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John D Fisher
In the words of the legendary late John Messenger, pacemakers have evolved from the equivalent of a pirate's peg leg that simply prevents you from falling down, to a fully articulated prosthesis. Each "ultimate" step has been succeeded by ever more sophisticated devices. Very early attempts at providing atrioventricular synchrony included metal wire connections between atrium and ventricle, and His bundle pacing with large screw-in electrodes. These efforts failed, largely because of poor conductivity, excessive fibrosis and loss of capture...
October 24, 2016: Pacing and Clinical Electrophysiology: PACE
Payam Safavi-Naeini, Mohammad Saeed
No abstract text is available yet for this article.
October 2016: Texas Heart Institute Journal
S Ram Kumar, Grace Kung, Nathan Noh, Novel Castillo, Brian Fagan, Winfield J Wells, Vaughn A Starnes
BACKGROUND: We have previously shown that neonates in profound cardiogenic shock caused by a severe Ebstein anomaly can be successfully salvaged with fenestrated right ventricular exclusion and systemic to pulmonary shunt (modified Starnes procedure). The long-term outcome of single-ventricle management in these patients is not known. METHODS: We retrospectively reviewed the records of patients who underwent neonatal Starnes procedure between 1989 and 2015. Patient demographics, clinical variables, and outcome data were collected...
October 25, 2016: Circulation
Jan-Malte Sinning, Anna Sonia Petronio, Nicolas Van Mieghem, Giulio Zucchelli, Georg Nickenig, Raffi Bekeredjian, Johan Bosmans, Francesco Bedogni, Marian Branny, Karl Stangl, Jan Kovac, Anna Nordell, Molly Schiltgen, Nicolo Piazza, Peter de Jaegere
Best practices for transcatheter aortic valve implantation with CoreValve include patient screening and valve size selection using multislice computed tomography, adherence to manufacturer recommendations for oversizing, control of implant depth to 6 mm or less, and management of conduction disturbances according to international guidelines. The ADVANCE II study implemented these strategies and demonstrated their relation to clinical outcomes. From October 2011 to April 2013, 200 patients with severe aortic stenosis were enrolled, and 194 were implanted...
September 30, 2016: American Journal of Cardiology
Xingqun Liang, Sylvia M Evans, Yunfu Sun
The sinoatrial node (SAN) is the dominant pacemaker of the heart. Abnormalities in SAN formation and function can cause sinus arrhythmia, including sick sinus syndrome and sudden death. A better understanding of genes and signaling pathways that regulate SAN development and function is essential to develop more effective treatment to sinus arrhythmia, including biological pacemakers. In this review, we briefly summarize the key processes of SAN morphogenesis during development, and focus on the transcriptional network that drives SAN development...
October 21, 2016: Cellular and Molecular Life Sciences: CMLS
Andreas Arendt, El-Sayed Baz, Monika Stengl
The circadian pacemaker of the Madeira cockroach Rhyparobia (Leucophaea) maderae is located in the accessory medulla (AME). Ipsi- and contralateral histaminergic compound eyes are required for photic entrainment. Light pulses delayed locomotor activity rhythms during the early night and advanced during the late night. Thus, different neuronal pathways might relay either light-dependent delays or advances to the clock. Injections of neuroactive substances combined with running-wheel assays suggested that GABA, PDF, myoinhibitory peptides (MIPs), and orcokinins (ORCs) are part of both entrainment pathways, while allatotropin (AT) only delayed locomotor rhythms at the early night...
October 20, 2016: Journal of Comparative Neurology
Lois Choy, Jie Ming Yeo, Vivian Tse, Shing Po Chan, Gary Tse
The mouse is the second mammalian species, after the human, in which substantial amount of the genomic information has been analyzed. With advances in transgenic technology, mutagenesis is now much easier to carry out in mice. Consequently, an increasing number of transgenic mouse systems have been generated for the study of cardiac arrhythmias in ion channelopathies and cardiomyopathies. Mouse hearts are also amenable to physical manipulation such as coronary artery ligation and transverse aortic constriction to induce heart failure, radiofrequency ablation of the AV node to model complete AV block and even implantation of a miniature pacemaker to induce cardiac dyssynchrony...
