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https://www.readbyqxmd.com/read/29202647/swallow-presyncope-in-an-athletic-patient-caused-by-third-degree-atrioventricular-block
#1
Axel Van Damme, Tine De Backer, Philippe Vanderheeren
Introduction Swallow syncope is a neurally mediated syncope. Multiple causes have been described in literature. A rare cause is arrhythmias. Only a limited amount of cases present the association of swallow syncope and third degree AV-block. Case presentation A 39-year-old man presented with episodes of presyncope while eating. Further medical history, physical examination, resting 12-lead ECG, cyclo-ergometry, transthoracic echocardiography and MRI of the heart were normal. 24 h Holter monitoring demonstrated high-grade third-degree atrioventricular (AV) block...
December 5, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29194518/coincidental-ganglionated-plexus-modification-during-radiofrequency-pulmonary-vein-isolation-and-post-ablation-arrhythmia-recurrence
#2
Georgios Giannopoulos, Charalampos Kossyvakis, Christos Angelidis, Vasiliki Panagopoulou, Dimitrios Tsiachris, Dimitrios A Vrachatis, Konstantinos Doudoumis, Konstantinos Letsas, Stamatina Pagoni, Christodoulos Stefanadis, Vassilios P Vassilikos, John Lekakis, Spyridon Deftereos
Aims: Vagal responses (VR) during left atrial ablation for atrial fibrillation (AF) treatment have been reported to be associated with less recurrences, presumably because they are a sign of ganglionated plexi modification. Our objective was to evaluate whether coincidentally elicited VR during left atrial ablation are associated with lower AF recurrence rates. Methods and results: This is a post hoc analysis of a prospective study of 291 patients with paroxysmal AF undergoing radiofrequency pulmonary vein isolation (PVI)...
December 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29192954/is-heart-rate-recovery-index-a-predictive-factor-for-cardioinhibitory-syncope
#3
Volkan Emren, Uğur Kocabaş
BACKGROUND: Cardionhibitory syncope is related with excessive bradycardia or asystole due to parasympathetic response. AIM: We investigated whether patients with cardioinhibitory syncope have higher heart rate recovery index (HRRi) considered as an parasympathetic system activation in exercises stress testing (EST) than other those with other neurogenic syncope forms METHODS: A total of 262 patients who had neurogenic syncope documented by head-up tilt test (HUTT) and 199 healthy control individuals were examined...
December 1, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29191702/association-of-initial-recorded-rhythm-and-underlying-cardiac-disease-in-sudden-cardiac-arrest
#4
Janna P Kauppila, Antti Hantula, Marja-Leena Kortelainen, Lasse Pakanen, Juha Perkiömäki, Matti Martikainen, Heikki V Huikuri, M Juhani Junttila
BACKGROUND: Asystole (ASY) and pulseless electrical activity (PEA) are increasing and ventricular fibrillation (VF) or ventricular tachycardia (VT) declining as presenting rhythms of sudden cardiac arrest (SCA). Since there is limited information on possible differences in the etiology of underlying structural heart disease, we analyzed the clinical and/or autopsy findings of victims with ASY, PEA or VT/VF. METHODS: All SCA cases with recorded ASY, PEA or VT/VF occurring after onset of witnessed collapse were analyzed by the emergency personnel between the years 2007-2012 within the Oulu University Hospital area...
November 27, 2017: Resuscitation
https://www.readbyqxmd.com/read/29185536/swallow-induced-syncope-in-5-patients-electrophysiologic-evaluation-during-swallowing
#5
Ibrahim Aydogdu, Can Hasdemir, Ahmet Acarer, Sezin Alpaydin, Cumhur Ertekin
Background: We sought to characterize a cohort of participants with swallow-induced syncope (SIS) with clinical and electrophysiologic evaluations. Methods: Using electrocardiographic monitoring and neurophysiologic methods of swallowing, we evaluated a cohort of 5 patients with SIS, 4 of whom had longitudinal follow-up. Results: We determined electrophysiologically that the duration between the onset of swallow and a bradyarrhythmia or asystole is extremely short (2-3 seconds) in SIS...
