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Second degree heart block

Simon Mifsud, Emma Louise Schembri, Matthew Mercieca Balbi, Mark Gruppetta, James Clark
The authors report a case of a 68-year-old man who was diagnosed with an irreversible second-degree atrioventricular (AV) Mobitz II 2:1 block temporally associated with profound hyponatraemia. The cause of the hyponatraemia was beer potomania. The co-occurrence of reversible first, second and third-degree heart blocks and hyponatraemia has been described in a few published case reports. However, this case is noteworthy as the AV block persisted, despite correction of serum sodium concentration as opposed to other published cases, which meant that the patient required a permanent pacemaker...
March 14, 2018: BMJ Case Reports
Kazunori Takemura, Ryuta Nakamura, Kazuhito Shimazu, Youichiro Sugimoto, Tetsuro Takase, Minamimoto Ryogo, Michiaki Hiroe
A 52-year-old male visited our hospital with abnormal electrocardiogram and exertional fatigue. The electrocardiogram showed first-degree atrioventricular block, complete right bundle branch block, and inverted T waves in Leads II, III, aVF, V3, and V4. Echocardiography showed biventricular wall thickening involving granular sparkling of the interventricular septum. Late gadolinium enhancement on cardiovascular magnetic resonance (CMR) was found at the circumferential right ventricular wall and patchy regions of the left ventricle...
February 5, 2018: ESC Heart Failure
Małgorzata Poręba, Paweł Gać, Lidia Usnarska-Zubkiewicz, Witold Pilecki, Kazimierz Kuliczkowski, Grzegorz Mazur, Małgorzata Sobieszczańska, Rafał Poręba
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a widely used procedure in the treatment of malignant diseases, including blood neoplasms and has increased survival in hematological diseases. The aim of the study was to analyze parameters of 24-hr ECG monitoring in patients with selected blood neoplasms in whom the procedure of hematopoietic stem cell transplantation was performed. METHODS: The study group consisted of 64 adults diagnosed with hematologic cancer qualified for HSCT with the previous high dose chemotherapy (HDC)...
January 24, 2018: Annals of Noninvasive Electrocardiology
Bridgette Kram, Maegan Greenland, Mollie Grant, Michael E Campbell, Charlotte Wells, Courtney Sommer
BACKGROUND: Neostigmine is traditionally administered intravenously for treatment of acute colonic pseudo-obstruction (ACPO), though use is associated with administration constraints and adverse effects. OBJECTIVE: To evaluate whether an alternative route of administration for neostigmine via subcutaneous (SQ) delivery is safe and effective in a broad cohort of medical and surgical patients. METHODS: This multicenter, retrospective observational study included adult patients administered SQ neostigmine for ileus, ACPO, or refractory constipation...
January 1, 2018: Annals of Pharmacotherapy
Alessandro Mantovani, Riccardo Rigolon, Isabella Pichiri, Giovanni Morani, Stefano Bonapace, Clementina Dugo, Giacomo Zoppini, Enzo Bonora, Giovanni Targher
AIMS: Several studies have reported that moderately elevated serum uric acid levels are associated with an increased risk of tachyarrhythmias (mainly atrial fibrillation) in patients with and without type 2 diabetes mellitus (T2DM). It is currently unknown whether an association also exists between elevated serum uric acid levels and cardiac conduction defects in patients with T2DM. METHODS: We retrospectively analyzed a hospital-based sample of 967 patients with T2DM discharged from our Division of Endocrinology over the years 2007-2014...
December 2017: Journal of Diabetes and its Complications
Fuanglada Tongprasert, Rekwan Sittiwangkul, Thitikarn Lerthiranwong, Theera Tongsong
Maternal autoantibodies to Ro/SSA are often linked to congenital heart block and rarely associated with structural defects. We describe the case of a fetus with anti-Ro-mediated second-degree block at 19 weeks, which progressed to a complete block, fibroelastosis, atrioventricular valve insufficiency, and semilunar valve stenosis/insufficiency at 20, 22, 24, and 26 weeks, respectively, although the fetus received transplacental anti-arrhythmic drugs. The 2150-g fetus was vaginally delivered at 35 weeks. An external pacemaker was inserted immediately after birth and replaced with permanent pacemaker at the age of 3 months...
October 12, 2017: Journal of Clinical Ultrasound: JCU
Alessandro Mantovani, Riccardo Rigolon, Isabella Pichiri, Stefano Bonapace, Giovanni Morani, Giacomo Zoppini, Enzo Bonora, Giovanni Targher
Recent studies suggested that nonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiac tachyarrhythmias (mainly atrial fibrillation) in patients with and without type 2 diabetes mellitus. The aim of this study was to examine whether an association also exists between NAFLD and heart block. We have retrospectively evaluated a hospital-based cohort of 751 patients with type 2 diabetes discharged from our Division of Diabetes and Endocrinology during years 2007-2014. Standard electrocardiograms were performed on all patients...
