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1.
Enferm. foco (Brasília) ; 15: 1-7, maio. 2024.
Article in Portuguese | LILACS, BDENF | ID: biblio-1579248

ABSTRACT

Objetivo: Analisar o conhecimento de enfermeiros sobre bradiarritmias e seus cuidados aos pacientes atendidos na porta de entrada de um hospital, abordando questões sobre habilidades, compreensão e experiência e descrever o perfil destes profissionais. Métodos: Trata-se de uma pesquisa qualitativa descritiva, realizada em um hospital no norte do Estado do Rio Grande do Sul, com 13 enfermeiros do setor de emergência, através de entrevistas semiestruturadas, as quais foram gravadas e submetidas à análise temática de conteúdo. Resultados: Constataram-se dificuldades no atendimento aos pacientes que necessitam de condutas rápidas, no entanto, os profissionais identificam as principais alterações e possuem habilidades para realizar o cuidado. Conclusão: Os enfermeiros têm conhecimento sobre as bradiarritmias, possuem experiência e habilidades que adquirem ao longo de sua atuação, mesmo enfrentando dificuldades técnicas e estruturais, desenvolvem assistência de maneira pertinente. Considera-se importante aprimorar os conhecimentos sobre as bradiarritmias, contribuindo para a melhoria da qualidade da assistência. (AU)


Objective: Analyzing the knowledge of nurses about bradyarrhythmias and their care to patients treated at the entrance of a hospital, addressing questions about skills, understanding and experience and describing the profile of these professionals. Methods: This is a descriptive qualitative research, conducted in a hospital in the north of the State of Rio Grande do Sul, with 13 nurses from the emergency department, through semi-structured interviews, which were recorded and submitted to thematic content analysis. Results: There were difficulties in the care of patients who need rapid conduct; however, the professionals identify the main changes and have the skills to perform care. Conclusion: Nurses have knowledge about bradyarrhythmias, have experience and skills that they acquire throughout their performance, even facing technical and structural difficulties, develop care in a pertinent way. It is considered important to improve the knowledge about bradyarrhythmias, contributing to the improvement of the quality of care. (AU)


Objetivo: Analizar el conocimiento de las enfermeras sobre las bradiarritmias y su atención a los pacientes tratados en la entrada de un hospital, abordando preguntas sobre habilidades, comprensión y experiencia y describiendo el perfil de estos profesionales. Métodos: Se trata de una investigación cualitativa descriptiva realizada en un hospital del norte del Estado de Rio Grande do Sul, con 13 enfermeras del servicio de urgencias, a través de entrevistas semiestructuradas, que fueron grabadas y sometidas a análisis de contenido temático. Resultados: Hubo dificultades en la atención de los pacientes que necesitan una conducta rápida, sin embargo, los profesionales identifican los principales cambios y tienen las habilidades para realizar la atención. Conclusión: Las enfermeras tienen conocimientos sobre bradiarritmias, tienen experiencia y habilidades que adquieren a lo largo de su desempeño, incluso enfrentando dificultades técnicas y estructurales, desarrollan el cuidado de manera pertinente. Se considera importante mejorar el conocimiento sobre las bradiarritmias, contribuyendo a la mejora de la calidad de la atención. (AU)


Subject(s)
Bradycardia , Arrhythmias, Cardiac , Nursing , Emergency Nursing , Nursing Care
2.
In. Taranto, Eliseo; Nuñez, Edgardo. Esenciales en emergencia y trauma. Montevideo, Bibliomédica, 2024. p.45-76, ilus, tab.
Monography in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1567365
3.
Rev. urug. cardiol ; 39(1): e302, 2024. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1576753

ABSTRACT

El embarazo se asocia con un mayor riesgo de arritmias y las pacientes con antecedentes de arritmias tienen un riesgo significativo de recurrencia durante el embarazo. Esta revisión analiza el diagnóstico y tratamiento de las arritmias más frecuentes durante el embarazo y algunas situaciones especiales. Debido a los potenciales riesgos para la madre y para la salud fetal, se necesita un enfoque multidisciplinario e integrador para el manejo de las arritmias desde el período preparto hasta el posparto.


Pregnancy is associated with an increased risk of arrhythmias, and patients with a history of arrhythmias have a significant risk of recurrence during pregnancy. This review analyzes the diagnosis and treatment of the most common arrhythmias during pregnancy and some special situations. Due to the potential risks to maternal and fetal health, a multidisciplinary and integrative approach is needed for the management of arrhythmias from the prepartum to the postpartum period.


A gravidez está associada a um risco acrescido de arritmias, as mulheres com um historial de arritmias apresentam um risco significativo de recorrência na gravidez. Esta revisão analisa o diagnóstico e o tratamento das arritmias mais comuns na gravidez e ainda algumas situações especiais. Devido aos riscos potenciais para a mãe e para a saúde do feto é necessária uma abordagem multidisciplinar e integrada para o tratamento das arritmias desde o período anteparto até ao pós-parto.


