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https://www.readbyqxmd.com/read/29672845/drug-induced-proarrhythmia-and-torsade-de-pointes-a-primer-for-students-and-practitioners-of-medicine-and-pharmacy
#1
REVIEW
J Rick Turner, Ignacio Rodriguez, Emily Mantovani, Gary Gintant, Peter R Kowey, Ralph J Klotzbaugh, Krishna Prasad, Philip T Sager, Norman Stockbridge, Colette Strnadova
Multiple marketing withdrawals due to proarrhythmic concerns occurred in the United States, Canada, and the United Kingdom in the late 1980s to early 2000s. This primer reviews the clinical implications of a drug's identified proarrhythmic liability, the issues associated with these safety-related withdrawals, and the actions taken by the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) and by regulatory agencies in terms of changing drug development practices and introducing new nonclinical and clinical tests to asses proarrhythmic liability...
April 19, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29650119/assessing-the-malignant-ventricular-arrhythmic-substrate-in-patients-with-brugada-syndrome
#2
Carlo Pappone, Giuseppe Ciconte, Francesco Manguso, Gabriele Vicedomini, Valerio Mecarocci, Manuel Conti, Luigi Giannelli, Paolo Pozzi, Valeria Borrelli, Lorenzo Menicanti, Zarko Calovic, Giuseppe Della Ratta, Josep Brugada, Vincenzo Santinelli
BACKGROUND: Guidelines recommend the use of implanted cardioverter-defibrillators in patients with Brugada syndrome and induced ventricular tachyarrhythmias, but there is no evidence supporting it. OBJECTIVES: This prospective registry study was designed to explore clinical and electrophysiological predictors of malignant ventricular tachyarrhythmia inducibility in Brugada syndrome. METHODS: A total of 191 consecutive selected patients with (group 1; n = 88) and without (group 2; n = 103) Brugada syndrome-related symptoms were prospectively enrolled in the registry...
April 17, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29624640/why-we-prefer-levetiracetam-over-phenytoin-for-treatment-of-status-epilepticus
#3
G Zaccara, F S Giorgi, A Amantini, G Giannasi, R Campostrini, F Giovannelli, M Paganini, P Nazerian
Over last fifty years, intravenous (iv) phenytoin (PHT) loading dose has been the treatment of choice for patients with benzodiazepine-resistant convulsive status epilepticus and several guidelines recommended this treatment regimen with simultaneous iv diazepam. Clinical studies have never shown a better efficacy of PHT over other antiepileptic drugs. In addition, iv PHT loading dose is a complex and time-consuming procedure which may expose patients to several risks, such as local cutaneous reactions (purple glove syndrome), severe hypotension and cardiac arrhythmias up to ventricular fibrillation and death, and increased risk of severe allergic reactions...
April 6, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29610207/the-cardiovascular-safety-of-macrolides-a-systematic-review-meta-analysis-and-network-meta-analysis
#4
Einat Gorelik, Reem Masarwa, Amichai Perlman, Victoria Rothschild, Mordechai Muszkat, Ilan Matok
Background: Studies reporting an increased risk for cardiac toxicities with macrolide antibiotics have raised concern regarding their cardiovascular safety. We sought to assess the cardiac safety of Macrolide antibiotics as a class and of the individual agents by conducting a systematic review and network meta-analysis. Methods: MEDLINE, EMBASE and the Cochrane Library were searched up to February 2018, for studies reporting on cardiovascular outcomes with macrolides. We followed the PRISMA 2009 guidelines for data selection and extraction...
April 2, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29608501/through-the-decades-%C3%AE-blocker-use-and-outcomes-in-acute-coronary-syndromes
#5
Alina Kukin, Zachary R Noel, Kristin Watson
Beta-adrenergic receptor antagonists, or β-blockers, have been a cornerstone of treatment in patients with acute coronary syndromes (ACS) for more than 4 decades. First studied in the 1960s, β-blockers in ACS have been shown to decrease the risk of death, recurrent ischemic events, and arrhythmias by reducing catecholamine-mediated effects and reducing myocardial oxygen demand. Through the decades, the β-blocker of choice, timing of initiation, duration of therapy, and dosing have evolved considerably. Despite having clear benefits in certain patient populations (eg, patients with systolic dysfunction who are hemodynamically stable), the benefit of β-blockers in other populations (ie, in patients at low risk for complications receiving modern revascularization therapies and optimal medical management) remains unclear...
