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https://www.readbyqxmd.com/read/28436550/epicardial-brugada-syndrome-ablation-unmasking-inferior-j-waves
#1
Adam Lee, Heidi Kohler, Daniel Wright, Haris M Haqqani
Patients with Brugada syndrome are at risk of life threatening ventricular arrhythmias. Epicardial substrate ablation for Brugada syndrome has been described as a means of controlling these arrhythmias and recent reports describe elimination of the Brugada phenotype with ablation. We describe a unique case in which a patient developed inferior J waves with an early repolarization-type electrocardiogram following successful epicardial infundibular substrate ablation (which eliminated the Brugada syndrome ECG on ajmaline challenge)...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28430109/acquisition-of-electrocardiogram-signals-during-magnetic-resonance-imaging
#2
Julien Oster, Gari Clifford
The recording of the electrocardiogram (ECG) during Magnetic Resonance Imaging (MRI) acquisition is of great interest and importance. Firstly, MRI acquisition is a relatively slow process, which therefore complicates the imaging of moving organs. Cardiac MRI requires the development of strategies for acquiring high quality images, which is mainly achieved by synchronising the image acquisition with a specific time during the cardiac cycle. The ECG is used to monitor the heart's activity, and the detection of the largest and steepest peak in the cardiac cycle (the QRS complex) triggers the acquisition of slices of the k-space...
April 21, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28408651/disease-severity-and-exercise-testing-reduce-subcutaneous-implantable-cardioverter-defibrillator-left-sternal-ecg-screening-success-in-hypertrophic-cardiomyopathy
#3
Neil T Srinivasan, Kiran H Patel, Kashif Qamar, Amy Taylor, Marco Bacà, Rui Providência, Maria Tome-Esteban, Perry M Elliott, Pier D Lambiase
BACKGROUND: The features of the hypertrophic cardiomyopathy (HCM) ECG make it a challenge for subcutaneous implantable cardioverter-defibrillator (S-ICD) screening. We aimed to investigate the causes of screening failure at rest and on exercise to inform optimal S-ICD ECG vector development. METHODS AND RESULTS: One hundred and thirty-one HCM patients (age, 50±16 years; 92 males and 39 females) with ≥1 HCM risk factor for sudden death underwent S-ICD ECG screening at rest and on exercise...
April 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28402450/sudden-cardiac-death-in-adults-with-congenital-heart-disease-does-qrs-complex-fragmentation-discriminate-in-structurally-abnormal-hearts
#4
Jim T Vehmeijer, Zeliha Koyak, Jouke P Bokma, Werner Budts, Louise Harris, Barbara J M Mulder, Joris R de Groot
Aims: Sudden cardiac death (SCD) causes a large portion of all mortality in adult congenital heart disease (ACHD) patients. However, identification of high-risk patients remains challenging. Fragmented QRS-complexes (fQRS) are a marker for SCD in patients with acquired heart disease but data in ACHD patients are lacking. We therefore aim to evaluate the prognostic value of fQRS for SCD in ACHD patients. Methods and results: From a multicentre cohort of 25 790 ACHD patients, we included tachyarrhythmic SCD cases (n = 147), and controls (n = 266) matched by age, gender, congenital defect and (surgical) intervention...
April 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28383399/poststroke-alterations-in-heart-rate-variability-during-orthostatic-challenge
#5
Joel Rodriguez, Andrew Philip Blaber, Markus Kneihsl, Irhad Trozic, Rebecca Ruedl, David A Green, James Broadbent, Da Xu, Andreas Rössler, Helmut Hinghofer-Szalkay, Franz Fazekas, Nandu Goswami
Older adults following recovery from ischemic stroke have a higher incidence of orthostatic hypotension, syncope, and fall risk, which may be related to impaired autonomic responses limiting the ability to maintain cerebral blood flow. Thus, we investigated cerebrovascular and cardiovascular regulation in 23 adults ≥55 years of age, 10 diagnosed with ischemic stroke, and 13 age-matched healthy controls when sitting at rest and upon standing to compare differences of autonomic variables at ∼7 months (218 ± 41 days) poststroke...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28381391/brugada-phenocopy-induced-by-propafenone-overdose-and-successful-treatment-a-case-report
#6
Mehmet Emre Arı, Filiz Ekici
BACKGROUND: Brugada syndrome is an inherited arrhythmogenic disease that may cause sudden cardiac death due to ventricular fibrillation in young adults. Brugada syndrome caused by propafenone intoxication has been noted rarely in the literature. We reported a rare case, Brugada-phenocopy due to propafenone intoxication and its treatment. CASE REPORT: A fifteen-year-old girl having a seizure was brought to the emergency room. She took 1.5 g propafenone (Rythmol, Abbott, Chicago, IL, USA) for suicidal intention...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28379344/a-score-model-to-predict-risk-of-events-in-patients-with-brugada-syndrome
#7
Juan Sieira, Giulio Conte, Giuseppe Ciconte, Gian-Battista Chierchia, Ruben Casado-Arroyo, Giannis Baltogiannis, Giacomo Di Giovanni, Yukio Saitoh, Justo Juliá, Giacomo Mugnai, Mark La Meir, Francis Wellens, Jens Czapla, Gudrun Pappaert, Carlo de Asmundis, Pedro Brugada
Aims: Risk stratification in Brugada Syndrome (BS) remains challenging. Arrhythmic events can occur life-long and studies with long follow-ups are sparse. The aim of our study was to investigate long-term prognosis and risk stratification of BS patients. Methods and results: A single centre consecutive cohort of 400 BS patients was included and analysed. Mean age was 41.1 years, 78 patients (19.5%) had a spontaneous type I electrocardiogram (ECG). Clinical presentation was aborted sudden cardiac death (SCD) in 20 patients (5...
