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https://www.readbyqxmd.com/read/29463140/premature-ventricular-beats-in-the-athlete-management-considerations
#1
Tamanna K Singh, Aaron L Baggish
Premature ventricular beats (PVBs) occur in competitive athletes and are often incidentally found during pre-participation ECG screening. There is ongoing debate regarding the clinical significance of PVBs in athletes with several studies suggesting they are a benign reflection of athlete's heart, and others concerned they may be the first indication of structural heart disease and thus heightened risk for sudden cardiac death. Areas covered: Effective management of athletes with PVBs may best be accomplished using an algorithmic approach for risk stratification with an ultimate goal of differentiating benign PVBs from those reflective of underlying cardiomyopathies...
February 21, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29458741/sleep-disordered-breathing-is-associated-with-disturbed-cardiac-repolarization-in-patients-with-a-coronary-artery-bypass-graft-surgery
#2
Christina Schmidleitner, Michael Arzt, Maria Tafelmeier, Sarah Ripfel, Miriam Fauser, Teresa Weizenegger, Bernhard Flörchinger, Daniele Camboni, Sigrid Wittmann, Florian Zeman, Christof Schmid, Lars S Maier, Stefan Wagner, Christoph Fisser
BACKGROUND: The development of malignant ventricular arrhythmias due to abnormal cardiac repolarization is a major complication after coronary artery bypass graft surgery (CABG). Sleep-disordered breathing (SDB) is linked to prolonged cardiac repolarization in non-surgical patients. This study evaluates cardiac repolarization in patients with and without SDB who underwent CABG. METHODS: 100 patients who had received CABG (84% men, age 68 ± 10 years, body-mass-index [BMI] 28...
February 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29450560/-ecg-results-tips-and-tricks-for-the-correct-diagnosis-bradycardia-and-tachycardia-rhythm-disorders
#3
H-J Trappe
The 12-lead surface electrocardiogram (ECG) is of great importance for the diagnostics of cardiac arrhythmias. For the correct and systematic analysis it has a sensitivity and specificity for the correct diagnosis of supraventricular tachycardia or ventricular tachycardia of more than 95%. Nevertheless, the assessment of cardiac rhythm disorders is difficult for many physicians. In this way errors can occur, frequently due to a non-systematic analysis of the ECG; therefore, the aim of this article is to present the techniques and the necessary knowledge for assessment of the most frequent bradycardiac and tachycardiac heart rhythm disorders...
February 15, 2018: Herz
https://www.readbyqxmd.com/read/29440187/repolarization-heterogeneity-measured-with-t-wave-area-dispersion-in-standard-12-lead-ecg-predicts-sudden-cardiac-death-in-general-population
#4
Tuomas V Kenttä, Moritz F Sinner, Bruce D Nearing, Rebecca Freudling, Kimmo Porthan, Jani T Tikkanen, Martina Müller-Nurasyid, Katharina Schramm, Matti Viitasalo, Antti Jula, Markku S Nieminen, Annette Peters, Veikko Salomaa, Lasse Oikarinen, Richard L Verrier, Stefan Kääb, M Juhani Junttila, Heikki V Huikuri
BACKGROUND: We developed a novel electrocardiographic marker, T-wave area dispersion (TW-Ad), which measures repolarization heterogeneity by assessing interlead T-wave areas during a single cardiac cycle and tested whether it can identify patients at risk for sudden cardiac death (SCD) in the general population. METHODS AND RESULTS: TW-Ad was measured from standard digital 12-lead ECG in 5618 adults (46% men; age, 50.9±12.5 years) participating in the Health 2000 Study-an epidemiological survey representative of the Finnish adult population...
February 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29434624/improvement-of-increased-cqtd-is-associated-with-heart-function-in-patients-with-ischemic-heart-failure
#5
Hui Guo, Miao Wang, Juan Zhao, Jing Liu, Jie-Mei Yang
Background: Chronic heart failure (CHF) is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate (cQTd) and heart function in patients with CHF. Methods: From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class (NYHA) III-IV with a left ventricular ejection fraction (LVEF) < 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy (DCM) group ( n = 120) and an ischemic cardiomyopathy (ICM) group ( n = 120)...
