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Journal of the American College of... Mar 2022
Topics: Atrial Fibrillation; Heart Atria; Heart Valve Diseases; Humans; Ventricular Remodeling
PubMed: 35272800
DOI: 10.1016/j.jacc.2021.12.028 -
Indian Pacing and Electrophysiology... 2019This article reviews important features for improving the diagnosis and management of fetal arrhythmias. The normal fetal heart rate ranges between 110 and 160 beats per... (Review)
Review
This article reviews important features for improving the diagnosis and management of fetal arrhythmias. The normal fetal heart rate ranges between 110 and 160 beats per minute. A fetal heart rate is considered abnormal if the heart rate is beyond the normal ranges or the rhythm is irregular. The rate, duration, and origin of the rhythm and degree of irregularity usually determine the potential for hemodynamic consequences. Most of the fetal rhythm disturbances are the result of premature atrial contractions (PACs) and are of little clinical significance. Other arrhythmias include tachyarrhythmias (heart rate in excess of 160 beats/min) such as atrioventricular (AV) reentry tachycardia, atrial flutter, and ventricular tachycardia, and bradyarrhythmias (heart rate <110 beats/min) such as sinus node dysfunction, complete heart block (CHB) and long QT syndrome (which is associated with sinus bradycardia and pseudo-heart block).
PubMed: 30817991
DOI: 10.1016/j.ipej.2019.02.007 -
International Heart Journal Nov 2020The risk of thromboembolic events is significantly increased among patients with heart failure, even in those without atrial fibrillation. However, it is still unclear... (Review)
Review
The risk of thromboembolic events is significantly increased among patients with heart failure, even in those without atrial fibrillation. However, it is still unclear whether patients with heart failure and sinus rhythm can benefit from prophylactic anticoagulant therapy.This was a retrospective review of the pathophysiological mechanisms, epidemiological studies, and clinical trials on anticoagulation in patients with heart failure and sinus rhythm.Some subgroup analyses of clinical trials found that prophylactic anticoagulant therapy could reduce the incidence of stroke in patients with heart failure and sinus rhythm, and the risk of bleeding was significantly increased. Regarding the incidence of primary endpoint outcomes, all results from clinical trials were negative.Prophylactic anticoagulation did not improve the clinical outcome in patients with heart failure and sinus rhythm.
Topics: Anticoagulants; Factor Xa Inhibitors; Heart Failure; Hemorrhage; Humans; Stroke; Thromboembolism
PubMed: 33191346
DOI: 10.1536/ihj.20-248 -
Pulmonary Therapy Jun 2022Cystic fibrosis (CF) is due to a mutation in the cystic fibrosis transmembrane conductance regulator gene (CFTR), which leads to unusual water and chloride secretion... (Review)
Review
Cystic fibrosis (CF) is due to a mutation in the cystic fibrosis transmembrane conductance regulator gene (CFTR), which leads to unusual water and chloride secretion across epithelial surfaces. The lungs are responsible for most morbidity, though other organs are frequently affected. Sleep abnormalities have long been recognized in CF. Abnormal ventilation and oxygenation, sinus disease, deconditioning due to muscle weakness and recurrent infections, and inflammation have been thought to play a role in sleep disorders in CF. However, there is evidence that CFTR gene dysregulation can affect circadian rhythms in CF. Early recognition and treatment of circadian rhythms may improve outcomes in CF.
PubMed: 35149967
DOI: 10.1007/s41030-022-00184-x -
Cells Nov 2021Rhythm disturbances are life-threatening cardiovascular diseases, accounting for many deaths annually worldwide. Abnormal electrical activity might arise in a... (Review)
Review
Rhythm disturbances are life-threatening cardiovascular diseases, accounting for many deaths annually worldwide. Abnormal electrical activity might arise in a structurally normal heart in response to specific triggers or as a consequence of cardiac tissue alterations, in both cases with catastrophic consequences on heart global functioning. Preclinical modeling by recapitulating human pathophysiology of rhythm disturbances is fundamental to increase the comprehension of these diseases and propose effective strategies for their prevention, diagnosis, and clinical management. In silico, in vivo, and in vitro models found variable application to dissect many congenital and acquired rhythm disturbances. In the copious list of rhythm disturbances, diseases of the conduction system, as sick sinus syndrome, Brugada syndrome, and atrial fibrillation, have found extensive preclinical modeling. In addition, the electrical remodeling as a result of other cardiovascular diseases has also been investigated in models of hypertrophic cardiomyopathy, cardiac fibrosis, as well as arrhythmias induced by other non-cardiac pathologies, stress, and drug cardiotoxicity. This review aims to offer a critical overview on the effective ability of in silico bioinformatic tools, in vivo animal studies, in vitro models to provide insights on human heart rhythm pathophysiology in case of sick sinus syndrome, Brugada syndrome, and atrial fibrillation and advance their safe and successful translation into the cardiology arena.
