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Antiarrhythmics

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https://www.readbyqxmd.com/read/28534025/atrial-fibrillation-dynamics-and-ionic-block-effects-in-six-heterogeneous-human-3d-virtual-atria-with-distinct-repolarization-dynamics
#1
Carlos Sánchez, Alfonso Bueno-Orovio, Esther Pueyo, Blanca Rodríguez
Atrial fibrillation (AF) usually manifests as reentrant circuits propagating through the whole atria creating chaotic activation patterns. Little is yet known about how differences in electrophysiological and ionic properties between patients modulate reentrant patterns in AF. The goal of this study is to quantify how variability in action potential duration (APD) at different stages of repolarization determines AF dynamics and their modulation by ionic block using a set of virtual whole-atria human models...
2017: Frontiers in Bioengineering and Biotechnology
https://www.readbyqxmd.com/read/28523857/arrhythmia-burden-and-related-outcomes-in-eisenmenger-syndrome
#2
Shankar Baskar, Philippa Horne, Samantha Fitzsimmons, Philip R Khoury, Joseph Vettukattill, Koichiro Niwa, Teiji Agaki, Mark Spence, Hisanori Sakazaki, Gruschen Veldtman
BACKGROUND: Patients with Eisenmenger syndrome have a shorter lifespan than the general population. A significant proportion develop arrhythmia and some, sudden death. OBJECTIVE: The aims of this study were to characterize the frequency, type and effects of arrhythmias in adult patients with Eisenmenger's syndrome and to identify risk factors for arrhythmias. METHODS: This retrospective study included patients aged ≥ 18 years of age with Eisenmenger's syndrome from three institutions...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28522677/synergistic-effect-of-dofetilide-and-mexiletine-on-prevention-of-atrial-fibrillation
#3
Guizhi Liu, Xiaolin Xue, Chuanyu Gao, Jiaqi Huang, Datun Qi, Yanzhou Zhang, Jian-Zeng Dong, Chang-Sheng Ma, Gan-Xin Yan
BACKGROUND: Although atrial fibrillation (AF) is the most common abnormal heart rhythm and its prevalence continues to rise, there is a marked paucity of effective and safe antiarrhythmic drugs for AF. This study was done to test whether combined use of dofetilide and mexiletine exhibits not only a synergistic effect on AF suppression but also a safer profile in drug-induced ventricular proarrhythmias. METHODS AND RESULTS: The effects of dofetilide plus mexiletine on atrial effective refractory period (ERP), AF inducibility, QT, and QT-related ventricular arrhythmias were studied using the isolated arterially perfused rabbit atrial and ventricular wedge preparations...
May 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28522367/qrs-t-wave-and-calcium-alternans-in-a-type-i-diabetic-mouse-model-for-spontaneous-post-myocardial-infarction-ventricular-tachycardia-a-mechanism-for-the-antiarrhythmic-effect-of-statins
#4
Hongwei Jin, Charles M Welzig, Mark Aronovitz, Farzad Noubary, Robert Blanton, Bo Wang, Mohammad Rajab, Alfred Albano, Mark S Link, Sami F Noujaim, Ho-Jin Park, Jonas B Galper
BACKGROUND: The incidence of sudden arrhythmic death is markedly increased in diabetics. OBJECTIVE: Develop a mouse model for Post MI VT in the diabetic heart and determine the mechanism of an antiarrhythmic effect of statins. METHODS: EKG transmitters were implanted in wild type (WT), placebo and pravastatin treated Type I diabetic Akita mice, MIs induced by coronary ligation, Ca(2+) transients studied by optical mapping, Ca(2+) transients and sparks in left VM (VM) by the Ionoptix system and confocal microscopy...
May 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28510647/epicardial-cardioverter-defibrillator-implantation-in-a-4-month-old-infant-bridged-to-heart-transplantation
#5
Cristina Carro, Alberto Francesco Cereda, Giuseppe Annoni, Stefano Maria Marianeschi
Implantable cardioverter-defibrillator (ICD) is the gold standard therapy for the prevention of sudden cardiac death. Nevertheless, ICD placement in the paediatric population is still limited because of several technical difficulties. Several implantation techniques have been proposed but experience in infants with very low weight and less than 6 months is very limited. We herein describe a case of a minimally invasive ICD epicardial implantation in a 4-month-old infant weighing 5 kg. A diagnosis of arrhythmic cardiomyopathy with left ventricular non-compaction disease with ventricular tachycardia storms, QT prolongation and Wolff-Parkinson-White pattern was made...
