Ken Grauer, MD
NOVEMBER 18, 2023
== — CLICK HERE — for a V ideo presentation of this case! ( 15 minutes ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #344 — == How would YOU interpret the lead II rhythm strip shown in Figure-1 ? Is the rhythm Mobitz I or Mobitz II 2nd-degree AV Block? Or — Is it “ something else ”? Figure-1: How would YOU interpret this lead II rhythm strip?
Physiologically Speaking
NOVEMBER 24, 2023
Greetings! Welcome to the Physiology Friday newsletter. This week, I’m reposting a post that initially appeared as a paid post in April. I know you’ll enjoy it (or potentially re-enjoy it if you read it already). This newsletter is brought to you by my ebook “VO2 Max Essentials” (on sale for $5 for Black Friday!) and Examine.com.
International Journal of Cardiovascular Sciences
NOVEMBER 24, 2023
The Abstract Submission System for the 1st Cardiology Departments Meeting (São Paulo, April 12-14, 2024) is now open! Check the regulations and submit your abstract by January 15th by visiting: [link]. IMPORTANT: Submission is free, but presenters of approved abstracts must be registered. Don’t miss the opportunity to discuss your research with leading experts in the field!
CardiacWire
NOVEMBER 24, 2023
The Factor XI inhibitor movement hit a setback last week, after Bayer announced that it halted its OCEANIC-AF trial due to asundexian’s lack of efficacy. Investigative Factor XI inhibitors have sparked optimism among cardiologists for their potential to become safer antithrombotics, avoiding anticoagulants’ typical bleeding risks Asundexian is Bayer’s most advanced Factor XIa inhibitor, and already gained two FDA Fast Track Designations (stroke & systemic embolism prevention in Afib patients
NOVARAD
NOVEMBER 22, 2023
The traditional mode of storing data in hospitals has primarily been through physical media storage, encompassing film, paper records, and on-premises digital storage systems.
Physiologically Speaking
NOVEMBER 24, 2023
Greetings! Welcome to the Physiology Friday newsletter. This week, I’m reposting a post that initially appeared as a paid post in April. I know you’ll enjoy it (or potentially re-enjoy it if you read it already). This newsletter is brought to you by my ebook “VO2 Max Essentials” (on sale for $5 for Black Friday!) and Examine.com.
GEMMS
NOVEMBER 22, 2023
What is cardiovascular health? Cardiovascular health refers to the overall well-being of the heart and blood vessels, and it plays a vital role in maintaining optimal physical function. It encompasses several factors, including the strength and efficiency of the heart, the flexibility and health of the blood vessels, and the ability of the cardiovascular system to deliver oxygen and nutrients to the body’s tissues.
Cardiovascular Update brings together the best content for cardiovascular medicine professionals from the widest variety of industry thought leaders.
Open Heart
NOVEMBER 20, 2023
Aims We evaluated the effects of the COVID-19 pandemic on hospital admission and quality of care for acute coronary syndrome. Methods and results Data for all patients admitted to hospital care for acute coronary syndromes in Slovenia (nationwide cohort) between 2014 and 2021 were obtained by merging the national hospital database, national medicines reimbursement database and population mortality registry using unique identifying numbers.
Physiologically Speaking
NOVEMBER 22, 2023
Greetings and Happy Holidays! Before getting to today’s post, I have TWO “Black Friday Week” promos to announce. First: now and through the end of November, all monthly and yearly Substack subscriptions are 20% off. If you want full access to all of my content (or want to give it as an early holiday gift), now’s the time. Get 20% off for 1 year Second: you can get the ePub or PDF version of my eBook “VO2 Max Essentials” for just $5 (formerly $15) on Gumroad.
Coronary Artery Disease Journal
NOVEMBER 20, 2023
Background: Gender-specific outcomes after percutaneous coronary interventions were studied by a number of research groups with different endpoints and cohorts of different ethnic extractions. The purpose of this report is to use propensity score matching to determine gender-specific differences in clinical outcomes after percutaneous coronary interventions with polymer-free sirolimus-coated stents.
