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sinus node

Michel Komajda
Ivabradine is a blocker of the funny current channels in the sinoatrial node cells. This results in pure heart rate reduction when elevated without direct effect on contractility or on the vessels. It was tested in a large outcome clinical trial in stable chronic heart failure (CHF) with low ejection fraction, in sinus rhythm, on a contemporary background therapy including betablockers (SHIFT: Systolic Heart Failure Treatment with the If inhibitor Trial).The primary composite endpoint (cardiovascular mortality or heart failure hospitalization) was reduced by 18% whereas the first occurrence of heart failure hospitalizations was reduced by 26%...
October 18, 2016: Handbook of Experimental Pharmacology
Thomas Sené, Olivier Lidove, Joel Sebbah, Jean-Marc Darondel, Hervé Picard, Laurent Aaron, Olivier Fain, Thierry Zenone, Dominique Joly, Philippe Charron, Jean-Marc Ziza
The incidence and predictive factors of arrhythmias and/or conduction abnormalities (ACAs) requiring cardiac device (CD) implantation are poorly characterized in Fabry disease (FD). The aim of our retrospective study was to determine the prevalence, incidence, and factors associated with ACA requiring CD implantation in a monocentric cohort of patients with confirmed FD who were followed up in a department of internal medicine and reference center for FD.Forty-nine patients (20M, 29F) were included. Nine patients (4M, 5F; 18%) had at least one episode of ACA leading to device therapy...
October 2016: Medicine (Baltimore)
Maria Cecilia Gonzalez Corcia, Juan Sieira, Andrea Sarkozy, Carlo de Asmundis, Gian-Battista Chierchia, Jaime Hernandez Ojeda, Gudrun Pappaert, Pedro Brugada
AIMS: To investigate the clinical characteristics, prognoses, and presence of risk factors in young patients with Brugada syndrome (BS). METHODS AND RESULTS: A consecutive cohort of 128 young BS patients (≤25 years old at diagnosis) was analysed. Eighty-eight patients (69%) were asymptomatic, whereas 40 (31%) presented with clinical manifestations of BS. Markers of prognosis and risk were identified upon comparison of these two groups. A history of malignant syncope was strong predictors of ventricular arrhythmic events...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Nathalie Behar, Bertrand Petit, Vincent Probst, Frederic Sacher, Gaelle Kervio, Jacques Mansourati, Paul Bru, Alfredo Hernandez, Philippe Mabo
AIM: Modulation of ST-segment elevation (STE) and tachyarrhythmic events by the autonomic nervous system (ANS) has been reported in patients with Brugada syndrome (BS). This study examined and compared the autonomic characteristics and STE in symptomatic vs. asymptomatic patients with BS. METHODS AND RESULT: We studied 40 symptomatic and 78 asymptomatic patients (mean age = 46.1 ± 13.7 years; 88 men) who underwent 24 h, 12-lead electrocardiograms, and exercise and a head-up tilt tests...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Matteo Ziacchi, Pietro Palmisano, Ernesto Ammendola, Gabriele Dell'era, Federico Guerra, Stefano Aquilani, Vittorio Aspromonte, Giuseppe Boriani, Michele Accogli, Giuseppe Del Giorno, Eraldo Occhetta, Alessandro Capucci, Renato Pietro Ricci, Giampiero Maglia, Mauro Biffi
AIM: The aim of this multicentre, observational, transversal study was to evaluate pacemaker (PM) choice and setting in a large number of patients, in order to understand their relationship with the patients' clinical characteristics. METHODS AND RESULTS: The study enrolled a total of 1858 patients (71 ± 14 years, 54% male), consecutively evaluated during scheduled PM follow-up visits in 7 Italian cardiac arrhythmia centres. To evaluate the appropriateness of PM choice in relation to the patients' clinical characteristics, we analysed their rhythm disorders at the time of device implantation and the characteristics of the devices implanted...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Barry H Greenberg
The treatment of heart failure with reduced ejection (HFrEF) is changing rapidly. Advances over the past several decades have focused on blocking the adverse effects of neurohormonal activation. This approach has resulted in marked improvement in outcomes in the HFrEF population. Despite these advances, however, mortality and morbidity remain high and HFrEF patients have poor quality of life. New approaches to therapy now offer additional benefits. Combined neprilysin inhibition and angiotensin receptor blockade using sacubitril-valsartan (LCZ696) has been shown to be superior to an angiotensin-converting enzyme inhibitor in HFrEF patients...
