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Hazem E Hassan, Deanna Kelly, Moshe Honick, Sagar Shukla, Ahmed Ibrahim, David A Gorelick, Matthew Glassman, Robert P McMahon, Heidi J Wehring, Ann Marie Kearns, Stephanie Feldman, Mingming Yu, Ken Bauer, Jia Bei Wang
Cocaine use disorder (CUD) remains a significant public health challenge. Levo-tetrahydropalmatine (L-THP), a well-tolerated and non-addictive compound, shows promise for the management of CUD. Its pharmacologic profile includes blockade at dopamine and other monoamine receptors and attenuation of cocaine self-administration, reinstatement, and rewarding properties in rats. This study evaluated the safety of L-THP in human cocaine users and its influence on the safety and pharmacokinetics (PK) of cocaine. Twenty-four cocaine-using adult men were randomized to receive L-THP (30 mg BID orally) or placebo double-blind for 4 days, with an intranasal cocaine (40 mg) challenge on the fourth day...
July 1, 2016: Journal of Clinical Pharmacology
Thein Tun Aung, Edward Samuel Roberto, Abdul Wase
BACKGROUND: Holt-Oram syndrome (HOS) is a rare but significant syndrome consisting of structural heart defects, conduction abnormalities, and upper extremity anomalies. It was first described in the British Heart Journal in 1960 by Mary Holt and Samuel Oram as a report of atrial septal defect, conduction disturbances, and hand malformations occurring in family members. Patients can present with heart blocks or symptoms of underlying congenital heart defects. CASE REPORT: A 41-year-old man with Holt-Oram syndrome presented with seizure-like activity and was found to have an underlying conduction disturbance...
2016: American Journal of Case Reports
Bellal Joseph, Tahereh O Jokar, Mazhar Khalil, Ansab A Haider, Narong Kulvatunyou, Bardiya Zangbar, Andrew Tang, Muhammad Zeeshan, Terence O'Keeffe, Daniyal Abbas, Rifat Latifi, Peter Rhee
BACKGROUND: Blunt cardiac injury (BCI) is an infrequent but potentially fatal finding in thoracic trauma. Its clinical presentation is highly variable and patient characteristics and injury pattern have never been described in trauma patients. The aim of this study was to identify predictors of mortality in BCI patients. METHODS: We performed an 8-year retrospective analysis of all trauma patients diagnosed with BCI at our Level 1 trauma center. Patients older than 18 years, blunt chest trauma, and a suspected diagnosis of BCI were included...
June 2016: American Journal of Surgery
Bogdan G Muntean, Mattias Roser, Saba Suhail, Patrick Nagel, Barbara Bellmann
CASE REPORT: This article reports the case of a 76-year-old patient with multiple implantable cardioverter defibrillator (ICD) interventions of the single chamber ICD. On admission the 12-lead electrocardiogram (ECG) documented a wide QRS complex tachycardia without clearly identifiable P waves. The patient had previously had two ventricular tachycardia (VT) ablations due to VT storms. The resting ECG revealed a sinus rhythm with a wide QRS complex. During the electrophysiological investigation typical atrial flutter could be detected and an ablation of the cavotricuspid isthmus was performed...
December 2015: Herzschrittmachertherapie & Elektrophysiologie
Arnon Adler, Raphael Rosso, Ehud Chorin, Ofer Havakuk, Charles Antzelevitch, Sami Viskin
Risk stratification in Brugada syndrome remains a clinical challenge because the event rate is low but the presenting symptom is often cardiac arrest (CA). We review the data on risk stratification. A history of CA or malignant syncope is a strong predictor of spontaneous ventricular fibrillation (VF), whereas the prognostic value of a history of familial sudden death and the presence of a SCN5A mutation are less well defined. On the electrocardiogram, the presence of spontaneous type I electrocardiogram increases the risk for VF in all studies, whereas the presence of fragmented QRS complexes and early repolarization correlates with increased risk in several studies...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Yaniel Castro-Torres, Raimundo Carmona-Puerta, Richard E Katholi
Malignant cardiac arrhythmias which result in sudden cardiac death may be present in individuals apparently healthy or be associated with other medical conditions. The way to predict their appearance represents a challenge for the medical community due to the tragic outcomes in most cases. In the last two decades some ventricular repolarization (VR) markers have been found to be useful to predict malignant cardiac arrhythmias in several clinical conditions. The corrected QT, QT dispersion, Tpeak-Tend, Tpeak-Tend dispersion and Tp-e/QT have been studied and implemented in clinical practice for this purpose...
