderson, Catalin Toma, Cara East, Ann E Remmers, James Goodrich, Akshay S Desai, David Recker, Anthony DeMaria
BACKGROUND: Ixmyelocel-T is an expanded, multicellular therapy produced from a patient's own bone marrow by selectively expanding two key types of bone marrow mononuclear cells: CD90+ mesenchymal stem cells and CD45+ CD14+ auto-fluorescent+ activated macrophages. Early phase clinical trials suggest that intramyocardial delivery of ixmyelocel-T might improve clinical, functional, symptomatic, and quality-of-life outcomes in patients with heart failure due to ischaemic dilated cardiomyopathy...
June 11, 2016: Lancet
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