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https://www.readbyqxmd.com/read/29668588/a-delayed-diagnosis-of-catecholaminergic-polymorphic-ventricular-tachycardia-with-a-mutant-of-ryr2-at-c-7580t-g-for-6-years-in-a-9-year-old-child
#1
Hongyu Duan, Yongyi Lu, Song Yan, Lina Qiao, Yimin Hua, Yifei Li, Kaiyu Zhou, Chuan Wang
RATIONALE: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare but potentially lethal inherited arrhythmia syndrome induced by adrenergic stress. Due to the atypical clinical manifestations in early age, limited recognition and experience of pediatric cardiologists, and low awareness of the significance of genetic diagnosis in some underdeveloped areas in China, a delayed or missed diagnosis of CPVT in children is common and concerning. PATIENT CONCERNS: A 9-year and 3-month male child with recurrent exercise-induced syncope accompanied by convulsion was initially misdiagnosed as epilepsy since the first manifestation at the age of 3 years...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29661475/usefulness-of-high-dose-oral-flecainide-for-termination-of-recent-onset-atrial-fibrillation-in-children
#2
Leonardo Liberman, Thomas J Starc, Eric S Silver
A high dose of oral flecainide has been used for acute termination of atrial fibrillation (AF) and atrial flutter or intra-atrial re-entry tachycardia (AFL-IART) in adults. The use of flecainide for these conditions in children has not been well described. We describe our institutional experience on acute termination of AF or AFL-IART in children with a single high dose of oral flecainide in a hospital setting. All patients who received a single high dose of oral flecainide from 2009 to 2016 who were <21 years of age were included...
March 21, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29652491/inhibition-of-voltage-gated-k-channel-kv1-5-by-anti-arrhythmic-drugs
#3
Rong Chen, Shin-Ho Chung
Molecular dynamics simulations are employed to determine the inhibitory mechanisms of three drugs, 5-(4- phenoxybutoxy)psoralen (PAP-1), vernakalant and flecainide, on the voltage-gated K+ channel Kv1.5, a target for the treatment of cardiac arrhythmia. At neutral pH, PAP-1 is neutral, whereas the other two molecules carry one positive charge. We show that PAP-1 forms stable dimers in water, primarily through the hydrophobic interactions between aromatic rings. All three molecules bind to the cavity between the Ile508 and Val512 residues from the four subunits of the channel...
April 13, 2018: Biochemistry
https://www.readbyqxmd.com/read/29610596/catecholaminergic-polymorphic-ventricular-tachycardia-looking-to-the-future
#4
Andreea Elena Velcea, Calin Siliste, Dragos Vinereanu
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inheritable cardiac disorder, characterized by polymorphic ventricular tachycardia (PVT) or bidirectional ventricular tachycardia, triggered by adrenergic stress, and manifested most frequently as syncope or sudden cardiac death. The disease has a heterogeneous genetic basis, with mutations in the genes encoding the ryanodine and calsequestrin channels accounting for the majority of cases. The diagnosis of CPVT is established in individuals with polymorphic ventricular premature beats, PVT or bidirectional ventricular tachycardia documented during exercise or adrenergic stress, who have a structurally normal heart and normal resting ECG...
December 2017: Mædica
https://www.readbyqxmd.com/read/29609685/stability-of-regularly-prescribed-oral-liquids-formulated-with-syrspend-%C3%A2-sf
#5
M Uriel, C Gómez-Rincón, D Marro
The purpose of this research was to evaluate the stability of 12 oral liquid formulations frequently compounded in hospital and community settings formulated in a specific vehicle: SyrSpend® SF. The stability of melatonin, glycopyrrolate, ciclosporin, chloral hydrate, flecainide acetate, tiagabine HCl, labetalol HCl, ciprofloxacin HCl, spironolactone/hydrochlorothiazide, hydrocortisone, itraconazole and celecoxib in SyrSpend SF PH4 (liquid) was investigated at 0, 30, 60 and 90 days and stored at both controlled room temperature and refrigerated...
April 2, 2018: Die Pharmazie
https://www.readbyqxmd.com/read/29594407/-fatal-flecainide-intoxication-in-a-17-year-old-girl
#6
M Dokter, G Talarico, S Armbrust, E Below, B Bockholdt
A 17-year-old girl was found vomiting and somnolent at home and was taken to a hospital. The girl initially presented with ventricular tachycardia with broad QRS complexes which was very difficult to control. During the course a subsequent cardiogenic shock developed and despite exhaustion of all therapeutic options the fatal outcome could not be averted. The medicolegal autopsy revealed no evidence of any form of violence but the signs of medical treatment. Furthermore, no pathology of internal organs was detected...
