Sat.Sep 02, 2023 - Fri.Sep 08, 2023

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ECG Blog #394 — Is QRS Morphology Disguised?

Ken Grauer, MD

The ECG in Figure-1 — was obtained from an older man with a history of prior infarction and coronary bypass surgery. How would you interpret this tracing? Clinical implications? Figure-1: The ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Thoughts on the ECG in Figure-1: The rhythm in ECG #1 is sinus at ~65/minute — with an upright P wave in lead II, and a constant and normal PR interval (ie, not more than 0.21 second in duration ).

Blog 118
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A 50-something with chest pain.

Dr. Smith's ECG Blog

This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant. More past history: hypertension, tobacco use, coronary artery disease with two vessel PCI to the right coronary artery and circumflex artery several years prior.

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Cold weather may pose challenges to treating high blood pressure

Science Daily - Heart Disease

An analysis of electronic health records for more than 60,000 adults in the United States found that systolic, or top-number, blood pressure rose slightly during the winter compared to summer months. The health records were of adults being treated for high blood pressure from 2018 to 2023 at six health care centers of varying sizes located in the southeast and midwestern United States.

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Does Your Radiology Recruitment Strategy Account for Technology?

Cassling

With the need to fill radiology roles with top talent — and to do so fast — hospitals are in a position where they need to step up their recruitment efforts and take action. A report from KaufmanHall found that 98% of hospital and health system leaders raised starting salaries and minimum wage while 84% introduced signing bonuses as part of their recruitment strategy.

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The STS Leadership Institute: A Year of Growth

Society of Thoracic Surgeons - Early Career

Blog The STS Leadership Institute: A Year of Growth KCummings Thu, 09/07/2023 - 12:57 Surgeon “The whole of life is but a moment of time” - Plutarch Professional Growth Image Dr. Hassan A. Tetteh, retired U.S. Navy captain and assoc. prof. of surgery, Uniformed Services University of the Health Sciences Dr. Michael Mack delivered the opening keynote, “The Totality of Life: You’re More than Just a Surgeon," to STS Leadership Institute participants in April 2022.

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50 year-old in remote rural community with chest pain and ‘normal’ ECG

Dr. Smith's ECG Blog

Submitted by anonymous, edited by Jesse McLaren The first person "I" and "me" is this anonymous sender. A 50 year old presented to the emergency department of a remote rural community (where the nearest cath lab is a plane ride away) with one hour of mild chest pain radiating to the back and jaw, and an ECG labeled ‘normal’ by the computer interpretation.

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Community-based, self-measured blood pressure control programs helped at-risk patients

American Heart News - Stroke News

Research Highlights: Community health centers participating in the National Hypertension Control Initiative (NHCI) that introduced self-measured blood pressure interventions to their patients — including individuals from Black, Hispanic and American.

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Successful Bypass Surgery In Hyderabad After Stents Blocked in Delhi.

Dr. Prateek Bhatnagar

A quadruple coronary bypass surgery using only arterial grafts and without any cuts on legs was performed successfully last week by renowned heart surgeon Dr. Prateek Bhatnagar Director Cardiac Surgery, on a 50 years man after stents placed in his left main coronary artery at Delhi just 3 months back, had blocked. Mr. Hemant, a resident of Delhi NCR, had developed chest pain (angina).

Stent 52
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Computer: "Normal ECG," TIMI-3 flow at angiography: Does this ECG manifest Occlusion MI?

Dr. Smith's ECG Blog

A 60-something awoke with 10/10 crushing chest pain. He walked in to triage. Here is the ECG: Computer interpretation: Normal ECG Interventionalist after doing PCI: SUBTLE STT CHANGES IN LIMB LEADS To me, this first ECG is diagnostic of inferior OMI. I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict: YOU TOO CAN HAVE THE PM Cardio AI BOT!!

