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Sinus bradycardia

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https://www.readbyqxmd.com/read/27909501/-two-for-the-price-of-one-a-single-lead-implantable-cardioverter-defibrillator-system-with-a-floating-atrial-dipole
#1
REVIEW
Nicole E Worden Md, Musab Alqasrawi Md, Siva M Krothapalli Md, Alexander Mazur Md
In patients known to be a high risk for sudden cardiac arrest, implantable cardioverter defibrillators (ICD) are a proven therapy to reduce risk of death. However, in patients without conventional indications for pacing, the optimal strategy for type of device, dual- versus single-chamber, remains debatable. The benefit of prophylactic pacing in this category of patients has never been documented. Although available atrial electrograms in a dual chamber system improve interpretation of stored arrhythmia events, allow monitoring of atrial fibrillation and may potentially reduce the risk of inappropriate shocks by enhancing automated arrhythmia discrimination, the use of dual-chamber ICDs has a number of disadvantages...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27871122/efficacy-and-safety-of-ablation-for-people-with-non-paroxysmal-atrial-fibrillation
#2
REVIEW
Jonathan Nyong, Guy Amit, Alma J Adler, Onikepe O Owolabi, Pablo Perel, David Prieto-Merino, Pier Lambiase, Juan Pablo Casas, Carlos A Morillo
BACKGROUND: The optimal rhythm management strategy for people with non-paroxysmal (persistent or long-standing persistent) atrial fibrilation is currently not well defined. Antiarrhythmic drugs have been the mainstay of therapy. But recently, in people who have not responded to antiarrhythmic drugs, the use of ablation (catheter and surgical) has emerged as an alternative to maintain sinus rhythm to avoid long-term atrial fibrillation complications. However, evidence from randomised trials about the efficacy and safety of ablation in non-paroxysmal atrial fibrillation is limited...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27869560/syncope-seizure-or-both
#3
Paraskevi Koutrolou-Sotiropoulou, Abhijeet Singh, Mason Leeman-Markowski, Eric J Rashba
Ictal asystole (IA) is a rare phenomenon in patients with seizures with an incidence of 0.27-0.4% and has been proposed as a possible mechanism of sudden unexpected death in epilepsy patients (SUDEP). We present a case of a 53-year-old woman who initially presented with episodes of expressive aphasia and was treated with antiepileptic drugs (AEDs). While on therapy she experienced episodes of syncope. During her hospitalization for tapering of AEDs and 24-hour EEG monitoring, the patient developed a seizure followed by sinus bradycardia and an 18-second sinus pause, resulting in loss of consciousness and slowing of cerebral activity...
November 21, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27836167/a-1-year-old-boy-with-long-pauses-caused-by-paroxysmal-atrioventricular-block-and-sinus-arrest-vagal-reflex-and-effect-of-pacing
#4
Sayaka Sakazaki, Satoshi Masutani, Yoichi Iwamoto, Yoshitaka Asano, Ai Miyamoto, Hirotaka Ishido, Masanori Tamura, Hideaki Senzaki
Paroxysmal atrioventricular block (PAVB) is rare in children. A 1-year-old boy presented with PAVB and sinus arrest that resulted in refractory life-threatening symptomatic long pauses. Continuous heart rate variability analysis with high time resolution (wavelet analysis) revealed an abrupt increase in parasympathetic activity just before a long pause, which indicated a vagal reflex. Although a pacemaker is not always effective because of a concomitant vasodepressive response in such cases, the complete stabilization after pacemaker implantation in this case supports the necessity and usefulness of pacemaker implantation in patients with reflex-induced highly symptomatic bradycardia...
