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Cardiac rhythm management

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https://www.readbyqxmd.com/read/28803515/protocol-driven-remote-monitoring-of-cardiac-resynchronization-therapy-as-part-of-a-heart-failure-disease-management-strategy
#1
Christophe J P Smeets, Frederik H Verbrugge, Julie Vranken, Jo Van der Auwera, Wilfried Mullens, Matthias Dupont, Lars Grieten, Hélène De Cannière, Dorien Lanssens, Thijs Vandenberk, Valerie Storms, Inge M Thijs, Pieter Vandervoort
BACKGROUND: Cardiac resynchronisation therapy (CRT) is an established treatment for heart failure (HF) with reduced ejection fraction. CRT devices are equipped with remote monitoring functions, which are pivotal in the detection of device problems, but may also facilitate disease management. The aim of this study was to provide a comprehensive overview of the clinical interventions taken based on remote monitoring. METHODS: This is a single centre observational study of consecutive CRT patients (n = 192) participating in protocol-driven remote follow-up...
August 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28800149/atrial-fibrillation-variability-on-long-term-monitoring-of-implantable-cardiac-rhythm-management-devices
#2
Rachel M Kaplan, Paul D Ziegler, Jodi Koehler, Taya V Glotzer, Rod S Passman
BACKGROUND: Atrial fibrillation (AF) burden and duration are predictors of thromboembolic events. The random nature of these measures may affect clinical decision making. The objective of this study was to determine temporal changes in AF burden as detected by continuous monitoring. HYPOTHESIS: AF burden changes over time when detected by continuous monitoring. METHODS: A post hoc analysis of patients enrolled in the TRENDS (A Prospective Study of the Clinical Significance of Atrial Arrhythmias Detected by Implanted Device Diagnostics) study with ≥1 stroke risk factor(s) who were implanted with a dual-chamber cardiac rhythm management device (CRMD) and had AF burden data available for ≥2 years was performed...
August 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28791240/critical-arrhythmia-in-postoperative-cardiac-children-recognition-and-management
#3
REVIEW
Mohamed Salim Kabbani, Hayan Al Taweel, Nasib Kabbani, Saleh Al Ghamdi
Arrhythmias after pediatric cardiac surgery are common and can be life-threatening. They occur intraoperatively or may appear shortly after surgery during postoperative care. They require early management and specific intervention. In this review, we describe important critical arrhythmias that are encountered during postoperative management of children undergoing cardiac surgery. We review the diagnosis, management, and explain the role of epicardial electrocardiogram in diagnosing certain types of postoperative rhythm abnormalities seen during early period after pediatric cardiac surgery...
July 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28790277/-management-of-right-heart-failure-after-cardiac-surgery
#4
Takeo Fujino, Akira Shiose
Perioperative right heart failure(RHF) is an important problem, especially in the field of heart failure surgery. Right ventricular performance is determined by the combination of preload, contractility, heart rate, rhythm and afterload. Many factors influence on these parameters in the perioperative period, and the deterioration of one of them can cause RHF. Recently, we often encounter perioperative RHF after left ventricular assist device (LVAD) implantation, and prompt LVAD pump speed optimization and treatment for RHF is required to avoid complications and hemodynamic deterioration...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28774383/atrial-cardiomyopathy-a-useful-notion-in-cardiac-disease-management-or-a-passing-fad
#5
REVIEW
Jean-Baptiste Guichard, Stanley Nattel
The term atrial cardiomyopathy, which has been used sporadically in the medical literature, was recently the subject of a detailed Consensus Document prepared by representatives of the European Heart Rhythm Association, Heart Rhythm Society, Asia-Pacific Heart Rhythm Society, and Sociedad Latinoamericana de Estimulación Cardiaca y Electrofisiología. They discussed aspects of the definition, histopathology, atrial-specific physiology, atrial pathology, impact on arrhythmia occurrence, imaging, mapping, and ablation...
August 8, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28767532/cardiac-arrest-secondary-to-lightning-strike-case-report-and-review-of-the-literature
#6
Elena L Rotariu, Mioara D Manole
Lightning strike injuries, although less common than electrical injuries, have a higher morbidity rate because of critical alterations of the circulatory system, respiratory system, and central nervous system. Most lightning-related deaths occur immediately after injury because of arrhythmia or respiratory failure. We describe the case of a pediatric patient who experienced cardiorespiratory arrest secondary to a lightning strike, where the Advanced Cardiac Life Support and Basic Life Support chain of survival was well executed, leading to return of spontaneous circulation and intact neurological survival...
August 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28745848/optimizing-survival-outcomes-for-adult-patients-with-nontraumatic-cardiac-arrest-digest
#7
Julianna Jung, Milana Zaurova
Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm...
