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https://www.readbyqxmd.com/read/28874934/emergency-physician-performed-transesophageal-echocardiography-in-simulated-cardiac-arrest
#1
Don V Byars, Jordan Tozer, John M Joyce, Michael J Vitto, Lindsay Taylor, Turan Kayagil, Matt Jones, Matthew Bishop, Barry Knapp, David Evans
INTRODUCTION: Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac pathology. It has many advantages over transthoracic echocardiography (TTE), including the ability to image the heart during active cardiopulmonary resuscitation. This prospective simulation study aims to evaluate the ability of emergency medicine (EM) residents to learn TEE image acquisition techniques and demonstrate those techniques to identify common pathologic causes of cardiac arrest...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28866284/intracardiac-electrocardiographic-assessment-of-precordial-taser-shocks-in-human-subjects-a-pilot-study
#2
Jason P Stopyra, James E Winslow, David M Fitzgerald, William P Bozeman
BACKGROUND: Case reports of cardiac arrest in temporal proximity to Conducted Electrical Weapon(CEW) exposure raise legitimate concerns about this as a rare possibility. In this pilot study, we respectfully navigate the oversight and regulatory hurdles and demonstrate the intra-shock electrocardiographic effects of an intentional transcardiac CEW discharge using subcutaneous probes placed directly across the precordium of patients with a previously implanted intracardiac EKG sensing lead...
August 24, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28851517/an-integrative-appraisal-of-mechano-electric-feedback-mechanisms-in-the-heart
#3
Viviane Timmermann, Lars A Dejgaard, Kristina H Haugaa, Andrew G Edwards, J Sundnes, Andrew D McCulloch, Samuel T Wall
Mechanically-induced alterations in cardiac electrophysiology are referred to as mechano-electric feedback (MEF), and play an important role in electrical regulation of cardiac performance. The influence of mechanical stress and strain on electrophysiology has been investigated at all levels, however the role of MEF in arrhythmia remains poorly understood. During the normal contraction of the heart, mechano-sensitive processes are an implicit component of cardiac activity. Under abnormal mechanical events, stretch-activated mechanisms may contribute to local or global changes in electrophysiology (EP)...
August 26, 2017: Progress in Biophysics and Molecular Biology
https://www.readbyqxmd.com/read/28845235/cardiac-electrophysiology-under-mri-guidance-an-emerging-technology
#4
Henry Chubb, Steven E Williams, John Whitaker, James L Harrison, Reza Razavi, Mark O'Neill
MR-guidance of electrophysiological (EP) procedures offers the potential for enhanced arrhythmia substrate assessment, improved procedural guidance and real-time assessment of ablation lesion formation. Accurate device tracking techniques, using both active and passive methods, have been developed to offer an interface similar to electroanatomic mapping platforms, and MR-compatible EP equipment continues to be developed. Progress to clinical implementation of these technically complex fields has been relatively slow over the last 10 years, but recent developments have led to successful clinical experience...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28766834/transseptal-puncture-using-surgical-electrocautery-in-children-and-adults-with-and-without-complex-congenital-heart-disease
#5
Srinath T Gowda, Athar M Qureshi, Daniel Turner, Nitin Madan, Justin Weigand, Richard Lorber, Harinder R Singh
BACKGROUND: Atrial transseptal puncture (TSP) for cardiac catheterization procedures remain challenging in children and adults with complex congenital heart disease (CHD). OBJECTIVES: We sought to evaluate our experience using radiofrequency (RF) current via surgical electrocautery needle for TSP to facilitate diagnostic and interventional procedures. METHODS: Retrospective chart review of all patients (pts) who underwent TSP using RF energy (10-25 W) via surgical electrocautery from three centers from January 2011 to January 2017 were evaluated...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28762918/-noninvasive-electrophysiological-mapping-in-patients-with-complete-left-bundle-branch-block-and-different-modes-of-biventricular-pacing
#6
S V Zubarev, M P Chmelevsky, M A Budanova, M A Trukshina, T A Lyubimtseva, V K Lebedeva, D S Lebedev
OBJECTIVE: to investigate possibilities of noninvasive electrophysiological mapping (NEM) during biventricular (BiV) pacing and to compare the results with data of 12 lead ECG and tissue Doppler echocardiography (TDI). MATERIAL AND METHODS: The study included 25 patients with complete left bundle branch block (LBBB) and implanted cardiac resynchronization therapy (CRT) system. Twenty-two patients were CRT responders, three other patients did not demonstrate a clear effect...