September 2016: IJC Heart & Vasculature
Abraham Speedie, Cinosh Mathew, Ramgopal S Shahi, Rajneesh Calton
INTRODUCTION: The development of implantable technology for cardiac rhythm management remains one of the seminal achievements of the second half of the 20th century. The development of artificial pacemakers for the electrical control of the cardiac rhythm has greatly enhanced the physician's ability to treat cardiac dysrhythmias. An ageing population and the extension of indications will in all probability result in an increasing number of cardiac device implantations. OBJECTIVE OF STUDY: To study mortality and morbidity in patients with permanent pacemaker implantation at a tertiary care hospital in North India...
September 2016: Journal of the Association of Physicians of India
Meki Bilici, Fikri Demir, Murat Muhtar Yılmazer, Fatma Bozkurt, Volkan Tuzcu
BACKGROUND: The clinical spectrum of Brucella infection is quite diverse and characterized by multi-system involvement. Patients present with myocarditis, endocarditis, or pericarditis. Infective endocarditis is the most common cardiovascular complication in patients with brucellosis. Although conduction abnormalities are seen in cases with endocarditis, they are reported very rarely in the setting of cardiac Brucella infection. CASE REPORT: An eight and a half-year-old male patient was referred to our clinic due to inadequate response to cotrimaxazole plus streptomycin treatment at the 15th day of admission...
September 2016: Balkan Medical Journal
Tomoyuki Tobushi, Soichiro Kashihara, Toshiaki Kadokami
Some acute complications are known during permanent pacemaker implantation such as pneumothorax, lead perforation, lead dislodgement, and hemorrhage. ST-segment elevation in electrocardiogram during implantation is rare, but it might indicate critical complication like myocardial ischemia or ventricular perforation. Physicians should pay attention about ST-segment change during pacemaker implantation.
October 2016: Clinical Case Reports
Taisuke Ishikawa, Yukiomi Tsuji, Naomasa Makita
Bradyarrhythmia is a common heart rhythm abnormality comprising number of diseases and is associated with decreased heart rate due to the failure of action potential generation and propagation at the sinus node. Permanent pacemaker implantation is often used therapeutically to compensate for decreased heart rate and cardiac output. The vast majority of bradyarrhythmia cases are attributable either to aging or to structural abnormalities of the cardiac conduction system, caused by underlying structural heart disease...
October 2016: Journal of Arrhythmia
Haitao Yu, Rishi R Dhingra, Thomas E Dick, Roberto Fernandez Galan
Neural activity generally displays irregular firing patterns even in circuits with apparently regular outputs, such as motor pattern generators, in which the output frequency fluctuates randomly around a mean value. This "circuit noise" is inherited from the random firing of single neurons, which emerges from stochastic ion-channel gating (channel noise), spontaneous neurotransmitter release, and its diffusion and binding to synaptic receptors. Here, we demonstrate how to expand conductance-based network models that are originally deterministic to include realistic, physiological noise, focusing on stochastic ion-channel gating...
October 19, 2016: Journal of Neurophysiology
Adrian Zurbuchen, Andreas Haeberlin, Lukas Bereuter, Joerg Wagner, Alois Pfenniger, Sammy Omari, Jakob Schaerer, Frank Jutzi, Christoph Huber, Juerg Fuhrer, Rolf Vogel
No abstract text is available yet for this article.
October 15, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
A Sami Chaouki, David S Spar, Philip Khoury, Jeffrey B Anderson, Timothy K Knilans, David L S Morales, Richard J Czosek
BACKGROUND: Complications related to epicardial pacemakers in infants have been reported though limited data are available regarding their incidence and associated risk factors. OBJECTIVE: The hypothesis of the study is that younger, smaller patients and larger devices would be associated with complications in neonates and infants. METHODS: This is a retrospective study of all patients at a single center receiving an epicardial pacemaker at ≤12 months of age (1996-2015)...
