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Gerrit Frommeyer, Harilaos Bogossian, Eleni Pechlivanidou, Philipp Conzen, Christopher Gemein, Kay Weipert, Inga Helmig, Ritvan Chasan, Victoria Johnson, Lars Eckardt, Christian W Hamm, Melchior Seyfarth, Bernd Lemke, Markus Zarse, Jörn Schmitt, Damir Erkapic
BACKGROUND: The presence of left bundle branch block (LBBB) due to right ventricular pacing represents a particular challenge in properly measuring the QTc interval. In 2014 a new formula for evaluation of QT interval in patients with LBBB was reported. METHODS: 145 patients with implantable cardioverter defibrillator (ICD) were included in this prospective multicenter observational study. Inclusion criteria were: no permanent right ventricular stimulation, an intrinsic QRS interval of <120ms and reduced left ventricular function...
February 5, 2017: Pacing and Clinical Electrophysiology: PACE
Adeep Puri, Andrew Niewiarowski, Yasumasa Arai, Hideaki Nomura, Mark Baird, Isobel Dalrymple, Steve Warrington, Malcolm Boyce
AIMS: to compare the pharmacokinetics, safety, tolerability, and immunogenicity of FKB327, a biosimilar of adalimumab, with European Union (EU)-approved Humira and United States (US)-licensed Humira after single subcutaneous doses in healthy subjects. METHODS: in a randomised, double-blind, parallel-group study, 180 healthy subjects received by subcutaneous injection 40 mg of EU-Humira, or US-Humira, or FKB327, in a 1:1:1 ratio, stratified by bodyweight. Pharmacokinetics, local tolerability, immunogenicity, adverse events, vital signs, ECG, and laboratory safety tests were assessed before and up to 1536 h after treatment...
January 30, 2017: British Journal of Clinical Pharmacology
Steffen Grautoff
The 12 lead ECG is difficult to evaluate if there is a persistent right or even left bundle block or a pace maker continually stimulating the right ventricle. Despite these pre-existing or new ECG changes it might still be possible to detect variations which can hint to an ST-elevation myocardial infarction (STEMI). Diagnosing significant ST elevations in a case of right bundle block is not very challenging. If the ECG shows a left bundle block the modified Sgarbossa criteria should be used for evaluation. These criteria can also be used in a pace maker ECG...
January 2017: Deutsche Medizinische Wochenschrift
Tilman Perrin, Lukas Daniel Trachsel, Simon Schneiter, Andrea Menafoglio, Silvia Albrecht, Tony Pirrello, Prisca Eser, Laurent Roten, Boris Gojanovic, Matthias Wilhelm
AIMS OF THE STUDY: Sudden cardiac arrest in athletes is a rare but dramatic event. The value of a routine electrocardiogram (ECG) during preparticipation screening (PPS) remains controversial, partly because of the relatively high number of false positive findings. Our study aimed to evaluate the prevalence of abnormal ECGs in consecutive Swiss elite athletes, overall and with regard to different sports classes, using modern screening criteria. METHODS: We analysed the 12-lead resting ECGs of high-level elite athletes (age ≥14 years) recorded at the Swiss Olympic Medical Centre Magglingen between 2013 and 2016 during routine PPS...
January 19, 2017: Swiss Medical Weekly
Thomas P Mast, Cynthia A James, Hugh Calkins, Arco J Teske, Crystal Tichnell, Brittney Murray, Peter Loh, Stuart D Russell, Birgitta K Velthuis, Daniel P Judge, Dennis Dooijes, Ryan J Tedford, Jeroen F van der Heijden, Harikrishna Tandri, Richard N Hauer, Theodore P Abraham, Pieter A Doevendans, Anneline S J M Te Riele, Maarten J Cramer
Importance: Considerable research has described the arrhythmic course of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). However, objective data characterizing structural progression, such as ventricular enlargement and cardiac dysfunction, in ARVD/C are relatively scarce. Objectives: To define the extent of structural progression, identify determinants of structural progression, and determine the association between structural progression and electrocardiographic (ECG) changes in patients with ARVD/C...
January 11, 2017: JAMA Cardiology
F Gianfagna, G Veronesi, L Bertù, M Tozzi, A Tarallo, M M Ferrario, P Castelli
BACKGROUND: Recent meta-analyses suggested that screening program for abdominal aortic aneurysms (AAA) in 65-year old males is cost-effective at prevalence of about 1%. Since some events occur also in females and among the youngers, screening could be feasible among those at higher risk, such as smokers or individuals with a family history of AAA. The RoCAV (Risk of Cardiovascular diseases and abdominal aortic Aneurysms in Varese) Project is a population-based study aimed to evaluate AAA prevalence in Northern Italy in males over-65 years as well as among females and younger males, and to identify new markers for risk stratification by collecting a large set of CVD risk factors...
