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Circulation ECG

Eva A H Lanters, Christophe P Teuwen, Ameeta Yaksh, Charles Kik, Lisette J M E van der Does, Elisabeth M J P Mouws, Paul Knops, Nicole J van Groningen, Thijmen Hokken, Ad J J C Bogers, Natasja M S de Groot
BACKGROUND: Early postoperative atrial fibrillation (EPoAF) is associated with thromboembolic events, prolonged hospitalization, and development of late PoAF (LPoAF). It is, however, unknown if EPoAF can be predicted by intraoperative AF inducibility. The aims of this study are therefore to explore (1) the value of intraoperative inducibility of AF for development of both EPoAF and LPoAF and (2) the predictive value of de novo EPoAF for recurrence of LPoAF. METHODS AND RESULTS: Patients (N=496, 75% male) undergoing cardiothoracic surgery for coronary and/or valvular heart disease were included...
March 10, 2018: Journal of the American Heart Association
Rickard Lagedal, Ludvig Elfwén, Stefan James, Jonas Oldgren, David Erlinge, Ollie Östlund, Ewa Wallin, Ing-Marie Larsson, Gisela Lilja, Tobias Cronberg, Sten Rubertsson, Per Nordberg
BACKGROUND: Acute coronary syndrome is a common cause of out-of-hospital cardiac arrest (OHCA). In patients with OHCA presenting with ST elevation, immediate coronary angiography and potential percutaneous coronary intervention (PCI) after return of spontaneous circulation are recommended. However, the evidence for this invasive strategy in patients without ST elevation is limited. Observational studies have shown a culprit coronary artery occlusion in about 30% of these patients, indicating the electrocardiogram's (ECG's) limited sensitivity...
March 2018: American Heart Journal
Gaurang Nandkishor Vaidya, Steve Antoine, Syed Haider Imam, Hani Kozman, Harold Smulyan, Daniel Villarreal
BACKGROUND: Reciprocal ST-depression in the electrocardiograms (ECGs) of patients with ST-elevation myocardial infarction (STEMI) results from either true ischemia at a distance via collateral circulation diverting blood to the infarcted region or an electrical phenomenon that results from a mirror reflection of ST-elevation. We aimed to identify the role of reciprocal ECG changes in predicting collateral circulation to the infarcted area determined angiographically. METHODS: In a retrospective study, ECG and angiography of 53 STEMI patients admitted to SUNY Upstate Medical University in 2014 were reviewed independently by experts blinded to the results of ECG and coronary angiography...
February 2018: American Journal of the Medical Sciences
Yun-Tao Zhao, Hang Zhou, Ruiqi Shi, Bin Wang
An ECG pattern of widespread ST depression in six or more precordial and inferior leads, accompanied by ST-segment elevation in the aVR and/or V1 leads, is typical of the non-ST-segment elevation myocardial infarction (NSTEMI) pattern associated left main (LM) artery occlusion, but this ECG pattern is really associated with a subocclusion of the LM, or in the case that the LM was occluded with the presence of collateral circulation. There are few reports of ST-elevation myocardial infarction (STEMI) due to acute total LM occlusion...
February 2, 2018: Journal of Electrocardiology
Kazuma Ohyama, Yasuharu Matsumoto, Kentaro Takanami, Hideki Ota, Kensuke Nishimiya, Jun Sugisawa, Satoshi Tsuchiya, Hirokazu Amamizu, Hironori Uzuka, Akira Suda, Tomohiko Shindo, Yoku Kikuchi, Kiyotaka Hao, Ryuji Tsuburaya, Jun Takahashi, Satoshi Miyata, Yasuhiko Sakata, Kei Takase, Hiroaki Shimokawa
BACKGROUND: Recent studies suggested that perivascular components, such as perivascular adipose tissue (PVAT) and adventitial vasa vasorum (VV), play an important role as a source of various inflammatory mediators in cardiovascular disease. OBJECTIVES: The authors tested their hypothesis that coronary artery spasm is associated with perivascular inflammation in patients with vasospastic angina (VSA) using18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT)...
January 30, 2018: Journal of the American College of Cardiology
I-Jeng Yeh, Kuan-Ting Liu
RATIONALE: Electrocardiography (ECG) was used to diagnose acute coronary syndrome, but many other diseases may also result in ST segment change. We report one case of ingested hydrochloric acid present with ST segment elevation in the ECG. However, subsequent coronary angiography did not reveal significant coronary occlusion. PATIENT CONCERNS: An 83-year-old female was transferred to our emergency department (ED) from the branch hospital due to ingestion of toilet bowl cleaner containing 9...
