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https://www.readbyqxmd.com/read/27896702/safety-of-regadenoson-stress-testing-in-patients-with-pulmonary-hypertension
#1
Victor M Moles, Thomas Cascino, Ashraf Saleh, Krasimira Mikhova, John J Lazarus, Michael Ghannam, Hong J Yun, Matthew Konerman, Richard L Weinberg, Edward P Ficaro, James R Corbett, Vallerie V McLaughlin, Venkatesh L Murthy
OBJECTIVES: We sought to determine the safety of regadenoson stress testing in patients with PH. BACKGROUND: PH is increasingly recognized at more advanced ages. As many as one-third of patients with PH have coronary artery disease. Because of their physical limitations, patients with PH are unable to adequately exercise. Regadenoson can potentially have an adverse impact due to their tenuous hemodynamics. Current guidelines suggest performing a coronary angiography in patients with PH who have angina or multiple coronary risk factors...
November 28, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27844191/-indications-for-implantable-loop-recorders-in-patients-with-channelopathies-and-ventricular-tachycardias
#2
Julia Köbe, Kristina Wasmer, Florian Reinke, Lars Eckardt
Implantable loop recorders (ILR) do not play a pivotal role in the current guidelines on ventricular arrhythmias except in identifying rhythm-symptom correlations if ventricular arrhythmias are assumed. Before a decision for a pure diagnostic implantable device is made, a thorough arrhythmic risk assessment is of major importance due to the potential lethal outcome of ventricular arrhythmias. Nevertheless, some clinical circumstances exist where long-term monitoring by an ILR may add significant information in electrical heart diseases, in patients with ventricular arrhythmias, or structural heart diseases and a potential risk of ventricular arrhythmias...
November 14, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27809623/onset-of-graves-disease-during-pregnancy-in-a-woman-with-established-hypothyroidism
#3
María Alberiche, Rosa María Sánchez-Hernández, Xabier López Mérida, Ana María Wägner
BACKGROUND: Pregnancy strongly influences the thyroid gland and its function. Thyroid guidelines recommend a 30 to 50% increase of the preconceptional levothyroxine dose in women with hypothyroidism, when pregnancy is diagnosed. CASE: A 33 year-old, 8-week pregnant woman with hypothyroidism, presents with a 2-week history of palpitations, sweating, nervousness and fatigue. Physical examination shows tachycardia (108 bpm), distal tremors and diffuse goiter. After biochemical confirmation of hyperthyroidism, her levothyroxine dose is reduced and finally interrupted...
November 4, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27799257/defibrillators-selecting-the-right-device-for-the-right-patient
#4
Sana M Al-Khatib, Paul Friedman, Kenneth A Ellenbogen
Advances in the field of defibrillation have brought to practice different types of devices that include the transvenous implantable cardioverter-defibrillator (ICD) with or without cardiac resynchronization therapy, the subcutaneous ICD (S-ICD), and the wearable cardioverter-defibrillator. To ensure optimal use of these devices and to achieve best patient outcomes, clinicians need to understand how these devices work, learn the characteristics of patients who qualify them for one type of device versus another, and recognize the remaining gaps in knowledge surrounding these devices...
November 1, 2016: Circulation
https://www.readbyqxmd.com/read/27790640/risk-stratification-in-arrhythmic-right-ventricular-cardiomyopathy-without-implantable-cardioverter-defibrillators
#5
Francesca Brun, Judith A Groeneweg, Kathleen Gear, Gianfranco Sinagra, Jeroen van der Heijden, Luisa Mestroni, Richard N Hauer, Mark Borgstrom, Frank I Marcus, Trina Hughes
OBJECTIVES: The primary objective of this study is risk stratification of patients with arrhythmic right ventricular cardiomyopathy (ARVC). BACKGROUND: There is a need to identify those who need an automatic implantable defibrillator (ICD) to prevent sudden death. METHODS: This is an analysis of 88 patients with ARVC from three centers who were not treated with an ICD. RESULTS: Risk factors for subsequent arrhythmic deaths were pre-enrollment sustained or nonsustained ventricular tachycardia (VT) and decreased left ventricular function...
October 2016: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/27755136/the-wearable-defibrillator-current-technology-indications-and-future-directions
#6
Sven Reek
PURPOSE OF REVIEW: The wearable cardioverter-defibrillator has been available for over a decade. In recent years, the device has been prescribed increasingly for a wide range of indications. The purpose of this review is to describe the technical and clinical aspects of the wearable cardioverter-defibrillator. The available literature on safety, efficacy and cost-effectiveness is reviewed, and indications for use will be discussed. RECENT FINDINGS: The wearable cardioverter-defibrillator has been used successfully in more than 100 000 patients for a variety of indications...