2017: PloS One
Dwain Tolbert, Judy Gordon, Stuart Harris, Mark Walzer, Ihor Bekersky, Susan Reid
PURPOSE: A thorough QT study was conducted to assess the proarrhythmic potential of clobazam and its active metabolite, N-desmethylclobazam (N-CLB). METHODS: In this Phase I, single-site, randomized, double-blind, double-dummy, parallel-group study, healthy participants were randomized to 1 of 4 treatment groups: clobazam 40 mg/d (maximum therapeutic dosage), clobazam 160 mg/d (supratherapeutic dosage), placebo, or moxifloxacin 400 mg (active control). FINDINGS: Of 280 enrolled participants (n = 70 per treatment arm), 250 (92%) completed the study; 194 were included in the pharmacokinetics population (clobazam 40 mg/d, n = 66; clobazam 160 mg/d, n = 62; and moxifloxacin, n = 66)...
September 25, 2017: Clinical Therapeutics
Igor Lakhno, Joachim A Behar, Julien Oster, Vyacheslav Shulgin, Oleksii Ostras, Fernando Andreotti
BACKGROUND: Complete atrioventricular block in fetuses is known to be mostly associated with autoimmune disease and can be irreversible if no steroids treatment is provided. Conventional methods used in clinical practice for diagnosing fetal arrhythmia are limited since they do not reflect the primary electrophysiological conduction processes that take place in the myocardium. The non-invasive fetal electrocardiogram has the potential to better support fetal arrhythmias diagnosis through the continuous analysis of the beat to beat variation of the fetal heart rate and morphological analysis of the PQRST complex...
2017: Maternal Health, Neonatology and Perinatology
István Sejben, Zoltán Som, Gábor Cserni
Sarcoidosis is a systemic granulomatous disease of unknown aetiology, which is characterized by bilateral hilar lymphadenopathy and pulmonary disease. Clinically detected cardiac involvement occurs in 5% of sarcoid patients, although cardiac manifestations are discovered in 25% of the cases at autopsy. Sarcoid heart disease frequently causes atrioventricular block. The authors present the case of a 44-year-old man with bradycardia. On admission, second degree Mobitz II, then third degree atrioventricular block was diagnosed...
July 2017: Orvosi Hetilap
Sujuan Yan, Jianhua Yu, Zhen Xia, Bo Zhu, Jinzhu Hu, Juxiang Li
Electrical ventricular separation, as a special complete intraventricular block, denotes that ventricles be electrically separated into two or more parts caused by severe and wide damage of myocardium and conduction. Electrical ventricular separation can be divided into homologous and heterologous, homologous electrical ventricular separation is a rare phenomenon, literally the excitement of whole ventricle originate from supraventricle, on ECG, there are two different QRS waves which connect with an isoelectric line, one ST segment and T wave...
June 29, 2017: Annals of Noninvasive Electrocardiology
Safwat A Aly, Sawsan M Awad, Ra-Id Abdulla, Suhaib Kazmouz, Hoang H Nguyen
Long-term prostaglandin use is commonly associated with side effects such as cortical proliferation of the bones, hypertrophic pyloric stenosis, and soft tissue swelling of the extremities. We report a neonate with critical coarctation of the aorta, who developed second and third degree atrioventricular blocks associated with prolonged prostaglandin E1 (PGE1) infusion. Interestingly, these conduction blocks only occurred at low PGE1 dose. The rhythm disturbances resolved promptly with the discontinuation of PGE1 following surgical repair...
October 2017: Pediatric Cardiology
Rajendra K Go Khroo, K Priti, Bhanwar L Ranwa, Kamal Kishor, Devendra Bisht, Sajal Gupta
BACKGROUND: Atrioventricular (AV) blocks are of concern with the use of beta blockers in inferior wall myocardial infarction (MI). Ivabradine lowers heart rate with a lesser risk of AV blocks. OBJECTIVES: To compare ivabradine with metoprolol in acute inferior wall MI in terms of feasibility, tolerability and efficacy METHODS: It was a prospective double blind single centre randomized controlled study. Of 1032 patients with acute inferior wall MI, 468 eligible patients were randomized in 1:1 manner to ivabradine (group A) and metoprolol (group B)...