March 28, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29545427/supraventricular-tachycardia-as-a-complication-of-severe-diabetic-ketoacidosis-in-an-adolescent-with-new-onset-type-1-diabetes
#7
Bryan Padraig Finn, Brian Fraser, Susan M O'Connell
Diabetic ketoacidosis (DKA) is one of the most common causes of morbidity and mortality in new-onset type 1 diabetes (T1D). Supraventricular tachycardia (SVT), however, is a very rare complication of DKA. We present the case of a patient with new-onset T1D who presented with DKA. He received intravenous fluid resuscitation, insulin and potassium supplementation and subsequently developed SVT, confirmed on a 12-lead electrocardiograph despite a structurally normal heart. Vagal manoeuvres and adenosine failed to restore sinus rhythm, but flecainide was successful...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29512803/attempted-suicide-by-fl%C3%A3-cainide-overdose-a-case-report
#8
Mouna Ben Kilani, Soufia Naccache, Rami Tlili, Dorra Mbarek, Salma Longo, Youssef Ben Ameur, Mohamed Rachid Boujnah
Class Ic antiarrythmic overdose is associated with a relatively high mortality. We presenta case report regarding a suicidal intoxication of an 18-year old female with a medical history of Wolff-Parkinson-White syndrome. The preliminary examination highlighted a profound cardiovascular collapse. The electrocardiogram showed a PR interval extended to 360 ms. The QRS complexes were enlarged to 360 ms with a right bundle brunch block appearance associated with left posterior hemibloc. There were repolarization abnormalities such as elevation of the J-point, convex ST segment and biphasic T wave in the right precordial leads ("Brugada-Like ECG pattern")...
June 2017: La Tunisie Médicale
https://www.readbyqxmd.com/read/29508636/emerging-pharmacotherapies-for-the-treatment-of-atrial-fibrillation
#9
Alessandro Capucci, Laura Cipolletta, Federico Guerra, Irene Giannini
The main aim of current research on the field of atrial fibrillation (AF) treatment is to find new antiarrhythmic drugs with less side effects. Areas covered: Dronedarone and vernakalant showed promising result in term of efficacy and safety in selected patients. Ranolazine and colchicine are obtaining a role as a potential antiarrhythmic drug. Ivabradine is used in experimental studies for the rate control of AF. Moreover, new compounds (vanoxerine, moxonidine, budiodarone) are still under investigation. Monoclonal antibodies or selective antagonist of potassium channel are under investigation for long term maintenance of sinus rhythm...
March 2018: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/29506689/multifocal-atrial-and-ventricular-premature-contractions-with-an-increased-risk-of-dilated-cardiomyopathy-caused-by-a-na-v-1-5-gain-of-function-mutation-g213d
#10
Kirstine Calloe, Anders K Broendberg, Alex H Christensen, Lisbeth N Pedersen, Morten S Olesen, Maria de Los Angeles Tejada, Soren Friis, Morten B Thomsen, Henning Bundgaard, Henrik K Jensen
BACKGROUND: SCN5A mutations can lead to different cardiac diseases. Recently, SCN5A mutations have been linked to the clinical entity multifocal ectopic Purkinje-related premature contractions (MEPPC) characterized by ventricular ectopy and dilated cardiomyopathy. METHODS & RESULTS: A family with a uniform MEPPC-like phenotype, associated with complex atrial and ventricular arrhythmias and dilated cardiomyopathy caused by a high frequency of ventricular ectopy was clinically assessed...
April 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29500139/assessing-the-risk-for-peripheral-neuropathy-in-patients-treated-with-dronedarone-compared-with-that-in-other-antiarrhythmics
#11
Chuntao Wu, Stephanie Tcherny-Lessenot, Wanju Dai, Yunxun Wang, Hayet Kechemir, Sampada Gandhi, Stephen Lin, Juhaeri Juhaeri
PURPOSE: There are few data on the risk for peripheral neuropathy associated with dronedarone, a newer antiarrhythmic medicine. The objective of this study was to assess whether dronedarone is potentially associated with an increased risk for peripheral neuropathy compared with other antiarrhythmics, including amiodarone, sotalol, flecainide, and propafenone. METHODS: The MarketScan database was used for identifying patients who were at least 18 years of age, had atrial fibrillation or flutter, and had not been diagnosed with peripheral neuropathy in the 180-day period prior to or on the date of the first prescription of an antiarrhythmic between July 20, 2009, and December 31, 2011...
February 27, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29405947/class-ic-antiarrhythmic-drugs-for-suspected-premature-ventricular-contraction-induced-cardiomyopathy
#12
Matthew C Hyman, Danielle Mustin, Gregory Supple, Robert D Schaller, Pasquale Santangeli, Jeffrey Arkles, David Lin, Daniele Muser, Sanjay Dixit, Saman Nazarian, Andrew E Epstein, David J Callans, Francis E Marchlinski, David S Frankel
BACKGROUND: Class IC antiarrhythmic drugs (IC-AADs) can effectively suppress premature ventricular contractions (PVCs). However, IC-AADs increase mortality in patients with PVCs and left ventricular dysfunction after myocardial infarction. Whether IC-AADs can be safely used to treat premature ventricular contraction-induced cardiomyopathy (PVC-CM) remains to be established. OBJECTIVE: The purpose of this study was to determine the safety and efficacy of IC-AADs in patients suspected of having PVC-CM...