Subject(s)
Humans , Female , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/therapy , Pregnancy Complications , Parturition , Postpartum Period
4.
ABC., imagem cardiovasc ; 37(3): e20240013, jul.-set. 2024. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1585654

ABSTRACT

Introdução: Foram identificados preditores de arritmias e morte cardíaca súbita em pacientes com cardiomiopatia hipertrófica (CMH). No entanto, não foram validados após ablação septal alcoólica (ASA), uma vez que há uma escassez de dados sobre a predição da ocorrência de arritmia após o procedimento. Objetivos: Analisar retrospectivamente pacientes submetidos à ASA e determinar os preditores de arritmia ventricular pós-operatória. Pacientes e Metodologia: Um total de 53 pacientes consecutivos com CMH, submetidos ao procedimento de ASA devido à obstrução sintomática da via de saída do ventrículo esquerdo (VSVE), foram inscritos retrospectivamente, apesar do tratamento médico tolerado ao máximo entre janeiro de 2010 e dezembro de 2022. Um valor de p < 0,05 foi considerado estatisticamente significativo. Resultados: A idade média dos pacientes foi de 56,45 anos e 55% eram do sexo masculino. Os pacientes foram submetidos à ASA bem-sucedida, com uma média de 1,76 cc de álcool sendo usada. Uma redução de 70,81% foi obtida nos gradientes da VSVE. Nenhum gradiente patológico da VSVE foi observado em nenhum paciente após o procedimento. Durante o acompanhamento pós-procedimento, o bloqueio atrioventricular total foi detectado em 12 pacientes e o implante de cardioversor desfibrilador implantável (CDI) foi realizado nesses pacientes. Quando pacientes com arritmias ventriculares pós ASA bem-sucedida foram comparados com um grupo sem procedimento, o escore de risco de cardiomiopatia hipertrófica de morte cardíaca súbita (HCMSCD) pré-operatório > 6 e a espessura da parede inferolateral do ventrículo esquerdo pré-operatória foram estatisticamente diferentes entre os dois grupos (p: 0,049, p: 0,006, respectivamente). Quando a regressão multilogística foi realizada, a espessura da parede inferolateral do ventrículo esquerdo basal > 15,5 mm foi considerada um fator de risco independente para arritmia ventricular pós ASA (p: 0,027). I O O Conclusões: A espessura da parede inferolateral do ventrículo esquerdo é um preditor independente de arritmia ventricular após ASA, podendo ser usada no acompanhamento pós-procedimento do paciente e na tomada de decisão para implantação do CDI. (AU)


Introduction: Predictors of arrhythmias and sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM) have been identified. However, they have not been validated after alcohol septal ablation (ASA). Data to predict the occurrence of arrhythmia after the procedure are not certain. Objectives: To retrospectively analyze patients who underwent ASA and to determine the predictors of post-op ventricular arrhythmia. Patients and Methods: We retrospectively enrolled 53 consecutive patients with HCM who underwent ASA procedure due to symptomatic left ventricular outflow tract (LVOT) obstruction despite maximally tolerated medical treatment between January 2010 and December 2022. P < 0.05 was considered statistically significant. Results: The mean age of the patients was 56.45 years, and 55% were male. Patients underwent successful ASA, and an average of 1.76 cc of alcohol was used. A 70.81% reduction in LVOT gradients was achieved. No pathological LVOT gradient was observed in any patient after the procedure. In the postprocedural follow-up, total atrioventricular block was detected in 12 patients and implantable cardiac defibrillator (ICD) implantation was performed in these patients. When patients with ventricular arrhythmias after successful ASA were compared with those without it, preoperative hypertrophic cardiomyopathy risk of sudden cardiac death (HCMSCD) Score > 6 and left ventricular inferolateral wall thickness were statistically different between the two groups (p: 0.049, p: 0.006, respectively). When multi-logistic regression was performed, basal left ventricular inferolateral wall thickness > 15.5 mm was found to be an independent risk factor for ventricular arrhythmia after ASA (p: 0.027). Conclusions: Left ventricular inferolateral wall thickness is an independent predictor of ventricular arrhythmia after ASA. It can be used in postprocedural patient follow-up and ICD decision-making. (AU)


Subject(s)
Humans , Male , Middle Aged , Arrhythmias, Cardiac/prevention & control , Cardiomyopathy, Hypertrophic/diagnosis , Cardiomyopathy, Hypertrophic/physiopathology , Cardiomyopathy, Hypertrophic/mortality , Defibrillators, Implantable/adverse effects , Ablation Techniques/methods , Heart Ventricles/anatomy & histology , Heart Ventricles/surgery
5.
Rev. cuba. med ; 62(3)sept. 2023.
Article in Spanish | LILACS, CUMED | ID: biblio-1530140

ABSTRACT

Introducción: Las evidencias científicas han demostrado que durante el período pandémico por la COVID-19 ha existido un incremento de la incidencia de muerte súbita cardiovascular, proporcional al incremento de los casos y a la letalidad por la enfermedad. Objetivos: Compilar información sobre los fármacos empleados en el tratamiento de la COVID-19 y sus posibles efectos en la prolongación del intervalo QT y la aparición de muerte súbita. Métodos: Se realizó una búsqueda de información a partir de las bases de datos PubMed, Medline y SciELO, en los idiomas español e inglés en el período de enero de 2020 a enero de 2023. Resultados: Los hallazgos más recientes sugieren que los factores relacionados con el tratamiento médico del paciente para sus enfermedades cardiovasculares previas, el empleo concomitante de drogas para otras comorbilidades, el ensayo de nuevas drogas que se investigan en la actualidad para el tratamiento de la enfermedad y el uso inadecuado de fármacos en complicaciones graves por la COVID-19, pueden ocasionar prolongación del intervalo QT y arritmias ventriculares tipo torsades de pointes, lo que puede conllevar a la aparición de muerte súbita. Conclusiones: Ha sido demostrado el efecto deletéreo de los fármacos en el tratamiento de la COVID-19 y sus posibles asociaciones a la terapéutica del paciente, en la prolongación del tiempo de repolarización ventricular cardíaca, cuya traducción eléctrica es un intervalo QT prolongado y su contribución a la génesis de arritmias malignas potencialmente fatales capaces de desencadenar un paro cardíaco y evolucionar a la muerte súbita(AU)


