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Journal articles on the topic 'Cardia arrhythmia'
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1
Zhou, Haiying, Xiancheng Zhu, Sishan Wang, et al. "A Novel Cardiac Arrhythmias Detection Approach for Real-Time Ambulatory ECG Diagnosis." International Journal of Pattern Recognition and Artificial Intelligence 31, no. 10 (2017): 1758004. http://dx.doi.org/10.1142/s0218001417580046.
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In view of requirements of low-resource consumption and high-efficiency in real-time Ambulatory Electrocardiograph Diagnosis (AED) applications, a novel Cardiac Arrhythmias Detection (CAD) algorithm is proposed. This algorithm consists of three core modules: an automatic-learning machine that models diagnostic criteria and grades the emergency events of cardiac arrhythmias by studying morphological characteristics of ECG signals and experiential knowledge of cardiologists; a rhythm classifier that recognizes and classifies heart rhythms basing on statistical features comparison and linear discriminant with confidence interval estimation; and an arrhythmias interpreter that assesses emergency events of cardia arrhythmias basing on a two rule-relative interpretation mechanisms. The experiential results on off-line MIT-BIH cardiac arrhythmia database as well as online clinical testing explore that this algorithm has 92.8% sensitivity and 97.5% specificity in average, so that it is suitable for real-time cardiac arrhythmias monitoring.
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Liu, Boheng, Mingbo Wang, Jiawei Dong, Hao Wang, and Ziqiang Tian. "Evaluation of Critical Factors of Postoperative Arrhythmia and Preventive Measures of Deep Venous Thrombosis." Journal of Oncology 2021 (November 24, 2021): 1–11. http://dx.doi.org/10.1155/2021/6103092.
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The study focused on the risk factors of postoperative arrhythmia and lung infection and the preventive effects of targeted low-molecular-weight heparin (LMWH) on the occurrence of deep venous thrombosis (DVT) in patients with esophageal/cardia cancer. In this article, 82 patients who were pathologically diagnosed with esophageal/cardia cancer and underwent surgical treatment were selected as the research subjects. According to the different preoperative treatment methods, the patients were divided into the control group (without anticoagulant drugs before the operation, 44 cases) and the anticoagulation group (anticoagulant drugs were administered before the operation, 38 cases), and they were compared for basic clinical indicators and disease history. Logistic regression analysis was performed to analyze the risk factors of adverse events, and the Wells and Autar scale scores were calculated. Different groups were compared for the operation time, blood loss, and postoperative drainage volume during the operation. D-dimer was detected on the first 1, 3, 5, and 7 days after the operation, and the lower extremity venous color Doppler ultrasound was performed on the 1st and 7th days after the operation. The results showed that age ≥65 years, abnormal preoperative ECG, preoperative coronary heart disease (CHD), preoperative chronic obstructive pulmonary disease (COPD), operative time ≥4 h, and preoperative blood sodium <4.04.0 mmol/L were all risk factors for postoperative arrhythmia. Age, preoperative diabetes mellitus, preoperative COPD, length of hospital stay, and FEV1 were all risk factors for postoperative lung infections. In the control group and anticoagulation group, 11 cases (13.41%) and 5 cases (16.10%) had lower extremity DVT, respectively. The incidence of lower extremity DVT was lower in the anticoagulation group than in the control group P < 0.01 . It suggested that age, preoperative disease history, hospital stay, and operation time were risk factors for postoperative adverse events in patients with esophageal/cardia cancer. The targeted anticoagulant LMWH has a significant preventive effect on the occurrence of lower extremity DVT in patients with esophageal/cardia cancer, providing an effective reference for the prognosis and prevention of esophageal/cardia cancer.
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Epifanio, Hindalis Ballesteros, Marcelo Katz, Melania Aparecida Borges, et al. "The use of external event monitoring (web-loop) in the elucidation of symptoms associated with arrhythmias in a general population." Einstein (São Paulo) 12, no. 3 (2014): 295–99. http://dx.doi.org/10.1590/s1679-45082014ao2939.
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Objective To correlate arrhythmic symptoms with the presence of significant arrhythmias through the external event monitoring (web-loop). Methods Between January and December 2011, the web-loop was connected to 112 patients (46% of them were women, mean age 52±21 years old). Specific arrhythmic symptoms were defined as palpitations, pre-syncope and syncope observed during the monitoring. Supraventricular tachycardia, atrial flutter or fibrillation, ventricular tachycardia, pauses greater than 2 seconds or advanced atrioventricular block were classified as significant arrhythmia. The association between symptoms and significant arrhythmias were analyzed. Results The web-loop recorded arrhythmic symptoms in 74 (66%) patients. Of these, in only 14 (19%) patients the association between symptoms and significant cardiac arrhythmia was detected. Moreover, significant arrhythmia was found in 11 (9.8%) asymptomatic patients. There was no association between presence of major symptoms and significant cardiac arrhythmia (OR=0.57, CI95%: 0.21-1.57; p=0.23). Conclusion We found no association between major symptoms and significant cardiac arrhythmia in patients submitted to event recorder monitoring. Event loop recorder was useful to elucidate cases of palpitations and syncope in symptomatic patients.
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Akhmedov, V. A., M. A. Livzan, and O. V. Gaus. "COVID-19 and arrhythmias - is there a relationship?" South Russian Journal of Therapeutic Practice 3, no. 3 (2022): 17–24. http://dx.doi.org/10.21886/2712-8156-2022-3-3-17-24.
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COVID-19 infection is associated with many different systemic complications. Among these, cardiovascular system complications are particularly important as these are associated with significant mortality. There are many different subgroups of cardiovascular complications, with arrhythmias being one of them. Arrhythmias are especially important as there are a substantial percentage of patients who have arrhythmia after a COVID-19 infection, and these patients are seen with an increased mortality rate. Arrhythmias in COVID-19 patients are associated with inflammation, electrolyte abnormalities, hypoxia, myocardial ischemia, cytokines, pro-arrhythmic or QT-prolonging medications, and underlying heart conditions such as severe congestive heart failure, inherited arrhythmia syndromes, or congenital heart conditions. In addition, arrhythmias and cardiac arrests are most prevalent in the critically ill intensive care unit COVID-19 patient population. This review of PubMed/MedLine articled presents an overview of the association between COVID-19 and arrhythmias by detailing possible pathophysiological mechanisms, existing knowledge of pro-arrhythmic factors, and results from studies in adult COVID-19 populations.
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Andelova, Katarina, Barbara Szeiffova Bacova, Matus Sykora, Peter Hlivak, Miroslav Barancik, and Narcis Tribulova. "Mechanisms Underlying Antiarrhythmic Properties of Cardioprotective Agents Impacting Inflammation and Oxidative Stress." International Journal of Molecular Sciences 23, no. 3 (2022): 1416. http://dx.doi.org/10.3390/ijms23031416.
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The prevention of cardiac life-threatening ventricular fibrillation and stroke-provoking atrial fibrillation remains a serious global clinical issue, with ongoing need for novel approaches. Numerous experimental and clinical studies suggest that oxidative stress and inflammation are deleterious to cardiovascular health, and can increase heart susceptibility to arrhythmias. It is quite interesting, however, that various cardio-protective compounds with antiarrhythmic properties are potent anti-oxidative and anti-inflammatory agents. These most likely target the pro-arrhythmia primary mechanisms. This review and literature-based analysis presents a realistic view of antiarrhythmic efficacy and the molecular mechanisms of current pharmaceuticals in clinical use. These include the sodium-glucose cotransporter-2 inhibitors used in diabetes treatment, statins in dyslipidemia and naturally protective omega-3 fatty acids. This approach supports the hypothesis that prevention or attenuation of oxidative and inflammatory stress can abolish pro-arrhythmic factors and the development of an arrhythmia substrate. This could prove a powerful tool of reducing cardiac arrhythmia burden.
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Chepurnenko, S. A., A. D. Nasytko, and G. V. Shavkuta. "Rare variant of Remkheld syndrome." Experimental and Clinical Gastroenterology, no. 12 (January 16, 2022): 147–53. http://dx.doi.org/10.31146/1682-8658-ecg-196-12-147-153.
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Introduction. Gastroesophageal reflux disease (GERD) can be accompanied by a triad of cardiac symptoms (arrhythmia, cardialgia, signs of autonomic dysfunction). This syndrome is called gastro-cardiac or Remheld syndrome. The most common rhythm disturbances in Remheld syndrome are atrial fibrillation, supraventricular extrasystole. In the clinical case we have described, a rare variant of Remheld’s syndrome is presented: paroxysmal ventricular tachycardia with GERD.Description of the clinical case. Patient V., 48 years old, applied to a cardiologist on 21.04.21 with complaints of attacks of sudden palpitations, disturbing for six months. From the anamnesis it is known that since 2017 he has been suffering from GERD, he does not take drugs for stopping reflux attacks for 6 months, canceling it on his own. According to Holter ECG monitoring from 03/20/21, paroxysmal ventricular tachycardia was revealed. According to echocardioscopy data from 04/26/21, no structural changes that could be the cause of this life-threatening rhythm disturbance were found. Video gastroscopy from 04/28/21: distal reflux esophagitis. Endoscopic signs of hiatal hernia. Lack of cardia 2 tbsp. Gastroesophageal prolapse. At the consultation with a gastroenterologist, the patient was prescribed both non-drug (lifestyle correction) and drug treatment: rabeprozole, clarithromycin, amoxicillin and others. In addition for the relief of paroxysmal ventricular tachycardia—amiodarone, telmisartan.Discussion. According to studies, one of the mechanisms of arrhythmia in GERD is associated with the excitation of the distal esophagus by refluctate with the development of viscero-visceral reflexes mediated through n. vagus. Increased activation of n. vagus creates an arrhythmogenic substrate for the re-entry mechanism, and thus increases the risk of arrhythmias. Antiarrhythmic therapy along with the treatment of GERD led to the elimination of VT paroxysms. Later, 2 months after the withdrawal of antiarrhythmic drugs against the background of ongoing GERD therapy, paroxysms of VT were not recorded. This was also a confirmation of the pathogenetic relationship between GERD and paroxysmal VT.Conclusion. The case is of interest to the development of a life-threatening rhythm disturbance: paroxysmal ventricular tachycardia against the background of GERD, which is a very rare variant of Remkheld’s syndrome and is not found in the available literature.