April 19, 2017: Cardiovascular Therapeutics
B Broux, D De Clercq, A Decloedt, S Ven, L Vera, G van Steenkiste, K Mitchell, C Schwarzwald, G van Loon
BACKGROUND: Atrial fibrillation (AF) is the most common pathological arrhythmia in horses. After successful treatment, recurrence is common. Heart rate monitors are easily applicable in horses and some devices offer basic heart rate variability (HRV) calculations. If HRV can be used to distinguish between AF and sinus rhythm (SR), this could become a monitoring tool for horses at risk for recurrence of AF. OBJECTIVES: The purpose of this study was to assess whether in horses AF (before cardioversion) and SR (after cardioversion) can be differentiated based upon HRV parameters...
March 21, 2017: Equine Veterinary Journal
Craig Barstow, Johnathan D McDivitt
Bradyarrhythmia (bradycardia) is a heart rate lower than 60 beats/min. It can be due to sinus, atrial, or junctional bradycardia or to a problem with the conduction system (eg, an atrioventricular block). Asymptomatic bradycardia is common, especially among trained athletes or during sleep. Bradycardia symptoms can include syncope, dizziness, chest pain, dyspnea, or fatigue. It is important to determine during the evaluation if bradycardia is the cause of the patient's symptoms. In the acute setting, symptomatic patients should be treated with atropine...
March 2017: FP Essentials
Munish Sharma, Daniel A N Mascarenhas
Ticagrelor is an antiplatelet agent prescribed to prevent the development of adverse cardiac events after acute coronary syndrome (ACS). According to the PLATO trial, ticagrelor is associated with ventricular pauses in the first week of treatment; however, these episodes were felt to be asymptomatic and nonfatal to the patient. We present a case of ticagrelor related second-degree type II heart block causing severe dizziness and diaphoresis that resolved after discontinuation of the medication.
2017: Case Reports in Cardiology
Nuria Martínez-Sánchez, Sergio Pérez-Pinto, Ángel Robles-Marhuenda, Francisco Arnalich-Fernández, María Martín Cameán, Edurne Hueso Zalvide, Jose Luis Bartha
Anti-Ro/SS-A is one specific type of antinuclear antibodies. They are in the majority of cases associated with primary Sjögren syndrome (SS) but also in Systemic Lupus Erythematosus (SLE), rheumatoid arthritis (RA), and in healthy people. During pregnancy, they are mainly associated to congenital heart block (CHB) and neonatal lupus (NL). The aim of this study was to compare the rate of maternal and fetal complications between a series of anti-Ro/SS-A positive pregnant women prospectively followed. Forty-two anti-Ro/SSA antibodies positive pregnant women that were referred to our hospital between 2011 and 2015...
April 2017: Immunologic Research
B H Eggensperger, C C Schwarzwald
OBJECTIVES: To assess the influence of 2nd-degree AV blocks (AVB) on RR interval-based heart rate variability (HRV) variables; to investigate the effect of using PP interval time series and of artifact filtering on HRV analyses; to investigate the influence of electrocardiogram (ECG) recording length and time of recording; and to calculate day-to-day variability and reference intervals of HRV variables. ANIMALS: Thirty healthy adult horses. METHODS: RR and PP interval time series were extracted from 10-h Holter ECGs and an automated filter was applied to the RR time series (RRf)...
April 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Volker Limmroth, Tjalf Ziemssen, Michael Lang, Stephan Richter, Bert Wagner, Judith Haas, Stephan Schmidt, Kathrin Gerbershagen, Christoph Lassek, Luisa Klotz, Olaf Hoffmann, Christian Albert, Katrin Schuh, Monika Baier-Ebert, Guillaume Wendt, Heinke Schieb, Susanne Hoyer, Ralf Dechend, Wilhelm Haverkamp
BACKGROUND: First dose observation for cardiac effects is required for fingolimod, but recommendations on the extent vary. This study aims to assess cardiac safety of fingolimod first dose. Individual bradyarrhythmic episodes were evaluated to assess the relevance of continuous electrocardiogram (ECG) monitoring. METHODS: START is an ongoing open-label, multi-center study. At the time of analysis 3951 patients were enrolled. The primary endpoints are the incidence of bradycardia (heart rate < 45 bpm) and second-/third-degree AV blocks during treatment initiation...
January 18, 2017: BMC Neurology
Junya Morita, Tomoko Izumi, Bunichiro Ogawa, Yoshiki Ban, Hironori Takagi, Minoru Sasaki, Shunsuke Tsutsumi
This study sought to clarify the effects of reduced feeding on physiological parameters in dogs to enable appropriate evaluations of the safety and toxicity of test compounds. We measured alkaline phosphatase isozymes and the circulating blood volume, as well as clinical signs, body weight, hematology, blood chemistry, electrocardiography, organ weight, and histopathology, in male beagle dogs fed a diet consisting of 300 g/day or 150 g/day for 4 weeks. There were no abnormal clinical signs in any of the dogs...
2017: Journal of Toxicological Sciences
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