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ACC/AHA 2002 Guideline Update for the Management Elevation Myocardial Infarction
ACC/AHA 2002 Guideline Update for the Management Elevation Myocardial Infarction

... These statements are reviewed by the parent task force, reported orally to all members of the writing panel at the first meeting, and updated as changes occur. These practice guidelines are intended to assist physicians in clinical decision making by describing a range of generally acceptable approa ...
2013 ESC guidelines on the management of stable coronary artery
2013 ESC guidelines on the management of stable coronary artery

... The content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permission can be obtaine ...
Intercapillary Distance and Capillary Reserve in
Intercapillary Distance and Capillary Reserve in

... WEARN et al.1-2 were the first to report that myocardial capillary circulation is compromised by the hypertrophy of disease. They concluded that neither the fibers nor the capillaries proliferate, and that the distance between capillaries increases because fiber diameter increases. This view has bee ...
Intercapillary Distance and Capillary Reserve in Hypertrophied Rat
Intercapillary Distance and Capillary Reserve in Hypertrophied Rat

... WEARN et al.1-2 were the first to report that myocardial capillary circulation is compromised by the hypertrophy of disease. They concluded that neither the fibers nor the capillaries proliferate, and that the distance between capillaries increases because fiber diameter increases. This view has bee ...
Pulmonary hypertension caused by pulmonary venous hypertension
Pulmonary hypertension caused by pulmonary venous hypertension

... emphasis on its effect on PVR; (3) the effect of reduction of pulmonary venous pressure on PVR; (4) mechanical forces, especially increased wall stress, as the putative proximate cause of increased PVR with PVH; and (5) issues related to evaluating pharmacologic therapy aimed at reducing PVHPH. The ...
Save as PDF
Save as PDF

... TactiCath Quartz would be used in a cardiac catheterisation laboratory during percutaneous PVI. It would be used by cardiac electrophysiologists trained in cardiac ablation who have appropriate training on TactiCath Quartz and the TactiSys Quartz system. The procedure is usually done with the patien ...
New Insights into Mechanisms of Atrial Fibrillation
New Insights into Mechanisms of Atrial Fibrillation

... An imbalance in autonomic nervous system activity can result in significant changes in cardiac electrophysiological properties of the atrial myocardium which may facilitate induction of AF. Vagal nerve stimulation causes the shortening of an effective refractory period and facilitates induction of A ...
Guidelines for the Management of Patients with Acute Myocardial
Guidelines for the Management of Patients with Acute Myocardial

... of such guidelines in the area of cardiovascular disease since 1980. This effort is directed by the ACC/AHA Task Force on Practice Guidelines, which is charged with developing and revising practice guidelines for important cardiovascular diseases and procedures. Experts in the subject under consider ...
healthcare professionals should be able to recognise cardiac arrest
healthcare professionals should be able to recognise cardiac arrest

... as soon as two minutes after starting chest compressions. An in-hospital patient study showed that, even while using real-time feedback, the mean depth of compression deteriorated between 1.5 and 3 min after starting CPR. It is therefore recommended that CPR providers change over about every two min ...
The Anomalous Origin of the Left Coronary Artery from the
The Anomalous Origin of the Left Coronary Artery from the

... oxygen, the baby may also need surgery to repair or replace the valve. The mitral valve controls blood flow between the chambers on the left side of the heart. If the baby's heart is already severely damaged from lack of oxygen, a heart transplant may be an option. Medicines used include: ...
Brugada Syndrome - Department of Medicine | Columbia University
Brugada Syndrome - Department of Medicine | Columbia University

Negative Inotropic and Chronotropic Effects of Oxytocin
Negative Inotropic and Chronotropic Effects of Oxytocin

... significant decrease in both beating rate and force of contraction. The effects developed rapidly, beginning within 40 seconds, which corresponded to transit time through the dead space of the tubing. The effects were transient, reaching a minimum then returning to the basal value within 80 seconds ...
ANTIARRHYTHMIC THERAPY FOR ATRIAL
ANTIARRHYTHMIC THERAPY FOR ATRIAL

