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72 záznamů v Medvik Filtry

Článek

Arrhythmic Risk in Biventricular Pacing Compared With Left Bundle Branch Area Pacing: Results From the I-CLAS Study

Herweg, Bengt
Autor Herweg, Bengt ORCID University of South Florida Morsani College of Medicine, Tampa (B.H., R.B., M.M.)
Sharma, Parikshit S
Autor Sharma, Parikshit S ORCID Rush University Medical Center, Chicago, IL (P.S.S., C.D., S.C.V.)
Cano, Óscar
Autor Cano, Óscar ORCID Hospital Universitari i Politècnic La Fe and Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares, Valencia, Spain (O.C.)
Ponnusamy, Shunmuga Sundaram
Autor Ponnusamy, Shunmuga Sundaram ORCID Velammal Medical College Hospital and Research Institute, Madurai, India (S.S.P.)
Zanon, Francesco
Autor Zanon, Francesco ORCID Santa Maria Della Misericordia Hospital, Rovigo, Italy (F.Z., L.M.)
Jastrzebski, Marek
Autor Jastrzebski, Marek ORCID First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland (M.J., P.M.)
Zou, Jiangang
Autor Zou, Jiangang ORCID The First Affiliated Hospital of Nanjing Medical University, Cardiology, Jiangsu, China (J.Z.)
Chelu, Mihail G
Autor Chelu, Mihail G ORCID The First Affiliated Hospital of Nanjing Medical University, Cardiology, Jiangsu, China (J.Z.)
Vernooy, Kevin
Autor Vernooy, Kevin ORCID Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Netherlands (K.V., A.v.S.)
Whinnett, Zachary I
Autor Whinnett, Zachary I ORCID National Heart and Lung Institute, Imperial College London, United Kingdom (Z.I.W., A.M.L.)

Circulation (New York, N.Y.). 2024 ; 149 (5) : 379-390. [pub] 20231111

Circulation (New York)
ISSN 1524-4539
Medvik
Zdroj

BACKGROUND: Left bundle branch area pacing (LBBAP) may be associated with greater improvement in left ventricular ejection fraction and reduction in death or heart failure hospitalization compared with biventricular pacing (BVP) in patients requiring cardiac resynchronization therapy. We sought to compare the occurrence of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) and new-onset atrial fibrillation (AF) in patients undergoing BVP and LBBAP. METHODS: The I-CLAS study (International Collaborative LBBAP Study) included patients with left ventricular ejection fraction ≤35% who underwent BVP or LBBAP for cardiac resynchronization therapy between January 2018 and June 2022 at 15 centers. We performed propensity score-matched analysis of LBBAP and BVP in a 1:1 ratio. We assessed the incidence of VT/VF and new-onset AF among patients with no history of AF. Time to sustained VT/VF and time to new-onset AF was analyzed using the Cox proportional hazards survival model. RESULTS: Among 1778 patients undergoing cardiac resynchronization therapy (BVP, 981; LBBAP, 797), there were 1414 propensity score-matched patients (propensity score-matched BVP, 707; propensity score-matched LBBAP, 707). The occurrence of VT/VF was significantly lower with LBBAP compared with BVP (4.2% versus 9.3%; hazard ratio, 0.46 [95% CI, 0.29-0.74]; P<0.001). The incidence of VT storm (>3 episodes in 24 hours) was also significantly lower with LBBAP compared with BVP (0.8% versus 2.5%; P=0.013). Among 299 patients with cardiac resynchronization therapy pacemakers (BVP, 111; LBBAP, 188), VT/VF occurred in 8 patients in the BVP group versus none in the LBBAP group (7.2% versus 0%; P<0.001). In 1194 patients with no history of VT/VF or antiarrhythmic therapy (BVP, 591; LBBAP, 603), the occurrence of VT/VF was significantly lower with LBBAP than with BVP (3.2% versus 7.3%; hazard ratio, 0.46 [95% CI, 0.26-0.81]; P=0.007). Among patients with no history of AF (n=890), the occurrence of new-onset AF >30 s was significantly lower with LBBAP than with BVP (2.8% versus 6.6%; hazard ratio, 0.34 [95% CI, 0.16-0.73]; P=0.008). The incidence of AF lasting >24 hours was also significantly lower with LBBAP than with BVP (0.7% versus 2.9%; P=0.015). CONCLUSIONS: LBBAP was associated with a lower incidence of sustained VT/VF and new-onset AF compared with BVP. This difference remained significant after adjustment for differences in baseline characteristics between patients with BVP and LBBAP. Physiological resynchronization by LBBAP may be associated with lower risk of arrhythmias compared with BVP.

