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Judson A Moore, Antonio G Cabrera, Jeffrey J Kim, Santiago O Valdés, Caridad de la Uz, Christina Y Miyake
Follow-up data and correlation of arrhythmias, electrocardiogram (ECG) changes, and cardiac function in anomalous left coronary artery from the pulmonary trunk or artery have not been previously studied. This is a retrospective single-center review of 44 anomalous left coronary artery from the pulmonary trunk or artery patients diagnosed between 1992 and 2014, at a median age of 3 months (3 days to 13 years). Clinical history, ECG, Holter, and echocardiogram data were reviewed. ECGs were reviewed for contiguous Q-or T-wave inversions, hypertrophy, bundle branch block, and axis deviation...
September 23, 2016: American Journal of Cardiology
Danielle L Brunjes, Adam Castano, Autumn Clemons, Jonah Rubin, Mathew S Maurer
Wild type transthyretin cardiac amyloidosis (ATTRwt), formerly called senile cardiac amyloidosis (SCA), is almost exclusively a disorder of older adults. As the population ages, the diagnosis of ATTRwt will increase making it the most common form of cardiac amyloidosis. An important precondition to reduce under-diagnosis and misdiagnosis is to maintain a high index of suspicion for cardiac amyloidosis. Several clues can be gleaned from the clinical history, physical exam, electrocardiogram and non-invasive imaging techniques...
October 18, 2016: Journal of Cardiac Failure
Anne-Maree Kelly, Sharon Klim
BACKGROUND: To determine the rate of all cause and cardiac death, new myocardial infarction (MI) or coronary revascularisation at over three years from index visit in emergency department chest pain patients without known coronary artery disease (CAD) at index presentation who had a negative electrocardiogram (ECG) and biomarker workup for acute coronary syndrome (ACS). METHODS: An unplanned sub-study of a prospective observational study of consecutive adult patients presenting to the ED with atraumatic chest pain (or equivalents)...
September 13, 2016: Heart, Lung & Circulation
Wesley T O'Neal, Kristine E Lee, Elsayed Z Soliman, Ronald Klein, Barbara E K Klein
PURPOSE: To determine the incidence and determinants of developing abnormalities on the 12-lead electrocardiogram (ECG) in persons with type 1 diabetes. METHODS: We evaluated the distribution of ECG abnormalities and risk factors for developing new abnormalities in 266 (mean age = 44 years ± 9.0; 50 % female) people with type 1 diabetes from the Wisconsin Epidemiologic Study of Diabetic Retinopathy. This analysis included participants with complete ECG data from study visit 5 (2000-2001) and follow-up ECGs from study visit 7 (2012-2014)...
October 20, 2016: Journal of Endocrinological Investigation
Marek Sramko, Dan Wichterle, Josef Kautzner
This study evaluated hemodynamic feasibility and reproducibility of a new method for in vivo simulation of human atrial fibrillation (AF). The method was tested during sinus rhythm in 10 patients undergoing catheter ablation for AF. A simple electronic device was assembled that allowed triggering a cardiac stimulator by predefined series of RR intervals. Irregular RR interval sequences with a mean heart rate of 90/min and 130/min were obtained from ECG recordings of another patients with AF. Simultaneous atrioventricular pacing was delivered by catheters placed inside the coronary sinus and at the His bundle region...
2016: PloS One
Giovanni Filardo, Gorav Ailawadi, Benjamin D Pollock, Briget da Graca, Danielle M Sass, Teresa K Phan, Debbie E Montenegro, Vinod Thourani, Ralph Damiano
BACKGROUND: New-onset atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG) is associated with increased morbidity and poorer long-term survival. Although many studies show differences in outcome in women versus men after CABG, little is known about the sex-specific incidence and characteristics of post-CABG AF. METHODS AND RESULTS: Overall, 11 236 consecutive patients without preoperative AF underwent isolated CABG from 2002 to 2010 at 4 US academic medical centers and 1 high-volume specialty cardiac hospital...
October 18, 2016: Circulation. Cardiovascular Quality and Outcomes
Hui Li, Jingbo Li, Xiaohong Zhou, Jianrong Zhao, Fengru Zhang, Liqun Wu, Hong Shen, Qing Wan, Jing Huang, Shungang Yang, Ping Wang
Heart failure patients have a high incidence of chronotropic incompetence (CI) that receives less clinical attention. This study assessed a method using wearable devices to identify CI in heart failure patients. Twenty-six heart failure patients (LVEF: 43.9  ±  5.7% with LVEF  ⩾40% in 19 patients; age: 52.8  ±  12.4 years, female patients  =  6) were enrolled. Each patient underwent symptom-limited treadmill maximal exercise testing during which the simultaneous recording of ECG Holter and physical activity using Actigraph was conducted...