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Sridhar, Anuradha, Alessandro Giamberti, Sara Foresti, et al. "Fontan conversion with concomitant arrhythmia surgery for the failing atriopulmonary connections: mid-term results from a single centre." Cardiology in the Young 21, no. 6 (2011): 665–69. http://dx.doi.org/10.1017/s1047951111000643.
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AbstractObjectivesClassical Atriopulmonary Fontan connections tend to fail in the long term due to progressive anastomotic site obstruction, right atrial enlargement, and refractory atrial arrhythmias. Conversion to total cavopulmonary connection with concomitant arrhythmia surgery is a promising treatment but optimal timing of the procedure remains controversial.MethodsBetween the years 2002 and 2009, 15 patients with a median age of 26.2 (12–43) years underwent Fontan conversion operation with concomitant arrhythmia surgery. All were symptomatic and 14 out of the 15 patients had refractory arrhythmias. The duration of pre-operative arrhythmia and the outcome of surgery were correlated to study the impact of delay in surgical intervention on post-operative survival and arrhythmia control.ResultsThere were two patients who died in the early post-operative period (13.3%). At the mid-term follow-up, 53 (20–86) months, late atrial arrhythmias had recurred in two of the 13 surviving patients (15.30%) and one patient developed late sinus node dysfunction. The need for anti-arrhythmic drugs decreased considerably from 93.5% to 15.3% on mid-term follow-up. There was no late death or need for cardiac transplantation. The duration of arrhythmia before surgery was prolonged for more than 10 years in patients who died as well as in those who had complications like late recurrence of arrhythmias, dependence on anti-arrhythmic medications, and worsening of ventricular dysfunction.ConclusionsFontan conversion is a well-established treatment option for salvaging the failing atriopulmonary connections. Concomitant arrhythmia surgery effectively resolves the refractory atrial arrhythmias and improves survival, but we need to optimise the timing of Fontan conversion to improve the long-term outcome.
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Eftekhari, Helen. "Pharmacotherapy in arrhythmias: an overview of anti-arrhythmic drug therapy." Journal of Prescribing Practice 2, no. 11 (2020): 582–88. http://dx.doi.org/10.12968/jprp.2020.2.11.582.
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The article aims to give an overview of the principles in anti-arrhythmic drug prescribing. Practitioners assessing cardiac patients are highly likely to review anti-arrhythmic drug therapies and need an understanding of the principles of therapy. The cardiac action potential is explained, followed by general principles involved in treating arrhythmias and prescribing decisions. An overview of the five classifications of anti-arrhythmic drugs is given, with examples of the main drugs in the classification and principles to consider within each. Finally anticoagulation is reviewed being a cornerstone prescribing decision in the most common arrhythmia, atrial fibrillation.
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Gauvrit, Sébastien, Jaclyn Bossaer, Joyce Lee, and Michelle M. Collins. "Modeling Human Cardiac Arrhythmias: Insights from Zebrafish." Journal of Cardiovascular Development and Disease 9, no. 1 (2022): 13. http://dx.doi.org/10.3390/jcdd9010013.
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Cardiac arrhythmia, or irregular heart rhythm, is associated with morbidity and mortality and is described as one of the most important future public health challenges. Therefore, developing new models of cardiac arrhythmia is critical for understanding disease mechanisms, determining genetic underpinnings, and developing new therapeutic strategies. In the last few decades, the zebrafish has emerged as an attractive model to reproduce in vivo human cardiac pathologies, including arrhythmias. Here, we highlight the contribution of zebrafish to the field and discuss the available cardiac arrhythmia models. Further, we outline techniques to assess potential heart rhythm defects in larval and adult zebrafish. As genetic tools in zebrafish continue to bloom, this model will be crucial for functional genomics studies and to develop personalized anti-arrhythmic therapies.
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Shashank, Shekhar Mishra, Kumar Neeraj, Sirvi Gajaram, Shekhar Sharma Chandra, Pratap Singh Hamendra, and Pandiya Harshda. "Computational Prediction of Pharmacokinetic, Bioactivity and Toxicity Parameters of Some Selected Anti arrhythmic Agents." Pharmaceutical and Chemical Journal 4, no. 5 (2017): 143–46. https://doi.org/10.5281/zenodo.13853911.
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Many pharmacological agents are available for the treatment of cardiac arrhythmias. Arrhythmia may be classified on the basis of rate (bradycardia and tachycardia), mechanism (automaticity, re-entry, triggered) or duration (isolated premature beats; couplets). The treatment approach to arrhythmia depends firstly on whether or not the affected person is stable or unstable. This research investigation finds the various pharmacokinetic, bioactivity and toxicity parameters for some selected anti-arrhythmic agents for designing new agents.
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Wong, OF, TSK Lam, and HT Fung. "Two Cases of Chloral Hydrate Overdose." Hong Kong Journal of Emergency Medicine 16, no. 3 (2009): 161–67. http://dx.doi.org/10.1177/102490790901600307.
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Chloral hydrate overdose is associated with cardiac toxicities, gastrointestinal tract injuries, central nervous system and respiratory depression. Among all the complications, cardiac arrhythmias are particularly concerning and frequently reported in the literature. The majorities of fatalities from chloral hydrate overdose are due to refractory cardiac arrhythmia. Chloral hydrate-induced arrhythmias are resistant to most of the standard anti-arrhythmic agents but have good response to propranolol. We report two cases of severe chloral hydrate overdose presenting with alarming cardiac rhythm disturbances. One of the patients was successfully treated with intravenous propranolol in the accident and emergency department. The management of chloral hydrate overdose in particular to its cardiac toxicity is reviewed.
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Eftekhari, Helen. "Pharmacotherapy in arrhythmias: an overview of anti-arrhythmic drug therapy." British Journal of Cardiac Nursing 16, no. 4 (2021): 1–9. http://dx.doi.org/10.12968/bjca.2021.0044.
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The article provides an overview of the principles in anti-arrhythmic drug prescribing. The cardiac action potential is explained, followed by general principles involved in treating arrhythmias and prescribing decisions. An overview of the five classifications of anti-arrhythmic drugs is given, with examples of the main drugs in the classification and principles to consider within each. Finally, anticoagulation is reviewed, being a cornerstone prescribing decision-making in the most common arrhythmia, atrial fibrillation.
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van Bavel, Joanne J. A., Henriëtte D. M. Beekman, Agnieszka Smoczyńska, Marcel A. G. van der Heyden, and Marc A. Vos. "IKs Activator ML277 Mildly Affects Repolarization and Arrhythmic Outcome in the CAVB Dog Model." Biomedicines 11, no. 4 (2023): 1147. http://dx.doi.org/10.3390/biomedicines11041147.
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Long QT syndrome type 1 with affected IKs is associated with a high risk for developing Torsade de Pointes (TdP) arrhythmias and eventually sudden cardiac death. Therefore, it is of high interest to explore drugs that target IKs as antiarrhythmics. We examined the antiarrhythmic effect of IKs channel activator ML277 in the chronic atrioventricular block (CAVB) dog model. TdP arrhythmia sensitivity was tested in anesthetized mongrel dogs (n = 7) with CAVB in series: (1) induction experiment at 4 ± 2 weeks CAVB: TdP arrhythmias were induced with our standardized protocol using dofetilide (0.025 mg/kg), and (2) prevention experiment at 10 ± 2 weeks CAVB: the antiarrhythmic effect of ML277 (0.6–1.0 mg/kg) was tested by infusion for 5 min preceding dofetilide. ML277: (1) temporarily prevented repolarization prolongation induced by dofetilide (QTc: 538 ± 65 ms at induction vs. 393 ± 18 ms at prevention, p < 0.05), (2) delayed the occurrence of the first arrhythmic event upon dofetilide (from 129 ± 28 s to 180 ± 51 s, p < 0.05), and (3) decreased the arrhythmic outcome with a significant reduction in the number of TdP arrhythmias, TdP score, arrhythmia score and total arrhythmic events (from 669 ± 132 to 401 ± 228, p < 0.05). IKs channel activation by ML277 temporarily suppressed QT interval prolongation, delayed the occurrence of the first arrhythmic event and reduced the arrhythmic outcome in the CAVB dog model.
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Zhu, Yujie, Isaac Shamblin, Efrain Rodriguez, et al. "Progressive cardiac arrhythmias and ECG abnormalities in the Huntington’s disease BACHD mouse model." Human Molecular Genetics 29, no. 3 (2019): 369–81. http://dx.doi.org/10.1093/hmg/ddz295.
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Abstract Huntington’s disease (HD) is a dominantly inherited neurodegenerative disease. There is accumulating evidence that HD patients have increased prevalence of conduction abnormalities and compromised sinoatrial node function which could lead to increased risk for arrhythmia. We used mutant Huntingtin (mHTT) expressing bacterial artificial chromosome Huntington’s disease mice to determine if they exhibit electrocardiogram (ECG) abnormalities involving cardiac conduction that are known to increase risk of sudden arrhythmic death in humans. We obtained surface ECGs and analyzed arrhythmia susceptibility; we observed prolonged QRS duration, increases in PVCs as well as PACs. Abnormal histological and structural changes that could lead to cardiac conduction system dysfunction were seen. Finally, we observed decreases in desmosomal proteins, plakophilin-2 and desmoglein-2, which have been reported to cause cardiac arrhythmias and reduced conduction. Our study indicates that mHTT could cause progressive cardiac conduction system pathology that could increase the susceptibility to arrhythmias and sudden cardiac death in HD patients.
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Eremeev, A. "Atrial extrasystoles associated with hypervitaminosis D3 (clinical case)." Vrach 35, no. 4 (2024): 52–56. http://dx.doi.org/10.29296/25877305-2024-04-10.
