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PACED Sudden Cardiac Arrest Prevention Powerpoint Seminar v2
PACED Sudden Cardiac Arrest Prevention Powerpoint Seminar v2

... Any deaths occurring during or after intense physical activity? Running, swimming, cycling, soccer, hockey. ...
Problems - Heart Failure Society of America
Problems - Heart Failure Society of America

Heart Failure and Circulatory Shock
Heart Failure and Circulatory Shock

... cells as well as in the adrenal gland, suggesting that these cells are capable of both producing aldosterone and responding to it.8,9 Thus, the progression of heart failure may be augmented by aldosterone-mediated vascular remodeling in the heart and other organs. In the recent international (Random ...
Site-Specific Transseptal Puncture for Emerging Structural Heart
Site-Specific Transseptal Puncture for Emerging Structural Heart

... transseptal puncture. As with MitraClip, a more posterior puncture would allow better height above the MV and a more coaxial plane; this would facilitate transit of the balloon across the valve. Although experienced operators clearly can perform BMV without such guidance, it is possible that, given ...
Does Ischemia Burden in Stable Coronary Artery Disease Effectively
Does Ischemia Burden in Stable Coronary Artery Disease Effectively

Extreme Clinical Presentations of Venous Stasis : Coronary
Extreme Clinical Presentations of Venous Stasis : Coronary

... results secondary to acute onset venous infarction of myocardium. However chronic development of thrombus does not present with ischaemic signs due to formation of efficient collateral circulation between coronary sinus, anterior cardiac and Thebesian veins. Thus chronic development may go unnoticed ...
Impact of Acute Hyperglycemia on Myocardial Infarct Size
Impact of Acute Hyperglycemia on Myocardial Infarct Size

... (STEMI) occurs frequently and is associated with adverse outcomes. It is, however, unsettled as to whether an elevated blood glucose level is the cause or consequence of increased myocardial damage. In addition, whether the cardioprotective effect of exenatide, a glucose-lowering drug, is dependent ...
Titanium dioxide nanoparticles promote arrhythmias via a direct
Titanium dioxide nanoparticles promote arrhythmias via a direct

... AFM imaging revealed that a relevant fraction of TiO2-NPs had a diameter <100 nm (Figure 1A): specifically, single NPs had a diameter in the 25–35 nm range (Figure 1B); the overall size distribution frequency of the NPs is given in Figure 1C. In addition, NP aggregates of variable size and morpholog ...
Full Article - College of Intensive Care Medicine
Full Article - College of Intensive Care Medicine

... chamber based on the volume or pressure in the other chamber.26 Of note, the effective volume septal elastance used in their analysis is not to be equated with a muscle property, and cannot be simply related to the shape of the septum on echocardiography. The model and experimental results indicate ...
Original Article - Arquivos Brasileiros de Cardiologia
Original Article - Arquivos Brasileiros de Cardiologia

... as the concepts expressed in signed articles are of the sole responsibility of their authors and do not necessarily reflect the views of SBC. ...
What Do We Know About the “Malignant€Form”€of Early
What Do We Know About the “Malignant€Form”€of Early

... (Rapidly Ascending) ST-Segment Morphology Tikkanen et al. (6) were the first to focus on the contour of the ST-segment in ER. To define a benign form, Tikkanen et al. (6) initially studied 2 populations of healthy athletes, knowing that ER is particularly frequent in this group who generally enjoys an ...
A case of single ventricular heart, pulmonary atresia, patent ductus
A case of single ventricular heart, pulmonary atresia, patent ductus

... obstruction, maintenance of pulmonary valve competency when possible, and establishment of laminar pulmonary blood flow to all segments of the pulmonary bed.10 In addition, it has been reported that the presence of foetal major aortopulmonary collateral arteries is associated with adverse outcome, t ...
Impact of obstructive sleep apnoea on diastolic function
Impact of obstructive sleep apnoea on diastolic function

... heart failure with preserved ejection fraction (HFprEF) and left ventricular (LV) diastolic dysfunction is considered to be a common underlying pathology [4]. HFprEF typically occurs in the elderly and is associated with classical risk factors, such as arterial hypertension [5], diabetes mellitus [6 ...
Aortic fat pad and atrial fibrillation: cardiac lymphatics revisited
Aortic fat pad and atrial fibrillation: cardiac lymphatics revisited

... Journal compilation ª 2009 Royal Australasian College of Surgeons ...
Epiblastic Cited2 deficiency results in cardiac phenotypic
Epiblastic Cited2 deficiency results in cardiac phenotypic

... Aims Deletion of the transcription factor Cited2 causes penetrant and phenotypically heterogenous cardiovascular and laterality defects and adrenal agenesis. Heterozygous human CITED2 mutation is associated with congenital heart disease, suggesting haploinsufficiency. Cited2 functions partly via a No ...
Downloaded - UNM Hospitalist Wiki
Downloaded - UNM Hospitalist Wiki

