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Jonathan W Waks, Christopher Hamilton, Saumya Das, Ashkan Ehdaie, Jessica Minnier, Sanjiv Narayan, Mark Niebauer, Merritt Raitt, Christine Tompkins, Niraj Varma, Sumeet Chugh, Larisa G Tereshchenko
PURPOSE: Implantable cardioverter-defibrillators (ICDs) improve survival of systolic heart failure (HF) patients who are at risk of sudden cardiac death (SCD). We recently showed that electrocardiographic (ECG) global electrical heterogeneity (GEH) is independently associated with SCD in the community-dwelling cohort and developed GEH SCD risk score. The Global Electrical Heterogeneity and Clinical Outcomes (GEHCO) study is a retrospective multicenter cohort designed with two goals: (1) validate an independent association of ECG GEH with sustained ventricular tachyarrhythmias and appropriate ICD therapies and (2) validate GEH ECG risk score for prediction of sustained ventricular tachyarrhythmias and appropriate ICD therapies in systolic HF patients with primary prevention ICD...
March 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Mark N Belkin, Cesar E Soria, Albert L Waldo, C Jan Willem Borleffs, David L Hayes, Roderick Tung, Jagmeet P Singh, Gaurav A Upadhyay
BACKGROUND: Despite the clear association between atrial fibrillation and risk for thromboembolic events (TEs), the clinical significance of new-onset device-detected atrial tachyarrhythmia (DDAT) and TE remains disputed. We aimed to determine the risk of TE in patients with new-onset DDAT. METHODS AND RESULTS: The OVID Medline, Cochrane, and Scopus databases (inception to November 2016) were searched. Randomized controlled trials, prospective, or retrospective studies of pacemaker or defibrillator patients reporting incidence of DDAT were selected...
March 2018: Circulation. Arrhythmia and Electrophysiology
Michał Orczykowski, Karolina Borowiec, Elzbieta Biernacka, Robert Bodalski, Piotr Urbanek, Pawel Derejko, Katarzyna Kodziszewska, Olgierd Wozniak, Aneta Fronczak, Kamil Marcinkiewicz, Krystyna Guzek, Agnieszka Fil, Grzegorz Warminski, Piotr Hoffman, Maria Bilinska, Lukasz Szumowski
BACKGROUND: After the surgical correction of Tetralogy of Fallot (TOF), surgical scars and natural obstacles form pathways capable of supporting an atrial tachyarrhythmia (AT). Radiofrequency ablation is effective, although the few studies to date on this topic had relatively short follow-up periods. AIM: The aims of the study were to evaluate the acute and long-term effects of RF ablation of AT and examine the characteristics of arrhythmia recurrence. METHODS: Tetralogy of Fallot patients (N 16, age 44...
March 14, 2018: Kardiologia Polska
M Marin-Gracia, D Cantero-Lozano, E Garces-Anton, A Lopez-Bravo, A Garrido-Fernandez, M P Navarro-Perez, S Santos-Lasaosa, M Garces-Redondo
INTRODUCTION: Lacosamide is an antiepileptic drug whose exact mechanism of action remains unknown. It acts by increasing the slow inactivation of the voltage-dependent sodium channels of the cell membranes. It is indicated in the treatment of focal seizures with or without secondary generalisation and is occasionally used as adjunct treatment in neuropathic pain. Although the most frequent side effects are mild (dizziness, diplopia, blurred vision, headache, tremor, etc.), others such as supraventricular tachyarrhythmias, changes in repolarisation, atrioventricular blocks and even cardiac arrest or sudden death have been reported...
March 16, 2018: Revista de Neurologia
Mouhannad M Sadek, Varsha Chaugai, Mark J Cleland, Timothy J Zakutney, David H Birnie, F Daniel Ramirez
BACKGROUND: The relevance of transthoracic impedance (TTI) to electrical cardioversion (ECV) success for atrial tachyarrhythmias when using biphasic waveform defibrillators is unknown. HYPOTHESIS: TTI is predictive of ECV success with contemporary defibrillators. METHODS: De-identified data stored in biphasic defibrillator memory cards from ECV attempts for atrial fibrillation (AF) or atrial flutter (AFL) over a two-year period at our center were evaluated...
