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Sample records for cardiac arrhythmias venice

  1. Sports and arrhythmias: a report of the International Workshop Venice Arrhythmias 2009.

    Science.gov (United States)

    Giada, Franco; Biffi, Alessandro; Cannom, David S; Cappato, Riccardo; Capucci, Alessandro; Corrado, Domenico; Delise, Pietro; Drezner, Jonathan A; El-Sherif, Nabil; Estes, Mark; Furlanello, Francesco; Heidbuchel, Hein; Inama, Giuseppe; Lindsay, Bruce D; Maron, Barry J; Maron, Martin S; Mont, Luis; Olshansky, Brian; Pelliccia, Antonio; Thiene, Gaetano; Viskin, Sami; Zeppilli, Paolo; Natale, Andrea; Raviele, Antonio

    2010-10-01

    This article is a report of an international symposium, endorsed by the Section on Sports Cardiology of the European Association for Cardiovascular Prevention and Rehabilitation, the Italian Society of Sports Cardiology, and the Italian Federation of Sports Medicine, which was held within the 11th International Workshop on Cardiac Arrhythmias (Venice Arrhythmias 2009, Venice, Italy, October 2009). The following main topics were discussed during the symposium: the role of novel diagnostic examinations to assess the risk of sudden death in athletes, controversies on arrhythmic risk evaluation in athletes, controversies on the relationship between sports and arrhythmias, and controversies on antiarrhythmic treatment in athletes.

  2. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both...... supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia......, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society...

  3. Hypertension and Cardiac Arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation......) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence...

  4. Gene Therapy in Cardiac Arrhythmias

    OpenAIRE

    Praveen, S.V; Francis, Johnson; Venugopal, K

    2006-01-01

    Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to vascular angiogenesis and cardiac arrhythmias. Gene based biological pacemakers using viral vectors or mesenchymal cells tested in animal models hold much promise. Induction of pacemaker activity within the left bundle branch can provide stable heart rates. Genetic modification of the AV...

  5. Gene Therapy in Cardiac Arrhythmias

    Directory of Open Access Journals (Sweden)

    Praveen S.V

    2006-04-01

    Full Text Available Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to vascular angiogenesis and cardiac arrhythmias. Gene based biological pacemakers using viral vectors or mesenchymal cells tested in animal models hold much promise. Induction of pacemaker activity within the left bundle branch can provide stable heart rates. Genetic modification of the AV node mimicking beta blockade can be therapeutic in the management of atrial fibrillation. G protein overexpression to modify the AV node also is experimental. Modification and expression of potassium channel genes altering the delayed rectifier potassium currents may permit better management of congenital long QT syndromes. Arrhythmias in a failing heart are due to abnormal calcium cycling. Potential targets for genetic modulation include the sarcoplasmic reticulum calcium pump, calsequestrin and sodium calcium exchanger.Lastly the ethical concerns need to be addressed.

  6. Targeting sodium channels in cardiac arrhythmia

    NARCIS (Netherlands)

    Remme, Carol Ann; Wilde, Arthur A. M.

    2014-01-01

    Cardiac voltage-gated sodium channels are responsible for proper electrical conduction in the heart. During acquired pathological conditions and inherited sodium channelopathies, altered sodium channel function causes conduction disturbances and ventricular arrhythmias. Although the clinical,

  7. Lysophosphatidylcholine (LPC) metabolism and cardiac arrhythmias

    International Nuclear Information System (INIS)

    Giffin, D.M.; Man, R.Y.K.; Arthur, G.; Choy, P.C.

    1986-01-01

    The effect of LPC in the production of cardiac arrhythmias in isolated mammalian hearts has been well-documented. Cardiac arrhythmias are initiated by the accumulation of the lysolipid in the cardiac membrane. When isolated rat hearts were perfused in 10 μM LPC for 10 min, severe arrhythmias were observed in all experiments. In isolated guinea pig hearts that were perfused under identical conditions, the development of severe arrhythmias was never observed, and mild arrhythmias were produced in less than 50% of the hearts used. When the hearts of both species were perfused with [ 14 C-palmitate]-LPC, the labellings found in the microsomal fractions (expressed in mg protein) were similar. However, a higher amount of labelled LPC (2-fold) was found in rat heart microsomes, whereas a higher amount of labelled fatty acid was located in the guinea pig heart microsomes. Determination of lysophospholipase activities in these microsomal fractions revealed that the specific activity of the enzyme was much higher in the guinea pig heart than the rat heart. The authors conclude that the differential effect of LPC-induced arrhythmias between the rat and guinea pig heart may be a direct result of the lysophospholipase activities in these hearts. The ability to catabolize LPC more rapidly in the guinea pig heart may decrease the accumulation of LPC in the membrane, and hence, reduce the production of arrhythmias

  8. Alcohol, cardiac arrhythmias and sudden death.

    Science.gov (United States)

    Kupari, M; Koskinen, P

    1998-01-01

    Studies in experimental animals have shown varying and apparently opposite effects of alcohol on cardiac rhythm and conduction. Given acutely to non-alcoholic animals, ethanol may even have anti-arrhythmic properties whereas chronic administration clearly increases the animals' susceptibility to cardiac arrhythmias. Chronic heavy alcohol use has been incriminated in the genesis of cardiac arrhythmias in humans. The evidence has come from clinical observations, retrospective case-control studies, controlled studies of consecutive admissions for arrhythmias, and prospective epidemiological investigations. Furthermore, electrophysiological studies have shown that acute alcohol administration facilitates the induction of tachyarrhythmias in selected heavy drinkers. The role of alcohol appears particularly conspicuous in idiopathic atrial fibrillation. Occasionally, ventricular tachyarrhythmias have also been provoked by alcohol intake. Several lines of evidence suggest that heavy drinking increases the risk of sudden cardiac death with fatal arrhythmia as the most likely mechanism. According to epidemiological studies this effect appears most prominent in middle-aged men and is only partly explained by confounding traits such as smoking and social class. The basic arrhythmogenic effects of alcohol are still insufficiently delineated. Subclinical heart muscle injury from chronic heavy use may be instrumental in producing patchy delays in conduction. The hyperadrenergic state of drinking and withdrawal may also contribute, as may electrolyte abnormalities, impaired vagal heart rate control, repolarization abnormalities with prolonged QT intervals and worsening of myocardial ischaemia or sleep apnoea. Most of what we know about alcohol and arrhythmias relates to heavy drinking. The effect of social drinking on clinical arrhythmias in non-alcoholic cardiac patients needs to be addressed further.

  9. Cardiac arrhythmias associated with spinal cord injury

    DEFF Research Database (Denmark)

    Hector, Sven Magnus; Biering-Sørensen, Tor; Krassioukov, Andrei

    2013-01-01

    CONTEXT/OBJECTIVES: To review the current literature to reveal the incidence of cardiac arrhythmias and its relation to spinal cord injury (SCI). METHODS: Data source: MEDLINE database, 304 hits, and 32 articles were found to be relevant. The relevant articles all met the inclusion criteria: (1...

  10. Cardiac arrhythmias in adult patients with asthma

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; Kors, Jan A

    2012-01-01

    OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias and electrocardio......OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias...... and electrocardiographic characteristics of arrhythmogenicity (ECG) and to explore the role of β2-mimetics. METHODS: A cross-sectional study was conducted among 158 adult patients with a diagnosis of asthma and 6303 participants without asthma from the cohort of the Utrecht Health Project-an ongoing, longitudinal, primary...... or flutter). Secondary outcomes were tachycardia, bradycardia, PVC, atrial fibrillation or flutter, mean heart rate, mean corrected QT (QTc) interval length, and prolonged QTc interval. RESULTS: Tachycardia and PVCs were more prevalent in patients with asthma (3% and 4%, respectively) than those without...

  11. Cardiac arrhythmia as initial presentation of aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    van der Kleij, FGH; Henselmans, JML; van de Loosdrecht, AA

    1999-01-01

    Cardiac arrhythmia and sudden death are most frequently caused by preexisting heart disease. Rarely, cardiac arrhythmia is a first symptom of an acute neurological event. We describe a patient with asystole and other cardiac arrhythmias, as initial symptoms of acute aneurysmal subarachnoid

  12. Thyroid hormones and cardiac arrhythmias

    Czech Academy of Sciences Publication Activity Database

    Tribulová, N.; Knezl, V.; Shainberg, A.; Seki, S.; Soukup, Tomáš

    2010-01-01

    Roč. 52, 3-4 (2010), s. 102-112 ISSN 1537-1891 R&D Projects: GA ČR(CZ) GA304/08/0256 Grant - others:VEGA(SK) 2/0049/09; APVV(SK) 51-059505; APVV(SK) 51-017905 Institutional research plan: CEZ:AV0Z50110509 Keywords : thyroid hormone * arrhythmias * ion channels * connexin-43 Subject RIV: FA - Cardiovascular Disease s incl. Cardiotharic Surgery Impact factor: 2.174, year: 2010

  13. Gated cardiac blood pool studies in arrhythmias

    International Nuclear Information System (INIS)

    Itti, R.; Casset, D.; Philippe, L.; Cosnay, P.; Fauchier, J.P.

    1988-01-01

    Biventricular phase analysis a gated blood pool studies may help to solve two fundamental questions raised by patients suffering from arrhythmias: localization of an electrical cardiac activation abnormality by means of contraction mapping and assesment of an underlying organic disease using the phase histograms and their standard deviations. Three groups of patients have been evaluated to demonstrate the usefulness of radioisotopic techniques in arrhythmias: 36 patients with a Wolff-Parkinson-White syndrom, 27 patients studied during a ventricular tachycardia attack and 32 patients suspected of arrhythmogenic ventricular dysplasia. Correlations with invasive electrophysiologic studies are presented and the diagnostic and therapeutic implications of these results are discussed [fr

  14. Gated cardiac blood pool studies in arrhythmias

    Energy Technology Data Exchange (ETDEWEB)

    Itti, R.; Casset, D.; Philippe, L.; Cosnay, P.; Fauchier, J.P.

    1988-01-01

    Biventricular phase analysis a gated blood pool studies may help to solve two fundamental questions raised by patients suffering from arrhythmias: localization of an electrical cardiac activation abnormality by means of contraction mapping and assesment of an underlying organic disease using the phase histograms and their standard deviations. Three groups of patients have been evaluated to demonstrate the usefulness of radioisotopic techniques in arrhythmias: 36 patients with a Wolff-Parkinson-White syndrom, 27 patients studied during a ventricular tachycardia attack and 32 patients suspected of arrhythmogenic ventricular dysplasia. Correlations with invasive electrophysiologic studies are presented and the diagnostic and therapeutic implications of these results are discussed.

  15. Illicit drugs and cardiac arrhythmias in athletes.

    Science.gov (United States)

    Furlanello, Francesco; Serdoz, Laura Vitali; Cappato, Riccardo; De Ambroggi, Luigi

    2007-08-01

    The current management of athletes with cardiac arrhythmias has become complicated by the widespread use of illicit drugs, which can be arrhythmogenic. The World Anti-Doping Agency annually updates a list of prohibited substances and methods banned by the International Olympic Committee that includes different classes of substances namely, anabolic androgenic steroids, hormones and related substances, beta2-agonists, diuretics, stimulants, narcotics, cannabinoids, glucocorticosteroids, alcohol, beta-blockers and others. Almost all illicit drugs may cause, through a direct or indirect arrhythmogenic effect, a wide range of cardiac arrhythmias (focal or reentry type, supraventricular and/or ventricular) that can even be lethal and which are frequently sport activity related. A large use of illicit drugs has been documented in competitive athletes, but the arrhythmogenic effect of specific substances is not precisely known. Precipitation of cardiac arrhythmias, particularly in the presence of a latent electrophysiologic substrate including some inherited cardiomyopathies, at risk of sudden death or due to long-term consumption of the substances, should raise the suspicion that illicit drugs may be a possible cause and lead cardiologists to investigate carefully this relationship and appropriately prevent the clinical consequences.

  16. QTc-prolonging drugs and hospitalizations for cardiac arrhythmias

    NARCIS (Netherlands)

    De Bruin, ML; Hoes, AW; Leufkens, HGM

    2003-01-01

    Cardiac arrhythmia as an adverse effect of noncardiac drugs has been an issue of growing importance during the past few years. In this population-based study, we evaluated the risk for serious cardiac arrhythmias during the use of several noncardiac QTc-prolonging drugs in day-to-day practice, and

  17. Frequency of Cardiac Arrhythmias in Patients with Aluminum Phosphide Poisoning

    Directory of Open Access Journals (Sweden)

    Umair Aziz

    2015-12-01

    Full Text Available Background: Cardiac failure is the major lethal consequence of aluminum phosphide (AlP poisoning. This study was designed to determine the frequency of cardiac arrhythmias in patients with AlP poisoning. Methods: In this prospective cross-sectional study, patients with definitive history of AlP poisoning treated at emergency department of Allied Hospital Faisalabad, Faisalabad, Pakistan, from July 2013 to November 2014 were included. On admission, twelve-lead electrocardiogram (ECG was performed for all patients. During admission, all patients underwent continuous cardiac monitoring using a cardiac monitor. If an arrhythmia was suspected on the cardiac monitor, another ECG was obtained immediately.  Results: During the study period, 100 patients with AlP poisoning (63% men were treated at Allied Hospital Faisalabad. Mean age of the patients was 26.7 ± 7.9 years ranging from 16 to 54 years. Tachycardia was detected in 68 patients and bradycardia in 12 patients. Hypotension was observed in 75 patients. Eighty patients developed cardiac arrhythmia. The most frequent arrhythmia was atrial fibrillation (31% of patients followed by ventricular fibrillation (20%, ventricular tachycardia (17%, 3rd degree AV block (7% and 2nd degree AV block (5%. In total, 78 patients died, depicting a 78% mortality rate following wheat pill poisoning. Among those who died, seventy-one patients had cardiac arrhythmia. Comparison of death rate between patients with and without cardiac arrhythmia showed a significant difference (71/80 (88.8% vs. 7/20 (35%; P < 0.001.  Conclusion: Wheat pill poisoning causes a very high mortality, and circulatory collapse is the major cause of death among these patients. Most of the patients with AlP poisoning develop cardiac arrhythmias which are invariably life threatening. Early detection of cardiac disorders and proper management of arrhythmias may reduce mortalities.

  18. Sleep Apnea and Nocturnal Cardiac Arrhythmia: A Populational Study

    Directory of Open Access Journals (Sweden)

    Fatima Dumas Cintra

    2014-11-01

    Full Text Available Background: The mechanisms associated with the cardiovascular consequences of obstructive sleep apnea include abrupt changes in autonomic tone, which can trigger cardiac arrhythmias. The authors hypothesized that nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea. Objective: To analyze the relationship between obstructive sleep apnea and abnormal heart rhythm during sleep in a population sample. Methods: Cross-sectional study with 1,101 volunteers, who form a representative sample of the city of São Paulo. The overnight polysomnography was performed using an EMBLA® S7000 digital system during the regular sleep schedule of the individual. The electrocardiogram channel was extracted, duplicated, and then analyzed using a Holter (Cardio Smart® system. Results: A total of 767 participants (461 men with a mean age of 42.00 ± 0.53 years, were included in the analysis. At least one type of nocturnal cardiac rhythm disturbance (atrial/ventricular arrhythmia or beat was observed in 62.7% of the sample. The occurrence of nocturnal cardiac arrhythmias was more frequent with increased disease severity. Rhythm disturbance was observed in 53.3% of the sample without breathing sleep disorders, whereas 92.3% of patients with severe obstructive sleep apnea showed cardiac arrhythmia. Isolated atrial and ventricular ectopy was more frequent in patients with moderate/severe obstructive sleep apnea when compared to controls (p < 0.001. After controlling for potential confounding factors, age, sex and apnea-hypopnea index were associated with nocturnal cardiac arrhythmia. Conclusion: Nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea and the prevalence increases with disease severity. Age, sex, and the Apnea-hypopnea index were predictors of arrhythmia in this sample.

  19. QTc-prolonging drugs and hospitalizations for cardiac arrhythmias

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Hoes, Arno W; Leufkens, Hubert G M

    2003-01-01

    Cardiac arrhythmia as an adverse effect of noncardiac drugs has been an issue of growing importance during the past few years. In this population-based study, we evaluated the risk for serious cardiac arrhythmias during the use of several noncardiac QTc-prolonging drugs in day-to-day practice......, and subsequently focused on several specific groups of patients who could be extremely vulnerable for drug-induced arrhythmias. We performed a case-control study in which patients (cases), hospitalized for nonatrial cardiac arrhythmias from 1987 to 1998, were compared with their matched controls regarding current...... use of QTc-prolonging drugs. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariate conditional logistic regression, adjusting for potential confounding factors. Data were obtained from the PHARMO record linkage system. We identified 501 cases, 39 of whom used QTc...

  20. ECG scaling properties of cardiac arrhythmias using detrended fluctuation analysis

    International Nuclear Information System (INIS)

    Rodriguez, E; Echeverria, J C; Alvarez-Ramirez, J; Lerma, C

    2008-01-01

    We applied detrended fluctuation analysis to characterize at very short time scales during episodes of cardiac arrhythmias the raw electrocardiogram (ECG) waveform, aiming to get a global insight into its dynamical behaviour in patients who experienced sudden death. We found that in 15 recordings involving different types of arrhythmias (taken from PhysioNet's Sudden Cardiac Death Holter Database), the ECG waveform, besides showing a less-random dynamics, becomes more regular during bigeminy, ventricular tachycardia or even atrial fibrillation and ventricular fibrillation. The ECG waveform scaling properties thus suggest that reduced complexity dominates the underlying mechanisms of arrhythmias. Among other explanations, this may result from shorted or restricted (i.e. less diverse) pathways of conduction of the electrical activity within ventricles

  1. Ischaemic stroke in hyperthyroidism without cardiac arrhythmia - A ...

    African Journals Online (AJOL)

    BACKGROUND: The relationship between hyperthyroidism and stroke is well established in the setting of atrial fibrillation. However there is limited literature for ischaemic stroke occurring in hyperthyroidism without cardiac arrhythmia. No such case had been described in South East Nigeria. METHOD: This report highlights ...

  2. Dofetilide: a new drug to control cardiac arrhythmia

    DEFF Research Database (Denmark)

    Elming, Hanne; Brendorp, Bente; Pedersen, Ole Dyg

    2003-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. Mortality, and especially morbidity caused by AF, are major and growing health problems in the western world. AF is strongly associated with arterial hypertension, congestive heart failure, valvular heart disease, ischaemic heart...

  3. Cardiac Arrhythmia: Atrial Flutter in a Newborn. Case Study

    Directory of Open Access Journals (Sweden)

    T.M. Klimenko

    2014-09-01

    Full Text Available The article gives case report of rare in neonatal period cardiac arrhythmia — atrial flutter. The disease is one of the manifestations of life-threatening heart rhythm disorders, has no characteristic clinical picture, is diagnosed only by means of an electrocardiogram.

  4. Nonlinear dynamics, chaos and complex cardiac arrhythmias

    Science.gov (United States)

    Glass, L.; Courtemanche, M.; Shrier, A.; Goldberger, A. L.

    1987-01-01

    Periodic stimulation of a nonlinear cardiac oscillator in vitro gives rise to complex dynamics that is well described by one-dimensional finite difference equations. As stimulation parameters are varied, a large number of different phase-locked and chaotic rhythms is observed. Similar rhythms can be observed in the intact human heart when there is interaction between two pacemaker sites. Simplified models are analyzed, which show some correspondence to clinical observations.

  5. Arrhythmia as a cardiac manifestation in MELAS syndrome.

    Science.gov (United States)

    Thomas, Tamara; Craigen, William J; Moore, Ryan; Czosek, Richard; Jefferies, John L

    2015-09-01

    A 44-year-old female with a diagnosis of mitochondrial myopathy, encephalopathy and stroke-like episodes (MELAS) syndrome had progressive left ventricular hypertrophy (LVH) on echocardiogram. A Holter monitor demonstrated episodes of non-sustained atrial tachycardia, a finding not been previously described in this population. This unique case of MELAS syndrome demonstrates the known associated cardiac manifestation of LVH and the new finding of atrial tachycardia which may represent the potential for subclinical arrhythmia in this population.

  6. The association of air temperature with cardiac arrhythmias

    Science.gov (United States)

    Čulić, Viktor

    2017-11-01

    The body response to meteorological influences may activate pathophysiological mechanisms facilitating the occurrence of cardiac arrhythmias in susceptible patients. Putative underlying mechanisms include changes in systemic vascular resistance and blood pressure, as well as a network of proinflammatory and procoagulant processes. Such a chain reaction probably occurs within the time window of several hours, so use of daily average values of meteorological elements do not seem appropriate for investigation in this area. In addition, overall synoptic situation, and season-specific combinations of meteorological elements and air pollutant levels probably cause the overall effect rather than a single atmospheric element. Particularly strong interrelations have been described among wind speed, air pressure and temperature, relative air humidity, and suspended particulate matter. This may be the main reason why studies examining the association between temperature and ventricular arrhythmias have found linear positive, negative, J-shaped or no association. Further understanding of the pathophysiological adaptation to atmospheric environment may help in providing recommendations for protective measures during "bad" weather conditions in patients with cardiac arrhythmias.

  7. Cardiac arrhythmias and left ventricular hypertrophy in systemic hypertension

    International Nuclear Information System (INIS)

    Sultana, R.; Sultana, N.; Rashid, A.; Rasheed, S.Z.; Ahmed, M.; Ishaq, M.; Samad, A.

    2010-01-01

    Background: Hypertensive left ventricular hypertrophy (LVH) is associated with increased risk of arrhythmias and mortality. Objective was to investigate the prevalence of cardiac arrhythmias and LVH in systemic hypertension. Methods: In all subjects blood pressure was measured, electrocardiography and echocardiography was done. Holter monitoring and exercise test perform in certain cases. There were 500 hypertensive patients, 156 (31.2%) men and 344 (69%) women >30 years of age in the study. Among them 177 (35.4%) were diabetic, 224 (45%) were dyslipidemia, 188 (37.6%) were smokers, and 14 (3%) had homocysteinemia. Mean systolic BP (SBP) was 180 +- 20 mm Hg and diastolic BP (DBP) was 95 +- 12 in male and female patients. Left ventricular mass index (LVMI) was 119.2 +- 30 2 2gm/m in male while 103 +- 22 gm/m in female patients. Palpitation was seen in 126 (25%) male and 299 (59.8%) female patients. Atrial fibrillation was noted in 108 (21.6%) male and 125 (25%) female patients, 30 (6%) male and 82 (16.4%) female patients had atrial flutter. Ventricular tachycardia was noted in 37 (7.4%) male and 59 (11.8%) female patients. Holter monitoring showed significant premature ventricular contractions (PVC'S) in 109 (21.8%) male and 128 (25.69%) female patients while Holter showed atrial arrhythmias (APC'S) in 89 (17.8%) males and 119 (23.8%) females. Angiography findings diagnosed coronary artery disease in 119 (23.8%) with CAD male and 225 (45%) without CAD while 47 (9.4%) females presented with CAD and 109 (21.8%) without CAD. Conclusion: A significant association has been demonstrated between hypertension and arrhythmias. Diastolic dysfunction of the left ventricle, left atrial size and function, as well as LVH have been suggested as the underlying risk factors for supraventricular, ventricular arrhythmias and sudden death in hypertensives with LVH. (author)

  8. Cardiac arrhythmias and left ventricular hypertrophy in systemic hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Sultana, R; Sultana, N; Rashid, A; Rasheed, S Z; Ahmed, M; Ishaq, M; Samad, A [Karachi Institute of Heart Diseases, Karachi (Pakistan)

    2010-10-15

    Background: Hypertensive left ventricular hypertrophy (LVH) is associated with increased risk of arrhythmias and mortality. Objective was to investigate the prevalence of cardiac arrhythmias and LVH in systemic hypertension. Methods: In all subjects blood pressure was measured, electrocardiography and echocardiography was done. Holter monitoring and exercise test perform in certain cases. There were 500 hypertensive patients, 156 (31.2%) men and 344 (69%) women >30 years of age in the study. Among them 177 (35.4%) were diabetic, 224 (45%) were dyslipidemia, 188 (37.6%) were smokers, and 14 (3%) had homocysteinemia. Mean systolic BP (SBP) was 180 +- 20 mm Hg and diastolic BP (DBP) was 95 +- 12 in male and female patients. Left ventricular mass index (LVMI) was 119.2 +- 30 2 2gm/m in male while 103 +- 22 gm/m in female patients. Palpitation was seen in 126 (25%) male and 299 (59.8%) female patients. Atrial fibrillation was noted in 108 (21.6%) male and 125 (25%) female patients, 30 (6%) male and 82 (16.4%) female patients had atrial flutter. Ventricular tachycardia was noted in 37 (7.4%) male and 59 (11.8%) female patients. Holter monitoring showed significant premature ventricular contractions (PVC'S) in 109 (21.8%) male and 128 (25.69%) female patients while Holter showed atrial arrhythmias (APC'S) in 89 (17.8%) males and 119 (23.8%) females. Angiography findings diagnosed coronary artery disease in 119 (23.8%) with CAD male and 225 (45%) without CAD while 47 (9.4%) females presented with CAD and 109 (21.8%) without CAD. Conclusion: A significant association has been demonstrated between hypertension and arrhythmias. Diastolic dysfunction of the left ventricle, left atrial size and function, as well as LVH have been suggested as the underlying risk factors for supraventricular, ventricular arrhythmias and sudden death in hypertensives with LVH. (author)

  9. Arrhythmias

    Science.gov (United States)

    ... some herbal remedies); injuries to the heart from chest trauma or heart surgery; use of illegal drugs, alcohol, or tobacco; caffeine; and stress. Arrhythmias also can happen for no apparent reason. Signs and ... of breath chest pain fainting Arrhythmias can ...

  10. Cardiac arrhythmia beat classification using DOST and PSO tuned SVM.

    Science.gov (United States)

    Raj, Sandeep; Ray, Kailash Chandra; Shankar, Om

    2016-11-01

    The increase in the number of deaths due to cardiovascular diseases (CVDs) has gained significant attention from the study of electrocardiogram (ECG) signals. These ECG signals are studied by the experienced cardiologist for accurate and proper diagnosis, but it becomes difficult and time-consuming for long-term recordings. Various signal processing techniques are studied to analyze the ECG signal, but they bear limitations due to the non-stationary behavior of ECG signals. Hence, this study aims to improve the classification accuracy rate and provide an automated diagnostic solution for the detection of cardiac arrhythmias. The proposed methodology consists of four stages, i.e. filtering, R-peak detection, feature extraction and classification stages. In this study, Wavelet based approach is used to filter the raw ECG signal, whereas Pan-Tompkins algorithm is used for detecting the R-peak inside the ECG signal. In the feature extraction stage, discrete orthogonal Stockwell transform (DOST) approach is presented for an efficient time-frequency representation (i.e. morphological descriptors) of a time domain signal and retains the absolute phase information to distinguish the various non-stationary behavior ECG signals. Moreover, these morphological descriptors are further reduced in lower dimensional space by using principal component analysis and combined with the dynamic features (i.e based on RR-interval of the ECG signals) of the input signal. This combination of two different kinds of descriptors represents each feature set of an input signal that is utilized for classification into subsequent categories by employing PSO tuned support vector machines (SVM). The proposed methodology is validated on the baseline MIT-BIH arrhythmia database and evaluated under two assessment schemes, yielding an improved overall accuracy of 99.18% for sixteen classes in the category-based and 89.10% for five classes (mapped according to AAMI standard) in the patient

  11. Arrhythmias

    Science.gov (United States)

    ... sign of other heart problems, or an immediate danger to your health. ... patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine . 25th ed. Philadelphia, PA: ...

  12. Ubiquitous health monitoring and real-time cardiac arrhythmias detection: a case study.

    Science.gov (United States)

    Li, Jian; Zhou, Haiying; Zuo, Decheng; Hou, Kun-Mean; De Vaulx, Christophe

    2014-01-01

    As the symptoms and signs of heart diseases that cause sudden cardiac death, cardiac arrhythmia has attracted great attention. Due to limitations in time and space, traditional approaches to cardiac arrhythmias detection fail to provide a real-time continuous monitoring and testing service applicable in different environmental conditions. Integrated with the latest technologies in ECG (electrocardiograph) analysis and medical care, the pervasive computing technology makes possible the ubiquitous cardiac care services, and thus brings about new technical challenges, especially in the formation of cardiac care architecture and realization of the real-time automatic ECG detection algorithm dedicated to care devices. In this paper, a ubiquitous cardiac care prototype system is presented with its architecture framework well elaborated. This prototype system has been tested and evaluated in all the clinical-/home-/outdoor-care modes with a satisfactory performance in providing real-time continuous cardiac arrhythmias monitoring service unlimitedly adaptable in time and space.

  13. Prediction of tonic parasympathetic cardiac control using respiratory sinus arrhythmia: the need for respiratory control

    NARCIS (Netherlands)

    GROSSMAN, P.; Karemaker, J.; Wieling, W.

    1991-01-01

    Respiratory sinus arrhythmia (RSA) has received much attention in recent years due to the large body of evidence indicating that variations in this phenomenon represent alterations in parasympathetic cardiac control. Although it appears that respiratory sinus arrhythmia is mediated by vagal

  14. Novel energy modalities for catheter ablation of cardiac arrhythmias : Pitfalls and possibilities of potent power sources

    NARCIS (Netherlands)

    Neven, K.G.E.J.

    2014-01-01

    The acceptance of catheter ablation as treatment for cardiac arrhythmias is amongst others dependent on its success rate, a high initial success rate will increase physician and patient acceptance. One of the reasons why recurrence of arrhythmia after ablation is substantial is non-transmurality of

  15. Family and population strategies for screening and counselling of inherited cardiac arrhythmias

    NARCIS (Netherlands)

    Van Langen, I.M.; Hofman, N.; Tan, H.L.; Wilde, A.A.M.

    2004-01-01

    Family screening in inherited cardiac arrhythmias has been performed in The Netherlands since 1996, when diagnostic DNA testing in long QT syndrome (LOTS) and hypertrophic cardiomyopathy (HCM) became technically possible. In multidisciplinary outpatient academic clinics, an adjusted protocol for

  16. Exercising arrhythmias and sudden cardiac death in horses: Review of the literature and comparative aspects.

    Science.gov (United States)

    Navas de Solis, C

    2016-07-01

    Arrhythmias are common in equine athletes during and immediately after exercise. Many of these rhythm variations are not clinically relevant. In horses, a link between different exercising arrhythmias and poor performance or between exercising arrhythmias and sudden cardiac death (SCD) is strongly suspected but not fully understood or proven. SCD during races or competitions is rare, but has catastrophic consequences for the safety of the human partner and public perceptions of welfare during equestrian sports. This review summarises current knowledge of equine exercise arrhythmias and their implications in SCD and compares existing principles and recommendations for equine subjects with those for human athletes. © 2016 EVJ Ltd.

  17. Effects of local cardiac denervation on cardiac innervation and ventricular arrhythmia after chronic myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Xudong Liu

    Full Text Available Modulation of the autonomic nervous system (ANS has already been demonstrated to display antiarrhythmic effects in patients and animals with MI. In this study, we investigated whether local cardiac denervation has any beneficial effects on ventricular electrical stability and cardiac function in the chronic phase of MI.Twenty-one anesthetized dogs were randomly assigned into the sham-operated, MI and MI-ablation groups, respectively. Four weeks after local cardiac denervation, LSG stimulation was used to induce VPCs and VAs. The ventricular fibrillation threshold (VFT and the incidence of inducible VPCs were measured with electrophysiological protocol. Cardiac innervation was determined with immunohistochemical staining of growth associated protein-43 (GAP43 and tyrosine hydroxylase (TH. The global cardiac and regional ventricular function was evaluated with doppler echocardiography in this study.Four weeks after operation, the incidence of inducible VPC and VF in MI-ablation group were significantly reduced compared to the MI dogs (p<0.05. Moreover, local cardiac denervation significantly improved VFT in the infarcted border zone (p<0.05. The densities of GAP43 and TH-positive nerve fibers in the infarcted border zone in the MI-ablation group were lower than those in the MI group (p<0.05. However, the local cardiac denervation did not significantly improve cardiac function in the chronic phase of MI, determined by the left ventricle diameter (LV, left atrial diameter (LA, ejection fraction (EF.Summarily, in the chronic phase of MI, local cardiac denervation reduces the ventricular electrical instability, and attenuates spatial heterogeneity of sympathetic nerve reconstruction. Our study suggests that this methodology might decrease malignant ventricular arrhythmia in chronic MI, and has a great potential for clinical application.

  18. Spiral Wave Initiation in Reaction-Diffusion-Mechanics Systems: A Model for the Onset of Reentrant Cardiac Arrhythmia

    NARCIS (Netherlands)

    Weise, L.D.

    2012-01-01

    Heart failure due to cardiac arrhythmias is a major cause of death in the industrialized world. Cardiac arrhythmia is often caused by spi- ral waves of electrical activity in the cardiac muscle. Therefore, it is a major task in cardiology to understand the mechanisms of spiral wave initiation in the

  19. The influence of motor activity on the development of cardiac arrhythmias during experimental emotional stress

    Science.gov (United States)

    Ulyaninskiy, L. S.; Urmancheyeva, T. G.; Stepanyan, Y. P.; Fufacheva, A. A.; Gritsak, A. V.; Kuznetsova, B. A.; Kvitka, A. A.

    1982-01-01

    Experimental emotional stress which can produce various disorders of cardiac rhythm: sinus tachycardia, atrial fibrillation, ventricular, extrasystoles and paroxysmal ventricular tachysystoles was studied. In these conditions the adrenalin content in the blood and myocardium is increased 3 to 4 times. It is found that moderate motor activity leads to a relative decrease of adrenalin in the myocardium and arrest of cardiac arrhythmias.

  20. Perinatal management and long-term cardiac outcome in fetal arrhythmia

    NARCIS (Netherlands)

    Hahurij, N.D.; Blom, N.A.; Lopriore, E.; Aziz, M.I.; Nagel, H.T.; Rozendaal, L.; Vandenbussche, F.P.H.A.

    2011-01-01

    BACKGROUND: cardiac arrhythmias are commonly observed in the fetus, however, may have major consequences for fetal development and post natal life. AIMS: to evaluate the perinatal management and cardiac outcome of fetuses with tachy- or bradyarrhythmia. STUDY DESIGN: perinatal management, outcome

  1. Non-sedating antihistamine drugs and cardiac arrhythmias -- biased risk estimates from spontaneous reporting systems?

    DEFF Research Database (Denmark)

    De Bruin, M L; van Puijenbroek, E P; Egberts, A C G

    2002-01-01

    AIMS: This study used spontaneous reports of adverse events to estimate the risk for developing cardiac arrhythmias due to the systemic use of non-sedating antihistamine drugs and compared the risk estimate before and after the regulatory action to recall the over-the-counter status of some...... of these drugs. METHODS: All suspected adverse drug reactions (ADRs) reported until July 1999 to the Netherlands Pharmacovigilance Foundation Lareb were used to calculate the ADR reporting odds ratio, defined as the ratio of exposure odds among reported arrhythmia cases, to the exposure odds of other ADRs (non......-sedating antihistamines. In general non-sedating antihistamines are associated with cardiac arrhythmia to a higher extent in comparison with other drugs (ADR reporting odds ratio 2.05 [95% CI: 1.45, 2.89]). The association between arrhythmias and non-sedating antihistamine drugs calculated before 1998...

  2. Non-sedating antihistamine drugs and cardiac arrhythmias -- biased risk estimates from spontaneous reporting systems?

    DEFF Research Database (Denmark)

    De Bruin, M L; van Puijenbroek, E P; Egberts, A C G

    2002-01-01

    of these drugs. METHODS: All suspected adverse drug reactions (ADRs) reported until July 1999 to the Netherlands Pharmacovigilance Foundation Lareb were used to calculate the ADR reporting odds ratio, defined as the ratio of exposure odds among reported arrhythmia cases, to the exposure odds of other ADRs (non......-sedating antihistamines. In general non-sedating antihistamines are associated with cardiac arrhythmia to a higher extent in comparison with other drugs (ADR reporting odds ratio 2.05 [95% CI: 1.45, 2.89]). The association between arrhythmias and non-sedating antihistamine drugs calculated before 1998...

  3. Chronic cardiac arrhythmias produced by focused cobalt-60 gamma irradiation of the canine atria

    International Nuclear Information System (INIS)

    Dick, H.L.H.; Saylor, C.B.; Reeves, M.M.; Davies, M.J.

    1979-01-01

    Cardiac arrhythmias following exposure of the human heart to ionizing radiation have been reported. Earlier experiments involving irradiation of the hearts of various animals failed to consistently produce similar arrhythmias. In the present work, cobalt-60 irradiation was focused on the interatrial septum of the hearts of 12 dogs. Ten animals developed arrhythmias: These were repetive junctional and atrial tachycardias, repetitive atrial fibrillation, and type one, second-degree atrial ventricular block. The duration varied from 1 to 52 days, with onsets varying from 48 to 146 days postirradiation

  4. A Proposal for Cardiac Arrhythmia Classification using Complexity Measures

    Directory of Open Access Journals (Sweden)

    AROTARITEI, D.

    2017-08-01

    Full Text Available Cardiovascular diseases are one of the major problems of humanity and therefore one of their component, arrhythmia detection and classification drawn an increased attention worldwide. The presence of randomness in discrete time series, like those arising in electrophysiology, is firmly connected with computational complexity measure. This connection can be used, for instance, in the analysis of RR-intervals of electrocardiographic (ECG signal, coded as binary string, to detect and classify arrhythmia. Our approach uses three algorithms (Lempel-Ziv, Sample Entropy and T-Code to compute the information complexity applied and a classification tree to detect 13 types of arrhythmia with encouraging results. To overcome the computational effort required for complexity calculus, a cloud computing solution with executable code deployment is also proposed.

  5. [Catheter ablation in patients with refractory cardiac arrhythmias with radiofrequency techniques].

    Science.gov (United States)

    de Paola, A A; Balbão, C E; Silva Netto, O; Mendonça, A; Villacorta, H; Vattimo, A C; Souza, I A; Guiguer Júnior, N; Portugal, O P; Martinez Filho, E E

    1993-02-01

    evaluate the efficacy of radiofrequency catheter ablation in patients with refractory cardiac arrhythmias. twenty patients with refractory cardiac arrhythmias were undertaken to electrophysiologic studies for diagnosis and radiofrequency catheter ablation of their reentrant arrhythmias. Ten patients were men and 10 women with ages varying from 13 to 76 years (mean = 42.4 years). Nineteen patients had supraventricular tachyarrhythmias: One patient had atrial tachycardia and 1 atrial fibrillation with rapid ventricular rate, 5 patients had reentrant nodal tachycardia, 12 patients had reentrant atrioventricular tachycardia and 1 patient had right ventricular outflow tract tachycardia. the mean time of the procedure was 4.1 hours. The radiofrequency current energy applied was 40-50 V for 30-40 seconds. Ablation was successful in 18/20 (90%) patients; in 15/18 (83%) of successfully treated patients the same study was done for diagnosis and radiofrequency ablation. One patient had femoral arterial occlusion and was treated with no significant sequelae. During a mean follow-up of 4 months no preexcitation or reentrant tachycardia occurred. the results of our experience with radiofrequency catheter ablation of cardiac arrhythmias suggest that this technique can benefit an important number of patients with cardiac arrhythmias.

  6. Protective effects of isorhynchophylline on cardiac arrhythmias in rats and guinea pigs.

    Science.gov (United States)

    Gan, Runtao; Dong, Guo; Yu, Jiangbo; Wang, Xu; Fu, Songbin; Yang, Shusen

    2011-09-01

    As one important constituent extracted from a traditional Chinese medicine, Uncaria Rhynchophylla Miq Jacks, isorhynchophylline has been used to treat hypertension, epilepsy, headache, and other illnesses. Whether isorhynchophylline protects hearts against cardiac arrhythmias is still incompletely investigated. This study was therefore aimed to examine the preventive effects of isorhynchophylline on heart arrhythmias in guinea pigs and rats and then explore their electrophysiological mechanisms. In vivo, ouabain and calcium chloride were used to establish experimental arrhythmic models in guinea pigs and rats. In vitro, the whole-cell patch-lamp technique was used to study the effect of isorhynchophylline on action potential duration and calcium channels in acutely isolated guinea pig and rat cardiomyocytes. The dose of ouabain required to induce cardiac arrhythmias was much larger in guinea pigs administered with isorhynchophylline. Additionally, the onset time of cardiac arrhythmias induced by calcium chloride was prolonged, and the duration was shortened in rats pretreated with isorhynchophylline. The further study showed that isorhynchophylline could significantly decrease action potential duration and inhibit calcium currents in isolated guinea pig and rat cardiomyocytes in a dose-dependent manner. In summary, isorhynchophylline played a remarkably preventive role in cardiac arrhythmias through the inhibition of calcium currents in rats and guinea pigs. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Scintigraphic assessment of cardiac sympathetic innervation with I-123-metaiodobenzylguanidine in cardiomyopathy. Special reference to cardiac arrhythmia

    Energy Technology Data Exchange (ETDEWEB)

    Asano, Takahisa; Otsuka, Nobuaki; Sone, Teruki; Mimura, Hiroaki; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Fukunaga, Masao [Kawasaki Medical School, Kurashiki, Okayama (Japan); Morita, Koichi

    1999-07-01

    Cardiac sympathetic imagings with I-123-metaiodobenzylguanidine (MIBG) were carried out in 5 cases with dilated cardiomyopathy (DCM), 26 cases with hypertrophic cardiomyopathy (HCM), and 4 cases without cardiac disease as a control to assess cardiac sympathetic innervation qualitatively and quantitatively, and to clarify the relation of MIBG accumulation to arrhythmia. MIBG scintigraphy was performed at 15 min. (early image) and 4 hr. (delayed image) after intravenous injection of MIBG 111 MBq. The MIBG uptake ratio of mediastinum (H/M) and the cardiac washout rate (WR) from early to delayed images were calculated. On both early and delayed SPECTs, MIBG uptake was assessed by defect scores (DSs). Regarding the cases with HCM, the MIBG uptake ratio, WR, and DS were also compared in cases with and without arrhythmia. In DCM, the MIBG uptake on delayed SPECT was markedly low, the H/M ratio was significantly lower, and the DS was significantly higher than in the control (all p<0.05). As for the WR, there was no significant difference between HCM, DCM and the control. In HCM, significantly reduced MIBG uptake was observed in cases with ventricular techycardia (VT) and in cases with atrial fibrillation (Af), as compared with cases without arrhythmia (all p<0.05). There results suggest that MIBG scintigraphy might be a useful tool in the assessment of cardiac sympathetic abnormalities in cardiomyopathy, especially in cases with arrhythmia. (author)

  8. Outcome for Fetuses with Prenatally Detected Congenital Heart Disease and Cardiac Arrhythmias in Taiwan

    Directory of Open Access Journals (Sweden)

    Sheng-Mou Hsiao

    2007-01-01

    Conclusion: Outcome for fetuses with prenatally detected CHD remains poor, with the prognosis negatively influenced by the presence of complex heart defects as well as extracardiac and chromosomal anomalies. However, prognosis is good for fetuses with cardiac arrhythmia, except with long QT syndrome or hydrops fetalis.

  9. Cardiac cell therapy: overexpression of connexin43 in skeletal myoblasts and prevention of ventricular arrhythmias

    NARCIS (Netherlands)

    Fernandes, Sarah; van Rijen, Harold V. M.; Forest, Virginie; Evain, Stéphane; Leblond, Anne-Laure; Mérot, Jean; Charpentier, Flavien; de Bakker, Jacques M. T.; Lemarchand, Patricia

    2009-01-01

    Cell-based therapies have great potential for the treatment of cardiovascular diseases. Recently, using a transgenic mouse model Roell et al. reported that cardiac engraftment of connexin43 (Cx43)-overexpressing myoblasts in vivo prevents post-infarct arrhythmia, a common cause of death in patients

  10. Cardiac arrhythmia with premature ventricular contractures induced by interferon beta in a patient with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Igor Sobol

    2015-03-01

    Full Text Available Multiple sclerosis (MS is an immune-mediated inflammatory and neurodegenerative disease of the central nervous system. Interferon (IFN beta is an active ingredient of five out of twelve disease modifying treatments approved for MS. We report a case of IFN-beta-induced cardiac arrhythmia with premature ventricular contractures in a patient recently diagnosed with MS.

  11. Sodium Channel (Dys)Function and Cardiac Arrhythmias

    NARCIS (Netherlands)

    Remme, Carol Ann; Bezzina, Connie R.

    2010-01-01

    P>Cardiac voltage-gated sodium channels are transmembrane proteins located in the cell membrane of cardiomyocytes. Influx of sodium ions through these ion channels is responsible for the initial fast upstroke of the cardiac action potential. This inward sodium current thus triggers the initiation

  12. A multiprocessor system for the analysis of cardiac arrhythmias

    International Nuclear Information System (INIS)

    Jugo, G. Diego J.

    1983-01-01

    The study presented here forms part of a real-time electrocardiographic signal analysis system project. The medical data analysis system consists of eight independent analyser units, all of which are connected to a controller unit by the standard IEEE-488 bus. Each bed is monitored by an arrhythmias analyser which has the facilities for analysing a patient's electrocardiogram automatically in real time. The measurements may be made in the presence of a pacemaker. The system described presents the technique of a separate and a simultaneous data analysis on two different ECG channels. This permit: a better diagnosis and an optimum use of the bus. (author) [fr

  13. Frequency of cardiac arrhythmias in high and low- yielding dairy cows

    Directory of Open Access Journals (Sweden)

    Afshin Jafari Dehkordi

    2014-06-01

    Full Text Available Electrocardiography (ECG may be used to recognize cardiac disorders. Levels of milk production may change the serum electrolytes which its imbalance has a role in cardiac arrhythmia. Fifty high yielding and fifty low yielding Holstein dairy cows were used in this study. Electrocardiography was recorded by base-apex lead and blood samples were collected from jugular vein for measurement of serum elements such as sodium, potassium, calcium, phosphorous, iron and magnesium. Cardiac dysrhythmias were detected more frequent in low yielding Holstein cows (62.00% compared to high yielding Holstein cows (46.00%. The cardiac dysrhythmias that were observed in low yielding Holstein cows included sinus arrhythmia (34.70%, wandering pacemaker (22.45 %, bradycardia (18.37%, tachycardia (10.20%, atrial premature beat (2.04%, sinoatrial block (2.04%, atrial fibrillation (8.16% and atrial tachycardia (2.04%. The cardiac dysrhythmias were observed in high yielding Holstein cows including, sinus arrhythmia (86.95% and wandering pacemaker (13.05%. Also, notched P wave was observed to be 30% and 14% in high- and low- yielding Holstein cows respectively. The serum calcium concentration of low yielding Holstein cows was significantly lower than that of high yielding Holstein cows. There was not any detectable significant difference in other serum elements between high- and low- yielding Holstein cows. Based on the result of present study, could be concluded that low serum concentration of calcium results to more frequent dysrhythmias in low yielding Holstein cows.

  14. Design of a hybrid model for cardiac arrhythmia classification based on Daubechies wavelet transform.

    Science.gov (United States)

    Rajagopal, Rekha; Ranganathan, Vidhyapriya

    2018-06-05

    Automation in cardiac arrhythmia classification helps medical professionals make accurate decisions about the patient's health. The aim of this work was to design a hybrid classification model to classify cardiac arrhythmias. The design phase of the classification model comprises the following stages: preprocessing of the cardiac signal by eliminating detail coefficients that contain noise, feature extraction through Daubechies wavelet transform, and arrhythmia classification using a collaborative decision from the K nearest neighbor classifier (KNN) and a support vector machine (SVM). The proposed model is able to classify 5 arrhythmia classes as per the ANSI/AAMI EC57: 1998 classification standard. Level 1 of the proposed model involves classification using the KNN and the classifier is trained with examples from all classes. Level 2 involves classification using an SVM and is trained specifically to classify overlapped classes. The final classification of a test heartbeat pertaining to a particular class is done using the proposed KNN/SVM hybrid model. The experimental results demonstrated that the average sensitivity of the proposed model was 92.56%, the average specificity 99.35%, the average positive predictive value 98.13%, the average F-score 94.5%, and the average accuracy 99.78%. The results obtained using the proposed model were compared with the results of discriminant, tree, and KNN classifiers. The proposed model is able to achieve a high classification accuracy.

  15. Acute effects of sex steroid hormones on susceptibility to cardiac arrhythmias: a simulation study.

    Directory of Open Access Journals (Sweden)

    Pei-Chi Yang

    2010-01-01

    Full Text Available Acute effects of sex steroid hormones likely contribute to the observation that post-pubescent males have shorter QT intervals than females. However, the specific role for hormones in modulating cardiac electrophysiological parameters and arrhythmia vulnerability is unclear. Here we use a computational modeling approach to incorporate experimentally measured effects of physiological concentrations of testosterone, estrogen and progesterone on cardiac ion channel targets. We then study the hormone effects on ventricular cell and tissue dynamics comprised of Faber-Rudy computational models. The "female" model predicts changes in action potential duration (APD at different stages of the menstrual cycle that are consistent with clinically observed QT interval fluctuations. The "male" model predicts shortening of APD and QT interval at physiological testosterone concentrations. The model suggests increased susceptibility to drug-induced arrhythmia when estradiol levels are high, while testosterone and progesterone are apparently protective. Simulations predict the effects of sex steroid hormones on clinically observed QT intervals and reveal mechanisms of estrogen-mediated susceptibility to prolongation of QT interval. The simulations also indicate that acute effects of estrogen are not alone sufficient to cause arrhythmia triggers and explain the increased risk of females to Torsades de Pointes. Our results suggest that acute effects of sex steroid hormones on cardiac ion channels are sufficient to account for some aspects of gender specific susceptibility to long-QT linked arrhythmias.

  16. The predictive value of CHADS₂ risk score in post myocardial infarction arrhythmias - a Cardiac Arrhythmias and RIsk Stratification after Myocardial infArction (CARISMA) substudy

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine Huth; Gang, Uffe; Thomsen, Poul Erik Bloch

    2014-01-01

    BACKGROUND: Previous studies have shown substantially increased risk of cardiac arrhythmias and sudden cardiac death in post-myocardial infarction (MI) patients. However it remains difficult to identify the patients who are at highest risk of arrhythmias in the post-MI setting. The purpose...... of this study was to investigate if CHADS₂ score (congestive heart failure, hypertension, age ≥75 years, diabetes and previous stroke/TCI [doubled]) can be used as a risk tool for predicting cardiac arrhythmias after MI. METHODS: The study included 297 post-MI patients from the CARISMA study with left....... Patients were stratified according to CHADS₂ score at enrollment. Congestive heart failure was defined as LVEF ≤40% and NYHA class II, III or IV. RESULTS: We found significantly increased risk of an arrhythmic event with increasing CHADS₂ score (CHADS₂ score=1-2: HR=2.1 [1.1-3.9], p=0.021, CHADS₂ score ≥ 3...

  17. The effect of Cardiac Arrhythmias Simulation Software on the nurses' learning and professional development.

    Science.gov (United States)

    Bazrafkan, Leila; Hemmati, Mehdi

    2018-04-01

    One of the important tasks of nurses in intensive care unit is interpretation of ECG. The use of training simulator is a new paradigm in the age of computers. This study was performed to evaluate the impact of cardiac arrhythmias simulator software on nurses' learning in the subspecialty Vali-Asr Hospital in 2016. This study was conducted by quasi-experimental randomized Salomon four group design with the participation of 120 nurses in subspecialty Vali-Asr Hospital in Tehran, Iran in 2016 that were selected purposefully and allocated in 4 groups. By this design other confounding factors such as the prior information, maturation and the role of sex and age were controlled by Solomon 4 design. The valid and reliable multiple choice test tools were used to gather information; the validity of the test was approved by experts and its reliability was obtained by Cronbach's alpha coefficient 0.89. At first, the knowledge and skills of the participants were assessed by a pre-test; following the educational intervention with cardiac arrhythmias simulator software during 14 days in ICUs, the mentioned factors were measured for the two groups again by a post-test in the four groups. Data were analyzed using the two way ANOVA. The significance level was considered as ptest results, using cardiac arrhythmias simulator software as an intervention was effective in the nurses' learning since a significant difference was found between pre-test and post-test in the first group (ptest showed that there was no interaction between pre-test and intervention in all of the three knowledge areas of cardiac arrhythmias, their treatments and their diagnosis (P>0.05). The use of software-based simulator for cardiac arrhythmias was effective in nurses' learning in light of its attractive components and interactive method. This intervention increased the knowledge of the nurses in cognitive domain of cardiac arrhythmias in addition to their diagnosis and treatment. Also, the package can be

  18. Comparison of two teaching methods for cardiac arrhythmia interpretation among nursing students.

    Science.gov (United States)

    Varvaroussis, Dimitrios P; Kalafati, Maria; Pliatsika, Paraskevi; Castrén, Maaret; Lott, Carsten; Xanthos, Theodoros

    2014-02-01

    The aim of this study was to compare the six-stage method (SSM) for instructing primary cardiac arrhythmias interpretation to students without basic electrocardiogram (ECG) knowledge with a descriptive teaching method in a single educational intervention. This is a randomized trial. Following a brief instructional session, undergraduate nursing students, assigned to group A (SSM) and group B (descriptive teaching method), undertook a written test in cardiac rhythm recognition, immediately after the educational intervention (initial exam). Participants were also examined with an unannounced retention test (final exam), one month after instruction. Altogether 134 students completed the study. Interpretation accuracy for each cardiac arrhythmia was assessed. Mean score at the initial exam was 8.71±1.285 for group A and 8.74±1.303 for group B. Mean score at the final exam was 8.25±1.46 for group A vs 7.84±1.44 for group B. Overall results showed that the SSM was equally effective with the descriptive teaching method. The study showed that in each group bradyarrhythmias were identified correctly by more students than tachyarrhythmias. No significant difference between the two teaching methods was seen for any specific cardiac arrhythmia. The SSM effectively develops staff competency for interpreting common cardiac arrhythmias in students without ECG knowledge. More research is needed to support this conclusion and the method's effectiveness must be evaluated if being implemented to trainee groups with preexisting basic ECG interpretation knowledge. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Combination of opium smoking and hypercholesterolemia augments susceptibility for lethal cardiac arrhythmia and atherogenesis in rabbit.

    Science.gov (United States)

    Najafipour, Hamid; Joukar, Siyavash

    2012-09-01

    Opium consumption is increasing in some eastern societies, where it is grown. We investigated the effect of opium smoking on plasma atherogenic index and incidence of lethal cardiac arrhythmia, i.e. ventricular tachycardia (VT) and ventricular fibrillation (VF) in rabbits. Animals were divided into two-, normo- and hyper-cholesterolemic main groups fed with normal or high cholesterol diet prior and during short-term and long-term exposure to opium smoke. Then, isoproterenol (3mg/kg, i.p.) was injected to induce cardiac ischemia and animals were followed for 3h for counting of lethal arrhythmia incidence. Long-term opium smoking significantly increased the plasma atherogenic index. In ischemic hearts, opium smoking along with hypercholesterolemia significantly enhanced the incidence of fatal arrhythmia. This vulnerability was not mediated by changes in QT interval. These data suggest that opium smoking, especially in hypercholesterolemic conditions, can be a predisposing factor for atherogenesis and lethal arrhythmia. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Effect of Cardiac Arrhythmia Simulation on Nursing Students' Knowledge Acquisition and Retention.

    Science.gov (United States)

    Tubaishat, Ahmad; Tawalbeh, Loai I

    2015-09-01

    The realistic and practical environment that simulation provides is an extremely useful part of the teaching process. Simulation is widely used in health and nursing education today. This study aims to evaluate the effect of simulation-based teaching on the acquisition and retention of arrhythmia-related knowledge among nursing students. A randomized controlled design involving a pretest-posttest was used. Nursing students were allocated randomly either to the experimental group (n = 47), who attended simulation scenarios on cardiac arrhythmia, or to the control group (n = 44) who received a traditional lecture on the same topic. A paired t test showed that the mean knowledge score at the posttest was significantly higher than at the pretest for both groups. However, participants in the experimental group demonstrated significantly increased knowledge of cardiac arrhythmia in the first and the second posttest compared with those in the control group. Thus, simulation is superior and significantly improves students' arrhythmia knowledge. © The Author(s) 2014.

  1. Cardiac arrhythmia detection using combination of heart rate variability analyses and PUCK analysis.

    Science.gov (United States)

    Mahananto, Faizal; Igasaki, Tomohiko; Murayama, Nobuki

    2013-01-01

    This paper presents cardiac arrhythmia detection using the combination of a heart rate variability (HRV) analysis and a "potential of unbalanced complex kinetics" (PUCK) analysis. Detection performance was improved by adding features extracted from the PUCK analysis. Initially, R-R interval data were extracted from the original electrocardiogram (ECG) recordings and were cut into small segments and marked as either normal or arrhythmia. HRV analyses then were conducted using the segmented R-R interval data, including a time-domain analysis, frequency-domain analysis, and nonlinear analysis. In addition to the HRV analysis, PUCK analysis, which has been implemented successfully in a foreign exchange market series to characterize change, was employed. A decision-tree algorithm was applied to all of the obtained features for classification. The proposed method was tested using the MIT-BIH arrhythmia database and had an overall classification accuracy of 91.73%. After combining features obtained from the PUCK analysis, the overall accuracy increased to 92.91%. Therefore, we suggest that the use of a PUCK analysis in conjunction with HRV analysis might improve performance accuracy for the detection of cardiac arrhythmia.

  2. Radiofrequency catheter ablation in the treatment of cardiac arrhythmias (first of two parts)

    International Nuclear Information System (INIS)

    Kou, W.H; Morady, F.

    1997-01-01

    The intravenous radiofrequency catheter inside cardiac s chambers, for inspect signals intracardiac s and to encourage, has been developed as diagnostic tool with the purpose to search arrhythmias physiology and physiopathology.Many energy sources has been used: direct energy, radiofrequency 11-15, laser 6,17, and microwave 18,19. A comparison between radiofrequency and electric energy shock has been described in cardiac arrhythmias treatment, in the present article. It has been tested the radiation biological effects and risk in Wolff Parkinson White patients as well as doctors who handling the fluoroscopy for image during the radiofrequency ablation. Has been described the following techniques: Catheter ablation radiofrequency slow way and fast way

  3. Late gadolinium enhancement by magnetic resonance explains adverse cardiac events in individuals with ventricular arrhythmia

    International Nuclear Information System (INIS)

    Courtis, J.; Vasallo, J.; Arabia, L.; Dimitroff, M.; Gonzalez, A.; Tibaldi, M.

    2012-01-01

    Objective: To determine whether the presence of late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) predict adverse cardiac events in patients with ventricular arrhythmia. Methods: We selected 74 consecutive patients with symptomatic ventricular arrhythmia (premature ventricular contractions and ventricular tachycardia) and left ventricular ejection fraction (LVEF) >55% sent to CMR for evaluation of structural heart disease previously undetected by other complementary methods. LGE, systolic function and volumes of both ventricles were analyzed. At follow-up was assessed a combined end point: hospitalization for ventricular arrhythmia, appropriate implantable cardioverter-defibrillator therapy and cardiac death. Results: During a median follow up of 575 days (interquartile range 24-1120 days) and by analyzing the population according to the presence (n=9, 12%) or not (n=65, 88%) LGE was observed that the group with positive Gd had lower LVEF (58% vs. 66% respectively, p=0.01) and larger volumes (EDV: 185 ml vs. 123 ml respectively, p=0.01 and ESV: 81 ml vs. 42 ml respectively, p=0.01) than the other group. Two (22%) patients in the LGE + group vs. one (4%) of those without LGE showed the combined endpoint (p=0.01) and when performing a logistic regression analysis it was found that the LGE is a predictor of adverse cardiac events analyzed (p=0.029). Conclusions: In this consecutive series of patients with ventricular arrhythmia we demonstrate a strong association between myocardial LGE and adverse cardiac events; this supports the hypothesis that myocardial fibrosis is an important arrhythmogenic substrate. In addition, almost all individuals without LGE were free of events during follow-up suggesting that it is possible to identify through the CMR low-risk individuals who can be treated conservatively. (authors) [es

  4. Induced pluripotent stem cell derived cardiomyocytes as models for cardiac arrhythmias

    Directory of Open Access Journals (Sweden)

    Maaike eHoekstra

    2012-08-01

    Full Text Available Cardiac arrhythmias are a major cause of morbidity and mortality. In younger patients, the majority of sudden cardiac deaths have an underlying Mendelian genetic cause. Over the last 15 years, enormous progress has been made in identifying the distinct clinical phenotypes and in studying the basic cellular and genetic mechanisms associated with the primary Mendelian (monogenic arrhythmia syndromes. Investigation of the electrophysiological consequences of an ion channel mutation is ideally done in the native cardiomyocyte environment. However, the majority of such studies so far have relied on heterologous expression systems in which single ion channel genes are expressed in non-cardiac cells. In some cases, transgenic mouse models haven been generated, but these also have significant shortcomings, primarily related to species differences.The discovery that somatic cells can be reprogrammed to pluripotency as induced pluripotent stem cells (iPSC has generated much interest since it presents an opportunity to generate patient- and disease-specific cell lines from which normal and diseased human cardiomyocytes can be obtained These genetically diverse human model systems can be studied in vitro and used to decipher mechanisms of disease and identify strategies and reagents for new therapies. Here we review the present state of the art with respect to cardiac disease models already generated using IPSC technology and which have been (partially characterized.Human iPSC (hiPSC models have been described for the cardiac arrhythmia syndromes, including LQT1, LQT2, LQT3-Brugada Syndrome, LQT8/Timothy syndrome and catecholaminergic polymorphic ventricular tachycardia. In most cases, the hiPSC-derived cardiomyoctes recapitulate the disease phenotype and have already provided opportunities for novel insight into cardiac pathophysiology. It is expected that the lines will be useful in the development of pharmacological agents for the management of these

  5. Risk Prediction of One-Year Mortality in Patients with Cardiac Arrhythmias Using Random Survival Forest

    Directory of Open Access Journals (Sweden)

    Fen Miao

    2015-01-01

    Full Text Available Existing models for predicting mortality based on traditional Cox proportional hazard approach (CPH often have low prediction accuracy. This paper aims to develop a clinical risk model with good accuracy for predicting 1-year mortality in cardiac arrhythmias patients using random survival forest (RSF, a robust approach for survival analysis. 10,488 cardiac arrhythmias patients available in the public MIMIC II clinical database were investigated, with 3,452 deaths occurring within 1-year followups. Forty risk factors including demographics and clinical and laboratory information and antiarrhythmic agents were analyzed as potential predictors of all-cause mortality. RSF was adopted to build a comprehensive survival model and a simplified risk model composed of 14 top risk factors. The built comprehensive model achieved a prediction accuracy of 0.81 measured by c-statistic with 10-fold cross validation. The simplified risk model also achieved a good accuracy of 0.799. Both results outperformed traditional CPH (which achieved a c-statistic of 0.733 for the comprehensive model and 0.718 for the simplified model. Moreover, various factors are observed to have nonlinear impact on cardiac arrhythmias prognosis. As a result, RSF based model which took nonlinearity into account significantly outperformed traditional Cox proportional hazard model and has great potential to be a more effective approach for survival analysis.

  6. Integrative computational models of cardiac arrhythmias -- simulating the structurally realistic heart

    Science.gov (United States)

    Trayanova, Natalia A; Tice, Brock M

    2009-01-01

    Simulation of cardiac electrical function, and specifically, simulation aimed at understanding the mechanisms of cardiac rhythm disorders, represents an example of a successful integrative multiscale modeling approach, uncovering emergent behavior at the successive scales in the hierarchy of structural complexity. The goal of this article is to present a review of the integrative multiscale models of realistic ventricular structure used in the quest to understand and treat ventricular arrhythmias. It concludes with the new advances in image-based modeling of the heart and the promise it holds for the development of individualized models of ventricular function in health and disease. PMID:20628585

  7. Chaos for cardiac arrhythmias through a one-dimensional modulation equation for alternans

    Science.gov (United States)

    Dai, Shu; Schaeffer, David G.

    2010-01-01

    Instabilities in cardiac dynamics have been widely investigated in recent years. One facet of this work has studied chaotic behavior, especially possible correlations with fatal arrhythmias. Previously chaotic behavior was observed in various models, specifically in the breakup of spiral and scroll waves. In this paper we study cardiac dynamics and find spatiotemporal chaotic behavior through the Echebarria–Karma modulation equation for alternans in one dimension. Although extreme parameter values are required to produce chaos in this model, it seems significant mathematically that chaos may occur by a different mechanism from previous observations. PMID:20590327

  8. Carbon monoxide exposure enhances arrhythmia after cardiac stress: involvement of oxidative stress.

    Science.gov (United States)

    André, Lucas; Gouzi, Fares; Thireau, Jérôme; Meyer, Gregory; Boissiere, Julien; Delage, Martine; Abdellaoui, Aldja; Feillet-Coudray, Christine; Fouret, Gilles; Cristol, Jean-Paul; Lacampagne, Alain; Obert, Philippe; Reboul, Cyril; Fauconnier, Jérémy; Hayot, Maurice; Richard, Sylvain; Cazorla, Olivier

    2011-11-01

    Arrhythmias following cardiac stress are a key predictor of death in healthy population. Carbon monoxide (CO) is a ubiquitous pollutant promoting oxidative stress and associated with hospitalization for cardiovascular disease and cardiac mortality. We investigated the effect of chronic CO exposure on the occurrence of arrhythmic events after a cardiac stress test and the possible involvement of related oxidative stress. Wistar rats exposed chronically (4 weeks) to sustained urban CO pollution presented more arrhythmic events than controls during recovery after cardiac challenge with isoprenaline in vivo. Sudden death occurred in 22% of CO-exposed rats versus 0% for controls. Malondialdehyde (MDA), an end-product of lipid peroxidation, was increased in left ventricular tissue of CO-exposed rats. Cardiomyocytes isolated from CO-exposed rats showed higher reactive oxygen species (ROS) production (measured with MitoSox Red dye), higher diastolic Ca(2+) resulting from SR calcium leak and an higher occurrence of irregular Ca(2+) transients (measured with Indo-1) in comparison to control cells after a high pacing sequence. Acute treatment with a ROS scavenger (N-acetylcysteine, 20 mmol/L, 1 h) prevented this sequence of alterations and decreased the number of arrhythmic cells following high pacing. Chronic CO exposure promotes oxidative stress that alters Ca(2+) homeostasis (through RYR2 and SERCA defects) and thereby mediates the triggering of ventricular arrhythmia after cardiac stress that can lead to sudden death.

