Abbott ’s Gallant Implantable Cardioverter Defibrillators FDA Approved
Abbott won FDA approval for its Gallant implantable cardioverter defibrillator and cardiac resynchronization therapy defibrillator devices. Cleared in Europe earlier this year, the implants feature Bluetooth connectivity, allowing data to stream to a physician for closer observation and monitoring. The devices connect to the myMerlinPulse smartphone app, available for Android and iOS smartphones and tablets, and can share details about adverse events, how the device is performing, and a log of all the transmissions. Such close scrutiny can help to diagnose difficult to spot events, such as arrhythmias, and review those eve...
Source: Medgadget - July 6, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiac Surgery Cardiology Source Type: blogs

Abbott ’s Gallant Heart Rhythm Implants FDA Approved
Abbott won FDA approval for its Gallant implantable cardioverter defibrillator and cardiac resynchronization therapy defibrillator devices. Cleared in Europe earlier this year, the implants feature Bluetooth connectivity, allowing data to stream to a physician for closer observation and monitoring. The devices connect to the myMerlinPulse smartphone app, available for Android and iOS smartphones and tablets, and can share details about adverse events, how the device is performing, and a log of all the transmissions. Such close scrutiny can help to diagnose difficult to spot events, such as arrhythmias, and review those...
Source: Medgadget - July 6, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiac Surgery Cardiology Source Type: blogs

Optimizer System for Cardiac Contractility Modulation: Interview with Dr. Ishu Rao, Medical Director of Impulse Dynamics
Impulse Dynamics, based in Mt. Laurel, New Jersey, has developed the Optimizer system, a device designed to improve myocardial contractility in patients with heart failure. The system is intended to improve the quality of life of heart failure patients by reducing the severity of their symptoms. At present, many heart failure patients have few options in terms of effective treatments to reduce and control their symptoms. Medication can help certain patients, but some still experience unacceptable symptoms. Pacemakers, which correct the heart’s rhythm, are beneficial for some, but not all patients, and they do not ...
Source: Medgadget - April 3, 2020 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Exclusive Radiology Rehab Source Type: blogs

Abbott ’s Gallant Cardiac Implants Cleared in Europe
Abbott won clearance in the European Union for its new Gallant implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) implants. The MRI compatible devices, which Abbott claims have an extended battery lifetime, can securely communicate with patients and physicians via Abbott’s myMerlinPulse smartphone app. Physicians can monitor their patients, including being able to spot asymptomatic events, and patients can trigger their own signals to notify their doctors when they are feeling something abnormal. Patients can also use the app to see what data their docs are re...
Source: Medgadget - February 25, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiac Surgery Cardiology Source Type: blogs

EU Clears Medtronic ’s Smart Cobalt and Crome Cardiac Implants
Medtronic has announced that its Cobalt and Crome implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy-defibrillators (CRT-D) won EU CE Mark clearance, allowing their introduction to the continent. The devices feature Medtronic’s OptiVol fluid status sensors that allow the introduction of the company’s new TriageHF technology. This classifies patients into one of three groups for potential for heart failure (high, medium, low) based on measures including heart rate variability, atrial fibrillation, and fluid status. Medtronic also announced that existing devices with the OptiV...
Source: Medgadget - February 1, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiac Surgery Cardiology Source Type: blogs

Why ventricular tachycardia has wide QRS complex ?
Why VTs have wide QRS complex? Brief answer: VT  usually presents with wide QRS tachycardia because it originates in ventricular myocardium, travels muscle to muscle instead of the normal conduction system. However, VTs need not be wide always, if it captures the conduction system early and more proximally it can be as narrow as SVT. Further reading: Only for cardiology fellows  Two empirical statements are made here. (The scientific chances of both being reasonably correct are fair) 80 % of wide QRS tachycardia by default is VT. That means 20 % of wide QRS is not VT. We all accept that. 80 % of narrow QRS tachy...
Source: Dr.S.Venkatesan MD - December 4, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs

Barostim Neo Neuromodulation Device for Heart Failure Wins FDA Approval
CVRx, a Minneapolis, Minnesota company, won FDA approval for the first neuromodulation device designed to address heart failure. Intended as a treatment option for patients with an ejection fraction ≤35% and New York Heart Failure Classification of III or II (with recent history of Class III), the device stimulates the carotid artery and in turn the baroreceptors that control cardiovascular activity. The system monitors and adjusts the signals it delivers to achieve optimal beat-to-beat stimulation. It has been approved in Europe for a number of years (see flashbacks below). “With the FDA’s approv...
Source: Medgadget - August 27, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiac Surgery Cardiology Vascular Surgery Source Type: blogs

Security Crisis of Cardiac Pacemakers Paves the Way for IoT Security Evolution in Cardiology
Conclusion Fortunately, there have been no malicious activities or attacks in which hackers tampered with pacemakers, programmers, or other cardiac devices so far. However, the possibility itself is critical enough to prioritize the security assurance of connected cardiology devices. The security crisis associated with cardiac devices might have hindered their adoption, yet it also pointed to a critical gap in policy-making and technology testing on the whole. While some measures are underway, fully bridging this gap will require a more coordinated effort from both regulators and manufacturers. Inga Shugalo is a...
Source: The Health Care Blog - July 29, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Health Tech Health Technology Inga Shugalo IoT Pacemakers Security Source Type: blogs

Attain Stability Quad MRI SureScan, World ’s Only Active Fixation Left Heart Lead, Approved in U.S.
Cardiac resynchronization therapy (CRT) devices are implanted into heart failure patients to try to improve the efficiency of the heart. How well the therapy ends up working depends very much on the positioning of the electrodes of the leads that stretch into the heart. Quadripolar leads, having two more electrodes than typical, provide a great deal of control to cardiologists to stimulate the heart from different spots, but they typically still suffer from too much physical movement. Medtronic just won FDA approval for the Attain Stability Quad MRI SureScan left heart lead that’s used with the company’s quadri...
Source: Medgadget - May 1, 2019 Category: Medical Devices Authors: Editors Tags: Cardiology Radiology Source Type: blogs

BIOTRONIK ’s Single Lead, Dual Chamber Acticor ICDs and CRT-Ds Coming to U.S.
BIOTRONIK is releasing in the United States its Acticor line of implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-Ds). These include the Acticor DX and CRT-DX, both of which can take advantage of the company’s Plexa ProMRI S DX lead. A single Plexa ProMRI S DX lead is capable of providing dual-chamber diagnostic information, something that otherwise would have required an additional lead. The devices all work with BIOTRONIK’s new DF4 header configuration that relies on a penta-polar cable design that makes implantation easier and faster. Overall shape of th...
Source: Medgadget - April 29, 2019 Category: Medical Devices Authors: Editors Tags: Cardiology Source Type: blogs

Investigations and management of dilated cardiomyopathy
Investigations in dilated cardiomyopathy Chest X-ray PA view will assess the cardiac size in dilated cardiomyopathy and show evidence of pulmonary congestion. Sick persons may present with features of frank pulmonary edema in the form of hilar haze or bat wing pattern of pulmonary edema. Significant left ventricular dysfunction can exist without much of cardiomegaly on chest X-ray as well. ECG may show sinus tachycardia, left atrial overload and sometimes left ventricular hypertrophy. A wide QRS complex with left bundle branch block pattern may indicate potential benefit from cardiac resynchronization therapy (CRT). ECG ...
Source: Cardiophile MD - March 30, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: General Cardiology Source Type: blogs

First Cardiac Contractility Modulation Device Approved by FDA
Most cardiac implants, such as pacemakers and AICDs, are designed to correct the underlying heart’s rhythm, and synchronize atrial and ventricular contractions. That’s how these devices can improve cardiac performance in people with heart failure. They don’t do anything to boost the intrinsic myocardial contractility of the heart. Now the FDA has just given approval to the first implant that actually uses electrical pulses to improve how hard the heart pushes blood through the body. The Optimizer Smart system from Impulse Dynamics, a company out of Orangeburg, New York, is implanted like any cardiac impla...
Source: Medgadget - March 22, 2019 Category: Medical Devices Authors: Editors Tags: Cardiology Source Type: blogs

