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goal heart rate in fibrilation

Mário Augusto Cray da Costa, Lucas Kraeski Krum, Juliana da Silva Geraldino, Marcelo Derbli Schafranski, Ricardo Zanetti Gomes, Elise Souza Dos Santos Reis
Introduction: In patients with mechanical prosthetic heart valves or atrial fibrillation requiring anticoagulation to prevent thromboembolic events, several factors influence adherence and anticoagulation complications. Objective: To evaluate the factors that interfere with the quality and complications of anticoagulation with vitamin K antagonists. Methods: A retrospective cohort study of 100 patients, in the period from 2011 to 2014, was performed...
May 2016: Brazilian Journal of Cardiovascular Surgery
Irene Marzona, Fausto Avanzini, Giuseppe Lucisano, Mauro Tettamanti, Marta Baviera, Antonio Nicolucci, Maria Carla Roncaglioni
AIMS: To verify whether it is possible, in people with diabetes mellitus (DM) considered at very high cardiovascular (CV) risk, stratify this risk better and identify significant modifiable risk factor (including lifestyle habits) to help patients and clinicians improve CV prevention. METHODS: People with DM and microvascular diseases or one or more CV risk factors (hypertension, hyperlipidemia, smoking, poor dietary habits, overweight, physical inactivity) included in the Risk and Prevention study were selected...
October 7, 2016: Acta Diabetologica
Nadi Sadr, Jacqueline Huvanandana, Doan Trang Nguyen, Chandan Kalra, Alistair McEwan, Philip de Chazal
This study developed algorithms to decrease the arrhythmia false alarms in the ICU by processing multimodal signals of photoplethysmography (PPG), arterial blood pressure (ABP), and two ECG signals. The goal was to detect the five critical arrhythmias comprising asystole (ASY), extreme bradycardia (EBR), extreme tachycardia (ETC), ventricular tachycardia (VTA), and ventricular flutter or fibrillation (VFB). The different characteristics of the arrhythmias suggested the application of individual signal processing for each alarm and the combination of the algorithms to enhance false alarm detection...
August 2016: Physiological Measurement
Shaobo Shi, Tao Liu, Dandan Wang, Yan Zhang, Jinjun Liang, Bo Yang, Dan Hu
AIMS: The goal of this study was to assess the effects of N-methyl-d-aspartate (NMDA) receptors activation on heart rate variability (HRV) and susceptibility to atrial fibrillation (AF). METHODS AND RESULTS: Rats were randomized for treatment with saline, NMDA (agonist of NMDA receptors), or NMDA plus MK-801 (antagonist of NMDA receptors) for 2 weeks. Heart rate variability was evaluated by using implantable electrocardiogram telemeters. Atrial fibrillation susceptibility was assessed with programmed stimulation in isolated hearts...
May 11, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Ming-Sum Lee, Wansu Chen, Zilu Zhang, Lewei Duan, Angie Ng, Hillard T Spencer, Damon M Kwan, Albert Y-J Shen
BACKGROUND: The goal of this study was to determine the prevalence of atrial fibrillation and atrial flutter (AF) in pregnant women and to examine the impact of AF on maternal and fetal outcomes. METHODS AND RESULTS: Between January 1, 2003 and December 31, 2013, there were 264 730 qualifying pregnancies (in 210 356 women) in the Kaiser Permanente Southern California hospitals, among whom AF was noted in 157 pregnancies (129 women; 61.3 per 100 000 women, or 59...
April 2016: Journal of the American Heart Association
Ravi Korabathina
Acute decompensated heart failure (HF) is one of most common reasons for hospitalization among individuals older than 65 years. A thorough evaluation, including history, physical examination, and laboratory assessment, is required to optimize care of these patients. In uncertain cases, serum brain-type natriuretic peptide (BNP) or N-terminal proBNP level, stress testing, and/or invasive coronary angiography may be helpful in establishing the diagnosis. The hospital setting provides an opportunity to identify etiologies and stabilize the patient...
March 2016: FP Essentials
Muhammad Rizwan Sardar, Wajeeha Saeed, Peter R Kowey
Atrial fibrillation (AF) is the most frequently encountered arrhythmia. Prevalence increases with advancing age and so as its associated comorbidities, like heart failure. Choice of pharmacologic therapy depends on whether the goal of treatment is maintaining sinus rhythm or tolerating AF with adequate control of ventricular rates. Antiarrhythmic therapy and conversion of AF into sinus rhythm comes with the side effect profile, and we should select best antiarrhythmic therapy, individualized to the patient...