  9. Carbon monoxide induces cardiac arrhythmia via induction of the late Na+ current.

    Science.gov (United States)

    Dallas, Mark L; Yang, Zhaokang; Boyle, John P; Boycott, Hannah E; Scragg, Jason L; Milligan, Carol J; Elies, Jacobo; Duke, Adrian; Thireau, Jérôme; Reboul, Cyril; Richard, Sylvain; Bernus, Olivier; Steele, Derek S; Peers, Chris

    2012-10-01

    Clinical reports describe life-threatening cardiac arrhythmias after environmental exposure to carbon monoxide (CO) or accidental CO poisoning. Numerous case studies describe disruption of repolarization and prolongation of the QT interval, yet the mechanisms underlying CO-induced arrhythmias are unknown. To understand the cellular basis of CO-induced arrhythmias and to identify an effective therapeutic approach. Patch-clamp electrophysiology and confocal Ca(2+) and nitric oxide (NO) imaging in isolated ventricular myocytes was performed together with protein S-nitrosylation to investigate the effects of CO at the cellular and molecular levels, whereas telemetry was used to investigate effects of CO on electrocardiogram recordings in vivo. CO increased the sustained (late) component of the inward Na(+) current, resulting in prolongation of the action potential and the associated intracellular Ca(2+) transient. In more than 50% of myocytes these changes progressed to early after-depolarization-like arrhythmias. CO elevated NO levels in myocytes and caused S-nitrosylation of the Na(+) channel, Na(v)1.5. All proarrhythmic effects of CO were abolished by the NO synthase inhibitor l-NAME, and reversed by ranolazine, an inhibitor of the late Na(+) current. Ranolazine also corrected QT variability and arrhythmias induced by CO in vivo, as monitored by telemetry. Our data indicate that the proarrhythmic effects of CO arise from activation of NO synthase, leading to NO-mediated nitrosylation of Na(V)1.5 and to induction of the late Na(+) current. We also show that the antianginal drug ranolazine can abolish CO-induced early after-depolarizations, highlighting a novel approach to the treatment of CO-induced arrhythmias.

  10. Automatic recognition of cardiac arrhythmias based on the geometric patterns of Poincaré plots

    International Nuclear Information System (INIS)

    Zhang, Lijuan; Guo, Tianci; Xi, Bin; Fan, Yang; Wang, Kun; Bi, Jiacheng; Wang, Ying

    2015-01-01

    The Poincaré plot emerges as an effective tool for assessing cardiovascular autonomic regulation. It displays nonlinear characteristics of heart rate variability (HRV) from electrocardiographic (ECG) recordings and gives a global view of the long range of ECG signals. In the telemedicine or computer-aided diagnosis system, it would offer significant auxiliary information for diagnosis if the patterns of the Poincaré plots can be automatically classified. Therefore, we developed an automatic classification system to distinguish five geometric patterns of the Poincaré plots from four types of cardiac arrhythmias. The statistics features are designed on measurements and an ensemble classifier of three types of neural networks is proposed. Aiming at the difficulty to set a proper threshold for classifying the multiple categories, the threshold selection strategy is analyzed. 24 h ECG monitoring recordings from 674 patients, which have four types of cardiac arrhythmias, are adopted for recognition. For comparison, Support Vector Machine (SVM) classifiers with linear and Gaussian kernels are also applied. The experiment results demonstrate the effectiveness of the extracted features and the better performance of the designed classifier. Our study can be applied to diagnose the corresponding sinus rhythm and arrhythmia substrates disease automatically in the telemedicine and computer-aided diagnosis system. (paper)

  11. Cardiac Resynchronization Therapy Defibrillator Treatment in a Child with Heart Failure and Ventricular Arrhythmia

    Directory of Open Access Journals (Sweden)

    Hak Ju Kim

    2016-08-01

    Full Text Available Cardiac resynchronization therapy (CRT is a new treatment for refractory heart failure. However, most patients with heart failure treated with CRT are adults, middle-aged or older with idiopathic or ischemic dilated cardiomyopathy. We treated a 12-year-old boy, who was transferred after cardiac arrest, with dilated cardiomyopathy, left bundle-branch block, and ventricular tachycardia. We performed cardiac resynchronization therapy with a defibrillator (CRT-D. After CRT-D, left ventricular ejection fraction improved from 22% to 4 4% a ssessed by e chocardiog ram 1 year p ostoperatively. On e lectrocardiog ram, Q RS d uration was shortened from 206 to 144 ms. The patient’s clinical symptoms also improved. For pediatric patients with refractory heart failure and ventricular arrhythmia, CRT-D could be indicated as an effective therapeutic option.

  12. hERG trafficking inhibition in drug-induced lethal cardiac arrhythmia.

    Science.gov (United States)

    Nogawa, Hisashi; Kawai, Tomoyuki

    2014-10-15

    Acquired long QT syndrome induced by non-cardiovascular drugs can cause lethal cardiac arrhythmia called torsades de points and is a significant problem in drug development. The prolongation of QT interval and cardiac action potential duration are mainly due to reduced physiological function of the rapidly activating voltage-dependent potassium channels encoded by human ether-a-go-go-related gene (hERG). Structurally diverse groups of drugs are known to directly inhibit hERG channel conductance. Therefore, the ability of acute hERG inhibition is routinely assessed at the preclinical stages in pharmaceutical testing. Recent findings indicated that chronic treatment with various drugs not only inhibits hERG channels but also decreases hERG channel expression in the plasma membrane of cardiomyocytes, which has become another concern in safety pharmacology. The mechanisms involve the disruption of hERG trafficking to the surface membrane or the acceleration of hERG protein degradation. From this perspective, we present a brief overview of mechanisms of drug-induced trafficking inhibition and pathological regulation. Understanding of drug-induced hERG trafficking inhibition may provide new strategies for predicting drug-induced QT prolongation and lethal cardiac arrhythmia in pharmaceutical drug development. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Beat-to-beat evaluation of left ventricular ejection in cardiac arrhythmias

    International Nuclear Information System (INIS)

    Itti, R.; Philippe, L.; Lorgeron, J.M.

    1982-01-01

    Conventional multi-gated cardiac blood pool studies suffer from two kinds of superimpositions: the spatial overlapping of various heart chambers and the temporal superimposition of a large number of cardiac cycles. The first problem can be partially solved by first pass techniques or by emission tomography. For the second one, which is specially critical arrhythmias, the single probe device (''nuclear stethoscope'') represents an original solution. Patients with normal cardiac rythm and patients presenting various kinds of cardiac rythm alterations were examined using a commercial ''nuclear stethoscope''. Some characteristic results achieved in these cases, were presented. For blood pool labeling, 20 mCi of 99mTc albumin was injected. The single probe detector was then positioned over the left ventricular area. The beat-to-beat left ventricular activity curve was then recorded for several minutes on paper in the same time as the E.C.G. signal. In cases with irregular cardiac rythm, the multigated techniques yield an average value of left ventricular ejection. Due to the relatively constant duration of systole, the superimposition of cycles may be valid during contration: differences mainly appear during diastole. But, as it could be demonstrated using the ''nuclear stethoscope'', individual cycles can show a large variability of ejection and average ejection fraction is only a very partial aspect of the real cardiac function

  14. Noninvasive risk stratification of lethal ventricular arrhythmias and sudden cardiac death after myocardial infarction

    Directory of Open Access Journals (Sweden)

    Kenji Yodogawa, MD

    2014-08-01

    Full Text Available Prediction of lethal ventricular arrhythmias leading to sudden cardiac death is one of the most important and challenging problems after myocardial infarction (MI. Identification of MI patients who are prone to ventricular tachyarrhythmias allows for an indication of implantable cardioverter-defibrillator placement. To date, noninvasive techniques such as microvolt T-wave alternans (MTWA, signal-averaged electrocardiography (SAECG, heart rate variability (HRV, and heart rate turbulence (HRT have been developed for this purpose. MTWA is an indicator of repolarization abnormality and is currently the most promising risk-stratification tool for predicting malignant ventricular arrhythmias. Similarly, late potentials detected by SAECG are indices of depolarization abnormality and are useful in risk stratification. However, the role of SAECG is limited because of its low predictive accuracy. Abnormal HRV and HRT patterns reflect autonomic disturbances, which may increase the risk of lethal ventricular arrhythmias, but the existing evidence is insufficient. Further studies of noninvasive assessment may provide a new insight into risk stratification in post-MI patients.

  15. Cardiac Arrhythmia: In vivo screening in the zebrafish to overcome complexity in drug discovery.

    Science.gov (United States)

    Macrae, Calum A

    2010-07-01

    IMPORTANCE OF THE FIELD: Cardiac arrhythmias remain a major challenge for modern drug discovery. Clinical events are paroxysmal, often rare and may be asymptomatic until a highly morbid complication. Target selection is often based on limited information and though highly specific agents are identified in screening, the final efficacy is often compromised by unanticipated systemic responses, a narrow therapeutic index and substantial toxicities. AREAS COVERED IN THIS REVIEW: Our understanding of complexity of arrhythmogenesis has grown dramatically over the last two decades, and the range of potential disease mechanisms now includes pathways previously thought only tangentially involved in arrhythmia. This review surveys the literature on arrhythmia mechanisms from 1965 to the present day, outlines the complex biology underlying potentially each and every rhythm disturbance, and highlights the problems for rational target identification. The rationale for in vivo screening is described and the utility of the zebrafish for this approach and for complementary work in functional genomics is discussed. Current limitations of the model in this setting and the need for careful validation in new disease areas are also described. WHAT THE READER WILL GAIN: An overview of the complex mechanisms underlying most clinical arrhythmias, and insight into the limits of ion channel conductances as drug targets. An introduction to the zebrafish as a model organism, in particular for cardiovascular biology. Potential approaches to overcoming the hurdles to drug discovery in the face of complex biology including in vivo screening of zebrafish genetic disease models. TAKE HOME MESSAGE: In vivo screening in faithful disease models allows the effects of drugs on integrative physiology and disease biology to be captured during the screening process, in a manner agnostic to potential drug target or targets. This systematic strategy bypasses current gaps in our understanding of disease

  16. Disturbance of cardiac gene expression and cardiomyocyte structure predisposes Mecp2-null mice to arrhythmias

    Science.gov (United States)

    Hara, Munetsugu; Takahashi, Tomoyuki; Mitsumasu, Chiaki; Igata, Sachiyo; Takano, Makoto; Minami, Tomoko; Yasukawa, Hideo; Okayama, Satoko; Nakamura, Keiichiro; Okabe, Yasunori; Tanaka, Eiichiro; Takemura, Genzou; Kosai, Ken-ichiro; Yamashita, Yushiro; Matsuishi, Toyojiro

    2015-01-01

    Methyl-CpG-binding protein 2 (MeCP2) is an epigenetic regulator of gene expression that is essential for normal brain development. Mutations in MeCP2 lead to disrupted neuronal function and can cause Rett syndrome (RTT), a neurodevelopmental disorder. Previous studies reported cardiac dysfunction, including arrhythmias in both RTT patients and animal models of RTT. In addition, recent studies indicate that MeCP2 may be involved in cardiac development and dysfunction, but its role in the developing and adult heart remains unknown. In this study, we found that Mecp2-null ESCs could differentiate into cardiomyocytes, but the development and further differentiation of cardiovascular progenitors were significantly affected in MeCP2 deficiency. In addition, we revealed that loss of MeCP2 led to dysregulation of endogenous cardiac genes and myocardial structural alterations, although Mecp2-null mice did not exhibit obvious cardiac functional abnormalities. Furthermore, we detected methylation of the CpG islands in the Tbx5 locus, and showed that MeCP2 could target these sequences. Taken together, these results suggest that MeCP2 is an important regulator of the gene-expression program responsible for maintaining normal cardiac development and cardiomyocyte structure. PMID:26073556

  17. Ventricular arrhythmias and sudden cardiac arrest in Takotsubo cardiomyopathy: Incidence, predictive factors, and clinical implications.

    Science.gov (United States)

    Jesel, Laurence; Berthon, Charlotte; Messas, Nathan; Lim, Han S; Girardey, Mélanie; Marzak, Halim; Marchandot, Benjamin; Trinh, Annie; Ohlmann, Patrick; Morel, Olivier

    2018-04-06

    Takotsubo cardiomyopathy (TTC) is a stress-related transient cardiomyopathy. Life-threatening arrhythmias (LTA) can occur and worsen prognosis. The purpose of this study was to assess the incidence and outcome of LTA in TTC, as well as its predictive factors and clinical implications. We studied 214 consecutive cases of TTC over 8 years. The study cohort was divided into 2 groups: those with LTA (LTA group) and those without (non-LTA group). LTA was defined as ventricular tachycardia, ventricular fibrillation, or cardiac arrest. LTA occurred in 10.7% of patients mainly in the first 24 hours of hospitalization: ventricular tachycardia (n = 2), ventricular fibrillation (n = 11), cardiac arrest (n = 10: 5 asystole, 3 complete heart block, and 2 sinoatrial block). LTA were associated with lower left ventricular ejection fraction (LVEF) and a high rate of conduction disturbances. In-hospital (39.1% vs 8.9%; P 105 ms were independent predictors of LTA. In cases where a device was implanted, conduction disturbances persisted after the index event despite complete recovery of LVEF. There was no ventricular arrhythmia recurrence during follow-up. LTA occur early in patients presenting with TTC and is associated with significantly worse short- and long-term prognosis. Left ventricular impairment and QRS duration >105 ms are independent predictors of LTA. Ventricular arrhythmias occurred in the acute phase without further recurrence recorded in hospital survivors, whereas severe conduction disorders persisted during long-term follow-up. These findings may have implications on the choice of device therapy for this specific patient subgroup. Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  18. Cardiac arrhythmias during aerobatic flight and its simulation on a centrifuge.

    Science.gov (United States)

    Zawadzka-Bartczak, Ewelina K; Kopka, Lech H

    2011-06-01

    It is well known that accelerations during centrifuge training and during flight can provoke cardiac arrhythmias. Our study was designed to investigate both the similarities and differences between heart rhythm disturbances during flights and centrifuge tests. There were 40 asymptomatic, healthy pilots who performed two training flights and were also tested in a human centrifuge according to a program of rapid onset rate acceleration (ROR) and of centrifuge simulation of the actual acceleration experienced in flight (Simulation). During the flight and centrifuge tests ECG was monitored with the Holter method. ECG was examined for heart rhythm changes and disturbances. During flights, premature ventricular contractions (PVCs) were found in 25% of the subjects, premature supraventricular contractions (PSVCs) and PVCs with bigeminy in 5%, and pairs of PVCs in 2.5% of subjects. During the centrifuge tests, PVCs were experienced by 45% of the subjects, PSVCs and pairs of PVCs by 7.5%, and PVCs with bigeminy by 2.5%. Sinus bradycardia was observed during flights and centrifuge tests in 7.5% of subjects. Comparative evaluation of electrocardiographic records in military pilots during flights and centrifuge tests demonstrated that: 1) there were no clinically significant arrhythmias recorded; and 2) the frequency and kind of heart rhythm disturbances during aerobatic flight and its simulation on a centrifuge were not identical and did not occur repetitively in the same persons during equal phases of the tests.

  19. Percutaneous autonomic neural modulation: A novel technique to treat cardiac arrhythmia

    International Nuclear Information System (INIS)

    DeSimone, Christopher V.; Madhavan, Malini; Venkatachalam, Kalpathi L.; Knudson, Mark B.; Asirvatham, Samuel J.

    2013-01-01

    Ablation and anti-arrhythmic medications have shown promise but have been met with varying success and unwanted side effects such as myocardial injury, arrhythmias, and morbidity from invasive surgical intervention. The answer to improving efficacy of ablation may include modulation of the cardiac aspect of the autonomic nervous system. Our lab has developed a novel approach and device to navigate the oblique sinus and to use DC current and saline/alcohol irrigation to selectively stimulate and block the autonomic ganglia found on the epicardial side of the heart. This novel approach minimizes myocardial damage from thermal injury and provides a less invasive and targeted approach. For feasibility, proof-of-concept, and safety monitoring, we carried out canine studies to test this novel application. Our results suggest a safer and less invasive way of modulating arrhythmogenic substrate that may lead to improved treatment of AF in humans

  20. Percutaneous autonomic neural modulation: A novel technique to treat cardiac arrhythmia

    Energy Technology Data Exchange (ETDEWEB)

    DeSimone, Christopher V.; Madhavan, Malini [Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN (United States); Venkatachalam, Kalpathi L. [Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Jacksonville, FL (United States); Knudson, Mark B. [Mayo Clinic, Rochester, MN (United States); EnteroMedics, EnteroMedics, St. Paul, MN (United States); Asirvatham, Samuel J., E-mail: asirvatham.samuel@mayo.edu [Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN (United States); Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN (United States)

    2013-05-15

    Ablation and anti-arrhythmic medications have shown promise but have been met with varying success and unwanted side effects such as myocardial injury, arrhythmias, and morbidity from invasive surgical intervention. The answer to improving efficacy of ablation may include modulation of the cardiac aspect of the autonomic nervous system. Our lab has developed a novel approach and device to navigate the oblique sinus and to use DC current and saline/alcohol irrigation to selectively stimulate and block the autonomic ganglia found on the epicardial side of the heart. This novel approach minimizes myocardial damage from thermal injury and provides a less invasive and targeted approach. For feasibility, proof-of-concept, and safety monitoring, we carried out canine studies to test this novel application. Our results suggest a safer and less invasive way of modulating arrhythmogenic substrate that may lead to improved treatment of AF in humans.

  1. Identifying potential functional impact of mutations and polymorphisms: Linking heart failure, increased risk of arrhythmias and sudden cardiac death.

    Directory of Open Access Journals (Sweden)

    BENOIT eJAGU

    2013-09-01

    Full Text Available Researchers and clinicians have discovered several important concepts regarding the mechanisms responsible for increased risk of arrhythmias, heart failure and sudden cardiac death. One major step in defining the molecular basis of normal and abnormal cardiac electrical behaviour has been the identification of single mutations that greatly increase the risk for arrhythmias and sudden cardiac death by changing channel-gating characteristics. Indeed, mutations in several genes encoding ion channels, such as SCN5A, which encodes the major cardiac Na+ channel, have emerged as the basis for a variety of inherited cardiac arrhythmias such as long QT syndrome, Brugada syndrome, progressive cardiac conduction disorder, sinus node dysfunction or sudden infant death syndrome. In addition, genes encoding ion channel accessory proteins, like anchoring or chaperone proteins, which modify the expression, the regulation of endocytosis and the degradation of ion channel α-subunits have also been reported as susceptibility genes for arrhythmic syndromes. The regulation of ion channel protein expression also depends on a fine-tuned balance among different other mechanisms, such as gene transcription, RNA processing, post-transcriptional control of gene expression by miRNA, protein synthesis, assembly and post-translational modification and trafficking.

  2. Non cancerous diseases following a chronic intern contamination by caesium 137: cataracts and cardiac arrhythmias

    International Nuclear Information System (INIS)

    Landon, G.

    2008-07-01

    This work of thesis joins within the framework of an analysis of the sanitary consequences of the nuclear accident of Chernobylsk. Since 2005, the I.R.S.N. is interested in the not cancerous pathologies (cataracts, and cardiac arrhythmias) observed among the children living on the contaminated territories after the fallout of Chernobylsk and has in this aim implemented a research programme called E.P.I.C.E. (Evaluation of the pathologies induced by a chronicle contamination by cesium) whom objective is to show an eventual link between the chronicle ingestion of contaminated food and these pathologies emergence. An exploitation of the results of the pilot study,first phase of the E.P.I.C.E. program was realized. The analysis was completed by two bibliographical reviews relative to the knowledge available on these diseases. The results of this pilot study suggest: on one hand, an absence of link between the activity in cesium 137 at the level of the heart, of the whole body and the emergence of disorder of the heart rhythm; on the other hand, for the cases of cataract, a link between the load in cesium 137 at the neck level and the emergence of the disease in 40 % of the cases. However, these results must be considered with caution because several limits and, in particular, a way of selection affect this study. concerning the scientific literature, this one stays rather poor because only thee articles make reference to a relationship between cesium 137 and the emergence of these non cancerous pathologies. After having exposed the context, this thesis draws up the situation of knowledge relative to cataracts and to cardiac arrhythmias and their possible relationship with ionizing radiations, collect the results stemming from the analysis of the pilot study and envisages future epidemiological studies. (N.C.)

  3. Single-Nucleotide Variations in Cardiac Arrhythmias: Prospects for Genomics and Proteomics Based Biomarker Discovery and Diagnostics

    Directory of Open Access Journals (Sweden)

    Ayman Abunimer

    2014-03-01

    Full Text Available Cardiovascular diseases are a large contributor to causes of early death in developed countries. Some of these conditions, such as sudden cardiac death and atrial fibrillation, stem from arrhythmias—a spectrum of conditions with abnormal electrical activity in the heart. Genome-wide association studies can identify single nucleotide variations (SNVs that may predispose individuals to developing acquired forms of arrhythmias. Through manual curation of published genome-wide association studies, we have collected a comprehensive list of 75 SNVs associated with cardiac arrhythmias. Ten of the SNVs result in amino acid changes and can be used in proteomic-based detection methods. In an effort to identify additional non-synonymous mutations that affect the proteome, we analyzed the post-translational modification S-nitrosylation, which is known to affect cardiac arrhythmias. We identified loss of seven known S-nitrosylation sites due to non-synonymous single nucleotide variations (nsSNVs. For predicted nitrosylation sites we found 1429 proteins where the sites are modified due to nsSNV. Analysis of the predicted S-nitrosylation dataset for over- or under-representation (compared to the complete human proteome of pathways and functional elements shows significant statistical over-representation of the blood coagulation pathway. Gene Ontology (GO analysis displays statistically over-represented terms related to muscle contraction, receptor activity, motor activity, cystoskeleton components, and microtubule activity. Through the genomic and proteomic context of SNVs and S-nitrosylation sites presented in this study, researchers can look for variation that can predispose individuals to cardiac arrhythmias. Such attempts to elucidate mechanisms of arrhythmia thereby add yet another useful parameter in predicting susceptibility for cardiac diseases.

  4. Fusion of ECG and ABP signals based on wavelet transform for cardiac arrhythmias classification.

    Science.gov (United States)

    Arvanaghi, Roghayyeh; Daneshvar, Sabalan; Seyedarabi, Hadi; Goshvarpour, Atefeh

    2017-11-01

    Each of Electrocardiogram (ECG) and Atrial Blood Pressure (ABP) signals contain information of cardiac status. This information can be used for diagnosis and monitoring of diseases. The majority of previously proposed methods rely only on ECG signal to classify heart rhythms. In this paper, ECG and ABP were used to classify five different types of heart rhythms. To this end, two mentioned signals (ECG and ABP) have been fused. These physiological signals have been used from MINIC physioNet database. ECG and ABP signals have been fused together on the basis of the proposed Discrete Wavelet Transformation fusion technique. Then, some frequency features were extracted from the fused signal. To classify the different types of cardiac arrhythmias, these features were given to a multi-layer perceptron neural network. In this study, the best results for the proposed fusion algorithm were obtained. In this case, the accuracy rates of 96.6%, 96.9%, 95.6% and 93.9% were achieved for two, three, four and five classes, respectively. However, the maximum classification rate of 89% was obtained for two classes on the basis of ECG features. It has been found that the higher accuracy rates were acquired by using the proposed fusion technique. The results confirmed the importance of fusing features from different physiological signals to gain more accurate assessments. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Prolonged hypoxia increases survival even in Zebrafish (Danio rerio showing cardiac arrhythmia.

    Directory of Open Access Journals (Sweden)

    Renate Kopp

    Full Text Available Tolerance towards hypoxia is highly pronounced in zebrafish. In this study even beneficial effects of hypoxia, specifically enhanced survival of zebrafish larvae, could be demonstrated. This effect was actually more pronounced in breakdance mutants, which phenotypically show cardiac arrhythmia. Breakdance mutants (bre are characterized by chronically reduced cardiac output. Despite an about 50% heart rate reduction, they become adults, but survival rate significantly drops to 40%. Normoxic bre animals demonstrate increased hypoxia inducible factor 1 a (Hif-1α expression, which indicates an activated hypoxic signaling pathway. Consequently, cardiovascular acclimation, like cardiac hypertrophy and increased erythrocyte concentration, occurs. Thus, it was hypothesized, that under hypoxic conditions survival might be even more reduced. When bre mutants were exposed to hypoxic conditions, they surprisingly showed higher survival rates than under normoxic conditions and even reached wildtype values. In hypoxic wildtype zebrafish, survival yet exceeded normoxic control values. To specify physiological acclimation, cardiovascular and metabolic parameters were measured before hypoxia started (3 dpf, when the first differences in survival rate occurred (7 dpf and when survival rate plateaued (15 dpf. Hypoxic animals expectedly demonstrated Hif-1α accumulation and consequently enhanced convective oxygen carrying capacity. Moreover, bre animals showed a significantly enhanced heart rate under hypoxic conditions, which reached normoxic wildtype values. This improvement in convective oxygen transport ensured a sufficient oxygen and nutrient supply and was also reflected in the significantly higher mitochondrial activity. The highly optimized energy metabolism observed in hypoxic zebrafish larvae might be decisive for periods of higher energy demand due to organ development, growth and increased activity. However, hypoxia increased survival only during a

  6. Particulate Air Pollution, Ambulatory Heart Rate Variability, and Cardiac Arrhythmia in Retirement Community Residents with Coronary Artery Disease

    Science.gov (United States)

    Longhurst, John; Tjoa, Thomas; Sioutas, Constantinos; Delfino, Ralph J.

    2013-01-01

    Background: Decreased heart rate variability (HRV) has been associated with future cardiac morbidity and mortality and is often used as a marker of altered cardiac autonomic balance in studies of health effects of airborne particulate matter. Fewer studies have evaluated associations between air pollutants and cardiac arrhythmia. Objectives: We examined relationships between cardiac arrhythmias, HRV, and exposures to airborne particulate matter. Methods: We measured HRV and arrhythmia with ambulatory electrocardiograms in a cohort panel study for up to 235 hr per participant among 50 nonsmokers with coronary artery disease who were ≥ 71 years of age and living in four retirement communities in the Los Angeles, California, Air Basin. Exposures included hourly outdoor gases, hourly traffic-related and secondary organic aerosol markers, and daily size-fractionated particle mass. We used repeated measures analyses, adjusting for actigraph-derived physical activity and heart rate, temperature, day of week, season, and community location. Results: Ventricular tachycardia was significantly increased in association with increases in markers of traffic-related particles, secondary organic carbon, and ozone. Few consistent associations were observed for supraventricular tachycardia. Particulates were significantly associated with decreased ambulatory HRV only in the 20 participants using ACE (angiotensin I–converting enzyme) inhibitors. Conclusions: Although these data support the hypothesis that particulate exposures may increase the risk of ventricular tachycardia for elderly people with coronary artery disease, HRV was not associated with exposure in most of our participants. These results are consistent with previous findings in this cohort for systemic inflammation, blood pressure, and ST segment depression. Citation: Bartell SM, Longhurst J, Tjoa T, Sioutas C, Delfino RJ. 2013. Particulate air pollution, ambulatory heart rate variability, and cardiac arrhythmia in

  7. Transcatheter radiofrequency ablation under the guidance of three-dimensional mapping for the treatment of complex cardiac arrhythmias

    International Nuclear Information System (INIS)

    Hong Lang; Wang Hong; Lai Hengli; Ying Qiulin; Chen Zhangqiang; Lu Linxiang; Qiu Yun; Xiao Chengwei

    2010-01-01

    Objective: To investigate the effectiveness and safety of transcatheter radiofrequency ablation guided by a three-dimensional mapping system (Ensite or Carto) for the treatment of complex cardiac arrhythmias. Methods: A cohort of 123 consecutive hospitalized inpatients during the period from February 2006 to December 2008 were selected for this study. These patients suffered from various arrhythmias, including paroxysmal atrial fibrillation (n = 58), persistent or permanent atrial fibrillation (n = 10), atrial flutter (n = 13), atrial tachycardia (n = 12) and ventricular tachycardia or frequent ventricular premature beats (n = 30). Transcatheter radiofrequency ablation for arrhythmias was performed under the guidance of an EnSite3000 / NavX or Array mapping system in 80 cases, and under the guidance of a CARTO mapping system in the remaining 43 cases. Results: Successful ablation of arrhythmias was obtained by single operation in 106 cases (86.18%), including 59 cases with atrial fibrillation, 11 cases with atrial flutter, 10 cases with atrial tachycardia, and 26 cases with ventricular tachycardia or premature ventricular beat.Ablation procedure was carried out and was successful in 10 cases with a successful rate of 94.31%, including 5 cases with atrial fibrillation, 1 case with recurred atrial flutter, 1 case with recurrent atrial tachycardia, and 3 cases with ventricular tachycardia or premature ventricular beat.After operation, complications occurred in 6 cases, including cardiac tamponade in 4 cases, distal embolism of the left anterior descending coronary artery in 1 case, and pulmonary embolism in 1 case. Conclusion: Three-dimensional mapping system can clearly and stereoscopically display the cardiac structures. Therefore, this technique is of great value in guiding the transcatheter radiofrequency ablation for complex arrhythmias, in improving the success rate of ablation and in increasing the safety of the procedure. (authors)

  8. Nonischemic Left Ventricular Scar as a Substrate of Life-Threatening Ventricular Arrhythmias and Sudden Cardiac Death in Competitive Athletes.

    Science.gov (United States)

    Zorzi, Alessandro; Perazzolo Marra, Martina; Rigato, Ilaria; De Lazzari, Manuel; Susana, Angela; Niero, Alice; Pilichou, Kalliopi; Migliore, Federico; Rizzo, Stefania; Giorgi, Benedetta; De Conti, Giorgio; Sarto, Patrizio; Serratosa, Luis; Patrizi, Giampiero; De Maria, Elia; Pelliccia, Antonio; Basso, Cristina; Schiavon, Maurizio; Bauce, Barbara; Iliceto, Sabino; Thiene, Gaetano; Corrado, Domenico

    2016-07-01

    The clinical profile and arrhythmic outcome of competitive athletes with isolated nonischemic left ventricular (LV) scar as evidenced by contrast-enhanced cardiac magnetic resonance remain to be elucidated. We compared 35 athletes (80% men, age: 14-48 years) with ventricular arrhythmias and isolated LV subepicardial/midmyocardial late gadolinium enhancement (LGE) on contrast-enhanced cardiac magnetic resonance (group A) with 38 athletes with ventricular arrhythmias and no LGE (group B) and 40 healthy control athletes (group C). A stria LGE pattern with subepicardial/midmyocardial distribution, mostly involving the lateral LV wall, was found in 27 (77%) of group A versus 0 controls (group C; P<0.001), whereas a spotty pattern of LGE localized at the junction of the right ventricle to the septum was respectively observed in 11 (31%) versus 10 (25%; P=0.52). All athletes with stria pattern showed ventricular arrhythmias with a predominant right bundle branch block morphology, 13 of 27 (48%) showed ECG repolarization abnormalities, and 5 of 27 (19%) showed echocardiographic hypokinesis of the lateral LV wall. The majority of athletes with no or spotty LGE pattern had ventricular arrhythmias with a predominant left bundle branch block morphology and no ECG or echocardiographic abnormalities. During a follow-up of 38±25 months, 6 of 27 (22%) athletes with stria pattern experienced malignant arrhythmic events such as appropriate implantable cardiac defibrillator shock (n=4), sustained ventricular tachycardia (n=1), or sudden death (n=1), compared with none of athletes with no or LGE spotty pattern and controls. Isolated nonischemic LV LGE with a stria pattern may be associated with life-threatening arrhythmias and sudden death in the athlete. Because of its subepicardial/midmyocardial location, LV scar is often not detected by echocardiography. © 2016 The Authors.

  9. Particles Alter Diesel Exhaust Gases-Induced Hypotension, Cardiac Arrhythmia,Conduction Disturbance, and Autonomic Imbalance in Heart Failure-Prone Rats

    Science.gov (United States)

    Epidemiologic studies indicate that acute exposures to vehicular traffic and particulate matter (PM) air pollution are key causes of fatal cardiac arrhythmia, especially in those with preexisting cardiovascular disease. Researchers point to electrophysiologic dysfunction and auto...

  10. Fatal cardiac arrhythmia after repeated exposure to 1,1-difluoroethane (DFE).

    Science.gov (United States)

    Avella, Joseph; Wilson, James C; Lehrer, Michael

    2006-03-01

    A 42-year-old man was found dead after repeated exposure to 1,1-difluoroethane (DFE, Freon 152a), a propellant found in CRC Duster, a product intended for the removal of dust and lint. Toxicologic analysis detected DFE in femoral blood 136.3 mg/L, brain 117.5 mg/kg, liver 87.6 mg/kg, lung 60.3 mg/kg, adipose 235.7 mg/kg, and vitreous fluid 25.1 mg/L. The cause of death was determined to be a fatal cardiac arrhythmia due to intoxication with 1,1-difluoroethane. After comparison to previously published cases involving DFE, we suggest that analysis of adipose tissue for DFE and similar compounds, along with blood and other tissues, may be useful in distinguishing between acute versus chronic exposure. Adipose may also be a valuable alternate specimen for detection in cases where loss or elimination from blood is likely to have occurred.

  11. Automatic detection of measurement points for non-contact vibrometer-based diagnosis of cardiac arrhythmias

    Science.gov (United States)

    Metzler, Jürgen; Kroschel, Kristian; Willersinn, Dieter

    2017-03-01

    Monitoring of the heart rhythm is the cornerstone of the diagnosis of cardiac arrhythmias. It is done by means of electrocardiography which relies on electrodes attached to the skin of the patient. We present a new system approach based on the so-called vibrocardiogram that allows an automatic non-contact registration of the heart rhythm. Because of the contactless principle, the technique offers potential application advantages in medical fields like emergency medicine (burn patient) or premature baby care where adhesive electrodes are not easily applicable. A laser-based, mobile, contactless vibrometer for on-site diagnostics that works with the principle of laser Doppler vibrometry allows the acquisition of vital functions in form of a vibrocardiogram. Preliminary clinical studies at the Klinikum Karlsruhe have shown that the region around the carotid artery and the chest region are appropriate therefore. However, the challenge is to find a suitable measurement point in these parts of the body that differs from person to person due to e. g. physiological properties of the skin. Therefore, we propose a new Microsoft Kinect-based approach. When a suitable measurement area on the appropriate parts of the body are detected by processing the Kinect data, the vibrometer is automatically aligned on an initial location within this area. Then, vibrocardiograms on different locations within this area are successively acquired until a sufficient measuring quality is achieved. This optimal location is found by exploiting the autocorrelation function.

  12. Exercise-induced ventricular arrhythmias and vagal dysfunction in Chagas disease patients with no apparent cardiac involvement

    Directory of Open Access Journals (Sweden)

    Henrique Silveira Costa

    2015-04-01

    Full Text Available INTRODUCTION : Exercise-induced ventricular arrhythmia (EIVA and autonomic imbalance are considered as early markers of heart disease in Chagas disease (ChD patients. The objective of the present study was to verify the differences in the occurrence of EIVA and autonomic maneuver indexes between healthy individuals and ChD patients with no apparent cardiac involvement. METHODS : A total of 75 ChD patients with no apparent cardiac involvement, aged 44.7 (8.5 years, and 38 healthy individuals, aged 44.0 (9.2 years, were evaluated using echocardiography, symptom-limited treadmill exercise testing and autonomic function tests. RESULTS : The occurrence of EIVA was higher in the chagasic group (48% than in the control group (23.7% during both the effort and the recovery phases. Frequent ventricular contractions occurred only in the patient group. Additionally, the respiratory sinus arrhythmia index was significantly lower in the chagasic individuals compared with the control group. CONCLUSIONS : ChD patients with no apparent cardiac involvement had a higher frequency of EIVA as well as more vagal dysfunction by respiratory sinus arrhythmia. These results suggest that even when asymptomatic, ChD patients possess important arrhythmogenic substrates and subclinical disease.

  13. Pulmonary arterial hypertension in congenital cardiac disease - the need for refinement of the Evian-Venice classification

    NARCIS (Netherlands)

    van Albada, Mirjam E.; Berger, Rolf M. F.

    Pulmonary hypertension associated with congenital systemic-to-pulmonary shunts has been classified, in the Evian-Venice classification, as Pulmonary Arterial Hypertension, which includes a heterogeneous group of conditions. Emerging options for treatment of patients with pulmonary arterial

  14. Geometric patterns of time-delay plots from different cardiac rhythms and arrhythmias using short-term EKG signals.

    Science.gov (United States)

    Borracci, Raúl A; Montoya Pulvet, José D; Ingino, Carlos A; Fitz Maurice, Mario; Hirschon Prado, Alfredo; Dominé, Enrique

    2017-12-27

    To date, no systematic work has been intended to describe spatio-temporal patterns of cardiac rhythms using only short series of RR intervals, to facilitate visual or computerized-aided identification of EKG motifs for use in clinical practice. The aim of this study was to detect and classify eye-catching geometric patterns of Poincaré time-delay plots from different types of cardiac rhythms and arrhythmias using short-term EKG signals. Approximately 150-300 representative, consecutive beats were retrieved from 24-h Holter registers of 100 patients with different heart rhythms. Two-dimensional Poincaré charts were created, and the resulting geometric patterns were transformed into representative familiar eye-catching drawings to interpret different arrhythmias. Poincaré plot representation of RR interval data revealed a wide variety of visual patterns: (i) comet-shaped for sinus rhythm; (ii) torpedo-shaped for sinus bradycardia; (iii) cigarette-shaped for sinus tachycardia; (iv) butterfly-shaped for sinus tachycardia and isolated atrial premature complexes; (v) arrow-shaped for isolated premature complexes and inappropriate sinus tachycardia; (vi) inverted fan-shaped for sinus rhythm with frequent atrial premature complexes; (vii) tornado-shaped for atrial flutter and atrial tachycardia; and (viii) fan-shaped for atrial fibrillation. Modified Poincaré plots with smoothed lines connecting successive points could accurately classify different types of arrhythmias based on short RR interval sequence variability. Characteristic emergent patterns can be visually identified and eventually could be distinguished by an automatic classification system able to discern between arrhythmias. This work provides an alternative method to interpret time-delay plots obtained from short-term EKG signal recordings. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. Dipyridamole-thallium tests are predictive of severe cardiac arrhythmias in patients with left ventricular hypertrophy

    International Nuclear Information System (INIS)

    Saragoca, M.A.; Canziani, M.E.; Gil, M.A.; Castiglioni, M.L.; Cassiolato, J.L.; Barbieri, A.; Lima, V.C.; Draibe, S.A.; Martinez, E.E.

    1991-01-01

    In a population of patients with chronic renal failure (CRF) and a high prevalence of left ventricular hypertrophy (LVH) undergoing chronic hemodialysis, the authors investigated the association between the results of dipyridamole-thallium tests (DTTs) and the occurrence of ventricular arrhythmias. They observed a positive significant association between positive DTTs and the occurrence of severe forms of ventricular arrhythmias. A significant association was also observed between the presence of severe LVH and the occurrence of severe ventricular arrhythmias. However, no association was found between the presence of LVH and the positivity of the DTT. As most of their patients with positive DTTs had unimpaired coronary circulations, they conclude that positive DTTs, although falsely indicative of impaired myocardial blood supply, does have an important clinical relevance, indicating increased risk of morbidity (and, possibly, mortality) due to ventricular arrhythmias in a population of CRF patients submitted to chronic renal function replacement program

  16. Effect of different doses of oxytocin on cardiac electrophysiology and arrhythmias induced by ischemia.

    Science.gov (United States)

    Houshmand, Fariba; Faghihi, Mahdieh; Imani, Alireza; Kheiri, Soleiman

    2017-01-01

    The onset of acute myocardial ischemia (MI) is accompanied by a rapid increase in electrical instability and often fatal ventricular arrhythmias. This study investigated that whether oxytocin (OT) can modulate ischemia-induced arrhythmias and considered relationships between the severity of arrhythmia and the electrocardiogram parameters during ischemia. OT (0.0001-1 μg) was administrated intraperitoneally 30 min before ischemia. To examine receptor involved, a selective OT-receptor antagonist, atosiban (ATO), was infused 10 min before OT. OT caused a significant and biphasic dose-dependent reduction in ectopic heart activity and arrhythmia score. OT doses that reduced ventricular arrhythmia elicited significant increase in QT interval. OT attenuated the electrophysiological changes associated with MI and there was significant direct relationship between QRS duration and arrhythmia score. ATO treatment reduced beneficial effects of OT on arrhythmogenesis. Nevertheless, ATO failed to alter OT effects on premature ventricular contractions. We assume that the ability of OT to modulate the electrical activity of the heart may play an important role in the antiarrhythmic actions of OT.

  17. Effect of different doses of oxytocin on cardiac electrophysiology and arrhythmias induced by ischemia

    Directory of Open Access Journals (Sweden)

    Fariba Houshmand

    2017-01-01

    Full Text Available The onset of acute myocardial ischemia (MI is accompanied by a rapid increase in electrical instability and often fatal ventricular arrhythmias. This study investigated that whether oxytocin (OT can modulate ischemia-induced arrhythmias and considered relationships between the severity of arrhythmia and the electrocardiogram parameters during ischemia. OT (0.0001–1 μg was administrated intraperitoneally 30 min before ischemia. To examine receptor involved, a selective OT-receptor antagonist, atosiban (ATO, was infused 10 min before OT. OT caused a significant and biphasic dose-dependent reduction in ectopic heart activity and arrhythmia score. OT doses that reduced ventricular arrhythmia elicited significant increase in QT interval. OT attenuated the electrophysiological changes associated with MI and there was significant direct relationship between QRS duration and arrhythmia score. ATO treatment reduced beneficial effects of OT on arrhythmogenesis. Nevertheless, ATO failed to alter OT effects on premature ventricular contractions. We assume that the ability of OT to modulate the electrical activity of the heart may play an important role in the antiarrhythmic actions of OT.

  18. Remote ischemic preconditioning differentially attenuates post-ischemic cardiac arrhythmia in streptozotocin-induced diabetic versus nondiabetic rats.

    Science.gov (United States)

    Hu, Zhaoyang; Chen, Mou; Zhang, Ping; Liu, Jin; Abbott, Geoffrey W

    2017-04-26

    Sudden cardiac death (SCD), a leading cause of global mortality, most commonly arises from a substrate of cardiac ischemia, but requires an additional trigger. Diabetes mellitus (DM) predisposes to SCD even after adjusting for other DM-linked cardiovascular pathology such as coronary artery disease. We previously showed that remote liver ischemia preconditioning (RLIPC) is highly protective against cardiac ischemia reperfusion injury (IRI) linked ventricular arrhythmias and myocardial infarction, via induction of the cardioprotective RISK pathway, and specifically, inhibitory phosphorylation of GSK-3β (Ser 9). We evaluated the impact of acute streptozotocin-induced DM on coronary artery ligation IRI-linked ventricular arrhythmogenesis and RLIPC therapy in rats. Post-IRI arrhythmia induction was similar in nondiabetic and DM rats, but, unexpectedly, DM rats exhibited lower incidence of SCD during reperfusion (41 vs. 100%), suggesting uncontrolled hyperglycemia does not acutely predispose to SCD. RLIPC was highly effective in both nondiabetic and DM rats at reducing incidence and duration of, and increasing latency to, all classes of ventricular tachyarrhythmias. In contrast, atrioventricular block (AVB) was highly responsive to RLIPC in nondiabetic rats (incidence reduced from 72 to 18%) but unresponsive in DM rats. RISK pathway induction was similar in nondiabetic and DM rats, thus not explaining the DM-specific resistance of AVB to therapy. Our findings uncover important acute DM-specific differences in responsiveness to remote preconditioning for ventricular tachyarrhythmias versus AVB, which may have clinical significance given that AVB is a malignant arrhythmia twofold more common in human diabetics than nondiabetics, and correlated to plasma glucose levels >10 mmol/L.

  19. Use of bipolar radiofrequency catheter ablation in treatment of cardiac arrhythmias.

    Science.gov (United States)

    Soucek, Filip; Starek, Zdenek

    2018-05-23

    Background Arrhythmia management is a complex process involving both pharmacological and non-pharmacological approaches. Radiofrequency ablation is the pillar of non-pharmacological arrhythmia treatment. Unipolar ablation is considered to be the gold standard in the treatment of the majority of arrhythmias; however, its efficacy is limited to specific cases. In particular, the creation of deep or transmural lesions to eliminate intramurally originating arrhythmias remains inadequate. Bipolar ablation is proposed as an alternative to overcome unipolar ablation boundaries. Results Despite promising results gained from in vitro and animal studies showing that bipolar ablation is superior in creating transmural lesions, the use of bipolar ablation in daily clinical practice is limited. Several studies have been published showing that bipolar ablation is effective in the treatment of clinical arrhythmias after failed unipolar ablation, however there is inconsistency regarding safety of bipolar ablation within the available research papers. According to research evidence the most common indications for bipolar ablation use are ventricular originating rhythmic disorders in patients with structural heart disease resistant to standard radiofrequency ablation. Conclusions To allow wider clinical application the efficiency and safety of bipolar ablation need to be verified in future studies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. THE USE OF OMEGA-3 FATTY ACIDS FOR THE TREATMENT OF PATIENTS WITH CARDIAC ARRHYTHMIAS

    Directory of Open Access Journals (Sweden)

    A. O. Malygin

    2015-09-01

    Full Text Available Antiarrhythmic effect of omega-3 polyunsaturated fatty acids (ω-3 PUFA, eicosapentaenoic and docosahexaenoic acids in patients with recurrent atrial fibrillation and ventricular arrhythmias had been proven. The positive effect of the ω-3 PUFA on the risk of sudden arrhythmic death and overall mortality in the patients after myocardial infarction and patients with chronic heart failure had been also proven.

  1. N-3 fatty acids from fish and markers of cardiac arrhythmia

    NARCIS (Netherlands)

    Geelen, A.

    2004-01-01

    N‑3 fatty acids from fish may protect against heart disease mortality by preventing fatal arrhythmias. The objective of this thesis was to investigate whether this possible antiarrhythmic effect of n-3 fatty acids is supported by short-term effects on electrophysiological markers. We performed two

  2. Multiclass Classification of Cardiac Arrhythmia Using Improved Feature Selection and SVM Invariants.

    Science.gov (United States)

    Mustaqeem, Anam; Anwar, Syed Muhammad; Majid, Muahammad

    2018-01-01

    Arrhythmia is considered a life-threatening disease causing serious health issues in patients, when left untreated. An early diagnosis of arrhythmias would be helpful in saving lives. This study is conducted to classify patients into one of the sixteen subclasses, among which one class represents absence of disease and the other fifteen classes represent electrocardiogram records of various subtypes of arrhythmias. The research is carried out on the dataset taken from the University of California at Irvine Machine Learning Data Repository. The dataset contains a large volume of feature dimensions which are reduced using wrapper based feature selection technique. For multiclass classification, support vector machine (SVM) based approaches including one-against-one (OAO), one-against-all (OAA), and error-correction code (ECC) are employed to detect the presence and absence of arrhythmias. The SVM method results are compared with other standard machine learning classifiers using varying parameters and the performance of the classifiers is evaluated using accuracy, kappa statistics, and root mean square error. The results show that OAO method of SVM outperforms all other classifiers by achieving an accuracy rate of 81.11% when used with 80/20 data split and 92.07% using 90/10 data split option.

  3. Cardiac Arrhythmia Classification by Multi-Layer Perceptron and Convolution Neural Networks

    Directory of Open Access Journals (Sweden)

    Shalin Savalia

    2018-05-01

    Full Text Available The electrocardiogram (ECG plays an imperative role in the medical field, as it records heart signal over time and is used to discover numerous cardiovascular diseases. If a documented ECG signal has a certain irregularity in its predefined features, this is called arrhythmia, the types of which include tachycardia, bradycardia, supraventricular arrhythmias, and ventricular, etc. This has encouraged us to do research that consists of distinguishing between several arrhythmias by using deep neural network algorithms such as multi-layer perceptron (MLP and convolution neural network (CNN. The TensorFlow library that was established by Google for deep learning and machine learning is used in python to acquire the algorithms proposed here. The ECG databases accessible at PhysioBank.com and kaggle.com were used for training, testing, and validation of the MLP and CNN algorithms. The proposed algorithm consists of four hidden layers with weights, biases in MLP, and four-layer convolution neural networks which map ECG samples to the different classes of arrhythmia. The accuracy of the algorithm surpasses the performance of the current algorithms that have been developed by other cardiologists in both sensitivity and precision.

  4. Cardiac Arrhythmia Classification by Multi-Layer Perceptron and Convolution Neural Networks.

    Science.gov (United States)

    Savalia, Shalin; Emamian, Vahid

    2018-05-04

    The electrocardiogram (ECG) plays an imperative role in the medical field, as it records heart signal over time and is used to discover numerous cardiovascular diseases. If a documented ECG signal has a certain irregularity in its predefined features, this is called arrhythmia, the types of which include tachycardia, bradycardia, supraventricular arrhythmias, and ventricular, etc. This has encouraged us to do research that consists of distinguishing between several arrhythmias by using deep neural network algorithms such as multi-layer perceptron (MLP) and convolution neural network (CNN). The TensorFlow library that was established by Google for deep learning and machine learning is used in python to acquire the algorithms proposed here. The ECG databases accessible at PhysioBank.com and kaggle.com were used for training, testing, and validation of the MLP and CNN algorithms. The proposed algorithm consists of four hidden layers with weights, biases in MLP, and four-layer convolution neural networks which map ECG samples to the different classes of arrhythmia. The accuracy of the algorithm surpasses the performance of the current algorithms that have been developed by other cardiologists in both sensitivity and precision.

  5. Examining the role of TRPA1 in air pollution-induced cardiac arrhythmias and autonomic imbalance

    Science.gov (United States)

    Here we describe how air pollution causes cardiac arrhythmogenesis through sensory irritation in the airways. Time-series studies show the risk of adverse cardiac events increases significantly in the hours to days after expos...

  6. Recommendations regarding dietary intake and caffeine and alcohol consumption in patients with cardiac arrhythmias: what do you tell your patients to do or not to do?

    Science.gov (United States)

    Glatter, Kathryn A; Myers, Richard; Chiamvimonvat, Nipavan

    2012-10-01

    The etiology of arrhythmias including atrial fibrillation is multifactorial. Most arrhythmias are associated with comorbid illnesses like hypertension, diabetes, thyroid disease, or advanced age. Although it is tempting to blame a stimulant like caffeine as a trigger for arrhythmias, the literature does not support this idea. There is no real benefit to having patients with arrhythmias limit their caffeine intake. Caffeine is a vasoactive substance that also may promote the release of norepinephrine and epinephrine. However, acute ingestion of caffeine (as coffee or tea) does not cause atrial fibrillation. Even patients suffering a myocardial infarction do not have an increased incidence of ventricular or other arrhythmias after ingesting several cups of coffee. Large epidemiologic studies have also failed to find a connection between the amount of coffee/caffeine used and the development of arrhythmias. As such, it does not make sense to suggest that patients with palpitations, paroxysmal atrial fibrillation, or supraventricular tachycardia, abstain from caffeine use. Energy drinks are a new phenomenon on the beverage market, with 30-50 % of young adults and teens using them regularly. Energy drinks are loaded with caffeine, sugar, and other chemicals that can stimulate the cardiac system. There is an increasing body of mainly anecdotal case reports describing arrhythmias or even sudden death triggered by exercise plus using energy drinks. Clearly, there must be more study in this area, but it is wise to either limit or avoid their use in patients with arrhythmias. Moderate to heavy alcohol use seems to be associated with the development of atrial fibrillation. The term "holiday heart" was coined back in 1978, to describe patients who had atrial fibrillation following binge alcohol use. Thus, it is reasonable to recommend to patients with arrhythmias that they limit their alcohol use, although unfortunately this treatment will likely not completely resolve their

  7. Adapting detection sensitivity based on evidence of irregular sinus arrhythmia to improve atrial fibrillation detection in insertable cardiac monitors.

    Science.gov (United States)

    Pürerfellner, Helmut; Sanders, Prashanthan; Sarkar, Shantanu; Reisfeld, Erin; Reiland, Jerry; Koehler, Jodi; Pokushalov, Evgeny; Urban, Luboš; Dekker, Lukas R C

    2017-10-03

    Intermittent change in p-wave discernibility during periods of ectopy and sinus arrhythmia is a cause of inappropriate atrial fibrillation (AF) detection in insertable cardiac monitors (ICM). To address this, we developed and validated an enhanced AF detection algorithm. Atrial fibrillation detection in Reveal LINQ ICM uses patterns of incoherence in RR intervals and absence of P-wave evidence over a 2-min period. The enhanced algorithm includes P-wave evidence during RR irregularity as evidence of sinus arrhythmia or ectopy to adaptively optimize sensitivity for AF detection. The algorithm was developed and validated using Holter data from the XPECT and LINQ Usability studies which collected surface electrocardiogram (ECG) and continuous ICM ECG over a 24-48 h period. The algorithm detections were compared with Holter annotations, performed by multiple reviewers, to compute episode and duration detection performance. The validation dataset comprised of 3187 h of valid Holter and LINQ recordings from 138 patients, with true AF in 37 patients yielding 108 true AF episodes ≥2-min and 449 h of AF. The enhanced algorithm reduced inappropriately detected episodes by 49% and duration by 66% with adapts sensitivity for AF detection reduced inappropriately detected episodes and duration with minimal reduction in sensitivity. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Cardiology

  8. Right ventricular function assessed by 2D strain analysis predicts ventricular arrhythmias and sudden cardiac death in patients after acute myocardial infarction

    DEFF Research Database (Denmark)

    Risum, Niels; Valeur, Nana; Søgaard, Peter

    2017-01-01

    Aims: Left ventricular function is a well-established predictor of malignant ventricular arrhythmias, but little is known about the importance of right ventricular (RV) function. The aim of this study was to investigate the importance of RV function for prediction of sudden cardiac death (SCD) or...

  9. Noninvasive cardiac activation imaging of ventricular arrhythmias during drug-induced QT prolongation in the rabbit heart.

    Science.gov (United States)

    Han, Chengzong; Pogwizd, Steven M; Killingsworth, Cheryl R; Zhou, Zhaoye; He, Bin

    2013-10-01

    Imaging myocardial activation from noninvasive body surface potentials promises to aid in both cardiovascular research and clinical medicine. To investigate the ability of a noninvasive 3-dimensional cardiac electrical imaging technique for characterizing the activation patterns of dynamically changing ventricular arrhythmias during drug-induced QT prolongation in rabbits. Simultaneous body surface potential mapping and 3-dimensional intracardiac mapping were performed in a closed-chest condition in 8 rabbits. Data analysis was performed on premature ventricular complexes, couplets, and torsades de pointes (TdP) induced during intravenous administration of clofilium and phenylephrine with combinations of various infusion rates. The drug infusion led to a significant increase in the QT interval (from 175 ± 7 to 274 ± 31 ms) and rate-corrected QT interval (from 183 ± 5 to 262 ± 21 ms) during the first dose cycle. All the ectopic beats initiated by a focal activation pattern. The initial beat of TdPs arose at the focal site, whereas the subsequent beats were due to focal activity from different sites or 2 competing focal sites. The imaged results captured the dynamic shift of activation patterns and were in good correlation with the simultaneous measurements, with a correlation coefficient of 0.65 ± 0.02 averaged over 111 ectopic beats. Sites of initial activation were localized to be ~5 mm from the directly measured initiation sites. The 3-dimensional cardiac electrical imaging technique could localize the origin of activation and image activation sequence of TdP during QT prolongation induced by clofilium and phenylephrine in rabbits. It offers the potential to noninvasively investigate the proarrhythmic effects of drug infusion and assess the mechanisms of arrhythmias on a beat-to-beat basis. © 2013 Heart Rhythm Society. All rights reserved.

  10. Ventricular arrhythmia and sudden cardiac death in Fabry disease: a systematic review of risk factors in clinical practice.

    Science.gov (United States)

    Baig, Shanat; Edward, Nicky C; Kotecha, Dipak; Liu, Boyang; Nordin, Sabrina; Kozor, Rebecca; Moon, James C; Geberhiwot, Tarekegn; Steeds, Richard P

    2017-10-17

    Fabry disease (FD) is an X-linked lysosomal storage disorder caused by deficiency of α-galactosidase A enzyme. Cardiovascular (CV) disease is a common cause of mortality in FD, in particular as a result of heart failure and arrhythmia, with a significant proportion of events categorized as sudden. There are no clear models for risk prediction in FD. This systematic review aims to identify the risk factors for ventricular arrhythmia (VA) and sudden cardiac deaths (SCD) in FD. A systematic search was performed following PRISMA guidelines of EMBASE, Medline, PubMed, Web of Science, and Cochrane from inception to August 2016, focusing on identification of risk factors for the development of VA or SCD. Thirteen studies were included in the review (n = 4185 patients) from 1189 articles, with follow-up of 1.2-10 years. Weighted average age was 37.6 years, and 50% were male. Death from any cause was reported in 8.3%. Of these, 75% was due to CV problems, with the majority being SCD events (62% of reported deaths). Ventricular tachycardia was reported in 7 studies, with an average prevalence of 15.3%. Risk factors associated with SCD events were age, male gender, left ventricular hypertrophy, late gadolinium enhancement on CV magnetic resonance imaging, and non-sustained ventricular tachycardia. Although a multi-system disease, FD is a predominantly cardiac disease from a mortality perspective, with death mainly from SCD events. Limited evidence highlights the importance of clinical and imaging risk factors that could contribute to improved decision-making in the management of FD. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  11. Inhibition of N-type Ca2+ channels ameliorates an imbalance in cardiac autonomic nerve activity and prevents lethal arrhythmias in mice with heart failure.

    Science.gov (United States)

    Yamada, Yuko; Kinoshita, Hideyuki; Kuwahara, Koichiro; Nakagawa, Yasuaki; Kuwabara, Yoshihiro; Minami, Takeya; Yamada, Chinatsu; Shibata, Junko; Nakao, Kazuhiro; Cho, Kosai; Arai, Yuji; Yasuno, Shinji; Nishikimi, Toshio; Ueshima, Kenji; Kamakura, Shiro; Nishida, Motohiro; Kiyonaka, Shigeki; Mori, Yasuo; Kimura, Takeshi; Kangawa, Kenji; Nakao, Kazuwa

    2014-10-01

    Dysregulation of autonomic nervous system activity can trigger ventricular arrhythmias and sudden death in patients with heart failure. N-type Ca(2+) channels (NCCs) play an important role in sympathetic nervous system activation by regulating the calcium entry that triggers release of neurotransmitters from peripheral sympathetic nerve terminals. We have investigated the ability of NCC blockade to prevent lethal arrhythmias associated with heart failure. We compared the effects of cilnidipine, a dual N- and L-type Ca(2+) channel blocker, with those of nitrendipine, a selective L-type Ca(2+) channel blocker, in transgenic mice expressing a cardiac-specific, dominant-negative form of neuron-restrictive silencer factor (dnNRSF-Tg). In this mouse model of dilated cardiomyopathy leading to sudden arrhythmic death, cardiac structure and function did not significantly differ among the control, cilnidipine, and nitrendipine groups. However, cilnidipine dramatically reduced arrhythmias in dnNRSF-Tg mice, significantly improving their survival rate and correcting the imbalance between cardiac sympathetic and parasympathetic nervous system activity. A β-blocker, bisoprolol, showed similar effects in these mice. Genetic titration of NCCs, achieved by crossing dnNRSF-Tg mice with mice lacking CACNA1B, which encodes the α1 subunit of NCCs, improved the survival rate. With restoration of cardiac autonomic balance, dnNRSF-Tg;CACNA1B(+/-) mice showed fewer malignant arrhythmias than dnNRSF-Tg;CACNA1B(+/+) mice. Both pharmacological blockade of NCCs and their genetic titration improved cardiac autonomic balance and prevented lethal arrhythmias in a mouse model of dilated cardiomyopathy and sudden arrhythmic death. Our findings suggest that NCC blockade is a potentially useful approach to preventing sudden death in patients with heart failure. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  12. Multimodality Cardiac Imaging for the Assessment of Left Atrial Function and the Association With Atrial Arrhythmias

    DEFF Research Database (Denmark)

    Olsen, Flemming Javier; Bertelsen, Litten; de Knegt, Martina Chantal

    2016-01-01

    Several cardiac imaging modalities are able to visualize the left atrium (LA) and, therefore, allow for quantification of both structural and functional properties of this cardiac chamber. In echocardiography, only the maximal LA volume is included in the assessment of diastolic function at the c......Several cardiac imaging modalities are able to visualize the left atrium (LA) and, therefore, allow for quantification of both structural and functional properties of this cardiac chamber. In echocardiography, only the maximal LA volume is included in the assessment of diastolic function...... atrial fibrillation, which will be a point of focus in this review. Pivotal cardiac magnetic resonance imaging studies have revealed high correlation between LA fibrosis and risk of atrial fibrillation recurrence after catheter ablation, and subsequent multimodality imaging studies have uncovered...... an inverse relationship between LA reservoir function and degree of LA fibrosis. This has sparked an increased interest into the application of advanced imaging modalities, including both speckle tracking echocardiography and tissue tracking by cardiac magnetic resonance imaging. Even though increasing...

  13. Toxicokinetics of ibogaine and noribogaine in a patient with prolonged multiple cardiac arrhythmias after ingestion of internet purchased ibogaine.

    Science.gov (United States)

    Henstra, Marieke; Wong, Liza; Chahbouni, Abdel; Swart, Noortje; Allaart, Cor; Sombogaard, Ferdi

    2017-07-01

    Ibogaine is an agent that has been evaluated as an unapproved anti-addictive agent for the management of drug dependence. Sudden cardiac death has been described to occur secondary to its use. We describe the clinical effects and toxicokinetics of ibogaine and noribogaine in a single patient. For this purpose, we developed a LC-MS/MS-method to measure ibogaine and noribogaine plasma-concentrations. We used two compartments with first order absorption. The maximum concentration of ibogaine was 1.45 mg/L. Our patient developed markedly prolonged QTc interval of 647ms maximum, several multiple cardiac arrhythmias (i.e., atrial tachycardia and ventricular tachycardia and Torsades des Pointes). QTc-prolongation remained present until 12 days after ingestion, several days after ibogaine plasma-levels were low, implicating clinically relevant noribogaine concentrations long after ibogaine had been cleared from the plasma. The ratio k 12 /k 21 for noribogaine was 21.5 and 4.28 for ibogaine, implicating a lower distribution of noribogaine from the peripheral compartment into the central compartment compared to ibogaine. We demonstrated a linear relationship between the concentration of the metabolite and long duration of action, rather than with parent ibogaine. Therefore, after (prolonged) ibogaine ingestion, clinicians should beware of long-term effects due to its metabolite.

  14. Safe Oral Triiodo-L-Thyronine Therapy Protects from Post-Infarct Cardiac Dysfunction and Arrhythmias without Cardiovascular Adverse Effects.

    Directory of Open Access Journals (Sweden)

    Viswanathan Rajagopalan

    Full Text Available A large body of evidence suggests that thyroid hormones (THs are beneficial for the treatment of cardiovascular disorders. We have shown that 3 days of triiodo-L-thyronine (T3 treatment in myocardial infarction (MI rats increased left ventricular (LV contractility and decreased myocyte apoptosis. However, no clinically translatable protocol is established for T3 treatment of ischemic heart disease. We hypothesized that low-dose oral T3 will offer safe therapeutic benefits in MI.Adult female rats underwent left coronary artery ligation or sham surgeries. T3 (~6 μg/kg/day was available in drinking water ad libitum immediately following MI and continuing for 2 month(s (mo. Compared to vehicle-treated MI, the oral T3-treated MI group at 2 mo had markedly improved anesthetized Magnetic Resonance Imaging-based LV ejection fraction and volumes without significant negative changes in heart rate, serum TH levels or heart weight, indicating safe therapy. Remarkably, T3 decreased the incidence of inducible atrial tachyarrhythmias by 88% and improved remodeling. These were accompanied by restoration of gene expression involving several key pathways including thyroid, ion channels, fibrosis, sympathetic, mitochondria and autophagy.Low-dose oral T3 dramatically improved post-MI cardiac performance, decreased atrial arrhythmias and cardiac remodeling, and reversed many adverse changes in gene expression with no observable negative effects. This study also provides a safe and effective treatment/monitoring protocol that should readily translate to humans.

  15. Applications of Dynamic Clamp to Cardiac Arrhythmia Research: Role in Drug Target Discovery and Safety Pharmacology Testing

    Directory of Open Access Journals (Sweden)

    Francis A. Ortega

    2018-01-01

    Full Text Available Dynamic clamp, a hybrid-computational-experimental technique that has been used to elucidate ionic mechanisms underlying cardiac electrophysiology, is emerging as a promising tool in the discovery of potential anti-arrhythmic targets and in pharmacological safety testing. Through the injection of computationally simulated conductances into isolated cardiomyocytes in a real-time continuous loop, dynamic clamp has greatly expanded the capabilities of patch clamp outside traditional static voltage and current protocols. Recent applications include fine manipulation of injected artificial conductances to identify promising drug targets in the prevention of arrhythmia and the direct testing of model-based hypotheses. Furthermore, dynamic clamp has been used to enhance existing experimental models by addressing their intrinsic limitations, which increased predictive power in identifying pro-arrhythmic pharmacological compounds. Here, we review the recent advances of the dynamic clamp technique in cardiac electrophysiology with a focus on its future role in the development of safety testing and discovery of anti-arrhythmic drugs.

  16. O-GlcNAcylation of cardiac Nav1.5 contributes to the development of arrhythmias in diabetic hearts.

    Science.gov (United States)

    Yu, Peng; Hu, Lili; Xie, Jinyan; Chen, Sisi; Huang, Lin; Xu, Zixuan; Liu, Xiao; Zhou, Qiongqiong; Yuan, Ping; Yan, Xia; Jin, Jiejin; Shen, Yang; Zhu, Wengen; Fu, Linghua; Chen, Qi; Yu, Jianhua; Hu, Jianxin; Cao, Qing; Wan, Rong; Hong, Kui

    2018-06-01

    Cardiovascular complications are major causes of mortality and morbidity in diabetic patients. The mechanisms underlying the progression of diabetic heart (DH) to ventricular arrhythmias are unclear. O-linked GlcNAcylation (O-GlcNAc) is a reversible post-translational modification for the regulation of diverse cellular processes. The purpose of this study was to assess whether the cardiac voltage-gated sodium channel (Nav1.5) is subjected to O-linked GlcNAcylation (O-GlcNAc), which plays an essential role in DH-induced arrhythmias. In this study, Sprague-Dawley rats (male, 200-230 g) were treated with a single high-dose of streptozotocin (STZ, 80 mg/kg) to generate a rat model of diabetes. STZ-induced 3-month diabetic rats displayed increased susceptibility to ventricular arrhythmias. The elevated O-GlcNAc modification was correlated with decreases in both total and cytoplasmic Nav1.5 expression in vivo and in vitro. In addition, both co-immunoprecipitation and immunostaining assays demonstrated that hyperglycemia could increase the O-GlcNAc-modified Nav1.5 levels and decrease the interaction between Nav1.5 and Nav1.5-binding proteins Nedd4-2/SAP-97. Furthermore, patch-clamp measurements in HEK-293 T cells showed that Nav1.5 current densities decreased by 30% after high-glucose treatment, and the sodium currents increased via O-GlcNAc inhibition. Our data suggested that hyperglycemia increased the O-GlcNAc modification of Nav1.5 expression and decreased the interaction between Nav1.5 and Nedd4-2/SAP-97, which led to the abnormal expression and distribution of Nav1.5, loss of function of the sodium channel, and prolongation of the PR/QT interval. Excessive O-GlcNAc modification of Nav1.5 is a novel signaling event, which may be an underlying contributing factor for the development of the arrhythmogenesis in DH. Copyright © 2017. Published by Elsevier B.V.

