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1.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 68(10): 1441-1446, Oct. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1406553

ABSTRACT

SUMMARY OBJECTIVE: The main objectives of this investigation were to determine whether there were any relationships between corrected cardiac-electrophysiological balance value and National Institutes of Health Stroke Scale scores at admission and discharge in patients with acute ischemic stroke and to assess whether cardiac-electrophysiological balance value was an independent predictor of high National Institutes of Health Stroke Scale scores (National Institutes of Health Stroke Scale score ≥5). METHODS: In this retrospective and observational study, 231 consecutive adult patients with acute ischemic stroke were evaluated. The cardiac-electrophysiological balance value was obtained by dividing the corrected QT interval by the QRS duration measured from surface electrocardiography. An experienced neurologist used the National Institutes of Health Stroke Scale score to determine the severity of the stroke at the time of admission and before discharge from the neurology care unit. The participants in the study were categorized into two groups: those with minor acute ischemic stroke (National Institutes of Health Stroke Scale score=1-4) and those with moderate-to-severe acute ischemic stroke (National Institutes of Health Stroke Scale scores ≥5). RESULTS: Acute ischemic stroke patients with National Institutes of Health Stroke Scale score ≥5 had higher heart rate, QT, corrected QT interval, T-peak to T-end corrected QT interval, cardiac-electrophysiological balance, and cardiac-electrophysiological balance values compared with those with an National Institutes of Health Stroke Scale score of 1-4. The cardiac-electrophysiological balance value was shown to be independently related to National Institutes of Health Stroke Scale scores ≥5 (OR 1.102, 95%CI 1.036-1.172, p<0.001). There was a moderate correlation between cardiac-electrophysiological balance and National Institutes of Health Stroke Scale scores at admission (r=0.333, p<0.001) and discharge (r=0.329, p<0.001). CONCLUSIONS: The findings of this study demonstrated that the cardiac-electrophysiological balance value was related to National Institutes of Health Stroke Scale scores at admission and discharge. Furthermore, an elevated cardiac-electrophysiological balance value was found to be an independent predictor of National Institutes of Health Stroke Scale score ≥5.

2.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 68(8): 1059-1063, Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1406612

ABSTRACT

SUMMARY OBJECTIVE: This study aimed to evaluate the agreement in the indication of implantable cardioverter-defibrillators in patients with Hypertrophic cardiomyopathy, as per the 2014 European Society of Cardiology and 2020 American Heart Association recommendations, and evaluate fragmented QRS as a predictor of cardiovascular outcome. METHODS: Retrospective cohort with 81 patients was evaluated between 2019 and 2021. Patients with hypertrophic cardiomyopathy ≥16 years old were included. Exclusion criteria include secondary myocardiopathy and follow-up <1 year. Kappa coefficient was used to determine the agreement. Survival and incidence curves were determined by Kaplan-Meier method. A p<0.05 was considered significant. RESULTS: The fragmented QRS was identified in 44.4% of patients. There were no differences between patients with and without fragmented QRS regarding clinical parameters, echocardiography, fibrosis, and sudden cardiac death risk. During follow-up of 4.8±3.4 years, there was no sudden cardiac death, but 20.6% patients with implantable cardioverter-defibrillator had at least one appropriate shock. Three of the seven appropriate shocks occurred in European Society of Cardiology low- to moderate-risk patients. Three shocks occurred in moderate-risk patients and four in American Heart Association high-risk patients. Overall recommendations agreement was 64% with a kappa of 0.270 (p=0.007). C-statistic showed no differences regarding the incidence of appropriate shock (p=0.644). CONCLUSION: sudden cardiac death risk stratification algorithms present discrepancies in implantable cardioverter-defibrillator indication, both with low accuracy.

3.
Nursing (Säo Paulo) ; 25(290): 8183-8194, julho.2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1379914

ABSTRACT

Objetivo: as arritmias cardíacas acometem mais de 20 milhões de brasileiros, desse modo, o presente estudo objetiva realizar um levantamento sobre as intervenções de enfermagem diante de um quadro de arritmia em ambiente hospitalar. Método: trata-se de revisão integrativa de literatura de caráter descritivo, realizada entre janeiro e fevereiro de 2022. Por meio de buscas na biblioteca virtual de saúde BVS (Lilacs, Medline, BDEnf, IBECs, PAHO) e Scielo BDenf de artigos publicados nos últimos 5 anos. Resultados: os enfermeiros têm aptidão para identificar anormalidades no ritmo cardíaco. A compreensão das complicações pós-operatórias contribui para a elaboração de um plano de cuidado mais eficaz. As intervenções de enfermagem devem ser pautadas no monitoramento da arritmia, bem como orientação sobre o uso dos antiarrítmicos e esclarecimento de dúvidas sobre a doença. Conclusão: é imprescindível a atuação do enfermeiro na assistência a pacientes com arritmias cardíacas, o qual necessitam monitorar os sinais vitais para determinar o efeito hemodinâmico de tal problema cardíaco, manter uma atitude tranquilizadora e compartilhar informações sobre a patologia e seu tratamento.(AU)


