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Cardiac rhythm management

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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
#1
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
#2
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
#3
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
#4
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...
November 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
#5
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
#6
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...
November 10, 2016: 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
#7
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
#8
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
#9
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...
September 30, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27812742/-implantable-loop-recorders-in-the-diagnosis-of-syncope
#10
B M Kaess, J R Ehrlich
In syncope patients, it is essential to make the right diagnosis with respect to underlying etiology. Cardiac (arrhythmic and structural) syncopal episodes carry untoward prognostic implication compared with reflex syncope. While rhythm-symptom correlation of a spontaneous syncopal episode is key to making the correct diagnosis, in case of unclear syncope the early implantation of a loop recorder leads to faster, more efficacious, and more cost-effective diagnosis. This review article summarizes the current data regarding diagnostic accuracy and clinical role of implantable loop recorders...
November 3, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27790939/ablatogenomics-can-genotype-guide-catheter-ablation-for-cardiac-arrhythmias
#11
Jason D Roberts, Gregory M Marcus
Previously confined to the management of rare inherited arrhythmia syndromes, a role for genetics within cardiac electrophysiology has begun to emerge for more common arrhythmias, including atrial fibrillation (AF). Catheter ablation for AF is an invasive procedure effective for restoring normal rhythm, however, fails in up to 40% of those undergoing their first procedure and carries a risk for serious adverse events. Recent studies have suggested that a common genetic variant within chromosome 4q25 may be a powerful predictor of procedural success, highlighting the potential of an 'ablatogenomic' strategy...
October 28, 2016: Pharmacogenomics
https://www.readbyqxmd.com/read/27773652/refractoriness-in-human-atria-time-and-voltage-dependence-of-sodium-channel-availability
#12
Lasse Skibsbye, Thomas Jespersen, Torsten Christ, Mary M Maleckar, Jonas van den Brink, Pasi Tavi, Jussi T Koivumäki
BACKGROUND: Refractoriness of cardiac cells limits maximum frequency of electrical activity and protects the heart from tonic contractions. Short refractory periods support major arrhythmogenic substrates and augmentation of refractoriness is therefore seen as a main mechanism of antiarrhythmic drugs. Cardiomyocyte excitability depends on availability of sodium channels, which involves both time- and voltage-dependent recovery from inactivation. This study therefore aims to characterise how sodium channel inactivation affects refractoriness in human atria...
October 20, 2016: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/27772643/intensive-hemodialysis-left-ventricular-hypertrophy-and-cardiovascular-disease
#13
Peter A McCullough, Christopher T Chan, Eric D Weinhandl, John M Burkart, George L Bakris
The prevalence of cardiovascular disease, including cardiac arrhythmia, coronary artery disease, cardiomyopathy, and valvular heart disease, is higher in hemodialysis (HD) patients than in the US resident population. Cardiovascular disease is the leading cause of death in HD patients and the principal discharge diagnosis accompanying 1 in 4 hospital admissions. Furthermore, the rate of hospital admissions for either heart failure or fluid overload is persistently high despite widespread use of β-blockers and renin-angiotensin system inhibitors and attempts to manage fluid overload with ultrafiltration...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27762510/long-term-mortality-in-patients-with-permanent-pacemaker-implantation
#14
Abraham Speedie, Cinosh Mathew, Ramgopal S Shahi, Rajneesh Calton
INTRODUCTION: The development of implantable technology for cardiac rhythm management remains one of the seminal achievements of the second half of the 20th century. The development of artificial pacemakers for the electrical control of the cardiac rhythm has greatly enhanced the physician's ability to treat cardiac dysrhythmias. An ageing population and the extension of indications will in all probability result in an increasing number of cardiac device implantations. OBJECTIVE OF STUDY: To study mortality and morbidity in patients with permanent pacemaker implantation at a tertiary care hospital in North India...
