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Naokata Sumitomo
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is induced by emotions or exercise in patients without organic heart disease and may be polymorphic or bidirectional in nature. The prognosis of CPVT is not good, and therefore prevention of sudden death is of utmost importance. Genetic variants of CPVT include RyR2, CASQ2, CALM2, TRD, and possibly KCNJ2 and ANK2 gene mutations. Hypotheses that suggest the causes of CPVT include weakened binding of FKBP12.6 and RyR2, a store overload-induced Ca(2+) release (SOICR), unzipping of intramolecular domain interactions in RyR2, and molecular and functional abnormalities caused by mutations in the CASQ2 gene...
October 2016: Journal of Arrhythmia
Myoung Jin Ko, Yong Han Kim, Eunsu Kang, Byeong-Cheol Lee, Sujung Lee, Jae-Wook Jung
A 76-year-old man with no notable medical history was scheduled for a robot-assisted radical prostatectomy. After the operation, he was given sugammadex. Two minutes later, ventricular premature contraction bigeminy began, followed by cardiac arrest. Cardiac arrest occurred three times and cardiopulmonary resuscitation was done. The patient recovered after the third cardiopulmonary resuscitation and was transferred to the intensive care unit. Coronary angiography was done on postoperative day 1. The patient was diagnosed with variant angina and discharged uneventfully on postoperative day 8...
October 2016: Korean Journal of Anesthesiology
Enrique Velázquez-Rodríguez, Horacio Rodríguez-Piña, Alex Pacheco-Bouthillier, Marcelo Paz Jiménez-Cruz
BACKGROUND: Typical diagnostic, coved-type 1, Brugada ECG patterns fluctuate spontaneously over time with a high proportion of non-diagnostic ECG patterns. Insulin modulates ion transport mechanisms and causes hyperpolarization of the resting potential. We report our experience with unmasking J-ST changes in response to a dextrose-insulin test. METHODS: Nine patients, mean age 40.5±19.4years (range: 15-65years), presented initially with a non-diagnostic ECG pattern, which was suggestive of Brugada syndrome (group I)...
August 19, 2016: Journal of Electrocardiology
Francisco Contijoch, Srikant Kamesh Iyer, James J Pilla, Paul Yushkevich, Joseph H Gorman, Robert C Gorman, Harold Litt, Yuchi Han, Walter R T Witschey
PURPOSE: Develop self-gated MRI for distinct heartbeat morphologies in subjects with arrhythmias. METHODS: Golden angle radial data was obtained in seven sinus and eight arrhythmias subjects. An image-based cardiac navigator was derived from single-shot images, distinct beat types were identified, and images were reconstructed for repeated morphologies. Image sharpness, contrast, and volume variation were quantified and compared with self-gated MRI. Images were scored for image quality and artifacts...
August 31, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
M A Hieger, K F Maskell, M J Moss, S W Powell, K L Cumpston
Dofetilide is a class III antiarrhythmic used for treating atrial dysrhythmias. Though its adverse effects are well described in routine use, very little is known about dofetilide toxicity in overdose. This is a retrospective case series of consecutive patients reported to our poison center after dofetilide overdose. Twenty-seven cases were included. Seventeen patients were treated at a healthcare facility, and of these, eight were admitted. Twenty-one patients took one extra capsule, four took someone else's medication, one took three extra capsules, and one had a large intentional overdose...
August 26, 2016: Cardiovascular Toxicology
Antonio F Saad, Luis Monsivais, Luis D Pacheco
BACKGROUND: Despite its seldom occurrence, fetal tachycardia can lead to poor fetal outcomes including hydrops and fetal death. Management can be challenging and result in maternal adverse effects secondary to high serum drug levels required to achieve effective transplacental antiarrhythmic drug therapy. CASE: A 33-year-old woman at 33 weeks of gestation with a diagnosis of a fetal sustained superior ventricular tachycardia developed chest pain, shortness of breath, and bigeminy on electrocardiogram secondary to digoxin toxicity despite subtherapeutic serum drug levels...
July 2016: American Journal of Perinatology Reports
Hiro Kawata, Seiko Ohno, Takeshi Aiba, Heima Sakaguchi, Aya Miyazaki, Naokata Sumitomo, Tsukasa Kamakura, Ikutaro Nakajima, Yuko Y Inoue, Koji Miyamoto, Hideo Okamura, Takashi Noda, Kengo Kusano, Shiro Kamakura, Yoshihiro Miyamoto, Isao Shiraishi, Minoru Horie, Wataru Shimizu
BACKGROUND: The long-term prognosis of cardiac ryanodine receptor (RyR2) positive catecholaminergic polymorphic ventricular tachycardia (CPVT) patients after initiation of medical therapy has not been well investigated. This study aimed to assess the recurrence of fatal cardiac event after initiation of medical therapy inRyR2-positive CPVT patients. METHODS AND RESULTS: Thirty-fourRyR2-positive CPVT patients with a history of cardiac events were enrolled. All patients had medical treatment initiated after the first symptom or diagnosis...
