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Bradycardia

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https://www.readbyqxmd.com/read/27911332/type-0-spinal-muscular-atrophy-further%C3%A2-delineation-of-prenatal-and%C3%A2-postnatal-features-in-16-patients
#1
Sarah Grotto, Jean-Marie Cuisset, Stéphane Marret, Séverine Drunat, Patricia Faure, Séverine Audebert-Bellanger, Isabelle Desguerre, Vincent Flurin, Anne-Gaëlle Grebille, Anne-Marie Guerrot, Hubert Journel, Gilles Morin, Ghislaine Plessis, Sylvain Renolleau, Joëlle Roume, Brigitte Simon-Bouy, Renaud Touraine, Marjolaine Willems, Thierry Frébourg, Eric Verspyck, Pascale Saugier-Veber
BACKGROUND: Spinal muscular atrophy (SMA) is caused by homozygous inactivation of the SMN1 gene. The SMN2 copy number modulates the severity of SMA. The 0SMN1/1SMN2 genotype, the most severe genotype compatible with life, is expected to be associated with the most severe form of the disease, called type 0 SMA, defined by prenatal onset. OBJECTIVE: The aim of the study was to review clinical features and prenatal manifestations in this rare SMA subtype. METHODS: SMA patients with the 0SMN1/1SMN2 genotype were retrospectively collected using the UMD-SMN1 France database...
November 29, 2016: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/27910101/early-safety-and-efficacy-of-fingolimod-treatment-in-denmark
#2
A Voldsgaard, N Koch-Henriksen, M Magyari, F Sellebjerg, P S Sørensen, A B Oturai
BACKGROUND: Initiation of fingolimod treatment is associated with a transient decrease of heart rate, and atrioventricular (AV) conduction block may occur. OBJECTIVE: To evaluate the therapeutic effect and safety of fingolimod treatment in MS patients in Denmark with focus on cardiac and pulmonary side effects at treatment onset. MATERIALS & METHODS: We analysed data from the first 496 fingolimod-treated Danish patients, observed for at least 3 months...
January 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/27909501/-two-for-the-price-of-one-a-single-lead-implantable-cardioverter-defibrillator-system-with-a-floating-atrial-dipole
#3
REVIEW
Nicole E Worden Md, Musab Alqasrawi Md, Siva M Krothapalli Md, Alexander Mazur Md
In patients known to be a high risk for sudden cardiac arrest, implantable cardioverter defibrillators (ICD) are a proven therapy to reduce risk of death. However, in patients without conventional indications for pacing, the optimal strategy for type of device, dual- versus single-chamber, remains debatable. The benefit of prophylactic pacing in this category of patients has never been documented. Although available atrial electrograms in a dual chamber system improve interpretation of stored arrhythmia events, allow monitoring of atrial fibrillation and may potentially reduce the risk of inappropriate shocks by enhancing automated arrhythmia discrimination, the use of dual-chamber ICDs has a number of disadvantages...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908913/comfrey-herbal-remedy-causing-second-degree-heart-block-do-not-be-outfoxed-by-digitalis
#4
Mathew Kurian Vithayathil, Matthew Edwards
A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular node block, Mobitz Type 2, a shortened QT interval, downsloping ST depression and presence of U waves...