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The article discusses a clinical case of a patient with hypervitaminosis D3. Cholecalciferol intoxication occurred against the background of long-term oral use of vitamin complexes and was manifested by the manifestation of arrhythmic syndrome – frequent atrial extrasystole of the “P on T” type. The probable pathogenetic cause of arrhythmia was a violation of ion homeostasis in the form of hypercalcemia. Calcium imbalance, affecting cardiac conduction and automatism, can provoke cardiac arrhythmias by increasing the dispersion of refractoriness. At the electrophysiological level, the cause of early atrial ectopia is increased trigger activity during a period of relative cardiac refractoriness. Thus, hypervitaminosis D, associated with subclinical hypercalcemia, may have an arrhythmic "mask".
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Pereira, Helder, Steven Niederer, and Christopher A. Rinaldi. "Electrocardiographic imaging for cardiac arrhythmias and resynchronization therapy." EP Europace 22, no. 10 (2020): 1447–62. http://dx.doi.org/10.1093/europace/euaa165.
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Abstract Use of the 12-lead electrocardiogram (ECG) is fundamental for the assessment of heart disease, including arrhythmias, but cannot always reveal the underlying mechanism or the location of the arrhythmia origin. Electrocardiographic imaging (ECGi) is a non-invasive multi-lead ECG-type imaging tool that enhances conventional 12-lead ECG. Although it is an established technology, its continuous development has been shown to assist in arrhythmic activation mapping and provide insights into the mechanism of cardiac resynchronization therapy (CRT). This review addresses the validity, reliability, and overall feasibility of ECGi for use in a diverse range of arrhythmias. A systematic search limited to full-text human studies published in peer-reviewed journals was performed through Medline via PubMed, using various combinations of three key concepts: ECGi, arrhythmia, and CRT. A total of 456 studies were screened through titles and abstracts. Ultimately, 42 studies were included for literature review. Evidence to date suggests that ECGi can be used to provide diagnostic insights regarding the mechanistic basis of arrhythmias and the location of arrhythmia origin. Furthermore, ECGi can yield valuable information to guide therapeutic decision-making, including during CRT. Several studies have used ECGi as a diagnostic tool for atrial and ventricular arrhythmias. More recently, studies have tested the value of this technique in predicting outcomes of CRT. As a non-invasive method for assessing cardiovascular disease, particularly arrhythmias, ECGi represents a significant advancement over standard procedures in contemporary cardiology. Its full potential has yet to be fully explored.
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Poeppel, T. D., M. Reinhardt, E. G. Vester, et al. "Myocardial perfusion/metabolism mismatch and ventricular arrhythmias in the chronic post infarction state." Nuklearmedizin 44, no. 03 (2005): 69–75. http://dx.doi.org/10.1055/s-0038-1625688.
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Summary Aim: Ventricular arrhythmias have been shown to originate in the myocardial peri-infarct region due to irregular heterotopic conduction. Hypoperfused but viable myocardium is often localised in those areas and may be involved in the pathogenesis of arrhythmias. We tested the hypothesis that these myocardial perfusion/metabolism mismatches (MM) are significantly associated with ventricular arrhythmias in the chronic post infarction state. Patients, methods: 47 post infarction patients were included in the study. 33 suffered from ventricular arrhythmia whereas 14 did not. All patients underwent 99mTc tetrofosmin SPECT and 18F-FDG PET. A region-of-interest(ROI)-analysis was used to assess viable myocardium based on predefined MM-criteria. Univariate analyses as well as a logistic regression model for the multivariate analysis were carried out. Results: 94% of the arrhythmic patients displayed at least one MM-segment as compared to 64% of the non-arrhythmic patients. MMsegments and arrhythmia showed a statistically significant relation (p = 0.018). The logistic regression model predicted the occurrence or absence of arrhythmia in 85% of all cases. Multivariate analysis gave consistent results, after adjusting for symptomatic chronic heart failure (CHF), aneurysms and age. Conclusion: Our results support the hypothesis that hypoperfused but viable myocardium represents an arrhythmogenic substrate and is a relevant risk factor for developing ventricular arrhythmias following myocardial infarction. Therefore, the detection of MM-segments allows the identification of patients with a higher risk for future cardiac events.
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Soniwala, Mujtaba, Saadia Sherazi, Susan Schleede, et al. "Arrhythmia Burden in Patients with Indolent Lymphoma." Blood 136, Supplement 1 (2020): 6–7. http://dx.doi.org/10.1182/blood-2020-140053.
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Introduction Indolent Non-Hodgkin lymphomas (NHL) comprise a heterogeneous group of diseases including marginal zone lymphoma (MZL), lymphoplasmacytic lymphoma (LPL), small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL), and follicular lymphoma (FL). These compose a heterogenous group of disorders that frequently measures survival in years due to the long natural history of these diseases. Frequency and morbidity of cardiac arrhythmias in patients with indolent lymphoma is unknown, but recent observations note that arrhythmias are an increasing problem. Due to advances in treatment for indolent NHL with emergence of novel therapeutics, combined with an aging population and a long natural history, understanding of arrhythmia burden in indolent lymphoma is an area of research with important implications for patients undergoing active treatment as well as for long term lymphoma survivors. Methods Adult patients 18 years or older with indolent NHL treated at the University of Rochester Wilmot Cancer Institute between 2013-2019 were included in the Cardio-Oncology Lymphoid Malignancies Database and analyzed. The primary objective of this study was to define the rate of arrhythmic events and sudden cardiac death in patients with indolent lymphoma during treatment. Cardiac arrhythmias including ventricular arrhythmias (VT/VF), atrial arrhythmias (atrial fibrillation (afib), flutter, SVT and atrial tachycardia), and bradyarrhythmias were identified using ICD-10 codes. Kaplan-Meier survival analysis was used to assess cumulative probability of arrhythmia. Results There were nine hundred and eighteen patients who were diagnosed with indolent lymphoma. Diagnoses included: CLL, N=414; FL, N=284; MZL, N=144; LPL, N=76. Median age was 64, and 43% were female. There were 383 (42%) patients who received treatment. Treatments were classified as chemotherapy, targeted therapy, monoclonal antibodies/immunotherapy, and combination therapy. There were no significant differences in baseline characteristics between treated and never treated patients. At the time of diagnosis, 277 patients (30%) had hypertension, 101 (11%) had prior history of arrhythmia. During median follow up of 24 months, 168 patients (18%) developed a new or recurrent arrhythmia based on ICD-10 codes documented in the electronic medical record. Sixty-three out of one hundred sixty-eight patients had both prior history of and recurrence of arrhythmia, while one hundred five had a new diagnosis of arrhythmia. Afib was the most common arrhythmia, noted in 81 patients (9%). At 6 months from diagnosis, cumulative probability of developing any arrhythmia was 8% (Figure 1). Of all arrhythmias, 89/168 (53%) occurred in SLL/CLL, 35/168 (21%) in FL, 17/168 (10%) in LPL, 27/168 (16%) in MZL. Arrhythmias on treatment occurred in 4/95 patients receiving chemotherapy alone (4.2%), 12/95 patients receiving monoclonal antibodies/immunotherapy (12.6%), and 28/95 patients receiving targeted therapy (29.4%). Most arrhythmias (51/95; 53.6%) occurred in patients receiving combination therapy (chemoimmunotherapy or targeted/immunotherapy). Overall, there were 80 (9%) deaths. Ten deaths were related to cardiovascular diseases; of which 8/10 (80%) were from sudden cardiac death. Conclusions This real-world cohort demonstrates that patients with indolent lymphoma could have an increased risk of cardiac arrhythmias that is increased by treatment. Afib was the most common arrhythmia identified in this study and appears increased compared to the incidence in the general age matched population (1-1.8 per 100 person-years). Surprisingly, of 80 deaths, 8 (10%) were attributed to sudden cardiac death. This data set contributes important information that can help identify patients at increased risk of cardiovascular morbidity and mortality that can impact treatment. Prospective monitoring in these patients may better define the incidence and associated risks of arrhythmias. Future directions will focus on risk factors for arrhythmias and developing an approach to prevent and treat arrhythmias in this patient population. Updated results will be presented at the meeting. Disclosures Zent: Acerta / Astra Zeneca: Research Funding; TG Therapeutics, Inc: Research Funding; Mentrik Biotech: Research Funding. Barr:Janssen: Consultancy; Abbvie/Pharmacyclics: Consultancy, Research Funding; Verastem: Consultancy; Celgene: Consultancy; Seattle Genetics: Consultancy; TG therapeutics: Consultancy, Research Funding; Morphosys: Consultancy; Gilead: Consultancy; AstraZeneca: Consultancy, Research Funding; Merck: Consultancy; Genentech: Consultancy. Reagan:Kite, a Gilead Company: Consultancy; Seattle Genetics: Research Funding; Curis: Consultancy. Friedberg:Seattle Genetics: Research Funding; Roche: Other: Travel expenses; Bayer: Consultancy; Astellas: Consultancy; Acerta Pharma - A member of the AstraZeneca Group, Bayer HealthCare Pharmaceuticals.: Other; Kite Pharmaceuticals: Research Funding; Portola Pharmaceuticals: Consultancy.
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Rezwan, Refaya, Sharmin Zafar, Abu Asad Chowdhury, Shaila Kabir, Mohammad Shah Amran, and Mohammad Abdur Rashid. "Studies of Anti-arrhythmic and Hypercholesterolemic Activities of Ayurvedic Preparation Lauhasab in Rat Model." Dhaka University Journal of Pharmaceutical Sciences 16, no. 1 (2017): 95–105. http://dx.doi.org/10.3329/dujps.v16i1.33387.
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Lauhasab, an Ayurvedic preparation, is widely used in anemia and cardiovascular diseases. Despite its claim as a cardio-tonic there is paucity of studies on pharmacological activities and toxicities. In this study, the anti-arrhythmic effect and impact on lipid profile were evaluated. Rats were pretreated with 0.28 and 2.8 ml/kg body weight of Lauhasab for 35 days and electrocardiographic tracings were recorded and analyzed to determine heart rate and occurrence of arrhythmia. Electrocardiogram recorded before digoxin administration showed significant decrease in mean heart rate along with longer duration of bradycardia than in digoxin control group after 35 days of chronic pretreatment with both doses of Lauhasab. In animal experiments, various arrhythmias were observed after intraperitoneal injection of digoxin. Lauhasab decreased the duration and delayed onset of time of various arrhythmias. It showed significant increase in cholesterol and triglyceride levels in a dose dependent manner. It can be concluded that Lauhasab possesses significant anti-arrhythmic activity against digoxin-induced arrhythmia. It also revealed hyperlipidemic effects.Dhaka Univ. J. Pharm. Sci. 16(1): 95-105, 2017 (June)
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Mei, Jenny Y., Liwen Xu, and Tina A. Nguyen. "Smartwatch detection of new-onset monomorphic ventricular tachycardia in pregnancy." BMJ Case Reports 17, no. 2 (2024): e258807. http://dx.doi.org/10.1136/bcr-2023-258807.
