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https://www.readbyqxmd.com/read/28079553/end-of-life-decisions-in-heart-failure-to-turn-off-the-intracardiac-device-or-not
#1
Bilal Ayach, Amrit Malik, Colette Seifer, Shelley Zieroth
PURPOSE OF REVIEW: Heart failure is a significant public health concern around the world. Implantable cardioverter defibrillators with or without cardiac resynchronization therapy (CRT-D) have proven survival benefit. As patients progress to end-stage disease, management shifts to palliative care, and cardiologists are often confronted with how to best manage these devices. RECENT FINDINGS: Studies suggest that up to one-third of patients with an implantable cardioverter defibrillator receive painful shocks in the last 24 h of life...
January 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28077816/incidence-of-atrial-tachyarrhythmias-in-patients-with-early-repolarization-syndrome
#2
Ki Won Hwang, Gi-Byoung Nam, Junhee Han, Yong Giun Kim, Hyung Oh Choi, Jun Kim, Kee-Joon Choi, You-Ho Kim
Atrial tachyarrhythmias (ATAs) occur in a significant proportion of Brugada syndrome (BrS) patients and are often an important cause of inappropriate shocks. The aim of this retrospective study was to evaluate the incidence of ATAs and ATA-induced inappropriate shocks in early repolarization syndrome (ERS) patients as compared to BrS patients.We analyzed data from 20 consecutive patients who were diagnosed with ERS and compared them with patients diagnosed with BrS (n = 31). Clinical and ICD interrogation data were collected and analyzed for all events with ICD shocks...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28077814/life-threatening-ventricular-arrhythmia-and-brugada-type-st-segment-elevation-associated-with-acute-ischemia-of-the-right-ventricular-outflow-tract
#3
Rena Nakamura, Mitsuhiro Nishizaki, Kiko Lee, Masato Shimizu, Hiroyuki Fujii, Noriyoshi Yamawake, Harumizu Sakurada, Masayasu Hiraoka, Mitsuaki Isobe
BACKGROUND: Brugada-type ECG (Br-ECG) is occasionally observed during acute myocardial ischemia of the right ventricular outflow tract (RVOT). No studies have explored, however, the association of ventricular tachyarrhythmia and development of Br-ECG due to acute ischemia of the RVOT.Methods and Results:The study included 13 consecutive patients with acute ischemia of the RVOT during coronary catheterization. Patients were divided into 2 groups: those with Br-ECG (group B) and those without (group N)...
January 11, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28073682/study-design-for-control-of-heart-rate-in-infant-and-child-tachyarrhythmia-with-heart-failure-using-landiolol-heartful-a-prospective-multicenter-uncontrolled-clinical-trial
#4
Naokata Sumitomo, Hitoshi Horigome, Masaru Miura, Hiroshi Ono, Hideaki Ueda, Kiyohiro Takigiku, Jun Yoshimoto, Naoki Ohashi, Tsugutoshi Suzuki, Koichi Sagawa, Hiroya Ushinohama, Kazuhiro Takahashi, Aya Miyazaki, Heima Sakaguchi, Mari Iwamoto, Motoki Takamuro, Chiho Tokunaga, Tetsuji Nagano
BACKGROUND: Persistent tachycardia in pediatric patients after congenital heart surgery further deteriorates their hemodynamic condition, and may become fatal. Therefore, immediate control of the tachycardia is mandatory in these patients. For this purpose, quick-acting, short-acting, titratable intravenous agents are required. However, there are no agents with such characteristics among the drugs approved for control of pediatric arrhythmias in Japan, and thus novel and effective medications for these patients are awaited...
January 7, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28069327/early-ventricular-tachyarrhythmias-after-coronary-artery-bypass-grafting-surgery-is-it-a-real-burden
#5
Elisabeth M J P Mouws, Ameeta Yaksh, Paul Knops, Charles Kik, Eric Boersma, Ad J J C Bogers, Natasja M S de Groot
BACKGROUND: The prevalence of ventricular dysrhythmias (VD) [ventricular premature beats (VPBs), ventricular couplets (Vcouplets), ventricular runs (Vruns)] after coronary artery bypass grafting (CABG) has so far not been examined. The goal of this study is to examine characteristics of VD and whether they precede ventricular tachyarrhythmias (VTA) during a postoperative follow-up period of 5 days using continuous rhythm registrations. In addition, we determined predictive factors of VD/VTA...