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29430560/epilepsy-is-associated-with-ventricular-alterations-following-convulsive-status-epilepticus-in-children
#6
Wail Ali, Beth A Bubolz, Linh Nguyen, Danny Castro, Jorge Coss-Bu, Michael M Quach, Curtis E Kennedy, Anne E Anderson, Yi-Chen Lai
Objective: Convulsive status epilepticus can exert profound cardiovascular effects in adults including ventricular depolarization-repolarization abnormalities. Whether status epilepticus adversely affects ventricular electrical properties in children is less understood. Therefore, we sought to characterize ventricular alterations and the associated clinical factors in children following convulsive status epilepticus. Methods: We conducted a 2-year retrospective, case-control study...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29428463/cardiac-repolarization-evolves-differently-during-the-course-of-benign-and-disabling-multiple-sclerosis
#7
Alma Mikkola, Aku Ojanen, Juha Ek Hartikainen, Anne M Remes, Sakari Simula
BACKGROUND: Cardiac repolarization is modulated by the autonomic nervous system. Even though multiple sclerosis associates with prolonged cardiac repolarization the physiology responsible for the phenomenon remains unknown. OBJECTIVE: To study in longitudinal setting whether the patients with confirmed benign and disabling outcome of relapsing-remitting multiple sclerosis (RRMS) differ in regard to changes of cardiac repolarization. METHODS: Total of 43 patients, 26% with benign (EDSS ≤2 at least 10y after onset symptom) and 74% with disabling (EDSS >2 at least 10y after onset symptom) RRMS, having 12-lead electrocardiogram (ECG) recorded at the time of onset symptom (ECG1) and for follow-up (ECG2), were studied...
February 1, 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29428237/could-persistency-of-current-of-injury-forecast-successful-active-fixation-pacing-lead-implantation
#8
Shalaimaiti Shali, Yangang Su, Shengmei Qin, Junbo Ge
BACKGROUND: Presence of adequate current of injury (COI) was recognized as a sign of favorable pacemaker lead outcome. Little is known regarding the value of its dynamic behavior. We sought to test whether persistency of COI could predict active-fixation pacing lead performance. METHODS: COI was monitored up to 10min after right ventricular (RV) pacing electrode fixation. COI persistency was defined as the percentage of COI magnitude relative to its initial measurement...
February 7, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29428132/implantable-loop-recorders-for-cryptogenic-stroke-plus-real-world-atrial-fibrillation-detection-rate-with-implantable-loop-recorders
#9
REVIEW
Dan L Musat, Nicolle Milstein, Suneet Mittal
Cryptogenic stroke (CS) represents 10%-40% of ischemic strokes and is associated with significant morbidity and mortality and high risk of recurrence. Undetected atrial fibrillation is an important consideration in these patients. Tools for electrocardiographic monitoring range from 12-lead electrocardiogram to implantable loop recorders (ILRs). ILRs have become an important tool for long-term electrocardiogram monitoring in CS patients. Advancements in ILR technology are needed to ensure more robust connectivity and to help triage incoming data...
March 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29427819/significance-of-t-wave-inversion-triggered-by-spontaneous-atrial-premature-beats-in-patients-with-long-qt-syndrome
#10
Nobuhiro Takasugi, Mieko Takasugi, Hiroko Goto, Takashi Kuwahara, Takashi Nakashima, Tomoki Kubota, Hiromitsu Kanamori, Masanori Kawasaki, Kazuhiko Nishigaki, Shinya Minatoguchi, Richard L Verrier
BACKGROUND: In patients with long QT syndrome (LQTS), a sudden increase in heart rate can cause T-wave alternans (TWA) with beat-to-beat alternating polarity of T wave. We hypothesized that LQTS patients at a high risk of Torsade de Pointes (TdP) may exhibit momentary atrial or sinoatrial premature beat-induced T-wave inversion (APB-TWI). OBJECTIVE: To assess the association of APB-TWI with TdP history and with microvolt TWA. METHODS: 24-h continuous 12-lead electrocardiograms (ECGs) were recorded in 18 healthy subjects and 39 consecutive patients with LQTS types 1 (n=21), 2 (n=4), 3 (n=4), and unidentified (n=10)...