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Smartwatches provide health tracking in various ways and there has been a recent rise in reporting cardiac arrhythmias. While original studies focused on atrial fibrillation, fewer reports have been made on other arrhythmias especially in pregnancy. We report a pregnant patient who presented at 34 weeks’ gestation with palpitations. An ECG recorded through her Apple Watch showed ventricular tachycardia. Hospital ECG confirmed monomorphic ventricular tachycardia likely caused by increased sympathetic tone from the gravid state. She was admitted to the cardiac intensive care unit for close monitoring with intravenous anti-arrhythmic agents; however, the rhythm persisted. She underwent a caesarean delivery and the arrhythmia resolved post partum. She later underwent a catheter ablation, after which she discontinued all anti-arrhythmic medications with no recurrence. This case highlights the importance of requesting relevant digital health information, if available, from patients in our modern era. Controlled clinical studies are needed to validate such practices.
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Liu, Yan, Hong-li Sun, Dan-lu Li, et al. "Choline produces antiarrhythmic actions in animal models by cardiac M3 receptors: improvement of intracellular Ca2+ handling as a common mechanism." Canadian Journal of Physiology and Pharmacology 86, no. 12 (2008): 860–65. http://dx.doi.org/10.1139/y08-094.
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It is well known that choline has protective effects on ischemic arrhythmias. We designed the present study to evaluate the antiarrhythmic effects of choline and to detect its related mechanisms in aconitine-induced rat and ouabain-induced guinea pig models of arrhythmia. Laser scanning confocal microscopy and patch-clamp technique were utilized to study the action of choline on intracellular calcium concentration and L-type calcium current (ICa-L) of cardiac myocytes. M3 receptor antagonist 4-DAMP (4-diphenylacetoxy-N-methylpiperidine-methiodide) was applied preliminarily to evaluate the role of the M3 receptor. Choline significantly increased the survival time of arrhythmic rats and guinea pigs, delayed the onset of arrhythmias and ventricular tachycardia, and decreased the arrhythmia score. The overload of intracellular Ca2+ induced by aconitine or ouabain was reduced in isolated myocytes pretreated with choline. Choline reduced the increased density of ICa-L induced by aconitine or ouabain. Moreover, the beneficial effects of choline were reversed by 4-DAMP. Choline produced antiarrhythmic actions on arrhythmia models by stimulating the cardiac M3 receptor. The mechanism may be related to the improvement of Ca2+ handling.
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Qu, Zhilin, and James N. Weiss. "Cardiac Alternans: From Bedside to Bench and Back." Circulation Research 132, no. 1 (2023): 127–49. http://dx.doi.org/10.1161/circresaha.122.321668.
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Cardiac alternans arises from dynamical instabilities in the electrical and calcium cycling systems of the heart, and often precedes ventricular arrhythmias and sudden cardiac death. In this review, we integrate clinical observations with theory and experiment to paint a holistic portrait of cardiac alternans: the underlying mechanisms, arrhythmic manifestations and electrocardiographic signatures. We first summarize the cellular and tissue mechanisms of alternans that have been demonstrated both theoretically and experimentally, including 3 voltage-driven and 2 calcium-driven alternans mechanisms. Based on experimental and simulation results, we describe their relevance to mechanisms of arrhythmogenesis under different disease conditions, and their link to electrocardiographic characteristics of alternans observed in patients. Our major conclusion is that alternans is not only a predictor, but also a causal mechanism of potentially lethal ventricular and atrial arrhythmias across the full spectrum of arrhythmia mechanisms that culminate in functional reentry, although less important for anatomic reentry and focal arrhythmias.
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Harkness, Weston, Paula Watts, Michael Kopstein, Oliwier Dziadkowiec, Gregory Hicks, and Dmitriy Scherbak. "Correcting Hypokalemia in Hospitalized Patients Does Not Decrease Risk of Cardiac Arrhythmias." Advances in Medicine 2019 (September 24, 2019): 1–4. http://dx.doi.org/10.1155/2019/4919707.
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Background. It is currently standard practice to correct hypokalemia for the purpose of preventing cardiac arrhythmias in all hospitalized patients. However, the efficacy of this intervention has never been previously studied. Objective. The objective of our study was to evaluate whether patients without acute coronary syndrome or history of arrhythmias were at increased risk of clinically significant cardiac arrhythmias if their potassium level was not corrected to ≥3.5 mEq/L. Design. A retrospective case control study. Setting. A community hospital. Participants. We enrolled selected patients who had episodes of hypokalemia during their hospital stay and were monitored on telemetry. Patients were split into groups based on success of replacing serum potassium to ≥3.5 mEq/L after 24 hours. Measurements. The primary outcome was the development of an arrhythmia. Arrhythmias included supraventricular tachycardia, atrial fibrillation, atrial flutter, Mobitz type II second-degree or third-degree AV block, ventricular tachycardia, or ventricular fibrillation. A one-tailed Fisher’s exact test and logistic regression were used for analysis. Results. A total of 1338 hypokalemic patient days were recorded. Out of these days, 22 arrhythmia events (1.6% of patient days) were observed, 8 in the uncorrected group (1% patient days) and 14 in the corrected group (2.6% patient days). We found no statistically significant relationship between successfully correcting potassium to ≥3.5 mEq/L and number of arrhythmic events (p=0.037, OR = 2.38 (95% CI: 0.99, 6.03)). Logistic regression revealed that correction of potassium does not seem to be significantly related to arrhythmias (β = 0.869, p=0.0517). Conclusions. In the acute care setting, we found that patients with hypokalemia whose potassium level did not correct to ≥3.5 mEq/L were not at increased odds of having an arrhythmia. This study suggests that the common practice of checking and replacing potassium is likely inconsequential.
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Merchant, Faisal M., Omid Sayadi, Dheeraj Puppala, Kasra Moazzami, Victoria Heller, and Antonis A. Armoundas. "A translational approach to probe the proarrhythmic potential of cardiac alternans: a reversible overture to arrhythmogenesis?" American Journal of Physiology-Heart and Circulatory Physiology 306, no. 4 (2014): H465—H474. http://dx.doi.org/10.1152/ajpheart.00639.2013.
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Electrocardiographic alternans, a phenomenon of beat-to-beat alternation in cardiac electrical waveforms, has been implicated in the pathogenesis of ventricular arrhythmias and sudden cardiac death (SCD). In the clinical setting, a positive microvolt T-wave alternans test has been associated with a heightened risk of arrhythmic mortality and SCD during medium- and long-term follow-up. However, rather than merely being associated with an increased risk for SCD, several lines of preclinical and clinical evidence suggest that cardiac alternans may play a causative role in generating the acute electrophysiological substrate necessary for the onset of ventricular arrhythmias. Deficiencies in Ca2+ transport processes have been implicated in the genesis of alternans at the subcellular and cellular level and are hypothesized to contribute to the conditions necessary for dispersion of refractoriness, wave break, reentry, and onset of arrhythmia. As such, detecting acute surges in alternans may provide a mechanism for predicting the impending onset of arrhythmia and opens the door to delivering upstream antiarrhythmic therapies. In this review, we discuss the preclinical and clinical evidence to support a causative association between alternans and acute arrhythmogenesis and outline the potential clinical implications of such an association.
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Ertugay, Serkan, Zehra Ünlü, Sedat Karaca, Yaprak Engin, Evrim Şimşek, and Mustafa Özbaran. "[MSB-11] Arrhythmia Course After Surgical Treatment of Mitral Annular Disjunction." Turkish Journal of Thoracic and Cardiovascular Surgery 32, no. 4 (2024): 28–29. https://doi.org/10.5606/tgkdc.dergisi.2024.msb-11.
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Objective: This study aimed to investigate the course of arrhythmia in patients with mitral annular disjunction (MAD) based on 24-h Holter electrocardiogram. Methods: In this retrospective study, 140 patients who underwent mitral valve surgery for type 2 dysfunction between ?? 2017 and May 2024 were reviewed. Forty-five patients with MAD were identified. A history of arrhythmia was identified in 30 (18 females, 12 males; mean age: 38.5±13.76 years) of these 45 patients. Results: The mean cardiopulmonary bypass time was 134.2 min, and the mean cross-clamp time was 99.1 min. One patient died due to low cardiac output. Control echocardiograms performed one month later showed no severe mitral regurgitation. The prevalence of supraventricular arrhythmia was 17.1% prior to surgery and 3.9% postoperatively. The prevalence of ventricular arrhythmia was 8.1% prior to surgery and 2.8% postoperatively. The relationship between MAD distance and the occurrence of arrhythmia was investigated. A notable correlation was observed between MAD exceeding 10 mm and a reduced prevalence of ventricular arrhythmia, with statistical significance (p<0.05). Conclusion: Mitral annular disjunction can lead to severe arrhythmic episodes and sudden death. In the presence of MAD over 10 mm, surgical treatment may reduce the incidence of ventricular arrhythmias. Surgical treatment of MAD decreased the incidence of arrhythmia; therefore, early operation may be considered in the presence of severe arrhythmic events, even if mitral regurgitation is not severe.
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Ertugay, Serkan, Zehra Ünlü, Sedat Karaca, Yaprak Engin, Evrim Şimşek, and Mustafa Özbaran. "[MSB-11] Arrhythmia Course After Surgical Treatment of Mitral Annular Disjunction." Cardiovascular Surgery and Interventions 11, no. 100 (2024): 17. https://doi.org/10.5606/e-cvsi.2024.msb-11.
