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cardiac arrhythmia interpretation

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https://www.readbyqxmd.com/read/29344737/the-125th-anniversary-of-the-his-bundle-discovery
#1
REVIEW
Georg H von Knorre
In 1893, Wilhelm His Jr. was the first to describe the AV (atrioventricular) bundle of the vertebrate heart, which now bears his name. Moreover, prior to the turn of the century, W. His Jr. had proved the function of the AV bundle by transection experiments in animals, and had interpreted Adams Stokes disease as heart block due to pathological changes within the bundle. In this way, he was ahead of his time. While clinical interest was limited to the bundle as the location of an AV block in the first half of the 125 years, it has gained attractiveness since then as a target of diagnostic and therapeutic procedures...
January 17, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29338148/novel-applications-of-bedside-monitoring-to-plumb-patient-hemodynamic-state-and-response-to-therapy
#2
Fabio Guarracino, Pietro Bertini, Michael R Pinsky
Hemodynamic monitoring is essential during the treatment of the critically ill in order to address the hemodynamic alterations and assess the response to treatment. Traditionally classified causes of shock and underlying pathophysiological mechanisms are often neglected by resuscitative strategies included in the guidelines. Most of hemodynamic management focuses on the ability to early recognise patients susceptible to increase cardiac output (CO) and mean arterial pressure (MAP) after a defined fluid challenge by eliciting Starling's law of the heart, and less is known of the ones presenting in shock and not volume responsive...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29282836/geometric-patterns-of-time-delay-plots-from-different-cardiac-rhythms-and-arrhythmias-using-short-term-ekg-signals
#3
Raúl A Borracci, José D Montoya Pulvet, Carlos A Ingino, Mario Fitz Maurice, Alfredo Hirschon Prado, Enrique Dominé
OBJECTIVE: To date, no systematic work has been intended to describe spatio-temporal patterns of cardiac rhythms using only short series of RR intervals, to facilitate visual or computerized-aided identification of EKG motifs for use in clinical practice. The aim of this study was to detect and classify eye-catching geometric patterns of Poincaré time-delay plots from different types of cardiac rhythms and arrhythmias using short-term EKG signals. METHODS: Approximately 150-300 representative, consecutive beats were retrieved from 24-h Holter registers of 100 patients with different heart rhythms...
December 27, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/29274391/electrophysiological-characteristics-and-pharmacological-sensitivity-of-two-lines-of-human-induced-pluripotent-stem-cell-derived-cardiomyocytes-coming-from-two-different-suppliers
#4
Sonia Goineau, Vincent Castagné
Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are increasingly used as preclinical tool for predicting drug-induced QT prolongation and arrhythmias. This study was conducted to assess the electrophysiological characteristics and the pharmacological sensitivity of two commercialized hiPSC-CMs. The baseline electrophysiological characteristics measured with a multi-electrode array (MEA) technology differ between Cor.4U and iCell2: higher beat rate (+32bpm) and shorter field potential duration (FPD, -201ms) for Cor...
December 20, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29250218/excellent-symptom-rhythm-correlation-in-patients-with-palpitations-using-a-novel-smartphone-based-event-recorder
#5
William George Newham, Muzahir Hassan Tayebjee
Background: Definitive diagnosis of arrhythmia relies on "symptom-rhythm correlation" when electrocardiographic (ECG) evidence of the patient's cardiac rhythm is obtained at the time of symptoms. The AliveCor smartphone App and device (AliveCor Inc, California, USA) has recently been introduced as an easy to use cardiac event recorder. The aim of this study was to investigate whether the smartphone based event recorder could be effectively used to achieve symptom rhythm correlation in unselected patients with palpitations...
