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https://www.readbyqxmd.com/read/28340026/high-rate-of-subcutaneous-implantable-cardioverter-defibrillator-sensing-screening-failure-in-patients-with-brugada-syndrome-a-comparison-with-other-inherited-primary-arrhythmia-syndromes
#1
Giulio Conte, Mihoko Kawabata, Carlo de Asmundis, Erika Taravelli, Francesco Petracca, Diego Ruggiero, Maria Luce Caputo, François Regoli, Gian-Battista Chierchia, Alessandra Chiodini, Alessandro Del Bufalo, Tiziano Moccetti, Masahiko Goya, Kenzo Hirao, Alessandro Vicentini, Gaetano M De Ferrari, Pedro Brugada, Angelo Auricchio
Aims: Subcutaneous implantable cardioverter-defibrillator (S-ICD) can avoid important complications associated with transvenous leads in patients with inherited primary arrhythmia syndromes, who do not need pacing therapy. Few data are available on the percentage of patients with inherited arrhythmia syndromes eligible for S-ICD implantation. Aim of this study was to analyse the eligibility for S-ICD in a series of patients with Brugada syndrome (BrS), and to compare it with patients with other channelopathies...
March 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28333976/early-diagnosis-of-acute-myocardial-infarction-using-high-sensitivity-troponin-i
#2
Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
OBJECTIVE: There is a clinical need for early and accurate diagnosis of acute myocardial infarction (AMI). Current European Society of Cardiology (ESC) guidelines recommend diagnosis of non-ST-elevation AMI based on serial troponin measurements. We aimed to challenge the ESC guidelines using 1) a high-sensitivity troponin I (hs-TnI) baseline cutoff, 2) an absolute hs-TnI change after 1 hour and 3) additional application of an ischemic ECG. METHODS: 1,516 patients with suspected AMI presenting to the emergency department were included...
2017: PloS One
https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#3
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28304194/out-of-hospital-cardiac-arrest-survivors-sent-for-emergency-angiography-a-clinical-score-for-predicting-acute-myocardial-infarction
#4
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28284506/sudden-cardiac-death-the-role-of-imaging
#5
Pieter van der Bijl, Victoria Delgado, Jeroen J Bax
Sudden cardiac death (SCD) is defined as "a non-traumatic, unexpected, fatal event occurring within one hour of the onset of symptoms in an apparently healthy subject", and it causes a fifth of all deaths worldwide. It often occurs in individuals not previously known with cardiac disease, which makes prevention challenging. The mechanism underlying SCD is thought to be a trigger (e.g. ischemia) acting upon a substrate (e.g. scar), causing a lethal arrhythmia. Primary prevention refers to patients at high risk of SCD and secondary prevention to those who have had an aborted episode of SCD...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28273368/silent-atrial-fibrillation-epidemiology-diagnosis-and-clinical-impact
#6
REVIEW
Polychronis E Dilaveris, Harold L Kennedy
Silent or subclinical asymptomatic atrial fibrillation (SAF) has currently gained wide interest in the epidemiologic, neurologic, and cardiovascular communities. It is well known that the electrophysiological and mechanical effects of symptomatic and silent atrial fibrillation (AF) are the same. It is probable that because "AF begets AF," progression from paroxysmal to persistent or permanent AF might be more rapid in patients with long-term unrecognized and untreated SAF, because no treatment is sought by or provided to such patients...
March 8, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28268082/discrimination-of-stress-takotsubo-cardiomyopathy-from-acute-coronary-syndrome-with-clinical-risk-factors-and-coronary-evaluation-in-real-world-clinical-practice
#7
So-Ryoung Lee, Sang Eun Lee, Tae-Min Rhee, Jin Joo Park, Hyunjai Cho, Hae-Young Lee, Dong-Ju Choi, Byung-Hee Oh
BACKGROUND: Diagnosing stress cardiomyopathy (SCMP) apart from acute coronary syndrome (ACS) is challenging since coronary evaluation is not always feasible in real-world clinical practice. We explored the current practice pattern of coronary evaluation in patients suspected to have SCMP and divulged the distinguishable features of SCMP from ACS. METHODS AND RESULTS: From 2010 to 2015, only 219 out of 691 (32%) hospitalized patients suspected to have SCMP have received coronary evaluation in two tertiary hospitals...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28265685/laparoscopic-partial-nephrectomy-in-a-patient-on-simvastatin-delayed-recovery-from-neuromuscular-blockade
#8
E E Abd El-Hakeem, A M Kaki, S A Almazlom, A J Alsayyad
Delayed recovery from anesthesia remains a very challenging subject for anesthesiologists. This case report describes the clinical course of delayed recovery from neuromuscular blockade after laparoscopic partial nephrectomy in a patient on simvastatin. The patient was hypertensive on regular treatment with oral captopril 25 mg twice daily and amlodipine 5 mg once daily and hypercholesterolemic on regular simvastatin 40 mg once daily with a normal electrocardiogram (ECG). All preoperative laboratory findings were within normal ranges...