Objective: cardiac arrhythmias affect more than 20 million Brazilians, thus, the present study aims to carry out a survey on nursing interventions in the face of arrhythmia in a hospital environment. Method: Method: this is an integrative literature review of a descriptive nature, carried out between January and February 2022. Through searches in the virtual health library VHL (Lilacs, Medline, BDEnf, IBECs, PAHO) and Scielo. Results: nurses are able to identify heart rhythm abnormalities. Understanding postoperative complications contributes to the development of a more effective care plan. Nursing interventions should be guided by the monitoring of arrhythmia, as well as guidance on the use of antiarrhythmics and clarification of doubts about the disease. Conclusion: it is essential for nurses to assist patients with cardiac arrhythmias, who need to monitor vital signs to determine the hemodynamic effect of such a heart problem, maintain a reassuring attitude and share information about the pathology and its treatment.(AU)


Objetivo: las arritmias cardíacas afectan a más de 20 millones de brasileños, por lo tanto, el presente estudio tiene como objetivo realizar una encuesta sobre las intervenciones de enfermería frente a la arritmia en un ambiente hospitalario. Método: se trata de una revisión integrativa de la literatura de carácter descriptivo, realizada entre enero y febrero de 2022. Mediante búsquedas en la biblioteca virtual en salud BVS (Lilacs, Medline, BDEnf, IBECs, PAHO) y Scielo. Resultados: los enfermeros logran identificar alteraciones del ritmo cardíaco. Comprender las complicaciones posoperatorias contribuye al desarrollo de un plan de atención más eficaz. Las intervenciones de enfermería deben estar guiadas por el seguimiento de la arritmia, así como orientación sobre el uso de antiarrítmicos y aclaración de dudas sobre la enfermedad. Conclusión: es fundamental que los enfermeros ayuden a los pacientes con arritmias cardíacas, que necesitan monitorear los signos vitales para determinar el efecto hemodinámico de tal problema cardíaco, mantener una actitud tranquilizadora y compartir información sobre la patología y su tratamiento.(AU)


Subject(s)
Arrhythmias, Cardiac , Nursing Care
5.
Interface (Botucatu, Online) ; 25: e190737, 2021.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1124963

ABSTRACT

Narrativa que percorre o conjunto de atendimentos clínicos vividos por uma dupla, médica e paciente, no Ambulatório de Arritmia durante o processo de tratamento de uma jovem, sem cardiopatia estrutural, com arritmia ventricular complexa, muito sintomática, sem resposta ao tratamento convencional. Utilizou-se abordagem médica ampliada, não convencional, em que o perfil psicoemocional da paciente foi levado em consideração. Por meio de um método cartográfico, buscou-se delinear os percursos trilhados, ressaltando-se os afetos vividos, os impasses, superações e paradas, enquanto vincos de intensidade que marcaram diversos acontecimentos. A paciente obteve reversão das arritmias e dos sintomas após três anos e meio de tratamento e segue sem arritmia após seis anos e meio. Com isso, acreditamos poder colaborar, de forma construtiva, com o questionamento de diversos aspectos das relações clínicas contemporâneas, das dimensões afetivas do adoecer e de processos implicados na construção da saúde. (AU)


arrative depicting the clinical care journey experienced by a doctor and her patient-a young woman with symptomatic ventricular tachycardia, with no structural heart disease, with no response to conventional treatment-at the Arrhythmia Outpatient Clinic. The non-conventional expanded medical approach-where the patient's psychoemotional profile is taken into consideration - was adopted. Through a cartographic method, we aim to trace the paths taken, highlighting feelings, deadlocks, achievements, and stoppage moments as lines of intensity marking several events. The patient reversed her arrhythmia and symptoms after three and a half years of treatment, and remains so after six and a half years. Therefore, we believe we can constructively cooperate with the discussions of several aspects of contemporary clinical relations, affective dimensions of becoming ill, and processes implied in the development of health. (AU)