BIOTRONIK Wins FDA Approval for Two High-Voltage Families of Cardiac Implants
The FDA has given BIOTRONIK approval to introduce the company’s Acticor and Rivacor lines of high-voltage cardiac rhythm implants. They’re designed to treat tachycardia (likely supraventricular tachycardia (SVT) and have been made to be smaller and have a longer battery life. Some of the implants have a nearly 15 year lifetime, helping to lower the number of replacement procedures. All of the implants are 3 Tesla MR-conditional, meaning that patients can undergo most MRI scans as long as certain precautions are taken. BIOTRONIK touts the shape of the implants, which are supposedly less irritating on tissues. Th...
Source: Medgadget - March 15, 2019 Category: Medical Devices Authors: Editors Tags: Cardiology Source Type: blogs

Mitral E/E ’ for assessment of left ventricular diastolic function
Mitral E/E’ for assessment of left ventricular diastolic function Mitral E/E’ for assessment of left ventricular diastolic function E/E’ measured using a combination of mitral flow Doppler and tissue Doppler of mitral annulus is an important measure of left ventricular diastolic function. Assessment of diastolic function of the left ventricle is assuming more importance after the recognition of diastolic heart failure which is otherwise known as heart failure with preserved ejection fraction (HFpEF). As the population ages, frequency of HFpEF is on the rise. The image illustrates measurement of E’ b...
Source: Cardiophile MD - September 10, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Uncategorized mitral flow Doppler tissue Doppler of mitral annulus Source Type: blogs

Coronary artery and veins are married life long . . . with a purpose !
Cardiologist are always worried about the supply side of coronary blood flow. It’s fair enough, we can condone our brain for this one way thinking , afterall arterial supply remain the life-line for the heart. Some of us could (should) realise the importance of these  humble coronary veins which are anatomically and physiologically tied together.Its existence is as unique as their arterial counterpart.Coronary blood flow of about 250 ml traverses both the arms every minute.Imagine the scenario if the veins refuse to clear the blood from previous cardiac cycle . . . total hemodynamic chaos rig...
Source: Dr.S.Venkatesan MD - September 9, 2018 Category: Cardiology Authors: dr s venkatesan Tags: cardaic physiology cardiology-Anatomy coronary sinus anatomy and physiology coronary sinus filling and emptying time drsvenkatesan coronary veno occlusive disorder coronary venous circulation acute coronary sinus syndrome coroanry vein cor Source Type: blogs

Patient with Paced Rhythm in Severe Cardiomyopathy Presents with SOB due to Acute Decompensated Heart Failure
This is a middle-aged male with h/o with a history ofheart failure with severely reducedejection fraction due to dilated ischemic cardiomyopathy (EF 5-10%), probably with some component of non-ischemic cardiomyopathy, with h/o CABG, who is status post ICD placement (and previous appropriate shocks for VT) and biventricular pacer ( " cardiac resynchronization therapy " ), who is on amiodarone for VT suppression, and has h/o LV thrombus and is on chronicanticoagulation with warfarin.He presented forparoxysmal nocturnal dyspnea that didn't resolve with use of his home prn diuretics.  He...
Source: Dr. Smith's ECG Blog - June 9, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

Syncope, History of Coronary Disease, and ST Elevation: Should Medics Activate the Cath Lab?
A 60-something male had a syncopal episode.  911 was called.  The patient had no complaint of chest pain or shortness of breath. A prehospital ECG was recorded:Limb leadsPrecordial LeadsThere is ST Elevation in V1-V3, and in aVL, with reciprocal ST depression in II, III, and aVF.There is also some ST depression in V5 and V6, and ST elevation in aVR.What do you think?The medics interpreted the ST elevation, with reciprocal ST depression, as STEMI, and activated the cath lab.Note that you cannot see the entire QRS on the prehospital ECG.  The R-waves in leads II and III are cut off.  The S-waves in V...
Source: Dr. Smith's ECG Blog - March 14, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

Boston Scientific ’s Resonate Cardiac Implants with HeartLogic Predict Adverse Events, Now FDA Approved
Boston Scientific won approval from the FDA and is launching its Resonate line of implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy defibrillators (CRT-D). The implants include the firm’s HeartLogic diagnostic capability that sends an alarm to the cardiologist if it believes the patient’s heart is exhibiting worse performance, which may lead to a serious event such as an infarct. HeartLogic relies on a number of sensors within the implant that provide data on heart sounds, heart rate, breathing rate and volume, thoracic impedance, as well as the patient&rsqu...
Source: Medgadget - September 27, 2017 Category: Medical Devices Authors: Editors Tags: Cardiology Medicine Source Type: blogs

