Arryhthmia

Introduction: Cardiac rhythm disturbances are common presentation in acute coronary syndromes and are cause of frequent serious complications in acute myocardial infarction (AMI). However due to availability of early reperfusion therapy and primary angioplasty, arrhythmias have cause a reduction in mortality. Arrhythmias are key events before, during or after the occurrence of acute MI. There are few clinical studies describing the types of arryhthmias, their correlation with the clinical profile of acute MI and effect on outcomes...

BACKGROUND: Neuraxial modulation with cardiac sympathetic denervation (CSD) can potentially reduce burden of ventricular tachyarrhythmia (VT). However, despite catheter ablation and CSD, VT can recur in patients with cardiomyopathy and the role of vagal nerve stimulation (VNS) in this setting is unclear. OBJECTIVE: The purpose of this study was to evaluate the electrophysiological effects of VNS after CSD in normal and infarcted hearts. METHODS: In 10 normal and 6 infarcted pigs, electrophysiological and hemodynamic parameters were evaluated before and during intermittent VNS pre-CSD (bilateral stellectomy and T2-T4 thoracic ganglia removal) as well as post-CSD...

BACKGROUND AND AIMS: The existence of non-excitable cells in the myocardium leads to the increasing conduction non-uniformity and decreasing myocardial electrical conductivity. Slowed myocardial conduction velocity (MCV) believed to enhance the probability of cardiac arryhthmia and alter the cardiac mechanical pumping efficacy, even in sinus rhythm. Though several studies on the correlation between MCV and cardiac electrical instabilities exist, there has been no study concerning correlation or causality between MCV and cardiac mechanical pumping efficacy, due to the limitation in clinical methods to document and evaluate cardiac mechanical responses directly...

Reports state that Down syndrome (DS) patients with congenitally normal hearts might experience the development of cardiac abnormalities such as cardiac autonomic dysfunction, valvular lesions, bradycardia, and atrioventricular block. However, the presence of any difference in terms of P-wave dispersion (PWd) and QT dispersion (QTd) was not evaluated previously. This study prospectively investigated 100 DS patients with structurally normal hearts and 100 age- and sex-matched healthy control subjects. Standard 12-lead electrocardiograms were used to assess and compare P-wave and QT durations together with PWd and QTd...

HISTORY AND ADMISSION FINDINGS: A 49-year-old man with loss of performance, ventricular ectopy and left bundle branch block was referred for diagnostic workup. He had dysmorphic skeletal features with shortening and muscular atrophy of arm and leg and syndactylia. INVESTIGATIONS: Echocardiography revealed peculiar hypertrabeculation of left ventricular myocardium which was confirmed by cardiac magnetic resonance imaging. Therefore a diagnosis of non-compaction cardiomyopathy was made...

cPLA2gamma was identified as an ortholog of cPLA2alpha, which is a key enzyme in eicosanoid production. cPLA2gamma was reported to be located in endoplasmic reticulum (ER) and mitochondria and to have lysophospholipase activity beside phospholipase A2 (PLA2) activity. However, subcellular localization, mechanism of membrane binding, regulation and physiological function have not been fully established. In the present study, we examined the subcellular localization and enzymatic properties of cPLA2gamma with C-terminal FLAG-tag...

OBJECTIVE: The surgical techniques was first described by Lower and Shumway for cardiac transplantation have not changed for many years; they are still being commonly used worldwide despite recently presented alternatives. We sought to evaluate the surgical complications among our cardiac transplantation patients in whom we performed the standard technique. PATIENTS AND METHODS: The standard biatrial anastomosis technique was used in 13 patients who have a mean follow-up of 18...

The aim of this study is to clarify the specificities of atrial fibrillation in hyperthyroidism. It's a retrospective study of 6 years, about 14 patients hospitalized for hyperthyroidism with atrial fibrillation. There were 9 Women and 5 men, 55.7 +/- 11.5 years old. Arryhthmia was discovered especially with palpitation and dyspnea. Cardiac echography diagnosed valvular disease in 83.3% of cases. Cardiovascular complications concerned 5 patients and consisted in cardiac insufficiency and cardiomyopathy in one case...