October 18, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27833764/an-endomyocardial-biopsy-of-the-left-ventricle-in-an-anorexia-nervosa-patient-with-sinus-bradycardia-and-left-ventricular-systolic-dysfunction
#5
Satoshi Takahashi, Takanao Mine
Anorexia nervosa (AN) is an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight, and a distorted perception of body weight. AN is a life-threatening condition that significantly increases the risk of death due to cardiac complications, such that at least one-third of all deaths in patients with AN are associated with cardiac causes including sudden death. In many reports, sudden death has been linked to reduced left ventricular function, structural changes, and QT abnormalities...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27830772/diagnosis-pathophysiology-and-management-of-exercise-induced-arrhythmias
#6
REVIEW
Eduard Guasch, Lluís Mont
The cardiovascular benefits of physical activity are indisputable. Nevertheless, growing evidence suggests that both atrial fibrillation and right ventricular arrhythmia can be caused by intense exercise in some individuals. Exercise-induced atrial fibrillation is most commonly diagnosed in middle-aged, otherwise healthy men who have been engaged in endurance training for >10 years, and is mediated by atrial dilatation, parasympathetic enhancement, and possibly atrial fibrosis. Cardiac ablation is evolving as a first-line tool for athletes with exercise-induced arrhythmia who are eager to remain active...
November 10, 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27787391/cardiac-arrest-in-a-patient-with-anterior-fascicular-block-after-administration-of-dexmedetomidine-with-spinal-anesthesia-a-case-report
#7
Baek Jin Kim, Bong Il Kim, Sung Hye Byun, Eugene Kim, Shin Yeung Sung, Jin Yong Jung
BACKGROUND: Dexmedetomidine is a sedative and analgesic agent that is administered intravenously as an adjunct to spinal anesthesia. It does not suppress the respiratory system significantly, but has adverse effects on the cardiovascular system, for example, bradycardia and hypotension. We here report a patient who underwent cardiac arrest during spinal anesthesia after intravenous infusion of dexmedetomidine. METHODS: A 57-year-old woman with no significant medical history underwent spinal anesthesia for arthroscopic meniscus resection after rupturing the right knee meniscus...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27780666/electrocardiographic-manifestations-in-three-psychiatric-patients-with-hypothermia-case-report
#8
Eleftherios Pelechas, Nikolaos Tsigaridas, Sofia Kyrama, Stratos Trogganis, Christoforos Kardamis
Hypothermia occurs when the core body temperature falls below 35°C, which, in severe cases, can lead to electrocardiographic changes. Several conditions that occur in the psychiatric population increase the risk of hypothermia. This risk can be further increased by the use of several classes of medications such as antipsychotics, beta-adrenergic antagonists and benzodiazepines. We report on three psychiatric patients who were admitted for hypothermia and developed electrocardiographic manifestations (sinus bradycardia, QT prolongation and Osborn waves), which completely resolved after treatment...
September 8, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27756424/isolated-congenital-complete-heart-block-in-a-five-year-old-seronegative-girl-born-to-a-woman-seropositive-for-human-immunodeficiency-virus-a-case-report
#9
Pedro Pallangyo, Isaac Mawenya, Paulina Nicholaus, Henry Mayala, Amida Kalombola, Godwin Sharau, Naiz Majani, Mohamed Janabi
BACKGROUND: Congenital complete heart block is a life-threatening condition which is highly associated with autoimmune and connective tissue disorders. Presence of maternal autoantibodies for associated conditions increases the risk of delivering a child with congenital complete heart block, however, less than a half of all women with such antibodies are symptomatic even after delivery. Mortality rate is highest during the neonatal period (45 %) and about two-thirds of all cases will require permanent pacing at some point in their lives...
October 19, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27752846/ivabradine
#10
Michel Komajda
Ivabradine is a blocker of the funny current channels in the sinoatrial node cells. This results in pure heart rate reduction when elevated without direct effect on contractility or on the vessels. It was tested in a large outcome clinical trial in stable chronic heart failure (CHF) with low ejection fraction, in sinus rhythm, on a contemporary background therapy including betablockers (SHIFT: Systolic Heart Failure Treatment with the If inhibitor Trial).The primary composite endpoint (cardiovascular mortality or heart failure hospitalization) was reduced by 18% whereas the first occurrence of heart failure hospitalizations was reduced by 26%...