CRT-D better than CRT-P in NIDCM with left ventricular midwall fibrosis
Francisco Leyva and colleagues compared the outcomes of cardiac resynchronization therapy with (CRT-D) or without defibrillation (CRT-P) in non ischemic cardiomyopathy (NIDCM) [1]. Of their 252 patients, 68 had left ventricular midwall fibrosis detected by cardiac magnetic resonance imaging (CMR). It was found that left ventricular mid wall fibrosis was an independent predictory of total mortality, death from pump failure and sudden cardiac death. Maximum follow up period in their study was 14 years. They documented lower total mortality or hospitalization for major adverse cardiac events in those with CRT-D compared with ...
Source: Cardiophile MD - September 4, 2017 Category: Cardiology Authors: Johnson Francis Tags: Cardiology Source Type: blogs

Medtronic ’s Attain Stability Quad MRI SureScan Cardiac Lead Cleared in Europe
Medtronic won CE Mark approval to introduce its Attain Stability Quad MRI SureScan left heart lead in Europe. The device works with the company’s quadripolar cardiac resynchronization therapy-defibrillators (CRT-D) and CRT-pacemakers (CRT-P) and is not only a conduit for electric current, but also a tool for the electricity to better target cardiac tissue. The device features a helix that works kind of like an anchor to secure the lead, adapting to whatever size anatomy each individual patient has. The four electrodes give multiple options for how to stimulate the heart, helping to achieve optimum efficiency and ther...
Source: Medgadget - August 23, 2017 Category: Medical Devices Authors: Editors Tags: Cardiology Radiology Source Type: blogs

BIOTRONIK ’s Tiny Quadripolar Cardiac Resynchronization Therapy Pacemaker FDA Approved
BIOTRONIK has obtained an FDA approval for its Edora HF-T QP MR conditional quadripolar cardiac resynchronization therapy pacemaker (CRT-P). It’s tiny, by comparison to similar devices, and features the BIOTRONIK’s MR AutoDetect technology that allows a physician to tell the implant that an MRI exam is coming up and for the device to automatically engage its MRI safety mode during a scan. The implant has a total volume of only 15 cc, making it the smallest MR-conditional CRT-P on the U.S. market. Being a modern pacemaker, it includes wireless monitoring for daily uploads of any unusual events to the patien...
Source: Medgadget - August 22, 2017 Category: Medical Devices Authors: Editors Tags: Cardiology Source Type: blogs

BIOTRONIK ’s New CRT-ICDs Alleviate Atrial Lead Without Sacrificing Diagnostics
BIOTRONIK won FDA approval and is releasing in the U.S. its Intica DX and Intica cardiac resynchronization therapy (CRT)-DX implantable cardioverter defibrillators (ICD). The DX indicator refers to BIOTRONIK’s technology that obviates the necessity of having an atrial lead to monitor the electrical activity in the atrium, a way that cardiologists use to spot atrial fibrillation and other more serious arrhythmic events. The Intica CRT-DX is the first cardiac rhythm management implant that provides atrial signal data without having an atrial lead, which should help reduce complications and make implantation easier, fas...
Source: Medgadget - July 19, 2017 Category: Medical Devices Authors: Editors Tags: Cardiology Source Type: blogs

Good Death, or Assisted Suicide?
The Case of Mr. Perry and his PacemakerTarris Rosell, PhD, DMinRosemary Flanigan Chair at the Center for Practical BioethicsNOTE: Dr. Rosell, a bioethics consultant and educator, will present the case of Mr. Perry for ethics discussion and likely debate on Thursday, June 22, 2017 at 7:00 PM in the artfully rebuilt Westport Presbyterian Church, 201 Westport Rd, Kansas City, MO. Bring your perspectives, arguments, and personal stories of moral medical dilemma. Admission is free. All are invited and welcome.Mr. Perry (not his real name) was 83 years old and had several medical problems. He had spent the past several months in...
Source: blog.bioethics.net - June 6, 2017 Category: Medical Ethics Authors: Practical Bioethics Tags: Health Care assisted suicide; advance care planning; Final Exit; aging and end of life syndicated Source Type: blogs