2016: Reviews in Cardiovascular Medicine
Sung-Won Jang, Robert W Rho, Tae-Seok Kim, Sung-Hwan Kim, Woo-Seung Shin, Ji-Hoon Kim, Yong-Seog Oh, Man Young Lee, Eiwa Zen, Tai-Ho Rho
BACKGROUND AND OBJECTIVES: The number of permanent pacemakers (PPMs) implanted in patients in Japan and Korea differs significantly. We aimed to investigate the differences in decision making processes of implanting a PPM. MATERIALS AND METHODS: Our survey included 15 clinical case scenarios based on the 2008 AHA/ACC/HRS guidelines for device-based therapy of cardiac rhythm abnormalities (class unspecified). Members of the Korean and Japanese Societies of Cardiology were asked to rate each scenario according to a 5-point scale and to indicate their decisions for or against implantation...
September 2016: Korean Circulation Journal
Satoshi Koyama, Yosuke Nakamura, Yuko Yokoyama, Tsuyoshi Morisaki, Takahiro Fukuhara, Kazunori Fujiwara, Hiroya Kitano, Hiromi Takeuchi
Basaloid squamous cell carcinoma (BSCC) is a histologically distinctive variant of squamous cell carcinoma comprising basal cell carcinoma and squamous cell carcinoma. BSCC is aggressive and shows a poor prognosis because of frequent lymph node invasion and distant metastases. BSCC preferentially occurs in the cervix, thymus, and esophagus and is uncommonly found in the head and neck region. BSCC in the nasal cavity or paranasal sinus is particularly rare. Inverted papilloma is an uncommon, benign tumor with a propensity to be associated with malignancy; however, BSCC arising in an inverted papilloma has never been reported...
October 6, 2016: Auris, Nasus, Larynx
Roman Brenner, Peter Ammann, See-Il Yoon, Stefan Christen, Jens Hellermann, Grégoire Girod, Urs Knaus, Firat Duru, Nazmi Krasniqi, David Ramsay, Christian Sticherling, Kurt Lippuner, Michael Kühne
AIMS: Elderly patients with sinus node dysfunction (SND) are at increased risk of falls with possible injuries. However, the incidence of these adverse events and its reduction after permanent pacemaker (PPM) implantation are not known. METHODS AND RESULTS: Eighty-seven patients (mean [SD] age 75.4 [8.3] years, 51% women) with SND and an indication for cardiac pacing were included and were examined by a standardized interview targeting fall history. The incidence and total number of falls, falls with injury, falls requiring treatment, and falls resulting in a fracture were assessed for the time period of 12 months before (retrospectively) and after PPM implantation (prospectively)...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
G Cellarier, J Bordes, T De Greslan, L Karkowski, N Gagnon, M Billhot, J-M Cournac, C Rousseau, C Mac Nab, P Dubrous
BACKGROUND: As part of French assistance for the outbreak of Ebola virus disease in west Africa, a military treatment center for infected healthcare workers was deployed in Conakry, Guinea. Although some cases of bradycardia have been reported since the first Ebola outbreak, they have never been documented to our knowledge. We studied heart rhythm in patients with Ebola virus disease to analyze inappropriate bradycardia and discuss its mechanism. METHODS: Nine patients who tested positive for Ebola were admitted in March 2015...
August 1, 2016: Médecine et Santé Tropicales
Peter H Ahn, Nandita Mitra, Michelle Alonso-Basanta, James N Palmer, Nithin D Adappa, Bert W O'Malley, Christopher Rassekh, Ara Chalian, Roger B Cohen, Alexander Lin
BACKGROUND: Risk of nodal involvement in patients with squamous cell carcinomas (SCC) of the nasal cavity and maxillary sinus has not been well defined, especially by risk factors beyond local T-stage. Additional criteria defining patients at highest risk, as well as specific nodal levels at highest risk, has been limited in small retrospective series. We describe a population-based assessment of specific nodal involvement in this group. MATERIAL AND METHODS: The Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2010 identified 1283 eligible patients with SCC of the nasal cavity or maxillary sinus...
September 2016: Acta Oncologica
Mette Christiansen, Sandra Ammann, Carsten Speckmann, Trine Hyrup Mogensen
A 16-year-old boy of Caucasian ethnicity was evaluated for recurrent febrile episodes occurring during most of his life without establishment of any microbial aetiology. During febrile episodes he developed extensive splenomegaly, lymphadenopathy, anaemia, severe abdominal pain and general malaise. Lymph node biopsies demonstrated inflammation and sinus histiocytosis but no malignancy or granuloma. The patient underwent seroconversion for Epstein-Barr virus (EBV) infection during the hospitalisation. Genetic testing identified a hemizygous frameshift mutation in the X linked inhibitor of apoptosis (XIAP)-gene as well as variants in the MEFV gene indicating Familial Mediterranean Fever (FMF)...