Dr. S. Venkatesan MD
NOVEMBER 21, 2023
ASDs are classically oval, but devices are typically circular.(Exact Incidence of ovoid ASD is not known. but it easily exceed 50 %.(Recall, the embryologically ill-fated hole expands around the fossa ovalis not circularis ) Do we have Oval devices ? I think, we don’t have one. Please check from this list , a good document on ASD device implantation from Poland Source : Grygier M, S.
Open Heart
NOVEMBER 20, 2023
Background We sought to examine a 1-year incidence of atrial fibrillation (AF) among patients with SARS-CoV-2 virus (COVID-19) in comparison to those with non-COVID-19 acute upper respiratory infection (AURI). Methods Patients with a diagnosis of COVID-19 (in any setting) between April 2020 and June 2021 were identified in Optum Clinformatics. Two comparator cohorts were constructed: an ‘AURI pandemic’ cohort (AURI diagnosis between April 2020 and June 2021) and an ‘AURI prepan
Physiologically Speaking
NOVEMBER 22, 2023
Greetings and Happy Holidays! Before getting to today’s post, I have TWO “Black Friday Week” promos to announce. First: now and through the end of November, all monthly and yearly Substack subscriptions are 20% off. If you want full access to all of my content (or want to give it as an early holiday gift), now’s the time. Get 20% off for 1 year Second: you can get the ePub or PDF version of my eBook “VO2 Max Essentials” for just $5 (formerly $15) on Gumroad.
Cardiology Update
NOVEMBER 19, 2023
The ORBITA-2 trial ( NCT03742050 ) investigated the efficacy of Percutaneous Coronary Intervention (PCI) compared to placebo in 301 patients with stable angina. The primary endpoint was the angina symptom score (0-79 scale), incorporating daily angina episodes, antianginal medication use, and clinical events such as unblinding due to severe angina, acute coronary syndrome (ACS), or death.
CardiacWire
NOVEMBER 19, 2023
The brand new US renal denervation arena gained its second major competitor on Friday, with the FDA approval and immediate commercial launch of Medtronic’s Symplicity Spyral RDN system. Renal denervation (RDN) is intended for hypertension that can’t be controlled by conventional therapies, either due to ineffectiveness, side effects, or adherence issues RDN is a minimally invasive procedure that lowers blood pressure by denervating the sympathetic nerves surrounding renal arteries, reducing over
ADN Center of Excellence
NOVEMBER 20, 2023
In the realm of interventional cardiology, the quest for precision is an ongoing pursuit. As technologies advance and methodologies evolve, two crucial tools stand out for their pivotal roles in enhancing accuracy and efficacy: Optical Coherence Tomography (OCT) and Intravascular Ultrasound (IVUS). Understanding the Intricacies OCT and IVUS serve as critical imaging techniques, offering a detailed view inside coronary arteries during procedures.
ECG Guru
NOVEMBER 20, 2023
Let's analyze the ECG. It comes from a pacemaker patient whose pacemaker was briefly switched to VVI at 30 bpm due to a stimulation threshold test. The first 3 beats show a sinus rhythm with a frequency of approx. 40 bpm. This is followed by a premature ventricular contraction (PVC). The P wave of the next sinus node beat lands exactly on the T of the PVC.
Journal of the American Heart Association
NOVEMBER 23, 2023
Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundPatients with nonalcoholic fatty liver disease are at increased risk to develop atherosclerotic cardiovascular diseases. FXR and GPBAR1 are 2 bile acid–activated receptors exploited in the treatment of nonalcoholic fatty liver disease: whether dual GPBAR1/FXR agonists synergize with statins in the treatment of the liver and cardiovascular components of nonalcoholic fatty liver disease is unknown.Methods
HeartRhythm
NOVEMBER 23, 2023
Brugada syndrome (BrS) is an inherited cardiac arrhythmogenic disease that predisposes patients to sudden cardiac death. It is associated with mutations in SCN5A, encoding the cardiac sodium channel alpha subunit (NaV1.5). BrS-related mutations have incomplete penetrance and variable expressivity within families.