Interview with Rupa Basu, BIOTRONIK ’s Senior VP of Marketing, Corporate Accounts and Strategy
Millions of people experience heart rhythm disturbances in their lifetime. This has propelled cardiac electrophysiology to become one of the most innovative fields in medicine today. BIOTRONIK, a privately owned, global company with headquarters in Germany, is one of the leaders in the cardiac rhythm management space. Aside from its European roots, the company has an increasingly global market and expanding US presence. Within the last ten years BIOTRONIK has managed to take a great portion of the American market share. The company continues to innovate and develop new cardio- and endovascular technology that aims to ...
Source: Medgadget - May 24, 2017 Category: Medical Devices Authors: Kenan Raddawi Tags: Cardiology Exclusive Source Type: blogs

BIOTRONIK ’s MultiPole Pacing for CRT Defibrillators Now Approved in U.S.
BIOTRONIK won FDA approval for its MultiPole Pacing (MPP) technology to be introduced in the U.S. on its CRT defibrillators (CRT-Ds). It’s designed to address the fact that the hearts of many patients on cardiac resynchronization therapy (CRT) fail to respond properly, and allowing cardiologists more pacing options can help overcome that in many cases. Specifically, the left ventricle can be paced twice per cycle, delivering the pulses either simultaneously or sequentially. The same BIOTRONIK CRT-Ds that feature MPP also sport the company’s ProMRI capability, which lets patients with the implants...
Source: Medgadget - May 11, 2017 Category: Medical Devices Authors: Editors Tags: Cardiology Source Type: blogs

Boston Sci ’s Long Lasting Resonate ICDs and CRT-Ds Get FDA Approval
Boston Scientific won FDA approval to introduce its Resonate line of implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy defibrillators (CRT-D). The same products were approved in Europe via a CE Mark earlier this year. Some of the notable features of the Resonate devices include multi-electrode pacing and integration with the company’s HeartLogic Heart Failure Diagnostic Service, essentially an algorithm that seems to do a good job predicting heart failure events. New battery technology allows Boston Scientific to claim an overall working lifetime for Resonate ICD devic...
Source: Medgadget - May 11, 2017 Category: Medical Devices Authors: Editors Tags: Cardiology Source Type: blogs

BIOTRONIK Releases New Line of MR-Conditional Pacemakers, CRT-Ps
BIOTRONIK is releasing a new line of MR-conditional pacemakers, the smallest the company has produced, and new quadripolar cardiac resynchronization therapy pacemakers (CRT-P). The Edora devices allow patients to receive MRI exams, as long as certain precautions are taken, and feature MRI AutoDetect feature that automatically puts an implant into safe mode when it’s near an MRI machine. When the scan is done and the patient moves away from the machine, the implant reverts back to its normal functionality. All the Edoras also feature wireless connectivity, unloading its data to BIOTRONIK Home Monitoring syst...
Source: Medgadget - March 23, 2017 Category: Medical Equipment Authors: Editors Tags: Cardiology Radiology Source Type: blogs

BIOTRONIK ’s New Personalizable and Energy Efficient CRTs
BIOTRONIK is releasing a new line of cardiac resynchronization therapy (CRT) implants, the Ilivia series, that are designed to improve patient response to the therapy and make it customizable for individual needs. The devices are compatible under MRI and feature the company’s MRI AutoDetect capability that automatically switches the devices to a special safe mode during an MRI scan. A problem with most CRTs is that achieving a more positive reaction from the heart often requires using more energy, thereby depleting the battery inside the implant too quickly and so necessitating extra surgeries. The Ilivia relies on B...
Source: Medgadget - February 2, 2017 Category: Medical Equipment Authors: Editors Tags: Cardiology Radiology Source Type: blogs