Scientific evidence has shown an increase in the incidence of sudden cardiovascular death during the COVID-19 pandemic period. This has been proportional to the increase in cases and mortality from the disease. Direct and indirect injury to the myocardium and vascular system allow to partially explain the statistics. Among the factors related to the medical treatment of the patient for previous cardiovascular diseases, it is the concomitant use of drugs for other comorbidities. The trial of new drugs for the treatment of this condition and the inappropriate use of drugs in serious complications from COVID-19 are currently being investigated. These can cause QT prolongation and torsades de pointes ventricular arrhythmias, which can lead to sudden death. Monitoring the QT interval is recommended, before and during treatment, in patients who come to the emergency room with a clinical condition suggestive of COVID-19. Additionally, modifiable factors favoring its prolongation should be evaluated. Decision-making in the application of therapeutic protocols in patients with COVID-19 with prolonged QTc at baseline, or with increased QTc after starting treatment, must go through the analysis of the risk/benefit ratio defined by a multi- and interdisciplinary team(AU)


Subject(s)
Humans , Male , Female , Arrhythmias, Cardiac , Long QT Syndrome , Death, Sudden, Cardiac/epidemiology , Drug-Related Side Effects and Adverse Reactions , COVID-19/epidemiology
6.
Front. med. (En línea) ; 18(3): 0155-0162, jul-sep. 2023.
Article in Spanish | LILACS | ID: biblio-1572248

ABSTRACT

Introducción. La fibrilación auricular (FA) es la arritmia más común del adulto. Su desarrollo y recurrencia ha sido vinculado con la apnea obstructiva del sueño (AOS). El objetivo fue identificar predictores de AOS moderada-severa (índice apnea hipopnea [IAH] ≥15 ev/h) en pacientes con FA. Materiales y métodos. Estudio retrospectivo en un centro de arritmias, correlacionando datos antropométricos, cuestionarios Berlín (BQ), STOP-BANG y de Epworth, laboratorio e índices ecocardiográficos. Resultados. Se incluyeron 82 pacientes (edad 65.7±12.0 años, 69.5% varones). La prevalencia de IAH ≥15 ev/h fue 54.8% (indicación de CPAP en 50%). Comparando los grupos con IAH <15 ev/h vs. ≥15 ev/h se observaron diferencias en la frecuencia cardíaca basal (lpm): 67.1±11.8 vs. 75.9±13.9 (p=0.003); intervalo PA-TDI: 117.6±19.6 vs. 135.5±19.7 (p=0.03); volumen indexado auricular izquierdo (VIAI) (ml/m2): 36.9±9.7 vs. 46.2±24.4 (p=0.03); creatinina sérica (p=0.003); NT-proBNP (p=0.016) y BQ (p<0.008). La severidad de la AOS tuvo asociación con el número de componentes del BQ: ≥4 obtuvo una S: 55%, Sp: 78.4%, AUC-ROC: 0.65 (p=0.015) y del VIAI una S: 82.9%, Sp: 51.3%, AUCROC: 0.69 (p=0.002). Por regresión logística se identificaron como predictores: ronquidos, circunferencia del cuello y BQ. Conclusiones. Los pacientes con FA tienen alta prevalencia de AOS. El ronquido, la circunferencia de cuello aumentada y BQ predijeron AOS de relevancia cardiovascular


Subject(s)
Atrial Fibrillation , Sleep Apnea, Obstructive , Apnea , Arrhythmias, Cardiac
7.
Int. j. morphol ; 41(4): 1027-1035, ago. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1514338

ABSTRACT

SUMMARY: Diabetic cardiomyopathy, characterized by diabetes mellitus (DM) -induced cardiac muscular abnormalities, is a strong inducer of impaired cardiac contraction and arrhythmia. Atrioventricular block, a serious type of arrhythmia resulting from interruption of cardiac impulse conduction via the atrioventricular node (AVN), frequently occurs among diabetic patients. However, details of structural changes in AVN in DM remain poorly explained. Here, this study defined the effects of DM on the morphological remodeling of the AVN in male Sprague Dawley rats induced by intraperitoneal injection of streptozotocin (60 mg/kg body weight). At 24 weeks, the pathological changes in the AVN were assessed by light microscopy (LM) and transmission electron microscopy (TEM). Under LM, the AVN in diabetic rats became a less compact mass and exhibited the intracellular vacuolation. The nodal cells were more varied in sizes with the absence or shrinkage of nuclei and clear cytoplasm compared to the control. The collagen content significantly increased in relation to the presence of myofibroblasts. Consistent with LM, TEM images of the diabetic nodal cells revealed several signs of cell damage, such as mitochondrial changes, deterioration of cell organelles, gap junction internalization, and cell separation. Furthermore, changes in AVN innervation, evidenced by damaged Schwann cells and axons, were also found. These results indicated alterations in important components in the AVN during diabetic condition, which may lead to the impairment of electrical conduction, causing abnormal cardiac functions in diabetic patients.


