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Cardiac rhythm management

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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
#1
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
#2
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...
May 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28509703/pathway-for-the-management-of-atrial-fibrillation-and-atrial-flutter
#3
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
#4
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
#5
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
#6
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 10, 2017: Neurology
https://www.readbyqxmd.com/read/28480632/2017-ishne-hrs-expert-consensus-statement-on-ambulatory-ecg-and-external-cardiac-monitoring-telemetry
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28458025/characteristics-and-outcomes-of-out-of-hospital-sudden-cardiac-arrest-according-to-the-time-of-occurrence
#12
Nicole Karam, Eloi Marijon, Florence Dumas, Lucile Offredo, Frankie Beganton, Wulfran Bougouin, Daniel Jost, Lionel Lamhaut, Jean-Philippe Empana, Alain Cariou, Christian Spaulding, Xavier Jouven
PURPOSE: The impact of time of occurrence has been extensively evaluated for in-hospital cardiac arrests but less for Out-of-Hospital Cardiac Arrests (OHCA). We assessed the impact of the time of occurrence on the characteristics and prognosis of OHCA. METHODS: Using data from the Paris Sudden Cardiac Death Expertise Center prospective study that includes all OHCA in the Paris Area, we compared characteristics and outcomes of off-hours OHCA (nights and days off) to regular-hours OHCA between 2011 and 2014...
April 27, 2017: Resuscitation
https://www.readbyqxmd.com/read/28457043/mycobacterium-tuberculosis-infection-at-pacemaker-implantation-site
#13
Rudra Prasad Samanta, Goli Vasu Babu
Expanding clinical indications of cardiac rhythm management have led to an increased use of pacemaker implantation which is associated with increased incidence of pacemaker infections. Staphylococcus aureus and epidermidis account for the majority of pacemaker infections. Infection of implantable cardiac devices by mycobacterium species, particularly mycobacterial tuberculosis is rare. We present a case of delayed pacemaker pocket infection with tuberculosis and review of literature of pacemaker infections with mycobacterium species...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28451588/lead-extraction-of-cardiac-rhythm-devices-a-report-of-a-single-center-experience
#14
Ana Isabel Azevedo, João Primo, Helena Gonçalves, Marco Oliveira, Luís Adão, Elisabeth Santos, José Ribeiro, Marlene Fonseca, Adelaide V Dias, Luís Vouga, Vasco Gama Ribeiro
INTRODUCTION AND OBJECTIVES: The rate of implanted cardiac electronic devices is increasing as is the need to manage long-term complications. Lead removal is becoming an effective approach to treat such complications. We present our experience in lead removal using different approaches, analyzing the predictors of the use of mechanical extractors/surgical removal. METHODS: Retrospective analysis of lead extractions in a series of 76 consecutive patients (mean age 70...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28449531/ablation-of-atrial-fibrillation-single-shot-techniques-poised-to-dominate-rhythm-control-strategies-the-future-is-here
#15
EDITORIAL
Antonis S Manolis
Over the recent years, the advent of single-shot techniques, such as circular catheter and cryoballoon ablation, has ushered in a new era in the catheter ablation approach and rhythm control strategies of patients with atrial fibrillation (AF). These techniques make it easier to navigate the heart and have the potential to decrease the threshold for, expand the access to, and increase patient and physician acceptance of rhythm-control therapies, that may lead to reduction of the AF disease burden and its socioeconomic impact...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28439158/trigemino-cardiac-reflex-a-phenomenon-neglected-in-maxillofacial-surgery
#16
Udupikrishna M Joshi, Ashwini Munnangi, Kundan Shah, Satishkumar G Patil, Nitin Thakur
BACKGROUND: Trigemino-cardiac reflex is a physiologic response of the body to pressure effects in the region of distribution of the trigeminal nerve. Oral and maxillofacial surgical procedures can induce the development of this reflex, which leads to significant changes in the heart rate and sinus rhythms. This study intends to evaluate the effects of this reflex in patients with facial fractures and its subsequent management. PATIENTS AND METHODS: A total of thirty-seven patients with facial fractures who reported to the Department of Oral and Maxillofacial Surgery at Basaveswar Teaching and General Hospital, Gulbarga during a period from July 2015-March 2016 were considered for the study...
June 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28432023/pulmonary-embolism-related-sudden-cardiac-arrest-admitted-alive-at-hospital-management-and-outcomes
#17
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
#18
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
#19
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
#20
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...
June 2017: Current Opinion in Critical Care
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