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Fibrillation and defibrillation of the heart
Fibrillation and defibrillation of the heart

... time to defibrillation; electrode size, contact, pressure, and distance from the heart; previous shocks; and ventilatory phase. The success of defibrillation depends not only on threshold but also on probability. Defibrillation at too high energy levels can be proarrhythmic and cause functional and ...
Serum Levels of the Interleukin-1 Receptor Family
Serum Levels of the Interleukin-1 Receptor Family

... weight, and extent of coronary artery disease, did not correlate with baseline ST2 levels (Table 1). Few patients in this population had either a prior history of or presented with clinical evidence of heart failure. Heart rate (P⬍0.0001) and systolic blood pressure (P⫽0.05) were associated with ST2 ...
Guidelines on the management of valvular heart disease (version 2012)
Guidelines on the management of valvular heart disease (version 2012)

... assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk-benefit-ratio of particular diagnostic or therapeutic means. Guidelines are not substitutes for-, but complements to, text ...
Guidelines on the management of valvular heart disease (version 2012)
Guidelines on the management of valvular heart disease (version 2012)

... assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk-benefit-ratio of particular diagnostic or therapeutic means. Guidelines are not substitutes for-, but complements to, text ...
ESC/EACTS Guidelines on valvular heart disease
ESC/EACTS Guidelines on valvular heart disease

... assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk-benefit-ratio of particular diagnostic or therapeutic means. Guidelines are not substitutes for-, but complements to, text ...
Fellowship Handbook - Penn State Hershey
Fellowship Handbook - Penn State Hershey

... cover specific subjects that the fellow will see during their training or that of which they should have a thorough knowledge. This document should be reviewed early in the fellowship. General Program Information: Entry into the adult Cardiovascular Disease fellowship is after completion of an Inter ...
Chapter 91 - Extras Springer
Chapter 91 - Extras Springer

... behavior of this arrhythmia during programmed electrical stimulation of the heart and its response to different antiarrhythmic drugs suggest that paroxysmal atrial tachycardia is based either on reentry or on triggered activity. Triggered activity is an arrhythmogenic mechanism resulting from delaye ...
Manifest and Concealed Reentry
Manifest and Concealed Reentry

... findings in both man and experimental animals are in agreement with those of Moe and Mendez who stated that reciprocal responses can be so readily induced in normal animal hearts that their occurrence must be considered a normal physiologic response.10 This reentry can be either manifest or conceale ...
818-2787-1-RV
818-2787-1-RV

... produced during ischemia was involved in the coordination of ATP supply and demand, and also in protection from cell death using cultured cardiac myocytes. Unexpectedly, the survival rate of myocytes for 3 h simulated ischemia (SI) was increased as compared with that for 2 h SI at 24 h after reperfu ...
7 The Pericardium
7 The Pericardium

... Between the left pulmonary artery and subjacent pulmonary vein is a triangular fold of the serous pericardium known as the ligament of the left vena cava (vestigial fold of Marshall). It is formed by a serous layer over the remnant of the lower part of the left superior vena cava (duct of Cuvier), w ...
2014 ACC/AHA Guideline on Perioperative Cardiovascular
2014 ACC/AHA Guideline on Perioperative Cardiovascular

... the collaboration, changes over time, current policies, and planned initiatives to meet the needs of an evolving health -care environment. Recommendations on value in proportion to resource utilization will be incorporated as high-quality comparative-effectiveness data become available (5). The rela ...
Committee papers
Committee papers

... randomised into the study. The main purpose of the first amendment was to modify the LVEF entry criterion from ≤40% to ≤35%. This modification was essential to ensure an adequate event rate in the study population where use of evidencebased, disease-modifying agents was increasing. This change was m ...
n-3 (omega-3) polyunsaturated fatty acids prevent acute atrial
n-3 (omega-3) polyunsaturated fatty acids prevent acute atrial

... ventricular sarcolemma accompanied by a shortened ventricular action potential duration (Verkerk et al., 2006). This was accompanied by significant reductions in both sarcolemmal calcium current and the sodium–calcium exchanger. In contrast, the slow component of the delayed rectifier K þ current an ...
Reflux of Contrast Medium into the Inferior Vena Cava on
Reflux of Contrast Medium into the Inferior Vena Cava on

... Pulmonary hypertension, CHF, CAF, and PE emerged as being the most frequent diagnoses associated with the highest grade of reflux. The common denominator of all these diagnoses is the possible existence of congestion at the entrance to the right atrium. The primary contribution of the present study ...
chronic congestive heart failure.
chronic congestive heart failure.