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1 in 2 patients had better blood pressure control after using remote, bilingual program

American Heart News - Stroke News

Research Highlights: More than half of adults (55%) with uncontrolled blood pressure who enrolled in a digital monitoring program that connected patients with clinical advice and included a bilingual app paired with at-home blood pressure monitors had.

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Dan Zampogna Celebrates 20 Years of Going the Extra Mile

Cassling

Committed, hard worker, team player – these are the exact words a company hopes to hear when describing an employee, and just a few of the adjectives used to describe Cassling Field Service Engineer (FSE) Dan Zampogna. After 20 years, Dan continues to wow his managers, peers and customers with his willingness to lend a hand and “go the extra mile” to get things done.

Blog 52
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Time to TAVI: streamlining the pathway to treatment

Open Heart

Introduction Severe aortic stenosis is a major cause of morbidity and mortality. The existing treatment pathway for transcatheter aortic valve implantation (TAVI) traditionally relies on tertiary Heart Valve Centre workup. However, this has been associated with delays to treatment, in breach of British Cardiovascular Intervention Society targets. A novel pathway with emphasis on comprehensive patient workup at a local centre, alongside close collaboration with a Heart Valve Centre, may help redu

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How to Stay Active When the Weather Gets Cold

AMS Cardiology

During the colder months, it can be challenging to maintain an active lifestyle and prioritize cardiovascular health. Staying motivated is crucial, especially for older individuals who want to improve their heart health. Below we’ll explore several ways to stay active and incorporate exercise into your daily routine even when the weather gets cold.

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Cold weather may pose challenges to treating high blood pressure

American Heart News - Stroke News

Research Highlights: An analysis of electronic health records for more than 60,000 adults in the United States found that systolic, or top-number, blood pressure rose slightly during the winter compared to summer months. The health records were of.

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Conquering CHD Welcomes Carissa Ostrom as Executive Director

Conquering CHD

Dear friends and community, As we celebrate ten years of Conquering CHD, it also marks my 18th year as an advocate for congenital heart disease. I am entering into a new season of life as our youngest son has successfully transitioned to managing his CHD care and is off to college this fall. It is time to pass the torch to Carissa Ostrom as Executive Director and Karen Grossich as Outreach Director.

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Will this $840,000 grant make a dent in women’s cardiac care?

Heart Sisters

Two-thirds of clinical research on heart disease is still done on white middle-aged men. Will this new grant fund a solution to an alarming gender gap?

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ECG characteristics of “true” left bundle branch block: Insights from transcatheter aortic valve–related LBBB and His-Purkinje conduction system pacing–correctable LBBB

HeartRhythm

Left bundle branch block (LBBB) pattern on the electrocardiogram includes patients with both complete conduction block in the His-Purkinje system as well as nonspecific left ventricular conduction delay without discrete block.

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Cost-effectiveness of new quadruple therapy compared with standard treatment for patients with heart failure in China

Journal of Cardiovascular Pharmacology

This study aimed to compare the cost-effectiveness of the new quadruple therapy regimen of adding sodium-glucose–linked transporter 2 (SGLT2) inhibitors, with standard treatment for patients with heart failure (HF) in China. From the payer's perspective, the dates of cardiovascular event recurrences were extracted from a meta-analysis including six trials, combined with the treatment cost for patients with HF in China to construct a Markov model.

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High blood pressure while lying down linked to higher risk of heart health complications

Science Daily - Heart Disease

An analysis of data from a long-running study of more than 11,000 adults from four diverse communities in the United States has found that adults who had high blood pressure while both seated upright and lying supine (flat on their backs) had a higher risk of heart disease, stroke, heart failure or premature death compared to adults without high blood pressure while upright and supine.

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Are antiarrhythmic agents indicated in premature ventricular complex?induced cardiomyopathy and when?

Journal of Cardiovascular Electrophysiology

Abstract Introduction Premature ventricular complexes (PVCs) are the most common ventricular arrhythmia that are encountered in the clinical practice. Recent data suggests that high PVC burden may lead to the development of PVC-induced cardiomyopathy (PVC-CM) even in patients without structural heart disease. Treatment for effective suppression of PVCs, can reverse PVC-CM.

