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https://www.readbyqxmd.com/read/29456381/evaluation-of-teaching-clinical-pharmacology-of-antiarrhythmic-drugs-to-first-year-mbbs-students-through-worksheet-based-small-group-discussion
#1
Ameya A Hasamnis, Aditya Arya
Cardiac arrhythmias are a major cause of morbidity and mortality across the world. Learning the science behind the use of antiarrhythmic drugs is essential for all medical graduates. However, many antiarrhythmic drugs are available, and most of them have complex pharmacodynamic and pharmacokinetic profiles. We tried to improvise our teaching by conducting interactive, worksheet-based, small-group discussion on antiarrhythmic drugs with preclinical students of School of Medicine, Taylor's University, Malaysia...
October 2017: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/29454929/hur-mediated-scn5a-mrna-stability-reduces-arrhythmic-risk-in-heart-failure
#2
Anyu Zhou, An Xie, Tae Yun Kim, Hong Liu, Guangbin Shi, Gyeoung-Jin Kang, Ning Jiang, Man Liu, Euy-Myoung Jeong, Bum-Rak Choi, Samuel C Dudley
BACKGROUND: Downregulated sodium currents in heart failure (HF) has been linked to increased arrhythmic risk. Reduced expression of mRNA stabilizing protein ELAVL1/HuR may be responsible for the downregulation of sodium channel gene SCN5A mRNA. OBJECTIVE: To investigate whether HuR regulates SCN5A mRNA expression and whether manipulation of HuR benefits arrhythmia control in HF. METHODS: Quantitative real-time reverse-transcriptase PCR (qRT-PCR) were used to investigate the expression of SCN5A...
February 15, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29438514/antiarrhythmic-drugs-clinical-use-and-clinical-decision-making-a-consensus-document-from-the-european-heart-rhythm-association-ehra-and-european-society-of-cardiology-esc-working-group-on-cardiovascular-pharmacology-endorsed-by-the-heart-rhythm-society-hrs
#3
Gheorghe-Andrei Dan, Antoni Martinez-Rubio, Stefan Agewall, Giuseppe Boriani, Martin Borggrefe, Fiorenzo Gaita, Isabelle van Gelder, Bulent Gorenek, Juan Carlos Kaski, Keld Kjeldsen, Gregory Y H Lip, Bela Merkely, Ken Okumura, Jonathan P Piccini, Tatjana Potpara, Birgitte Klindt Poulsen, Magdi Saba, Irina Savelieva, Juan L Tamargo, Christian Wolpert
No abstract text is available yet for this article.
February 9, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29435949/a-pharmacokinetic-model-for-amiodarone-in-infants-developed-from-an-opportunistic-sampling-trial-and-published-literature-data
#4
Samantha H Dallefeld, Andrew M Atz, Ram Yogev, Janice E Sullivan, Amira Al-Uzri, Susan R Mendley, Matthew Laughon, Christoph P Hornik, Chiara Melloni, Barrie Harper, Andrew Lewandowski, Jeff Mitchell, Huali Wu, Thomas P Green, Michael Cohen-Wolkowiez
Amiodarone is a first-line antiarrhythmic for life-threatening ventricular fibrillation or ventricular tachycardia in children, yet little is known about its pharmacokinetics (PK) in this population. We developed a population PK (PopPK) model using samples collected via an opportunistic study design of children receiving amiodarone per standard of care supplemented by amiodarone PK data from the literature. Both study data and literature data were predominantly from infants < 2 years old, so our analysis was restricted to this group...