October 18, 2016: Physiological Measurement
P Gal, T J Buist, J J J Smit, A Adiyaman, A R Ramdat Misier, P P H M Delnoy, A Elvan
INTRODUCTION: Pulmonary vein (PV) reconnection is frequently the cause of recurrence of atrial fibrillation (AF) after ablation. The second-generation gold multi-electrode ablation (Gold-MEA) catheter has a new design possibly resulting in improved lesion formation compared with its predecessor. We aimed to determine the association between effective radiofrequency applications with the Gold-MEA catheter and outcome after AF ablation. METHODS: 50 consecutive patients with paroxysmal AF underwent Gold-MEA (PVAC GOLD(TM), Medtronic Inc...
October 17, 2016: Netherlands Heart Journal
Ivan Co, Wesley Eilbert, Terry Chiganos
BACKGROUND: The electronic medical record is a relatively new technology that allows quick review of patients' previous medical records, including previous electrocardiograms (ECGs). Previous studies have evaluated ECG patterns predictive of pulmonary embolism (PE) at the time of PE diagnosis, though none have examined ECG changes in these patients when compared with their previous ECGs. OBJECTIVE: Our aim was to identify the most common ECG changes in patients with known PE when their ECGs were compared with their previous ECGs...
October 11, 2016: Journal of Emergency Medicine
Shohreh Honarbakhsh, Neil Srinivasan, Claire Kirkby, Eileen Firman, Liam Tobin, Malcolm Finlay, Ross J Hunter, Cliona Murphy, Martin D Lowe, Richard J Schilling, Pier D Lambiase
AIMS: Early repolarization (ER) has been linked to poorer outcomes in idiopathic ventricular fibrillation (IVF). The role of family screening in IVF is not clear. Our aim was to review predictors for poorer outcomes and evaluate the role of family screening in IVF. METHODS AND RESULTS: This was a retrospective multicentre cohort study including all patients diagnosed with IVF. Data were collected on baseline characteristics, ECG findings, and recurrence of ventricular arrhythmia (VA) during follow-up...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Andrzej Wojtarowicz, Zdzisława Kornacewicz-Jach
BACKGROUND: Alcohol septal ablation (ASA) is a method of treatment in obstructive hypertrophic cardiomyopathy (HOCM), but there is little data on the long-term results of ASA and the natural course after treatment. The aim of the study was to evaluate the results of ASA in HOCM in multiannual observation, and its impact on patient survival, exercise capacity, electrical complications, and changes in the anatomy and function of the heart. METHODS: The study evaluated 47 patients with HOCM with a high left ventricular outflow tract (LVOT gradient) treated between 1997 and 2014 with ASA...
October 13, 2016: Cardiology Journal
Christoph Beck, Julius Georgiou
In this Letter, the authors describe the characterisation design and development of the authors' wearable, multimodal vitals acquisition unit for intelligent field triage. The unit is able to record the standard electrocardiogram, blood oxygen and body temperature parameters and also has the unique capability to record up to eight custom designed acoustic streams for heart and lung sound auscultation. These acquisition channels are highly synchronised to fully maintain the time correlation of the signals. The unit is a key component enabling systematic and intelligent field triage to continuously acquire vital patient information...
September 2016: Healthcare Technology Letters
Maartje S Jacobs, Femke Kaasenbrood, Maarten J Postma, Marinus van Hulst, Robert G Tieleman
AIMS: Atrial fibrillation (AF) is the most common arrhythmia and prevalence increases with age. Patients with AF have a high risk of stroke, and screening for AF is recommended in all people aged 65 years or older to identify patients eligible for stroke prevention. A handheld, single-lead electrocardiogram (ECG) device can be used for systematic screening in the population at risk. The objective of this study is to estimate the cost-effectiveness of screening for AF in primary care with the MyDiagnostick(®) during seasonal influenza vaccination in the Netherlands...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Erik Skobel, Christian Knackstedt, Alvaro Martinez-Romero, Dario Salvi, Cecilia Vera-Munoz, Andreas Napp, Jean Luprano, Ramon Bover, Sigrid Glöggler, Birna Bjarnason-Wehrens, Nikolaus Marx, Alan Rigby, John Cleland
Low adherence to cardiac rehabilitation (CR) might be improved by remote monitoring systems that can be used to motivate and supervise patients and tailor CR safely and effectively to their needs. The main objective of this study was to evaluate the feasibility of a smartphone-guided training system (GEX) and whether it could improve exercise capacity compared to CR delivered by conventional methods for patients with coronary artery disease (CAD). A prospective, randomized, international, multi-center study comparing CR delivered by conventional means (CG) or by remote monitoring (IG) using a new training steering/feedback tool (GEx System)...
