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https://www.readbyqxmd.com/read/29129350/evaluation-of-ecg-algorithms-designed-to-improve-detect-of-transient-myocardial-ischemia-to-minimize-false-alarms-in-patients-with-suspected-acute-coronary-syndrome
#1
Michele M Pelter, Yuan Xu, Richard Fidler, Ran Xiao, David W Mortara, Hu Xiao
BACKGROUND: Patients hospitalized for suspected acute coronary syndrome (ACS) are at risk for transient myocardial ischemia. During the "rule-out" phase, continuous ECG ST-segment monitoring can identify transient myocardial ischemia, even when asymptomatic. However, current ST-segment monitoring software is vastly underutilized due to false positive alarms, with resultant alarm fatigue. Current ST algorithms may contribute to alarm fatigue because; (1) they are not designed with a delay (minutes), rather alarm to brief spikes (i...
October 24, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29108790/the-association-between-electrocardiographic-r-wave-peak-time-and-coronary-artery-disease-severity-in-patients-with-non-st-segment-elevation-myocardial-infarction-and-unstable-angina-pectoris
#2
İbrahim Rencüzoğulları, Metin Çağdaş, Süleyman Karakoyun, Yavuz Karabağ, Mahmut Yesin, İnanç Artaç, Doğan İliş, Murat Selçuk, Mesut Öterkuş, Halil İbrahim Tanboğa
BACKGROUND: We aimed to evaluate possible association between QRS duration (QRSD), R wave peak time (RWPT), and coronary artery disease severity identified using the SYNTAX score (SS) in patients with unstable angina pectoris (USAP) or non-ST segment elevation myocardial infarction (NSTEMI). METHOD: A total of 176 USAP/NSTEMI patients were enrolled in the study. RESULTS: The high SS group (>22, n:45) patients had a higher prevalence of diabetes mellitus (DM); presence of ST segment depression ≥0...
September 27, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29107324/daytime-variation-of-perioperative-myocardial-injury-in-cardiac-surgery-and-its-prevention-by-rev-erb%C3%AE-antagonism-a-single-centre-propensity-matched-cohort-study-and-a-randomised-study
#3
David Montaigne, Xavier Marechal, Thomas Modine, Augustin Coisne, Stéphanie Mouton, Georges Fayad, Sandro Ninni, Cédric Klein, Staniel Ortmans, Claire Seunes, Charlotte Potelle, Alexandre Berthier, Celine Gheeraert, Catherine Piveteau, Rebecca Deprez, Jérome Eeckhoute, Hélène Duez, Dominique Lacroix, Benoit Deprez, Bruno Jegou, Mohamed Koussa, Jean-Louis Edme, Philippe Lefebvre, Bart Staels
BACKGROUND: On-pump cardiac surgery provokes a predictable perioperative myocardial ischaemia-reperfusion injury which is associated with poor clinical outcomes. We determined the occurrence of time-of-the-day variation in perioperative myocardial injury in patients undergoing aortic valve replacement and its molecular mechanisms. METHODS: We studied the incidence of major adverse cardiac events in a prospective observational single-centre cohort study of patients with severe aortic stenosis and preserved left ventricular ejection fraction (>50%) who were referred to our cardiovascular surgery department at Lille University Hospital (Lille, France) for aortic valve replacement and underwent surgery in the morning or afternoon...
October 26, 2017: Lancet
https://www.readbyqxmd.com/read/29102453/timing-of-conduction-abnormalities-leading-to-permanent-pacemaker-insertion-after-transcatheter-aortic-valve-implantation-a-single-centre-review
#4
Daniel Ozier, Nevena Zivkovic, Gabby Elbaz-Greener, Sheldon M Singh, Harindra C Wijeysundera
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is the preferred alternative to traditional surgical aortic valve replacement; however, it remains expensive. One potential driver of cost is the need for postprocedural monitoring for conduction abnormalities after TAVI. Given the paucity of literature on the optimal length of monitoring, we aimed to determine when clinically significant conduction abnormalities leading to permanent pacemaker (PPM) insertion after TAVI were first identified...