May 2017: Kardiologiia
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#7
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28641381/supraventricular-tachyarrhythmias-in-patients-with-a-persistent-left-superior-vena-cava
#8
Jongmin Hwang, Hyoung-Seob Park, Jun Kim, Jeong Su Kim, Jong Sung Park, Ki-Hun Kim, Myung Hwan Bae, Sang-Hee Lee, Young Soo Lee, Seongwook Han, Dae-Kyeong Kim, Tae-Joon Cha, Dong Gu Shin, Byung Chun Jung, Yoon-Nyun Kim
Aims: A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. This venous anomaly can impact the evaluation and treatment of supraventricular tachyarrhythmia (SVA). The aim of this study was to assess the proportion and characteristics of PLSVC in adult SVA patients. Methods and results: From July 2002 to July 2012, clinical and procedural data from databases of 10 cardiac electrophysiology laboratories in the Yeungnam region of the Republic of Korea were reviewed...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28630564/cathrob-a-highly-compact-and-versatile-remote-catheter-navigation-system
#9
Laura Cercenelli, Barbara Bortolani, Emanuela Marcelli
Several remote catheter navigation systems have been developed and are now commercially available. However, these systems typically require specialized catheters or equipment, as well as time-consuming operations for the system set-up. In this paper, we present CathROB, a highly compact and versatile robotic system for remote navigation of standard tip-steerable electrophysiology (EP) catheters. Key features of CathROB include an extremely compact design that minimizes encumbrance and time for system set-up in a standard cath lab, a force-sensing mechanism, an intuitive command interface, and functions for automatic catheter navigation and repositioning...
2017: Applied Bionics and Biomechanics
https://www.readbyqxmd.com/read/28593399/mri-use-for-atrial-tissue-characterization-in-arrhythmias-and-for-ep-procedure-guidance
#10
Ehud J Schmidt, Henry R Halperin
We review the utilization of magnetic resonance imaging methods for classifying atrial tissue properties that act as a substrate for common cardiac arrhythmias, such as atrial fibrillation. We then review state-of-the-art methods for mapping this substrate as a predicate for treatment, as well as methods used to ablate the electrical pathways that cause arrhythmia and restore patients to sinus rhythm.
June 7, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28541499/hypertension-and-cardiac-arrhythmias-executive-summary-of-a-consensus-document-from-the-european-heart-rhythm-association-ehra-and-esc-council-on-hypertension-endorsed-by-the-heart-rhythm-society-hrs-asia-pacific-heart-rhythm-society-aphrs-and-sociedad-latinoamericana
#11
Gregory Y H Lip, Antonio Coca, Thomas Kahan, Giuseppe Boriani, Antonis S Manolis, Michael Hecht Olsen, Ali Oto, Tatjana S Potpara, Jan Steffel, Francisco Marín, Márcio Jansen de Oliveira Figueiredo, Giovanni de Simone, Wendy S Tzou, Chern En Chiang, Bryan Williams
Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD, or HF. In addition, high doses of thiazide diuretics commonly used to treat HTN, may result in electrolyte abnormalities (e...
October 1, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28507742/mark-e-josephson-the-boston-years
#12
Peter Zimetbaum
Mark Josephson came to Beth Israel Hospital from the University of Pennsylvania in 1992, having firmly established a reputation as a master clinician, scientist and educator. He had built one of the premier electrophysiology (EP) services in the world in Pennsylvania and had become Chief of Cardiology there by the age of 35. In those days, Beth Israel was well known for its interventional cardiology and cardiac imaging but had not yet committed to the development of a modern EP section. The buzz surrounding Mark's arrival predicted an outspoken, larger than life and irreverent character who would profoundly change the place...
April 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28507738/mark-e-josephson-clinical-investigator
#13
EDITORIAL
John M Miller
Mark E Josephson entered the world of clinical cardiac electrophysiology (EP) almost at its inception (1972); with so much to learn and so many directions one could take, he dived into the field with unbridled enthusiasm and an uncommon - perhaps almost unique - aptitude for asking questions and finding ways to answer them. Few aspects of EP escaped his indelible influence. In this short paper, I will attempt to touch on some of the high points of his astounding career as a clinical investigator.
April 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28459685/spatially-adaptive-multi-scale-optimization-for-local-parameter-estimation-in-cardiac-electrophysiology
#14
Jwala Dhamala, Hermenegild J Arevalo, John Sapp, Milan Horacek, Katherine C Wu, Natalia A Trayanova, Linwei Wang
To obtain a patient-specific cardiac electro-physiological (EP) model, it is important to estimate the 3-D distributed tissue properties of the myocardium. Ideally, the tissue property should be estimated at the resolution of the cardiac mesh. However, such high-dimensional estimation faces major challenges in identifiability and computation. Most existing works reduce this dimension by partitioning the cardiac mesh into a pre-defined set of segments. The resulting low-resolution solutions have a limited ability to represent the underlying heterogeneous tissue properties of varying sizes, locations, and distributions...
