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Certain Mechanical Peculiarities of the Human Cardiac
Certain Mechanical Peculiarities of the Human Cardiac

... The ratio of the volume to the area is, therethe cardiac cycle. Although the left ventricle fore, 1 r. Thus, when the size of the sphere is of the human heart is considered throughout altered, its volume changes more rapidly than this presentation, the same concepts may be its surface area. The hear ...
Arrhythmia ToolBox Resources
Arrhythmia ToolBox Resources

... Content Course I: AACN - Basic ECG Interpretation by American Association of Critical-Care Nurses (ACCN) is designed to provide knowledge and enhance skills in adult ECG interpretation basics including rhythm categories of sinus, atrial, junctional, ventricular, and heart blocks, cardiac anatomy and ...
HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis
HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis

... review of the literature with respect to the clinical data on patients affected by channelopathies. This document does not address the indications of genetic testing in patients affected by inherited arrhythmias and their family members. Diagnostic, prognostic, and therapeutic implications of the re ...
Identification of Microvascular Obstruction Christopher M. Kramer
Identification of Microvascular Obstruction Christopher M. Kramer

... demonstrated on steady state free precession cine imaging after gadolinium infusion[3]. The latter imaging strategy has been shown to correlate with findings on first pass-contrast enhanced perfusion imaging and inversion recovery gradient echo imaging[3]. These regions are generally subendocardial ...
Targeted Metabolic Imaging to Improve the Management of Heart
Targeted Metabolic Imaging to Improve the Management of Heart

... in preference to carbohydrates (the Randle hypothesis) (10), but it increases carbohydrate oxidation when stressed (11). When myocardial blood flow is impaired, the balance between cellular metabolism and contractile function is perturbed. The decrease in coronary flow and concomitant reduction in o ...
Do Angiographic Characteristics Explain Racial Differences In
Do Angiographic Characteristics Explain Racial Differences In

... access issues. Arm access also facilitates internal mammary access, especially in patients with tortuous innominant or subclavian arteries. Radial artery access is also used commonly in some practice settings. Before radial access is performed, competence of the radial artery arch should be assessed ...
Defining the mid-diastolic imaging period for cardiac CT – lessons
Defining the mid-diastolic imaging period for cardiac CT – lessons

... University of New South Wales, Sydney, NSW, Australia ...
The Association between Glomerular Hyperfiltration and Left
The Association between Glomerular Hyperfiltration and Left

... with a multivariate linear regression test with stepwise subset selection to identify independent factors associated with LVMI or E/E’. In the present study, the mean LVMI was 156.73 ± 26.80 g/m2 in group 1 patients. In our previous study, the mean LVMI in essential hypertensive patients was 102 ± 2 ...
Change in end-tidal carbon dioxide outperforms other surrogates for
Change in end-tidal carbon dioxide outperforms other surrogates for

... During acute circulatory failure, volume expansion (VE) is often the first-line therapy1 to increase cardiac output (CO). But either insufficient2 or overzealous VE3 can negatively impact patient outcome. Therefore, rational administration of fluids requires reliable identification of patients in wh ...
Elevated circulating cardiotrophin-1 in heart failure
Elevated circulating cardiotrophin-1 in heart failure

... biology and medicine. This is the first report of elevated plasma CT-1 levels in subjects with LVSD. While the exact role of CT-1 in LVSD and its relationship with ventricular remodelling remain to be defined, related cytokines such as tumour necrosis factor-α and certain interleukins are capable of ...
15.0 Hours Cardiac Dysrhythmias and Therapeutic Modalities
15.0 Hours Cardiac Dysrhythmias and Therapeutic Modalities

... Once the carbon dioxide and oxygen is exhaled, oxygen is inhaled and an exchange of gases or diffusion occurs at the millions of alveolar capillary membranes in the lungs. It is at this location that oxygen attaches to the hemoglobin receptor sites on the red blood cell. The oxygenated blood is carr ...
placing epicardial pacing wires in isolated coronary artery bypass
placing epicardial pacing wires in isolated coronary artery bypass

