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https://www.readbyqxmd.com/read/28633348/lifelong-arrhythmic-risk-stratification-in-arrhythmogenic-right-ventricular-cardiomyopathy-distribution-of-events-and-impact-of-periodical-reassessment
#1
Chiara Cappelletto, Davide Stolfo, Antonio De Luca, Bruno Pinamonti, Giulia Barbati, Alberto Pivetta, Marco Gobbo, Francesca Brun, Marco Merlo, Gianfranco Sinagra
Aims: The arrhythmic risk stratification of arrhythmogenic right ventricular cardiomyopathy (ARVC) remains controversial. We evaluated the long-term distribution of life-threatening arrhythmic events assessing the impact of periodical risk reassessment. Methods and results: Ninety-eight ARVC patients with no previous major ventricular arrhythmias were retrospectively analysed. Patients were assessed at baseline, at 22 [inter-quartile range (IQR) 16-26], 49 (IQR 41-55) and 97 months (IQR 90-108)...
June 13, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28631761/-management-of-outpatients-with-cardiac-disease-follow-up-timing-and-modalities
#2
Roberta Rossini, Daniela Lina, Marco Ferlini, Giuseppina Belotti, Salvatore Ivan Caico, Fabrizio Caravati, Pompilio Faggiano, Annamaria Iorio, Davide Lauri, Corrado Lettieri, Emanuela Teresa Locati, Antonio Maggi, Ferdinando Massari, Andrea Mortara, Luigi Moschini, Giuseppe Musumeci, Daniele Nassiacos, Fabrizio Negri, Domenico Pecora, Simona Pierini, Roberto Pedretti, Pierfranco Ravizza, Michele Romano, Fabrizio Oliva
The increasing rate of cardiovascular diseases, the improved survival after the acute phase, the aging of the population and the implementation of primary prevention caused an exponential increase in outpatient cardiac performance, thereby making it difficult to maintain a balance between the citizen-patient request and the economic sustainability of the healthcare system. On the other side, the prescription of many diagnostic tests with a view to defensive medicine and the related growth of patients' expectations, has led several scientific societies to educational campaigns highlighting the concept that "less is more"...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28630998/annals-consult-guys-syncope-how-do-i-figure-this-one-out
#3
Geno J Merli, Howard H Weitz
No abstract text is available yet for this article.
June 20, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28627977/masquerading-bundle-branch-block-as-a-presenting-manifestation-of-complete-atrioventricular-block-that-caused-syncope
#4
Zhenyu Jiao, Ying Tian, Xinchun Yang, Xingpeng Liu
A 59-year-old male patient was admitted with the main complaints of stuffiness and shortness of breath. An ECG from precordial leads on admission showed masquerading bundle branch block. Syncope frequently occurred after admission. During syncope episodes, ECG telemetry showed that the syncope was caused by intermittent complete atrioventricular block, with the longest RR interval lasting for 4.36 s. At the gap of syncope, ECG showed complete right bundle branch block accompanied by alternation of left anterior fascicular block and left posterior fascicular block...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28623036/-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-literature-review-and-case-report
#5
William Alejandro Camargo-Ariza, Silvia Juliana Galvis-Blanco, Tatiana Del Pilar Camacho-Enciso, Carlos Alberto Quiroz-Romero, Juan José Bermudez-Echeverry
Arrhythmogenic right ventricular cardiomyopathy/dysplasia is an inherited autosomal dominant pathology with an estimated prevalence of 1:2,500 to 1:5,000, being higher in males (3:1). It is characterized histologically by replacement of cardiomyocytes by fibro-adipose tissue, which predisposes to ventricular arrhythmias, right ventricular failure, and sudden cardiac death. The main goal of treatment is to reduce the risk of sudden death and improve the quality of life of patients. We present the case of a 23 year old woman whose clinical symptoms started with palpitations, chest pain with physical activity, syncope and headache 6 years ago during her first pregnancy...
June 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28622073/neighborhood-poverty-and-9-1-1-ambulance-contacts
#6
Josh Seim, Joshua English, Karl Sporer
BACKGROUND: Neighborhood poverty is positively associated with frequency of 9-1-1 ambulance utilization, but it is unclear whether this association remains significant when accounting for variations in the severities and types of ambulance contacts. METHODS: We merged EMS ambulance contact records in a single California county (n = 88,027) with data from the American Community Survey at the census tract level (n = 300). Using tract as a proxy for neighborhood and negative binomial regression as an analytical tool, we predicted 16 outcomes: any ambulance contacts, ambulance contacts stratified by three intervention severities, and ambulance contacts varied by 12 primary impression categories...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28621042/clinical-evaluation-of-anomalous-aortic-origin-of-a-coronary-artery-aaoca
#7
Silvana Molossi, Hitesh Agrawal
The clinical evaluation of patients with an anomalous aortic origin of a coronary artery (AAOCA), a congenital abnormality of the origin or course of a coronary artery that arises from the aorta, is challenging given its first presentation being sudden cardiac arrest in about half of the patients. Symptoms of chest pain, shortness of breath and syncope during exertion should be of concern in evaluating young athletes and nonathletes. The lack of abnormal signs on the physical exam and electrocardiogram further adds to the difficulty in establishing the diagnosis...
