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Brit Long, Alex Koyfman
BACKGROUND: Ventricular tachycardia (VT) and ventricular fibrillation are the causes of approximately 300,000 deaths per year in the United States. VT is classified based on hemodynamic status and appearance. Stable, monomorphic VT treatment is controversial. OBJECTIVE: Our aim was to provide emergency physicians with an evidence-based review of the medical management of stable, monomorphic VT. DISCUSSION: Stable, monomorphic VT is part of a larger class of ventricular dysrhythmias defined by a rate of at least 120 beats/min with QRS > 120 ms without regularly occurring P:QRS association...
October 14, 2016: Journal of Emergency Medicine
Sandeep Tak, Manoj Lakhotia, Alok Gupta, Amit Sagar, Gopal Bohra, Rajesh Bajari
A 55-year-old male presented with history of nausea, vomiting, palpitation paresthesis and profuse sweating in emergency department 2h after ingestion of "Bachnaag" (Aconite) root. Examination revealed shock with irregular pulses. Initial ECG showed frequent multifocal ventricular ectopics (VE), which later turned to short runs of ventricular tachycardia (VT). Immediate gastric lavage was done and activated charcoal given. Patient was treated with fluid resuscitation without any improvement in blood pressure...
September 2016: Indian Heart Journal
Mengqi Gong, Zhiwei Zhang, Nikolaos Fragakis, Panagiotis Korantzopoulos, Konstantinos P Letsas, Guangping Li, Gan-Xin Yan, Tong Liu
BACKGROUND: Randomized controlled trials (RCTs) regarding use of ranolazine (RN) for the prevention and cardioversion of atrial fibrillation (AF) have yielded conflicting results. OBJECTIVE: we conducted a meta-analysis of RCTs to examine the potential role of RN in the prevention and cardioversion of AF. METHODS: PubMed and EMBASE were searched until June 2016. Of 484 initially identified studies, eight RCTs were finally analyzed. RESULTS: The analysis of RCTs showed that RN significantly reduced the incidence of AF compared to the control group in various clinical settings as following cardiac surgery, in acute coronary syndromes, and post electrical cardioversion of AF (RR = 0...
October 13, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
A Paini, M Mennecozzi, T Horvat, K Gerloff, T Palosaari, J V Sala Benito, A Worth
The Virtual Cell Based Assay (VCBA) was applied to simulate the long-term (repeat dose) toxic effects of chemicals, including substances in cosmetics and personal care products. The presented model is an extension of the original VCBA for simulation of single exposure and is implemented in a KNIME workflow. This work illustrates the steps taken to simulate the repeat dose effects of two reference compounds. i) Using caffeine, in vitro experimental viability data in single and repeated exposure from two human liver cell lines, HepG2 and HepaRG, were measured and used to optimize the VCBA...
October 13, 2016: Toxicology in Vitro: An International Journal Published in Association with BIBRA
Zdeňka Límanová, Jan Jiskra
Cardiovascular system is essentially affected by thyroid hormones by way of their genomic and non-genomic effects. Untreated overt thyroid dysfunction is associated with higher cardiovascular risk. Although it has been studied more than 3 decades, in subclinical thyroid dysfunction the negative effect on cardiovascular system is much more controversial. Large meta-analyses within last 10 years have shown that subclinical hyperthyroidism is associated with higher cardiovascular risk than subclinical hypothyroidism...
2016: Vnitr̆ní Lékar̆ství
Daniele Muser, Pasquale Santangeli, Simon A Castro, Rajeev K Pathak, Jackson J Liang, Tatsuya Hayashi, Silvia Magnani, Fermin C Garcia, Mathew D Hutchinson, Gregory G Supple, David S Frankel, Michael P Riley, David Lin, Robert D Schaller, Sanjay Dixit, Erica S Zado, David J Callans, Francis E Marchlinski
BACKGROUND: Catheter ablation (CA) of ventricular tachycardia (VT) in patients with nonischemic dilated cardiomyopathy can be challenging because of the complexity of underlying substrates. We sought to determine the long-term outcomes of endocardial and adjuvant epicardial CA in nonischemic dilated cardiomyopathy. METHODS AND RESULTS: We examined 282 consecutive patients (aged 59±15 years, 80% males) with nonischemic dilated cardiomyopathy who underwent CA. Ablation was guided by activation/entrainment mapping for tolerated VT and pacemapping/targeting of abnormal electrograms for unmappable VT...