May 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28509703/pathway-for-the-management-of-atrial-fibrillation-and-atrial-flutter
#6
Eyal Herzog, Edgar Argulian, Steven B Levy, Emad F Aziz
Atrial fibrillation (AF) is the most common cardiac rhythm disturbance encountered in clinical practice, and its prevalence is increasing as the population ages. The American College of Cardiology, the American Heart Association, and the European Society of Cardiology established guidelines for the management of patients with AF. Atrial flutter (Afl) is less common and is often associated with or preceded by AF or occurs in an isolated pattern. A major limitation of the currently published guidelines for the management of patients with AF and Afl is their complexity, the fact that official guidelines are published separately for each of these arrhythmias, and that they were published several years ago...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28508055/antiarrhythmics-cure-brain-arrhythmia-the-imperativeness-of-subthalamic-erg-k-channels-in-parkinsonian-discharges
#7
Chen-Syuan Huang, Guan-Hsun Wang, Chun-Hwei Tai, Chun-Chang Hu, Ya-Chin Yang
ERG K(+) channels have long been known to play a crucial role in shaping cardiac action potentials and, thus, appropriate heart rhythms. The functional role of ERG channels in the central nervous system, however, remains elusive. We demonstrated that ERG channels exist in subthalamic neurons and have similar gating characteristics to those in the heart. ERG channels contribute crucially not only to the setting of membrane potential and, consequently, the firing modes, but also to the configuration of burst discharges and, consequently, the firing frequency and automaticity of the subthalamic neurons...
May 2017: Science Advances
https://www.readbyqxmd.com/read/28506710/outcomes-after-repeat-ablation-of-ventricular-tachycardia-in-structural-heart-disease-an-analysis-from-the-international-vt-ablation-center-collaborative-group
#8
Wendy S Tzou, Roderick Tung, David S Frankel, Luigi Di Biase, Pasquale Santangeli, Marmar Vaseghi, T Jared Bunch, J Peter Weiss, Venkatakrishna N Tholakanahalli, Dhanunjaya Lakkireddy, Rama Vunnam, Timm Dickfeld, Nilesh Mathuria, Usha Tedrow, Pasquale Vergara, Kairav Vakil, Shiro Nakahara, J David Burkhardt, William G Stevenson, David J Callans, Paolo Della Bella, Andrea Natale, Kalyanam Shivkumar, Francis E Marchlinski, William H Sauer
BACKGROUND: Data evaluating repeat radiofrequency ablation (>1RFA) of ventricular tachycardia (VT) are limited. OBJECTIVE: The purpose of this study was to determine the safety and outcomes of VT >1RFA in patients with structural heart disease. METHODS: Patients with structural heart disease undergoing VT RFA at 12 centers with data on prior RFA history were included. Characteristics and outcomes were compared between first-time (1RFA) and >1RFA patients...
April 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28506549/impact-of-chronic-obstructive-pulmonary-disease-on-in-hospital-morbidity-and-mortality-in-patients-with-st-segment-elevation-myocardial-infarction-treated-by-primary-percutaneous-coronary-intervention
#9
Răzvan Constantin Șerban, Laszlo Hadadi, Ioana Șuș, Eva Katalin Lakatos, Zoltan Demjen, Alina Scridon
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) presenting with ST-segment elevation myocardial infarction (STEMI) are less likely to beneficiate of primary percutaneous coronary intervention (pPCI), and have poorer prognosis. We aimed to evaluate the impact of COPD on the in-hospital outcomes of pPCI-treated STEMI patients. METHODS: Data were collected from 418 STEMI patients treated by pPCI. Inotropics and diuretics usage, cardiogenic shock, asystole, kidney dysfunction, and left ventricular ejection fraction were used as markers of hemodynamic complications...
May 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28506548/antiarrhythmic-medication-is-superior-to-catheter-ablation-in-suppressing-supraventricular-ectopic-complexes-in-patients-with-atrial-fibrillation
#10
Christina Alhede, Trine K Lauridsen, Arne Johannessen, Ulrik Dixen, Jan S Jensen, Pekka Raatikainen, Gerhard Hindricks, Haakan Walfridsson, Ole Kongstad, Steen Pehrson, Anders Englund, Juha Hartikainen, Peter S Hansen, Jens C Nielsen, Christian Jons
BACKGROUND: Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24months of follow-up...
