- Rapid Fire: Pericardial Effusion and Tamponade. [Case Reports]
- EMEmerg Med Clin North Am 2018; 36(3):557-565
- One of the most common causes of pericardial effusion in the Western world is malignancy. Emergency physicians must maintain vigilance in suspecting pericardial effusion and tamponade in patients wit...
One of the most common causes of pericardial effusion in the Western world is malignancy. Emergency physicians must maintain vigilance in suspecting pericardial effusion and tamponade in patients with known or suspected malignancy who present with tachycardia, dyspnea, and hypotension. Diagnosis can be expedited by key physical examination, electrocardiogram, and sonographic findings. Unstable or crashing patients with tamponade must undergo emergent pericardiocentesis for removal of fluid and pressure to restore cardiac output.
- Massive pericardial effusion: A rare and easily missed finding in myocardial perfusion scintigraphy. [Journal Article]
- WJWorld J Nucl Med 2018 Jul-Sep; 17(3):198-200
- A 72-year-old gentleman underwent myocardial perfusion scintigraphy (MPS) for sinus tachycardia of unknown cause. Baseline electrocardiography (ECG) showed sinus tachycardia and electrical alternans....
A 72-year-old gentleman underwent myocardial perfusion scintigraphy (MPS) for sinus tachycardia of unknown cause. Baseline electrocardiography (ECG) showed sinus tachycardia and electrical alternans. Thallium-201 stress-redistribution MPS was performed with dipyridamole stress. On the raw projection images, a photopenic "halo" was noted surrounding the heart. Reconstructed slices showed small left ventricle with no obvious perfusion defect. Review of single-photon emission computed tomography/computed tomography images showed suspected large pericardial effusion. The patient was admitted and Echocardiography showed significant circumferential pericardial effusion with early tamponade effect. Subsequent bedside pericardiocentesis aspirated 800 ml blood-stained fluid and the cytology yielded metastatic adenocarcinoma with features suggestive of pulmonary primary. Pericardial effusion is a rare finding in MPS. Finding of a "halo" around the heart should raise suspicion on the presence of pericardial effusion and confirmatory investigation such as ECG may be warranted.
- Automatic detection of T wave alternans using tensor decompositions in multilead ECG signals. [Journal Article]
- PMPhysiol Meas 2017 Jul 26; 38(8):1513-1528
- CONCLUSIONS: Results on different artificial and clinical signals show that the presented methods are a robust and reliable way for TWA detection, and show the potential benefit of tensors in ECG signal processing.
- Risk stratification personalised model for prediction of life-threatening ventricular tachyarrhythmias in patients with chronic heart failure. [Journal Article]
- KPKardiol Pol 2017; 75(7):682-688
- CONCLUSIONS: The method of personalised risk stratification using Cox logistic regression allows correct classification of more than 93.9% of CHF cases. A robust body of evidence concerning logistic regression prognostic significance to define VTA risk allows inclusion of this method into the algorithm of subsequent control and selection of the optimal treatment modality to treat patients with CHF.
- Augmented QRS notching and macroscopic T-wave alternans preceding polymorphic ventricular tachycardia in a patient with electrical storm. [Case Reports]
- EEuropace 2017 Apr 01; 19(4):643
- Electrophysiological Twisting: Electrical Alternans in Congenital Dilated Cardiomyopathy. [Journal Article]
- CACirc Arrhythm Electrophysiol 2017; 10(2)
- The E23K variant of the Kir6.2 subunit of the ATP-sensitive potassium channel increases susceptibility to ventricular arrhythmia in response to ischemia in rats. [Journal Article]
- IJInt J Cardiol 2017 Apr 01; 232:192-198
- CONCLUSIONS: The E23K variant of the KATP channel increased the susceptibility to ventricular arrhythmia under acute ischemia stress.
- Beat-to-beat T-wave alternans detection using the Ensemble Empirical Mode Decomposition method. [Journal Article]
- CBComput Biol Med 2016 10 01; 77:1-8
- CONCLUSIONS: In conclusion, the proposed Ensemble EMD method with Ensemble classifier can be utilized for detecting beat-to-beat TWA in the ECG signal.
- Molsidomine Attenuates Ventricular Electrical Remodeling and Arrhythmogenesis in Rats With Chronic β-Adrenergic Receptor Activation Through the NO/cGMP/PKG Pathway. [Journal Article]
- JCJ Cardiovasc Pharmacol 2016; 68(5):342-355
- This study investigated the effects and associated underlying mechanisms of molsidomine, a nitric oxide (NO) donor, on cardiac electrical remodeling and ventricular tachycardias (VTs) induced by chro...
This study investigated the effects and associated underlying mechanisms of molsidomine, a nitric oxide (NO) donor, on cardiac electrical remodeling and ventricular tachycardias (VTs) induced by chronic isoprenaline (ISO) stimulation in rats. The rats were randomly divided into groups that were treated with saline (control group), ISO (ISO group), ISO + molsidomine (ISO + M group), and ISO + molsidomine + the soluble guanylate cyclase inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, ISO + M + O group) for 14 days. An electrophysiological study was performed to assess cardiac repolarization, action potential duration restitution, and the induction of action potential duration alternans and VTs in vitro. The properties of the Ca transients, Ca handling-related proteins, and NO/guanosine 3'5'-cyclic monophosphate (cGMP)/protein kinase G (PKG) pathway were examined. Compared with the control group, chronic ISO stimulation prolonged the cardiac repolarization, decreased the Ca transient alternans and action potential duration alternans thresholds, and increased the maximum slope (Smax) of the action potential duration restitution curve and incidence of VTs in vitro. All these effects were attenuated by molsidomine treatment (P < 0.05). Moreover, molsidomine activated cGMP/PKG signaling and stabilized the expression of calcium handling-related proteins compared with the ISO group. However, the protective effects of molsidomine were partially inhibited by ODQ. Our results suggest that molsidomine stabilizes calcium handling and attenuates cardiac electrical remodeling and arrhythmogenesis in rats with chronic β-adrenergic receptor activation. These effects are at least partially mediated by the activation of NO/cGMP/PKG pathway.
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- Baseline elevation and reduction in cardiac electrical instability assessed by quantitative T-wave alternans in patients with drug-resistant epilepsy treated with vagus nerve stimulation in the AspireSR E-36 trial. [Journal Article]
- EBEpilepsy Behav 2016; 62:85-9
- CONCLUSIONS: These findings suggest significant interictal cardiac electrical instability in this population of patients with drug-resistant epilepsy and suggest that VNS may be a novel approach to reducing risk.