... ventricular, or bichamber pacing was used leaving the operating room or in the immediate postoperative period. All patients underwent median sternotomy. Cardiopulmonary bypass was carried out. Moderate systemic hypothermia (32 °C) and topical cardiac hypothermia was used to reduce temperature. Mostl ...
Exercise Prescription for Cardiovascular Diseases
Exercise Prescription for Cardiovascular Diseases

... (Noncompetitive) Sports Activities and Exercise in Patients With Genetic CVD ...
Non-Linear Relationship between Heart Period and Root Mean
Non-Linear Relationship between Heart Period and Root Mean

... Semi-log and log-log relationships have been used to relate inter-subject mean heart period and rMSSD [2-4]. In the present work, both regressions presented high correlation values for intra-subject assessment, although log-log regression was slightly better for most of the participants. Correlation ...
Clinical approach to determination of the need for prophylaxis in
Clinical approach to determination of the need for prophylaxis in

... • Previous rheumatic fever without valvular dysfunction • Cardiac pacemakers and implanted defibrillators Prevention of Bacterial Endocarditis: Recommendations by the American Heart Association ...
Prognosis of Patients with Acute Pulmonary After Acute
Prognosis of Patients with Acute Pulmonary After Acute

... had unexpectedly normal or only mildly depressed ,ejection fractions (0.55 ± 0.06). This was in contrast to the study by Schelbert et al.,14 which showed that patients who had manifested overt pulmonary edema in the course of acute myocardial infarction had ejection fractions that were severely depr ...
Atrial Fibrillation - CardiacAndVascular.com
Atrial Fibrillation - CardiacAndVascular.com

... especially during physical activity. For this reason people with atrial fibrillation have a decreased ability to exercise. Stroke is the major complication caused by atrial fibrillation. When blood does not completely empty out of the rapidly beating atria, a clot can develop in the blood that pools ...
Module I E.C.G. RHYTHM INTERPRETATION
Module I E.C.G. RHYTHM INTERPRETATION

... transmission of the impulses throughout the heart in a coordinated manner, producing the rhythmic contraction associated with normal cardiac output. Impulses generated by the SA node travel along specialized tissue known as the conduction pathways. The impulse travels to the AV node where it is dela ...
Coronary Heart Disease
Coronary Heart Disease

... Key Words: coronary artery disease ◼ receptor, IGF type 1 ◼ stem cells ◼ telomerase ◼ telomere ◼ ventricular remodeling ...
Assessment of heart murmurs in childhood
Assessment of heart murmurs in childhood

... agents and become ill more frequently due to other systemic pathologies.7-9 Acquired heart diseases, as well as congenital, can also be identified later in life, especially in the case of patients who perform strenuous physical activities. Kawasaki disease, for instance, can be a cause for stroke, v ...
Copy of Layout 1 - The Practitioner
Copy of Layout 1 - The Practitioner

... of young athletes. The ECG has the ability to detect congenital accessory pathways and ion channelopathies, and is frequently abnormal in individuals with cardiomyopathy. Screening with a 12-lead ECG in older athletes is of limited value given the overwhelming contribution of atherosclerotic CAD to ...
The Effects of Nitroglycerin on the Heart Rate of the 120
The Effects of Nitroglycerin on the Heart Rate of the 120

... Bradycardia did occur for all concentrations of NG in both the in vivo and in vitro embryos, which supports our hypothesis. The heart rate of the in vitro embryo decreased in direct proportion to the increase in NG concentration, but did not in the in vivo embryo. The discrepancy may be due to the i ...
Diagnostic exercise tests on 4000 consecutive men
Diagnostic exercise tests on 4000 consecutive men

Diastolic Dysfunction and Anaesthetic Implications Dr S Kumar MD
Diastolic Dysfunction and Anaesthetic Implications Dr S Kumar MD

... degree of diastolic dysfunction [7]. Induction of anaesthesia results in significant alterations in ventricular filling in patients with diastolic dysfunction. In patients requiring cardiac surgery, diastolic dysfunction has been shown to be a better predictor of haemodynamic instability than systol ...
Relationship of Left Ventricular Structure to
Relationship of Left Ventricular Structure to

... relatively poor relationship between HRmax and age therefore limits the prediction of HRmax as an indicator of maximal effort during exercise testing, to establish a target heart rate for exercise training, and to identify individuals with a truly abnormal HRmax. Previous studies have used age as th ...
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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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