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Sinus bradycardia

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https://www.readbyqxmd.com/read/28507743/electrophysiological-testing-for-the-investigation-of-bradycardias
#1
Demosthenes G Katritsis, Mark E Josephson
In this article we review the role of electrophysiological testing in patients presenting with bradycardia due to sinus node or atrioventricular node disease. In sinus bradycardia the role of electrophysiology studies is not established. In AV conduction disturbances, an electrophysiology study may be necessary both for the establishment of atrioventricular block as the main cause of symptoms, and for identification of the anatomic site of block that may dictate the potential need of permanent pacing.
April 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28465117/a-novel-splice-site-hcn4-gene-mutation-c-1737-1-g-t-causes-familial-bradycardia-reduced-heart-rate-response-impaired-chronotropic-competence-and-increased-short-term-heart-rate-variability
#2
Lidia Hategan, Beáta Csányi, Balázs Ördög, Kornél Kákonyi, Annamária Tringer, Orsolya Kiss, Andrea Orosz, László Sághy, István Nagy, Zoltán Hegedűs, László Rudas, Márta Széll, András Varró, Tamás Forster, Róbert Sepp
BACKGROUND: The most important molecular determinant of heart rate regulation in sino-atrial pacemaker cells includes hyperpolarization-activated, cyclic nucleotide-gated ion channels, the major isoform of which is encoded by the HCN4 gene. Mutations affecting the HCN4 gene are associated primarily with sick sinus syndrome. METHODS AND RESULTS: A novel c.1737+1 G>T 'splice-site' HCN4 mutation was identified in a large family with familial bradycardia which co-segregated with the disease providing a two-point LOD score of 4...
April 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28460803/an-unexpected-presentation-of-sick-sinus-syndrome-isolated-ventricular-asystole
#3
Harun Gunes, Feruza Turan Sonmez, Halit Berk Canga, Ayhan Saritas
Sick sinus syndrome is a disorder of sinus node function characterized by various dysrhythmias such as sinus bradycardia or pause, paroxysmal regular or irregular atrial tachycardia, tachycardiabradycardia attacks or atrial fibrillation with slow ventricular response. Ventricular asystole with preserved atrial electrical activity is a rarely seen presenting rhythm in the ED and an extremely rare cause of syncope. A 67-year-old male having a syncope attack was admitted to the emergency department. His Glasgow coma scale score was 15 on admission...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28459715/biphasic-renal-sympathetic-response-to-hemorrhagic-hypotension-in-mice
#4
Tao Zhang, Mamoru Tanida, Kunitoshi Uchida, Yoshiro Suzuki, Wei Yang, Yuhichi Kuda, Yasutaka Kurata, Makoto Tominaga, Toshishige Shibamoto
AIM: The inhibitory responses of renal sympathetic nerve activity (RSNA) and heart rate (HR) to sustained hemorrhagic shock occurred in anesthetized rats, but have not yet been determined in mice. Here, we investigated the responses of RSNA and HR to hemorrhagic hypotension in anesthetized mice, with an emphasis on the molecule-based mechanism for roles of afferent vagal nerves. METHODS: RSNA, HR, and mean systemic arterial pressure (MAP) were continuously measured in male pentobarbital-anesthetized C57BL/6N mice...
April 28, 2017: Shock
https://www.readbyqxmd.com/read/28458438/chronic-lithium-intoxication-varying-electrocardiogram-manifestations
#5
Raja Naga Mahesh Maddala, A J Ashwal, M Sudhakar Rao, R Padmakumar
Lithium is a commonly used drug in psychiatric practice. It is used in the treatment of depression and bipolar disorder. It has a narrow therapeutic index with documented adverse effects even near therapeutic levels. It has myriad of manifestations at toxic levels. The cardiovascular effects range from relatively benign ST-T wave changes to fatal arrhythmias. We describe a case of lithium toxicity which presented as a junctional rhythm and later showed a variety of manifestations such as complete heart block, atrial fibrillation, sinus bradycardia, and finally reverted to sinus rhythm at par with serum lithium levels...
January 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28451840/clinical-characteristics-associated-with-bradycardia-and-asystole-in-patients-with-syncope-undergoing-long-term-electrocardiographic-monitoring-with-implantable-loop-recorder
#6
Peter Mitro, Miloš Šimurda, Ervin Müller
BACKGROUND: The aim of this retrospective single center cohort study was to assess the occurrence of bradycardia during implantable loop recorder (ILR) monitoring in patients with unexplained syncope and negative conventional testing and to identify clinical predictors of bradycardia and pacemaker implantation. METHODS: An ILR was implanted in 112 patients (31 men, 81 women, mean age 64 ±13 years) with syncope which was not explained after conventional diagnostic work-up...
