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https://www.readbyqxmd.com/read/29779529/inhibition-and-restoration-of-crt-pacing-what-is-the-mechanism
#1
Andrzej Ząbek, Barbara Małecka, Maciej Dębski, Krzysztof Boczar, Katarzyna Holcman, Mateusz Ulman, Jacek Lelakowski
The electrocardiogram (ECG) interpretation in patients with cardiac resynchronization therapy (CRT) may be challenging. The difficulty increases if not well-known pacemaker algorithm is turned on. We show a T-wave protection algorithm (LVTP) in a patient with CRT. Accelerated sinus rhythm and intermittent oversensing in left ventricular channel resulted in loss of CRT pacing. The restoration of biventricular pacing occurred when atrial rate decreased. We provide detailed descriptions of the electrocardiogram and intracardiac electrogram...
May 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29779296/the-assessment-and-management-of-chest-pain-in-primary-care-a-focus-on-acute-coronary-syndrome
#2
Richard Thomsett, Louise Cullen
BACKGROUND: Chest pain is a common presentation and diagnosis can be challenging. There are many causes for chest pain, including life-threatening conditions such as acute coronary syndrome (ACS), which can prove difficult to diagnose. OBJECTIVE: This article focuses on diagnosis and early management of patients with possible ACS. Key differentials and essential primary care investigations and management are outlined. Hospital-based risk stratification and management are described, providing an outline of what patients can expect if referred to hospital...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29767635/detecting-atrial-fibrillation-from-short-single-lead-ecgs-using-statistical-and-morphological-features
#3
Mohamed Athif, Pamodh Chanuka Yasawardene, Chathuri Daluwatte
Point of care ECG devices can improve the early detection of atrial fibrillation (AF). Efficiency of such devices depend on the capability of automatic AF detection against normal sinus rhythm and other arrhythmias from a short single lead ECG record in the presence of noise and artefacts. The objective of this study was to develop an algorithm that classifies a short single lead ECG record into "Normal", "AF", "Other" and "Noisy" classes, and identify challenges in developing such algorithms and potential mitigation steps...
May 16, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29754204/diagnosing-arvc-in-pediatric-patients-applying-the-revised-task-force-criteria-importance-of-imaging-12-lead-ecg-and-genetics
#4
Michael Steinmetz, Ulrich Krause, Peter Lauerer, Frank Konietschke, Randolph Aguayo, Christian Oliver Ritter, Andreas Schuster, Joachim Lotz, Thomas Paul, Wieland Staab
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a potentially lethal disease that is well described in adults. In pediatric patients, however, identification of patients at risk of adverse events of ARVC remains a challenge. We aimed to determine which criteria of the revised Task Force Criteria (rTFC), alone or combined, have an impact on diagnosis of ARVC when compared to disease-specific genetic mutations in pediatric patients ≤ 18 years. Between September 2010 and December 2013, 48 consecutive young patients ≤ 18 years of age (mean 14, range of 12...
May 12, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29752526/application-of-the-bogossian-formula-for-evaluation-of-the-qt-interval-in-pacemaker-patients-with-stimulated-left-bundle-branch-block
#5
K F Weipert, H Bogossian, P Conzen, G Frommeyer, C Gemein, I Helmig, R Chasan, L Eckardt, M Seyfarth, B Lemke, M Zarse, C W Hamm, J Schmitt, D Erkapic
BACKGROUND: The presence of left bundle branch block (LBBB) represents a particular challenge in properly measuring the QT interval. Here we demonstrate the applicability of the "Bogossian formula" in pacemaker patients with LBBB due to apical or nonapical right ventricular (RV) pacing and preserved left ventricular function. METHODS: A total of 163 patients with a cardiac one- or two-chamber pacemaker were included in this prospective, multicentre observational study...
