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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/28070060/the-brugada-syndrome%C3%A3-from-gene-to-therapy
#2
Antonio Curcio, Giuseppe Santarpia, Ciro Indolfi
It is almost a quarter of century that a pioneering work of 2 researchers named Brugada brought the entire scientific community to understanding the molecular, clinical, and electrophysiological aspects of a distinctive syndrome. It affects mainly young adults with syncope and/or sudden cardiac death caused by polymorphic ventricular tachycardia or ventricular fibrillation in the absence of any sign of cardiac degeneration or alteration. Although the involvement of the epicardial layer of the right ventricular outflow tract, and the requirement of pharmacologic challenge for unveiling concealed forms, have been fully characterized, many areas of uncertainties remain to be elucidated, such as the unpredictable usefulness of programmed ventricular stimulation, the role of radiofrequency catheter ablation for reducing ST-segment elevation, and the value of risk stratification in patients diagnosed with upper displacement of right precordial leads...
January 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28057896/out-of-hospital-cardiac-arrest-in-hong-kong-a-territory-wide-study
#3
K L Fan, L P Leung, Y C Siu
INTRODUCTION: Out-of-hospital cardiac arrest is a global health care problem. Like other cities in the world, Hong Kong faces the impact of such events. This study is the first territory-wide investigation of the epidemiology and outcomes of out-of-hospital cardiac arrest in Hong Kong. It is hoped that the findings can improve survival of patients with cardiac arrest. METHODS: This study was a retrospective analysis of the prospectively collected data on out-of-hospital cardiac arrest managed by the emergency medical service from 1 August 2012 to 31 July 2013...
January 6, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28051284/analysis-of-out-of-hospital-cardiac-arrest-in-croatia-survival-bystander-cardiopulmonary-resuscitation-and-impact-of-physician-s-experience-on-cardiac-arrest-management-a-single-center-observational-study
#4
Anita Lukić, Ileana Lulić, Dinka Lulić, Zoran Ognjanović, Davorin Cerovečki, Siniša Telebar, Ivica Mašić
AIM: To analyze the initial rhythm, bystander cardiopulmonary resuscitation (CPR) rate, and survival after out-of-hospital cardiac arrests (OHCA) in Varaľdin County (Croatia), and to investigate whether physician's inexperience in emergency medical services (EMS) has an impact on resuscitation management. METHODS: We reviewed clinical records and Revised Utstein cardiac arrest forms of all out-of-hospital resuscitations performed by EMS Varaľdin (EMSVz), Croatia, from 2007-2013...
December 31, 2016: Croatian Medical Journal
https://www.readbyqxmd.com/read/28029315/left-ventricular-dysfunction-with-trastuzumab-therapy-is-primary-prevention-the-best-option
#5
Paaladinesh Thavendiranathan, Eitan Amir
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
December 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28024548/canadian-cardiovascular-society-canadian-cardiovascular-critical-care-society-canadian-association-of-interventional-cardiology-position-statement-on-the-optimal-care-of-the-postarrest-patient
#6
Graham C Wong, Sean van Diepen, Craig Ainsworth, Rakesh C Arora, Jean G Diodati, Mark Liszkowski, Michael Love, Chris Overgaard, Greg Schnell, Jean-Francois Tanguay, George Wells, Michel Le May
Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28011703/optogenetic-termination-of-ventricular-arrhythmias-in-the-whole-heart-towards-biological-cardiac-rhythm-management
#7
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/28007240/the-society-of-thoracic-surgeons-2017-clinical-practice-guidelines-for-the-surgical-treatment-of-atrial-fibrillation
#8
Vinay Badhwar, J Scott Rankin, Ralph J Damiano, A Marc Gillinov, Faisal G Bakaeen, James R Edgerton, Jonathan M Philpott, Patrick M McCarthy, Steven F Bolling, Harold G Roberts, Vinod H Thourani, Rakesh M Suri, Richard J Shemin, Scott Firestone, Niv Ad
Surgical ablation for atrial fibrillation (AF) can be performed without additional risk of operative mortality or major morbidity, and is recommended at the time of concomitant mitral operations to restore sinus rhythm. (Class I, Level A) Surgical ablation for AF can be performed without additional operative risk of mortality or major morbidity, and is recommended at the time of concomitant isolated aortic valve replacement, isolated coronary artery bypass graft surgery, and aortic valve replacement plus coronary artery bypass graft operations to restore sinus rhythm...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28005193/trek-1-k2p2-1-k-channels-are-suppressed-in-patients-with-atrial-fibrillation-and-heart-failure-and-provide-therapeutic-targets-for-rhythm-control
#9
