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Cardiac rhythm management

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https://www.readbyqxmd.com/read/28629374/multi-purpose-ecg-telemetry-system
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28562571/hemodynamic-instability-after-pulmonary-veins-isolation-in-a-patient-with-dual-chamber-pacemaker-the-phantom-injury-of-the-ventricular-lead
#6
Márcio Galindo Kiuchi, Guilherme Miglioli Lobato, Shaojie Chen
INTRODUCTION: The standard treatment of sinus node dysfunction (SND) is the pacemaker implantation, and the ideal methodology for the management of atrial fibrillation (AF) is rhythm control, but this is sometimes very hard to accomplish. For such actions, complete isolation of all pulmonary veins (PVI) is currently widely accepted as the best endpoint. CASE PRESENTATION: In this case, we report a female patient, 81 years old, with controlled hypertension, without coronary artery disease, bearer of bilateral knee replacement, and dual chamber pacemaker implanted 1...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28557694/targeted-temperature-management-effectiveness-in-the-elderly-insights-from-a-large-registry
#7
Timothy J Mader, Lauren M Westafer, Brian H Nathanson, Nadia Villarroel, Ryan A Coute, Bryan F McNally
Targeted temperature management (TTM) is recommended for all comatose adult out-of-hospital cardiac arrest (OHCA) patients with shockable first documented rhythm. However, studies examining the use and benefits of TTM among patients aged 75 and older are lacking. Using the Cardiac Arrest Registry to Enhance Survival (CARES) dataset registry from 2013 to 2015. Study criteria included being 75 years of age or older, survival to hospital admission, and known in-hospital mortality and CPC (Cerebral Performance Categories Scale) Scores...
May 30, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28553848/implementation-of-targeted-temperature-management-after-cardiac-arrest-in-polish-intensive-care-units-what-has-changed-in-the-last-five-years
#8
Paweł Krawczyk, Anna Tarczyńska, Grzegorz Dziadek, Miłosz Gołębiowski, Andrzej A Kononowicz, Janusz Andres
BACKGROUND: Studies conducted up to 2010 indicate the underuse of targeted temperature management (TTM) in Poland. AIM: This study evaluated the current degree of TTM implementation in Polish intensive care units (ICUs) and analysed the implementation process since 2005. METHODS: A telephone survey, conducted from December 2014 to July 2015, was carried out to determine the number of ICUs using TTM in patients after cardiac arrest. We collected data on the details and prevalence of TTM, and the impact of organisational and financial issues and recently published papers on its use...
May 29, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28543286/impact-of-treatment-crossovers-on-clinical-outcomes-in-the-rate-and-rhythm-control-strategies-for-atrial-fibrillation-insights-from-the-affirm-atrial-fibrillation-follow-up-investigation-of-rhythm-management-trial
#9
Abhishek Maan, Zheng Zhang, Ziling Qin, Yanbing Wang, Samuel Dudley, Kaustubh Dabhadakar, Marwan Refaat, Moussa Mansour, Jeremy N Ruskin, E Kevin Heist
We investigated the rates and reasons for crossover to alternative treatment strategies and its impact on mortality in patients who were enrolled in the AFFIRM trial. Over a mean follow-up period of 3.5 years, 842 patients underwent crossover to the alternative treatment arms in AFFIRM. The rate of crossover from rhythm to rate control (594/2033, 29.2%) was more frequent than the rate of crossover from rate to rhythm control (248/2027, 12.2%, p < 0.0001). The leading reasons for crossover from rhythm to rate control were failure to achieve or maintain sinus rhythm (272/594, 45...
May 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28528323/c-graph-a-validated-scoring-system-for-early-stratification-of-neurologic-outcome-after-out-of-hospital-cardiac-arrest-treated-with-targeted-temperature-management
#10
Erich L Kiehl, Alex M Parker, Ralph M Matar, Matthew F Gottbrecht, Michelle C Johansen, Mark P Adams, Lori A Griffiths, Steven P Dunn, Katherine L Bidwell, Venu Menon, Kyle B Enfield, Lawrence W Gimple
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) results in significant morbidity and mortality, primarily from neurologic injury. Predicting neurologic outcome early post-OHCA remains difficult in patients receiving targeted temperature management. METHODS AND RESULTS: Retrospective analysis was performed on consecutive OHCA patients receiving targeted temperature management (32-34°C) for 24 hours at a tertiary-care center from 2008 to 2012 (development cohort, n=122)...