October 22, 2016: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28722339/structured-pain-management-reduces-patient-discomfort-after-catheter-ablation-and-rhythm-device-surgery
#8
M Dörschner, A Bollmann, B Dinov, S Richter, M Döring, A Arya, A Müssigbrodt, S Kircher, N Dagres, P Sommer, G Hindricks, K Bode
BACKGROUND: The goal was to test the effectiveness of a structured pain management programme after invasive electrophysiological interventions in cardiology including ablation of atrial fibrillation (AF) or ventricular tachycardia (VT) and implantation, or explantation, of pacemakers or implantable cardioverter defibrillators. METHODS: This was a prospective study with a pre-/post-design where a post-intervention group (116 consecutive patients) was compared to a pre-intervention group (102 consecutive patients) after implementation of a structured pain-management programme using the numeric rating scale (NRS 0-10) and classified as moderate-to-severe if NRS > 3...
July 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28706585/atrial-tachyarrhythmia-in-adult-congenital-heart-disease
#9
REVIEW
Arsha Karbassi, Krishnakumar Nair, Louise Harris, Rachel M Wald, S Lucy Roche
The adult congenital heart disease (ACHD) population continues to grow and most cardiologists, emergency room physicians and family doctors will intermittently come into contact with these patients. Oftentimes this may be in the setting of a presentation with atrial tachyarrhythmia; one of the commonest late complications of ACHD and problem with potentially serious implications. Providing appropriate initial care and ongoing management of atrial tachyarrhythmia in ACHD patients requires a degree of specialist knowledge and an awareness of certain key issues...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28698191/manual-versus-semiautomatic-rhythm-analysis-and-defibrillation-for-out-of-hospital-cardiac-arrest
#10
Ziad Nehme, Emily Andrew, Resmi Nair, Stephen Bernard, Karen Smith
BACKGROUND: Although manual and semiautomatic external defibrillation (SAED) are commonly used in the management of out-of-hospital cardiac arrest, the optimal strategy is not known. We hypothesized that SAED would reduce the time to first shock and lead to higher rates of cardioversion and survival compared with a manual strategy. METHODS AND RESULTS: Between July 2005 and June 2015, we included adult out-of-hospital cardiac arrest of presumed cardiac pathogenesis...
July 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28685702/a-focus-on-pharmacological-management-of-catecholaminergic-polymorphic-ventricular-tachycardia
#11
Claudio Barbanti, Alice Maltret, Daniel Sidi
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a channelopathy characterized by adrenergic mediated ventricular arrhythmia. Untreated CPVT is a malignant syndrome with more than 50% of arrhythmic event and up to 25% of fatal or near-fatal cardiac event at 8 years follow-up. Prevention of sudden cardiac death starts with exclusion of competitive sports. Beta blockers (BB) are the cornerstone pharmacological therapy for prevention of cardiac event in CPVT patients. Dose of BB should be the highest tolerable, preferably nadolol...
July 7, 2017: Mini Reviews in Medicinal Chemistry
https://www.readbyqxmd.com/read/28655755/out-of-hospital-cardiac-arrests-in-the-older-population-in-ireland
#12
Richard Tanner, Siobhan Masterson, Mette Jensen, Peter Wright, David Hennelly, Martin O'Reilly, Andrew W Murphy, Gerard Bury, Cathal O'Donnell, Conor Deasy
INTRODUCTION: Age influences survival from an out-of-hospital cardiac arrest (OHCA) but it is unclear to what extent. Improved understanding of the impact of increasing age may be helpful in improving decision making on who should receive attempted resuscitation to optimise outcomes and minimise inappropriate end-of-life management. Our aim is to describe the demographics, characteristics and outcomes following resuscitation attempts in OHCA patients aged 70 years and older in Ireland...
June 27, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28647407/external-validation-of-the-simple-null-please-clinical-score-in-predicting-outcome-of-out-of-hospital-cardiac-arrest
#13
Tatjana S Potpara, Miroslav Mihajlovic, Sanja Stankovic, Tanja Jozic, Irena Jozic, Milika R Asanin, Rajai Ahmad, Gregory Y H Lip
BACKGROUND: Rapid clinical decision-making on further management of patients with out-of-hospital cardiac arrest may be challenging. Recently, a 'futility' score (NULL-PLEASE) incorporating multiple adverse resuscitation features (Non-shockable rhythm, Unwitnessed arrest, Long no-flow or Long low-flow period, blood pH <7.2, Lactate >7.0 mmol/l, End-stage chronic kidney disease on dialysis, Age ≥85 years, Still resuscitation and Extra-cardiac cause) has been proposed to help identify out-of-hospital cardiac arrest patients unlikely to survive; however, external independent score validation is lacking...