October 18, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27752809/national-experience-with-long-term-use-of-the-wearable-cardioverter-defibrillator-in-patients-with-cardiomyopathy
#11
Madhab Lamichhane, Joseph C Gardiner, Nicole R Bianco, Steven J Szymkiewicz, Ranjan K Thakur
PURPOSE: The wearable cardioverter defibrillator (WCD) is generally used for short periods of sudden cardiac death (SCD) risk; circumstances may occasionally result in prolonged use (over 1 year). The aim of this study was to determine the benefits and risks of prolonged use in patients with systolic heart failure (HF). METHODS: ZOLL's post-market US database included adult patients (≥18 years) with ischemic and/or non-ischemic cardiomyopathy (ICM, NICM) and at least 1 year of use...
October 17, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27751678/prognosis-of-super-elderly-healthy-japanese-patients-after-pacemaker-implantation-for-bradycardia
#12
Tetsuo Yamaguchi, Takamichi Miyamoto, Takamasa Iwai, Junji Yamaguchi, Sadahiro Hijikata, Ryoichi Miyazaki, Naoyuki Miwa, Masahiro Sekigawa, Nobuhiro Hara, Yasutoshi Nagata, Toshihiro Nozato, Yasuteru Yamauchi, Toru Obayashi, Mitsuaki Isobe
BACKGROUND: The prognosis of super-elderly patients (age≥85 years) who undergo bradycardia pacemaker (PM) implantation remains unknown. METHODS: We retrospectively enrolled 868 patients (men 49.0%, 76.6±10.6 years) who could walk unassisted and whose expected life expectancy was more than 1 year, receiving their first bradycardia PM implantation between January 1, 2006, and June 30, 2013. Clinical outcomes were compared between super-elderly patients (n=201, mean age 88...
October 15, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27747725/high-dose-verapamil-in-episodic-and-chronic-cluster-headaches-and-cardiac-adverse-events-is-it-as-safe-as-we-think
#13
Joachim Alexandre, Xavier Humbert, Marion Sassier, Paul Milliez, Antoine Coquerel, Sophie Fedrizzi
Cluster headache (CH) is a primary headache disorder with relatively effective treatments. Although few sufficiently controlled trials are available, verapamil is recommended as the first-line prophylactic drug for CH by the French Headache Society (with a low level of evidence, level B) and by the EFNS (European Federation of Neurological Societies, level A). Daily doses of more than 480 mg (and up to 1200 mg daily) are frequently used off-label, while 360 mg daily is the only dosage to have demonstrated its effectiveness in a double-blind trial against placebo, and the usual label posology used by cardiologists is 240 mg daily in hypertension...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27735146/a-study-on-the-cardiac-manifestations-of-dengue
#14
S Sheetal, Elizabeth Jacob
OBJECTIVE: This study was done to study the prevalence of cardiac manifestations of dengue fever in patients presenting to our hospital and to find out the correlation of cardiac manifestations to warning signs of dengue and severe dengue. METHODS: The study was conducted at Sree Gokulam Medical College and Research Foundation, which is a tertiary care hospital, in the Department of Medicine in the month of July 2013. One hundred consecutive patients aged 13 years or more with positive dengue serology were interviewed and examined...
May 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27733495/ranolazine-for-congenital-long-qt-syndrome-type-iii-experimental-and-long-term-clinical-data
#15
Ehud Chorin, Dan Hu, Charles Antzelevitch, Aviram Hochstadt, Luiz Belardinelli, David Zeltser, Hector Barajas-Martinez, Uri Rozovski, Raphael Rosso, Arnon Adler, Jesaia Benhorin, Sami Viskin
BACKGROUND: The basic defect in long-QT syndrome type III (LQT3) is an excessive inflow of sodium current during phase 3 of the action potential caused by mutations in the SCN5A gene. Most sodium channel blockers reduce the early (peak) and late components of the sodium current (INa and INaL), but ranolazine preferentially reduces INaL. We, therefore, evaluated the effects of ranolazine in LQT3 caused by the D1790G mutation in SCN5A. METHODS AND RESULTS: We performed an experimental study of ranolazine in TSA201 cells expressing the D1790G mutation...