March 13, 2018: Clinical Cardiology
Timothy L Surman, Robert G Stuklis, Justin C Chan
BACKGROUND: Multiple case studies have suggested that video-assisted thoracoscopic sympathectomy (VATS) reduces the occurrence and frequency of symptoms in long QT syndrome (LQTS) [1,2,3]. To date there has not been a literature review to report on the short-term and long-term outcomes of this procedure. Our primary aims are to review the literature findings on the clinical outcomes of VATS sympathectomy for long QT and present a local centre case report on the outcomes of T2-T5 sympathectomy...
February 13, 2018: Heart, Lung & Circulation
Shinya Iwasawa, Tomomi Uyeda, Mika Saito, Taku Ishii, Akio Inage, Yuji Hamamichi, Satoshi Yazaki, Tadahiro Yoshikawa
Amiodarone (AMD) is a class III anti-arrhythmic drug that is highly effective for tachyarrhythmia treatment. AMD is widely used in adults with congenital heart disease (CHD); however, higher doses of AMD (> 200 mg/day) can cause various non-cardiac side effects. The purpose of this study was to assess the efficacy, safety, and adverse events of low-dose AMD (≤ 200 mg/day) for tachyarrhythmia in patients with CHD. We retrospectively studied 80 patients with CHD and tachyarrhythmia who received oral low-dose AMD (≤ 200 mg/day) from January 2004 to March 2016...
March 9, 2018: Pediatric Cardiology
Luke D Plant, David McDonald Taylor, Thomas Worland, Arvind Puri, Antony Ugoni, Sheila K Patel, Douglas F Johnson, Louise M Burrell
BACKGROUND: We aimed to investigate the incidence, precipitants, and outcomes of acute decompensated heart failure (ADHF) that develops during the inpatient stay. METHODS: We undertook a case-control study in the medical, oncology, surgical, and orthopaedic wards of a tertiary referral hospital (February-May, 2016). Patients aged ≥18 years who developed ADHF during their inpatient stay were enrolled as cases. One control patient was matched to each case by age, gender, presenting complaint/surgery performed and co-morbidities...
December 23, 2017: Heart, Lung & Circulation
Gabriele Dell'Era, Matteo Ziacchi, Eleonora Prenna, Igor Diemberger, Marco Varalda, Cristian Martignani, Federico Guerra, Mauro Biffi, Eraldo Occhetta
BACKGROUND: The management of patients explanted for implantable defibrillator (ICD) infections may be complex when anti-bradycardia pacing and tachyarrhythmia protection are needed. We aimed to test the efficacy and safety of a conventional ICD externally connected to a transvenous dual-coil lead as bridging therapy before the re-implantation. METHODS AND RESULTS: We enrolled seven patients explanted for ICD infections and needing prolonged antibiotic therapy in two high-volume hospitals in Italy and treated them with a passive can external ICD for a mean of 13 (4-30) days before re-implant...
March 8, 2018: Pacing and Clinical Electrophysiology: PACE
Dallas Duncan, Ashwin Sankar, W Scott Beattie, Duminda N Wijeysundera
BACKGROUND: The surgical stress response plays an important role on the pathogenesis of perioperative cardiac complications. Alpha-2 adrenergic agonists attenuate this response and may help prevent postoperative cardiac complications. OBJECTIVES: To determine the efficacy and safety of α-2 adrenergic agonists for reducing mortality and cardiac complications in adults undergoing cardiac surgery and non-cardiac surgery. SEARCH METHODS: We searched CENTRAL (2017, Issue 4), MEDLINE (1950 to April Week 4, 2017), Embase (1980 to May 2017), the Science Citation Index, clinical trial registries, and reference lists of included articles...