August 16, 2015: World Journal of Clinical Cases
Laure Léger, Boris Gojanovic, Nicole Sekarski, Erik J Meijboom, Yvan Mivelaz
Sudden cardiac death (SCD) affects 2/100,000 young, active athletes per year of which 40% are less than 18 years old. In 2004, the International Olympic Committee accepted the Lausanne Recommendations, including a 12-lead electrocardiogram (ECG), as a pre-participation screening tool for adult Olympic athletes. The debate on extending those recommendations to the pediatric population has recently begun. The aims of our study were to highlight the characteristics of the young athlete ECG, phenotypical manifestations of SCD-related disease in children, and challenges of implanting ECG screening in athletic children...
January 2016: Pediatric Cardiology
Xue-Yang Deng, Jun-Jun Chen, Hong-Yan Li, Zhan-Qiang Ma, Shi-Ping Ma, Qiang Fu
The aim of the present study was to investigate the cardioprotective effects of Timosaponin B II (TB), a main bioactive constituent from Anemarrhenae asphodeloides Bge, on an isoproterenol (ISO)-induced myocardial infarction model in rats and explore its underlying mechanisms. Rats were treated with TB (50 mg/kg, 100 mg/kg) or diltiazem hydrochloride (DH, 5 mg/kg) by gastric gavage for five days. At the 4th and 5th days, myocardial injury was induced by ISO injection (85 mg/kg) at an interval of 24 h for 2 consecutive days...
October 5, 2015: Chemico-biological Interactions
L Zou, J Liu, H Zhang, S Wu, C Long, B Ji, Z Yu, Y Tang, L Meng, A Wu
OBJECTIVE: Due to the weak ascending aorta, it is extremely challenging to establish an anterograde selective cerebral perfusion (ASCP) model in rabbits, especially when cardioplegic arrest is required. Herein, the aim of this study was to establish a rabbit ASCP model with cardiac arrest being easily performed and being similar to the clinical scenario. MATERIALS AND METHODS: Twenty-two adult New Zealand white rabbits were selected for ASCP model establishment and another 22 rabbits were utilized for blood donation...
May 2016: Perfusion
Luca Di Lullo, Vincenzo Barbera, Alberto Santoboni, Antonio Bellasi, Mario Cozzolino, Antonio De Pascalis, Rodolfo Rivera, Alessandro Balducci, Domenico Russo, Claudio Ronco
Coronary thrombosis was recognized since 19th century as clinical entity with bad outcomes; only in 1912 it was reported that acute myocardial infarction had to been distinguished from angina pectoris. First diagnostic test was electrocardiogram, while white blood cells count and erythrocytes sedimentation rate were the only available laboratory tests. Late in the 60s and 70s glutammic oxaloacetic and glutamic pyravate transaminase, lactate dehydrogenase and creatine kinase were added to biomarkers pool to provide a diagnosis of myocardial infarction related to myocardial cells injury...
July 2015: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Nasim Montazeri Ghahjaverestan, Mohammad B Shamsollahi, Di Ge, Alfredo I Hernández
Apnea bradycardia (AB) is an outcome of apnea occurrence in preterm infants and is an observable phenomenon in cardiovascular signals. Early detection of apnea in infants under monitoring is a critical challenge for the early intervention of nurses. In this paper, we introduce two switching Kalman filter (SKF) based methods for AB detection using electrocardiogram (ECG) signal.The first SKF model uses McSharry's ECG dynamical model integrated in two Kalman filter (KF) models trained for normal and AB intervals...
September 2015: Physiological Measurement
Robert J Ellis, Bilei Zhu, Julian Koenig, Julian F Thayer, Ye Wang
As the literature on heart rate variability (HRV) continues to burgeon, so too do the challenges faced with comparing results across studies conducted under different recording conditions and analysis options. Two important methodological considerations are (1) what sampling frequency (SF) to use when digitizing the electrocardiogram (ECG), and (2) whether to interpolate an ECG to enhance the accuracy of R-peak detection. Although specific recommendations have been offered on both points, the evidence used to support them can be seen to possess a number of methodological limitations...
September 2015: Physiological Measurement
M Javad Mollakazemi, S Abbas Atyabi, Ali Ghaffari
The most straightforward method for heart beat estimation is R-peak detection based on an electrocardiogram (ECG) signal. Current R-peak detection methods do not work properly when the ECG signal is contaminated or missing, which leads to the incorrect estimation of the heart rate. This raises the need for reliable algorithms which can locate heart beats in continuous long-term multimodal data, allowing robust analysis.In this paper, three peak detectors are evaluated for heart beat detection using various cardiovascular signals...