Narrativa que trascurre por el conjunto de atenciones clínicas vividas por dos personas, una médica y una paciente, en el Ambulatorio de Arritmia, durante el proceso de tratamiento de una joven, sin cardiopatía estructural, con arritmia ventricular compleja, muy sintomática, sin respuesta al tratamiento convencional. Se utilizó el abordaje médico ampliado, no convencional, en el que el perfil psicoemocional de la paciente se llevó en consideración. Por medio de un método cartográfico, se buscó delinear los recorridos seguidos, subrayándose los afectos vividos, los callejones sin salida, las superaciones y las paradas, como marcas de intensidad que señalaron diversos acontecimientos. La paciente tuvo reversión de las arritmias y de los síntomas después de tres años y medio de tratamiento y continúa sin arritmia pasados seis años y medio. De esa forma, creemos que podemos colaborar, de forma constructiva, con el cuestionamiento de diversos aspectos de las relaciones clínicas contemporáneas, de las dimensiones afectivas del enfermarse y de procesos implicados en la construcción de la salud. (AU)

6.
Article | IMSEAR | ID: sea-212411

ABSTRACT

Background: ACS represents a global epidemic. Arrhythmia in ACS is common. Careful investigation may lead to further improvement of prognosis. Retrospectively analyzed the year- round data of our center. Study was undertaken to analyze the incidence, frequency and type of arrhythmias in ACS. This is to aid timely intervention and to modify the outcome. Identification of the type of arrhythmia is of therapeutic and prognostic importance.Methods: This cross sectional analytical study was conducted in the Department of Cardiology, Apollo Hospitals Dhaka, from January 2019 to January 2020 with ACS patients. Enrolled consecutively and data analyzed.Results: There were 500 patients enrolled considering inclusion and exclusion criteria. Sample was subdivided into 3 groups on the type of ACS. Group-I with UA, Group-II with NSTE - ACS and Group-III with STE - ACS. Different types of arrhythmia noted. Types of arrhythmia were correlated with type of ACS. 500 patients included. Mean age 55.53±12.70, 71.6% male and 28.4% female. 60.4% hypertensive, 46.2% diabetic, 20.2% positive family history of CAD, 32.2% current smoker, 56.4% dyslipidaemic and 9.6% asthmatic. 31.2% UA, 39.2% NSTE-ACS and 29.6% STE-ACS. Type of arrhythmias noted. 22% sinus tachycardia, 20.2% sinus bradycardia, 9% atrial fibrillation, 5.2% ventricular ectopic, 4.8% supra ventricular ectopic, 2.8% bundle branch block, 2.2% atrio-ventricular block, 1% broad complex tachycardia, 0.4% narrow complex tachycardia, 0.2% sinus node dysfunction and 32.2% without any arrhythmia. Significant incidences of arrhythmia detected - respectively 29.8%, 39.2% and 31%, p<0.001.Conclusions: In conclusion, arrhythmias in ACS are common. More attention should be paid to improve their treatment and prognosis.

7.
Rev. méd. Hosp. José Carrasco Arteaga ; 12(2): 98-105, 31-07-2020. Tablas, Gráficos
Article in Spanish | LILACS | ID: biblio-1178726

ABSTRACT

INTRODUCCIÓN: Las taquicardias supraventriculares son comunes en la práctica clínica, a pesar de tener buen pronóstico, puede afectar significativamente la calidad de vida de los pacientes. El tratamiento médico no da como resultado la ausencia total de la arritmia, por lo que la terapia por ablación se ha convertido en el tratamiento de elección en muchos de los casos por su alto índice de éxito brindando una solución definitiva. El objetivo de este estudio es determinar la frecuencia de presentación de las principales taquicardias supraventriculares, distribuidas por edad y sexo, la frecuencia de éxito de la ablación percutánea y los factores relacionados con el mismo y la frecuencia de las complicaciones presentadas. MATERIALES Y MÉTODOS: Se realizó un estudio descriptivo transversal y de correlación, que incluyó 156 con diagnóstico de taquicardia supraventricular y ablacionados en los cinco centros hospitalarios en donde se realizó el procedimiento, basándonos en los registros clínicos de los mismos. RESULTADOS: De los 156 pacientes, 51.9% fueron mujeres y 48.1% hombres, con edades comprendidas entre los 10 y 80 años de edad. Las arritmias reportadas fueron taquicardia de reentrada nodal, taquicardia reentrante auriculoventricular y flutter auricular, de estas la más frecuente fue la taquicardia por reentrada auriculoventricular. El éxito global del tratamiento fue del 93.5%, sin reportar complicaciones, los factores relacionados estudiados no presentaron asociación estadísticamente significativa. CONCLUSIÓN: El tratamiento por ablación tuvo un alto porcentaje de éxito y una tasa nula de complicaciones, esto es un indicador tanto de eficacia como seguridad de este procedimiento.(au)