February 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29387326/performance-of-electrophysiologic-study-in-an-asymptomatic-patient-with-type-2-intermittent-brugada-syndrome-to-do-or-not-to-do
#13
Kaveh Hosseini, Mansour Jahangiri, Ali Vasheghani Farahani
Background: Brugada syndrome (BrS) is an inherited channelopathy, which is associated with sudden cardiac death due to rapid polymorphic VT or VF. There is no definite consensus regarding the management of asymptomatic patients. Some experts advocate close follow-up; others propose the programmed stimulation for risk stratification. We aimed to evaluate the benefit of complete atrial and ventricular stimulation in patients with BrS and palpitation. Case Presentation: A 30-year-old man was admitted to our hospital because of a family history of sudden cardiac death (SCD) at age less than 45 years...
2018: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/29352276/arrhythmogenic-drugs-can-amplify-spatial-heterogeneities-in-the-electrical-restitution-in-perfused-guinea-pig-heart-an-evidence-from-assessments-of-monophasic-action-potential-durations-and-jt-intervals
#14
Oleg E Osadchii
Non-uniform shortening of the action potential duration (APD90) in different myocardial regions upon heart rate acceleration can set abnormal repolarization gradients and promote arrhythmia. This study examined whether spatial heterogeneities in APD90 restitution can be amplified by drugs with clinically proved proarrhythmic potential (dofetilide, quinidine, procainamide, and flecainide) and, if so, whether these effects can translate to the appropriate changes of the ECG metrics of ventricular repolarization, such as JT intervals...
2018: PloS One
https://www.readbyqxmd.com/read/29309564/role-of-syncope-in-predicting-adverse-outcomes-in-patients-with-suspected-brugada-syndrome-undergoing-standardized-flecainide-testing
#15
Juan Pablo Flórez, Daniel García, Irene Valverde, José Rubín, Diego Pérez, Mar González-Vasserot, Julián Reguero, Jesús María de la Hera, Pablo Avanzas, Juan Gómez, Eliecer Coto, César Morís, David Calvo
Aims: Sensitivity to flecainide testing results in suboptimal findings in patients with Brugada syndrome (BrS), leading to safety concerns. Because cardiac syncope effectively predicts outcomes in BrS, we aimed to explore its predictive value in a large cohort of negative and positive responders (NR and PR) to standard flecainide testing. Methods and results : We analysed the data of 251 consecutive patients, 177 NR vs. 74 PR, to flecainide testing, performed according to standard recommendations...
December 22, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29306643/drug-induced-thrombocytopenia-after-anticoagulation-with-rivaroxaban
#16
Marianne K Pop, Farhad Farokhi, Lela Iduna
A 66-year-old man presented to the emergency department with complaints of dark-colored stool and rash developing over the last couple of days. The patient was started on rivaroxaban and flecainide for months prior for atrial fibrillation. Upon arrival, he was awake, alert, and oriented with a blood pressure of 111/63mmHg, heart rate of 68 beats per minute, and oxygen saturation of 96% on room air. A review of systems was unremarkable with the exception of skin rash and light-headedness. The patient's initial laboratory results were significant for red blood cell (RBC) count of 4...
March 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29276267/limited-influence-of-excipients-in-extemporaneous-compounded-suspensions
#17
Eli Dijkers, Valerie Nanhekhan, Astrid Thorissen, Diego Marro, Marta Uriel
Objective: The objective of this study was to identify whether compounding oral suspensions with SyrSpend SF based on tablets or capsules is a suitable alternative for using raw pharmaceutical materials. Methods: Suspensions based on 5 different tablets and capsules were studied in SyrSpend SF. The summary of product characteristics of these different tablets and capsules were obtained from the manufacturer. Our hypothesis was that, if the maximum beyond-use date of the study was reached, the excipient did not seem to have an influence on the stability of the active pharmaceutical ingredient (API) within the studied time frame...
June 2017: Hospital Pharmacy
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
#18
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...
March 2018: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29246961/first-line-antiarrhythmic-transplacental-treatment-for-fetal-tachyarrhythmia-a-systematic-review-and-meta-analysis
#19
REVIEW
Tarek Alsaied, Shankar Baskar, Munes Fares, Fares Alahdab, Richard J Czosek, Mohammad Hassan Murad, Larry J Prokop, Allison A Divanovic
BACKGROUND: There is no consensus on the most effective and best tolerated first-line antiarrhythmic treatment for fetal tachyarrhythmia. The purpose of this systematic review and meta-analysis was to compare the efficacy, safety, and fetal-maternal tolerance of first-line monotherapies for fetal supraventricular tachycardia and atrial flutter. METHODS AND RESULTS: A comprehensive search of several databases was conducted through January 2017. Only studies that made a direct comparison between first-line treatments of fetal tachyarrhythmia were included...
December 15, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29225848/delayed-diagnosis-of-brugada-syndrome-in-a-patient-with-aborted-sudden-cardiac-death-and-initial-negative-flecainide-challenge
#20
Samuel Chauveau, Olivier Le Vavasseur, Philippe Chevalier
A negative flecainide challenge does not rule out Brugada syndrome even in the presence of nonfatal cardiac arrest as the first manifestation of the disease. This should prompt clinicians to ensure long-term ECG follow-up and consider repeating a drug test with another sodium channel blocker.
December 2017: Clinical Case Reports
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