February 7, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29419690/association-between-paced-qrs-duration-and-atrial-fibrillation-after-permanent-pacemaker-implantation-a-retrospective-observational-cohort-study
#11
FuWei Xing, JingZhou Jiang, XiaoLiang Hu, Chong Feng, JianGui He, YuGang Dong, YueDong Ma, AnLi Tang
Right ventricular pacing often results in prolonged QRS duration (QRSd) as the result of right ventricular stimulation, and atrial fibrillation (AF) may result. The association of pacing-induced prolonged QRSd and AF in patients with permanent pacemakers is unknown.We selected 180 consecutive patients who underwent pacemaker implantation for complete/advanced atrioventricular block. All of the patients were paced from the right ventricular septum. Electrocardiography recordings were obtained at the beginning and the end of pacemaker implantation...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29414527/echocardiographic-risk-markers-of-sudden-death-in-patients-with-temporal-lobe-epilepsy
#12
Guilherme L Fialho, Arthur G Pagani, Peter Wolf, Roger Walz, Katia Lin
Patients with epilepsy (PWE) have an increased risk for sudden unexpected death compared to the general population. Echocardiography can analyze structural and functional heart changes that have impact on outcomes, including sudden cardiac and all-cause death. Our hypothesis is that subtle heart abnormalities occur in PWE. Thirty patients with temporal lobe epilepsy without any known cardiovascular disease, followed for at least 1 year, were enrolled between July 2015 and July 2016 and submitted to a 12-lead electrocardiogram, treadmill test and transthoracic echocardiogram...
February 2, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29409525/pre-hospital-transthoracic-echocardiography-for-early-identification-of-non-st-elevation-myocardial-infarction-in-patients-with-acute-coronary-syndrome
#13
Ingo Bergmann, Benedikt Büttner, Elena Teut, Claudius Jacobshagen, José Hinz, Michael Quintel, Ashham Mansur, Markus Roessler
BACKGROUND: Non-ST elevation myocardial infarction (NSTEMI) is a common manifestation of acute coronary syndrome (ACS), but delayed diagnosis can increase mortality. In this proof of principle study, the emergency physician performed transthoracic echocardiography (TTE) on scene to determine whether NSTEMI could be correctly diagnosed pre-hospitalization. This could expedite admission to the appropriate facility and reduce the delay until initiation of correct therapy. METHODS: Pre-hospital TTE was performed on scene by the emergency physician in patients presenting with ACS but without ST-elevation in the initial 12-lead electrocardiography (ECG) (NSTE-ACS)...
February 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29407007/new-insights-into-the-use-of-the-12-lead-electrocardiogram-for-diagnosing-acute-myocardial-infarction-in-the-emergency-department
#14
REVIEW
David F Miranda, Angie S Lobo, Brooks Walsh, Yader Sandoval, Stephen W Smith
The 12-lead electrocardiogram (ECG) remains the most immediately accessible and widely used initial diagnostic tool for guiding management in patients with suspected myocardial infarction (MI). Although the development of high-sensitivity cardiac troponin assays has improved the rule-in and rule-out and risk stratification of acute MI without ST elevation, the immediate management of the subset of acute MI with acute coronary occlusion depends on integrating clinical presentation and ECG findings. Careful interpretation of the ECG might yield subtle features suggestive of ischemia that might facilitate more rapid triage of patients with subtle acute coronary occlusion or, conversely, in identification of ST-elevation MI mimics (pseudo ST-elevation MI patterns)...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29406398/resuscitation-room-management-of-critically-ill-nontraumatic-patients-in-a-german-emergency-department-observe-study
#15
Michael Bernhard, Stephanie Döll, Thomas Hartwig, Alexandra Ramshorn-Zimmer, Maryam Yahiaoui-Doktor, Lorenz Weidhase, Sirak Petros, André Gries
BACKGROUND: Management of critically ill nontrauma (CINT) patients in the resuscitation room (RR) of the emergency department (ED) is very challenging. Detailed data describing the characteristics and management of this population are lacking. This observational study describes the epidemiology, management and outcome in CINT ED patients in the RR. PATIENTS AND METHODS: From September 2014 to August 2015, data were collected prospectively on adult CINT patients admitted to the RR of a single German University ED...