October 11, 2016: Heart and Vessels
Radu Campean, Matthias Hasun, Claudia Stöllberger, Johannes Bucher, Josef Finsterer, Christoph Schnack, Franz Weidinger
BACKGROUND: Reversible left ventricular dysfunction, also termed Takotsubo cardiomyopathy, is rarely reported in Addison's disease after initiation of hormone replacement therapy. The pathogenesis of this cardiomyopathy is unknown. CASE PRESENTATION: A 41-year-old white woman with a history of autoimmune Hashimoto thyroiditis diagnosed 3 years earlier and acute adrenal insufficiency diagnosed 3 weeks earlier presented with new onset of heart failure New York Heart Association class IV, which had started shortly after initiation of hormone replacement therapy with hydrocortisone 20 mg/day and fludrocortisone 0...
October 12, 2016: Journal of Medical Case Reports
Desheng Zhai, Yan Lang, Gaopan Dong, Yijun Liu, Xin Wang, Dushuang Zhou, Taizhen Cui, Yuxin Yang, Wenxi Zhang, Ying Zhao, Ruiling Zhang
Antipsychotic use is reported to be associated with a higher risk of sudden cardiac death and new users are especially susceptible to that risk. In this study, we focused on the ability of antipsychotics to prolong the QTc interval at the earliest stages of antipsychotic use. We employed a retrospective cohort study design in a naturalistic setting where having three ECG measurements over time (at baseline and after drug exposure) in antipsychotic-naïve, first-episode schizophrenia (FES) inpatients. The results revealed, in this relatively homogeneous, drug naïve FES patient sample, that QTc intervals were statistically significantly prolongated after a relatively short term (2-4weeks) of antipsychotic treatments, compared with baseline...
October 7, 2016: Schizophrenia Research
Lin-Peng Jin, Jun Dong
Ensemble learning has been proved to improve the generalization ability effectively in both theory and practice. In this paper, we briefly outline the current status of research on it first. Then, a new deep neural network-based ensemble method that integrates filtering views, local views, distorted views, explicit training, implicit training, subview prediction, and Simple Average is proposed for biomedical time series classification. Finally, we validate its effectiveness on the Chinese Cardiovascular Disease Database containing a large number of electrocardiogram recordings...
2016: Computational Intelligence and Neuroscience
Robert M Lester, Joy Olbertz
hERG assays and thorough ECG trials have been mandated since 2005 to evaluate the QT interval and potential proarrhythmic risk of new chemical entities. The high cost of these studies and the shortcomings inherent in these binary and limited approaches to drug evaluation have prompted regulators to search for more cost effective and mechanistic paradigms to assess drug liability as exemplified by the CiPA initiative and the exposure response ICH E14(R3) guidance document. Areas Covered: This review profiles the changing regulatory landscape as it pertains to early drug development and outlines the analyses that can be performed to characterize preclinical and early clinical cardiovascular risk...
October 10, 2016: Expert Review of Clinical Pharmacology
Alan Kennedy, Dewar D Finlay, Daniel Guldenring, Raymond R Bond, Kieran Moran, James McLaughlin
Automated detection of AF from the electrocardiogram (ECG) still remains a challenge. In this study, we investigated two multivariate-based classification techniques, Random Forests (RF) and k-nearest neighbor (k-nn), for improved automated detection of AF from the ECG. We have compiled a new database from ECG data taken from existing sources. R-R intervals were then analyzed using four previously described R-R irregularity measurements: (1) the coefficient of sample entropy (CoSEn), (2) the coefficient of variance (CV), (3) root mean square of the successive differences (RMSSD), and (4) median absolute deviation (MAD)...
August 12, 2016: Journal of Electrocardiology
Rabie Soliman, Gomaa Zohry
OBJECTIVE: The aim of the study was to assess the effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery. DESIGN: A randomized prospective study. SETTING: Cairo University, Egypt. MATERIALS AND METHODS: The study included 150 patients undergoing aortic vascular surgery. INTERVENTION: The patients were classified into two groups (n = 75). Group D: The patients received a loading dose of 1 μg/kg dexmedetomidine over 15 min before induction and maintained as an infusion of 0...
October 2016: Annals of Cardiac Anaesthesia
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