March 31, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28373095/out-of-hospital-cardiac-arrest-survivors-with-inconclusive-coronary-angiogram-impact-of-cardiovascular-magnetic-resonance-on-clinical-management-and-decision-making
#8
A Baritussio, A Zorzi, A Ghosh Dastidar, A Susana, G Mattesi, J C L Rodrigues, G Biglino, A Scatteia, E De Garate, J Strange, L Cacciavillani, S Iliceto, A Nisbet, G D Angelini, D Corrado, M Perazzolo Marra, C Bucciarelli-Ducci
BACKGROUND: Non-traumatic out of hospital cardiac arrest (OHCA) is the leading cause of death worldwide, mainly due to acute coronary syndromes. Urgent coronary angiography with view to revascularisation is recommended in patients with suspected acute coronary syndrome. Diagnosis and management of patients with inconclusive coronary angiogram (unobstructed coronaries or unidentified culprit lesion) is challenging. We sought to assess the role of Cardiovascular Magnetic Resonance (CMR) in the diagnosis and management of OHCA survivors with an inconclusive coronary angiogram...
March 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28364045/diagnostic-accuracy-of-3-0-t-magnetic-resonance-t1-and-t2-mapping-and-t2-weighted-dark-blood-imaging-for-the-infarct-related-coronary-artery-in-non-st-segment-elevation-myocardial-infarction
#9
Jamie Layland, Samuli Rauhalammi, Matthew M Y Lee, Nadeem Ahmed, Jaclyn Carberry, Vannesa Teng Yue May, Stuart Watkins, Christie McComb, Kenneth Mangion, John D McClure, David Carrick, Anna O'Donnell, Arvind Sood, Margaret McEntegart, Keith G Oldroyd, Aleksandra Radjenovic, Colin Berry
BACKGROUND: Patients with recent non-ST-segment elevation myocardial infarction commonly have heterogeneous characteristics that may be challenging to assess clinically. METHODS AND RESULTS: We prospectively studied the diagnostic accuracy of 2 novel (T1, T2 mapping) and 1 established (T2-weighted short tau inversion recovery [T2W-STIR]) magnetic resonance imaging methods for imaging the ischemic area at risk and myocardial salvage in 73 patients with non-ST-segment elevation myocardial infarction (mean age 57±10 years, 78% male) at 3...
March 31, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28362581/non-invasive-fetal-ecg-signal-quality-assessment-for-multichannel-heart-rate-estimation
#10
Fernando Andreotti, Felix Grasser, Hagen Malberg, Sebastian Zaunseder
OBJECTIVE: The non-invasive fetal ECG (NI-FECG) from abdominal recordings offers novel prospects for prenatal monitoring. However, NI-FECG signals are corrupted by various non-stationary noise sources, making the processing of abdominal recordings a challenging task. In this contribution, we present an online approach that dynamically assess the quality of NI-FECG to improve fetal heart rate (FHR) estimation. METHODS: Using a Naive Bayes classifier, state-of-the-art and novel signal quality indices (SQIs), and an existing adaptive Kalman filter, FHR estimation was improved...
March 1, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28359292/cardiac-4d-phase-contrast-cmr-at-9-4%C3%A2-t-using-self-gated-ultra-short-echo-time-ute-imaging
#11
M Krämer, A G Motaal, K-H Herrmann, B Löffler, J R Reichenbach, G J Strijkers, V Hoerr
BACKGROUND: Time resolved 4D phase contrast (PC) cardiovascular magnetic resonance (CMR) in mice is challenging due to long scan times, small animal ECG-gating and the rapid blood flow and cardiac motion of small rodents. To overcome several of these technical challenges we implemented a retrospectively self-gated 4D PC radial ultra-short echo-time (UTE) acquisition scheme and assessed its performance in healthy mice by comparing the results with those obtained with an ECG-triggered 4D PC fast low angle shot (FLASH) sequence...
March 31, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28357825/the-prevalence-of-electrocardiogram-abnormalities-in-professional-divers
#12
Ali Erdal Gunes, Maide Cimsit
BACKGROUND: The underwater environment presents physiological challenges for the cardiovascular, renal and pulmonary systems. Increases in external hydrostatic pressure reduce the capacity of the venous compartment and cause blood to move toward the lung. The aim of this study was to evaluate retrospectively electrocardiographic (ECG) changes in a cohort of professional divers. METHODS: Between January 2009 and January 2012, 225 randomly selected professional divers, 204 male (91%) and 21 female (9%) attended our clinic for their biannual diving medical assessment...