... end-diastolic pressure was normal. Ascites was addition, studies were made on myosin from the present in all dogs but Na excretion varied from left ventricle of a dog with naturally occurring 1.4 to 50.5 mEq per day. The ratio of right right- and left-sided failure. Qualitatively the sedimentation p ...
Narrow therapeutic index drugs: a clinical pharmacological
Narrow therapeutic index drugs: a clinical pharmacological

... risk and benefit. It is generally considered that a drug has a good safety profile if its TI exceeds the value of 10. The situation is quite different with the so-called narrow TI drugs (NTIDs), where there is only a very small range of doses at which the drug produces a beneficial effect without ca ...
HeartNews - Philippine Heart Association
HeartNews - Philippine Heart Association

... stress, whether physical or emotional stress, and relieved by rest or intake of medications. This condition is generally called Chronic Stable Angina. Other accompanying symptoms of the pain include shortness of breath, cold sweats, and nausea. Sometimes, CAD may present initially as a heart attack, ...
The value of tools to assess pulmonary arterial hypertension
The value of tools to assess pulmonary arterial hypertension

... vasodilator test is insufficient to identify all patients who may be responsive to long-term CCB therapy, it is sufficiently specific to identify patients who have a high likelihood of benefiting from chronic CCB therapy. Caution should be exercised while performing this test as these agents could l ...
PDF - Circulation: Arrhythmia and Electrophysiology
PDF - Circulation: Arrhythmia and Electrophysiology

... Figure 7.  Schematic for activation in clockwise bundle-branch re-entrant ventricular tachycardia. The anatomy of bundle-branches is drawn, as previously described by Massing and James.7 The left bundle-branch divides in the basal septum at a variable length below aortic valve to anterior and poster ...
Exercise Training, Genetics And Heart Failure
Exercise Training, Genetics And Heart Failure

... Resumo..................................................................................................................XVII   Abstract ..................................................................................................................XIX   List of Abbreviations .................. ...
Arrhythmogenesis by single ectopic beats originating in the Purkinje
Arrhythmogenesis by single ectopic beats originating in the Purkinje

... resistance, which allows small charge displacements to cause large changes in Vm (37). Finally, since Purkinje cells are only coupled in one dimension, there is reduced electrotonic suppression of myocardial EAD propagation. Persistent bundle branch reentry (BBR) as a mechanism of sustained tachycar ...
Pulmonary Vascular Diseases
Pulmonary Vascular Diseases

... shown to increase RV inotropy4 and decrease RV hypertrophy,5 in addition to its effects on the pulmonary circulation), others might have untoward effects on the RV. For example, imatinib, an antiproliferative/proapoptotic agent that shows preliminary promise in reversing pulmonary vascular remodelin ...
Monitoring - PULSION Medical Systems SE
Monitoring - PULSION Medical Systems SE

... SVV is more accurate for predicting volume responsiveness than CVP ...
Current Status of Transcatheter Aortic Valve Replacement
Current Status of Transcatheter Aortic Valve Replacement

... When patients develop symptoms due to aortic stenosis, functional limitation is inevitably followed by physical deterioration, heart failure, and mortality. Aortic valve replacement (AVR), specifically surgical AVR (SAVR), improves symptoms and is generally accepted to prolong survival on the basis ...
Artery in Man: Evaluation of Ventricular Volume Measurements from
Artery in Man: Evaluation of Ventricular Volume Measurements from

... equal to the mean transit time between the tip of the catheter and the corresponding detecting device for an immediate, direct comparison. For a quantitative evaluation of the observed differences in peak-concentration of the washout curves the following ratio was calculated: I/C, = DVa (where I is ...
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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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