BACKGROUND: Supraventricular tachycardia is commonly diagnosed in clinical practice, despite having a good prognosis, it can significantly affect the patient's life quality. Pharmacological treatment does not result in the total absence of the arrhythmia, which is why ablation therapy has become the treatment of choice, due to its high success rate, and for offering a definitive solution. The aim of this study was to determine the frequency of each supraventricular tachycardia type, according to age and sex, the rate of success of percutaneous ablation and its related factors, and the frequency of complications due to the procedure. METHODS: A cross-sectional, descriptive, correlational study was conducted, including 156 patients diagnosed with supraventricular tachycardia and ablated, from five hospitals where the procedure was performed, based on their clinical records. RESULTS: From the 156 patients in this study, 51.9% were women and 48.1% men, the age ranged between 10 and 80 years. The most commonly reported arrhythmias were nodal reentrant tachycardia, atrioventricular reentrant tachycardia and atrial flutter, being the atrioventricular reentrant tachycardia the most frequent of all. The global success rate was 93.5%, no complications were reported, and none of the studied factors had significant statistical association with the success rate. CONCLUSION: Ablation treatment had a high success rate, with cero complications in this study, demonstrating the efficacy and safety of the procedure.(au)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Arrhythmias, Cardiac , Tachycardia , Tachycardia, Supraventricular , Therapeutics , Diagnosis , Methods
8.
Article in English | WPRIM | ID: wpr-786213

ABSTRACT

BACKGROUND AND OBJECTIVES: Antiarrhythmic effect of renal denervation (RDN) after acute myocardial infarction (AMI) remains unclear. The goal of this study was to evaluate the effect of RDN on ventricular arrhythmia (VA) after AMI in a porcine model.METHODS: Twenty pigs were randomly divided into 2 groups based on RDN (RDN, n=10; Sham, n=10). After implanting a loop recorder, AMI was induced by occlusion of the middle left anterior descending coronary artery. Catheter-based RDN was performed for each renal artery immediately after creating AMI. Sham procedure used the same method, but a radiofrequency current was not delivered. Electrocardiography was monitored for 1 hour to observe VA. One week later, the animals were euthanized and the loop recorder data were analyzed.RESULTS: Ventricular fibrillation event rate and the interval from AMI creation to first VA in acute phase were not different between the 2 groups. However, the incidence of premature ventricular complex (PVC) was lower in the RDN than in the Sham. Additionally, RDN inhibited prolongation of the corrected QT (QTc) interval after AMI. The frequency of non-sustained or sustained ventricular tachycardia, arrhythmic death was lower in the RDN group in the early period.CONCLUSIONS: RDN reduced the incidence of PVC, inhibited prolongation of the QTc interval, and reduced VA in the early period following an AMI. These results suggest that RDN might be a therapeutic option in patients with electrical instability after AMI.


Subject(s)
Animals , Arrhythmias, Cardiac , Autonomic Denervation , Coronary Vessels , Denervation , Electrocardiography , Humans , Incidence , Methods , Myocardial Infarction , Renal Artery , Swine , Tachycardia, Ventricular , Ventricular Fibrillation , Ventricular Premature Complexes
9.
Article in Korean | WPRIM | ID: wpr-766815

ABSTRACT

Myasthenia gravis (MG) crisis is a life-threatening condition characterized by respiratory failure requiring intubation and mechanical ventilation. Cardiac problem in patients with MG crisis is a rare condition, presenting as cardiomyopathy, arrhythmia, heart failure and sudden death. We report two cases that developed arrhythmia and stress-induced cardiomyopathy during MG crisis episodes.


Subject(s)
Arrhythmias, Cardiac , Cardiomyopathies , Death, Sudden , Heart Failure , Humans , Intubation , Myasthenia Gravis , Respiration, Artificial , Respiratory Insufficiency
10.
Chinese Pharmacological Bulletin ; (12): 1308-1314, 2018.
Article in Chinese | WPRIM | ID: wpr-705194

ABSTRACT

Aim To investigate the effects of mono-clonal antibody NCX-2D2 on isoproterenol-induced ar-rhythmias in rat hearts, and to explore the electrophys-iological mechanism. Methods Using isoproterenol to establish in vitro and in vivo arrhythmic rat models to observe the effect of NCX-2D2 antibody on ventricular arrhythmias in rats. The whole-cell patch clamp tech-nique was used to investigate the effects of NCX-2D2 antibody on INa/Ca, ICa-Lat voltage-clamp mode and on DADs at current-clamp mode in single rat ventricular myocytes. Results 10 mg·L-1NCX-2D2 antibody significantly inhibited cardiac arrhythmias induced by ISO in vitro ( P<0.01) . 80 μg·kg-1NCX-2D2 anti-body markedly inhibit the occurrence of arrhythmias in ISO-induced anesthetized rats in vivo ( P <0.01 ) . 5 mg·L-1NCX-2D2 antibody partially inhibited the in-crease of INa/Ca(P<0.01) and the increase of ICa-L(P<0.01 ) , and could effectively inhibit ISO-induced DADs in rat ventricular myocytes ( P <0.05 ) . Con-clusions The sodium-calcium exchanger monoclonal antibody NCX-2D2 significantly inhibits isoproterenol-induced ventricular arrhythmias in rats. The mecha-nism against ventricular arrhythmias is mainly due to its inhibition of cardiomyocyte sodium-calcium exchanger and L-type calcium channel and marked suppression of DADs in rat ventricular myocytes.

