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CAR
CAR

... Division of Neonatology, Apollo Centre for Advanced Pediatrics, Indraprastha Apollo Hospitals, New Delhi. Background : It may be difficult to rule out congenital heart disease in a sick newborn on clinical grounds alone. In addition persistent pulmonary hypertension can complicate RDS and diagnosis ...
COTM0114 - California Tumor Tissue Registry
COTM0114 - California Tumor Tissue Registry

... and that large CR projecting into the ventricular cavity may cause flow abnormalities and mechanical obstruction. Potential clinical manifestations of problematic CR include murmurs, arrhythmias, and heart failure and may necessitate partial surgical resection, depending on symptom severity. Althoug ...
Effect of the FXR Agonist Obeticholic Acid on Portal Pressure in
Effect of the FXR Agonist Obeticholic Acid on Portal Pressure in

... In 2 non-responders, one showed no change in HVPG; the other an increase from 12 mmHg at baseline. Mean arterial pressure (MAP) did not decrease across the whole cohort and aside form 2 patients with high baseline MAP, the remainder of the group showed a net increase in MAP after therapy. These d ...
ECG
ECG

... Horizontally even with V4 and V5 in the midaxillary line. (The midaxillary line is the imaginary line that extends down from the middle of the patient's armpit.) ...
Systolic Heart Failure
Systolic Heart Failure

... ICD therapy is recommended for primary prevention of sudden cardiac death to reduce total mortality in patients with nonischemic dilated cardiomyopathy or ischemic heart disease at least 40 days post-myocardial infraction, have an LVEF less than or equal to 35%, with NYHA functional class II or III ...
Spironolactone reduced mortality in severe congestive heart failure
Spironolactone reduced mortality in severe congestive heart failure

... nearly 20% of patients discontinued treatment because of perceived lack of response or administrative problems, and 35% of treated patients died within 2 years. Spironolactone provides large survival and symptomatic benefits for patients with severe symptoms despite conventional treatment, requires ...
RIGHT VENTRICULAR DYSFUNCTION ON THE ICU
RIGHT VENTRICULAR DYSFUNCTION ON THE ICU

... Gentle volume challenge in the early stage of RV failure (only shown for acute PE) Close monitoring of fluid status either with echo or using the CVP waveform, trend(, and number) Excessive volume loading may worsen RV performance (RV distention, TR, ventricular interdependence) Diuretics or ultrafi ...
BNP - yeditepetip4
BNP - yeditepetip4

...  Even if total plasma CK is eleveted (trauma, severe exercises), presence of more than about 5% of total as CK-MB suggests cardiac muscle damage  CK-BB is found primarily in the brain and contributes very little to the serum TCK level  Most of the serum CK is derived from skeletal muscle and the ...
Levosimendan in a neonate with severe coarctation of aorta and low
Levosimendan in a neonate with severe coarctation of aorta and low

... In this case, we noted that the level of BNP correlated with the clinical observations as well as with the echocardiographic findings. After the failed attempt at balloon dilatation, BNP did not decrease and the ventricular and multiorgan dysfunction persisted. After 12 h, of the onset of treatment ...
Heart Health Screening Guidelines for Young People
Heart Health Screening Guidelines for Young People

... The American Heart Association (AHA) and the American College of Cardiology (ACC) issued a joint statement recommending a new heart health screening process for young people aged 12 to 25 years and clarifying any misconceptions about sudden heart-related deaths. Healthcare professionals are advised ...
Vocabulary Definitions Handout
Vocabulary Definitions Handout

... transdermal patches, or sprays administered sublingually. Patients who experience angina when doing certain physical activities can often prevent symptoms by taking nitroglycerin 5 to 10 minutes before the activity. Pulseless electrical activity or PEA (also known by the older terms electromechanica ...
Current® PlusDR - Sante International
Current® PlusDR - Sante International

... The Current ® pulse generators are intended to provide ventricular antitachycardia pacing and ventricular defibrillation for automated treatment of life-threatening ventricular arrhythmias. AF Suppression pacing is indicated for suppression of paroxysmal or persistent atrial fibrillation in patients ...
Safety, Efficacy, and Performance of Implanted Recycled Cardiac Rhythm Management (CRM)
Safety, Efficacy, and Performance of Implanted Recycled Cardiac Rhythm Management (CRM)