European Journal of Heart Failure
NOVEMBER 23, 2023
Clinical presentation, shock severity and mortality in patients with de novo versus acute-on-chronic heart failure-related cardiogenic shock. ACHF-CS, acute-on-chronic failure-related cardiogenic shock; CI, confidence interval; DNHF-CS, de novo heart failure-related cardiogenic shock; HR, hazard ratio. Aims Heart failure-related cardiogenic shock (HF-CS) accounts for a significant proportion of CS cases.
ECG Guru
NOVEMBER 19, 2023
Many people are considerably unsettled by ECG recordings from smart watches. However, smartwatch ECGs can be helpful in the diagnosis of paroxysmal atrial fibrillation. Here. you can see an example. It is a 1-channel ECG that corresponds to lead I. Initially there is an irregular fast pulse without P waves, which corresponds to a tachyarrhythmia in atrial fibrillation.
Dr. S. Venkatesan MD
NOVEMBER 23, 2023
Now, you can view who all are reading this site live on a rotating globe. It makes all the more happier to note that all those grateful and honourable dots (i.e., you) are literally drawing the world map. Six million reads from 190 countries, right from the Solomon Islands in Micronesian Pacific, abutting the International date line, to the extreme west, reaching Chile and Hawaii has happened so far.
HeartRhythm
NOVEMBER 23, 2023
Pulsed field ablation (PFA) is a nonthermal method to achieve selective cell death with little inflammation response. However, there are no reports in septal reduction therapy (SRT).
European Journal of Heart Failure
NOVEMBER 24, 2023
The different risk of new-onset, chronic, worsening, and advanced heart failure. CI, confidence interval; HF, heart failure; OR, odds ratio. Abstract Aims Heart failure (HF) is a chronic and progressive syndrome associated with a poor prognosis. While it may seem intuitive that the risk of adverse outcomes varies across the different stages of HF, an overview of these risks is lacking.
Journal of Cardiovascular Pharmacology
NOVEMBER 22, 2023
Abstract: The role of phosphodiesterase 5 (Pde5) in obstructive sleep apnea (OSA) induced damage remains unclear. Our study aimed to investigate the role of Pde5 in chronic intermittent hypoxia (CIH) model. C57BL/6J wild-type (WT) mice (n=48) and Pde5 knockout (Pde5-/-) mice (n=24) were randomly assigned to CIH group and room air (RA) group. After 6 weeks, some WT mice (n=24) in CIH group were given sildenafil or saline gavage for another 4 weeks.
The New England Journal of Medicine
NOVEMBER 22, 2023
Aortic-valve stenosis is an increasingly important cause of cardiovascular disease, particularly among older adults, with an overall prevalence of 2.8% among adults older than 75 years of age.1 Aortic stenosis is a progressive disease in which the rate of change of the aortic-valve area is estimated to be.
Circulation: Arrhythmia and Electrophysiology
NOVEMBER 23, 2023
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. Background:Pulsed field ablation (PFA) has emerged as an alternative to radiofrequency ablation. However, data on focal point-by-point PFA are scarce. The aim of this study was to compare lesion durability and collateral damage between focally delivered unipolar/biphasic PFA versus radiofrequency in swine.Methods:Eighteen swine were randomized to low-dose PFA, high-dose PFA, and radiofrequency using a multimodality generator.
European Journal of Heart Failure
NOVEMBER 22, 2023
Aims Growth differentiation factor-15 (GDF-15) is upregulated in part in response to cardiomyocyte stretch and stress, and it exerts a protective role that is mediated by its action to suppress signalling through insulin-like growth factor (IGF) and enhance signalling through adenosine monophosphate-activated protein kinase (AMPK). Sodium–glucose cotransporter 2 (SGLT2) inhibitors improve outcomes in heart failure, which has been experimentally linked to AMPK.