  17. Dental caries, periodontal disease, and cardiac arrhythmias in community-dwelling older persons aged 80 and older: is there a link?

    DEFF Research Database (Denmark)

    Holm-Pedersen, Poul; Avlund, Kirsten; Morse, Douglas E

    2005-01-01

    lesions had 2.8 times higher odds (95% confidence interval=1.1-7.0) of arrhythmia than persons without active coronal caries, but there was no greater risk for persons with three or more coronal caries lesions. There was no association between periodontal disease and arrhythmia. CONCLUSION: The findings......OBJECTIVES: To examine whether caries or periodontitis is associated with cardiac arrhythmias in community-dwelling people aged 80 and older. SETTING: Urban, community-based population in Stockholm, Sweden. DESIGN: Cross-sectional. PARTICIPANTS: Eligible persons were identified through...... by a physician or the Stockholm Inpatient Register. Active root caries, active coronal caries, and periodontitis were assessed using previously defined National Institute of Dental and Craniofacial Research diagnostic criteria. RESULTS: The primary finding of the multivariate logistic regression analysis...

  18. Derivation of Human Induced Pluripotent Stem (iPS) Cells to Heritable Cardiac Arrhythmias

    Science.gov (United States)

    2017-08-10

    Inherited Cardiac Arrythmias; Long QT Syndrome (LQTS); Brugada Syndrome (BrS); Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT); Early Repolarization Syndrome (ERS); Arrhythmogenic Cardiomyopathy (AC, ARVD/C); Hypertrophic Cardiomyopathy (HCM); Dilated Cardiomyopathy (DCM); Muscular Dystrophies (Duchenne, Becker, Myotonic Dystrophy); Normal Control Subjects

  19. Mechanical Dyssynchrony by Tissue Doppler Cross-Correlation is Associated with Risk for Complex Ventricular Arrhythmias after Cardiac Resynchronization Therapy

    DEFF Research Database (Denmark)

    Tayal, Bhupendar; Gorcsan, John; Delgado-Montero, Antonia

    2015-01-01

    BACKGROUND: Tissue Doppler cross-correlation analysis has been shown to be associated with long-term survival after cardiac resynchronization defibrillator therapy (CRT-D). Its association with ventricular arrhythmia (VA) is unknown. METHODS: From two centers 151 CRT-D patients (New York Heart...... Association functional classes II-IV, ejection fraction ≤ 35%, and QRS duration ≥ 120 msec) were prospectively included. Tissue Doppler cross-correlation analysis of myocardial acceleration curves from the basal segments in the apical views both at baseline and 6 months after CRT-D implantation was performed...... with a substantially increased risk for VA (hazard ratio [HR], 4.4; 95% CI, 1.2-16.3; P = .03) and VA or death (HR, 4.0; 95% CI, 1.7-9.6; P = .002) after adjusting for other covariates. Similarly, patients with new dyssynchrony had increased risk for VA (HR, 10.6; 95% CI, 2.8-40.4; P = .001) and VA or death (HR, 5...

  20. Is exposure to ionising radiation associated with childhood cardiac arrhythmia in the Russian territories contaminated by the Chernobyl fallout? A cross-sectional population-based study.

    Science.gov (United States)

    Jourdain, Jean-Rene; Landon, Geraldine; Clero, Enora; Doroshchenko, Vladimir; Silenok, Aleksandr; Kurnosova, Irina; Butsenin, Andrei; Denjoy, Isabelle; Franck, Didier; Heuze, Jean-Pierre; Gourmelon, Patrick

    2018-03-25

    To investigate childhood cardiac arrhythmia and chronic exposure to caesium-137 ( 137 Cs) resulting from the Chernobyl accident. Prospective cross-sectional study using exposed/unexposed design conducted in the Bryansk region from May 2009 to May 2013 on children selected on the basis of 137 Cs soil deposition: control territories ([ 137 Cs]555 kBq per square metre, where children were considered as exposed). Russian territories affected by the Chernobyl fallout (Bryansk region). This cross-sectional study included 18 152 children aged 2-18 years and living in the Bryansk region (Russia). All children received three medical examinations (ECG, echocardiography and 137 Cs whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests. Cardiac arrhythmia was diagnosed in 1172 children living in contaminated territories and 1354 children living in control territories. The crude prevalence estimated to 13.3% in contaminated territories was significantly lower than in control territories with 15.2% over the period 2009-2013 (PChernobyl fallout. The suspected increase of cardiac arrhythmia in children exposed to Chernobyl fallout is not confirmed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Use of asymmetric bidirectional catheters with different curvature radius for catheter ablation of cardiac arrhythmias.

    Science.gov (United States)

    Mantziari, Lilian; Suman-Horduna, Irina; Gujic, Marko; Jones, David G; Wong, Tom; Markides, Vias; Foran, John P; Ernst, Sabine

    2013-06-01

    The impact of recently introduced asymmetric bidirectional ablation catheters on procedural parameters and acute success rates of ablation procedures is unknown. We retrospectively analyzed data regarding ablations using a novel bidirectional catheter in a tertiary cardiac center and compared these in 1:5 ratio with a control group of procedures matched for age, gender, operator, and ablation type. A total of 50 cases and 250 controls of median age 60 (50-68) years were studied. Structural heart disease was equally prevalent in both groups (39%) while history of previous ablations was more common in the study arm (54% vs 30%, P = 0.001). Most of the ablation cases were for atrial fibrillation (46%), followed by atrial tachycardia (28%), supraventricular tachycardia (12%), and ventricular tachycardia (14%). Median procedure duration was 128 (52-147) minutes with the bidirectional, versus 143 (105-200) minutes with the conventional catheter (P = 0.232), and median fluoroscopy time was 17 (10-34) minutes versus 23 (12-39) minutes, respectively (P = 0.988). There was a trend toward a lower procedure duration for the atrial tachycardia ablations, 89 (52-147) minutes versus 130 (100-210) minutes, P = 0.064. The procedure was successfully completed in 96% of the bidirectional versus 84% of the control cases (P = 0.151). A negative correlation was observed between the relative fluoroscopy duration and the case number (r = -0.312, P = 0.028), reflecting the learning curve for the bidirectional catheter. The introduction of the bidirectional catheter resulted in no prolongation of procedure parameters and similar success rates, while there was a trend toward a lower procedure duration for atrial tachycardia ablations. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  2. Mobile Cardiac Health-care Monitoring and Notification with Real Time Tachycardia and Bradycardia Arrhythmia Detection.

    Science.gov (United States)

    Golzar, Mina; Fotouhi-Ghazvini, Faranak; Rabbani, Hossein; Zakeri, Fahimeh Sadat

    2017-01-01

    The increasing trend of heart disease has turned the attention of researchers toward the use of portable connected technologies. The necessity of continuous special care for cardiovascular patients is an inevitable fact. In this research, a new wireless electrocardiographic (ECG) signal-monitoring system based on smartphone is presented. This system has two main sections. The first section consists of a sensor which receives ECG signals via an amplifier, then filters and digitizes the signal, and prepares it to be transmitted. The signals are stored, processed, and then displayed in a mobile application. The application alarms in dangerous situations and sends the location of the cardiac patient to family or health-care staff. The results obtained from the analysis of the electrocardiogram signals on 20 different people have been compared with the traditional ECG in hospital by a cardiologist. The signal is instantly transmitted by 200 sample per second to mobile phone. The raw data are processed, the anomaly is detected, and the signal is drawn on the interface in about 70 s. Therefore, the delay is not noticeable by the patient. With respect to rate of data transmission to hospital, different internet connections such as 2G, 3G, 4G, WiFi, WiMax, or Long-Term Evolution (LTE) could be used. Data transmission ranges from 9.6 kbps to 20 Mbps. Therefore, the physician could receive data with no delay. A performance accuracy of 91.62% is obtained from the wireless ECG system. It conforms to the hospital's diagnostic standard system while providing a portable monitoring anywhere at anytime.

  3. Relationships between cardiac innervation/perfusion imbalance and ventricular arrhythmias: impact on invasive electrophysiological parameters and ablation procedures

    International Nuclear Information System (INIS)

    Gimelli, Alessia; Menichetti, Francesca; Soldati, Ezio; Liga, Riccardo; Vannozzi, Andrea; Bongiorni, Maria Grazia; Marzullo, Paolo

    2016-01-01

    To assess the relationship between regional myocardial perfusion and sympathetic innervation parameters at myocardial scintigraphy and intra-cavitary electrophysiological data in patients with ventricular arrhythmias (VA) submitted to invasive electrophysiological study and ablation procedure. Sixteen subjects underwent invasive electrophysiological study with electroanatomical mapping (EAM) followed by trans-catheter ablations of VA. Before ablation all patients were studied with a combined evaluation of regional myocardial perfusion and sympathetic innervation by means of tomographic "9"9"mTc-tetrofosmin and "1"2"3I- metaiodobenzylguanidine cadmium-zinc-telluride (CZT) scintigraphies, respectively. Off-line spatial co-registration of CZT perfusion and innervation data with the three-dimensional EAM reconstruction was performed in every patient. CZT revealed the presence of myocardial scar in 55 (20 %) segments. Of the viable myocardial segments, 131 (60 %) presented a preserved adrenergic innervation, while 86 (40 %) showed a significantly depressed innervation (i.e. innervation/perfusion mismatch). On EAM, the invasively measured intra-cavitary voltage was significantly lower in scarred segments than in viable ones (1.7 ± 1.5 mV vs. 4.0 ± 2.2 mV, P < 0.001). Interestingly, among the viable segments, those showing an innervation/perfusion mismatch presented a significantly lower intra-cavitary voltage than those with preserved innervation (1.9 ± 2.5 mV vs. 4.7 ± 2.3 mV, P < 0.001). Intra-cardiac ablation was performed in 63 (23 %) segments. On multivariate analysis, after correction for scar burden, the segments showing an innervation/perfusion mismatch remained the most frequent ablation targets (OR 5.6, 95 % CI 1.5-20.8; P = 0.009). In patients with VA, intra-cavitary electrical abnormalities frequently originate at the level of viable myocardial segments with depressed sympathetic innervation that frequently represents the ultimate ablation target. (orig.)

  4. Relationships between cardiac innervation/perfusion imbalance and ventricular arrhythmias: impact on invasive electrophysiological parameters and ablation procedures

    Energy Technology Data Exchange (ETDEWEB)

    Gimelli, Alessia [Fondazione Toscana Gabriele Monasterio, Pisa (Italy); Menichetti, Francesca; Soldati, Ezio; Liga, Riccardo; Vannozzi, Andrea; Bongiorni, Maria Grazia [University Hospital of Pisa, Cardio-Thoracic and Vascular Department, Pisa (Italy); Marzullo, Paolo [Fondazione Toscana Gabriele Monasterio, Pisa (Italy); CNR, Institute of Clinical Physiology, Pisa (Italy)

    2016-12-15

    To assess the relationship between regional myocardial perfusion and sympathetic innervation parameters at myocardial scintigraphy and intra-cavitary electrophysiological data in patients with ventricular arrhythmias (VA) submitted to invasive electrophysiological study and ablation procedure. Sixteen subjects underwent invasive electrophysiological study with electroanatomical mapping (EAM) followed by trans-catheter ablations of VA. Before ablation all patients were studied with a combined evaluation of regional myocardial perfusion and sympathetic innervation by means of tomographic {sup 99m}Tc-tetrofosmin and {sup 123}I- metaiodobenzylguanidine cadmium-zinc-telluride (CZT) scintigraphies, respectively. Off-line spatial co-registration of CZT perfusion and innervation data with the three-dimensional EAM reconstruction was performed in every patient. CZT revealed the presence of myocardial scar in 55 (20 %) segments. Of the viable myocardial segments, 131 (60 %) presented a preserved adrenergic innervation, while 86 (40 %) showed a significantly depressed innervation (i.e. innervation/perfusion mismatch). On EAM, the invasively measured intra-cavitary voltage was significantly lower in scarred segments than in viable ones (1.7 ± 1.5 mV vs. 4.0 ± 2.2 mV, P < 0.001). Interestingly, among the viable segments, those showing an innervation/perfusion mismatch presented a significantly lower intra-cavitary voltage than those with preserved innervation (1.9 ± 2.5 mV vs. 4.7 ± 2.3 mV, P < 0.001). Intra-cardiac ablation was performed in 63 (23 %) segments. On multivariate analysis, after correction for scar burden, the segments showing an innervation/perfusion mismatch remained the most frequent ablation targets (OR 5.6, 95 % CI 1.5-20.8; P = 0.009). In patients with VA, intra-cavitary electrical abnormalities frequently originate at the level of viable myocardial segments with depressed sympathetic innervation that frequently represents the ultimate ablation target

  5. Genetically engineered excitable cardiac myofibroblasts coupled to cardiomyocytes rescue normal propagation and reduce arrhythmia complexity in heterocellular monolayers.

    Directory of Open Access Journals (Sweden)

    Luqia Hou

    Full Text Available The use of genetic engineering of unexcitable cells to enable expression of gap junctions and inward rectifier potassium channels has suggested that cell therapies aimed at establishing electrical coupling of unexcitable donor cells to host cardiomyocytes may be arrhythmogenic. Whether similar considerations apply when the donor cells are electrically excitable has not been investigated. Here we tested the hypothesis that adenoviral transfer of genes coding Kir2.1 (I(K1, Na(V1.5 (I(Na and connexin-43 (Cx43 proteins into neonatal rat ventricular myofibroblasts (NRVF will convert them into fully excitable cells, rescue rapid conduction velocity (CV and reduce the incidence of complex reentry arrhythmias in an in vitro model.We used adenoviral (Ad- constructs encoding Kir2.1, Na(V1.5 and Cx43 in NRVF. In single NRVF, Ad-Kir2.1 or Ad-Na(V1.5 infection enabled us to regulate the densities of I(K1 and I(Na, respectively. At varying MOI ratios of 10/10, 5/10 and 5/20, NRVF co-infected with Ad-Kir2.1+ Na(V1.5 were hyperpolarized and generated action potentials (APs with upstroke velocities >100 V/s. However, when forming monolayers only the addition of Ad-Cx43 made the excitable NRVF capable of conducting electrical impulses (CV = 20.71±0.79 cm/s. When genetically engineered excitable NRVF overexpressing Kir2.1, Na(V1.5 and Cx43 were used to replace normal NRVF in heterocellular monolayers that included neonatal rat ventricular myocytes (NRVM, CV was significantly increased (27.59±0.76 cm/s vs. 21.18±0.65 cm/s, p<0.05, reaching values similar to those of pure myocytes monolayers (27.27±0.72 cm/s. Moreover, during reentry, propagation was faster and more organized, with a significantly lower number of wavebreaks in heterocellular monolayers formed by excitable compared with unexcitable NRVF.Viral transfer of genes coding Kir2.1, Na(V1.5 and Cx43 to cardiac myofibroblasts endows them with the ability to generate and propagate APs. The results

  6. Acebutolol in Cardiac Arrhythmias

    African Journals Online (AJOL)

    1974-04-20

    Apr 20, 1974 ... of VPSs in 1 patient with digitalis excess, and was. -ineffective in the other 2. It was given orally in another. 3 patients; it reduced the number of VPSs per minute in one, was effective for a short period in another, and was ineffective in the third. Ventricular tachycardia (VT). Acebutolol was given intravenously ...

  7. In Search of Hidden Arrhythmia

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2015-10-01

    Full Text Available Cardiac rhythm disorders could be very common and minimal significance like isolated ventricular ectopics are very serious and life threatening like ventricular tachycardia or fibrillation. Often it is an irregular pulse or heart beats which calls our attention to the presence of cardiac rhythm disorders. But many times, cardiac arrhythmia is intermittent and not manifest at the time of physical examination. A simple 12 lead electrocardiogram with a long rhythm strip can document cardiac arrhythmia which is frequent, but often fails to record intermittent arrhythmia which can still be quite symptomatic and sometimes life threatenting. This brief review is on the various modalities of electrocardiographic recordings used for documenting arrhythmia which is not easily documented by a 12 lead electrocardiogram with a long rhythm strip.

  8. Growth factor-induced mobilization of cardiac progenitor cells reduces the risk of arrhythmias, in a rat model of chronic myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Leonardo Bocchi

    Full Text Available Heart repair by stem cell treatment may involve life-threatening arrhythmias. Cardiac progenitor cells (CPCs appear best suited for reconstituting lost myocardium without posing arrhythmic risks, being commissioned towards cardiac phenotype. In this study we tested the hypothesis that mobilization of CPCs through locally delivered Hepatocyte Growth Factor and Insulin-Like Growth Factor-1 to heal chronic myocardial infarction (MI, lowers the proneness to arrhythmias. We used 133 adult male Wistar rats either with one-month old MI and treated with growth factors (GFs, n = 60 or vehicle (V, n = 55, or sham operated (n = 18. In selected groups of animals, prior to and two weeks after GF/V delivery, we evaluated stress-induced ventricular arrhythmias by telemetry-ECG, cardiac mechanics by echocardiography, and ventricular excitability, conduction velocity and refractoriness by epicardial multiple-lead recording. Invasive hemodynamic measurements were performed before sacrifice and eventually the hearts were subjected to anatomical, morphometric, immunohistochemical, and molecular biology analyses. When compared with untreated MI, GFs decreased stress-induced arrhythmias and concurrently prolonged the effective refractory period (ERP without affecting neither the duration of ventricular repolarization, as suggested by measurements of QTc interval and mRNA levels for K-channel α-subunits Kv4.2 and Kv4.3, nor the dispersion of refractoriness. Further, markers of cardiomyocyte reactive hypertrophy, including mRNA levels for K-channel α-subunit Kv1.4 and β-subunit KChIP2, interstitial fibrosis and negative structural remodeling were significantly reduced in peri-infarcted/remote ventricular myocardium. Finally, analyses of BrdU incorporation and distribution of connexin43 and N-cadherin indicated that cytokines generated new vessels and electromechanically-connected myocytes and abolished the correlation of infarct size with deterioration

  9. Ambulatory cardiac arrhythmias in relation to mild hypokalaemia and prognosis in community dwelling middle-aged and elderly subjects

    DEFF Research Database (Denmark)

    Mattsson, Nick; Sadjadieh, Golnaz; Kumarathurai, Preman

    2016-01-01

    with frequency of premature ventricular complexes (PVCs) especially in combination with diuretic treatment (r = -0.22, P = 0.015). Hypokalaemia was not associated with supraventricular arrhythmias. Subjects at lowest quintile of p-potassium (mean 3.42, range 2.7-3.6 mmol/L) were defined as hypokalaemic......, 10 and 15 per 1000 patient-year in those with one abnormality, and 3 per 1000 patient-year in subjects with no abnormality. One variable combining hypokalaemia with excessive supraventricular arrhythmias gave similar results in univariate analysis, but not after multivariate adjustments. CONCLUSION...

  10. ECG-based 4D-dose reconstruction of cardiac arrhythmia ablation with carbon ion beams: application in a porcine model

    Science.gov (United States)

    Richter, Daniel; Immo Lehmann, H.; Eichhorn, Anna; Constantinescu, Anna M.; Kaderka, Robert; Prall, Matthias; Lugenbiel, Patrick; Takami, Mitsuru; Thomas, Dierk; Bert, Christoph; Durante, Marco; Packer, Douglas L.; Graeff, Christian

    2017-09-01

    Noninvasive ablation of cardiac arrhythmia by scanned particle radiotherapy is highly promising, but especially challenging due to cardiac and respiratory motion. Irradiations for catheter-free ablation in intact pigs were carried out at the GSI Helmholtz Center in Darmstadt using scanned carbon ions. Here, we present real-time electrocardiogram (ECG) data to estimate time-resolved (4D) delivered dose. For 11 animals, surface ECGs and temporal structure of beam delivery were acquired during irradiation. R waves were automatically detected from surface ECGs. Pre-treatment ECG-triggered 4D-CT phases were synchronized to the R-R interval. 4D-dose calculation was performed using GSI’s in-house 4D treatment planning system. Resulting dose distributions were assessed with respect to coverage (D95 and V95), heterogeneity (HI  =  D5-D95) and normal tissue exposure. Final results shown here were performed offline, but first calculations were started shortly after irradiation The D95 for TV and PTV was above 95% for 10 and 8 out of 11 animals, respectively. HI was reduced for PTV versus TV volumes, especially for some of the animals targeted at the atrioventricular junction, indicating residual interplay effects due to cardiac motion. Risk structure exposure was comparable to static and 4D treatment planning simulations. ECG-based 4D-dose reconstruction is technically feasible in a patient treatment-like setting. Further development of the presented approach, such as real-time dose calculation, may contribute to safe, successful treatments using scanned ion beams for cardiac arrhythmia ablation.

  11. A model of cardiac ryanodine receptor gating predicts experimental Ca2+-dynamics and Ca2+-triggered arrhythmia in the long QT syndrome

    Science.gov (United States)

    Wilson, Dan; Ermentrout, Bard; Němec, Jan; Salama, Guy

    2017-09-01

    Abnormal Ca2+ handling is well-established as the trigger of cardiac arrhythmia in catecholaminergic polymorphic ventricular tachycardia and digoxin toxicity, but its role remains controversial in Torsade de Pointes (TdP), the arrhythmia associated with the long QT syndrome (LQTS). Recent experimental results show that early afterdepolarizations (EADs) that initiate TdP are caused by spontaneous (non-voltage-triggered) Ca2+ release from Ca2+-overloaded sarcoplasmic reticulum (SR) rather than the activation of the L-type Ca2+-channel window current. In bradycardia and long QT type 2 (LQT2), a second, non-voltage triggered cytosolic Ca2+ elevation increases gradually in amplitude, occurs before overt voltage instability, and then precedes the rise of EADs. Here, we used a modified Shannon-Puglisi-Bers model of rabbit ventricular myocytes to reproduce experimental Ca2+ dynamics in bradycardia and LQT2. Abnormal systolic Ca2+-oscillations and EADs caused by SR Ca2+-release are reproduced in a modified 0-dimensional model, where 3 gates in series control the ryanodine receptor (RyR2) conductance. Two gates control RyR2 activation and inactivation and sense cytosolic Ca2+ while a third gate senses luminal junctional SR Ca2+. The model predicts EADs in bradycardia and low extracellular [K+] and cessation of SR Ca2+-release terminate salvos of EADs. Ca2+-waves, systolic cell-synchronous Ca2+-release, and multifocal diastolic Ca2+ release seen in subcellular Ca2+-mapping experiments are observed in the 2-dimensional version of the model. These results support the role of SR Ca2+-overload, abnormal SR Ca2+-release, and the subsequent activation of the electrogenic Na+/Ca2+-exchanger as the mechanism of TdP. The model offers new insights into the genesis of cardiac arrhythmia and new therapeutic strategies.

  12. Genetic mutation in Korean patients of sudden cardiac arrest as a surrogating marker of idiopathic ventricular arrhythmia.

    Science.gov (United States)

    Son, Myoung Kyun; Ki, Chang-Seok; Park, Seung-Jung; Huh, June; Kim, June Soo; On, Young Keun

    2013-07-01

    Mutation or common intronic variants in cardiac ion channel genes have been suggested to be associated with sudden cardiac death caused by idiopathic ventricular tachyarrhythmia. This study aimed to find mutations in cardiac ion channel genes of Korean sudden cardiac arrest patients with structurally normal heart and to verify association between common genetic variation in cardiac ion channel and sudden cardiac arrest by idiopathic ventricular tachyarrhythmia in Koreans. Study participants were Korean survivors of sudden cardiac arrest caused by idiopathic ventricular tachycardia or fibrillation. All coding exons of the SCN5A, KCNQ1, and KCNH2 genes were analyzed by Sanger sequencing. Fifteen survivors of sudden cardiac arrest were included. Three male patients had mutations in SCN5A gene and none in KCNQ1 and KCNH2 genes. Intronic variant (rs2283222) in KCNQ1 gene showed significant association with sudden cardiac arrest (OR 4.05). Four male sudden cardiac arrest survivors had intronic variant (rs11720524) in SCN5A gene. None of female survivors of sudden cardiac arrest had SCN5A gene mutations despite similar frequencies of intronic variants between males and females in 55 normal controls. Common intronic variant in KCNQ1 gene is associated with sudden cardiac arrest caused by idiopathic ventricular tachyarrhythmia in Koreans.

  13. Ventricular arrhythmias in Chagas disease

    Directory of Open Access Journals (Sweden)

    Marco Paulo Tomaz Barbosa

    2015-02-01

    Full Text Available Sudden death is one of the most characteristic phenomena of Chagas disease, and approximately one-third of infected patients develop life-threatening heart disease, including malignant ventricular arrhythmias. Fibrotic lesions secondary to chronic cardiomyopathy produce arrhythmogenic substrates that lead to the appearance and maintenance of ventricular arrhythmias. The objective of this study is to discuss the main clinical and epidemiological aspects of ventricular arrhythmias in Chagas disease, the specific workups and treatments for these abnormalities, and the breakthroughs needed to determine a more effective approach to these arrhythmias. A literature review was performed via a search of the PubMed database from 1965 to May 31, 2014 for studies of patients with Chagas disease. Clinical management of patients with chronic Chagas disease begins with proper clinical stratification and the identification of individuals at a higher risk of sudden cardiac death. Once a patient develops malignant ventricular arrhythmia, the therapeutic approach aims to prevent the recurrence of arrhythmias and sudden cardiac death by the use of implantable cardioverter defibrillators, antiarrhythmic drugs, or both. In select cases, invasive ablation of the reentrant circuit causing tachycardia may be useful. Ventricular arrhythmias are important manifestations of Chagas cardiomyopathy. This review highlights the absence of high-quality evidence regarding the treatment of ventricular arrhythmias in Chagas disease. Recognizing high-risk patients who require specific therapies, especially invasive procedures such as the implantation of cardioverter defibrillators and ablative approaches, is a major challenge in clinical practice.

  14. Arritmias cardiacas generadas por heterogeneidad electrofisiológica: estudio mediante simulación Cardiac arrhythmias generated by electrophysiological heterogeneity: simulation study

    Directory of Open Access Journals (Sweden)

    Oscar Henao

    2007-08-01

    Full Text Available Las arritmias ventriculares usualmente se presentan como consecuencia de isquemia miocárdica aguda, lo cual causa la mayoría de las muertes súbitas. La heterogeneidad cardiaca tanto funcional (diferente comportamiento eléctrico en los miocitos como bioquímica (diferentes concentraciones iónicas en isquemia, altera el comportamiento eléctrico del ventrículo y genera dispersión en la repolarización del potencial de acción, por lo que se convierte en sustrato funcional para la generación de arritmias fatales. En este trabajo se revisan las técnicas experimentales para el estudio y la detección de arritmias por reentrada, y se valida un modelo geométrico de isquemia, en presencia de heterogeneidad eléctrica en la región transmural de la pared ventricular. Para ello se utilizaron simulaciones bidimensionales de un modelo biofísicamente detallado y se obtuvieron reentradas lobulares en diferentes configuraciones de las células M de la pared ventricular.Ventricular arrhythmias usually appear as consequence of acute myocardial ischemia, responsible for most of sudden deaths. Functional (different electrical behavior of myocytes as well as biochemical (different ionic concentrations during ischemia cardiac heterogeneity alter the ventricle electric performance and generate dispersion in the action potential repolarization that turns into functional substrate for the generation of fatal arrhythmias. In this work the experimental techniques for the study and detection of arrhythmias by re-entry are reviewed and a geometrical model of ischemia is validated in the presence of electrical heterogeneity in the trans-mural region of the ventricular wall. For this purpose, bi-dimensional simulations of a detailed biophysical model were used and lobular re-entries in different configurations of the M cells of the ventricular wall were obtained.

  15. Computers and clinical arrhythmias.

    Science.gov (United States)

    Knoebel, S B; Lovelace, D E

    1983-02-01

    Cardiac arrhythmias are ubiquitous in normal and abnormal hearts. These disorders may be life-threatening or benign, symptomatic or unrecognized. Arrhythmias may be the precursor of sudden death, a cause or effect of cardiac failure, a clinical reflection of acute or chronic disorders, or a manifestation of extracardiac conditions. Progress is being made toward unraveling the diagnostic and therapeutic problems involved in arrhythmogenesis. Many of the advances would not be possible, however, without the availability of computer technology. To preserve the proper balance and purposeful progression of computer usage, engineers and physicians have been exhorted not to work independently in this field. Both should learn some of the other's trade. The two disciplines need to come together to solve important problems with computers in cardiology. The intent of this article was to acquaint the practicing cardiologist with some of the extant and envisioned computer applications and some of the problems with both. We conclude that computer-based database management systems are necessary for sorting out the clinical factors of relevance for arrhythmogenesis, but computer database management systems are beset with problems that will require sophisticated solutions. The technology for detecting arrhythmias on routine electrocardiograms is quite good but human over-reading is still required, and the rationale for computer application in this setting is questionable. Systems for qualitative, continuous monitoring and review of extended time ECG recordings are adequate with proper noise rejection algorithms and editing capabilities. The systems are limited presently for clinical application to the recognition of ectopic rhythms and significant pauses. Attention should now be turned to the clinical goals for detection and quantification of arrhythmias. We should be asking the following questions: How quantitative do systems need to be? Are computers required for the detection of

  16. Biobehavioral Triggers of Cardiac Arrhythmia during Daily Life: The Role of Emotion, Physical Activity, and Heart Rate Variability

    National Research Council Canada - National Science Library

    McCeney, Melissa K

    2004-01-01

    Biobehavioral factors, such as physical activity and emotions, have been associated with adverse cardiac outcomes, including myocardial ischemia and infarction, in individuals with coronary artery disease...

  17. The Effect of Threshold Values and Weighting Factors on the Association between Entropy Measures and Mortality after Myocardial Infarction in the Cardiac Arrhythmia Suppression Trial (CAST

    Directory of Open Access Journals (Sweden)

    Christopher Mayer

    2016-04-01

    Full Text Available Heart rate variability (HRV is a non-invasive measurement based on the intervals between normal heart beats that characterize cardiac autonomic function. Decreased HRV is associated with increased risk of cardiovascular events. Characterizing HRV using only moment statistics fails to capture abnormalities in regulatory function that are important aspects of disease risk. Thus, entropy measures are a promising approach to quantify HRV for risk stratification. The purpose of this study was to investigate this potential for approximate, corrected approximate, sample, fuzzy, and fuzzy measure entropy and its dependency on the parameter selection. Recently, published parameter sets and further parameter combinations were investigated. Heart rate data were obtained from the "Cardiac Arrhythmia Suppression Trial (CAST RR Interval Sub-Study Database" (Physionet. Corresponding outcomes and clinical data were provided by one of the investigators. The use of previously-reported parameter sets on the pre-treatment data did not significantly add to the identification of patients at risk for cardiovascular death on follow-up. After arrhythmia suppression treatment, several parameter sets predicted outcomes for all patients and patients without coronary artery bypass grafting (CABG. The strongest results were seen using the threshold parameter as a multiple of the data’s standard deviation ( r = 0 . 2 · σ . Approximate and sample entropy provided significant hazard ratios for patients without CABG and without diabetes for an entropy maximizing threshold approximation. Additional parameter combinations did not improve the results for pre-treatment data. The results of this study illustrate the influence of parameter selection on entropy measures’ potential for cardiovascular risk stratification and support the potential use of entropy measures in future studies.

  18. Short-term Effects of High-Dose Caffeine on Cardiac Arrhythmias in Patients With Heart Failure: A Randomized Clinical Trial.

    Science.gov (United States)

    Zuchinali, Priccila; Souza, Gabriela C; Pimentel, Maurício; Chemello, Diego; Zimerman, André; Giaretta, Vanessa; Salamoni, Joyce; Fracasso, Bianca; Zimerman, Leandro I; Rohde, Luis E

    2016-12-01

    The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital. The trial included patients with chronic heart failure with moderate-to-severe systolic dysfunction (left ventricular ejection fraction capsules, in addition to 5 doses of 100 mL decaffeinated coffee at 1-hour intervals, for a total of 500 mg of caffeine or placebo during a 5-hour protocol. After a 1-week washout period, the protocol was repeated. Number and percentage of ventricular and supraventricular premature beats assessed by continuous electrocardiographic monitoring. We enrolled 51 patients (37 [74%] male; mean [SD] age, 60.6 [10.9] years) with predominantly moderate-to-severe left ventricular systolic dysfunction (mean [SD] left ventricular ejection fraction, 29% [7%]); 31 [61%] had an implantable cardioverter-defibrillator device. No significant differences between the caffeine and placebo groups were observed in the number of ventricular (185 vs 239 beats, respectively; P = .47) and supraventricular premature beats (6 vs 6 beats, respectively; P = .44), as well as in couplets, bigeminal cycles, or nonsustained tachycardia during continuous electrocardiographic monitoring. Exercise test-derived variables, such as ventricular and supraventricular premature beats, duration of exercise, estimated peak oxygen consumption, and heart rate, were not influenced by caffeine ingestion. We observed no increases in ventricular premature beats (91 vs 223 vs 207 beats, respectively

  19. High-throughput cardiac safety evaluation and multi-parameter arrhythmia profiling of cardiomyocytes using microelectrode arrays

    Energy Technology Data Exchange (ETDEWEB)

    Gilchrist, Kristin H., E-mail: kgilchrist@rti.org; Lewis, Gregory F.; Gay, Elaine A.; Sellgren, Katelyn L.; Grego, Sonia

    2015-10-15

    Microelectrode arrays (MEAs) recording extracellular field potentials of human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CM) provide a rich data set for functional assessment of drug response. The aim of this work is the development of a method for a systematic analysis of arrhythmia using MEAs, with emphasis on the development of six parameters accounting for different types of cardiomyocyte signal irregularities. We describe a software approach to carry out such analysis automatically including generation of a heat map that enables quick visualization of arrhythmic liability of compounds. We also implemented signal processing techniques for reliable extraction of the repolarization peak for field potential duration (FPD) measurement even from recordings with low signal to noise ratios. We measured hiPS-CM's on a 48 well MEA system with 5 minute recordings at multiple time points (0.5, 1, 2 and 4 h) after drug exposure. We evaluated concentration responses for seven compounds with a combination of hERG, QT and clinical proarrhythmia properties: Verapamil, Ranolazine, Flecainide, Amiodarone, Ouabain, Cisapride, and Terfenadine. The predictive utility of MEA parameters as surrogates of these clinical effects were examined. The beat rate and FPD results exhibited good correlations with previous MEA studies in stem cell derived cardiomyocytes and clinical data. The six-parameter arrhythmia assessment exhibited excellent predictive agreement with the known arrhythmogenic potential of the tested compounds, and holds promise as a new method to predict arrhythmic liability. - Highlights: • Six parameters describing arrhythmia were defined and measured for known compounds. • Software for efficient parameter extraction from large MEA data sets was developed. • The proposed cellular parameter set is predictive of clinical drug proarrhythmia.

  20. Selected Abstracts of the 2nd Congress of joint European Neonatal Societies (jENS 2017; Venice (Italy; October 31-November 4, 2017; Session "Cardiac Physiology and Pathology"

    Directory of Open Access Journals (Sweden)

    --- Various Authors

    2017-10-01

    Full Text Available Selected Abstracts of the 2nd Congress of joint European Neonatal Societies (jENS 2017; Venice (Italy; October 31-November 4, 201758th ESPR Annual Meeting, 7th International Congress of UENPS, 3rd International Congress of EFCNIORGANIZING INSTITUTIONSEuropean Society for Paediatric Research (ESPR, European Society for Neonatology (ESN, Union of European Neonatal & Perinatal Societies (UENPS, European Foundation for the Care of Newborn Infants (EFCNIORGANIZING COMMITTEELuc Zimmermann (President of ESPR, Morten Breindahl (President of ESN, Manuel Sánchez Luna (President of UENPS, Silke Mader (Chairwoman of the Executive Board and Co-Founder of EFCNISCIENTIFIC COMMITTEEVirgilio P. Carnielli (Congress President Chair, Pierre Gressens (Past Scientific President, Umberto Simeoni, Manon Benders, Neil Marlow, Ola D. Saugstad, Petra Hüppi, Agnes van den HoogenSession "Cardiac Physiology and Pathology"ABS 1. EVALUATION OF THE RELATIONSHIP BETWEEN PATENT DUCTUS ARTERIOSUS AND THE PLATELET MASS INDEX IN PRETERM INFANTS • M. Kara, İ. Caner, K.Ş. Tekgündüz, İ. Polat, H. KeskinABS 2. DIAGNOSIS OF DIGEORGE SYNDROME: THE CONTRIBUTION OF MOLECULAR GENETICS • Y. Halleb, H. Hadj-Abdallah, S. Nouri, A. Touati, M. Bellallah, J. Mathlouthi, N. Mahdhaoui, H. Sboui, A. Saad, D. H’midaABS 3. ASSOCIATION BETWEEN SIZE OF PATENT DUCTUS ARTERIOSUS AND CO-MORBIDITIES • S. Bellis, Y. SinghABS 4. EFFICACY OF MEDICAL TREATMENT IN CLOSING PATENT DUCTUS ARTERIOSUS IN ELBW INFANTS • S. Bellis, Y. SinghABS 5. ACETAMINOPHEN FOR CLOSING PDA. SHOULD IT BE A FIRST LINE THERAPEUTIC OPTION? • I. Tofé, M.D. Ruiz, M.P. Jaraba, M.V. Rodriguez, R.L. Rueda, M.D. Ordoñez, M.J. ParragaABS 6. PATENT DUCTUS ARTERIOSUS WITH HEMODYNAMIC REPERCUSSION IN VERY LOW WEIGHT PRETERM INFANTS TREATED WITH ORAL IBUPROFEN PRESENTS A HIGH RATE OF BRONCHOPULMONARY DYSPLASIA • M.M. Lourenço, E. Sacramento, F. Carmona, C. Calixto, F. Martin-Celini, G.H. Seribelli, W.A. Gonçalves-FerriABS 7

  1. Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study

    Directory of Open Access Journals (Sweden)

    Haeusler Karl

    2012-08-01

    Full Text Available Abstract Background Regular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent brain lesions during and after marathon running are missing. Methods/ Design In the prospective observational “Berlin Beat of Running” study experienced endurance athletes underwent clinical examination (CE, 3 Tesla brain magnetic resonance imaging (MRI, carotid ultrasound imaging (CUI and serial blood sampling (BS within 2-3 days prior (CE, MRI, CUI, BS, directly after (CE, BS and within 2 days after (CE, MRI, BS the 38th BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year. Results Here we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 ± 6.0 years, 24.5% were female, 8.2% had hypertension and 2.7% had hyperlipidaemia. Participants have attended a mean of 7.5 ± 6.6 marathon races within the last 5 years and a mean of 16 ± 36 marathon races in total. Their weekly running distance prior to the 38th BMW BERLIN-MARATHON was 65 ± 17 km. Finally, 108 (98.2% Berlin Beat-Study participants successfully completed the 38th BMW BERLIN-MARATHON 2011. Discussion Findings from the “Berlin Beats of Running” study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link

  2. Dual Optical Recordings for Action Potentials and Calcium Handling in Induced Pluripotent Stem Cell Models of Cardiac Arrhythmias Using Genetically Encoded Fluorescent Indicators

    Science.gov (United States)

    Song, LouJin; Awari, Daniel W.; Han, Elizabeth Y.; Uche-Anya, Eugenia; Park, Seon-Hye E.; Yabe, Yoko A.; Chung, Wendy K.

    2015-01-01

    Reprogramming of human somatic cells to pluripotency has been used to investigate disease mechanisms and to identify potential therapeutics. However, the methods used for reprogramming, in vitro differentiation, and phenotyping are still complicated, expensive, and time-consuming. To address the limitations, we first optimized a protocol for reprogramming of human fibroblasts and keratinocytes into pluripotency using single lipofection and the episomal vectors in a 24-well plate format. This method allowed us to generate multiple lines of integration-free and feeder-free induced pluripotent stem cells (iPSCs) from seven patients with cardiac diseases and three controls. Second, we differentiated human iPSCs derived from patients with Timothy syndrome into cardiomyocytes using a monolayer differentiation method. We found that Timothy syndrome cardiomyocytes showed slower, irregular contractions and abnormal calcium handling compared with the controls. The results are consistent with previous reports using a retroviral method for reprogramming and an embryoid body-based method for cardiac differentiation. Third, we developed an efficient approach for recording the action potentials and calcium transients simultaneously in control and patient cardiomyocytes using genetically encoded fluorescent indicators, ArcLight and R-GECO1. The dual optical recordings enabled us to observe prolonged action potentials and abnormal calcium handling in Timothy syndrome cardiomyocytes. We confirmed that roscovitine rescued the phenotypes in Timothy syndrome cardiomyocytes and that these findings were consistent with previous studies using conventional electrophysiological recordings and calcium imaging with dyes. The approaches using our optimized methods and dual optical recordings will improve iPSC applicability for disease modeling to investigate mechanisms underlying cardiac arrhythmias and to test potential therapeutics. PMID:25769651

  3. Toxicokinetics of ibogaine and noribogaine in a patient with prolonged multiple cardiac arrhythmias after ingestion of internet purchased ibogaine

    NARCIS (Netherlands)

    Henstra, Marieke; Wong, Liza; Chahbouni, Abdel; Swart, Noortje; Allaart, Cor; Sombogaard, Ferdi

    2017-01-01

    Ibogaine is an agent that has been evaluated as an unapproved anti-addictive agent for the management of drug dependence. Sudden cardiac death has been described to occur secondary to its use. We describe the clinical effects and toxicokinetics of ibogaine and noribogaine in a single patient. For

  4. Effect of Skeletal Muscle Na+ Channel Delivered Via a Cell Platform on Cardiac Conduction and Arrhythmia Induction

    NARCIS (Netherlands)

    Boink, Gerard J. J.; Lu, Jia; Driessen, Helen E.; Duan, Lian; Sosunov, Eugene A.; Anyukhovsky, Evgeny P.; Shlapakova, Iryna N.; Lau, David H.; Rosen, Tove S.; Danilo, Peter; Jia, Zhiheng; Ozgen, Nazira; Bobkov, Yevgeniy; Guo, Yuanjian; Brink, Peter R.; Kryukova, Yelena; Robinson, Richard B.; Entcheva, Emilia; Cohen, Ira S.; Rosen, Michael R.

    2012-01-01

    Background-In depolarized myocardial infarct epicardial border zones, the cardiac sodium channel is largely inactivated, contributing to slow conduction and reentry. We have demonstrated that adenoviral delivery of the skeletal muscle Na+ channel (SkM1) to epicardial border zones normalizes

  5. Lethal arrhythmias in Tbx3-deficient mice reveal extreme dosage sensitivity of cardiac conduction system function and homeostasis

    NARCIS (Netherlands)

    Frank, Deborah U.; Carter, Kandis L.; Thomas, Kirk R.; Burr, R. Michael; Bakker, Martijn L.; Coetzee, William A.; Tristani-Firouzi, Martin; Bamshad, Michael J.; Christoffels, Vincent M.; Moon, Anne M.

    2012-01-01

    TBX3 is critical for human development: mutations in TBX3 cause congenital anomalies in patients with ulnar-mammary syndrome. Data from mice and humans suggest multiple roles for Tbx3 in development and function of the cardiac conduction system. The mechanisms underlying the functional development,

  6. Early Echocardiographic Deformation Analysis for the Prediction of Sudden Cardiac Death and Life-Threatening Arrhythmias After Myocardial Infarction

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Valeur, Nana; Andersen, Mads Jønsson

    2013-01-01

    This study sought to hypothesize that global longitudinal strain (GLS) as a measure of infarct size, and mechanical dispersion (MD) as a measure of myocardial deformation heterogeneity, would be of incremental importance for the prediction of sudden cardiac death (SCD) or malignant ventricular...

  7. Burden of arrhythmia in recreational marijuana users.

    Science.gov (United States)

    Desai, Rupak; Patel, Upenkumar; Deshmukh, Abhishek; Sachdeva, Rajesh; Kumar, Gautam

    2018-03-27

    Marijuana or Cannabis is extensively used as a recreational substance globally. Case reports have reported cardiac arrhythmias immediately following recreational marijuana use. However, the burden of arrhythmias in hospitalized marijuana users have not been evaluated through prospective or cross-sectional studies. Therefore, we planned to measure temporal trends of the frequency of arrhythmias in hospitalized marijuana users using National Inpatient Sample (NIS) database in the United States. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Biobehavioral Triggers of Cardiac Arrhythmia during Daily Life: The Role of Emotion, Physical Activity, and Heart Rate Variability

    Science.gov (United States)

    2004-01-01

    increases among deaths from drug use, cancer , or other diseases. It should be noted that there was a proportionate decrease in sudden cardiac deaths in the...Smith, Tumer , Guijarro & Hallet, 1996) and may be higher in some ethnic groups than others (e.g., Iribarren, Sidney, Bild, Liu, Markovitz, et al... Tumer , Guijarro & Hallet, 1996) and may be higher in some ethnic groups than others (e.g., Iribarren, Sidney, Bild, Liu, Markovitz, et al., 2000

  9. Disease and drug-induced arrhythmias : the example of obstructive pulmonary disease

    NARCIS (Netherlands)

    Warnier, M.J.

    2014-01-01

    Notwithstanding the clinical importance of cardiac arrhythmias, relevant information about the background risk and the exact underlying mechanisms of cardiac arrhythmias in patients with obstructive pulmonary disease (asthma and chronic obstructive pulmonary disease [COPD]) is still lacking. The

  10. Hypertension and cardiac arrhythmias : A consensus document fromthe European Heart RhythmAssociation (EHRA) and ESC Council on Hypertension, endorsed by the Heart RhythmSociety (HRS), Asia-Pacific Heart RhythmSociety (APHRS) and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE)

    NARCIS (Netherlands)

    Lip, Gregory Y. H.; Coca, Antonio; Kahan, Thomas; Boriani, Giuseppe; Manolis, Antonis S.; Olsen, Michael Hecht; Oto, Ali; Potpara, Tatjana S.; Steffel, Jan; Marin, Francisco; de Oliveira Figueiredo, Marcio Jansen; de Simone, Giovanni; Tzou, Wendy S.; Chiang, Chern-En; Williams, Bryan; Dan, Gheorghe-Andrei; Gorenek, Bulent; Fauchier, Laurent; Savelieva, Irina; Hatala, Robert; van Gelder, Isabelle; Brguljan-Hitij, Jana; Erdine, Serap; Lovic, Dragan; Kim, Young-Hoon; Salinas-Arce, Jorge; Field, Michael

    2017-01-01

    Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both

  11. SU-C-303-06: Treatment Planning Study for Non-Invasive Cardiac Arrhythmia Ablation with Scanned Carbon Ions in An Animal Model

    International Nuclear Information System (INIS)

    Eichhorn, A; Constantinescu, A; Prall, M; Kaderka, R; Durante, M; Graeff, C; Lehmann, H I; Takami, M; Packer, D L; Lugenbiel, P; Thomas, D; Richter, D; Bert, C

    2015-01-01

    Purpose: Scanned carbon ion beams might offer a non-invasive alternative treatment for cardiac arrhythmia, which are a major health-burden. We studied the feasibility of this procedure in an animal model. The underlying treatment planning and motion mitigation strategies will be presented. Methods: The study was carried out in 15 pigs, randomly distributed to 3 target groups: atrioventricular node (AVN, 8 animals with 25, 40, and 55 Gy target dose), left ventricular free-wall (LV, 4 animals with 40 Gy) and superior pulmonary vein (SPV, 3 animals with 40 Gy). Breathing motion was suppressed by repeated enforced breathholds at end exhale. Cardiac motion was mitigated by an inhomogeneous rescanning scheme with up to 15 rescans. The treatment planning was performed using the GSI in-house software TRiP4D on cardiac-gated 4DCTs, applying a range-considering ITV based on an extended CTV. For AVN and SPV isotropic 5 mm margins were applied to the CTV, while for the LV 2mm+2% range margins were used. The opposing fields for AVN and LV targets were optimized independently (SFUD), while SPV treatments were optimized as IMPT deliveries, including dose restrictions to the radiosensitive AVN. Results: Median value of D 95 over all rescanning simulations was 99.1% (AVN), 98.0% (SPV) and 98.3% (LV) for the CTV and 94.7% (AVN) and 92.7% (SPV) for the PTV, respectively. The median D 5 -D 95 was improved with rescanning compared to unmitigated delivery from 13.3 to 6.5% (CTV) and from 23.4 to 11.6% (PTV). ICRP dose limits for aorta, trachea, esophagus and skin were respected. The maximal dose in the coronary arteries was limited to 30 Gy. Conclusion: We demonstrated the feasibility of a homogeneous dose delivery to different cardiac structures in a porcine model using a time-optimized inhomogeneous rescanning scheme. The presented treatment planning strategies were applied in a pig study with the analysis ongoing. Funding: This work was supported in part by the Helmholtz Association

  12. SU-C-303-06: Treatment Planning Study for Non-Invasive Cardiac Arrhythmia Ablation with Scanned Carbon Ions in An Animal Model

    Energy Technology Data Exchange (ETDEWEB)

    Eichhorn, A; Constantinescu, A; Prall, M; Kaderka, R; Durante, M; Graeff, C [GSI Helmholtz Center, Darmstadt, DE (Germany); Lehmann, H I; Takami, M; Packer, D L [Mayo Clinic, Rochester, Minnesota (United States); Lugenbiel, P; Thomas, D [University of Heidelberg, Heidelberg, DE (Germany); Richter, D; Bert, C [University Clinic Erlangen, Erlagen, DE (Germany)

    2015-06-15

    Purpose: Scanned carbon ion beams might offer a non-invasive alternative treatment for cardiac arrhythmia, which are a major health-burden. We studied the feasibility of this procedure in an animal model. The underlying treatment planning and motion mitigation strategies will be presented. Methods: The study was carried out in 15 pigs, randomly distributed to 3 target groups: atrioventricular node (AVN, 8 animals with 25, 40, and 55 Gy target dose), left ventricular free-wall (LV, 4 animals with 40 Gy) and superior pulmonary vein (SPV, 3 animals with 40 Gy). Breathing motion was suppressed by repeated enforced breathholds at end exhale. Cardiac motion was mitigated by an inhomogeneous rescanning scheme with up to 15 rescans. The treatment planning was performed using the GSI in-house software TRiP4D on cardiac-gated 4DCTs, applying a range-considering ITV based on an extended CTV. For AVN and SPV isotropic 5 mm margins were applied to the CTV, while for the LV 2mm+2% range margins were used. The opposing fields for AVN and LV targets were optimized independently (SFUD), while SPV treatments were optimized as IMPT deliveries, including dose restrictions to the radiosensitive AVN. Results: Median value of D{sub 95} over all rescanning simulations was 99.1% (AVN), 98.0% (SPV) and 98.3% (LV) for the CTV and 94.7% (AVN) and 92.7% (SPV) for the PTV, respectively. The median D{sub 5}-D{sub 95} was improved with rescanning compared to unmitigated delivery from 13.3 to 6.5% (CTV) and from 23.4 to 11.6% (PTV). ICRP dose limits for aorta, trachea, esophagus and skin were respected. The maximal dose in the coronary arteries was limited to 30 Gy. Conclusion: We demonstrated the feasibility of a homogeneous dose delivery to different cardiac structures in a porcine model using a time-optimized inhomogeneous rescanning scheme. The presented treatment planning strategies were applied in a pig study with the analysis ongoing. Funding: This work was supported in part by the

  13. Non-invasive Drosophila ECG recording by using eutectic gallium-indium alloy electrode: a feasible tool for future research on the molecular mechanisms involved in cardiac arrhythmia.

    Directory of Open Access Journals (Sweden)

    Po-Hung Kuo

    electrophysiological signal research on the molecular mechanism involved in cardiac arrhythmia, as well as research related to drug screening and development.

  14. Evaluation of lidocaine treatment on frequency of cardiac arrhythmias, acute kidney injury, and hospitalization time in dogs with gastric dilatation volvulus.

    Science.gov (United States)

    Bruchim, Yaron; Itay, Srugo; Shira, Ben-Halevy; Kelmer, Efrat; Sigal, Yudelecitch; Itamar, Aroch; Gilad, Segev

    2012-08-01

    To assess the efficacy of IV lidocaine in decreasing complication rate and improving the outcome in dogs with gastric dilatation volvulus (GDV). Prospective non-controlled study of 83 lidocaine-treated dogs with GDV compared to 47 untreated historical controls with GDV. University veterinary teaching hospital. One hundred and thirty client-owned dogs with naturally occurring GDV. Study group dogs were treated at presentation with lidocaine (2 mg/kg, IV bolus) followed by constant rate infusion (CRI) of 0.05 mg/kg/min for 24 h. Historical control dogs did not receive any lidocaine. There were no group differences in age, body weight, time lag from onset of clinical signs to presentation, rectal temperature and pulse rate at presentation, and proportion of gastric wall necrosis. The proportions of cardiac arrhythmias and acute kidney injury (AKI) were significantly (Pdogs with GDV compared to untreated historical controls. Due to the nonblinded, placebo-uncontrolled, nonrandomized nature of the current study, further evaluation of the efficacy of lidocaine in dogs with GDV is warranted. © Veterinary Emergency and Critical Care Society 2012.

  15. venice: Mask utility

    Science.gov (United States)

    Coupon, Jean

    2018-02-01

    venice reads a mask file (DS9 or fits type) and a catalogue of objects (ascii or fits type) to create a pixelized mask, find objects inside/outside a mask, or generate a random catalogue of objects inside/outside a mask. The program reads the mask file and checks if a point, giving its coordinates, is inside or outside the mask, i.e. inside or outside at least one polygon of the mask.

  16. Morning surge of ventricular arrhythmias in a new arrhythmogenic canine model of chronic heart failure is associated with attenuation of time-of-day dependence of heart rate and autonomic adaptation, and reduced cardiac chaos.

    Science.gov (United States)

    Zhu, Yujie; Hanafy, Mohamed A; Killingsworth, Cheryl R; Walcott, Gregory P; Young, Martin E; Pogwizd, Steven M

    2014-01-01

    Patients with chronic heart failure (CHF) exhibit a morning surge in ventricular arrhythmias, but the underlying cause remains unknown. The aim of this study was to determine if heart rate dynamics, autonomic input (assessed by heart rate variability (HRV)) and nonlinear dynamics as well as their abnormal time-of-day-dependent oscillations in a newly developed arrhythmogenic canine heart failure model are associated with a morning surge in ventricular arrhythmias. CHF was induced in dogs by aortic insufficiency & aortic constriction, and assessed by echocardiography. Holter monitoring was performed to study time-of-day-dependent variation in ventricular arrhythmias (PVCs, VT), traditional HRV measures, and nonlinear dynamics (including detrended fluctuations analysis α1 and α2 (DFAα1 & DFAα2), correlation dimension (CD), and Shannon entropy (SE)) at baseline, as well as 240 days (240 d) and 720 days (720 d) following CHF induction. LV fractional shortening was decreased at both 240 d and 720 d. Both PVCs and VT increased with CHF duration and showed a morning rise (2.5-fold & 1.8-fold increase at 6 AM-noon vs midnight-6 AM) during CHF. The morning rise in HR at baseline was significantly attenuated by 52% with development of CHF (at both 240 d & 720 d). Morning rise in the ratio of low frequency to high frequency (LF/HF) HRV at baseline was markedly attenuated with CHF. DFAα1, DFAα2, CD and SE all decreased with CHF by 31, 17, 34 and 7%, respectively. Time-of-day-dependent variations in LF/HF, CD, DFA α1 and SE, observed at baseline, were lost during CHF. Thus in this new arrhythmogenic canine CHF model, attenuated morning HR rise, blunted autonomic oscillation, decreased cardiac chaos and complexity of heart rate, as well as aberrant time-of-day-dependent variations in many of these parameters were associated with a morning surge of ventricular arrhythmias.

  17. Morning surge of ventricular arrhythmias in a new arrhythmogenic canine model of chronic heart failure is associated with attenuation of time-of-day dependence of heart rate and autonomic adaptation, and reduced cardiac chaos.

    Directory of Open Access Journals (Sweden)

    Yujie Zhu

    Full Text Available Patients with chronic heart failure (CHF exhibit a morning surge in ventricular arrhythmias, but the underlying cause remains unknown. The aim of this study was to determine if heart rate dynamics, autonomic input (assessed by heart rate variability (HRV and nonlinear dynamics as well as their abnormal time-of-day-dependent oscillations in a newly developed arrhythmogenic canine heart failure model are associated with a morning surge in ventricular arrhythmias. CHF was induced in dogs by aortic insufficiency & aortic constriction, and assessed by echocardiography. Holter monitoring was performed to study time-of-day-dependent variation in ventricular arrhythmias (PVCs, VT, traditional HRV measures, and nonlinear dynamics (including detrended fluctuations analysis α1 and α2 (DFAα1 & DFAα2, correlation dimension (CD, and Shannon entropy (SE at baseline, as well as 240 days (240 d and 720 days (720 d following CHF induction. LV fractional shortening was decreased at both 240 d and 720 d. Both PVCs and VT increased with CHF duration and showed a morning rise (2.5-fold & 1.8-fold increase at 6 AM-noon vs midnight-6 AM during CHF. The morning rise in HR at baseline was significantly attenuated by 52% with development of CHF (at both 240 d & 720 d. Morning rise in the ratio of low frequency to high frequency (LF/HF HRV at baseline was markedly attenuated with CHF. DFAα1, DFAα2, CD and SE all decreased with CHF by 31, 17, 34 and 7%, respectively. Time-of-day-dependent variations in LF/HF, CD, DFA α1 and SE, observed at baseline, were lost during CHF. Thus in this new arrhythmogenic canine CHF model, attenuated morning HR rise, blunted autonomic oscillation, decreased cardiac chaos and complexity of heart rate, as well as aberrant time-of-day-dependent variations in many of these parameters were associated with a morning surge of ventricular arrhythmias.

  18. Cardiac ablation

    Directory of Open Access Journals (Sweden)

    Kelly Ratheal

    2016-01-01

    Full Text Available Cardiac ablation is a procedure that uses either radiofrequency or cryothermal energy to destroy cells in the heart to terminate and/or prevent arrhythmias. The indications for cardiac catheter ablation include refractory, symptomatic arrhythmias, with more specific guidelines for atrial fibrillation in particular. The ablation procedure itself involves mapping the arrhythmia and destruction of the aberrant pathway in an effort to permanently prevent the arrhythmia. There are many types of arrhythmias, and they require individualized approaches to ablation based on their innately different electrical pathways. Ablation of arrhythmias, such as Wolff-Parkinson-White syndrome, AV nodal reentrant tachycardia, and atrial-fibrillation, is discussed in this review. Ablation has a high success rate overall and minimal complication rates, leading to improved quality of life in many patients.

  19. New theory of arrhythmia. Conceptual substantiation of arrhythmia mechanisms

    Directory of Open Access Journals (Sweden)

    Vladimir I. Ermoshkin

    2015-11-01

    Full Text Available Aims A new attempt is made to substantiate the concept of the mechanism of arrhythmia and sudden cardiac death. Methods The paper is based on a theoretical analysis of special literature, personal experience of participation in conferences and discussions with leading Russian cardiologists. Results We have succeeded in demonstrating the fact that researchers ignore the fact that cardiomyocytes can be excited by mechanical pulses, when considering the arrhythmia mechanisms. We have conducted trials using the Cardiocode device. Under stress in a human, opened may be large and small arteriovenous anastomoses, via which blood under high pressure is ejected into veins. It leads to pressure surges in arteries and veins. The vena cava dilates, its tonus increases. In some cases, the pulse waves travel via anastomoses along the vena cava walls to the atria and the ventricles. An above-threshold concentration of tensions from mechanical pulses may excite cardiomyocytes from different points of the myocardium, disturbing the sinus rhythm. As a result, extrasystoles, tachycardia attacks, blocking of blood circulation in the peripheral segments of the venous arterial networks, edemata, thrombosis and metabolism disorders appear. Arrhythmia, tachycardia attacks and concomitant myocardial ischemia lead to progression of heart fibrosis. Such changes increase the probability of fibrillations and sudden cardiac death. Conclusion Unhealthy lifestyle, the presence of opening and not properly closing anastomoses may provoke a number of diseases. To avoid the cardiac arrhythmia attacks and prevent SCD, it is necessary to suppress travel of the mechanical waves within the following circuitry: aorta – artery – anastomosis – vein – vena cava – atria – ventricles. The travel of the mechanical waves within the same vessel circuitry explains the fact that the fixed couplings under extrasystoles are observed, and the beat-to-beat RR intervals under tachycardia

  20. Numerous Brugada syndrome-associated genetic variants have no effect on J-point elevation, syncope susceptibility, malignant cardiac arrhythmia, and all-cause mortality

    DEFF Research Database (Denmark)

    Ghouse, Jonas; Have, Christian T; Skov, Morten W

    2017-01-01

    PURPOSE: We investigated whether Brugada syndrome (BrS)-associated variants identified in the general population have an effect on J-point elevation as well as whether carriers of BrS variants were more prone to experience syncope and malignant ventricular arrhythmia and had increased mortality c...

  1. Arrhythmia risk in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Ioana Mozos

    2015-01-01

    Interactions between the functioning of the heart andthe liver have been described, with heart diseasesaffecting the liver, liver diseases affecting the heart,and conditions that simultaneously affect both. Theheart is one of the most adversely affected organs inpatients with liver cirrhosis. For example, arrhythmiasand electrocardiographic changes are observed inpatients with liver cirrhosis. The risk for arrhythmia isinfluenced by factors such as cirrhotic cardiomyopathy,cardiac ion channel remodeling, electrolyte imbalances,impaired autonomic function, hepatorenal syndrome, metabolic abnormalities, advanced age, inflammatory syndrome, stressful events, impaired drug metabolism and comorbidities. Close monitoring of cirrhotic patients is needed for arrhythmias, particularly when QT intervalprolonging drugs are given, or if electrolyte imbalances or hepatorenal syndrome appear. Arrhythmia risk may persist after liver transplantation due to possible QT interval prolongation, persistence of the parasympathetic impairment, post-transplant reperfusion and chronic immunosuppression, as well as consideration of the fact that the transplant itself is a stressful event for the cardiovascular system. The aims of the present article were to provide a review of the most important data regarding the epidemiology, pathophysiology, and biomarkers of arrhythmia risk in patients with liver cirrhosis, to elucidate the association with long-term outcome, and to propose future research directions.

  2. General anxiety, depression, and physical health in relation to symptoms of heart-focused anxiety- a cross sectional study among patients living with the risk of serious arrhythmias and sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Hamang Anniken

    2011-11-01

    Full Text Available Abstract Objective To investigate the role of three distinct symptoms of heart-focused anxiety (cardio-protective avoidance, heart-focused attention, and fear about heart sensations in relation to general anxiety, depression and physical health in patients referred to specialized cardio-genetics outpatient clinics in Norway for genetic investigation and counseling. Methods Participants were 126 patients (mean age 45 years, 53.5% women. All patients were at higher risk than the average person for serious arrhythmias and sudden cardiac death (SCD because of a personal or a family history of an inherited cardiac disorder (familial long QT syndrome or hypertrophic cardiomyopathy. Patients filled in, Hospital Anxiety and Depression Scale, Short-Form 36 Health Survey, and Cardiac Anxiety Questionnaire, two weeks before the scheduled counseling session. Results The patients experienced higher levels of general anxiety than expected in the general population (mean difference 1.1 (p Conclusion Avoidance and fear may be potentially modifiable symptoms. Because these distinct symptoms may have important roles in determining general anxiety, depression and physical health in at-risk individuals of inherited cardiac disorders, the present findings may have implications for the further development of genetic counseling for this patient group.

  3. Arrhythmias (For Parents)

    Science.gov (United States)

    ... some herbal remedies ); injuries to the heart from chest trauma or heart surgery; use of illegal drugs, alcohol, or tobacco; caffeine; and stress. Arrhythmias can be temporary or permanent. An ... of breath chest pain fainting Arrhythmias can ...

  4. Hypertension and cardiac arrhythmias: a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

    Science.gov (United States)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas; Boriani, Giuseppe; Manolis, Antonis S; Olsen, Michael Hecht; Oto, Ali; Potpara, Tatjana S; Steffel, Jan; Marín, Francisco; de Oliveira Figueiredo, Márcio Jansen; de Simone, Giovanni; Tzou, Wendy S; Chiang, Chern-En; Williams, Bryan; Dan, Gheorghe-Andrei; Gorenek, Bulent; Fauchier, Laurent; Savelieva, Irina; Hatala, Robert; van Gelder, Isabelle; Brguljan-Hitij, Jana; Erdine, Serap; Lovic, Dragan; Kim, Young-Hoon; Salinas-Arce, Jorge; Field, Michael

    2017-06-01

    Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit to comprehensively review the available evidence to publish a joint consensus document on hypertension and cardiac arrhythmias, and to provide up-to-date consensus recommendations for use in clinical practice. The ultimate judgment regarding care of a particular patient must be made by the healthcare provider and the patient in light of all of the circumstances presented by that patient. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  5. Epidemiology of Arrhythmias in Children

    Directory of Open Access Journals (Sweden)

    R Prem Sekar

    2008-05-01

    Full Text Available Unlike the adult population, arrhythmias occur less commonly in childhood. Only 5% of the emergency hospital admissions in the paediatric population is attributed to symptomatic arrhythmias. Majority of these tend to be accessory pathway mediated supraventricular tachyarrhythmias such as Wolff-Parkinson-White (WPW syndrome, permanent junctional reciprocating tachycardia (PJRT and Mahaim tachycardia. The non accessory pathway mediated supraventricular tachyarrhythmias commonly seen in children are junctional ectopic tachycardia (JET and automatic ectopic atrial tachycardia (AET and occur mostly in the post operative period after intracardiac repair for a structural heart defect. Ventricular tachycardia (VT although uncommon, occurs in the paediatric age group in association with hypertrophic cardiomyopathy (HCM, long QT syndrome (LQTS and Brugada syndrome. Occasionally, VT can also present symptomatically as incessant idiopathic infant ventricular tachycardia, right ventricular outflow tract tachycardia, benign VT, catecholaminic VT, idiopathic left ventricular tachycardia and in post cardiac surgical patients.

  6. Arrhythmia and exercise intolerance in Fontan patients

    DEFF Research Database (Denmark)

    Idorn, L; Juul, K; Jensen, A S

    2013-01-01

    BACKGROUND: Long-term survival after the Fontan procedure shows excellent results but is associated with a persistent risk of arrhythmias and exercise intolerance. We aimed to analyze the current burden of clinically relevant arrhythmia and severe exercise intolerance in Danish Fontan patients...... and estimated to 99.1% per year. Prevalence of clinically relevant arrhythmia and severe exercise intolerance increased significantly with age and was found in 32% and 85% of patients ≥20years, respectively. Thus, from survival data and logistic regression models the future prevalence of patients, clinically...... relevant arrhythmia and severe exercise intolerance were estimated, revealing a considerable augmentation. Furthermore, resting and maximum cardiac index, resting stroke volume index and pulmonary diffusing capacity decreased significantly with age while diastolic and systolic ventricular function...