June 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29172980/high-cost-sarcoidosis-patients-in-the-united-states-patient-characteristics-and-patterns-of-health-care-resource-utilization
#6
J Bradford Rice, Alan White, Andrea Lopez, Winnie W Nelson
BACKGROUND: Sarcoidosis is a multisystem inflammatory disorder characterized by the presence of noncaseating granulomas in involved organs. Prior research has found that sarcoidosis imposes a significant economic burden to U.S. payers. However, the drivers of high health care costs among sarcoidosis patients are unknown. OBJECTIVE: To characterize sarcoidosis patients who were among the top 20% of total health care costs. METHODS: Patients with a first diagnosis of sarcoidosis between January 1, 1998, and March 31, 2015 (index date) were selected from a deidentified privately insured administrative claims database...
December 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29155283/comparative-analysis-of-media-effects-on-human-induced-pluripotent-stem-cell-derived-cardiomyocytes-in-proarrhythmia-risk-assessment
#7
Derek Schocken, Jayna Stohlman, Jose Vicente, Dulciana Chan, Dakshesh Patel, Murali Krishna Matta, Vikram Patel, Mathew Brock, Daniel Millard, James Ross, David G Strauss, Ksenia Blinova
INTRODUCTION: Cardiotoxicity assessment using human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) forms a key component of the Comprehensive in Vitro Proarrhythmia Assay (CiPA). A potentially impactful factor on iPSC-CM testing is the presence of serum in the experimental media. Generally, serum-free media is used to most accurately reproduce "free" drug concentration. However, caution is needed; drug solubility and cardiomyocyte electrophysiology could be affected by media formulation, potentially impacting interpretation of drug-induced effects...
November 16, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29135467/univariate-and-multivariate-conditional-entropy-measures-for-the-characterization-of-short-term-cardiovascular-complexity-under-physiological-stress
#8
Martina Valente, Michal Javorka, Alberto Porta, Vlasta Bari, Jana Krohova, Barbora Czippelova, Zuzana Turianikova, Giandomenico Nollo, Luca Faes
A defining feature of physiological systems under the neuroautonomic regulation is their dynamical complexity. The most common approach to assess physiological complexity from short-term recordings, i.e. to compute the rate of entropy generation of an individual system by means of measures of conditional entropy (CE), does not consider that complexity may change when the investigated system is part of a network of physiological interactions. This study aims at extending the concept of short-term complexity towards the perspective of network physiology, defining multivariate CE measures whereby multiple physiological processes are accounted for in the computation of entropy rates...
November 14, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/29127703/comparison-of-two-highly-automated-ecg-algorithms-for-detection-of-drug-induced-cardiac-ion-channel-block
#9
M Brockway, A A Fossa, J W Mason
FDA investigators recently demonstrated in a crossover study that early (J-Tpeak c) and late (Tpeak -Tend ) repolarization duration can differentiate selective potassium block with a high arrhythmia risk from multichannel block with lower risk in subjects receiving dofetilide, verapamil, quinidine or ranolazine. The purpose of this study was to determine if findings by FDA using their published software algorithm could be corroborated using an alternative software algorithm for the same metrics and to determine if methodological differences resulted in clinically meaningful differences in interpretation...
November 11, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29119744/cardiac-monitoring-and-the-use-of-a-systematic-approach-in-interpreting-electrocardiogram-rhythms
#10
Richard Hatchett
Attaching a patient to a cardiac monitor and obtaining a clear electrocardiogram (ECG) trace may now be considered basic nursing skills. In line with the UK professional standards and code of conduct, healthcare practitioners are required to practise effectively and preserve patients' safety. Therefore, healthcare practitioners undertaking cardiac monitoring are required to have a basic understanding of normal sinus rhythms and some of the common types of cardiac arrhythmia. This will enable prompt recognition of early warning signs of potential and actual clinical conditions, and the timely initiation of treatment...
November 8, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29109195/sleep-apnea-and-cardiovascular-disease-lessons-from-recent-trials-and-need-for-team-science
#11
REVIEW
Luciano F Drager, R Doug McEvoy, Ferran Barbe, Geraldo Lorenzi-Filho, Susan Redline
Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation...
