Quinidine for Brugada syndrome
Brugada syndrome is an inherited cardiac channelopathy with potential for life threatening ventricular arrhythmias and sudden cardiac death [1]. Coved ST segment elevation of 2 mm or more with negative T wave in right precordial leads V1 and V2, either spontaneously or after challenge with sodium channel blocker drug is the characteristic ECG finding. Though implantation of an ICD (implantable cardioverter-defibrillator is the main treatment, quinidine for Brugada syndrome is an option worth it in certain situations [2].
Quinidine is a Class I antiarrhythmic agent which can block Ito and IKr currents. It has been shown to...
Source: Cardiophile MD - April 19, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Will a good night ’s sleep help my heart?
This study followed nearly 2,000 adult men and women without CVD for five years. Participants wore wrist trackers to track sleep and activity. Study participants also completed a comprehensive sleep study and answered questions about their lives, including diet.
Researchers found that irregular sleep duration increased the risk of heart disease. Those with the most irregular sleep duration and variable bedtimes had more than double the risk of developing heart disease, compared to those with less variability in sleep duration and more consistent bedtimes. Researchers think that multiple factors could link irregular sleep p...
Source: Harvard Health Blog - April 17, 2020 Category: Consumer Health News Authors: Alyson Kelley-Hedgepeth, MD Tags: Healthy Eating Heart Health Sleep Source Type: blogs
DOAC in renal impairment – Cardiology MCQ
DOAC in renal impairment – Cardiology MCQ
Which of the following direct oral anticoagulants (DOACs) is most suitable in a patient with atrial fibrillation and renal dysfunction:
a) Dabigatran
b) Apixaban
c) Rivaroxaban
d) Betrixaban
Please post your answer as a comment below
The post DOAC in renal impairment – Cardiology MCQ appeared first on All About Cardiovascular System and Disorders. (Source: Cardiophile MD)
Source: Cardiophile MD - April 17, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Direct oral anticoagulant (DOAC) – Cardiology MCQ
Direct oral anticoagulant (DOAC) – Cardiology MCQ
Which of the following is not an indication for direct oral anticoagulant (DOAC) like dabigatran:
a) Prophylaxis against stroke in AF
b) Prophylaxis against systemic embolism in nonvalvular atrial fibrillation AF
c) Treatment and prevention of recurrent venous thromboembolism
d) Mechanical prosthetic mitral valve
Post your answer as a comment below
The post Direct oral anticoagulant (DOAC) – Cardiology MCQ appeared first on All About Cardiovascular System and Disorders. (Source: Cardiophile MD)
Source: Cardiophile MD - April 17, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Weight-loss surgery may lower risk of heart disease in people with diabetes
Obesity is a serious, chronic, treatable, and global disease epidemic. Over 98 million people currently have the disease of obesity, and in a recent New England Journal of Medicine article, Harvard researchers predicted that by 2030, 50% of the population in the United States will have the disease of obesity.
Type 2 diabetes (T2D) is significantly associated with obesity. While many people with obesity do not have diabetes, most people with T2D have the disease of obesity. Excess adiposity (body fat storage), which is present in obesity, contributes to many chronic diseases beyond T2D. These include high blood pressure, he...
Source: Harvard Health Blog - April 16, 2020 Category: Consumer Health News Authors: Angela Fitch, MD Tags: Diabetes Diet and Weight Loss Health Heart Health Surgery Source Type: blogs
Can Health Sensors Help Prevent A Coronavirus Infection?
It has almost become a meme to state that your smartphone is more powerful than the computer aboard Apollo 11 that helped men land on the Moon. In fact, your phone probably boasts over 100,000 times the processing power of that computer. Now, even laptop chargers claim to be more powerful than Apollo 11’s computer…
The computer in your pocket or on your wall socket will not land you on the Moon any time soon, but these comparisons do help put technological progress into perspective. Considering that an Apple Watch can detect life-threatening conditions like atrial fibrillation, while a Fitbit could detect a woma...
Source: The Medical Futurist - April 16, 2020 Category: Information Technology Authors: Prans Tags: Health Sensors & Trackers digital health sensors coronavirus covid covid19 Source Type: blogs
CXR Case 157
Michael A. Gibbs, MD CXR Case 157
A 79 year old female with a history of atrial fibrillation and hypertension presents with increasing dyspnea. Interpret the evolving CXR's (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - April 16, 2020 Category: Emergency Medicine Authors: Michael A. Gibbs, MD Tags: Cardiology Radiology Respiratory adult cxr Chronic pericardial effusion CXR interpretation CXR Quiz Source Type: blogs
Mitral isthmus – Cardiology MCQ – Answer
Mitral isthmus – Cardiology MCQ – Answer
Mitral isthmus, often targeted during ablation of atrial fibrillation is between the mitral valve and – Correct answer: a) Left inferior pulmonary vein
It is a narrow isthmus of myocardium between the lateral mitral annulus and the left inferior pulmonary vein [1]. It was first described by Luria DM et al 2001 during left accessory pathway ablation [2]. It was considered to be analogous to the cavotricuspid isthmus in the right atrium which is targeted for atrial flutter ablation. Feasibility and safety of ablation of the isthmus for atrial fibrillation was fi...
