New pacemaker offers heart failure hope
ConclusionThis laboratory research describes the complex design and animal testing of an ACPG that aims to restore the natural synchronisation of the heart rate with the breathing pattern. Naturally in the body, our heart rate alters slightly as we breathe in and out (RSA). In people with heart failure (a disease process with many causes, where the heart is unable to pump enough blood to meet the body’s demands), RSA is described as being "lost", and previous research has suggested this to be a prognostic indicator for poor outcome.This research described the development of an ACPG and its testing in rats. The generator received incoming signals from the phrenic connected to the diaphragm, and then produced voltage oscillations that stimulated the vagus nerve, which controls heart rate. The results were promising, demonstrating that the technology was able to coordinate the heart rate with breathing pattern. The heart rate varied, depending on the stage during breathing that the vagus nerve was stimulated. When stimulated during the inspiratory phase, it decreased heart rate by around 50% of the normal rate, but had little effect on heart rate during the late expiratory phase. Overall, this technique shows promise, but having only so far been tested in rats in the laboratory, it is far too early to tell if and when it will be developed for testing in humans and, importantly, whether it would actually have any effect on health outcomes.We expect that further an...
This article discusses the pathophysiology and molecular mechanisms that contribute to cancer therapeutics-related cardiac dysfunction and presents an napproach to the evaluation and treatment of these patients.
AbstractPurpose of ReviewThis review aims to discuss the role of ECMO in the treatment of cardiogenic shock in heart failure.Recent FindingsTrials done previously have shown that IABP does not improve survival in cardiogenic shock compared to medical treatment, and that neither Impella 2.5 nor TandemHeart improves survival compared to IABP. The “IMPRESS in severe shock” trial compared Impella CP with IABP and found no difference in survival. A meta-analysis of cohort studies comparing ECMO with IABP showed 33% improved 30-day survival with ECMO (risk difference 33%; 95% CI 14–52%;p = 0.0008; N...
Authors: Okuda Y, Yamada T, Ueda M, Ando Y Abstract Objective To clarify the underlying diseases, clinical manifestations, and treatment strategies for AA amyloidosis (AAA) in Japanese patients. Methods We conducted a survey on Japanese patients with AAA treated between January 1, 2012, and December 31, 2014. Results A total of 199 patients with AAA were included in the present study. The underlying diseases of AAA were rheumatoid arthritis (60.3%), uncharacterized inflammatory disorders (11.1%), neoplasms (7.0%), other rheumatic diseases (6.5%), inflammatory bowel diseases (4.5%), chronic infection (4.5%), Castlem...
ConclusionThe assessment of myocardial sympathetic activity in patients with heart failure with PET will play a pivotal role in clinical practice. Its capability to predict the occurrence of life-threatening VA and the effectiveness of resynchronization therapy makes this technique ideal in the era of personalized medicine.
ConclusionsICM either revealed progression of 1st-degree AV block to a higher grade block (53%) or detected an already existing more severe bradycardia warranting an IPG in 40.5% patients. This finding supports the conclusion that 1st-degree AV block might be a risk marker for more severe intermittent conduction disease and is not benign in all patients. Further studies may reveal patient subgroups which are at risk for demonstrating or developing higher grade AV block and may warrant a future IPG implantation.
Publication date: Available online 8 August 2018Source: Canadian Journal of CardiologyAuthor(s): Mikael Laredo, Victor Waldmann, Paul Khairy, Stanley NattelAbstractThe incidence of atrial fibrillation (AF), the most common sustained arrhythmia and a major public health burden, increases exponentially with age. However, mechanisms underlying this long-recognized association remain incompletely understood. Experimental and human studies have demonstrated the involvement of aging in several arrhythmogenic processes, including atrial electrical and structural remodeling, disturbed calcium homeostasis, and enhanced atrial ectop...
We aimed to investigate the impact of interleukin (IL)-17 on ventricular remodeling and the genesis of ventricular arrhythmia (VA) in an ischemic heart failure (HF) model. The expression of the proinflammatory cytokine IL-17 is upregulated during myocardial ischemia and plays a fundamental role in postinfarct inflammation. However, the influence of IL-17 on the genesis of VA has not yet been studied.
ESC Heart Failure, EarlyView.
CONCLUSIONS: Several cardiac phenotypes were age-dependently increased in LMNA mutation carriers, suggesting that ICD or CRT-D could suppress SCD after middle age; however, LVD leading to end-stage heart failure was the only independent predictor for total mortality. PMID: 30078822 [PubMed - as supplied by publisher]
CONCLUSION: The present analysis suggested that older age and history of heart failure were significant risk factors for POAF consistently whether the included studies were prospective or retrospective datasets. PMID: 30071562 [PubMed - as supplied by publisher]
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