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ORal anticoagulants In fraGile patients with percutAneous endoscopic gastrostoMy and atrIal fibrillation: the (ORIGAMI) study
Conclusion ORIGAMI prospectively investigates PEG-administration of edoxaban in PEG-treated patients requiring long-term anticoagulation. Our preliminary retrospective data support this route of DOAC administration. ClinicalTrials.gov Identifier NCT04271293
Source: Journal of Cardiovascular Medicine - February 4, 2021 Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research

Characteristics and Outcomes of Patients 80 Years and Older Hospitalized With Coronavirus Disease 2019 (COVID-19)
Patients older than 65 years hospitalized with COVID-19 have higher rates of intensive care unit admission and death when compared with younger patients. Cardiovascular conditions associated with COVID-19 include myocardial injury, acute myocarditis, cardiac arrhythmias, cardiomyopathies, cardiogenic shock, thromboembolic disease, and cardiac arrest. Few studies have described the clinical course of those at the upper extreme of age. We characterize the clinical course and outcomes of 73 patients with 80 years of age or older hospitalized at an academic center between March 15 and May 13, 2020. These patients had multiple ...
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Increased Rate of Pump Thrombosis and Cardioembolic Events Following Ventricular Tachycardia Ablation in Patients Supported With Left Ventricular Assist Devices
Ventricular arrhythmias are common following left ventricular assist device implantation (LVAD), and the effects of ventricular tachycardia (VT) ablation on thrombosis and embolic events are unknown. We aimed to assess LVAD thrombosis, stroke, and embolic event rates after VT ablation. Left ventricular assist device implantation patients from two academic centers who underwent endocardial VT ablation between 2009 and 2016 were compared to a control group with VT who were not ablated and followed for one year. The primary composite outcome was confirmed or suspected LVAD thrombosis, stroke, or other embolic event. Survival ...
Source: ASAIO Journal - November 1, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

The diagnostic yield of implantable loop recorders stratified by indication: “real-world” use in a large academic hospital
ConclusionsIn a “real-world” academic hospital setting, the diagnostic rate of ILRs was highest for AF, palpitations, and VA; however, these high yield indications comprised only 29% of all indications. The diagnostic yield for the commonest indication (syncope) was approximately half that reported in the previ ously published trials. With increasing implantation rates, additional studies are required to refine guideline-based indications for ILR implantation to improve diagnostic yield.
Source: Journal of Interventional Cardiac Electrophysiology - July 3, 2020 Category: Cardiology Source Type: research

COVID-19-related strokes in adults below 55  years of age: a case series
ConclusionStroke may be unrelated to age and the extent of lung involvement. However, different factors may play roles in co-occurrence of stroke and COVID-19 and its outcome. Future studies with long-term follow-up and more cases are needed to assess prognostic factors.
Source: Neurological Sciences - June 23, 2020 Category: Neurology Source Type: research

Tufts Medical Center Offers Unique Procedure To Combat Abnormal Heart Rhythm
BOSTON (CBS) — More than six million Americans have an abnormal heart rhythm called atrial fibrillation. For some people, traditional treatments just don’t work but doctors at a local medical center are using a new procedure to get those patients back in normal rhythm. As the owner of an office cleaning service, 65-year old Pat DeGregorio walks about 10 miles a day, but three years ago, the Winthrop native woke up and could barely move. “I couldn’t breathe,” he said. “I was just gasping for air.” Pat was in an abnormal heart rhythm called atrial fibrillation or AFib where pacemaker cells in the he...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - November 28, 2019 Category: Consumer Health News Authors: Health – CBS Boston Tags: Boston News Health Healthwatch Seen On WBZ-TV Syndicated CBSN Boston Syndicated Local Atrial Fibrillation Dr. Mallika Marshall Tufts Medical Center Source Type: news

Impaired Activity of Ryanodine Receptors Contributes to Calcium Mishandling in Cardiomyocytes of Metabolic Syndrome Rats
Conclusion Principal findings of this work are that abnormal Ca2+ transient amplitude, contractile dysfunction; and impaired relaxation of MetS cardiomyocytes underlies intrinsic dysfunctional RyR2 and SERCA pump. Abnormal activity of RyRs was evidenced by its decreased ability to bind [3H]-ryanodine. Although the MetS condition does not modify RyR2 protein expression, its phosphorylation at Ser2814 is decreased, which impairs its capacity for activation during ECC. The dysfunctional RyRs, together with a decreased activity of SERCA pump due to decreased Thr17-PLN phosphorylation suggest a downregulation of CaMKII in MetS...
Source: Frontiers in Physiology - April 29, 2019 Category: Physiology Source Type: research