June 16, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28617840/a-new-test-for-diagnosing-vasovagal-syncope-standing-after-treadmill-test-with-sublingual-nitrate-administration
#8
Tae-Hoon Kim, Ho-Jun Jang, Sihun Kim, Sung Yun Cho, Kyung Sun Song, Christopher Pickett, Heiko J Schmitt, Juyong Lee
INTRODUCTION: Increased adrenergic tone might be an additional trigger of orthostatic stress of vasovagal syncope (VVS). Exercise before standing might provide increased sensitivity compared to standing using a sublingual nitroglycerines protocol during tilt table testing. The aim of this study was to evaluate the diagnostic value of treadmill testing before standing with nitroglycerin administration. METHODS AND RESULTS: A total of 36 patients with syncope or presyncope were enrolled for the test...
2017: PloS One
https://www.readbyqxmd.com/read/28617713/gastric-emphysema-a-cannot-miss-emergency-medicine-diagnosis
#9
Sean D Murnan, Jill Miller, Anne Kuhn
The radiographic finding of gastric emphysema with portal venous gas is classically an ominous finding, associated with a high rate of mortality. Although classically the case, this imaging finding must be quickly correlated with the overall clinical picture, allowing for the essential differentiation between the highly lethal emphysematous gastritis and the much more benign gastric emphysema, each of which has drastically different management strategies. We report a case of gastric emphysema with portal venous gas likely attributable to a gastric outlet obstruction and gastric mucosal defect in a 17-year-old girl with a chief complaint of syncope that was diagnosed in the emergency department and treated conservatively...
June 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28617040/complete-atrioventricular-block-in-acute-coronary-syndrome-prevalence-characterisation-and-implication-on-outcome
#10
Silvia Aguiar Rosa, Ana Teresa Timóteo, Lurdes Ferreira, Ramiro Carvalho, Mario Oliveira, Pedro Cunha, André Viveiros Monteiro, Guilherme Portugal, Luis Almeida Morais, Pedro Daniel, Rui Cruz Ferreira
PURPOSE: The aim was to characterise acute coronary syndrome patients with complete atrioventricular block and to assess the effect on outcome. METHODS: Patients admitted with acute coronary syndrome were divided according to the presence of complete atrioventricular block: group 1, with complete atrioventricular block; group 2, without complete atrioventricular block. Clinical, electrocardiographic and echocardiographic characteristics and prognosis during one year follow-up were compared between the groups...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28616731/renal-nerve-stimulation-for-treatment-of-neurocardiogenic-syncope-a-review-from-perspective-of-commercialization-potential
#11
REVIEW
B O'Brien, H Zafar, F Sharif
A strong evidence of outcomes for vasovagal syncope is not easily identified. It would seem reasonable that the proposed Mayo Clinic technology would be reserved for cases with severe recurrent or refractory syncope. However, recurrence levels are relatively low, and while some predictive methods have been proposed, recurrence is also influenced by the interaction that occurs during screening and examinations, i.e. recurrence diminishes once an initial diagnosis has been made. Finally, a key factor in being able to identify suitable patients relates to understanding the relative significance of the vasodepression and cardioinhibitory components-the therapy is best suited to patients that have a significant level of both components...
June 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28616729/prediction-of-the-estimated-5-year-risk-of-sudden-cardiac-death-and-syncope-or-non-sustained-ventricular-tachycardia-in-patients-with-hypertrophic-cardiomyopathy-using-late-gadolinium-enhancement-and-extracellular-volume-cmr
#12
Maxim Avanesov, Julia Münch, Julius Weinrich, Lennart Well, Dennis Säring, Christian Stehning, Enver Tahir, Sebastian Bohnen, Ulf K Radunski, Kai Muellerleile, Gerhard Adam, Monica Patten, Gunnar Lund
OBJECTIVES: To evaluate the ability of late gadolinium enhancement (LGE) and mapping cardiac magnetic resonance (CMR) including native T1 and global extracellular volume (ECV) to identify hypertrophic cardiomyopathy (HCM) patients at risk for sudden cardiac death (SCD) and to predict syncope or non-sustained ventricular tachycardia (VT). METHODS: A 1.5-T CMR was performed in 73 HCM patients and 16 controls. LGE size was quantified using the 3SD, 5SD and full width at half maximum (FWHM) method...
June 14, 2017: European Radiology
https://www.readbyqxmd.com/read/28614562/assessment-and-treatment-of-syncope
#13
Win-Kuang Shen, Robert S Sheldon
No abstract text is available yet for this article.
