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Adrenal Insufficiency - Circulation Research
Adrenal Insufficiency - Circulation Research

... Cardiac function was evaluated by ventricular function curves during the cardiovascular collapse observed in acute and chronic adrenal insufficiency. A progressive decline in peak cardiac work was observed in the acutely adrenalectomized cat (303; decrease at 1.8 hours and 50% at 3.5 hours after adr ...
Aorta to Left Atrial Fistula Following Transcatheter Closure of Atrial
Aorta to Left Atrial Fistula Following Transcatheter Closure of Atrial

... Although percutaneous transcatheter ASD closure provides superior cosmetics it is not completely risk free. In this article we have reported a late fistula formation between aorta and left atrium following transcatheter closure of secundum type ASD. Review of similar complications shows that lifelon ...
Optical mapping of activation patterns in an animal - AJP
Optical mapping of activation patterns in an animal - AJP

... photodiode array with 4-[-[2-(di-n-butylamino)-6-naphthyl]vinyl]pyridinium. Optical APs were recorded to simultaneously image activation patterns from the RA and RV. Perfusion of positive IgG (800–1,200 ␮g/ml) resulted in sinus bradycardia and varying degrees of heart block. Activation maps revealed ...
The role of electrocardiogram in the diagnosis of dextrocardia with
The role of electrocardiogram in the diagnosis of dextrocardia with

... considered was right ventricular hypertrophy. The ECG electrodes were then placed in reverse order (mirror image position) on his body, which produced a normal standard 12-lead ECG pattern of a young adult. This confirmed dextrocardia with mirror image atrial arrangement (Fig. 2). On further evaluat ...
Breakdown of blood pressure and body fluid homeostasis in
Breakdown of blood pressure and body fluid homeostasis in

... calories to maintain their current weight and provided 87 mEQ/24 h of sodium and 80 mE+/24 h of potassium. This diet was served as three meals taken at 8 AM, 12 PM and 5 PM. Water was restricted to 1,000 ml on day 3 but was provided ad libitum on all other days of the study. Consumption of alcohol, ...
Percutaneous Left Atrial Appendage Closure Devices for Stroke
Percutaneous Left Atrial Appendage Closure Devices for Stroke

... Amplatzer devices) for stroke prevention in patients with AF includes uncontrolled case series. Relevant outcomes are overall survival, morbid events, and treatment-related morbidity. Case series of these devices report high procedural success but also numerous complications. In addition, these devi ...
Module 3 - Cardiac Arrhythmias-Mechanisms of Arrhythmias
Module 3 - Cardiac Arrhythmias-Mechanisms of Arrhythmias

... Developed by Tony Curran (Clinical Nurse Educator) and Gill Sheppard (Clinical Nurse Specialist) Cardiology, June ...
Cold acclimation increases cardiac myofilament function and
Cold acclimation increases cardiac myofilament function and

... phosphorylation. In addition, we show that the magnitude and rate of ventricular pressure generation was greater in hearts from trout acclimated to 4°C compared with those from animals acclimated to 11 or 17°C. Taken together, these results suggest that enhanced myofilament function, caused by modif ...
Management of Paradoxical Low-Flow, Low
Management of Paradoxical Low-Flow, Low

Advantages and Concerns of Aquatic Exercise for Cardiovascular
Advantages and Concerns of Aquatic Exercise for Cardiovascular

... exercise longer from a reduced HR. A concern is cardiac remodeling from the increased BP in the heart chambers over time (34). Strength training has positive effects on cardiovascular health (20,46). “Strength is the neuromuscular ability to overcome or oppose external resistance by means of muscul ...
Plasma atrial natriuretic peptide in patients with acute
Plasma atrial natriuretic peptide in patients with acute

... initially raised plasma atrial natriuretic peptide concentrations in patients with myocardial infarction fell soon after admission. The extent of the fall found by Tan et al is unclear. Despite this fall plasma atrial natriuretic peptide concentrations remained raised in the patients reported by Sva ...
Cardiac Remodeling in Obesity
Cardiac Remodeling in Obesity