April 27, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28439158/trigemino-cardiac-reflex-a-phenomenon-neglected-in-maxillofacial-surgery
#7
Udupikrishna M Joshi, Ashwini Munnangi, Kundan Shah, Satishkumar G Patil, Nitin Thakur
BACKGROUND: Trigemino-cardiac reflex is a physiologic response of the body to pressure effects in the region of distribution of the trigeminal nerve. Oral and maxillofacial surgical procedures can induce the development of this reflex, which leads to significant changes in the heart rate and sinus rhythms. This study intends to evaluate the effects of this reflex in patients with facial fractures and its subsequent management. PATIENTS AND METHODS: A total of thirty-seven patients with facial fractures who reported to the Department of Oral and Maxillofacial Surgery at Basaveswar Teaching and General Hospital, Gulbarga during a period from July 2015-March 2016 were considered for the study...
June 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28427082/perioperative-outcomes-and-safety-of-atrial-fibrillation-catheter-ablation-in-octogenarians-a-retrospective-study-and-review-of-the-benefits-of-rhythm-control
#8
Stephanie Hakimian, Juan C Camacho, Edwin Grajeda Silvestri, Farid AbdelMalak, Elie Donath, Robert Chait
OBJECTIVES: Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control. METHODS: Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified. The primary outcome was normal sinus rhythm (NSR) on electrocardiogram at discharge...
April 21, 2017: Cardiology
https://www.readbyqxmd.com/read/28412052/-the-relationship-between-preoperative-anxiety-levels-and-vasovagal-incidents-during-the-administration-of-spinal-anesthesia
#9
Mürsel Ekinci, Birzat Emre Gölboyu, Onur Dülgeroğlu, Murat Aksun, Pınar Karaca Baysal, Erkan Cem Çelik, Ayşe Nur Yeksan
BACKGROUND: It was aimed to investigate the relationship between preoperative anxiety and vasovagal symptoms observed during the administration of spinal anesthesia in patients undergoing surgery in the perianal and inguinal regions. METHODS: The study included patients with planned surgery for inguinal hernia repair, anal fissure, hemorrhoid and pilonidal sinus excision. The study included a total of 210 patients of ASA I-II, aged 18-65 years. Patients were evaluated in respect of demographic characteristics, smoking and alcohol consumption, ASA grade and educational level...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28400936/clinical-profile-and-management-of-poisoning-with-suicide-tree-an-observational-study
#10
M Suraj Menon, Prasantha Kumar, C I Jayachandran
INTRODUCTION: The clinical features, management, and the associations of dosage in poisoning with the cardiotoxic plant Cerbera odollam (suicide tree), responsible for more than half of plant poisoning deaths in the South Indian State of Kerala alone, have not been evaluated. There are only few studies on its clinical features and none on the usage of cardiac pacing in its management, given its rarity in the Western world. We depend on data for similar toxins to form our management protocols...
October 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28400822/pacemaker-placement-in-patients-with-stroke-mediated-autonomic-dysregulation
#11
Ali A Alsaad, Christopher O Austin, Maisha T Robinson, Michael B Phillips
Lateral medullary syndrome (LMS) is an ischemic disease of the medulla oblongata, which involves the territory of the posterior inferior cerebellar artery. Lateral medullary syndrome is often missed as the cause of autonomic dysregulation in patients with recent brain stem stroke. Due to the location of the baroreceptor regulatory center in the lateral medulla oblongata, patients with LMS occasionally have autonomic dysregulation-associated clinical manifestations. We report a case of LMS-associated autonomic dysregulation...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28394550/refractory-bradycardia-a-rare-complication-of-carboprost-tromethamine-for-induction-of-abortion
#12
Jasna Čerkez Habek, Dubravko Habek, Dario Gulin
We report a first case of refractory several-hour sinus bradycardia, a rare but already described side effect of intramuscular administration of carboprost tromethamine to induce abortion for medical indication in a patient without cardiovascular and other diseases. After administration of atropine sulfate 3x0.5 mg intravenously without effect, the patient‘s sinus rhythm spontaneously normalized as carboprost was eliminated from the body (it has a 3-hour half-life). It is reasonable to believe that the specific prostaglandin underlay the etiology of bradycardia...
June 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/28385917/exercise-training-induced-bradycardia-is-caused-by-changes-in-intrinsic-sinus-node-function
#13
Mark R Boyett, Yanwen Wang, Shu Nakao, Jonathan Ariyaratnam, George Hart, Oliver Monfredi, Alicia D'Souza, George E Billman
N/A.
April 6, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28376710/electrocardiographic-changes-mimicking-acute-coronary-syndrome-in-a-large-intracranial-tumour-a-diagnostic-dilemma
#14
Nilukshana Yogendranathan, H M M T B Herath, S P Pahalagamage, Aruna Kulatunga
BACKGROUND: ST elevation Myocardial infarction is a medical emergency. A variety of noncardiac conditions had been known to mimic the ECG changes that are seen in acute coronary syndrome. Although the common ECG changes that are documented with raised intracranial pressure are T inversions, prolongation of QT interval and sinus bradycardia, ST elevation or depression, arrhythmias and prominent U waves have also been recognized. However, ST elevations in association with primary intracranial tumours are rarely reported...