September 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27754946/clinical-implications-of-brief-device-detected-atrial-tachyarrhythmias-in-a-cardiac-rhythm-management-device-population-results-from-the-registry-of-atrial-tachycardia-and-atrial-fibrillation-episodes
#15
Steven Swiryn, Michael V Orlov, David G Benditt, John P DiMarco, Donald M Lloyd-Jones, Edward Karst, Fujian Qu, Mara T Slawsky, Melanie Turkel, Albert L Waldo
BACKGROUND: The RATE Registry (Registry of Atrial Tachycardia and Atrial Fibrillation Episodes) is a prospective, outcomes-oriented registry designed to document the prevalence of atrial tachycardia and/or fibrillation (AT/AF) of any duration in patients with pacemakers and implantable cardioverter defibrillators (ICDs) and evaluate associations between rigorously adjudicated AT/AF and predefined clinical events, including stroke. The appropriate clinical response to brief episodes of AT/AF remains unclear...
October 18, 2016: Circulation
https://www.readbyqxmd.com/read/27702865/atrial-fibrillation-detection-using-a-novel-three-vector-cardiac-implantable-monitor-the-atrial-fibrillation-detect-study
#16
Giuseppe Ciconte, Massimo Saviano, Luigi Giannelli, Zarko Calovic, Mario Baldi, Cristiano Ciaccio, Amarild Cuko, Raffaele Vitale, Daniele Giacopelli, Manuel Conti, Felicia Lipartiti, Federica Giordano, Fabio Maresca, Mario Moscatiello, Gabriele Vicedomini, Vincenzo Santinelli, Carlo Pappone
AIMS: Continuous rhythm monitoring is valuable for adequate atrial fibrillation (AF) management in the clinical setting. Subcutaneous leadless implantable cardiac monitors (ICMs) yield an improved AF detection, overcoming the intrinsic limitations of the currently available external recording systems, thus resulting in a more accurate patient treatment. The study purpose was to assess the detection performance of a novel three-vector ICM device equipped with a dedicated AF algorithm. METHODS AND RESULTS: Sixty-six patients (86...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27693168/-cardiac-permanent-pacemaker-after-transcatheter-aortic-valve-implantation-a-predictive-and-scientific-review
#17
C Moini, B Sidia, D Poindron, L Fiorina, A Farge, W Amara, M El Issa
Transcatheter aortic valve implantation (TAVI) is nowadays a worldwide technique in the field of treating aortic stenosis. One of the main side effects linked to the technique are mostly attached to rhythm disturbances, such as atrioventricular (AV) and intraventricular blocks. Consequently, a pacemaker implantation is often required. That implantation rate is estimated between 8 and 30%, depending on the valve chosen. Thanks to main meta analysis on the subject, it has been managed to isolate the following risks factors for AV block development: preoperative right bundle branch block (RBBB: the most powerful element), complete AV block during the procedure, male gender, a so-called porcelain aorta, the absence of previous valvular surgery, the aortic annulus size (i...
September 29, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27693167/-safety-of-device-implantation-under-antipatelet-therapy-with-ticagrelor-about-20-cases
#18
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...
September 29, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27692225/atrial-fibrillation-in-endurance-athletes-from-mechanism-to-management
#19
REVIEW
Adrian D Elliott, Rajiv Mahajan, Dennis H Lau, Prashanthan Sanders
Exercise training has considerable health benefits. However, recent research has demonstrated a greater risk of atrial arrhythmias in endurance athletes. The mechanisms promoting atrial fibrillation in athletes are unclear but there seems to be a central role for atrial remodeling, accompanied by autonomic alterations and inflammation. Animal studies have provided unique insights, yet prospective human data are lacking. Treatment options seem to yield similar efficacy to that seen in a nonathletic population and may be justified as an early rhythm control strategy...
November 2016: Cardiology Clinics
https://www.readbyqxmd.com/read/27690674/loop-recorders-for-syncope-evaluation-what-is-the-evidence
#20
Christopher C Cheung, Andrew D Krahn
Implantable loop recorders (ILRs) have become an important pillar in the diagnostic work-up of patients with unexplained syncope. Areas covered: The modern ILR is minimally-invasive and provides an extended-duration of monitoring with high diagnostic yield. These insertable cardiac monitors (ICMs) enable prolonged monitoring that extends the opportunity for symptom-rhythm correlation from days-weeks to years, with associated incremental diagnostic yield. Over the years, observational studies and randomized trials have supported a unique role for ILRs in the assessment of recurrent or high-risk unexplained syncope...
November 2016: Expert Review of Medical Devices
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