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Iain Mactier, Jonathan R Dalzell, David Carrick
CLINICAL INTRODUCTION: A 50-year-old woman presented with an inferoposterior ST-elevation myocardial infarction (STEMI) and underwent emergency percutaneous coronary intervention (PCI). Angiography revealed acute occlusion of the circumflex and right coronary (RCA) arteries. PCI was uncomplicated. Her medical history included asthma, hypertension and chronic sinusitis.Three months later, she presented with a non-STEMI (NSTEMI), and angiogram showed a new focal stenosis in the left anterior descending artery...
February 14, 2019: Heart: Official Journal of the British Cardiac Society
Anish N Bhuva, Patricia Feuchter, Angela Hawkins, Lizette Cash, Redha Boubertakh, Jane Evanson, Richard Schilling, Martin Lowe, James C Moon, Charlotte H Manisty
BACKGROUND: Patients with cardiac pacemakers and defibrillators are disadvantaged because of poor access to MRI scans, leading to late and misdiagnosis particularly for cancer and neurological disease. New technology allied to tested protocols now allows safe MRI scanning of such patients; however, logistical barriers persist. AIM: To deliver a streamlined sustainable service that provides timely MRI scans to patients with cardiac implantable electronic devices (CIEDs)...
February 13, 2019: BMJ Quality & Safety
Andreu Porta-Sánchez, Andrew C T Ha, Xuesong Wang, Fahad Almehmadi, Peter C Austin, Hadas D Fischer, Atif Al-Qubbany, Diego Chemello, Vijay Chauhan, Eugene Downar, Douglas S Lee, Kumaraswamy Nanthakumar
BACKGROUND: Catheter ablation of ventricular tachycardia (VT) can reduce the burden of ventricular arrhythmia (VA) but its effect on health care utilization and costs after such therapy is poorly known. We sought to compare the rates of cardiovascular (CV)-related hospitalizations, survival, and health care costs in patients with recurrent VT treated either with VT ablation or with medical therapy. METHODS: One-hundred implantable cardioverter-defibrillator patients with structural heart disease who underwent VT ablation were included...
February 2019: Canadian Journal of Cardiology
Dominic P Morgan, David Muscatello, Andrew Hayen, Joanne Travaglia
OBJECTIVE: Programmes that reduce the time to defibrillation are likely to improve overall survival rates from out-of-hospital cardiac arrests (OHCAs). This research sought to identify human factors common among community responders taking an automated external defibrillator (AED) to a victim of an OHCA that are either barriers or enablers of desired behaviour. METHODS: A qualitative methodology was used. Community members who had access to an AED and who had been notified of an incident of OHCA near them were approached to participate in the research...
February 13, 2019: Emergency Medicine Australasia: EMA
U H Ferdaushi, M A Ali, N Islam, S Nabi, M Islam, M S Alom, G K Paul
Cardiac resynchronization therapy (CRT) reduces symptoms and improves left ventricular function in patients with heart failure due to left ventricular systolic dysfunction and cardiac dyssynchrony. We analyzed the clinical and echocardiographic outcome of CRT in heart failure patients. Thirty five (35) heart failure patients were included in this prospective observational study, conducted from February 2015 to February 2016 in the Department of cardiology, National Institute of Cardiology & Vascular Disease (NICVD) hospital, Dhaka, Bangladesh...
January 2019: Mymensingh Medical Journal: MMJ
Simon Ermakov, Radhika Gulhar, Lisa Lim, Dwight Bibby, Qizhi Fang, Gregory Nah, Theodore P Abraham, Nelson B Schiller, Francesca N Delling
OBJECTIVE: Bileaflet mitral valve prolapse (MVP) with either focal or diffuse myocardial fibrosis has been linked to ventricular arrhythmia and/or sudden cardiac arrest. Left ventricular (LV) mechanical dispersion by speckle-tracking echocardiography (STE) is a measure of heterogeneity of ventricular contraction previously associated with myocardial fibrosis. The aim of this study is to determine whether mechanical dispersion can identify MVP at higher arrhythmic risk. METHODS: We identified 32 consecutive arrhythmic MVPs (A-MVP) with a history of complex ventricular ectopy on Holter/event monitor (n=23) or defibrillator placement (n=9) along with 27 MVPs without arrhythmic complications (NA-MVP) and 39 controls...
February 12, 2019: Heart: Official Journal of the British Cardiac Society
Peter V Bui, Nathan L Haas, Nicholas W C Herrman, Matthew Macias, Victoria Hoch, William Schaeffer, Christopher Wallace
BACKGROUND: Brugada pattern on electrocardiography (ECG) can manifest as type 1 (coved pattern) and type 2 (saddleback pattern). Brugada syndrome represents an ECG with Brugada pattern in a patient with symptoms or clinical factors, including syncope, cardiac arrest, ventricular dysrhythmias, and family history. Brugada syndrome is caused by a genetic channelopathy, but the Brugada pattern may be drug-induced. Epinephrine-induced Brugada pattern has not been reported previously. CASE REPORT: A 63-year-old man developed anaphylaxis secondary to a bee sting, had a transient loss of consciousness, and self-administered intramuscular epinephrine...