February 5, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29404363/electrocardiographic-artifact-potentially-misleading-to-the-wrong-management
#16
Srishti Sareen, Mannu Nayyar, Brian Wheeler, Michelle Skelton, Rami N Khouzam
Atrial flutter (AF) is the second most common supraventricular tachyarrhythmia following atrial fibrillation. We present an interesting case of a diagnostic challenge manifested as an electrocardiogram (ECG) recording mimicking AF in a patient with Parkinson's disease (PD). A 72-year-old African-American female with history of PD presented to our Emergency Department with a one day history of chest pain. Her vital signs were within normal limits. Physical exam was remarkable for bilateral resting hand tremors at a frequency of 6-8 hertz and mild cogwheel rigidity in both upper extremities...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29403612/evaluation-of-cardiac-functions-in-children-with-duchenne-muscular-dystrophy-a-prospective-case-control-study
#17
Abdelrahim Abdrabou Sadek, Shaimaa Mohamed Mahmoud, Mohammed Abd El-Aal, Ahmed Ahmed Allam, Walaa Ibrahim Abd El-Halim
Background: Duchenne muscular dystrophy (DMD) is the most common childhood form of muscular dystrophy. The incidence of cardiomyopathy in DMD increases with age, so its early detection is important because institution of cardioprotective medical therapies may slow adverse remodeling and attenuate heart failure symptoms in these patients. Objective: To assess the cardiac functions in children clinically suspected to have DMD. Methods: Over a one-year period, 28 male children aged from 3 to 18 years old, who met the criteria for diagnosis of DMD compared to 47 healthy controls children, were approached to participate in the study...
November 2017: Electronic Physician
https://www.readbyqxmd.com/read/29394253/risk-factors-for-heart-failure-hospitalizations-among-patients-with-atrial-fibrillation
#18
Lucien Eggimann, Steffen Blum, Stefanie Aeschbacher, Andreas Reusser, Peter Ammann, Paul Erne, Giorgio Moschovitis, Marcello Di Valentino, Dipen Shah, Jürg Schläpfer, Nadine Mondet, Michael Kühne, Christian Sticherling, Stefan Osswald, David Conen
BACKGROUND: Patients with atrial fibrillation (AF) have an increased risk for the development of heart failure (HF). In this study, we aimed to detect predictors of HF hospitalizations in an unselected AF population. METHODS: The Basel Atrial Fibrillation Cohort Study is an ongoing observational multicenter cohort study in Switzerland. For this analysis, 1193 patients with documented AF underwent clinical examination, venous blood sampling and resting 12-lead ECG at baseline...
2018: PloS One
https://www.readbyqxmd.com/read/29392521/a%C3%A2-new-consensus-document-on-electrocardiographic-interpretation-in-athletes-does-it-help-to-prevent-sudden-cardiac-death-in-athletes
#19
REVIEW
N M Panhuyzen-Goedkoop, H T Jørstad, J L R M Smeets
Sudden cardiac arrest or death (SCA/SCD) in athletes has a low event rate. Pre-participation or eligibility screening is a widely accepted method of primary prevention of SCA/SCD in athletes. Most European countries and international sports governing bodies perform ECG-inclusive screening. However, implementation of a resting 12-lead ECG in pre-participation or eligibility cardiac screening is still a topic of debate. Recently, the 'International recommendations for electrocardiographic interpretation in athletes' was published in three leading international medical journals...
February 1, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29389729/a-narrative-review-of-cardiovascular-abnormalities-after-spontaneous-intracerebral-hemorrhage
#20
Abhijit Lele, Viharika Lakireddy, Sergii Gorbachov, Nophanan Chaikittisilpa, Vijay Krishnamoorthy, Monica S Vavilala
BACKGROUND: The recommended cardiac workup of patients with spontaneous intracerebral hemorrhage (ICH) includes an electrocardiogram (ECG) and cardiac troponin. However, abnormalities in other cardiovascular domains may occur. We reviewed the literature to examine the spectrum of observed cardiovascular abnormalities in patients with ICH. METHODS: A narrative review of cardiovascular abnormalities in ECG, cardiac biomarkers, echocardiogram, and hemodynamic domains was conducted on patients with ICH...
January 31, 2018: Journal of Neurosurgical Anesthesiology
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