11.
Journal of Medical Postgraduates ; (12): 653-656, 2018.
Article in Chinese | WPRIM | ID: wpr-700891

ABSTRACT

Epac acts as a guanine nucleotide exchange factor for the Raslike small G-proteins Rap1 and Rap2,which activates independently classical effector of cAMP,protein kinase A. Many studies have demonstrated that Epac modulates various cAMP-de-pendent cardiovascular functions,such as calcium handling and ion channel remodeling,which are involved in the development of ar-rhythmias and heart failure. The novel cAMP sensor may represent an attractive therapeutic target for the treatment of several cardiovas-cular disorders,including cardiac arrhythmias and heart failure,because themodulation of Epac function is expected to enable morespe-cific regulation of particular cAMP-mediated signals than therapies targeting β-AR and Acs.

12.
Article in English | WPRIM | ID: wpr-691382

ABSTRACT

<p><b>OBJECTIVE</b>To exam the effect and safety of conventional acupuncture (CA) on cardiac arrhythmia.</p><p><b>METHODS</b>Nine medical databases were searched until February 2016 for randomized controlled trials. Heterogeneity was measured by Cochran Q test. Meta-analysis was conducted if I was less than 85% and the characteristics of included trials were similar.</p><p><b>RESULTS</b>Nine qualified studies involving 638 patients were included. Only 1 study had definitely low risk of bias, while 7 trials were rated as unclear and 1 as high. Meta-analysis of CA alone did not have a significant benefit on response rate compared to amiodarone in patients with atrial fibrillation (Af) and atrial flutter (AF) [relative risk (RR): 1.09; 95% confidence interval (CI): 0.79-1.49; P=0.61; I=61%, P=0.11]. However, 1 study with higher methodological quality detected a lower recurrence rate of Af in CA alone as compared with sham acupuncture plus no treatment, and benefits on ventricular rate and time of conversion to normal sinus rhythm were found in CA alone group by 1 study, as well as the response rate in CA plus deslanoside group by another study. Meta-analysis of CA plus anti-arrhythmia drug (AAD) was associated with a significant benefit on the response rate when compared with AAD alone in ventricular premature beat (VPB) patients (RR, 1.19, 95% CI: 1.05-1.34; P=0.005; I=13%, P=0.32), and an improvement in quality-of-life score (QOLS) of VPB also showed in 1 individual study. Besides, a lower heart rate was detected in the CA alone group by 1 individual study when compared with no treatment in sinus tachycardia patients (MD-21.84 [-27.21,-16.47]) and lower adverse events of CA alone were reported than amiodarone.</p><p><b>CONCLUSIONS</b>CA may be a useful and safe alternative or additive approach to AADs for cardiac arrhythmia, especially in VPB and Af patients, which mainly based on a pooled estimate and result from 1 study with higher methodological quality. However, we could not reach a robust conclusion due to low quality of overall evidence.</p>


Subject(s)
Acupuncture Therapy , Arrhythmias, Cardiac , Therapeutics , Atrial Fibrillation , Therapeutics , Atrial Flutter , Therapeutics , Humans , Randomized Controlled Trials as Topic , Treatment Outcome , Ventricular Premature Complexes , Therapeutics
13.
Horiz. méd. (Impresa) ; 17(3): 24-28, jul. 2017. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-989919

ABSTRACT

Objetivo: Reportar la frecuencia de los efectos adversos a nivel cardiaco (cardiotoxicidad) producida por la quimioterapia en los pacientes del Instituto Nacional de Enfermedades Neoplásicas en el período 2012-2016. Materiales y métodos: El estudio realizado fue de tipo no experimental, descriptivo y retrospectivo. La población estudiada fueron los pacientes atendidos en el Servicio de Cardiología por presentar durante la quimioterapia molestias cardiovasculares. Resultados: Se realizaron 985 evaluaciones por sintomatología cardiaca de pacientes en tratamiento antineoplásico. Entre los efectos adversos a nivel del corazón de la terapia oncológica, las arritmias cardiacas fueron las más frecuentes (41,2%), en segundo lugar estuvieron los episodios de angina de pecho con un 18,7% y la insuficiencia cardiaca tuvo una frecuencia del 4,9%. La bradicardia sinusal ha sido la arritmia más usual (55,9%), seguida por la taquicardia sinusal sintomática (17,7%) y, en tercer lugar, la fibrilación auricular (12,0%). Conclusiones: La arritmia cardiaca fue el efecto adverso más frecuente del tratamiento oncológico, siendo la bradicardia sinusal asintomática la de mayor prevalencia