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Objective: This study aimed to investigate the course of arrhythmia in patients with mitral annular disjunction (MAD) based on 24-h Holter electrocardiogram. Methods: In this retrospective study, 140 patients who underwent mitral valve surgery for type 2 dysfunction between ?? 2017 and May 2024 were reviewed. Forty-five patients with MAD were identified. A history of arrhythmia was identified in 30 (18 females, 12 males; mean age: 38.5±13.76 years) of these 45 patients. Results: The mean cardiopulmonary bypass time was 134.2 min, and the mean cross-clamp time was 99.1 min. One patient died due to low cardiac output. Control echocardiograms performed one month later showed no severe mitral regurgitation. The prevalence of supraventricular arrhythmia was 17.1% prior to surgery and 3.9% postoperatively. The prevalence of ventricular arrhythmia was 8.1% prior to surgery and 2.8% postoperatively. The relationship between MAD distance and the occurrence of arrhythmia was investigated. A notable correlation was observed between MAD exceeding 10 mm and a reduced prevalence of ventricular arrhythmia, with statistical significance (p<0.05). Conclusion: Mitral annular disjunction can lead to severe arrhythmic episodes and sudden death. In the presence of MAD over 10 mm, surgical treatment may reduce the incidence of ventricular arrhythmias. Surgical treatment of MAD decreased the incidence of arrhythmia; therefore, early operation may be considered in the presence of severe arrhythmic events, even if mitral regurgitation is not severe.
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Patel, Kiran Haresh Kumar, Rohin K. Reddy, Arunashis Sau, Pavidra Sivanandarajah, Maddalena Ardissino, and Fu Siong Ng. "Obesity as a risk factor for cardiac arrhythmias." BMJ Medicine 1, no. 1 (2022): e000308. http://dx.doi.org/10.1136/bmjmed-2022-000308.
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Obesity is global health problem with an estimated three billion people worldwide being classified as overweight or obese. In addition to being associated with a range of adverse health outcomes, obesity is linked to higher risks of atrial and ventricular arrhythmias, as well as sudden cardiac death. Obesity is a multifactorial disease that often co-exists with hypertension, diabetes, and sleep apnoea, which are also independent risk factors for cardiac arrhythmias. Nevertheless, compelling evidence suggests that increasing adiposity is an independent proarrhythmic risk factor and that weight loss can be a mitigating and preventative intervention to reduce arrhythmia incidence. This review briefly outlines the economic and social burden of obesity and summarises evidence for the direct and indirect effects of increasing adiposity on risk of atrial and ventricular arrhythmias. The paper also summarises the evidence for electrocardiographic changes indicative of obesity-related atrial and ventricular remodelling and how weight reduction and management of comorbidity might reduce arrhythmic burden.
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Sclafani, Matteo, Giulio Falasconi, Giacomo Tini, et al. "Substrates of Sudden Cardiac Death in Hypertrophic Cardiomyopathy." Journal of Clinical Medicine 14, no. 4 (2025): 1331. https://doi.org/10.3390/jcm14041331.
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Sudden cardiac death (SCD), the most devastating complication of hypertrophic cardiomyopathy (HCM), is primarily triggered by ventricular tachycardia or fibrillation. Despite advances in knowledge, the mechanisms driving ventricular arrhythmia in HCM remain incompletely understood, stemming from an interplay of multiple pro-arrhythmic factors. Myocyte disarray and myocardial fibrosis form a structural substrate favorable to re-entrant arrhythmias by altering myocardial electrophysiological properties, while cellular abnormalities predominate in patients without evident structural remodeling. Traditional SCD risk prediction models rely on clinical risk factors and regression-based risk estimation, often overlooking specific arrhythmic substrates. Emerging techniques now allow for the direct assessment of these substrates, providing deeper insights into the arrhythmogenic mechanisms and paving the way for more personalized SCD risk stratification. This review explores the contribution of cellular, structural, and electrophysiological substrates to arrhythmic risk in HCM, emphasizing their distinct roles. Furthermore, it highlights the potential of substrate-based approaches to refining SCD prevention strategies and improving outcomes for patients with HCM.
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Лидохова, O. Lidokhova, Макеева, et al. "Hyperbaric oxygen correction of experimental cardiac arrhythmias caused by the aconitine." Journal of New Medical Technologies. eJournal 8, no. 1 (2014): 1–4. http://dx.doi.org/10.12737/4111.
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In experiments on white rats the authors simulated the cardiac arrhythmias with intravenous introduction of the Aconitine (30 mg / kg body weight) and the registration of ECG II standard lead. Introduction of the Aconitine in rats caused abnormal heart rhythm as a function of changes in excitability, which was manifested in the emergence of paired and group of ventricular arrythmias. Electrocardiographic changes in the rats were observed and were associated with the development of hypoxia in the myocardium and metabolic disorders of electrolytes at excessive accumulation of sodium ions in cardiomyocytes. Arrhythmia caused death of all experimental animals within 120 minutes after drag introduction. Application of hyperbaric oxygenation (HBO) (300 kPa, 60 min) in animals with Aconitine arrhythmia contributed to the recovery of heart rate to 40-min HBO session. After decompression, the viability of experimental animals during the first 120 minutes of observation was 70%. Positive effect of hyperbaric oxygen at aconitine arrhythmias is due to elimination of hypoxia, reduction of energy deficit in the myocardium and normalization of electrolyte metabolism in the heart muscle. The obtained results allow the authors to recommend a method of HBO as an important component in the complex treatment of cardiac arrhythmias by means of the pharmacological anti-arrhythmic drags.
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Zylla, Maura M., Uta Merle, Johannes A. Vey, et al. "Predictors and Prognostic Implications of Cardiac Arrhythmias in Patients Hospitalized for COVID-19." Journal of Clinical Medicine 10, no. 1 (2021): 133. http://dx.doi.org/10.3390/jcm10010133.
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Background: Cardiac manifestation of COVID-19 has been reported during the COVID pandemic. The role of cardiac arrhythmias in COVID-19 is insufficiently understood. This study assesses the incidence of cardiac arrhythmias and their prognostic implications in hospitalized COVID-19-patients. Methods: A total of 166 patients from eight centers who were hospitalized for COVID-19 from 03/2020–06/2020 were included. Medical records were systematically analyzed for baseline characteristics, biomarkers, cardiac arrhythmias and clinical outcome parameters related to the index hospitalization. Predisposing risk factors for arrhythmias were identified. Furthermore, the influence of arrhythmia on the course of disease and related outcomes was assessed using univariate and multiple regression analyses. Results: Arrhythmias were detected in 20.5% of patients. Atrial fibrillation was the most common arrhythmia. Age and cardiovascular disease were predictors for new-onset arrhythmia. Arrhythmia was associated with a pronounced increase in cardiac biomarkers, prolonged hospitalization, and admission to intensive- or intermediate-care-units, mechanical ventilation and in-hospital mortality. In multiple regression analyses, incident arrhythmia was strongly associated with duration of hospitalization and mechanical ventilation. Cardiovascular disease was associated with increased mortality. Conclusions: Arrhythmia was the most common cardiac event in association with hospitalization for COVID-19. Older age and cardiovascular disease predisposed for arrhythmia during hospitalization. Whereas in-hospital mortality is affected by underlying cardiovascular conditions, arrhythmia during hospitalization for COVID-19 is independently associated with prolonged hospitalization and mechanical ventilation. Thus, incident arrhythmia may indicate a patient subgroup at risk for a severe course of disease.
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CHIU, CHUANG-CHIEN, TONG-HONG LIN, and BEN-YI LIAU. "USING CORRELATION COEFFICIENT IN ECG WAVEFORM FOR ARRHYTHMIA DETECTION." Biomedical Engineering: Applications, Basis and Communications 17, no. 03 (2005): 147–52. http://dx.doi.org/10.4015/s1016237205000238.
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Arrhythmia is one kind of diseases that gives rise to the death and possibly forms the immedicable danger. The most common cardiac arrhythmia is the ventricular premature beat. The main purpose of this study is to develop an efficient arrhythmia detection algorithm based on the morphology characteristics of arrhythmias using correlation coefficient in ECG signal. Subjects for experiments included normal subjects, patients with atrial premature contraction (APC), and patients with ventricular premature contraction (PVC). So and Chan's algorithm was used to find the locations of QRS complexes. When the QRS complexes were detected, the correlation coefficient and RR-interval were utilized to calculate the similarity of arrhythmias. The algorithm was tested using MIT-BIH arrhythmia database and every QRS complex was classified in the database. The total number of test data was 538, 9 and 24 for normal beats, APCs and PVCs, respectively. The results are presented in terms of, performance, positive predication and sensitivity. High overall performance (99.3%) for the classification of the different categories of arrhythmic beats was achieved. The positive prediction results of the system reach 99.44%, 100% and 95.35% for normal beats, APCs and PVCs, respectively. The sensitivity results of the system are 99.81%, 81.82% and 95.83% for normal beats, APCs and PVCs, respectively. Results revealed that the system is accurate and efficient to classify arrhythmias resulted from APC or PVC. The proposed arrhythmia detection algorithm is therefore helpful to the clinical diagnosis.
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Wagner, Michael, Mirna S. Sadek, Nataliya Dybkova, et al. "Cellular Mechanisms of the Anti-Arrhythmic Effect of Cardiac PDE2 Overexpression." International Journal of Molecular Sciences 22, no. 9 (2021): 4816. http://dx.doi.org/10.3390/ijms22094816.
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Background: Phosphodiesterases (PDE) critically regulate myocardial cAMP and cGMP levels. PDE2 is stimulated by cGMP to hydrolyze cAMP, mediating a negative crosstalk between both pathways. PDE2 upregulation in heart failure contributes to desensitization to β-adrenergic overstimulation. After isoprenaline (ISO) injections, PDE2 overexpressing mice (PDE2 OE) were protected against ventricular arrhythmia. Here, we investigate the mechanisms underlying the effects of PDE2 OE on susceptibility to arrhythmias. Methods: Cellular arrhythmia, ion currents, and Ca2+-sparks were assessed in ventricular cardiomyocytes from PDE2 OE and WT littermates. Results: Under basal conditions, action potential (AP) morphology were similar in PDE2 OE and WT. ISO stimulation significantly increased the incidence of afterdepolarizations and spontaneous APs in WT, which was markedly reduced in PDE2 OE. The ISO-induced increase in ICaL seen in WT was prevented in PDE2 OE. Moreover, the ISO-induced, Epac- and CaMKII-dependent increase in INaL and Ca2+-spark frequency was blunted in PDE2 OE, while the effect of direct Epac activation was similar in both groups. Finally, PDE2 inhibition facilitated arrhythmic events in ex vivo perfused WT hearts after reperfusion injury. Conclusion: Higher PDE2 abundance protects against ISO-induced cardiac arrhythmia by preventing the Epac- and CaMKII-mediated increases of cellular triggers. Thus, activating myocardial PDE2 may represent a novel intracellular anti-arrhythmic therapeutic strategy in HF.