August 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Shi Bol, Xiangyong Kong, Xiaozhi Ma, Genxuan Zhang
Based on the ECG-specific BMD 101 integrated circun chip, this study designed a digital ECG sensor. In practical application, users just need to connect the ECG sensor 'o upper computer (such as PC or mobile phone) through USB interface, to realize the functions including display, alarm, saving, transfer etc. After tests, They demonstrate that the sensor can be applied to the detection of arrhythmia, such as bigeminy coupled rhythm, proiosystole etc. Besides, the sensor has various advantages in monitoring an managing the heart health of people out of hospital, including low cost, small volume, usableness, simplicity of operation etc...
January 2016: Zhongguo Yi Liao Qi Xie za Zhi, Chinese Journal of Medical Instrumentation
Francisco Contijoch, Kelly Rogers, Hannah Rears, Mohammed Shahid, Peter Kellman, Joseph Gorman, Robert C Gorman, Paul Yushkevich, Erica S Zado, Gregory E Supple, Francis E Marchlinski, Walter R T Witschey, Yuchi Han
BACKGROUND: Premature ventricular complexes (PVCs) are prevalent in the general population and are sometimes associated with reduced ventricular function. Current echocardiographic and cardiovascular magnetic resonance imaging techniques do not adequately address the effect of PVCs on left ventricular function. METHODS AND RESULTS: Fifteen subjects with a history of frequent PVCs undergoing cardiovascular magnetic resonance imaging had real-time slice volume quantification performed using a 2-dimensional (2D) real-time cardiovascular magnetic resonance imaging technique...
April 2016: Circulation. Arrhythmia and Electrophysiology
Bernardo J Selim, Brian B Koo, Li Qin, Sangchoon Jeon, Christine Won, Nancy S Redeker, Rachel J Lampert, John P Concato, Dawn M Bravata, Jared Ferguson, Kingman Strohl, Adam Bennett, Andrey Zinchuk, Henry K Yaggi
STUDY OBJECTIVES: To determine whether sleep-disordered breathing (SDB) is associated with cardiac arrhythmia in a clinic-based population with multiple cardiovascular comorbidities and severe SDB. METHODS: This was a cross-sectional analysis of 697 veterans who underwent polysomnography for suspected SDB. SDB was categorized according to the apnea-hypopnea index (AHI): none (AHI < 5), mild (5 ≥ AHI < 15), and moderate-severe (AHI ≥ 15). Nocturnal cardiac arrhythmias consisted of: (1) complex ventricular ectopy, (CVE: non-sustained ventricular tachycardia, bigeminy, trigeminy, or quadrigeminy), (2) combined supraventricular tachycardia, (CST: atrial fibrillation or supraventricular tachycardia), (3) intraventricular conduction delay (ICD), (4) tachyarrhythmias (ventricular and supraventricular), and (5) any cardiac arrhythmia...
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Edgar Jaeggi, Annika Öhman
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...
March 2016: Clinics in Perinatology
R K Tripathy, L N Sharma, S Dandapat
Ventricular tachycardia (VT) and ventricular fibrillation (VF) are shockable ventricular cardiac ailments. Detection of VT/VF is one of the important step in both automated external defibrillator (AED) and implantable cardioverter defibrillator (ICD) therapy. In this paper, we propose a new method for detection and classification of shockable ventricular arrhythmia (VT/VF) and non-shockable ventricular arrhythmia (normal sinus rhythm, ventricular bigeminy, ventricular ectopic beats, and ventricular escape rhythm) episodes from Electrocardiogram (ECG) signal...
April 2016: Journal of Medical Systems
Tushar Acharya, Steven Tringali, Manminder Bhullar, Marta Nalbandyan, Vishnu Karthik Ilineni, Enrique Carbajal, Prakash Deedwania
Identification of precursors of atrial fibrillation (AF) may lead to early detection and prevent associated morbidity and mortality. This study aimed to examine the association between frequent atrial premature complexes (APCs) and incidence of AF. For this retrospective cohort study, we analyzed Holter recordings obtained from 2000 to 2010 of 1,357 veterans free of AF at baseline. All pertinent data in electronic medical records were reviewed to ascertain baseline characteristics. Holter groups with frequent (≥100/day) and infrequent (<100/day) APCs were compared for development of new AF over a median follow-up of 7...