... this might explain their increased survival post-MI (85). However, this seems doubtful given the widely accepted and well-publicized guidelines for the treatment of cardiovascular disease. One recent study has suggested that overweight and obese individuals were in fact protected from short-term dea ...
Outcomes According to Cardiac Catheterization Referral and
Outcomes According to Cardiac Catheterization Referral and

Sudden Cardiac Death in the Young
Sudden Cardiac Death in the Young

Percutaneous Mitral Valve Interventions
Percutaneous Mitral Valve Interventions

... with a decrease in LV systolic and diastolic dimensions and reduction in the need for hospitalizations among high-risk patients have been demonstrated. Compared to match-controls who were also considered high risk for surgery, there was improved 1-year survival. A phase II randomized trial (EVEREST ...
Regulation of Cardiac Output by Stroke Volume and Heart Rate in
Regulation of Cardiac Output by Stroke Volume and Heart Rate in

... ventricle and increasing stroke volume."7 Indeed, in the present study, in dogs anesthetized and with an open chest, the increased cardiac output observed with volume loading occurred entirely through increases in stroke volume (Fig. 3). This is consistent with findings of other investigators who us ...
Common Types of Supraventricular Tachycardia
Common Types of Supraventricular Tachycardia

... AVNRT and AVRT are electrical aberrancies that occur mainly as a result of reentry. Less commonly, increased automaticity or triggered activity can be the mechanism and usually results in a narrow complex tachycardia. AT can result from one of the three mechanisms (Table 1).3-6 AVNRT and AVRT are at ...
cardiac imaging guidelines - Chapter Affairs Extranet
cardiac imaging guidelines - Chapter Affairs Extranet

...  Generally brought on by exertion or emotional stress  May radiate to the left arm or jaw  Atypical angina (probable): Chest pain or discomfort (arm or jaw pain) that lacks one of the characteristics of definite or typical angina.  Non-anginal chest pain: Chest pain or discomfort that meets one ...
22. Heart
22. Heart

... inflammation) is an inflammation of the pericardium typically caused by viruses, bacteria, or fungi. Whatever the cause of pericarditis, the pericardium is inflamed. The inflammation causes an increase in capillary permeability. Thus, the capillaries become more “leaky,” resulting in fluid accumulat ...
Seminar Acute myocardial infarction
Seminar Acute myocardial infarction

... assessment to optimise patient outcomes and mitigate adverse events and costs. Although several risk scores in patients with STEMI and NSTEMI have been developed, their use lies not only in improved appreciation of risk and communication to patients, but also in identifying patient subsets who warra ...
Evaluation of Left Coronary Artery Anatomy In Vitro by Cross
Evaluation of Left Coronary Artery Anatomy In Vitro by Cross

... LAD and LCCA as visualized echocardiographically. We hope that this will provide insight into the feasibility of and lend direction to further attempts at imaging these structures. To obtain reliable reference data, a model was required that optimized the ability to record the proximal left coronary ...
Diagnosis of Stable Ischemic Heart Disease: Summary of a Clinical
Diagnosis of Stable Ischemic Heart Disease: Summary of a Clinical

... diagnosis of stable known or suspected ischemic heart disease (IHD). This is the first of 2 guidelines addressing stable IHD; the second guideline addresses the management of patients with stable IHD (1). Internists and other primary care physicians are the target audiences for this guideline. The t ...
2015 ESC Guidelines for the management of patients with
2015 ESC Guidelines for the management of patients with

... the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthc ...
Short-Acting Я-Adrenergic Antagonist Esmolol Given at
Short-Acting Я-Adrenergic Antagonist Esmolol Given at

... esmolol-treated animals (open bars). Same number of shocks was initially required to defibrillate both control and esmololtreated animals, but controls required significantly more shocks during resuscitation than esmolol-treated animals. ...
The Prognostic Value of T Wave Amplitude in Lead aVR in Males
The Prognostic Value of T Wave Amplitude in Lead aVR in Males

... From the National Heart Centre, Singapore; and † Palo Alto Veterans Affairs Health Care System and Stanford University School of Medicine, Palo Alto, CA Background: Since there is an uncertainty regarding which of the 12 leads provides the most information, we investigated the association between re ...
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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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