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The Autonomic Nervous System and Heart Failure
The Autonomic Nervous System and Heart Failure

... reduced in patients with HF,62,63 resulting in increased heart rate and decreased heart rate variability (HRV), both of which are correlated with increased mortality.64 Muscarinic receptor stimulation in the failing human left ventricle was shown to have an independent negative lusitropic effect and ...
Anatomical Variants of Coronary Venous System on Cardiac
Anatomical Variants of Coronary Venous System on Cardiac

... Background:  In a few studies, huge anatomical variability of coronary venous system (CVS) has been documented without analysis of its variants. The aim of the present study was to evaluate anatomical variants of CVS in multislice computed tomography (MSCT). Methods and Results:  In 199 patients (11 ...
echocardiography
echocardiography

... • The test also identify areas of heart ms that are not contracting normally due to poor blood flow or injury from previous heart attack • Helps in calculation of C.O as well as ejection fraction,cardiac dimensions • A type of echo called doppler ultrasound shows how well blood flows through the ch ...
Cardiac Disease In Cats 2016
Cardiac Disease In Cats 2016

... Hypertrophic Cardiomyopathy (HCM): This is the most common form of heart disease in domestic cats. In humans, HCM has a genetic basis, and several hundred mutations have been associated with the disease. HCM is known to be inherited in several breeds, and genetic mutations (in “Myosin Binding Protei ...
Heart Failure
Heart Failure

... functioning properly, and the valves opening and closing correctly, this process is usually extremely efficient. However, if the ventricles cannot contract strongly enough to pump blood adequately, the valves are impaired, or the ventricles are too stiff to fill properly, heart failure occurs. Heart ...
Outcomes following aortic valve replacement for
Outcomes following aortic valve replacement for

... evaluate the isolated effect of AVR in those without concomitant CAD. There is no known published data available on survival, changes in ventricular function and long-term follow up from any South African institute to date. The purpose of this ...
Acute Management of Wide QRS
Acute Management of Wide QRS

... Patients with paroxysmal arrhythmias are most often asymptomatic at the time of evaluation. Arrhythmia-related symptoms include palpitations; fatigue; lightheadedness; chest discomfort; dyspnea; presyncope; or, more rarely, syncope. ...
Cardiac muscle structure
Cardiac muscle structure

... The most important forces are capillary hydrostatic pressure (PC) & plasma protein protein osmotic pressure (P) 3-4 L/day more fluid is filtered than is absorbed That 3-4 L re-enters blood via the lymph ...
Quantification of Myocardial Extracellular Volume Fraction in
Quantification of Myocardial Extracellular Volume Fraction in

... pro-brain natriuretic peptide [NT-proBNP] and Troponin T), echocardiography, SAP scintigraphy, including measurement of total body amyloid load, and a 6-minute walk test, although this was not possible in some patients(n=23, 38%) mainly because of other comorbid factors (eg, arthritis, postural hypo ...
Cardiomyopathies - Society of Cardiovascular Anesthesiologists
Cardiomyopathies - Society of Cardiovascular Anesthesiologists

... throughout the heart. For children under 10 years of age, the survival is less than 2 years, while more than 60% of adults survive beyond 4 years. Echocardiographic evaluation reveals diastolic dysfunction, relatively normal systolic function, variable myocardial thickening, atrial enlargement with ...
Beyond ejection fraction: an integrative approach for assessment of
Beyond ejection fraction: an integrative approach for assessment of

... As a measure of cardiac function, ejection fraction has several important limitations. Calculated as the stroke volume divided by end-diastolic volume, the estimation of ejection fraction is generally based on geometric assumptions that allow for assessment of volumes based on linear or two-dimensio ...
Effects of Epoprostenol on Right Ventricular Hypertrophy and
Effects of Epoprostenol on Right Ventricular Hypertrophy and

... between the three follow-up measurements were not significant). Without any significant change of mean heart rate throughout the study (Fig 3, bottom left), this increase in stroke volume lead to an equal increase in COmri. Within the first 4 months, COmri increased from an average of 3.0 to 3.5 L/m ...
Long-term outcome in congenitally corrected transposition of
Long-term outcome in congenitally corrected transposition of