La miocardiopatía diabética, caracterizada por anomalías musculares cardíacas inducidas por diabetes mellitus (DM), es un fuerte inductor de alteración de la contracción cardíaca y arritmia. El bloqueo atrioventricular, un tipo grave de arritmia resultante de la interrupción de la conducción del impulso cardíaco a través del nodo atrioventricular (NAV), se produce con frecuencia entre los pacientes diabéticos. Sin embargo, los detalles de los cambios estructurales en NAV en DM siguen estando pobremente explicados. Aquí, este estudio definió los efectos de la DM en la remodelación morfológica del NAV en ratas macho Sprague Dawley inducidas por inyección intraperitoneal de estreptozotocina (60 mg/kg de peso corporal). A las 24 semanas, los cambios patológicos en el NAV se evaluaron mediante microscopía óptica (MO) y microscopía electrónica de transmisión (MET). Bajo MO, el NAV en ratas diabéticas se convirtió en una masa menos compacta y exhibió la vacuolización intracelular. Las células nodales tenían tamaños más variados con ausencia o contracción de núcleos y citoplasma claro en comparación con el control. El contenido de colágeno aumentó significativamente en relación con la presencia de miofibroblastos. De acuerdo con MO, las imágenes MET de las células nodales diabéticas revelaron varios signos de daño celular, como cambios mitocondriales, deterioro de los orgánulos celulares, internalización de uniones comunicantes y separación celular. Además, también se encontraron cambios en la inervación del NAV, evidenciados por schwannocitos y axones dañados. Estos resultados indicaron alteraciones en componentes importantes en el NAV durante la condición diabética, lo que puede conducir al deterioro de la conducción eléctrica, causando funciones cardíacas anormales en estos pacientes.


Subject(s)
Animals , Male , Rats , Arrhythmias, Cardiac , Atrioventricular Node/pathology , Diabetes Mellitus, Experimental , Rats, Sprague-Dawley , Microscopy, Electron, Transmission
8.
Rev. chil. cardiol ; 42(2): 113-118, ago. 2023. ilus
Article in Spanish | LILACS | ID: biblio-1515093

ABSTRACT

Se presenta el caso de una mujer joven con arritmia ventricular compleja, disyunción anular mitral y QT largo. Se muestran los aspectos más relevantes de su presentación clínica, estudio, tratamiento y evolución. Se acompaña una revisión de la literatura.


We present the case of a young woman with complex ventricular arrhythmia, mitral annular disjunction and long QT. The most relevant aspects of its clinical presentation, study, treatment and evolution are shown. A review of the literature is included.


Subject(s)
Humans , Female , Adult , Arrhythmias, Cardiac/therapy , Radiofrequency Ablation/methods , Mitral Valve/abnormalities , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/etiology , Adrenergic beta-Antagonists/therapeutic use
9.
Nursing (Ed. bras., Impr.) ; 26(300): 9625-9632, ju.2023. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1444206

ABSTRACT

Objetivo: relatar a elaboração de um algoritmo para facilitar a interpretação rápida das principais arritmias cardíacas no eletrocardiograma. Método: estudo descritivo, exploratório, com abordagem qualitativa, do tipo relato de experiência, realizado mediante um projeto de intervenção em educação em saúde durante o ano de 2021. Resultados: a elaboração do algoritmo denominado Scaritmo contribuiu para sistematizar as etapas de identificação de arritmias cardíacas, favorecendo o processo didático e aprendizado dos estudantes e otimizando a interpretação rápida do eletrocardiograma. Conclusão: o uso do algoritmo Scaritmo permite a sistematização teórico-prática das etapas necessárias para a interpretação do eletrocardiograma tornando sua avaliação mais didática e assertiva pelo examinador em treinamento.(AU)


Objective: to report the development of an algorithm to facilitate the rapid interpretation of the main cardiac arrhythmias in electrocardiogram. Method: a descriptive, exploratory study with qualitative approach, of experience report type, conducted through an intervention project in health education during the year 2021. Results: The development of the algorithm called Scaritmo contributed to systematize the steps of cardiac arrhythmia identification, favoring the didactic process and student learning, and optimizing the rapid interpretation of the electrocardiogram. Conclusion: The use of the Scaritm algorithm allows the theoretical and practical systematization of the steps necessary for the interpretation of electrocardiograms, making its evaluation more didactic and assertive by the examiner in training.(AU)


Objetivo: relatar el desarrollo de un algoritmo para facilitar la interpretación rápida de las principales arritmias cardíacas en electrocardiograma. Método: estudio descriptivo, exploratorio, con abordaje cualitativo, de tipo relato de experiencia, realizado a través de un proyecto de intervención en educación para la salud durante el año 2021. Resultados: el desarrollo del algoritmo denominado Scaritmo contribuyó para sistematizar los pasos de identificación de arritmias cardíacas, favoreciendo el proceso didáctico y el aprendizaje de los alumnos y optimizando la rápida interpretación del electrocardiograma. Conclusión: El uso del algoritmo Scaritmo permite la sistematización teórica y práctica de los pasos necesarios para la interpretación del electrocardiograma, tornando su evaluación más didáctica y asertiva por el examinador en formación.(AU)


Subject(s)
Arrhythmias, Cardiac , Health Education , Electrocardiography
11.
Rev. chil. cardiol ; 42(1): 59-64, abr. 2023. ilus
Article in Spanish | LILACS | ID: biblio-1441378

ABSTRACT

Presentamos el caso de un paciente quien presentó un evento presincopal en el que destacan 3 patologías asociadas a muerte súbita de forma independiente: miocardiopatía hipertrófica, origen anómalo coronario y enfermedad arterial coronaria epicárdica; diagnósticos coexistentes. Se describe las patologías, diagnóstico, manejo médico y terapéutico y se revisa la literatura.


A patient presented with a presyncopal event. Three conditions independently associated with sudden death, hypertrophic cardiomyopathy, anomalous origin of coronary arteries and epicardial coronary artery disease were found. Diagnosis, and medical management are described, followed by a review of the literature.