December 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27904846/complete-congenital-heart-block-in-a-neonate-with-a-complex-congenital-heart-defect-in-africa
#5
Clovis Nkoke, Edvine Yonta Wawo, Liliane Kuate Mfeukeu, Larissa Makamte, Sandrine Dikosso Edie, Flore Esiene Balana
Congenital heart block (CHB) is rare disorder that has a higher mortality when associated with structural congenital heart defects. Very few cases have been reported in Sub-Saharan Africa (SSA). We present a case of complete CHB associated with a complex congenital heart defect in a neonate in Cameroon. A 1-month-old neonate in Cameroon was referred for the evaluation of bradycardia. The obstetrical ultrasound done during pregnancy revealed fetal bradycardia without further evaluation. Clinical examination showed well a developed neonate with bradycardia at 62 beats/minute, and mild cyanosis with oxygen saturation at 93% at room air...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27903390/-current-status-of-antiarrhythmic-drug-use-and-safety-assessment-in-chinese-patients-with-atrial-fibrillation
#6
R He, X Du, S W Liu, L J Sun, Y Li, H Zeng, Y Y Li, C Sun, Y Zhang, C S Ma, W Gao
Objective: To investigate the current status of antiarrhythmic drugs (AADs) use in Chinese patients with atrial fibrillation(AF) and assess the safety of AADs in this patient cohort. Methods: From January 2011 to December 2013, a total of 4 008 AF patients treated with AADs was enrolled in this study and patients were followed up for 24 months. Detailed information of prescribed drug, the causes of drug discontinuation and side effects were recorded. Results: Amiodarone was prescribed to 64.3%(2 579 cases) and propafenone to 31...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27903028/-cardiovascular-morbidity-and-mortality-in-patients-with-kidney-disease
#7
Ivo Quack, Ralf Westenfeld
Patients with kidney disease have a significantly increased cardiovascular morbidity and mortality. Especially diabetics have an increased risk to develop renal insufficiency and cardiovascular events. Two recent studies show that the SGLT2 inhibitor Empagliflozin and the GLP1 agonist Liraglutid are able to lower the cardiovascular risk of type2 diabetics with renal insufficiency. Recent observations suggest that bradycardia and asystole are main triggers for sudden cardiac death in patients with chronic kidney disease...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27898379/predicting-bradycardia-in-preterm-infants-using-point-process-analysis-of-heart-rate
#8
Alan H Gee, Riccardo Barbieri, David Paydarfar, Premananda Indic
OBJECTIVE: Episodes of bradycardia are common and recur sporadically in preterm infants, posing a threat to the developing brain and other vital organs. We hypothesize that bradycardias are a result of transient temporal destabilization of the cardiac autonomic control system and that fluctuations in the heart rate signal might contain information that precedes bradycardia. We investigate infant heart rate fluctuations with a novel application of point process theory. METHODS: In 10 preterm infants, we estimate instantaneous linear measures of the heart rate signal in neonates, use these measures to extract statistical features of bradycardia, and propose a simplistic framework for prediction of bradycardia...
November 24, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27898164/dexmedetomidine-reduces-catheter-related-bladder-discomfort-a-prospective-randomized-placebo-controlled-double-blind-study
#9
Yang Zhao Yun, Xu Jun Mei, Zhu Rong, Dai Ru Ping, Liu Lei
OBJECTIVE: To evaluate the efficacy of dexmedetomidine in preventing catheterrelated bladder discomfort (CRBD) in a postanesthesia care unit (PACU). METHODS: A total of 138 consecutive adult male patients, classified by the American Society of Anesthesiologists (ASA) as ASA class I and ASA class II, were scheduled for elective open upper-middle abdominal surgery. They were randomized into 2 groups, C and D, comprising 69 patients each. Group C was given a saline solution as placebo, and group D received dexmedetomidine...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27894597/unexpected-cardiac-death-during-anaesthesia-of-a-young-rabbit-associated-with-fibro-fatty-replacement-of-the-right-ventricular-myocardium
#10
M Romanucci, S V P Defourny, M Massimini, V Valerii, A Arbuatti, V Giordano, L Bongiovanni, C Perrone, L Della Salda
A 6-month-old female pet rabbit was presented for routine ovariectomy. The pre-anaesthetic evaluation was unremarkable and no anaesthetic complications occurred during the procedure. However, at the end of the surgery, the rabbit suddenly showed acute bradycardia and cardiac death. Necropsy examination revealed marked dilation of the right ventricle, associated with diffuse thinning of the right ventricular free wall. Gross and histopathological findings were suggestive of a congenital dilated cardiomyopathy characterized by fibro-fatty replacement of the right ventricular myocardium...