October 15, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
James E Dalen, Joseph S Alpert
A new suspected cause of cryptic strokes is "silent atrial fibrillation". Pacemakers and other implanted devices allow continuous recording of cardiac rhythm for months or years. They have discovered that short periods of atrial fibrillation lasting minutes or hours are frequent and usually are asymptomatic. A meta-analysis of 50 studies involving more than 10,000 patients with a recent stroke found that 7.7% had atrial fibrillation on their admitting EKG. In 3 weeks during and after hospitalization, another 16...
October 15, 2016: American Journal of Medicine
Eunjoo Cho, Euna Lee, Eun Young Kim
The circadian clock system enables organisms to anticipate the rhythmic environmental changes and to manifest behavior and physiology at advantageous times of day. Transcriptional/translational feedback loop (TTFL) is the basic feature of eukaryotic circadian clock and is based on the rhythmic association of circadian transcriptional activator and repressor. In Drosophila, repression of dCLOCK/CYCLE (dCLK/CYC) mediated transcription by PERIOD (PER) is critical for inducing circadian rhythms of gene expression...
October 19, 2016: BMB Reports
Pedro Pallangyo, Isaac Mawenya, Paulina Nicholaus, Henry Mayala, Amida Kalombola, Godwin Sharau, Naiz Majani, Mohamed Janabi
BACKGROUND: Congenital complete heart block is a life-threatening condition which is highly associated with autoimmune and connective tissue disorders. Presence of maternal autoantibodies for associated conditions increases the risk of delivering a child with congenital complete heart block, however, less than a half of all women with such antibodies are symptomatic even after delivery. Mortality rate is highest during the neonatal period (45 %) and about two-thirds of all cases will require permanent pacing at some point in their lives...
October 19, 2016: Journal of Medical Case Reports
Steven Swiryn, Michael V Orlov, David G Benditt, John P DiMarco, Donald M Lloyd-Jones, Edward Karst, Fujian Qu, Mara T Slawsky, Melanie Turkel, Albert L Waldo
BACKGROUND: The RATE Registry (Registry of Atrial Tachycardia and Atrial Fibrillation Episodes) is a prospective, outcomes-oriented registry designed to document the prevalence of atrial tachycardia and/or fibrillation (AT/AF) of any duration in patients with pacemakers and implantable cardioverter defibrillators (ICDs) and evaluate associations between rigorously adjudicated AT/AF and predefined clinical events, including stroke. The appropriate clinical response to brief episodes of AT/AF remains unclear...
October 18, 2016: Circulation
Gennaro Giustino, Robert M A Van der Boon, Javier Molina-Martin de Nicolas, Nicolas Dumonteil, Alaide Chieffo, Peter P T de Jaegere, Didier Tchetche, Bertrand Marcheix, Damien Millischer, Romain Cassagneau, Didier Carrié, Nicolas M Van Mieghem, Antonio Colombo
AIMS: We sought to evaluate the impact of permanent pacemaker (PPM) implantation on two-year mortality and one-year left ventricular ejection fraction recovery (∆LVEFR=one-year LVEF-baseline LVEF) after transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We pooled patient-level data from four European institutions with significant TAVI volume. Outcomes were compared between patients without PPM (no-PPM), patients with PPM prior to TAVI (old-PPM) and patients with PPM implanted after TAVI (new-PPM)...
October 20, 2016: EuroIntervention
Stefano Schiaffino, Bert Blaauw, Kenneth A Dyar
The circadian oscillations of muscle genes are controlled either directly by the intrinsic muscle clock or by extrinsic factors, such as feeding, hormonal signals, or neural influences, which are in turn regulated by the central pacemaker, the suprachiasmatic nucleus of the hypothalamus. A unique feature of circadian rhythms in skeletal muscle is motor neuron-dependent contractile activity, which can affect the oscillation of a number of muscle genes independently of the muscle clock. The role of the intrinsic muscle clock has been investigated using different Bmal1 knockout (KO) models...
2016: Skeletal Muscle
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