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Bommer, Thea, Maria Knierim, Julia Unsöld, et al. "Simulation of cardiac arrhythmias in human induced pluripotent stem cell-derived cardiomyocytes." PLOS ONE 19, no. 9 (2024): e0310463. http://dx.doi.org/10.1371/journal.pone.0310463.
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The effects and mechanisms of cardiac arrhythmias are still incompletely understood and an important subject of cardiovascular research. A major difficulty for investigating arrhythmias is the lack of appropriate human models. Here, we present a protocol for a translational simulation of different types of arrhythmias using human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) and electric cell culture pacing. The protocol comprises the handling of ventricular and atrial hiPSC-CM before and during in vitro arrhythmia simulation and possible arrhythmia simulation protocols mimicking clinical arrhythmias like atrial fibrillation. Isolated or confluent hiPSC-CM can be used for the simulation. In vitro arrhythmia simulation did not impair cell viability of hiPSC-CM and could reproduce arrhythmia associated phenotypes of patients. The use of hiPSC-CM enables patient-specific studies of arrhythmias, genetic interventions, or drug-screening. Thus, the in vitro arrhythmia simulation protocol may offer a versatile tool for translational studies on the mechanisms and treatment options of cardiac arrhythmias.
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Kim, Esther D., Elsayed Z. Soliman, Josef Coresh, Kunihiro Matsushita, and Lin Yee Chen. "Two-Week Burden of Arrhythmias across CKD Severity in a Large Community-Based Cohort: The ARIC Study." Journal of the American Society of Nephrology 32, no. 3 (2021): 629–38. http://dx.doi.org/10.1681/asn.2020030301.
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BackgroundCKD is associated with sudden cardiac death and atrial fibrillation (AF). However, other types of arrhythmia and different measures of the burden of arrhythmias, such as presence and frequency, have not been well characterized in CKD.MethodsTo quantify the burden of arrhythmias across CKD severity in 2257 community-dwelling adults aged 71–94 years, we examined associations of major arrhythmias with CKD measures (eGFR and albuminuria) among individuals in the Atherosclerosis Risk in Communities study. Participants underwent 2 weeks of noninvasive, single-lead electrocardiogram monitoring. We examined types of arrhythmia burden: presence and frequency of arrhythmias and percent time in arrhythmias.ResultsOf major arrhythmias, there was a higher prevalence of AF and nonsustained ventricular tachycardia among those with more severe CKD, followed by long pause (>30 seconds) and atrioventricular block. Nonsustained ventricular tachycardia was the most frequent major arrhythmia (with 4.2 episodes per person-month). Most participants had ventricular ectopy, supraventricular tachycardia, and supraventricular ectopy. Albuminuria consistently associated with higher AF prevalence and percent time in AF, and higher prevalence of nonsustained ventricular tachycardia. When other types of arrhythmic burden were examined, lower eGFR was associated with a lower frequency of atrioventricular block. Although CKD measures were not strongly associated with minor arrhythmias, higher albuminuria was associated with a higher frequency of ventricular ectopy.ConclusionsCKD, especially as measured by albuminuria, is associated with a higher burden of AF and nonsustained ventricular tachycardia. Additionally, eGFR is associated with less frequent atrioventricular block, whereas albuminuria is associated with more frequent ventricular ectopy. Use of a novel, 2-week monitoring approach demonstrated a broader range of arrhythmias associated with CKD than previously reported.
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Shomanova, Zornitsa, Bernhard Ohnewein, Christiane Schernthaner, et al. "Classic and Novel Biomarkers as Potential Predictors of Ventricular Arrhythmias and Sudden Cardiac Death." Journal of Clinical Medicine 9, no. 2 (2020): 578. http://dx.doi.org/10.3390/jcm9020578.
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Sudden cardiac death (SCD), most often induced by ventricular arrhythmias, is one of the main reasons for cardiovascular-related mortality. While coronary artery disease remains the leading cause of SCD, other pathologies like cardiomyopathies and, especially in the younger population, genetic disorders, are linked to arrhythmia-related mortality. Despite many efforts to enhance the efficiency of risk-stratification strategies, effective tools for risk assessment are still missing. Biomarkers have a major impact on clinical practice in various cardiac pathologies. While classic biomarkers like brain natriuretic peptide (BNP) and troponins are integrated into daily clinical practice, inflammatory biomarkers may also be helpful for risk assessment. Indeed, several trials investigated their application for the prediction of arrhythmic events indicating promising results. Furthermore, in recent years, active research efforts have brought forward an increasingly large number of “novel and alternative” candidate markers of various pathophysiological origins. Investigations of these promising biological compounds have revealed encouraging results when evaluating the prediction of arrhythmic events. To elucidate this issue, we review current literature dealing with this topic. We highlight the potential of “classic” but also “novel” biomarkers as promising tools for arrhythmia prediction, which in the future might be integrated into clinical practice.
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Alonso, Sergio, Enrique Alvarez-Lacalle, Jean Bragard, and Blas Echebarria. "Biophysical Modeling of Cardiac Cells: From Ion Channels to Tissue." Biophysica 5, no. 1 (2025): 5. https://doi.org/10.3390/biophysica5010005.
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Cardiovascular diseases have become the leading cause of death in developed countries. Among these, some are related to disruptions in the electrical synchronization of cardiac tissue leading to arrhythmias such as atrial flutter, ventricular tachycardia, or ventricular fibrillation. Their origin is diverse and involves several spatial and temporal scales, ranging from nanoscale ion channel dysfunctions to tissue-level fibrosis and ischemia. Mathematical models play a crucial role in elucidating the mechanisms underlying cardiac arrhythmias by simulating the electrical and physiological properties of cardiac tissue across different spatial scales. These models investigate the effects of genetic mutations, pathological conditions, and anti-arrhythmic interventions on heart dynamics. Despite their varying levels of complexity, they have proven to be important in understanding the triggers of arrhythmia, optimizing defibrillation protocols, and exploring the nonlinear dynamics of cardiac electrophysiology. In this work, we present diverse modeling approaches to the electrophysiology of cardiac cells and share examples from our own research where these approaches have significantly contributed to understanding cardiac arrhythmias. Although computational modeling of the electrical properties of cardiac tissue faces challenges in integrating data across multiple spatial and temporal scales, it remains an indispensable tool for advancing knowledge in cardiac biophysics and improving therapeutic strategies.
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Falco, Raffaele, Chiara Tognola, Lorenzo Gigli, et al. "Idiopathic Ventricular Arrhythmias Originating from the Left Ventricular Summit: A Diagnostic and Therapeutic Challenge." Journal of Clinical Medicine 14, no. 12 (2025): 4261. https://doi.org/10.3390/jcm14124261.
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Premature ventricular contractions (PVCs) originating from the left ventricular summit (LVS) present a diagnostic and therapeutic challenge due to their complex anatomical location. The LVS includes an epicardial area of the left ventricle bordered by major coronary arteries, which has been increasingly recognized as an arrhythmic focus. Idiopathic ventricular arrhythmias from this area may exhibit specific electrocardiographic characteristics, making accurate localization essential for effective management. Methods: This narrative review explores the primary features of this arrhythmia, emphasizing key diagnostic and therapeutic aspects, including both pharmacological and interventional approaches, considering the recent technological advances in cardiac mapping and ablations. Conclusions: PVCs originating from the left ventricular summit (LVS) exhibit characteristic electrocardiographic features. Prompt recognition of this arrhythmia may facilitate appropriate referral for targeted treatment.
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Varrenti, Marisa, Eleonora Bonvicini, Matteo Baroni, et al. "Arrhythmia-Induced Cardiomyopathy: Predictors of Improvement in Left Ventricular Systolic Function After Catheter Ablation." Journal of Clinical Medicine 14, no. 5 (2025): 1636. https://doi.org/10.3390/jcm14051636.
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Background: Arrhythmia-induced cardiomyopathy (AIC) is a relatively common yet poorly understood cardiac condition that occurs when arrhythmias cause left ventricular systolic dysfunction, which can be reversed with the resolution of the arrhythmia. Catheter ablation serves as a cornerstone treatment for eliminating the arrhythmic trigger. However, the variability in left ventricular recovery following ablation highlights the need to identify reliable predictors of reverse remodeling. Methods: This review explores key studies on AIC patients undergoing catheter ablation, primarily derived from observational cohorts, to identify significant predictors of left ventricular function recovery. Results: While echocardiography and cardiac magnetic resonance imaging remain the primary diagnostic modalities, additional insights have emerged from electrocardiograms and laboratory biomarkers. Despite these advancements, a comprehensive framework for identifying optimal candidates for ablation remains lacking. Conclusions: By synthesizing existing evidence, this review aims to pinpoint the most robust predictors of systolic recovery in AIC patients following ablation.
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Walsh, Stewart R., Tjun Tang, Chandana Wijewardena, Sahah I. Yarham, Jonathan R. Boyle, and Michael E. Gaunt. "Postoperative Arrhythmias in General Surgical Patients." Annals of The Royal College of Surgeons of England 89, no. 2 (2007): 91–95. http://dx.doi.org/10.1308/003588407x168253.
