Ken Grauer, MD

OCTOBER 6, 2023

The ECG in Figure-1 was obtained from a middle-aged woman who presented with "palpitations". Of note — she has a history of untreated hyperthyroidism. QUESTIONS: How would YOU interpret the rhythm in Figure-1 ? Can you explain the atrial activity in this rhythm strip? Figure-1: The initial long lead II rhythm strip in today's case. MY Approach to the Rhythm in Figure-1: As per ECG Blog #185 — I favor the P s, Q s, 3 R Approach for interpretation of the cardiac rhythm — beginning with whichever o

Blog 166

Blog Arrhythmia Cardiac Arrest Tachycardia 166

Dr. Smith's ECG Blog

OCTOBER 1, 2023

This is a re-post of an excellent case from 2021. See it again now, along with our new Queen of Hearts functionality. We've come a long way in 2 years! And the pace only quickens. A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. He called EMS who brought him to the ED.

Stents 126

Stents Stent STEMI Physiology 126

All About Cardiovascular System and Disorders

OCTOBER 5, 2023

Gardner Treadmill Protocol Gardner Treadmill Protocol, also known as Gardner-Skinner Protocol was described in 1991 [1]. It is used mainly in the evaluation of peripheral arterial disease. The seminal article evaluated the effect of handrail support on claudication distance. Handrail support reduces energy cost of treadmill walking, and can affect claudication distance and hemodynamic responses in persons with peripheral vascular disease.

Peripheral Arterial Disease 52

Peripheral Arterial Disease Cardiac Rehabilitation Coronary Artery Disease Blood Pressure 52

Cassling

OCTOBER 6, 2023

At Cassling, we believe imaging equipment is the heartbeat of healthcare facilities. Our customers rely on us to keep their equipment up and running, and their patients rely on our customers to keep them healthy. So when you have a service team that treats equipment like patients and customers like family, the result is a world-class experience with superhero service.

Blog 52

Blog 52

ADN Center of Excellence

OCTOBER 5, 2023

Are you a dedicated cardiologist who's eager to discover the latest insights on the #TAVI procedure? Look no further! Our upcoming session is just around the corner, and we've gathered all the crucial information you need to stay at the forefront of this game-changing technology. Demystifying the #TAVIProcedure: Let's get straight to the heart of the matter.

Aortic valve 52

Aortic valve Quality of Life Technology Aortic 52

Dr. Smith's ECG Blog

OCTOBER 3, 2023

By Magnus Nossen, from Norway I was shown this print out of a rhythm strip from a patient on telemetry. I was asked what's going on? There are four leads shown (II, dV2, V1 and V5). The three images beneath one and other are consecutive rhythm strips each 10 seconds long. The patient was on telemetry due to acute MI. Can you correctly describe what's going on in this interesting rhythm strip?

Arrhythmia 99

Arrhythmia Pacemaker Blog 99

Open Heart

OCTOBER 3, 2023

Objective To determine the diagnostic yield of a ‘high’ N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with suspected heart failure (HF) referred from primary to secondary care. Methods In this retrospective study, cardiac diagnoses were quantified in consecutive patients with an NT-proBNP>400 ng/L referred from primary care centres to a specialist HF service.

Heart Failure 52

Heart Failure Atrial Fibrillation 52

Dr. Paddy Barrett

OCTOBER 3, 2023

Even if you live a long life with your physical and cognitive capacities intact, you still have to choose ‘ How ’ to live your life. For me, the only reason I wish to live a long life at a high quality is that I get more time and capacity to do what I believe my life was intended for. This is the domain of soul span: What will you do with the time allotted to you?

Quality of Life 52

Quality of Life Article 52

Dr. Smith's ECG Blog

OCTOBER 6, 2023

What is the infarct artery? I usually don't ask this question, as it is rarely relevant to the decision to activate the cath lab. This is one case where it made a difference: Right Ventricular MI seen on ECG helps Angiographer to find Culprit Lesion Nevertheless, it is sometimes a fun academic exercise to try to predict the infarct artery: An elderly patient had onset of chest pain one hour prior.