August 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29175357/hemodynamic-effects-of-iv-sodium-nitrite-in-hospitalized-comatose-survivors-of-out-of-hospital-cardiac-arrest
#6
Cameron Dezfulian, Michele Olsufka, Deborah Fly, Sue Scruggs, Rose Do, Charles Maynard, Graham Nichol, Francis Kim
BACKGROUND: Patients resuscitated from cardiac arrest have brain and cardiac injury. Recent animal studies suggest that the administration of sodium nitrite after resuscitation from 12minutes of asystole limits acute cardiac dysfunction and improves survival and neurologic outcomes. It has been hypothesized that low doses of IV sodium nitrite given during resuscitation of out of hospital cardiac arrest (OHCA) will improve survival. Low doses of sodium nitrite (e.g., 9.6mg of sodium nitrite) are safe in healthy individuals, however the effect of nitrite on blood pressure in resuscitated cardiac arrest patients is unknown...
November 23, 2017: Resuscitation
https://www.readbyqxmd.com/read/29175014/influence-of-sedation-on-onset-and-quality-of-euthanasia-in-sheep
#7
Michele Barletta, Erik H Hofmeister, John F Peroni, Merrilee Thoresen, Alexandra M Scharf, Jane E Quandt
The purpose of this study was to determine if dexmedetomidine administered IV prior to euthanasia in sheep affected the speed or quality of euthanasia. Twenty clinically healthy Dorset-cross adult ewes between 1 and 3years of age were enrolled in a randomized blinded experimental trial. The subjects were randomly assigned to receive dexmedetomidine 5μg/kg IV or an equivalent volume of saline. Five minutes later, euthanasia was accomplished with a pentobarbital/phenytoin overdose given IV. The time to apnea, asystole, cessation of audible heartbeat, and absence of corneal reflex were recorded by two blinded investigators...
November 21, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/29173410/sudden-cardiac-death-in-ischemic-heart-disease-pathophysiology-and-risk-stratification
#8
REVIEW
Nabil El-Sherif, Mohamed Boutjdir, Gioia Turitto
Sudden cardiac death (SCD) accounts for approximately 360,000 deaths annually in the United States. Ischemic heart disease is the major cause of death in the general adult population. SCD can be due to arrhythmic or nonarrhythmic cardiac causes. Arrhythmic SCD may be caused by ventricular tachyarrhythmia or pulseless electrical activity/asystole. This article reviews the most recent pathophysiology and risk stratification strategies for SCD, emphasizing electrophysiologic surrogates of conduction disorder, dispersion of repolarization, and autonomic imbalance...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29158921/a-nearly-lethal-screw-an-unusual-cause-of-recurrent-bradycardia-and-asystole-episodes-after-fixation-of-the-cervical-spine
#9
Amit Frenkel, Yair Binyamin, Evgeni Brotfain, Leonid Koyfman, Aviel Roy-Shapira, Ilan Shelef, Moti Klein
We present a case of a 51-year-old man who was injured in a bicycle accident. His main injury was an unstable fracture of the cervical and thoracic vertebral column. Several hours after his arrival to the hospital the patient underwent open reduction and internal fixation (ORIF) of the cervical and thoracic spine. The patient was hospitalized in our critical care unit for 99 days. During this time patient had several episodes of severe bradycardia and asystole; some were short with spontaneous return to sinus and some required pharmacological treatment and even Cardiopulmonary Resuscitation (CPR)...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29157790/improving-the-neurological-prognosis-following-ohca-using-real-time-evaluation-of-cerebral-tissue-oxygenation-a-case-report
#10
Yasuaki Koyama, Yoshiaki Inoue, Shuhei Hisago, Aiki Marushima, Keiichi Hagiya, Yuichiro Yamasaki, Yuki Enomoto, Nobutake Shimojo, Satoru Kawano, Taro Mizutani
BACKGROUND: The neurological prognosis is poor for patients suffering from out-of-hospital cardiac arrest (OHCA), in the absence of bystander cardio pulmonary resuscitation (CPR), and showing asystole as the initial waveform. However, such patients have the potential of resuming social activity if cerebral tissue oxygen saturation can be preserved. CASE PRESENTATION: We recently encountered a 60-year-old man who had suffered an OHCA in the absence of bystander CPR, and who successfully resumed complete social activity despite initial asystole and requiring at least 75min of chest compressions before return of spontaneous circulation (ROSC)...