June 14, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28612913/the-usefulness-of-soluble-st2-and-galectin-3-as-novel-biomarkers-for-better-risk-stratification-in-hypertrophic-cardiomyopathy
#14
Monika Gawor, Mateusz Śpiewak, Jadwiga Janas, Katarzyna Kożuch, Aleksandra Wróbel, Łukasz Mazurkiewicz, Rafał Baranowski, Magdalena Marczak, Jacek Grzybowski
BACKGROUND: Estimation of sudden cardiac death (SCD) risk is an integral part of clinical management of patients with hypertrophic cardiomyopathy (HCM). Identification of novel biomarkers of this disease can provide additional criteria for SCD risk stratification. Soluble suppression of tumorigenicity (sST2) and galectin-3 (Gal-3) are useful biomarkers for prognosis of heart failure (HF). Both of them appear to mediate cardiac fibrosis - an important pathogenetic process in HCM. Data about sST2 and Gal-3 usefulness in patients with HCM are limited...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28611366/safety-of-acupuncture-overview-of-systematic-reviews
#15
Malcolm W C Chan, Xin Yin Wu, Justin C Y Wu, Samuel Y S Wong, Vincent C H Chung
Acupuncture is increasingly used worldwide. It is becoming more accepted by both patients and healthcare providers. However, the current understanding of its adverse events (AEs) is fragmented. We conducted this overview to collect all systematic reviews (SRs) on the AEs of acupuncture and related therapies. MEDLINE and EMBASE were searched from inception to December 2015. Methodological quality of included reviews was assessed with a validated instrument. Evidence was narratively reported. Seventeen SRs covering various types of acupuncture were included...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28608926/the-pharmacodynamic-effects-of-combined-administration-of-flibanserin-and-alcohol
#16
D M Stevens, J M Weems, L Brown, K A Barbour, S M Stahl
WHAT IS KNOWN AND OBJECTIVE: Flibanserin is a serotonin 5-HT1A agonist and 5-HT2A antagonist approved for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Because of the increased risk of hypotension- and syncope-related adverse events (AEs) observed with coadministration of flibanserin and alcohol, alcohol use is contraindicated. To provide a more comprehensive understanding of the interaction between flibanserin and alcohol, the results of a dedicated phase 1 alcohol-interaction study and a pooled analysis of phase 3 studies of premenopausal women with HSDD are presented...
June 13, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28608915/abc-om-pediatrisk-ekg-tolkning
#17
Caroline Fransson, Stefan Johansson, Cecilia Halvorsen
The ABC of paediatric ECG interpretation In paediatric patients, ECG is used as a tool for investigation of arrhythmias, chest pain, syncope, intoxications and congenital heart abnormalities. Paediatric ECGs differ significantly from adult ECGs, and change gradually during childhood, largely because of the changes that start with the transition of foetal circulation at birth. This evolution is most prominent during the first year of life, but it is not until the late adolescent years that the ECG corresponds to that of adults...
June 9, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28607622/syncope-in-a-patient-with-a-dual-chamber-pacemaker-what-is-the-possible-mechanism
#18
Yavuzer Koza, Ziya Simsek, Selim Aydemir, Remziye Doğan
No abstract text is available yet for this article.
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28607621/epicardially-placed-implantable-cardioverter-defibrillator-for-a-child-with-congenital-long-qt-syndrome
#19
Hirotaro Sugiyama, Motomi Tachibana, Hiroshi Morita, Nobuhiro Nishii, Akihito Miyoshi, Hiroyasu Sugiyama, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Ito
A 7-year-old boy presented at our hospital with syncope. At birth, electrocardiography had shown a long QT interval with torsade de pointes (TdP). Congenital long QT syndrome (LQTS) had been diagnosed by genetic testing, and was successfully controlled with oral propranolol. At age 7, TdP had recurred with syncope. Electrocardiography revealed a prominent long QT interval with T-wave alternans. The propranolol dose was increased, but TdP remained uncontrolled. A cardioverter-defibrillator (ICD) was implanted epicardially, and TdP completely resolved with atrial pacing...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28607616/a-proposal-of-clinical-ecg-index-vagal-score-for-determining-the-mechanism-of-paroxysmal-atrioventricular-block
#20
Sayaka Komatsu, Masataka Sumiyoshi, Seiji Miura, Yuki Kimura, Tomoyuki Shiozawa, Keiko Hirano, Fuminori Odagiri, Haruna Tabuchi, Hidemori Hayashi, Gaku Sekita, Takashi Tokano, Yuji Nakazato, Hiroyuki Daida
BACKGROUND: Paroxysmal atrioventricular block (P-AVB) is a well-known cause of syncope; however, its underlying mechanism is difficult to determine. This study aimed to evaluate a new ECG index, the "vagal score (VS)," to determine the mechanism of P-AVB. METHODS: We evaluated the VS in 20 patients with P-AVB (13 men, 7 women; aged 25-78 years [mean, 59.3 years]). The VS was developed by assigning 1 point each for the following: (1) no AVB or intraventricular conduction disturbance on the baseline ECG, (2) PR prolongation immediately before P-AVB, (3) sinus slowing immediately before P-AVB, (4) initiation of P-AVB by PP prolongation, (5) sinus slowing during ventricular asystole, and (6) resumption of AV conduction with PP shortening, and by assigning -1 point each for (7) the initiation of P-AVB by a premature beat, and (8) resumption of AV conduction by an escape beat...
June 2017: Journal of Arrhythmia
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