Source: Cardiophile MD - April 15, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Mitral isthmus – Cardiology MCQ
Mitral isthmus – Cardiology MCQ
Mitral isthmus, often targeted during ablation of atrial fibrillation is between the mitral valve and:
a) Left inferior pulmonary vein
b) Left superior pulmonary vein
c) Right inferior pulmonary vein
d) Right superior pulmonary vein
Post your answer as a comment below.
The post Mitral isthmus – Cardiology MCQ appeared first on All About Cardiovascular System and Disorders. (Source: Cardiophile MD)
Source: Cardiophile MD - April 15, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
DR-FLASH score for arrhythmogenic left atrial substrate
DR-FLASH score is based on diabetes mellitus, renal dysfunction, persistent form of AF (atrial fibrillation), LA (left atrial) diameter above 45 mm, age above 65 years, female sex, and hypertension. It was developed as a clinical for left atrial arrhythmogenic substrate based on voltage analysis [1]. Left atrial low voltage areas noted in patients with AF may predict recurrence after ablation, hence the need for the score. The probability for the presence of left atrial substrate requiring additional ablation other than the routine pulmonary vein isolation done for AF ablation, increased by a factor of 2.2 with each e...
Source: Cardiophile MD - April 15, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Ablation index to guide AF ablation
Ablation Index (AI) is used in the context of pulmonary vein isolation with radiofrequency catheter ablation for atrial fibrillation (AF) [1]. Pulmonary vein reconnection is an important problem which reduces the long term success rate of AF ablation. Other studies have shown that force sensing is important in AF ablation and optimal results are obtained when 90% or more of the lesions receive a local force of more than 10 grams and the time in contact force range exceeds 80%. Durability of pulmonary vein isolation depends on full thickness gap free ablation. When the gaps exceed 10 mm, there is increase in the recurrence...
Source: Cardiophile MD - April 15, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Left atrial appendage closure devices
Anticoagulation for prevention of stroke is a well established modality of treatment in atrial fibrillation. But a significant number of them have bleeding complications. Hence the option of left atrial appendage closure with multiple types of devices have been developed. Left atrial appendage with its sluggish flow is the most common location for thrombus formation in atrial fibrillation.
Following devices have been used with varying success:
Watchman
Amplatzer Cardiac Plug/Amulet
Lariat suture ligation
Atriclip
PROTECT-AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillatio...
Source: Cardiophile MD - April 15, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
AF in cryptogenic stroke – Cardiology MCQ – Answer
This study high lights the fact that a 24 hour Holter monitoring grossly underestimates the occurrence of AF in those with cryptogenic stroke. Guidelines recommend a minimum of 72 hour ECG monitoring in patients with transient ischemic attack (TIA) or ischemic stroke to screen for AF [3].
Back to question
Reference
Sanna T, Diener HC, Passman RS, Di Lazzaro V, Bernstein RA, Morillo CA, Rymer MM, Thijs V, Rogers T, Beckers F, Lindborg K, Brachmann J; CRYSTAL AF Investigators. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. 2014 Jun 26;370(26):2478-86.
Brachmann J, Morillo CA, Sanna T, Di Lazzaro ...
Source: Cardiophile MD - April 15, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
60-something with wide complex tachycardia: from where does the rhythm originate?
p.p1 {margin: 0.1px 0.0px 0.1px 0.1px; font: 9.0px Helvetica}An elderly woman with history of coronary disease presented with CP and SOB and hypotension by EMS. EMS had attempted adenosine x 2 without success.Here is her ED ECG:Here is the ED physician ' s interpretation:IMPRESSIONUNCERTAIN REGULAR RHYTHM, wide complex tachycardia, likely p-waves.LEFT BUNDLE BRANCH BLOCK [120+ ms QRS DURATION, 80+ ms Q/S IN V1/V2, 85+ ms R IN I/aVL/V5/V6]Comparison Summary: LBBB and tachycardia are new.What do you think?Smith: This is indeed a regular wide complex tachycardia. I do not see P-waves. Retrograde P...
Source: Dr. Smith's ECG Blog - April 14, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
SAMe-TT ₂R₂ score for poor INR control
SAMe-TT₂R₂ score for poor INR control
SAMe-TT₂R₂ score aims at predicting those likely to have poor INR (International Normalized Ratio of Prothrombin Time) control while on vitamin K antagonists [1]. The investigators divided the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial cohort randomly into a derivation cohort and an internal validation cohort.
They used linear regression analysis to find out the clinical parameters associated with time in therapeutic window (TTR) while on warfarin. Binary logistic regression analysis was used to evaluate the predictive performance of a mode...
Source: Cardiophile MD - April 14, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