November 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29149854/cardiac-arrest-in-a-toddler-treated-with-propranolol-for-infantile-hemangioma-a-case-report
#11
Alvise Tosoni, Mario Cutrone, Maurizio Dalle Carbonare, Andrea Pettenazzo, Giorgio Perilongo, Stefano Sartori
BACKGROUND: Propranolol has become the first-line treatment for complicated Infantile Hemangioma (IH), showing so far a good risk-benefit profile. CASE PRESENTATION: We report the case of a toddler, on propranolol, who suffered cardiac arrest during an acute viral infection. She had a neurally-mediated syncope that progressed to asystole, probably because of concurrent factors as dehydration, beta-blocking and probably individual susceptibility to vaso-vagal phenomena...
November 17, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29146416/fulminant-adrenergic-myocarditis-complicated-by-pulmonary-edema-cardiogenic-shock-and-cardiac-arrest
#12
Pawel Rostoff, Bohdan Nessler, Patrycja Pikul, Karolina Golinska-Grzybala, Tomasz Miszalski-Jamka, Jadwiga Nessler
Adrenergic myocarditis is an uncommon presentation of pheochromocytoma and extremely rare cause of de novo acute heart failure (AHF). We present a case of a 31-year-old Caucasian woman with a history of hypertension and recurrent occipital headaches who was admitted to the emergency department due to severe de novo AHF presenting as pulmonary edema and cardiogenic shock. During the hospital admission the patient experienced asystolic cardiac arrest and was successfully resuscitated, intubated, and mechanically ventilated...
November 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29122647/an-automatic-system-for-the-comprehensive-retrospective-analysis-of-cardiac-rhythms-in-resuscitation-episodes
#13
Ali Bahrami Rad, Trygve Eftestøl, Unai Irusta, Jan Terje Kvaløy, Lars Wik, Jo Kramer-Johansen, Aggelos K Katsaggelos, Kjersti Engan
AIM: An automatic resuscitation rhythm annotator (ARA) would facilitate and enhance retrospective analysis of resuscitation data, contributing to a better understanding of the interplay between therapy and patient response. The objective of this study was to define, implement, and demonstrate an ARA architecture for complete resuscitation episodes, including chest compression pauses (CC-pauses) and chest compression intervals (CC-intervals). METHODS: We analyzed 126...