  7. Channelopathies - emerging trends in the management of inherited arrhythmias

    NARCIS (Netherlands)

    Chockalingam, Priya; Mizusawa, Yuka; Wilde, Arthur A. M.

    2015-01-01

    In spite of their relative rarity, inheritable arrhythmias have come to the forefront as a group of potentially fatal but preventable cause of sudden cardiac death in children and (young) adults. Comprehensive management of inherited arrhythmias includes diagnosing and treating the proband and

  8. Emerging molecular therapies targeting myocardial infarction-related arrhythmias

    NARCIS (Netherlands)

    Driessen, Helen E.; van Veen, Toon A. B.; Boink, Gerard J. J.

    2017-01-01

    Cardiac disease is the leading cause of death in the developed world. Ventricular arrhythmias associated with myocardial ischaemia and/or infarction are a major contributor to cardiovascular mortality, and require improved prevention and treatment. Drugs, devices, and radiofrequency catheter

  9. Non cancerous diseases following a chronic intern contamination by caesium 137: cataracts and cardiac arrhythmias; Pathologies non cancereuses potentiellement consecutives a une contamination interne chronique par le cesium 137: cataractes et arythmies cardiaques

    Energy Technology Data Exchange (ETDEWEB)

    Landon, G

    2008-07-15

    This work of thesis joins within the framework of an analysis of the sanitary consequences of the nuclear accident of Chernobylsk. Since 2005, the I.R.S.N. is interested in the not cancerous pathologies (cataracts, and cardiac arrhythmias) observed among the children living on the contaminated territories after the fallout of Chernobylsk and has in this aim implemented a research programme called E.P.I.C.E. (Evaluation of the pathologies induced by a chronicle contamination by cesium) whom objective is to show an eventual link between the chronicle ingestion of contaminated food and these pathologies emergence. An exploitation of the results of the pilot study,first phase of the E.P.I.C.E. program was realized. The analysis was completed by two bibliographical reviews relative to the knowledge available on these diseases. The results of this pilot study suggest: on one hand, an absence of link between the activity in cesium 137 at the level of the heart, of the whole body and the emergence of disorder of the heart rhythm; on the other hand, for the cases of cataract, a link between the load in cesium 137 at the neck level and the emergence of the disease in 40 % of the cases. However, these results must be considered with caution because several limits and, in particular, a way of selection affect this study. concerning the scientific literature, this one stays rather poor because only thee articles make reference to a relationship between cesium 137 and the emergence of these non cancerous pathologies. After having exposed the context, this thesis draws up the situation of knowledge relative to cataracts and to cardiac arrhythmias and their possible relationship with ionizing radiations, collect the results stemming from the analysis of the pilot study and envisages future epidemiological studies. (N.C.)

  10. Arrhythmias in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Gaurav Agarwal

    2017-01-01

    Full Text Available Chronic hyperglycaemia of Type 2 diabetes mellitus causes long term damage to heart resulting in coronary artery disease (CAD, myocardial infarction (MI, congestive heart failure (CHF, and sudden death from arrhythmias. AIMS: To study the prevalence of different types of arrhythmias in T2DM, particularly in association with Cardiac Autonomic Neuropathy (CAN. METHODS: A cross-sectional study including 100 patients of Type 2 Diabetes Mellitus (T2DM presenting with cardiac arrhythmias, was done at our hospital over 2 years. Detailed history along with physical examination and tests for CAN were done. Routine investigations along with echocardiography, stress test, Holter monitoring were done. RESULTS: Sinus Tachycardia (ST was the commonest arrhythmia, found in 32% of patients. 20% had Complete Heart Block (CHB, 15% had Sinus Bradycardia (SB, and 15% had Atrial Fibrillation (AF. Ventricular Premature Complex (VPC was found in 10% and 3% had Atrial Premature Complex (APC. 3% had first degree AV block, whereas 1% had Paroxysmal Supra Ventricular Tachycardia (PSVT, and another 1% had Ventricular Tachycardia (VT. Poorly controlled diabetes and co-morbidities was associated with higher incidence of arrhythmias. 62% of patients had prolonged QTc, majority of which had CAN. Most of the patients responded to standard therapy.

  11. Remote Arrhythmia Monitoring System Developed

    Science.gov (United States)

    York, David W.; Mackin, Michael A.; Liszka, Kathy J.; Lichter, Michael J.

    2004-01-01

    Telemedicine is taking a step forward with the efforts of team members from the NASA Glenn Research Center, the MetroHealth campus of Case Western University, and the University of Akron. The Arrhythmia Monitoring System is a completed, working test bed developed at Glenn that collects real-time electrocardiogram (ECG) signals from a mobile or homebound patient, combines these signals with global positioning system (GPS) location data, and transmits them to a remote station for display and monitoring. Approximately 300,000 Americans die every year from sudden heart attacks, which are arrhythmia cases. However, not all patients identified at risk for arrhythmias can be monitored continuously because of technological and economical limitations. Such patients, who are at moderate risk of arrhythmias, would benefit from technology that would permit long-term continuous monitoring of electrical cardiac rhythms outside the hospital environment. Embedded Web Technology developed at Glenn to remotely command and collect data from embedded systems using Web technology is the catalyst for this new telemetry system (ref. 1). In the end-to-end system architecture, ECG signals are collected from a patient using an event recorder and are transmitted to a handheld personal digital assistant (PDA) using Bluetooth, a short-range wireless technology. The PDA concurrently tracks the patient's location via a connection to a GPS receiver. A long distance link is established via a standard Internet connection over a 2.5-generation Global System for Mobile Communications/General Packet Radio Service (GSM/GPRS)1 cellular, wireless infrastructure. Then, the digital signal is transmitted to a call center for monitoring by medical professionals.

  12. Frequency of exercise-induced ST-T-segment deviations and cardiac arrhythmias in recreational endurance athletes during a marathon race: results of the prospective observational Berlin Beat of Running study.

    Science.gov (United States)

    Herm, Juliane; Töpper, Agnieszka; Wutzler, Alexander; Kunze, Claudia; Krüll, Matthias; Brechtel, Lars; Lock, Jürgen; Fiebach, Jochen B; Heuschmann, Peter U; Haverkamp, Wilhelm; Endres, Matthias; Jungehulsing, Gerhard Jan; Haeusler, Karl Georg

    2017-08-03

    While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was that pathological laboratory findings in these athletes are (in part) associated with cardiac arrhythmias. Prospective observational cohort study including healthy volunteers. One hundred and nine experienced marathon runners wore a portable ECG recorder during a marathon race in Berlin, Germany. Athletes underwent blood tests 2-3 days prior, directly after and 1-2 days after the race. Overall, 108 athletes (median 48 years (IQR 45-53), 24% women) completed the marathon in 249±43 min. Blinded ECG analysis revealed abnormal findings during the marathon in 18 (16.8%) athletes. Ten (9.3%) athletes had at least one episode of non-sustained ventricular tachycardia, one of whom had atrial fibrillation; eight (7.5%) individuals showed transient ST-T-segment deviations. Abnormal ECG findings were associated with advanced age (OR 1.11 per year, 95% CI 1.01 to 1.23), while sex and cardiovascular risk profile had no impact. Directly after the race, high-sensitive troponin T was elevated in 18 (16.7%) athletes and associated with ST-T-segment deviation (OR 9.9, 95% CI 1.9 to 51.5), while age, sex and cardiovascular risk profile had no impact. ECG monitoring during a marathon is feasible. Abnormal ECG findings were present in every sixth athlete. Exercise-induced transient ST-T-segment deviations were associated with elevated high-sensitive troponin T (hsTnT) values. ClinicalTrials.gov NCT01428778; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

  13. Teaching Cardiac Electrophysiology Modeling to Undergraduate Students: Laboratory Exercises and GPU Programming for the Study of Arrhythmias and Spiral Wave Dynamics

    Science.gov (United States)

    Bartocci, Ezio; Singh, Rupinder; von Stein, Frederick B.; Amedome, Avessie; Caceres, Alan Joseph J.; Castillo, Juan; Closser, Evan; Deards, Gabriel; Goltsev, Andriy; Ines, Roumwelle Sta.; Isbilir, Cem; Marc, Joan K.; Moore, Diquan; Pardi, Dana; Sadhu, Sandeep; Sanchez, Samuel; Sharma, Pooja; Singh, Anoopa; Rogers, Joshua; Wolinetz, Aron; Grosso-Applewhite, Terri; Zhao, Kai; Filipski, Andrew B.; Gilmour, Robert F., Jr.; Grosu, Radu; Glimm, James; Smolka, Scott A.; Cherry, Elizabeth M.; Clarke, Edmund M.; Griffeth, Nancy; Fenton, Flavio H.

    2011-01-01

    As part of a 3-wk intersession workshop funded by a National Science Foundation Expeditions in Computing award, 15 undergraduate students from the City University of New York collaborated on a study aimed at characterizing the voltage dynamics and arrhythmogenic behavior of cardiac cells for a broad range of physiologically relevant conditions…

  14. Hypertension and cardiac arrhythmias: executive summary of a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

    Science.gov (United States)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas; Boriani, Giuseppe; Manolis, Antonis S; Olsen, Michael Hecht; Oto, Ali; Potpara, Tatjana S; Steffel, Jan; Marín, Francisco; de Oliveira Figueiredo, Márcio Jansen; de Simone, Giovanni; Tzou, Wendy S; En Chiang, Chern; Williams, Bryan

    2017-10-01

    Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD, or HF. In addition, high doses of thiazide diuretics commonly used to treat HTN, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnesaemia), contributing further to arrhythmias, while effective blood pressure control may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between HTN and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence and publishing a joint consensus document on HTN and cardiac arrhythmias, and providing up-to-date consensus recommendations for use in clinical practice. The ultimate judgment on the care of a specific patient must be made by the healthcare provider and the patient in light of all individual factors presented. This is an executive summary of the full document co-published by EHRA in EP-Europace. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  15. Age-Related Differences in the Effect of Psychological Distress on Mortality: Type D Personality in Younger versus Older Patients with Cardiac Arrhythmias

    Directory of Open Access Journals (Sweden)

    Johan Denollet

    2013-01-01

    Full Text Available Background. Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD treatment in younger patients but not in older patients. Methods. The Type D Scale (DS14 was used to assess general psychological distress in 455 younger (≤70 y,. Cardiac resynchronization therapy (CRT, but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95% CI 1.09–3.34 and 2.26 (95% CI 1.16–4.41 for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking. Conclusion. Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.

  16. Evocations of a Historical Night in Venice

    DEFF Research Database (Denmark)

    Fisker, Anna Marie; Hvejsel, Marie Frier

    Venice is a big dream, at once ineffably meaningful and yet still intangible; not merely to the authors of this paper but to many others as well. Why? Not only are we drawn by its mystery and romance; Venice, this otherworldly city, unfolds an architectural nocturne that in many ways makes history...

  17. Late gadolinium enhancement by magnetic resonance explains adverse cardiac events in individuals with ventricular arrhythmia; Realce tardío con gadolinio por resonancia magnética explica eventos cardíacos adversos en individuos con arritmia ventricular

    Energy Technology Data Exchange (ETDEWEB)

    Courtis, J.; Vasallo, J.; Arabia, L. [Departamento de Imágenes, Cardiología Intervencionista y Electrofisiología Instituto Oulton, Córdoba (Argentina); Dimitroff, M.; Gonzalez, A. [Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Códoba (Argentina); Tibaldi, M., E-mail: javiercourtis@oulton.com.ar [Técnicas no Invasivas y Arritmias, Instituto Modelo de Cardiología, Córdoba (Argentina)

    2012-07-01

    Objective: To determine whether the presence of late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) predict adverse cardiac events in patients with ventricular arrhythmia. Methods: We selected 74 consecutive patients with symptomatic ventricular arrhythmia (premature ventricular contractions and ventricular tachycardia) and left ventricular ejection fraction (LVEF) >55% sent to CMR for evaluation of structural heart disease previously undetected by other complementary methods. LGE, systolic function and volumes of both ventricles were analyzed. At follow-up was assessed a combined end point: hospitalization for ventricular arrhythmia, appropriate implantable cardioverter-defibrillator therapy and cardiac death. Results: During a median follow up of 575 days (interquartile range 24-1120 days) and by analyzing the population according to the presence (n=9, 12%) or not (n=65, 88%) LGE was observed that the group with positive Gd had lower LVEF (58% vs. 66% respectively, p=0.01) and larger volumes (EDV: 185 ml vs. 123 ml respectively, p=0.01 and ESV: 81 ml vs. 42 ml respectively, p=0.01) than the other group. Two (22%) patients in the LGE + group vs. one (4%) of those without LGE showed the combined endpoint (p=0.01) and when performing a logistic regression analysis it was found that the LGE is a predictor of adverse cardiac events analyzed (p=0.029). Conclusions: In this consecutive series of patients with ventricular arrhythmia we demonstrate a strong association between myocardial LGE and adverse cardiac events; this supports the hypothesis that myocardial fibrosis is an important arrhythmogenic substrate. In addition, almost all individuals without LGE were free of events during follow-up suggesting that it is possible to identify through the CMR low-risk individuals who can be treated conservatively. (authors) [Spanish] Objetivo: determinar si la presencia de realce tardío con gadolinio (RTG) por resonancia magnética cardiovascular (RMC

  18. Electromechanical wave imaging for arrhythmias

    International Nuclear Information System (INIS)

    Provost, Jean; Nguyen, Vu Thanh-Hieu; Legrand, Diégo; Okrasinski, Stan; Costet, Alexandre; Konofagou, Elisa E; Gambhir, Alok; Garan, Hasan

    2011-01-01

    Electromechanical wave imaging (EWI) is a novel ultrasound-based imaging modality for mapping of the electromechanical wave (EW), i.e. the transient deformations occurring in immediate response to the electrical activation. The correlation between the EW and the electrical activation has been established in prior studies. However, the methods used previously to map the EW required the reconstruction of images over multiple cardiac cycles, precluding the application of EWI for non-periodic arrhythmias such as fibrillation. In this study, new imaging sequences are developed and applied based on flash- and wide-beam emissions to image the entire heart at very high frame rates (2000 fps) during free breathing in a single heartbeat. The methods are first validated by imaging the heart of an open-chest canine while simultaneously mapping the electrical activation using a 64-electrode basket catheter. Feasibility is then assessed by imaging the atria and ventricles of closed-chest, conscious canines during sinus rhythm and during right-ventricular pacing following atrio-ventricular dissociation, i.e., during a non-periodic rhythm. The EW was validated against electrode measurements in the open-chest case, and followed the expected electrical propagation pattern in the closed-chest setting. These results indicate that EWI can be used for the characterization of non-periodic arrhythmias in conditions similar to the clinical setting, in a single heartbeat, and during free breathing. (fast track communication)

  19. Cardiac Arrest: MedlinePlus Health Topic

    Science.gov (United States)

    ... Handouts Cardiac arrest (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Cardiac Arrest updates ... this? GO MEDICAL ENCYCLOPEDIA Cardiac arrest Related Health Topics Arrhythmia CPR Pacemakers and Implantable Defibrillators National Institutes ...

  20. Application of optical action potentials in human induced pluripotent stem cells-derived cardiomyocytes to predict drug-induced cardiac arrhythmias.

    Science.gov (United States)

    Lu, H R; Hortigon-Vinagre, M P; Zamora, V; Kopljar, I; De Bondt, A; Gallacher, D J; Smith, G

    2017-09-01

    Human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs) are emerging as new and human-relevant source in vitro model for cardiac safety assessment that allow us to investigate a set of 20 reference drugs for predicting cardiac arrhythmogenic liability using optical action potential (oAP) assay. Here, we describe our examination of the oAP measurement using a voltage sensitive dye (Di-4-ANEPPS) to predict adverse compound effects using hiPS-CMs and 20 cardioactive reference compounds. Fluorescence signals were digitized at 10kHz and the records subsequently analyzed off-line. Cells were exposed to 30min incubation to vehicle or compound (n=5/dose, 4 doses/compound) that were blinded to the investigating laboratory. Action potential parameters were measured, including rise time (T rise ) of the optical action potential duration (oAPD). Significant effects on oAPD were sensitively detected with 11 QT-prolonging drugs, while oAPD shortening was observed with I Ca -antagonists, I Kr -activator or ATP-sensitive K + channel (K ATP )-opener. Additionally, the assay detected varied effects induced by 6 different sodium channel blockers. The detection threshold for these drug effects was at or below the published values of free effective therapeutic plasma levels or effective concentrations by other studies. The results of this blinded study indicate that OAP is a sensitive method to accurately detect drug-induced effects (i.e., duration/QT-prolongation, shortening, beat rate, and incidence of early after depolarizations) in hiPS-CMs; therefore, this technique will potentially be useful in predicting drug-induced arrhythmogenic liabilities in early de-risking within the drug discovery phase. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Spatially Discordant Alternans and Arrhythmias in Tachypacing-Induced Cardiac Myopathy in Transgenic LQT1 Rabbits: The Importance of IKs and Ca2+ Cycling.

    Directory of Open Access Journals (Sweden)

    Emily Lau

    Full Text Available Remodeling of cardiac repolarizing currents, such as the downregulation of slowly activating K+ channels (IKs, could underlie ventricular fibrillation (VF in heart failure (HF. We evaluated the role of Iks remodeling in VF susceptibility using a tachypacing HF model of transgenic rabbits with Long QT Type 1 (LQT1 syndrome.LQT1 and littermate control (LMC rabbits underwent three weeks of tachypacing to induce cardiac myopathy (TICM. In vivo telemetry demonstrated steepening of the QT/RR slope in LQT1 with TICM (LQT1-TICM; pre: 0.26±0.04, post: 0.52±0.01, P<0.05. In vivo electrophysiology showed that LQT1-TICM had higher incidence of VF than LMC-TICM (6 of 11 vs. 3 of 11, respectively. Optical mapping revealed larger APD dispersion (16±4 vs. 38±6 ms, p<0.05 and steep APD restitution in LQT1-TICM compared to LQT1-sham (0.53±0.12 vs. 1.17±0.13, p<0.05. LQT1-TICM developed spatially discordant alternans (DA, which caused conduction block and higher-frequency VF (15±1 Hz in LQT1-TICM vs. 13±1 Hz in LMC-TICM, p<0.05. Ca2+ DA was highly dynamic and preceded voltage DA in LQT1-TICM. Ryanodine abolished DA in 5 out of 8 LQT1-TICM rabbits, demonstrating the importance of Ca2+ in complex DA formation. Computer simulations suggested that HF remodeling caused Ca2+-driven alternans, which was further potentiated in LQT1-TICM due to the lack of IKs.Compared with LMC-TICM, LQT1-TICM rabbits exhibit steepened APD restitution and complex DA modulated by Ca2+. Our results strongly support the contention that the downregulation of IKs in HF increases Ca2+ dependent alternans and thereby the risk of VF.

  2. Fatal cardiac arrhythmia and long-QT syndrome in a new form of congenital generalized lipodystrophy with muscle rippling (CGL4 due to PTRF-CAVIN mutations.

    Directory of Open Access Journals (Sweden)

    Anna Rajab

    2010-03-01

    Full Text Available We investigated eight families with a novel subtype of congenital generalized lipodystrophy (CGL4 of whom five members had died from sudden cardiac death during their teenage years. ECG studies revealed features of long-QT syndrome, bradycardia, as well as supraventricular and ventricular tachycardias. Further symptoms comprised myopathy with muscle rippling, skeletal as well as smooth-muscle hypertrophy, leading to impaired gastrointestinal motility and hypertrophic pyloric stenosis in some children. Additionally, we found impaired bone formation with osteopenia, osteoporosis, and atlanto-axial instability. Homozygosity mapping located the gene within 2 Mbp on chromosome 17. Prioritization of 74 candidate genes with GeneDistiller for high expression in muscle and adipocytes suggested PTRF-CAVIN (Polymerase I and transcript release factor/Cavin as the most probable candidate leading to the detection of homozygous mutations (c.160delG, c.362dupT. PTRF-CAVIN is essential for caveolae biogenesis. These cholesterol-rich plasmalemmal vesicles are involved in signal-transduction and vesicular trafficking and reside primarily on adipocytes, myocytes, and osteoblasts. Absence of PTRF-CAVIN did not influence abundance of its binding partner caveolin-1 and caveolin-3. In patient fibroblasts, however, caveolin-1 failed to localize toward the cell surface and electron microscopy revealed reduction of caveolae to less than 3%. Transfection of full-length PTRF-CAVIN reestablished the presence of caveolae. The loss of caveolae was confirmed by Atomic Force Microscopy (AFM in combination with fluorescent imaging. PTRF-CAVIN deficiency thus presents the phenotypic spectrum caused by a quintessential lack of functional caveolae.

  3. Investigation of the relationship between venticular fibrillation duration and cardiac/neurological damage in a rabbit model of electrically induced arrhythmia.

    Science.gov (United States)

    Hu, Chun-Lin; Wei, Hong-Yan; Liu, Zi-You; Li, Xing; Liao, Xiao-Xing; Li, Yu-Jie; Zhan, Hong; Jing, Xiao-Li; Xiong, Yan; Liu, Yan-Yan; Wu, Gui-Fu

    2010-12-01

    To establish a simple, economic, and reliable alternating current (AC)-induced cardiac arrest (ACCA) model in rabbits for cardiopulmonary cerebral resuscitation research. Ventricular fibrillation was induced in 27 New Zealand rabbits by external transthoracic AC, which were randomly divided into three groups according to the duration of untreated ACCA (ACCA-3 minutes, ACCA-5 minutes, and ACCA-8 minutes). After ACCA, all animals received cardiopulmonary resuscitation for 2 minutes and subsequent defibrillation until return of spontaneous circulation (ROSC). The troponin I levels were measured at 4 hours after ROSC. Animals died spontaneously or were killed at 72 hours after ROSC. The hippocampus were removed and fixed in 3% formalin. TdT-mediated dUTP-biotin nick end labeling and Nissl stainings were performed in 10-μm thickness coronal sections. Furthermore, two rabbits (without induction of ventricular fibrillation, cardiopulmonary resuscitation, and defibrillation) served as normal control group. Mean survival times after ROSC were 48.57 hours ± 24.70 hours, 18.0 hours ± 15.13 hours, and 3.88 hours ± 2.39 hours for groups ACCA-3 minutes, ACCA-5 minutes, and ACCA-8 minutes, respectively. Survival was significantly different between ACCA-3 minutes and other two groups (p = 0.002 and p = 0.01). Neuronal necrosis and apoptosis were found in the hippocampus CA1, CA2, and CA3 areas of group ACCA-3 minutes. In contrast, neuronal necrosis and TdT-mediated dUTP-biotin nick end labeling positive cells were fewer in control animals. The rabbits in group ACCA-3 minutes had significant neuronal damage with apoptosis in hippocampus CA1, CA2, and CA3 areas at 72 hours after ROSC and survived longer than those in other groups. The model we describe may be a simple, economic, and reliable model for experimental investigation on cardiopulmonary cerebral resuscitation.

  4. Gypsies, Jews, and "The Merchant of Venice."

    Science.gov (United States)

    McKendy, Thomas

    1988-01-01

    Shows how looking at Shakespeare's prejudices and their roots, as seen in "The Merchant of Venice," can teach students not only about historical attitudes but also about their own unacknowledged assumptions and stereotypes. (MM)

  5. Arrhythmia during extracorporeal shock wave lithotripsy.

    Science.gov (United States)

    Zeng, Z R; Lindstedt, E; Roijer, A; Olsson, S B

    1993-01-01

    A prospective study of arrhythmia during extracorporeal shock wave lithotripsy (ESWL) was performed in 50 patients, using an EDAP LT01 piezoelectric lithotriptor. The 12-lead standard ECG was recorded continuously for 10 min before and during treatment. One or more atrial and/or ventricular ectopic beats occurred during ESWL in 15 cases (30%). The occurrence of arrhythmia was similar during right-sided and left-sided treatment. One patient developed multifocal ventricular premature beats and ventricular bigeminy; another had cardiac arrest for 13.5 s. It was found that various irregularities of the heart rhythm can be caused even by treatment with a lithotriptor using piezoelectric energy to create the shock wave. No evidence was found, however, that the shock wave itself rather than vagal activation and the action of sedo-analgesia was the cause of the arrhythmia. For patients with severe underlying heart disease and a history of complex arrhythmia, we suggest that the ECG be monitored during treatment. In other cases, we have found continuous monitoring of oxygen saturation and pulse rate with a pulse oximeter to be perfectly reliable for raising the alarm when depression of respiration and vaso-vagal reactions occur.

  6. Loperamide Induced Life Threatening Ventricular Arrhythmia

    Directory of Open Access Journals (Sweden)

    Ankit Upadhyay

    2016-01-01

    Full Text Available Loperamide is over-the-counter antidiarrheal agent acting on peripherally located μ opioid receptors. It is gaining popularity among drug abusers as opioid substitute. We report a case of a 46-year-old male that was presented after cardiac arrest. After ruling out ischemia, cardiomyopathy, pulmonary embolism, central nervous system pathology, sepsis, and other drug toxicity, we found out that patient was using around 100 mg of Loperamide to control his chronic diarrhea presumably because of irritable bowel syndrome for last five years and consumed up to 200 mg of Loperamide daily for last two days before the cardiac arrest. We hypothesize that the patient’s QTc prolongation and subsequent cardiac arrest are due to Loperamide toxicity. Patient experienced gradual resolution of tachyarrhythmia and gradual decrease in QTc interval during hospitalization which supports the evidence of causal relationship between Loperamide overdose and potentially fatal arrhythmias. It also provided the clue that patient may have congenital long QT syndrome which was unmasked by Loperamide causing ventricular arrhythmias. This case adds one more pearl in the literature to support that Loperamide overdose related cardiac toxicity does exist and it raises concerns over Loperamide abuse in the community.

  7. Risk of arrhythmia induced by psychotropic medications

    DEFF Research Database (Denmark)

    Fanoe, Søren; Kristensen, Diana; Fink-Jensen, Anders

    2014-01-01

    with psychotropic medications. The algorithm integrates the risk categories of the individual drugs and pre-disposing risk factors and suggests a prudent follow-up for patients with an increased risk. We believe this clinically manageable guideline might improve safety in the many and rapidly increasing number...... of the major mental disorders are associated with a large risk of suicide if untreated. The observed risk of malignant arrhythmia associated with treatment with psychotropic drugs calls for clinical guidelines integrating the risk of the individual drug and other potentially interacting risk factors......Several drugs used in the treatment of mental diseases are associated with an increased risk of sudden cardiac death (SCD). A general cause-relationship between the intake of these drugs and SCD is unattainable, but numerous case reports of drug-induced malignant arrhythmia and epidemiological...

  8. Obstructive sleep apnoea-hypopnoea and arrhythmias: new updates.

    Science.gov (United States)

    Vizzardi, Enrico; Sciatti, Edoardo; Bonadei, Ivano; D'Aloia, Antonio; Curnis, Antonio; Metra, Marco

    2017-07-01

    Obstructive sleep apnoea-hypopnoea (OSAH) is a prevalent condition characterized by repetitive pharyngeal collapse during sleep, leading to hypoxemia, hypercapnia, and persistent inspiratory efforts against an occluded airway until arousal. Several studies demonstrated that OSAH exerts acute and chronic effects on the cardiovascular system. Thus, although being a respiratory problem, the most important consequences of OSAH are cardiovascular, among which there are arrhythmias. The purpose of this review is to systematically analyse what has been recently published about the relationship between OSAH and every cardiac arrhythmia separately. We searched Pubmed, Scopus, Web of Science and Cochrane Collaboration databases for 'OSAHS arrhythmias', 'OSAH arrhythmias' and 'OSA arrhythmias'. We analyse 1298 articles and meta-analyses, excluding already edited reviews. Arrhythmias, especially of ventricular origin, are frequent in OSAH. Ventricular premature beats, couplets and ventricular tachycardia runs are even more frequent in patients suffering from heart failure. They may be due to left heart remodelling, overwork and ischaemia and can explain at least some sudden deaths occurring between midnight and 6 a.m. Sinus pauses and atrioventricular blocks are increased according to the severity of the disturbance and may be reduced by continuous positive airway pressure therapy, preventing pace-maker implantation. Finally, atrial fibrillation, resistance against antiarrhythmic drugs and recurrences after surgical procedures are strongly related to OSAH. Arrhythmias are frequent in OSAH. Treatment of OSAH may reduce some of them. An implantable cardioverter-defibrillator and continuous positive airway pressure should be considered in some patients.

  9. Sudden Cardiac Death As a Result of Neglected Hypopituitarism

    OpenAIRE

    Hajsheikholeslami, Farhad; Yazdani, Shahrooz

    2013-01-01

    Cardiac involvement infrequently occurs in hypopituitarism, and lethal cardiac arrhythmias are rarely reported. We present a middle age female who died as a consequence of refractory ventricular arrhythmia whose medical history and previous laboratory investigation were consistent with hypopituitarism. We conclude that hypopituitarism may lead to electrocardiographic changes and malignant ventricular arrhythmia and should be included in laboratory investigation and differential diagnosis of p...

  10. Flecainide Therapy Reduces Exercise-Induced Ventricular Arrhythmias in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia

    NARCIS (Netherlands)

    van der Werf, Christian; Kannankeril, Prince J.; Sacher, Frederic; Krahn, Andrew D.; Viskin, Sami; Leenhardt, Antoine; Shimizu, Wataru; Sumitomo, Naokata; Fish, Frank A.; Bhuiyan, Zahurul A.; Willems, Albert R.; van der Veen, Maurits J.; Watanabe, Hiroshi; Laborderie, Julien; Haïssaguerre, Michel; Knollmann, Björn C.; Wilde, Arthur A. M.

    2011-01-01

    Objectives This study evaluated the efficacy and safety of flecainide in addition to conventional drug therapy in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). Background CPVT is an inherited arrhythmia syndrome caused by gene mutations that destabilize cardiac

  11. Mortality of Inherited Arrhythmia Syndromes Insight Into Their Natural History

    NARCIS (Netherlands)

    Nannenberg, Eline A.; Sijbrands, Eric J. G.; Dijksman, Lea M.; Alders, Marielle; van Tintelen, J. Peter; Birnie, Martijn; van Langen, Irene M.; Wilde, Arthur A. M.

    Background-For most arrhythmia syndromes, the risk of sudden cardiac death for asymptomatic mutation carriers is ill defined. Data on the natural history of these diseases, therefore, are essential. The family tree mortality ratio method offers the unique possibility to study the natural history at

  12. Long-term neurodevelopmental outcome after fetal arrhythmia

    NARCIS (Netherlands)

    Lopriore, Enrico; Aziz, Muhammed I.; Nagel, Helene T.; Blom, Nico A.; Rozendaal, Lieke; Kanhai, Humphrey H. H.; Vandenbussche, Frank P. H. A.

    2009-01-01

    OBJECTIVE: The purpose of this study was to determine the long-term neurodevelopmental outcome in fetuses with severe tachy- or bradyarrhythmia. STUDY DESIGN: This was a follow-up study to assess the neurologic, mental, and psychomotor development in cases with fetal cardiac arrhythmia. RESULTS: A

  13. Cholera in Thomas Mann's Death in Venice.

    Science.gov (United States)

    Rütten, Thomas

    2009-01-01

    The article sets the cholera motif in Thomas Mann's famous novella Death in Venice against the historical context from which it partially originates. It is shown that this motif, while undoubtedly appropriated to serve Mann's own poetic ends, has a solid grounding in historical and autobiographical fact, thus blurring the boundaries between fact and fiction. The article illustrates the verifiable events of the outbreak of the Venetian cholera epidemic in May 1911, which Mann partly witnessed himself, during a holiday trip to Brioni and Venice, and partly heard and read about. It is established that Thomas Mann's account of the cholera in Venice in his novella is characterised by a rare and almost preternatural insightfulness into an otherwise murky affair that was marked by rumours, speculations and denials.

  14. Qt interval prolongation and ventricular arrhythmias in patients with chronic heart failure

    International Nuclear Information System (INIS)

    Sarwar, M.; Majeed, S.M.I.; Khan, M.A.; Majeed, S.M.

    2014-01-01

    To determine the association of QTc interval prolongation with ventricular arrhythmias in patients with chronic heart failure. Study Design: Descriptive study. Place and Duration of Study: This study was conducted at Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, Pakistan from April 2013 to August 2013. Patients and Methods: Fifty three heart failure patients were monitored for 48 hours using ambulatory holter electrocardiography recorders. Digital ECG data was analyzed for QTc interval along with frequency and severity of arrhythmias. Association of prolonged QTc interval with ventricular arrhythmias and severity of arrhythmias was analyzed. Results: Cardiac arrhythmias were observed in 79.2% patients. QT analysis revealed that 69.8% patients had prolonged QTc interval, 86.4% patients with prolonged QTc had ventricular arrhythmias. Of these 66% patients were found to have severe ventricular arrhythmias. Comparison of mean QTc interval of our study population with a reference value showed significantly higher QTc interval of our study group than the test value. Conclusion: Arrhythmia frequency and severity significantly increases with an increase in QTc interval in heart failure demonstrating association of prolonged QTc interval with high risk of severe ventricular arrhythmias and sudden cardiac death in chronic heart failure. (author)

  15. Computer-assisted education system for arrhythmia (CAESAR).

    Science.gov (United States)

    Fukushima, M; Inoue, M; Fukunami, M; Ishikawa, K; Inada, H; Abe, H

    1984-08-01

    A computer-assisted education system for arrhythmia (CAESAR) was developed for students to acquire the ability to logically diagnose complicated arrhythmias. This system has a logical simulator of cardiac rhythm using a mathematical model of the impulse formation and conduction system of the heart. A simulated arrhythmia (ECG pattern) is given on a graphic display unit with simulated series of the action potential of five pacemaker centers and the "ladder diagram" of impulse formation and conduction, which show the mechanism of that arrhythmia. For the purpose of the evaluation of this system, 13 medical students were given two types of tests concerning arrhythmias before and after 2-hr learning with this system. The scores they obtained after learning increased significantly from 73.3 +/- 11.9 to 93.2 +/- 3.0 (P less than 0.001) in one test and from 47.2 +/- 17.9 to 64.9 +/- 19.6 (P less than 0.001) in another one. These results proved that this CAI system is useful and effective for training ECG interpretation of arrhythmias.

  16. Leptospirosis acquired by tourists in Venice, Italy.

    Science.gov (United States)

    Lagi, Filippo; Corti, Giampaolo; Meli, Massimo; Pinto, Antonella; Bartoloni, Alessandro

    2013-01-01

    We present the case of two Australian tourists aged 25 and 26  years who, after immersion in a canal in Venice, developed severe leptospirosis. After a 1-week history of fever, headache, myalgia, and vomiting they developed jaundice and renal failure. Complete remission was achieved by antibiotic therapy and hemodialysis. © 2012 International Society of Travel Medicine.

  17. The great industrial boatyard of Venice

    OpenAIRE

    Macfarlane, Alan

    2004-01-01

    The arsenal or boat building centre of Venice in the middle ages was one of the greatest industrial centres in the world. Through a mechanical division of work and high precision it turned out ships very rapidly and inspired Dante’s vision of ‘Inferno’. Explained by Alan Macfarlane.

  18. TECRL, a new life-threatening inherited arrhythmia gene associated with overlapping clinical features of both LQTS and CPVT

    NARCIS (Netherlands)

    Devalla, Harsha D.; Gélinas, Roselle; Aburawi, Elhadi H.; Beqqali, Abdelaziz; Goyette, Philippe; Freund, Christian; Chaix, Marie-A.; Tadros, Rafik; Jiang, Hui; Le Béchec, Antony; Monshouwer-Kloots, Jantine J.; Zwetsloot, Tom; Kosmidis, Georgios; Latour, Frédéric; Alikashani, Azadeh; Hoekstra, Maaike; Schlaepfer, Jurg; Mummery, Christine L.; Stevenson, Brian; Kutalik, Zoltan; de Vries, Antoine Af; Rivard, Léna; Wilde, Arthur Am; Talajic, Mario; Verkerk, Arie O.; Al-Gazali, Lihadh; Rioux, John D.; Bhuiyan, Zahurul A.; Passier, Robert

    2016-01-01

    Genetic causes of many familial arrhythmia syndromes remain elusive. In this study, whole-exome sequencing (WES) was carried out on patients from three different families that presented with life-threatening arrhythmias and high risk of sudden cardiac death (SCD). Two French Canadian probands

  19. Venice: a meeting, a plague, a death

    Directory of Open Access Journals (Sweden)

    Óscar Botasso

    2008-10-01

    Full Text Available Death in Venice is based on the novella of the same name by Thomas Mann, except that in the cinema version the main character, Gustav von Aschenbach, is a musician instead of a writer. Owing to poetic license not always within the layman’s grasp, Luchino Visconti also wished to identify the artist with Gustav Mahler. Beyond such dissimilarities, however, the film is a feasible recreation of the story and a faithful reconstruction of those times: a Venice divorced from its former splendor and invaded by a plague and yet at the same time still able to evoke the captivating, nostalgic legacy of its magnificent past. An ideal scenario indeed for the musical ideas of Mahler, and perfectly reflected in the Midnight Song and the adagietto of his third and fifth symphonies.

  20. Understand Your Risk for Arrhythmia

    Science.gov (United States)

    ... is likely monitoring your heart rhythm with regular EKGs ( electrocardiograms ). But arrhythmias that occur infrequently may not ... patient sheets Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  1. Types of Arrhythmia in Children

    Science.gov (United States)

    ... even though they may need to keep taking medicine. Your child will probably need periodic check-ups but will ... minute. Understand and manage medications Parents of a child taking medicine for an arrhythmia should give the medicine at ...

  2. Is the Venice Lagoon Noisy? First Passive Listening Monitoring of the Venice Lagoon: Possible Effects on the Typical Fish Community.

    Science.gov (United States)

    Bolgan, Marta; Picciulin, Marta; Codarin, Antonio; Fiorin, Riccardo; Zucchetta, Matteo; Malavasi, Stefano

    2016-01-01

    Three passive listening surveys have been carried out in two of the three Venice lagoon tide inlets and inside the Venice island. The spectral content and the intensity level of the underwater noise as well as the presence or absence of Sciaena umbra and the distribution of its different sound patterns have been investigated in all the recording sites. The passive listening proved to be successful in detecting S. umbra drumming sounds in both Venice lagoon tide inlets. Our results indicate that the spectral content and the level of underwater noise pollution in the Venice lagoon could affect fish acoustic communication.

  3. Land Subsidence International Symposium held in Venice

    Science.gov (United States)

    The Third International Symposium on Land Subsidence was held March 18-25, 1984, in Venice, Italy. Sponsors were the Ground-Water Commission of the International Association of Hydrological Sciences (IAHS), the United Nations Educational, Scientific, and Cultural Organization (UNESCO), the Italian National Research Council (CNR), the Italian Regions of Veneto and Emilia-Romagna, the Italian Municipalities of Venice, Ravenna, and Modena, the Venice Province, and the European Research Office. Cosponsors included the International Association of Hydrogeologists (IAH), the International Society for Soil Mechanics and Foundation Engineering (ISSMFE), and the Association of Geoscientists for International Development (AGID).Organized within the framework of UNESCO's International Hydrological Program, the symposium brought together over 200 international interdisciplinary specialists in the problems of land subsidence due to fluid and mineral withdrawal. Because man's continuing heavy development of groundwater, gas, oil, and minerals is changing the natural regime and thus causing more and more subsiding areas in the world, there had been sufficient new land subsidence occurrence, problems, research, and remedial measures since the 1976 Second International Symposium held in Anaheim, California, to develop a most interesting program of nearly 100 papers from about 30 countries. The program consisted of papers covering case histories of fluid and mineral withdrawal, engineering theory and analysis, karst “sink-hole”-type subsidence, subsidence due to dewatering of organic deposits or due to application of water (hydrocompaction), instrumentation, legal, socioeconomic, and environmental effects of land subsidence, and remedial works.

  4. 76 FR 4651 - Venice Gathering System, L.L.C.; Notice of Request Under Blanket Authorization

    Science.gov (United States)

    2011-01-26

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-58-000] Venice... on January 7, 2011, Venice Gathering System, L.L.C. (Venice), 1000 Louisiana, Suite 4300, Houston... existing 20- inch diameter natural gas supply lateral pipeline, offshore Louisiana, under Venice's blanket...

  5. Multi-arrhythmias detection with an XML rule-based system from 12-Lead Electrocardiogram.

    Science.gov (United States)

    Khelassi, Abdeldjalil; Yelles-Chaouche, Sarra-Nassira; Benais, Faiza

    2017-05-01

    The computer-aided detection of cardiac arrhythmias stills a crucial application in medical technologies. The rule based systems RBS ensure a high level of transparency and interpretability of the obtained results. To facilitate the diagnosis of the cardiologists and to reduce the uncertainty made in this diagnosis. In this research article, we have realized a classification and automatic recognition of cardiac arrhythmias, by using XML rules that represent the cardiologist knowledge. Thirteen experiments with different knowledge bases were realized for improving the performance of the used method in the detection of 13 cardiac arrhythmias. In the first 12 experiments, we have designed a specialized knowledge base for each cardiac arrhythmia, which contains just one arrhythmia detection rule. In the last experiment, we applied the knowledge base which contains rules of 12 arrhythmias. We used, for the experiments, an international data set with 279 features and 452 records characterizing 12 leads of ECG signal and social information of patients. The data sets were constructed and published at Bilkent University of Ankara, Turkey. In addition, the second version of the self-developed software "XMLRULE" was used; the software can infer more than one class and facilitate the interpretability of the obtained results. The 12 first experiments give 82.80% of correct detection as the mean of all experiments, the results were between 19% and 100% with a low rate in just one experiment. The last experiment in which all arrhythmias are considered, the results of correct detection was 38.33% with 90.55% of sensibility and 46.24% of specificity. It was clearly show that in these results the good choice of the classification model is very beneficial in terms of performance. The obtained results were better than the published results with other computational methods for the mono class detection, but it was less in multi-class detection. The RBS is the most transparent method for

  6. Ventricular arrhythmias in the absence of structural heart disease.

    Science.gov (United States)

    Prystowsky, Eric N; Padanilam, Benzy J; Joshi, Sandeep; Fogel, Richard I

    2012-05-15

    Ventricular arrhythmia (VA) in structurally normal hearts can be broadly considered under non-life-threatening monomorphic and life-threatening polymorphic rhythms. Monomorphic VA is classified on the basis of site of origin in the heart, and the most common areas are the ventricular outflow tracts and left ventricular fascicles. The morphology of the QRS complexes on electrocardiogram is an excellent tool to identify the site of origin of the rhythm. Although these arrhythmias are common and generally carry an excellent prognosis, rare sudden death events have been reported. Very frequent ventricular ectopy may also result in a cardiomyopathy in a minority of patients. Suppression of VA may be achieved using calcium-channel blockers, beta-adrenergic blockers, and class I or III antiarrhythmic drugs. Radiofrequency ablation has emerged as an excellent option to eliminate these arrhythmias, although certain foci including aortic cusps and epicardium may be technically challenging. Polymorphic ventricular tachycardia (VT) is rare and generally occurs in patients with genetic ion channel disorders including long QT syndrome, Brugada syndrome, catecholaminergic polymorphic VT, and short QT syndrome. Unlike monomorphic VT, these arrhythmic syndromes are associated with sudden death. While the cardiac gross morphology is normal, suggesting a structurally normal heart, abnormalities exist at the molecular level and predispose them to arrhythmias. Another fascinating area, idiopathic ventricular fibrillation and early repolarization syndrome, are undergoing research for a genetic basis. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Channelopathies - Emerging Trends in The Management of Inherited Arrhythmias

    Directory of Open Access Journals (Sweden)

    Priya Chockalingam, MBBS, MRCPCH, PhD

    2015-01-01

    Full Text Available In spite of their relative rarity, inheritable arrhythmias have come to the forefront as a group of potentially fatal but preventable cause of sudden cardiac death in children and (young adults. Comprehensive management of inherited arrhythmias includes diagnosing and treating the proband and identifying and protecting affected family members. This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome. The ensuing knowledge of the genotype-phenotype correlations enables us to risk-stratify, prognosticate and treat based on the genetic test results. The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals. The therapeutic armamentarium of inherited arrhythmias includes pharmacological agents, device therapies and surgical interventions. A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective. While opportunities for research are numerous in this expanding field of medicine, there is also tremendous scope for incorporating the emerging trends in managing patients and families with inherited arrhythmias in the Indian subcontinent.

  8. A new era for cardiac rhythm management devices : Solutions for transvenous lead complications

    NARCIS (Netherlands)

    Knops, R.E.

    2017-01-01

    Both pacemakers and cardiac defibrillators (ICD) have been designed to treat cardiac arrhythmias. These arrhythmias often lead to life-threatening conditions. Numerous studies have shown the benefits on survival and quality of life of these cardiac rhythm management (CRM) devices. These devices rely

  9. Deposition in St. Mark's Basilica of Venice.

    Science.gov (United States)

    Morabito, E; Zendri, E; Piazza, R; Ganzerla, R; Montalbani, S; Marcoleoni, E; Bonetto, F; Scandella, A; Barbante, C; Gambaro, A

    2013-04-01

    Atmospheric pollutants may cause damage to monuments and historical buildings. Besides air contaminants, soluble salts are also responsible for stone deterioration and decay in outdoor and indoor monuments. The problem of how to conserve works of arts thus requires a deep knowledge of contaminants' concentration and distribution inside buildings. In this work, water-soluble ions inside St. Mark's Basilica in Venice were studied, with the aim of understanding their principal source and distribution inside the building. With the aid of Fourier transform infrared spectroscopy and scanning electron microscopy analysis, the interaction between ions and surface's material was also investigated. Ion chromatographic analysis of depositions highlighted a large amount of "deteriorating agents" such as sulphates and chlorides. A possible source in the innermost area of the basilica has been found for formates and nitrates. On the contrary, a decrease of chloride, from the entrance to the innermost area, has been found, which indicates that the source is outside the building. It is emphasized that different contaminants behave differently on different material, and the effect of pollution inside churches and monuments is not easy to predict. Wood and brick seem to react differently than stone and mortar to the damaging action of salts and pollutants. The present work should be considered a useful tool for the future preservation of St. Mark's Basilica in Venice.

  10. Hypokalemia and sudden cardiac death

    DEFF Research Database (Denmark)

    Kjeldsen, Keld

    2010-01-01

    Worldwide, approximately three million people suffer sudden cardiac death annually. These deaths often emerge from a complex interplay of substrates and triggers. Disturbed potassium homeostasis among heart cells is an example of such a trigger. Thus, hypokalemia and, also, more transient...... of fatal arrhythmia and sudden cardiac death a patient is, the more attention should be given to the potassium homeostasis....

  11. LITERATURE CURRICULUM III--TEST FOR "THE MERCHANT OF VENICE."

    Science.gov (United States)

    KITZHABER, ALBERT R.

    THIS TEST--"THE MERCHANT OF VENICE"--WAS DESIGNED BY THE OREGON CURRICULUM STUDY CENTER FOR A NINTH-GRADE LITERATURE CURRICULUM. IT IS INTENDED TO ACCOMPANY CURRICULUM UNITS AVAILABLE AS ED 010 815 AND ED 010 816. (MM)

  12. Wired! and Visualizing Venice: Scaling up Digital Art History

    OpenAIRE

    Lanzoni, Kristin Huffman; Olson, Mark James-Vrooman; Szabo, Victoria E.

    2015-01-01

    This article focuses on Visualizing Venice, an interdisciplinary, cross-cultural collaboration that engages in mapping, 3-D modeling, and multimedia representations of historical change in Venice, Italy. Through a “laboratory” approach that integrates students and faculty in multi-year research teams, we ask new questions and pursue emerging lines of inquiry about architectural monuments, their relation to the larger urban setting, and the role of sculptural and painted decoration in sacred s...

  13. Inhibition of Rac1 reduces store overload-induced calcium release and protects against ventricular arrhythmia.

    Science.gov (United States)

    Zhang, Lili; Lu, Xiangru; Gui, Le; Wu, Yan; Sims, Stephen M; Wang, Guoping; Feng, Qingping

    2016-08-01

    Rac1 is a small GTPase and plays key roles in multiple cellular processes including the production of reactive oxygen species (ROS). However, whether Rac1 activation during myocardial ischaemia and reperfusion (I/R) contributes to arrhythmogenesis is not fully understood. We aimed to study the effects of Rac1 inhibition on store overload-induced Ca(2+) release (SOICR) and ventricular arrhythmia during myocardial I/R. Adult Rac1(f/f) and cardiac-specific Rac1 knockdown (Rac1(ckd) ) mice were subjected to myocardial I/R and their electrocardiograms (ECGs) were monitored for ventricular arrhythmia. Myocardial Rac1 activity was increased and ventricular arrhythmia was induced during I/R in Rac1(f/f) mice. Remarkably, I/R-induced ventricular arrhythmia was significantly decreased in Rac1(ckd) compared to Rac1(f/f) mice. Furthermore, treatment with Rac1 inhibitor NSC23766 decreased I/R-induced ventricular arrhythmia. Ca(2+) imaging analysis showed that in response to a 6 mM external Ca(2+) concentration challenge, SOICR was induced with characteristic spontaneous intracellular Ca(2+) waves in Rac1(f/f) cardiomyocytes. Notably, SOICR was diminished by pharmacological and genetic inhibition of Rac1 in adult cardiomyocytes. Moreover, I/R-induced ROS production and ryanodine receptor 2 (RyR2) oxidation were significantly inhibited in the myocardium of Rac1(ckd) mice. We conclude that Rac1 activation induces ventricular arrhythmia during myocardial I/R. Inhibition of Rac1 suppresses SOICR and protects against ventricular arrhythmia. Blockade of Rac1 activation may represent a new paradigm for the treatment of cardiac arrhythmia in ischaemic heart disease. © 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  14. A Novel Alpha Cardiac Actin (ACTC1 Mutation Mapping to a Domain in Close Contact with Myosin Heavy Chain Leads to a Variety of Congenital Heart Defects, Arrhythmia and Possibly Midline Defects.

    Directory of Open Access Journals (Sweden)

    Céline Augière

    Full Text Available A Lebanese Maronite family presented with 13 relatives affected by various congenital heart defects (mainly atrial septal defects, conduction tissue anomalies and midline defects. No mutations were found in GATA4 and NKX2-5.A set of 399 poly(AC markers was used to perform a linkage analysis which peaked at a 2.98 lod score on the long arm of chromosome 15. The haplotype analysis delineated a 7.7 meganucleotides genomic interval which included the alpha-cardiac actin gene (ACTC1 among 36 other protein coding genes. A heterozygous missense mutation was found (c.251T>C, p.(Met84Thr in the ACTC1 gene which changed a methionine residue conserved up to yeast. This mutation was absent from 1000 genomes and exome variant server database but segregated perfectly in this family with the affection status. This mutation and 2 other ACTC1 mutations (p.(Glu101Lys and p.(Met125Val which result also in congenital heart defects are located in a region in close apposition to a myosin heavy chain head region by contrast to 3 other alpha-cardiac actin mutations (p.(Ala297Ser,p.(Asp313His and p.(Arg314His which result in diverse cardiomyopathies and are located in a totally different interaction surface.Alpha-cardiac actin mutations lead to congenital heart defects, cardiomyopathies and eventually midline defects. The consequence of an ACTC1 mutation may in part be dependent on the interaction surface between actin and myosin.

  15. Reduction of false arrhythmia alarms using signal selection and machine learning

    NARCIS (Netherlands)

    Eerikäinen, L.M.; Vanschoren, J.; Rooijakkers, M.J.; Vullings, R.; Aarts, R.M.

    2016-01-01

    In this paper, we propose an algorithm that classifies whether a generated cardiac arrhythmia alarm is true or false. The large number of false alarms in intensive care is a severe issue. The noise peaks caused by alarms can be high and in a noisy environment nurses can experience stress and

  16. 75 FR 38589 - Culturally Significant Objects Imported for Exhibition Determinations: “Venice: Canaletto and His...

    Science.gov (United States)

    2010-07-02

    ... DEPARTMENT OF STATE [Public Notice: 7072] Culturally Significant Objects Imported for Exhibition Determinations: ``Venice: Canaletto and His Rivals'' SUMMARY: Notice is hereby given of the following... exhibition ``Venice: Canaletto and His Rivals,'' imported from abroad for temporary exhibition within the...

  17. Novel Calmodulin (CALM2) Mutations Associated with Congenital Arrhythmia Susceptibility

    Science.gov (United States)

    Makita, Naomasa; Yagihara, Nobue; Crotti, Lia; Johnson, Christopher N.; Beckmann, Britt-Maria; Roh, Michelle S.; Shigemizu, Daichi; Lichtner, Peter; Ishikawa, Taisuke; Aiba, Takeshi; Homfray, Tessa; Behr, Elijah R.; Klug, Didier; Denjoy, Isabelle; Mastantuono, Elisa; Theisen, Daniel; Tsunoda, Tatsuhiko; Satake, Wataru; Toda, Tatsushi; Nakagawa, Hidewaki; Tsuji, Yukiomi; Tsuchiya, Takeshi; Yamamoto, Hirokazu; Miyamoto, Yoshihiro; Endo, Naoto; Kimura, Akinori; Ozaki, Kouichi; Motomura, Hideki; Suda, Kenji; Tanaka, Toshihiro; Schwartz, Peter J.; Meitinger, Thomas; Kääb, Stefan; Guicheney, Pascale; Shimizu, Wataru; Bhuiyan, Zahurul A.; Watanabe, Hiroshi; Chazin, Walter J.; George, Alfred L.

    2014-01-01

    Background Genetic predisposition to life-threatening cardiac arrhythmias such as in congenital long-QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) represent treatable causes of sudden cardiac death in young adults and children. Recently, mutations in calmodulin (CALM1, CALM2) have been associated with severe forms of LQTS and CPVT, with life-threatening arrhythmias occurring very early in life. Additional mutation-positive cases are needed to discern genotype-phenotype correlations associated with calmodulin mutations. Methods and Results We employed conventional and next-generation sequencing approaches including exome analysis in genotype-negative LQTS probands. We identified five novel de novo missense mutations in CALM2 in three subjects with LQTS (p.N98S, p.N98I, p.D134H) and two subjects with clinical features of both LQTS and CPVT (p.D132E, p.Q136P). Age of onset of major symptoms (syncope or cardiac arrest) ranged from 1–9 years. Three of five probands had cardiac arrest and one of these subjects did not survive. Although all probands had LQTS, two subjects also exhibited electrocardiographic features consistent with CPVT. The clinical severity among subjects in this series was generally less than that originally reported for CALM1 and CALM2 associated with recurrent cardiac arrest during infancy. Four of five probands responded to β-blocker therapy whereas one subject with mutation p.Q136P died suddenly during exertion despite this treatment. Mutations affect conserved residues located within calcium binding loops III (p.N98S, p.N98I) or IV (p.D132E, p.D134H, p.Q136P) and caused reduced calcium binding affinity. Conclusions CALM2 mutations can be associated with LQTS and with overlapping features of LQTS and CPVT. PMID:24917665

  18. Arrhythmias After Tetralogy of Fallot Repair

    Science.gov (United States)

    Folino, Antonio Franco; Daliento, Luciano

    2005-01-01

    Tetralogy of Fallot is the most common cyanotic congenital heart disease, with a good outcome after total surgical correction. In spite of a low perioperative mortality and a good quality of life, late sudden death remains a significant clinical problem, mainly related to episodes of sustained ventricular tachycardia and ventricular fibrillation. Fibro-fatty substitution around infundibular resection, intraventricular septal scar, and patchy myocardial fibrosis, may provide anatomical substrates of abnormal depolarization and repolarization causing reentrant ventricular arrhythmias. Several non-invasive indices based on classical examination such as ECG, signal-averaging ECG, and echocardiography have been proposed to identify patients at high risk of sudden death, with hopeful results. In the last years other more sophisticated invasive and non-invasive tools, such as heart rate variability, electroanatomic mapping and cardiac magnetic resonance added a relevant contribution to risk stratification. Even if each method per se is affected by some limitations, a comprehensive multifactorial clinical and investigative examination can provide an accurate risk evaluation for every patient. PMID:16943881

  19. Arrhythmias After Tetralogy of Fallot Repair

    Directory of Open Access Journals (Sweden)

    Antonio Franco Folino

    2005-10-01

    Full Text Available Tetralogy of Fallot is the most common cyanotic congenital heart disease, with a good outcome after total surgical correction. In spite of a low perioperative mortality and a good quality of life, late sudden death remains a significant clinical problem, mainly related to episodes of sustained ventricular tachycardia and ventricular fibrillation. Fibro-fatty substitution around infundibular resection, intraventricular septal scar, and patchy myocardial fibrosis, may provide anatomical substrates of abnormal depolarization and repolarization causing reentrant ventricular arrhythmias. Several non-invasive indices based on classical examination such as ECG, signal-averaging ECG, and echocardiography have been proposed to identify patients at high risk of sudden death, with hopeful results. In the last years other more sophisticated invasive and non-invasive tools, such as heart rate variability, electroanatomic mapping and cardiac magnetic resonance added a relevant contribution to risk stratification. Even if each method per se is affected by some limitations, a comprehensive multifactorial clinical and investigative examination can provide an accurate risk evaluation for every patient.

  20. 78 FR 69803 - Drawbridge Operation Regulations; Gulf Intracoastal Waterway, Venice, FL

    Science.gov (United States)

    2013-11-21

    ...-AA09 Drawbridge Operation Regulations; Gulf Intracoastal Waterway, Venice, FL AGENCY: Coast Guard, DHS... that governs the Hatchett Creek (US-41) Twin Bridges, Gulf Intracoastal Waterway mile 56.9, Venice, FL... mile 56.9 at Venice, FL as listed in Sec. 117.287(b), provides the draw of the Hatchett Creek (US-41...

  1. Arrhythmia

    Science.gov (United States)

    ... information about the heart's electrical system, including detailed animations, go to the Health Topics How the Heart ... Your doctor watches your symptoms, heart rate, EKG reading, and blood pressure throughout the test. He or ...

  2. Arrhythmia

    Science.gov (United States)

    ... Kids and Teens Pregnancy and Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, Procedures & Devices Over-the- ...

  3. Mortality and risk of cardiac complications among immediate survivors of accidental electric shock

    DEFF Research Database (Denmark)

    Hansen, Steen Møller; Riahi, Sam; Hjortshøj, Søren

    2017-01-01

    OBJECTIVE: Exposure to electric shock has been associated with an increased risk of developing delayed cardiac arrhythmias and cardiac diseases. We examined whether electric shock patients have an increased risk of developing cardiac disease, cardiac arrhythmias or death compared with the general...... suggest that nearly all patients can be discharged safely from the emergency room after electric shock without further observation.......OBJECTIVE: Exposure to electric shock has been associated with an increased risk of developing delayed cardiac arrhythmias and cardiac diseases. We examined whether electric shock patients have an increased risk of developing cardiac disease, cardiac arrhythmias or death compared with the general...... Danish population. DESIGN: Matched cohort study. SETTING: A nationwide study in Denmark from 1994 to 2011. PARTICIPANTS: We identified 11 462 Danish patients who visited an emergency ward or were admitted to a hospital due to electric shock from 1994 to 2011. Each patient was matched for age and sex...

  4. Natural versus anthropogenic subsidence of Venice.

    Science.gov (United States)

    Tosi, Luigi; Teatini, Pietro; Strozzi, Tazio

    2013-09-26

    We detected land displacements of Venice by Persistent Scatterer Interferometry using ERS and ENVISAT C-band and TerraSAR-X and COSMO-SkyMed X-band acquisitions over the periods 1992-2010 and 2008-2011, respectively. By reason of the larger observation period, the C-band sensors was used to quantify the long-term movements, i.e. the subsidence component primarily ascribed to natural processes. The high resolution X-band satellites reveal a high effectiveness to monitor short-time movements as those induced by human activities. Interpolation of the two datasets and removal of the C-band from the X-band map allows discriminating between the natural and anthropogenic components of the subsidence. A certain variability characterizes the natural subsidence (0.9 ± 0.7 mm/yr), mainly because of the heterogeneous nature and age of the lagoon subsoil. The 2008 displacements show that man interventions are responsible for movements ranging from -10 to 2 mm/yr. These displacements are generally local and distributed along the margins of the city islands.

  5. Ion Channel Trafficking: Control of Ion Channel Density as a Target for Arrhythmias?

    Directory of Open Access Journals (Sweden)

    Elise Balse

    2017-10-01

    Full Text Available The shape of the cardiac action potential (AP is determined by the contributions of numerous ion channels. Any dysfunction in the proper function or expression of these ion channels can result in a change in effective refractory period (ERP and lead to arrhythmia. The processes underlying the correct targeting of ion channels to the plasma membrane are complex, and have not been fully characterized in cardiac myocytes. Emerging evidence highlights ion channel trafficking as a potential causative factor in certain acquired and inherited arrhythmias, and therapies which target trafficking as opposed to pore block are starting to receive attention. In this review we present the current evidence for the mechanisms which underlie precise control of cardiac ion channel trafficking and targeting.

  6. Tourist attractiveness of Venice in Żnin district

    Directory of Open Access Journals (Sweden)

    Rafał Gotowski

    2016-10-01

    Full Text Available The article concerns the tourist attractiveness of Venice, a small town in northern Poland with a rich historical past associated with the Middle Ages and the beginnings of railway transport. The aim of this work was the identification of the main symbols of this part of the Polish, identification of tourist attractions of Venice, and the determination of the attractiveness degree of the various tourist attractions located in the village and defining directions of further development of the tourist offer. Based on the survey, it was found the most important symbol of this polish tourist region is  the Archaeological Museum in Biskupin. The main attraction of Venice is the Narrow Gauge Railway Museum and the Castle ,,Bloody Devil" which is mostly visited during the waiting for the train arrivals or is overlooked by tourists.

  7. Unique Association of Rare Cardiovascular Disease in an Athlete With Ventricular Arrhythmias.

    Science.gov (United States)

    Santomauro, V; Contursi, M; Dellegrottaglie, S; Borsellino, G

    2015-01-01

    Ventricular arrhythmias are a leading cause of non-elegibility to competitive sport. The failure to detect a significant organic substrate in the initial stage of screening does not preclude the identification of structural pathologies in the follow-up by using advanced imaging techniques. Here we report the case of a senior athlete judged not elegible because an arrhythmia with the morphology consistent with the origin of the left ventricle, in which subsequent execution of a cardiac MR and a thoracic CT scan has allowed the identification of an unique association between an area of myocardial damage, probable site of origine of the arrhythma, and a rare aortic malformation.

  8. Electrical Signs predictors of malignant ventricular arrhythmias

    International Nuclear Information System (INIS)

    Aleman Fernandez, Ailema Amelia; Dorantes Sanchez, Margarita

    2012-01-01

    Recurrence of malignant ventricular arrhythmia is frequent in cardioverter-defibrillators related patients. The risk stratification is difficult, there are numerous electrocardiographic predictors but his sensibility and specificity are not absolute. The limit between normal and pathological is not defined, besides the complexity of ventricular arrhythmias. We expose different electrocardiographic predictors that can help to better individual risk stratification

  9. Thomas Mann's Death in Venice or Plutarch's way towards Eros

    OpenAIRE

    Gilabert Barberà, Pau

    2010-01-01

    In Death in Venice Thomas Mann refers explicitly to Plato's Symposium and Phaedrus in order to explain the relationship between Gustav von Aschenbach and Tadzio but he hides that his novel also depends on Plutarch's Eroticus. Why? The aim of this article is precisely to reveal the different reasons for such an attitude. Indeed, Plutarch speaks highly of conjugal love in his Eroticus and this way is not followed by Mann in Death in Venice but, at the same, the German writer finds in this Pluta...

  10. Diagnosis of traumatic cardiac contusion

    International Nuclear Information System (INIS)

    Waxman, K.; Soliman, M.H.; Braunstein, P.; Formosa, P.; Cohen, A.J.; Matsuura, P.; Mason, G.R.

    1986-01-01

    Cardiac contusion following blunt chest trauma remains a diagnostic problem because of a lack of sensitive diagnostic tests. This study evaluated thallous chloride Tl 201 single-photon-emission computed tomography in a series of 48 patients following blunt chest trauma. Of the 48 patients, 23 had normal scans. None of these patients proved to have serious arrhythmias during three days of continuous monitoring. Of 25 patients with abnormal or ambiguous studies, five (20%) developed serious arrhythmias requiring therapy. Single-photon-emission computed tomography scanning thus was sensitive in indicating that group of patients at risk of serious arrhythmias, and may therefore prove to be a useful screening test to determine the need for hospitalization and arrhythmia monitoring following blunt chest trauma

  11. Sudden Cardiac Death in Children. Part 2

    Directory of Open Access Journals (Sweden)

    Ye.V. Pshenichnaya

    2013-03-01

    Full Text Available This article deals with the dysplastic changes in musculo-valve structures of the heart, arrhythmias and conduction disorders, associated with a risk of sudden cardiac death. The diagnostic criteria for sudden cardiac death, the events of cardio-pulmonary resuscitation, prevention of life-threatening conditions in children are provided.

  12. Fractal ventilation enhances respiratory sinus arrhythmia

    Directory of Open Access Journals (Sweden)

    Girling Linda G

    2005-05-01

    Full Text Available Abstract Background Programming a mechanical ventilator with a biologically variable or fractal breathing pattern (an example of 1/f noise improves gas exchange and respiratory mechanics. Here we show that fractal ventilation increases respiratory sinus arrhythmia (RSA – a mechanism known to improve ventilation/perfusion matching. Methods Pigs were anaesthetised with propofol/ketamine, paralysed with doxacurium, and ventilated in either control mode (CV or in fractal mode (FV at baseline and then following infusion of oleic acid to result in lung injury. Results Mean RSA and mean positive RSA were nearly double with FV, both at baseline and following oleic acid. At baseline, mean RSA = 18.6 msec with CV and 36.8 msec with FV (n = 10; p = 0.043; post oleic acid, mean RSA = 11.1 msec with CV and 21.8 msec with FV (n = 9, p = 0.028; at baseline, mean positive RSA = 20.8 msec with CV and 38.1 msec with FV (p = 0.047; post oleic acid, mean positive RSA = 13.2 msec with CV and 24.4 msec with FV (p = 0.026. Heart rate variability was also greater with FV. At baseline the coefficient of variation for heart rate was 2.2% during CV and 4.0% during FV. Following oleic acid the variation was 2.1 vs. 5.6% respectively. Conclusion These findings suggest FV enhances physiological entrainment between respiratory, brain stem and cardiac nonlinear oscillators, further supporting the concept that RSA itself reflects cardiorespiratory interaction. In addition, these results provide another mechanism whereby FV may be superior to conventional CV.