September 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28453186/emergency-physicians-are-able-to-detect-right-ventricular-dilation-with-good-agreement-compared-to-cardiology
#15
Matt A Rutz, Julie M Clary, Jeffrey A Kline, Frances M Russell
OBJECTIVE: Focused cardiac ultrasound (FOCUS) is a useful tool in evaluating patients presenting to the emergency department (ED) with acute dyspnea. Prior work has shown that right ventricular (RV) dilation is associated with repeat hospitalizations and shorter life expectancy. Traditionally, RV assessment has been evaluated by cardiologist-interpreted comprehensive echocardiography. The primary goal of this study was to determine the inter-rater reliability between emergency physicians (EPs) and a cardiologist for determining RV dilation on FOCUS performed on ED patients with acute dyspnea...
July 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28367164/single-dose-methotrexate-for-the-treatment-of-ectopic-pregnancy-our-experience-from-2010-to-2015
#16
Emre Erdem Tas, Gulin Feykan Yegin Akcay, Ayse Filiz Avsar
OBJECTIVE: To evaluate the success of systemic single-dose methotrexate (MTX) treatment in patients with ectopic pregnancy (EP) and to investigate factors related to treatment success. METHODS: This retrospective study had been performed in Yildirim Beyazit University between January 2010 and December 2015. Demographic and clinical characteristics, ultrasonografic findings, pretreatment serum β-human chorionic gonadotropin (β-hCG) and progesterone levels of 58 patients with EP were retrieved from hospital records retrospectively...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28294370/is-there-a-prognostic-relevance-of-electrophysiological-studies-in-bundle-branch-block-patients
#17
Harilaos Bogossian, Gerrit Frommeyer, Kornelius Göbbert, Fuad Hasan, Quy Suu Nguyen, Ilias Ninios, Dejan Mijic, Dirk Bandorski, Reinhard Hoeltgen, Melchior Seyfarth, Bernd Lemke, Lars Eckardt, Markus Zarse
BACKGROUND: The present European guidelines suggest a diagnostic electrophysiological (EP) study to determine indication for cardiac pacing in patients with bundle branch block and unexplained syncope. We evaluated the prognostic relevance of an EP study for mortality and the development of permanent complete atrioventricular (AV) block in patients with symptomatic bifascicular block and first-degree AV block. HYPOTHESIS: The HV interval is a poor prognostic marker to predict the development of permanent AV block in patients with symptomatic bifascicular block (BFB) and AV block I°...
August 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28256250/high-sensitivity-troponin-as-a-biomarker-in-heart-rhythm-disease
#18
REVIEW
Cian P McCarthy, Omair Yousuf, Alvaro Alonso, Elizabeth Selvin, Hugh Calkins, John W McEvoy
Biomarkers are important prognostic tools in various cardiovascular conditions, including coronary artery disease and heart failure. Although their utility in cardiac electrophysiology (EP) is less established, biomarkers may guide EP clinical practice by identifying patients at risk for developing arrhythmias and their complications, in addition to augmenting therapeutic decisions by targeting appropriate pharmacologic and interventional therapies to patients who may benefit most. In this review, we focus on the prognostic role of high-sensitivity cardiac troponin (hs-cTn) assays-which detect subclinical cardiac myocyte damage-in cardiac arrhythmias and their sequelae...
May 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28249993/moderate-sedation-in-cardiac-electrophysiology-laboratory-a-retrospective-safety-analysis
#19
V Sawhney, E Bacuetes, M Wray, M Dhinoja, M J Earley, R J Schilling, S Sporton
OBJECTIVE: Cardiac electrophysiology (EP) procedures can be performed under moderate sedation without the direct involvement of an anaesthetist. However, concerns have been raised over the safety of this approach. This study examines the use of a standardised nurse-led physician-directed sedation protocol for EP procedures to determine the safety of moderate sedation administered by non-anaesthesia personnel who have been trained in sedation techniques. METHODS AND RESULTS: Consecutive EP procedures done under moderate sedation over 12 years at our institution were evaluated...
August 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28241971/an-interactive-platform-to-guide-catheter-ablation-in-human-persistent-atrial-fibrillation-using-dominant-frequency-organization-and-phase-mapping
#20
Xin Li, João L Salinet, Tiago P Almeida, Frederique J Vanheusden, Gavin S Chu, G André Ng, Fernando S Schlindwein
BACKGROUND AND OBJECTIVE: Optimal targets for persistent atrial fibrillation (persAF) ablation are still debated. Atrial regions hosting high dominant frequency (HDF) are believed to participate in the initiation and maintenance of persAF and hence are potential targets for ablation, while rotor ablation has shown promising initial results. Currently, no commercially available system offers the capability to automatically identify both these phenomena. This paper describes an integrated 3D software platform combining the mapping of both frequency spectrum and phase from atrial electrograms (AEGs) to help guide persAF ablation in clinical cardiac electrophysiological studies...
April 2017: Computer Methods and Programs in Biomedicine
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