Atrial Transcriptional Profiles of Molecular Targets Mediating Electrophysiological Function in Aging and Pgc-1 β Deficient Murine Hearts
Conclusion: These findings limit the possible roles of gene transcriptional changes in previously reported age-dependent pro-arrhythmic electrophysiologial changes observed in Pgc-1β-/- atria to an altered Ca2+-ATPase (Atp2a2) expression. This directly parallels previously reported arrhythmic mechanism associated with p21-activated kinase type 1 deficiency. This could add to contributions from the direct physiological outcomes of mitochondrial dysfunction, whether through reactive oxygen species (ROS) production or altered Ca2+ homeostasis. Introduction Atrial arrhythmias constitute a major public health pro...
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology Source Type: research

Anticipatory Postural Adjustments During Gait Initiation in Stroke Patients
Conclusion This systematic review provides an update on GI-APA reorganization following stroke. Stroke patients present atypical GI-APA patterns, longer GI-APA duration and lower GI-APA amplitude compared to healthy people, regardless of which leg is used as the leading or trailing leg. GI is facilitated when the non-paretic leg is used as the trailing leg because the weakness of the paretic leg leads to difficulties in supporting body weight during the upcoming stance phase. Further experiments should include distinct groups of patients in order to describe GI-APA features in acute, subacute and chronic stroke, and the i...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Cardiovascular Programming During and After Diabetic Pregnancy: Role of Placental Dysfunction and IUGR
This study demonstrated that the incidence of ischemic heart disease and death were three times higher among men with low birth weight compared to men with high birth weight (5). Epidemiological investigations of adults born at the time of the Dutch famine between 1944 and 1945 revealed an association between maternal starvation and a low infant birth weight with a high incidence of hypertension and coronary heart disease in these adults (23). Furthermore, Painter et al. reported the incidence of early onset coronary heart disease among persons conceived during the Dutch famine (24). In that regard, Barker's findin...
Source: Frontiers in Endocrinology - April 8, 2019 Category: Endocrinology Source Type: research

Atrial Fibrillation and the Weekend Effect Regarding Cardioversion, Length of Stay, Readmission, and Mortality
Conclusion: In conclusion, a weekend effect was not identified regarding AF in an academic hospital.
Source: Critical Pathways in Cardiology - July 25, 2018 Category: Cardiology Tags: Original Article Source Type: research

Outcomes for Emergency Department Patients With Recent-Onset Atrial Fibrillation and Flutter Treated in Canadian Hospitals
Conclusion Although most recent-onset atrial fibrillation and flutter patients were treated aggressively in the ED, there were few 30-day serious outcomes. Physicians underprescribed oral anticoagulants. Potential risk factors for adverse events include longer duration from arrhythmia onset, previous stroke or transient ischemic attack, pulmonary congestion on chest radiograph, and not being in sinus rhythm at discharge. An ED strategy of sinus rhythm restoration and discharge in most patients is effective and safe.
Source: Annals of Emergency Medicine - January 19, 2017 Category: Emergency Medicine Source Type: research

Safety of Immediate-Release Nifedipine
Abstract: Nifedipine immediate release (IR) is a short-acting dihydropyridine calcium channel blocker historically used for hypertensive crisis, but its use has decreased because of reports of adverse reactions such as myocardial infarction (MI), arrhythmias, and stroke. This was a retrospective evaluation of the safety of nifedipine IR in 122 patients at an academic medical center from January 1, 2009, to December 31, 2014. Patients were separated into high- and low-risk groups. High risk was defined as a medical history significant for arrhythmia, MI, or stroke. The primary outcome was a comparison of the composite incid...
Source: Journal of Cardiovascular Pharmacology - November 1, 2016 Category: Cardiology Tags: Rapid Communication Source Type: research

Safety of vasodilator stress myocardial perfusion imaging in patients with elevated cardiac biomarkers
Conclusion In the setting of elevated troponin, serious complications associated with either exercise or vasodilator stress testing appear to be relatively rare with no increased risk attributable to a particular vasodilator agent.
Source: Journal of Nuclear Cardiology - February 22, 2016 Category: Nuclear Medicine Source Type: research

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