February 9, 2019: Journal of Emergency Medicine
Violeta González-Salvado, Cristian Abelairas-Gómez, Carlos Peña-Gil, Carmen Neiro-Rey, Roberto Barcala-Furelos, José Ramón González-Juanatey, Antonio Rodríguez-Núñez
The aim of this study was to examine the effectiveness of a novel cardiopulmonary resuscitation (CPR) training method embedded in a cardiac rehabilitation program at enhancing patients' CPR and defibrillation skills. One hundred and fourteen participants with coronary heart disease enrolled on an exercise-based cardiac rehabilitation program were included. Two groups were randomly allocated to different training programs: CPR-retraining based on hands-on rolling refreshers during the 2-month program (G-CPR, n = 53) versus standard one-time training (G-Stan, n = 61)...
February 11, 2019: Health Education Research
Tobias Schupp, Michael Behnes, Christel Weiß, Christoph Nienaber, Siegfried Lang, Linda Reiser, Armin Bollow, Gabriel Taton, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Thomas Bertsch, Muharrem Akin, Kambis Mashayekhi, Martin Borggrefe, Ibrahim Akin
This study sought to assess the prognostic impact of treatment with angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) on recurrences of ventricular tachyarrhythmias in recipients of implantable cardioverter defibrillators (ICD).Using a large retrospective registry including consecutive ICD recipients with documented episodes of ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2016, those patients treated with ACEi/ARB were compared to patients without (non-ACEi/ARB)...
February 8, 2019: Journal of Cardiovascular Pharmacology
Kim M Nielsen, Ann-Dorthe Zwisler, Rod S Taylor, Jesper H Svendsen, Jane Lindschou, Lindsey Anderson, Janus C Jakobsen, Selina K Berg
BACKGROUND: An effective way of preventing sudden cardiac death is the use of an implantable cardioverter defibrillator (ICD). In spite of the potential mortality benefits of receiving an ICD device, psychological problems experienced by patients after receiving an ICD may negatively impact their health-related quality of life, and lead to increased readmission to hospital and healthcare needs, loss of productivity and employment earnings, and increased morbidity and mortality. Evidence from other heart conditions suggests that cardiac rehabilitation should consist of both exercise training and psychoeducational interventions; such rehabilitation may benefit patients with an ICD...
February 12, 2019: Cochrane Database of Systematic Reviews
Tsukasa Oshima, Katsuhito Fujiu, Jun Matsuda, Takumi Matsubara, Eriko Hasumi, Oguri Gaku, Toshiya Kojima, Issei Komuro
A 41-year-old man developed cardiac arrest. A resting 12-lead electrocardiogram showed a delta wave, suggestive of preexcitation syndrome. An electrophysiological test revealed the existence of inducible atrial fibrillation and a fasciculoventricular accessory pathway (FVAP). After these examinations, idiopathic ventricular arrhythmia was suspected. For evaluating concealed Brugada syndrome, pilsicainide was administered, which diminished the delta wave and no Brugada-like electrocardiogram was observed. Ventricular double extra-stimulation from the RV apex easily induced VF, which could not be defibrillated by an external defibrillator, and later stopped spontaneously...
February 8, 2019: International Heart Journal
Takehito Sasaki, Kohki Nakamura, Shigeto Naito
A 28-year-old female presented with fulminant lymphocytic myocarditis. She developed cardiogenic shock, frequent sustained ventricular tachycardia, and fibrillation (VT and VF). The left ventricular ejection fraction improved from 5% to 40% after medical therapy, but the right ventricular systolic dysfunction and enlargement persisted. In addition, sustained VTs, requiring direct current cardioversion, occurred during oral administration of amiodarone following intravenous amiodarone, even after percutaneous stellate ganglion block...
February 8, 2019: International Heart Journal
Masaru Yamamoto, Katsunori Okajima, Akira Shimane, Tomoya Ozawa, Itsuro Morishima, Toru Asai, Masahiko Takagi, Atsunobu Kasai, Eitaro Fujii, Ken Kiyono, Eiichi Watanabe, Yukio Ozaki
Implantable cardioverter-defibrillators (ICDs) improve survival in patients who are at risk of sudden death. However, inappropriate therapy is commonly given to ICD recipients, and this situation may be associated with an increased risk of death. This study aimed to construct a risk stratification scheme by using decision tree analysis in patients who received inappropriate ICD therapy.Mortality was calculated from a retrospective data analysis of a multicenter cohort involving 417 ICD recipients. Inappropriate therapy was defined as therapy for nonventricular arrhythmias, including sinus tachycardia, supraventricular tachycardia, atrial fibrillation/flutter, oversensing, and lead failure...