2016: BMJ Case Reports
José Francisco Sales Chagas, Maria Beatriz Nogueira Pascoal, José Luís Braga Aquino, Luís Antônio Brandi, Evandro Von Zuben Previtale, Ana Sofia Pontes Trillo, Otávio Alberto Curioni, Abrão Rapoport, Rogério Aparecido Dedivitis
OBJECTIVE: to assess the efficacy of the single transverse extended cervical incision in radical neck dissection. METHOD: we conducted a prospective study, from January 2008 to January 2009, with 18 patients undergoing surgical treatment of malignant tumors of the upper aero-digestive tract. The primary lesion was located in the oral cavity in eight cases, in the oropharynx in three, in the hypopharynx in three, in the larynx in two, in the maxillary sinus, and in one case, the primary injury was hidden...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
S H Jeon, C I Park, D H Han, T B Won, H J Kim, D Y Kim, C S Rhee, B Keam, D S Heo, J H Kim, H G Wu
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Wanwarang Wongcharoen, Adisai Ruttanaphol, Siriluck Gunaparn, Arintaya Phrommintikul
BACKGROUND: It has been shown that If channels can be found in AV node, apart from the sinus node. Previous animal studies showed that If inhibitor resulted in the rate-dependent reduction in AV node conduction during atrial fibrillation (AF). Therefore, we aimed to examine the effect of ivabradine on ventricular rate in patients with non-paroxysmal AF. METHOD: This study was a prospective randomized, double blind, placebo-controlled study. Ivabradine, 5mg twice a day (n=21), or placebo (n=11) was administered for 1month to adult patients with non-paroxysmal AF, in addition to standard therapy...
September 16, 2016: International Journal of Cardiology
Laurent Fauchier, Christine Alonso, Frédéric Anselme, Hugues Blangy, Pierre Bordachar, Serge Boveda, Nicolas Clementy, Pascal Defaye, Jean-Claude Deharo, Patrick Friocourt, Daniel Gras, Franck Halimi, Didier Klug, Jacques Mansourati, Benjamin Obadia, Jean-Luc Pasquié, Dominique Pavin, Nicolas Sadoul, Jérôme Taieb, Olivier Piot, Olivier Hanon
Despite the increasingly high rate of implantation of pacemakers (PM) and cardioverter-defibrillators (ICD) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety, and effectiveness of the conventional pacing, ICD and cardiac resynchronization therapy (CRT) in elderly patients. Although peri-procedural risk may be slightly higher in the elderly, the procedure of implantation of PMs and ICDs is still relatively safe in this age group...
September 1, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Hyun Jung Gu, Young Jin Kim, Hee Joo Lee, Sung Hwa Dong, Sung Wan Kim, Hee Jae Huh, Chang-Seok Ki
Human Lasiodiplodia theobromae infection has not been reported frequently. We report the first case of invasive L. theobromae nasal and neck infection. A 66-year-old male visited our hospital with anemia and general weakness. He showed pancytopenia, and his bone marrow examination revealed markedly decreased hematopoietic cells. The patient was presumed to have iatrogenic aplastic anemia due to mushroom toxicity. He began treatment for multiple organ infections with broad-spectrum antibiotics and antifungal agents...
September 20, 2016: Mycopathologia
Anja Lieder, Thomas Guenzel, Steffen Lebentrau, Constanze Schneider, Achim Franzen
PURPOSE: Renal cell carcinoma (RCC) is a malignant tumor that metastasizes early, and patients often present with metastatic disease at the time of diagnosis. The aim of our evaluation was to assess the diagnostic and differential diagnostic relevance of metastatic renal cell carcinoma (RCC) with particular emphasis on head and neck manifestations in a large patient series. PATIENTS AND METHODS: We retrospectively evaluated 671 consecutive patients with RCC who were treated in our urology practice between 2000 and 2013...
September 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Hans-Joachim Trappe
Consciousness disorders may have many causes, mainly cardiac arrhythmias. The incidence of bradyarrhythmias (BA) in patients with acute coronary syndrome (ACS) is 0.3-18 % and caused by sinus node dysfunction (SND), high degree atrioventricular (AV) block or bundle branch blocks. SND are sinus bradycardia or sinus arrest. 1st degree AV-block occurs in 4-13 % of patients with ACS caused by rhythm disturbances in atrium, AV node, bundle of His or the Tawara system. 1st or 2nd degree AV block is seen very frequently within 24 hours after beginning of ACS and these arrhythmias are frequently transient and no more present after 72 hours...
September 2016: Deutsche Medizinische Wochenschrift
Ahmet Ilker Tekkesin, Göksel Çinier, Yasin Cakilli, Mert İlker Hayıroğlu, Ahmet Taha Alper
BACKGROUND: Interatrial block which is defined as P wave duration longer than 120 milliseconds is underappreciated but highly prevalent electrocardiographic abnormality and associated with atrial tachyarrhythmias and ischemic stroke. Impaired left atrial mechanics and atrial fibrillation are potential mechanisms contributing to the embolic events associated with interatrial block. Detection of atrial high rate episodes by cardiac implantable electronic devices provides clinicians to diagnose asymptomatic atrial fibrillation...
September 8, 2016: Journal of Electrocardiology
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