October 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27729680/bradycardia-after-intravenous-ondansetron-with-asystole-on-rechallenge-a-case-report
#16
EDITORIAL
Jonathan H Rapp, Meggie Yuen, Teena Abraham
PURPOSE: There have been 3 published reports (4 cases) of symptomatic sinus bradycardia occurring after intravenous (IV) administration of the selective 5-hydroxytryptamine 3 (5-HT3) receptor antagonist ondansetron. We report a fifth case in which the patient developed asystole after rechallenge with ondansetron. SUMMARY: A 36-year-old pregnant patient with no cardiac history, status post cerclage for cervical insufficiency, experienced nausea in the post ambulatory care unit after administration of morphine and indomethacin for pain...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27716078/a-case-of-asystole-from-carotid-sinus-hypersensitivity-during-patient-positioning-for-thyroidectomy
#17
Emmanuel Lilitsis, Alexia Papaioannou, Aikaterini Hatzimichali, Konstantinos Spyridakis, Sofia Xenaki, George Chalkiadakis, Emmanuel Chrysos
BACKGROUND: We present a case of a patient with multinodular goiter disease who suffered asystole during head hyperextension for surgical positioning on the operational table. CASE PRESENTATION: Manipulation of carotid sinus may trigger bradycardia or even asystole even in patients without prior history of carotid sinus hypersensitivity. The time proximity between patient positioning and asystole, the late responsiveness to atropine, the immediate increase of heart rate after head elevation and the lack of any other trigger factor or prior history support the hypothesis of carotid sinus syndrome...
October 6, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27694085/inappropriate-bradycardia-in-ebola-virus-disease
#18
G Cellarier, J Bordes, T De Greslan, L Karkowski, N Gagnon, M Billhot, J-M Cournac, C Rousseau, C Mac Nab, P Dubrous
BACKGROUND: As part of French assistance for the outbreak of Ebola virus disease in west Africa, a military treatment center for infected healthcare workers was deployed in Conakry, Guinea. Although some cases of bradycardia have been reported since the first Ebola outbreak, they have never been documented to our knowledge. We studied heart rhythm in patients with Ebola virus disease to analyze inappropriate bradycardia and discuss its mechanism. METHODS: Nine patients who tested positive for Ebola were admitted in March 2015...
August 1, 2016: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/27687923/diagnostic-accuracy-of-a-smartphone-electrocardiograph-in-dogs-comparison-with-standard-6-lead-electrocardiography
#19
T Vezzosi, C Buralli, F Marchesotti, F Porporato, R Tognetti, E Zini, O Domenech
The diagnostic accuracy of a smartphone electrocardiograph (ECG) in evaluating heart rhythm and ECG measurements was evaluated in 166 dogs. A standard 6-lead ECG was acquired for 1 min in each dog. A smartphone ECG tracing was simultaneously recorded using a single-lead bipolar ECG recorder. All ECGs were reviewed by one blinded operator, who judged if tracings were acceptable for interpretation and assigned an electrocardiographic diagnosis. Agreement between smartphone and standard ECG in the interpretation of tracings was evaluated...
October 2016: Veterinary Journal
https://www.readbyqxmd.com/read/27648505/atypical-findings-in-massive-bupropion-overdose-a-case-report-and-discussion-of-psychopharmacologic-issues
#20
Yuanjia Zhu, Tiwalola Kolawole, Xavier F Jimenez
Bupropion is an atypical antidepressant that is structurally similar to amphetamines. Its primary toxic effects include seizure, sinus tachycardia, hypertension, and agitation; however, at higher amounts of ingestion, paradoxical cardiac effects are seen. We report the case of a 21-year-old woman who ingested 13.5 g of bupropion, a dose higher than any other previously reported. The patient presented with seizure, sinus tachycardia with prolonged QTc and QRS intervals, dilated pupils, and agitation. Four days after overdose, the patient's sinus tachycardia and prolonged QTc and QRS intervals resolved with symptomatic management, but she soon developed sinus bradycardia, hypotension, and mild transaminitis...
September 2016: Journal of Psychiatric Practice
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