May 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28501100/comparison-of-direct-current-synchronized-cardioversion-to-ibutilide-guided-catheter-ablation-for-long-term-sinus-rhythm-maintenance-after-isolated-pulmonary-vein-isolation-of-persistent-atrial-fibrillation
#11
Maojing Wang, Qing Zhao, Wei Ding, Shanglang Cai
Use of the antiarrhythmic ibutilide after isolated pulmonary vein isolation (PVI) might distinguish atrial remodeling severity and cases requiring further substrate modification, thereby improving efficacy of persistent atrial fibrillation (AF) treatment. Ninety-six consecutive patients with persistent AF were randomized after PVI to either direct current synchronized cardioversion (DCC group, n = 48) or 1 mg of intravenous ibutilide (ibutilide group, n = 48) followed by no further intervention if AF converted to sinus rhythm (SR) within 30 minutes (ibutilide conversion subgroup) or by complex fractionated atrial electrogram (CFAE) ablation until SR recovery or complete CFAE elimination (ibutilide nonconversion subgroup)...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28497941/antiarrhythmic-effects-of-ranolazine-used-both-alone-for-prevention-of-atrial-fibrillation-and-as-an-add-on-to-intravenous-amiodarone-for-its-pharmacological-cardioversion-a-meta-analysis
#12
Renato DE Vecchis, Carmelina Ariano, Anna Giasi, Carmela Cioppa
BACKGROUND: Recent evidence from relatively small randomized controlled trials would seem to support a useful role of ranolazine for the prevention and treatment of atrial fibrillation (AF). The present study is aimed at providing information about the possible beneficial anti-arrhythmic properties of ranolazine. In particular, the meta-analysis carried out in this study focuses on the application of ranolazine to prophylaxis and treatment of atrial fibrillation. METHODS: Both randomized controlled trials (RCTs) and non randomized observational studies concerning the effects of ranolazine on AF were included in the meta-analysis...
May 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28497050/the-role-of-biologically-active-ingredients-from-natural-drug-treatments-for-arrhythmias-in-different-mechanisms
#13
REVIEW
Jie Li, Dan Hu, Xiaoli Song, Tao Han, Yonghong Gao, Yanwei Xing
Arrhythmia is a disease that is caused by abnormal electrical activity in the heart rate or rhythm. It is the major cause of cardiovascular morbidity and mortality. Although several antiarrhythmic drugs have been used in clinic for decades, their application is often limited by their adverse effects. As a result, natural drugs, which have fewer side effects, are now being used to treat arrhythmias. We searched for all articles on the role of biologically active ingredients from natural drug treatments for arrhythmias in different mechanisms in PubMed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28496937/amiodarone-induced-third-degree-atrioventricular-block-and-extreme-qt-prolongation-generating-torsade-des-pointes-in-paroxysmal-atrial-fibrillation
#14
Orlando Robert Sequeira, Nelson Javier Aquino, Nancy Beatriz Gómez, Laura Beatriz García, Cristina Cáceres, Oscar A Lovera, Osmar Antonio Centurión
Amiodarone is still the most potent antiarrhythmic drug in the prevention of life threatening ventricular arrhythmias and demonstrates a very low incidence of torsade de pointes. An unusual case of an 81-year-old woman who developed serious abnormalities of the conduction system of the heart and torsade des pointes during intravenous infusion of amiodarone for the treatment of paroxysmal atrial fibrillation is described. To the best of our knowledge, this is the first case showing an association of intravenous amiodarone-induced third degree atrioventricular block and extreme QT interval prolongation generating torsade des pointes in a patient with paroxysmal atrial fibrillation who required an implantable cardioverter-defibrillator...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28494969/rate-dependent-role-of-ikur-in-human-atrial-repolarization-and-atrial-fibrillation-maintenance
#15
Martin Aguilar, Jianlin Feng, Edward Vigmond, Philippe Comtois, Stanley Nattel
The atrial-specific ultrarapid delayed rectifier K(+) current (IKur) inactivates slowly but completely at depolarized voltages. The consequences for IKur rate-dependence have not been analyzed in detail and currently available mathematical action-potential (AP) models do not take into account experimentally observed IKur inactivation dynamics. Here, we developed an updated formulation of IKur inactivation that accurately reproduces time-, voltage-, and frequency-dependent inactivation. We then modified the human atrial cardiomyocyte Courtemanche AP model to incorporate realistic IKur inactivation properties...