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INTRODUCTION New-onset arrhythmias are a common problem in cardiothoracic surgery. They are also common following major non-cardiac surgery. This review examines the available literature to establish the incidence and significance of new-onset arrhythmias following major non-cardiothoracic surgery. MATERIALS AND METHODS A literature search was performed using the Medline and Pubmed databases using the terms ‘postoperative arrhythmia’, ‘peri-operative arrhythmia’, ‘atrial fibrillation/flutter’, ‘supraventricular arrhythmia/tachycardia’, ‘cardiac complications’ and ‘non-cardiothoracic surgery’. Articles were cross-referenced for additional relevant publications and reviewed for data regarding new-onset arrhythmias following major non-cardiothoracic surgery. RESULTS There was considerable heterogeneity in the literature regarding cardiac monitoring, types of arrhythmias considered and potential associations investigated, thus hindering interpretation. The available data suggest that new-onset arrhythmias affect about 7% of patients following major non-cardiothoracic surgery. These arrhythmias are often associated with other underlying complications.
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Guarracini, Fabrizio, Massimo Tritto, Antonio Di Monaco, et al. "Stereotactic Arrhythmia Radioablation Treatment of Ventricular Tachycardia: Current Technology and Evolving Indications." Journal of Cardiovascular Development and Disease 10, no. 4 (2023): 172. http://dx.doi.org/10.3390/jcdd10040172.
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Ventricular tachycardia in patients with structural heart disease is a significant cause of morbidity and mortality. According to current guidelines, cardioverter defibrillator implantation, antiarrhythmic drugs, and catheter ablation are established therapies in the management of ventricular arrhythmias but their efficacy is limited in some cases. Sustained ventricular tachycardia can be terminated by cardioverter-defibrillator therapies although shocks in particular have been demonstrated to increase mortality and worsen patients’ quality of life. Antiarrhythmic drugs have important side effects and relatively low efficacy, while catheter ablation, even if it is actually an established treatment, is an invasive procedure with intrinsic procedural risks and is frequently affected by patients’ hemodynamic instability. Stereotactic arrhythmia radioablation for ventricular arrhythmias was developed as bail-out therapy in patients unresponsive to traditional treatments. Radiotherapy has been mainly applied in the oncological field, but new current perspectives have developed in the field of ventricular arrhythmias. Stereotactic arrhythmia radioablation provides an alternative non-invasive and painless therapeutic strategy for the treatment of previously detected cardiac arrhythmic substrate by three-dimensional intracardiac mapping or different tools. Since preliminary experiences have been reported, several retrospective studies, registries, and case reports have been published in the literature. Although, for now, stereotactic arrhythmia radioablation is considered an alternative palliative treatment for patients with refractory ventricular tachycardia and no other therapeutic options, this research field is currently extremely promising.
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Muralinath, E., Devi Pooja, Chbukdhara Prasanta, et al. "Drugs Acting on Arrhythmics." Journal of Advanced Research and Reviews in Virology & Microbiology 1, no. 1 (2024): 10–12. https://doi.org/10.5281/zenodo.10716057.
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<em>Antiarrhythmic drugs play a key role regarding abnormal heart rhythms. Anti-arrhythmic drugs are divided into different classes dependent on their primary mechanism of action. These drugs are regarded as into four main categories such as class I (sodium channel blockers), class II(beta _ blockers), class III (potassium channel blockers) and class IV (calcium channel blockers). Class I anti arrhythmics specifically act on sodium channels, which play a role in the initiation and conduction of action potentials particularly in Cardiac cells. Class II anti arrhythmics act by decreasing the effects of adrenaline on the heart. Class III antiarrhythmics affect potassium channels and carry on the repolarization phase of the Cardiac action potential. Potential class IV antiarthmics stop calcium influx during depolarization and result in acdecrement in the heart rate and the forcec of contraction. Finally it is concluded that anti arrhythmic drugs play a critical role in managing various vtyoes of arrhythmias.</em>
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Abdel Gawad, Tarek Ahmed, Waleed Mohamed Elguindy, Omneya Ibrahim Youssef, and Tamer Ashraf Abosalem. "The Prevalence and Risk Factors of Early Arrhythmias Following Pediatric Open Heart Surgery in Egyptian Children." Open Access Macedonian Journal of Medical Sciences 5, no. 7 (2017): 940–44. http://dx.doi.org/10.3889/oamjms.2017.177.
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AIM: This study aimed to assess the prevalence of early postoperative arrhythmias after cardiac operation in the pediatric population, and to analyse possible risk factors.MATERIAL AND METHODS: Cross-sectional study included 30 postoperative patients, with age range four up to 144 months. They were selected from those admitted to the Cardiology Unit in the Pediatric department of Ain Shams University hospitals, after undergoing cardiopulmonary bypass (CPB) surgery for correction of congenital cardiac defects. All patients had preoperative sinus rhythm and normal preoperative electrolytes levels. All patients’ records about age, weight, type of surgery, intraoperative arrhythmias, cardiopulmonary bypass time, ischemic time and use of inotropic drugs were taken before they were admitted to the specialised pediatric post-surgery intensive care unit (ICU).RESULTS: Arrhythmia was documented in 15 out of 30 patients (50%). Statistically significant difference between the arrhythmic and non-arrhythmic group were recorded in relation to the age of operation (23 vs 33 months), weight (12 vs. 17 kg), ischemic time (74.5 vs. 54 min), cardiopulmonary bypass time (125.5 vs. 93.5min), inotrope use (1.6 vs. 1.16) and postoperative ICU stay (5.8 vs. 2.7 days), P<0.05.CONCLUSION: Early postoperative arrhythmias following surgery for congenital heart disease are relatively frequent in children (50%).Younger age, lower body weight, longer ischemic time and bypass time, and more inotrope use are all risk factors for postoperative arrhythmias and lead to increase the hospital stay.
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Arunachalam Karikalan, Suganya, Ali Yusuf, and Hicham El Masry. "Arrhythmias in Cardiac Sarcoidosis: Management and Prognostic Implications." Journal of Clinical Medicine 13, no. 11 (2024): 3165. http://dx.doi.org/10.3390/jcm13113165.
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Cardiac sarcoidosis (CS) is characterized by various arrhythmic manifestations ranging from catastrophic sudden cardiac death secondary to ventricular arrhythmia, severe conduction disease, sinus node dysfunction, and atrial fibrillation. The management of CS is complex and includes not only addressing the arrhythmia but also controlling the myocardial inflammation resultant from the autoimmune reaction. Arrhythmic manifestations of CS carry significant prognostic implications and invariably affect long-term survival in these patients. In this review, we focus on management of arrhythmic manifestation of cardiac sarcoidosis as well as risk stratification for sudden cardiac death in these patients.
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khanam, Shaista. "Analysing and Evaluating the Performance of Deep-Learning-Based Arrhythmia Detection Using Electrocardiogram Signals." international journal of advanced research in computer science 15, no. 2 (2024): 74–83. http://dx.doi.org/10.26483/ijarcs.v15i2.7065.
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Cardiac arrhythmia is a cardiac irregularity that impacts a significant number of individuals globally. Certain arrhythmias may be benign or occur only once, while recurring arrhythmias have the potential to cause organ failure, increase the risk of stroke by a factor of five, and even lead to sudden cardiac death. Thus, in order to identify and treat arrhythmia and prevent potentially fatal cardiac problems, the rapid detection and categorization of Electrocardiogram (ECG) signals is of paramount importance. The non-invasive technique employs electrodes to examine the electrical potentials of the heart, facilitating the detection of structural and functional irregularities that contribute to the diagnosis of cardiovascular illnesses. Nevertheless, the high likelihood of manual interpretation, which is both time-consuming and susceptible to error caused by weariness, poses a significant challenge for cardiologists in identifying and diagnosing cardiac issues. In recent times, there has been a growing utilization of Deep Learning (DL) models in the field of arrhythmia prediction, with the aim of enhancing clinical decision-making and potentially mitigating the likelihood of valetudinarian fatality. These models enhance the diagnostic capabilities of electrocardiography by detecting pathological situations, extracting anatomically meaningful data, evaluating cardio-motion, and assessing the quality of echo images. As a result, they serve as an alternative tool for precise diagnosis and treatment of arrhythmias. In order to forecast and categorize arrhythmias based on ECG signal data, this study provides a comprehensive review of various deep learning approaches. The initial section of the study provides a concise overview of various deep learning-based prediction models that have been developed by multiple researchers for echocardiography systems. Subsequently, a comparative analysis is undertaken to comprehend the limitations of those algorithms and propose a novel approach to improve the accuracy of cardiac view classification in echocardiography systems.
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Upadia, J. "Chromosome 12p12.2p11.22 Deletion in a Patient with Ventricular Fibrillation, Mitral Valve Prolapse, Dilation of Aorta and Intellectual Disability: A Case Report." Clinical Case Reports Journal 4, no. 3 (2023). https://doi.org/10.5281/zenodo.14888802.
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Interstitial deletion within chromosome 12p is a rare chromosome abnormality. Described clinical phenotypes include short stature, psychomotor delay, microcephaly, brachydactyly, and optic nerve hypoplasia. Here we report a 24-year-old female with 8050 kilobase deletion at 12p12.2p11.22, who has a history of sudden cardiac arrest secondary to cardiac arrhythmia. Cardiac features presented in our case have not been reported in 12p deletion patients. Among 40 OMIM genes in the deleted region, ABCC9 heterozygous deletion is one of the susceptible causes for the cardiac arrhythmia phenotype in this patient.
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Yinadsawaphan, Thanaboon, Mustafa Suppah, Srekar N. Ravi, JUAN FARINA, Robert L. Scott, and Dan Sorajja. "Abstract 14098: Epidemiology and Clinical Outcomes of Cardiac Arrhythmias in Pulmonary Arterial Hypertension." Circulation 148, Suppl_1 (2023). http://dx.doi.org/10.1161/circ.148.suppl_1.14098.
