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https://www.readbyqxmd.com/read/28220940/pharmacologic-conversion-during-dofetilide-treatment-for-persistent-atrial-fibrillation
#1
Jonathan S Steinberg, Yash Shah, Barbara Szepietowska
BACKGROUND: Dofetilide is a pure IKr blocker and is one of the few drugs specifically studied and approved in the United States for the management of persistent AF. Dofetilide has been noted to have a high rate of pharmacologic conversion during initial dosing in prior smaller studies. The intent of the study was to examine the safety of an inpatient loading strategy, and the incidence and patterns of pharmacologic conversion by dofetilide during the treatment of persistent AF in a large consecutive cohort...
February 21, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28220073/enhanced-late-na-and-ca-currents-as-effective-antiarrhythmic-drug-targets
#2
REVIEW
Hrayr S Karagueuzian, Arash Pezhouman, Marina Angelini, Riccardo Olcese
While recent advances clarified the molecular and cellular modes of action of antiarrhythmic drugs (AADs), their link to suppression of dynamical arrhythmia mechanisms remains only partially understood. The current classifications of AADs (Classes I, III, and IV) rely on blocking peak Na, K and L-type calcium currents (ICa,L), with Class II with dominant beta receptor blocking activity and Class V including drugs with diverse classes of actions. The discovery that the calcium and redox sensor, cardiac Ca/calmodulin-dependent protein kinase II (CaMKII) enhances both the late Na (INa-L) and the late ICa,L in patients at high risk of VT/VF provided a new and a rational AAD target...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28219565/epicardial-implantable-cardioverter-defibrillator-in-a-2-month-old-infant
#3
Koichi Sughimoto, Yuta Tsuchida, Hidenori Hayashi, Shinzo Torii, Tadashi Kitamura, Tetsuya Horai, Kagami Miyaji
We describe the implantation of an implantable cardioverter defibrillator (ICD) in a 2-month-old infant with frequent sustained ventricular tachycardia (VT) refractory to antiarrhythmic agents. An epicardial ICD shock coil lead and pacing leads were placed, as was a cumbersome device console that was stored in a pocket between the left external and internal oblique muscles. These methods were safe and feasible even for such a small infant, and possible adverse events were avoided.
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28217909/successful-use-of-sirolimus-for-refractory-atrial-ectopic-tachycardia-in-a-child-with-cardiac-rhabdomyoma
#4
Sanja Ninic, Marija Kalaba, Bosiljka Jovicic, Vladislav Vukomanovic, Sergej Prijic, Biljana Vucetic, Ruzica Kravljanac, Ana Vujic, Jovan Kosutic
Cardiac rhabdomyomas are common in tuberous sclerosis. We report a child who developed rhabdomyoma related arrhythmia refractory to antiarrhythmic drug therapy. Reversion of the atrial ectopic tachycardia was achieved with mammalian target of rapamycin pathway (mTOR) inhibitor sirolimus. As per our knowledge, this is the first time that sirolimus has been successfully used in this setting.
February 19, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28215479/lessons-from-individualized-cryoballoon-sizing-is-there-a-role-for-the-small-balloon
#5
Stefan Hartl, Uwe Dorwarth, Benedikt Bunz, Michael Wankerl, Ullrich Ebersberger, Ellen Hoffmann, Florian Straube
BACKGROUND: Cryoablation for paroxysmal atrial fibrillation (PAF) is well established. The single-big-balloon strategy has been preferred for pulmonary vein isolation (PVI) using the second generation cryoballoon (CBG2). Individual PV-morphologies raise the question if an individualized anatomic approach using the 23-mm or 28-mm CB is reasonable. METHODS: Consecutive patients were prospectively enrolled in the non-randomized single-center study. Patients were treated with the 28-mm CB, if any PV was >21mm, the 23-mm CB, if all PV were ≤21mm, or both sizes, if PVI was difficult...