March 6, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28253254/novel-non-invasive-algorithm-to-identify-the-origins-of-re-entry-and-ectopic-foci-in-the-atria-from-64-lead-ecgs-a-computational-study
#9
Erick A Perez Alday, Michael A Colman, Philip Langley, Henggui Zhang
Atrial tachy-arrhytmias, such as atrial fibrillation (AF), are characterised by irregular electrical activity in the atria, generally associated with erratic excitation underlain by re-entrant scroll waves, fibrillatory conduction of multiple wavelets or rapid focal activity. Epidemiological studies have shown an increase in AF prevalence in the developed world associated with an ageing society, highlighting the need for effective treatment options. Catheter ablation therapy, commonly used in the treatment of AF, requires spatial information on atrial electrical excitation...
March 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28247306/a-double-chaotic-layer-encryption-algorithm-for-clinical-signals-in-telemedicine
#10
M A Murillo-Escobar, L Cardoza-Avendaño, R M López-Gutiérrez, C Cruz-Hernández
Recently, telemedicine offers medical services remotely via telecommunications systems and physiological monitoring devices. This scheme provides healthcare delivery services between physicians and patients conveniently, since some patients can not attend the hospital due to any reason. However, transmission of information over an insecure channel such as internet or private data storing generates a security problem. Therefore, authentication, confidentiality, and privacy are important challenges in telemedicine, where only authorized users should have access to medical or clinical records...
April 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28244558/assessing-the-appropriateness-of-oral-anticoagulation-for-atrial-fibrillation-in-advanced-frailty-use-of-stroke-and-bleeding-risk-prediction-models
#11
R O'Caoimh, E Igras, A Ramesh, B Power, K O'Connor, R Liston
BACKGROUND: Atrial fibrillation (AF) is common among frail older adults. Oral anticoagulation (OAC) is particularly challenging for these due to overlapping stroke and bleeding risk factor profiles. OBJECTIVE: To compare the utility of stroke and haemorrhage risk-prediction instruments in the treatment of AF among frail older adults. DESIGN: Cross-sectional study. SETTINGS AND PARTICIPANTS: Frail residents in four nursing homes with a Clinical Frailty Scale score ≥5 (median 7±0)...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28240372/using-the-surface-ecg-to-identify-right-ventricular-pacing-lead-position-a-cautionary-tale
#12
Gerald C Kaye, Matthew K Rowe, Paul A Gould
Chronic right ventricular (RV) apical pacing may lead to the development of heart failure in some patients. Although pacing of the right ventricular septum has been proposed as an alternative, positioning a lead in the true septum has proven challenging. In addition to fluoroscopy at implant it has been suggested that 12-lead surface ECG can be used to determine septal lead position, however studies show this may be inaccurate. We present a case where a change in the ECG QRS axis late after pacemaker insertion with an active fixation lead highlights the difficulties of ECG localisation of pacing leads...
February 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28238152/myocardial-infarction-in-neonates-a-review-of-an-entity-with-significant-morbidity-and-mortality
#13
REVIEW
Koyelle Papneja, Anthony K Chan, Tapas K Mondal, Bosco Paes
Coronary artery disease is a global problem with high mortality rates and significant residual sequelae that affect long-term quality of life. Myocardial infarction (MI) in neonates is a recognized, uncommon entity, but the incidence and broad spectrum of the disease is unknown and likely underestimated due to limited reporting which in the majority is confined to acute ischemic events. The challenges involve clinical diagnosis which masquerades in the early phase as non-specific symptoms and signs that are commonly found in a host of neonatal disorders...
February 25, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28210991/extraction-of-fetal-ecg-signal-by-an-improved-method-using-extended-kalman-smoother-framework-from-single-channel-abdominal-ecg-signal
#14
D Panigrahy, P K Sahu
This paper proposes a five-stage based methodology to extract the fetal electrocardiogram (FECG) from the single channel abdominal ECG using differential evolution (DE) algorithm, extended Kalman smoother (EKS) and adaptive neuro fuzzy inference system (ANFIS) framework. The heart rate of the fetus can easily be detected after estimation of the fetal ECG signal. The abdominal ECG signal contains fetal ECG signal, maternal ECG component, and noise. To estimate the fetal ECG signal from the abdominal ECG signal, removal of the noise and the maternal ECG component presented in it is necessary...