May 9, 2017: Biophysical Journal
https://www.readbyqxmd.com/read/28494889/influence-of-the-perioperative-administration-of-magnesium-sulfate-on-the-total-dose-of-anesthetics-during-general-anesthesia-a-systematic-review-and-meta-analysis
#16
REVIEW
Laura Rodríguez-Rubio, Eduardo Nava, Julián Solís García Del Pozo, Joaquín Jordán
BACKGROUND: Magnesium sulfate displays numerous characteristics that make it a useful drug in anesthesiology (N-methyl-d-aspartate receptor antagonist, vasodilator, antiarrhythmic, inhibitor of catecholamine release and of acetylcholine in the terminal motor plate). The perioperative use of this drug as an adjuvant capable of decreasing the required dose of anesthetics, has been proposed. OBJECTIVES: To assess the influence of intravenous magnesium sulfate administration during general anesthesia on the overall dose of required anesthetics...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28490617/systemic-inflammation-as-a-novel-qt-prolonging-risk-factor-in-patients-with-torsades-de-pointes
#17
Pietro Enea Lazzerini, Franco Laghi-Pasini, Iacopo Bertolozzi, Gabriella Morozzi, Sauro Lorenzini, Antonella Simpatico, Enrico Selvi, Maria Romana Bacarelli, Francesco Finizola, Francesca Vanni, Deana Lazaro, Ademuyiwa Aromolaran, Nabil El Sherif, Mohamed Boutjdir, Pier Leopoldo Capecchi
OBJECTIVE: Increasing evidence indicates systemic inflammation as a new potential cause of acquired long QT syndrome (LQTS), via cytokine-mediated changes in cardiomyocyte ion channels. Torsade de pointes (TdP) is a life-threatening polymorphic ventricular tachycardia occurring in patients with LQTS, usually when multiple QT-prolonging factors are simultaneously present. Since classical risk factors cannot fully explain TdP events in a number of patients, we hypothesised that systemic inflammation may represent a currently overlooked risk factor contributing to TdP development in the general population...
May 10, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28488108/-ventricular-tachyarrhythmia-as-a-side-effect-of-pharmacotherapy
#18
REVIEW
Thomas Demming, Hendrik Bonnemeier
Ventricular tachyarrhythmia is a severe and life-threatening potential side effect of pharmacotherapy. Substances with proarrhythmic potential belong to various groups of medication. Apart from antiarrhythmic agents, especially antibiotics and psychiatric drugs are worth mentioning owing to their broad application. Interaction with cardiac potassium channels is the most important reason for drug-induced ventricular tachyarrhythmia. Over 20 years of research in animal models and clinical studies have uncovered the underlying mechanisms...
May 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28484842/conventional-mapping-and-ablation-of-focal-ventricular-tachycardias-in-the-healthy-heart
#19
REVIEW
Sonia Busch, Johannes Brachmann, Ahmed Saleh, Mathias Forkmann
Ventricular tachycardias (VT) in the healthy heart, also known as idiopathic VTs, often have a focal origin. Triggered activity due to delayed after-depolarization is the most likely mechanism of focal VTs. Localization of the site of origin of focal VTs is based on activation mapping with or without combination with pace mapping. The characteristic anatomic site of origin of idiopathic VTs is the right and left outflow tract. Other sites include the tricuspid and mitral annulus, the papillary muscles, and Purkinje fibers...
May 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28472842/diterpene-lipo-alkaloids-with-selective-activities-on-cardiac-k-channels
#20
Tivadar Kiss, Botond Borcsa, Péter Orvos, László Tálosi, Judit Hohmann, Dezső Csupor
Aconitum diterpene alkaloids are known for their remarkable toxicity, which is due to their effect on ion channels. Activation of voltage-gated Na(+) channels is the major cause of their cardiotoxicity, however, influence on K(+) channels may also play a role in the overall effect.Here we report the synthesis of a series of lipo-alkaloids, including four new compounds, based on the 14-benzoylaconine structure, which is the core of a vast number of diterpene alkaloids naturally occurring in Aconitum species...
May 4, 2017: Planta Medica
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