Aneurysm 66

Aneurysm Chest Pain Cardiogenic Shock Blog 66

Open Heart

OCTOBER 3, 2023

Objective To assess gender, ethnicity, and deprivation-based differences in provision of aortic valve replacement (AVR) in England for adults with aortic stenosis (AS). Methods We retrospectively identified adults with AS from the English Hospital Episode Statistics (HES) between April 2016 and March 2019 and those who subsequently had an AVR. We separately used HES-linked Clinical Practice Research Datalink (CPRD) to identify people with AVR and evaluate the timeliness of their procedure (CPRD-

Aortic valve 52

Aortic valve Aortic Stenosis Public Health 52

HeartRhythm

OCTOBER 6, 2023

The remote monitoring process for cardiac implantable electronic devices is evolving, creating challenges for staff and patient compliance. Current standards of care for remote monitoring require a modernized and structured process to keep in compliance. Pediatric populations have unique issues to consider.

Pediatrics 40

Pediatrics Education 40

Dr. Paddy Barrett

SEPTEMBER 30, 2023

This July, thousands of you said that you wanted me to produce a course that would synthesise best practices for: Understanding heart disease. Assessing your risk. Maximally reducing that risk. Thousands of you completed a questionnaire addressing your objectives and obstacles in addressing cardiovascular risk. Although there were many and varied responses, the primary message was that most of you: Are concerned about your future risk of heart disease because of a risk factor or family history o

Heart Disease 52

Heart Disease Best Practices Risk Factors Download 52

Hypertension Journal

OCTOBER 6, 2023

Hypertension, Volume 80, Issue 12 , Page 2495-2500, December 1, 2023. There are mounting data that at least 30% of hypertensives who are appropriately screened have primary aldosteronism (PA), rather than the commonly reported figure of 5% to 10%. Second, there are similar data that undertreated patients with PA have a 3-fold higher risk profile than essential hypertensives with the same blood pressure levels.

Blood Pressure 40

Blood Pressure Hypertension Public Health 40

Open Heart

SEPTEMBER 30, 2023

Introduction Atrial fibrillation (AF) is associated with a fivefold increased risk of stroke. Oral anticoagulation reduces the risk of stroke, but AF is elusive. A machine learning algorithm (Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF)) developed to predict incident AF within 6 months using data in primary care electronic health records (EHRs) could be used to guide AF screening.

Atrial Fibrillation 52

Atrial Fibrillation Innovation Stroke Strokes 52

HeartRhythm

OCTOBER 5, 2023

This paper reviews the literature on image-guided cardiac resynchronization therapy (CRT) studies. Improved outcome to CRT has been associated with the placement of an LV lead in the latest activated segment free from scar. The majority of randomized clinical trials investigating a guided LV lead implantation did not show superiority over conventional implantation approaches.

Anatomy 40

Anatomy Outcomes 40

European Journal of Heart Failure

OCTOBER 5, 2023

Abstract Aims Patients with heart failure (HF) and mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) are often treated with calcium channel blockers (CCBs), although the safety of CCBs in these patients is uncertain. We aimed to investigate the association between CCB use and clinical outcomes in patients with HFmrEF/HFpEF; CCBs were examined overall, as well as by subtype (dihydropyridine and non-dihydropyridine).

Preserved Ejection Fraction 40

Preserved Ejection Fraction Heart Failure Outcomes Hospital 40

Hypertension Journal

OCTOBER 6, 2023

Hypertension, Volume 80, Issue 12 , Page 2621-2626, December 1, 2023. BACKGROUND:Circadian rhythm regulates many important biological functions in humans. The goal of this study is to explore the impact of day-to-day deviations in the sleep-wake cycle on nighttime blood pressure (BP) dipping and further examine whether the ethnic difference in day-to-day deviations in sleep patterns can explain the ethnic difference in nighttime BP dipping.METHODS:Twenty-four-hour ambulatory BP monitoring and 7-

Blood Pressure 40

Blood Pressure Health Disparities Hypertension 40

Stroke: Vascular and Interventional Neurology

OCTOBER 4, 2023

Stroke: Vascular and Interventional Neurology, Volume 3, Issue 6 , November 1, 2023. BackgroundThe optimal blood pressure management strategy in patients undergoing endovascular therapy for acute ischemic stroke is unknown. This pilot study aimed to assess the feasibility of a standard versus individualized blood pressure management strategy during endovascular therapy.MethodsThis randomized controlled pilot trial included adult patients with acute ischemic stroke with large‐vessel occlusion in

Blood Pressure 40

Blood Pressure Stroke Strokes Outcomes 40

Science Daily - Heart Disease

OCTOBER 5, 2023

Researchers play ultra-brief tones to stimulate the brain during deep sleep. This stimulation improves cardiac output and relaxation of the left ventricle. Such technology to improve cardiovascular function could be relevant both in disease treatment and competitive sports.

