2009 and Circulation - Cardiovascular Update

AFib Might Be Far More Common Than We Think

CardiacWire

SEPTEMBER 11, 2024

AFib rates increased dramatically during the study period, from 4.49% in 2005-2009 to 6.82% in 2015-2019. That’s far higher than previous estimates, including a pair of JAMA and Circulation studies that estimated nationwide AFib rates of 2.26M and 5.1M When these results are applied across the U.S., adult population. adult population.

AFIB

AFIB Atrial Fibrillation Arrhythmia Research

Trends Favoring an Anatomical Approach to Radiofrequency Catheter Ablation of Idiopathic Ventricular Arrhythmias Originating From the Left Ventricular Summit

Circulation: Arrhythmia and Electrophysiology

APRIL 17, 2024

Circulation: Arrhythmia and Electrophysiology, Ahead of Print. The evolving trends in the approaches and outcomes of RFCA of LVS-VAs at a single center were evaluated.METHODS:We studied 88 consecutive patients with idiopathic LVS-VAs at our institute from 2009 to 2019.

Arrhythmia

Arrhythmia Ablation Electrophysiology Outcomes

Abstract 133: Asymmetry of Arteriopathy in Pediatric Moyamoya

Stroke Journal

JANUARY 30, 2025

Introduction:Moyamoya is a progressive steno-occlusive cerebrovascular arteriopathy of bilateral anterior circulation. Twenty-three (34%) children had complete occlusion of bilateral anterior circulation without asymmetry at diagnosis. Chi-square test was used for statistical analysis, with p-value <0.05

Pediatrics

Pediatrics Circulation Stroke Strokes

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

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Abstract TP296: How Often is Nonstenotic Carotid Plaque in Cryptogenic Stroke Causal Versus Incidental?

Stroke Journal

JANUARY 30, 2025

We then applied Bayes theorem (method of Alsheikh-Ali et al, Stroke 2009) to determine the probability that nonstenotic carotid plaque is causal or incidental.Results:The systematic search identified 6 cohort studies enrolling 1551 patients (761 CS, 790 KS). and incidental in 47.3%.

Plaque

Plaque Stroke Strokes Ultrasound

How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Dr. Smith's ECG Blog

OCTOBER 8, 2024

Given that this is before it is released into the circulation by reperfusion therapy, this is a massively elevated troponin. 2009;Available from: [link] 4. The EKG was not repeated until 7 AM the next morning, about 16 hours later. High-sensitivity troponin I went from 158 to 1482 to 9639 ng/L overnight. Hyperacute T-waves persist.

Cardiac Arrest

Cardiac Arrest Myocardial Infarction STEMI Cardiogenic Shock

Abstract 4141474: Impact of Serum 5-Hydroxytryptophan Levels on Coronary Artery Calcification Severity in Acute Coronary Syndrome Patients: Insights from the Microbiota-Gut-Brain Axis

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4141474-A4141474, November 12, 2024. The study period was from February 4, 2009, to August 9, 2020. Background:5-Hydroxytryptophan (5-HTP) has shown positive clinical effects on various neuropsychiatric and metabolic disorders, particularly depression.

Kidney Disease

Kidney Disease Risk Factors Pharmacology Diabetes

No, we can’t call OMT, as a re-vascularisation procedure.

Dr. S. Venkatesan MD

FEBRUARY 25, 2024

Intentionally or unintentionally , we have made PCI and CABG appear invincible and conferred the sole-rights to be referred to as re-vascularsation procedures , Realistically looking medical therapy also provide good revascualrisation (re-or neo) especially where it is needed ie in the coronary micro circulation.

Chest Pain

Chest Pain Plaque Stents Stent

Abstract 4142376: Impact of Atrial Fibrillation on Outcomes in Patients with Esophageal Cancer Receiving Neoadjuvant Chemoradiation

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4142376-A4142376, November 12, 2024. Limited data indicate an elevated risk of atrial fibrillation (AF) after neoadjuvant chemoradiation in esophageal cancer however the role of AF as an independent predictor of outcomes post-esophagectomy remains under-studied.

Atrial Fibrillation

Atrial Fibrillation Cancer Outcomes BMI

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

JANUARY 1, 2024

Cannon waves are associated with reduced RV compliance or elevated RV end-diastolic pressure ( Ali et al — Ann Noninvasic Electrocard 22:e12423, 2017 — and — Chen and Pel-Ying Pai — Circulation 119:e381, 2009 ).