September 1, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29050623/death-and-dialysis-after-transcatheter-aortic-valve-replacement-an-analysis-of-the-sts-acc-tvt-registry
#5
James W Hansen, Andrew Foy, Pradeep Yadav, Ian C Gilchrist, Mark Kozak, Amanda Stebbins, Roland Matsouaka, Sreekanth Vemulapalli, Alice Wang, Dee Dee Wang, Marvin H Eng, Adam B Greenbaum, William O O'Neill
OBJECTIVES: The authors sought to elucidate the true incidence of renal replacement therapy (RRT) after transcatheter aortic valve replacement (TAVR). BACKGROUND: There is a wide discrepancy in the reported rate of RRT after TAVR (1.4% to 40%). The true incidence of RRT after TAVR is unknown. METHODS: The STS/ACC TVT (Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy) registry was linked to the Centers for Medicare & Medicaid database to identify all patients that underwent TAVR from November 2011 through September 2015 and their outcomes...
October 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29027810/electrocardiographic-characteristics-associated-with-in-hospital-outcome-in-patients-with-left-main-acute-coronary-syndrome-for-contriving-a-new-risk-stratification-score
#6
Takayuki Iida, Fumito Tanimura, Kyoko Takahashi, Hideki Nakamura, Satoshi Nakajima, Motoyuki Nakamura, Yoshihiro Morino, Tomonori Itoh
AIM: The aim of this study was to evaluate electrocardiographic characteristics associated with in-hospital prognosis in patients with left main acute coronary syndrome. METHODS AND RESULTS: A total of 89 left main acute coronary syndrome subjects were selected from 3357 consecutive acute coronary syndrome patients (2.7%). Patients of this study were divided into two groups; those who survived and those who died. Patients' characteristics and electrocardiogram on admission were then retrospectively analyzed between the two groups...
December 1, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28980129/rupture-of-the-aortic-root-a%C3%A2-rare-but-life-threatening-complication-of-transcatheter-aortic-valve-replacement
#7
Christian Reiter, Michael Grund, Alexander Nahler, Clemens Steinwender, Thomas Lambert
Transcatheter aortic valve replacement (TAVR) has been shown to be a valid treatment option for patients with significant symptomatic aortic valve stenosis and high surgical risk. Rupture of the aortic root is a rare but life-threatening complication that occurs in approximately 1% of procedures and usually manifests as an acute complication at the time of valve implantation; however, physicians should be aware of a potentially subacute onset, since early recognition and immediate management are crucial...
October 4, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28964778/predictors-and-prognostic-impact-of-new-left-bundle-branch-block-after-surgical-aortic-valve-replacement
#8
Moukda Khounlaboud, Erwan Flécher, Maxime Fournet, Hervé Le Breton, Erwan Donal, Christophe Leclercq, Philippe Mabo, Alain Leguerrier, Claude Daubert
BACKGROUND: Left bundle branch block (LBBB) induces mechanical dyssynchrony that may lead to left ventricular systolic dysfunction. AIMS: To evaluate the incidence, predictors and clinical impact of new LBBB in patients undergoing surgical aortic valve replacement (SAVR). METHODS: After exclusion of patients with pre-existing LBBB, a previous pacemaker or a paced rhythm at hospital discharge, 547 consecutive patients undergoing SAVR were included...
September 27, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28952048/p-wave-morphology-and-electrical-activity-of-the-isolated-left-atrial-appendage-on-12-lead-ecg-in-patients-with-recurrent-atrial-tachyarrhythmias-after-pulmonary-vein-isolation
#9
Tina Lin, Andreas Rillig, Andreas Metzner, Shibu Mathew, Christian Heeger, Peter Wohlmuth, Roland Tilz, Karl-Heinz Kuck, Feifan Ouyang
PURPOSE: Left atrial appendage isolation(LAAI) may occur during catheter ablation of complex atrial tachyarrhythmias(aTa). We compare P-waves before and after LAAI and characterize LAA activity on the 12-lead ECG after LAAI. METHODS: Twenty-five patients were analyzed after LAAI. P-wave amplitude, duration, and morphology before and after LAAI were analyzed. Automaticity in the isolated LAA was identified, and magnified 12-lead surface ECGs were analyzed for LAA activity, amplitude, duration, and morphology...