February 12, 2018: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/29425568/time-to-isolation-guided-titration-of-freeze-duration-in-3rd-generation-short-tip-cryoballoon-pulmonary-vein-isolation-comparable-clinical-outcome-and-shorter-procedure-duration
#5
Alexander Pott, Christoph Kraft, Tilman Stephan, Kerstin Petscher, Wolfgang Rottbauer, Tillman Dahme
BACKGROUND: The optimal freeze duration in cryoballoon pulmonary vein isolation (PVI) is unknown. The 3rd generation cryoballoon facilitates observation of the time-to-isolation (TTI) and thereby enables individualized cryoenergy titration. To evaluate the efficacy of an individualized freeze duration we compared the clinical outcome of patients treated with a TTI-guided ablation protocol to the outcome of patients treated with a fixed ablation protocol. METHODS: We compared 100 patients treated with the 3rd generation cryoballoon applying a TTI-based protocol (TTI group) to 100 patients treated by a fixed freeze protocol (fixed group)...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29415993/evaluation-of-autophagy-inducers-in-epithelial-cells-carrying-the-%C3%AE-f508-mutation-of-the-cystic-fibrosis-transmembrane-conductance-regulator-cftr
#6
Shaoyi Zhang, Gautier Stoll, José Manuel Bravo San Pedro, Valentina Sica, Allan Sauvat, Florine Obrist, Oliver Kepp, Yousheng Li, Luigi Maiuri, Naoufal Zamzami, Guido Kroemer
Cystic Fibrosis (CF) due to the ΔF508 mutation of cystic fibrosis transmembrane conductance regulator (CFTR) can be treated with a combination of cysteamine and Epigallocatechin gallate (EGCG). Since ECGC is not a clinically approved drug, we attempted to identify other compounds that might favourably interact with cysteamine to induce autophagy and thus rescuing the function of ΔF508 CFTR as a chloride channel in the plasma membrane. For this, we screened a compound library composed by chemically diverse autophagy inducers for their ability to enhance autophagic flux in the presence of cysteamine...
February 7, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29415597/prediction-of-postnatal-arrhythmia-in-fetuses-with-cardiac-rhabdomyoma
#7
Tetsuya Ide, Takekazu Miyoshi, Shinji Katsuragi, Reiko Neki, Ken-Ichi Kurosaki, Isao Shiraishi, Jun Yoshimatsu, Tomoaki Ikeda
OBJECTIVES: Fetal cardiac rhabdomyomas are rare but well known to be associated with arrhythmia or conduction abnormalities. However, since in utero electrophysiological information is quite limited, it remains unclear which type of rhabdomyoma will develop arrhythmia after birth. The aim of this study is to identify factors that predict postnatal arrhythmia requiring therapy in fetuses with cardiac rhabdomyoma. STUDY DESIGN: A retrospective review of infants prenatally diagnosed with cardiac rhabdomyoma was performed at our tertiary pediatric cardiac center between 1990 and 2016...
February 7, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29409086/-update-ventricular-tachycardia
#8
Alexander Fürnkranz, Hisaki Makimoto
Idiopathic ventricular tachycardia: Frequent monomorphic premature ventricular contractions or non-sustained ventricular tachycardia without underlying structural heart disease is not a rare condition and may cause significant symptoms. A subgroup of patients develops IVT-associated cardiomyopathy. Current ESC guidelines recommend primary catheter ablation in symptomatic patients with right ventricular outflow tract IVT. Catheter ablation is also recommended in symptomatic patients with a left ventricular outflow tract (or other rare) origin, if antiarrhythmic drugs are ineffective or not desired...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29405948/class-ic-antiarrhythmic-agents-in-structural-heart-disease-is-nothing-cast-in-stone
#9
EDITORIAL
Christopher Madias, N A Mark Estes
No abstract text is available yet for this article.
February 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29405947/class-ic-antiarrhythmic-drugs-for-suspected-premature-ventricular-contraction-induced-cardiomyopathy
#10
Matthew C Hyman, Danielle Mustin, Gregory Supple, Robert D Schaller, Pasquale Santangeli, Jeffrey Arkles, David Lin, Daniele Muser, Sanjay Dixit, Saman Nazarian, Andrew E Epstein, David J Callans, Francis E Marchlinski, David S Frankel
BACKGROUND: Class IC antiarrhythmic drugs (IC-AADs) can effectively suppress premature ventricular contractions (PVCs). However, IC-AADs increase mortality in patients with PVCs and left ventricular dysfunction after myocardial infarction. Whether IC-AADs can be safely used to treat premature ventricular contraction-induced cardiomyopathy (PVC-CM) remains to be established. OBJECTIVE: The purpose of this study was to determine the safety and efficacy of IC-AADs in patients suspected of having PVC-CM...
February 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29399883/dna-damage-induced-apoptosis-and-mitogen-activated-protein-kinase-pathway-contribute-to-the-toxicity-of-dronedarone-in-hepatic-cells
#11
Si Chen, Zhen Ren, Dianke Yu, Baitang Ning, Lei Guo
Dronedarone, an antiarrhythmic drug, has been marketed as an alternative to amiodarone. The use of dronedarone has been associated with severe liver injury; however, the mechanisms remain unclear. In this study, the possible mechanisms of dronedarone induced liver toxicity were characterized in HepG2 cells. Dronedarone decreased cells viability and induced apoptosis and DNA damage in a concentration- and time-dependent manner. Pretreatment of the HepG2 cells with apoptosis inhibitors (caspase-3, -8, and -9) or the necrosis inhibitor (Necrox-5), partially, but significantly, reduced the release of lactate dehydrogenase...