... oronary artery disease (CAD) with associated myocardial infarction (MI) is the most common cause of morbidity and mortality in the United States.1 Often MI is the first symptom of CAD, suggesting the need for more effective screening of high-risk, asymptomatic patients.1,2 Diabetes mellitus is the m ...
Risk assessment in patients with an acute ST
Risk assessment in patients with an acute ST

... infarction (TIMI) score. A low systolic blood pressure (<100 mmHg) and high heart rate (>100 bpm) are associated with poor short-term clinical outcomes. An observational study on 2310 STEMI patients treated with primary PCI showed that increased heart rate on admission was an independent prognostic ...
Guidelines for the Management of Patients With Atrial Fibrillation
Guidelines for the Management of Patients With Atrial Fibrillation

... †Beta blockers should be instituted following stabilization of patients with decompensated HF. The choice of beta blocker (e.g., cardioselective) depends on the patient’s clinical condition. ‡Digoxin is not usually first-line therapy. It may be combined with a beta blocker and/or a nondihydropyridin ...
Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death
Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death

... females, median age 32 years, range 19-40) with MVP due to myxomatous valve disease were identified. They represent 7% of all SCD cases and 13% of women who died suddenly, being the first structural cause in the latter group. Main clinical and pathologic data are reported in Table 1. SCD occurred mo ...
Population-based study of congenital heart defects in Down syndrome
Population-based study of congenital heart defects in Down syndrome

How to use echo-Doppler in clinical trials: different modalities for
How to use echo-Doppler in clinical trials: different modalities for

... size in ventricles with symmetric geometry and contraction [e.g. arterial hypertension, aortic stenosis (AS)] and have good reproducibility.9 Comparison of controls and patients in epidemiological studies often requires the use of gender-specific cut-off values, and normalization for body surface ar ...
Print - Circulation
Print - Circulation

... these patients had a hypertrophied, nondilated left ventricle in the absence of another cardiac or systemic disease that could produce left ventricular hypertrophy (such as valvular, hypertensive or coronary heart disease or infiltrative cardiomyopathy).11 For the diagnosis of hypertrophic cardiomyo ...


... load; the ventricle loses its ability to eject blood into a high-pressure aorta and the ejection fraction falls. The term diastolic dysfunction implies that the myofibrils do not rapidly or completely return to their resting length; the ventricle cannot accept blood at low pressures, and ventricular ...
Cardiology/EKG Board Review
Cardiology/EKG Board Review

... •  PSVT- regular; P waves retrograde if visible; rate 150-250 bpm; caroCd massage: slows or terminates •  Fluger – regular; saw-toothed pagern; 2:1, 3:1, 4:1, etc. block; atrial rate 250-350 bpm; ventricular rate ½, ⅓, ¼, etc. of atrial rate; caroCd massage: increases block •  FibrillaCon – irr ...
Coronary Artery Atherosclerosis Is Related to Reduced Regional
Coronary Artery Atherosclerosis Is Related to Reduced Regional

... Key Words: atherosclerosis 䡲 coronary circulation 䡲 calcification 䡲 MRI 䡲 myocardial function ...
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Cardiac contractility modulation



Cardiac contractility modulation (CCM) is a treatment for patients with moderate to severe left ventricular systolic heart failure (NYHA class II–IV). The short- and long-term use of this therapy enhances both the strength of ventricular contraction and the heart’s pumping capacity. The CCM mechanism is based on stimulation of the cardiac muscle by non-excitatory electrical signals (NES). CCM treatment is delivered by a pacemaker-like device that applies the NES, adjusted to and synchronized with the electrical action in the cardiac cycle.In CCM therapy, electrical stimulation is applied to the cardiac muscle during the absolute refractory period. In this phase of the cardiac cycle, electrical signals cannot trigger new cardiac muscle contractions, hence this type of stimulation is known as a non-excitatory stimulation. However, the electrical CCM signals increase the influx of calcium ions into the cardiac muscle cells (cardiomyocytes). In contrast to other electrical stimulation treatments for heart failure, such as pacemaker therapy or implantable cardioverter defibrillators (ICD), CCM does not affect the cardiac rhythm directly. Rather, the aim is to enhance the heart’s natural contraction (the native cardiac contractility) sustainably over long periods of time. Furthermore, unlike most interventions that increase cardiac contractility, CCM is not associated with an unfavorable increase in oxygen demand by the heart (measured in terms of Myocardial Oxygen Consumption or MVO2). This may be explained by the beneficial effect CCM has in improving cardiac efficiency. A meta-analysis in 2014 and an overview of device-based treatment options in heart failure in 2013 concluded that CCM treatment is safe, that it is generally beneficial to patients and that CCM treatment increases the exercise tolerance (ET) and quality of life (QoL) of patients. Furthermore, preliminary long-term survival data shows that CCM is associated with lower long-term mortality in heart failure patients when compared with expected rates among similar patients not treated with CCM.
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