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Hyun-Seok Cho, Wook-Jong Kim, Byungdoo Andrew Lee, Junki Cho, Won-Jung Shin, Gyu-Sam Hwang
Structural alterations in the cirrhotic heart may contribute to electromechanical abnormalities, represented by QT prolongation. The aim of this study was to investigate the changes in QTc according to the operative stage during pediatric LT and to identify which baseline echocardiographic parameters were associated with intraoperative QTc prolongation. Data were evaluated from 39 children undergoing LT for chronic liver disease (median age 9 months). In 19 patients (48.7%), baseline QTc was prolonged ≥440 ms (462 ± 19 ms)...
June 15, 2018: Pediatric Transplantation
Renato De Vecchis, Carmelina Ariano, Giuseppina Di Biase, Michel Noutsias
Background: Several drug classes (antiarrhythmics, antimicrobials, antidepressants, phenothiazines, opiates, prokinetics of digestive tract, etc.) have been related to ventricular hyperkinetic arrhythmias such as torsade de pointes (TdP). TdPs are usually heralded by an abnormal prolongation of heart rate-corrected QT interval on the electrocardiogram, so-called drug-induced long heart rate-corrected QT (diLQTc). We don't know to what extent the drug-induced QTc prolongation is able to predict malignant arrhythmias...
July 2018: Journal of Clinical Medicine Research
Flávia Medeiros Fernandes, Eliane Pereira Silva, Rand Randall Martins, Antonio Gouveia Oliveira
PURPOSE: To investigate the prevalence and risk factors of acquired long QT syndrome (LQTS) on admission to a general Intensive Care Unit (ICU), and to assess the risk of LQTS associated with prescribed medications. METHODS: Prospective observational, cross-sectional study approved by the Institutional Review Board. Between May 2014 and July 2016, 412 patients >18 years-old consecutively admitted to the ICU of a university hospital were included. LQTS was defined as a QT interval on the admission electrocardiogram corrected using Bazett's formula (QTc) >460 ms for men and >470 ms for women...
2018: PloS One
Cinzia D'Angelo, Silvia Zagnoni, Pamela Gallo, Gianfranco Tortorici, Gianni Casella, Giuseppe Di Pasquale
BACKGROUND: Left main trunk (LMT) occlusion is a rare angiographic finding. The primary purpose was to investigate the ECG pattern of patients with angiographic confirmation of LMT as culprit lesion. METHODS: Forty-eight patients (32 men; mean age 73 years) with angiographic total (21 patients; 44%) or subtotal (27 patients; 56%) occlusion of the LMT were analyzed. Twenty patients (42%) were found to have concomitant coronary lesions. Eighteen patients (38%) required intra-aortic balloon pump support...
June 7, 2018: Journal of Cardiovascular Medicine
Silvia Castelletti, Federica Dagradi, Karine Goulene, Aurora I Danza, Enrico Baldi, Marco Stramba-Badiale, Peter J Schwartz
BACKGROUND: A correct measurement of the QT interval in the out-of-hospital setting is important whenever the long QT syndrome (LQTS) is suspected or a therapy might lead to drug-induced LQTS (diLQTS) because QT interval monitoring in the initial days of therapy could alert to dangerous QT prolongation. We explored whether automated QTc measurements (BGM) by BodyGuardian™ (BG), a wearable remote monitoring system, are sufficiently reliable compared to our own manual measurements (MM) performed on the same beats during 12‑lead Holter recordings in LQTS patients (pts) and in healthy controls...
September 1, 2018: International Journal of Cardiology
Elena Tomaselli Muensterman, James E Tisdale
Prolongation of the heart rate-corrected QT (QTc) interval increases the risk for torsades de pointes (TdP), a potentially fatal arrhythmia. The likelihood of TdP is higher in patients with risk factors, which include female sex, older age, heart failure with reduced ejection fraction, hypokalemia, hypomagnesemia, concomitant administration of ≥ 2 QTc interval-prolonging medications, among others. Assessment and quantification of risk factors may facilitate prediction of patients at highest risk for developing QTc interval prolongation and TdP...
June 8, 2018: Pharmacotherapy
Yi-Chen Lai, Na Li, William Lawrence, Sufen Wang, Amber Levine, Daniela M Burchhardt, Robia G Pautler, Miguel Valderrábano, Xander H Wehrens, Anne E Anderson
Objective: Sympathetic predominance and ventricular repolarization abnormalities represent epilepsy-associated cardiac alterations and may underlie seizure-induced ventricular arrhythmias. Myocardial ion channel and electrical remodeling have been described early in epilepsy development and may contribute to ventricular repolarization abnormalities and excitability. Using the pilocarpine-induced acquired epilepsy model we sought to examine whether altered myocardial ion channel levels and electrophysiological changes also occur in animals with long-standing epilepsy...