February 16, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28215065/application-of-computer-models-on-atrial-fibrillation-research
#6
Michela Masè
Atrial fibrillation (AF) is a multifactorial and multiscale disease, where electrical, structural, anatomical and genetic factors contribute to the emergence of a complex and dynamic macroscopic phenotype. The incomplete understanding of AF mechanisms and the diversity and multiplicity of factors promoting the arrhythmia in humans have hampered the development of effective therapeutic approaches. Computer models and simulation of atrial arrhythmias may represent an unique allied to investigate AF mechanisms and direct therapeutic strategies, being able to merge and provide interpretation for multiscale data from cellular to entire organ scale levels...
February 17, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28203090/exploring-targeted-therapy-of-osteosarcoma-using-proteomics-data
#7
Parunya Chaiyawat, Jongkolnee Settakorn, Apiruk Sangsin, Pimpisa Teeyakasem, Jeerawan Klangjorhor, Aungsumalee Soongkhaw, Dumnoensun Pruksakorn
Despite multimodal therapeutic treatments of osteosarcoma (OS), some patients develop resistance to currently available regimens and eventually end up with recurrent or metastatic outcomes. Many attempts have been made to discover effective drugs for improving outcome; however, due to the heterogeneity of the disease, new therapeutic options have not yet been identified. This study aims to explore potential targeted therapy related to protein profiles of OS. In this review of proteomics studies, we extracted data on differentially expressed proteins (DEPs) from archived literature in PubMed and our in-house repository...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28196179/concomitant-atrial-fibrillation-surgery-for-people-undergoing-cardiac-surgery
#8
Mark D Huffman, S Chris Malaisrie, Kunal N Karmali
Clinical Question: Should patients with preoperative atrial fibrillation who are undergoing cardiac surgery undergo concomitant atrial fibrillation surgery? Bottom Line: There is moderate-quality evidence that concomitant atrial fibrillation surgery approximately doubles the likelihood of freedom from atrial fibrillation, atrial flutter, or atrial tachycardia while not receiving antiarrhythmic medications at least 3 months after the procedure with a small absolute increase in needing a permanent pacemaker...
February 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28195947/alpha-msh-induces-vasodilatation-and-exerts-cardioprotection-via-the-heme-oxygenase-pathway-in-rat-hearts
#9
Miklos Vecsernyes, Miklos Szokol, Mariann Bombicz, Daniel Priksz, Rudolf Gesztelyi, Gabor Aron Fulop, Balazs Varga, Bela Juhasz, David Haines, Arpad Tosaki
Alpha-melanocyte-stimulating hormone (α-MSH) is a protein with known capacity for protection against cardiovascular ischemia-reperfusion (I/R) injury. The present investigation evaluates the capacity of α-MSH to mitigate I/R effects in an isolated working rat heart model and determine the dependency of these alterations on the activity of heme oxygenase-1 (HO-1, hsp-32), a heat shock protein that functions as a major antioxidant defense molecule. Healthy male Sprague-Dawley rats were used for all experiments...
February 13, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28188270/dual-mechanism-for-inhibition-of-inwardly-rectifying-kir2-x-channels-by-quinidine-involving-direct-pore-block-and-pip2-interference
#10
Christoph Koepple, Daniel Scherer, Claudia Seyler, Eberhard Scholz, Dierk Thomas, Hugo A Katus, Edgar Zitron
Class IA antiarrhythmic drug quinidine was one of the first clinically used compounds to terminate atrial fibrillation and acts as multichannel inhibitor with well-documented inhibitory effects on several cardiac potassium channels. In the mammalian heart, heteromeric assembly of Kir2.1-2.3 channels underlies IK1 current. While a low-affinity block of quinidine on Kir2.1 has already been described, a comparative analysis of effects on other Kir2.x channels has not been performed to date. Therefore, we analyzed the effects of quinidine on wild type and mutant Kir2...