May 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29598884/outcome-of-clinical-management-in-relatives-of-sudden-cardiac-death-victims
#6
Katrine M Müllertz, Morten K Christiansen, Anders K Broendberg, Lisbeth N Pedersen, Henrik K Jensen
BACKGROUND: International guidelines recommend clinical assessment of the surviving first-degree relatives of sudden cardiac death (SCD) victims to identify a probable cause of death and protect surviving relatives. Only few studies have reported the outcome of clinical management and follow-up of relatives to SCD victims. METHODS: We performed a retrospective cohort study of the clinical and genetic assessment of surviving relatives of SCD victims referred to the Clinic of Inherited Cardiac Diseases at Aarhus University Hospital, Denmark, between 1995 and 2016...
March 8, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29581800/impact-of-drug-induced-long-qt-syndrome-a-systematic-review
#7
Karuppiah Arunachalam, Seetha Lakshmanan, Abhishek Maan, Narendra Kumar, Paari Dominic
Background: Drug induced long QT syndrome is quite common in daily clinical practice but its impact is unknown. Methods: PubMed and EMBASE databases (until May 2, 2017) were searched to identify studies reporting drug induced long QT syndrome and followed the PRISMA guidelines. The main outcomes measured in these studies were QTc prolongation, ventricular arrhythmias, torsade de pointes (TdP) and death. Results: Out of 176 non-duplicate reports, 36 studies satisfied inclusion criteria and provided data on patients exposed to drugs that can potentially cause long QT...
May 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29576967/prognostic-value-of-new-onset-right-bundle-branch-block-in-acute-myocardial-infarction-patients-a-systematic-review-and-meta-analysis
#8
Juntao Wang, Hongxing Luo, Chunling Kong, Shujuan Dong, Jingchao Li, Haijia Yu, Yingjie Chu
Background: Patients with acute myocardial infarction (AMI) and bundle-branch block have poor prognoses. The new European Society of Cardiology guideline suggests a primary percutaneous coronary intervention strategy when persistent ischemic symptoms occur in patients with persistent ischemic symptoms and right bundle-branch block (RBBB), but the level of evidence is not high. In fact, the presence of RBBB may lead to the misdiagnosis of transmural ischemia and mask the early diagnosis of ST-elevation myocardial infarction...
2018: PeerJ
https://www.readbyqxmd.com/read/29575965/atrial-fibrillation-in-the-middle-east-unmapped-underdiagnosed-undertreated
#9
Warkaa Al-Shamkhani, Harold Ayetey, Gregory Y H Lip
Atrial fibrillation (AF) is the commonest persistent cardiac arrhythmia with an estimated incidence rate of between 1.5-2% and an important cause of strokes. Few epidemiological studies and clinical trials on the management of AF have been conducted outside Europe and North America. These gaps in our understanding of AF likely lead to sub-optimal management of patients with AF in the rest of the world. Areas covered: We discuss the epidemiology, treatment and clinical outcomes for AF in the Middle East after a systematic review of published work for AF from the Middle East...
March 26, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29567351/interatrial-block-to-predict-atrial-fibrillation-in-myotonic-dystrophy-type-1
#10
Vincenzo Russo, Andrea Antonio Papa, Anna Rago, Carmine Ciardiello, Marco Marano, Riccardo Proietti, Luisa Politano, Gerardo Nigro
Paroxysmal atrial fibrillation frequently occurs in Myotonic dystrophy type 1 (DM1) patients. Interatrial block is recognized as predictor of atrial arrhythmias, particularly atrial fibrillation (AF). The aim of this study was to evaluate the role of interatrial block in predicting the onset of atrial fibrillation during 2-year follow-up in DM1 patients who underwent pacemaker implantation for conduction system disorders. The study prospectively enrolled 70 DM1 patients (aged 36-69; 31 M) who underwent pacemaker implantation for cardiac rhythm abnormalities in accordance with the current guidelines...