Technology 40

Technology Research 40

Journal of Cardiovascular Electrophysiology

OCTOBER 5, 2023

We aimed to investigate differences in tissue temperature characteristics during radiofrequency ablation using three catheters, commonly employed in the 50 W high-power short-duration (HPSD) setting and a 90 W/4 s very HPSD setting catheter. We identified temperature variations across the four ablation settings and their association with collateral damage, including injuries to the esophagus and phrenic nerve.

Ablation 40

Ablation Atrial Fibrillation Pulmonary Article 40

Hypertension Journal

OCTOBER 6, 2023

Hypertension, Volume 80, Issue 12 , Page 2650-2664, December 1, 2023. BACKGROUND:Inflammation plays a critical role in the development of hypertension and vascular remodeling. Resolvin E1 (RvE1), as one of the specialized proresolving lipid mediators, promotes inflammation resolution by binding with a G protein-coupled receptor, ChemR23 (chemerin receptor 23).

Hypertension 40

Hypertension Aortic Blood Pressure 40

HeartRhythm

OCTOBER 4, 2023

Implantable cardioverter defibrillator (ICD) programming influences the rate of ICD therapies. Randomized, controlled trials and prospective studies have shown a mortality reduction with strategies that reduce ICD therapies.1 International electrophysiology societies subsequently published manufacturer-specific consensus recommendations for ICDs, last updated in 2019.2 Recommendation implementation has been heterogeneous and slow.

Defibrillator 40

Defibrillator Electrophysiology 40

European Journal of Heart Failure

OCTOBER 5, 2023

In this study, two independent cohorts were used to investigate for cardiovascular magnetic resonance (CMR) and genetic features of dilated cardiomyopathy (DCM) in individuals with coronary artery disease (CAD). First, the UK Biobank was used to assess for the association between rare variants in DCM-associated genes, phenotype and outcomes in participants with CAD.

Coronary Artery Disease 40

Coronary Artery Disease Cardiomyopathy Outcomes Myocardial Infarction 40

Circulation

OCTOBER 5, 2023

Circulation, Ahead of Print. BACKGROUND:We investigated the usefulness of invasive coronary function testing to diagnose the cause of angina in patients with no obstructive coronary arteries.METHODS:Outpatients referred for coronary computed tomography angiography in 3 hospitals in the United Kingdom were prospectively screened. After coronary computed tomography angiography, patients with unobstructed coronary arteries, and who consented, underwent invasive endotyping.

Angina 40

Angina Coronary Artery Disease Circulation Hospital 40

Hypertension Journal

OCTOBER 5, 2023

Hypertension, Ahead of Print. Background:Cigarette smoking/nicotine exposure in pregnancy shows an increased risk of hypertension in offspring, but the mechanisms are unclear. This study tested the hypothesis that m6A RNA hypomethylation epigenetically regulates vascular NOX (NADPH oxidase) and reactive oxygen species production, contributing to the fetal programming of a hypertensive phenotype in nicotine-exposed offspring.Methods:Pregnant rats were exposed to episodic chronic intermittent nico

Blood Pressure 40

Blood Pressure Hypertension Obesity 40

HeartRhythm

OCTOBER 3, 2023

Pulmonary vein isolation (PVI) remains the cornerstone of atrial fibrillation (AF) ablation. In patients with more advanced AF subtypes, atypical atrial flutter, and extensive atrial myopathy, additional linear ablation is often required; however, durable block of these remains challenging. Gardziejczyk et al ([link] shared a case of a 61-year-old patient with recurrent symptomatic persistent AF despite 2 prior ablation attempts and confirmed PVI and posterior wall isolation.

Atrial Flutter 40

Atrial Flutter Atrial Fibrillation Ablation Pulmonary 40

European Journal of Heart Failure

OCTOBER 3, 2023

Characteristics of heart failure with improved ejection fraction (HFimpEF) patients and outcome comparison with heart failure with persistently reduced ejection fraction (pHFrEF). Arrows indicate a higher number of elements/level in HFimpEF compared to the comparison population (pHFrEF). BNP, B-type natriuretic peptide; CPET, cardiopulmonary exercise test; CV, cardiovascular; ECG, electrocardiogram; EOV, exercise oscillatory ventilation; MECKI, Metabolic Exercise Cardiac Kidney Indexes; LBBB, le

Heart Failure 40

Heart Failure Exercise Laboratory Transplant 40

Stroke: Vascular and Interventional Neurology

OCTOBER 2, 2023

Stroke: Vascular and Interventional Neurology, Volume 3, Issue 6 , November 1, 2023. BackgroundProcedural intravenous cangrelor has been proposed as an effective platelet inhibition strategy for stenting in acute ischemic stroke. We aimed to compare the safety profile of low‐dose intravenous cangrelor versus dual oral antiplatelet therapy (DAPT) loading in patients with acute cervical tandem lesions.MethodsWe retrospectively identified cases from an international multicenter cohort who underwent