November 29, 2016: BMC Cardiovascular Disorders
Oliver P Guttmann, Menelaos Pavlou, Constantinos O'Mahony, Lorenzo Monserrat, Aristides Anastasakis, Claudio Rapezzi, Elena Biagini, Juan Ramon Gimeno, Giuseppe Limongelli, Pablo Garcia-Pavia, William J McKenna, Rumana Z Omar, Perry M Elliott
OBJECTIVES: Atrial fibrillation (AF) is associated with increased morbidity and mortality in patients with hypertrophic cardiomyopathy (HCM). The primary aim of this study (HCM Risk-AF) was to determine the predictors of AF in a large multicentre cohort of patients with HCM. Exploratory analyses were performed to investigate the association between AF and survival and the efficacy of antiarrhythmic therapy in maintaining sinus rhythm (SR). METHODS: A retrospective, longitudinal cohort of patients recruited between 1986 and 2008 in seven centres was used to develop multivariable Cox regression models fitted with preselected predictors...
October 28, 2016: Heart: Official Journal of the British Cardiac Society
John J Wang, Olle Pahlm, Galen S Wagner, James W Warren, B Milan Horáček, John L Sapp
BACKGROUND: Existing criteria recommended by ACC/ESC for identifying patients with ST elevation myocardial infarction (STEMI) from the 12-lead ECG perform with high specificity (SP) but low sensitivity (SE). In our previous studies, we found that the SE of acute ischemia detection can be markedly improved without any loss of SP by calculating, from the 12-lead ECG, ST deviation in 3 "optimal" vessel-specific leads (VSLs). To further validate the method, we evaluated the SP performance using a dataset with non-ischemic ST-segment changes...
November 2016: Journal of Electrocardiology
Peter Seizer, Michaela Rockenstiehl, Suzanne Fateh-Moghadam, Susanne Haen, Ferruh Artunc, Martin R Müller, Azadeh Ebrahimi, Reimer Riessen, Meinrad Gawaz, Falko Fend, Michael Haap
HISTORY AND ADMISSION FINDINGS: A 55-year old man suffers from progressive, distinctive dyspnoea and physical weakness since 5 days. Due to ST-segment changes in the ECG and a positive troponin-test, the primary care physician initiates an hospitalization. INVESTIGATIONS: After admission, the laboratory tests confirm the elevated troponin-values, and show additionally elevated pro-brain-natriuric-peptide-values. The coronary angiography presents a highly reduced left ventricular function, an aortic insufficiency III° and a coronary heart disease...
September 2016: Deutsche Medizinische Wochenschrift
Arshad A Khan, Trent Williams, Lindsay Savage, Paul Stewart, Asma Ashraf, Allan J Davies, Steven Faddy, John Attia, Christopher Oldmeadow, Rohan Bhagwandeen, Peter J Fletcher, Andrew J Boyle
OBJECTIVE: The system of care in the Hunter New England Local Health District for patients with ST-segment elevation myocardial infarction (STEMI) foresees pre-hospital thrombolysis (PHT) administered by paramedics to patients more than 60 minutes from the cardiac catheterisation laboratory (CCL), and primary percutaneous coronary intervention (PCI) at the CCL for others. We assessed the safety and effectiveness of the pre-hospital diagnosis strategy, which allocates patients to PHT or primary PCI according to travel time to the CCL...
August 1, 2016: Medical Journal of Australia
Marcus Eng Hock Ong, Ying Hao, Susan Yap, Pin Pin Pek, Terrance Siang Jin Chua, Faith Suan Peng Ng, Swee Han Lim
OBJECTIVES: The new Vancouver Chest Pain (VCP) Rule recommends early discharge for chest pain patients who are at low risk of developing acute coronary syndrome (ACS), and thus can be discharged within 2 hours of arrival at the emergency department (ED). This study aimed to assess the performance of the new VCP Rule for Asian patients presenting with chest pain at the ED. METHODS: This prospective cohort study involved patients attended to at the ED of a large urban centre...
January 2017: CJEM
Pedro Freitas, Miguel Borges Santos, Mariana Faria, Gustavo Rodrigues, Nélson Vale, Rui Campante Teles, Manuel Almeida, Miguel Mendes
BACKGROUND/PURPOSE: In patients with right ventricular pacing, the ECG shows a left bundle branch block (LBBB) pattern. There are several criteria to diagnose ST-elevation myocardial infarction (STEMI) in patients with LBBB. The aim of this study was to validate and compare Sgarbossa's with two new scores - Selvester's and Smith's - in this context. METHODS: We identified pacemaker patients submitted to coronary angiography due to acute coronary syndrome. ECGs were analyzed by 2 blinded cardiologists...
September 2016: Journal of Electrocardiology
Xin Huang, Sachin K Ramdhany, Yong Zhang, Zuyi Yuan, Gary S Mintz, Ning Guo
OBJECTIVES: In acute inferior ST-segment elevation myocardial infarction (STEMI), multiple criteria have been proposed to predict the culprit artery based on the 12-lead electrocardiogram (ECG). We assessed the utilities of 11 traditional and 2 new criteria to devise a new ECG algorithm to localize the culprit artery in acute inferior STEMI. METHODS: We analyzed electrocardiographic and angiographic findings of 194 consecutive patients with acute inferior STEMI to devise a new ECG algorithm, further validated in another cohort of 80 patients with acute inferior STEMI...