February 10, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28183572/cervical-sympathetic-blockade-for-the-management-of-electrical-storm
#11
Rehan Ali, Jeffrey Ciccone, Victor Tseng
A 75-year-old man presented with dizziness and fatigue secondary to ventricular and supraventricular arrhythmias. He underwent an elective ablation but continued to suffer from ventricular tachycardia with cardiovascular instability despite antiarrhythmic therapy with multiple agents. The patient continued to develop episodes of ventricular tachycardia and an episode of ventricular fibrillation. Electrical storm encompasses a situation of cardiac instability which may present as several episodes of ventricular tachycardia or ventricular fibrillation in a short period...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28177694/is-there-a-role-of-inos-activation-in-the-delayed-antiarrhythmic-effect-of-sodium-nitrite
#12
Vivien Demeter-Haludka, László Juhász, Mária Kovács, János Gardi, Ágnes Végh
This study aimed to examine whether inducible nitric oxide synthase (iNOS) plays a role in the delayed antiarrhythmic effect of sodium nitrite. Twenty-one dogs were infused intravenously with sodium nitrite (0.2 µmol/kg/min) for 20 min, either in the absence (<i>n</i>=12) or in the presence of the iNOS inhibitor S-(2-aminoethyl)-isothiourea (AEST; total dose: 2.0 mg/kg;<i> i.v.</i>, <i>n</i>=9). Control dogs (<i>n</i>=12) were given saline. Twenty-four hours later, all the dogs were subjected to a 25 min period occlusion of the left anterior descending (LAD) coronary artery, followed by rapid reperfusion...
November 24, 2016: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28169085/long-term-antiarrhythmic-effects-of-thrombolytic-therapy-in-pulmonary-embolism
#13
Mert İlker Hayıroğlu, Muhammed Keskin, Ahmet Okan Uzun, Ahmet İlker Tekkeşin, Şahin Avşar, Ahmet Öz, Özlem Yıldırımtürk, Barış Güngör, Göksel Çinier, Ahmet Taha Alper
BACKGROUND: The role of thrombolytic therapy in acute pulmonary embolism patients is still controversial considering the occurrence of arrhythmias. Short-term effects of thrombolytics are well-known whereas long-term effects on cardiac electrophysiology have not been reported before. The objective of our study was to assess the arrhythmic differences in pulmonary embolism patients who received thrombolytics followed by anticoagulation or anticoagulation alone. METHODS: Sixty patients who received thrombolytic therapy followed by anticoagulation (group 1) and 60 patients who received anticoagulation alone (group 2) were included in this retrospective, single-centre observational study...
January 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28168639/chemical-cardioversion-of-recent-onset-atrial-fibrillation-in-the-emergency-department-using-vernakalant-hydrochloride-achieves-safe-and-rapid-restoration-of-sinus-rhythm-and-facilitates-same-day-discharge
#14
P Stoneman, P Gilligan, P Mahon, R Sheahan
BACKGROUND: Vernakalant hydrochloride is a rapid-acting antiarrhythmic drug licensed in the EU since 2010 for the conversion of recent-onset atrial fibrillation with proven efficacy and safety when compared with placebo and amiodarone in randomized clinical trials. AIMS: The aim of our study was to determine the feasibility of same day discharge (following 2 h monitoring) from the emergency department after successful cardioversion using vernakalant hydrochloride...
February 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28167219/the-pro-or-antiarrhythmic-actions-of-polyunsaturated-fatty-acids-and-of-cholesterol
#15
REVIEW
R Coronel
In this review, the pro- and anti-arrhythmic effects of a diet rich in fish oil fatty acids and hypercholesterolemia will be discussed in relation to two major mechanisms of arrhythmogenesis (triggered activity and re-entry). Whereas a diet rich in fish oil is pro-arrhythmic in relation to re-entry based arrhythmias (as occur in acute myocardial ischemia) and anti-arrhythmic in relation to triggered activity based arrhythmias (as occur in heart failure), the reverse is true for hypercholesterolemia. Changing the lipid composition of cardiomyocytes likely has powerful pro- or anti-arrhythmic consequences, depending on the mechanism of arrhythmias, and has corresponding therapeutic potential...