Topics: Animals; Atrial Fibrillation; Brugada Syndrome; Disease Models, Animal; Heart Rate; Humans; Multifactorial Inheritance; Sick Sinus Syndrome
PubMed: 34831398
DOI: 10.3390/cells10113175 -
Animals : An Open Access Journal From... Jun 2021The Lorenz plot (LP), a graphical representation of heart rate variability, has been poorly studied in dogs to date. The present study aimed to describe the graphic...
The Lorenz plot (LP), a graphical representation of heart rate variability, has been poorly studied in dogs to date. The present study aimed to describe the graphic features of LP in dogs with sinus rhythm (SR) and tachyarrhythmias, and to analyze the usefulness of its pattern recognition. One hundred and nineteen canine Holter recordings were retrospectively evaluated. Cardiac rhythms were classified as: SR; SR with frequent (>100) premature ectopies (atrial, SR-APCs; ventricular, SR-VPCs; atrial and ventricular, SR-APCs-VPCs); atrial fibrillation (AF); and AF with frequent VPCs (AF-VPCs). Lorenz plots were studied qualitatively and quantitatively, and classified by distinct LP patterns (LPPs). Repeatability and reproducibility of LPP classification and diagnostic value were determined. Recordings included: 48 SR, 9 SR-APCs, 35 SR-VPCs, 5 SR-APCs-VPCs, 4 AF, and 18 AF-VPCs. Ten LPPs were identified: comet ( = 12), torpedo ( = 3), Y-shaped ( = 6), diamond ( = 10), diamond with a central silent zone ( = 17), double side-lobe (DSL) ( = 47), triple side-lobe ( = 1), quadruple side-lobe ( = 2), fan ( = 18), and fan with DSL ( = 3). Repeatability and reproducibility of LPP classification were excellent. The DSL pattern was both highly sensitive (91.3%) and specific (94.5%) for SR with frequent premature ectopies, either APCs, or VPCs, or both. The remaining LPPs had lower diagnostic value (high specificity but low sensitivity). Distinct rhythms imprint distinct and reproducible LPPs in dogs. The majority of canine LPPs are specific but insensitive indicators of SR and tachyarrhythmias.
PubMed: 34206036
DOI: 10.3390/ani11061645 -
JACC. Heart Failure Apr 2021Despite advances in medical and device therapy, patients with heart failure remain at high risk for morbidity and mortality. Experimental and clinical studies have shown... (Review)
Review
Despite advances in medical and device therapy, patients with heart failure remain at high risk for morbidity and mortality. Experimental and clinical studies have shown an association between heart failure and a hypercoagulable state, and that patients with heart failure experience an increased incidence of stroke and other thromboembolic events, regardless of whether they are in atrial fibrillation. Although oral anticoagulation is recommended when atrial fibrillation is present, the benefits of this therapy in patients with heart failure in sinus rhythm are uncertain. Older randomized controlled trials comparing warfarin with antiplatelet therapy were, for the most part, underpowered and failed to show convincing benefits of warfarin therapy in this population. Several recent studies that assessed the effects of low-dose direct-acting oral anticoagulant therapy in patients with coronary artery disease in sinus rhythm either included or specifically targeted patients with heart failure. Post hoc analysis of their results showed that this treatment strategy was associated with improved outcomes in patients with acute coronary syndrome or stable coronary artery disease and also a significant reduction in thromboembolic events, including ischemic stroke. This review presents the rationale for anticoagulant therapy in patients with heart failure in sinus rhythm, discusses gaps in our knowledge base, offers suggestions for when anticoagulation might be considered, and identifies potential directions for future research.
Topics: Anticoagulants; Atrial Fibrillation; Factor Xa Inhibitors; Heart Failure; Humans; Thromboembolism; Warfarin
PubMed: 33714744
DOI: 10.1016/j.jchf.2021.01.009