March 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28352466/systems-for-physical-health-care-for-mental-health-patients-in-the-community-different-approaches-to-improve-patient-care-and-safety-in-an-early-intervention-in-psychosis-service
#13
Josie Mouko, Rebecca Sullivan
Patients with mental illnesses have a high rate of physical comorbidity, and specifically, those with psychosis are at an increased risk of cardiometabolic disease and shortened lifespans, due to medication, lifestyle and illness factors. There are recognised challenges with physical health care in this group. At baseline, no patients on the Bath and North East Somerset Early Intervention in Psychosis caseload had a fully completed physical health assessment. Our aim was to offer a physical health check, blood tests, and ECG for all patients, trialling four phases of interventions...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28343654/negative-concordant-t-waves-during-paced-ventricular-rhythm-an-honest-enemy-is-better-than-a-false-friend
#14
Irene di Matteo, Pasquale Crea
The ECG diagnosis of myocardial infarction and ischemia in pacemaker patients is often challenging. The three criteria, proposed by Sgarbossa et al. in 1996, useful to suspect myocardial ischaemia in patient with left bundle branch block were demonstrated to be valid also in pacemaker patients. In the last years, concordant negative T waves in patients with ventricular paced rhythm were linked to various expressions of acute myocardial injury. If available, comparison with previous ECG is crucial. Partial persistence of cardiac memory during fusion beats created an anomalous concordance between negative T waves and QRS axis and could induce erroneous suspicions...
March 14, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28342096/-emergency-treatment-of-tachycardias
#15
N Deubner, H Greiss, T Neumann
The treatment of symptomatic tachycardia is a key challenge in intensive care medicine and emergency care. Making a quick and authoritative diagnosis on an ECG and applying adequate emergency treatment requires a structured approach to analyzing and treating arrhythmias. This CME article offers a practical categorization of the multitude of tachycardias, with medical and electrical treatment options and ECG examples. Appropriate first- and second-line treatment options are presented for most common tachyarrhythmias...
March 24, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28340026/high-rate-of-subcutaneous-implantable-cardioverter-defibrillator-sensing-screening-failure-in-patients-with-brugada-syndrome-a-comparison-with-other-inherited-primary-arrhythmia-syndromes
#16
Giulio Conte, Mihoko Kawabata, Carlo de Asmundis, Erika Taravelli, Francesco Petracca, Diego Ruggiero, Maria Luce Caputo, François Regoli, Gian-Battista Chierchia, Alessandra Chiodini, Alessandro Del Bufalo, Tiziano Moccetti, Masahiko Goya, Kenzo Hirao, Alessandro Vicentini, Gaetano M De Ferrari, Pedro Brugada, Angelo Auricchio
Aims: Subcutaneous implantable cardioverter-defibrillator (S-ICD) can avoid important complications associated with transvenous leads in patients with inherited primary arrhythmia syndromes, who do not need pacing therapy. Few data are available on the percentage of patients with inherited arrhythmia syndromes eligible for S-ICD implantation. Aim of this study was to analyse the eligibility for S-ICD in a series of patients with Brugada syndrome (BrS), and to compare it with patients with other channelopathies...
March 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28333976/early-diagnosis-of-acute-myocardial-infarction-using-high-sensitivity-troponin-i
#17
Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
OBJECTIVE: There is a clinical need for early and accurate diagnosis of acute myocardial infarction (AMI). Current European Society of Cardiology (ESC) guidelines recommend diagnosis of non-ST-elevation AMI based on serial troponin measurements. We aimed to challenge the ESC guidelines using 1) a high-sensitivity troponin I (hs-TnI) baseline cutoff, 2) an absolute hs-TnI change after 1 hour and 3) additional application of an ischemic ECG. METHODS: 1,516 patients with suspected AMI presenting to the emergency department were included...
2017: PloS One
https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#18
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28304194/out-of-hospital-cardiac-arrest-survivors-sent-for-emergency-angiography-a-clinical-score-for-predicting-acute-myocardial-infarction
#19
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28284506/sudden-cardiac-death-the-role-of-imaging
#20
Pieter van der Bijl, Victoria Delgado, Jeroen J Bax
Sudden cardiac death (SCD) is defined as "a non-traumatic, unexpected, fatal event occurring within one hour of the onset of symptoms in an apparently healthy subject", and it causes a fifth of all deaths worldwide. It often occurs in individuals not previously known with cardiac disease, which makes prevention challenging. The mechanism underlying SCD is thought to be a trigger (e.g. ischemia) acting upon a substrate (e.g. scar), causing a lethal arrhythmia. Primary prevention refers to patients at high risk of SCD and secondary prevention to those who have had an aborted episode of SCD...
March 6, 2017: International Journal of Cardiology
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