December 15, 2015: American Journal of Cardiology
Kobra Haghighi, Tracy J Pritchard, Guan-Sheng Liu, Vivek P Singh, Philip Bidwell, Chi Keung Lam, Elizabeth Vafiadaki, Parthib Das, Jianyong Ma, Swati Kunduri, Despina Sanoudou, Stela Florea, Erica Vanderbilt, Hong-Shang Wang, Jack Rubinstein, Roger J Hajjar, Evangelia G Kranias
A hallmark of human and experimental heart failure is deficient sarcoplasmic reticulum (SR) Ca-uptake reflecting impaired contractile function. This is at least partially attributed to dephosphorylation of phospholamban by increased protein phosphatase 1 (PP1) activity. Indeed inhibition of PP1 by transgenic overexpression or gene-transfer of constitutively active inhibitor-1 improved Ca-cycling, preserved function and decreased fibrosis in small and large animal models of heart failure, suggesting that inhibitor-1 may represent a potential therapeutic target...
December 2015: Journal of Molecular and Cellular Cardiology
Ida S Leren, Jørg Saberniak, Eman Majid, Trine F Haland, Thor Edvardsen, Kristina H Haugaa
BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inheritable cardiac disease predisposing to malignant ventricular arrhythmias. OBJECTIVE: We aimed to explore the incidence and severity of ventricular arrhythmias in patients with CPVT before the initiation of β-blocker treatment, when treated with β1-selective β-blockers, and when treated with nadolol. METHODS: In this study, 34 patients with CPVT were included (mean age 34 ± 19 years; 15 (44%) women; 30 (88%) ryanodine receptor 2 variant positive)...
February 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Yasuaki Tanaka, Dolkun Rahmutula, Srikant Duggirala, Babak Nazer, Qizhi Fang, Jeffrey Olgin, Richard Sievers, Edward P Gerstenfeld
BACKGROUND: Frequent premature ventricular contractions (PVCs) may lead to dilated cardiomyopathy. A leftward shift in the unipolar voltage distribution in patients with cardiomyopathy has also been described and attributed to increased fibrosis. OBJECTIVES: We established a swine model of PVC-induced cardiomyopathy and assessed (1) whether an increase in left ventricular fibrosis occurs and (2) whether increased fibrosis leads to a leftward shift in the unipolar voltage distribution...
February 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Masahiro Mizobuchi, Yoshihisa Enjoji
We describe a case of idiopathic left ventricular outflow ventricular tachycardia. Monomorphic ventricular arrhythmia (VA) with a right bundle branch block morphology and an inferior axis was induced through exercise or isoproterenol infusion. During VA bigeminy, a spiked presystolic potential (PP) preceding the VA with a qrS pattern in the unipolar electrogram was recorded at the aortomitral continuity (AMC). Radiofrequency catheter ablation eliminated the VA despite the persistence of sinus-PP bigeminy. Furthermore, these PP rates were dependent on the preceding sinus rhythm rates...
June 2015: Journal of Arrhythmia
Avi Sabbag, Yechezkel Sidi, Shaye Kivity, Roy Beinart, Michael Glikson, Shlomo Segev, Ilan Goldenberg, Elad Maor
BACKGROUND: Obesity and overweight are strongly associated with cardiovascular morbidity and mortality. However, there are limited data on the association between excess weight and the risk of ectopic ventricular activity. DESIGN AND METHODS: We investigated the association between body mass index (BMI) and the risk for ectopic ventricular activity (defined as multiple ventricular premature beats (≥3), ventricular bigeminy, nonsustained ventricular tachycardia or sustained ventricular tachycardia) during exercise stress testing among 22,516 apparently healthy men and women who attended periodic health screening examinations between the years 2000 and 2014...
March 2016: European Journal of Preventive Cardiology
Olufemi E Ajayi, Olugbenga O Abiodun, Anthony O Akintomide, Rasaaq A Adebayo, Suraj A Ogunyemi, Michael O Balogun, Olaniyi J Bamikole, Adeola O Ajibare, Adesuyi A Ajayi
BACKGROUND: In patients with heart failure, death is often sudden due to life-threatening arrhythmias. This work was carried out to evaluate the pattern of arrhythmias in Nigerians with heart failure. MATERIALS AND METHODS: Thirty subjects with congestive heart failure (CHF), 30 subjects with hypertensive heart disease, and 15 normal subjects with no obvious features of heart disease were evaluated with resting and 24-hour electrocardiographic monitoring and transthoracic echocardiography...
2015: International Journal of General Medicine
Jean B Kassem, Steven E Katz, Ashraf M Mahmoud, Robert H Small, Subha V Raman, Cynthia J Roberts
Ocular pulse amplitude (OPA) is defined as the difference between maximum and minimum intraocular pressure (IOP) during a cardiac cycle. Average values of OPA range from 1 to 4 mmHg. The purpose of this investigation is to determine the source of an irregular IOP waveform with elevated OPA in a 48-year-old male. Ocular pressure waveforms had an unusual shape consistent with early ventricular contraction. With a normal IOP, OPA was 9 mmHg, which is extraordinarily high. The subject was examined by a cardiologist and was determined to be in ventricular bigeminy...
January 2015: Indian Journal of Ophthalmology
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