March 6, 2018: Cochrane Database of Systematic Reviews
Ethan J Rowin, Barry J Maron, Patrick Abt, Michael S Kiernan, Amanda Vest, Fred Costantino, Martin S Maron, David DeNofrio
Heart transplant has become an increasingly important option for patients with end-stage nonobstructive hypertrophic cardiomyopathy (HC). However, clinical details related specifically to the overall HC transplant experience remain sparse. We assessed outcomes of HC heart transplants, from 2002 to 2016, at Tufts Medical Center. Fifty-two nonobstructive severely symptomatic patients underwent evaluation at 47 ± 13 years; 11 (21%) declined or failed to qualify, most commonly because of co-morbidities (n = 7)...
January 31, 2018: American Journal of Cardiology
Xiaoyan Ling, Hongmei Zhou, Yunjian Ni, Cheng Wu, Caijun Zhang, Zhipeng Zhu
BACKGROUND: Cardiac surgery patients often experience several types of tachyarrhythmias after admission to the intensive care unit (ICU), which increases mortality and morbidity. Dexmedetomidine (DEX) is a popular medicine used for sedation in the ICU, and its other pharmacological characteristics are gradually being uncovered. PURPOSE: To determine whether DEX has an antiarrhythmic effect after cardiac surgery. METHODS: The three primary databases MEDLINE, Embase (OVID SP) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched, and all English-language and randomized control-designed clinical publications comparing DEX to control medicines for sedation after elective cardiac surgery were included...
2018: PloS One
Kivanc Yalin, Amr Abdin, Evgeny Lyan, Noureddin Sawan, Spyridon Liosis, Christian Elsner, Alexander Jobs, Ben Brüggemann, Jelena Koester, Ingo Eitel, Charlotte Eitel, Roland Richard Tilz
BACKGROUND: The second-generation cryoballoon (CB) is increasingly used for treatment of persistent atrial fibrillation (AF). Data regarding the clinical outcome and mechanism of arrhythmia recurrence following persistent AF ablation using CB is sparse. In this study, we aimed to assess the efficacy of CB and mechanisms of atrial tachyarrhythmia (ATA) recurrence in patients with persistent AF. METHODS AND RESULTS: A total of 133 patients (66 ± 10 years, 60% male) with symptomatic persistent AF, who were scheduled for PVI using the second-generation CB were enrolled...
February 28, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
David M P van Meenen, Sophia M van der Hoeven, Jan M Binnekade, Corianne A J M de Borgie, Maruschka P Merkus, Frank H Bosch, Henrik Endeman, Jasper J Haringman, Nardo J M van der Meer, Hazra S Moeniralam, Mathilde Slabbekoorn, Marcella C A Muller, Willemke Stilma, Bart van Silfhout, Ary Serpa Neto, Hans F M Ter Haar, Jan Van Vliet, Jan Willem Wijnhoven, Janneke Horn, Nicole P Juffermans, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J Schultz, Frederique Paulus
Importance: It remains uncertain whether nebulization of mucolytics with bronchodilators should be applied for clinical indication or preventively in intensive care unit (ICU) patients receiving invasive ventilation. Objective: To determine if a strategy that uses nebulization for clinical indication (on-demand) is noninferior to one that uses preventive (routine) nebulization. Design, Setting, and Participants: Randomized clinical trial enrolling adult patients expected to need invasive ventilation for more than 24 hours at 7 ICUs in the Netherlands...
February 27, 2018: JAMA: the Journal of the American Medical Association
Montaser Elsawy Abd Elaziz, Amr Mohammad Allama
Temporary pacemaker wires are usually inserted in patients after valve replacement and may be beneficial for optimizing myocardial function in patients that develop postoperative hemodynamically significant arrhythmias [Elmi 2002]. Indications for temporary cardiac pacing (TCP) are atrial, ventricular or atrioventricular pacing for bradyarrhythmias and for management of both atrial and ventricular tachyarrhythmias [De Belder 1990; Liebold 1998].Pacemaker wires have two ends - one end has a small needle, which is passed into the myocardial surface, then is cut off...
