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18(4) Oct 05 for web.indd
18(4) Oct 05 for web.indd

... book is a historical account of the Heart Study, it is sprinkled with personal stories of scientists, physicians, patients, and study volunteers who stand out as road markers on the trail of discovery. Their contributions form the foundation for the successes the Heart Study has delivered, and Dr. L ...
BIOL 424 Circulation 1 I. Circulation A. Open
BIOL 424 Circulation 1 I. Circulation A. Open

... 3. AV valves closed 4. blood forced out of ventricles a. portion of blood ejected b. remaining volume is end-systolic volume D. Ventricular diastole 1. pressure drops in ventricles to about 0 mmHg - isovolumetric relaxation 2. blood flows from atria to ventricles ...
Cardiac Arrhythmia www.AssignmentPoint.com Cardiac arrhythmia
Cardiac Arrhythmia www.AssignmentPoint.com Cardiac arrhythmia

... depends on age. A number of tests can help with diagnosis including an electrocardiogram (ECG) and holter monitor. ...
Normal and Abnormal Exercise Response Potential Measurements
Normal and Abnormal Exercise Response Potential Measurements

... The predictive value of exercise testing is improved by considering exercise responses in addition to EKG Reduced VO2max Blunted hemodynamic response ...
Program - Association of University Cardiologists Home Page
Program - Association of University Cardiologists Home Page

... HF symptoms reflect is a heterogeneous clinical syndrome, which can present with preserved or reduced ejection fraction. The case mix of HF has changed markedly over time with a growing proportion of cases presenting with preserved ejection fraction. It is increasingly recognized that HF with preser ...
When to stop after cardiac arrest?
When to stop after cardiac arrest?

... Clinical Associate, Critical Care Medicine & Neurocritical Care Medicine Interdepartmental Division of Critical Care and Department of Medicine University of Toronto ...
Arrhythmias Complicating AMI
Arrhythmias Complicating AMI

... Beta blockers are indicated for patients without evidence of significant LV dysfunction or hypovolemia. Persistent sinus tachycardia as an early manifestation of heart failure is an indicator of poor prognosis. ...
Intensive care of the patient with acute myocardial infarction
Intensive care of the patient with acute myocardial infarction

... normally has a greater effect on oxygen uptake than on tissue perfusion. The hypoxaemia is always partially correctible by oxygen, and often is completely correctible (McKenzie et al., 1964; McNicol et al., 1965). High concentrations of oxygen should be used to obtain the maximum effect, and all pat ...
Observations Normal Individuals Patients Coronary Heart
Observations Normal Individuals Patients Coronary Heart

... occurred a significant increase in cardiac work, stroke volume and heart rate. The cardiac work increased 226 units* (54 per cent), the stroke volume 26 cc. (32 per cent) and the heart rate 8 beats (13 per cent). In the patients with coronary heart disease there was a significant increase in pulse p ...
3&4-Antiarrhythmic drugs
3&4-Antiarrhythmic drugs

... Prolong action potential duration and refractory period Additional actions of classes Ia, 2 & 4 vasodilating effects ( α- and βadrenoceptor blocking effects and calcium channel blocking effects ) ...
Fateme Jahanshahifar
Fateme Jahanshahifar

... diarrhoea and dyspepsia were more common. A transient moderate increase during the first 2 months of treatment was reported. Recently, there were two reports of PML, one with psoriasis and another with a diagnosis of MS, who received fumaric acid preparations containing dimethyl fumarate . Prolonged ...
Document
Document

... sleep and even asystolia requiring pacemaker implantation, dysrhythmias, paroxysmal ventricular tachycardias and hypertension with frequent arousals in REM sleep), frequent paroxysmal atrial fibrillation in second part of the night for incipient pulmonary congestion due to atrial dilation and diasto ...
Congestive Heart Failure (CHF)
Congestive Heart Failure (CHF)

... and tachypnoea, pulmonary edema (cardiac asthma)   arterial hypoxemia and hypercapnia.... ...
Case AORTIC HEART DISEASE
Case AORTIC HEART DISEASE

... Mitral regurgitation is mild does not require special treatment. When mitral regurgitation of moderate or severe shown careful assignment of ACE inhibitors. Reduction of they help value afterload understandably easy release of blood aorta, and amount of regurgitation in LP decreases regularly. If yo ...
Sudden death: managing the patient who survives
Sudden death: managing the patient who survives

... any prior condition that would appear to be fatal. It represents a major public health problem affecting more than 500 000 patients annually in the USA, and accounts for approximately 50% of deaths from cardiovascular causes. The most common electrical mechanism leading to SCD is the interaction of ...
50 years of cardac surgery
50 years of cardac surgery

... insufficient annual volume. They should have never been allowed to conduct a scientific trial. ...
Imaging in heart failure: role of echocardiography
Imaging in heart failure: role of echocardiography

... Cardiac resynchronization therapy CRT in sinus rhythm and a persistently reduced LVEF ...
SCD Lecture (Medical School)
SCD Lecture (Medical School)

... Primary Prevention • Large numbers of patients at risk – Need for simple, inexpensive, non-invasive tests with high sensitivity ...
Characterization of Suitability of Coronary Venous Anatomy for
Characterization of Suitability of Coronary Venous Anatomy for

... function, which contributes to a reduction in hospital admission and improvement in survival.1-5 On the other hand, non-responders may represent a consistently high proportion of all recipients of biventricular stimulation (estimated at 25 to 30%), which can be in consequence of inappropriate patien ...
World Journal of Surgical Oncology
World Journal of Surgical Oncology

... Primary cardiac sarcomas constitute a rare entity. At present, only a few hundred primary cardiac sarcomas have been reported, most of which are based on autopsy series. Despite this rarity, they are the second most common type of primary cardiac neoplasm and account for most of the malignant primar ...
Dilated Cardiomyopathy: the silent killer
Dilated Cardiomyopathy: the silent killer

... sound. Yes, some dogs with DCM do have heart murmurs that we can hear. But, they are often soft. Again, this is in opposition to the CDVD dogs. These dogs have good, if not exagerated left ventricular systolic function (their heart is contracting very well). This leads to high velocity blood flow ac ...
Ch 21: The Heart -
Ch 21: The Heart -

... SA node – ”pacemaker,” spontaneously depolarizes most rapidly and initiate heart beat, positioned on back wall of right atrium , transmits action potential to the AV node. ...
Severe Heart Failure and Large Left Ventricular Thrombus Following
Severe Heart Failure and Large Left Ventricular Thrombus Following

... patient, he had a left assist device inserted during the surgery to help reduce the LV workload and provide a bridge to cardiac transplantation. ...
Post-MI Patients at High Risk of SCD
Post-MI Patients at High Risk of SCD

... Review the scientific evidence to support the contentions that: – In patients with LV dysfunction, the combined use of ACE inhibition and beta-blockade is recommended as the cornerstone of therapy. – Modest incremental benefit may be seen with the addition of other antagonists of the RAS in post-MI ...
Electrocardiography: Atrial Fibrillation - e
Electrocardiography: Atrial Fibrillation - e

... blitz of atrial impulses, the AV node allows only occasional impulses to pass through at variable intervals, generating an irregularly irregular ventricular rate, usually between 75 and 180 beats per minute. However, slower and faster rates are often seen. The QRS complex is usually narrow, unless t ...
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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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