  13. Double hazards of ischemia and reperfusion arrhythmias in a patient with variant angina pectoris.

    Science.gov (United States)

    Xu, Mingzhu; Yang, Xiangjun

    2015-01-01

    Variant angina pectoris, also called Prinzmetal's angina, is a syndrome caused by vasospasms of the coronary arteries. It can lead to myocardial infarction, ventricular arrhythmias, atrioventricular block and even sudden cardiac death. We report the case of a 53 year-old male patient with recurrent episodes of chest pain and arrhythmias in the course of related variant angina pectoris. It is likely that the reperfusion following myocardial ischemia was responsible for the ventricular fibrillation while the ST-segment returned to the baseline. This case showed that potential lethal arrhythmias could arise due to variant angina pectoris. It also indicated that ventricular fibrillation could be self-terminated. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Sediment budget in the Lagoon of Venice, Italy

    OpenAIRE

    Sarretta, Alessandro; Pillon, Simone; Molinaroli, Emanuela; Guerzoni, Stefano; Fontolan, Giorgio

    2009-01-01

    This is the accepted manuscript of the paper "Sediment budget in the Lagoon of Venice, Italy", published ad final paper in "Continental Shelf Research Volume 30, Issue 8, 15 May 2010, Pages 934-9499" (https://doi.org/10.1016/j.csr.2009.07.002)

  15. A Teacher's Guide for "The Merchant of Venice" and "Othello."

    Science.gov (United States)

    WGBH-TV, Boston, MA.

    William Shakespeare has influenced most, if not all, Western playwrights. His techniques, themes, characters, and plots are contained in much of what is produced today, from television to Broadway. This teacher's guide provides summaries of the plays "The Merchant of Venice" and "Othello," essays, and corresponding student…

  16. Venice GIS Portal: la punta dell'iceberg

    Directory of Open Access Journals (Sweden)

    Rudj Maria Todaro

    2010-03-01

    Full Text Available Venice GIS portal Single information system, the only methodology but an undetermined number of working groups. The basic principle, which underpins Insula, is flexibility, a philosophy which has enabled it to test the adoption of new processes of governance of assets, as a strategic resource of the Public.

  17. Discovering Site-Specific Qualities in Venice and Marseille

    DEFF Research Database (Denmark)

    Reeh, Henrik

    2015-01-01

    . For centuries, both of these cities – Venice and Marseille – have forged long-term and intimate symbolic relationships between surrounding waters and diverse harbor functions. Today, encoun-ters with such urban spaces and practices invite the visiting researchers to single out particular and maybe unexpected...

  18. MERCHANT OF VENICE. LITERATURE CURRICULUM III, TEACHER VERSION.

    Science.gov (United States)

    KITZHABER, ALBERT R.

    THIS TEACHING GUIDE ON "THE MERCHANT OF VENICE" WAS PREPARED FOR USE IN A NINTH-GRADE LITERATURE CURRICULUM. THE PURPOSE OF THE GUIDE WAS TO ILLUMINATE THE PLAY AS A WHOLE, AND TO SUGGEST TO THE TEACHER SOME USEFUL PRINCIPLES FOR FRAMING QUESTIONS AND GUIDING DISCUSSIONS IN THE CLASSROOM. THE GUIDE WAS NOT TO BE USED, HOWEVER, AS A BASE…

  19. Case Studies in Censorship: Censoring "The Merchant of Venice."

    Science.gov (United States)

    Gray, Richard A.

    1991-01-01

    Reviews censorship of "The Merchant of Venice," which has been based on its portrayal of the Jewish character Shylock. Background information is followed by an annotated bibliography which includes 15 citations dealing with Shylock, 22 citations to articles that address the censorship of the play, and 64 works of literature that have…

  20. Overview of ecotoxicological studies performed in the Venice Lagoon (Italy).

    Science.gov (United States)

    Losso, C; Ghirardini, A Volpi

    2010-01-01

    This work reports on the state of the art of the bioindicators used to assess environmental quality (regarding chemical pollutant impacts) in the Venice lagoon. After a brief description of the roles, advantages and limitations of bioindicators in marine and transitional environments and a summary of the Venice lagoon characteristics, the ecotoxicological methods used during scientific studies and research projects in the Lagoon are reported. Since not all data are available and no database can be formulated, the main evidence from toxicity bioassays, biomarkers and bioaccumulation analyses since the end of the 1970s is spatially synthesized using maps and discussed according to the four Venice lagoon basins. The majority of indicators showed that the Lido basin (north-central lagoon), affected by the presence of the industrial area and the city of Venice, is the one most highly impacted (particularly in the sites located within or in front of the industrial area, which showed very high sediment toxicity and high levels of DNA damage). The Malamocco basin (south-central lagoon) seems to be the least problematic. The southern basin (Chioggia basin) was shown to be impacted by urban contaminants from the town of Chioggia. The northern basin (Treporti basin) presented both impacted sites (high toxicity and high bioaccumulation factor) and relatively unpolluted sites (absence of toxicity, absence of imposex and low levels of bioaccumulation). This review can serve as a basis on which to select pragmatic, cost-effective biomonitoring techniques for environmental effects in lagoon ecosystems.

  1. THE MERCHANT OF VENICE. LITERATURE CURRICULUM III, STUDENT VERSION.

    Science.gov (United States)

    KITZHABER, ALBERT R.

    A GUIDE WAS PRODUCED FOR STUDENT USE IN NINTH-GRADE STUDY OF "THE MERCHANT OF VENICE." THE GUIDE PRESENTED SEVERAL ALTERNATE APPROACHES FOR UNDERSTANDING THE PLAY AND LEARNING ITS CONTENT. A MAJOR EMPHASIS OF THE GUIDE WAS PLACED ON THREE FORMS OF STUDENT QUESTIONS, RELATED TO SPECIFIC ACTS AND SCENES, THE CHARACTERS IN THE DRAMA, AND…

  2. Using "The Merchant of Venice" in Teaching Monetary Economics.

    Science.gov (United States)

    Kish-Goodling, Donna M.

    1998-01-01

    Uses the theme of usury in Shakespeare's "The Merchant of Venice," and the history of Christian and Jewish beliefs concerning the charging of interest on loans to crystallize lending practices throughout history, particularly the medieval period and the transition to modern capitalism. Outlines themes addressed in the unit and…

  3. The Venice specimen of Ouranosaurus nigeriensis (Dinosauria, Ornithopoda

    Directory of Open Access Journals (Sweden)

    Filippo Bertozzo

    2017-06-01

    Full Text Available Ouranosaurus nigeriensis is an iconic African dinosaur taxon that has been described on the basis of two nearly complete skeletons from the Lower Cretaceous Gadoufaoua locality of the Ténéré desert in Niger. The entire holotype and a few bones attributed to the paratype formed the basis of the original description by Taquet (1976. A mounted skeleton that appears to correspond to O. nigeriensis has been on public display since 1975, exhibited at the Natural History Museum of Venice. It was never explicitly reported whether the Venice specimen represents a paratype and therefore, the second nearly complete skeleton reported in literature or a third unreported skeleton. The purpose of this paper is to disentangle the complex history of the various skeletal remains that have been attributed to Ouranosaurus nigeriensis (aided by an unpublished field map of the paratype and to describe in detail the osteology of the Venice skeleton. The latter includes the paratype material (found in 1970 and collected in 1972, with the exception of the left femur, the right coracoid and one manus ungual phalanx I, which were replaced with plaster copies, and (possibly other manus phalanges. Some other elements (e.g., the first two chevrons, the right femur, the right tibia, two dorsal vertebrae and some pelvic bones were likely added from other individual/s. The vertebral column of the paratype was articulated and provides a better reference for the vertebral count of this taxon than the holotype. Several anatomical differences are observed between the holotype and the Venice specimen. Most of them can be ascribed to intraspecific variability (individual or ontogenetic, but some are probably caused by mistakes in the preparation or assemblage of the skeletal elements in both specimens. The body length of the Venice skeleton is about 90% the linear size of the holotype. Osteohistological analysis (the first for this taxon of some long bones, a rib and a dorsal

  4. The Venice specimen of Ouranosaurus nigeriensis (Dinosauria, Ornithopoda).

    Science.gov (United States)

    Bertozzo, Filippo; Dalla Vecchia, Fabio Marco; Fabbri, Matteo

    2017-01-01

    Ouranosaurus nigeriensis is an iconic African dinosaur taxon that has been described on the basis of two nearly complete skeletons from the Lower Cretaceous Gadoufaoua locality of the Ténéré desert in Niger. The entire holotype and a few bones attributed to the paratype formed the basis of the original description by Taquet (1976). A mounted skeleton that appears to correspond to O. nigeriensis has been on public display since 1975, exhibited at the Natural History Museum of Venice. It was never explicitly reported whether the Venice specimen represents a paratype and therefore, the second nearly complete skeleton reported in literature or a third unreported skeleton. The purpose of this paper is to disentangle the complex history of the various skeletal remains that have been attributed to Ouranosaurus nigeriensis (aided by an unpublished field map of the paratype) and to describe in detail the osteology of the Venice skeleton. The latter includes the paratype material (found in 1970 and collected in 1972), with the exception of the left femur, the right coracoid and one manus ungual phalanx I, which were replaced with plaster copies, and (possibly) other manus phalanges. Some other elements (e.g., the first two chevrons, the right femur, the right tibia, two dorsal vertebrae and some pelvic bones) were likely added from other individual/s. The vertebral column of the paratype was articulated and provides a better reference for the vertebral count of this taxon than the holotype. Several anatomical differences are observed between the holotype and the Venice specimen. Most of them can be ascribed to intraspecific variability (individual or ontogenetic), but some are probably caused by mistakes in the preparation or assemblage of the skeletal elements in both specimens. The body length of the Venice skeleton is about 90% the linear size of the holotype. Osteohistological analysis (the first for this taxon) of some long bones, a rib and a dorsal neural spine

  5. Controversies in Cardiovascular Research: Induced pluripotent stem cell-derived cardiomyocytes – boutique science or valuable arrhythmia model?

    Science.gov (United States)

    Knollmann, Björn C

    2013-01-01

    As part of the series on Controversies in Cardiovascular Research, the article reviews the strengths and limitations of induced pluripotent stem cell-derived cardiomyocytes (iPSC-CM) as models of cardiac arrhythmias. Specifically, the article attempts to answer the following questions: Which clinical arrhythmias can be modeled by iPSC-CM? How well can iPSC-CM model adult ventricular myocytes? What are the strengths and limitations of published iPSC-CM arrhythmia models? What new mechanistic insight has been gained? What is the evidence that would support using iPSC-CM to personalize anti-arrhythmic drug therapy? The review also discusses the pros and cons of using the iPSC-CM technology for modeling specific genetic arrhythmia disorders such as long QT syndrome, Brugada Syndrome or Catecholaminergic Polymorphic Ventricular Tachycardia. PMID:23569106

  6. Electroversion in treatment of arrhythmia in a patient with Wolff-Parkinson-White syndrome and cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    SHEN Peng

    2013-06-01

    Full Text Available 【Abstract】We report electroversion in treatment of atrial fibrillation (AF and atrioventricular nodal reentry ta-chycardia (AVNRT in a patient with Wolff-Parkinson-White syndrome and cervical spinal cord injury. At first, the pa-tient sustained respiratory failure and weak cough reflex, thereafter repeated bronchoscopy was used to aspirate the sputum as well as control the pneumonia, which resulted in arrhythmia (AF and AVNRT. Two doses of intravenous amiodarone failed to correct the arrhythmia. After restora-tion of sinus rhythm by electroversion, he was successfully weaned from mechanical ventilation and discharged from the intensive care unit without recurrent arrhythmia. Key words: Arrhythmia, cardiac; Atrial fibrillation; Electric countershock; Wolff-Parkinson-White syndrome; Spinal cord injuries

  7. Quantitative Assessment of Arrhythmia Using Non-linear Approach: A Non-invasive Prognostic Tool

    Science.gov (United States)

    Chakraborty, Monisha; Ghosh, Dipak

    2018-04-01

    Accurate prognostic tool to identify severity of Arrhythmia is yet to be investigated, owing to the complexity of the ECG signal. In this paper, we have shown that quantitative assessment of Arrhythmia is possible using non-linear technique based on "Hurst Rescaled Range Analysis". Although the concept of applying "non-linearity" for studying various cardiac dysfunctions is not entirely new, the novel objective of this paper is to identify the severity of the disease, monitoring of different medicine and their dose, and also to assess the efficiency of different medicine. The approach presented in this work is simple which in turn will help doctors in efficient disease management. In this work, Arrhythmia ECG time series are collected from MIT-BIH database. Normal ECG time series are acquired using POLYPARA system. Both time series are analyzed in thelight of non-linear approach following the method "Rescaled Range Analysis". The quantitative parameter, "Fractal Dimension" (D) is obtained from both types of time series. The major finding is that Arrhythmia ECG poses lower values of D as compared to normal. Further, this information can be used to access the severity of Arrhythmia quantitatively, which is a new direction of prognosis as well as adequate software may be developed for the use of medical practice.

  8. [Observation of antiarrhythmic effects of Cinnamomum migao H. W. Li on experimental arrhythmia].

    Science.gov (United States)

    Sui, Y; Qiu, D; Xie, C; Chen, K

    1998-08-01

    To investigate the effects of Cinnamomum migao on experimental arrhythmia. Arrhythmic models of mice, rabbits, guinea pigs and rats were built using chloroform(Chl), adrenalin(Adr), strophanthin-K (Spt-K) and barium chloride (BaCl2). The affected animals were divided randomly into three groups: control group, Cinnamomum migao (CV-3) group and mexiletine (MXL) group, so as to observe and compare the antiarrhythmic effects. CV-3 could reduce the incidence of ventricular fibrillation caused by ch1 in mice and the ventricular tachycardia induced by Adr in rabbits, delay the onset time of this arrhythmia, increase the arrhythmic doses of Spt-K in guinea pigs, reduce the incidence of some arrhythmia caused by BaCl2 in rats and slow down their heart rate. CV-3 has obvious antiarrhythmic effects on experimental arrhythmia. The mechanism of these effects is probably related to the arrest of the intraflow of Na+, Ca2+ in the cardiac cells and the depression of their cardiac autoarrhythmicity and conductivity.

  9. Evaluation of heart rhythm variability and arrhythmia in children with systemic and localized scleroderma.

    Science.gov (United States)

    Wozniak, Jacek; Dabrowski, Rafal; Luczak, Dariusz; Kwiatkowska, Malgorzata; Musiej-Nowakowska, Elzbieta; Kowalik, Ilona; Szwed, Hanna

    2009-01-01

    To evaluate possible disturbances in autonomic regulation and cardiac arrhythmias in children with localized and systemic scleroderma. There were 40 children included in the study: 20 with systemic and 20 with localized scleroderma. The control group comprised 20 healthy children. In 24-hour Holter recording, the average rate of sinus rhythm was significantly higher in the groups with systemic and localized scleroderma than in the control group, but there was no significant difference between them. The variability of heart rhythm in both groups was significantly decreased. In the group with systemic scleroderma, single supraventricular ectopic beats were observed in 20% and runs were seen in 40% of patients. In the group with localized scleroderma, supraventricular single ectopic beats occurred in 35% of patients and runs in 45% of those studied. Ventricular arrhythmia occurred in 2 children with systemic scleroderma, but in 1 child, it was complex. The most frequent cardiac arrhythmias in both types of scleroderma in children were of supraventricular origin, whereas ventricular arrhythmias did not occur very often. There were no significant differences in autonomic disturbances manifesting as a higher heart rate and decreased heart rate variability between localized and systemic scleroderma.

  10. β1-Adrenoceptor blocker aggravated ventricular arrhythmia.

    Science.gov (United States)

    Wang, Yan; Patel, Dimpi; Wang, Dao Wu; Yan, Jiang Tao; Hsia, Henry H; Liu, Hao; Zhao, Chun Xia; Zuo, Hou Juan; Wang, Dao Wen

    2013-11-01

    To assess the impact of β1 -adrenoceptor blockers (β1 -blocker) and isoprenaline on the incidence of idiopathic repetitive ventricular arrhythmia that apparently decreases with preprocedural anxiety. From January 2010 to July 2012, six patients were identified who had idiopathic ventricular arrhythmias that apparently decreased (by greater than 90%) with preprocedural anxiety. The number of ectopic ventricular beats per hour (VPH) was calculated from Holter or telemetry monitoring to assess the ectopic burden. The mean VPH of 24 hours from Holter before admission (VPH-m) was used as baseline (100%) for normalization. β1 -Blockers, isoprenaline, and/or aminophylline were administrated successively on the ward and catheter lab to evaluate their effects on the ventricular arrhythmias. Among 97 consecutive patients with idiopathic ventricular arrhythmias, six had reduction in normalized VPHs in the hour before the scheduled procedure time from (104.6 ± 4.6%) to (2.8 ± 1.6%) possibly due to preprocedural anxiety (P < 0.05), then increased to (97.9 ± 9.7%) during β1 -blocker administration (P < 0.05), then quickly reduced to (1.6 ± 1.0%) during subsequent isoprenaline infusion. Repeated β1 -blocker quickly counteracted the inhibitory effect of isoprenaline, and VPHs increased to (120.9 ± 2.4%) from (1.6 ± 1.0%; P < 0.05). Isoprenaline and β1 -blocker showed similar effects on the arrhythmias in catheter lab. In some patients with structurally normal heart and ventricular arrhythmias there is a marked reduction of arrhythmias associated with preprocedural anxiety. These patients exhibit a reproducible sequence of β1 -blocker aggravation and catecholamine inhibition of ventricular arrhythmias, including both repetitive ventricular premature beats and monomorphic ventricular tachycardia. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

  11. Arrhythmias in the developing heart

    Czech Academy of Sciences Publication Activity Database

    Sedmera, David; Kočková, Radka; Vostárek, František; Raddatz, E.

    2015-01-01

    Roč. 213, č. 2 (2015), s. 303-320 ISSN 1748-1708 R&D Projects: GA ČR(CZ) GAP302/11/1308; GA ČR(CZ) GA13-12412S Institutional support: RVO:67985823 Keywords : anti-arrhythmic drugs * cardiac development * chick embryo * conduction system * hypoxia * mouse Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 4.066, year: 2015

  12. Cardiac sympathetic nervous system imaging with (123)I-meta-iodobenzylguanidine: Perspectives from Japan and Europe

    NARCIS (Netherlands)

    Nakajima, K.; Scholte, A.; Nakata, T.; Dimitriu-Leen, A.C.; Chikamori, T.; Vitola, J.V.; Yoshinaga, K.

    2017-01-01

    Cardiac sympathetic nervous system dysfunction is closely associated with risk of serious cardiac events in patients with heart failure (HF), including HF progression, pump-failure death, and sudden cardiac death by lethal ventricular arrhythmia. For cardiac sympathetic nervous system imaging,

  13. Serum Potassium Changes During Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest-Should It Be Treated?

    DEFF Research Database (Denmark)

    Soeholm, Helle; Kirkegaard, Hans

    2012-01-01

    Background: Therapeutic hypothermia (TH) after out-of-hospital cardiac arrest (OHCA) is associated with adverse events, for example hypokalemia and arrhythmias. In the present study, we report the impact of serum potassium changes related to the rate of cardiac arrhythmias, and the advantages...

  14. Heart rate turbulence and variability in patients with ventricular arrhythmias

    Directory of Open Access Journals (Sweden)

    Diego Tarricone

    2009-08-01

    Full Text Available Background: To evaluate the changes in autonomic neural control mechanisms before malignant ventricular arrhythmias, we measured heart rate variability (HRV and heart rate turbulence (HRT in patients with ventricular tachycardia or fibrillation (Group I; n=6, non sustained ventricular tachycardia (Group II; n=32, frequent premature ventricular beats (Group III; n=26 and with ICD implantation (Group IV; n=11. Methods: Time domain parameters of HRV and turbulence onset (TO and slope (TS were calculated on 24 hour Holter recordings. Normal values were: SDNN > 70 msec for HRV, TO <0% and TS >2.5 msec/RR-I for HRT. Results: Whereas SDNN was within normal range and similar in all study groups, HRT parameters were significantly different in patients who experienced VT/VF during Holter recording. Abnormal TO and/or TS were present in 100% of Group I patients and only in about 50% of Group II and IV. On the contrary, normal HRT parameters were present in 40-70% of Group II, III and IV patients and none of Group I. Conclusions: These data suggest that HRT analysis is more suitable than HRV to detect those transient alterations in autonomic control mechanisms that are likely to play a major trigger role in the genesis of malignant cardiac arrhythmias. (Heart International 2007; 3: 51-7

  15. Arrhythmias and hemodialysis: role of potassium and new diagnostic tools.

    Science.gov (United States)

    Buemi, Michele; Coppolino, Giuseppe; Bolignano, Davide; Sturiale, Alessio; Campo, Susanna; Buemi, Antoine; Crascì, Eleonora; Romeo, Adolfo

    2009-01-01

    Cardiovascular diseases represent the main causes of death in patients affected by renal failure, and arrhythmias are frequently observed in patients undergoing hemodialysis. Dialytic treatment per se can be considered as an arrhythmogenic stimulus; moreover, uraemic patients are characterized by a "pro-arrhythmic substrate" because of the high prevalence of ischaemic heart disease, left ventricular hypertrophy and autonomic neuropathy. One of the most important pathogenetic element involved in the onset of intra-dialytic arrhythmias is the alteration in electrolytes concentration, particularly calcium and potassium. It may be very useful to monitor the patient's cardiac activity during the whole hemodilaytic session. Nevertheless, the application of an extended intradialytic electrocardiographic monitoring is not simple because of several technical and structural impairments. We tried to overcome these difficulties using Whealthy, a wearable system consisting in a t-shirt composed of conductors and piezoresistive materials, integrated to form fibers and threads connected to tissutal sensors, electrodes, and connectors. ECG and pneumographic impedance signals are acquired by the electrodes in the tissue, and the data are registered by a small computer and transmitted via GPRS or Bluetooth.

  16. Acebutolol in Cardiac Arrhythmias | Lewis | South African Medical ...

    African Journals Online (AJOL)

    Acebutolol was most effective in supraventricular tachyarrhythmias, to control the ventricular response when digital's was ineffective, as a synergist with quinidine to convert patients to sinus rhythm, or prophylactically to prevent relapse to atrial fibrillation. It also terminated ventricular tachycardia in two patients. Side-effects ...

  17. Stochastic Petri Net Modeling of Wave Sequences in Cardiac Arrhythmias.

    Science.gov (United States)

    1987-11-01

    Wolff - Parkinson - White syndrome . The ventricles are divided into two parts. One of these is excited normally and produces R...example, in a condition called the Wolff - Parkinson - White syn- drome the ECG displays an abnormally early onset of the ventricular activity. It also...8217. , ’ ", -’ , .’ %,,? .’ ,; ’ .- ’ ’ -’ € ’ , . ’ - I. 32 Wolfe- Parkinson - White Syndrome (Fig. 8c) This model uses "basic" elements for the

  18. Cardiac Arrhythmias in Children with Sickle Cell Anaemia | Bode ...

    African Journals Online (AJOL)

    Background : Sickle cell anaemia (SCA) is an important cause of morbidity and mortality in tropical Africa. Recurrent episodes of vaso-occlusive crisis often lead to organ ischaemia and/or infarction. Arrythmias are common and reliable manifestations of myocardial ischaemia and often follow infarction. The prevalence and ...

  19. [Surgery of refractory ischemic arrhythmia].

    Science.gov (United States)

    Viganò, M; Graffigna, A; Salerno, G

    1992-03-01

    Since June 1980, 138 patients have undergone surgical treatment for refractory ventricular tachycardia due to ischemic heart disease. Electrically guided surgical ablation (EGSA) of the focus was performed in 117 patients, while 14 patients underwent application of automatic implantable cardioverter-defibrillator (AICD), and 8 patients underwent heart transplantation. During the whole period considered, among the EGSA patients an operative mortality of 13 patients was observed (11.4%), with a late mortality of another 14 patients (13.4%). Two early and six late recurrences were described, and 4 cases of sudden or unexplained death, with 2 cases clearly due to an arrhythmic event. Multivariate analysis showed preoperative ejection fraction lower than 25% as a powerful predictor of early mortality (32% vs 0%). Actuarial survival rate of patients with LVEF lower than 25% was 67 +/- 12% vs 95 +/- 2% at one year and 37 +/- 25% vs 94 +/- 8% at 8 years. A high operative mortality was then observed in patients who underwent aneurysmectomy alone or visually guided procedures as compared to electrically guided procedures (75% or 3 deaths out of 4 patients vs 8.5% or 10 out of 113 patients, respectively). Patients who received an AICD with or without associated procedures showed 1 case of in-hospital mortality and no late mortality; in 6 patients at least one shock was delivered; in two patients the AICD was implanted during an EGSA procedure, due to multiple or difficult origins of the arrhythmias. Of patients who underwent heart transplantation one case of later mortality was observed due to malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Patient characteristics associated with false arrhythmia alarms in intensive care

    Directory of Open Access Journals (Sweden)

    Harris PR

    2017-04-01

    Full Text Available Patricia R Harris,1,2 Jessica K Zègre-Hemsey,3,4 Daniel Schindler,5 Yong Bai,6 Michele M Pelter,2,7 Xiao Hu2,8 1Department of Nursing, School of Health and Natural Sciences, Dominican University of California, San Rafael, 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, 3School of Nursing, 4Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC, 5Intensive Care Unit, The Neuroscience Center, Sutter Eden Medical Center, Castro Valley, 6Hu Research Laboratory, Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 7ECG Monitoring Research Lab, Department of Physiological Nursing, School of Nursing, 8Physiological Nursing and Neurological Surgery, Affiliate Faculty of Institute for Computational Health Sciences Core Faculty UCB/UCSF Joint Bio-Engineering Graduate Program, University of California, San Francisco, CA, USA Introduction: A high rate of false arrhythmia alarms in the intensive care unit (ICU leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms. Objective: The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU. Methods: This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds at an urban medical center over a period of 31 days in 2013. All monitor alarms and continuous waveforms were stored on a secure server. Nurse scientists with expertise in cardiac monitoring used a standardized protocol to annotate six clinically important types of arrhythmia alarms (asystole, pause, ventricular fibrillation, ventricular tachycardia, accelerated ventricular rhythm, and

  1. High level of oxygen treatment causes cardiotoxicity with arrhythmias and redox modulation

    Energy Technology Data Exchange (ETDEWEB)

    Chapalamadugu, Kalyan C.; Panguluri, Siva K. [Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL (United States); Bennett, Eric S. [Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL (United States); Kolliputi, Narasaiah [Division of Allergy and Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL (United States); Tipparaju, Srinivas M., E-mail: stippara@health.usf.edu [Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL (United States)

    2015-01-01

    Hyperoxia exposure in mice leads to cardiac hypertrophy and voltage-gated potassium (Kv) channel remodeling. Because redox balance of pyridine nucleotides affects Kv function and hyperoxia alters cellular redox potential, we hypothesized that hyperoxia exposure leads to cardiac ion channel disturbances and redox changes resulting in arrhythmias. In the present study, we investigated the electrical changes and redox abnormalities caused by 72 h hyperoxia treatment in mice. Cardiac repolarization changes were assessed by acquiring electrocardiogram (ECG) and cardiac action potentials (AP). Biochemical assays were employed to identify the pyridine nucleotide changes, Kv1.5 expression and myocardial injury. Hyperoxia treatment caused marked bradycardia, arrhythmia and significantly prolonged (ms) the, RR (186.2 ± 10.7 vs. 146.4 ± 6.2), PR (46.8 ± 3.1 vs. 39.3 ± 1.6), QRS (10.8 ± 0.6 vs. 8.5 ± 0.2), QTc (57.1 ± 3.5 vs. 40 ± 1.4) and JT (13.4 ± 2.1 vs. 7.0 ± 0.5) intervals, when compared with normoxia group. Hyperoxia treatment also induced significant increase in cardiac action potential duration (APD) (ex-APD{sub 90}; 73.8 ± 9.5 vs. 50.9 ± 3.1 ms) and elevated levels of serum markers of myocardial injury; cardiac troponin I (TnI) and lactate dehydrogenase (LDH). Hyperoxia exposure altered cardiac levels of mRNA/protein expression of; Kv1.5, Kvβ subunits and SiRT1, and increased ratios of reduced pyridine nucleotides (NADH/NAD and NADPH/NADP). Inhibition of SiRT1 in H9C2 cells using Splitomicin resulted in decreased SiRT1 and Kv1.5 expression, suggesting that SiRT1 may mediate Kv1.5 downregulation. In conclusion, the cardiotoxic effects of hyperoxia exposure involve ion channel disturbances and redox changes resulting in arrhythmias. - Highlights: • Hyperoxia treatment leads to arrhythmia with prolonged QTc and action potential duration. • Hyperoxia treatment alters cardiac pyridine nucleotide [NAD(P)H/NAD(P)] levels. • SiRT1 and Kv1.5 are co

  2. High level of oxygen treatment causes cardiotoxicity with arrhythmias and redox modulation

    International Nuclear Information System (INIS)

    Chapalamadugu, Kalyan C.; Panguluri, Siva K.; Bennett, Eric S.; Kolliputi, Narasaiah; Tipparaju, Srinivas M.

    2015-01-01

    Hyperoxia exposure in mice leads to cardiac hypertrophy and voltage-gated potassium (Kv) channel remodeling. Because redox balance of pyridine nucleotides affects Kv function and hyperoxia alters cellular redox potential, we hypothesized that hyperoxia exposure leads to cardiac ion channel disturbances and redox changes resulting in arrhythmias. In the present study, we investigated the electrical changes and redox abnormalities caused by 72 h hyperoxia treatment in mice. Cardiac repolarization changes were assessed by acquiring electrocardiogram (ECG) and cardiac action potentials (AP). Biochemical assays were employed to identify the pyridine nucleotide changes, Kv1.5 expression and myocardial injury. Hyperoxia treatment caused marked bradycardia, arrhythmia and significantly prolonged (ms) the, RR (186.2 ± 10.7 vs. 146.4 ± 6.2), PR (46.8 ± 3.1 vs. 39.3 ± 1.6), QRS (10.8 ± 0.6 vs. 8.5 ± 0.2), QTc (57.1 ± 3.5 vs. 40 ± 1.4) and JT (13.4 ± 2.1 vs. 7.0 ± 0.5) intervals, when compared with normoxia group. Hyperoxia treatment also induced significant increase in cardiac action potential duration (APD) (ex-APD 90 ; 73.8 ± 9.5 vs. 50.9 ± 3.1 ms) and elevated levels of serum markers of myocardial injury; cardiac troponin I (TnI) and lactate dehydrogenase (LDH). Hyperoxia exposure altered cardiac levels of mRNA/protein expression of; Kv1.5, Kvβ subunits and SiRT1, and increased ratios of reduced pyridine nucleotides (NADH/NAD and NADPH/NADP). Inhibition of SiRT1 in H9C2 cells using Splitomicin resulted in decreased SiRT1 and Kv1.5 expression, suggesting that SiRT1 may mediate Kv1.5 downregulation. In conclusion, the cardiotoxic effects of hyperoxia exposure involve ion channel disturbances and redox changes resulting in arrhythmias. - Highlights: • Hyperoxia treatment leads to arrhythmia with prolonged QTc and action potential duration. • Hyperoxia treatment alters cardiac pyridine nucleotide [NAD(P)H/NAD(P)] levels. • SiRT1 and Kv1.5 are co-regulated in

  3. Monitoring and Modeling Farmland Productivity Along the Venice Coastland, Italy

    DEFF Research Database (Denmark)

    Manoli, G.; Bonetti, S.; Scudiero, E.

    2013-01-01

    The southern portion of the Venice coastland is a very precarious environment and salt contamination of land and groundwater is a severe problem that is seriously impacting the farmland productivity. Geophysical surveys, lab testing and continuous monitoring of hydrological parameters together wi...... model is linked to the atmosphere by the calculation of the stomatal conductance which is optimized for maximum carbon gain. The model is applied to the field site to understand the impact of land elevation, soil heterogeneities, and seawater contamination on land productivity.......The southern portion of the Venice coastland is a very precarious environment and salt contamination of land and groundwater is a severe problem that is seriously impacting the farmland productivity. Geophysical surveys, lab testing and continuous monitoring of hydrological parameters together...

  4. Phosphate gypsum wastes in Venice lagoon. Radiological impact

    International Nuclear Information System (INIS)

    Belli, M; Blasi, M; Guogang, J.; Rosamilia, S.; Sansone, U.; Biancotto, R.; Bidoli, P.; Sepulcri, D.

    2000-03-01

    The phosphoric minerals utilized in phosphoric acid production, presents high concentrations of radioactive materials: U238, Th 232, K 40. The phosphogypsum is the waste material obtained in the phosphoric acid production in wet process. This type of production method is employed for many years in Venice lagoon (Porto Marghera chemical plants). In this paper are reported evaluations of radiological impact on aquatic environment of lagoon [it

  5. Fair Apportionment in the View of the Venice Commission's Recommendation

    OpenAIRE

    Biró, Péter; Kóczy, László Á.; Sziklai, Balázs

    2013-01-01

    In this paper we analyze the consequences of the fairness recommendation of the Venice Commission in allocating voting districts among larger administrative regions. This recommendation requires the size of any constituency not to differ from the average constituency size by more than a fixed limit. We show that this minimum difference constraint, while attractive per definition, is not compatible with monotonicity and Hare-quota properties, two standard requirements of apportionment rules. W...

  6. Hydrogen: a new resource for the Venice industrial area

    International Nuclear Information System (INIS)

    Giorgio Mattiello

    2006-01-01

    Hydrogen Park is based in Marghera, inside the Venice Municipality, where it is produced the 40% of the Italian production of hydrogen, as by-product of industrial processes. This availability gives the possibility to develop and to test new technologies based on hydrogen without the gas generation constrain. The Company deal is to coordinate the partners activities to utilize the Hydrogen resources available in Marghera. (authors)

  7. Estrogenic potential of the Venice, Italy, lagoon waters.

    Science.gov (United States)

    Pojana, Giulio; Bonfà, Angela; Busetti, Francesco; Collarin, Anna; Marcomini, Antonio

    2004-08-01

    The exposure of the Venice lagoon (Italy) to endocrine-disrupting compounds (EDCs) from different sources was investigated. Spatial and time distribution of EDC concentrations were determined in four sampling sessions (December 2001-May 2002) by solid phase extraction followed by high-performance liquid chromatography separation coupled with mass spectrometry detection via electrospray interface (SPE-HPLC-ESI-MS), which allowed identification of natural (estradiol, estrone) and synthetic estrogenic compounds, both steroidal (ethinylestradiol, mestranol) and nonsteroidal (benzophenone, bisphenol-A, nonylphenol, nonylphenol monoethoxylate carboxylate). No significant differences in the EDC distribution were observed between stations located near selected sources (raw sewage from the historical center of Venice, treated municipal and industrial effluents from sewage treatment plants, and areas undergoing the inflow of rivers). While synthetic nonsteroidal analytes were recorded in the 1 to 1040 ng/L range (average concentration: 34 ng/L), steroidal EDC (estradiol, ethinylestradiol) concentrations were lower (1-125 ng/L; average concentration: 8 ng/L). The estrogenic activity of lagoon waters was estimated in terms of estradiol equivalent concentration (EEQ) by applying the estradiol equivalency factors (EEFs). Steroidal EDCs (estradiol, ethinylestradiol) contributed >97% to the total potential estrogenicity of the waters, which accounted for 4 to 172 ng/L (average: 25 ng/L), as total EEQs. These levels are likely to pose adverse effects on the Venice lagoon aquatic organisms.

  8. Is Venice an ideal habitat for Legionella pneumophila?

    Science.gov (United States)

    Ziprani, C; Selle, V; Palazzi, B; Capretta, F; Ghio, L; Flora, M E; Baldo, V

    2012-09-01

    Legionella bacterium manifests itself in Legionnaire's disease and Pontiac fever, it is mainly found and transmitted by aerosol produced in cooling towers, water distribution plants and medical equipment, and it affects mainly elder persons in poor health. The population of Venice Local Health Unit was divided in two areas of study and the incidence of legionellosis in residents of Venice historical centre (Distretto Sanitario 1) and in residents of the mainland and coastal areas (Distretti Sanitari 2, 3, 4) was calculated. The cases were those notified to the Public Health Unit by law, and the population of residents was that of the eligible for health care in the archives of the Local Health Unit. Only cases of legionellosis in residents who had not travelled in the 10 days previous of the onset of disease, and not related to nosocomial clusters were considered. The standardized incidence ratio was then calculated and confidence interval were defined by Poisson distribution. Given the population of the two areas, 59801 in Distretto Sanitario 1 and 237555 in Distretti 2, 3, 4, the raw incidence of disease is respectively 87 per 100000 and 20 per 100000 in time 2002-2010. The standardized incidence ratio for the population of Distretto Sanitario 1 vs the remaining population is 4.3. The difference in risk of getting the disease in this two residential areas geographically very close, is probably related to the different buildings' characteristics, old and difficult to maintain in Venice historical centre.

  9. 23. Symposium On Fusion Technology (SOFT), Venice - A personal view

    International Nuclear Information System (INIS)

    Spears, W.R.

    2004-01-01

    This conference, examining the advances in our leading-edge technology, took place on 22-24 September 2004 against the wonderful and historic backdrop of Venice, at a monastery of the Cini Foundation, on the Island of St. Giorgio, directly opposite St. Marks. The strong connection between the ancient and modern was brought home to us in the very first talk, from the Mayor of Venice and MEP Prof. P. Costa, who reminded us of Venice's particular problem with global warming, and urged us to do our part to develop an energy source that should help to avoid it drowning. Prof. Sir C. Llewellyn-Smith, head of the UK Fusion Programme and Chairman of Euratom CCE-FU, took up this theme and elaborated how we should reach our goal, showing in particular the urgency of pursuing a fast track, proceeding with ITER and the International Fusion Materials Irradiation Facility (IFMIF) without further delay, and envisaging that the subsequent machine would be prototypical of future commercial fusion power plants. The conference proceeded through plenary and oral sessions, and through poster sessions, covering plasma heating, fuelling, control and diagnostics, magnets and power supplies, plasma-facing components, blanket and vessel, remote handling, materials technology, the experiences gained on existing experiments, and projections for future experiments and fusion power plants. There were 570 participants, from 25 countries, of whom a third came from outside Europe

  10. Autogenous Crack Control during Construction Phases of MOSE Venice Dams

    Science.gov (United States)

    Bertagnoli, Gabriele; Anerdi, Constanza; Malavisi, Marzia; Zoratto, Nadia

    2017-10-01

    The design of concrete structures exposed to severe environmental attack, like in marine environment, requires serious attention for concrete durability. Early age cracking due to autogenous deformations can be detrimental to the performance of tidal structures. The study of the structural effects of hydration heat and rheological behaviour of a set of huge concrete structures of the Mobile Venice Dams known with the MOSE acronym (Experimental Electromechanical Module) is presented in this paper. Together with other measures such as coastal reinforcement, the raising of quaysides, and the paving and improvement of the lagoon, MOSE is designed to protect Venice and the lagoon from tides of up to 3 meters. Construction began simultaneously in 2003 at all three lagoon inlets, and the project has been completed in 2014. Floods have caused damage since ancient times and have become more frequent and intense as a result of the combined effect of eustatism (a rise in sea level) and subsidence (a drop in land level) caused by natural and man-induced phenomena. Nowadays, towns and villages in the lagoon are about 23 cm lower with respect to the water level than at the beginning of the 1900s. Each year, floods can cause serious problems for the inhabitants as well as deterioration of architecture, urban structures and the ecosystem. Over the entire lagoon area, there is also a constant risk of a catastrophic event such as that of 4 November 1966, when a tide of 194 cm submerged Venice, Chioggia and the other built-up areas.

  11. Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals.

    Science.gov (United States)

    Elhaj, Fatin A; Salim, Naomie; Harris, Arief R; Swee, Tan Tian; Ahmed, Taqwa

    2016-04-01

    Arrhythmia is a cardiac condition caused by abnormal electrical activity of the heart, and an electrocardiogram (ECG) is the non-invasive method used to detect arrhythmias or heart abnormalities. Due to the presence of noise, the non-stationary nature of the ECG signal (i.e. the changing morphology of the ECG signal with respect to time) and the irregularity of the heartbeat, physicians face difficulties in the diagnosis of arrhythmias. The computer-aided analysis of ECG results assists physicians to detect cardiovascular diseases. The development of many existing arrhythmia systems has depended on the findings from linear experiments on ECG data which achieve high performance on noise-free data. However, nonlinear experiments characterize the ECG signal more effectively sense, extract hidden information in the ECG signal, and achieve good performance under noisy conditions. This paper investigates the representation ability of linear and nonlinear features and proposes a combination of such features in order to improve the classification of ECG data. In this study, five types of beat classes of arrhythmia as recommended by the Association for Advancement of Medical Instrumentation are analyzed: non-ectopic beats (N), supra-ventricular ectopic beats (S), ventricular ectopic beats (V), fusion beats (F) and unclassifiable and paced beats (U). The characterization ability of nonlinear features such as high order statistics and cumulants and nonlinear feature reduction methods such as independent component analysis are combined with linear features, namely, the principal component analysis of discrete wavelet transform coefficients. The features are tested for their ability to differentiate different classes of data using different classifiers, namely, the support vector machine and neural network methods with tenfold cross-validation. Our proposed method is able to classify the N, S, V, F and U arrhythmia classes with high accuracy (98.91%) using a combined support

  12. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Tassi, Eduardo Marinho, E-mail: etassi@ibest.com.br [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Continentino, Marcelo Abramoff [Hospital Frei Galvão, Guaratinguetá, SP (Brazil); Nascimento, Emília Matos do; Pereira, Basílio de Bragança [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Coppe - Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia - UFRJ, Rio de Janeiro, RJ (Brazil); Pedrosa, Roberto Coury [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2014-05-15

    Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups.

  13. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

    International Nuclear Information System (INIS)

    Tassi, Eduardo Marinho; Continentino, Marcelo Abramoff; Nascimento, Emília Matos do; Pereira, Basílio de Bragança; Pedrosa, Roberto Coury

    2014-01-01

    Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups

  14. 75 FR 57017 - Venice Gathering System, LLC; Notice of Request Under Blanket Authorization

    Science.gov (United States)

    2010-09-17

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP10-497-000] Venice Gathering System, LLC; Notice of Request Under Blanket Authorization September 10, 2010. Take notice that on September 3, 2010, Venice Gathering System, LLC (VGS), 1000 Louisiana, Suite 4300, Houston, Texas 77002...

  15. 76 FR 60113 - Culturally Significant Objects Imported for Exhibition Determinations: “Masters of Venice...

    Science.gov (United States)

    2011-09-28

    ... DEPARTMENT OF STATE [Public Notice 7616] Culturally Significant Objects Imported for Exhibition Determinations: ``Masters of Venice: Renaissance Paintings of Passion and Power from Kunsthistorisches Museum..., 2003), I hereby determine that the objects to be included in the exhibition ``Masters of Venice...

  16. Use of whole exome sequencing for the identification of Ito-based arrhythmia mechanism and therapy.

    Science.gov (United States)

    Sturm, Amy C; Kline, Crystal F; Glynn, Patric; Johnson, Benjamin L; Curran, Jerry; Kilic, Ahmet; Higgins, Robert S D; Binkley, Philip F; Janssen, Paul M L; Weiss, Raul; Raman, Subha V; Fowler, Steven J; Priori, Silvia G; Hund, Thomas J; Carnes, Cynthia A; Mohler, Peter J

    2015-05-26

    Identified genetic variants are insufficient to explain all cases of inherited arrhythmia. We tested whether the integration of whole exome sequencing with well-established clinical, translational, and basic science platforms could provide rapid and novel insight into human arrhythmia pathophysiology and disease treatment. We report a proband with recurrent ventricular fibrillation, resistant to standard therapeutic interventions. Using whole-exome sequencing, we identified a variant in a previously unidentified exon of the dipeptidyl aminopeptidase-like protein-6 (DPP6) gene. This variant is the first identified coding mutation in DPP6 and augments cardiac repolarizing current (Ito) causing pathological changes in Ito and action potential morphology. We designed a therapeutic regimen incorporating dalfampridine to target Ito. Dalfampridine, approved for multiple sclerosis, normalized the ECG and reduced arrhythmia burden in the proband by >90-fold. This was combined with cilostazol to accelerate the heart rate to minimize the reverse-rate dependence of augmented Ito. We describe a novel arrhythmia mechanism and therapeutic approach to ameliorate the disease. Specifically, we identify the first coding variant of DPP6 in human ventricular fibrillation. These findings illustrate the power of genetic approaches for the elucidation and treatment of disease when carefully integrated with clinical and basic/translational research teams. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  17. The 1966 Flooding of Venice: What Time Taught Us for the Future

    Science.gov (United States)

    Trincardi, Fabio; Barbanti, Andrea; Bastianini, Mauro; Benetazzo, Alvise; Chiggiato, Jacopo; Papa, Alvise; Pomaro, Angela; Sclavo, Mauro; Tosi, Luigi; Umgiesser, Georg

    2017-04-01

    Upon this fiftieth anniversary of the storm that flooded the historical Italian centers of Venice and Florence, we review the event from the perspective of today's scientific knowledge. In particular, we discuss the components of relative sea level rise in Venice that contribute to flooding, the monitoring networks and forecast capabilities that are currently in place, and the engineering actions adopted since the 1966 flood to safeguard the Venice lagoon and the city. Focusing on the meteo-oceanographic aspects, we also show how sheer luck at the time avoided a much worse disaster in Venice. Reference Trincardi, F., A. Barbanti, M. Bastianini, A. Benetazzo, L. Cavaleri, J. Chiggiato, A. Papa, A. Pomaro, M. Sclavo, L. Tosi, and G. Umgiesser. 2016. The 1966 flooding of Venice: What time taught us for the future. Oceanography 29(4), https://doi.org/10.5670/ oceanog.2016.87.

  18. Ablação da fibrilação atrial no Brasil: resultados do registro da Sociedade Brasileira de Arritmias Cardíacas Atrial fibrillation ablation in Brazil: results of the registry of the Brazilian Society of Cardiac Arrhythmias

    Directory of Open Access Journals (Sweden)

    Guilherme Fenelon

    2007-11-01

    Full Text Available FUNDAMENTO: Buscando delinear o perfil da ablação curativa de fibrilação atrial (FA no Brasil, a Sociedade Brasileira de Arritmias Cardíacas (SOBRAC idealizou o Registro Brasileiro de Ablação da FA. OBJETIVO: Descrever os resultados desse registro. MÉTODOS: Foi enviado um formulário aos sócios da SOBRAC, inquirindo sobre os dados de pacientes submetidos a ablação de FA entre setembro de 2005 e novembro de 2006. RESULTADOS: No total, 29 grupos, de 13 Estados, responderam ao formulário. Desses, 22 (76% realizaram ablações de FA. Entre 1998 e 2001, 7 grupos (32% iniciaram ablações de FA e entre 2002 e 2006, 15 grupos (68%. De 1998 a 2006, 2.374 pacientes foram submetidos a ablação, sendo 755 (32% no período do registro. A maioria (70% era do sexo masculino e 89% apresentavam FA paroxística ou persistente. Métodos auxiliares de imagem (ecocardiografia intracardíaca e mapeamento eletroanatômico foram utilizados por 9 grupos (41%. Durante seguimento médio de cinco meses, o sucesso total foi de 82% e o sucesso sem uso de antiarrítmicos foi de 57%. Contudo, 35% dos pacientes necessitaram de dois ou mais procedimentos. Houve 111 complicações (14,7% e 2 óbitos (0,26%. CONCLUSÃO: A ablação curativa de FA vem crescendo significativamente em nosso País, com taxas de sucesso comparáveis às internacionais, mas comumente há necessidade de mais de um procedimento. Apesar dos resultados promissores, a ablação de FA ainda acarreta morbidade significativa. Métodos auxiliares de imagem têm sido cada vez mais utilizados, visando a aumentar a eficácia e a segurança do procedimento. Esses achados devem ser considerados pelos órgãos pagadores públicos e privados.BACKGROUND: Aiming to define the profile of curative atrial fibrillation (AF ablation in Brazil, the Brazilian Cardiac Arrhythmia Society [Sociedade Brasileira de Arritmias Cardíacas] (SOBRAC created the Brazilian Registry of AF Ablation [Registro Brasileiro de Abla

  19. Symmetrical compression distance for arrhythmia discrimination in cloud-based big-data services.

    Science.gov (United States)

    Lillo-Castellano, J M; Mora-Jiménez, I; Santiago-Mozos, R; Chavarría-Asso, F; Cano-González, A; García-Alberola, A; Rojo-Álvarez, J L

    2015-07-01

    The current development of cloud computing is completely changing the paradigm of data knowledge extraction in huge databases. An example of this technology in the cardiac arrhythmia field is the SCOOP platform, a national-level scientific cloud-based big data service for implantable cardioverter defibrillators. In this scenario, we here propose a new methodology for automatic classification of intracardiac electrograms (EGMs) in a cloud computing system, designed for minimal signal preprocessing. A new compression-based similarity measure (CSM) is created for low computational burden, so-called weighted fast compression distance, which provides better performance when compared with other CSMs in the literature. Using simple machine learning techniques, a set of 6848 EGMs extracted from SCOOP platform were classified into seven cardiac arrhythmia classes and one noise class, reaching near to 90% accuracy when previous patient arrhythmia information was available and 63% otherwise, hence overcoming in all cases the classification provided by the majority class. Results show that this methodology can be used as a high-quality service of cloud computing, providing support to physicians for improving the knowledge on patient diagnosis.

  20. Arrhythmia Mechanism and Scaling Effect on the Spectral Properties of Electroanatomical Maps With Manifold Harmonics.

    Science.gov (United States)

    Sanroman-Junquera, Margarita; Mora-Jimenez, Inmaculada; Garcia-Alberola, Arcadio; Caamano, Antonio J; Trenor, Beatriz; Rojo-Alvarez, Jose L

    2018-04-01

    Spatial and temporal processing of intracardiac electrograms provides relevant information to support the arrhythmia ablation during electrophysiological studies. Current cardiac navigation systems (CNS) and electrocardiographic imaging (ECGI) build detailed 3-D electroanatomical maps (EAM), which represent the spatial anatomical distribution of bioelectrical features, such as activation time or voltage. We present a principled methodology for spectral analysis of both EAM geometry and bioelectrical feature in CNS or ECGI, including their spectral representation, cutoff frequency, or spatial sampling rate (SSR). Existing manifold harmonic techniques for spectral mesh analysis are adapted to account for a fourth dimension, corresponding to the EAM bioelectrical feature. Appropriate scaling is required to address different magnitudes and units. With our approach, simulated and real EAM showed strong SSR dependence on both the arrhythmia mechanism and the cardiac anatomical shape. For instance, high frequencies increased significantly the SSR because of the "early-meets-late" in flutter EAM, compared with the sinus rhythm. Besides, higher frequency components were obtained for the left atrium (more complex anatomy) than for the right atrium in sinus rhythm. The proposed manifold harmonics methodology opens the field toward new signal processing tools for principled EAM spatiofeature analysis in CNS and ECGI, and to an improved knowledge on arrhythmia mechanisms.

  1. Temporal abstraction and inductive logic programming for arrhythmia recognition from electrocardiograms.

    Science.gov (United States)

    Carrault, G; Cordier, M-O; Quiniou, R; Wang, F

    2003-07-01

    This paper proposes a novel approach to cardiac arrhythmia recognition from electrocardiograms (ECGs). ECGs record the electrical activity of the heart and are used to diagnose many heart disorders. The numerical ECG is first temporally abstracted into series of time-stamped events. Temporal abstraction makes use of artificial neural networks to extract interesting waves and their features from the input signals. A temporal reasoner called a chronicle recogniser processes such series in order to discover temporal patterns called chronicles which can be related to cardiac arrhythmias. Generally, it is difficult to elicit an accurate set of chronicles from a doctor. Thus, we propose to learn automatically from symbolic ECG examples the chronicles discriminating the arrhythmias belonging to some specific subset. Since temporal relationships are of major importance, inductive logic programming (ILP) is the tool of choice as it enables first-order relational learning. The approach has been evaluated on real ECGs taken from the MIT-BIH database. The performance of the different modules as well as the efficiency of the whole system is presented. The results are rather good and demonstrate that integrating numerical techniques for low level perception and symbolic techniques for high level classification is very valuable.

  2. Probing cardiac repolarization reserve in drug safety assessment

    NARCIS (Netherlands)

    Nalos, L.

    2011-01-01

    Excessive prolongation of cardiac repolarization, manifested as QT prolongation on ECG, is common unwanted side effect of many drugs and drug candidates. Prolongation of QT interval may lead to life threatening cardiac arrhythmia – Torsade de Point (TdP). Number of drugs was withdrawn from the

  3. Alterations in cardiac autonomic control in spinal cord injury

    DEFF Research Database (Denmark)

    Biering-Sørensen, Fin; Biering-Sørensen, Tor; Liu, Nan

    2018-01-01

    parasympathetic cardiac control. Decreases in sympathetic activity result in heart rate and the arterial blood pressure changes, and may cause arrhythmias, in particular bradycardia, with the risk of cardiac arrest in those with cervical or high thoracic injuries. The objective of this review is to give an update...

  4. Remodeling of repolarization and arrhythmia susceptibility in a myosin-binding protein C knockout mouse model.

    Science.gov (United States)

    Toib, Amir; Zhang, Chen; Borghetti, Giulia; Zhang, Xiaoxiao; Wallner, Markus; Yang, Yijun; Troupes, Constantine D; Kubo, Hajime; Sharp, Thomas E; Feldsott, Eric; Berretta, Remus M; Zalavadia, Neil; Trappanese, Danielle M; Harper, Shavonn; Gross, Polina; Chen, Xiongwen; Mohsin, Sadia; Houser, Steven R

    2017-09-01

    Hypertrophic cardiomyopathy (HCM) is one of the most common genetic cardiac diseases and among the leading causes of sudden cardiac death (SCD) in the young. The cellular mechanisms leading to SCD in HCM are not well known. Prolongation of the action potential (AP) duration (APD) is a common feature predisposing hypertrophied hearts to SCD. Previous studies have explored the roles of inward Na + and Ca 2+ in the development of HCM, but the role of repolarizing K + currents has not been defined. The objective of this study was to characterize the arrhythmogenic phenotype and cellular electrophysiological properties of mice with HCM, induced by myosin-binding protein C (MyBPC) knockout (KO), and to test the hypothesis that remodeling of repolarizing K + currents causes APD prolongation in MyBPC KO myocytes. We demonstrated that MyBPC KO mice developed severe hypertrophy and cardiac dysfunction compared with wild-type (WT) control mice. Telemetric electrocardiographic recordings of awake mice revealed prolongation of the corrected QT interval in the KO compared with WT control mice, with overt ventricular arrhythmias. Whole cell current- and voltage-clamp experiments comparing KO with WT mice demonstrated ventricular myocyte hypertrophy, AP prolongation, and decreased repolarizing K + currents. Quantitative RT-PCR analysis revealed decreased mRNA levels of several key K + channel subunits. In conclusion, decrease in repolarizing K + currents in MyBPC KO ventricular myocytes contributes to AP and corrected QT interval prolongation and could account for the arrhythmia susceptibility. NEW & NOTEWORTHY Ventricular myocytes isolated from the myosin-binding protein C knockout hypertrophic cardiomyopathy mouse model demonstrate decreased repolarizing K + currents and action potential and QT interval prolongation, linking cellular repolarization abnormalities with arrhythmia susceptibility and the risk for sudden cardiac death in hypertrophic cardiomyopathy. Copyright © 2017

  5. Copper complexation capacity in surface waters of the Venice Lagoon.

    Science.gov (United States)

    Delgadillo-Hinojosa, Francisco; Zirino, Alberto; Nasci, Cristina

    2008-10-01

    Total copper (Cu(T)), copper ion activity (pCu) and the copper complexation capacity (CuCC) were determined in samples of seawater collected in July 2003 from the Venice Lagoon. Cu(T) and CuCC showed considerable spatial variability: Cu(T) ranged from 1.8 to 70.0nM, whereas the CuCC varied from 195 to 573nM. pCu values varied from 11.6 to 12.6 and are consistent with those previously reported in estuarine and coastal areas (10.9-14.1). The range of Cu(T) values compares well with those reported in the past in the lagoon and in the adjacent Adriatic Sea. The highest concentrations of Cu(T) were found in samples collected near the industrial area of Porto Marghera, whereas the lowest were measured near the Chioggia and Malamocco inlets, where an intense tidally-driven renewal of seawater takes place. Although CuCC showed a high degree of spatial variability, the values recorded in the Venice Lagoon are comparable to those reported in other estuarine systems. In addition, CuCC was positively correlated with dissolved organic carbon (DOC), suggesting that organic ligands responsible for Cu complexation are part of the bulk organic matter pool in the lagoon. The CuCC:Cu(T) molar ratio was, on average 55:1, indicating that a large excess of complexation capacity exists in the Venice Lagoon. The high levels of CuCC and the narrow range of pCu indicates the importance of the role played by organic ligands in controlling the free ion Cu concentrations in the lagoon, and as a consequence, regulating its availability and/or toxicity.

  6. Shakespeare and Christianity—Studies in the Merchant of Venice

    Institute of Scientific and Technical Information of China (English)

    黄琼英

    2016-01-01

    Christianity, by far the most influential religion in the west, touches every phase of man's life so much so that it has shaped the western civilization more decisively and become the blood of western culture. William Shakespeare is the greatest hu-manist, but he is also a Christian rooted in western culture, so it is observed that Shakespeare's thinking pattern and writing were influenced by Christianity. The paper, taking the Merchant of Venice as an example, analyzed Biblical references in Shake-speare's thinking pattern, Christianity and Shakespeare's idealistic character.

  7. Venice Film Festival before, during and after Pontecorvo

    Directory of Open Access Journals (Sweden)

    Roberto Donati

    2016-07-01

    Full Text Available A brief historical introduction to Venice Film Festival. The reasons that led Gillo Pontecorvo to become Director in 1992. Pontecorvo’s programmatic standpoint, successes and first false steps: the Unforgiven case. The five Pontecorvo editions in detail: titles, directors, discoveries, reassessments. His initiatives aimed to repopulate the Lido of common moviegoers, specifically young spectators, after years when the Mostra had become an insiders’ exclusive destination. Gillo’s comeback as a former Director, again as a filmmaker, with the short movie Nostalgia di protezione. Pontecorvo’ aftermath: from Felice Laudadio to Alberto Barbera, from Moritz de Hadeln to Marco Müller, until Barbera’s comeback.

  8. Floating call boys and agile homosexuals: homophobia/Venice/history.

    Science.gov (United States)

    Champagne, John

    2014-01-01

    Because works of nonfiction are always composed of literary tropes and metaphors, they have to be read critically for the ways in which their truth claims are potentially structured by ideologies and stereotypes. This essay reads passages from Richard Sennett's sociological analysis Flesh and Stone, The Body and the City in Western Civilization and Joseph Brodsky's memoir Watermark in order to demonstrate how these alleged works of nonfiction shore up some dishearteningly familiar literary stereotypes of male homosexuality and participate in a tradition, dating from the 19th century, of linking the city of Venice with homosexuality and death.

  9. Classification of ECG signal with Support Vector Machine Method for Arrhythmia Detection

    Science.gov (United States)

    Turnip, Arjon; Ilham Rizqywan, M.; Kusumandari, Dwi E.; Turnip, Mardi; Sihombing, Poltak

    2018-03-01

    An electrocardiogram is a potential bioelectric record that occurs as a result of cardiac activity. QRS Detection with zero crossing calculation is one method that can precisely determine peak R of QRS wave as part of arrhythmia detection. In this paper, two experimental scheme (2 minutes duration with different activities: relaxed and, typing) were conducted. From the two experiments it were obtained: accuracy, sensitivity, and positive predictivity about 100% each for the first experiment and about 79%, 93%, 83% for the second experiment, respectively. Furthermore, the feature set of MIT-BIH arrhythmia using the support vector machine (SVM) method on the WEKA software is evaluated. By combining the available attributes on the WEKA algorithm, the result is constant since all classes of SVM goes to the normal class with average 88.49% accuracy.

  10. Anti-HERG activity and the risk of drug-induced arrhythmias and sudden death

    DEFF Research Database (Denmark)

    De Bruin, M L; Pettersson, M; Meyboom, R H B

    2005-01-01

    AIMS: Drug-induced QTc-prolongation, resulting from inhibition of HERG potassium channels may lead to serious ventricular arrhythmias and sudden death. We studied the quantitative anti-HERG activity of pro-arrhythmic drugs as a risk factor for this outcome in day-to-day practice. METHODS...... defined as reports of cardiac arrest, sudden death, torsade de pointes, ventricular fibrillation, and ventricular tachycardia (n = 5591), and compared with non-cases regarding the anti-HERG activity, defined as the effective therapeutic plasma concentration (ETCPunbound) divided by the HERG IC50 value......, of suspected drugs. We identified a significant association of 1.93 (95% CI: 1.89-1.98) between the anti-HERG activity of drugs, measured as log10 (ETCPunbound/IC50), and reporting of serious ventricular arrhythmias and sudden death to the WHO-UMC database. CONCLUSION: Anti-HERG activity is associated...

  11. Vernakalant hydrochloride for the rapid conversion of atrial fibrillation after cardiac surgery

    DEFF Research Database (Denmark)

    Kowey, Peter R; Dorian, Paul; Mitchell, L Brent

    2009-01-01

    Postoperative atrial arrhythmias are common and are associated with considerable morbidity. This study was designed to evaluate the efficacy and safety of vernakalant for the conversion of atrial fibrillation (AF) or atrial flutter (AFL) after cardiac surgery....

  12. Possible influence of the polarity reversal of the solar magnetic field on the various types of arrhythmias

    International Nuclear Information System (INIS)

    Giannaropoulou, E; Papailiou, M; Mavromichalaki, H; Preka-Papadema, P; Gigolashvili, M; Tvildiani, L; Janashia, K; Papadima, Th

    2013-01-01

    Over the last few years various researches have reached the conclusion that cosmic ray variations and geomagnetic disturbances are related to the condition of the human physiological state. In this study medical data concerning the number of incidents of different types of cardiac arrhythmias for the time period 1983 – 1992 which refer to 1902 patients in Tbilisi, Georgia were used. The smoothing method and the Pearson r-coefficients were used to examine the possible effect of different solar and geomagnetic activity parameters and cosmic ray intensity variations on the different types of arrhythmias. The time interval under examination was separated into two different time periods which coincided with the polarity reversal of the solar magnetic field that occurred in the years 1989-1990 and as a result a different behavior of all the above mentioned parameters as well as of the different types of arrhythmias was noticed during the two time intervals. In addition, changing of polarity sign of the solar magnetic field was found to affect the sign of correlation between the incidence of arrhythmias and the aforementioned parameters. The primary and secondary maxima observed in the solar parameters during the solar cycle 22, also appeared in several types of arrhythmias with a time lag of about five months.

  13. Pharmacogenetics of drug-induced arrhythmias

    DEFF Research Database (Denmark)

    De Bruin, Marie L; van Puijenbroek, Eugene P; Bracke, Madelon

    2006-01-01

    PURPOSE: The bottleneck in pharmacogenetic research on rare adverse drug reactions (ADR) is retrieval of patients. Spontaneous reports of ADRs may form a useful source of patients. We investigated the feasibility of a pharmacogenetic study, in which cases were selected from the database...... of a spontaneous reporting system for ADRs, using drug-induced arrhythmias as an example. METHODS: Reports of drug-induced arrhythmias to proarrhythmic drugs were selected from the database of the Netherlands Pharmacovigilance Centre (1996-2003). Information on the patient's general practitioner (GP) was obtained...... be included in the study, giving an overall participation rate of 9% (4/45). The main reason for GPs not being willing to participate was lack of time. Variants were identified in KCNH2, SCN5A and KCNE1. CONCLUSIONS: Spontaneous reporting systems for ADRs may be used for pharmacogenetic research. The methods...

  14. Architectures drawn / digital models: the Venices (impossible on line

    Directory of Open Access Journals (Sweden)

    Malvina Borgherini

    2011-12-01

    Full Text Available A contemporary city representation talks not only about architecture and landscape but also about the effects that political institutions, cultural traditions and economic enterprises have on the urban community. Methods and ways traditionally used to present the complexity and, at the same time, the personality of a town, or on a smaller scale of one of his monument, are not suitable with the contemporary reality. A very famous panel presented at Venice Biennale in 1976, Aldo Rossi’s «Città Analoga», within real and ideal architectures, ancient monuments and contemporary landscapes, individual and collective memories, human presences and empty spaces, can be taken as an example for the preparation of a new ‘story’ or a new ‘map’ for a city like Venice. The space of a digital model can become a place for discussion and analysis, a place where to see together historical records and projects never realized, where to put subjective and objective visions, which overlap daily and occasional tracks.

  15. Effect of Partial Use of Venice Flood Barriers

    Directory of Open Access Journals (Sweden)

    Luca Cavallaro

    2017-12-01

    Full Text Available The Venice lagoon is one of the most important areas in Italy because of its history and its particular structure and form. In order to defend Venice and other towns within the lagoon from severe floods, the Italian Government promotes a project that includes, among other measures, the construction of the Experimental Electromechanical Module (MoSE. The MoSE is a system of mobile gates installed at the lagoon inlets that are able to temporarily isolate the Venetian lagoon from the Adriatic Sea during severe storm surge events, thus ensuring acceptable safeguarding water levels. To prevent interference between the barriers and the normal port activities, locks have been constructed at each lagoon inlet. However, the use of such locks causes a slowdown in maritime traffic. In order to evaluate a means of reducing such interference during the flooding events characterized by high but not extreme water levels, the present paper demonstrates, by means of a numerical approach, that one of the three inlets can be left open so as to ensure the transit of the vessels. The present paper also points out the meteorological conditions for which the safeguarding water levels of the lagoon are not exceeded when closing only two inlets.

  16. Vibrio trends in the ecology of the Venice lagoon.

    Science.gov (United States)

    Rahman, Mohammad Shamsur; Martino, Maria Elena; Cardazzo, Barbara; Facco, Pierantonio; Bordin, Paola; Mioni, Renzo; Novelli, Enrico; Fasolato, Luca

    2014-04-01

    Vibrio is a very diverse genus that is responsible for different human and animal diseases. The accurate identification of Vibrio at the species level is important to assess the risks related to public health and diseases caused by aquatic organisms. The ecology of Vibrio spp., together with their genetic background, represents an important key for species discrimination and evolution. Thus, analyses of population structure and ecology association are necessary for reliable characterization of bacteria and to investigate whether bacterial species are going through adaptation processes. In this study, a population of Vibrionaceae was isolated from shellfish of the Venice lagoon and analyzed in depth to study its structure and distribution in the environment. A multilocus sequence analysis (MLSA) was developed on the basis of four housekeeping genes. Both molecular and biochemical approaches were used for species characterization, and the results were compared to assess the consistency of the two methods. In addition, strain ecology and the association between genetic information and environment were investigated through statistical models. The phylogenetic and population analyses achieved good species clustering, while biochemical identification was demonstrated to be imprecise. In addition, this study provided a fine-scale overview of the distribution of Vibrio spp. in the Venice lagoon, and the results highlighted a preferential association of the species toward specific ecological variables. These findings support the use of MLSA for taxonomic studies and demonstrate the need to consider environmental information to obtain broader and more accurate bacterial characterization.