June 2018: Epilepsia Open
Borje Darpo, Jean-Philippe Couderc
INTRODUCTION: This paper is based on a presentation held at the Annual Safety Pharmacology Society meeting in September 2017, at which challenges for the clinical component of CiPA were presented. FDA has published an automated algorithm for measurement of the J-Tpeak interval on a median beat from a vector magnitude lead derived from a 12-lead ECG. CiPA proposes that J-Tpeak prolongation < 10 ms can be used for drugs with a QTc effect < 20 ms to differentiate between safe and unsafe delayed repolarization and to reduce the level of ECG monitoring in late stage clinical trials...
June 4, 2018: Journal of Pharmacological and Toxicological Methods
Yoshihiro Kimura, Masahiro Yamada, Kenji Hanada, Tomohide Endo, Noritomo Narita, Masato Narita, Maiko Senoo, Manabu Yonekura, Hiroaki Ichikawa, Shizuka Kurauchi, Shigeyuki Nakaji, Ken Okumura, Hirofumi Tomita
We previously showed that J-waves were found more frequently in patients with low levels of serum eicosapentaenoic acid (EPA) in the acute phase of myocardial infarction, and were associated with the incidence of ischemia-related ventricular arrhythmias. However, the relationship between J-waves and serum EPA levels in a general population remains to be elucidated.The Iwaki Health Promotion Project is an ongoing community-based health promotion study in Iwaki, Hirosaki, which is in northern Japan. A total of 1,052 residents (mean age, 53...
June 6, 2018: International Heart Journal
K Hager, T Temps, O Krause
BACKGROUND: Antidementia drugs, antidepressants and antipsychotics are among the most frequently prescribed medication in old and multimorbid patients. Due to side effects (e. g. prolonged QTc interval) in emergency medicine/intensive care unit or patients' wishes the question is often raised whether these drugs can be stopped and how this may be done. ANTIDEMENTIA DRUGS: If the cognition is stable under antidementia drugs or if the patient is in favour of the medication, it should be continued...
June 6, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Jialin Duan, Jingwen Tao, Maocai Zhai, Chengpeng Li, Ning Zhou, Jiagao Lv, Lin Wang, Li Lin, Rong Bai
Anticancer drugs may have proarrhythmic effects including drug-induced QT interval prolongation, which is of particular importance because it can lead to a fatal polymorphic ventricular tachycardia termed torsade de pointes (TdP). QT interval prolongation and TdP are rare life-threatening untoward effects of anticancer therapy, particularly with arsenic trioxides and anthracyclines, and even some novel molecular targeted drugs touted as 'tumor specific'. Several factors that affect myocardial repolarization can further increase the risk of TdP...
May 22, 2018: Oncotarget
Jessica Pepe, Cristiana Cipriani, Mario Curione, Federica Biamonte, Luciano Colangelo, Vittoria Danese, Veronica Cecchetti, Chiara Sonato, Federica Ferrone, Mirella Cilli, Salvatore Minisola
OBJECTIVE: Hypercalcemia may induce arrhythmias. There are no data on the prevalence of arrhythmias in primary hyperparathyroidism (PHPT) in daily life. Aim of the study was to investigate both the prevalence of arrhythmias in patients with PHPT compared to controls and the impact of parathyroidectomy, evaluated by 24 hour electrocardiogram (ECG) monitoring. DESIGN: This is a randomized study. METHODS: 26 postmenopausal women with PHPT and 26 controls were enrolled...
June 6, 2018: European Journal of Endocrinology
Saylav Bora, Mümin Alper Erdoğan, Gürkan Yiğittürk, Oytun Erbaş, İsmet Parlak
The aim of this study was to evaluate the effects of metoprolol, lipid emulsion and MgSO4 which can be recommended for prevention of long QT that is one of the lethal consequences of amitriptyline intoxication. Thirty Sprague-Dawley male rats were included. Five groups respectively received the following: saline intraperitoneally (i.p.); amitriptyline (AMT) 100 mg/kg per os (p.o.) and saline i.p.; AMT 100 mg/kg p.o. and 5 mg/kg metoprolol i.p.; AMT 100 mg/kg p.o. and 20 ml/kg lipid emulsion i.p.; AMT 100 mg/kg p...
June 5, 2018: Cardiovascular Toxicology
Jukka A Lipponen, Sudhir Kurl, Jari A Laukkanen
Aims: The aim of this study was to investigate the contribution of depolarization and repolarization abnormalities, specially abnormalities in global electrical heterogeneity of heart in cardiovascular disease (CVD) and all-cause mortality. Methods and results: Eight hundred and forty men and 911 women, average age of 63 years participated in this study with average follow-up was 14 years. Six electrocardiogram/vector electrocardiogram (ECG/VECG) markers QRS-duration, QTc-interval, QRST-angle, sum of absolute QRST integral (SAI QRST), T-wave roundness, and TV1-amplitude were estimated from VECG measurements...