November 25, 2016: Journal of Comparative Pathology
https://www.readbyqxmd.com/read/27890310/same-day-total-hip-arthroplasty-performed-at-an-ambulatory-surgical-center-90-day-complication-rate-on-549-patients
#11
Gregg R Klein, Jason M Posner, Harlan B Levine, Mark A Hartzband
BACKGROUND: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied. METHODS: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed. All patients were discharged to home on the day of surgery...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27889726/prolonged-infusion-of-dexmedetomidine-in-critically-ill-children
#12
Cinara Andreolio, Jefferson Pedro Piva, Elisa Baldasso, Roberta Ferlini, Rafaela Piccoli
OBJECTIVE: To describe main indications, doses, length of infusion and side effects related to dexmedetomidine infusion. METHODS: Observational and retrospective study evaluating dexmedetomidine use in pediatric intensive care unit. RESULTS: 77 children received dexmedetomidine infusion longer than 6 hours for mechanical ventilation weaning (32.5%), post- neurosurgery and post-upper airway surgery (24.7%), non-invasive ventilation (13%), refractory tachycardia (6...
November 15, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27884666/anesthetic-considerations-in-a-parturient-with-congenital-insensitivity-to-pain-with-anhidrosis
#13
Z Pirani, F Qasem, S Katsiris
Congenital insensitivity to pain is a rare autosomal recessive disease characterized by varying degrees of autonomic dysfunction and sensory loss, including nociceptive hyposensitivity. It is this autonomic dysfunction that makes both general and neuraxial anesthesia challenging. Testing the block during neuraxial anesthesia may be difficult and the patient may be prone to hypotension and bradycardia. This case report describes the anesthetic management of a parturient with congenital insensitivity to pain presenting for cesarean delivery...
October 21, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27878578/the-double-guidewire-approach-for-transcoronary-pacing-in-a%C3%A2-porcine-model
#14
K M Heinroth, S Unverzagt, D Mahnkopf, S Frantz, R Prondzinsky
BACKGROUND: Transcoronary pacing is used for treatment of unheralded bradycardias in the setting of percutaneous coronary interventions (PCI). OBJECTIVES: In the present study we introduced a new concept - the double guidewire approach - for transcoronary pacing in a porcine model. METHODS: Transcoronary pacing was applied in 16 adult pigs under general anaesthesia in an animal catheterization laboratory. A special guidewire with electrical insulation by PTFE coating except for the distal part of the guidewire was positioned in the periphery of a coronary artery serving as the cathode...
November 23, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27878488/peculiar-aspects-in-influence-of-%C3%AE-1-adrenoceptor-stimulation-on-isolated-rat-heart
#15
T L Zefirov, I I Khabibrakhmanov, N I Ziyatdinova, A L Zefirov
The study examined the effect of α1-adrenoceptor stimulation with methoxamine on chronotropic function of isolated heart perfused ex vivo according to Langendorff and cardiac chronotropy in vivo. Stimulation of α1-adrenoceptors in isolated heart induced gradually developing bradycardia, which progressed during several minutes. Similar stimulation in vivo produced a short-term bradycardia probably terminated by the compensatory influences in the whole organism. Comparison of the data obtained in both experimental paradigms during α1-adrenoceptor stimulation revealed unidirectional changes in cardiac chronotropy characterized with time-related peculiarities...
November 22, 2016: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/27878135/control-of-the-heart-rate-of-rat-embryos-during-the-organogenic-period
#16
Helen E Ritchie, Carolina Ragnerstam, Elin Gustafsson, Johanna M Jonsson, William S Webster
The aim of this study was to gain insight into whether the first trimester embryo could control its own heart rate (HR) in response to hypoxia. The gestational day 13 rat embryo is a good model for the human embryo at 5-6 weeks gestation, as the heart is comparable in development and, like the human embryo, has no functional autonomic nerve supply at this stage. Utilizing a whole-embryo culture technique, we examined the effects of different pharmacological agents on HR under normoxic (95% oxygen) and hypoxic (20% oxygen) conditions...