April 2016: Heart Failure Clinics
J Bohlender, J Nussberger, B Bohlender
BACKGROUND: Hypertension increases dramatically with age. In clinically stable nonagenarians, ESH guidelines would recommend lowering blood pressure (BP) to 140-150mmHg systolic (SBP) and <90mmHg diastolic (DBP) if it is higher, but it is not clear if all of the oldest old comply with or need these goals. We prospectively analysed antihypertensive treatment decisions and BP outcome in a rural primary care hospital. METHODS: All patients aged >89 years with BP medication admitted to the medical ward were prospectively included over 12 months...
December 2015: Annales de Cardiologie et D'angéiologie
Carolyn Cammarano, Matthew Silva, Morgan Comee, Jennifer L Donovan, Michael J Malloy
PURPOSE: Ivabradine is a novel If-channel antagonist that controls heart rate and may be helpful in treating patients with left ventricular dysfunction (LVD) who are unable to tolerate β-blockers or achieve a heart rate of 70 beats/min with standard therapy. Three landmark trials were used for the approval of ivabradine in the United States. These trials tested ivabradine in addition to a standard of care (including β-blockers) in patients with stable coronary artery disease (CAD) and found modest benefit in those with established LVD unable to tolerate β-blockers...
February 2016: Clinical Therapeutics
Danielle Tientcheu, Colby Ayers, Sandeep R Das, Darren K McGuire, James A de Lemos, Amit Khera, Norman Kaplan, Ronald Victor, Wanpen Vongpatanasin
BACKGROUND: Multiple epidemiological studies from Europe and Asia have demonstrated increased cardiovascular risks associated with isolated elevation of home blood pressure (BP) or masked hypertension (MH). Previous studies have not addressed cardiovascular outcomes associated with MH and white-coat hypertension (WCH) in the general population in the United States. OBJECTIVES: The goal of this study was to determine hypertensive target organ damage and adverse cardiovascular outcomes associated with WCH (high clinic BP, ≥140/90 mm Hg; normal home BP, <135/85 mm Hg), MH (high home BP, ≥135/85 mm Hg; normal clinic BP, <140/90 mm Hg), and sustained hypertension (high home and clinic BP) in the DHS (Dallas Heart Study), a large, multiethnic, probability-based population cohort...
November 17, 2015: Journal of the American College of Cardiology
Gülay Özkeçeci, Bekir Serdar Ünlü, Hüseyin Dursun, Önder Akçi, Gülengül Köken, Ersel Onrat, Alaettin Avşar
OBJECTIVE: Cardiac autonomic dysfunction may develop in patients with polycystic ovary syndrome (PCOS). Heart rate variability (HRV) and heart rate turbulence (HRT) are used in assessing cardiac autonomic functions. The goal of this study was to compare the cardiac autonomic functions in patients with PCOS and healthy controls. To our knowledge, this is the first study evaluating cardiac autonomic functions in patients with PCOS with respect to both HRV and HRT. METHODS: Twenty-three patients with PCOS (mean age 22...
May 2016: Anatolian Journal of Cardiology
Kirti K Joshi, Mihaela Tiru, Thomas Chin, Marshal T Fox, Mihaela S Stefan
New postoperative atrial fibrillation (POAF) is the most common perioperative arrhythmia and its reported incidence ranges from 0.4 to 26% in patients undergoing non-cardiac non-thoracic surgery. The incidence varies according to patient characteristics such as age, presence of structural heart disease and other co-morbidities, as well as the type of surgery performed. POAF occurs as a consequence of adrenergic stimulation, systemic inflammation, or autonomic activation in the intra or postoperative period (e...
2015: Hospital Practice (Minneapolis)
Basel Ramlawi, Walid K Abu Saleh
The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions were performed using a surgical cut-and-sew approach that ensured transmurality...
April 2015: Methodist DeBakey Cardiovascular Journal
Shobhit V Minhas, Preeya Goyal, Alpesh A Patel
BACKGROUND: Perioperative cerebrovascular accidents (CVAs) are one of the leading causes of patient morbidity, mortality, and medical costs. However, little is known regarding the rates of these events and risk factors for CVA after elective orthopaedic surgery. QUESTIONS/PURPOSES: Our goals were to (1) establish the national, baseline proportion of patients experiencing a 30-day CVA and the timing of CVA; and (2) determine independent risk factors for 30-day CVA rates after common elective orthopaedic procedures...