November 2017: Medicine (Baltimore)
Jaume Figueras, Imanol Otaegui, Gerard Marti, Enric Domingo, Jordi Bañeras, José A Barrabés, Bruno Garcia Del Blanco, David Garcia-Dorado
BACKGROUND: It is unclear why among patients with first acute myocardial infarction and an occluded culprit artery only some present ST segment elevation. In fact, there is no study that compares the angiographic area at risk and the collateral circulation in first NSTEMI vs STEMI patients. METHODS AND RESULTS: 205 patients admitted for myocardial infarction with occluded culprit artery were included, 132 STEMI and 73 NSTEMI. Demographic data, the area at risk determined by the BARI score and collateral supply by the Rentrop score from the 2 groups were compared...
January 17, 2018: International Journal of Cardiology
Øyvind Heiberg Sundby, Lars Øivind Høiseth, Ingebjørg Irgens, Iacob Mathiesen, Eivind Lundgaard, Hanne Haugland, Harald Weedon-Fekjær, Jon O Sundhagen, Gunnar Sanbæk, Jonny Hisdal
STUDY DESIGN: Experimental prestudy and poststudy. OBJECTIVES: Examine the acute effects of intermittent negative pressure (INP) applied to the lower limb on foot circulation in people with spinal cord injuries (SCIs). SETTING: Vascular laboratory, Oslo University Hospital. METHODS: Twenty-four people with SCI (median age 59 years, range 29-74) were exposed to lower leg INP (-40 mm Hg) using an air-tight pressure chamber connected to an INP generator...
December 28, 2017: Spinal Cord
D Corcoran, R Young, P Cialdella, P McCartney, A Bajrangee, B Hennigan, D Collison, D Carrick, A Shaukat, R Good, S Watkins, M McEntegart, J Watt, P Welsh, N Sattar, A McConnachie, K G Oldroyd, C Berry
BACKGROUND: Remote ischaemic preconditioning (RIPC) is a cardioprotective intervention invoking intermittent periods of ischaemia in a tissue or organ remote from the heart. The mechanisms of this effect are incompletely understood. We hypothesised that RIPC might enhance coronary vasodilatation by an endothelium-dependent mechanism. METHODS: We performed a prospective, randomised, sham-controlled, blinded clinical trial. Patients with stable coronary artery disease (CAD) undergoing elective invasive management were prospectively enrolled, and randomised to RIPC or sham (1:1) prior to angiography...
February 1, 2018: International Journal of Cardiology
Takuya Shimizu, Ken Umetani, Yu Murata, Tomoko Harama, Toshiaki Yano, Aritaka Makino, Keita Sano, Masahiko Nakamura
Coronary artery spasm (CAS) rarely worsens from single-vessel to simultaneous multivessel CAS naturally, and simultaneous multivessel CAS leads to serious conditions such as cardiopulmonary arrest (CPA). A 77-year-old Japanese man who took medications for CAS was transferred to our hospital due to persistent chest pain. On arrival, his vital signs were stable, but his electrocardiogram (ECG) showed ST-segment elevation in leads II, III and aVF. Ventricular fibrillation developed suddenly. Although routine cardiopulmonary resuscitation (CPR) including intravenous administration of epinephrine was performed immediately, he could not be resuscitated...
December 12, 2017: American Journal of Emergency Medicine
Liang Wei, Gang Chen, Zhengfei Yang, Tao Yu, Weilun Quan, Yongqin Li
BACKGROUND: Reliable detection of return of spontaneous circulation with minimal interruptions of chest compressions is part of high-quality cardiopulmonary resuscitation (CPR) and routinely done by checking pulsation of carotid arteries. However, manual palpation was time-consuming and unreliable even if performed by expert clinicians. Therefore, automated accurate pulse detection with minimal interruptions of chest compression is highly desirable during cardiac arrest especially in out-of-hospital settings...
2017: PloS One
Anusha Battineni, Naresh Mullaguri, Shail Thanki, Anand Chockalingam, Raghav Govindarajan
Introduction: Patients with myasthenia crisis can develop Takotsubo stress cardiomyopathy (SC) due to emotional or physical stress and high level of circulating catecholamines. We report a patient who developed recurrent Takotsubo cardiomyopathy during myasthenia crisis. Coexisting autoimmune disorders known to precipitate stress cardiomyopathy like Grave's disease need to be evaluated. Case Report: A 69-year-old female with seropositive myasthenia gravis (MG), Grave's disease, and coronary artery disease on monthly infusion of intravenous immunoglobulin (IVIG), prednisone, pyridostigmine, and methimazole presented with shortness of breath and chest pain...
2017: Case Reports in Critical Care
Mariana De Alba-Alvarado, Paz María Salazar-Schettino, Luis Jiménez-Álvarez, Margarita Cabrera-Bravo, Cecilia García-Sancho, Edgar Zenteno, Clara Vazquez-Antona, Alfredo Cruz-Lagunas, Joaquín Zúñiga, Martha Irene Bucio-Torres
In Chagas disease the clinical, acute and chronic manifestations are the result of the interaction between the parasite and the host factors. The balance between inflammatory and anti-inflammatory immune responses is essential for the increase or resolution of the manifestations in individuals infected with T. cruzi. To identify if children with chronic Chagas disease and heart injury is related with non-regulated Th1, Th2 and Th17 responses. We included 31 children with T. cruzi confirmed chronic infection from endemic areas of Mexico...