January 6, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28065832/a-novel-method-to-enhance-phenotype-epicardial-functional-substrates-and-ventricular-tachyarrhythmias-in-brugada-syndrome
#6
Fa-Po Chung, Sunu Budhi Raharjo, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Chin-Yu Lin, Yao-Ting Chang, Yuan Hung, Abigail Te, Shinya Yamada, Hiroshi Tasaka, Shih-Ann Chen, Chin-Tien Wang
BACKGROUND: Fever is associated with the manifestation of Brugada phenotype and ventricular tachycardia/fibrillation (VT/VF) in patients with Brugada syndrome (BrS). The thermal effect on the pathogenesis of functional substrates in BrS remains unknown. OBJECTIVE: The study aimed to elucidate the thermal effect on BrS phenotype, VT/VF, and electrophysiological characteristics of epicardial functional substrates in BrS. METHODS: We consecutively studied 15 patients with BrS receiving radiofrequency catheter ablation (RFCA) for drug-refractory ventricular tachyarrhythmias...
January 5, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28058031/massive-myocardial-staining-and-thebesian-venous-opacification-during-complicated-coronary-angiography
#7
Fatih Mehmet Ucar, Ozcan Ozeke, Ilker Duman, Ugur Canpolat, Halil Lutfi Kisacik
Myocardial staining is a complication of coronary angiography or intervention procedures and consists of extravasations of contrast material into the myocardium. The powerful injection of contrast (myocardial staining) is caused by the improper positioning of the angiography or guiding catheter and can lead to refractory ventricular tachyarrhythmias and occasionally cardiac death. It results in small puffs of dye extravasating into pericoronary space (epicardial or myocardial).We presented an interesting image of a massive myocardial staining and dense coronary and thebesian venous opacification during complicated right coronary angiography...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28056022/l-type-calcium-channel-inhibition-contributes-to-the-proarrhythmic-effects-of-aconitine-in-human-cardiomyocytes
#8
Jianjun Wu, Xiangchong Wang, Ying Ying Chung, Cai Hong Koh, Zhenfeng Liu, Huicai Guo, Qiang Yuan, Chuan Wang, Suwen Su, Heming Wei
Aconitine (ACO) is well-known for causing lethal ventricular tachyarrhythmias. While cardiac Na+ channel opening during repolarization has long been documented in animal cardiac myocytes, the cellular effects and mechanism of ACO in human remain unexplored. This study aimed to assess the proarrhythmic effects of ACO in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). ACO concentration-dependently (0.3 ~ 3.0 μM) shortened the action potentials (AP) durations (APD) in ventricular-like hiPSC-CMs by > 40% and induced delayed after-depolarization...
2017: PloS One
https://www.readbyqxmd.com/read/28054729/comparison-of-the-efficacy-of-empiric-thoracic-vein-isolation-for-the-treatment-of-paroxysmal-and-persistent-atrial-fibrillation-in-patients-without-structural-heart-disease
#9
Koichiro Ejima, Ryuta Henmi, Yuji Iwanami, Daigo Yagishita, Morio Shoda, Nobuhisa Hagiwara
INTRODUCTION: The guidelines suggest that an adjuvant substrate modification in addition to pulmonary vein isolation (PVI) may be needed for persistent atrial fibrillation (PerAF) assuming that catheter ablation is less successful for PerAF than paroxysmal AF (PAF). To revisit the above assumption, we compared the outcome of the same catheter ablation strategy between PAF and PerAF. METHODS AND RESULTS: Two-hundred and thirty-three consecutive patients (mean age 60±10 years, 53 PerAF and 8 long-lasting PerAF) without structural heart disease underwent catheter ablation of AF by the same strategy using an empiric thoracic vein isolation (a wide circumferential PVI plus empiric superior vena cava isolation) as a major part of the strategy without any adjuvant substrate modification...
January 5, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28041702/can-we-predict-new-af-occurrence-in-single-chamber-icd-patients-insights-from-an-observational-investigation
#10
Mauro Biffi, Matteo Ziacchi, Renato Pietro Ricci, Domenico Facchin, Giovanni Morani, Maurizio Landolina, Maurizio Lunati, Saverio Iacopino, Alessandro Capucci, Stefano Bianchi, Tommaso Infusino, Giovanni Luca Botto, Luigi Padeletti, Giuseppe Boriani
BACKGROUND: Atrial tachyarrhythmias (AT/AF) have been associated with an increased risk of mortality, morbidity and ischemic stroke. Up to now, single chamber ICD diagnostics was not able to detect AT/AF, therefore the incidence of new onset AT/AF in patients with single chamber ICD is not known. OBJECTIVE: To evaluate incidence and predictors of AT/AF occurrence in patients with dual-chamber ICD with no pacing indications and no history of AT/AF that strictly mimic single chamber ICD recipient...