June 2, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Clémence Louis, Thomas Godet, Gérald Chanques, Nathalie Bourguignon, Dominique Morand, Bruno Pereira, Jean-Michel Constantin
BACKGROUND: Delirium during intensive care unit (ICU) stay is frequent and associated with significant morbidity, mortality and healthcare-related costs. International guidelines suggest its prevention. However, curative treatment remains unclearly established. Despite contradictory and ambiguous academic literature, international guidelines suggest the use of second-generation (atypical) antipsychotics over haloperidol. However, haloperidol remains the most widely used neuroleptic worldwide as a first-line treatment of agitation and/or delirium...
June 4, 2018: Trials
Marco Stramba-Badiale, Dilip R Karnad, Karine M Goulene, Gopi Krishna Panicker, Federica Dagradi, Carla Spazzolini, Snehal Kothari, Yash Y Lokhandwala, Peter J Schwartz
Aims: There is an almost endless controversy regarding the choice of the QT correction formula to be used in electrocardiograms (ECG) in neonates for screening for long QT syndrome (LQTS). We compared the performance of four commonly used formulae and a new formula derived from neonates. Methods and results: From a cohort of 44 596 healthy neonates prospectively studied in Italy between 2001 and 2006, 5000 ECGs including 17 with LQTS-causing mutation identified by genotyping were studied using four QT correction formulae [Bazett's (QTcB), Fridericia's (QTcF), Framingham (QTcL), and Hodges (QTcH)]...
May 30, 2018: European Heart Journal
Chin-Wei W Huang, Suzan Brown, Neelan Pillay, Martin Del Campo, Jose Tellez-Zenteno, Richard S McLachlan
PURPOSE: Lacosamide selectively enhances slow inactivation of voltage-gated sodium channels to achieve seizure reduction. We studied the effect of intravenous lacosamide given as one of three single doses on EEG and electrocardiogram, as well as its tolerability in patients with drug-resistant epilepsy. METHODS: This Canadian, investigator-initiated, multicenter, double-blind study recruited patients with refractory focal epilepsy admitted to a seizure monitoring unit...
May 30, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Mücahid Yılmaz, Hidayet Kayançiçek
OBJECTIVES: Intense exercise elevates all heart chambers' dimensions, left ventricular mass (LV mass), and left ventricular mass index (LV mass index). The relationship between increased ventricular arrhythmias and sudden cardiac death with LV dilatation and elevated LV mass has been previously demonstrated. We investigated whether sports-related LV dilatation and elevated LV mass and LV mass index cause an increase in ventricular repolarization heterogeneity. PATIENTS AND METHODS: This prospective observational study recruited 565 participants...
May 28, 2018: Journal of Clinical Medicine
Harrie J M Gijsen, Sergio A Alonso de Diego, Michel De Cleyn, Aránzazu García-Molina, Gregor J Macdonald, Carolina Martinez-Lamenca, Daniel Oehlrich, Hana Prokopcova, Frederik J R Rombouts, Michel Surkyn, Andrés A Trabanco, Sven Van Brandt, Dries Van den Bossche, Michiel Van Gool, Nigel Austin, Herman Borghys, Deborah Dhuyvetter, Diederik Moechars
In previous studies, the introduction of electron withdrawing groups to 1,4-oxazine BACE1 inhibitors reduced the pKa of the amidine group, resulting in compound 2 that showed excellent in vivo efficacy, lowering Aβ levels in brain and CSF. However, a suboptimal cardiovascular safety margin, based on QTc prolongation, prevented further progression. Further optimization resulted in the replacement of the 2-fluoro substituent by a CF3-group, which reduced hERG inhibition. This has led to compound 3, with an improved cardiovascular safety margin and sufficiently safe in GLP toxicity studies to progress into clinical trials...
May 29, 2018: Journal of Medicinal Chemistry
Nicholas J Conn, Karl Q Schwarz, David A Borkholder
BACKGROUND: Wearable and connected in-home medical devices are typically utilized in uncontrolled environments and often measure physiologic signals at suboptimal locations. Motion artifacts and reduced signal-to-noise ratio, compared with clinical grade equipment, results in a highly variable signal quality that can change significantly from moment to moment. The use of signal quality classification algorithms and robust feature delineation algorithms designed to achieve high accuracy on poor quality physiologic signals can prove beneficial in addressing concerns associated with measurement accuracy, confidence, and clinical validity...
May 28, 2018: JMIR MHealth and UHealth
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