Very wide QRS complex
Width of the QRS complex in this ECG is about 200 ms. It is so wide that there is hardly any ST segment visible. The QRS merges into the T wave. One situation in which this occurs is severe hyperkalemia. But here the T wave are not tall and P waves are of reasonable amplitude, both against severe hyperkalemia. In severe hyperkalemia, P waves are flattened and disappear resulting in the so called sinoventricular conduction. Wide QRS in hyperkalemia merges with the tall T waves, producing a sine wave pattern, which is also absent here. Initial upstroke of the QRS is sharp in this ECG while the terminal slurring is very promi...
Source: Cardiophile MD - November 25, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology ECG / Electrophysiology ECG Library Source Type: blogs

Medtronic ’s Claria MRI Quad CRT-D SureScan with EffectivCRT Approved by FDA
Medtronic just announced that its Claria MRI Quad Cardiac Resynchronization Therapy Defibrillator (CRT-D) SureScan implant has been approved for use on patients with heart failure. The “MRI” in the name of the device indicates that its safe for magnetic resonance scanning in both 1.5 and 3 Tesla machines, given certain precautions. The device features the firm’s EffectivCRT algorithm that assesses the outcome of each stimulation of the left ventricle and adjusts therapy accordingly. Because a lot of people treated with CRT-D’s suffer from atrial fibrillation, the effectiveness of the therapy is ofte...
Source: Medgadget - November 14, 2016 Category: Medical Equipment Authors: Editors Tags: Cardiology Source Type: blogs

BIOTRONIK Releases Most Powerful Implantable Cardioverter Defibrillator in U.S.
BIOTRONIK is releasing the world’s most powerful implantable cardioverter defibrillator (ICD) in the United States. The Inventra HF-T cardiac resynchronization therapy defibrillator (CRT-D) can deliver 42 joules of energy in one punch to jolt even difficult to manage hearts back into a proper rhythm. Most ICDs generate about 36 joules of energy, but larger hearts and those with a reduced ejection fraction may need a stronger shock to get their arrhythmia under control. The Inventra HF-T sends 42 joules immediately on the first shock, potentially able to save the lives of more patients on CRT-D therapy....
Source: Medgadget - November 7, 2016 Category: Medical Equipment Authors: Editors Tags: Cardiac Surgery Cardiology Source Type: blogs

Ablation better than amiodarone for persistent AF with congestive heart failure
AATAC Multicenter Randomized Trial [1] has demonstrated that catheter ablation is clearly superior to amiodarone for heart failure and persistent atrial fibrillation having an implanted device. The study involved about two hundred patients with dual chamber defibrillator or cardiac resynchronization therapy and left ventricular ejection fraction less than 40% with functional class of New York Heart Association II or III. The primary endpoint was recurrence of atrial fibrillation while secondary endpoints were all cause mortality and unplanned hospitalization. All the endpoints were better in the catheter ablation group com...
Source: Cardiophile MD - April 28, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs

A Patient with Ischemic symptoms and a Biventricular Pacemaker
This case was sent by Gary Giorgio from Summa Health Emergency Medicine Residency in Akron, Ohio.  He frequently sends very interesting cases.Background:There are many who say that STEMI cannot be diagnosed in the setting of a ventricular paced rhythm.  In a recent survey, as part of a case posted on Medscape by my mentor, K. Wang, 48% of respondants answered that "One cannot diagnose an infarction from ventricularly paced complexes."CaseAn elderly woman presented with 6 hours of arm, back, jaw pain, diaphoresis, and dyspnea (no chest pain!).  There was an unclear history of CAD as previo...
Source: Dr. Smith's ECG Blog - April 2, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 19
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 19. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - February 25, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 10
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 10. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - February 1, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 8
This study found that though it is often associated with coronary artery disease (CAD), it can also occur in those without significant CAD. It was not specifically associated with disease of right coronary artery disease. This cardioinhibitory response may be a manifestation of the Bezold-Jarisch reflex. Bezold-Jarisch reflex inhibits sympathetic activity (sympathetic withdrawal) and increases parasympathetic activity, resulting in bradycardia, which may be associated with vasodilatation, nausea and hypotension. Bezold-Jarisch has been described in the setting of inferior wall infarction and coronary angiography. Origin...
Source: Cardiophile MD - January 26, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ Cardiology X-ray Featured Source Type: blogs