February 19, 2018: Heart Surgery Forum
Bin Wang, He Li, Li Zhang, Lin He, Jing Zhang, Cong Liu, Jing Wang, Qing Lv, Xiaoke Shang, Jinping Liu, Mingxing Xie
RATIONALE: Left atrial appendage aneurysms (LAAA) are rare. Patients with LAAA are often diagnosed incidentally or after cardiac tachyarrhythmia or systemic thromboembolism happen. Early diagnosis and surgical resection is of utmost importance to prevent hazardous adverse events. PATIENT CONCERNS: We present a case of 46-year-old man with congenital LAAA. The individual in this manuscript has given written informed consent to publish these case details. DIAGNOSES: Imaging studies, such as echocardiography, cardiovascular computed tomography (CT) and magnetic resonance imaging (MRI), demonstrated the large cavity arising from the left atrial appendage...
January 2018: Medicine (Baltimore)
Kang An, Jiaquan Zhu, Nan Ma, Min Tang, Ju Mei
BACKGROUND: Our previous study reported a modified endoscopic procedure for nonvalvular atrial fibrillation (AF) that requires only 3 ports in the left chest wall. HYPOTHESIS: Certain preoperative variables might be predictive risk factors for AF recurrence among patients who underwent this procedure. METHODS: From October 2010 to April 2014, 114 patients with either paroxysmal AF (PAF) or nonparoxysmal AF (non-PAF) underwent the procedure and completed postoperative cardiac-rhythm measurement via electrocardiography and Holter monitoring...
February 26, 2018: Clinical Cardiology
Arash Yavari, Dhruv Sarma, Eduardo B Sternick
In humans, dominant mutations in the gene encoding the regulatory γ2-subunit of AMP-activated protein kinase (PRKAG2) result in a highly penetrant phenotype dominated by cardiac features: left ventricular hypertrophy, ventricular pre-excitation, atrial tachyarrhythmia, cardiac conduction disease, and myocardial glycogen storage. The discovery of a link between the cell's fundamental energy sensor, AMPK, and inherited cardiac disease catalyzed intense interest into the biological role of AMPK in the heart. In this chapter, we provide an introduction to the spectrum of human disease resulting from pathogenic variants in PRKAG2, outlining its discovery, clinical genetics, and current perspectives on its pathogenesis and highlighting mechanistic insights derived through the evaluation of disease models...
2018: Methods in Molecular Biology
Yahiya Y Syed
Intravenous landiolol [Rapibloc® (EU)], an ultra short-acting highly cardioselective β1 -blocker, is approved in the EU for the rapid short-term control of tachyarrhythmias in the perioperative and intensive care settings. It has long been used in Japan to treat perioperative tachyarrhythmias. The efficacy of landiolol has been demonstrated in a large number of randomized controlled clinical trials. Landiolol significantly reduced heart rate in patients with postoperative or intraoperative supraventricular tachycardia relative to placebo and in those with atrial fibrillation/flutter and left ventricular dysfunction relative to digoxin...
February 22, 2018: Drugs
Matteo Ziacchi, Pietro Palmisano, Mauro Biffi, Renato P Ricci, Maurizio Landolina, Massimo Zoni-Berisso, Eraldo Occhetta, Giampiero Maglia, Gianluca Botto, Luigi Padeletti, Giuseppe Boriani
: Modern pacemakers have an increasing number of programable parameters and specific algorithms designed to optimize pacing therapy in relation to the individual characteristics of patients. When choosing the most appropriate pacemaker type and programing, the following variables must be taken into account: the type of bradyarrhythmia at the time of pacemaker implantation; the cardiac chamber requiring pacing, and the percentage of pacing actually needed to correct the rhythm disorder; the possible association of multiple rhythm disturbances and conduction diseases; the evolution of conduction disorders during follow-up...
April 2018: Journal of Cardiovascular Medicine
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