Subject(s)
Humans , Male , Aged , Arrhythmias, Cardiac/complications , Cardiomyopathy, Hypertrophic/complications , Atherosclerosis/complications , Cardiomyopathy, Hypertrophic/diagnostic imaging , Magnetic Resonance Imaging , Echocardiography , Coronary Vessel Anomalies , Coronary Vessel Anomalies/diagnostic imaging , Atherosclerosis/diagnostic imaging
12.
Zhonghua xinxueguanbing zazhi ; (12): 977-983, 2023.
Article in Chinese | WPRIM | ID: wpr-1045725

ABSTRACT

Objective: To investigate the impact of COVID-19 on treatment of patients with acute ST segment elevation myocardial infarction(STEMI) undergoing primary percutaneous coronary intervention(PPCI). Methods: This was a multicenter retrospective study. STEMI patients undergoing PPCI from January 1, 2019 to December 31, 2021 were selected, based on the data of Xinnaolvsetongdao App. Clinical data and treatment time indicators, including symptom to first medical contact (S-FMC), symptom to door (StoD), first medical contact to ECG (FMC-ECG), first medical contact to guide wire (FMC-W), door to balloon (DtoB) and total ischemic time in 2019, 2020 and 2021 were compared. STEMI patients aged<60 years were sub-grouped as the young and middle-aged group, and STEMI patients aged≥60 years were sub-grouped as the elderly group. Results: A total of 7 435 (3 305 in 2019, 1 796 in 2020 and 2 334 in 2021) STEMI patients aged (59.6±12.6) years undergoing PPCI were included in this analysis. There were 5 990 males. For STEMI patients with PPCI in 2019, 2020 and 2021, FMC-ECG was 3 (1, 5) min, 3(1, 7) min and 4 (1, 7) min. FMC-W was 73 (56, 87) min, 78 (62, 95) min and 77 (62, 87) min. DtoB was 73 (56, 85) min, 78 (62, 95) min and 77 (62, 86) min. Total ischemic time was 189 (130, 273) min, 196 (138, 295) min and 209 (143, 276) min. FMC-ECG, FMC-W, DtoB and total ischemic time were longer in 2020 and 2021 than in 2019 (all P<0.05). The proportions of patients with FMC-ECG≤10 min (88.4% (1 588/1 796) vs. 92.7% (3 064/3 305), P<0.05), FMC-W≤120 min (87.9% (1 579/1796) vs. 91.7% (3 030/3 305), P<0.05) and DtoB≤90 min (72.3% (1 298/1 796) vs. 80.8% (2 672/3 305), P<0.05) were lower in 2020 than in 2019, whereas no differences were observed in the proportions of patients with FMC-ECG≤10 min (91.3% (2 131/2 334) vs. 92.7% (3 064/3 305), P=0.054), FMC-W≤120 min (92.0% (2 148/2 334) vs. 91.7% (3 030/3 305), P=0.635) and DtoB≤90 min (80.0% (1 867/2 334) vs. 80.8% (2 672/3 305), P=0.424) in 2021 compared with 2019. In the subgroup analysis, the proportions of patients with FMC-ECG≤10 min, FMC-W≤120 min and DtoB≤90 min were lower in the elderly group than in young and middle-aged group in 2019 (all P<0.05). The proportions of patients with FMC-W≤120 min and DtoB≤90 min were lower in the elderly group than in young and middle-aged group in 2021(all P<0.05). No differences were observed in the proportions of patients with FMC-ECG≤10 min, FMC-W≤120 min and DtoB≤90 min between the two group in 2020 (all P>0.05). Conclusions: Affected by the COVID-19, there is a reduction in the number of PPCI cases and treatment delays in STEMI patients, especially in the elderly. After adjusting the treatment strategy and widely applying the Xinnaolvsetongdao APP, the above indicators are significantly improved in 2021 as compared with 2020.


Subject(s)
Aged , Male , Middle Aged , Humans , ST Elevation Myocardial Infarction , Beijing , COVID-19 , Retrospective Studies , Anterior Wall Myocardial Infarction , Arrhythmias, Cardiac , Percutaneous Coronary Intervention
13.
Article in Chinese | WPRIM | ID: wpr-1009196