January 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27751700/best-clinical-practice-emergency-medicine-management-of-stable-monomorphic-ventricular-tachycardia
#7
Brit Long, Alex Koyfman
BACKGROUND: Ventricular tachycardia (VT) and ventricular fibrillation are the causes of approximately 300,000 deaths per year in the United States. VT is classified based on hemodynamic status and appearance. Stable, monomorphic VT treatment is controversial. OBJECTIVE: Our aim was to provide emergency physicians with an evidence-based review of the medical management of stable, monomorphic VT. DISCUSSION: Stable, monomorphic VT is part of a larger class of ventricular dysrhythmias defined by a rate of at least 120 beats/min with QRS > 120 ms without regularly occurring P:QRS association...
October 14, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27749559/cardiac-device-implantation-in-fabry-disease-a-retrospective-monocentric-study
#8
Thomas Sené, Olivier Lidove, Joel Sebbah, Jean-Marc Darondel, Hervé Picard, Laurent Aaron, Olivier Fain, Thierry Zenone, Dominique Joly, Philippe Charron, Jean-Marc Ziza
The incidence and predictive factors of arrhythmias and/or conduction abnormalities (ACAs) requiring cardiac device (CD) implantation are poorly characterized in Fabry disease (FD). The aim of our retrospective study was to determine the prevalence, incidence, and factors associated with ACA requiring CD implantation in a monocentric cohort of patients with confirmed FD who were followed up in a department of internal medicine and reference center for FD.Forty-nine patients (20M, 29F) were included. Nine patients (4M, 5F; 18%) had at least one episode of ACA leading to device therapy...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27690207/prehospital-nitroglycerin-in-tachycardic-chest-pain-patients-a-risk-for-hypotension-or-not
#9
Marie-Hélène Proulx, Luc de Montigny, Dave Ross, Charlene Vacon, Louis Enock Juste, Eli Segal
BACKGROUND: The American Heart Association guidelines (AHA) guidelines list tachycardia as a contraindication for the administration of nitroglycerin (NTG), despite limited evidence of adverse events. We sought to determine whether NTG administered for chest pain was a predictor of hypotension (systolic blood pressure <90 mmHg) in patients with tachycardia, compared to patients without tachycardia (50≥ heart rate ≤100). METHODS: We performed a retrospective cohort study using patient care reports completed by basic life support (BLS) providers in a large urban Canadian EMS system for the period 2010-2012...
September 30, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27688235/location-of-in-hospital-cardiac-arrest-in-the-united-states-variability-in-event-rate-and-outcomes
#10
Sarah M Perman, Emily Stanton, Jasmeet Soar, Robert A Berg, Michael W Donnino, Mark E Mikkelsen, Dana P Edelson, Matthew M Churpek, Lin Yang, Raina M Merchant
BACKGROUND: In-hospital cardiac arrest (IHCA) is a major public health problem with significant mortality. A better understanding of where IHCA occurs in hospitals (intensive care unit [ICU] versus monitored ward [telemetry] versus unmonitored ward) could inform strategies for reducing preventable deaths. METHODS AND RESULTS: This is a retrospective study of adult IHCA events in the Get with the Guidelines-Resuscitation database from January 2003 to September 2010...
2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27638460/initial-end-tidal-co2-partial-pressure-predicts-outcomes-of-in-hospital-cardiac-arrest
#11
An-Yi Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Chih-Hung Wang, Wen-Jone Chen
INTRODUCTION: Monitoring the partial pressure of end-tidal carbon dioxide (PEtco2) has been advocated since 2010 as an index of resuscitation efforts. However, related research has largely focused on out-of-hospital cardiac arrest victims. In-hospital cardiac arrest (IHCA) differs in terms of etiologies and demographics, the merit of initial PEtco2 values was explored. METHODS: This was a retrospective study in a single medical center between February 2011 and August 2014...
August 27, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27627616/trends-and-outcomes-of-coronary-angiography-and-percutaneous-coronary-intervention-after-out-of-hospital-cardiac-arrest-associated-with-ventricular-fibrillation-or-pulseless-ventricular-tachycardia
#12
Nish Patel, Nileshkumar J Patel, Conrad J Macon, Badal Thakkar, Maheshkumar Desai, Pablo Rengifo-Moreno, Carlos E Alfonso, Robert J Myerburg, Deepak L Bhatt, Mauricio G Cohen
Importance: The 2015 cardiopulmonary resuscitation and emergency cardiovascular care guidelines recommend performing coronary angiography in resuscitated patients after cardiac arrest with or without ST-segment elevation (STE). Objective: To assess the temporal trends, predictors, and outcomes of performing coronary angiography and percutaneous coronary intervention (PCI) in patients resuscitated after out-of-hospital cardiac arrest (OHCA) with initial rhythms of ventricular tachycardia or pulseless ventricular fibrillation (VT/VF)...