June 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28644155/transvenous-before-surgical-hybrid-procedure
#14
Joseph J Tiano, Robert Drennan, John Novella, Rafael Squiteri, Malcolm Robinson, Albert DiMeo, Lindsey Scierka, Paul LeLorier
BACKGROUND: Historically, persistent atrial fibrillation (PeAF) and long standing persistent atrial fibrillation (LSPeAF) have demonstrated limited clinical success despite hybrid approaches. OBJECTIVE: We describe our experience with the endocardial-before-epicardial approach defined by a comprehensive endovascular approach preceding and guiding the epicardial approach which includes an extensive posterior wall ablation. METHODS: 40 patients were followed over a 12 month period...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28638298/uncertainty-of-myocardial-perfusion-imaging-in-chest-pain-risk-stratification
#15
Htoo Kyaw, Sivacharan Buddhavarapu, Joseph Abboud, Deepika Misra
BACKGROUND: Chest pain is a common presenting symptom in the emergency department (ED). Although the diagnostic workup for chest pain is well established, the best time to perform invasive cardiac catheterization in patients with low to moderate risk of coronary artery disease is still unclear, particularly if noninvasive tests such as the electrocardiogram (ECG) and nuclear myocardial perfusion scan show nonsignificant findings. CASE REPORT: We present the case of a 52-year-old female who presented to the ED with acute-onset chest pain that had started early in the morning while she was sleeping...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28629374/multi-purpose-ecg-telemetry-system
#16
Mohamed Marouf, Goran Vukomanovic, Lazar Saranovac, Miroslav Bozic
BACKGROUND: The Electrocardiogram ECG is one of the most important non-invasive tools for cardiac diseases diagnosis. Taking advantage of the developed telecommunication infrastructure, several approaches that address the development of telemetry cardiac devices were introduced recently. Telemetry ECG devices allow easy and fast ECG monitoring of patients with suspected cardiac issues. Choosing the right device with the desired working mode, signal quality, and the device cost are still the main obstacles to massive usage of these devices...
June 19, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28627934/adult-patient-decision-making-regarding-implantation-of-complex-cardiac-devices-a-scoping-review
#17
Alison Malecki-Ketchell, Paul Marshall, Joan Maclean
BACKGROUND: Complex cardiac rhythm management device (CRMD) therapy provides an important treatment option for people at risk of sudden cardiac death. Despite the survival benefit, device implantation is associated with significant physical and psychosocial concerns presenting considerable challenges for the decision-making process surrounding CRMD implantation for patients and physicians. AIMS: The purpose of this scoping review was to explore what is known about how adult (>16 years) patients make decisions regarding implantation of CRMD therapy...
June 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28626989/electrical-isolation-of-the-left-atrial-appendage-by-maze-like-catheter-substrate-modification-a-reproducible-strategy-for-pulmonary-vein-isolation-non-responders
#18
Stefano Bordignon, Laura Perrotta, Daniela Dugo, Fabrizio Bologna, Takahiko Nagase, Alexander Fuernkranz, Kr Julian Chun, Boris Schmidt
INTRODUCTION: The ablation strategy for atrial fibrillation (AF) despite pulmonary vein isolation (PVI) is controversial. Left atrial appendage isolation (LAAI) may contribute to improve outcome. We describe an ablation approach ("Maze-like"-LAAI) that (1) modifies the underlying LA substrate by linear ablation (2) eliminates the LAA as a putative AF trigger site and (3) incorporates an unambiguous procedural endpoint. The role of LAA closure (LAAC) after LAAI was investigated. METHODS: Patients with atrial tachyarrhythmias non-responsive to PVI underwent a LAAI ablation procedure...
June 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28624147/characteristics-and-outcome-among-14-933-adult-cases-of-in-hospital-cardiac-arrest-a-nationwide-study-with-the-emphasis-on-gender-and-age
#19
Nooraldeen Al-Dury, Araz Rawshani, Johan Israelsson, Anneli Strömsöe, Solveig Aune, Jens Agerström, Thomas Karlsson, Annica Ravn-Fischer, Johan Herlitz
AIM: To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age. METHODS: Using the Swedish Register of Cardiopulmonary Resuscitation, we analyzed associations between gender, age and co-morbidities, etiology, management, 30-day survival and cerebral function among survivors in 14,933 cases of IHCA. Age was divided into three ordered categories: young (18-49years), middle-aged (50-64years) and older (65years and above)...
June 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28602671/atrial-fibrillation-in-hypertrophic-cardiomyopathy
#20
REVIEW
Kaivan Vaidya, Christopher Semsarian, Kim H Chan
Hypertrophic cardiomyopathy (HCM) is an inherited cardiac disorder with a spectrum of clinical manifestations. Patients with HCM are predisposed to developing atrial fibrillation (AF) due primarily to advanced diastolic dysfunction and left atrial (LA) dilatation and remodelling. Atrial fibrillation causes a progressive symptomatic and functional decline, as well as increased thromboembolic risk and mortality, particularly in the setting of rapid ventricular rates and left ventricular outflow tract (LVOT) obstruction...
May 23, 2017: Heart, Lung & Circulation
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