October 2016: Circulation. Arrhythmia and Electrophysiology
Bing-Cheng Zhao, Tong-Yi Huang, Qi-Wen Deng, Wei-Feng Liu, Jian Liu, Wen-Tao Deng, Ke-Xuan Liu, Cai Li
BACKGROUND: Postoperative atrial fibrillation/flutter (POAF) is associated with significant morbidity and mortality after general thoracic surgery, but the need and the best agent for prophylaxis remains obscure. METHODS: A systematic literature search was performed to identify randomized controlled trials that compared regimens for POAF prophylaxis after general thoracic surgery. Random-effects meta-analyses with trial sequential analyses were performed to compare the effects of medical prophylaxis versus placebo/usual care...
October 8, 2016: Chest
Bhaskar Nandi, R Ajay Handa, K S Brar, Umar Nazir Kabli
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Jean-Luc Vorng, Anna M Kotowska, Melissa K Passarelli, Andrew West, Peter S Marshall, Rasmus Havelund, Martin P Seah, Colin T Dollery, Paulina D Rakowska, Ian S Gilmore
There is an increasing need in the pharmaceutical industry to reduce drug failure at late stage and so reduce the cost of developing a new medicine. Since most drug targets are intracellular this requires a better understanding of the drug disposition within a cell. Secondary ion mass spectrometry has been identified as a potentially important technique to do this as it is label-free and allows imaging in 3D with sub-cellular resolution and recent studies have shown promise for amiodarone. An important analytical parameter is sensitivity and we measure this in a bovine liver homogenate reference sample for twenty drugs representing important class-types relevant to the pharmaceutical industry...
October 11, 2016: Analytical Chemistry
J A Van Heerden, J R Burger, J J Gerber
BACKGROUND: Prescribing for older patients is a well-recognised problem, and inappropriate items are prescribed frequently. Several tools and criteria are available to promote rational prescribing in older patients. OBJECTIVE: To determine the prevalence of potentially inappropriate prescriptions (PIPs) in older South African patients. METHODS: A retrospective drug utilisation review was conducted using medicine claims data over a 1-year period...
September 9, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
M Braun, C Siauw, J Schirrmeister, J Wirbelauer
We report a male newborn who became symptomatic with supraventricular tachycardia on the first day of life. Neither adenosine nor electric cardioversion could terminate the tachycardia, therefore intravenous esmolol (β-receptor blocker) was initiated. Inspite of subsequent administration of various antiarrhythmic medications in increasingly higher doses, repeated supraventricular tachycardic episodes occurred. The electrocardiogram showed typical findings of a multifocal atrial tachycardia as the underlying cause...
October 10, 2016: Zeitschrift Für Geburtshilfe und Neonatologie
Sayaka Sasaoka, Toshinobu Matsui, Yuuki Hane, Junko Abe, Natsumi Ueda, Yumi Motooka, Haruna Hatahira, Akiho Fukuda, Misa Naganuma, Shiori Hasegawa, Yasutomi Kinosada, Mitsuhiro Nakamura
Long QT syndrome (LQTS) is a disorder of the heart's electrical activity that infrequently causes severe ventricular arrhythmias such as a type of ventricular tachycardia called torsade de pointes (TdP) and ventricular fibrillation, which can be fatal. There have been no previous reports on the time-to-onset for LQTS based on data from spontaneous reporting systems. The aim of this study was to assess the time-to-onset of LQTS according to drug treatment. We analyzed the association between 113 drugs in 37 therapeutic categories and LQTS including TdP using data obtained from the Japanese Adverse Drug Event Report database...
2016: PloS One
Jeppe Egedal Kirchhoff, Jonas Goldin Diness, Lea Abildgaard, Majid Sheykhzade, Morten Grunnet, Thomas Jespersen
Dose is an important parameter in terms of both efficacy and adverse effects in pharmacological treatment of atrial fibrillation (AF). Both of the class III antiarrhythmics dofetilide and amiodarone have documented anti-AF effects. While dofetilide has dose-related ventricular side effects, amiodarone primarily has adverse non-cardiac effects. Pharmacological inhibition of small conductance Ca(2+)-activated K(+) (SK) channels has recently been reported to be antiarrhythmic in a number of animal AF models. In a Langendorff model of acutely induced AF on guinea pig hearts, it was investigated whether a combination of the SK channel blocker N-(pyridin-2-yl)-4-(pyridin-2-yl)thiazol-2-amine (ICA) together with either dofetilide or amiodarone provided a synergistic effect...