February 5, 2018: Environmental and Molecular Mutagenesis
https://www.readbyqxmd.com/read/29390872/the-potassium-channel-blocker-dalfampridine-diminishes-ouabain-induced-arrhythmia-in-isolated-rat-atria
#12
Nahid Ghebleh Zadeh, Gholamhassan Vaezi, Azam Bakhtiarian, Zahra Mousavi, Abdolhossein Shiravi, Vahid Nikoui
The aim of the present experiment was to investigate the possible antiarrhythmic effects of dalfampridine in ouabain-induced arrhythmia in rats. Twenty-four male rats including the control and dalfampridine-incubated (100 µM to 10 mM) ouabain-stimulated (40 µM) groups were used. After induction of anesthesia, the atria were isolated and the time of onset of arrhythmia and asystole were recorded. The contractile force of atria was also measured. Dalfampridine at concentration of 1 mM significantly postponed the onset of arrhythmia and asystole compared to control group (p ≤ ...
February 1, 2018: Archives of Physiology and Biochemistry
https://www.readbyqxmd.com/read/29385569/dronedarone-induced-cardiac-mitochondrial-dysfunction-and-its-mitigation-by-epoxyeicosatrienoic-acids
#13
Aneesh Karkhanis, Jacqueline Wen Hui Leow, Thilo Hagen, Eric Chun Yong Chan
Dronedarone and amiodarone are structurally similar antiarrhythmic drugs. Dronedarone worsens cardiac adverse effects with unknown causes while amiodarone has no cardiac adversity. Dronedarone induces preclinical mitochondrial toxicity in rat liver and exhibits clinical hepatotoxicity. Here, we further investigated the relative potential of the antiarrhythmic drugs in causing mitochondrial injury in cardiomyocytes. Differentiated rat H9c2 cardiomyocytes were treated with dronedarone, amiodarone and their respective metabolites namely N-desbutyldronedarone (NDBD) and N-desethylamiodarone (NDEA)...
January 27, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29385358/catheter-ablation-for-atrial-fibrillation-with-heart-failure
#14
Nassir F Marrouche, Johannes Brachmann, Dietrich Andresen, Jürgen Siebels, Lucas Boersma, Luc Jordaens, Béla Merkely, Evgeny Pokushalov, Prashanthan Sanders, Jochen Proff, Heribert Schunkert, Hildegard Christ, Jürgen Vogt, Dietmar Bänsch
BACKGROUND: Mortality and morbidity are higher among patients with atrial fibrillation and heart failure than among those with heart failure alone. Catheter ablation for atrial fibrillation has been proposed as a means of improving outcomes among patients with heart failure who are otherwise receiving appropriate treatment. METHODS: We randomly assigned patients with symptomatic paroxysmal or persistent atrial fibrillation who did not have a response to antiarrhythmic drugs, had unacceptable side effects, or were unwilling to take these drugs to undergo either catheter ablation (179 patients) or medical therapy (rate or rhythm control) (184 patients) for atrial fibrillation in addition to guidelines-based therapy for heart failure...
February 1, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29377987/antiarrhythmic-effect-of-antazoline-in-experimental-models-of-acquired-short-and-long-qt-syndromes
#15
Christian Ellermann, Magdalena Sterneberg, Simon Kochhäuser, Dirk G Dechering, Michael Fehr, Lars Eckardt, Gerrit Frommeyer
Aims: Antazoline is a first-generation antihistamine with antiarrhythmic properties. This study examines potential electrophysiological effects of antazoline in short-QT-syndrome (SQTS) and long-QT-syndrome (LQTS). Methods and results: Sixty-five rabbit hearts were Langendorff-perfused. Action potential duration at 90% of repolarization (APD90), QT-interval, spatial dispersion (DISP), and effective refractory period (ERP) were measured. The IK, ATP-opener pinacidil (1 µM, n = 14) reduced APD90 (-14 ms, P < 0...