  17. Dioxins in the Venice lagoon: Present situation, projects and recovering hypotheses.

    Science.gov (United States)

    Raccanelli, S; Bonamin, V

    2000-01-01

    Venice is famous around the world for its uniqueness and architectural splendours, arts and the history of the "Serenissima Repubblica", as it was known in the past, but few are aware that Venice economy is strongly dependent on the industrial activities based mainly on the adjacent Porto Marghera area. For many years, the lagoon that physically separates the city from the dry land has avoided association between the concern connected with the pollution derived from these industrial activities and the public perception of Venice. Since 1995, dioxins have appeared as a lagoon contaminant, and their presence, at such a level requiring immediate "in depth" studies and interventions, has been fully realized for decades.

  18. Cardiac damage in athlete's heart: When the "supernormal" heart fails!

    Science.gov (United States)

    Carbone, Andreina; D'Andrea, Antonello; Riegler, Lucia; Scarafile, Raffaella; Pezzullo, Enrica; Martone, Francesca; America, Raffaella; Liccardo, Biagio; Galderisi, Maurizio; Bossone, Eduardo; Calabrò, Raffaele

    2017-06-26

    Intense exercise may cause heart remodeling to compensate increases in blood pressure or volume by increasing muscle mass. Cardiac changes do not involve only the left ventricle, but all heart chambers. Physiological cardiac modeling in athletes is associated with normal or enhanced cardiac function, but recent studies have documented decrements in left ventricular function during intense exercise and the release of cardiac markers of necrosis in athlete's blood of uncertain significance. Furthermore, cardiac remodeling may predispose athletes to heart disease and result in electrical remodeling, responsible for arrhythmias. Athlete's heart is a physiological condition and does not require a specific treatment. In some conditions, it is important to differentiate the physiological adaptations from pathological conditions, such as hypertrophic cardiomyopathy, arrhythmogenic dysplasia of the right ventricle, and non-compaction myocardium, for the greater risk of sudden cardiac death of these conditions. Moreover, some drugs and performance-enhancing drugs can cause structural alterations and arrhythmias, therefore, their use should be excluded.

  19. A Psychological Factor Affecting a Cardiac Condition in a Psychotherapist

    OpenAIRE

    R Waxman; K Khorasani; A Lenny; S Bhalerao

    2009-01-01

    It has been established that intense emotions can affect the development and course of cardiac arrhythmias. This study sought to convey that a lack of expression of emotion can also have an effect on arrhythmias. A psychotherapist with Idiopathic Ventricular Fibrillation and an Implantable Cardioverter Defibrillator measured his rate of Premature Ventricular Contractions using a Holter monitor during three separate six-week periods and in three domains: A) work days vs. off days, B) a 27 hour...

  20. Electron-beam CT coronary angiography in the patients with high heart rate arrhythmia or pacemaker

    International Nuclear Information System (INIS)

    Dong Zhi; Zhu Jiemin; Liu Zhe; Liu Junbo; Li Youjie; Qi Ji

    2006-01-01

    Objective: To report the clinical applicability of coronary angiography for patients with high heart rate, arrhythmia or cardiac pacing using the new-generation of electron-beam CT (e-Speed). Methods: EBCT (GE e-Speed) coronary angiography was performed in 36 eases (male 27, female 9, mean age 58), including the heart rate more than 90 bpm in 20 patients, frequent ectopic beats in 11 cases, implantation of cardiac pacemaker in 4 patients and the unacceptable MSCT image quality due to variability of interscan heart rate (from 82 bpm to 104 bpm) in 1 case. After volume data set was acquired using spiral mode with prospective ECG-gating, the reconstructions of MIP, CPR, VR and Cine were performed. The VR quality was evaluated using a five-point scale. Results: The quality of coronary imaging in all of 36 cases were acceptable. The total visualization rate of coronary artery branches was 80.0%. Left main, left anterior artery and right coronary artery were visualized in all patients and in 94.3% of all cases circumflex artery were visible. Conclusion: EBCT (e-Speed) is applicable in noninvasive coronary angiography for patients with high heart rate, arrhythmia or implanted cardiac pacemaker', and this examination can obtain satisfied diagnosis. (authors)

  1. Differential roles of two delayed rectifier potassium currents in regulation of ventricular action potential duration and arrhythmia susceptibility.

    Science.gov (United States)

    Devenyi, Ryan A; Ortega, Francis A; Groenendaal, Willemijn; Krogh-Madsen, Trine; Christini, David J; Sobie, Eric A

    2017-04-01

    Arrhythmias result from disruptions to cardiac electrical activity, although the factors that control cellular action potentials are incompletely understood. We combined mathematical modelling with experiments in heart cells from guinea pigs to determine how cellular electrical activity is regulated. A mismatch between modelling predictions and the experimental results allowed us to construct an improved, more predictive mathematical model. The balance between two particular potassium currents dictates how heart cells respond to perturbations and their susceptibility to arrhythmias. Imbalances of ionic currents can destabilize the cardiac action potential and potentially trigger lethal cardiac arrhythmias. In the present study, we combined mathematical modelling with information-rich dynamic clamp experiments to determine the regulation of action potential morphology in guinea pig ventricular myocytes. Parameter sensitivity analysis was used to predict how changes in ionic currents alter action potential duration, and these were tested experimentally using dynamic clamp, a technique that allows for multiple perturbations to be tested in each cell. Surprisingly, we found that a leading mathematical model, developed with traditional approaches, systematically underestimated experimental responses to dynamic clamp perturbations. We then re-parameterized the model using a genetic algorithm, which allowed us to estimate ionic current levels in each of the cells studied. This unbiased model adjustment consistently predicted an increase in the rapid delayed rectifier K + current and a drastic decrease in the slow delayed rectifier K + current, and this prediction was validated experimentally. Subsequent simulations with the adjusted model generated the clinically relevant prediction that the slow delayed rectifier is better able to stabilize the action potential and suppress pro-arrhythmic events than the rapid delayed rectifier. In summary, iterative coupling of

  2. Venice, Genoa, and John VIII Palaeologus’ Renovation of the Fortifications of Constantinople

    Directory of Open Access Journals (Sweden)

    Marios Philippides

    2016-05-01

    Full Text Available Chalcocondyles’ account of John’s conflict with the Genoese ca. 1434 is supplemented by a contemporary panegyric that shows the events to be part of a larger conflict between Genoa and Venice.

  3. POPDC1S201F causes muscular dystrophy and arrhythmia by affecting protein trafficking

    Science.gov (United States)

    Schindler, Roland F.R.; Scotton, Chiara; Zhang, Jianguo; Passarelli, Chiara; Ortiz-Bonnin, Beatriz; Simrick, Subreena; Schwerte, Thorsten; Poon, Kar-Lai; Fang, Mingyan; Rinné, Susanne; Froese, Alexander; Nikolaev, Viacheslav O.; Grunert, Christiane; Müller, Thomas; Tasca, Giorgio; Sarathchandra, Padmini; Drago, Fabrizio; Dallapiccola, Bruno; Rapezzi, Claudio; Arbustini, Eloisa; Di Raimo, Francesca Romana; Neri, Marcella; Selvatici, Rita; Gualandi, Francesca; Fattori, Fabiana; Pietrangelo, Antonello; Li, Wenyan; Jiang, Hui; Xu, Xun; Bertini, Enrico; Decher, Niels; Wang, Jun; Brand, Thomas; Ferlini, Alessandra

    2015-01-01

    The Popeye domain–containing 1 (POPDC1) gene encodes a plasma membrane–localized cAMP-binding protein that is abundantly expressed in striated muscle. In animal models, POPDC1 is an essential regulator of structure and function of cardiac and skeletal muscle; however, POPDC1 mutations have not been associated with human cardiac and muscular diseases. Here, we have described a homozygous missense variant (c.602C>T, p.S201F) in POPDC1, identified by whole-exome sequencing, in a family of 4 with cardiac arrhythmia and limb-girdle muscular dystrophy (LGMD). This allele was absent in known databases and segregated with the pathological phenotype in this family. We did not find the allele in a further screen of 104 patients with a similar phenotype, suggesting this mutation to be family specific. Compared with WT protein, POPDC1S201F displayed a 50% reduction in cAMP affinity, and in skeletal muscle from patients, both POPDC1S201F and WT POPDC2 displayed impaired membrane trafficking. Forced expression of POPDC1S201F in a murine cardiac muscle cell line (HL-1) increased hyperpolarization and upstroke velocity of the action potential. In zebrafish, expression of the homologous mutation (popdc1S191F) caused heart and skeletal muscle phenotypes that resembled those observed in patients. Our study therefore identifies POPDC1 as a disease gene causing a very rare autosomal recessive cardiac arrhythmia and LGMD, expanding the genetic causes of this heterogeneous group of inherited rare diseases. PMID:26642364

  4. Relations between constructive peculiarities and structural behavior in Venice buildings

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    Doglioni, F.

    2012-12-01

    Full Text Available Here we are synthetically describing some constructive peculiarities of Venice civil buildings, analyzing the relation with the features of their structural decay and behavior in the long run. We suppose Venetian buildings, especially those parts which are conceived to suit the lagoon environment, to have undergone an evolution made of some adjustments, which were based on the observation of damages in previous buildings. That is we suppose ancient builders to rely on their awareness of the behavior of structures yet to come, and to be able to forecast it in part. This process brought some building contrivances to perfection, as exclusive and enduring features of Venice, overcoming changes in style and architectural layout, till they grew into essential elements of a whole and adaptable “device”. This writing is meant for a concise interpretation of this device, which is the result of some research works carried out at Venice IUAV University.

    En este texto, se describen sintéticamente algunas peculiaridades de la edificación residencial de Venecia, analizando su relación con el abanico de problemas estructurales que caracterizan el comportamiento estructural del edificio a lo largo del tiempo. Se aventura la hipótesis que las construcciones venecianas y, en particular, algunos de sus detalles, concebidos específicamente para la laguna donde se enclava, han sido objeto de una adaptación evolutiva a través de la observación de los problemas estructurales de los edificios precedentes. Los alarifes venecianos aprendieron a tener en cuenta el comportamiento estructural posterior del edificio, que previeron en cierta medida. Este proceso ha llevado a perfeccionar algunos detalles constructivos exclusivos de Venecia que han perdurado en el tiempo, que han resistido impertérritos a mutaciones de estilo y de configuración arquitectónica, hasta constituir elementos esenciales de un aparato indivisible y adaptable cuya interpretaci

  5. The high resolution mapping of the Venice Lagoon tidal network

    Science.gov (United States)

    Madricardo, Fantina; Foglini, Federica; Kruss, Aleksandra; Bellafiore, Debora; Trincardi, Fabio

    2017-04-01

    One of the biggest challenges of the direct observation of the ocean is to achieve a high resolution mapping of its seafloor morphology and benthic habitats. So far, sonars have mapped just 0.05% of the ocean floor with less than ten-meter resolution. The recent efforts of the scientific community have been devoted towards the mapping of both Deep Ocean and very shallow coastal areas. Coastal and transitional environments in particular undergo strong morphological changes due to natural and anthropogenic pressure. Nowadays, only about 5% of the seafloor of these environments † have been mapped: the shallowness of these environments has prevented the use of underwater acoustics to reveal their morphological features. The recent technological development of multibeam echosounder systems, however, enables these instruments to achieve very high performances also in such shallow environments. In this work, we present results and case studies of an extensive multibeam survey carried out in the Lagoon of Venice in 2013. The Lagoon of Venice is the biggest lagoon in the Mediterranean Sea with a surface of about 550 km2 and with an average depth of about 1 m. In the last century, the morphological and ecological properties of the lagoon changed dramatically: the surface of the salt marshes was reduced by 60% and some parts of the lagoon are deepening with a net sediment flux exiting from the inlets. Moreover, major engineering interventions are currently ongoing at the inlets (MOSE project). These changes at the inlets could affect substantially the lagoon environment. To understand and monitor the future evolution of the Lagoon of Venice, ISMAR within the project RITMARE (a National Research Programme funded by the Italian Ministry of University and Research) carried out an extensive survey, involving a team of more than 25 scientists, to collect high resolution (0.5 m) bathymetry of key study areas such as the tidal inlets and channels. Following a broad

  6. CODE SETTING TRENDS IN ELECTORAL MATTERS - CODE OF GOOD PRACTICE IN ELECTORAL MATTERS - VENICE 2002

    Directory of Open Access Journals (Sweden)

    Mircea-Constantin SINESCU

    2016-05-01

    Full Text Available The integrated and ongoing effort of the of the states in the European area to modernize and adapt their laws to the current needs and exigencies of the citizens is transposed, in terms of constitutional matters, in the actions of the European Commission for Democracy through Law, better known as the Venice Commission, as Venice is the place of the proceedings of this Council of Europe's advisory body on constitutional matters.

  7. CODE SETTING TRENDS IN ELECTORAL MATTERS - CODE OF GOOD PRACTICE IN ELECTORAL MATTERS - VENICE 2002

    OpenAIRE

    Mircea-Constantin SINESCU; Mihai-Daniel ONIȘOR

    2016-01-01

    The integrated and ongoing effort of the of the states in the European area to modernize and adapt their laws to the current needs and exigencies of the citizens is transposed, in terms of constitutional matters, in the actions of the European Commission for Democracy through Law, better known as the Venice Commission, as Venice is the place of the proceedings of this Council of Europe's advisory body on constitutional matters.

  8. Ruling the Market: How Venice Dominated the Early Music Printing World

    OpenAIRE

    Elizabeth M. Poore

    2015-01-01

    This paper attempts to prove that Venice was the main geographical center of music printing and publishing from the 1300s to the late 1500s using several economic, legal, and cultural factors. The primary research method was examining secondary sources on music printing, publishing, and European and Venetian history. From the 1300s to the late 1500s, Venetian commercial trade and activity, including book publishing, reached unheard of levels. Venice held a powerful position in the European...

  9. Arrhythmia Classification Based on Multi-Domain Feature Extraction for an ECG Recognition System

    Directory of Open Access Journals (Sweden)

    Hongqiang Li

    2016-10-01

    Full Text Available Automatic recognition of arrhythmias is particularly important in the diagnosis of heart diseases. This study presents an electrocardiogram (ECG recognition system based on multi-domain feature extraction to classify ECG beats. An improved wavelet threshold method for ECG signal pre-processing is applied to remove noise interference. A novel multi-domain feature extraction method is proposed; this method employs kernel-independent component analysis in nonlinear feature extraction and uses discrete wavelet transform to extract frequency domain features. The proposed system utilises a support vector machine classifier optimized with a genetic algorithm to recognize different types of heartbeats. An ECG acquisition experimental platform, in which ECG beats are collected as ECG data for classification, is constructed to demonstrate the effectiveness of the system in ECG beat classification. The presented system, when applied to the MIT-BIH arrhythmia database, achieves a high classification accuracy of 98.8%. Experimental results based on the ECG acquisition experimental platform show that the system obtains a satisfactory classification accuracy of 97.3% and is able to classify ECG beats efficiently for the automatic identification of cardiac arrhythmias.

  10. [The De affectibus oris, of Vittorio Trincavella of Venice].

    Science.gov (United States)

    Vidal, F

    1993-01-01

    The author states that starting with a work published in 1575 in the city of Venice, it is possible to rebuild in a complete way the Dentistry History of the XVI century; it is indeed an important testimony considering specially the lack of existing information and of authors dedicated specifically to this subject. The article center its interest in the Book number V and in the 13 chapters it is composed of and where there are described the common affections of the mouth and its surroundings. It is also given a biography of Trincavella and a panorama of Medicine of that time and by XVI and XVII centuries. Prof. Vidal offers also the translation from latin to french of Vittorio Trincavella, text made by Jean Marc Galeazzi, Paris.

  11. The Frari bell tower in Venice: study and restoration

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    Ilaria Cavaggioni

    2010-12-01

    Full Text Available The preliminary study, project and restoration process of the bell tower of the Frari church in Venice is an exemplary case of intervention on a historic building. This intervention started within depth research into the documentary data along with a detailed study of the material fabric which has made it possible to compare the verisimilitude and gaps in the historic sources, the evolution of the building, its built reality and the effects of the repair works carried out in the past at the same time as the damages in the fabric were monitored. Thanks to the knowledge thus gleaned, the restoration works proceeded with great caution in order to respect the material history of the building and short and long-term structural compatibility.

  12. Cardiac Delayed Rectifier Potassium Channels in Health and Disease

    Science.gov (United States)

    Chen, Lei; Sampson, Kevin J.; Kass, Robert S.

    2016-01-01

    Cardiac delayed rectifier potassium channels conduct outward potassium currents during the plateau phase of action potentials and play pivotal roles in cardiac repolarization. These include IKs, IKr and the atrial specific IKur channels. In this chapter, we will review the molecular identities and biophysical properties of these channels. Mutations in the genes encoding delayed rectifiers lead to loss- or gain-of-function phenotypes, disrupt normal cardiac repolarization and result in various cardiac rhythm disorders, including congenital Long QT Syndrome, Short QT Syndrome and familial atrial fibrillation. We will also discuss the possibility and prospect of using delayed rectifier channels as therapeutic targets to manage cardiac arrhythmia. PMID:27261823

  13. Cardiac Delayed Rectifier Potassium Channels in Health and Disease.

    Science.gov (United States)

    Chen, Lei; Sampson, Kevin J; Kass, Robert S

    2016-06-01

    Cardiac delayed rectifier potassium channels conduct outward potassium currents during the plateau phase of action potentials and play pivotal roles in cardiac repolarization. These include IKs, IKr and the atrial specific IKur channels. In this article, we will review their molecular identities and biophysical properties. Mutations in the genes encoding delayed rectifiers lead to loss- or gain-of-function phenotypes, disrupt normal cardiac repolarization and result in various cardiac rhythm disorders, including congenital Long QT Syndrome, Short QT Syndrome and familial atrial fibrillation. We will also discuss the prospect of using delayed rectifier channels as therapeutic targets to manage cardiac arrhythmia. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Venice, the city and the lagoon: a lost relationship?

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    Piero Pedrocco

    2014-01-01

    Full Text Available In June 2011, the Venetians Engineers organized a conference entitled: The Eighth district. The Laguna as a connection matrix. In a world where the concept of “city”, which has become improper, applies to so-called historical centers that increasingly large conurbations, much of the Laguna is peripheral space, where inedited stories and resonant events living with full-blown environmental degradation and decay culture, make it a place of margin. Today, the lagoon and coastal areas are a continuous with the water spaces and islands that separate them, facing with unfinished waterfront towards brackish non-places. In this context, the debates and choices around the Laguna alternate without a unified design. Venice is always less connected with the surroundings by water, and the water itself become a limit to mobility, where, on the contrary, it was the element that guaranteed it.In the renewed debate on development strategies, realized the MOSE, it will be asked for which city it has been made. The conference drew attention to the rediscovery of the central role of the Lagoon. Between local development and global challenges, including heritage and environmental protection. Is it possible to envisage a revitalization of the lagoon system as a matrix of physical and cultural connection? Which opportunities are offered today to the city of Venice to rediscover its amphibious and cosmopolitan size and discover the Laguna as an Eighth District? A place of sites for residence, recreation, work, in a renovated urban dimension across the board, opened towards the spaces of the islands.

  15. Malignant Arrhythmia in Apical Ballooning Syndrome: Risk Factors and Outcomes

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    Samuel J. Asirvatham

    2008-08-01

    Full Text Available Objectives: We sought to determine the frequency and outcomes with symptomatic arrhythmia in patients with apical ballooning syndrome (ABS. Methods: A retrospective review of the Mayo Clinic Angiography database was conducted to identify patients who met the Mayo criteria for ABS. Patients with documented arrhythmias formed the study group, and 31 randomly selected patients with ABS but without arrhythmia formed the control group.Results: Out of 105 patients identified with ABS, 6 (5.7% women aged 69 +/- 9 years experienced significant arrhythmia (ventricular fibrillation, asystole, 2 patients died, and 1 required permanent pacemaker implantation. When compared with controls, the study group showed no significant difference with respect to ECG characteristics (QT, QRS duration or axis except for R-R interval variability (see comments below (30.6±6 vs 14.5±17 p = 0.0004, QTc, and P-R interval. Patients without arrhythmia were more likely to be on beta-blocker therapy than the study population (33% vs 80.6% p = 0.02. Conclusion: Life-threatening arrhythmia is uncommon (5.7% with ABS despite marked, structural abnormalities. When arrhythmias do occur, the outcome is poor. Prominent variability in R-R intervals appears to be predictive of significant arrhythmias in ABS. The role of beta-blocker therapy in preventing arrhythmia with ABS requires further investigation.

  16. Risk of malignant arrhythmias in initially symptomatic patients with Wolff-Parkinson-White syndrome: results of a prospective long-term electrophysiological follow-up study.

    Science.gov (United States)

    Pappone, Carlo; Vicedomini, Gabriele; Manguso, Francesco; Baldi, Mario; Pappone, Alessia; Petretta, Andrea; Vitale, Raffaele; Saviano, Massimo; Ciaccio, Cristiano; Giannelli, Luigi; Calovic, Zarko; Tavazzi, Luigi; Santinelli, Vincenzo

    2012-02-07

    The available amount of detailed long-term data in patients with Wolff-Parkinson-White syndrome is limited, and no prospective electrophysiological studies looking at predictors of malignant arrhythmia are available. Among 8575 symptomatic Wolff-Parkinson-White patients with atrioventricular reentrant tachycardia referred for electrophysiological test, 369 (mean age, 23±12.5 years) declined catheter ablation and were followed up. The primary end point of the study was to evaluate over a 5-year follow-up the predictors and characteristics of patients who develop malignant arrhythmias. After a mean follow-up of 42.1±10 months, malignant arrhythmias developed in 29 patients (mean age, 13.9±5.6 years; 26 male), resulting in presyncope/syncope (25 patients), hemodynamic collapse (3 patients), or cardiac arrest caused by ventricular fibrillation (1 patient). Of the remaining 340 patients, 168 (mean age, 34.2±9.0 years) remained asymptomatic up to 5 years, and 172 (mean age, 13.6±5.1 years) had benign recurrence, including sustained atrioventricular reentrant tachycardia (132 patients) or atrial fibrillation (40 patients). Compared with the group with no malignant arrhythmias, the group with malignant arrhythmias showed shorter accessory-pathway effective refractory period (PWolff-Parkinson-White syndrome generally have a good outcome, and predictors of malignant arrhythmias are similar to those reported for asymptomatic patients with ventricular pre-excitation.

  17. Coi-wiz: An interactive computer wizard for analyzing cardiac optical signals.

    Science.gov (United States)

    Yuan, Xiaojing; Uyanik, Ilyas; Situ, Ning; Xi, Yutao; Cheng, Jie

    2009-01-01

    A number of revolutionary techniques have been developed for cardiac electrophysiology research to better study the various arrhythmia mechanisms that can enhance ablating strategies for cardiac arrhythmias. Once the three-dimensional high resolution cardiac optical imaging data is acquired, it is time consuming to manually go through them and try to identify the patterns associated with various arrhythmia symptoms. In this paper, we present an interactive computer wizard that helps cardiac electrophysiology researchers to visualize and analyze the high resolution cardiac optical imaging data. The wizard provides a file interface that accommodates different file formats. A series of analysis algorithms output waveforms, activation and action potential maps after spatial and temporal filtering, velocity field and heterogeneity measure. The interactive GUI allows the researcher to identify the region of interest in both the spatial and temporal domain, thus enabling them to study different heart chamber at their choice.

  18. Observational cohort study of ventricular arrhythmia in adults with Marfan syndrome caused by FBN1 mutations.

    Directory of Open Access Journals (Sweden)

    Ali Aydin

    Full Text Available Marfan syndrome is associated with ventricular arrhythmia but risk factors including FBN1 mutation characteristics require elucidation.We performed an observational cohort study of 80 consecutive adults (30 men, 50 women aged 42±15 years with Marfan syndrome caused by FBN1 mutations. We assessed ventricular arrhythmia on baseline ambulatory electrocardiography as >10 premature ventricular complexes per hour (>10 PVC/h, as ventricular couplets (Couplet, or as non-sustained ventricular tachycardia (nsVT, and during 31±18 months of follow-up as ventricular tachycardia (VT events (VTE such as sudden cardiac death (SCD, and sustained ventricular tachycardia (sVT. We identified >10 PVC/h in 28 (35%, Couplet/nsVT in 32 (40%, and VTE in 6 patients (8%, including 3 with SCD (4%. PVC>10/h, Couplet/nsVT, and VTE exhibited increased N-terminal pro-brain natriuretic peptide serum levels(P10/h and Couplet/nsVT also related to increased indexed end-systolic LV diameters (P = .024 and P = .020, to moderate mitral valve regurgitation (P = .018 and P = .003, and to prolonged QTc intervals (P = .001 and P = .006, respectively. Moreover, VTE related to mutations in exons 24-32 (P = .021. Kaplan-Meier analysis corroborated an association of VTE with increased NT-proBNP (P<.001 and with mutations in exons 24-32 (P<.001.Marfan syndrome with causative FBN1 mutations is associated with an increased risk for arrhythmia, and affected persons may require life-long monitoring. Ventricular arrhythmia on electrocardiography, signs of myocardial dysfunction and mutations in exons 24-32 may be risk factors of VTE.

  19. Monitoring of arrhythmia and sudden death in a hemodialysis population: The CRASH-ILR Study.

    Directory of Open Access Journals (Sweden)

    Paul R Roberts

    Full Text Available It has been suggested that sudden cardiac death (SCD contributes around 50% of cardiovascular and 27% of all-cause mortality in hemodialysis patients. The true burden of arrhythmias and arrhythmic deaths in this population, however, remains poorly characterised. Cardio Renal Arrhythmia Study in Hemodialysis (CRASH-ILR is a prospective, implantable loop recorder single centre study of 30 established hemodialysis patients and one of the first to provide long-term ambulatory ECG monitoring.30 patients (60% male aged 68±12 years receiving hemodialysis for 45±40 months with varied etiology (diabetes 37%, hypertension 23% and left ventricular ejection fraction (LVEF 55±8% received a Reveal XT implantable loop recorder (Medtronic, USA between August 2011 and October 2014. ECG data from loop recorders were transmitted at each hemodialysis session using a remote monitoring system. Primary outcome was SCD or implantation of a (tachy or bradyarrhythmia controlling device and secondary outcome, the development of arrhythmia necessitating medical intervention.During 379,512 hours of continuous ECG monitoring (mean 12,648±9,024 hours/patient, there were 8 deaths-2 SCD and 6 due to generalised deterioration/sepsis. 5 (20% patients had a primary outcome event (2 SCD, 3 pacemaker implantations for bradyarrhythmia. 10 (33% patients reached an arrhythmic primary or secondary end point. Median event free survival for any arrhythmia was 2.6 years (95% confidence intervals 1.6-3.6 years.The findings confirm the high mortality rate seen in hemodialysis populations and contrary to initial expectations, bradyarrhythmias emerged as a common and potentially significant arrhythmic event.

  20. Pit-a-Pat: A Smart Electrocardiogram System for Detecting Arrhythmia.

    Science.gov (United States)

    Park, Juyoung; Lee, Kuyeon; Kang, Kyungtae

    2015-10-01

    Electrocardiogram (ECG) telemonitoring is one of the most promising applications of medical telemetry. However, previous approaches to ECG telemonitoring have largely relied on public databases of ECG results. In this article we propose a smart ECG system called Pit-a-Pat, which extracts features from ECG signals and detects arrhythmia. It is designed to run on an Android™ (Google, Mountain View, CA) device, without requiring modifications to other software. We implemented the Pit-a-Pat system using a commercial ECG device, and the experimental results demonstrate the effectiveness and accuracy of Pit-a-Pat for monitoring the ECG signal and analyzing the cardiac activity of a mobile patient. The proposed system allows monitoring of cardiac activity with automatic analysis, thereby providing a convenient, inexpensive, and ubiquitous adjunct to personal healthcare.

  1. Improvements of Storm Surge Modelling in the Gulf of Venice with Satellite Data: The ESA Due Esurge-Venice Project

    Science.gov (United States)

    De Biasio, F.; Bajo, M.; Vignudelli, S.; Papa, A.; della Valle, A.; Umgiesser, G.; Donlon, C.; Zecchetto, S.

    2016-08-01

    Among the most detrimental natural phenomena, storm surges heavily endanger the environment, the economy and the everyday life of sea-side countries and coastal zones. Considering that 120.000.000 people live in the Mediterranean area, with additional 200.000.000 presences in Summer for tourism purposes, the correct prediction of storm surges is crucial to avoid fatalities and economic losses. Earth Observation (EO) can play an important role in operational storm surge forecasting, yet it is not widely diffused in the storm surge community. In 2011 the European Space Agency (ESA), through its Data User Element (DUE) programme, financed two projects aimed at encouraging the uptake of EO data in this sector: eSurge and eSurge-Venice (eSV). The former was intended to address the issues of a wider users' community, while the latter was focused on a restricted geographical area: the northern Adriatic Sea and the Gulf of Venice. Among the objectives of the two projects there were a number of storm surge hindcast experiments using satellite data, to demonstrate the improvements on the surge forecast brought by EO. We report here the results of the hindcast experiments of the eSV project. They were aimed to test the sensitivity of a storm surge model to a forcing wind field modified with scatterometer data in order to reduce the bias between simulated and observed winds. Hindcast experiments were also performed to test the response of the storm surge model to the assimilation, with a dual 4D-Var system, of satellite altimetry observations as model errors of the initial state of the sea surface level. Remarkable improvements on the storm surge forecast have been obtained for what concerns the modified model wind forcing. Encouraging results have been obtained also in the assimilation experiments.

  2. Is the lagoon of Venice health? A look at budgets and pathways of POP's in Venice

    Energy Technology Data Exchange (ETDEWEB)

    Guerzoni, S.; Sarretta, A. [CNR - Istituto di Scienze Marine, Venezia (Italy); Ferrari, G. [Magistrato alle Acque, Venezia (Italy); Molinaroli, E. [Univ. Ca Foscari, Venezia (Italy). Dip. Scienze Ambientali; Rossini, P. [Istituto di Ricerca Gruppo CSA, Rimini (Italy)

    2004-09-15

    The rapid deterioration of the world's major ecosystems has intensified the need for effective monitoring and development of operational indicators of ecosystem health, and the extension of health to describe regional ecosystems is a response to accumulating evidence that humandominated ecosystems have become highly dysfunctional. The Lagoon of Venice is probably one of the world's best-known examples of an ecosystem that has been historically influenced by human intervention since the XVth century. The area has a long history of industrial activity (even recent, mainly after World War II), with oil refining and several chemical production plants around the Lagoon. Only recently has Venice also been recognised because of its environmental problems, mainly due to POPs accumulating in sediments and seafood which has aroused local concern. It is well-known that one important effect of ecosystem degradation is an increased risk to the health of human populations. In the case of POPs, the simplest way for humans to be exposed is through the consumption of food contaminated by dioxins and PCBs. Due to bio-accumulation and long-term exposure (additives) to these pollutants, even minimal doses of dioxins and PCBs can result in negative effects on health. Human health should thus be understood within an ecological framework as an expression of the life-supporting capacity of the environment. Consequently, human health becomes an important criterion of sustainability - one which, over time, signals whether we are satisfactorily sustaining the social and ecological realms. This paper gathers together recent data on dioxins and PCBs, related both to the environment and to human health, in order to emphasize the need for intervention.

  3. Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: a prospective study at baseline and after 1 year of somatostatin analogs treatment.

    Science.gov (United States)

    Warszawski, Leila; Kasuki, Leandro; Sá, Rodrigo; Dos Santos Silva, Cintia Marques; Volschan, Isabela; Gottlieb, Ilan; Pedrosa, Roberto Coury; Gadelha, Mônica R

    2016-12-01

    The incidence of arrhythmias may be increased in acromegaly, but the pathophysiologic mechanisms involved are still unclear, and it has never been correlated with structural heart changes analyzed by the gold-standard method cardiac magnetic resonance (CMR). Evaluate the frequency of arrhythmias in drug-naïve acromegaly patients at baseline and after 1 year of somatostatin analogs (SA) treatment and to correlate the occurrence of arrhythmias with the presence of structural heart changes. Consecutive drug-naïve acromegaly patients were recruited. The occurrence of arrhythmias and structural heart changes were studied through 24-h Holter and CMR, respectively, at baseline and after 1-year SA treatment. Thirty-six patients were studied at baseline and 28 were re-evaluated after 1 year of SA treatment. There were 13 females and median age was 48 years (20-73 years). Nine patients (32 %) were controlled after treatment. No sustained arrhythmias were reported in the 24-h Holter. No arrhythmia-related symptoms were observed. Only two patients presented left ventricular hypertrophy and three patients presented fibrosis at baseline. There was no correlation of the left ventricular mass with the number of episodes of arrhythmias and they were not more prevalent in the patients presenting cardiac fibrosis. We found no sustained arrhythmias and a lack of arrhythmia-related symptoms at baseline and after 1 year of SA treatment in a contemporary cohort of acromegaly patients that also present a low frequency of structural heart changes, indicating that these patients may have a lower frequency of heart disease than previously reported.

  4. From Incidental, Mechanically-Induced Arrhythmias to Reflex-Defined Arrhythmogenicity: On The Track of The Ternary Reflex System Resemblance to The "Infancy" of New Era or Rediscovery.

    Science.gov (United States)

    Stirbys, Petras

    2016-01-01

    The underlying pathophysiology of supraventricular and ventricular arrhythmias remains a matter of intense investigation. Though evolving, the contemporary explanations do not encompass all aspects of arrhythmogenicity. An improved understanding of arrhythmia substrate is needed to augment therapeutic capabilities. Our observation and literature sources demonstrate relatively high incidence of transitory arrhythmias which are non-intentionally generated by the endocardial lead/catheter manipulation. These findings are interesting and potentially may crystallize the reflex-dependent proarrhythmic cardiac activity. Herein we suggest the "reflexogenic arrhythmogenicity" concept extending an overall spectrum of known hypotheses. Cardiovascular reflex action can be categorized into three-tiered levels - intra-cellular, inter-cellular and inter-organic. The first two levels of the triplicate system reside within the cardiac anatomical landmarks (in fact intramurally, intra-organically), however the third one implicates central (cerebral) activity which boomerangs back via centripetal and centrifugal connections. These levels likely compose synoptic ternary reflex set system which may be validated in future studies. To hypothesize, coordinated mutual reciprocity of reflex activity results in stabilization of heart rhythm in robust heart. Any stressful cardiac event may lead to the shift of the rhythm toward unfavorable clinical entity probably via the loss of the influence of dominant reflex. Overall, an interaction and likely intrinsic inter-tiered competition along with possible interplay between physiological and pathological reflexes may be treated as contributing factors for the inception and maintaining of arrhythmias and cardiac performance as well. These assumptions await further documentation. If such a tenet were recognized, the changes in the clinical approach to arrhythmia management might be anticipated, preferably by selective reflex suppression or

  5. Stress biomarkers and alkali-labile phosphate level in mussels (Mytilus galloprovincialis) collected in the urban area of Venice (Venice Lagoon, Italy)

    International Nuclear Information System (INIS)

    Pampanin, Daniela M.; Marangon, Ilenia; Volpato, Elisa; Campesan, Giancarlo; Nasci, Cristina

    2005-01-01

    In this study, a spatial and temporal survey at three sites located in the 'canals' of the Venice historic centre (Italy) and at a reference site was undertaken to evaluate stress effects on mussels sampled in the Venice urban area, where raw sewage is discharged without treatment directly into the water. A battery of biomarkers (metallothionein, micronuclei, condition index and survival in air) was used to evaluate the stress condition of the animals. At the same time the alkali-labile phosphate assay (ALP) was performed in mussel' hemolymph with the aim to find an estrogenic effect biomarker in this mussel species. Biomarker results showed an impairment of the general health condition in the mussels coming from the urban area, in agreement with the chemical analysis. Significantly higher level of the ALP was found in male mussels sampled in April in the urban area, in comparison with the ones from the reference site (P0.001). Finally, the PCA proved an easy and useful tool to summarize the obtained results, also able to classify the data to indicate a pollution gradient in the Venice urban area. - The overall biological and chemical data show a higher stress condition in the mussels (Mytilus galloprovincialis) from the urban area of Venice

  6. Monitor of cardiac events implemented in PDA platform

    International Nuclear Information System (INIS)

    Bustamante, John; Saenz, Jose F; Amaya, Adrian

    2007-01-01

    Ambulatory monitoring of electrocardiac events constitutes a valuable tool in the diagnosis of cardiac arrhythmias involved in pathologic processes such as myocardiopathies, post-infarction stages, autonomous cardiac system injuries, etc.; unfortunately, its extensive use is not possible yet, due to the high costs that imply the acquisition of these equipment. For this purpose, through the utilization of personal digital assistants, a monitor of cardiac events with pre and post-symptomatic recording capacity, electrocardiographic signal visualization in real time, automatic recording of bradycardias and tachycardias and the possibility of annotation of symptoms by the patient, is designed and developed. It consists of a hardware component for the acquisition and treatment of the signals, software for the monitoring in Palm OSO platform and an appliance for the discharge and analysis of the stored data. Prototype validations were realized through an electrocardiographic simulator, an arrhythmia simulator Based on arrhythmia data base registers of the Massachusetts Institute of Technology and 8eth Israel Hospital and on pilot tests of healthy people and of patients with arrhythmias. In this preliminary report, we show the way in which the developed prototype constitutes a viable alternative for ambulatory monitoring of arrhythmia, taking advantages of the storage capacity, processing and visualization that have the actual digital assistances with the additional advantages that its use is not restricted to only one utility and its economic accessibility is facilitated due to its wide commercial availability

  7. 1998 survey of cardiac pacing in South Africa report of the working ...

    African Journals Online (AJOL)

    1998 survey of cardiac pacing in South Africa report of the working group on registries of the Cardiac Arrhythmia Society of South Africa (CASSA). RN Scott Millar. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...

  8. Population-based studies of antithyroid drugs and sudden cardiac death

    NARCIS (Netherlands)

    C. van Noord (Charlotte); M.C.J.M. Sturkenboom (Miriam); S.M.J.M. Straus (Sabine); A. Hofman (Albert); J.C.M. Witteman (Jacqueline); B.H.Ch. Stricker (Bruno)

    2009-01-01

    textabstractWHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Thyroid hormone free T4 is associated with QTc-interval prolongation, which is a risk factor for sudden cardiac death. • The association between hyperthyroidism and ventricular arrhythmias or sudden cardiac death has been reported in several

  9. SHADES OF VENICE IN THE BIOGRAPHY OF HEGUMEN PALLADY ROGOVSKY

    Directory of Open Access Journals (Sweden)

    Alex YASTREBOV

    2014-05-01

    Full Text Available Pallady Rogovsky was the fi rst Russian doctor of theology and philosophy. While a student of the Slavyano-Greek-Latin Academy directed by the Brothers Lichudes, he left his homeland for the West in order to obtain a full university education. The years which he spent in Europe and particularly in Italy have attracted little notice on the part of Church historians. The study of unpublished materials in Italian archives together with those already published by the Russian researcher E. Shmurlo from the archive of the Propaganda de Fide and the Greek College, which however, remain unnoticed for the great majority of academics, permit us to have an idea of what occupied Rogovsky during this time, as well as to draw a more precise portrait of his personality. Most remarkable is the fact of his priestly ordination in the Roman Catholic Church and the correspondence relating to Rome’s acceptance of his Russian Orthodox diaconal ordination. One of the most informative documents found among those relating to his ordination and addressed to the Roman Curia is the letter of a Russian Catholic, the deacon (later defrocked Petr Artem’ev, in which Artem’ev revealed that Rogovsky already had converted to Roman Catholicism before he left Russia. Equally noteworthy is Rogovsky’s own letter which he composed while in Venice and in which he formulated his plans for the propagation of Roman Catholicism in Russia.

  10. Fragrances as new contaminants in the Venice lagoon.

    Science.gov (United States)

    Vecchiato, Marco; Cremonese, Simone; Gregoris, Elena; Barbaro, Elena; Gambaro, Andrea; Barbante, Carlo

    2016-10-01

    Fragrance Materials (FMs) are omnipresent components of household and Personal Care Products (PCPs). In spite of their widespread use, little is known about their environmental occurrence. We selected 17 among the longest-lasting and most stable fragrance ingredients that are commercially available, namely: Amberketal, Ambrofix, Amyl Salicylate, Benzyl Salicylate, Bourgeonal, Dupical, Hexyl Salicylate, Isobutavan, Lemonile, Mefranal, Myraldene, Okoumal, Oranger Crystals, Pelargene, Peonile, Tridecene-2-Nitrile, Ultravanil. A new analytical method was developed to quantify FMs in water samples and it was applied to perform the first study about the distribution of these compounds in the surface waters of the city of Venice and its lagoon. Total FMs concentrations range from about 30ngL(-1) to more than 10μgL(-1) in polluted canals during the low tide. Sewage discharges were supposed to be the main sources of the selected FMs in the environment. Salicylates, oestrogenic and allergenic compounds, were in general the most abundant and widespread components. This study reports for the first time the detection of most of the selected FMs in surface waters and represent the first step to understand their environmental fate. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. [Idiopathic ventricular arrhythmia in children. Apropos of 24 cases].

    Science.gov (United States)

    Coeurderoy, A; Almange, C; Laurent, M; Biron, Y; Leborgne, P

    1985-12-01

    The severity and prognosis of idiopathic ventricular arrhythmias in childhood were studied in 24 patients (12 boys, 12 girls) with an average age of 8 years at the time of diagnosis of the arrhythmia. Investigations included clinical assessment and analysis of basal ECG (morphology of the arrhythmias) and dynamic recordings (Holter and exercise stress testing). The clinical course was followed for an average of 3.8 years. The patients were classified in two groups: monomorphic arrhythmias (Group I) and polymorphic arrhythmias (Group II). Group I was divided into 4 subgroups: isolated ventricular extrasystoles (IA), 11 patients; ventricular extrasystoles with bursts of ventricular tachycardia (IB), 6 patients; sustained ventricular tachycardia without intercritical extrasystoles (IC), 1 patient; accelerated idioventricular rhythm (ID), 2 patients. Subgroups IA, IB and ID were characterised by the absence of symptoms, the disappearance of the arrhythmia on exercise, the decreased efficacy of antiarrhythmic drugs and an excellent prognosis. Therapeutic abstention was the rule in these patients. Patients in Group IC were characterised by the variability of their symptoms, the absence of exercise induced arrhythmias, the need for treatment in most cases and a good long-term prognosis. Group II was divided into 2 subgroups: adrenergic polymorphic ventricular tachycardia (IIA), 2 patients, and non-adrenergic polymorphic ventricular tachycardia (IIB), 2 patients. Patients in Subgroup IIA were characterised by syncope on exercise or emotion, the need for betablocker therapy which considerably improved the patients symptoms but which did not usually prevent sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Giant cardiac fibroma: an unusual cause of failure to thrive.

    Science.gov (United States)

    Navarini, Susanne; Latzin, Philipp; Kadner, Alexander; Carrel, Thierry; Hutter, Damian

    2013-06-01

    Cardiac fibromas are extremely rare in the general pediatric population and may present with a wide spectrum of clinical signs, including life-threatening arrhythmias and sudden death. We report a 14-month-old boy who presented with failure to thrive as the only symptom. Echocardiography showed a large cardiac fibroma in the right ventricle. Cardiac magnetic resonance imaging confirmed the diagnosis. After complete surgical tumor resection, the boy showed normal catch-up growth. This case underlines the diversity of clinical features of cardiac tumors, which implies that they should be considered early in the differential diagnosis of infants with failure to thrive.

  13. A Decade of Information on the Use of Cardiac Implantable Electronic Devices and Interventional Electrophysiological Procedures in the European Society of Cardiology Countries

    DEFF Research Database (Denmark)

    Raatikainen, M J Pekka; Arnar, David O; Merkely, Bela

    2017-01-01

    Aims: The aim of this analysis was to provide comprehensive information on invasive cardiac arrhythmia therapies in the European Society of Cardiology (ESC) area over the past 10 years. Methods and results: The European Heart Rhythm Association (EHRA) has collected data on invasive arrhythmia...

  14. Venice and I: How a City Can Determine the Fate of a Career.

    Science.gov (United States)

    Malanotte-Rizzoli, Paola

    2017-01-03

    Quoting the ancient Romans: Audentes Fortuna iuvat. Being in the right place at the right time is useless if you do not grasp your Fortuna and build upon it. In this article, I expound on the milestones of my multiform research career, which over more than 40 years brought me from Venice to California to MIT; from the Venice problem to highly nonlinear, coherent structures in the ocean and atmosphere; and from the mare nostrum (the Mediterranean Sea), a laboratory for global processes, to the tropical ocean-atmosphere systems and regional coupled climate models of the Maritime Continent. The climate system, with its daunting complexity, is arguably the greatest challenge for, and the future of, the entirety of the earth sciences. Finally, living in and working for Venice has been the privilege and Fortuna of my life.

  15. Dioxins in the Venice lagoon. Present situation, projects and recovering hypotheses

    Energy Technology Data Exchange (ETDEWEB)

    Raccanelli, S. [Interuniversity Consortium Chemistry for the Environment, Marghera (Italy); Bonamin, V. [SGS Ecologia Srl, Villafranca (Italy)

    2000-07-01

    Venice is famous around the world for its uniqueness and architectural splendours, arts and the history of the ''Serenissima Repubblica'', as it was known in the past, but few are aware that Venice economy is strongly dependent on the industrial activities based mainly on the adjacent Porto Marghera area. For many years, the lagoon that physically separates the city from the dry land has avoided association between the concern connected with the pollution derived from these industrial activities and the public perception of Venice. Since 1995, dioxins have appeared as a lagoon contaminant, and their presence, at such a level requiring immediate ''in depth'' studies and interventions, has been fully realized for decades. (orig.)

  16. Demons, nature, or God? Witchcraft accusations and the French disease in early modern Venice.

    Science.gov (United States)

    McGough, Laura J

    2006-01-01

    In early modern Venice, establishing the cause of a disease was critical to determining the appropriate cure: natural remedies for natural illnesses, spiritual solutions for supernatural or demonic ones. One common ailment was the French disease (syphilis), widely distributed throughout Venice's neighborhoods and social hierarchy, and evenly distributed between men and women. The disease was widely regarded as curable by the mid-sixteenth century, and cases that did not respond to natural remedies presented problems of interpretation to physicians and laypeople. Witchcraft was one possible explanation; using expert testimony from physicians, however, the Holy Office ruled out witchcraft as a cause of incurable cases and reinforced perceptions that the disease was of natural origin. Incurable cases were explained as the result of immoral behavior, thereby reinforcing the associated stigma. This article uses archival material from Venice's Inquisition records from 1580 to 1650, as well as mortality data.

  17. [Silent myocardial ischemia and exercise-induced arrhythmia detected by the exercise test in the total health promotion plan (THP)].

    Science.gov (United States)

    Iwane, M; Shibe, Y; Itoh, K; Kinoshita, F; Kanagawa, Y; Kobayashi, M; Mugitani, K; Ohta, M; Ohata, H; Yoshikawa, A; Ikuta, Z; Nakamura, Y; Mohara, O

    2001-03-01

    We investigated the prevalence and characteristics of ischemic heart disease especially silent myocardial ischemia (SMI) and arrhythmia in need of careful observation in the exercise stress tests in the Total Health Promotion Plan (THP), which was conducted between 1994-96 for the purpose of measuring cardiopulmonary function. All workers (n = 4,918, 4,426 males) aged 18-60 yr old in an occupational field were studied. Exercise tests with an ergometer were performed by the LOPS protocol, in which the maximal workload was set up as a presumed 70-80% maximal oxygen intake, or STEP (original multistage protocol). ECG changes were evaluated with a CC5 lead. Two hundred and fifteen people refused the study because of a common cold, lumbago and so on. Of 4,703 subjects, 17 with abnormal rest ECG and 19 with probable anginal pain were excluded from the exercise tests. Of 4,667 who underwent the exercise test, 37 (0.79%) had ischemic ECG change, and 155 (3.32%) had striking arrhythmia. These 228 subjects then did a treadmill exercise test with Bruce protocol. Twenty-two (0.47% of 4,703) showed positive ECG change, 9 (0.19%) of 22 had abnormal findings on a 201Tl scan. 8 (0.17%) were diagnosed as SMI (Cohn I), in which the prevalence of hypertension, hyperlipidemia, diabetes mellitus, smoker and positive familial history of ischemic heart disease was greater than that of all subjects. In a 15-30 month follow up, none has developed cardiac accidents. Exercise-induced arrhythmia was detected in 11 (0.23%) subjects. Four were non-sustained ventricular tachycardia without any organic disease, 4 were ventricular arrhythmia based on cardiomyopathy detected by echocardiography, 2 were atrial fibrillation and another was WPW syndrome. It is therefore likely that the ergometer exercise test in THP was effective in preventing sudden death caused by ischemic heart disease or striking arrhythmia.

  18. The Lagoon of Venice : the result of both natural factors and human influence

    Directory of Open Access Journals (Sweden)

    Oscar RAVERA

    2000-02-01

    Full Text Available This paper aims to present a picture of the lagoon of Venice and analyze the combined effects of natural factors and human influence on this fragile ecotone. The structure, functioning and evolution of the lagoon are illustrated. Under natural conditions, the solid load from the tributaries would transform the lagoon into dry land or, if the violence of the sea exceeded the solid load from the watershed, the lagoon would evolve into a marine bay. This natural succession has been hindered by the works undertaken by the Republic of Venice uninterruptedly through the centuries, because the lagoon environment was essential to the life and power of Venice. The effects of human activities from the beginning of the Venetian Republic to the present are described. In addition, the influence of socio-economic development on the lagoon area and, particularly, the impact of intensive agriculture and industrialization are discussed. A possible effect of eutrophication was the dramatic proliferation of the opportunistic macroalga Ulva rigida, which for about a decade played an important role in the physical, chemical and biological characteristics of the lagoon. At present, the most crucial problems of Venice and its lagoon are: the lowering of the level of the city in relation to that of the sea, the continuous decline in the number of inhabitants, the increasing frequency of the “high water” phenomenon, air and water pollution, and the increased erosion and salinity of the lagoon. The recent measures taken and those still to be applied for conserving and recovering Venice and its lagoon and, particularly, the works for preventing the risk of high water are compared. There is an evident need for a new type of socio-economic development in symbiosis with the environment and tradition of Venice.

  19. Determination of myocardial energetic output for cardiac rhythm pacing

    Czech Academy of Sciences Publication Activity Database

    Heřman, D.; Převorovská, Světlana; Maršík, František

    2007-01-01

    Roč. 7, č. 4 (2007), s. 156-161 ISSN 1567-8822 R&D Projects: GA ČR GA106/03/1073 Institutional research plan: CEZ:AV0Z20760514 Keywords : heart arrhythmia * cardiac pacing modes * numerical simulation Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  20. Guidelines for autopsy investigation of sudden cardiac death

    NARCIS (Netherlands)

    Basso, Cristina; Burke, Margaret; Fornes, Paul; Gallagher, Patrick J.; de Gouveia, Rosa Henriques; Sheppard, Mary; Thiene, Gaetano; van der Wal, Allard

    2010-01-01

    Although sudden cardiac death is one of the most important mode of death in Western Countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed, and the accurate diagnosis of

  1. Guidelines for autopsy investigation of sudden cardiac death

    NARCIS (Netherlands)

    Basso, C.; Burke, M.; Fornes, P.; Gallagher, P. J.; de Gouveia, R. H.; Sheppard, M.; Thiene, G.; van der Wal, A.

    2010-01-01

    Although sudden cardiac death is one of the most important mode of death in Western Countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed and the accurate diagnosis of

  2. Guidelines for autopsy investigation of sudden cardiac death

    NARCIS (Netherlands)

    Basso, Cristina; Burke, Margaret; Fornes, Paul; Gallagher, Patrick J.; de Gouveia, Rosa Henriques; Sheppard, Mary; Thiene, Gaetano; van der Wal, Allard

    2008-01-01

    Although sudden cardiac death is one of the most important mode of death in Western Countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed, and the accurate diagnosis of

  3. Relationship of serum magnesium level and supplemental magnesium dosage with post coronary artery bypass graft surgery arrhythmias

    Directory of Open Access Journals (Sweden)

    Najafi M

    2007-06-01

    Full Text Available Background: Atrial and ventricular arrhythmias are among the most common complications after coronary artery bypass graft (CABG surgery. Previous studies demonstrated that cardiopulmonary bypass itself results in reduced serum magnesium levels. In this study, we evaluated the effect of total blood magnesium level (TMG on the prevention of perioperative arrhythmias with routine regimens of 2-4 grams supplemental magnesium (SMG. Methods: TMG was measured in patients who were scheduled for CABG on three occasions: just before anesthesia, just after entering the intensive care unit (ICU after completion of the sugery, and on the first morning after the operation. Patients were evaluated for primary cardiac rhythm and other variables that could have an influence on the magnesium level, including serum creatinine, urine output in the operating room and diuretic therapy. The SMG dosage was also recorded in the operating room and ICU. Patients were then evaluated for the rate and type of arrhythmia for the next three days. Results: The mean TMG levels in 174 cases were 2.2 (0.5, 2.6 (0.6 and 2.4 (0.6 mg/dl for the three occasions, respectively. The mean SMG was 2.5 (1.2 grams. Of 164 patients, 51 (31% developed the following post-operative arrhythmias: AF (7.3%, non-AF SVA (15.2% and ventricular (16.5%. The mean serum creatinine level and urine output were 1.2 mg/dl and 1800 ml, respectively. Although there was a significant difference between the TMG levels on the three different occasions (P<0.001, all values were within normal range. When we stratified the TMG levels of the patients based on administered SMG, the Mentel-Haenszel test revealed no significant difference between the first and third TMG (P=0.6. Although the TMG levels were higher in arrhythmic patients compared to those without arrhythmia (2.25 vs. 2.14 mg/dl, both values were within the normal range and there was no significant difference between the two groups. Serum creatinine levels

  4. Atrial Arrhythmias in Astronauts. Summary of a NASA Summit

    Science.gov (United States)

    Barr, Yael; Watkins, Sharmila; Polk, J. D.

    2011-01-01

    This slide presentation reviews the findings of a panel of heart experts brought together to study if atrial arrhythmias more prevalent in astronauts, and potential risk factors that may predispose astronauts to atrial arrhythmias. The objective of the panel was to solicit expert opinion on screening, diagnosis, and treatment options, identify gaps in knowledge, and propose relevant research initiatives. While Atrial Arrhythmias occur in approximately the same percents in astronauts as in the general population, they seem to occur at younger ages in astronauts. Several reasons for this predisposition were given: gender, hypertension, endurance training, and triggering events. Potential Space Flight-Related Risk factors that may play a role in precipitating lone atrial fibrillation were reviewed. There appears to be no evidence that any variable of the space flight environment increases the likelihood of developing atrial arrhythmias during space flight.

  5. Migration Rate Of Tidal Meanders: Inferences From The Venice Lagoon

    Science.gov (United States)

    Finotello, A.; D'Alpaos, A.; Ghinassi, M.; Lanzoni, S.; Marani, M.; Rinaldo, A.

    2015-12-01

    Meandering channels are ubiquitous features of tidal landscapes. However, despite their fundamental role on the eco-morphodynamic evolution of these landscapes, tidal meanders have received less attention when compared to their fluvial counterparts. Improving current understanding of tidal meander migration, a largely-examined topic in fluvial landscapes, is a key step to highlight analogies and differences between tidal and fluvial cases. The migration of about 400 meander bends, belonging to 40 salt-marsh channels in the Northern Venice Lagoon (Italy), from 1968 to nowadays, has been investigated by means of both a classical method in fluvial frameworks and new procedure. Similarities with fluvial meanders occur, although important difference also emerge. Meanders cutting through the San Felice marsh follow the relationship between cartesian length and channel width, typical of meanders developed within different settings. However, meander migration rates proved to be smaller than those characterizing fluvial meanders. Indeed, the analysis of meander migration suggests a mean migration rate of about 0.10 m/year, consistent with the few data available in the literature. As for the fluvial case, the maximum-potential migration rate (i.e. the envelope curve of the relationship between migration rate and bend radius, both divided by channel width) reaches a maximum for radius-over-width ratio included between 2 and 3, regardless of the considered method. Nevertheless, the new-proposed method allows us to provide a more objective and continuous characterization. By using this new procedure, the channel curvature has finally been Fourier-analyzed, confirming the importance of even harmonics along the curvature spectrum. A correlation between migration rates and dominant harmonics seems to drive the evolution of tidal meanders and might represent a key-feature to distinguish them from their fluvial counterparts.

  6. Pediatric cardiac emergencies: Children are not small adults

    Directory of Open Access Journals (Sweden)

    Frazier Aisha

    2011-01-01

    Full Text Available Compared with adults, cardiac emergencies are infrequent in children and clinical presentation is often quite variable. In adults, cardiac emergencies are most commonly related to complications of coronary artery disease; however, in pediatric cases, the coronaries are only rarely the underlying problem. Pediatric cardiac emergencies comprise a range of pathology including but not limited to undiagnosed congenital heart disease in the infant; complications of palliated congenital heart disease in children; arrhythmias related to underlying cardiac pathology in the teenager and acquired heart disease. The emergency room physician and pediatric intensivist will usually be the first and second lines of care for pediatric cardiac emergencies and thus it is imperative that they have knowledge of the diverse presentations of cardiac disease in order to increase the likelihood of delivering early appropriate therapy and referral. The objective of this review is to outline cardiac emergencies in the pediatric population and contrast the presentation with adults.

  7. Primary haemochromatosis. Early detection of commitment myocardium through cardiac magnetic resonance

    International Nuclear Information System (INIS)

    Corbella, F.; Rivas, Carlos; Dragonetti, Laura; Eyheremendy, Eduardo; Calo, Claudia

    2009-01-01

    Primary haemochromatosis is the most common genetic disease of the West (1 in 300 to 400 people). Cardiac involvement during its early stages is not detected by imaging techniques.During this period potentially lethal arrhythmias can occur. Using cardiac magnetic resonance (CMR) with T2 star sequence it is possible an early detection of cardiac involvement as well as a risk stratification and a monitoring the progress of the therapy. [es

  8. QUANTIFICATION OF RESPIRATORY SINUS ARRHYTHMIA WITH HIGH-FRAMERATE ELECTRICAL IMPEDANCE TOMOGRAPHY

    Directory of Open Access Journals (Sweden)

    Christoph Hoog Antink

    2013-12-01

    Full Text Available Respiratory Sinus Arrhythmia, the variation in the heart rate synchronized with the breathing cycle, forms an interconnection between cardiac-related and respiratory-related signals. It can be used by itself for diagnostic purposes, or by exploiting the redundancies it creates, for example by extracting respiratory rate from an electrocardiogram (ECG. To perform quantitative analysis and patient specific modeling, however, simultaneous information about ventilation as well as cardiac activity needs to be recorded and analyzed. The recent advent of medically approved Electrical Impedance Tomography (EIT devices capable of recording up to 50 frames per second facilitates the application of this technology. This paper presents the automated selection of a cardiac-related signal from EIT data and quantitative analysis of this signal. It is demonstrated that beat-to-beat intervals can be extracted with a median absolute error below 20 ms. A comparison between ECG and EIT data shows a variation in peak delay time that requires further analysis. Finally, the known coupling of heart rate variability and tidal volume can be shown and quantified using global impedance as a surrogate for tidal volume.

  9. 78 FR 39597 - Safety Zone; Hilton Fourth of July Fireworks, San Joaquin River, Venice Island, CA

    Science.gov (United States)

    2013-07-02

    ... Zone; Hilton Fourth of July Fireworks, San Joaquin River, Venice Island, CA AGENCY: Coast Guard, DHS... the Hilton Fourth of July Fireworks in the Captain of the Port, San Francisco area of responsibility...'' W (NAD83) for the Hilton Fourth of July Fireworks in 33 CFR 165.1191, Table 1, Item number 17. This...

  10. Mathematical-statistical model for analysis of Ulva algal net photosynthesis in Venice lagoon

    International Nuclear Information System (INIS)

    Izzo, G.; Rizzo, V.; Bella, A.; Picci, M.; Giordano, P.

    1996-08-01

    The algal net photosynthesis, an important factor for the characterization of water quality in Venice lagoon, has been studied experimentally providing a mathematical model, validated by using statistical methods. This model relates oxygen production with irradiance, according to a well known law in biological literature. Its observed an inverted proportion between algal oxygen production and temperature, thus seasonality

  11. On the Major Dramatic Conftict of Shakespeare's the Merchant of Venice

    Institute of Scientific and Technical Information of China (English)

    蒋文

    2000-01-01

    "The Merchant of Venice", a master piece with humanist idea by William Shakespeare, presents readers a dramatic conflict between friendship and greediness, love and cruelty.This essay illustrates briefly how this conflict is created, developed and dramatized. At the same time, the root causes for this conflict is analysed.

  12. "Rulers of Venice, 1349 to 1524". Alcune osservazioni sulla schedatura dei registri del Segretario alle Voci

    Directory of Open Access Journals (Sweden)

    Andrea Mozzato

    2005-12-01

    Full Text Available Illustrazione dei criteri di compilazione del data-base Rulers of Venice, progettato dallo storico americano Benjamin Kohl utilizzando l’archivio della magistratura della repubblica di Venezia denominata “Segretario alle voci”, ed esemplificazione del funzionamento di tale repertorio mediante alcuni case-studies.

  13. Transcriptomic resources for environmental risk assessment: a case study in the Venice lagoon

    International Nuclear Information System (INIS)

    Milan, M.; Pauletto, M.; Boffo, L.; Carrer, C.; Sorrentino, F.; Ferrari, G.; Pavan, L.; Patarnello, T.; Bargelloni, L.

    2015-01-01

    The development of new resources to evaluate the environmental status is becoming increasingly important representing a key challenge for ocean and coastal management. Recently, the employment of transcriptomics in aquatic toxicology has led to increasing initiatives proposing to integrate eco-toxicogenomics in the evaluation of marine ecosystem health. However, several technical issues need to be addressed before introducing genomics as a reliable tool in regulatory ecotoxicology. The Venice lagoon constitutes an excellent case, in which the assessment of environmental risks derived from the nearby industrial activities represents a crucial task. In this context, the potential role of genomics to assist environmental monitoring was investigated through the definition of reliable gene expression markers associated to chemical contamination in Manila clams, and their subsequent employment for the classification of Venice lagoon areas. Overall, the present study addresses key issues to evaluate the future outlooks of genomics in the environmental monitoring and risk assessment. - Highlights: • Growing need to develop new resources for the evaluation of the environmental status. • Identification of gene expression markers associated to chemical contamination. • Employment of genomics to evaluate the environmental status of Venice lagoon areas. • Hurdles and future outlooks of genomic tools in environmental risk assessment. - Genomics in risk assessment of Venice lagoon

  14. Understanding "The Merchant of Venice": A Student Casebook to Issues, Sources, and Historical Documents.

    Science.gov (United States)

    Halio, Jay L.

    "The Merchant of Venice," even in its own time, was considered William Shakespeare's most controversial play. Now, one of the most popular read and performed works, the play raises even more important issues for today, particularly anti-Semitism and the treatment of Jews. The analysis of the play in this casebook helps students interpret…

  15. Investigation of residence time and groundwater flux in Venice Lagoon: comparing radium isotope and hydrodynamic models.

    Science.gov (United States)

    Rapaglia, John; Ferrarin, Christian; Zaggia, Luca; Moore, Willard S; Umgiesser, Georg; Garcia-Solsona, Ester; Garcia-Orellana, Jordi; Masqué, Pere

    2010-07-01

    The four naturally-occurring isotopes of radium were coupled with a previously evaluated hydrodynamic model to determine the apparent age of surface waters and to quantify submarine groundwater discharge (SGD) into the Venice Lagoon, Italy. Mean apparent age of water in the Venice Lagoon was calculated using the ratio of 224Ra to 228Ra determined from 30 monitoring stations and a mean pore water end member. Average apparent age was calculated to be 6.0 d using Ra ratios. This calculated age was very similar to average residence time calculated for the same period using a hydrodynamic model (5.8 d). A mass balance of Ra was accomplished by quantifying each of the sources and sinks of Ra in the lagoon, with the unknown variable being attributed to SGD. Total SGD were calculated to be 4.1 +/- 1.5, 3.8 +/- 0.7, 3.0 +/- 1.3, and 3.5 +/- 1.0 x 10(10) L d(-1) for (223,224,226, 228)Ra, respectively, which are an order of magnitude larger than total mean fluvial discharge into the Venice Lagoon (3.1 x 10(9) L d(-1)). The SGD as a source of nutrients in the Venice Lagoon is also discussed and, though significant to the nutrient budget, is likely to be less important as the dominant control on SGD is recirculated seawater rather than freshwater. 2009 Elsevier Ltd. All rights reserved.

  16. Investigation of residence time and groundwater flux in Venice Lagoon: comparing radium isotope and hydrodynamical models

    International Nuclear Information System (INIS)

    Rapaglia, John; Ferrarin, Christian; Zaggia, Luca; Moore, Willard S.; Umgiesser, Georg; Garcia-Solsona, Ester; Garcia-Orellana, Jordi; Masque, Pere

    2010-01-01

    The four naturally-occurring isotopes of radium were coupled with a previously evaluated hydrodynamic model to determine the apparent age of surface waters and to quantify submarine groundwater discharge (SGD) into the Venice Lagoon, Italy. Mean apparent age of water in the Venice Lagoon was calculated using the ratio of 224 Ra to 228 Ra determined from 30 monitoring stations and a mean pore water endmember. Average apparent age was calculated to be 6.0 d using Ra ratios. This calculated age was very similar to average residence time calculated for the same period using a hydrodynamic model (5.8 d). A mass balance of Ra was accomplished by quantifying each of the sources and sinks of Ra in the lagoon, with the unknown variable being attributed to SGD. Total SGD were calculated to be 4.1 ± 1.5, 3.8 ± 0.7, 3.0 ± 1.3, and 3.5 ± 1.0 x 10 10 L d -1 for 223,224,226,228 Ra, respectively, which are an order of magnitude larger than total mean fluvial discharge into the Venice Lagoon (3.1 x 10 9 L d -1 ). The SGD as a source of nutrients in the Venice Lagoon is also discussed and, though significant to the nutrient budget, is likely to be less important as the dominant control on SGD is recirculated seawater rather than freshwater.

  17. Prejudice, Pedagogy, and the Play: A Study of "The Merchant of Venice."

    Science.gov (United States)

    Eiferman, Sharon

    There is little critical agreement on the meaning of Shakespeare's "The Merchant of Venice." One must confront the mindset of the play that systematically dehumanizes, stereotypes, excoriates, and seeks the extermination of one group on the grounds that their existence is repugnant to the controlling majority. Such a mindset is the…

  18. [Work-related stress in nursery school educators in the Venice and Marghera districts].