September 26, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28916172/biometric-verification-by-cross-correlation-analysis-of-12-lead-ecg-patterns-ranking-of-the-most-reliable-peripheral-and-chest-leads
#10
Vessela Krasteva, Irena Jekova, Roger Abächerli
BACKGROUND: Electrocardiogram (ECG)-based biometrics relies on the most stable and unique beat patterns, i.e. those with maximal intra-subject and minimal inter-subject waveform differences seen from different leads. We investigated methodology to evaluate those differences, aiming to rank the most prominent single and multi-lead ECG sets for biometric verification across a large population. METHODS: A clinical standard 12-lead resting ECG database, including 460 pairs of remote recordings (distanced 1year apart) was used...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28906534/management-of-a-complicated-redo-giant-dissecting-aortic-aneurysm
#11
Ibrahim Kara, Alper Erkin, MHalil Ibrahim Erkengel, Kiyasettin Asil
Giant aortic aneurysm is defined as an aneurysm of the aorta of greater than 10 cm in diameter. This rare condition is associated with a high risk of morbidity and mortality and it may lead to fatal complications such as rupture and/or dissection if not managed with proper surgical planning and expertise. Other than atherosclerosis, the main causes of giant ascending aortic aneurysms include Marfan and Ehlers-Danhlos syndromes. Herein we report on a young male patient who had had an aortic valve replacement five years earlier due to a bicuspid aortic valve leading to aortic failure, accompanied by aortic coarctation...
July 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28899954/differentiating-the-qrs-morphology-of-posterior-fascicular-ventricular-tachycardia-from-right-bundle-branch-block-and-left-anterior-hemiblock-aberrancy
#12
MULTICENTER STUDY
Yoav Michowitz, Oholi Tovia-Brodie, Ishai Heusler, Avi Sabbag, Michael Rahkovich, Hezzy Shmueli, Aharon Glick, Bernard Belhassen
BACKGROUND: Left posterior fascicular ventricular tachycardia (LPF-VT) is frequently misdiagnosed as supraventricular tachycardia with aberrant right bundle branch block (RBBB) and left anterior hemiblock (LAHB). The purpose of the present study was to define the morphological ECG characteristics of LPF-VT and attempt to differentiate it from RBBB and LAHB aberrancy. METHODS AND RESULTS: A systematic Medline search was used to identify or locate ECG tracings from patients with LPF-VTs...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28872094/-transcatheter-aortic-valve-implantation-present-and-development-trend
#13
Yi He, Haiting Zhou, Shuqiang Zhu, Yongbing Wu
Currently, although surgical aortic valve replacement (SAVR) is still the golden standard in treatment of severe aortic stenosis according to the guideline, transcatheter aortic valve implantation (TAVI) is gradually becoming a common treatment for patients who are prohibitive or in high risk for SAVR. Recently, the valve manufacturers, including medical companies in China, are making their utmost to develop valve device, leading remarkable results achieved by TAVI. With the complications being controlled, TAVI displays promising future...
August 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28853533/-the-importance-of-lead-avr-in-the-evaluation-of-an-ecg-strip
#14
Asaf Shemer, Pinchas Halpern
Over the years, the aVR lead has been overlooked by clinicians while observing a normal 12-lead ECG (electrocardiogram). A positive P-QRS complex in the aVR lead should raise prompt suspicion for either a congenital heart malrotation or a lead misplacement. In this article we present a case of an asymptomatic patient and a pathological ECG strip displaying ST elevations and a positive QRS in the aVR lead. A follow-up ECG was performed in the emergency department, and revealed a normal sinus rhythm with no abnormalities indicating acute ischemia...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28833552/a-rare-complication-of-mechanical-aortic-valve-replacement-separation-in-the-region-of-the-mitral-aortic-intervalvular-fibrosa
#15
Mehmet Celik, Ahmet Güner, Alev Kılıçgedik, Sabahattin Gunduz, Abdulrahman Naser, Elif Eroglu Büyüköner, Muzaffer Kahyaoglu, Cagatay Onal, Gokhan Kahveci
A 28-year-old man was admitted to our emergency service with a shortness of breath and palpitation. On admission, his blood pressure was high and he was in hypertensive pulmonary edema. His physical examination showed rales in both lungs and pansystolic murmur at mitral focus. His medical history included aortic valve replacement (AVR) because of native aortic valve infective endocarditis. Transthoracic echocardiography (TTE) showed normal functional aortic valve. Color flow imaging demonstrated severe mitral regurgitation with posterior eccentric jet...