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/29017930/cardiac-magnetic-resonance-imaging-using-wideband-sequences-in-patients-with-nonconditional-cardiac-implanted-electronic-devices
#12
Duc H Do, Vaughn Eyvazian, Aileen J Bayoneta, Peng Hu, J Paul Finn, Jason S Bradfield, Kalyanam Shivkumar, Noel G Boyle
BACKGROUND: Magnetic resonance imaging (MRI) has been performed safely in patients without MRI-conditional cardiac implantable electronic devices (CIEDs), but experience specifically with cardiac magnetic resonance imaging (CMR) is limited in this patient population. OBJECTIVE: Evaluate the safety of CMR in non-MRI-conditional CIEDs and the interpretability of images using wideband sequences. METHODS: We performed 114 consecutive CMR studies in 111 patients (mean age 59 ± 14 years, with 12 pacemakers, 73 implantable cardioverter defibrillators, 29 biventricular defibrillators) using a wideband pulse sequence for late gadolinium enhancement (LGE) imaging...
October 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28964134/extremes-of-fractional-noises-a-model-for-the-timings-of-arrhythmic-heart-beats-in-post-infarction-patients
#13
Annette Witt, Frithjof Ehlers, Stefan Luther
We have analyzed symbol sequences of heart beat annotations obtained from 24-h electrocardiogram recordings of 184 post-infarction patients (from the Cardiac Arrhythmia Suppression Trial database, CAST). In the symbol sequences, each heart beat was coded as an arrhythmic or as a normal beat. The symbol sequences were analyzed with a model-based approach which relies on two-parametric peaks over the threshold (POT) model, interpreting each premature ventricular contraction (PVC) as an extreme event. For the POT model, we explored (i) the Shannon entropy which was estimated in terms of the Lempel-Ziv complexity, (ii) the shape parameter of the Weibull distribution that best fits the PVC return times, and (iii) the strength of long-range correlations quantified by detrended fluctuation analysis (DFA) for the two-dimensional parameter space...
September 2017: Chaos
https://www.readbyqxmd.com/read/28940739/entrainment-mapping-theoretical-considerations-and-practical-implementation
#14
REVIEW
Benjamin Schaeffer, William G Stevenson
Entrainment mapping enables the diagnosis and characterization of reentrant arrhythmias from analysis of the specific interaction between pacing maneuvers and tachycardia. Described 40 years ago, the implementation and interpretation of pacing maneuvers to entrain tachycardias has evolved into an indispensible tool for diagnosis and mapping reentrant cardiac arrhythmias. For complex re-entry pathways entrainment mapping allows determination of the relation of pacing sites to the re-entry circuit and discrimination of relevant re-entry parts from bystander areas...
September 22, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28936235/health-literacy-and-atrial-fibrillation-relevance-and-future-directions-for-patient-centred-care
#15
Konstantinos N Aronis, Brittany Edgar, Wendy Lin, Maria Auxiliadora Parreiras Martins, Michael K Paasche-Orlow, Jared W Magnani
Atrial fibrillation (AF) is a common cardiac arrhythmia with significant clinical outcomes, and is associated with high medical and social costs. AF is complicated for patients because of its specialised terminology, long-term adherence, symptom monitoring, referral to specialty care, array of potential interventions and potential for adversity. Health literacy is a frequently under-recognised, yet fundamental, component towards successful care in AF. Health literacy is defined as the capacity to obtain, process and understand health information, and has had markedly limited study in AF...