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Background: There is limited evidence regarding the impact of cardiac arrhythmias in patients with pulmonary arterial hypertension (PAH). We aim to comprehensively investigate the epidemiology and clinical outcomes of cardiac arrhythmias in patients with PAH. Methods: In a retrospective cohort study including 512 PAH patients from 2001-2021 at 3 Mayo Clinic sites, PAH patients were identified via echocardiogram, pulmonary function tests, and right heart catheterization. Demographic data at PAH diagnosis and clinical outcomes over a 10-year period were collected. The PAH patients were categorized into three groups based on arrhythmic onset: 1) patients with arrhythmia prior to PAH diagnosis, 2) patients diagnosed with arrhythmia during 10-year PAH follow-up, and 3) patients without arrhythmia during 10-year PAH follow-up. Survival outcomes were analyzed using multivariable Cox proportional hazards regression, adjusted with the REVEAL 2.0 score. Results: Among 512 PAH patients (mean age 56.1 years, 81.8% female), the prevalence of cardiac arrhythmias at PAH diagnosis was 10.5%. The cumulative incidences of new-onset arrhythmias at 1, 5, and 10 years were 6.6%, 18.4%, and 29.2%, respectively. Patients with arrhythmia diagnosed before and after PAH diagnosis showed significantly higher all-cause mortality rates with adjusted HR of 2.06 [95% CI 1.36-3.12] and 1.57 [95% CI 1.17-2.20] respectively (Figure 1). Similarly in both arrhythmic groups, there was a shorter median time to the first all-cause hospitalization (9.5 and 15.9 months vs. 21.2 months) and a higher number of all-cause hospitalizations (0.38 and 0.64 times per year vs. 0.10 times per year) compared to the non-arrhythmic group. Conclusions: Cardiac arrhythmias can develop in nearly one-third of PAH patients within 10 years of PAH diagnosis and independently contribute to increased mortality and hospitalization frequency.
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Senarath, Sachintha, Pavitra Nanayakkara, Anna L. Beale, Monique Watts, David M. Kaye, and Shane Nanayakkara. "Diagnosis and management of arrhythmias in pregnancy." EP Europace, December 14, 2021. http://dx.doi.org/10.1093/europace/euab297.
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Abstract Arrhythmias are the most common cardiac complications occurring in pregnancy. Although the majority of palpitations in pregnancy may be explained by atrial or ventricular premature complexes, the full spectrum of arrhythmias can occur. In this article, we establish a systematic approach to the evaluation and management of arrhythmias in pregnancy. Haemodynamically unstable arrhythmias warrant urgent cardioversion. For mild cases of benign arrhythmia, treatment is usually not needed. Symptomatic but haemodynamically stable arrhythmic patients should first undergo a thorough evaluation to establish the type of arrhythmia and the presence or absence of structural heart disease. This will ultimately determine the necessity for treatment given the potential risks of anti-arrhythmic pharmacotherapy in pregnancy. We will discuss the main catalogue of anti-arrhythmic medications, which have some established evidence of safety in pregnancy. Based on our appraisal, we provide a treatment algorithm for the tachyarrhythmic pregnant patient.
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Komar, M., T. Przewlocki, P. Prochownik, et al. "285Arrhythmias after transcatheter closure of persistent foramen ovale are related to the type and size of the implanted device." European Heart Journal 40, Supplement_1 (2019). http://dx.doi.org/10.1093/eurheartj/ehz747.0089.
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Abstract Transient supraventricular arrhythmias may occur in patients following persistent foramen ovale (PFO) closure. Therefore, the aim of the study was to prospectively perform 24-hour ECG monitoring to assess the electrocardiographic effects of transcatheter closure of PFO depending on the type of implanted devices. Material and methods 351 consecutive adult subjects (196 F, 155M; mean age: 40.9±15.3) were enrolled into the study to undergo PFO closure with an Amplatzer Septal Occluder - ASO (157 pts: 117 occluders – size 25; 40 pts – size 30), and Cardia device (194 pts: 163 occluders – size 25; 31 – size 30). Holter monitoring was performed on all patients before, at 1 and 12 months after the procedure. Results The success rate of PFO closure was 97.8% (351 cases from 359 qualified in TEE), in 8 cases the PFO tunnels were too small to be forced by a catheter, in one case the PFO device caused an injury of the septum and an ASD Amplatzer device was implanted. During the procedure in 3 (0.85%) cases transient supraventricular arrhythmia and in 1 (0.28%) case bradycardia to 27 bpm occurred. At 1 month: in 7 (2%) pts changes in AV conduction occurred: 1 pt (0.28%) had complete AV dissociation, 6 (1.7%) pts intermittent first degree AV block; paroxysmal atrial fibrillation (pAF) occurred in 6 (1.7%) pts, 2 of whom had pAF prior to closure. A significant increase in the number of SVE premature beats/24h was noted at 1 month after the procedure: 1167.9±409 (27–9976) compared to baseline data 60.2±44 (0–601) (p<0.0001), at 12 months the SVE number decreased to 57.2±51 (7–752) and did not differ significantly from the baseline data. There was no change in the mean number of ventricular arrhythmias/24h after the procedure. There was a significant correlation between SVE premature beats/24h at 1 month after the procedure and device size (p<0.001 r=97211). Pts with ASO device had a significantly higher number of SVE ectopy at 1 month after PFO closure (19123.9±70) compared to pts with Cardia device (811.9±324), p<0.0001. Conclusions 1. Transcatheter closure of PFO is associated with a transient increase in supraventricular premature beats and a small risk of AV conduction abnormalities and paroxysmal atrial fibrillation in the early follow-up. There is regression of periprocedural arrhythmias after 12 months of PFO closure. 2. Transcatheter closure of PFO with Cardia device is related to a lower risk of supraventricular arrhythmias in the early follow-up. 3. The smaller device is implanted the lower risk of periprocedural arrhythmias is expected.
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Yang, Huaxiao, Nicolas Rogozinski, Hung-Ta Wo, Gautham Mohanraj, Joseph Wu, and Oscar Abilez. "Abstract We015: Modeling Cardiac Arrhythmogenicity of hiPSC-CMs and Cardiac Fibroblasts Nanopatterned Coculture and Machine Learning." Circulation Research 135, Suppl_1 (2024). http://dx.doi.org/10.1161/res.135.suppl_1.we015.
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Background: Sudden cardiac death is one of the most threatening heart conditions in the U.S. Most individuals have an underlying structural cardiac disease associated with cardiac fibrosis and ventricular arrhythmia. The relationship between fibrosis and arrhythmias is found to be related to cardiovascular cell couplings, especially cardiomyocytes (CMs) and cardiac fibroblasts (CFs). While animal models have been applied to model cardiac arrhythmias, the disparities between animal models and humans limit the accuracy of pro-arrhythmic predictions. The use of human induced pluripotent stem cells (hiPSCs)-derived CMs has permitted highly modular testing conditions, specifically the ratio of CFs to CMs in an engineered coculture system. Moreover, machine learning (ML) has become an emerging tool in cardiology, such as cardiac toxicity and function evaluation and classification, with its unique advantages of high accuracy and efficiency with less human bias and intuition. Hypothesis: We hypothesize that cardiac fibrosis-associated arrhythmia will be modeled by nanopatterned coculture of hiPSC-CMs and CFs at varied ratios, and the arrhythmic samples will be accurately and efficiently classified by ML algorithms. Approach: The hiPSC-CMs were cocultured and nanopatterned with CFs at ratios of 0 to 30% for 7 days. Upon the electrical pacing at 1Hz, the action potential was recorded by live-cell optical mapping with FluoVolt. The recorded membrane potential and electrical propagation were analyzed by Matlab-based Electomap software. Results: The cocultured hiPSC-CMs and CFs were aligned with aligned sarcomeres and uni-directional contraction ( Fig. 1a ). The cardiac arrhythmia was observed in 15% CFs with spiral wave ( Fig. 1b ) in comparison to the hiPSC-CMs with 0% CF. Beat-to-beat and depolarization durations were found significant with top ranks in Feature Importance to facilitate the distinction between arrhythmic and non-arrhythmic samples by the unsupervised K-means Clustering ( Figs. 1c and d ). Conclusions: We have successfully established a nanopatterned coculturing system of hiPSC-CMs and CFs for modeling cardiac fibrosis-induced arrhythmia, which was further analyzed and classified by ML algorithms. This system reveals great potential for better understanding the relationship between cardiac fibrosis-associated arrhythmia and sudden cardiac death and also drug evaluation for anti-cardiac arrhythmia.
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Yang, Kai-Chien, Cody A. Rutledge, Mao Mao, et al. "Abstract 9861: Caveolin 1-Regulated Src-dependent Cardiac Connexin 43 Degradation Mediates Renin-Angiotensin System Activation-Induced Arrhythmias." Circulation 128, suppl_22 (2013). http://dx.doi.org/10.1161/circ.128.suppl_22.a9861.
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Background: Activation of the cardiac renin-angiotensin system (RAS) is associated with increased risk of ventricular arrhythmia and sudden cardiac death. Increased cardiac RAS activity leads to conduction block and spontaneous ventricular arrhythmias as a result of connexin 43 (Cx43) degradation mediated by the activation of redox-sensitive tyrosine kinase c-Src signaling. The molecular mechanism of c-Src activation downstream of RAS signaling remains elusive. Results: Using a transgenic mouse model of cardiac-specific overexpression of angiotensin converting enzyme (ACE8/8) and a heterologous expression system, we uncovered a ~50% reduction in the binding of c-Src to caveolin 1 (Cav1) and subsequent c-Src activation as a result of S-nitrosylation of Cav-1 at Cys156 (Cav1-SNO) upon enhanced RAS signaling. RAS-induced Cav1-SNO and Src activation was mediated by eNOS-derived NO in response to increased mitochondrial oxidative stress. Knockout of Cav1 (but not caveolin 3) resulted in activation of c-Src, degradation of Cx43 (42% reduction from WT level), reduced cardiac conduction velocity (by 30%), and increased arrhythmic risk (75% Cav1-/- vs. 0% WT mice showed induced ventricular arrhythmia). Arrhythmic risk in Cav1-/- mice was mitigated by pharmacological inhibition of c-Src. Conclusions: Cav1 S-nitrosylation plays a critical role in mediating RAS-induced arrhythmias by increasing c-Src activity. Oxidative stress-induced Cav1 S-nitrosylation in response to cardiac RAS signaling promotes Src-dependent disruption of Cx43 hemichannels and ventricular arrhythmia. These findings may explain the genetic association of Cav1 with arrhythmias and suggests that targeted regulation of Cav1 or antioxidant therapy may reduce arrhythmic risk during RAS activation.