December 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28039924/focal-impulse-and-rotor-modulation-for-the-treatment-of-atrial-fibrillation-locations-and-one-year-outcomes-of-human-rotors-identified-using-a-64-electrode-basket-catheter
#11
Roland Richard Tilz, Tina Lin, Andreas Rillig, Christian-H Heeger, Leonie Scholz, Peter Wohlmuth, Tudor Bucur, Andreas Metzner, Shibu Mathew, Erik Wissner, Feifan Ouyang, Karl-Heinz Kuck
INTRODUCTION: Pulmonary vein isolation (PVI) is currently the gold standard for catheter ablation of atrial fibrillation (AF). The mechanism for AF-maintenance is still controversial. The concept of rapidly-activating spiral rotors perpetuating AF has led to the development of several rotor-mapping systems. We present our experience with focal impulse and rotor modulation (FIRM) using a 64-electrode basket catheter and computational system and evaluate its feasibility in conjunction with PVI to treat AF...
December 31, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28039126/are-olympic-athletes-free-from-cardiovascular-diseases-systematic-investigation-in-2352-participants-from-athens-2004-to-sochi-2014
#12
Antonio Pelliccia, Paolo Emilio Adami, Filippo Quattrini, Maria Rosaria Squeo, Stefano Caselli, Luisa Verdile, Viviana Maestrini, Fernando Di Paolo, Cataldo Pisicchio, Roberto Ciardo, Antonio Spataro
CONTEXT: Olympic athletes represent model of success in our society, by enduring strenuous conditioning programmes and achieving astonishing performances. They also raise scientific and clinical interest, with regard to medical care and prevalence of cardiovascular (CV) abnormalities. OBJECTIVE: Our aim was to assess the prevalence and type of CV abnormalities in this selected athlete's cohort. DESIGN, SETTING AND PARTICIPANTS: 2352 Olympic athletes, mean age 25±6, 64% men, competing in 31 summer or 15 winter sports, were examined with history, physical examination, 12-lead and exercise ECG and echocardiography...
December 30, 2016: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28027785/sinusal-reversion-of-supraventricular-tachyarrhythmias-after-propofol-administration-a-case-series
#13
J Montero-Tinnirello, M Magaldi, J Fontanals, P Masgoret, J C Bravo
No abstract text is available yet for this article.
December 24, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/28012188/video-assisted-thoracoscopic-left-cardiac-sympathetic-denervation-in-patients-with-hereditary-ventricular-arrhythmias
#14
Se Yong Jang, Yongkeun Cho, Nam Kyun Kim, Chang-Yeon Kim, Jihyun Sohn, Jae-Hyung Roh, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Shung Chull Chae, Tak-Hyuk Oh, Gun Jik Kim
BACKGROUND: Left cardiac sympathetic denervation (LCSD) has been underutilized in patients with hereditary ventricular arrhythmia syndromes such as congenital long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT). The purpose of this study was to investigate the safety and efficacy of video-assisted thoracoscopic (VATS) LCSD in such patients. METHODS: Fifteen patients (4 men, 24.6 ± 10.5 years old) who underwent VATS-LCSD between November 2010 and January 2015 for hereditary ventricular arrhythmia syndromes at Kyungpook National University Hospital were enrolled in this study...
December 24, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28011703/optogenetic-termination-of-ventricular-arrhythmias-in-the-whole-heart-towards-biological-cardiac-rhythm-management
#15
Emile C A Nyns, Annemarie Kip, Cindy I Bart, Jaap J Plomp, Katja Zeppenfeld, Martin J Schalij, Antoine A F de Vries, Daniël A Pijnappels
AIMS: Current treatments of ventricular arrhythmias rely on modulation of cardiac electrical function through drugs, ablation or electroshocks, which are all non-biological and rather unspecific, irreversible or traumatizing interventions. Optogenetics, however, is a novel, biological technique allowing electrical modulation in a specific, reversible and trauma-free manner using light-gated ion channels. The aim of our study was to investigate optogenetic termination of ventricular arrhythmias in the whole heart...