September 2016: American Journal of Emergency Medicine
Patrick S Moran, Conor Teljeur, Mairin Ryan, Susan M Smith
BACKGROUND: Atrial fibrillation (AF), the most common arrhythmia in clinical practice, is a leading cause of morbidity and mortality. Screening for AF in asymptomatic patients has been proposed as a way of reducing the burden of the disease by detecting people who would benefit from prophylactic anticoagulation therapy before the onset of symptoms. However, for screening to be an effective intervention, it must improve the detection of AF and provide benefit for those detected earlier as a result of screening...
2016: Cochrane Database of Systematic Reviews
András Vereckei, Gábor Katona, Zsuzsanna Szelényi, Gábor Szénási, Bálint Kozman, István Karádi
Cardiac resynchronization therapy (CRT) is associated with a favorable outcome only in patients with left bundle branch block (LBBB) pattern and in patients with a QRS duration > 150 ms, in patients with non-LBBB pattern with a QRS duration of 120-150 ms usually is not beneficial. After adjusting for QRS duration, QRS morphology was no longer a determinant of the clinical response to CRT. In contrast to the mainstream view, we hypothesized that the unfavorable CRT outcome in patients with non-LBBB and a QRS duration of 120-150 ms is not due to the QRS morphology itself, but to less dyssynchrony and unfavorable patient characteristics in this subgroup, such as more ischemic etiology and greater prevalence of male patients compared with patients with LBBB pattern...
February 2016: Journal of Geriatric Cardiology: JGC
Hong Yang, Ying Wang, Mark Nolan, Kazuaki Negishi, Peter M Okin, Thomas H Marwick
A process to identify and target a selected population at risk of heart failure (HF) could facilitate screening and prevention. We sought to develop an effective screening process from clinical characteristics, functional capacity, and electrocardiogram (ECG). Asymptomatic subjects ≥65 years, with ≥1 HF risks were recruited from the community. Subjects with valvular disease, ejection fraction <40%, and atrial fibrillation were excluded. All underwent clinical evaluation including assessment of HF risk using Framingham HF score and Atherosclerosis Risk in Communities (ARIC) score, ECG, echocardiography, and 6-minute walk (6 MW) test...
June 15, 2016: American Journal of Cardiology
David Pickham, David Hsu, Muhammad Soofi, Jana M Goldberg, Divakar Saini, David Hadley, Marco Perez, Victor F Froelicher
PURPOSE: Sudden cardiac death is the leading cause of death in athletes. Long QT syndrome (LQTS) is one of the most common cardiogenetic diseases that can lead to sudden cardiac death and is identified by QT interval prolongation on an ECG. Recommendations for QT monitoring in athletes are adopted from nonathlete populations. To improve screening, ECG data of athletes are assessed to determine a more appropriate method for QT interval estimation. METHODS: ECG (CardeaScreen) data were collected from June 2010 to March 2015...
September 2016: Medicine and Science in Sports and Exercise
Antonio Curcio, Andrea Mazzanti, Raffaella Bloise, Nicola Monteforte, Ciro Indolfi, Silvia G Priori, Carlo Napolitano
INTRODUCTION: The 2013 HRS/EHRA/APHRS consensus statement recommends the use of V1 and V2 leads recorded in the second and third intercostal spaces (High-ICS) for diagnosis of Brugada syndrome (BrS) creating a new category of patients discovered only with modified leads. The clinical presentation and the arrhythmic risk in these patients are ill defined. This study was aimed at assessing the role of High-ICS in the analysis of BrS and the clinical profile of the patients diagnosed only when ECG leads are moved to upper intercostal spaces...
August 2016: Journal of Cardiovascular Electrophysiology
Patrizio Pascale, Julien Regamey, Juan F Iglesias, Vincent Gabus, Mathieu Clair, Patrick Yerly, Roger Hullin, Olivier Müller, Éric Eeckhout, Pierre Vogt
The present review provides a selected choice of clinical trials and therapeutic advances in the field of cardiology in 2015. A new treatment option in heart failure will become available this year in Switzerland. In interventional cardiology, new trials have been published on the duration of dual antiplatelet therapy, the new stents with bioresorbable scaffold and the long-term results of TAVR in patients who are not surgical candidates or at high surgical risk. RegardingAF the BRIDGE trial provides new evidences to guide the management of patients during warfarin interruption for surgery...
January 13, 2016: Revue Médicale Suisse
Jonah M Pozen, Anit K Mankad, John T Owens, Ion S Jovin
CONTEXT: ST-segment elevations in two or more contiguous leads or new left bundle branch block (LBBB) on electrocardiography (ECG) in a patient with acute onset chest pain are diagnostic criteria for acute myocardial infarction (AMI) and generally warrant urgent coronary angiography and cardiac catheterization. However, the significance of new right bundle branch block (RBBB) without other acute ECG changes is unclear and is currently not considered a criterion. CASE REPORT: We present a patient with chest pain, positive biomarkers of myocardial necrosis and isolated new right bundle block on ECG...
December 2015: North American Journal of Medical Sciences
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