Tachycardia

Tachycardia Blog Ischemia Heart Failure

Why You Need To Measure apoB To Assess Your Cardiovascular Risk

Dr. Paddy Barrett

NOVEMBER 7, 2023

In this case, the only lipid particles remaining in circulation are usually LDL and Lp(a) particles. LDL cholesterol, when measured in the context of diabetes, metabolic syndrome or insulin resistance, is not an accurate reflection of the number of apoB particles in circulation. 2009 Aug;58(8):1887-92. Eur Heart J.

Cholesterol

Cholesterol Atherosclerosis Stenosis Aortic

APOE4 & Cardiovascular Risk

Dr. Paddy Barrett

AUGUST 22, 2023

In general, for an APOB particle to be cleared from circulation, it attaches to an LDL receptor in the liver and is cleared from circulation. This results in higher circulating levels of LDL particles. 2009 Apr;29(4):431-8. APO E is also centrally involved in cholesterol metabolism. i.e. LDL-Cholesterol/APOB goes down.

Cholesterol

Cholesterol Dementia Coronary Artery Disease Cardiovascular Disease

Large Transmural STEMI with Myocardial "Rupture" of Ventricular Septum

Dr. Smith's ECG Blog

JULY 7, 2013

Apr 28, 2009. Circulation 1993;88(3):896-904. Baseline Q-wave surpasses time from symptom onset as a prognostic marker in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention. J Am Coll Cardiol 53(17):1503-9. 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 3.

STEMI

STEMI Myocardial Infarction Pericarditis Ultrasound

Middle Aged Woman with Asystolic Cardiac Arrest, Resuscitated: Cath Lab?

Dr. Smith's ECG Blog

OCTOBER 20, 2013

The combination of sudden increased intracranial pressure with loss of spontaneous circulation results in near total loss of cerebral perfusion. Circulation 122:Abstract 101. Methods: Between June 2007 - July 2009 all NT-OHCA patients aged >18, transported to our hospital, an urban, level one trauma teaching hospital were included.

Cardiac Arrest

Cardiac Arrest STEMI Hemorrhage Hospital

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Dr. Smith's ECG Blog

JULY 18, 2014

Apr 28, 2009. Circulation 1993;88(3):896-904. Baseline Q-wave surpasses time from symptom onset as a prognostic marker in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention. J Am Coll Cardiol 53(17):1503-9. Brunette D. Ann Emerg Med 1994; 23(6):1333-42. Hammill SC. Edwards WD.

STEMI

STEMI Pericarditis Myocardial Infarction Cardiogenic Shock

Assessment of LV Diastolic Function by Echo in SR and AF

All About Cardiovascular System and Disorders

APRIL 14, 2024

Circulation. 2009 Sep;17(3):86-95. Severe ischemic mitral regurgitation despite normally contracting subpapillary myocardium. 2012; 126: 138-141. Kumar V et al. L wave in echo Doppler. Indian Heart J. 2014 May-Jun;66(3):392-3. Ha J et al. Therapeutic strategies for diastolic dysfunction: a clinical perspective. J Cardiovasc Ultrasound.

Bicuspid/Mitral

Bicuspid/Mitral Pulmonary Atrial Fibrillation Ultrasound

Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

JANUARY 1, 2013

Blackwell Publishing 2009. Circulation 2007;115(10):1306-24. Here is a short summary of data on posterior leads, from: 1 utf-8 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Critical Decisions in Emergency and Acute Care Electrocardiography. William Brady and JD Truwit, editors. O’laughlin, MD, and edited by me.

STEMI

STEMI Ischemia Chest Pain Myocardial Infarction

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

NEJM 362(9):779; March 4, 2009. Circulation. Circulation 67, No. Circulation 1970;41:623-627 9. NEJM 362(9):779; March 4, 2009. Dobutamine may be preferred in patients without severe hypotension who have high vascular resistance. -- De Backer D et al. Contemporary Reviews in Cardiovascular Medicine. link] 13.

Ischemia

Ischemia Cardiogenic Shock Aortic Stenosis

RBBB and LAFB. Is it trifascicular block? The complexities of Wenckebach, with Ken Grauer analysis.

Dr. Smith's ECG Blog

APRIL 6, 2023

The physiologic reason for this — is thought to be the result of momentarily increased circulation from mechanical contraction arising from the "sandwiched in" QRS complex. That said — the term, “trifascicular block” is no longer recommended ( Surawicz et al, Circulation — AHA/ACCF/HRS Recs, 2009 ).

