Increased likelihood of arrhythmic events associated with increased anxiety in patients with implanted cardiac defibrillators after the Ahar-Varzegan Earthquake in East Azarbaijan, 2012

Objective: To determine the type and pattern of arrhythmic events following the 2012 Ahar-Varzegan Earthquake among patients implanted with cardiac defibrillators [ICDs] in East Azarbaijan province

Methods: In a prospective cohort study, conducted in East Azerbaijan Province of Iran, 132 patients were enrolled in two comparison groups according to the region of residence i.e., earthquake region [n=98] and non-earthquake [n=34] region in 2012. Data were collected for those meeting standard criteria for sustained ventricular arrhythmias [Vas], or supraventricular tachycardias [SVTs] and triggered ICD therapies, either shock or anti-tachycardia pacing [ATP]. The state version of the State-Trait Anxiety Inventory [STAI-S] was used to assess general symptoms of anxiety in both groups

Results: Males comprised 81.1% of the participants. Mean age of the participants was 59.7+/-15 years

The frequency of patients with sustained VAs increased significantly after the earthquake [p=0.008]

There were more VAs [mean 2.16 vs. 6.23; p=0.008] and they occurred earlier [6th vs. 16th day; p=0.01] in the earthquake area

The mean frequency of SVTs and the total number of delivered ICD therapies were similar between groups

Differences in anxiety levels were not significant between groups but there was a trend for presence of greater number of patients with anxiety [p=0.07] and the relative severity of anxiety [p=0.08] in the earthquake area

Conclusion: In the earthquake area, the mean frequency of VAs increased and they occurred earlier in the earthquake area. The stress of anxiety might have served as a trigger for these events

effects of enhanced external counterpulsation on cardiac electrophysiologic properties of patients with ischemic heart disease and refractory angina at function class II-III

Enhanced external Counterpulsation [EECP] is a noninvasive circulatory assist device that has been recently emerged as a treatment option for refractory angina or left ventricular [LV] dysfunction. The aims of this study were to examine the effects of EECP on the elecrocardiographic parameters and the heart rate variability indices of patients with the coronary heart disease and function class II-III angina resistant to medication. In a descriptive study, the patients who presented with sever angina at function class II-III were studied. Those meeting the inclusion criteria were invited to participate and provided informed consent. The standard enhanced external Counterpulsation treatment [35 one-hour procedures 5-6 times a week] was done. Thirty minute ambulatory electrocardiographic monitoring and electrocardiogram before starting and at the end of treatment sessions were done. Data entry and analysis of data was done finally. Twenty five patients with mean age 68 +/- 9 year including 21[84%] men and 4[16%] women were enrolled in this study. Electocardiogarphic parameters before and after treatment by EECP were not different statistically. Time domain indices of heart rate variability according to ambulatory monitoring findings were not changed significantly. Results of this study revealed that EECP didn't improve the electrocardiographic and heart rate variability parameters of ischemic heart disease patients with refractory angina at function class II or III

Effect of preoperative information and reassurance in decreasing anxiety of patients who are candidate for coronary artery bypass graft surgery

Psychological problems like as anxiety in patients who are coronary artery bypass graft [CABGs] may increase mortality and morbidity. The effect of reassurance and preoperative information in decreasing of anxiety is uncertain. This study designed to address the effect of preoperative information and decreasing of anxiety of patients who are candidate for CABGs. With experimental study and randomize sampling 85 [55male and 30female] of 238 patients who were candidate for CABGs included and completed spilberger anxiety test on the day of admission. Preoperative information and reassurance done and test completed again on the day before surgery. Mean number of anxiety score in patients with mild anxiety disorder [21 patients] were 34 +/- 4.2 before and 39 +/- 5.8 after intervention. In patients with moderate anxiety disorder [39 patients] the number decreased to 53.88 +/- 7.6. All of differences were significant statistically. In patients with mild anxiety preparative information and reassurance resulted in increasing anxiety but in patients with moderate or server anxiety disorder, anxiety level decreased significantly

Quality of life of patients with implanted cardiac pacemakers in north west of Iran

Introducing a foreign body into the heart, a part of the human anatomy that symbolically represents emotions, is a major life event which may result in a change in the body image, changes in physical and emotional wellbeing and quality of life. In a descriptive study in Fall 2006, 78 out of 267 patients with implanted cardiac pacemakers [PPM] were randomly evaluated by using a quality of life questionnaire for patients published by Salud Co. Data entry and analysis were done by SPSS 11.5. Thirty-two men and 46 women with mean ages of 67.4 and 66.7 years, respectively, were included in the study. Thirty-six patients had single chamber VVIR, 15 had dual chamber VDD and 27 had dual chamber DDDR PPM implanted. Scores of physical and emotional wellbeing were grater than 75, but those of social/family and functional wellbeing were lower than 50 in the majority of patients. Except for a few questions, there was no significant difference between patients with single or dual chamber PPM in terms of quality of life [P=0.34]. Quality of life of patients with PPM is good in respect of physical and emotional wellbeing. However, the results were not desirable in terms of family/social and functional wellbeing. Thus, family and social educational programs are recommended

Relaxation therapy in the background of standard antihypertensive drug treatment is effective in management of moderate to severe essential hypertension

To evaluate the efficacy of relaxation technique as an adjunctive therapy for control of hypertension. From April 2004 to January 2005, with a single blinded randomized controlled design, 220 patients with newly diagnosed essential moderate to severe hypertension who needed drug therapy were included in the study. The study took place in the Hypertension Clinic, Sina Hospital, Tabriz, Iran. Patients were systematically randomized to receive standard plus relaxation therapy, 2 times per week, for 8 weeks, or standard therapy alone. We collected the demographic data, blood pressure measurements, and the data on prescribed drugs. The mean age of patients was 54 in the case group and 56 years in the control group. The mean blood pressure level [systolic and diastolic] was 192.86/105.16 and 192.09/102.25 mm Hg on admission in the case and the control groups, which decreased to 133.46/81.48 and 146.21/83.57 mm Hg, at the end of study. The difference of blood pressure on admission was not statistically significant, but became significant at the end of the study. Fifty-nine percent in the case group and 36% in the control group had good control of blood pressure. Relaxation therapy on the background of standard antihypertensive drug treatment results in better control of blood pressure

Surgical Radiofrequency MAZE III Ablation for Treatment of Atrial Fibrillation During Open Heart Surgery

Atrial fibrillation is a common arrhythmia in patients with rheumatic mitral and other valve diseases who are c and idates for valve repair surgeries. Conversion of rhythm to sinus has positive effects on quality of life and lower use of medications. The aim of this clinical study was to evaluate the effectiveness of the radiofrequency ablation Maze III procedure in the treatment of atrial fibrillation associated with rheumatic heart valve disease We applied a modified Cox III Maze procedure using radiofrequency ablation in the treatment of atrial fibrillation associated with rheumatic heart valve disease and evaluated the outcome of 20 patients of atrial fibrillation associated rheumatic valve disease who underwent radiofrequency ablation Maze III procedure plus heart valve surgery. Demographic, echocardiographic, Electrocardiographic and Doppler study data were calculated before surgery, six month and one year after surgery.No perioperative deaths occurred in the study group. Duration of additional time for doing radiofrequency ablation was about 22 minutes. Freedom from atrial fibrillation was 85% and 75% at six months and one year follow-up respectively.The addition of the radiofrequency ablation Maze procedure to heart valve surgery is safe and effective in the treatment of atrial fibrillation associated with rheumatic heart valve disease