December 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28008694/a-narrow-qrs-tachycardia-and-cannon-a-waves-what-is-the-mechanism
#16
Hussam Ali, Gianluca Epicoco, Guido De Ambroggi, Pierpaolo Lupo, Sara Foresti, Riccardo Cappato
Regular narrow QRS tachycardia, particularly if well-tolerated, is usually considered a "benign" arrhythmia of a supraventricular origin. This case concerns an 82-year-old male with ischemic heart disease who presented with recurrent episodes of a narrow QRS tachycardia that was initially diagnosed and treated as atrial tachyarrhythmia. However, careful physical examination and ECG analysis established the correct diagnosis, and the patient was managed appropriately. Remarkably, the observation of irregular cannon A waves, and Lewis lead recording, confirmed atrioventricular dissociation during tachycardia and indicated its underlying mechanism...
December 23, 2016: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28007868/systemic-right-ventricular-morphology-in-the-early-postoperative-course-after-extracardiac-fontan-operation-is-there-still-a-need-for-special-care
#17
Sarah Nordmeyer, Melanie Rohder, Johannes Nordmeyer, Oliver Miera, Björn Peters, Mi-Young Cho, Joachim Photiadis, Felix Berger, Stanislav Ovroutski
OBJECTIVES: We aimed to compare early postoperative outcome after extracardiac (EC) Fontan operation between patients with right (RV) or left (LV) systemic ventricles. METHODS: In total, 173 consecutive patients (median age 4 years, median weight 14 kg) underwent EC Fontan between 1995 and 2013. Pre- and intraoperative data as well as detailed postoperative haemodynamic variables were compared between patients with LV [n = 109 (63%)] and RV [n = 64 (37%)]...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28003221/regional-longitudinal-deformation-improves-prediction-of-ventricular-tachyarrhythmias-in-patients-with-heart-failure-with-reduced-ejection-fraction-a-madit-crt-substudy-multicenter-automatic-defibrillator-implantation-trial-cardiac-resynchronization-therapy
#18
Tor Biering-Sørensen, Dorit Knappe, Anne-Catherine Pouleur, Brian Claggett, Paul J Wang, Arthur J Moss, Scott D Solomon, Valentina Kutyifa
BACKGROUND: Left ventricular dysfunction is a known predictor of ventricular arrhythmias. We hypothesized that measures of regional longitudinal deformation by speckle-tracking echocardiography predict ventricular tachyarrhythmias and provide incremental prognostic information over clinical and conventional echocardiographic characteristics. METHODS AND RESULTS: We studied 1064 patients enrolled in the MADIT-CRT trial (Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy) with speckle-tracking data available...
January 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28002530/visceral-and-tissular-reactivity-in-acute-heart-failure-due-to-supraventricular-tachyarrhythmia-in-a-young-patient
#19
Maria Cristina Beznă, Doina Cârstea, Marinela Beznă, Octavian Istrătoaie, Ionela Cristina Deliu, Petru Răzvan Melinte
Observation of major pathological alterations in a young person involves etiological and clinical justifications, in order to properly assess, treat and control these conditions. The aim of this paper is to present severe, acute pathological lesions, installed in a young person, secondary to hypodiastolic heart failure, due to persistent supraventricular tachyarrhythmia, triggered by a post-traumatic external stimulus, with complete remission post-electrical conversion. Pathological and clinical modification are revealed, in a young person, shortly after a minor thoracic trauma, in the absence of traumatic injury but with high-frequency palpitations onset and progressive installation of vascular, visceral and interstitial stasis modifications, as well as of vascular and tissular hypoperfusion with reactive vasoconstriction...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27995745/towards-an-integrated-understanding-of-cardiac-arrhythmogenesis-growing-roles-of-experimental-pathology
#20
REVIEW
Hideo Tanaka, Taka-Aki Matsuyama, Tetsuro Takamatsu
Cardiac arrhythmias have long been regarded as derangement of electrical impulse initiation and conduction within the heart. However, underlying mechanisms for arrhythmogenesis are not fully understood solely from the electrophysiological viewpoint. This review article discusses pathogenesis of arrhythmias from non-electrical aspects, which were elucidated by spatiotemporal imaging of functional molecules in combination with morphological analysis of living heart tissues. Intracellular Ca(2+) ([Ca(2+) ]i ) overload, caused by myocardial injury, provokes Ca(2+) waves that could lead to abnormal excitations, i...
January 2017: Pathology International
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