May 11, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29748178/prognostic-significance-of-the-sodium-channel-blocker-test-in-patients-with-brugada-syndrome
#6
Akira Ueoka, Hiroshi Morita, Atsuyuki Watanabe, Yoshimasa Morimoto, Satoshi Kawada, Motomi Tachibana, Masakazu Miyamoto, Koji Nakagawa, Nobuhiro Nishii, Hiroshi Ito
BACKGROUND: A drug provocation test using a sodium channel blocker (SCB) can unmask a type 1 ECG pattern in patients with Brugada syndrome. However, the prognostic value of the results of an SCB challenge is limited in patients with non-type 1 ECG. We investigated the associations of future risk for ventricular fibrillation with SCB-induced ECG changes and ventricular tachyarrhythmias (VTAs). METHODS AND RESULTS: We administered intravenous pilsicainide to 245 consecutive patients with Brugada syndrome (181 patients with spontaneous type 1 ECG, 64 patients with non-type 1 ECG)...
May 10, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29744011/noninvasive-evaluation-of-symptomatic-women-with-suspected-coronary-artery-disease
#7
REVIEW
Mohammed A Chamsi-Pasha, Karla M Kurrelmeyer
Cardiovascular disease (CVD) is the leading cause of death in the United States, yet several factors make it challenging to diagnose in women. Although women have more frequent chest pain than men, atypical symptoms such as nausea, dyspnea, and fatigue make it difficult to determine their risk of coronary artery disease (CAD) before testing. Current guidelines recommend exercise electrocardiography (ex-ECG) as the initial test in symptomatic women with intermediate pretest probability who can exercise and have a normal resting ECG; however, treadmill ex-ECG testing has a significantly lower positive predictive value in women...
October 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29724227/mobile-gpu-based-implementation-of-automatic-analysis-method-for-long-term-ecg
#8
Xiaomao Fan, Qihang Yao, Ye Li, Runge Chen, Yunpeng Cai
BACKGROUND: Long-term electrocardiogram (ECG) is one of the important diagnostic assistant approaches in capturing intermittent cardiac arrhythmias. Combination of miniaturized wearable holters and healthcare platforms enable people to have their cardiac condition monitored at home. The high computational burden created by concurrent processing of numerous holter data poses a serious challenge to the healthcare platform. An alternative solution is to shift the analysis tasks from healthcare platforms to the mobile computing devices...
May 3, 2018: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29723994/virtual-sensor-of-surface-electromyography-in-a-new-extensive-fault-tolerant-classification-system
#9
Karina de O A de Moura, Alexandre Balbinot
A few prosthetic control systems in the scientific literature obtain pattern recognition algorithms adapted to changes that occur in the myoelectric signal over time and, frequently, such systems are not natural and intuitive. These are some of the several challenges for myoelectric prostheses for everyday use. The concept of the virtual sensor, which has as its fundamental objective to estimate unavailable measures based on other available measures, is being used in other fields of research. The virtual sensor technique applied to surface electromyography can help to minimize these problems, typically related to the degradation of the myoelectric signal that usually leads to a decrease in the classification accuracy of the movements characterized by computational intelligent systems...
May 1, 2018: Sensors
https://www.readbyqxmd.com/read/29723392/high-frequency-autonomic-modulation-a-new-model-for-analysis-of-autonomic-cardiac-control
#10
Pascal Champéroux, Pierre Fesler, Sebastien Judé, Serge Richard, Jean-Yves Le Guennec, Jérôme Thireau
BACKGROUND AND PURPOSES: Increase in high-frequency (HF) beat-to-beat heart rate oscillations by torsadogenic hERG blockers appears to be associated with signs of parasympathetic and sympathetic co-activation which cannot be assessed directly using classic methods of heart rate variability (HRV) analysis. The present work aimed to find a translational model that would allow this particular state of heart rate autonomic control to be assessed. EXPERIMENTAL APPROACH: HF heart rate (HFHR) and heart period (HFRR) oscillations were analyzed within discrete 10-second intervals in a cohort of 200 healthy human subjects...