October 8, 2016: Pflügers Archiv: European Journal of Physiology
Nagat S El-Shmaa, Doaa El Amrousy, Wael El Feky
OBJECTIVE: The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery. DESIGN: This is a prospective, controlled study. SETTING: This study was carried out at a single university hospital. SUBJECTS AND METHODS: Ninety patients of both sexes, American Society of Anesthesiologists Physical Status II and III, age range from 2 to 18 years, and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants...
October 2016: Annals of Cardiac Anaesthesia
Robin Paudel, Prerna Dogra, Saurav Suman, Saurav Acharya, Jyoti Matta
Amiodarone is an antiarrhythmic drug which is highly effective against a wide spectrum of ventricular tachyarrhythmias making it irreplaceable in certain group of patients. We report an unusual case of acute liver and renal failure within 24 hours of initiation of intravenous (IV) amiodarone which resolved after stopping the medication. The mechanism of acute liver and renal toxicity is not clearly known but is believed to be secondary to amiodarone induced (relative) hypotension, idiosyncratic reaction to the drug, and toxicity of the vector that carries the medication, polysorbate-80...
2016: Case Reports in Critical Care
Anastasia Zagorianou, Meletios Marougkas, Stavros G Drakos, Nikolaos Diakos, Panagiotis Konstantopoulos, Despina N Perrea, Maria Anastasiou-Nana, Konstantinos Malliaras
Amiodarone is effective in suppressing arrhythmias in heart failure patients. We investigated the effect of long-term amiodarone administration on myocardial fibrosis and left ventricular (LV) remodeling in a porcine model of ischemic cardiomyopathy. Eighteen infarcted farm pigs were randomized to receive long-term amiodarone administration for 3 months (n = 9) or conventional follow-up (n = 9). Evolution of LV remodeling over 3 months post-myocardial infarction was examined at tissue level (myocyte size, myocardial fibrosis and vascular density assessed by whole-field digital histopathology), organ level (LV structure and function assessed by echocardiography), and systemic level (BNP and MMP-9 levels)...
2016: SpringerPlus
I E Templeton, Y Chen, J Mao, J Lin, H Yu, S Peters, M Shebley, M V Varma
This subteam under the Drug Metabolism Leadership Group (Innovation and Quality Consortium) investigated the quantitative role of circulating inhibitory metabolites in drug-drug interactions using physiologically based pharmacokinetic (PBPK) modeling. Three drugs with major circulating inhibitory metabolites (amiodarone, gemfibrozil, and sertraline) were systematically evaluated in addition to the literature review of recent examples. The application of PBPK modeling in drug interactions by inhibitory parent-metabolite pairs is described and guidance on strategic application is provided...
September 19, 2016: CPT: Pharmacometrics & Systems Pharmacology
Nur Adila Ahmad Hatib, Jan Hau Lee, Lik Eng Loh, Yee Hui Mok, Anuradha P Menon, Tsee Foong Loh, Teng Hong Tan
No abstract text is available yet for this article.
October 2016: Critical Care Medicine
Mariam Semmo, Nasser Abdalla Dhayat
No abstract text is available yet for this article.
October 2016: Kidney International
Carsten W Israel, Tatsiana Burmistrava
Optimal implantable cardioverter-defibrillator (ICD) programming can reduce the incidence of inappropriate shock therapy and improve prognosis in patients with an ICD. Only after results from randomized trials became available was the "safety first" feeling overcome that mandated early shock therapy, waived the use of antitachycardia pacing and forced shock therapy after a time of 30 s expired, even if tachycardia discriminators would have withheld the therapy. The strong evidence to limit ICD therapy to longer ventricular tachycardia (VT) should not result in individually dangerous ICD programming, particularly in patients with a high risk of slow VT (known monomorphic VT, post VT ablation, during treatment with amiodarone, very dilated left ventricle)...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
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