January 25, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29369441/repeat-ablation-or-medical-management-alone-for-recurrent-arrhythmias-after-ablation-of-persistent-atrial-fibrillation
#16
Amr F Barakat, Oussama M Wazni, Walid I Saliba, Edlira Yzeiraj, Ram Amuthan, Karim Abdur Rehman, Khaldoun G Tarakji, Mohamed Bassiouny, Bryan Baranowski, Patrick Tchou, Mandeep Bhargava, Thomas Dresing, Thomas Callahan, Daniel Cantillon, Mohamed Kanj, Mina Chung, Bruce D Lindsay, Ayman A Hussein
INTRODUCTION: Management of persistent atrial fibrillation (PersAF) remains challenging, and many patients are left on medical therapy after a failed first ablation. In patients with recurrent symptomatic arrhythmias after PersAF ablation, we aimed to compare outcomes of repeat ablation and medical therapy versus medical therapy alone. METHODS AND RESULTS: All 682 consecutive patients with recurrent symptomatic arrhythmia after a first ablation for PersAF at our institution (2005-2012) were included...
January 25, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29365077/programmed-electrical-stimulation-guided-encircling-cryoablation-concomitant-to-surgical-ventricular-reconstruction-for-primary-prevention-of-ventricular-arrhythmias
#17
Carine F van Huls van Taxis, Adrianus P Wijnmaalen, Patrick Klein, Olaf M Dekkers, Jerry Braun, Harriette F Verwey, Martin J Schalij, Robert J Klautz, Katja Zeppenfeld
OBJECTIVES: Surgical ventricular reconstruction (SVR) is an effective treatment to improve left ventricular (LV) function in patients with ischaemic heart failure and an LV anterior-apical aneurysm. Ventricular arrhythmia (VA) is an important cause for morbidity and mortality in these patients. Therefore, encircling cryoablation targeting the VA substrate may be required. Programmed electrical stimulation (PES) can identify patients at risk for VA. The objective of this study was to evaluate the incidence and type of VA during long-term follow-up after PES-guided encircling cryoablation concomitant to SVR for primary prevention of VA...
January 22, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29364912/left-atrial-emptying-fraction-predicts-recurrence-of-atrial-fibrillation-after-radiofrequency-catheter-ablation
#18
Chung-Chuan Chou, Hui-Ling Lee, Po-Cheng Chang, Hung-Ta Wo, Ming-Shien Wen, San-Jou Yeh, Fen-Chiung Lin, Yi-Ting Hwang
BACKGROUND: Compared with left atrial (LA) dimension, LA emptying fraction (LAEF) has received less emphasis as a predictor of atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). In addition, patients experiencing post-RFCA AF recurrence may respond to previously ineffective antiarrhythmic drugs (AADs). Classifying these patients into a third RFCA outcome category is recommended. OBJECTIVE: To identify predictors of RFCA outcome classified into three categories, and to build proportional odds logistic regression models for clinical applicability to predict AF recurrence...
2018: PloS One
https://www.readbyqxmd.com/read/29361520/divergent-effect-of-adrenaline-in-human-induced-pluripotent-stem-cell-derived-cardiomyocytes-obtained-from-hypertrophic-cardiomyopathy
#19
Chandra Prajapati, Marisa Ojala, Katriina Aalto-Setälä
Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac disease that affects the heart muscle with diverse clinical outcomes. HCM can cause sudden cardiac death (SCD) during or immediately after mild to rigorous physical work in young patients. However, the mechanism causing SCD as a result of exercise remains unknown, but exercise-induced ventricular arrhythmias are thought to be responsible for this fatal consequence. To understand the disease mechanism behind HCM in a better way, we generated patient-specific induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from HCM patients carrying either the MYBPC3-Gln1061X or TPM1-Asp175Asn mutation...
January 3, 2018: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/29357957/double-sequential-cardioversion-for-refractory-ventricular-tachycardia-a-case-report
#20
Hasan Sheikh, Edward Xie, Emily Austin
Sustained monomorphic ventricular tachycardia (VT) can result in hypoperfusion or devolve into more dangerous rhythms such as ventricular fibrillation. In an unstable patient with VT and a pulse, synchronized cardioversion is the first-line treatment. When the VT is refractory to standard cardioversion, the next step is to add an antiarrhythmic, such as amiodarone, that carries with it the risk of lowering blood pressure in the already hypotensive patient. Here we describe a case of double sequential synchronized cardioversion of a patient with unstable VT refractory to standard direct current cardioversion, resulting in a rapid conversion to sinus rhythm and return to hemodynamic stability...
January 23, 2018: CJEM
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