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Rate Versus Rhythm Control Pharmacotherapy For Atrial Fibrillation
Rate Versus Rhythm Control Pharmacotherapy For Atrial Fibrillation

... produce worsened sinus node function inpatients with the brady-tachy syndrome, and hence, is the preferred agent inthis condition where its use may avoid the necessity of inserting a pacemakerto support the use of an alternative AV nodal blocking agent; 3) ablation of ordrug suppression of an antegr ...
Adrenomedullin-epinephrine cotreatment enhances cardiac output and left
Adrenomedullin-epinephrine cotreatment enhances cardiac output and left

... a physiological interaction. We assessed the hemodynamic and energetic profile of AM-EPI cotreatment, exploring whether drug interaction improves cardiac function. Left ventricular (LV) mechanoenergetics were evaluated in 14 open-chest pigs using pressure-volume analysis and the pressure-volume area ...
Core and peripheral temperature response to exercise
Core and peripheral temperature response to exercise

... index of core temperature reported similar findings.8 It is not easy to explain this fall in temperature but recycling of blood from relatively cool vasoconstricted peripheries and decrease in the central temperature as this blood mixes with the central blood would seem to offer the best explanation ...
ELECTROCARDIOGRAM
ELECTROCARDIOGRAM

... Most common sustained arrhythmia associated with increased CV mortality and morbidity Prevalence increasing with age, doubling with each successive decade, 70% in ages 65-85 Multiplier effect on risk ...
Basic Cardiac Echo
Basic Cardiac Echo

... o I.E. angled along the short axis of the heart o In this view, the heart appears in transverse section o Then tilt the probe from apex to base of the heart. This allows a number of different ‘slices’ to be obtained: § PSAX- AV [level of aortic valve] § PSAX-MV [level of mitral valve = base of LV] ...
Atrial Fibrillation, Inflammation and Statins
Atrial Fibrillation, Inflammation and Statins

... techniques, pharmacological therapy remains the main approach in the treatment of AF.19 Treatment is based on rate or rhythm control to reduce symptoms, the prevention of tachycardia-mediated cardiomyopathy20 and anticoagulation to reduce the thromboembolic risk.21 Statins have potent anti-inflammat ...
Closing the Pore on Reperfusion InjuryMyocardial
Closing the Pore on Reperfusion InjuryMyocardial

... to cyclosporine in that it prevents the opening of the mPTP and protects the heart from reperfusion injury, has recently been shown to be more effective than cyclosporine in an in vivo rat heart and isolated mouse heart experiment.3 How much this is applicable to humans and how much the effect of in ...
THE ANGLE OF ELECTRICAL CARDIAC AXIS IN TRAINED
THE ANGLE OF ELECTRICAL CARDIAC AXIS IN TRAINED

... The most pronounced rotation of electrical cardiac axis in horses is due to the body growth and to one-sided so-called growth hypertrophy of the left heart (Deegen and Matthiesen 1977; Hanak 1979, 1980a,b). Starting from the age of 13-15 months, bilateral hypertrophy is developing and the electrical ...
gradual recovery of impaired cardiac autonomic balance within first
gradual recovery of impaired cardiac autonomic balance within first

... Cardiac autonomic balance was evaluated by analysis of HRV. All HRV variables were measured through the 23.2-hour period (ranged 21 to 24 hours). Ambulatory ECG recordings were made by 3-channel Medilog Digital Holter recorders FD3, Oxford, with 1024 Hz resolution. HRV was analyzed by computer and ...
European Heart Rhythm Association/Heart Failure Association joint
European Heart Rhythm Association/Heart Failure Association joint

... (NYHA) functional Class I symptoms8 to nearly 50% in the NYHA Class IV patients.9 The prevalence of AF is high in HF patients with preserved left ventricular (LV) ejection fraction (HF-pEF) as well. The co-existence of HF and AF may be, at least partly, explained by the presence of common risk facto ...
Assessment and management of patients with ischemic heart disease
Assessment and management of patients with ischemic heart disease

... of perioperative cardiac complications, and 3) minor clinical predictors (hypertension, left bundle branch block, nonspecific ST-T wave changes, history of stroke) are recognized markers of CAD that have not been proven to independently increase perioperative risk (11). Functional capacity, also ref ...
Ch19.Heart
Ch19.Heart

... – Anchors valve cusps – Prevents overdilation of valve openings – Main point of insertion for cardiac muscle – Blocks direct spread of electrical impulses ...
High-resolution reconstruction of the beating zebrafish heart
High-resolution reconstruction of the beating zebrafish heart