May 3, 2018: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29720499/gene-transfer-of-engineered-calmodulin-alleviates-ventricular-arrhythmias-in-a-calsequestrin-associated-mouse-model-of-catecholaminergic-polymorphic-ventricular-tachycardia
#11
Bin Liu, Shane D Walton, Hsiang-Ting Ho, Andriy E Belevych, Svetlana B Tikunova, Ingrid Bonilla, Vikram Shettigar, Bjorn C Knollmann, Silvia G Priori, Pompeo Volpe, Przemysław B Radwański, Jonathan P Davis, Sándor Györke
BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a familial arrhythmogenic syndrome characterized by sudden death. There are several genetic forms of CPVT associated with mutations in genes encoding the cardiac ryanodine receptor (RyR2) and its auxiliary proteins including calsequestrin (CASQ2) and calmodulin (CaM). It has been suggested that impairment of the ability of RyR2 to stay closed (ie, refractory) during diastole may be a common mechanism for these diseases...
May 2, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29713203/evaluating-cardiac-risk-exposure-response-analysis-in-early-clinical-drug-development
#12
REVIEW
Julie Grenier, Sabina Paglialunga, Bruce H Morimoto, Robert M Lester
The assessment of a drug's cardiac liability has undergone considerable metamorphosis by regulators since International Council for Harmonization of Technical Requirement for Pharmaceuticals for Human Use E14 guideline was introduced in 2005. Drug developers now have a choice in how proarrhythmia risk can be evaluated; the options include a dedicated thorough QT (TQT) study or exposure response (ER) modeling of intensive electrocardiogram (ECG) captured in early clinical development. The alternative approach of ER modeling was incorporated into a guidance document in 2015 as a primary analysis tool which could be utilized in early phase dose escalation studies as an option to perform a dedicated TQT trial...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29707188/improved-multiscale-entropy-technique-with-nearest-neighbor-moving-average-kernel-for-nonlinear-and-nonstationary-short-time-biomedical-signal-analysis
#13
S P Arunachalam, S Kapa, S K Mulpuru, P A Friedman, E G Tolkacheva
Analysis of biomedical signals can yield invaluable information for prognosis, diagnosis, therapy evaluation, risk assessment, and disease prevention which is often recorded as short time series data that challenges existing complexity classification algorithms such as Shannon entropy (SE) and other techniques. The purpose of this study was to improve previously developed multiscale entropy (MSE) technique by incorporating nearest-neighbor moving-average kernel, which can be used for analysis of nonlinear and non-stationary short time series physiological data...
2018: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29703454/wide-complex-tachycardia-discrimination-using-dynamic-time-warping-of-ecg-beats
#14
F Niknejad Mazandarani, M Mohebbi
BACKGROUND AND OBJECTIVE: Automatic processing and accurate diagnosis of wide complex tachycardia (WCT) arrhythmia groups using electrocardiogram signals (ECG) remains a challenge. WCT arrhythmia consists of two main groups: ventricular tachycardia (VT) and supraventricular tachycardia with aberrancy (SVT-A). These two groups have similar morphologies in the realm of ECG signals. VT and SVT-A arrhythmias originate from the ventricle and atrium, respectively. Hence, inaccurate diagnosis of SVT-A instead of VT can be fatal...
April 20, 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29700054/ventricular-electrical-delay-measured-from-body-surface-ecgs-is-associated-with-cardiac-resynchronization-therapy-response-in-left-bundle-branch-block-patients-from-the-madit-crt-trial-multicenter-automatic-defibrillator-implantation-cardiac-resynchronization
#15
Filip Plesinger, Pavel Jurak, Josef Halamek, Petr Nejedly, Pavel Leinveber, Ivo Viscor, Vlastimil Vondra, Scott McNitt, Bronislava Polonsky, Arthur J Moss, Wojciech Zareba, Jean-Philippe Couderc
BACKGROUND: Although cardiac resynchronization therapy (CRT) is beneficial in heart failure patients with left bundle branch block, 30% of these patients do not respond to the therapy. Identifying these patients before implantation of the device is one of the current challenges in clinical cardiology. METHODS: We verified the diagnostic contribution and an optimized computerized approach to measuring ventricular electrical activation delay (VED) from body surface 12-lead ECGs...