February 8, 2019: International Heart Journal
Emma Burnhope, Yael Rodriguez-Guadarrama, Michael Waring, Andrew Guilder, Bharti Malhotra, Reza Razavi, Aldo Rinaldi, Mark Pennington, Gerald Carr-White
BACKGROUND AND AIMS: Infection is a serious and expensive complication of Cardiac Implantable Electronic Device (CIED) procedures. We performed a retrospective based cost analysis to estimate Trust level savings of using the TYRX antibacterial envelope as a primary prevention measure against infection in a tertiary referral centre in South London, United Kingdom. METHODS: A retrospective cohort of heart failure patients with reduced ejection fraction undergoing Implantable Cardioverter Defibrillator (ICD) or Cardiac Resynchronization Therapy (CRT) procedures were evaluated...
February 12, 2019: Journal of Medical Economics
Monica L Chen, Neal S Parikh, Alexander E Merkler, Dawn O Kleindorfer, Prashant D Bhave, Emily B Levitan, Elsayed Z Soliman, Hooman Kamel
Background Black individuals in the United States experience higher rates of ischemic stroke than other racial groups but have lower rates of clinically apparent atrial fibrillation ( AF ). It is unclear whether blacks truly have less AF or simply more undiagnosed AF . Methods and Results We performed a retrospective cohort study using inpatient and outpatient claims from 2009 to 2015 for a 5% nationally representative sample of Medicare beneficiaries. We included patients aged ≥66 years with at least 1 documented Current Procedural Terminology code for interrogation of an implantable pacemaker, cardioverter-defibrillator, or loop recorder and no documented history of AF , atrial flutter, or stroke before their first device interrogation...
February 19, 2019: Journal of the American Heart Association
Jürgen Hörer
Today, more than two thirds of patients with congenital heart disease (CHD) are adults. Cardiac surgery plays an essential role in restoring and maintaining cardiac function, aside from evolving medical treatment and catheter-based interventions. The aim of the present publication was to describe the spectrum of operations performed on adults with CHD (ACHD) by reviewing current literature. Currently, surgery for ACHD is predominantly valve surgery, since valvular pathologies are often either a part of the basic heart defect or develop as sequelae of corrective or palliative surgery...
December 2018: Cardiovascular Diagnosis and Therapy
O Lairez
Hypertrophic cardiomyopathies represent a heterogeneous group of pathophysiological mechanisms and etiologies (genetic or not), which lead to the development of left ventricular hypertrophy. Left ventricular hypertrophy, when not explained by a significant and prolonged increase in post-load (such as severe poorly controlled arterial hypertension or severe aortic stenosis) justifies etiological exploration. The etiology may range from physiological adaptation in the athlete to myocardial involvement, isolated or integrated as part of a global neuromuscular involvement; metabolic or mitochondrial disease to deposition disease...
February 7, 2019: La Revue de Médecine Interne
Amita Singh, Keigo Kawaji, Neha Goyal, Noreen T Nazir, Andrew Beaser, Virginia O'Keefe-Baker, Karima Addetia, Roderick Tung, Peng Hu, Victor Mor-Avi, Amit R Patel
Implantable cardioverter defibrillators (ICDs) have been a relative contraindication to cardiovascular magnetic resonance imaging. Although cardiovascular magnetic resonance provides valuable information regarding scar in patients with ventricular arrhythmias or cardiomyopathy, ICDs in these patients frequently cause artifacts hindering accurate interpretation of both cine and late gadolinium enhancement (LGE) images. We sought to quantify the frequency and severity of artifact on LGE images and assess whether a modified wideband LGE protocol could improve the diagnostic yield of scar identification in agreement with invasive electroanatomic mapping (EAM)...
January 31, 2019: American Journal of Cardiology
Fadi Shamoun, Teresa De Marco, David DeMets, Chaoqun Mei, JoAnn Lindenfeld, Leslie A Saxon, John P Boehmer, Jill Leigh, Patrick Yong, Arthur M Feldman, Michael R Bristow
OBJECTIVES: This study tested the hypothesis that the extent of left ventricular (LV) eccentric structural remodeling in heart failure with reduced ejection fraction (HFrEF) is directly associated with clinical event responses to cardiac resynchronization therapy (CRT). BACKGROUND: Whether the severity of LV structural remodeling influences CRT treatment effects is unknown. METHODS: COMPANION (Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure) trial data were analyzed retrospectively...
February 4, 2019: JACC. Heart Failure
Carmen M Martínez-Caballero, Eva Sierra Quintana
INTRODUCTION: Cardiac events are one of the leading causes of death in the Spanish population. Given the increase in the nontraumatic medical conditions found in mountain rescues, the objective of this study was to report on the heart conditions of patients rescued in the mountains of Aragón in the Spanish Pyrenees. METHODS: We conducted a retrospective observational study based on data collected from patients' medical histories for rescues undertaken in from 2010 to 2016 (at altitudes between 500 m [1640 ft] and 3404 m [11,168 ft])...
February 5, 2019: Wilderness & Environmental Medicine
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