Journal of Cardiovascular Pharmacology
NOVEMBER 22, 2023
Abstract: As the pathogenesis of arterial thrombosis often includes platelet adhesion and aggregation, antiplatelet agents are commonly used to prevent thromboembolic events. Here, a new microfluidic method without additional adhesion protein modification was developed to quantify the inhibitory effect of antiplatelet drugs on the adhesion and aggregation behavior of platelets on glass surfaces under physiological flow conditions.
The New England Journal of Medicine
NOVEMBER 22, 2023
Hypoxemia and shock developed in a woman with atrial fibrillation who had been admitted for management of an ischemic stroke. Imaging (shown in videos) showed a thrombus in transit across a patent foramen ovale.
Circulation
NOVEMBER 23, 2023
Circulation, Ahead of Print. BACKGROUND:Bleeding rates on dual antiplatelet therapy (DAPT) within 1 month after percutaneous coronary intervention (PCI) remain high in clinical practice, particularly in patients with acute coronary syndrome or high bleeding risk. Aspirin-free strategy might result in lower bleeding early after PCI without increasing cardiovascular events, but its efficacy and safety have not yet been proven in randomized trials.METHODS:We randomly assigned 6002 patients with acu
European Journal of Heart Failure
NOVEMBER 22, 2023
Rates of guideline-directed medical therapy (GDMT) prescription in real-world patients with severe heart failure (HF) with reduced ejection fraction (HFrEF), reasons for underdosing and association with outcome. Upper left panel: rates of GDMT prescription and dosing, including beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor neprilysin inhibitors (ACEi/ARB/ARNI) and mineralocorticoid receptor antagonists (MRA).
Journal of Cardiovascular Pharmacology
NOVEMBER 21, 2023
In the latest years several studies described the impact of repetitive/intermittent i.v levosimendan treatment in the management of advanced heart failure. For this updated review we systematically searched the literature for clinical trials, registries, and real-world data, and identified 31 studies that we commented in a narrative review: 3814 patients were described, of whom 1744 were treated repetitively with levosimendan.
The New England Journal of Medicine
NOVEMBER 22, 2023
Among patients at low surgical risk who underwent TAVR or surgery, there was no apparent difference between groups in the incidence of the composite end point of death, stroke, or rehospitalization at 5 years.
Circulation
NOVEMBER 23, 2023
Circulation, Ahead of Print. BACKGROUND:Frequent premature atrial complexes (PACs) are associated with future incident atrial fibrillation (AF), but whether PACs contribute to development of AF through adverse atrial remodeling has not been studied. This study aimed to explore the effect of frequent PACs from different sites on atrial remodeling in a swine model.METHODS:Forty swine underwent baseline electrophysiologic studies and echocardiography followed by pacemaker implantations and paced PA
European Journal of Heart Failure
NOVEMBER 23, 2023
Abstract Aims Transthyretin cardiac amyloidosis (ATTR-CA) is an infiltrative cardiomyopathy that commonly presents with concomitant chronic kidney disease. Albuminuria is common in heart failure and associated with worse outcomes, but its prevalence and relationship to outcome in ATTR-CA remains unclear. Methods and Results A total of 1181 patients with ATTR-CA were studied (mean age 78.1±7.9 years; 1022[86.5%] male; median eGFR 59ml/min/1.73m 2 [IQR: 47–74]).
Journal of Cardiovascular Pharmacology
NOVEMBER 21, 2023
Abstract: Dapagliflozin (DAPA) is a novel oral hypoglycemic agent, and there is increasing evidence that DAPA has a protective effect against cardiovascular disease. The study aimed to investigate how DAPA inhibits cardiac hypertrophy and explore its potential mechanisms. By continuously infusing isoprenaline (ISO) for two weeks using a subcutaneous osmotic pump, a cardiac hypertrophic model was established in male C57BL/6 mice.
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