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Cardiac rhythm management

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https://www.readbyqxmd.com/read/28432023/pulmonary-embolism-related-sudden-cardiac-arrest-admitted-alive-at-hospital-management-and-outcomes
#1
Wulfran Bougouin, Eloi Marijon, Benjamin Planquette, Nicole Karam, Florence Dumas, David S Celermajer, Daniel Jost, Lionel Lamhaut, Frankie Beganton, Alain Cariou, Guy Meyer, Xavier Jouven
AIM: Pulmonary Embolism (PE) is a relatively common cardiovascular condition, occasionally and tragically manifesting as Sudden Cardiac Arrest (SCA). The natural history of SCA complicating PE has been poorly evaluated.In this study, we described the management and outcome of PE-related SCA. METHODS: In this prospective population--based study, we included all patients admitted at hospital alive after out- of- hospital SCA, in Paris and suburbs, France (6.6 million inhabits), from May 2011 to September 2015...
April 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28426467/neuron-specific-enolase-predicts-poor-outcome-after-cardiac-arrest-and-targeted-temperature-management-a-multicenter-study-on-1-053-patients
#2
Kaspar Josche Streitberger, Christoph Leithner, Michael Wattenberg, Peter H Tonner, Julia Hasslacher, Michael Joannidis, Tommaso Pellis, Elena Di Luca, Markus Födisch, Alexander Krannich, Christoph J Ploner, Christian Storm
OBJECTIVE: Outcome prediction after cardiac arrest is important to decide on continuation or withdrawal of intensive care. Neuron-specific enolase is an easily available, observer-independent prognostic biomarker. Recent studies have yielded conflicting results on its prognostic value after targeted temperature management. DESIGN, SETTING, AND PATIENTS: We analyzed neuron-specific enolase serum concentrations 3 days after nontraumatic in-hospital cardiac arrest and out-of-hospital cardiac arrest and outcome of patients from five hospitals in Germany, Austria, and Italy...
April 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28410590/early-predictors-of-poor-outcome-after-out-of-hospital-cardiac-arrest
#3
Louise Martinell, Niklas Nielsen, Johan Herlitz, Thomas Karlsson, Janneke Horn, Matt P Wise, Johan Undén, Christian Rylander
BACKGROUND: Early identification of predictors for a poor long-term outcome in patients who survive the initial phase of out-of-hospital cardiac arrest (OHCA) may facilitate future clinical research, the process of care and information provided to relatives. The aim of this study was to determine the association between variables available from the patient's history and status at intensive care admission with outcome in unconscious survivors of OHCA. METHODS: Using the cohort of the Target Temperature Management trial, we performed a post hoc analysis of 933 unconscious patients with OHCA of presumed cardiac cause who had a complete 6-month follow-up...
April 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28402986/no-small-matter-pediatric-resuscitation
#4
Taylor McCormick, Kevin McVaney, Paul E Pepe
PURPOSE OF REVIEW: To present advancements in pediatric cardiac arrest research, highlighting articles most relevant to clinical practice published since the latest international guidelines for cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Clinical trials examining targeted temperature management in children support avoidance of hyperthermia for both pediatric in-hospital cardiac arrest (PIHCA) and out-of-hospital cardiac arrest (POHCA), but no statistically significant outcome differences were confirmed comparing 33 and 36 °C in the limited populations studied...
April 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28389857/predictors-of-good-neurologic-outcome-after-resuscitation-beyond-30%C3%A2-min-in-out-of-hospital-cardiac-arrest-patients-undergoing-therapeutic-hypothermia
#5
Shin Ahn, Byung Kook Lee, Chun Song Youn, Youn-Jung Kim, Chang Hwan Sohn, Dong-Woo Seo, Won Young Kim
Neurologically intact survival after cardiac arrest is possible even after prolonged resuscitation efforts. However, the factors associated with good neurologic outcome in these patients remain unknown. This study identifies predictors associated with good neurologic outcome after resuscitation beyond 30 min in out-of-hospital cardiac arrest (OHCA) patients treated with targeted temperature management (TTM). This multicenter, registry-based, retrospective cohort study conducted in 24 hospitals across South Korea between 2007 and 2012 includes adult (≥18 years) non-traumatic OHCA patients with prolonged (>30 min) downtime who underwent TTM treatment...