... as complete a CCTGA population capture as possible. Because CCTGA is such an unusual diagnosis, it is our hypothesis that most patients would be included in this review. These chart reviews were performed without any patient being identified except by number. The study was in compliance with each in ...
Recruitment of Patients
Recruitment of Patients

... The observation period was continued through the planned completion date of January 31, 1992, by which time the last patient enrolled had finished the prespecified minimal follow-up period of two years. As prospectively specified by the Data, and Safety Monitoring Committee, patients who underwent c ...
Cardiovascular Perspective - Circulation: Cardiovascular Quality
Cardiovascular Perspective - Circulation: Cardiovascular Quality

... or housekeeping); only 4% reported such activity levels before implantation.11 Tested patients reported significantly improved quality of life at 2 years compared with before MCS.9,10 Impact on quality of life, rather than only survival, is central to the decision-making process for a patient consid ...
A rare case: Coronary sinus thrombosis
A rare case: Coronary sinus thrombosis

... References: The McGraw-Hill Companies, Inc. Tributaries with contribution to the coronary sinus include: the anterior interventricular vein, also known as the great cardiac vein, running in the anterior interventricular sulcus parallel to the left anterior descending coronary arterry; the posterior ...
Echocardiographic assessment of systemic cardiac
Echocardiographic assessment of systemic cardiac

... pathophysiological aspects, typical of this disease, that outline its basic hemodynamic performance, influence on cardiac output and create potential conditions for the short-term prognosis. METHOD Patients and type of study The William Soler Pediatric Cardiology Hospital re- ...
Classification of Electrocardiogram (ECG) Waveforms for the
Classification of Electrocardiogram (ECG) Waveforms for the

... algorithm based on slope, amplitude and width of the QRS complexes ...
Advances in Environmental Biology
Advances in Environmental Biology

... Objective: Cardiac rehabilitation after coronary artery bypass surgery (CABG) is one of the well-known and effective methods in increasing physiologic function and functional capacity of patients. In this study, we compared the effects of two short-term (8-session and 24-session) cardiac rehabilitat ...
A Large Whale Heart
A Large Whale Heart

... of 10 beats per minute was chosen arbitrarily, since the actual heart beat was not measured. At this assumed rate, the cardiac output would be a staggering 453 L. per minute with assumed complete ventricular emptying at each stroke. Similar calculation for the cardiac output of the fetal whale was n ...
No Slide Title
No Slide Title

... Class III  Marked limitation of physical activity (Pre-transplant)  Less-than-ordinary activity results in symptoms Class IV  Inability to carry on any physical activity with discomfort and (Pre-transplant) symptoms ...
Studying Heart Rate
Studying Heart Rate

... most important include age, gender, heart disease, stress, thyroid problems, anemia, stimulants, depressants, and other medications. The maximum rate that a heart can beat is generally the same for people within the same age group. The maximum cardiac rate for an individual is calculated by subtract ...
10. Heart - Dr. Salah A. Martin
10. Heart - Dr. Salah A. Martin

... i. This gives a reserve amount of blood that could also be ejected if necessary (e.g., during exercise). c. Amount of blood ejected during this phase is known as the stroke volume. i. Stroke volume is the difference btwn end diastolic and end systolic volumes: SV=EDV-ESV. ii. A more vigorous contrac ...
Subclinical Left Ventricular Dysfunction in Chronic Asymptomatic
Subclinical Left Ventricular Dysfunction in Chronic Asymptomatic

... atherosclerosis, hypertension or valvular disease(1). Although left ventricular (LV) dysfunction is a frequent finding among chronic alcoholic patients, it would be crucial to find a method for the reliable detection of LV dysfunction onset in chronic asymptomatic alcoholic patients before irreversi ...
ECG Leads - Pediatric Associates of Newnan
ECG Leads - Pediatric Associates of Newnan

... – Some monitor from one to five different leads – Others are capable of monitoring up to twelve or more leads simultaneously ...
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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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