May 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28514878/anticoagulant-cessation-following-atrial-fibrillation-ablation-limits-of-the-ecg-guided-approach
#11
Matteo Anselmino, Chiara Rovera, Giovanni Marchetto, Federico Ferraris, Davide Castagno, Fiorenzo Gaita
Long-term cessation of oral anticoagulation (OAC) following successful catheter or surgical ablation of atrial fibrillation (AF) is debated. Usually, in the presence of sinus rhythm at serial ECG recordings, the CHADS2, CHA2DS2VASc, and HAS-BLED scores are adopted to guide decision regarding OAC management. Areas covered: The safety of OAC cessation in patients without recurrent AF but with historically elevated risk for thromboembolism remains largely unknown. Taking the cue from two clinical cases, we provide an updated summary of the latest evidence regarding how to manage OAC after a successful atrial fibrillation ablation...
June 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28509703/pathway-for-the-management-of-atrial-fibrillation-and-atrial-flutter
#12
Eyal Herzog, Edgar Argulian, Steven B Levy, Emad F Aziz
Atrial fibrillation (AF) is the most common cardiac rhythm disturbance encountered in clinical practice, and its prevalence is increasing as the population ages. The American College of Cardiology, the American Heart Association, and the European Society of Cardiology established guidelines for the management of patients with AF. Atrial flutter (Afl) is less common and is often associated with or preceded by AF or occurs in an isolated pattern. A major limitation of the currently published guidelines for the management of patients with AF and Afl is their complexity, the fact that official guidelines are published separately for each of these arrhythmias, and that they were published several years ago...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28496929/management-of-patients-with-atrial-fibrillation-focus-on-treatment-options
#13
REVIEW
Pawel Matusik, Jacek Lelakowski, Barbara Malecka, Jacek Bednarek, Remigiusz Noworolski
Atrial fibrillation (AF) is leading cardiac arrhythmia with important clinical implications. Its diagnosis is usually made on the basis on 12-lead ECG or 24-hour Holter monitoring. More and more clinical evidence supports diagnostic use of cardiac event recorders and cardiovascular implantable electronic devices (CIED). Treatment options in patients with atrial fibrillation are extensive and are based on chosen rhythm and/or rate control strategy. The use and selected contraindications to AF related pharmacotherapy, including anticoagulants are shown...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28495301/2017-ishne-hrs-expert-consensus-statement-on-ambulatory-ecg-and-external-cardiac-monitoring-telemetry
#14
Jonathan S Steinberg, Niraj Varma, Iwona Cygankiewicz, Peter Aziz, Paweł Balsam, Adrian Baranchuk, Daniel J Cantillon, Polychronis Dilaveris, Sergio J Dubner, Nabil El-Sherif, Jaroslaw Krol, Malgorzata Kurpesa, Maria Teresa La Rovere, Suave S Lobodzinski, Emanuela T Locati, Suneet Mittal, Brian Olshansky, Ewa Piotrowicz, Leslie Saxon, Peter H Stone, Larisa Tereshchenko, Gioia Turitto, Neil J Wimmer, Richard L Verrier, Wojciech Zareba, Ryszard Piotrowicz
Ambulatory ECG (AECG) is very commonly employed in a variety of clinical contexts to detect cardiac arrhythmias and/or arrhythmia patterns which are not readily obtained from the standard ECG. Accurate and timely characterization of arrhythmias is crucial to direct therapies that can have an important impact on diagnosis, prognosis or patient symptom status. The rhythm information derived from the large variety of AECG recording systems can often lead to appropriate and patient-specific medical and interventional management...
May 4, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28490655/practice-guideline-summary-reducing-brain-injury-following-cardiopulmonary-resuscitation-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#15
Romergryko G Geocadin, Eelco Wijdicks, Melissa J Armstrong, Maxwell Damian, Stephan A Mayer, Joseph P Ornato, Alejandro Rabinstein, José I Suarez, Michel T Torbey, Richard M Dubinsky, Jason Lazarou
OBJECTIVE: To assess the evidence and make evidence-based recommendations for acute interventions to reduce brain injury in adult patients who are comatose after successful cardiopulmonary resuscitation. METHODS: Published literature from 1966 to August 29, 2016, was reviewed with evidence-based classification of relevant articles. RESULTS AND RECOMMENDATIONS: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32-34°C for 24 hours) is highly likely to be effective in improving functional neurologic outcome and survival compared with non-TH and should be offered (Level A)...