February 2018: Acta Tropica
Pavel Antiperovitch, Wojciech Zareba, Jonathan S Steinberg, Ljuba Bacharova, Larisa G Tereshchenko, Jeronimo Farre, Kjell Nikus, Takanori Ikeda, Adrian Baranchuk
Despite its importance in everyday clinical practice, the ability of physicians to interpret electrocardiograms (ECGs) is highly variable. ECG patterns are often misdiagnosed, and electrocardiographic emergencies are frequently missed, leading to adverse patient outcomes. Currently, many medical education programs lack an organized curriculum and competency assessment to ensure trainees master this essential skill. ECG patterns that were previously mentioned in literature were organized into groups from A to D based on their clinical importance and distributed among levels of training...
March 1, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Stephanie Kullmann, Ralf Veit, Andreas Peter, Rolf Pohmann, Klaus Scheffler, Hans-Ulrich Häring, Andreas Fritsche, Hubert Preissl, Martin Heni
Context: Insulin action in the human brain influences eating behavior, cognition, and whole-body metabolism. Studies investigating brain insulin rely on intranasal application. Objective: To investigate effects of three doses of insulin and placebo as nasal sprays on the central and autonomous nervous system and analyze absorption of insulin into the bloodstream. Design, participants and methods: Nine healthy men received placebo, 40U, 80U and 160U insulin spray in randomized order...
October 31, 2017: Journal of Clinical Endocrinology and Metabolism
Tsuyoshi Matsumura, Misa Matsui, Yuko Iwata, Masanori Asakura, Toshio Saito, Harutoshi Fujimura, Saburo Sakoda
Objective Heart failure is currently the most serious complication of muscular dystrophy. The transient receptor potential cation channel, subfamily V, member 2 (TRPV2) is a stretch-sensitive Ca channel. In damaged myocytes or cardiomyocytes, TRPV2 translocates to the cytoplasmic membrane and enhances Ca influx, triggering cell damage. Evidence suggests that the inhibition of TRPV2 may be a new therapeutic target in heart failure. We found that tranilast, which is widely used as an anti-allergic drug, inhibits TRPV2...
November 1, 2017: Internal Medicine
Christian Tronstad, Ole Elvebakk, Havard Kalvoy, Marit R Bjorgaas, Orjan G Martinsen
Detection of sympathoadrenal discharge is valuable for stress monitoring, but measuring the circulating adrenaline level directly is inconvenient, making non-invasive physiological sensors an attractive alternative. Little is known however, about their performance in detecting different adrenaline levels. In this study, adrenaline measurements over time from 20 subjects × 2 trials were compared with skin conductance (SC) from different skin sites and ECG recordings from which the heart rate and QT interval were derived...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Michael L Ho, Mathieu Gatien, Christian Vaillancourt, Veronica Whitham, Ian G Stiell
BACKGROUND: It is unclear if there are predictors of survival, including ECG characteristics, that can guide resuscitative efforts in pulseless electrical activity (PEA) cardiac arrests. We studied the predictive potential of presenting prehospital ECGs on survival for patients with out-of-hospital cardiac arrest (OHCA) with PEA. METHODS: We studied prehospital ECGs of patients with OHCA prospectively enrolled between June 2007 and November 2009 at the Ottawa/OPALS (Ontario Prehospital Advanced Life Support Study) site of the Resuscitation Outcomes Consortium PRIMED study (Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis)...
October 21, 2017: Emergency Medicine Journal: EMJ
Vladinis O Miranda, Fernando C Oliveira, Jenniffer H Dias, Sergio F Vargas Júnior, Karina L Goularte, Manoel F Sá Filho, Ocilon G de Sá Filho, Hernan Baldassarre, Arnaldo D Vieira, Thomaz Lucia, Bernardo G Gasperin
Although fixed-time artificial insemination (FTAI) protocols are available for sheep, estrus resynchronization has not been previously reported. The objectives of this study were to evaluate the effect of estrus resynchronization with exogenous progestogen on endogenous progesterone levels and to compare pregnancy rates after two consecutive estrus synchronizations in ewes. In Experiment 1, ewes (n = 20) received an intravaginal device (IVD) containing 60 mg medroxyprogesterone acetate (MPA) for 10 days...
October 10, 2017: Theriogenology
Leonie Korn, Daniel Rüschen, Niklas Zander, Steffen Leonhardt, Marian Walter
Classically, mock circulatory loops only simulate mechanical properties of the circulation. To connect the hydraulic world with electrophysiology, we present a real-time electrical activity model of the heart and show how to integrate this model into a real-time mock loop simulation. The model incorporates a predefined conduction pathway and a simplified volume conductor to solve the bidomain equations and the forward problem of electrocardiography, resulting in a physiological simulation of the electrocardiogram (ECG) at arbitrary electrode positions...
October 12, 2017: Artificial Organs
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