2016: Hypoxia
https://www.readbyqxmd.com/read/27876179/prevalence-and-risk-factors-of-peri-ictal-autonomic-changes-in-children-with-temporal-lobe-seizures
#17
Mark Whealy, Elaine Wirrell, Lily Wong-Kisiel, Katherine Nickels, Eric T Payne
BACKGROUND: We determined the prevalence of signs and symptoms of autonomic dysfunction in seizures of temporal lobe onset in children. METHODS: We evaluated the prevalence and risk factors of peri-ictal autonomic changes in temporal lobe onset seizures in children from a single-center pediatric epilepsy monitoring unit between June 1, 2009 and October 31, 2013. Age, gender, epilepsy etiology, current antiepileptic drug therapy, ictal electroencephalographic lateralization, brain magnetic resonance imaging results, and the presence of generalized tonic-clonic seizures over the preceding year were recorded from medical record review...
October 11, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27872766/an-atypical-case-of-myxedema-coma-with-concomitant-nonconvulsive-seizure
#18
Pratik Patel, Mikhael Bekkerman, Cristina Varallo-Rodriguez, Rajendra Rampersaud
Hypothyroidism is a prevalent condition in the general population that is treatable with appropriately dosed thyroid hormone replacement medication. Infrequently, patients will present with myxedema coma, characterized by hypothermia, hypotension, bradycardia, and altered mental status in the setting of severe hypothyroidism. Myxedema coma has also been known to manifest in a number of unusual and dangerous forms. Here, we present the case of a woman we diagnosed with an uncharacteristic expression of myxedema coma and nonconvulsive seizure complicated by a right middle cerebral artery infarct...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27872214/effects-of-prolonged-anoxia-on-electrical-activity-of-the-heart-in-crucian-carp-carassius-carassius
#19
Elisa Tikkanen, Jaakko Haverinen, Stuart Egginton, Minna Hassinen, Matti Vornanen
The effects of sustained anoxia on cardiac electrical excitability were examined in the anoxia-tolerant Crucian carp (Carassius carassius). The electrocardiogram (ECG) and expression of excitation-contraction coupling genes were studied in fish acclimatised to normoxia in summer (+18°C) or winter (+2°C), and in winter fish after 1, 3 and 6 weeks of anoxia. Anoxia induced a sustained bradycardia from a heart rate of 10.3±0.77 to 4.1±0.29 bpm (P<0.05) after 5 weeks, and heart rate slowly recovered to control levels when oxygen was restored...
November 21, 2016: Journal of Experimental Biology
https://www.readbyqxmd.com/read/27871603/prophylactic-phenylephrine-infusion-for-the-prevention-of-hypotension-after-spinal-anesthesia-in-the-elderly-a-randomized-controlled-clinical-trial
#20
Fabrice Ferré, Philippe Marty, Laura Bruneteau, Virgine Merlet, Benoît Bataille, Anne Ferrier, Claude Gris, Matt Kurrek, Olivier Fourcade, Vincent Minville, Agnes Sommet
STUDY OBJECTIVE: Hypotension frequently occurs during spinal anesthesia (SA), especially in the elderly. Phenylephrine is effective to prevent SA-induced hypotension during cesarean delivery. The objective of this study was to evaluate the efficacy and safety of prophylactic infusion of phenylephrine after SA for orthopedic surgery in the elderly. DESIGN: This prospective, randomized, double-blind, and placebo-controlled study included 54 patients older than 60 years undergoing elective lower limb surgery under SA (injection of 10 mg of isobaric bupivacaine with 5 μg of sufentanyl)...
December 2016: Journal of Clinical Anesthesia
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