August 2017: Echocardiography
https://www.readbyqxmd.com/read/28829829/intermediate-cd14-cd16-monocytes-decline-after-transcatheter-aortic-valve-replacement-and-correlate-with-functional-capacity-and-left-ventricular-systolic-function
#16
Jonas Neuser, Paolo Galuppo, Daniela Fraccarollo, Jens Willig, Tibor Kempf, Dominik Berliner, Johann Bauersachs, Julian Daniel Widder
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is the method of choice for patients with severe aortic valve stenosis, who are ineligible or at high risk for surgery. Though TAVR leads to a significant reduction in mortality, a notable amount of patients are re-hospitalized early after TAVR. Parameters or biomarkers predicting outcome are therefore needed to identify patients who benefit most. Specific monocyte subsets have been associated with cardiovascular diseases and were shown to possess prognostic value...
2017: PloS One
https://www.readbyqxmd.com/read/28804970/arrhythmogenic-gene-remodelling-in-elderly-patients-with-type-2-diabetes-with-aortic-stenosis-and-normal-left-ventricular-ejection-fraction
#17
R Ashrafi, P Modi, A Y Oo, D M Pullan, K Jian, H Zhang, J Yanni Gerges, G Hart, M R Boyett, G K Davis, J P H Wilding
What is the central question of this study? Type 2 diabetes is associated with a higher rate of ventricular arrhythmias compared with the non-diabetic population, but the associated myocardial gene expression changes are unknown; furthermore, it is also unknown whether any changes are attributable to chronic hyperglycaemia or are a consequence of structural changes. What is the main finding and its importance? We found downregulation of left ventricular ERG gene expression and increased NCX1 gene expression in humans with type 2 diabetes compared with control patients with comparable left ventricular hypertrophy and possible myocardial fibrosis...
August 14, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28764236/clinical-significance-of-the-forsaken-avr-in-evaluation-of-tachyarrhythmias-a-reminder
#18
Dharmendra Jain, Pradeep Nigam, Manoj Indurkar, Riyas Chiramkara
INTRODUCTION: Mechanism of a regular, monomorphic Wide QRS Complex Tachycardia (WCT) is an important diagnostic challenge in day to day practice for the clinicians and affects further management and prognosis. Many of the WCT and Narrow Complex Tachycardia (NCT) produce certain characteristic changes in lead aVR by which we can differentiate between them. AIM: The present study was aimed to evaluate tachyarrhythmias in relation to lead aVR and to highlight the clinical significance of lead aVR, "The Neglected Lead"...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761561/coronary-perforation-of-distal-diagonal-branch-followed-by-prolonged-recurrent-cardiac-tamponade-finally-resolved-with-pericardiotomy-the-potential-risk-of-hydrophilic-guide-wires
#19
Rafał Januszek, Krzysztof Bartuś, Radosław Litwinowicz, Artur Dziewierz, Łukasz Rzeszutko
PURPOSE: Coronary artery perforation (CAP) is a complication of percutaneous coronary interventions (PCIs). Hydrophilic guide-wires have been shown to increase the probability of CAP. Depending on the size of perforations we adopt different treatments. CASE: We present the case of a 73-year old male with coronary artery disease and severe aortic valve stenosis. The patient was in the process of qualifying for a transcatheter aortic valve implantation. Unfortunately, CAP of the first diagonal branch of the LAD occurred during PCI...
2017: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/28757765/pulseless-electrical-activity-in-acute-massive-pulmonary-embolism-during-thrombolytic-therapy
#20
Han-Hua Yu, Jing-Ren Jeng
We report a case of acute pulmonary embolism with hemodynamic instability diagnosed by a computed tomography pulmonary angiogram. The patient developed pulseless electrical activity during systemic thrombolytic therapy with recombinant tissue plasminogen activator. Successful return of spontaneous circulation was achieved after immediate cardiopulmonary resuscitation with chest compressions for 6 min. His electrocardiogram (ECG) on arrival in the emergency department displayed sinus tachycardia, an S wave in lead I, a Q wave in lead III, incomplete right bundle branch block (RBBB), T-wave inversion (TWI) in leads V1-V3, ST elevation in leads aVR and V1, and ST depression in leads I, II, III, aVF, and V4-V6...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
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