March 2016: Clinical Orthopaedics and related Research
Allan J Collins, Robert N Foley, David T Gilbertson, Shu-Cheng Chen
The United States Renal Data System (USRDS) began in 1989 through US Congressional authorization under National Institutes of Health competitive contracting. Its history includes five contract periods, two of 5 years, two of 7.5 years, and the fifth, awarded in February 2014, of 5 years. Over these 25 years, USRDS reporting transitioned from basic incidence and prevalence of end-stage renal disease (ESRD), modalities, and overall survival, as well as focused special studies on dialysis, in the first two contract periods to a comprehensive assessment of aspects of care that affect morbidity and mortality in the second two periods...
June 2015: Kidney International Supplements
Alice Hutin, Fanny Lidouren, Matthias Kohlhauer, Luc Lotteau, Aurélien Seemann, Nicolas Mongardon, Bertrand Renaud, Daniel Isabey, Pierre Carli, Benoit Vivien, Jean-Damien Ricard, Thierry Hauet, Richard E Kerber, Alain Berdeaux, Bijan Ghaleh, Renaud Tissier
INTRODUCTION: Total liquid ventilation (TLV) can cool down the entire body within 10-15 min in small animals. Our goal was to determine whether it could also induce ultra-fast and whole-body cooling in large animals using a specifically dedicated liquid ventilator. Cooling efficiency was evaluated under physiological conditions (beating-heart) and during cardiac arrest with automated chest compressions (CC, intra-arrest). METHODS: In a first set of experiments, beating-heart pigs were randomly submitted to conventional mechanical ventilation or hypothermic TLV with perfluoro-N-octane (between 15 and 32 °C)...
August 2015: Resuscitation
Peter M Okin, Darcy A Hille, Anne Cecilie K Larstorp, Kristian Wachtell, Sverre E Kjeldsen, Björn Dahlöf, Richard B Devereux
UNLABELLED: There is a well-established association between hypertension and atrial fibrillation (AF); indeed, even upper normal systolic blood pressures (SBP) are long-term predictors of incident AF. These findings suggest that more aggressive BP control may reduce the risk of new AF. However, whether lower achieved SBP is associated with a lower incidence of AF remains unclear. The risk of new-onset AF was examined in relation to last in-treatment SBP before AF diagnosis or last in-study measurement in the absence of new AF in 8831 hypertensive patients with ECG left ventricular hypertrophy with no history of AF, in sinus rhythm on their baseline ECG, randomly assigned to losartan- or atenolol-based treatment...
August 2015: Hypertension
Kaustubha D Patil, Henry R Halperin, Lance B Becker
The modern treatment of cardiac arrest is an increasingly complex medical procedure with a rapidly changing array of therapeutic approaches designed to restore life to victims of sudden death. The 2 primary goals of providing artificial circulation and defibrillation to halt ventricular fibrillation remain of paramount importance for saving lives. They have undergone significant improvements in technology and dissemination into the community subsequent to their establishment 60 years ago. The evolution of artificial circulation includes efforts to optimize manual cardiopulmonary resuscitation, external mechanical cardiopulmonary resuscitation devices designed to augment circulation, and may soon advance further into the rapid deployment of specially designed internal emergency cardiopulmonary bypass devices...
June 5, 2015: Circulation Research
M Arrigo, D Bettex, A Rudiger
BACKGROUND: Atrial fibrillation is the most common arrhythmia in patients hospitalized in intensive care units and emergency departments and is associated with an increased morbidity and mortality. In critically ill patients, atrial fibrillation can cause hemodynamic instability and cardiogenic shock. The mechanisms and the management of atrial fibrillation are significantly different in critically ill patients compared to outpatients. DIAGNOSIS AND TREATMENT: The initial management includes the evaluation of the hemodynamic consequences of new-onset atrial fibrillation and the optimization of reversible causes...
November 2015: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Abi Fitzgerald, Meshell Johnson, Jan Hirsch, Mary-Ann Rich, Richard Fidler
BACKGROUND: Cardiovascular disease and sudden cardiac arrest are the leading causes of death in the United States. Early defibrillation is key to successful resuscitation for patients who experience shockable rhythms during a cardiac arrest. It is therefore vital that the shock advisory of AEDs (automated external defibrillators) or defibrillators in AED mode be reliable and appropriate. The goal of this study was to better understand the performance of multiple lay-rescuer and hospital professional defibrillators in AED mode in their analysis of ventricular arrhythmias...
July 2015: Resuscitation
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