objective: To report the frequency of cardiac adverse effects (cardiotoxicity) induced by chemotherapy in patients of the Instituto Nacional de Enfermedades Neoplásicas during the period 2012-2016. Materials and methods: The study had a non-experimental, descriptive and retrospective design. The study population consisted of patients treated at the Cardiology Service due to cardiovascular discomfort during chemotherapy. Results: Nine hundred eighty-five (985) evaluations were performed because of cardiac symptoms in patients undergoing antineoplastic treatment. Among the oncological treatment-related cardiovascular adverse effects, cardiac arrhythmias were the most frequent ones (41.2%), episodes of angina pectoris were in the second place with 18.7%, and heart failure had a frequency of 4.9%. The most frequent arrhythmia was sinus bradycardia (55.9%), followed by symptomatic sinus tachycardia (17.7%) and, in the third place, atrial fibrillation (12.0%). Conclusions: Cardiac arrhythmia was the most frequent adverse effect induced by oncological treatment, with asymptomatic sinus bradycardia being the most prevalent one

14.
Article | IMSEAR | ID: sea-184582

ABSTRACT

Background and Objectives: Atrial fibrillation (AF) is a frequently encountered cardiac arrhythmia which may be either symptomatic or asymptomatic. So, this study was conducted to know clinical presentation and to find out possible clinical and etiological profile of patients with AF.Material and Methods: This cross sectional study was conducted at Osh Regional Integrated Clinical Hospital, Osh Territorial City Clinical Hospital, The Kyrgyz Republic in collaboration with Janaki Medical College Teaching Hospital, Janakpurdham, Nepal. Sixty consecutive patients with AF were taken. Presenting complaints, past history, personal history was recorded. A thorough clinical examination was done, electrocardiogram, chest X-Ray posterio-anterior view, echocardiogram, thyroid function test and relevant test were done and analyzed.Results: Forty percent of the patients complained palpitation. Systemic thrombo-embolism was found in 15% of the patients. Other presenting complaints were cough, chest pain, shortness of breath, dizziness, swelling of the legs, tremors. Eighteen percent of patients presented with features of congestive cardiac failure and 30% of the patients gave history of rheumatic heart disease, 16.6% and 11.6% hypertension and ischemic heart disease respectively. Etiology-wise, rheumatic heart disease was the most common (46.6%) followed by hypertension (21.6%), ischemic heart disease (11.6%), dilated cardiomyopathy (6.6%), hyperthyroidism (5%), pneumonia (5%).Conclusion: Rheumatic heart disease, especially mitral stenosis is the most common cause of AF in this study. Systemic hypertension was next common etiology of AF, followed by ischaemic heart disease, dilated cardiomyopathy, thyroid disease. Heart failure, Systemic thromboembolism, decreased exercise tolerance are a major determinants for development of significant morbidity and mortality.

15.
Chinese Pharmacological Bulletin ; (12): 934-941, 2017.
Article in Chinese | WPRIM | ID: wpr-620131

ABSTRACT

Aim To observe the effect of antibody NCX-3F10 on the main ion current of rat ventricular myocytes and its effect on arrhythmias induced by ischemia/reperfusion(I/R).Methods ① The whole-cell patch clamp technique was employed to record the Na+/Ca2+ exchange current(INa/Ca) and other major ion currents in rat ventricular myocytes.② The rat models of arrhythmia induced by ischemia/reperfusion were established by ligating the left coronary artery to in vivo and in vitro.Then the effects of antibody on the arrhythmia were observed.③ The IonOptix ion imaging system was used to observe the effect of antibody on calcium transients in single ventricular myocytes.Results ① The antibody NCX-3F10 dose-dependently inhibited INa/Ca from 5 to 40 mg·L-1.The IC50 for outward and inward currents was 11.15 and 11.69 mg·L-1, and the maximum inhibitory rates were 61% and 62%, respectively.The antibody also had an inhibitory effect on calcium current(ICa-L), and had no significant effect on inward rectifier potassium current(IK1), transient outward potassium current(Ito) and sodium current(INa).② In the isolated rat heart group I/R, 100% rats showed ventricular tachycardia, and 88.89% rats had ventricular fibrillation.After administration of antibody NCX-3F10(10 mg·L-1) 5 min before reperfusion, the incidence of ventricular tachycardia decreased to 44.43%(P<0.05), and the duration of ventricular tachycardia and ventricular fibrillation was also shortened remarkably(P<0.05).③ In the anesthetized rats after administration of antibody NCX-3F10(50 μg·kg-1) 5 min before reperfusion, the incidence and duration of ventricular tachycardia,the incidence and duration of ventricular fibrillation, and total number of ventricular premature beats were significantly decreased(P<0.05).④ From 5 to 40 mg·L-1, NCX-3F10 antibody decreased calcium transient amplitude in rat single ventricular myocytes dose-dependently(P<0.05).Conclusions The NCX-3F10 antibody shows significant arrhythmic effects on ischemia-reperfusion induced arrhythmia in rats both in vitro and in vivo, the underlying mechanism of which is related to NCX and L-type calcium current inhibition and calcium overload reduction by the NCX antibody.