November 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29114312/a-case-of-high-dose-adenosine-usage-for-anterior-communicating-artery-aneurysm-clip-ligation-what-is-the-dose-limit-for-a-resistant-response
#14
Shahid M Nimjee, David L McDonagh, Abhishek Agrawal, Gavin W Britz
Intraoperative adenosine is used to induce asystole to facilitate clip ligation of intracranial aneurysms. Typically, 5-10 mg doses are used per administration and approximately 30 mg is used for a given case. An obvious concern with using adenosine is that the patient can remain in asystole or that prolonged hypotension can result in cerebral or cardiovascular ischemia. The upper limit of adenosine administration remains unclear. We present a case of a patient with a large anterior communicating artery aneurysm requiring large doses of adenosine, far exceeding previously reported cases...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29109881/hypothermia-with-extreme-bradycardia-following-spinal-cord-infarction-of-septic-origin
#15
Philippe Hantson, Thierry Duprez
Among other autonomic dysfunctions complicating acute spinal cord injury, deep hypothermia is rare but may induce serious cardiovascular complications. There are few pharmacological options to influence hypothermia. A 66-year-old woman was transferred to the intensive care unit (ICU) for serious cardiac arrhythmias (atrial fibrillation and asystole) in the context of a deep hypothermia (axillary temperature below 32°C). She had been admitted to the hospital two months before for an acute L4-L5 infectious spondylodiscitis without any initial neurological deficit...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29107412/ketamine-infusion-for-refractory-status-epilepticus-a-case-report-of-cardiac-arrest
#16
Lauren Koffman, Ho Yan Yiu, Salia Farrokh, John Lewin, Romergryko Geocadin, Wendy Ziai
BACKGROUND: Refractory status epilepticus (RSE) has a high mortality rate and is often difficult to treat. When traditional therapies fail ketamine may be considered. There are limited reports of adverse cardiac events with the use of ketamine for RSE and no reports of cardiac arrest in this context. OBJECTIVE: Evaluate the occurrence of cardiac arrhythmias associated with the use of ketamine for RSE. METHODS: Retrospective chart review of nine patients who underwent ketamine infusion for RSE...
October 26, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29102470/long-term-survival-trends-of-medicare-patients-after-in-hospital-cardiac-arrest-insights-from-get-with-the-guidelines-resuscitation-%C3%A2
#17
Lauren E Thompson, Paul S Chan, Fengming Tang, Brahmajee K Nallamothu, Saket Girotra, Sarah M Perman, Somnath Bose, Stacie L Daugherty, Steven M Bradley
BACKGROUND: Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge. OBJECTIVE: To examine 1-year survival trends overall and by rhythm after IHCA. METHODS: Using Medicare beneficiaries (age≥65years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival...
November 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/29098486/implantable-loop-recorders-in-the-real-world-a-study-of-two-canadian-centers
#18
Omar A Ibrahim, Doran Drew, Christopher J Hayes, William McIntyre, Colette M Seifer, Wilma Hopman, Benedict Glover, Adrian M Baranchuk
PURPOSE: Implantable loop recorders (ILRs) are increasingly being used for ambulatory electrocardiography. We sought to evaluate ILR indications, diagnostic yield, ILR-guided interventions, and complications in two Canadian centers. METHODS: This was a retrospective study using electronic medical records to identify ILR implants at Queen's University and the University of Manitoba. Information was collected on patient characteristics, medications, indication for implant, results of prior investigations, diagnostic outcome, and subsequent management...
November 2, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29082864/fitness-to-drive-in-cardiovascular-disease
#19
Hermann H Klein, Udo Sechtem, Hans-Joachim Trappe
BACKGROUND: Medical students are taught little or nothing about the medical considerations related to the driving of motor vehicles. Physicians treating patients with cardiovascular disease need to acquire competence in traffic medicine in order to be able to advise them about their fitness to drive. METHODS: We present the current governmental regulations and recommendations concerning fitness to drive in patients with cardiovascular disease. We also review pertinent publications that were retrieved by a selective search in PubMed with the search terms "cardiovascular disease and traffic accidents" and "cardiovascular disease and traffic deaths" for the decade 2007-2016, as well as further publications collected by us individually...
October 13, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29077663/anesthetic-management-of-a-patient-with-de-novo-hereditary-sensory-and-autonomic-neuropathy-type-vii-a-case-report
#20
Lorenzo Rafer, James Mooney
An 18-month-old patient with hereditary sensory and autonomic neuropathy, type VII undergoing general anesthesia for Nissen fundoplication and gastrostomy tube is presented. This is the first reported case of a patient with this particular genetic mutation receiving general anesthesia. We presented the major intraoperative events during the procedure. The anesthetic considerations and implications of caring for a patient with this particular mutation and patients with other variations of hereditary sensory and autonomic neuropathy are also discussed...
October 26, 2017: A & A Case Reports
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