2017: European Cardiology
https://www.readbyqxmd.com/read/28840316/clinical-outcomes-associated-with-sarcomere-mutations-in-hypertrophic-cardiomyopathy-a-meta-analysis-on-7675-individuals
#16
Farbod Sedaghat-Hamedani, Elham Kayvanpour, Oguz Firat Tugrul, Alan Lai, Ali Amr, Jan Haas, Tanja Proctor, Philipp Ehlermann, Katrin Jensen, Hugo A Katus, Benjamin Meder
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease, which goes along with increased risk for sudden cardiac death (SCD). Despite the knowledge about the different causal genes, the relationship between individual genotypes and phenotypes is incomplete. METHODS AND RESULTS: We retrieved PubMed/Medline literatures on genotype-phenotype associations in patients with HCM and mutations in MYBPC3, MYH7, TNNT2, and TNNI3. Altogether, 51 studies with 7675 HCM patients were included in our meta-analysis...
August 24, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28838545/general-introduction-classification-and-electrocardiographic-diagnosis-of-cardiac-arrhythmias
#17
REVIEW
Luigi Padeletti, Giuseppe Bagliani
The conduction system includes a primary pacemaker, the internodal tracts, the atrioventricular node, and the His bundle with the right and left branches. In "emergency" conditions, accessory pacemakers may be triggered. The conduction system produces very low-intensity currents; a surface electrocardiogram (ECG) detects only the big myocardial masses. Electrogenetic mechanisms are reduced automaticity and/or impaired conduction at the base of bradycardias. An increased automaticity and/or reentry phenomenon are at the base of ectopic beats and tachycardias...
September 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28797251/the-cardioprotective-and-antiarrhythmic-effects-of-nardostachys-chinensis-in-animal-and-cell-experiments
#18
REVIEW
Min Li, Xue Xu, Xinyu Yang, Joey S W Kwong, Hongcai Shang
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of premature death throughout the world. An estimated 17.5 million people died from CVD in 2012, representing 31% of all global deaths. Nardostachys chinensis (NC), a typical traditional Chinese medicine (TCM), plays a crucial role in the management of patients with CVD, especially for those with cardiac arrhythmia. The purpose of this study was to evaluate the cardioprotective and antiarrhythmic effects of NC in animal and cell experiments...
August 10, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28790152/lamin-a-c-related-cardiac-disease-late-onset-with-a-variable-and-mild-phenotype-in-a-large-cohort-of-patients-with-the-lamin-a-c-p-arg331gln-founder-mutation
#19
Edgar T Hoorntje, Ilse A Bollen, Daniela Q Barge-Schaapveld, Florence H van Tienen, Gerard J Te Meerman, Joeri A Jansweijer, Anthonie J van Essen, Paul G Volders, Alina A Constantinescu, Peter C van den Akker, Karin Y van Spaendonck-Zwarts, Rogier A Oldenburg, Carlo L Marcelis, Jasper J van der Smagt, Eric A Hennekam, Aryan Vink, Marianne Bootsma, Emmelien Aten, Arthur A Wilde, Arthur van den Wijngaard, Jos L Broers, Jan D Jongbloed, Jolanda van der Velden, Maarten P van den Berg, J Peter van Tintelen
BACKGROUND: Interpretation of missense variants can be especially difficult when the variant is also found in control populations. This is what we encountered for the LMNA c.992G>A (p.(Arg331Gln)) variant. Therefore, to evaluate the effect of this variant, we combined an evaluation of clinical data with functional experiments and morphological studies. METHODS AND RESULTS: Clinical data of 23 probands and 35 family members carrying this variant were retrospectively collected...
August 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28743479/integrating-heart-rate-variability-vital-signs-electrocardiogram-and-troponin-to-triage-chest-pain-patients-in-the-ed
#20
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Current triage methods for chest pain patients typically utilize symptoms, electrocardiogram (ECG), and vital sign data, requiring interpretation by dedicated triage clinicians. In contrast, we aimed to create a quickly obtainable model integrating the objective parameters of heart rate variability (HRV), troponin, ECG, and vital signs to improve accuracy and efficiency of triage for chest pain patients in the emergency department (ED). METHODS: Adult patients presenting to the ED with chest pain from September 2010 to July 2015 were conveniently recruited...
July 17, 2017: American Journal of Emergency Medicine
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