April 7, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28383338/complications-of-heart-rhythm-management-devices-after-cardiac-rehabilitation-program
#6
Mahnaz Rakhshan, Leyla Ansari, Zahra Molazem, Najaf Zare
OBJECTIVE: The aim of this study was to examine physical and heart rhythm management device malfunction complications after participating in a cardiac rehabilitation program intervention compared with usual care. METHOD: This study was a clinical trial of 100 patients. After randomization, intervention group patients received 8 cardiac rehabilitation program sessions for 8 weeks and follow-up phone calls. Each session consisted of exercise training, education, and psychological interventions...
May 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/28377297/effect-of-prolonged-targeted-temperature-management-on-left-ventricular-myocardial-function-after-out-of-hospital-cardiac-arrest-a-randomised-controlled-trial
#7
Anders Morten Grejs, Bent Roni Ranghøj Nielsen, Peter Juhl-Olsen, Jakob Gjedsted, Erik Sloth, Johan Heiberg, Christian Alcaraz Frederiksen, Anni Nørgaard Jeppesen, Christophe Henri Valdemar Duez, Per Dreyer Hamre, Eldar Søreide, Hans Kirkegaard
AIM: To evaluate post-cardiac arrest myocardial dysfunction during prolonged targeted temperature management (TTM) compared with standard TTM in comatose out-of-hospital cardiac arrest (OHCA) survivors. METHODS: A randomised, controlled trial comparing myocardial function after TTM at 33 ±1°C for 48h compared with 24h. A total of 105 OHCA patients were computer-randomised to 24h (n=50) or 48h (n=55) of TTM. Transthoracic echocardiography was performed after 24h, 48h and 72h...
April 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28376069/supraventricular-tachycardia-associated-with-severe-anemia
#8
Daniel J Corwin, Richard J Scarfone
We present the unusual case of a 7-year-old girl with severe iron-deficiency anemia who concurrently was determined to be in a supraventricular tachycardia (SVT) rhythm. To our knowledge, the association of anemia with SVT has not been reported previously. We review the presentation of SVT, management strategies for treating both severe anemia and SVT, risks and benefits of using the classic treatments for SVT in a severely anemic patient and discuss iron-deficiency anemia-related cardiac disease.
April 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28373784/left-ventricular-noncompaction-a-rare-form-of-cardiomyopathy-revelation-modes-and-predictors-of-mortality-in-adults-through-23-cases
#9
Iliyasse Asfalou, Sanae Boulaamayl, Maha Raissouni, Najat Mouine, Mohamed Sabry, Jamal Kheyi, Nawal Doghmi, Aatif Benyass
OBJECTIVES: To describe modes of clinical presentation and echocardiographic, angiographic, and rhythmic features, and prognostic characteristics of left ventricular noncompaction cardiomyopathy (LVNC) in North African adults, through one of the first series in Morocco. BACKGROUND: LVNC is a rare congenital disorder, described for the first time by Engberding in 1984. The suspected diagnosis in thromboembolic, hemodynamic, or rhythm events requires both echocardiography and cardiovascular magnetic resonance (CMR)...