ABSTRACT

OBJECTIVE@#To explore incidence, risk factors and the relationship between preoperative heart failure and prognosis in elderly patients with hip fracture.@*METHODS@#A retrospective analysis was performed on 1 569 elderly patients with hip fracture treated from January 2012 to December 2019, including 522 males and 1 047 females, aged 81.00 (75.00, 90.00) years old;896 intertrochanteric fractures and 673 femoral neck fractures. Patients were divided into heart failure and non-heart failure groups according to whether they developed heart failure before surgery, and heart failure was set as the dependent variable, with independent variables including age, gender, fracture type, comorbidities and hematological indicators, etc. Univariate analysis was performed at first, and independent variables with statistical differences were included in multivariate Logistic regression analysis. Independent risk factors for preoperative heart failure were obtained. The length of hospital stay, perioperative complications, mortality at 30 days and 1 year after surgery were compared between heart failure and non-heart failure groups.@*RESULTS@#There were 91 patients in heart failure group, including 40 males and 51 females, aged 82.00 (79.00, 87.00) years old;55 patients with intertrochanteric fracture and 36 patients with femoral neck fracture. There were 1 478 patients in non-heart failure groups, including 482 males and 996 females, aged 81.00(75.00, 86.00) years old;841 patients with intertrochanteric fracture and 637 patients with femoral neck fracture. There were significant differences in age, sex, coronary heart disease, arrhythmia and dementia between two groups(P<0.05). Multivariate Logistic analysis of statistically significant factors showed that males(OR=1.609, P=0.032), age(OR=1.032, P=0.031), arrhythmia(OR=2.045, P=0.006), dementia (OR=2.106, P=0.014) were independent risk factor for preoperative heart failure. The 30-day and 1-year mortality rates were 9.9% and 26.4% in heart failure group and 3.6% and 13.8% in non-heart failure group, respectively;and had statistical significance between two groups (P<0.05). There were significant differences in pulmonary infection, cerebrovascular complications and cardiovascular complications between two groups (P<0.05). The duration of hospitalization in heart failure group was (16.21±10.64) d compared with that in non-heart failure group (13.26±8.00) d, and the difference was statistically significant (t=2.513, P=0.012).@*CONCLUSION@#Male, old age, arrhythmia and dementia are independent risk factors for heart failure after hip fracture in elderly patients. Patients with preoperative heart failure have a higher incidence of postoperative pulmonary infection, cerebrovascular and cardiovascular complications, higher mortality at 30 d and 1 year after surgery, and longer hospital stay.


Subject(s)
Aged , Female , Humans , Male , Aged, 80 and over , Retrospective Studies , Hip Fractures/surgery , Femoral Neck Fractures , Heart Failure/etiology , Prognosis , Heart Diseases , Risk Factors , Postoperative Complications/etiology , Dementia , Arrhythmias, Cardiac
14.
Article in Chinese | WPRIM | ID: wpr-1009197

ABSTRACT

OBJECTIVE@#To investigate risk factors of acute cerebrovascular events and effects on the prognosis within 1 year after hip fracture surgery.@*METHODS@#A retrospective analysis was performed on 320 elderly patients with hip fracture treated from July 2017 to December 2020, including 111 males and 209 females, aged from 60 to 101 years old with an average of (79.05±8.48) years old. According to whether acute cerebrovascular events occurred within 1 year after surgery, patients were divided into cerebrovascular events and non-cerebrovascular events group. Clinical data of patients were collected, including age, sex, comorbidities, fracture type, white blood cell count, hemoglobin, albumin, activities of daily living (ADL) score, walking ability, type of anesthesia, type of surgery, and length of hospital stay, Univariate analysis and multivariate Logistic regression were used to analyze the independent risk factors of acute cerebrovascular events within 1 year after hip fracture in elderly patients. ADL, walking ability and mortality were compared between the two groups 1 year after surgery.@*RESULTS@#Acute cerebrovascular events occurred in 38 patients (11.9%) within 1 year after surgery. In the cerebrovascular events group, there were 20 males and 18 females, aged (82.53±7.91) years. In the non-cerebrovascular event group, there were 91 males and 191 females, aged with an average of (78.59±8.46) years old . Univariate analysis showed that acute cerebrovascular events were associated with age (t=2.712, P=0.007), male (χ2=6.129, P=0.013), hypertension (χ2=8.449, P=0.004), arrhythmia (χ2=6.360, P=0.012), stroke history (χ2=34.887, P=0.000), diabetes mellitus (χ2=4.574, P=0.032) and length of hospital stay (t=2.249, P=0.025) were closely related. Multivariate Logistic regression analysis showed age (OR=1.068, P=0.018), male (OR=2.875, P=0.008), arrhythmia (OR=2.722, P=0.017) and stroke history (OR=7.382, P=0.000) was an independent risk factor for acute cerebrovascular events 1 year after surgery. The patients with cerebrovascular events died at 1 year after surgery (11 cases) compared with those without cerebrovascular events (41 cases), and the difference was statistically significant(χ2=5.108, P=0.024). ADL scores of patients with cerebrovascular events at 1 year after operation were (58.70±14.45) points compared with those without cerebrovascular events (67.83±10.45) points, and the difference was statistically significant(t=4.122, P=0.000). Independent walking, assisted walking and bed rest were 3, 17 and 7 cases in cerebrovascular event group, and 54, 174 and 13 cases in non-cerebrovascular event group, respectively;and the difference was statistically significant(χ2=11.030, P=0.003).@*CONCLUSION@#Acute cerebrovascular events were common in elderly patients 1 year after hip fracture. Age, male, arrhythmia and stroke history were independent risk factors for acute stroke. The patients in the cerebrovascular event group had higher mortality and worse self-care ability and walking ability one year after operation.


Subject(s)
Female , Humans , Male , Aged , Middle Aged , Aged, 80 and over , Retrospective Studies , Activities of Daily Living , Hip Fractures , Risk Factors , Prognosis , Stroke , Arrhythmias, Cardiac
15.
Zhongguo Yi Liao Qi Xie Za Zhi ; (6): 602-607, 2023.
Article in Chinese | WPRIM | ID: wpr-1010247

ABSTRACT

OBJECTIVE@#Reduce the number of false alarms and measurement time caused by movement interference by the sync waveform of the movement.@*METHODS@#Vital signal monitoring system based on motion sensor was developed, which collected and processed the vital signals continuously, optimized the features and results of vital signals and transmitted the vital signal results and alarms to the interface.@*RESULTS@#The system was tested in many departments, such as digestive department, cardiology department, internal medicine department, hepatobiliary surgery department and emergency department, and the total collection time was 1 940 h. The number of false electrocardiograph (ECG) alarms decreased by 82.8%, and the proportion of correct alarms increased by 28%. The average measurement time of non-invasive blood pressure (NIBP) decreased by 16.1 s. The total number of false respiratory rate measurement decreased by 71.9%.@*CONCLUSIONS@#False alarms and measurement failures can be avoided by the vital signal monitoring system based on accelerometer to reduce the alarm fatigue in clinic.