February 3, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28167083/ventricular-tachycardia-ablation-clinical-trials
#16
REVIEW
Jackson J Liang, Daniele Muser, Pasquale Santangeli
Catheter ablation is an increasingly used treatment option for patients with ventricular tachycardia (VT) in the setting of structural heart disease. Although there are extensive data from several retrospective studies as well as prospective nonrandomized observational studies, there are limited data from relatively few randomized controlled trials, especially comparing VT ablation with antiarrhythmic drugs. In this review, the authors aim to summarize the major studies examining efficacy of VT ablation in patients with structural heart disease, discuss barriers to enrollment and completion of randomized clinical trials, and propose areas of future research in the field...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167081/premature-ventricular-complex-ablation-in-structural-heart-disease
#17
REVIEW
Rakesh Latchamsetty, Frank Bogun
Frequent premature ventricular complexes (PVCs) in patients with underlying structural heart disease, particular after myocardial infarction, can predict increased mortality. Use of antiarrhythmic medications to suppress PVCs in this setting can result in a further increase in mortality. High PVC burdens in patients with structural heart disease can cause or worsen cardiomyopathy and successful elimination of PVCs with catheter ablation can improve or, in some cases normalize, cardiac function. PVCs may also trigger more malignant ventricular arrhythmias, particularly in patients with previous myocardial infarction, and when identified can be mapped and ablated...
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28161513/the-burden-of-proof-the-current-state-of-atrial-fibrillation-prevention-and-treatment-trials
#18
Rosita Zakeri, David R Van Wagoner, Hugh Calkins, Tom Wong, Heather M Ross, E Kevin Heist, Timothy E Meyer, Peter R Kowey, Robert J Mentz, John G Cleland, Bertram Pitt, Faiez Zannad, Cecilia Linde
Atrial fibrillation (AF) is an age-related arrhythmia of enormous socio-economic significance. In recent years, our understanding of the basic mechanisms that initiate and perpetuate AF has evolved rapidly, catheter ablation of AF has progressed from concept to reality, and recent studies suggest lifestyle modification may help prevent AF recurrence. Emerging developments in genetics, imaging, and informatics also present new opportunities for personalised care. However considerable challenges remain. These include a paucity of studies examining AF prevention, modest efficacy of existing antiarrhythmic therapies, diverse ablation technologies and practice, and limited evidence to guide management in high-risk patients with multiple comorbidities...
February 1, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28159849/close-look-at-the-experiences-of-patients-enrolled-in-a-clinical-trial-of-acupuncture-treatment-for-atrial-fibrillation-in-korea-a-qualitative-study-nested-within-a-randomised-controlled-trial
#19
Seung Min Kathy Lee, Jungtae Leem, Jun Hyeong Park, Kang Hyun Yoon, Jong Shin Woo, Jung Myung Lee, Jin-Bae Kim, Weon Kim, Sanghoon Lee
OBJECTIVE: To explore the experiences of patients with atrial fibrillation (AF) in the context of a prospective, two-parallel-armed, participant-blinded and assessor-blinded sham-controlled randomised trial. DESIGN: A nested qualitative study within an ongoing randomised controlled trial to explore acupuncture's antiarrhythmic effects on drug refractory acupuncture in persistent atrial fibrillation (AF) (ACU-AF trial). PARTICIPANTS: Participants were recruited using purposeful sampling and a maximum variation strategy with regard to treatment allocation (treatment or control) and protocol completion (completion or non-completion)...
February 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28158934/inducibility-of-ventricular-arrhythmia-1-year-following-treatment-with-heavy-ion-irradiation-in-dogs-with-myocardial-infarction
#20
Mari Amino, Koichiro Yoshioka, Yoshiya Furusawa, Sachie Tanaka, Noboru Kawabe, Tadashi Hashida, Teruyo Tsukada, Masako Izumi, Sadaki Inokuchi, Teruhisa Tanabe, Yuji Ikari
BACKGROUND: Targeted external heavy ion irradiation (THIR) of rabbit hearts 2 weeks after myocardial infarction (MI) reduced the vulnerability of fatal ventricular tachyarrhythmias (VT/VF) in association with the increased connexin43 (Cx43). Increased Cx43 was maintained for at least 1 year in normal rabbits, but the long-term antiarrhythmic effects in the MI model are unknown. We investigated the propensity for late potentials and VT/VF inducibility. METHODS: Intracoronary injection of microspheres was performed to induce non-transmural MI in anaesthetized 8 beagles...
February 3, 2017: Pacing and Clinical Electrophysiology: PACE
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