MeSH
elektrokardiografie MeSH
fibrilace komor epidemiologie etiologie terapie MeSH
funkce levé komory srdeční MeSH
komorová tachykardie * epidemiologie etiologie terapie MeSH
lidé MeSH
srdeční resynchronizační terapie * škodlivé účinky MeSH
srdeční selhání * epidemiologie terapie MeSH
tepový objem MeSH
výsledek terapie MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH

Článek

Mitral valve prolapse: arrhythmic risk during pregnancy and postpartum

European heart journal. 2024 ; 45 (20) : 1831-1839. [pub] 20240527

Eur Heart J
ISSN 1522-9645
Medvik
Zdroj

BACKGROUND AND AIMS: Arrhythmic mitral valve prolapse (AMVP) is linked to life-threatening ventricular arrhythmias (VAs), and young women are considered at high risk. Cases of AMVP in women with malignant VA during pregnancy have emerged, but the arrhythmic risk during pregnancy is unknown. The authors aimed to describe features of women with high-risk AMVP who developed malignant VA during the perinatal period and to assess if pregnancy and the postpartum period were associated with a higher risk of malignant VA. METHODS: This retrospective international multi-centre case series included high-risk women with AMVP who experienced malignant VA and at least one pregnancy. Malignant VA included ventricular fibrillation, sustained ventricular tachycardia, or appropriate shock from an implantable cardioverter defibrillator. The authors compared the incidence of malignant VA in non-pregnant periods and perinatal period; the latter defined as occurring during pregnancy and within 6 months after delivery. RESULTS: The authors included 18 women with AMVP from 11 centres. During 7.5 (interquartile range 5.8-16.6) years of follow-up, 37 malignant VAs occurred, of which 18 were pregnancy related occurring in 13 (72%) unique patients. Pregnancy and 6 months after delivery showed increased incidence rate of malignant VA compared to the non-pregnancy period (univariate incidence rate ratio 2.66, 95% confidence interval 1.23-5.76). CONCLUSIONS: The perinatal period could impose increased risk of malignant VA in women with high-risk AMVP. The data may provide general guidance for pre-conception counselling and for nuanced shared decision-making between patients and clinicians.

MeSH
defibrilátory implantabilní MeSH
dospělí MeSH
fibrilace komor epidemiologie etiologie MeSH
incidence MeSH
kardiovaskulární komplikace v těhotenství * epidemiologie MeSH
komorová tachykardie epidemiologie etiologie MeSH
lidé MeSH
poporodní období MeSH
poruchy v puerperiu epidemiologie etiologie MeSH
prolaps mitrální chlopně * komplikace epidemiologie MeSH
retrospektivní studie MeSH
rizikové faktory MeSH
srdeční arytmie epidemiologie etiologie MeSH
těhotenství MeSH
Check Tag
dospělí MeSH
lidé MeSH
těhotenství MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH

Článek

Multiorgánové selhání po opakované intoxikaci tisem červeným

Suchý, Tomáš
Autor Suchý, Tomáš Koronární jednotka interního oddělení, Oblastní nemocnice Kladno

Vox pediatriae. 2022 ; 22 (5) : 28-29.

ISSN 1213-2241
Medvik
Zdroj

MeSH
fibrilace komor etiologie terapie MeSH
lidé MeSH
mladý dospělý MeSH
multiorgánové selhání etiologie MeSH
otrava rostlinami * patofyziologie terapie MeSH
pokus o sebevraždu MeSH
taxoidy otrava MeSH
tis * otrava MeSH
Check Tag
lidé MeSH
mladý dospělý MeSH
Publikační typ
kazuistiky MeSH