Exercise training for patients with coronary artery disease (CAD) is recommended in a wide range between 40-85% of maximum functional capacity (MFC) or 55-90% of maximum heart rate (HR). During exercise, high levels of catecholamines and metabolic acidosis could induce arrhythmia and ischemia. But catecholamines have never been determined in CAD during constant load exercise in the upper range of recommended intensities. In 11 CAD patients (age 58+/-8 years, BMI 26.1+/-4.0 kg x m(-2), NYHA I n=7, II n=4) we tested the maximum functional capacity (MFC), norepinephrine (NE), epinephrine (E) and blood lactate ([Lac(-)](B)) in a symptom-limited incremental ergometer test...

The Fontan procedure has allowed to improve the outcome of complex congenital cardiopathy involving single ventricle. A better understanding of the systemic venous circulation has favored bicavo-bipulmonary derivation instead of atrio-pulmonary derivation. However, in spite of the improvement in surgical procedures, post-operative arrhythmias still occur with an increasing rate during follow-up reaching 40 to 50% of the patients in some series. We report a series of 52 patients of which 92% presented a severe atrial arrhythmia (atrial fibrillation or atrial flutter) during a 6-year follow-up...

Arryhthmias can afflict any heart, even in the absence of disease. Given that Cardiac Output (CO) is a product of heart rate and stroke volume, the end-result of brady- and tachy-arrhythmias is the same: low CO with symptoms of low-output state. In bradyarrhythmias, myocardial inotropy operates maximally but the product of stroke volume and slow heart rate yields a low CO. In tacharryhthmias, myocardial inotropy is redundant because the product of low stroke volume arising from low Diastolic Filling Time (DFT) and heart rate also yields a low CO...

Directional coronary atherectomy (DCA) has proven to be an effective treatment for coronary artery disease, both in multiple anatomical locations and in various clinical settings. Little has been published, however, regarding efficacy of DCA for treatment of acute myocardial infarction (MI). This brief report reviews our early experience with DCA in this new role. Twelve patients presenting from April 1993 through February 1994 were identified by review of the DCA Registry at Hamot Medical Center. The group comprised six men and six women mean age 60 years (range 39-81 years)...

Anagrelide is an oral imidazoquinazoline agent with an anti-cyclic AMP phosphodiesterase activity and inhibits platelet aggregation in both humans and animals. In addition, it has in humans a species-specific platelet-lowering activity observed at dose levels lower than those required to inhibit platelet aggregation. Because of this, the drug has been tested in patients with clonal thrombocytosis and has been shown to have potent platelet-reducing activity in essential thrombocythemia (ET) and related disorders...

BACKGROUND: Intermittent antegrade warm blood cardioplegia (IAWBC) is a well established technique of myocardial protection for coronary artery surgery, with metabolic and experimental basis. METHODS: To evaluate its effectiveness in aortic valve replacement (AVR), we compared 171 consecutive patients who underwent first AVR using IAWBC (group A) with the last 100 consecutive patients who underwent first AVR using intermittent antegrade cold blood cardioplegia (IACBC) (group B)...

Ungated lithotripsy has raised the specter of possible cardiac arrhythmias. We reviewed ungated outpatient lithotripsy performed on 82 patients to evaluate the incidence of arrhythmias encountered and time saved. All patients were chosen in a random nonselected, prospective fashion. All treatments were performed on a mobile Medstone 1050 STS lithotriptor. The incidence of arrhythmias was 21%. All but 2 arryhthmias were benign and all reversed with gating. No arrhythmias occurred during treatment of right ureteral stones...

Silent myocardial ischemia and ventricular arrhythmias were known to be independent risk factors in patients with coronary artery disease. This has become more important since the technique of Holter monitoring has been improved and has demonstrated a high incidence of silent myocardial ischemia in the majority of patients with coronary artery disease, as well as a close relation to the occurrence of sudden cardiac death. Unfortunately, prospective data on the interaction of both risk factors are missing. We therefore studied patients undergoing exercise-testing, percutaneous transluminal angioplasty and 24-h-Holter-monitoring to assess such an interaction...

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