... one movie per plane (movie stack), with each movie covering at least one cardiac cycle (Fig. 1b). A movie stack across the entire heart consisted of 150–250 movies with a spacing of 1–2 m between planes. Cardiac contractions in these movies were out of phase and could not be directly assembled into ...
Analysis of the RSR` Complex in Lead V1
Analysis of the RSR` Complex in Lead V1

... crista supraventricularis, possibly due to variations in the density of the Purkinje fibers in this region of the myocardium. It would be interesting to know if the RSR' pattern in lead V1 has a genetic basis. In any case the R' wave may be a manifestation of slow conduction in the last few hundreds ...
Cardiology Presentation
Cardiology Presentation

... • *1 patient from each group 1 and 2 had thrombus at one month and was receiving warfarin when the stroke occurred (at 6 and 8 weeks) Pharmacy Services ...
presentation, diagnosis, and management
presentation, diagnosis, and management

... There is some evidence that the use of leucocyte interferonalpha controls the secretion of tumour products. It stimulates T lymphocytes and can produce a notable reduction in tumour size with evidence of survival benefit. Interferonalpha can be used in conjunction with somatostatin antagonists. Unfo ...
2- Left circumflex coronary artery
2- Left circumflex coronary artery

... - In most cases there is a history of MI - causes: 1- usually results from postinfarction cardiac decompensation 2- in other cases severe obstructive CAD may be present without prior infarction, but with diffuse myocardial dysfunction - is seen typically in elderly patients who insidiously ...
Cardiac cycle
Cardiac cycle

... Pressure changes during cardiac cycle Right Atrium Pressure = 0-8 mmHg (some books write 2-8) Explanation of the phases: o A wave: due to right atrial contraction o C wave: due to bulging of tricuspid valve into the atrium (which one?) during isovolumetric contraction. o V wave: increased pressure i ...
The Acuity Trial - Clinical Trial Results
The Acuity Trial - Clinical Trial Results

...  Patients with NSTE ACS and high risk features are typically administered an anticoagulant in the ED as empiric therapy. Whether UFH or enox is used in this setting is an issue of local preference and policy.  Hypothesis: The nature of upstream anticoagulant therapy—UFH or enox—will not affect out ...
Shot Through the Heart and I`m OK : Procainamide Cardioversion of
Shot Through the Heart and I`m OK : Procainamide Cardioversion of

... 3. Amiodarone and sotalol are not recommended for recent-onset AF a. No more effective than placebo in initial 6–8 hours b. Associated with adverse reactions IV. Recent-onset AF Management in the ED A. Strategies for ED management of AF 1. Aggressive treatment = rhythm control12,23,24 a. Meth ...
Increased Central Venous Pressure Is Associated With Impaired
Increased Central Venous Pressure Is Associated With Impaired

... and mean CVP (5.9 ⫾ 4.3 mm Hg) were within the normal range. The distribution of CVP among the study population is shown in Figure 1. Mean eGFR was moderately impaired: 65 ⫾ 24 ml/min/1.73 m2. The distribution of different factors over tertiles of CVP is shown in Table 2. Most of the characteristics ...
Pathophysiology of hypertrophic cardiomyopathy determines its
Pathophysiology of hypertrophic cardiomyopathy determines its

... Physicians treating hypertrophic cardiomyopathy (HCM) are faced with unique management challenges. Appreciating overall good prognosis in unselected patients forms the basis for medical treatment. Treatment is tailored by the presence or absence of outflow tract gradient and individual symptoms. In ...
Structural Remodeling of Cardiac Myocytes in Patients
Structural Remodeling of Cardiac Myocytes in Patients

... sure, increased chamber radius, and normal or reduced wall thickness. Consequently, both diastolic and systolic wall stress are increased. The relatively small myocyte diameter in cells from patients with ICM indicates an inappropriate response to the increase in systolic wall stress. Although the u ...
Introduction to ECG
Introduction to ECG

... ♥ Clinical correlation: Negative (often called “inverted) P waves in Lead II are a clue that the cardiac rhythm does not originate from the SA node. Later in the course, you will see some specific examples and learn more about these abnormal rhythms. ♥ Clinical correlation: P waves that are taller a ...
No Slide Title
No Slide Title

... • Myocardial infarction—sudden death of a patch of myocardium resulting from long-term obstruction of coronary circulation – Atheroma (blood clot or fatty deposit) often obstructs coronary arteries – Cardiac muscle downstream of the blockage dies – Heavy pressure or squeezing pain radiating into the ...
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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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