April 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28371832/timed-sequential-therapy-of-the-selective-t-type-calcium-channel-blocker-mibefradil-and-temozolomide-in-patients-with-recurrent-high-grade-gliomas
#15
Matthias Holdhoff, Xiaobu Ye, Jeffrey G Supko, Louis B Nabors, Arati S Desai, Tobias Walbert, Glenn J Lesser, William L Read, Frank S Lieberman, Martin A Lodge, Jeffrey Leal, Joy D Fisher, Serena Desideri, Stuart A Grossman, Richard L Wahl, David Schiff
Background: Mibefradil (MIB), previously approved for treatment of hypertension, is a selective T-type calcium channel blocker with preclinical activity in high-grade gliomas (HGGs). To exploit its presumed mechanism of impacting cell cycle activity (G1 arrest), we designed a phase I study to determine safety and the maximum tolerated dose (MTD) of MIB when given sequentially with temozolomide (TMZ) in recurrent (r)HGG. Methods: Adult patients with rHGG ≥3 months from TMZ for initial therapy received MIB in 4 daily doses (q...
June 1, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28350118/tachycardia-bradycardia-syndrome-electrophysiological-mechanisms-and-future-therapeutic-approaches-review
#16
Gary Tse, Tong Liu, Ka Hou Christien Li, Victoria Laxton, Andy On-Tik Wong, Yin Wah Fiona Chan, Wendy Keung, Camie W Y Chan, Ronald A Li
Sick sinus syndrome (SSS) encompasses a group of disorders whereby the heart is unable to perform its pacemaker function, due to genetic and acquired causes. Tachycardia‑bradycardia syndrome (TBS) is a complication of SSS characterized by alternating tachycardia and bradycardia. Techniques such as genetic screening and molecular diagnostics together with the use of pre-clinical models have elucidated the electrophysiological mechanisms of this condition. Dysfunction of ion channels responsible for initiation or conduction of cardiac action potentials may underlie both bradycardia and tachycardia; bradycardia can also increase the risk of tachycardia, and vice versa...
February 6, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28348915/bradycardia-during-transradial-cardiac-catheterization-due-to-catheter-manipulation-resolved-by-catheter-removal
#17
Maheedhar Gedela, Vishesh Kumar, Kashif Abbas Shaikh, Adam Stys, Tomasz Stys
Purpose. To report the resolution of bradycardia encountered during transradial cardiac catheterization through the catheter pullback technique in two cases. Case Report. A 62-year-old male and an 81-year-old male underwent coronary angiogram to evaluate for coronary artery disease and as a result of positive stress test, respectively. Upon engagement of the FL 3.5 catheter into the ascending aorta through the transradial approach, the first case developed bradycardia with a heart rate of 39 beats per minute...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/28345730/electrocardiographic-abnormalities-in-treatment-na%C3%A3-ve-hiv-subjects-in-south-east-nigeria
#18
Innocent Chukwuemeka Okoye, Ernest Ndukaife Anyabolu
BACKGROUND: Cardiac complications of human immunodeficiency virus (HIV) infection are important causes of morbidity and mortality. We set out to determine the electrocardiographic (ECG) abnormalities in treatment-naïve HIV-positive patients in Enugu, south-east Nigeria. METHODS: This was a cross-sectional study involving 250 HIV-positive and 200 HIV-negative subjects. Demographic and anthropometric data, relevant investigations and ECG results were compared between the groups...
March 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28345212/cardiac-iodine-123-metaiodobenzylguanidine-scintigraphy-may-be-useful-to-identify-pathologic-from-physiologic-sinus-bradycardia
#19
Akihiro Sunaga, Masaharu Masuda, Masashi Fujita, Osamu Iida, Takashi Kanda, Yasuhiro Matsuda, Takakazu Morozumi, Toshiaki Mano, Masaaki Uematsu
BACKGROUND: Sinus bradycardia includes pathologic sick sinus syndrome (SSS) and physiologic bradycardia such as athletes' heart. Pacemaker implantation is indicated for patients with symptomatic SSS; however, the indication remains difficult to determine in those with mild and/or unspecific symptoms. The sympathetic tone is increased in response to reduced cardiac output in SSS, whereas excessive vagal tone has been seen in physiological bradycardia. We sought to determine if cardiac iodine-123-metaiodobenzylguanidine scintigraphy ((123) I-MIBG) was useful in differentiating pathologic from physiologic sinus bradycardia...
March 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28343653/swallow-induced-syncope-and-carotid-sinus-hypersensitivity-coincident-or-associated-conditions
#20
Eed Abu Zaid, Moti Haim, Hilmi Alnsasra, Yuval Konstantino
Swallow induced syncope is a rare clinical condition which is thought to result from an abnormal vagal reflex leading to bradycardia and cerebral hypoperfusion. It mostly occurs in patients with organic or functional disorders of the esophagus, and often requires permanent pacemaker implantation, along with treatment of the underlying esophageal pathology. In the following case, we report of a 71-year-old male with achalasia post per oral endoscopic myectomy, who presented with syncope and documented AV-block while eating solid food...
March 14, 2017: Journal of Electrocardiology
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