Briefly without pulse, has pulmonary edema and LBBB with 10 mm of ST Elevation
A middle-aged male was found down.  EMS was able to get the patient to climb onto the ambulance by himself, then during transport he became less responsive.  They briefly could not find pulses, and gave a short period of CPR with ROSC, but he did not require a shock. They gave Narcan without improvement.  An oral airway was placed and BVM oxygenation provided.  The patient arrived unable to provide any further history.BP was 180/100, HR 130, Oxygen saturations 84%.He was intubated.  A bedside ultrasound showed poor global function and B-lines of pulmonary edema.Here was the first ECG:There is sinus...
Source: Dr. Smith's ECG Blog - December 13, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Physiological Interventricular de-synchrony : Right ventricle contracts like an Intestine !
Right ventricle,being a venous chamber has distinct anatomical and physiological features to carry out this function.RV has a complex shape, its triangular in long axis and  crescent like in short axis , thin (
Source: Dr.S.Venkatesan MD - May 5, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Anatomy of heart Right ventricle best articles on right ventricle cardiac peristalsis physiological inter ventricualr desynchrony Right ventricle anatomy and physiology right ventricular sequential peristaltic contraction Source Type: blogs

Cardiac resynchronization therapy (CRT)
Brief Review Abstract: Cardiac resynchronization therapy (CRT) is biventricular pacing in which one lead paces the right ventricle endocardially, another the left ventricle epicardially through a coronary vein and a third paces the right atrial appendage. It is a mode of treatment of left ventricular failure due to cardiac dyssynchrony, usually with left bundle branch block and wide QRS complex. X-ray Chest in CRT showing pulse generator and three leads Pulse generator is seen in the left infraclavicular region with three leads connected. One lead is seen free behind the pulse generator, possibly an earlier right ven...
Source: Cardiophile MD - January 26, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs

Cardiac resynchronization therapy (CRT) – X-ray
Brief Review Abstract: Cardiac resynchronization therapy (CRT) is biventricular pacing in which one lead paces the right ventricle endocardially, another the left ventricle epicardially through a coronary vein and a third paces the right atrial appendage. It is a mode of treatment of left ventricular failure due to cardiac dyssynchrony, usually with left bundle branch block and wide QRS complex. X-ray Chest in CRT showing pulse generator and three leads Pulse generator is seen in the left infraclavicular region with three leads connected. One lead is seen free behind the pulse generator, possibly an earlier right vent...
Source: Cardiophile MD - January 26, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs

Coronary sinus atresia
Brief Review Abstract: Coronary sinus atresia is usually a congenital anomaly. Sometimes it is acquired, due to an AV fistula involving the middle cardiac vein which becomes grossly enlarged and impinges on the coronary sinus ostium and closes it off. Congenital atresia of the right atrial ostium of the coronary sinus can lead to different pathways for drainage of coronary venous outflow. In some cases, coronary venous outflow may move through a persistent left superior vena cava into the left brachiocephalic vein. From the left brachiocephalic vein it reaches the right atrium through the right superior vena cav...
Source: Cardiophile MD - January 10, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Cardiology MCQ: Selvester QRS scoring
Leads not included in the Selvester QRS scoring system: a) Lead I and aVL b) Lead II and aVF c) Lead III and aVR d) None of the above Correct answer: c) Lead III and aVR Selvester QRS scoring system is a 50 criteria 31 point QRS scoring system which was developed for estimating the infarct size from ECG. Each point on the scoring system will account for about 3% of left ventricular myocardium. The scoring system used 10 of the standard 12 leads with weighting for each criteria ranging from 1 to 3 points. Lead III and aVR are not included in this scoring system. Maximum points that can be taken from each lead are as f...
Source: Cardiophile MD - November 25, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Even Crazy Eddie Knows "Corporations Don't Commit Crimes, People Commit Crimes" - But Biotronik Settles
The deals the government gives are INSANE!!!  Just ask Crazy Eddie's former Chief Financial Officer. The Former Crazy Eddie CFO on Impunity Those of a certain age who were in or near the New York area remember Crazy Eddie, a discount appliance and electronics retailer with insane advertisements.As reported by CNN, Sam F Antar, the former Chief Financial Officer of Crazy Eddie, was a speaker on a conference on financial fraud,The U.S. government is losing the war against white collar crime.That's the message from Sam E. Antar, one of the masterminds of the massive Crazy Eddie fraud of the 1980s. 'We are in the golden e...
Source: Health Care Renewal - November 18, 2014 Category: Health Management Tags: Biotronik deception impunity kickbacks legal settlements marketing medical devices Source Type: blogs