February 16, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28204915/-acute-chest-pain-and-new-ecg-changes-in-pacemaker-patients-a%C3%A2-clinical-challenge
#15
Matthias Hoyme, Ralf Surber, P Christian Schulze, Dirk Prochnau
We report the case of a 82-year-old woman who was admitted to our institution with acute chest pain, nausea, and vomiting. Because of atrial fibrillation with intermittent bradycardia, a single-chamber pacemaker was implanted 4 years ago. The initial 12-lead ECG showed atrial fibrillation with a heart rate of 70 bpm, narrow QRS, and T‑wave inversions in the inferolateral leads. Coronary artery disease was excluded by immediate cardiac catheterization. A subsequent ECG three hours later showed a ventricular paced rhythm...
February 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28185080/wellens-syndrome-can-indicate-high-grade-lad-stenosis-in-case-of-left-bundle-branch-block
#16
Steffen Grautoff
Diagnosing acute myocardial infarction (AMI) in left bundle branch block (LBBB) is challenging. Modified Sgarbossa criteria are known to help detect AMI in LBBB. This is a report about an electrocardiogram (ECG) with Wellens' signs in combination with a pre-existing LBBB. The ECG of a patient with fluctuating chest pain showed very subtle and one day later more obvious Wellens'signs. A left anterior descending artery (LAD) stenosis was diagnosed and successfully treated. Wellens' syndrome can be diagnosed in a case of LBBB and help detect a high-grade LAD stenosis even if modified Sgarbossa criteria are not met...
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28183320/real-time-phase-contrast-flow-cardiovascular-magnetic-resonance-with-low-rank-modeling-and-parallel-imaging
#17
Aiqi Sun, Bo Zhao, Yunduo Li, Qiong He, Rui Li, Chun Yuan
BACKGROUND: Conventional phase-contrast cardiovascular magnetic resonance (PC-CMR) employs cine-based acquisitions to assess blood flow condition, in which electro-cardiogram (ECG) gating and respiration control are generally required. This often results in lower acquisition efficiency, and limited utility in the presence of cardiovascular pathology (e.g., cardiac arrhythmia). Real-time PC-CMR, without ECG gating and respiration control, is a promising alternative that could overcome limitations of the conventional approach...
February 10, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28166774/highly-wearable-cuff-less-blood-pressure-and-heart-rate-monitoring-with-single-arm-electrocardiogram-and-photoplethysmogram-signals
#18
Qingxue Zhang, Dian Zhou, Xuan Zeng
BACKGROUND: Long-term continuous systolic blood pressure (SBP) and heart rate (HR) monitors are of tremendous value to medical (cardiovascular, circulatory and cerebrovascular management), wellness (emotional and stress tracking) and fitness (performance monitoring) applications, but face several major impediments, such as poor wearability, lack of widely accepted robust SBP models and insufficient proofing of the generalization ability of calibrated models. METHODS: This paper proposes a wearable cuff-less electrocardiography (ECG) and photoplethysmogram (PPG)-based SBP and HR monitoring system and many efforts are made focusing on above challenges...
February 6, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28164349/applicability-of-a-novel-formula-bogossian-formula-for-evaluation-of-the-qt-interval-in-heart-failure-and-left-bundle-branch-block-due-to-right-ventricular-pacing
#19
Gerrit Frommeyer, Harilaos Bogossian, Eleni Pechlivanidou, Philipp Conzen, Christopher Gemein, Kay Weipert, Inga Helmig, Ritvan Chasan, Victoria Johnson, Lars Eckardt, Christian W Hamm, Melchior Seyfarth, Bernd Lemke, Markus Zarse, Jörn Schmitt, Damir Erkapic
BACKGROUND: The presence of left bundle branch block (LBBB) due to right ventricular pacing represents a particular challenge in properly measuring the QTc interval. In 2014 a new formula for evaluation of QT interval in patients with LBBB was reported. METHODS: 145 patients with implantable cardioverter defibrillator (ICD) were included in this prospective multicenter observational study. Inclusion criteria were: no permanent right ventricular stimulation, an intrinsic QRS interval of <120ms and reduced left ventricular function...
February 5, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28131609/geriatric-syncope-and-cardiovascular-risk-in-the-emergency-department
#20
Nissa J Ali, Shamai A Grossman
BACKGROUND: Syncope is a transient loss of consciousness that is caused by a brief loss in generalized cerebral blood flow. OBJECTIVE: This article reviews the background, epidemiology, etiologies, evaluation, and disposition considerations of geriatric patients with syncope, with a focus on cardiovascular risk. DISCUSSION: Although syncope is one of the most common symptoms in elderly patients presenting to the emergency department, syncope causes in geriatric patients can present differently than in younger populations, and the underlying etiology is often challenging to discern...
January 25, 2017: Journal of Emergency Medicine
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