    Science.gov (United States)

    Camerino, Donatella; Fichera, G P; Punzi, Silvia; Campanini, P; Conway, P M; Prevedello, Laura; Costa, G

    2011-01-01

    Based on an investigation on organizational well-being in the Municipality of Venice (2009), we examined 110 public nursery school and preschool teachers working in the Venice and Marghera districts. The aim of this study was to develop and implement a procedure for work-related stress assessment and management in Municipality of Venice, in the light of Law 81/2008. Occupational stress and its impact on teachers' well-being and health were assessed by means of self-administered questionnaires and semi-structured interviews. Descriptive analyses were conducted to compare teachers' data with those concerning employees operating in other services in the Venice and Marghera districts. According to the results, while nursery school and preschool teachers work with considerable commitment, vigor, dedication and involvement, problems were observed related to: assignment of administrative tasks without appropriate support from the district offices; difficult access to support services; shortage of temporary teachers and auxiliary personnel and, limited to some facilities, lack of adequate physical space devoted to teaching activities. Such adverse conditions result in an increase in vigilance levels required to ensure children's safety. Personnel also suffer from a lack of career prospects, with scarce opportunities for contact with other facilities in the area and inadequate involvement in the decisional processes at Municipality level. Improving such adverse conditions could solve the current marginalization of public nursery school and preschool teachers and encourage mutual exchange of information, which would in turn favour more appropriate methods of managing each single facility.

  19. Situation Venice: Towards a Performative "Ex-Planation" of a City

    Science.gov (United States)

    Whybrow, Nicolas

    2011-01-01

    The article's main concern is to analyse theoretical and artistic factors influencing the attempt by a group of undergraduate students (at the University of Warwick, UK) to produce a "performative mapping" of the city of Venice. In other words, it asks what kind of performance-based strategies might usefully be applied in the process of…

  20. Malignant arrhythmia as the first manifestation of Wolff-Parkinson-White syndrome: a case with minimal preexcitation on electrocardiography.

    Science.gov (United States)

    Gungor, B; Alper, A T

    2013-09-01

    Wolff-Parkinson-White (WPW) syndrome is defined as the presence of an accessory atrioventricular pathway which is manifested as delta waves and short PR interval on electrocardiography (ECG). However, some WPW cases do not have typical findings on ECG and may remain undiagnosed unless palpitations occur. Sudden cardiac death may be the first manifestation of WPW and develops mostly secondary to degeneration of atrial fibrillation into ventricular fibrillation. In this report, we present a case of undiagnosed WPW with minimal preexcitation on ECG and who suffered an episode of malignant arrhythmia as the first manifestation of the disease.

  1. Design and implementation of an electrocardiographical signal acquisition and digital processing system orientated to the detection of paroxysmal arrhythmias

    International Nuclear Information System (INIS)

    Braceli, Agustín Iriart; Morani, Jorge Exequiel

    2011-01-01

    This article describes the design, technical aspects and implementation of a device capable of acquiring electrocardiograph signals; visualize them in real time over a graphic liquid crystal display (GLCD), and the storage of these ECG registers on a SD memory card. It also details a noise suppression algorithm using the Wavelet Transform. This system was specially developed to cover some bankruptcy that presents actual Holters or ECG regarding the detection of paroxysmal arrhythmias. The contribution of this work is settled on its portability and low production cost. The filtering method used provides an ECG signal without any significant noise and appropriate to the diagnosis of cardiac pathologies.

  2. Design and implementation of an electrocardiographical signal acquisition and digital processing system orientated to the detection of paroxysmal arrhythmias

    Science.gov (United States)

    Iriart Braceli, Agustín; Exequiel Morani, Jorge

    2011-12-01

    This article describes the design, technical aspects and implementation of a device capable of acquiring electrocardiograph signals; visualize them in real time over a graphic liquid crystal display (GLCD), and the storage of these ECG registers on a SD memory card. It also details a noise suppression algorithm using the Wavelet Transform. This system was specially developed to cover some bankruptcy that presents actual Holters or ECG regarding the detection of paroxysmal arrhythmias. The contribution of this work is settled on its portability and low production cost. The filtering method used provides an ECG signal without any significant noise and appropriate to the diagnosis of cardiac pathologies.

  3. An update on insertable cardiac monitors

    DEFF Research Database (Denmark)

    Olsen, Flemming J; Biering-Sørensen, Tor; Krieger, Derk W

    2015-01-01

    Continuous cardiac rhythm monitoring has undergone compelling progress over the past decades. Cardiac monitoring has emerged from 12-lead electrocardiograms being performed at the discretion of the treating physician to in-hospital telemetry, Holter monitoring, prolonged external event monitoring...... turning point in the field of arrhythmia management. However, their role in the detection of paroxysmal atrial fibrillation after cryptogenic strokes has yet to evolve. This will be the main focus of this review. Issues surrounding patient selection, clinical relevance and determination of cost......-effectiveness for prolonged cardiac monitoring require further studies. Furthermore, insertable cardiac monitoring has not only the potential to augment diagnostic capabilities but also to improve the management of paroxysmal atrial fibrillation....

  4. Cardiac sympathetic neuronal imaging using PET

    International Nuclear Information System (INIS)

    Lautamaeki, Riikka; Tipre, Dnyanesh; Bengel, Frank M.

    2007-01-01

    Balance of the autonomic nervous system is essential for adequate cardiac performance, and alterations seem to play a key role in the development and progression of various cardiac diseases. PET imaging of the cardiac autonomic nervous system has advanced extensively in recent years, and multiple pre- and postsynaptic tracers have been introduced. The high spatial and temporal resolution of PET enables noninvasive quantification of neurophysiologic processes at the tissue level. Ligands for catecholamine receptors, along with radiolabeled catecholamines and catecholamine analogs, have been applied to determine involvement of sympathetic dysinnervation at different stages of heart diseases such as ischemia, heart failure, and arrhythmia. This review summarizes the recent findings in neurocardiological PET imaging. Experimental studies with several radioligands and clinical findings in cardiac dysautonomias are discussed. (orig.)

  5. Respiratory Sinus Arrhythmia: A Transdiagnostic Biomarker of Emotion Dysregulation and Psychopathology

    Science.gov (United States)

    Beauchaine, Theodore P.

    2015-01-01

    In the past two decades, respiratory sinus arrhythmia (RSA)—an index of parasympathetic nervous system (PNS)-mediated cardiac control—has emerged as a reliable peripheral biomarker of emotion regulation (ER). Reduced RSA and excessive RSA reactivity (i.e., withdrawal) to emotional challenge are observed consistently among individuals with poor ER capabilities, including those with various forms of internalizing and externalizing psychopathology, and those with specific psychopathological syndromes, including anxiety, phobias, attention problems, autism, callousness, conduct disorder, depression, non-suicidal self-injury, panic disorder, and trait hostility. Emerging evidence suggests that low RSA and excessive RSA reactivity index poor ER because they are downstream peripheral markers of prefrontal cortex (PFC) dysfunction. Poorly modulated inhibitory efferent pathways from the medial PFC to the PNS result in reduced RSA and excessive RSA reactivity. According to this perspective, RSA is a non-invasive proxy for poor executive control over behavior, which characterizes most forms of psychopathology. PMID:25866835

  6. Dobutamine use for arrhythmia induction during electrical programmed heart stimulation

    International Nuclear Information System (INIS)

    Vanegas, Diego I; Perez, Climaco de J; Montenegro, Juan de J; Orjuela, Alejandro

    2006-01-01

    isoproterenol is the traditionally used drug for incrementing arrhythmia induction when this induction is not achieved during electric programmed heart stimulation under basal conditions. Dobutamine is an adrenergic agent, chemical precursor of isoproterenol, which can be an alternative for inducing arrhythmia during electrical programmed heart stimulation (PES). Patients and methods: a retrospective comparative study of the experience with dobutamine for inducing arrhythmia during electrical programmed heart stimulation was performed. The following data were collected: number of studies, data about the patient (medical record, age, gender, and study indication) protocol of programmed electrical stimulation, basal and under dobutamine or isoproterenol, and result of the study. Isoproterenol was used in doses of 1 to 3 micrograms per minute until the basal heart rate was incremented at least in 25%. Dobutamine was used in doses of 10 to 40 micrograms per kg of body weight, until obtaining the same increment in the basal heart rate. Results: 1054 electrophysiological studies were evaluated. In 144 patients (group A) isoproterenol was used and in 140, dobutamine (group B). In A group the mean age was 39.2 ± 16.2 and 58.3% were females. In-group B, mean age was 41.9 ± 18.6 and 51% were females. The most frequent symptom was palpitation and the most commonly induced arrhythmia was AV nodal reentry tachycardia in both groups. The induction of arrhythmia during the electrical programmed heat stimulation under drugs was similar in-group A (isoproterenol) respect to group B (dobutamine). Conclusions: There were no statistical significant differences in the induction of arrhythmia during electrical programmed heart stimulation using dobutamine or isoproterenol. Dobutamine may be safe and may be successfully used as an alternative to isoproterenol for arrhythmia induction during electrical programmed stimulation

  7. Sediment remediation treatment techniques for the Venice industrial canals

    Energy Technology Data Exchange (ETDEWEB)

    Pippa, R.; Scanferla, P.; Cammarata, F.; Zampieri, L.; Carlon, C. [Consorzio Venezia Ricerche (Italy); Pavoni, B. [Ca' Foscari University of Venice (Italy). Dept. of Environmental Sciences; Pannocchia, G. [Venezia Technologie SpA, Venice (Italy); Hreglich, S. [Stazione Sperimentale del Vetro, Venice (Italy); Avezzu, F. [Depuracque Impianti srl, Venice (Italy)

    2003-07-01

    The main objective of SeRTech project (Sediment Remediation Technologies) is to develop an integrated cost-effective treatment system to address heterogeneous contamination and matrixes, such as those of Venice lagoon dredged materials. Seven treatment techniques, selected over a large array, have been tested: Thermal Desorption. A preliminary set of isothermal treatments at different temperatures was performed to evaluated the losses of organic and the most volatile metals (such as Pb and As). An almost full volatilisation of organic compounds was observed at temperatures ranging between 200 and 300 C. Chemical stabilization-solidification. Depuracque Impianti srl process uses innovative patented additives (polimers and superplasticizers) to immobilize heavy metals into cement pellets. Solvent extraction. Organic contaminants such as PAHs and PCBs were extracted from sediments by using ethyl acetate. The results showed that solvent extraction obtained high efficiency in removal of PAHs and other organic contaminants. Immobilization of heavy metals employing sulfate-reducing bacteria. High Gradient Magnetic Separation (HGMS). Sulfate reducing bacteria (SBR) produce an iron sulfide containing biomass with a high capability to adsorbe hevy metals and some organic compounds. This biomass can be separated through a high gradient magnetic field removing a substantial fraction of contaminants. Vitrification. Sediment was mixed with other inorganic wastes (glass cullet, feldsphatic tailings) and low amounts of row material to obtain an inert glass, which in turn can be recycled into other useful products, for example glass fibres, foam glass and glass ceramics. Phytoremediation. Phragmites australis (Cav.), Trin; Juncus Iacustrus, Arthrocnmemum fruticosum, Spartina maritima, Helianthus annuus L., Zea mais L., Brassica napus L., Brassica juncea L. have been selected to verify limit and efficiency of phytoextraction for heavy metals (Zn, Pb, Hg, Cd, As, Ni). Not only

  8. Effects of renal sympathetic denervation on cardiac sympathetic activity and function in patients with therapy resistant hypertension

    NARCIS (Netherlands)

    van Brussel, Peter M.; Eeftinck Schattenkerk, Daan W.; Dobrowolski, Linn C.; de Winter, Robbert J.; Reekers, Jim A.; Verberne, Hein J.; Vogt, Liffert; van den Born, Bert-Jan H.

    2016-01-01

    Renal sympathetic denervation (RSD) is currently being investigated in multiple studies of sympathetically driven cardiovascular diseases such as heart failure and arrhythmias. Our aim was to assess systemic and cardiac sympatholytic effects of RSD by the measurement of cardiac sympathetic activity

  9. Computational model based approach to analysis ventricular arrhythmias: Effects of dysfunction calcium channels

    Science.gov (United States)

    Gulothungan, G.; Malathi, R.

    2018-04-01

    Disturbed sodium (Na+) and calcium (Ca2+) handling is known to be a major predisposing factor for life-threatening cardiac arrhythmias. Cardiac contractility in ventricular tissue is prominent by Ca2+ channels like voltage dependent Ca2+ channels, sodium-calcium exchanger (Na+-Ca2+x) and sacroplasmicrecticulum (SR) Ca2+ pump and leakage channels. Experimental and clinical possibilities for studying cardiac arrhythmias in human ventricular myocardium are very limited. Therefore, the use of alternative methods such as computer simulations is of great importance. Our aim of this article is to study the impact on action potential (AP) generation and propagation in single ventricular myocyte and ventricular tissue under different dysfunction Ca2+ channels condition. In enhanced activity of Na+-Ca2+x, single myocyte produces AP duration (APD90) and APD50 is significantly smaller (266 ms and 235 ms). Its Na+-Ca2+x current at depolarization is increases 60% from its normal level and repolarization current goes more negative (nonfailing= -0.28 pA/pF and failing= -0.47 pA/pF). Similarly, same enhanced activity of Na+-Ca2+x in 10 mm region of ventricular sheet, raises the plateau potential abruptly, which ultimately affects the diastolic repolarization. Compare with normal ventricular sheet region of 10 mm, 10% of ventricular sheet resting state is reduces and ventricular sheet at time 250 ms is goes to resting state very early. In hypertrophy condition, single myocyte produces APD90 and APD50 is worthy of attention smaller (232 mS and 198 ms). Its sodium-potassium (Na+-K+) pump current is 75% reduces from its control conditions (0.13 pA/pF). Hypertrophy condition, 50% of ventricular sheet is reduces to minimum plateau potential state, that starts the repolarization process very early and reduces the APD. In a single failing SR Ca2+ channels myocyte, recovery of Ca2+ concentration level in SR reduces upto 15% from its control myocytes. At time 290 ms, 70% of ventricular sheet

  10. Arrhythmias and sudden death among older children and young adults following tetralogy of Fallot repair in the current era: are previously reported risk factors still applicable?

    Science.gov (United States)

    Arya, Swati; Kovach, Julie; Singh, Harinder; Karpawich, Peter P

    2014-01-01

    Young adult patients (pts) with repaired tetralogy of Fallot (TOF) remain at risk for arrhythmias (Ar) and sudden cardiac death (SCD). Based on past studies with earlier pt subsets, Ar/SCD events were associated with right ventricular (RV) systolic pressures >60 mm Hg, outflow tract gradients >20 mm Hg, and QRS duration >180 ms. However, there are limited recent studies to evaluate these risk factors in the current patient generation. Patients with TOF followed over the past 50 years were grouped by presence of any arrhythmias (group 1), absence of arrhythmias (group 2), and presence of SCD or significant ventricular arrhythmias (group 3) and correlated with current pt age, gender, age at repair, repair types, echocardiogram, cardiac magnetic resonance imaging, electrocardiogram/Holter, hemodynamics, and electrophysiology findings. Of 109 pts, 52 were male aged 17-58 years. Of these, 59 (54%) had Ar, two of whom had SCD. These 59 pts were chronologically older at the time of analysis, with repair at an older age and wider QRS duration (78-240, mean 158 ms) when compared with those without Ar. However, there was no correlation with surgical era, surgical repair, gender, RV pressure >60 mm Hg, right ventricular outflow tract gradient >20 mm Hg, or RV end-diastolic volume on CMRI. Ar/SCD risk continues to correlate with repair age and advancing pt age. QRS duration is longer in these patients but at a shorter interval (mean 158 ms) and less RV pressure (mean 43 mm Hg) than previously reported. In the current TOF patient generation, neither surgical era, type of repair, RV outflow gradient nor RV volume correlate with Ar/SCD. Electrophysiologic testing to verify and identify arrhythmias remains clinically effective. © 2013 Wiley Periodicals, Inc.

  11. Andrographolide inhibits arrhythmias and is cardioprotective in rabbits.

    Science.gov (United States)

    Zeng, Mengliu; Jiang, Wanzhen; Tian, Youjia; Hao, Jie; Cao, Zhenzhen; Liu, Zhipei; Fu, Chen; Zhang, Peihua; Ma, Jihua

    2017-09-22

    Andrographolide has a protective effect on the cardiovascular system. To study its cardic-electrophysiological effects, action potentials and voltage-gated Na + (I Na ), Ca 2+ (I CaL ), and K + (I K1 , I Kr , I to and I Kur ) currents were recorded using whole-cell patch clamp and current clamp techniques. Additionally, the effects of andrographolide on aconitine-induced arrhythmias were assessed on electrocardiograms in vivo . We found that andrographolide shortened action potential duration and reduced maximum upstroke velocity in rabbit left ventricular and left atrial myocytes. Andrographolide attenuated rate-dependence of action potential duration, and reduced or abolished delayed afterdepolarizations and triggered activities induced by isoproterenol (1 μM) and high calcium ([Ca 2+ ] o =3.6 mM) in left ventricular myocytes. Andrographolide also concentration-dependently inhibited I Na and I CaL , but had no effect on I to , I Kur , I K1 , or I Kr in rabbit left ventricular and left atrial myocytes. Andrographolide treatment increased the time and dosage thresholds of aconitine-induced arrhythmias, and reduced arrhythmia incidence and mortality in rabbits. Our results indicate that andrographolide inhibits cellular arrhythmias (delayed afterdepolarizations and triggered activities) and aconitine-induced arrhythmias in vivo , and these effects result from I Na and I CaL inhibition. Andrographolide may be useful as a class I and IV antiarrhythmic therapeutic.

  12. Calcium-dependent arrhythmias in transgenic mice with heart failure.

    Science.gov (United States)

    London, Barry; Baker, Linda C; Lee, Joon S; Shusterman, Vladimir; Choi, Bum-Rak; Kubota, Toru; McTiernan, Charles F; Feldman, Arthur M; Salama, Guy

    2003-02-01

    Transgenic mice overexpressing the inflammatory cytokine tumor necrosis factor (TNF)-alpha (TNF-alpha mice) in the heart develop a progressive heart failure syndrome characterized by biventricular dilatation, decreased ejection fraction, atrial and ventricular arrhythmias on ambulatory telemetry monitoring, and decreased survival compared with nontransgenic littermates. Programmed stimulation in vitro with single extra beats elicits reentrant ventricular arrhythmias in TNF-alpha (n = 12 of 13 hearts) but not in control hearts. We performed optical mapping of voltage and Ca(2+) in isolated perfused ventricles of TNF-alpha mice to study the mechanisms that lead to the initiation and maintenance of the arrhythmias. When compared with controls, hearts from TNF-alpha mice have prolonged of action potential durations (action potential duration at 90% repolarization: 23 +/- 2 ms, n = 7, vs. 18 +/- 1 ms, n = 5; P < 0.05), no increased dispersion of refractoriness between apex and base, elevated diastolic and depressed systolic [Ca(2+)], and prolonged Ca(2+) transients (72 +/- 6 ms, n = 10, vs. 54 +/- 5 ms, n = 8; P < 0.01). Premature beats have diminished action potential amplitudes and conduct in a slow, heterogeneous manner. Lowering extracellular [Ca(2+)] normalizes conduction and prevents inducible arrhythmias. Thus both action potential prolongation and abnormal Ca(2+) handling may contribute to the initiation of reentrant arrhythmias in this heart failure model by mechanisms distinct from enhanced dispersion of refractoriness or triggered activity.

  13. Fetal Primary Cardiac Tumors During Perinatal Period

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2017-06-01

    Full Text Available Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas. Neonatal cardiac surgery for the resection of primary cardiac tumors found by fetal echocardiography has been reported sporadically. However, open fetal surgery for pericardial teratoma resection, which was performed successfully via a fetal median sternotomy in one case report, could be a promising intervention to rescue these patients with large pericardial effusions. These recent achievements undoubtedly encourage further development in early management of fetal cardiac tumors. Owing to the rarity of fetal primary cardiac tumors, relevant information in terms of prenatal diagnosis, treatment, and prognosis remains to be clarified.

  14. European Heart Rhythm Association (EHRA) position paper on arrhythmia management and device therapies in endocrine disorders, endorsed by Asia Pacific Heart Rhythm Society (APHRS) and Latin American Heart Rhythm Society (LAHRS).

    Science.gov (United States)

    Gorenek, Bulent; Boriani, Giuseppe; Dan, Gheorge-Andrei; Fauchier, Laurent; Fenelon, Guilherme; Huang, He; Kudaiberdieva, Gulmira; Lip, Gregory Y H; Mahajan, Rajiv; Potpara, Tatjana; Ramirez, Juan David; Vos, Marc A; Marin, Francisco

    2018-03-16

    Endocrine disorders are associated with various tachyarrhythmias, including atrial fibrillation (AF), ventricular tachycardia (VT), ventricular fibrillation (VF), and bradyarrhythmias. Along with underlying arrhythmia substrate, electrolyte disturbances, glucose, and hormone levels, accompanying endocrine disorders contribute to development of arrhythmia. Arrhythmias may be life-threatening, facilitate cardiogenic shock development and increase mortality. The knowledge on the incidence of tachy- and bradyarrhythmias, clinical and prognostic significance as well as their management is limited; it is represented in observational studies and mostly in case reports on management of challenging cases. It should be also emphasized, that the topic is not covered in detail in current guidelines. Therefore, cardiologists and multidisciplinary teams participating in care of such patients do need the evidence-based, or in case of limited evidence expert-opinion based recommendations, how to treat arrhythmias using contemporary approaches, prevent their complications and recurrence in patients with endocrine disorders. In recognizing this close relationship between endocrine disorders and arrhythmias, the European Heart Rhythm Association (EHRA) convened a Task Force, with representation from Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLAECE), with the remit of comprehensively reviewing the available evidence and publishing a joint consensus document on endocrine disorders and cardiac arrhythmias, and providing up-to-date consensus recommendations for use in clinical practice.

  15. Mutations in calmodulin cause ventricular tachycardia and sudden cardiac death

    DEFF Research Database (Denmark)

    Nyegaard, Mette; Overgaard, Michael Toft; Sondergaard, M.T.

    2012-01-01

    a substantial part of sudden cardiac deaths in young individuals. Mutations in RYR2, encoding the cardiac sarcoplasmic calcium channel, have been identified as causative in approximately half of all dominantly inherited CPVT cases. Applying a genome-wide linkage analysis in a large Swedish family with a severe......Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating inherited disorder characterized by episodic syncope and/or sudden cardiac arrest during exercise or acute emotion in individuals without structural cardiac abnormalities. Although rare, CPVT is suspected to cause...... calmodulin-binding-domain peptide at low calcium concentrations. We conclude that calmodulin mutations can cause severe cardiac arrhythmia and that the calmodulin genes are candidates for genetic screening of individual cases and families with idiopathic ventricular tachycardia and unexplained sudden cardiac...

  16. Inflammation markers are associated with metabolic syndrome and ventricular arrhythmia in patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Krzysztof Safranow

    2016-02-01

    previous studies have suggested that the inflammatory process plays an important role in generation of cardiac arrhythmia, but the majority of these reports concerned atrial fibrillation (AF [28]. These findings are supported by experimental studies, since atrial biopsies taken from patients with AF compared with controls have demonstrated evidence of inflammatory infiltrates and oxidative damage within the atrial tissue [10]. Inflammation and oxidative injury directly affect atrial myocyte contraction, electrical conduction, myocyte apoptosis, and cardiac fibrosis [39]. CRP can induce AF, causing the disarray of normal cell membrane structure by interaction with lysophospholipids followed by activation of the complement system and phagocytosis [35]. Our results did not show an association of AF with inflammation markers, but there were only 9 patients with AF in our study group. Similar mechanisms may be involved in the generation of ventricular arrhythmia. Moreover, inflammatory biomarkers can transform a stable atherosclerotic plaque into an unstable lesion, leading to ischemia-induced ventricular arrhythmias and sudden cardiac death events [40]. In the study of Albert et al., higher CRP levels were independently associated with an increased risk of sudden cardiac death over a 17-year follow-up period [2]. In another study, frequent premature ventricular contractions together with high CRP were associated with higher risk of death and acute myocardial infarction [50]. High peak serum CRP was an independent predictor of VT/VF in STEMI patients treated with primary percutaneous coronary intervention, while WBC was also significantly higher in patients with VT/VF [33]. High serum CRP was an independent predictor of VT/VF or cardiac death after ICD implantation [58]. In another study, increased CRP was an independent predictor of VT in ICD recipients after myocardial infarction [7]. Elevated preimplantation hs-CRP serum level was independently associated with increased

  17. Cardiac involvement in children with neuro-muscular disorders

    Directory of Open Access Journals (Sweden)

    E. N. Arkhipova

    2015-01-01

    Full Text Available Many inherited neuromuscular disorders include cardiac involvement as a typical clinical feature. Among the most common of them is the group of muscular dystrophies. Dilated cardiomyopathy, ventricular arrhythmias, atrial fibrillations, atrioventricular and intraventricular conduction abnormalities, and sudden cardiac death are well known pathological findings in Duchenne muscular dystrophies, myotonic dystrophy type I and 2, Emery-Dreifuss muscular dystrophies and different types of limb-girdle muscular dystrophies and other disorders. Detection of cardiac pathology in patients with different muscular dystrophies is possible with ECG, echocardiography and cardiovascular magnetic resonance imaging, which are recommended for screening and early cardioprotective treatment.

  18. Cardiac rehabilitation

    Science.gov (United States)

    ... rehab; Heart failure - cardiac rehab References Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: ... of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed ...

  19. Sevoflurane causes less arrhythmias than desflurane after off-pump coronary artery bypass grafting: A pilot study

    Directory of Open Access Journals (Sweden)

    Hemmerling Thomas

    2010-01-01

    Full Text Available Background: Volatile anesthetics provide myocardial protection during cardiac surgery. Sevoflurane and desflurane are both efficient agents that allow immediate extubation after off-pump coronary artery bypass grafting (OPCABG. This study compared the incidence of arrhythmias after OPCABG with the two agents. Materials and Methods: Forty patients undergoing OPCABG with immediate extubation and perioperative high thoracic analgesia were included in this controlled, double-blind study; anesthesia was either provided using 1 MAC of sevoflurane (SEVO-group or desflurane (DES-group. Monitoring of perioperative arrhythmias was provided by continuous monitoring of the EKG up to 72 hours after surgery, and routine EKG monitoring once every day, until time of discharge. Patient data, perioperative arrhythmias, and myocardial protection (troponin I, CK, CK-MB-ratio, and transesophageal echocardiography examinations were compared using t-test, Fisher′s exact test or two-way analysis of variance for repeated measurements; P < 0.05. Results: Patient data and surgery-related data were similar between the two groups; all the patients were successfully extubated immediately after surgery, with similar emergence times. Supraventricular tachycardia occurred only in the DES-group (5 of 20 patients, atrial fibrillation was significantly more frequent in the DES group versus SEVO-group, at five out of 20 versus one out of 20 patients, respectively. Myocardial protection was equally achieved in both groups. Discussion: Ultra-fast track anesthesia using sevoflurane seems more advantageous than desflurane for anesthesia, for OPCABG, as it is associated with significantly less atrial fibrillation or supraventricular arrhythmias after surgery.

  20. Prevention of fatal arrhythmias in high-risk subjects by fish oil n-3 fatty acid intake.

    Science.gov (United States)

    Leaf, Alexander; Albert, Christine M; Josephson, Mark; Steinhaus, David; Kluger, Jeffrey; Kang, Jing X; Cox, Benjamin; Zhang, Hui; Schoenfeld, David

    2005-11-01

    The long-chain n-3 fatty acids in fish have been demonstrated to have antiarrhythmic properties in experimental models and to prevent sudden cardiac death in a randomized trial of post-myocardial infarction patients. Therefore, we hypothesized that these n-3 fatty acids might prevent potentially fatal ventricular arrhythmias in high-risk patients. Four hundred two patients with implanted cardioverter/defibrillators (ICDs) were randomly assigned to double-blind treatment with either a fish oil or an olive oil daily supplement for 12 months. The primary end point, time to first ICD event for ventricular tachycardia or fibrillation (VT or VF) confirmed by stored electrograms or death from any cause, was analyzed by intention to treat. Secondary analyses were performed for "probable" ventricular arrhythmias, "on-treatment" analyses for all subjects who had taken any of their oil supplements, and "on-treatment" analyses only of those subjects who were on treatment for at least 11 months. Compliance with double-blind treatment was similar in the 2 groups; however, the noncompliance rate was high (35% of all enrollees). In the primary analysis, assignment to treatment with the fish oil supplement showed a trend toward a prolonged time to the first ICD event (VT or VF) or of death from any cause (risk reduction of 28%; P=0.057). When therapies for probable episodes of VT or VF were included, the risk reduction became significant at 31%; P=0.033. For those who stayed on protocol for at least 11 months, the antiarrhythmic benefit of fish oil was improved for those with confirmed events (risk reduction of 38%; P=0.034). Although significance was not achieved for the primary end point, this study provides evidence that for individuals at high risk of fatal ventricular arrhythmias, regular daily ingestion of fish oil fatty acids may significantly reduce potentially fatal ventricular arrhythmias.

  1. Low-Cost Optical Mapping Systems for Panoramic Imaging of Complex Arrhythmias and Drug-Action in Translational Heart Models

    Science.gov (United States)

    Lee, Peter; Calvo, Conrado J.; Alfonso-Almazán, José M.; Quintanilla, Jorge G.; Chorro, Francisco J.; Yan, Ping; Loew, Leslie M.; Filgueiras-Rama, David; Millet, José

    2017-02-01

    Panoramic optical mapping is the primary method for imaging electrophysiological activity from the entire outer surface of Langendorff-perfused hearts. To date, it is the only method of simultaneously measuring multiple key electrophysiological parameters, such as transmembrane voltage and intracellular free calcium, at high spatial and temporal resolution. Despite the impact it has already had on the fields of cardiac arrhythmias and whole-heart computational modeling, present-day system designs precludes its adoption by the broader cardiovascular research community because of their high costs. Taking advantage of recent technological advances, we developed and validated low-cost optical mapping systems for panoramic imaging using Langendorff-perfused pig hearts, a clinically-relevant model in basic research and bioengineering. By significantly lowering financial thresholds, this powerful cardiac electrophysiology imaging modality may gain wider use in research and, even, teaching laboratories, which we substantiated using the lower-cost Langendorff-perfused rabbit heart model.

  2. Dual chamber arrhythmia detection in the implantable cardioverter defibrillator.

    Science.gov (United States)

    Dijkman, B; Wellens, H J

    2000-10-01

    Dual chamber implantable cardioverter defibrillator (ICD) technology extended ICD therapy to more than termination of hemodynamically unstable ventricular tachyarrhythmias. It created the basis for dual chamber arrhythmia management in which dependable detection is important for treatment and prevention of both ventricular and atrial arrhythmias. Dual chamber detection algorithms were investigated in two Medtronic dual chamber ICDs: the 7250 Jewel AF (33 patients) and the 7271 Gem DR (31 patients). Both ICDs use the same PR Logic algorithm to interpret tachycardia as ventricular tachycardia (VT), supraventricular tachycardia (SVT), or dual (VT+ SVT). The accuracy of dual chamber detection was studied in 310 of 1,367 spontaneously occurring tachycardias in which rate criterion only was not sufficient for arrhythmia diagnosis. In 78 episodes there was a double tachycardia, in 223 episodes SVT was detected in the VT or ventricular fibrillation zone, and in 9 episodes arrhythmia was detected outside the boundaries of the PR Logic functioning. In 100% of double tachycardias the VT was correctly diagnosed and received priority treatment. SVT was seen in 59 (19%) episodes diagnosed as VT. The causes of inappropriate detection were (1) algorithm failure (inability to fulfill the PRarrhythmias. Dual chamber detection algorithms evaluated in a subset of diagnostically difficult arrhythmias allow safe detection of double tachycardias but require further extension and programmability to

  3. Arrhythmia phenotype in mouse models of human long QT.

    Science.gov (United States)

    Salama, Guy; Baker, Linda; Wolk, Robert; Barhanin, Jacques; London, Barry

    2009-03-01

    Enhanced dispersion of repolarization (DR) was proposed as a unifying mechanism, central to arrhythmia genesis in the long QT (LQT) syndrome. In mammalian hearts, K(+) channels are heterogeneously expressed across the ventricles resulting in 'intrinsic' DR that may worsen in long QT. DR was shown to be central to the arrhythmia phenotype of transgenic mice with LQT caused by loss of function of the dominant mouse K(+) currents. Here, we investigated the arrhythmia phenotype of mice with targeted deletions of KCNE1 and KCNH2 genes which encode for minK/IsK and Merg1 (mouse homolog of human ERG) proteins resulting in loss of function of I(Ks) and I(Kr), respectively. Both currents are important human K(+) currents associated with LQT5 and LQT2. Loss of minK, a protein subunit that interacts with KvLQT1, results in a marked reduction of I(Ks) giving rise to the Jervell and Lange-Nielsen syndrome and the reduced KCNH2 gene reduces MERG and I(Kr). Hearts were perfused, stained with di-4-ANEPPS and optically mapped to compare action potential durations (APDs) and arrhythmia phenotype in homozygous minK (minK(-/-)) and heterozygous Merg1 (Merg(+/-)) deletions and littermate control mice. MinK(-/-) mice has similar APDs and no arrhythmias (n = 4). Merg(+/-) mice had prolonged APDs (from 20 +/- 6 to 32 +/- 9 ms at the base, p mice (60% vs. 10%). A comparison of mouse models of LQT based on K(+) channel mutations important to human and mouse repolarization emphasizes DR as a major determinant of arrhythmia vulnerability.

  4. Low vagally-mediated heart rate variability and increased susceptibility to ventricular arrhythmias in rats bred for high anxiety.

    Science.gov (United States)

    Carnevali, Luca; Trombini, Mimosa; Graiani, Gallia; Madeddu, Denise; Quaini, Federico; Landgraf, Rainer; Neumann, Inga D; Nalivaiko, Eugene; Sgoifo, Andrea

    2014-04-10

    In humans, there is a documented association between anxiety disorders and cardiovascular disease. Putative underlying mechanisms may include an impairment of the autonomic nervous system control of cardiac function. The primary objective of the present study was to characterize cardiac autonomic modulation and susceptibility to arrhythmias in genetic lines of rats that differ largely in their anxiety level. To reach this goal, electrocardiographic recordings were performed in high-anxiety behavior (HAB, n=10) and low-anxiety behavior (LAB, n=10) rats at rest, during stressful stimuli and under autonomic pharmacological manipulations, and analyzed by means of time- and frequency-domain indexes of heart rate variability. During resting conditions, HAB rats displayed a reduced heart rate variability, mostly in terms of lower parasympathetic (vagal) modulation compared to LAB rats. In HAB rats, this relatively low cardiac vagal control was associated with smaller heart rate responsiveness to acute stressors compared to LAB counterparts. In addition, beta-adrenergic pharmacological stimulation induced a larger incidence of ventricular tachyarrhythmias in HABs compared to LABs. At sacrifice, a moderate increase in heart-body weight ratio was observed in HAB rats. We conclude that high levels of anxiety-related behavior in rats are associated with signs of i) impaired autonomic modulation of heart rate (low vagally-mediated heart rate variability), ii) poor adaptive heart rate responsiveness to stressful stimuli, iii) increased arrhythmia susceptibility, and iv) cardiac hypertrophy. These results highlight the utility of the HAB/LAB model for investigating the mechanistic basis of the comorbidity between anxiety disorders and cardiovascular disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. The assessment of sediment screening risk in Venice Lagoon and other coastal areas using international sediment quality guidelines

    International Nuclear Information System (INIS)

    Apitz, S.A.; Barbanti, A.; Bocci, M.; Delaney, E.; Bernstein, A.G.; Montobbio, L.

    2007-01-01

    A number of studies carried out in recent years have shown the presence of a wide range of contaminants in the Venice Lagoon. It is important to have a good understanding of the ecological quality of Venice Lagoon sediments, in order to: i) define and locate areas where a threat to the environment is present and therefore an intervention is needed (i.e. in situ assessment and management); and ii) define sustainable and environmentally correct ways of managing sediments which are to be dredged for navigational purposes or in relation to other interventions (i.e., ex situ management). Materials and Methods: To examine how various regional and international SQGs 'classed' screening risk in Venice Lagoon sediments, data on median contaminant levels in surface sediments in Venice Lagoon resulting from a literature review were compared to a range of local and international sediment quality guidelines (SQGs). Then data on sediment contaminant levels in various areas and sub-basins of Venice Lagoon (main Lagoon, Porto Marghera and Venice City Canals) and in other regional and international transitional and coastal ecosystems with various levels of human impact (urbanization and industrialization) were evaluated based upon a selected consensus-based SQG. Finally, screening sediment quality for all of Venice Lagoon was mapped and contoured, relative to this consensus-based SQG and briefly compared with direct toxicity measurement through a battery of bioassays. Results: SQGs allow the sediment areas to be put in terms of potential, or screening, risk. Although there were some differences depending upon which specific SQGs were applied, the Venice SQGs and other international SQGs provided the same general picture of screening risk in Venice Lagoon despite geographic differences. Venice Lagoon South has the lowest screening risk levels, Venice Lagoon Central/North has the highest (and is nearest to the Porto Marghera and Venice City Canals sites). Discussion: The Venice

  6. Delayed-enhancement MRI of apical hypertrophic cardiomyopathy: assessment of the intramural distribution and comparison with clinical symptoms, ventricular arrhythmias, and cine MRI

    International Nuclear Information System (INIS)

    Amano, Yasuo; Fukushima, Yoshimitsu; Kumita, Shinichiro; Takayama, Morimasa; Kitamura, Mitsunobu

    2011-01-01

    Background: Hypertrophic cardiomyopathy (HCM) is reported to show patchy midwall myocardial hyper enhancement on delayed-enhancement magnetic resonance imaging (DE-MRI). The intramural distribution of myocardial hyper enhancement and its correlation with clinical symptoms, ventricular arrhythmias, and cardiac function have not been described for symptomatic apical HCM. Purpose: To evaluate the features and significance of myocardial hyper enhancement on DE-MRI in symptomatic apical HCM. Material and Methods: Thirteen patients with symptomatic apical HCM and their 65 apical segments were investigated. Myocardial hyper enhancement and regional and global functional parameters were determined with MRI. We investigated the intramural distribution and frequencies of this myocardial hyper enhancement and compared them with the patients' clinical symptoms, the presence of ventricular arrhythmias, and cine MRI. Results: Eight (61.5%) patients with symptomatic apical HCM displayed apical myocardial hyper enhancement, and 22 (33.8%) of the 65 apical segments examined showed myocardial hyper enhancement. Of the myocardial hyper enhancement observed, 81.8% showed a subendocardial pattern.The Hyperenhanced apical myocardium had a lower percentage of systolic myocardial thickening, and was associated with serious symptoms (e.g. syncope) and ventricular arrhythmias. Conclusion: Patients with symptomatic apical HCM showed myocardial hyper enhancement involving the subendocardial layer, which might be related to regional systolic dysfunction, serious clinical symptoms, and ventricular arrhythmias

  7. PCDD/PCDF presence in the waste water to depuration plant of Fusina - Venice

    Energy Technology Data Exchange (ETDEWEB)

    Paoli, P.; Cuomo, M.; Rubino, B.; Cossettini, P.; Zaccone, C. [Vesta spa, Venice (Italy); Pavanato, A. [Provincia di Venezia, Venice (Italy); Aimo, E. [Arpav Venezia, Venice (Italy)

    2004-09-15

    In July 1999 the Environmental Department issued a decree, well-known as Ronchi -Costa referring to authors' names, that imposed limits more and more restrictive for micropollutants concentrations, as PCDD/PCDF in waste water discharging in Venice Lagoon. Prior to the application of this decree, VESTA S.p.A., that manages the Fusina WWTP situated near Venice Lagoon, planned a systematic monitoring on all flows entering the plant, on produced sludge and on water discharging in lagoon. The aims of monitoring were: the determination of micropollutants source and nature; the individualization of tendency of the concentrations in final discharge and in sludge and to state possible correlations between entering and leaving quantities of pollutants.

  8. Ecotoxicological evaluation of industrial port of Venice (Italy) sediment samples after a decontamination treatment.

    Science.gov (United States)

    Libralato, Giovanni; Losso, Chiara; Arizzi Novelli, Alessandra; Citron, Marta; Della Sala, Stefano; Zanotto, Emanuele; Cepak, Franka; Volpi Ghirardini, Annamaria

    2008-12-01

    This work assesses the ecotoxicological effects of polluted sediment after a decontamination treatment process using a new sediment washing technique. Sediment samples were collected from four sites in Marghera Port industrial channels (Venice, Italy). Ecotoxicological evaluations were performed with Vibrio fischeri and Crassostrea gigas bioassays. Whole sediment and elutriate were deemed as the most suitable environmental matrices for this study. Toxicity scores developed in the Lagoon of Venice for V. fischeri on whole sediment and for C. gigas on elutriate were considered for the final ranking of samples. Ecotoxicological results showed that the treated sediment samples presented both acute and sub-chronic toxicities, which were mainly attributed to the presence of some remaining chemicals such as metals and polyaromatic hydrocarbons. The acute toxicity ranged from low to medium, while the sub-chronic one from absent to very high, suggesting that treated sediments could not be reused in direct contact with seawater.

  9. Atmospheric fall-out of metals around the Murano glass-making district (Venice, Italy).

    Science.gov (United States)

    Rossini, Paolo; Matteucci, Gabriele; Guerzoni, Stefano

    2010-01-01

    Murano's glass-makers have held a monopoly on quality glass-making for centuries known all over the world. Artistic glass manufacture entails exposure to complex mixtures of pollutants, including metals. A few studies have reported high levels of trace elements in marine waters, sediments and mussels around Murano and shown that emissions from Murano glass-making workshops significantly influence air quality in the Venice area. Nevertheless, to date, there is very little information on atmospheric concentrations and virtually none on atmospheric deposition fluxes of trace elements around the island. This study presents data on the distribution of trace elements in the air and atmospheric depositions around Murano, based on a 2-year sampling period. Airborne PM10 particulate matter was collected daily in the period December 2001-June 2003 (254 air samples), and atmospheric depositions were collected every 19 +/- 6 days, in the period August 2001-July 2003 (38 samples) on the roof of the Experimental Glass Laboratory on the island of Murano. All samples were analysed by ICP-MS for As, Cd, Cr, Cu, Fe, Mn, Ni, Pb, Sb, Se and Zn contents. Atmospheric concentrations of As, Cd, Cr, Ni, Pb, Se and Zn were 1-2 orders of magnitude greater on the island of Murano than in the nearest urban areas (Venice and Mestre), with values higher than those reported for European industrial sites. The atmospheric deposition fluxes of all elements were also higher in Murano than those detected by other studies in Venice and Mestre and in the Porto Marghera industrial zone, with As, Cd, Sb and Se 1-2 orders of magnitude higher. In order to study the spatial variability of the atmospheric fall-out, data from other sampling stations belonging to Venice atmospheric deposition monitoring networks were used. A decreasing gradient from Murano to the closer leeward stations was observed for As, Cd and Se. Pb and Zn deposition fluxes in Venice were also comparable to those observed in the Porto

  10. Clam bioaccumulation of Alkylphenols and Polyciclic aromatic hydrocarbons in the Venice lagoon under different pressures.

    Science.gov (United States)

    Ademollo, N; Patrolecco, L; Matozzo, V; Marin, M G; Valsecchi, S; Polesello, S

    2017-11-15

    Biota-Sediment Accumulation Factors (BSAFs) of nonylphenols (NPs) and polycyclic aromatic hydrocarbons (PAHs) in Ruditapes philippinarum from the Venice Lagoon (Italy) were determined with the aim to verify whether the routine biomonitoring studies are reliable in contaminated sites. Clams and sediments were collected in field campaigns (October 2003 to June 2004) in three sites of the Venice Lagoon. Results showed that Marghera and Campalto sediments were more contaminated by NPs and PAHs than Poveglia. Different trends were observed in the contamination of clams with the highest BSAFs found at Poveglia. BSAF trend appeared to be inversely related to the contaminant pressure on the sites. These results suggest that clam bioaccumulation is not always representative of the chemical pressure on aquatic biota. The direct correlation between sediment and biota concentrations in contaminated sites can be lost as a function of the site-specific conditions such as sediment toxicity and food availability. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Transcriptomic resources for environmental risk assessment: a case study in the Venice lagoon.

    Science.gov (United States)

    Milan, M; Pauletto, M; Boffo, L; Carrer, C; Sorrentino, F; Ferrari, G; Pavan, L; Patarnello, T; Bargelloni, L

    2015-02-01

    The development of new resources to evaluate the environmental status is becoming increasingly important representing a key challenge for ocean and coastal management. Recently, the employment of transcriptomics in aquatic toxicology has led to increasing initiatives proposing to integrate eco-toxicogenomics in the evaluation of marine ecosystem health. However, several technical issues need to be addressed before introducing genomics as a reliable tool in regulatory ecotoxicology. The Venice lagoon constitutes an excellent case, in which the assessment of environmental risks derived from the nearby industrial activities represents a crucial task. In this context, the potential role of genomics to assist environmental monitoring was investigated through the definition of reliable gene expression markers associated to chemical contamination in Manila clams, and their subsequent employment for the classification of Venice lagoon areas. Overall, the present study addresses key issues to evaluate the future outlooks of genomics in the environmental monitoring and risk assessment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. 210Pb and 210Po in Venice Lagoon Biota and their contribution to population dose

    International Nuclear Information System (INIS)

    Jia Guogang; Rosamilia, S.; Blasi, M.; Sansone, U.; Belli, M.; Sepulcri, D.; Bidoli, P.

    2002-01-01

    Phosphogypsum is a by-product resulting from the processes applied in phosphoric acid or phosphate fertilizer production. The phosphate ore used in these chemical processes contains the naturally occurring radioactive materials U, and Th, along with their decay products. Large volumes of solid waste products were discharged from a phosphoric acid production plant on the edge of the Venice lagoon (Italy). Water, suspended matter, and biota were monitored in the Venice lagoon, since this aquatic environment can be considered to represent the final area of deposition for the radionuclides transported from inland. The present paper reports data on the activity concentrations of 210 Po and 210 Pb determined in biota living in the lagoon, and an estimation of the contribution to internal dose to man from the ingestion of food originating in the investigated area. (orig.)

  13. Venice: Fifty years after the great flood of November 4, 1966

    Science.gov (United States)

    Rizzoli, P. M.

    2017-12-01

    Fifty years ago Venice and its lagoon suffered the most devastating flood in their millennial history. The causes of the increasingly recurring floods will be examined, namely the man-induced subsidence in the period 1925-1970 and the storm surges of the Adriatic sea. The engineering solution designed for their protection , named the MOSE system, will be discussed in detail. The MOSE was started in 2003 and is near completion. It consists of four barriers , invisible in normal conditions, which will close the inlets to the lagoon under the prediction of a forthcoming flood. Finally, the perspective of the MOSE capability of protecting the city under scenarios of future global sea level rise will be assessed. This assessment must critically take into account that Venice and its lagoon are confined in the northernmost corner of the semi-enclosed, marginal Mediterranean sea for which the uncertainties of future sea level rise greatly exceed the uncertainties of the global averages.

  14. The image of Venice in The Mountain Wreath: Some imagological observations

    Directory of Open Access Journals (Sweden)

    Ivanova Najda

    2015-01-01

    Full Text Available Draško’s story about his trip to Venice represented in the poem The Mountain Wreath (1847, written by Peter Petrović Njegoš, is an object of many interpretations in theoretical Njegoš studies as well as in the educational, popular science, the media, political and many other types of discourse. In this article, we aim at providing a linguo-imagological analysis of the fragment. The mechanisms of shaping and the semantic structure of the hetero-stereotypes about Venice and the Venetians are examined. In addition, both the influence of the author’s intention and that of the socio-cultural discourse regarding the creation of the poem on the way of selection and the use of expressive means are examined.

  15. Linking pipefishes and seahorses to their habitat: implications for species conservation in the Venice lagoon

    Directory of Open Access Journals (Sweden)

    Luca Scapin

    2015-11-01

    Full Text Available Seagrass meadows of the Venice lagoon (Northern Adriatic Sea, Italy are spatially heterogeneous systems, with attributes such as degree of coverage and plant assemblages varying along multiple environmental gradients. They play a particularly relevant role in conservation of fish diversity, since they provide vital habitats for pipefish and seahorse species (family Syngnathidae. Aim of the study was to investigate the diversity of syngnathid assemblages in the Venice lagoon and link species distributions to habitat characteristics, in order to evaluate the importance of seagrass meadows of the lagoon for the conservation of these species. The analyses of this work are based on eight years of fish data collected between 2001 and 2014 in 186 shallow water sites across the entire lagoon. Water parameters, presence of macroalgae, seagrass presence and coverage, as well as meadows species composition, were considered as predictors in a modelling framework, to explain the distribution of each species. Overall, two species of seahorses and seven species of pipefishes including the Adriatic endemism Syngnathus taenionotus were found. Three species (S. abaster, S. typhle and Nerophis ophidion were the most abundant, together accounting for 98% of total individuals caught. Both seagrass presence and its coverage resulted significant predictors, with densities of S. abaster, S. typhle, N. ophidion and Hippocampus guttulatus being positively associated with higher percentages of seagrass cover. In addition, some evidences suggested a different functionality of different meadow types in supporting both S. typhle and N. ophidion. The study highlighted the role of Venice lagoon as biodiversity hotspot for syngnathids, since it supports nine out of the 10 species known in the Mediterranean (with only S. phlegon being absent. Results also suggested the importance of habitat management, which should aim at compensating for seagrass habitat loss and therefore

  16. Extreme events in Italy from documentary sources: Venice as a case study

    International Nuclear Information System (INIS)

    Camuffo, D.; Pagan, E.; Colacino, M.; Enzi, S.; Cocheo, C.; Sturaro, G.

    2006-01-01

    Venice risks to be submerged as a consequence of two problems: local land subsidence and sea level rise due to global warming. They both contribute to what is referred as Apparent Sea Level Rise (ASLR). Flooding Tides (locally: Acqua Alta) submerge Venice with an exponentially increasing frequency. The Acqua Alta is generated by a number of factors, the main of them being the Sirocco wind blowing over the Adriatic Sea, that ultimately displaces waters towards Venice. These extreme events have been investigated by using the documentary description of past floods, accurately reported over the last millennium, and tide gauge records for the recent period. A fundamental problem is to know the trend of the ASLR, possibly distinguishing between land subsidence and sea level components. Instrumental data go back to 1872 and a key point is to extend our knowledge back in time. Long-term ASLR has been investigated with the help of a biological indicator, the height of the green belt of the algae that live in the tidal range and whose upper front shows the average high tide level. Fortunately, in the first half of the 18. century, this indicator was accurately drawn by the famous painter Antonio Canaletto (1697-1768) and his pupils, mainly Bernardo Bellotto (1722-1780), in their photographic paintings made with an optical 'camera obscura'. It has been possible to compare the tidal level, as it was in the 1700s and today. After careful spot investigation and minor corrections for some changes to the hydrological system occurred in the meantime, the bulk submersion of Venice estimated from the paintings is 61±11 cm with average yearly trend 1.9 mm y -1

  17. Kraków, the Old Town – A Continental Venice

    Directory of Open Access Journals (Sweden)

    Maria Urmă

    2017-05-01

    Full Text Available Surviving the destructions of the war, the old town of Krakow is a lesson of architecture and urbanism through the multitude of architectural styles, coherence and urban continuity. These features were preserved despite the numerous stages of construction, just as in San Marco Square from Venice, thus proving the power of consolidation of the values which had naturally been constituted, in time.

  18. Extracorporeal life support for cardiac arrest in a 13-year-old girl caused by Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Song, Kyoung Hwan; Lee, Byung Kook; Jeung, Kyung Woon; Lee, Dong Hun

    2015-10-01

    Generally, Wolff-Parkinson-White (WPW) syndrome presents good prognosis. However, several case reports demonstrated malignant arrhythmia or sudden cardiac death as WPW syndrome's first presentation. Cardiopulmonary resuscitation using extracorporeal life support is a therapeutic option in refractory cardiac arrest. We present a WPW syndrome patient who had sudden cardiac arrest as the first presentation of the disease and treated it using extracorporeal life support with good neurologic outcome.

  19. Life threatening arrhythmias: Knowledge and skills among nurses ...

    African Journals Online (AJOL)

    Conclusion: Although the majority of the participants scored highly in their level of knowledge regarding life threatening arrhythmias, they scored poorly in most of the observed skills when identifying and treating this patient group. It is important that hospital administration take into consideration the identified areas of ...

  20. Life threatening arrhythmias: Knowledge and skills among nurses ...

    African Journals Online (AJOL)

    User

    this study was to assess knowledge and skills of nurses in identifying life ... Much of the literature considers ventricular tachycardia, ventricular fibrillation, ... In critical care settings, bedside nurses play a critical role in arrhythmia identification and ..... Lambert, V.A. & Lambert, C.E. (2008) Nurses' workplace stressors and ...

  1. Regional and local land subsidence at the Venice coastland by TerraSAR-X PSI

    Directory of Open Access Journals (Sweden)

    L. Tosi

    2015-11-01

    Full Text Available Land subsidence occurred at the Venice coastland over the 2008–2011 period has been investigated by Persistent Scatterer Interferometry (PSI using a stack of 90 TerraSAR-X stripmap images with a 3 m resolution and a 11-day revisiting time. The regular X-band SAR acquisitions over more than three years coupled with the very-high image resolution has significantly improved the monitoring of ground displacements at regional and local scales, e.g., the entire lagoon, especially the historical palaces, the MoSE large structures under construction at the lagoon inlets to disconnect the lagoon from the Adriatic Sea during high tides, and single small structures scattered within the lagoon environments. Our results show that subsidence is characterized by a certain variability at the regional scale with superimposed important local displacements. The movements range from a gentle uplift to subsidence rates of up to 35 mm yr−1. For instance, settlements of 30–35 mm yr−1 have been detected at the three lagoon inlets in correspondence of the MoSE works, and local sinking bowls up to 10 mm yr−1 connected with the construction of new large buildings or restoration works have been measured in the Venice and Chioggia historical centers. Focusing on the city of Venice, the mean subsidence of 1.1 ± 1.0 mm yr−1 confirms the general stability of the historical center.

  2. Impact of maritime traffic on polycyclic aromatic hydrocarbons, metals and particulate matter in Venice air.

    Science.gov (United States)

    Gregoris, Elena; Barbaro, Elena; Morabito, Elisa; Toscano, Giuseppa; Donateo, Antonio; Cesari, Daniela; Contini, Daniele; Gambaro, Andrea

    2016-04-01

    Harbours are important hubs for economic growth in both tourism and commercial activities. They are also an environmental burden being a source of atmospheric pollution often localized near cities and industrial complexes. The aim of this study is to quantify the relative contribution of maritime traffic and harbour activities to atmospheric pollutant concentration in the Venice lagoon. The impact of ship traffic was quantified on various pollutants that are not directly included in the current European legislation for shipping emission reduction: (i) gaseous and particulate PAHs; (ii) metals in PM10; and (iii) PM10 and PM2.5. All contributions were correlated with the tonnage of ships during the sampling periods and results were used to evaluate the impact of the European Directive 2005/33/EC on air quality in Venice comparing measurements taken before and after the application of the Directive (year 2010). The outcomes suggest that legislation on ship traffic, which focused on the issue of the emissions of sulphur oxides, could be an efficient method also to reduce the impact of shipping on primary particulate matter concentration; on the other hand, we did not observe a significant reduction in the contribution of ship traffic and harbour activities to particulate PAHs and metals. Graphical abstract Impact of maritime traffic on polycyclic aromatic hydrocarbons, metals and particulate matter and evaluation of the effect of an European Directive on air quality in Venice.

  3. The City, the Ghetto and Two Books. Venice and Jewish Early Modernity

    Directory of Open Access Journals (Sweden)

    Cristiana Facchini

    2011-10-01

    Full Text Available In 1638 two books written by two Venitian rabbis were published in Venice. They were both destined successfully to reach wide circulation over the following decades. This article aims at exploring the intimate connection between Venice, a city which deeply influenced the imagination of European culture during the early modern period, and its Jewish ghetto, the first of its kind to be founded within Catholic lands.The author suggests that it was here in Venice, within the liminal space of the ghetto, that the theory of Jews as merchants, marked by undertones of utilitarianism was finally drafted. It also suggests that, in conjunction with this well-known theory, other theories based on religious tolerance were elaborated.The paper also invites the reader to view the ghetto as a space capable of enacting special religious encounters, mainly driven by an interest in religion and rituals. Therefore, the very specific local and tangible conditions of the urban environment – the city and the ghetto – performed a very important undertaking, for example, debates over the place and role of Jews in Christian society.

  4. Methyl-CpG binding-protein 2 function in cholinergic neurons mediates cardiac arrhythmogenesis.

    Science.gov (United States)

    Herrera, José A; Ward, Christopher S; Wehrens, Xander H T; Neul, Jeffrey L

    2016-11-15

    Sudden unexpected death occurs in one quarter of deaths in Rett Syndrome (RTT), a neurodevelopmental disorder caused by mutations in Methyl-CpG-binding protein 2 (MECP2). People with RTT show a variety of autonomic nervous system (ANS) abnormalities and mouse models show similar problems including QTc interval prolongation and hypothermia. To explore the role of cardiac problems in sudden death in RTT, we characterized cardiac rhythm in mice lacking Mecp2 function. Male and female mutant mice exhibited spontaneous cardiac rhythm abnormalities including bradycardic events, sinus pauses, atrioventricular block, premature ventricular contractions, non-sustained ventricular arrhythmias, and increased heart rate variability. Death was associated with spontaneous cardiac arrhythmias and complete conduction block. Atropine treatment reduced cardiac arrhythmias in mutant mice, implicating overactive parasympathetic tone. To explore the role of MeCP2 within the parasympathetic neurons, we selectively removed MeCP2 function from cholinergic neurons (MeCP2 ChAT KO), which recapitulated the cardiac rhythm abnormalities, hypothermia, and early death seen in RTT male mice. Conversely, restoring MeCP2 only in cholinergic neurons rescued these phenotypes. Thus, MeCP2 in cholinergic neurons is necessary and sufficient for autonomic cardiac control, thermoregulation, and survival, and targeting the overactive parasympathetic system may be a useful therapeutic strategy to prevent sudden unexpected death in RTT.

  5. Noninvasive predictors of perioperative atrial arrhythmias in patients with tetralogy of Fallot undergoing pulmonary valve replacement.

    Science.gov (United States)

    Cortez, Daniel; Barham, Waseem; Ruckdeschel, Emily; Sharma, Nandita; McCanta, Anthony C; von Alvensleben, Johannes; Sauer, William H; Collins, Kathryn K; Kay, Joseph; Patel, Sonali; Nguyen, Duy T

    2017-08-01

    Patients with tetralogy of Fallot (TOF) have increased risk of atrial arrhythmias. A measure of atrial dispersion, the P-wave vector magnitude (Pvm), can identify patients at risk for perioperative atrial flutter (AFL) or intra-atrial re-entrant tachycardia (IART) in a large TOF cohort. We performed a blinded, retrospective analysis of 158 TOF patients undergoing pulmonary valve replacement between 1997 and 2015. History of AFL/IART was documented using electrocardiogram, Holter monitor, exercise stress test, implanted cardiac device, and electrophysiology study. P-R intervals, Pvm, QRS duration, and QRS vector magnitude were assessed from resting sinus-rhythm 12-lead electrocardiograms and identification of those with AFL/IART was determined. Fourteen patients (8.9%) were found to have AFL/IART. Pvm, QRS duration, and QRS vector magnitude significantly differentiated those with AFL/IART from those without on univariate analysis: 0.09 ± 0.04 vs 0.18 ± 0.07 mV, 161.3 ± 21.9 vs 137.7 ± 31.4 ms, and 1.2 (interquartile range, 1.0-1.2) vs 1.6 mV (1.0-2.3), respectively (P < 0.05 for each). The Pvm had the highest area under the ROC curve (0.88) and was the only significant predictor on multivariate analysis, with odds ratio of 0.02 (95% confidence interval: 0.01-0.53). P-R duration, MRI volumes, and right-heart hemodynamics did not significantly differentiate those with vs those without AFL/IART. In TOF patients undergoing pulmonary valve replacement, Pvm has significant value in predicting those with perioperative AFL/IART. These clinical features may help further evaluate TOF patients at risk for perioperative atrial arrhythmias. Prospective studies are warranted. © 2017 Wiley Periodicals, Inc.

  6. Arrhythmia and conduction disorders in acute inferior myocardial infarction with right ventricular involvement

    International Nuclear Information System (INIS)

    Samadikhah, J.; Hakim, S.H.; Azarfarin, R.; Ghaffari, S.

    2007-01-01

    To assess the prognostic impact of Right Ventricular (RV) myocardial involvement in patients with inferior MI. One hundred seventy patients who were admitted to cardiac care unit of Madani Heart Hospital, Tabriz, Iran with the diagnosis of inferior MI with (group 1) or without (group 2) simultaneous involvement of RV were studied from 2005 to 2006. Patients presenting within 12 hours of symptom onset were eligible for inclusion. Those with simultaneous Anterior wall MI, patients undergoing primary percutaneous transluminal coronary angioplasty and those with renal impairment (creatinine >2 mg/dl) were excluded. Eighty eight percent of the patients with RVMI and 75% with isolated inferior MI had some type of arrhythmia. AV block occurred in 42% of the infarctions with RV involvement and only in 29% of the control group. Intra ventricular conduction disturbance (IVCD) also were more frequent in RVMI (29.4% VS 13.1%, p=0.021), especially the RBBB (20% VS 7.4%, P=0.003). Ventricular fibrillation (VF) was observed in 5.2% and 1.2% and ventricular tachycardia in 26% and 12.2% respectively. In 27% of patients with RVMI it was necessary to implant a pacemaker as compared to 10% in control group. Mortality was higher in the patients with inferior infarction extended to the RV (15.3% vs 3.5%., P=0.0001). There was not a meaningful difference in incidence of LBBB between group 1 and 2 (3.1% vs 2.9% P=0.9). Patients with inferior MI who also have RV myocardial involvement are at increased risk of death and arrhythmias. (author)

  7. Effects of valsartan on ventricular arrhythmia induced by programmed electrical stimulation in rats with myocardial infarction

    Science.gov (United States)

    Jiao, Kun-Li; Li, Yi-Gang; Zhang, Peng-Pai; Chen, Ren-Hua; Yu, Yi

    2012-01-01

    Abstract The impact of angiotensin II receptor blockers (ARBs) on electrical remodelling after myocardial infarction (MI) remains unclear. The purpose of the present study was to evaluate the effect of valsartan on incidence of ventricular arrhythmia induced by programmed electrical stimulation (PES) and potential link to changes of myocardial connexins (Cx) 43 expression and distribution in MI rats. Fifty-nine rats were randomly divided into three groups: Sham (n = 20), MI (n = 20) and MI + Val (20 mg/kg/day per gavage, n = 19). After eight weeks, the incidence of PES-induced ventricular tachycardia (VT) and fibrillation (VF) was compared among groups. mRNA and protein expressions of Cx43, angiotensin II type 1 receptor (AT1R) in the LV border zone (BZ) and non-infarct zone (NIZ) were determined by real-time PCR and Western blot, respectively. Connexins 43 protein and collagen distribution were examined by immunohistochemistry in BZ and NIZ sections from MI hearts. Valsartan effectively improved the cardiac function, reduced the prolonged QTc (163.7 ± 3.7 msec. versus 177.8 ± 4.5 msec., P valsartan. The mRNA and protein expressions of Cx43 in BZ were significantly reduced after MI and up-regulated by valsartan. Increased collagen deposition and reduced Cx43 expression in BZ after MI could be partly attenuated by Valsartan. Valsartan reduced the incidence of PES-induced ventricular arrhythmia, this effect was possibly through modulating the myocardial AT1R and Cx43 expression. PMID:22128836

  8. Cardiac disturbances after pneumonectomy--the value of prophylactic digitalization.

    Science.gov (United States)

    Järvinen, A; Mattila, T; Appelqvist, P; Meurala, H; Mattila, S

    1978-01-01

    The incidence of postoperative cardiac disturbances and the value of prophylactic digitalization were studied retrospectively in 143 patients undergoing pneumonectomy for carcinoma of the lung. Cardiac arrhythmias occurred in 29% and tachycardia episodes in 30% of the patients. The incidence of myocardial infarction was 2%. Operative mortality was 4%. The cardiac disturbances developed more often after left than after right pneumonectomy. The age of the patients, a history of angina pectoris or hypertension did not markedly increase the incidence of cardiac disturbances, neither did operative factors, such as pericardiotomy, left atrial resection, major bleeding nor postoperative empyema. Prophylactic digitalization significantly reduced postoperative cardiac disorders, their frequency being 33% in the group of patients who received prophylactic digitalis compared with 65% in the group that did not.

  9. [Cardiac sarcoidosis: diagnostics, treatment and follow-up].

    Science.gov (United States)

    Dudziak, Maria; Jankowska, Hanna; Dorniak, Karolina

    2018-03-27

    Sarcoidosis is a generalised granulomatous disorder of unknown aetiology. Cardiac involvement may affect conduction system, myocardium, valvular apparatus and pericardium. Clinical spectrum ranges from asymptomatic involvement to sudden cardiac death. Patients with biopsy-proven extracardiac sarcoidosis should be screened for cardiac involvement (standard ECG, 24-hour Holter ECG, echocardiography) and in case of any abnormalities found on these tests, more advanced diagnostic methods should be used. Steroid treatment is still the mainstay of therapy in cardiac sarcoidosis. Several immunosuppresive agents are also effective and used in different combinations with steroids, as well as heart failure treatment (including ACE inhibitors, angiotensin receptor blockers, beta-blockers and diuretics). Advanced heart block requires pacemaker implantation, and implantable cardioverterdefibrillator is an effective treatment in primary and secondary prophylaxis of sudden cardiac death. Heart transplantation is considered in advanced, drug-resistant heart failure or incessant ventricular arrhythmias unresponsive to other forms of therapy. © 2018 MEDPRESS.

  10. Percutaneous cardiopulmonary support for catheter ablation of unstable ventricular arrhythmias in high-risk patients.