January 31, 2018: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/29566462/safety-profile-of-blind-bronchial-sampling-a-prospective-study-in-pediatric-intensive-care-unit
#11
Neeraj Gupta, Anil Sachdev, Dhiren Gupta, Suresh Gupta
OBJECTIVE: To study the safety profile of blind bronchial sampling in mechanically ventilated children. DESIGN: Prospective interventional study. SETTING: Tertiary level pediatric intensive care unit of a multispecialty hospital. PATIENTS: Children aged 1 month to 16 years on mechanical ventilator for ≥48 h, were assessed by clinical pulmonary infection score for ventilator-associated pneumonia (VAP). INTERVENTIONS: Blind bronchial sampling was performed following standard procedural guidelines...
March 22, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29566135/european-heart-rhythm-association-ehra-position-paper-on-arrhythmia-management-and-device-therapies-in-endocrine-disorders-endorsed-by-asia-pacific-heart-rhythm-society-aphrs-and-latin-american-heart-rhythm-society-lahrs
#12
Bulent Gorenek, Giuseppe Boriani, Gheorge-Andrei Dan, Laurent Fauchier, Guilherme Fenelon, He Huang, Gulmira Kudaiberdieva, Gregory Y H Lip, Rajiv Mahajan, Tatjana Potpara, Juan David Ramirez, Marc A Vos, Francisco Marin
Endocrine disorders are associated with various tachyarrhythmias, including atrial fibrillation (AF), ventricular tachycardia (VT), ventricular fibrillation (VF), and bradyarrhythmias. Along with underlying arrhythmia substrate, electrolyte disturbances, glucose, and hormone levels, accompanying endocrine disorders contribute to development of arrhythmia. Arrhythmias may be life-threatening, facilitate cardiogenic shock development and increase mortality. The knowledge on the incidence of tachy- and bradyarrhythmias, clinical and prognostic significance as well as their management is limited; it is represented in observational studies and mostly in case reports on management of challenging cases...
March 16, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29561311/cardiac-magnetic-resonance-imaging-and-primary-prevention-implantable-cardioverter-defibrillator-therapy-current-recommendations-and-future-directions
#13
Andrea I Guaricci, Delia De Santis, Mark G Rabbat, Gianluca Pontone
: Implantable cardioverter defibrillators (ICDs) have proven to be the most effective preventive therapy of sudden cardiac death (SCD). Based on current guidelines, the indication for prophylactic ICD therapy is primarily based on a left ventricular ejection fraction (LVEF) less than 35%. However, patients with low LVEF may never have an arrhythmic event while patients with normal to moderately reduced LVEF, who are traditionally felt to be at lower risk, can experience SCD. Therefore, LVEF alone is not an ideal risk stratification parameter to determine ICD therapy...
May 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29544612/the-taiwan-heart-registries-its-influence-on-cardiovascular-patient-care
#14
REVIEW
Cho-Kai Wu, Jyh-Ming Jimmy Juang, Jiun-Yang Chiang, Yi-Heng Li, Chia-Ti Tsai, Fu-Tien Chiang
Taiwanese heart registries for the main cardiovascular diseases have been conducted in the past 10 years, with the goal of examining the quality of cardiovascular patient care, which cannot be guaranteed by the universal Taiwan National Health Insurance. The results show suboptimal adherence to guideline recommendations. Door-to-balloon time and dual antiplatelet therapy use in acute coronary syndrome, standard medications for management of heart failure, low-density lipoprotein cholesterol levels in dyslipidemia, anticoagulant agent use in atrial fibrillation, and the understanding of sudden arrhythmia death syndrome were all found to be inadequate...