Patrick Lugenbiel, Fabian Wenz, Pascal Syren, Pascal Geschwill, Katharina Govorov, Claudia Seyler, Derk Frank, Patrick A Schweizer, Jennifer Franke, Tanja Weis, Claus Bruehl, Bastian Schmack, Arjang Ruhparwar, Matthias Karck, Norbert Frey, Hugo A Katus, Dierk Thomas
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Concomitant heart failure (HF) poses a particular therapeutic challenge and is associated with prolonged atrial electrical refractoriness compared with non-failing hearts. We hypothesized that downregulation of atrial repolarizing TREK-1 (K2P2.1) K(+) channels contributes to electrical remodeling during AF with HF, and that TREK-1 gene transfer would provide rhythm control via normalization of atrial effective refractory periods in this AF subset...
January 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/27968767/safety-of-device-implantation-under-antipatelet-therapy-with-ticagrelor-about-20-cases
#10
W Amara, S Naccache, C Akret, S Cheggour, S M'Zoughi, G Galuscan, A Dompnier
INTRODUCTION: Management of antiplatelet therapy at the time of device implantation remains controversial. This study aimed to assess the risk of bleeding complications in patients receiving ticagrelor at the time of cardiac device surgery. METHODS: We performed a multicentre (N=4), retrospective study from January 2015 to January 2016. The survey included all patients (pts) treated with ticagrelor before undergoing pacemaker, implantable-cardioverter defibrillator (ICD) implantation or generator replacement...
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27935015/extracorporeal-cardiopulmonary-resuscitation-after-out-of-hospital-cardiac-arrest-in-a-danish-health-region
#11
J Fjølner, J Greisen, M R S Jørgensen, C J Terkelsen, L B Ilkjaer, T M Hansen, H Eiskjaer, S Christensen, J Gjedsted
BACKGROUND: Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region...
December 9, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27909483/from-incidental-mechanically-induced-arrhythmias-to-reflex-defined-arrhythmogenicity-on-the-track-of-the-ternary-reflex-system-resemblance-to-the-infancy-of-new-era-or-rediscovery
#12
REVIEW
Petras Stirbys Md PhD
The underlying pathophysiology of supraventricular and ventricular arrhythmias remains a matter of intense investigation. Though evolving, the contemporary explanations do not encompass all aspects of arrhythmogenicity. An improved understanding of arrhythmia substrate is needed to augment therapeutic capabilities. Our observation and literature sources demonstrate relatively high incidence of transitory arrhythmias which are non-intentionally generated by the endocardial lead/catheter manipulation. These findings are interesting and potentially may crystallize the reflex-dependent proarrhythmic cardiac activity...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27886922/atrial-fibrillation-during-cardiac-resynchronization-therapy
#13
REVIEW
Mariëlle Kloosterman, Alexander H Maass, Michiel Rienstra, Isabelle C Van Gelder
The landmark trials on cardiac resynchronization therapy (CRT) have focused on patients with sinus rhythm at inclusion. Little data are available on the efficacy of CRT in patients with atrial fibrillation (AF), while AF has a high prevalence (20-40%) among patients receiving CRT. This review focuses on the detrimental effect of AF on CRT response and discusses management of patients with AF during CRT. Uncertainty remains as to which thresholds of AF burden can lead to a reduced response to CRT and every effort should be made in trying to assess and guarantee successful biventricular pacing in patients with AF...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27877067/similar-long-term-survival-of-consecutive-in-hospital-and-out-of-hospital-cardiac-arrest-patients-treated-with-targeted-temperature-management
#14
Magaly Engsig, Helle Søholm, Fredrik Folke, Peter J Gadegaard, Julie Therese Wiis, Rune Molin, Thomas Mohr, Frederik N Engsig
OBJECTIVE: The long-term survival of in-hospital cardiac arrest (IHCA) patients treated with targeted temperature management (TTM) is poorly described. The aim of this study was to compare the outcomes of consecutive IHCA with out-of-hospital cardiac arrest (OHCA) patients treated with TTM. DESIGN SETTING AND PATIENTS: Retrospectively collected data on all consecutive adult patients treated with TTM at a university tertiary heart center between 2005 and 2011 were analyzed...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27871122/efficacy-and-safety-of-ablation-for-people-with-non-paroxysmal-atrial-fibrillation
#15
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...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27868000/rhythm-is-a-dancer-the-immediate-management-of-postoperative-atrial-fibrillation-following-cardiac-surgery
#16
COMMENT
Martin I Sigurdsson, Simon C Body
No abstract text is available yet for this article.