Arrhythmia

Arrhythmia Atrial Fibrillation AFIB Outpatient

A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!

Dr. Smith's ECG Blog

JUNE 2, 2023

J Electrocardiol, 42 (2009), pp. 756-764 Google Scholar == MY Comment , by K EN G RAUER, MD ( 6/3 /2023 ): == Today's case is gratifying — in that it illustrates an uncommon phenomenon that Dr. J Electrocardiol, 42 (2009), pp.

Tachycardia

Tachycardia Cardiomyopathy Electrocardiogram Article

Circulating Sex-Specific Markers of Plaque Instability in Women and Men With Severe Carotid Atherosclerosis

Stroke Journal

JANUARY 21, 2024

BACKGROUND:Sex-specific differences in plaque composition and instability underscore the need to explore circulating markers for better prediction of high-risk plaques. Adipokine, lipid, and immune profiling was conducted. Plaque stability was determined by gold-standard histological classifications.

Plaque

Plaque Circulation Atherosclerosis Hemorrhage

Abstract 4139458: Trends and Disparities in Arrhythmia-Related Deaths among Older Adults in the United States, 1999-2020

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4139458-A4139458, November 12, 2024. Mortality rates decreased from 1999 to 2009 (APC: -0.9; p = 0.007), increased from 2009 to 2018 (APC: 1.5; Conclusions:After initially declining from 1999 to 2009, arrhythmia-related mortality have increased thereafter with evident disparities.

Arrhythmia

Arrhythmia Circulation

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

APRIL 8, 2015

in 2010 EM Clinics of North America (full text link) For an Exhaustive Review of Syncope and its full management outside the ED environment, go to the 2009 European Society of Cardiology Guidelines (full text pdf). Yield of Diagnostic Tests in Evaluating Syncopal Episodes in Older Patients Arch Intern Med 2009 Jul 27; 169:1299-1305.

Arrhythmia

Arrhythmia Outcomes Chest Pain Risk Factors

Syncope and a short pause on event monitor

Dr. Smith's ECG Blog

FEBRUARY 4, 2025

Circulation , 143 (10), 10621065. Journal of the American College of Cardiology , 33 (1), 1620. link] Lee, S., Wellens, H. & Josephson, M. Paroxysmal atrioventricular block. Heart Rhythm , 6 (8), 12291234. link] Pillai, A., Ellenbogen, K. & Padala, S. A tale of 2 blocks.

Pacemaker

Pacemaker Bradycardia Document Heart Rhythm

AFib Might Be Far More Common Than We Think

Trends Favoring an Anatomical Approach to Radiofrequency Catheter Ablation of Idiopathic Ventricular Arrhythmias Originating From the Left Ventricular Summit

Abstract 133: Asymmetry of Arteriopathy in Pediatric Moyamoya

Webinars

Abstract TP296: How Often is Nonstenotic Carotid Plaque in Cryptogenic Stroke Causal Versus Incidental?

How terrible can it be to fail to recognize OMI? To whom is OMI Obvious or Not Obvious?

Abstract 4141474: Impact of Serum 5-Hydroxytryptophan Levels on Coronary Artery Calcification Severity in Acute Coronary Syndrome Patients: Insights from the Microbiota-Gut-Brain Axis

No, we can’t call OMT, as a re-vascularisation procedure.

Abstract 4142376: Impact of Atrial Fibrillation on Outcomes in Patients with Esophageal Cancer Receiving Neoadjuvant Chemoradiation

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Why You Need To Measure apoB To Assess Your Cardiovascular Risk

APOE4 & Cardiovascular Risk

Large Transmural STEMI with Myocardial "Rupture" of Ventricular Septum

Middle Aged Woman with Asystolic Cardiac Arrest, Resuscitated: Cath Lab?

Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Assessment of LV Diastolic Function by Echo in SR and AF

Precordial ST depression. What is the diagnosis?

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

RBBB and LAFB. Is it trifascicular block? The complexities of Wenckebach, with Ken Grauer analysis.

A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!

Circulating Sex-Specific Markers of Plaque Instability in Women and Men With Severe Carotid Atherosclerosis

Abstract 4139458: Trends and Disparities in Arrhythmia-Related Deaths among Older Adults in the United States, 1999-2020

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Syncope and a short pause on event monitor

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