April 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28371908/acute-right-ventricular-resynchronization-improves-haemodynamics-in-children-after-surgical-repair-of-tetralogy-of-fallot
#10
Pavel Vojtovic, Filip Kucera, Peter Kubuš, Roman Gebauer, Tomáš Matejka, Tomáš Tláskal, Miroslav Ložek, Jan Kovanda, Jan Janoušek
Aims: Right bundle branch block is associated with right ventricular (RV) electromechanical dyssynchrony, which may contribute to acute haemodynamic impairment after repair of tetralogy of Fallot (ToF). We sought to evaluate the effects of RV resynchronization on haemodynamics and tissue oxygenation during the first 24 h after surgery. Methods and results: Arterial pressures, cardiac output, and tissue oxygenation were measured in 28 consecutive patients (median age 10...
March 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28363619/body-mass-index-and-outcome-of-out-of-hospital-cardiac-arrest-patients-not-treated-by-targeted-temperature-management
#11
Ioanna Galatianou, George Karlis, Aristotelis Apostolopoulos, Georgios Intas, Eleftheria Chalari, Anil Gulati, Nicoletta Iacovidou, Athanasios Chalkias, Theodoros Xanthos
BACKGROUND: Obesity has been demonstrated to increase the risk of out-of-hospital cardiac arrest (OHCA) and may influence the quality and effectiveness of cardiopulmonary resuscitation. Our aim was to investigate the association between body mass index (BMI) and the outcome of OHCA victims not treated by targeted temperature management. METHODS: This was a prospective observational study of OHCA patients. The patients were categorized according to BMI into two groups: the normal BMI group (nBMI) and the elevated BMI group (eBMI)...
March 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28339794/short-term-dabigatran-interruption-before-cardiac-rhythm-device-implantation-multi-centre-experience-from-the-re-ly-trial
#12
Vidal Essebag, Riccardo Proietti, David H Birnie, Jia Wang, James Douketis, Benoit Coutu, Ratika Parkash, Gregory Y H Lip, Stefan H Hohnloser, Andrew Moriarty, Jonas Oldgren, Stuart J Connolly, Michael Ezekowitz, Jeff S Healey
Aims: Cardiac implantable electronic device (CIED) surgery is commonly performed in patients with atrial fibrillation (AF). The current analysis was undertaken to compare peri-operative anticoagulation management, bleeding, and thrombotic events in AF patients treated with dabigatran vs. warfarin. Methods and results: This study included 611 patients treated with dabigatran vs. warfarin who underwent CIED surgery during the RE-LY trial. Among 201 warfarin-treated patients, warfarin was interrupted a median of 144 (inter-quartile range, IQR: 120-216) h, and 37 (18...
February 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28336077/out-of-hospital-cardiac-arrest-concise-review-of-strategies-to-improve-outcome
#13
REVIEW
Richard J Jabbour, Sayan Sen, Ghada W Mikhail, Iqbal S Malik
Despite decades of research, cardiac arrest remains a major cause of morbidity and mortality, with frustratingly poor survival rates of approximately 10% to hospital discharge. Various strategies have been shown to improve survival, but differing degrees of implementation have led to a disparity in survival rates. These improvements, however, are balanced against the increasing age of patients presenting with out of hospital cardiac arrest and decreasing incidence of ventricular fibrillation, the rhythm with the best outcome...
March 15, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28314170/-pseudo-subarachnoid-hemorrhage-sign-on-early-brain-computed-tomography-in-out-of-hospital-cardiac-arrest-survivors-receiving-targeted-temperature-management
#14
Byung Kook Lee, Youn-Jung Kim, Seung Mok Ryoo, Su Jin Kim, Dong Hun Lee, Kyung Woon Jeung, Won Young Kim
PURPOSE: Newly updated guidelines suggest brain computed tomography for out-of-hospital cardiac arrest survivors to identify a neurologic cardiac arrest cause. We hypothesized that the "pseudo-subarachnoid hemorrhage" (p-SAH) sign in cardiac arrest survivors is associated with poor outcome. MATERIALS AND METHODS: We retrospectively evaluated the registries of 2 tertiary hospitals, identifying 836 adult (≥18 years) patients achieving return of spontaneous circulation after out-of-hospital cardiac arrest...