16.
Biomedical Engineering Letters ; (4): 325-332, 2017.
Article in English | WPRIM | ID: wpr-654109

ABSTRACT

In this paper, we focus on classifying cardiac arrhythmias. The MIT-BIH database is used with 14 original classes of labeling which is then mapped into 5 more general classes, using the Association for the Advancement of Medical Instrumentation standard. Three types of features were selected with a focus on the time-frequency aspects of ECG signal. After using the Wigner-Ville distribution the time-frequency plane is split into 9 windows considering the frequency bandwidth and time duration of ECG segments and peaks. The summation over these windows are employed as pseudo-energy features in classification. The “subject-oriented” scheme is used in classification, meaning the train and test sets include samples from different subjects. The subject-oriented method avoids the possible overfitting issues and guaranties the authenticity of the classification. The overall sensitivity and positive predictivity of classification is 99.67 and 98.92%, respectively, which shows a significant improvement over previous studies.


Subject(s)
Arrhythmias, Cardiac , Classification , Decision Trees , Electrocardiography , Methods
17.
Article in English | WPRIM | ID: wpr-633447

ABSTRACT

BACKGROUND: Patients with acute ischemic stroke are susceptible  to  cardiac  arrhythmias  however,fatal arrhythmias  are  rare  in  the  absence  of  cardiac  disease.Cardiac arrhythmias can develop in lesions at the right side of the brain specifically the insular,frontal and parietal area.Data that show the direct relationship of ischemic stroke and arrhythmia are scarce but they are indirectly attributed to an imbalance in the autonomic nervous system.This paper aims to present a rare case of an association between a fatal arrhythmia and right thalamic infarct.   CASE: Presenting a case of a 39-year-old admitted as a survivor of sudden cardiac death from ventricular fibrillation.She presented with a history of left sided weakness a week prior but no work-up was done. Baseline serum electrolytes and  cardiac markers were all normal.Electrocardiogram (ECG) post-cardioversion showed sinus tachycardia.Echocardiogram   and cardiac computed tomography (CT) angiography were normal.  Magnetic resonance imaging (MRI) and angiography (MRA) of the brain showed an acute infarct at the right thalamus and an absent left internal carotid artery (ICA).Electroencephalogram (EEG) was negative.Bisoprolol was given and an Automatic Implantable Cardioverter Defibrillator (AICD) was subsequently placed.No recurrence of cardiac arrhythmia was noted on continuous cardiac telemetry monitoring during her hospitalization and on six months of follow-up.CONCLUSION: Fatal cardiac arrhythmias, can occur in patients with  acute  thalamic  infarct  even  beyond  24  hours  in  the presence of other confounding factors despite the absence of cardiac pathology. This case showed the association of heightened  autonomic  imbalance  caused  by  an  acute stroke, decreased cerebral flow, and fatal arrhythmia. This elucidates the importance of cardiac monitoring in acute ischemic stroke. With the paucity of information on serious cardiac arrhythmia and ischemic stroke, a future study on this correlation will be useful.


Subject(s)
Humans , Female , Adult , Bisoprolol , Tachycardia, Sinus , Ventricular Fibrillation , Carotid Artery, Internal , Defibrillators, Implantable , Electric Countershock , Arrhythmias, Cardiac , Electrocardiography , Death, Sudden, Cardiac , Heart Conduction System , Stroke , Thalamus , Brain , Autonomic Nervous System , Telemetry , Angiography , Hospitalization , Survivors , Electrolytes
18.
Article in Chinese | WPRIM | ID: wpr-669229

ABSTRACT

Syncope is a clinical symptom for many kinds of diseases.The reasons for some syncope are still not clear even after a comprehensive and systematic examination,known as unexplained syncope.The clinical data of one patient with recurrent syncope,who had received the implanted loop recorder (ILR) in Xiangya Hospital,Central South University,were retrospectively analyzed.The instrument recorded the first syncope at a time of recurrence for the sustained ventricular tachycardia in 704 days after ILR.The patient was thus diagnosed as arrhythmic syncope and received an operation with implantable cardioverter defibrillator.The ILR is a new type of examination device for patients suffering from syncope with suspected cardiac rhythm due to its long monitoring time,low infection rate and high safety.It possesses high clinical value in the diagnosis of patients with arrhythmic syncope.