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Blocking interleukin-6 trans-signaling in AF: Promises and challenges

HeartRhythm

Atrial fibrillation (AF) stands as the most prevalent cardiovascular disease, posing significant risks of stroke, heart failure (HF), and other complications that contribute to morbidity and mortality. While traditional research on AF has primarily focused on electrophysiological components such as ionic currents and Ca2+ handling system, treatment strategies have mainly revolved around the rate-limiting β-blockers and Ca2+ channel blockers or rhythm-control methods such as cardioversion, antiar

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Sodium as an Important Regulator of Immunometabolism

Hypertension Journal

Hypertension, Ahead of Print. Salt sensitivity concerns blood pressure alterations after a change in salt intake (sodium chloride). The heart is a pump, and vessels are tubes; sodium can affect both. A high salt intake increases cardiac output, promotes vascular dysfunction and capillary rarefaction, and chronically leads to increased systemic vascular resistance.

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Low-Cost High-Throughput Genotyping for Diagnosing Familial Hypercholesterolemia

Circulation: Genomic and Precision Medicine

Circulation: Genomic and Precision Medicine, Volume 16, Issue 5 , Page 462-469, October 1, 2023. BACKGROUND:Familial hypercholesterolemia (FH) is a common but underdiagnosed genetic disorder characterized by high low-density lipoprotein cholesterol levels and premature cardiovascular disease. Current sequencing methods to diagnose FH are expensive and time-consuming.

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Stress test abnormalities reveal more than just cardiovascular risks

Science Daily - Heart Disease

The treadmill exercise test with electrocardiogram (ECG), also known as an exercise stress test, is one of the most familiar tests in medicine. While exercise testing typically is focused on diagnosing coronary artery disease, a recent study finds that exercise test abnormalities, such as low functional aerobic capacity, predicted non-cardiovascular causes of death such as cancer in addition to cardiovascular-related deaths.

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Association between nighttime heart rate and cardiovascular mortality in patients with implantable cardioverter-defibrillator: A cohort study

HeartRhythm

Although studies have shown that an increased resting heart rate measured randomly at a single point of the day has been associated with adverse cardiovascular outcomes, the utility of continuous monitoring of nighttime heart rate (NTHR) has remained largely uninvestigated.

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Eicosanoid-Regulated Myeloid ENaC and Isolevuglandin Formation in Human Salt-Sensitive Hypertension

Hypertension Journal

Hypertension, Ahead of Print. Background:The mechanisms by which salt increases blood pressure in people with salt sensitivity remain unclear. Our previous studies found that high sodium enters antigen-presenting cells (APCs) via the epithelial sodium channel and leads to the production of isolevuglandins and hypertension. In the current mechanistic clinical study, we hypothesized that epithelial sodium channel–dependent isolevuglandin-adduct formation in APCs is regulated by epoxyeicosatrienoic

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Targeting pharmacotherapies for inflammatory and cardiorenal endpoints in kidney disease

Journal of Cardiovascular Pharmacology

Inflammation is an important contributor to excess cardiovascular risk and progressive renal injury in people with CKD. Dysregulation of the innate and adaptive immune system is accelerated by CKD and results in increased systemic inflammation, a heightened local vascular inflammatory response leading to accelerated atherosclerosis, and dysfunction of the cardiac and renal endothelium and microcirculation.

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New cause of Alzheimer's, vascular dementia

Science Daily - Stroke

Researchers have discovered a new avenue of cell death in Alzheimer's disease and vascular dementia. The study reveals for the first time that a form of cell death known as ferroptosis -- caused by a buildup of iron in cells -- destroys microglia cells in cases of Alzheimer's and vascular dementia.