March 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29537971/current-state-of-risk-stratification-for-sudden-cardiac-death-in-adults-with-congenital-heart-disease
#15
Jim T Vehmeijer, Barbara Jm Mulder, Joris R de Groot
Sudden cardiac death (SCD), mainly caused by ventricular arrhythmias, is one of the leading causes of mortality in adult congenital heart disease (ACHD) patients. An implantable cardioverter defibrillator (ICD) may prevent SCD, but risk stratification remains challenging. In this review, we will address the current guideline recommendations for ICD implantation in ACHD patients, as well as review a recent study in which the discriminative ability for SCD of these guidelines is evaluated. In this study, the guideline recommendations were applied to patients who died of SCD and living controls...
March 13, 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29520510/variant-angina-and-aborted-sudden-cardiac-death
#16
REVIEW
Amartya Kundu, Aditya Vaze, Partha Sardar, Ahmed Nagy, Wilbert S Aronow, Naomi F Botkin
PURPOSE OF REVIEW: Variant angina, which is characterized by recurrent chest pain and transient ECG changes along with angiographic evidence of coronary artery spasm, generally has a favorable prognosis. However, episodes of ischemia caused by vasospasm may lead to potentially life-threatening ventricular arrhythmias and cardiac arrest, even in patients with no history of prior cardiac disease. This review describes the epidemiology, pathogenesis, clinical spectrum, and management of variant angina, as well as outcomes in patients who present with aborted sudden cardiac death (ASCD)...
March 8, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29518801/new-atrial-fibrillation-diagnosed-perioperatively-anticoagulation-practices-in-a-secondary-hospital
#17
Alyssa Kirby, Sisira Jayathissa
BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia encountered perioperatively in patients undergoing non-cardiac surgery. There is emerging evidence suggesting high risk of ischaemic stroke. There are no clear guidelines surrounding initiation of anticoagulation in this setting. This study evaluates current practice in anticoagulant management of new perioperative AF at Hutt Hospital. METHODS: We have undertaken a retrospective study of 3,558 patients aged 60 years and over admitted for non-cardiac surgery at Hutt Hospital in 2014, to assess incidence of new AF/flutter and review how they were managed in regards to anticoagulation...
March 9, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29506740/oral-anticoagulant-therapy-in-adults-with-congenital-heart-disease-and-atrial-arrhythmias-implementation-of-guidelines
#18
H Yang, J F Heidendael, J R de Groot, T C Konings, G Veen, A P J van Dijk, F J Meijboom, G Tj Sieswerda, M C Post, M M Winter, B J M Mulder, B J Bouma
BACKGROUND: Current guidelines on oral anticoagulation (OAC) in adults with congenital heart disease (ACHD) and atrial arrhythmias (AA) consist of heterogeneous and divergent recommendations with limited level of evidence, possibly leading to diverse OAC management and different outcomes. Therefore, we aimed to evaluate real-world implementation and outcome of three guidelines on OAC management in ACHD patients with AA. METHODS: The ESC GUCH 2010, PACES/HRS 2014 and ESC atrial fibrillation (AF) 2016 guidelines were assessed for implementation...
April 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29504129/gender-differences-in-the-development-of-cardiac-complications-a-multicentre-study-in-a-large-cohort-of-thalassaemia-major-patients-to-optimize-the-timing-of-cardiac-follow-up
#19
Alessia Pepe, Maria R Gamberini, Massimiliano Missere, Laura Pistoia, Maurizio Mangione, Liana Cuccia, Anna Spasiano, Silvia Maffei, Christian Cadeddu, Massimo Midiri, Caterina Borgna, Antonella Meloni
We assessed whether male gender was associated with a higher risk of cardiac iron accumulation and fibrosis, heart dysfunction and complications in a large, multicentre cohort of thalassaemia major (TM) patients, in order to optimize the timing in cardiac follow-up. We considered 1711 TM patients (899 females, 31·09 ± 9·08 years), enrolled in the Myocardial Iron Overload in Thalassaemia Network. Clinical/instrumental data are recorded from birth to the first Cardiovascular Magnetic Resonance Imaging scan...
March 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29493570/arrhythmias-atrial-fibrillation-in-heart-failure-time-to-revise-the-guidelines
#20
Luigi Di Biase, Mohammadali Habibi
No abstract text is available yet for this article.
March 1, 2018: Nature Reviews. Cardiology
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