19.
Res. Biomed. Eng. (Online) ; 32(1): 74-84, Jan.-Mar. 2016. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-829465

ABSTRACT

Abstract Introduction: Cardiomyocytes are more sensitive to stimulatory electrical fields when the latter are applied longitudinally to the cell major axis. In the whole heart, cells have different spatial orientations, which may limit the effectiveness of conventional electrical defibrillation (i.e., shock delivery in a single direction). This article describes the constructive aspects of a portable system for rapidly-switching, multidirectional stimulus delivery, composed of an electrical defibrillator and multielectrode-bearing paddles for direct cardiac defibrillation. Methods: The defibrillator delivers monophasic, truncated monoexponential waveforms with energy up to 7.3 J. Upon selection of the defibrillation modality (unidirectional or multidirectional), shock delivery is triggered through 1 or 3 outputs. In the latter case, triggering is sequentially switched to the outputs, without interval or temporal overlap. Each paddle contains 3 electrodes that define shock pathways spaced by 60°. The system was tested in vivo for reversal of experimentally-induced ventricular fibrillation in healthy swine, using 30- and 20-ms long shocks (N= 4 in each group). Results: The defibrillator delivers identical stimulus waveforms through all outputs in both stimulation modalities. In all animals, successful defibrillation required lower shock energy when 20 ms-long stimuli were applied in 3 directions, compared to a single direction. However, performance was poorer with multidirectional defibrillation for 30 ms-long shocks. Conclusion: The delivery of identical shock waveforms allowed confirmation that multidirectional defibrillation can promote restoration of sinus rhythm with lower shock energy, which may reduce myocardial electrical damage during defibrillation. Nevertheless, increase in shock duration greatly impairs the effectiveness of this defibrillation modality.

20.
Chinese Pharmacological Bulletin ; (12): 1127-1132,1133, 2016.
Article in Chinese | WPRIM | ID: wpr-604465

ABSTRACT

Aim To investigate the effect of zacopride ( Zac) on cardiac arrhythmia in isoproterenol ( ISO)-in-duced myocardial hypertrophic rats and the underlying electrophysiological mechanisms .Methods ① Fifty-one rats were randomly divided into control group ( n=17 ) , ISO group ( n=17 ) and ISO +Zac group ( n =17 ) .Rat model with cardiac arrhythmia and hypertro-phy was established by intraperitoneal ISO ( 5 mg?kg -1 ) injection.②ECGs were recorded to observe the effects of Zac on arrhythmia in model rats .③ Whole-cell patch clamp was applied to record inwardly rectifi-er potassium current(IK1), resting membrane potential ( RMP ) and amplicated delayed afterdepolarizations (DADs).Results ① Echocardiographic examination showed that , left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) significantly decreased in rats in ISO group compared with control group , whereas left ventricular posterior wall end-diastolic thickness ( LVPWd) and in-terventricular septum end-diastolic thickness ( IVSd ) increased ( P<0.05 ) , suggesting rat model of isoprot-erenol-induced myocardial hypertrophy was successfully established .② ECGs showed that 88.89% of rats in ISO group had ventricular premature beats ( VPBs ) , which significantly decreased to 11.11% after the ap-plication of Zac ( P <0.05 ) .③ Values of RMP de-creased from ( -71.05 ±1.27 ) mV in control group to (-69.38 ±1.21 ) mV in ISO group ( P<0.05 ) . After Zac administration , RMP significantly increased to ( -73.86 ±1.33 ) mV compared with control and ISO group(P<0.05).④DADs and TA incidence sig-nificantly decreased from 88.24% in ISO group to 11.76%in ISO+Zac group ( P<0.05 ) .⑤ Compared with control group , IK1 density was markedly reduced in ISO group, whereas Zac could effectively rescue IK1 suppression to normal level .Conclusions Zac, as a selective IK1 channel agonist , can significantly inhibit cardiac arrhythmia in isoproterenol-induced myocardial hypertrophic rats , which is mainly attributed to in-creased RMP by enhancing IK1 and subsequent suppres-sion of DADs.

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