Subject(s)
Humans , Monitoring, Physiologic , Electrocardiography , Arrhythmias, Cardiac , Blood Pressure , Accelerometry , Clinical Alarms
16.
Zhongguo Yi Liao Qi Xie Za Zhi ; (6): 617-623, 2023.
Article in Chinese | WPRIM | ID: wpr-1010250

ABSTRACT

In view of the high incidence of malignant diseases such as malignant arrhythmias in the elderly population, accidental injuries such as falls, and the problem of no witnesses when danger occurs, the study developed a human vital signs and body posture monitoring and positioning alarm system. Through the collection and analysis of electrocardiogram (ECG), respiration (RESP) and acceleration (ACC) signals, the system monitors human vital signs and body posture in real time, automatically judges critical states such as malignant arrhythmias and accidental falls on the local device side, and then issues alarm information, opens the positioning function, and uploads physiological information and patient location information through 4G communication. Experiments have shown that the system can accurately determine the occurrence of ventricular fibrillation and falls, and issue position and alarm information.


Subject(s)
Humans , Aged , Arrhythmias, Cardiac/diagnosis , Ventricular Fibrillation , Electrocardiography , Accidental Falls , Vital Signs , Posture , Monitoring, Physiologic
17.
Chin. med. j ; Chin. med. j;(24): 1349-1357, 2023.
Article in English | WPRIM | ID: wpr-980848

ABSTRACT

BACKGROUND@#Dysfunction of the gap junction channel protein connexin 43 (Cx43) contributes to myocardial ischemia/reperfusion (I/R)-induced ventricular arrhythmias. Cx43 can be regulated by small ubiquitin-like modifier (SUMO) modification. Protein inhibitor of activated STAT Y (PIASy) is an E3 SUMO ligase for its target proteins. However, whether Cx43 is a target protein of PIASy and whether Cx43 SUMOylation plays a role in I/R-induced arrhythmias are largely unknown.@*METHODS@#Male Sprague-Dawley rats were infected with PIASy short hairpin ribonucleic acid (shRNA) using recombinant adeno-associated virus subtype 9 (rAAV9). Two weeks later, the rats were subjected to 45 min of left coronary artery occlusion followed by 2 h reperfusion. Electrocardiogram was recorded to assess arrhythmias. Rat ventricular tissues were collected for molecular biological measurements.@*RESULTS@#Following 45 min of ischemia, QRS duration and QTc intervals statistically significantly increased, but these values decreased after transfecting PIASy shRNA. PIASy downregulation ameliorated ventricular arrhythmias induced by myocardial I/R, as evidenced by the decreased incidence of ventricular tachycardia and ventricular fibrillation, and reduced arrythmia score. In addition, myocardial I/R statistically significantly induced PIASy expression and Cx43 SUMOylation, accompanied by reduced Cx43 phosphorylation and plakophilin 2 (PKP2) expression. Moreover, PIASy downregulation remarkably reduced Cx43 SUMOylation, accompanied by increased Cx43 phosphorylation and PKP2 expression after I/R.@*CONCLUSION@#PIASy downregulation inhibited Cx43 SUMOylation and increased PKP2 expression, thereby improving ventricular arrhythmias in ischemic/reperfused rats heart.


Subject(s)
Rats , Male , Animals , Myocardial Reperfusion Injury/metabolism , Connexin 43/genetics , Sumoylation , Down-Regulation , Rats, Sprague-Dawley , Arrhythmias, Cardiac/drug therapy , Myocardial Ischemia/metabolism , RNA, Small Interfering/metabolism
18.
Zhongguo Zhong Yao Za Zhi ; (24): 2595-2605, 2023.
Article in Chinese | WPRIM | ID: wpr-981362

ABSTRACT

Zhenwu Decoction is recorded in Treatise on Febrile Diseases by an outstanding physician ZHANG Zhong-jing in the Han dynasty. With effect of warming yang, transforming Qi, and promoting urination, Zhenwu Decoction is mainly used to treat edema due to yang deficiency. The studies of the severe and critical cases and the pathophysiological mechanisms have demonstrated that the record of Zhenwu Decoction in Treatise on Febrile Diseases describes the clinical symptoms and therapeutic regimen of acute heart failure. The syndrome treated by this formula may be related to the misdiagnosis and wrong treatment. Due to the difficult distinguishing between cardiogenic dyspnea and pulmonary dyspnea, high doses of Ephedrae Herba may be misused for inducing sweating, which may finally lead to the acute aggravation of heart failure, electrolyte disorder, and pulmonary infection. The syndrome treated by Zhenwu Decoction can illustrate the lack of experience of ancient physicians in treating acute heart failure. The description of "trembling and shivering" may be the clinical manifestation of heart failure, which is an upgraded version of "trembling and shaking" treated by Linggui Zhugan Decoction.(1)In terms of diseases, Zhenwu Decoction is suitable for the treatment of acute or chronic heart failure, cardiorenal syndrome, and diuretic resistance. The decoction is especially suitable for treating whole heart failure, acute heart failure, heart failure with reduced ejection fraction, and heart failure with the syndrome of sold and dampness. In addition, it can be used to treat both type Ⅱ and type Ⅳ cardiorenal syndrome.(2)In terms of symptoms, Zhenwu Decoction can be used for treating chest tightness, palpitations, lower limb edema, difficult urination or increased urine output, fear of cold, pale fat tongue with teeth marks, white and slippery tongue fur, and deep or slow pulse.(3)In terms of the pharmacological mechanism, Zhenwu Decoction treats heart failure following the principle of promoting urination, expanding blood vessels, and invigorating heart in modern medicine. Aconiti Lateralis Radix Praparata is the sovereign herb in the formula, with the recommended dosage of 30-60 g. However, arrhythmia may be caused by high doses of Aconiti Lateralis Radix Praparata, which should be used with concern. In addition to Zhenwu Decoction, Shenqi Pills, Renshen Decoction, Wuling Powder, and Fangji Huangqi Decoction with the effect of invigorating spleen, replenishing Qi, warming Yang, and promoting urination can be used in the recovery stage. The therapy of reinforcing Yang was the last choice for critical cases due to the lack of medical conditions, unclear clinical diagnosis in history, which should be treated objectively now.