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27863355/changes-in-the-severity-of-aortic-regurgitation-at-peak-effort-during-exercise
#17
José Francisco Forteza Albertí, Marta Noris Mora, Andrés Carrillo López, Pere Pericàs, Lucía Pasamar Márquez, Francisco Javier Calderón Montero, Antonio Rodríguez Fernández
BACKGROUND: Chronic aortic regurgitation can be well tolerated for a long time. Some patients with normal ventricular function can even reach high levels of sporting performance. How the severity of regurgitation may change during exercise, however, is little known, although some studies suggest it diminishes. The present work examines, during exercise, the functional capacity, ventricular function, and regurgitation fraction (RF) in asymptomatic subjects with moderate or severe aortic regurgitation with preserved ejection fraction...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27835072/the-outcomes-of-targeted-temperature-management-after-cardiac-arrest-at-emergency-department-a-real-world-experience-in-a-developing-country
#18
Winchana Srivilaithon, Sombat Muengtaweepongsa
Targeted temperature management (TTM) is indicated for comatose survivors of cardiac arrest to improve outcomes. However, the benefit of TTM was verified by rigid controlled clinical trials. This study aimed at evaluating its effects in real-world practices. A prospective observational study was done at the emergency department of tertiary care, Thammasat Hospital, from March 2012 until October 2015. We included all who did not obey verbal commands after being resuscitated from cardiac arrest regardless of initial cardiac rhythm...
November 11, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27820847/outcomes-of-adult-in-hospital-cardiac-arrest-treated-with-targeted-temperature-management-a-retrospective-cohort-study
#19
Chih-Hung Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Wen-Jone Chen
AIM: Targeted temperature management (TTM) for in-hospital cardiac arrest (IHCA) is given different recommendation levels within international resuscitation guidelines. We aimed to identify whether TTM would be associated with favourable outcomes following IHCA and to determine which factors would influence the decision to implement TTM. METHODS: We conducted a retrospective observational study in a single medical centre. We included adult patients suffering IHCA between 2006 and 2014...
2016: PloS One
https://www.readbyqxmd.com/read/27816112/regional-lack-of-consistency-in-the-management-of-atrial-fibrillation-from-the-record-af-trial
#20
Yousef H Darrat, Jignesh Shah, Claude-Samy Elayi, Gustavo X Morales, Lisa Naditch-Brûlé, Sandrine Brette, Christine Taniou, Peter R Kowey, Peter J Schwartz
American and European society guidelines for atrial fibrillation management mostly agree on the utilization of rate and rhythm control strategies and the indications for oral anticoagulant (OAC) use. However, the level of adherence to guidelines in clinical practice may vary by region. In this study, data analysis from The Registry on Cardiac rhythm disorders assessing the control of Atrial Fibrillation (RECORD-AF) registry, an international registry in patients with newly diagnosed atrial fibrillation of <1 year, shows that differences in practice exist between 3 regions, namely Western Europe, Eastern Europe, and North America...
January 1, 2017: American Journal of Cardiology
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