Cardiology MCQ 313: Predictors of response to CRT
Predictors of response to CRT from the MADIT-CRT trial a) Nonischemic origin b) Left bundle-branch block c) QRS duration of 150 milliseconds or more d) All of the above ["Click here for the answer with explanation", "Correct Answer:"] d) All of the above Predictors of response to CRT in the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT) [Circulation. 2011; 124: 1527-1536] were: female sex, nonischemic origin, left bundle-branch block, QRS duration of 150 milliseconds or more, prior hospitalization for heart failure, left ventricular end-di...
Source: Cardiophile MD - September 18, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs

Cardiovascular Implantable Electronic Devices (CIED)
CIED: Cardiovascular Implantable Electronic Devices Dual chamber pacemaker with leads Cardiovascular Implantable Electronic Devices (CIED) are devices implanted for diagnostic or therapeutic purposes. These include: Pacemaker: for providing protection against bradycardia. A wide array of functions are available in modern pacemakers including dual chamber atrioventricular synchronous pacing, minimization of ventricular pacing, atrial fibrillation suppression algorithms and automatic capture control by constantly monitoring the pacing threshold so that minimum required output is delivered at all times. Implantable card...
Source: Cardiophile MD - August 13, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Electrophysiology Cardiovascular Implantable Electronic Device Source Type: blogs

Cardiovascular Implantable Electronic Devices (CIED)
CIED: Cardiovascular Implantable Electronic Devices Dual chamber pacemaker with leads Cardiovascular Implantable Electronic Devices (CIED) are devices implanted for diagnostic or therapeutic purposes. These include: Pacemaker: for providing protection against bradycardia. A wide array of functions are available in modern pacemakers including dual chamber atrioventricular synchronous pacing, minimization of ventricular pacing, atrial fibrillation suppression algorithms and automatic capture control by constantly monitoring the pacing threshold so that minimum required output is delivered at all times. Implantable card...
Source: Cardiophile MD - August 13, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Electrophysiology Cardiovascular Implantable Electronic Device Source Type: blogs

Prediction of superresponders to CRT (cardiac resynchronization therapy)
Various types of responses are possible after implantation of a cardiac resynchronization device (CRT) in a person with heart failure. There could be no response (non-responder), good response (responder), and a super response (superresponder). Some could even have a negative response. Superresponders have a good clinical outcome. Those with wide QRS complex indicating extensive intraventricular conduction disease are likely to have a superresponse. They typically have a QRS duration of 150 milliseconds or more and left bundle branch block. Females and those with no previous infarction are likely to have a better response....
Source: Cardiophile MD - July 5, 2014 Category: Cardiology Authors: Johnson Francis Tags: Electrophysiology Source Type: blogs

Cardiac Resynchronization Therapy (CRT) for Heart Failure
In some patients with heart failure, a new kind of pacemaker can re-coordinate the muscular function of the damaged heart, relieving the symptoms of heart failure, and reducing the odds of dying. Read about CRT here. (Source: About.com Heart Disease)
Source: About.com Heart Disease - April 24, 2014 Category: Cardiology Source Type: blogs

MADIT-CRT Long-Term Follow-Up Shows Survival Benefit with CRT-D
MADIT-CRT was an influential trial that showed a reduction in heart failure complications — but not mortality — when cardiac resynchronization therapy (CRT) was added to an implantable defibrillator in patients with mild heart failure who also had left bundle-branch block (LBBB). Patients in the trial were followed for 2.4 years, raising questions about the long-term effects of CRT. Now, a second look at 854 patients who participated in a follow-up study, presented at the American College of Cardiology and published in the New England Journal of Medicine, suggests that over the long term, CRT More… (Source: CardioBrief)
Source: CardioBrief - March 30, 2014 Category: Cardiology Authors: Larry Husten Tags: Heart Failure Heart Rhythms CRT ICD MADIT resynchronization Source Type: blogs