A pharmacokinetic model for amiodarone in infants developed from an opportunistic sampling trial and published literature data
AbstractAmiodarone is a first-line antiarrhythmic for life-threatening ventricular fibrillation or ventricular tachycardia in children, yet little is known about its pharmacokinetics (PK) in this population. We developed a population PK (PopPK) model using samples collected via an opportunistic study design of children receiving amiodarone per standard of care supplemented by amiodarone PK data from the literature. Both study data and literature data were predominantly from infants
Aims: One-third of DCM patients experience ventricular tachycardia (VT), but a clear biological basis for this has not been established. The purpose of this study was to identify transcriptome signatures and enriched pathways in the hearts of dilated cardiomyopathy (DCM) patients with VT.Methods and Results: We used RNA-sequencing in explanted heart tissue from 49 samples: 19 DCM patients with VT, 16 DCM patients without VT, and 14 non-failing controls. We compared each DCM cohort to the controls and identified the genes that were differentially expressed in DCM patients with VT but not without VT.
In conclusion, ivabradine does not exhibit anti-arrhythmic properties in CPVT, which indicates that this blocker cannot be used as a plausible treatment for CPVT ventricular arrhythmias.
Patients with nonischemic cardiomyopathy (NICM) often require an epicardial ventricular tachycardia (VT) ablation procedures via subxiphoid access. The coronary venous system (CVS) provides limited access to the epicardial space
Conclusions: We found no significant effect modification by drug administration route for amiodarone or lidocaine compared to placebo during OHCA. However, point estimates for the effects of both drugs compared to placebo were greater for the IV than IO route across all outcomes and beneficial only for IV. Given that the study was underpowered to statistically assess interactions, these findings signal the potential importance of the drug administration route during resuscitation that merits further investigation. PMID: 31941354 [PubMed - as supplied by publisher]
Lidocaine and amiodarone are both included in the pediatric cardiac arrest guidelines as treatments of shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, although there is limited evidence to support this recommendation.
We examined frequency, clinical characteristics and AF‐related management and outcomes amongst this patient population.MethodsWe retrospectively studied consecutive probands with inherited cardiomyopathy (n=962) and inherited arrhythmia syndromes (n=195) evaluated between 2002 ‐2018.ResultsAF was observed in 5 ‐31% of patients, with the highest frequency in HCM. Age of AF onset was 45.8 ± 21.9 years in the inherited arrhythmia syndromes compared to 53.3 ± 15.3 years in the inherited cardiomyopathies, with 4 CPVT patients developing AF at median age of 20 years. Overall, 11% of patients with AF had a t r...
ConclusionHD wave mapping using the novel HDG catheter integrated with the Precision ™ EAM is safe and feasible in VA procedures in the LV, RV and Aorta. Mapping times are consistent with other multi‐electrode mapping catheters.This article is protected by copyright. All rights reserved.
AbstractA 76 ‐year‐old woman with permanent atrial fibrillation and a mechanical aortic valve came to our attention. Echocardiography showed a 50‐55% ejection fraction (EF) with good prosthesis performance. For symptomatic bradyarrhythmia, she received a VVI pacemaker (Proponent MRI L2010 model; Boston Sci entific.). During follow‐up, frequent symptomatic (presyncopal) episodes of nonsustained episodes of ventricular tachycardia (VT) were detected. Amiodarone proved unsuccessful; she was then offered an upgrade to an implantable cardioverter defibrillator (ICD) and a subcutaneous ICD (S‐ICD) was c hosen by the pa...
ConclusionCatheter ablation of drug ‐refractory VT in CS is effective, often requiring epicardial approach. Incomplete success and recurrence of VT was higher in the inflammatory phase of the disease.This article is protected by copyright. All rights reserved.