Subject(s)
Humans , Cardio-Renal Syndrome/drug therapy , Drugs, Chinese Herbal/pharmacology , Medicine, Chinese Traditional , Heart Failure/drug therapy , Arrhythmias, Cardiac/drug therapy , Critical Care
19.
Zhongguo Zhong Yao Za Zhi ; (24): 2613-2619, 2023.
Article in Chinese | WPRIM | ID: wpr-981364

ABSTRACT

Arrhythmia, a common and frequently occurring cardiovascular disease, causes a heavy burden on the public health of China. Approximately 20 million patients are suffering from this disease in China and treated by pharmacological and surgical therapies. However, antiarrhythmic drugs can cause arrhythmia and surgical treatment has the risks of failure and recurrence. Therefore, the clinical outcome of arrhythmia remains to be improved. According to the traditional Chinese medicine(TCM) theory, arrhythmia is a disease of palpitation induced by 7 conditions: liver depression and Qi stagnation, accumulation of turbid phlegm, fluid retention attacking the heart, fire-heat disturbing the heart, stasis obstruction of heart vessel, cold congealing in heart vessel, and the deficiency of Qi, blood, Yin, and Yang. Therefore, this study concisely proposed 7 TCM syndromes of arrhythmia, including the palpitation due to depression, phlegm, fluid retention, fire, blood stasis, cold, and deficiency. The corresponding treatment strategies were recommended as follows: Chaihu Longgu Muli Decoction for the palpitation due to depression, Wendan Decoction for the palpitation due to phlegm, Linggui Zhugan Decoction for the palpitation due to fluid retention, Sanhuang Xiexin Decoction for the palpitation due to fire, Xuefu Zhuyu Decoction for the palpitation due to blood stasis, and Mahuang Fuzi Xixin Decoction for the palpitation due to cold, and Guizhi Gancao Decoction, Guizhi Gancao Longgu Muli Decoction, Huanglian Ejiao Decoction, Zhigancao Decoction, and Guipi Decoction for the palpitation due to the deficiency of Qi, blood, Yin, and Yang. Multiple formulas should be combined if the patient presents several TCM syndromes simultaneously. According to the principles of the correspondence between formula and syndrome and the treatment with consideration to both pathogenesis and pathology and both herbal nature and pharmacology, this study proposed an integrated treatment model of "pathogenesis-pathology-nature-pharmacology" to enhance the clinical efficacy of classic herbal formulas in the treatment of arrhythmia.


Subject(s)
Humans , Medicine, Chinese Traditional , Syndrome , Drugs, Chinese Herbal/therapeutic use , Heart Failure/drug therapy , Arrhythmias, Cardiac/drug therapy , China
20.
Zhongguo Zhong Yao Za Zhi ; (24): 2620-2624, 2023.
Article in Chinese | WPRIM | ID: wpr-981365

ABSTRACT

Chaihu Jia Longgu Muli Decoction was firstly recorded in Treatise on Cold Damage(ZHANG Zhong-jing, Eastern Han dynasty). According to this medical classic, it is originally used in the treatment of the Shaoyang and Yangming syndrome. Based on the modern pathophysiological mechanism, this study interpreted the classic provisions of Chaihu Jia Longgu Muli Decoction. Original records of "chest fullness" "annoyance" "shock" "difficult urination" "delirium" "heavy body and failing to turn over" all have profound pathophysiological basis, involving disorders in cardiovascular, respiratory, nervous, and mental systems. This formula is widely used, which can be applied to treat epilepsy, cerebral arteriosclerosis, cerebral infarction, and other cerebrovascular diseases, hypertension, arrhythmia, and other cardiovascular diseases, insomnia, constipation, anxiety, depression, cardiac neurosis and other acute and chronic diseases as well as diseases in psychosomatic medicine. The clinical indications include Bupleuri Radix-targeted syndrome such as fullness and discomfort in chest and hypochondrium, bitter taste mouth, dry throat, and dizziness, the insomnia, anxiety, depression, susceptibility to fright, upset, dreamfulness and other psychiatric symptoms, red tongue, thick and yellow tongue coating, and wiry hard and powerful pulse. This formula was found to be used in combination with other formulas, such as Gualou Xiebai Decoction, Wendan Decoction, Zhizhu Pills, Juzhijiang Decoction, Suanzaoren Decoction, and Banxia Baizhu Tianma Decoction.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/drug therapy , Drugs, Chinese Herbal/therapeutic use , Hypertension/drug therapy , Syndrome , Arrhythmias, Cardiac/drug therapy , Medicine, Chinese Traditional
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