... and in AF with either a short arrhythmia duration or a normal left atrial size. For the prevention of AFL and AF, the following drugs have been recommended: disopyramide, quinidine, propafenone, flecainide, sotalol and amiodarone. Currently, catheter ablation using radiofrequency electrical energy i ...
avandamet tablets
avandamet tablets

... function. Treatment with AVANDAMET should not be initiated in patients ≥80 years of age unless measurement of creatinine clearance demonstrates that renal function is not reduced, as these patients are more susceptible to developing lactic acidosis. In addition, AVANDAMET should be promptly withheld ...
pulmonary hypertension and a continuous murmur due to
pulmonary hypertension and a continuous murmur due to

... given in detail. Three of the four patients were females aged 13, 15, and 33 years. The fourth was a male aged 10 years. All had pulmonary hypertension (56/18, 56/13, 72/7, 108/22 mm. Hg). The girl aged 13 years had a continuous murmur over the entire chest and the angiocardiographic appearances wer ...
After reading this chapter you will be able to
After reading this chapter you will be able to

... two leads the axis falls midway between the two leads. Figure 11-12 shows the degree at which each lead lies and thus it is easy to determine the axis ...
The Influence of Cardiac Trabeculae on Ventricular
The Influence of Cardiac Trabeculae on Ventricular

... a fundamental parameter in heart functioning; more than the 50% of the patients suffering of heart failure symptoms show a normal ejection fraction and are referred to as diastolic heart failure patients. In this context, the trabeculae can play a fundamental role, since they significantly contribut ...
Role of SR in tuna atrial muscle contraction
Role of SR in tuna atrial muscle contraction

... frequencies (0.2–0.5 Hz) and a negative staircase within the more physiologically relevant frequency range (greater than 1.0 Hz) (Fig. 1). At 15 °C and 18 °C, trabecular contractions often became irregular at frequencies greater than 2.0 Hz and 3.0 Hz, respectively (denoted by the unconnected data p ...
Public Access Defibrillation Program Guide
Public Access Defibrillation Program Guide

... recommend not shocking when defibrillation is not indicated). Due to the wide variety of situations in which it will typically be used, the AED is designed with multiple safeguards and warnings before any energy is released. The AED is programmed to deliver a shock only when it has detected VF. Howe ...
and Absence of Coronary Sinus
and Absence of Coronary Sinus

... atrial septal defect was closed and 1 day before death. The brain, although not the site of a distinct abscess, showed unilateral acute encephalomalacia with thrombosis of the right internal carotid artery and signs of meningitis. In the second case (case 8), a brief and self-limited illness suggest ...
T wave alternans in experimental myocardial infarction: Time course
T wave alternans in experimental myocardial infarction: Time course

... likely explanation for the TWA that occurred independently of heart rate increase was severe acute ischemia that impairs cellular calcium cycling, which would permit alternans to be initiated at slower heart rates. 25,26 Clinical data on TWA occurrence in the acute phase of STEMI are scarce 27,28 wh ...
Mitral Valve Regurgitation: Surgical Treatment
Mitral Valve Regurgitation: Surgical Treatment

... there is a clear indication for emergency operation if, after more than one week’s antibiotic treatment, the patient remains septic, there is haemodynamic deterioration and mobile vegetations can be seen on the echocardiogram33. 420 ñ HJC (Hellenic Journal of Cardiology) ...
2014 ACC/AHA Guideline on Perioperative Cardiovascular
2014 ACC/AHA Guideline on Perioperative Cardiovascular

... 3. Calculation of Risk to Predict Perioperative Cardiac Morbidity ...................................................................... 24 3.1. Multivariate Risk Indices: Recommendations ........................................................................................... 24 3.2. Inclusion of ...
Indications for Coronary Angiography
Indications for Coronary Angiography

... (Anderson et al, 2011) acknowledge that in selective patients without high-risk features who have been stabilized, an initially conservative strategy may not be inappropriate, especially those with serious co morbidities or contraindications to angiography and intervention who have an elevated risk ...
2014 ACC/AHA Guideline on Perioperative Cardiovascular
2014 ACC/AHA Guideline on Perioperative Cardiovascular

... 3. Calculation of Risk to Predict Perioperative Cardiac Morbidity ...................................................................... 24 3.1. Multivariate Risk Indices: Recommendations ........................................................................................... 24 3.2. Inclusion of ...
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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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