November 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27619722/correction-to-2015-acc-aha-hrs-guideline-for-the-management-of-adult-patients-with-supraventricular-tachycardia-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-rhythm-society
#13
https://www.readbyqxmd.com/read/27619721/correction-to-2015-acc-aha-hrs-guideline-for-the-management-of-adult-patients-with-supraventricular-tachycardia-executive-summary-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart
#14
https://www.readbyqxmd.com/read/27567133/usefulness-of-14-day-holter-for-detection-of-nonsustained-ventricular-tachycardia-in-patients-with-hypertrophic-cardiomyopathy
#15
Adaya Weissler-Snir, Raymond H Chan, Arnon Adler, Melanie Care, Vijay Chauhan, Michael H Gollob, Tomer Ziv-Baran, Dana Fourey, Waseem Hindieh, Harry Rakowski, Danna A Spears
Nonsustained ventricular tachycardia (NSVT), defined as ≥3 consecutive ventricular beats at ≥120 beats/min lasting <30 seconds, is an independent predictor of sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HC). Current guidelines recommend 24- to 48-hour Holter monitoring as part of SCD risk stratification. We sought to assess the difference in diagnostic yield of 14-day Holter monitoring compared to 24-48 hours for the detection of NSVT and to assess the prevalence and characteristics of NSVT in patients with HC with prolonged monitoring...
October 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27556656/noise-exposure-on-pediatric-inpatient-units
#16
Nancy M Daraiseh, Cheryl L Hoying, William P Vidonish, Li Lin, Michael Wagner
BACKGROUND: Noise is a problem placing registered nurses (RNs) at risk for safety events, decreased job performance, fatigue, irritability, and hearing loss. OBJECTIVE: The purpose of this study is to measure noise levels and sources on pediatric inpatient units as well as to explore the health impact of noise on RNs. METHODS: This was a descriptive nonexperimental study with 65 pediatric RNs from 14 units. Noise (levels, source, location, and activity), heart rate (HR), and stress were measured...
September 2016: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27551062/predictors-of-fever-related-admissions-to-a-paediatric-assessment-unit-ward-and-reattendances-in-a-south-london-emergency-department-the-cabin-2-study
#17
Amaya L Bustinduy, Irina Chis Ster, Rebecca Shaw, Adam Irwin, Jaiganesh Thiagarajan, Rhys Beynon, Shamez Ladhani, Mike Sharland
OBJECTIVE: To explore the risk factors for ward and paediatric assessment unit (PAU) admissions from the emergency department (ED). DESIGN: Prospective observational study. SETTING AND PATIENTS: Febrile children attending a large tertiary care ED during the winter of 2014-2015. MAIN OUTCOME MEASURES: Ward and PAU admissions, National Institute for Health and Care Excellence (NICE) guidelines classification, reattendance to the ED within 28 days and antibiotic use...
August 22, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27538377/integration-of-60-000-exomes-and-acmg-guidelines-question-the-role-of-catecholaminergic-polymorphic-ventricular-tachycardia-associated-variants
#18
C Paludan-Müller, G Ahlberg, J Ghouse, C Herfelt, J H Svendsen, S Haunsø, J K Kanters, M S Olesen
Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) is a highly lethal cardiac arrhythmia disease occurring during exercise or psychological stress. CPVT has an estimated prevalence of 1:10,000 and has mainly been associated with variants in calcium-regulating genes. Identification of potential false-positive pathogenic variants was conducted by searching the Exome Aggregation Consortium (ExAC) database (n = 60,706) for variants reported to be associated with CPVT. The pathogenicity of the interrogated variants was assessed using guidelines from the American College of Medical Genetics and Genomics (ACMG) and in silico prediction tools...
August 19, 2016: Clinical Genetics
https://www.readbyqxmd.com/read/27454616/epicardial-catheter-ablation-for-ventricular-tachycardia-on-uninterrupted-warfarin-a-safe-approach-for-those-with-a-strong-indication-for-peri-procedural-anticoagulation
#19
V Sawhney, A Breitenstein, W Ullah, M Finlay, S Sporton, M J Earley, A W Chow, M Dhinoja, P Lambiase, R J Schilling, R J Hunter
BACKGROUND: Current guidelines for epicardial catheter ablation for ventricular tachycardia (VT) advocate that epicardial access is avoided in anticoagulated patients and should be performed prior to heparinisation. Recent studies have shown that epicardial access may be safe in heparinised patients. However, no data exist for patients on oral anticoagulants. We investigated the safety of obtaining epicardial access on uninterrupted warfarin. METHODS: A prospective registry of patients undergoing epicardial VT ablation over two years was analysed...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27434349/amiodarone-and-cardiac-arrest-systematic-review-and-meta-analysis
#20
REVIEW
Ageliki Laina, George Karlis, Aris Liakos, Georgios Georgiopoulos, Dimitrios Oikonomou, Evangelia Kouskouni, Athanasios Chalkias, Theodoros Xanthos
INTRODUCTION: The 2015 Guidelines for Resuscitation recommend amiodarone as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia. We reviewed the effects of amiodarone on survival and neurological outcome after cardiac arrest. METHODS: We systematically searched MEDLINE and Cochrane Library from 1940 to March 2016 without language restrictions. Randomized control trials (RCTs) and observational studies were selected...
October 15, 2016: International Journal of Cardiology
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