August 2015: Physiological Measurement
Marco A F Pimentel, Mauro D Santos, David B Springer, Gari D Clifford
Accurate heart beat detection in signals acquired from intensive care unit (ICU) patients is necessary for establishing both normality and detecting abnormal events. Detection is normally performed by analysing the electrocardiogram (ECG) signal, and alarms are triggered when parameters derived from this signal exceed preset or variable thresholds. However, due to noisy and missing data, these alarms are frequently deemed to be false positives, and therefore ignored by clinical staff. The fusion of features derived from other signals, such as the arterial blood pressure (ABP) or the photoplethysmogram (PPG), has the potential to reduce such false alarms...
August 2015: Physiological Measurement
Loriano Galeotti, Christopher G Scully, Jose Vicente, Lars Johannesen, David G Strauss
Alarm fatigue is a top medical device hazard in patient monitoring that could be reduced by merging physiological information from multiple sensors, minimizing the impact of a single sensor failing. We developed a heart beat detection algorithm that utilizes multi-modal physiological signals (e.g. electrocardiogram, blood pressure, stroke volume, photoplethysmogram and electro-encephalogram) by merging the heart beats obtained from signal-specific detectors. We used the PhysioNet/Computing in Cardiology Challenge 2014 training set to develop the algorithm, and we refined it with a mix of signals from the multiparameter intelligent monitoring in intensive care (MIMIC II) database and artificially disrupted waveforms...
August 2015: Physiological Measurement
Thomas De Cooman, Griet Goovaerts, Carolina Varon, Devy Widjaja, Tim Willemen, Sabine Van Huffel
Accurate R peak detection in the electrocardiogram (ECG) is a well-known and highly explored problem in biomedical signal processing. Although a lot of progress has been made in this area, current methods are still insufficient in the presence of extreme noise and/or artifacts such as loose electrodes. Often, however, not only the ECG is recorded, but multiple signals are simultaneously acquired from the patient. Several of these signals, such as blood pressure, can help to improve the heart beat detection...
August 2015: Physiological Measurement
Christoph Hoog Antink, Christoph Brüser, Steffen Leonhardt
The heart rate and its variability play a vital role in the continuous monitoring of patients, especially in the critical care unit. They are commonly derived automatically from the electrocardiogram as the interval between consecutive heart beat. While their identification by QRS-complexes is straightforward under ideal conditions, the exact localization can be a challenging task if the signal is severely contaminated with noise and artifacts. At the same time, other signals directly related to cardiac activity are often available...
August 2015: Physiological Measurement
Alistair E W Johnson, Joachim Behar, Fernando Andreotti, Gari D Clifford, Julien Oster
The electrocardiogram (ECG) is a well studied signal from which many clinically relevant parameters can be derived, such as heart rate. A key component in the estimation of these parameters is the accurate detection of the R peak in the QRS complex. While corruption of the ECG by movement artefact or sensor failure can result in poor delineation of the R peak, use of synchronously measured signals could allow for resolution of the R peak even scenarios with poor quality ECG recordings. Robust estimation of R peak locations from multimodal signals facilitates real time monitoring and is likely to reduce false alarms due to inaccurate derived parameters...
August 2015: Physiological Measurement
Urška Pangerc, Franc Jager
In this work, we present the development, architecture and evaluation of a new and robust heart beat detector in multimodal records. The detector uses electrocardiogram (ECG) signals, and/or pulsatile (P) signals, such as: blood pressure, artery blood pressure and pulmonary artery pressure, if present. The base approach behind the architecture of the detector is collecting signal energy (differentiating and low-pass filtering, squaring, integrating). To calculate the detection and noise functions, simple and fast slope- and peak-sensitive band-pass digital filters were designed...
August 2015: Physiological Measurement
Simi Susan Thomas, Viswam Nathan, Chengzhi Zong, Karthikeyan Soundarapandian, Xiangrong Shi, Roozbeh Jafari
Noninvasive continuous blood pressure (BP) monitoring is not yet practically available for daily use. Challenges include making the system easily wearable, reducing noise level and improving accuracy. Variations in each person's physical characteristics, as well as the possibility of different postures, increase the complexity of continuous BP monitoring, especially outside the hospital. This study attempts to provide an easily wearable solution and proposes training to specific posture and individual for further improving accuracy...
September 2016: IEEE Journal of Biomedical and Health Informatics
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