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Feasibility and efficacy of dual cathode modality in left bundle branch pacing

HeartRhythm

Left bundle branch pacing (LBBP) is an increasingly popular physiological pacing strategy for its advantage in left ventricular (LV) function through maintaining or restoring LV electrical and mechanical synchrony.1 However, LBBP can result in right bundle branch block (RBBB) and subsequent negative effects on right ventricular (RV) function. Notably, the simultaneous capture of the tip and ring electrode in LBBP could correct this iatrogenic RBBB and realize better electrical synchrony.2 Clinic

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Physiological Mechanisms of Dietary Salt Sensing in the Brain, Kidney, and Gastrointestinal Tract

Hypertension Journal

Hypertension, Ahead of Print. Excess dietary salt (NaCl) intake is strongly correlated with cardiovascular disease and is a major contributing factor to the pathogenesis of hypertension. NaCl-sensitive hypertension is a multisystem disorder that involves renal dysfunction, vascular abnormalities, and neurogenically-mediated increases in peripheral resistance.

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Contiguous Gene Deletion of Chromosome 15q25.2q25.3 in Biallelic ALPK3-Related Cardiomyopathy: Novel Insights Into Phenotypic Presentation and Variant Spectrum

Circulation: Genomic and Precision Medicine

Circulation: Genomic and Precision Medicine, Volume 16, Issue 5 , Page 493-495, October 1, 2023.

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The Proangiogenic Action of Thyroid Hormone Analogue GC-1 Is Initiated at an Integrin: Retraction

Journal of Cardiovascular Pharmacology

No abstract available

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Restoration of calcium release synchrony: A novel target for heart failure and ventricular arrhythmia

HeartRhythm

Myocardial calcium (Ca2+) signaling plays a crucial role in contractile function and membrane electrophysiology. An abnormal myocardial Ca2+ transient is linked to heart failure and ventricular arrhythmias. At the subcellular level, the synchronous release of Ca2+ sparks from sarcoplasmic Ca2+ release units determines the configuration and amplitude of the global Ca2+ transient.

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Comparison of Ambulatory and Home Blood Pressure Variability for Cardiovascular Prognosis and Biomarkers

Hypertension Journal

Hypertension, Volume 80, Issue 12 , Page 2547-2555, December 1, 2023. BACKGROUND:Although blood pressure variability (BPV) is reported to be associated with cardiovascular prognoses, it has not been established whether ambulatory BPV (ABPV; ie, short-term 24-hour BPV) or home BPV (HBPV; day-to-day BPV) is a superior clinical marker.METHODS:We analyzed the associations of ABPV and HBPV with cardiovascular prognoses and biomarkers in 1314 hypertensive outpatients who underwent both home and ambula

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DMD-Associated Dilated Cardiomyopathy: Genotypes, Phenotypes, and Phenocopies

Circulation: Genomic and Precision Medicine

Circulation: Genomic and Precision Medicine, Volume 16, Issue 5 , Page 421-430, October 1, 2023. Background:Variants in theDMDgene, that encodes the cytoskeletal protein, dystrophin, cause a severe form of dilated cardiomyopathy (DCM) associated with high rates of heart failure, heart transplantation, and ventricular arrhythmias. Improved early detection of individuals at risk is needed.Methods:Genetic testing of 40 male probands with a potential X-linked genetic cause of primary DCM was underta

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Dual coil system for the subcutaneous implantable cardioverter-defibrillator: Going back to the future

HeartRhythm

Over the course of several decades, the transvenous implantable cardioverter-defibrillator (TV-ICD) has grown to become a safe and effective treatment for the prevention of sudden cardiac death. During this time, there have been numerous iterative refinements to the system and implant technique. Generator sizes have decreased while preserving long battery life, owing in part to advancements in battery technology.

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ECG, the old kid around the block who betrays conduction secrets in patients with tetralogy of Fallot

HeartRhythm

Over the past years, patients with tetralogy of Fallot (TOF) have experienced numerous improvements in different treatment modalities consisting of a mixture of surgical procedures, transcatheter interventions including ablation therapy, and implantable cardioverter-defibrillator implantation procedures. However, progress in these therapeutic options have also introduced novel clinical hurdles.