May 30, 2017: Neurology
https://www.readbyqxmd.com/read/28480632/2017-ishne-hrs-expert-consensus-statement-on-ambulatory-ecg-and-external-cardiac-monitoring-telemetry
#16
Jonathan S Steinberg, Niraj Varma, Iwona Cygankiewicz, Peter Aziz, Paweł Balsam, Adrian Baranchuk, Daniel J Cantillon, Polychronis Dilaveris, Sergio J Dubner, Nabil El-Sherif, Jaroslaw Krol, Malgorzata Kurpesa, Maria Teresa La Rovere, Suave S Lobodzinski, Emanuela T Locati, Suneet Mittal, Brian Olshansky, Ewa Piotrowicz, Leslie Saxon, Peter H Stone, Larisa Tereshchenko, Gioia Turitto, Neil J Wimmer, Richard L Verrier, Wojciech Zareba, Ryszard Piotrowicz
Ambulatory ECG (AECG) is very commonly employed in a variety of clinical contexts to detect cardiac arrhythmias and/or arrhythmia patterns which are not readily obtained from the standard ECG. Accurate and timely characterization of arrhythmias is crucial to direct therapies that can have an important impact on diagnosis, prognosis or patient symptom status. The rhythm information derived from the large variety of AECG recording systems can often lead to appropriate and patient-specific medical and interventional management...
May 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28463098/when-is-a-cardiac-arrest-non-cardiac
#17
Ryan M Carter, David C Cone
Introduction While the overall survival rate for out-of-hospital cardiac arrest (OHCA) is low, ranging from 5%-10%, several characteristics have been shown to decrease mortality, such as presence of bystander cardiopulmonary resuscitation (CPR), witnessed vs unwitnessed events, and favorable initial rhythm (VF/VT). More recently, studies have shown that modified CPR algorithms, such as chest-compression only or cardio-cerebral resuscitation, can further increase survival rates in OHCA. Most of these studies have included only OHCA patients with "presumed cardiac etiology," on the assumption that airway management is of lesser impact than chest compressions in these patients...
May 2, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28460828/the-future-of-atrial-fibrillation-management-integrated-care-and-stratified-therapy
#18
REVIEW
Paulus Kirchhof
Atrial fibrillation is one of the major cardiovascular health problems: it is a common, chronic condition, affecting 2-3% of the population in Europe and the USA and requiring 1-3% of health-care expenditure as a result of stroke, sudden death, heart failure, unplanned hospital admissions, and other complications. Early diagnosis of atrial fibrillation, ideally before the first complication occurs, remains a challenge, as shown by patients who are only diagnosed with the condition when admitted to hospital for acute cardiac decompensation or stroke...
April 28, 2017: Lancet
https://www.readbyqxmd.com/read/28460654/myocarditis-flail-tricuspid-valve-and-normal-rhythm-an-exceptional-form-of-neonatal-cardiac-lupus
#19
María-Teresa González-López, Ramón Pérez-Caballero-Martínez, Juan-Miguel Gil-Jaurena
Neonatal cardiac lupus is a rare, passively acquired autoimmune disease. We report a case of in utero myocarditis, confirmed postnatally, with papillary muscle rupture and severe tricuspid regurgitation after birth in the absence of conduction disturbances. Tricuspid repair was successfully performed with polytetrafluoroethylene neochordae. In this article, we discuss the pathophysiology, medical and surgical management, and implications at follow-up in this unique scenario.
May 2, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28458554/patient-characteristics-associated-with-false-arrhythmia-alarms-in-intensive-care
#20
Patricia R Harris, Jessica K Zègre-Hemsey, Daniel Schindler, Yong Bai, Michele M Pelter, Xiao Hu
INTRODUCTION: A high rate of false arrhythmia alarms in the intensive care unit (ICU) leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms. OBJECTIVE: The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU. METHODS: This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds) at an urban medical center over a period of 31 days in 2013...
2017: Therapeutics and Clinical Risk Management
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