May 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29684148/antiviral-activity-of-oral-jnj-53718678-in-healthy-adult-volunteers-challenged-with-respiratory-syncytial-virus-a-placebo-controlled-study
#16
Marita Stevens, Sarah Rusch, John DeVincenzo, Young-In Kim, Lisa Harrison, Elizabeth A Meals, Alison Boyers, Juin Fok-Seang, Dymphy Huntjens, Nacer Lounis, Kris Mari N, Bart Remmerie, Dirk Roymans, Anil Koul, René Verloes
Background: Respiratory syncytial virus (RSV) disease has no effective treatment. JNJ-53718678 is a fusion inhibitor with selective activity against RSV. Methods: After confirmation of RSV infection or 5 days post inoculation with RSV, participants (n=69) were randomized to JNJ-53718678 75 mg (n=15), 200 mg (n=17), 500 mg (n=18), or placebo (n=17), orally once-daily for 7 days. Antiviral effects were evaluated by assessing RSV RNA viral load (VL) area-under-the-curve (AUC) from baseline (prior to the first dose) until discharge, time-to-peak VL, duration of viral shedding, clinical symptoms, and quantity of nasal secretions...
April 19, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29671366/a-new-approach-for-identification-of-heartbeats-in-multimodal-physiological-signals
#17
Omkar Singh, Ramesh Kumar Sunkaria
In this paper, a technique is proposed for detection of heartbeats in multimodal data. Recording of multiple physiological signals from the same subject is common practice nowadays. Multiple physiological signals are generally available but are processed separately without taking into consideration information from other relevant signals. The heartbeats are generally detected from R peaks in electrocardiogram (ECG) signal, however, if ECG is noisy, other signals reflecting the cardiac activity may be used for identifying heartbeats...
April 19, 2018: Journal of Medical Engineering & Technology
https://www.readbyqxmd.com/read/29669562/comfort-in-palliative-sedation-compas-a-transdisciplinary-mixed-method-study-protocol-for-linking-objective-assessments-to-subjective-experiences
#18
Stefaan Six, Steven Laureys, Jan Poelaert, Johan Bilsen, Peter Theuns, Reginald Deschepper
BACKGROUND: In case of untreatable suffering at the end of life, palliative sedation may be chosen to assure comfort by reducing the patient's level of consciousness. An important question here is whether such sedated patients are completely free of pain. Because these patients cannot communicate anymore, caregivers have to rely on observation to assess the patient's comfort. Recently however, more sophisticated techniques from the neurosciences have shown that sometimes consciousness and pain are undetectable with these traditional behavioral methods...
April 18, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29661666/pseudo-wellens-syndrome-and-intermittent-left-bundle-branch-block-in-a-case-of-acute-cholecystitis
#19
Steffen Grautoff, Martin Balog, Guenther Winde
We present a case of a 54-year-old male patient who was admitted to our Emergency Department (ED) with localized epigastric pain. Inflammation markers, ultrasound, and CT scan were inconsistent with an initial diagnosis of cholecystitis. However, there was additional evidence of cholecystolithiasis. The ECG showed new anterior biphasic T waves typical for a Wellens' type A ECG. Additionally, the patient had an intermittent left bundle branch block (LBBB). The diagnostic challenges in differentiating possible diagnoses will be described, to which in this case, were either acute cholecystitis or acute coronary syndrome (ACS)...
April 7, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29661665/combining-early-post-resuscitation-eeg-and-hrv-features-improves-the-prognostic-performance-in-cardiac-arrest-model-of-rats
#20
Chenxi Dai, Zhi Wang, Liang Wei, Gang Chen, Bihua Chen, Feng Zuo, Yongqin Li
OBJECTIVE: Early and reliable prediction of neurological outcome remains a challenge for comatose survivors of cardiac arrest (CA). The purpose of this study was to evaluate the predictive ability of EEG, heart rate variability (HRV) features and the combination of them for outcome prognostication in CA model of rats. METHODS: Forty-eight male Sprague-Dawley rats were randomized into 6 groups (n=8 each) with different cause and duration of untreated arrest. Cardiopulmonary resuscitation was initiated after 5, 6 and 7min of ventricular fibrillation or 4, 6 and 8min of asphyxia...
April 9, 2018: American Journal of Emergency Medicine
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