Článek

Terminal T-wave inversion predicts reperfusion tachyarrhythmias in STEMI

Journal of electrocardiology. 2022 ; 71 (-) : 28-31. [pub] 20220105

J Electrocardiol
ISSN 1532-8430
Medvik
Zdroj

INTRODUCTION: A reliable electrocardiographic predictor of ventricular fibrillation (VF) in patients with ST elevation myocardial infarction (STEMI) is lacking so far. Previous experimental/simulation study suggested a terminal T-wave inversion (TTWI) in ischemia-related ECG leads corresponding to anterior infarct localization as an independent predictor of reperfusion VF (rVF). This T-wave characteristic has never been tested as a rVF predictor in clinical settings. The aim of this study was to test if terminal T-wave inversion (TTWI) at admission ECG (before reperfusion) can serve as a predictor of ventricular fibrillation during reperfusion (rVF) in patients with anterior STEMI undergoing primary PCI. METHODS AND RESULTS: Study population included consecutive patients with anterior infarct localization admitted for primary PCI (n = 181, age 65 [57; 76] years, 66% male). Of those, 14 patients had rVF (rVF group, age 59 [47; 76] years, 64% male) and patients without rVF comprised the No-rVF group (n = 167, age 65 [57; 76] years, 66% male). Association of TTWI with rVF was analyzed using logistic regression analysis adjusted for relevant clinical and electrocardiographic covariates. The prevalence of TTWI in rVF group was 62% comparing to 23% in the No-rVF group, p = 0.005. TTWI was associated with increased risk of rVF (OR 5.51; 95% CI 1.70-17.89; p = 0.004) and remained a significant predictor after adjustment for age, gender, history of MI prior to index admission, VF before reperfusion, Tpeak-Tend, maximal ST elevation, and QRS duration (OR 23.49; 95% CI 3.14-175.91; p = 0.002). CONCLUSIONS: The terminal T-wave inversion in anterior leads before PCI independently predicted rVF in patients with anterior MI thus confirming the previous experimental/simulation findings.

MeSH
elektrokardiografie metody MeSH
fibrilace komor etiologie MeSH
infarkt myokardu přední stěny * MeSH
infarkt myokardu s elevacemi ST úseků * komplikace diagnóza MeSH
koronární angioplastika * MeSH
lidé středního věku MeSH
lidé MeSH
reperfuze škodlivé účinky MeSH
retrospektivní studie MeSH
senioři MeSH
tachykardie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
práce podpořená grantem MeSH

Článek

Excess ischemic tachyarrhythmias trigger protection against myocardial infarction in hypertensive rats

Clinical science (1979). 2021 ; 135 (17) : 2143-2163. [pub] 20210917

Clin Sci (Lond)
ISSN 1470-8736
Medvik
Zdroj

Increased level of C-reactive protein (CRP) is a risk factor for cardiovascular diseases, including myocardial infarction and hypertension. Here, we analyzed the effects of CRP overexpression on cardiac susceptibility to ischemia/reperfusion (I/R) injury in adult spontaneously hypertensive rats (SHR) expressing human CRP transgene (SHR-CRP). Using an in vivo model of coronary artery occlusion, we found that transgenic expression of CRP predisposed SHR-CRP to repeated and prolonged ventricular tachyarrhythmias. Excessive ischemic arrhythmias in SHR-CRP led to a significant reduction in infarct size (IS) compared with SHR. The proarrhythmic phenotype in SHR-CRP was associated with altered heart and plasma eicosanoids, myocardial composition of fatty acids (FAs) in phospholipids, and autonomic nervous system imbalance before ischemia. To explain unexpected IS-limiting effect in SHR-CRP, we performed metabolomic analysis of plasma before and after ischemia. We also determined cardiac ischemic tolerance in hearts subjected to remote ischemic perconditioning (RIPer) and in hearts ex vivo. Acute ischemia in SHR-CRP markedly increased plasma levels of multiple potent cardioprotective molecules that could reduce IS at reperfusion. RIPer provided IS-limiting effect in SHR that was comparable with myocardial infarction observed in naïve SHR-CRP. In hearts ex vivo, IS did not differ between the strains, suggesting that extra-cardiac factors play a crucial role in protection. Our study shows that transgenic expression of human CRP predisposes SHR-CRP to excess ischemic ventricular tachyarrhythmias associated with a drop of pump function that triggers myocardial salvage against lethal I/R injury likely mediated by protective substances released to blood from hypoxic organs and tissue at reperfusion.