Hemorrhage 40

Hemorrhage Thrombosis Stents Stent 40

Hypertension Journal

OCTOBER 5, 2023

Hypertension, Volume 80, Issue 12 , Page 2627-2640, December 1, 2023. BACKGROUND:Endothelial dysfunction plays a crucial role in aortic remodeling. Aerobic glycolysis and endothelial-to-mesenchymal transition (EndoMT) have, respectively, been suggested to contribute to endothelial dysfunction in many cardiovascular diseases. Here, we tested the hypothesis that glycolytic reprogramming is critical for EndoMT induction in aortic remodeling through an epigenetic mechanism mediated by a transcriptio

Aortic 40

Aortic Cardiovascular Disease Hypertension 40

HeartRhythm

OCTOBER 3, 2023

In this retrospective analysis of sinus rhythm (SR) rates before and during ventricular tachycardia (VT) episodes occurring during ablation procedures in patients with structural heart disease, Pujol-Lopez et al (J Am Coll Cardiol 2023;82:1096) sought to assess whether the failure to increase the SR rate during VT occurred more frequently during hemodynamically nontolerated VT than during tolerated VT.

Tachycardia 40

Tachycardia Ablation Heart Disease 40

European Journal of Heart Failure

OCTOBER 4, 2023

The impact of non-cardiac comorbidities (NNCs) on rapid up-titration of guideline-directed medical therapies (GDMTs) and interactions between NNCs and treatment effect of high-intensity care (HIC) versus usual care (UC) on the primary endpoint. Proportion of patients with 0, 1, 2 and ≥3 NCCs and the prevalence of each individual comorbidity ( A ). Average percentage of the optimal doses of GDMTs by number of NCCs ( B ).

Heart Failure 40

Heart Failure Hospital Quality of Life Pulmonary 40

Stroke: Vascular and Interventional Neurology

OCTOBER 2, 2023

Stroke: Vascular and Interventional Neurology, Volume 3, Issue 6 , November 1, 2023. BackgroundSoutheast Asia accounts for approximately 10% of stroke‐related mortalities worldwide, yet there are limited data regarding mechanical thrombectomy (MT) outcomes in this region. PROSPR‐SEA (Post‐Market Registry of Stroke Patients Treated With Medtronic Neurothrombectomy Devices to Collect Real‐World Data in Southeast Asia) assessed post‐market clinical outcomes of MT using the Solitaire Revascularizati

Stroke 40

Stroke Strokes Hemorrhage Thrombolysis 40

Science Daily - Heart Disease

OCTOBER 3, 2023

An individual diagnosed with type 2 diabetes at age 30 years could see their life expectancy fall by as much as 14 years, an international team of researchers has warned. Even people who do not develop the condition until later in life – with a diagnosis at age 50 years – could see their life expectancy fall by up to six years, an analysis of data from 19 high-income countries found.

Diabetes 40

Diabetes Research 40

HeartRhythm

OCTOBER 3, 2023

Al-Kaisey et al (JAMA 2023;330:925, PMID 37698564) investigated whether atrial fibrillation (AF) catheter ablation is associated with a greater improvement in psychological distress compared with medical therapy in a prospective, randomized, multicenter trial. Participants were randomized to receive AF catheter ablation (n = 52) or medical therapy (n = 48).

Atrial Fibrillation 40

Atrial Fibrillation Ablation Pulmonary Hospital 40

JAMA Cardiology

SEPTEMBER 30, 2023

This randomized clinical trial investigates the long-term efficacy of mavacamten in reducing the need for septal reduction therapy in patients with obstructive hypertrophic cardiomyopathy.

Cardiomyopathy 40

Cardiomyopathy 40

Heart Sisters

OCTOBER 1, 2023

Two sisters, diagnosed four days apart with a serious heart condition, explain how hypertrophic cardiomyopathy (and having defibrillators implanted) has changed their lives in surprising ways.

Defibrillator 40

Defibrillator Cardiomyopathy Heart Disease 40

Science Daily - Heart Disease

OCTOBER 2, 2023

People looking to reduce their cholesterol and trim fat from around their waist could try swapping meat for Quorn protein, according to the findings from a new study, which saw positive effects in both areas in just two weeks.

Cholesterol 40

Cholesterol 40