... 30.0 ± 6.4% (Table I). The baseline characteristics are summarized in Table I. The mean follow-up period was 68 ± 38 months. All but one of the patients was a first-time recipient of an implanted device. Among recipients, three had transvenous pacemakers prior to implant, one received a cardiac resy ...
ECG Interpretation
ECG Interpretation

... ventricles don’t contract at the same time, and blood flows effectively from the atria to the ventricles. The delay in the AV node forms much of the PR segment on the ECG. Part of atrial repolarization can also be represented by PR segment. It is usually 120 to 200 ms long. A PR interval of over 200 ...
I. Atrial tachy
I. Atrial tachy

... B. Ventricular fibrillation: The effects of ventricular fibrillation: The fibrillating ventricles, like the fibrillating atria, look like a quivering "bag of worms". The fibrillating ventricles cannot pump blood effectively and circulation of the blood stops. Therefore, in the absence of emergency ...
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)

... A neonate, 1st of the twin born via LSCS at 34 weeks of gestation with a birth weight of 2.02 Kgs. Antenasal USG at 31 weeks had shown Rhabdomyoma in Right ventricular (RV) free wall. Baby was delivered via normal vaginal delivery, baby cried immediately after birth, APGAR at 1 min and 5 minutes was ...
Right ventricular function / Advances in cardiomyopathies 209
Right ventricular function / Advances in cardiomyopathies 209

... reduced global RV strain (RV-GS) (-20.8±4.8% vs-24.8±3.3% p<0.0001). Segmental strain analysis showed the reduction was major in the lateral-basal segment (RV-LBasS), the lateral-mid segment (RV-LMidS) and the septum-basal segment (RV-SBasS). Bordeline’s patients had no significant altered RV strain ...
Heart Failure - doc meg`s hideout
Heart Failure - doc meg`s hideout

... weakening the heart still more • (2) filtration of fluid into the lungs, causing pulmonary edema and consequent deoxygenation of the blood • (3) development of extensive edema in most parts of the body ...
Q1 March 2009 Relate the surface ECG to the events of the cardiac
Q1 March 2009 Relate the surface ECG to the events of the cardiac

... QT intervals may be prolonged by the action of drugs. Diagram modified from CV Physiology website: http://www.cvphysiology.com/Heart% 20Disease/HD002.htm ...
Answer Key for student worksheet for Cariac Normal ranges for
Answer Key for student worksheet for Cariac Normal ranges for

... After students use the site, additional in class discussion questions (which can also act as assessment tools) can be asked or assignments made: If these two lines of research make it through clinical trials and are approved by the FDA (Food and Drug Administration), what other applications do you s ...
Modern Management of Heart Failure
Modern Management of Heart Failure

... • Huge health costs $27 billion pa in US • Primarily a disease of the elderly • Incidence of 10/100 in those over 65yrs ...
Third-Degree Heart Block in Thalassemia major: A Case Report
Third-Degree Heart Block in Thalassemia major: A Case Report

... Case Presentation: This 15-year-old boy, a known case of major β-thalassemia was admitted to our emergency unit with dyspnea and cough because of decompensated heart failure. The electrocardiogram showed complete heart block with junctional escape rhythm. Interestingly, his previous electrocardiogra ...
Third-Degree Heart Block in Thalassemia major: A Case Report
Third-Degree Heart Block in Thalassemia major: A Case Report

... Case Presentation: This 15-year-old boy, a known case of major β-thalassemia was admitted to our emergency unit with dyspnea and cough because of decompensated heart failure. The electrocardiogram showed complete heart block with junctional escape rhythm. Interestingly, his previous electrocardiogra ...
Corlentor : EPAR - Summary for the public
Corlentor : EPAR - Summary for the public

... 2.9% yearly incidence rates). However it should be noted that patients in this study were given doses higher than the recommended dose (up to 10 mg twice a day). ...
Amiodarone for Resuscitation After Out-of
Amiodarone for Resuscitation After Out-of

... Kudenchuck PJ, Cobb LA, Copass MK, et al. NEJM. 1999. 341(12): 871-878 Objective: To conduct a randomized clinical trial to determine the efficacy of IV amiodarone in patients with out-of-hospital cardiac arrest due to shock-refractory (defined as no ROSC after >3 precordial shocks) VF or VT Methods ...
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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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