February 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28298843/ictal-asystole-a-rare-cardiac-manifestation-of-temporal-lobe-epilepsy-treated-with-epilepsy-surgery
#15
Shreyas Hasmukh Ravat, Amit Ashok Bhatti, Mansi Viraj Shah, Dattatraya P Muzumdar, Sangeeta Hasmukh Ravat
Seizures are associated with fascinatingly varied cardiac and autonomic manifestations, of which ictal tachycardia is common, and asystole and bradycardia are rare. Ictal asystole (IA), an often unsought autonomic phenomenon, occurs most commonly with temporal followed by frontal lobe seizures. Prolonged IA may lead to cerebral anoxic ischemia. As the mysteries of sudden unexplained death in epilepsy are unraveled, it is quite possible that the key to it lays within these seizure-induced cardiac rhythm abnormalities...
January 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28294644/electrocardiogram-changes-and-atrial-arrhythmias-in-individuals-carrying-sodium-channel-scn5a-d1275n-mutation
#16
Sari U M Vanninen, Kjell Nikus, Katriina Aalto-Setälä
INTRODUCTION: The cardiac sodium channel SCN5A regulates atrioventricular and ventricular depolarization as well as cardiac conduction. Patients with cardiac electrical abnormalities have an increased risk of sudden cardiac death (SCD) and cardio-embolic stroke. Optimal management of cardiac disease includes the understanding of association between the causative mutations and the clinical phenotype. A 12-lead electrocardiogram (ECG) is an easy and inexpensive tool for finding risk patients...
March 15, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28291620/pacing-in-congenital-heart-disease-a-four-decade-experience-in-a-single-tertiary-centre
#17
Disha Midha, Zhong Chen, David G Jones, Howell J Williams, Karen Lascelles, Julian Jarman, Jonathan Clague, Janice Till, Konstatinos Dimopoulos, Sonya V Babu-Narayan, Vias Markides, Michael A Gatzoulis, Tom Wong
BACKGROUND: The increased risk of brady- and tachy-arrhythmias in the congenital heart disease (CHD) population means that cardiac rhythm management devices are often required at an early age and expose patients to device-related complications. The present study drew upon four decades of experience at a tertiary adult congenital heart disease ACHD center and aimed to investigate the indication for cardiac implantable electronic devices (CIEDs) and predictors of late device-related complication requiring re-intervention...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28284166/the-effect-of-targeted-temperature-management-on-qt-and-corrected-qt-intervals-in-patients-with-cardiac-arrest
#18
Zachary Rosol, David F Miranda, Yader Sandoval, Bradley A Bart, Stephen W Smith, Steven R Goldsmith
BACKGROUND: Targeted Temperature Management (TTM) improves outcomes after cardiac arrest but may affect the QT and QTc intervals which could increase the chance of subsequent arrhythmia. We report here the effects of TTM on both computer-derived and manually calculated QT and QTc as well as the relationship of the length of the QTc and serious arrhythmia in a retrospective single-center experience. METHODS: 193 patients undergoing TTM for cardiac arrest were studied...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#19
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28271726/molecular-mechanisms-of-atrial-fibrosis-implications-for-the-clinic
#20
REVIEW
Shivshankar Thanigaimani, Dennis H Lau, Thomas Agbaedeng, Adrian D Elliott, Rajiv Mahajan, Prashanthan Sanders
Recent research has unravelled an increasing list of cardiac conditions and risk factors that may be responsible for the abnormal underlying atrial substrate that predisposes to atrial fibrillation (AF). Atrial fibrosis has been demonstrated as the pivotal structural abnormality underpinning conduction disturbances that promote AF in different disease models. Despite the advancement in our discoveries of the molecular mechanisms involved in the profibrotic milieu, targeted therapeutics against atrial fibrosis remain lacking...
April 2017: Expert Review of Cardiovascular Therapy
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