Sat.Nov 18, 2023 - Fri.Nov 24, 2023

article thumbnail

ECG Video Blog #404 (344) — Mobitz I, Mobitz II. or neither?

Ken Grauer, MD

== — 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?

Blog 99
article thumbnail

Infection and DKA, then sudden dyspnea while in the ED

Dr. Smith's ECG Blog

To learn more about Occlusion MI, join us in this Free Webinar on November 27 12 noon US Central Time: Sign up at this link: [link] Infection and DKA, then sudden dyspnea while in the ED A 63 year old male with a PMH of CAD and peripheral vascular disease from type 1 DM presented to clinic and was found to have a very high blood sugar and so was sent to the emergency department.

article thumbnail

Physiology Friday #193: Low-carb diets for high-intensity performance

Physiologically Speaking

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.

article thumbnail

Submit your Abstract!

International Journal of Cardiovascular Sciences

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!

article thumbnail

Bayer Halts Asundexia Factor XI Trial Due to Inefficacy

CardiacWire

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

AFIB 52
article thumbnail

Why Hospitals Are Moving beyond the Limits of Physical Media Storage

NOVARAD

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.

article thumbnail

Physiology Friday #193: Low-carb diets for high-intensity performance

Physiologically Speaking

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.

More Trending

article thumbnail

How To Live A Meaningful Life

Dr. Paddy Barrett

“The decisive question for man is: Is he related to something infinite or not? That is the telling question of his life.” Carl Jung The answer to this question for those who came before us was clear. It was an emphatic yes. For with a God, our connection to the infinite was obvious. With this relationship, a set of beliefs and values were laid out that made ‘ knowing what to do’ with your life very obvious.

article thumbnail

Impact of the COVID-19 pandemic on acute coronary syndrome hospital admission and management in Slovenia

Open Heart

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.

article thumbnail

How Alcohol Affects Your Sleep

Physiologically Speaking

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.

article thumbnail

The effect of gender on clinical outcomes following routine revascularizations with polymer-free sirolimus-eluting stents

Coronary Artery Disease Journal

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.

Stent 52
article thumbnail

Why Oval shaped ASD device are not popular ?

Dr. S. Venkatesan MD

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.

article thumbnail

The association between COVID-19 infection and incident atrial fibrillation: results from a retrospective cohort study using a large US commercial insurance database

Open Heart

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

article thumbnail

How Alcohol Affects Your Sleep

Physiologically Speaking

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.

article thumbnail

ORBITA 2: The power of PCI revealed for stable angina

Cardiology Update

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.

Angina 52
article thumbnail

Medtronic’s Symplicity Spyral RDN System Lands FDA Approval

CardiacWire

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

article thumbnail

Unlocking Precision in Interventional Cardiology: The Vital Role of OCT and IVUS

ADN Center of Excellence

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.

article thumbnail

Sinus Bradycardia and More

ECG Guru

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.

article thumbnail

Defective Bile Acid Signaling Promotes Vascular Dysfunction, Supporting a Role for G?Protein Bile Acid Receptor 1/Farnesoid X Receptor Agonism and Statins in the Treatment of Nonalcoholic Fatty Liver Disease

Journal of the American Heart Association

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

Aortic 40
article thumbnail

Loss of sodium current caused by a Brugada syndrome-associated variant is determined by patient-specific genetic background

HeartRhythm

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.

article thumbnail

Clinical presentation, shock severity and mortality in patients with de novo versus acute?on?chronic heart failure?related cardiogenic shock

European Journal of Heart Failure

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.

article thumbnail

SMART WATCH ECG

ECG Guru

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.

article thumbnail

Live view of yourself on the globe : Find, which dot are you ?

Dr. S. Venkatesan MD

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.

40
article thumbnail

A novel method for septal reduction therapy by 3D-guided transvenous intra-septal pulse field ablation

HeartRhythm

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).

article thumbnail

The different risk of new?onset, chronic, worsening, and advanced heart failure: A systematic review and meta?regression analysis

European Journal of Heart Failure

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.

article thumbnail

Pde5 Inhibition Reduced Blood Pressure and Alleviated Target Organ Damage in Chronic Intermittent Hypoxia

Journal of Cardiovascular Pharmacology

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.

article thumbnail

The Changing Landscape of Aortic-Valve Stenosis Management

The New England Journal of Medicine

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.

article thumbnail

Point-by-Point Pulsed Field Ablation Using a Multimodality Generator and a Contact Force–Sensing Ablation Catheter: Comparison With Radiofrequency Ablation in a Remapped Chronic Swine Heart

Circulation: Arrhythmia and Electrophysiology

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.

article thumbnail

Growth differentiation factor?15 and the effect of empagliflozin in heart failure: Findings from the EMPEROR program

European Journal of Heart Failure

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.

article thumbnail

Anti-platelet agents inhibit platelet adhesion and aggregation on glass surface under physiological flow conditions: Toward a microfluidic platelet functional assay without additional adhesion protein modification

Journal of Cardiovascular Pharmacology

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.

article thumbnail

Thrombus in Transit across a Patent Foramen Ovale

The New England Journal of Medicine

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.

article thumbnail

An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting: STOPDAPT-3 Randomized Trial

Circulation

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

Stent 40
article thumbnail

Guideline?directed medical therapy in severe heart failure with reduced ejection fraction: an analysis from the HELP?HF registry

European Journal of Heart Failure

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).

article thumbnail

Repeated levosimendan infusions in the management of advanced heart failure: review of the evidence and meta-analysis of the effect on mortality

Journal of Cardiovascular Pharmacology

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.

article thumbnail

Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Years

The New England Journal of Medicine

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.

article thumbnail

Frequent Premature Atrial Contractions Lead to Adverse Atrial Remodeling and Atrial Fibrillation in a Swine Model

Circulation

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

article thumbnail

Albuminuria in cardiac ATTR amyloidosis: prevalence, progression and prognostic importance

European Journal of Heart Failure

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]).