    Science.gov (United States)

    Carbucicchio, Corrado; Della Bella, Paolo; Fassini, Gaetano; Trevisi, Nicola; Riva, Stefania; Giraldi, Francesco; Baratto, Francesca; Marenzi, Giancarlo; Sisillo, Erminio; Bartorelli, Antonio; Alamanni, Francesco

    2009-11-01

    In patients with severe cardiomyopathy, recurrent episodes of nontolerated ventricular tachycardia (VT) or electrical storm (ES) frequently cause acute heart failure and cardiac death; the suppression of the arrhythmia is therefore lifesaving, but feasibility of catheter ablation (CA) is precluded by the adverse hemodynamic conditions together with the characteristics of the arrhythmia that interdicts efficacious mapping. The use of the percutaneous cardiopulmonary support (CPS) for circulatory assistance may allow patient's stabilization and enhance efficacy and safety of CA in this emergency setting. 19 patients (19 males; mean age 61 +/- 6 years; chronic ischemic cardiomyopathy, eleven patients; primary dilated cardiomyopathy, six patients; arrhythmogenic right ventricular dysplasia/ cardiomyopathy, two patients) with recurrent nontolerated VT episodes undergoing CPS-assisted CA were retrospectively evaluated. Twelve patients had acute hemodynamic failure refractory to inotropic agents and ventilatory assistance, seven patients had undergone a failing nonconventional CA procedure. 14 patients presented with ES, and in twelve the procedure was undertaken under emergency conditions within 24 h from admission. Patients were ventilated under general anesthesia and assisted by a multidisciplinary team. The CPS system consisted in a Medtronic Bio-Medicus centrifugal pump and in a Maxima Plus oxygenator, a 15-F arterial cannula, and a 17-F venous cannula. Flows between 2 and 3 l/min were activated after induction of 56/62 forms of nontolerated VT, achieving hemodynamic stabilization in all patients. CA was mainly guided by conventional activation mapping and was effective in abolishing 45/56 supported VTs; in 10/19 patients all clinical VTs were suppressed by CA. Mean procedural time was 4 h and 20 min. Complete stabilization was achieved in 13 patients (68%) without VT recurrence during a 7-day in-hospital monitoring. A significant clinical improvement was observed in

  11. Gated blood pool imaging in the diagnosis and management of arrhythmia

    International Nuclear Information System (INIS)

    Yamamoto, Shuhei; Kawai, Naoki; Okada, Mitsuhiro; Matsushima, Hideo; Kato, Rinya; Sotobata, Iwao; Tanahashi, Yoshibumi.

    1985-01-01

    The usefulness of multigated cardiac blood pool imaging in evaluating left ventricular function and ventricular activation was studied in patients with cardiac arrhythmias. Subjects consisted of 12 patients with the Wolff-Parkinson-White (WPW) syndrome; 20 with ventricular premature contractions (VPC); 21 with various modes of artificial pacemakers; and two normal controls. 1. Phase analysis was useful in localizing the bypass tract in patients with the WPW syndrome. In four patients with the WPW syndrome and five with VVI pacing, the phase difference between the posterolateral wall of the left ventricle (LV) and the right ventricular apex correlated significantly with the activation time difference between these two regions as assessed by endocardial electrograms (r = 0.94, p < 0.001). 2. Images of VPC were obtained using the bad beat rejection program in an ADAC computer system. The origin of VPCs evaluated by phase image coincided with results of standard 12-lead electrograms. 3. The LV ejection fraction (LVEF) decreased significantly (p < 0.001) after the injection of lidocaine (-3.7 %) or disopyramide (-6.2 %). The percent reduction in LVEF was significantly greater with disopyramide than with lidocaine (-15.1 vs -11.2 %). There was a significant correlation between the percent reduction in LVEF and the disopyramide plasma concentrations (r = -0.62, p < 0.001). 4. The influence of the pacing mode and exercise on LV function was studied in 21 patients with artificial pacemakers. In the VDD and DDD modes, end-diastolic volume (EDV) and cardiac output (CO) decreased after converting to VVI mode. CO increased markedly to approximately 250 % of the control value in the VDD and DDD, and moderately in the VVI and AAI modes during ergometer exercise. (J.P.N.)

  12. Recessive cardiac phenotypes in induced pluripotent stem cell models of Jervell and Lange-Nielsen syndrome: disease mechanisms and pharmacological rescue

    NARCIS (Netherlands)

    Zhang, Miao; D'Aniello, Cristina; Verkerk, Arie O.; Wrobel, Eva; Frank, Stefan; Ward-van Oostwaard, Dorien; Piccini, Ilaria; Freund, Christian; Rao, Jyoti; Seebohm, Guiscard; Atsma, Douwe E.; Schulze-Bahr, Eric; Mummery, Christine L.; Greber, Boris; Bellin, Milena

    2014-01-01

    Jervell and Lange-Nielsen syndrome (JLNS) is one of the most severe life-threatening cardiac arrhythmias. Patients display delayed cardiac repolarization, associated high risk of sudden death due to ventricular tachycardia, and congenital bilateral deafness. In contrast to the autosomal dominant

  13. QRS Complex Enlargement as a Predictor of Ventricular Arrhythmias in Patients Affected by Surgically Treated Tetralogy of Fallot: A Comprehensive Literature Review and Historical Overview

    Science.gov (United States)

    Bassareo, Pier Paolo; Mercuro, Giuseppe

    2013-01-01

    Tetralogy of Fallot (TOF) is a congenital heart disease frequently treated by surgical repair to relieve symptoms and improve survival. However, despite the performing of an optimal surgical repair, TOF patients are at times characterized by a poor long-term survival rate, likely due to cardiac causes such as ventricular arrhythmias, with subsequent sudden death. In the 80s it was irrefutably demonstrated that QRS prolongation ≥180 msec at basal electrocardiogram is a strong predictor for refining risk stratification for ventricular tachycardia in these patients. The aim of this research was to undertake a review of all studies conducted to assess the impact of QRS duration on the development of life-threatening ventricular arrhythmias in repaired TOF subjects. PMID:23509638

  14. Left ventricular dysfunction in repaired tetralogy of Fallot: incidence and impact on atrial arrhythmias at long term-follow up.

    Science.gov (United States)

    Ait Ali, Lamia; Trocchio, GianLuca; Crepaz, Roberto; Stuefer, Josef; Stagnaro, Nicola; Siciliano, Valeria; Molinaro, Sabrina; Sicari, Rosa; Festa, Pierluigi

    2016-09-01

    Left ventricle (LV) systolic dysfunction in repaired tetralogy of Fallot (TOF) has been identified as a risk factor for functional status and adverse outcome. The aims of this cross-sectional followed by a prospective study were: (1) to evaluate the prevalence of LV systolic dysfunction in a large cohort of adults with repaired tetralogy of Fallot, (2) to test the relationship between LV systolic dysfunction and other known risk factors and (3) to evaluate the impact of LV systolic dysfunction on adverse cardiac events. In a multicenter study, 237 adults repaired TOF (58 % males, age 30 ± 10 years) were evaluated by cardiac magnetic resonance (CMR). Demographics, surgical history, ECG, Echo-Color Doppler and follow-up data were recorded. LV was dilated (Z value >2) in 16 patients (6 %), however 56 patients (23.6 %) had a reduced LV systolic function left ventricle ejection fraction (LVEF) (Z value <-2). Patients with LV systolic dysfunction were mainly males (82 %), had reduced right ventricle ejection fraction (RVEF), and higher right and left Late Gadolinium Enhanced scores. In a multivariate regression analysis male gender and RVEF resulted to be independent factors associated to LV systolic dysfunction. Atrial arrhythmias were the main adverse cardiac event at the follow-up and were associated to higher biventricular volumes and lower biventricular ejection fraction (EF); however multivariable analysis identified age, right ventricle end-diastolic volume (RVEDVi) and tricuspid regurgitation as independents factors associated to atrial arrhythmias. At long term follow-up at least ¼ of repaired TOF has LV dysfunction. Lower LVEF is associated to male gender and lower RVEF.

  15. Transitory electrocardiographic abnormalities following blunt cardiac trauma: Case report and literature review

    Directory of Open Access Journals (Sweden)

    J. Valle-Alonso

    2018-01-01

    Full Text Available Blunt cardiac trauma (BCT includes a number of diseases ranging from clinically silent arrhythmias to lethal cardiac wall rupture. The most common form is “cardiac contusion”, which is currently under debate. The absence of a clear definition and the lack of diagnostic tests of choice make diagnosing cardiac contusion difficult. We present the case report of a healthy young patient who went to the emergency department with electrocardiogram changes following blunt chest trauma, and review the current literature on the subject.

  16. Polyunsaturated fatty acid analogs act antiarrhythmically on the cardiac IKs channel

    DEFF Research Database (Denmark)

    Liin, Sara I.; Silverå Ejneby, Malin; Barro-Soria, Rene

    2015-01-01

    Polyunsaturated fatty acids (PUFAs) affect cardiac excitability. Kv7.1 and the β-subunit KCNE1 form the cardiac IKs channel that is central for cardiac repolarization. In this study, we explore the prospects of PUFAs as IKs channel modulators. We report that PUFAs open Kv7.1 via an electrostatic...... charge at neutral pH, restore the sensitivity to open IKs channels. PUFA analogs with a positively charged head group inhibit IKs channels. These different PUFA analogs could be developed into drugs to treat cardiac arrhythmias. In support of this possibility, we show that PUFA analogs act...

  17. Protecting the historic centre of Venice. A coordinated analysis of the physical and perceived wear processes to define mitigating actions

    Directory of Open Access Journals (Sweden)

    Renata Codello

    2014-05-01

    Full Text Available The research aims to identify "physical" and "perceptual" wear factors of the historic center of Venice (with particular attention to the effects of anthropogenic pressure related to the phenomenon of tourism and to assess the damages they could produce to identify criteria and tools of mitigation and control. Research is part of the Action Plan "Protection and conservation of the heritage", established by the Plan of Management for the UNESCO Site of Venice and its Lagoon. Through a systemic reading and analysis of the forces of change in place, this study identifies the " macro-emergencies", i.e. the main factors that adversely affect the site’s safeguarding. The research project "Evaluation of wear processes and critical factors of the City of Venice and its lagoon, and its impact on the site’s protection" is part of the actions set out by the Management Plan of the UNESCO site of Venice and its Lagoon. The main objective of the project is the identification of physical and perceptual factors of wear, which threaten the conservation of the historical and artistic heritage of the historic center of Venice, with a particular focus on the effects of anthropogenic pressure linked to tourism, and the evaluation of their level of danger. A further objective is the recognition of measurable parameters (indicators for monitoring and, subsequently, mitigation strategies for the most significant phenomena.

  18. Electrocardiographic Patch Devices and Contemporary Wireless Cardiac Monitoring

    Directory of Open Access Journals (Sweden)

    Erik eFung

    2015-05-01

    Full Text Available Cardiac electrophysiologic derangements often coexist with disorders of the circulatory system. Capturing and diagnosing arrhythmias and conduction system disease may lead to a change in diagnosis, clinical management and patient outcomes. Standard 12-lead electrocardiogram (ECG, Holter monitors and event recorders have served as useful diagnostic tools over the last few decades. However, their shortcomings are only recently being addressed by emerging technologies. With advances in device miniaturization and wireless technologies, and changing consumer expectations, wearable ‘on-body’ ECG patch devices have evolved to meet contemporary needs. These devices are unobtrusive and easy to use, leading to increased device wear time and diagnostic yield. While becoming the standard for detecting arrhythmias and conduction system disorders in the outpatient setting where continuous ECG monitoring in the short to medium term (days to weeks is indicated, these cardiac devices and related digital mobile health technologies are reshaping the clinician-patient interface with important implications for future healthcare delivery.

  19. Evaluating the Cancer Therapeutic Potential of Cardiac Glycosides

    Directory of Open Access Journals (Sweden)

    José Manuel Calderón-Montaño

    2014-01-01

    Full Text Available Cardiac glycosides, also known as cardiotonic steroids, are a group of natural products that share a steroid-like structure with an unsaturated lactone ring and the ability to induce cardiotonic effects mediated by a selective inhibition of the Na+/K+-ATPase. Cardiac glycosides have been used for many years in the treatment of cardiac congestion and some types of cardiac arrhythmias. Recent data suggest that cardiac glycosides may also be useful in the treatment of cancer. These compounds typically inhibit cancer cell proliferation at nanomolar concentrations, and recent high-throughput screenings of drug libraries have therefore identified cardiac glycosides as potent inhibitors of cancer cell growth. Cardiac glycosides can also block tumor growth in rodent models, which further supports the idea that they have potential for cancer therapy. Evidence also suggests, however, that cardiac glycosides may not inhibit cancer cell proliferation selectively and the potent inhibition of tumor growth induced by cardiac glycosides in mice xenografted with human cancer cells is probably an experimental artifact caused by their ability to selectively kill human cells versus rodent cells. This paper reviews such evidence and discusses experimental approaches that could be used to reveal the cancer therapeutic potential of cardiac glycosides in preclinical studies.

  20. Mechanical perturbation control of cardiac alternans

    Science.gov (United States)

    Hazim, Azzam; Belhamadia, Youssef; Dubljevic, Stevan

    2018-05-01

    Cardiac alternans is a disturbance in heart rhythm that is linked to the onset of lethal cardiac arrhythmias. Mechanical perturbation control has been recently used to suppress alternans in cardiac tissue of relevant size. In this control strategy, cardiac tissue mechanics are perturbed via active tension generated by the heart's electrical activity, which alters the tissue's electric wave profile through mechanoelectric coupling. We analyze the effects of mechanical perturbation on the dynamics of a map model that couples the membrane voltage and active tension systems at the cellular level. Therefore, a two-dimensional iterative map of the heart beat-to-beat dynamics is introduced, and a stability analysis of the system of coupled maps is performed in the presence of a mechanical perturbation algorithm. To this end, a bidirectional coupling between the membrane voltage and active tension systems in a single cardiac cell is provided, and a discrete form of the proposed control algorithm, that can be incorporated in the coupled maps, is derived. In addition, a realistic electromechanical model of cardiac tissue is employed to explore the feasibility of suppressing alternans at cellular and tissue levels. Electrical activity is represented in two detailed ionic models, the Luo-Rudy 1 and the Fox models, while two active contractile tension models, namely a smooth variant of the Nash-Panfilov model and the Niederer-Hunter-Smith model, are used to represent mechanical activity in the heart. The Mooney-Rivlin passive elasticity model is employed to describe passive mechanical behavior of the myocardium.

  1. Diabetic cardiac autonomic dysfunction. Parasympathetic versus sympathetic

    International Nuclear Information System (INIS)

    Uehara, Akihiko; Kurata, Chinori; Sugi, Toshihiko; Mikami, Tadashi; Shouda, Sakae

    1999-01-01

    Diabetic cardiac autonomic dysfunction often causes lethal arrhythmia and sudden cardiac death. 123 I-Metaiodobenzylguanidine (MIBG) can evaluate cardiac sympathetic dysfunction, and analysis of heart rate variability (HRV) can reflect cardiac parasympathetic activity. We examined whether cardiac parasympathetic dysfunction assessed by HRV may correlate with sympathetic dysfunction assessed by MIBG in diabetic patients. In 24-hour electrocardiography, we analyzed 4 HRV parameters: high-frequency power (HF), HF in the early morning (EMHF), rMSSD and pNN50. MIBG planar images and SPECT were obtained 15 minutes (early) and 150 minutes (late) after injection and the heart washout rate was calculated. The defect score in 9 left ventricular regions was scored on a 4 point scale (0=normal - 3=severe defect). In 20 selected diabetic patients without congestive heart failure, coronary artery disease and renal failure, parasympathetic HRV parameters had a negative correlation with the sum of defect scores (DS) in the late images (R=-0.47 to -0.59, p<0.05) and some parameters had a negative correlation with the washout rate (R=-0.50 to -0.55, p<0.05). In a total of 64 diabetic patients also, these parameters had a negative correlation with late DS (R=-0.28 to -0.35, p<0.05) and early DS (R=-0.27 to -0.32, p<0.05). The progress of diabetic cardiac parasympathetic dysfunction may parallel the sympathetic one. (author)

  2. Cardiac amyloidosis induces up-regulation of Deleted in Malignant Brain Tumors 1 (DMBT1)

    DEFF Research Database (Denmark)

    Müller, Hanna; Renner, Marcus; Bergmann, Frank

    2013-01-01

    Amyloidosis is a life-threatening protein misfolding disease and affects cardiac tissue, leading to heart failure, myocardial ischemia and arrhythmia. Amyloid deposits result in oxidative stress, inflammation and apoptosis. The purpose of this study was to examine the role of innate defense compo...... components, i.e., Deleted in Malignant Brain Tumors 1 (DMBT1) and the complement system, in different types of cardiac amyloidosis....

  3. Cardiac angioscintigraphy in patients with arrhytmias

    International Nuclear Information System (INIS)

    Itti, R.; Bontemps, L.; Philippe, L.; Casset-Senon, D.; Cosnay, P.; Fauchier, J.P.

    1990-01-01

    The time course of ventricular activation can be characterized by the Fourier analysis of a dynamic series of cardiac images. Bi-ventricular activation mapping and quantitative phase histogram analysis may be useful for evaluation of patients with arrhythmias. Three clinical problems can benefit from the method: localization of the site of pre-excitation in the Wolff-Parkinson-White syndrom, assessment of an ectopic activation focus responsible for premature contraction in patients with ventricular tachycardia and diagnosis of an underlying organic disease when arrhytmogenic right ventricular dysplasia is suspected [fr

  4. Cardiac ion channels and mechanisms for protection against atrial fibrillation

    DEFF Research Database (Denmark)

    Grunnet, Morten; Bentzen, Bo Hjorth; Sørensen, Ulrik S

    2011-01-01

    Atrial fibrillation (AF) is recognised as the most common sustained cardiac arrhythmia in clinical practice. Ongoing drug development is aiming at obtaining atrial specific effects in order to prevent pro-arrhythmic, devastating ventricular effects. In principle, this is possible due to a differe...... to the recent discovery that Ca(2+)-activated small conductance K(+) channels (SK channels) are important for the repolarisation of atrial action potentials. Finally, an overview of current pharmacological treatment of AF is included....

  5. 320-detector row CT coronary angiography in patients with arrhythmia

    International Nuclear Information System (INIS)

    Lu Li; Zhang Zhaoqi; Xu Lei; Yang Lin

    2011-01-01

    Objective: To evaluate the feasibility of CT coronary angiography (CTCA) in patients with arrhythmia using 320-detector row CT. Methods: Thirty-one patients with persistent atrial fibrillation and 8 patients with premature ventricular contraction were enrolled in this study. All patients underwent 320- detector row CTCA. CT image quality was evaluated with 4-point grading scale by two radiologists. Inter- observer agreement was evaluated by Kappa statistics. The radiation dose was calculated. Results: In total 510 coronary segments, 496 (97.2%) segments met diagnostic standard. The mean effective dose was (12.7±4.8) mSv in this study. There was a good agreement in image quality scoring between the two reviewers (Kappa = 0.72). Conclusion: 320-detector row CTCA is feasible in patients with atrial fibrillation and premature ventricular contraction. Arrhythmia may not be considered as a contraindication to CTCA. (authors)

  6. Hereditary arrhythmias and cardiomyopathies: decision-making about genetic testing.

    Science.gov (United States)

    Louis, Clauden; Calamaro, Emily; Vinocur, Jeffrey M

    2018-01-01

    The modern field of clinical genetics has advanced beyond the traditional teachings familiar to most practicing cardiologists. Increased understanding of the roles of genetic testing may improve uptake and appropriateness of use. Clinical genetics has become integral to the management of patients with hereditary arrhythmia and cardiomyopathy diagnoses. Depending on the condition, genetic testing may be useful for diagnosis, prognosis, treatment, family screening, and reproductive planning. However, genetic testing is a powerful tool with potential for underuse, overuse, and misuse. In the absence of a substantial body of literature on how these guidelines are applied in clinical practice, we use a case-based approach to highlight key lessons and pitfalls. Importantly, in many scenarios genetic testing has become the standard of care supported by numerous class I recommendations; genetic counselors can improve accessibility to and appropriate use and application of testing. Optimal management of hereditary arrhythmias and cardiomyopathies incorporates genetic testing, applied as per consensus guidelines, with involvement of a multidisciplinary team.

  7. Molecular basis for class Ib anti-arrhythmic inhibition of cardiac sodium channels

    DEFF Research Database (Denmark)

    Pless, Stephan Alexander; Galpin, Jason D; Frankel, Adam

    2011-01-01

    Cardiac sodium channels are established therapeutic targets for the management of inherited and acquired arrhythmias by class I anti-arrhythmic drugs (AADs). These drugs share a common target receptor bearing two highly conserved aromatic side chains, and are subdivided by the Vaughan-Williams...

  8. In Vivo Phosphoproteomics Analysis Reveals the Cardiac Targets of β-Adrenergic Receptor Signaling

    DEFF Research Database (Denmark)

    Lundby, Alicia; Andersen, Martin N; Steffensen, Annette B

    2013-01-01

    β-Blockers are widely used to prevent cardiac arrhythmias and to treat hypertension by inhibiting β-adrenergic receptors (βARs) and thus decreasing contractility and heart rate. βARs initiate phosphorylation-dependent signaling cascades, but only a small number of the target proteins are known. We...

  9. Glucose ingestion causes cardiac repolarization disturbances in type 1 long QT syndrome patients and healthy subjects

    DEFF Research Database (Denmark)

    Hyltén-Cavallius, Louise; Iepsen, Eva W; Christiansen, Michael

    2017-01-01

    BACKGROUND: Both hypoglycemia and severe hyperglycemia constitute known risk factors for cardiac repolarization changes potentially leading to malignant arrhythmias. Patients with loss of function mutations in KCNQ1 are characterized by long QT syndrome (LQTS) and may be at increased risk...

  10. Susac’s Syndrome: A Case with Unusual Cardiac Vestibular and Imaging Manifestations

    Directory of Open Access Journals (Sweden)

    Yaron River

    2015-01-01

    Full Text Available Susac’s syndrome (SS is a disease of the microvasculature of the retina, brain, and inner ear. We describe a patient with unusual manifestations of SS with possible involvement of the brainstem, cardiac arrhythmia, and MRI findings lacking the characteristic lesions found in Susac’s syndrome.

  11. Aconitine-induced Ca2+ overload causes arrhythmia and triggers apoptosis through p38 MAPK signaling pathway in rats

    International Nuclear Information System (INIS)

    Sun, Gui-bo; Sun, Hong; Meng, Xiang-bao; Hu, Jin; Zhang, Qiang; Liu, Bo; Wang, Min; Xu, Hui-bo; Sun, Xiao-bo

    2014-01-01

    Aconitine is a major bioactive diterpenoid alkaloid with high content derived from herbal aconitum plants. Emerging evidence indicates that voltage-dependent Na + channels have pivotal roles in the cardiotoxicity of aconitine. However, no reports are available on the role of Ca 2+ in aconitine poisoning. In this study, we explored the importance of pathological Ca 2+ signaling in aconitine poisoning in vitro and in vivo. We found that Ca 2+ overload lead to accelerated beating rhythm in adult rat ventricular myocytes and caused arrhythmia in conscious freely moving rats. To investigate effects of aconitine on myocardial injury, we performed cytotoxicity assay in neonatal rat ventricular myocytes (NRVMs), as well as measured lactate dehydrogenase level in the culture medium of NRVMs and activities of serum cardiac enzymes in rats. The results showed that aconitine resulted in myocardial injury and reduced NRVMs viability dose-dependently. To confirm the pro-apoptotic effects, we performed flow cytometric detection, cardiac histology, transmission electron microscopy and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay. The results showed that aconitine stimulated apoptosis time-dependently. The expression analysis of Ca 2+ handling proteins demonstrated that aconitine promoted Ca 2+ overload through the expression regulation of Ca 2+ handling proteins. The expression analysis of apoptosis-related proteins revealed that pro-apoptotic protein expression was upregulated, and anti-apoptotic protein BCL-2 expression was downregulated. Furthermore, increased phosphorylation of MAPK family members, especially the P-P38/P38 ratio was found in cardiac tissues. Hence, our results suggest that aconitine significantly aggravates Ca 2+ overload and causes arrhythmia and finally promotes apoptotic development via phosphorylation of P38 mitogen-activated protein kinase. - Highlights: • Aconitine-induced Ca 2+ overload causes arrhythmia in rats

  12. Association of ventricular arrhythmia and in-hospital mortality in stroke patients in Florida: A nonconcurrent prospective study.

    Science.gov (United States)

    Dahlin, Arielle A; Parsons, Chase C; Barengo, Noël C; Ruiz, Juan Gabriel; Ward-Peterson, Melissa; Zevallos, Juan Carlos

    2017-07-01

    Stroke remains one of the leading causes of death in the United States. Current evidence identified electrocardiographic abnormalities and cardiac arrhythmias in 50% of patients with an acute stroke. The purpose of this study was to assess whether the presence of ventricular arrhythmia (VA) in adult patients hospitalized in Florida with acute stroke increased the risk of in-hospital mortality.Secondary data analysis of 215,150 patients with ischemic and hemorrhagic stroke hospitalized in the state of Florida collected by the Florida Agency for Healthcare Administration from 2008 to 2012. The main outcome for this study was in-hospital mortality. The main exposure of this study was defined as the presence of VA. VA included the ICD-9 CM codes: paroxysmal ventricular tachycardia (427.1), ventricular fibrillation (427.41), ventricular flutter (427.42), ventricular fibrillation and flutter (427.4), and other - includes premature ventricular beats, contractions, or systoles (427.69). Differences in demographic and clinical characteristics and hospital outcomes were assessed between patients who developed versus did not develop VA during hospitalization (χ and t tests). Binary logistic regression was used to estimate unadjusted and adjusted odds ratios and 95% confidence intervals (CIs) between VA and in-hospital mortality.VA was associated with an increased risk of in-hospital mortality after adjusting for all covariates (odds ratio [OR]: 1.75; 95% CI: 1.6-1.2). There was an increased in-hospital mortality in women compared to men (OR: 1.1; 95% CI: 1.1-1.14), age greater than 85 years (OR: 3.9, 95% CI: 3.5-4.3), African Americans compared to Whites (OR: 1.1; 95% CI: 1.04-1.2), diagnosis of congestive heart failure (OR: 2.1; 95% CI: 2.0-2.3), and atrial arrhythmias (OR: 2.1, 95% CI: 2.0-2.2). Patients with hemorrhagic stroke had increased odds of in-hospital mortality (OR: 9.0; 95% CI: 8.6-9.4) compared to ischemic stroke.Identifying VAs in stroke patients may help in

  13. Andrographolide inhibits arrhythmias and is cardioprotective in rabbits

    OpenAIRE

    Zeng, Mengliu; Jiang, Wanzhen; Tian, Youjia; Hao, Jie; Cao, Zhenzhen; Liu, Zhipei; Fu, Chen; Zhang, Peihua; Ma, Jihua

    2017-01-01

    Andrographolide has a protective effect on the cardiovascular system. To study its cardic-electrophysiological effects, action potentials and voltage-gated Na+ (INa), Ca2+ (ICaL), and K+ (IK1, IKr, Ito and IKur) currents were recorded using whole-cell patch clamp and current clamp techniques. Additionally, the effects of andrographolide on aconitine-induced arrhythmias were assessed on electrocardiograms in vivo. We found that andrographolide shortened action potential duration and reduced ma...

  14. Intracoronary infusion of catecholamines causes focal arrhythmias in pigs.

    Science.gov (United States)

    Doppalapudi, Harish; Jin, Qi; Dosdall, Derek J; Qin, Hao; Walcott, Gregory P; Killingsworth, Cheryl R; Smith, William M; Ideker, Raymond E; Huang, Jian

    2008-09-01

    Acute ischemia causes myriad changes including increased catecholamines. We tested the hypothesis that elevated catecholamines alone are arrhythmogenic. A 504 electrode sock was placed over both ventricles in six open-chest pigs. During control infusion of saline through a catheter in the left anterior descending coronary artery (LAD), no sustained arrhythmias occurred, and the refractory period estimated by the activation recovery interval (ARI) was 175 +/- 14 ms in the LAD bed below the catheter. After infusion of isoproterenol at 0.1 microg/kg/min through the catheter, the ARI in this bed was significantly reduced to 109 +/- 10 ms. A sharp gradient of refractoriness of 43 +/- 10 ms was at the border of the perfused bed. Sustained monomorphic ventricular tachycardia occurred after drug infusion in the perfused bed or near its boundary in all animals with a cycle length of 329 +/- 26 ms and a focal origin. The maximum slope of the ARI restitution curve at the focal origins of the tachyarrhythmias was always <1 (0.62 +/- 0.15). Similar results with a focal arrhythmia origin occurred in two additional pigs in which intramural mapping was performed with 36 plunge needle electrodes in the left ventricular perfused bed. Regional elevation of a catecholamine, which is one of the alterations produced by acute ischemia, can by itself cause tachyarrhythmias. These arrhythmias are closely associated with a shortened refractory period and a large gradient of the spatial distribution of refractoriness but not with a steep restitution curve.

  15. Cardiac disease and arrhythmogenesis: Mechanistic insights from mouse models

    Directory of Open Access Journals (Sweden)

    Lois Choy

    2016-09-01

    Full Text Available The mouse is the second mammalian species, after the human, in which substantial amount of the genomic information has been analyzed. With advances in transgenic technology, mutagenesis is now much easier to carry out in mice. Consequently, an increasing number of transgenic mouse systems have been generated for the study of cardiac arrhythmias in ion channelopathies and cardiomyopathies. Mouse hearts are also amenable to physical manipulation such as coronary artery ligation and transverse aortic constriction to induce heart failure, radiofrequency ablation of the AV node to model complete AV block and even implantation of a miniature pacemaker to induce cardiac dyssynchrony. Last but not least, pharmacological models, despite being simplistic, have enabled us to understand the physiological mechanisms of arrhythmias and evaluate the anti-arrhythmic properties of experimental agents, such as gap junction modulators, that may be exert therapeutic effects in other cardiac diseases. In this article, we examine these in turn, demonstrating that primary inherited arrhythmic syndromes are now recognized to be more complex than abnormality in a particular ion channel, involving alterations in gene expression and structural remodelling. Conversely, in cardiomyopathies and heart failure, mutations in ion channels and proteins have been identified as underlying causes, and electrophysiological remodelling are recognized pathological features. Transgenic techniques causing mutagenesis in mice are extremely powerful in dissecting the relative contributions of different genes play in producing disease phenotypes. Mouse models can serve as useful systems in which to explore how protein defects contribute to arrhythmias and direct future therapy.

  16. Bacterioplankton diversity and community composition in the Southern Lagoon of Venice.

    Science.gov (United States)

    Simonato, Francesca; Gómez-Pereira, Paola R; Fuchs, Bernhard M; Amann, Rudolf

    2010-04-01

    The Lagoon of Venice is a large water basin that exchanges water with the Northern Adriatic Sea through three large inlets. In this study, the 16S rRNA approach was used to investigate the bacterial diversity and community composition within the southern basin of the Lagoon of Venice and at one inlet in October 2007 and June 2008. Comparative sequence analysis of 645 mostly partial 16S rRNA gene sequences indicated high diversity and dominance of Alphaproteobacteria, Gammaproteobacteria and Bacteroidetes at the lagoon as well as at the inlet station, therefore pointing to significant mixing. Many of these sequences were close to the 16S rRNA of marine, often coastal, bacterioplankton, such as the Roseobacter clade, the family Vibrionaceae, and class Flavobacteria. Sequences of Actinobacteria were indicators of a freshwater input. The composition of the bacterioplankton was quantified by catalyzed reporter deposition fluorescence in situ hybridization (CARD-FISH) with a set of rRNA-targeted oligonucleotide probes. CARD-FISH counts corroborated the dominance of members of the phyla Alphaproteobacteria, Gammaproteobacteria and Bacteroidetes. When assessed by a probe set for the quantification of selected clades within Alphaproteobacteria and Gammaproteobacteria, bacterioplankton composition differed between October 2007 and June 2008, and also between the inlet and the lagoon. In particular, members of the readily culturable copiotrophic gammaproteobacterial genera Vibrio, Alteromonas and Pseudoalteromonas were enriched in the southern basin of the Lagoon of Venice. Interestingly, the alphaproteobacterial SAR11 clade and related clusters were also present in high abundances at the inlet and within the lagoon, which was indicative of inflow of water from the open sea.

  17. Effects of Statin on Arrhythmia and Heart Rate Variability in Healthy Persons With 48-Hour Sleep Deprivation.

    Science.gov (United States)

    Chen, Wei Ren; Liu, Hong Bin; Sha, Yuan; Shi, Yang; Wang, Hao; Yin, Da Wei; Chen, Yun Dai; Shi, Xiang Min

    2016-10-31

    It has been reported that sleep deprivation is associated with cardiac autonomic disorder, inflammation, and oxidative stress. Statins have significant cardiovascular protective effects in patients with cardiovascular disease. This study aimed to investigate the protective effect of statins on arrhythmia and heart rate variability in young healthy persons after 48-hour sleep deprivation. This study enrolled 72 young healthy participants aged 26.5±3.5 years. All participants received 48-hour continuous ambulatory electrocardiogram monitoring. Arrhythmia, time, and frequency domain parameters were analyzed for all participants. The primary end point, low/high frequency ratio, was significantly lower in the statin group than in the control group (2.48±1.12 versus 3.02±1.23, Psleep deprivation, low frequency-the frequency of premature atrial complexes and premature ventricular complexes-was significantly decreased in the statin group compared with the control group (Psleep deprivation in the statin group compared with the control group (Psleep deprivation. This finding should be confirmed by larger scale trials. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02496962. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. A Vision of Venice in the next Fin-de-Siècle

    Science.gov (United States)

    Tagliapietra, Davide

    2014-05-01

    The IPCC's Fifth Assessment Report projections of sea level rise are larger than in the previous one. In the Adriatic a sea level rise higher than 60 cm is considered possible and rise of one meter cannot be excluded. An end-of-century a scenario in which the mobile barrier at the inlets will not be sufficient to protect the City of Venice from permanent floods is realistic and the closure of the lagoon will become inevitable. The possibility of converting the lagoon of Venice in an enclosed non-tidal basin is discussed. The aim is to protect the City preserving as much as possible the features of a healthy brackish ecosystem able to provide many of the ecosystem services it provides at present. This involves technological challenges, a deeper understanding of the ecological functioning of enclosed coastal basins, and last but not least, a shift in the educational and cultural paradigms. There is the need to endorse a coordinated and large-scale research effort to understand what will be the new hydrology and ecohydrology of the lagoon. The relationship between ecosystem metabolism and hydrology should be approached in the conceptual framework of lagoonal saprobity. Ad hoc research programs with experimental studies and observational monitoring should be implemented to improve our understanding of new ecological scenarios. Among the new opportunities arising from an heavy hydrological management there is the possibility to keep the water at an optimum level for the fruition of the City as it was a few centuries ago. It is likely that the sea level rise would change the entire geographical context. Brackish and freshwater wetlands surrounding the lagoon of Venice, reclaimed during the last century, will be probably ingressed by the sea. An attentive adaptive policy of wetland re-creation could supply both the ecological functions and the ecosystem services lost by the lagoon of Venice. The rapid adoption of a long-term strategy is therefore needed. Strategies should

  19. TerraSAR-X InSAR multipass analysis on Venice, Italy)

    Science.gov (United States)

    Nitti, D. O.; Nutricato, R.; Bovenga, F.; Refice, A.; Chiaradia, M. T.; Guerriero, L.

    2009-09-01

    The TerraSAR-X (copyright) mission, launched in 2007, carries a new X-band Synthetic Aperture Radar (SAR) sensor optimally suited for SAR interferometry (InSAR), thus allowing very promising application of InSAR techniques for the risk assessment on areas with hydrogeological instability and especially for multi-temporal analysis, such as Persistent Scatterer Interferometry (PSI) techniques, originally developed at Politecnico di Milano. The SPINUA (Stable Point INterferometry over Unurbanised Areas) technique is a PSI processing methodology which has originally been developed with the aim of detection and monitoring of coherent PS targets in non or scarcely-urbanized areas. The main goal of the present work is to describe successful applications of the SPINUA PSI technique in processing X-band data. Venice has been selected as test site since it is in favorable settings for PSI investigations (urban area containing many potential coherent targets such as buildings) and in view of the availability of a long temporal series of TerraSAR-X stripmap acquisitions (27 scenes in all). The Venice Lagoon is affected by land sinking phenomena, whose origins are both natural and man-induced. The subsidence of Venice has been intensively studied for decades by determining land displacements through traditional monitoring techniques (leveling and GPS) and, recently, by processing stacks of ERS/ENVISAT SAR data. The present work is focused on an independent assessment of application of PSI techniques to TerraSAR-X stripmap data for monitoring the stability of the Venice area. Thanks to its orbital repeat cycle of only 11 days, less than a third of ERS/ENVISAT C-band missions, the maximum displacement rate that can be unambiguously detected along the Line-of-Sight (LOS) with TerraSAR-X SAR data through PSI techniques is expected to be about twice the corresponding value of ESA C-band missions, being directly proportional to the sensor wavelength and inversely proportional to the

  20. Cardiac Channelopathies and Sudden Death: Recent Clinical and Genetic Advances.

    Science.gov (United States)

    Fernández-Falgueras, Anna; Sarquella-Brugada, Georgia; Brugada, Josep; Brugada, Ramon; Campuzano, Oscar

    2017-01-29

    Sudden cardiac death poses a unique challenge to clinicians because it may be the only symptom of an inherited heart condition. Indeed, inherited heart diseases can cause sudden cardiac death in older and younger individuals. Two groups of familial diseases are responsible for sudden cardiac death: cardiomyopathies (mainly hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic cardiomyopathy) and channelopathies (mainly long QT syndrome, Brugada syndrome, short QT syndrome, and catecholaminergic polymorphic ventricular tachycardia). This review focuses on cardiac channelopathies, which are characterized by lethal arrhythmias in the structurally normal heart, incomplete penetrance, and variable expressivity. Arrhythmias in these diseases result from pathogenic variants in genes encoding cardiac ion channels or associated proteins. Due to a lack of gross structural changes in the heart, channelopathies are often considered as potential causes of death in otherwise unexplained forensic autopsies. The asymptomatic nature of channelopathies is cause for concern in family members who may be carrying genetic risk factors, making the identification of these genetic factors of significant clinical importance.

  1. The Spectrum of Epidemiology Underlying Sudden Cardiac Death

    Science.gov (United States)

    Hayashi, Meiso; Shimizu, Wataru; Albert, Christine M.

    2015-01-01

    Sudden cardiac death (SCD) from cardiac arrest is a major international public health problem accounting for an estimated 15–20% of all deaths. Although resuscitation rates are generally improving throughout the world, the majority of individuals who suffer a sudden cardiac arrest will not survive. SCD most often develops in older adults with acquired structural heart disease, but it also rarely occurs in the young, where it is more commonly due to inherited disorders. Coronary heart disease (CHD) is known to be the most common pathology underlying SCD, followed by cardiomyopathies, inherited arrhythmia syndromes, and valvular heart disease. Over the past three decades, declines in SCD rates have not been as steep as for other causes of CHD deaths, and there is a growing fraction of SCDs not due to CHD and/or ventricular arrhythmias, particularly among certain subsets of the population. The growing heterogeneity of the pathologies and mechanisms underlying SCD present major challenges for SCD prevention, which are magnified further by a frequent lack of recognition of the underlying cardiac condition prior to death. Multifaceted preventative approaches, which address risk factors in seemingly low risk and known high-risk populations will be required to decrease the burden of SCD. In this Compendium, we review the wide-ranging spectrum of epidemiology underlying SCD within both the general population and in high-risk subsets with established cardiac disease placing an emphasis on recent global trends, remaining uncertainties, and potential targeted preventive strategies. PMID:26044246

  2. Cardiac arrest

    Science.gov (United States)

    ... magnesium. These minerals help your heart's electrical system work. Abnormally high or low levels can cause cardiac arrest. Severe physical stress. Anything that causes a severe stress on your ...

  3. Cardiac Ochronosis

    Science.gov (United States)

    Erek, Ersin; Casselman, Filip P.A.; Vanermen, Hugo

    2004-01-01

    We report the case of 67-year-old woman who underwent aortic valve replacement and mitral valve repair due to ochronotic valvular disease (alkaptonuria), which was diagnosed incidentally during cardiac surgery. PMID:15745303

  4. Cardiac catheterization

    Science.gov (United States)

    ... tests. However, it is very safe when done by an experienced team. The risks include: Cardiac tamponade Heart attack Injury to a coronary artery Irregular heartbeat Low blood pressure Reaction to the contrast dye Stroke Possible complications ...

  5. Altered thyroid status affects myocardial expression of connexin-43 and susceptibility of rat heart to malignant arrhythmias that can be partially normalized by red palm oil intake

    Czech Academy of Sciences Publication Activity Database

    Szeiffová Bačová, B.; Vinczenzová, C.; Žurmanová, J.; Kašparová, Dita; Knezl, V.; Egan Beňová, T.; Pavelka, Stanislav; Soukup, Tomáš; Tribulová, N.

    2017-01-01

    Roč. 147, č. 1 (2017), s. 63-73 ISSN 0948-6143 R&D Projects: GA MŠk(CZ) LH15279; GA MŠk(CZ) 7AMB14SK123 Grant - others:AV ČR(CZ) SAV-15-03 Program:Bilaterální spolupráce Institutional support: RVO:67985823 Keywords : thyroid hormones * cardiac arrhythmias * connexin-43 * PKC * red palm oil Subject RIV: ED - Physiology OBOR OECD: Physiology (including cytology) Impact factor: 2.553, year: 2016

  6. 78 FR 36787 - Rechanneling the Current Cardiac Risk Paradigm: Arrhythmia Risk Assessment During Drug...

    Science.gov (United States)

    2013-06-19

    ... importance of a uniform assay schema. Date and Time: The public workshop will be held on July 23, 2013, from... . SUPPLEMENTARY INFORMATION: This workshop will introduce for discussion a new nonclinical paradigm for assessing... guidelines, and the importance of a uniform assay schema. A description of the planned activities for the...

  7. Primary cardiac tumor presenting as left ventricular outflow tract obstruction and complex arrhythmia.

    Science.gov (United States)

    Fries, R; Achen, S; O'Brien, M T; Jackson, N D; Gordon, S

    2017-10-01

    An adult female mixed breed dog presented for recurrent collapsing episodes over several weeks. Holter evaluation revealed periods of sinus arrest and echocardiography identified a soft tissue mass with subsequent severe dynamic obstruction of the left ventricular outflow tract. The patient was euthanized five days after presentation for severe dyspnea. Necropsy revealed an irregular mass circumferentially lining the left ventricular outflow tract as well as multiple myocardial metastases. The final diagnosis was an undifferentiated pleomorphic endocardial sarcoma. Published by Elsevier B.V.

  8. [Surgical therapy of life-threatening tachycardic cardiac arrhythmias in children].

    Science.gov (United States)

    Frank, G; Schmid, C; Baumgart, D; Lowes, D; Klein, H; Kallfelz, H C

    1989-05-01

    Surgical techniques for tachyarrhythmias refractory to medical treatment are used with increasing frequency. Among 211 patients undergoing antiarrhythmic surgery 10 children (2 to 14 years old) were operated by electrophysiologically directed procedures. 7 patients suffered from WPW syndrome, 2 from focal atrial tachycardias and 1 from recurrent ventricular tachycardia following the repair of Fallot's tetralogy. In all cases preoperative electrophysiologic study and intraoperative mapping preceded operative ablation. Surgical treatment consisted of interruption of the bundle of Kent (3 right-sided, 2 left-sided, 3 septal), ablation of the atrial focus (1 right-sided, 1 left-sided) and right ventricular outflow tract incision. In 7 operations cryo-techniques were added. 2 children with WPW syndrome had two interventions because of tachycardia recurrences due to multiple accessory pathways. In 1 case a VVI-pacemaker was implanted postoperatively due to complete atrioventricular block. Another 2 children with prolonged postoperative bradycardia received a pacemaker prophylactically. Only the child with previous tetralogy of Fallot is still under antiarrhythmic medication while all other children are free of tachycardiac episodes. Our data confirm the efficacy of surgical treatment of tachyarrhythmias in children thereby abolishing the need for life-long antiarrhythmic medication.

  9. ST Depression, Arrhythmia, Vagal Dominance, and Reduced Cardiac MicroRNA in Particulate-exposed Rats

    Science.gov (United States)

    Recently, investigators demonstrated associations between fine particulate matter (PM)-associated metals and adverse health effects. Residual oil fly ash (ROFA), a waste product of fossil fuel combustion from boilers, is rich in the transition metals Fe, Ni, and V, and when relea...

  10. Nuclear cardiac

    International Nuclear Information System (INIS)

    Slutsky, R.; Ashburn, W.L.

    1982-01-01

    The relationship between nuclear medicine and cardiology has continued to produce a surfeit of interesting, illuminating, and important reports involving the analysis of cardiac function, perfusion, and metabolism. To simplify the presentation, this review is broken down into three major subheadings: analysis of myocardial perfusion; imaging of the recent myocardial infarction; and the evaluation of myocardial function. There appears to be an increasingly important relationship between cardiology, particularly cardiac physiology, and nuclear imaging techniques

  11. Improving Managers' Psychophysical Well-Being: Effectiveness of Respiratory Sinus Arrhythmia Biofeedback.

    Science.gov (United States)

    Munafò, Marianna; Patron, Elisabetta; Palomba, Daniela

    2016-06-01

    High work stress has been consistently associated with disturbed autonomic balance, specifically, lowered vagal cardiac control and increased sympathetic activity, which may lead to increased cardiovascular risk. Stress management procedures have been proposed to reduce autonomic dysfunctions related to work stress in different categories of workers exposed to heightened work demands, while a limited number of studies addressed this issue in managers. The present study was aimed at evaluating the effectiveness of a respiratory sinus arrhythmia (RSA) biofeedback (BF) intervention on psychological and physiological outcomes, in managers with high-level work responsibilities. Thirty-one managers leading outstanding private or public companies were randomly assigned to either a RSA-BF training (RSA-BF; N = 16) or a control group (N = 15). The RSA-BF training consisted of five weekly 45 min sessions, designed to increase RSA, whereas controls had to provide a daily stress diary once a week. After the training, managers in both groups reported reduced heart rate at rest, lower anxiety levels and improvement in health-related quality of life. More importantly, managers in the RSA-BF group showed increased vagal control (as indexed by increased RSA), decreased sympathetic arousal (as indexed by reduced skin conductance and systolic blood pressure) and lower emotional interferences, compared to managers in the control group. Results from this study showed that RSA-BF training was effective in improving cardiac autonomic balance at rest. Moreover, findings from this study underline the effectiveness of biofeedback in reducing psychophysiological negative outcomes associated with stress in managers.

  12. Respiratory sinus arrhythmia reactivity to a sad film predicts depression symptom improvement and symptomatic trajectory.

    Science.gov (United States)

    Panaite, Vanessa; Hindash, Alexandra Cowden; Bylsma, Lauren M; Small, Brent J; Salomon, Kristen; Rottenberg, Jonathan

    2016-01-01

    Respiratory sinus arrhythmia (RSA) reactivity, an index of cardiac vagal tone, has been linked to self-regulation and the severity and course of depression (Rottenberg, 2007). Although initial data supports the proposition that RSA withdrawal during a sad film is a specific predictor of depression course (Fraguas, 2007; Rottenberg, 2005), the robustness and specificity of this finding are unclear. To provide a stronger test, RSA reactivity to three emotion films (happy, sad, fear) and to a more robust stressor, a speech task, were examined in currently depressed individuals (n=37), who were assessed for their degree of symptomatic improvement over 30weeks. Robust RSA reactivity to the sad film uniquely predicted overall symptom improvement over 30weeks. RSA reactivity to both sad and stressful stimuli predicted the speed and maintenance of symptomatic improvement. The current analyses provide the most robust support to date that RSA withdrawal to sad stimuli (but not stressful) has specificity in predicting the overall symptomatic improvement. In contrast, RSA reactivity to negative stimuli (both sad and stressful) predicted the trajectory of depression course. Patients' engagement with sad stimuli may be an important sign to attend to in therapeutic settings. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Disritmias cardíacas e alterações do segmento ST em idosos no perioperatório de ressecção transuretral da próstata sob raquianestesia: estudo comparativo Disritmias cardíacas y alteraciones del segmento ST en ancianos en el perioperatorio de resección transuretral de la próstata sobre raquianestesia: estudio comparativo Cardiac arrhythmias and ST changes in the perioperative period of elderly patients submitted to transurethral prostatectomy under spinal anesthesia: comparative study

    Directory of Open Access Journals (Sweden)

    Beatriz Lemos da Silva Mandim

    2004-04-01

    ón transuretral de la próstata, bien como por la herniorrafia inguinal, en los períodos intra y pos-operatorio.BACKGROUND AND OBJECTIVES: Elderly account for 25% of surgical patients. Several patients with arterial heart disease have normal preoperative ECG and a high incidence of silent myocardial acute infarction in the first postoperative week. Arrhythmias increase with age and supraventricular and ventricular premature complexes, atrial fibrillation and intraventricular conduction abnormalities are observed. This study aimed at evaluating the prevalence of perioperative arrhythmias and ST changes through Holter System in elderly patients submitted to transurethral prostatectomy and inguinal hernia repair under spinal anesthesia. METHODS: Participated in this study 21 patients aged 65 to 84 years submitted to transurethral prostatectomy (TUP and 16 patients aged 63 to 86 years submitted to inguinal hernia repair under spinal anesthesia. Monitoring with Holter System was performed in the preoperative (12 hours, intraoperative (3 hours and postoperative (12 hours periods. RESULTS: The prevalence of supraventricular premature complex was 85.7% vs. 93.7% in the preoperative period, 85.7% vs. 81.2% in the intraoperative and 76.2% vs. 100% in the postoperative period, respectively for groups TUP and control. The prevalence of ventricular premature complex was 76.2% vs. 81.2% in the preoperative period, 80.9% vs. 68.7% in the intraoperative period, and 80.9% vs. 81.2% in the postoperative period, respectively for groups TUP and control. The prevalence of ST changes was 19% vs. 18.7% in the preoperative period, 4.7% vs. 18.7% in the in the intraoperative period, and 14.3% vs. 18.7% in the postoperative period between groups TUP and control, without statistical significance. CONCLUSIONS: Elderly patients have a high prevalence of supraventricular and ventricular cardiac arrhythmias. The total number of preoperative arrhythmias and ST changes was not changed as a function of

  14. Paolo Sarpi’s vow of obedience: catholic political thought in early seventeenth-century Venice

    Directory of Open Access Journals (Sweden)

    Kainulainen, Jaska

    2016-06-01

    Full Text Available The aim of this paper is to study the idea of obedience in early-modern Catholic political thought. I focus on early seventeenth-century Venice and on one of its leading political thinkers, Paolo Sarpi. I argue that for Sarpi and the Venetian nobility obedience was a religious, Catholic concept, which they nonetheless applied to a secular system of governance; notwithstanding their refusal to obey the papal ban during the interdict of Venice in 1606-1607, Venetians regarded obedience as an act of piety and an indispensable element of civic life.El objetivo de este artículo es estudiar la idea de obediencia en el pensamiento político católico de la edad moderna, en particular en Venecia en el siglo XVII y en Paolo Sarpi, uno de sus pensadores políticos más importantes. Este artículo argumenta que para Sarpi y la nobleza la obediencia era un concepto católico, que a pesar de ello, aplicaron a un sistema de gobierno secular. A pesar de su negativa a obedecer la prohibición papal durante el interdicto de Venecia en 1606-1607, los venecianos consideraban la obediencia como un acto de piedad y un elemento indispensable de la vida cívica.

  15. An integrated approach to prevent the erosion of salt marshes in the lagoon of Venice

    Directory of Open Access Journals (Sweden)

    Alberto Barausse

    2015-12-01

    Full Text Available The loss of coastal habitats is a widespread problem in Europe. To protect the intertidal salt marshes of the lagoon of Venice from the erosion due to natural and human causes which is diffusely and intensely impacting them, the European Commission has funded the demonstrative project LIFE VIMINE. LIFE VIMINE aims to protect the most interior, hard-to-access salt marshes in the northern lagoon of Venice through an integrated approach, whose core is the prevention of erosion through numerous, small but spatially-diffuse soil-bioengineering protections works, mainly placed through semi-manual labour and with low impact on the environment and the landscape. The effectiveness of protection works in the long term is ensured through routine, temporally-continuous and spatially-diffuse actions of monitoring and maintenance. This method contrasts the common approach to managing hydraulic risk and erosion in Italy which is based on large, one-off and irreversible protection actions. The sustainability of the LIFE VIMINE approach is ensured by the participatory involvement of stakeholders and the recognition that protecting salt marshes means defending the benefits they provide to society through their ecological functions, as well as protecting the jobs linked to the existence or conservation of this habitat.

  16. Haiti’s first national pavilion at the Venice Biennale: anachronism or illuminating opportunity?

    Directory of Open Access Journals (Sweden)

    Wendy Asquith

    2014-02-01

    Full Text Available A barrage of criticism has been levelled against the Venice Biennale’s national pavilion structure in recent decades, chiefly accusing it of anachronism on account of its western biases. Yet the tide has begun to turn, making much of this criticism sound a little worn-out. As this event increasingly attracts debuting ‘non-western’ national exhibitors each year, its pavilion structure event is beginning to be reassessed. Haiti was one such debutant at the 54th edition of La Biennale di Venezia held in 2011. This article will explore in detail the debates raised by Haiti’s national pavilion, particularly as they related to the central exhibition theme of ILLUMInations selected by the International Art Exhibition Director for 2011, Bice Curiger. In doing so this piece will consider both: how the national pavilion structure at the Venice Biennale was challenged, and our wider understanding of it deepened, by Haiti’s participation; and what Venice’s national pavilion structure might be able to offer a post-colonial, ‘third-world’ nation like Haiti.

  17. Shylock’s Speech in The Merchant of Venice: Critical Discourse Analysis

    Directory of Open Access Journals (Sweden)

    Hamada Dawood

    2014-12-01

    Full Text Available This paper aims to examine, reveal and analyse Shylock's speech in Shakespeare's The Merchant of Venice, by connecting his words to the power, identity, and ideology in the play. The purposes of this study are to examine the effects of linguistic manipulation on power, to link language with the structure of a society, and to find the impact of a combination of different ideologies on each other. Hence, this descriptive qualitative study explores the literature to answer the aforementioned questions. What is found in this paper is that Shylock, the Jew, lacks power, Jewish ideology and Jewish identity, but when he tries to find these aspects, he fails to gain any of them. The reasons behind Shylock's failure in obtaining "the self" can be attributed to his brutal character. His insistence on the literal implementation of the bond leads to his destruction. He neglects the fact that those charged with power are able to edit the language of "his bond" the way they like. To conclude, language is one of the most influencing factors aiding in imposing power, destroying "unwanted" identities, and appropriating others' ideology by the "upper hands" in any society. Keywords: The Merchant of Venice Shylock's Speech, Critical Discourse Analysis.

  18. Organic micropollutants in wet and dry depositions in the Venice Lagoon.

    Science.gov (United States)

    Gambaro, Andrea; Radaelli, Marta; Piazza, Rossano; Stortini, Angela Maria; Contini, Daniele; Belosi, Franco; Zangrando, Roberta; Cescon, Paolo

    2009-08-01

    Atmospheric transport is an important route by which pollutants are conveyed from the continents to both coastal and open sea. The role of aerosol deposition in the transport of polycyclic aromatic hydrocarbons (PAHs), polychlorobiphenyls (PCBs) and polybromodiphenyls ethers (PBDEs) to water and soil systems has been evaluated by measuring their concentrations in wet and dry depositions to the Venice Lagoon. The organic micropollutant flux data indicate that they contribute to the total deposition flux in different ways through wet and dry deposition, showing that the prevalent contribution derives from wet deposition. The fluxes calculated for PBDEs, showed the prevalence of 47, 99, 100 and 183 congeners, both in dry and wet fluxes. With regard to PCBs, the flux of summation operatorPCB for wet deposition is in the same order of magnitude of the diffusive flux at the air-water interface. The PAH fluxes obtained in the present study are similar to those obtained in previous studies on the atmospheric bulk deposition to the Venice Lagoon. The ratios between Phe/Ant and Fl/Py indicate that the pollutants sources are pyrolytic, deriving from combustion fuels.

  19. Sedimentation rate and lateral migration of tidal channels in the Lagoon of Venice (Northern Italy)

    Science.gov (United States)

    Donnici, Sandra; Madricardo, Fantina; Serandrei-Barbero, Rossana

    2017-11-01

    Tidal channels are crucial for the functioning of highly valuable coastal environments, such as estuaries and lagoons. Their properties, however, are currently less understood than those of river systems. To elucidate their past behaviour, an extensive geophysical investigation was performed to reconstruct the evolution of channels and tidal surfaces in the central part of the Lagoon of Venice (Italy) over the past 5000 years. Comparing high-spatial-resolution acoustic data and sedimentary facies analyses of 41 cores, 29 of which were radiocarbon dated, revealed the sedimentation rates in different lagoonal environments and allowed the migration of two large meanders to be reconstructed. The average sedimentation rate of the study succession in the different sedimentary environments was 1.27 mm yr-1. The lateral migration rates were 13-23 m/century. This estimate is consistent with the lateral migration rates determined by comparing aerial photographs of recent channels. Comparing the buried channels with historical and current maps showed that, in general, the number of active channels is now reduced. Their morphology was sometimes simplified by artificial interventions. An understanding of the impact of the artificial interventions over time is useful for the management and conservation of tidal environments, particularly for the Lagoon of Venice, where management authorities are currently debating the possible deepening and rectification of large navigation channels.

  20. An Approach to Remove the Systematic Bias from the Storm Surge forecasts in the Venice Lagoon

    Science.gov (United States)

    Canestrelli, A.

    2017-12-01

    In this work a novel approach is proposed for removing the systematic bias from the storm surge forecast computed by a two-dimensional shallow-water model. The model covers both the Adriatic and Mediterranean seas and provides the forecast at the entrance of the Venice Lagoon. The wind drag coefficient at the water-air interface is treated as a calibration parameter, with a different value for each range of wind velocities and wind directions. This sums up to a total of 16-64 parameters to be calibrated, depending on the chosen resolution. The best set of parameters is determined by means of an optimization procedure, which minimizes the RMS error between measured and modeled water level in Venice for the period 2011-2015. It is shown that a bias is present, for which the peaks of wind velocities provided by the weather forecast are largely underestimated, and that the calibration procedure removes this bias. When the calibrated model is used to reproduce events not included in the calibration dataset, the forecast error is strongly reduced, thus confirming the quality of our procedure. The proposed approach it is not site-specific and could be applied to different situations, such as storm surges caused by intense hurricanes.

  1. Thorium isotopes as indicators of scavenging rates in the Venice lagoon

    International Nuclear Information System (INIS)

    Cochran, J. K.; Hirschberg, D.J.; Barnes, C.

    1995-01-01

    The naturally occurring thorium isotopes 228 Th and 234 Th, produced in sea water from decay of 228 Ra and 238 U, respectively, were used to estimate the rate of scavenging onto particle surfaces and the rate of removal of particles from the water column of the Venice Lagoon. Large water samples (1000-2000 L) were collected at three sites in the shallow ( 2 -impregnated cartridges to extract dissolved thorium. Activities of particulate 234 Th ranged from 510 to 1335 μBq L -1 and dissolved 234 Th was -1 . Relative to calculated 238 U activities in the lagoon, the 234 Th data yielded mean residence times as short as 2 h for the scavenging of dissolved 234 Th onto particles and 12 h for the removal of particulate 234 Th. Resuspension rates of 0.6 to 8 mg cm -2 day -1 were estimated from the data on dissolved and particulate 234 Th, these values being comparable to those determined by sediment traps (1.8-9.5 mg cm -2 day -1 ) at the same sites. These results suggest that Th and other similarly reactive trace metals are removed rapidly from the waters of the Venice Lagoon to the sediments. 23 refs., 4 tabs., 2 figs

  2. Dermatologic care in the homeless and underserved populations: observations from the Venice Family Clinic.

    Science.gov (United States)

    Grossberg, Anna L; Carranza, Dafnis; Lamp, Karen; Chiu, Melvin W; Lee, Catherine; Craft, Noah

    2012-01-01

    Dermatologic care in the homeless and impoverished urban underserved populations is rarely described despite the wide prevalence of skin concerns in this population. Because the homeless population may be subject to increased sun exposure compared to the nonhomeless population, they also may be at increased risk for skin cancer. We sought to describe the spectrum of dermatologic diseases seen in a free clinic in Venice, California--the Venice Family Clinic (VFC)--as well as the differences in diagnoses between the homeless and nonhomeless patients seen at this clinic. A retrospective chart review was performed of dermatology patients (N = 82) seen at VFC throughout the 2006 calendar year. The homeless population (n = 22) was found to have more diagnoses of malignant/premalignant growths (25% [16/64] of all homeless diagnoses) compared to their nonhomeless (n = 60) counterparts (6.1% [8/132] of all nonhomeless diagnoses; P < .0001). This difference was sustained when ethnicity was controlled, with 29.6% [16/54] of diagnoses in the homeless white group consisting of malignant/ premalignant growths compared to 8.9% [4/45] of diagnoses in the nonhomeless white cohort (P < .005). Homeless patients may have a higher incidence of skin cancers and precancerous skin lesions due to increased sun exposure and/or limited access to dermatologic care.

  3. Ecotoxicological evaluation of industrial port of Venice (Italy) sediment samples after a decontamination treatment

    International Nuclear Information System (INIS)

    Libralato, Giovanni; Losso, Chiara; Arizzi Novelli, Alessandra; Citron, Marta; Della Sala, Stefano; Zanotto, Emanuele; Cepak, Franka; Volpi Ghirardini, Annamaria

    2008-01-01

    This work assesses the ecotoxicological effects of polluted sediment after a decontamination treatment process using a new sediment washing technique. Sediment samples were collected from four sites in Marghera Port industrial channels (Venice, Italy). Ecotoxicological evaluations were performed with Vibrio fischeri and Crassostrea gigas bioassays. Whole sediment and elutriate were deemed as the most suitable environmental matrices for this study. Toxicity scores developed in the Lagoon of Venice for V. fischeri on whole sediment and for C. gigas on elutriate were considered for the final ranking of samples. Ecotoxicological results showed that the treated sediment samples presented both acute and sub-chronic toxicities, which were mainly attributed to the presence of some remaining chemicals such as metals and polyaromatic hydrocarbons. The acute toxicity ranged from low to medium, while the sub-chronic one from absent to very high, suggesting that treated sediments could not be reused in direct contact with seawater. - A sediment washing technique was assessed for port contaminated sediment remediation and reuse, indicating its reduced efficiency and the need for further improvements

  4. Contaminant fate and transport in the Venice Lagoon: results from a multi-segment multimedia model.

    Science.gov (United States)

    Sommerfreund, J K; Gandhi, N; Diamond, M L; Mugnai, C; Frignani, M; Capodaglio, G; Gerino, M; Bellucci, L G; Giuliani, S

    2010-03-01

    Contaminant loadings to the Venice Lagoon peaked from 1950s-1980s and although they have since declined, contaminant concentrations remain elevated in sediment and seafood. In order to identify the relative importance of contaminant sources, inter-media exchange and removal pathways, a modified 10-segment fugacity/aquivalence-based model was developed for octachlorodibenzodioxin/furan (OCDD/F), PCB-180, Pb and Cu in the Venice Lagoon. Results showed that in-place pollution nearby the industrial area, current industrial discharges, and tributary loadings were the main sources of contaminants to the lagoon, with negligible contributions from the atmosphere. The fate of these contaminants was governed by sediment-water exchange with simultaneous advective transport by water circulation. Contaminants circulated amongst the northern and central basins with a small fraction reaching the far southern basin and the Chioggia inlet. As a consequence, we estimated limited contaminant transfer to the Adriatic Sea, trapping the majority of contaminants in the sediment in this "average" circulation scenario which does not account for periodic flooding events. (c) 2009 Elsevier Inc. All rights reserved.

  5. Salinity and its variability in the Lagoon of Venice, 2000–2009

    Directory of Open Access Journals (Sweden)

    Alberto Zirino

    2014-04-01

    Full Text Available Yearly averages computed from monthly and bimonthly salinity data collected between 2000 and 2009 from 13 broadly spaced stations in the Venice Lagoon were analysed in view of 30 min data collected semi-continuously during 2009 at nine similarly located stations. Data from all stations and all years indicate that, based on yearly averages, the lagoon may be divided along its major (long axis into three areas: 1 a northern, freshwater impacted area (S = 32 PSU of low, tidally-caused, variability, and 3 an intermediate zone. Salinity changes are closely associated with rainfall events, and the incoming freshwater is consistently distributed throughout the lagoon by tidal action. Much variability is simply a result of the forward and backward motion of the tides and is not caused by a salinity change in the water itself. The consistency of the 2000–2009 data and the historical (to 1961 watershed record support the hypothesis that the Venice Lagoon has been and is currently at steady-state with respect to its salinity distribution. As such, it is conducive to the development of (at least three separate ecosystems.

  6. Ecotoxicological evaluation of industrial port of Venice (Italy) sediment samples after a decontamination treatment

    Energy Technology Data Exchange (ETDEWEB)

    Libralato, Giovanni [Environmental Sciences Department, Venice University Ca Foscari, Campo della Celestia 2737/b, I-30122 Venice (Italy)], E-mail: giovanni.libralato@unive.it; Losso, Chiara; Arizzi Novelli, Alessandra [Environmental Sciences Department, Venice University Ca Foscari, Campo della Celestia 2737/b, I-30122 Venice (Italy); Citron, Marta; Della Sala, Stefano; Zanotto, Emanuele [Environmental Department, Venice Port Authority, Zattere 1401, I-30123, Venice (Italy); Cepak, Franka [Institute of Public Health, Vojkovo nabrezje 4a, 6000 Koper (Slovenia); Volpi Ghirardini, Annamaria [Environmental Sciences Department, Venice University Ca Foscari, Campo della Celestia 2737/b, I-30122 Venice (Italy)

    2008-12-15

    This work assesses the ecotoxicological effects of polluted sediment after a decontamination treatment process using a new sediment washing technique. Sediment samples were collected from four sites in Marghera Port industrial channels (Venice, Italy). Ecotoxicological evaluations were performed with Vibrio fischeri and Crassostrea gigas bioassays. Whole sediment and elutriate were deemed as the most suitable environmental matrices for this study. Toxicity scores developed in the Lagoon of Venice for V. fischeri on whole sediment and for C. gigas on elutriate were considered for the final ranking of samples. Ecotoxicological results showed that the treated sediment samples presented both acute and sub-chronic toxicities, which were mainly attributed to the presence of some remaining chemicals such as metals and polyaromatic hydrocarbons. The acute toxicity ranged from low to medium, while the sub-chronic one from absent to very high, suggesting that treated sediments could not be reused in direct contact with seawater. - A sediment washing technique was assessed for port contaminated sediment remediation and reuse, indicating its reduced efficiency and the need for further improvements.

  7. Atmospheric Deposition of Inorganic Elements and Organic Compounds at the Inlets of the Venice Lagoon

    Directory of Open Access Journals (Sweden)

    E. Morabito

    2014-01-01

    Full Text Available The Venice Lagoon is subjected to long-range transport of contaminants via aerosol from the near Po Valley. Moreover, it is an area with significant local anthropogenic emissions due to the industrial area of Porto Marghera, the urban centres, and the glass factories and with emissions by ships traffic within the Lagoon. Furthermore, since 2005, the Lagoon has also been affected by the construction of the MOSE (Modulo Sperimentale Elettromeccanico—Electromechanical Experimental Module mobile dams, as a barrier against the high tide. This work presents and discusses the results from chemical analyses of bulk depositions, carried out in different sites of the Venice Lagoon. Fluxes of pollutants were also statistically analysed on PCA with the aim of investigating the spatial variability of depositions and their correlation with precipitations. Fluxes of inorganic pollutants depend differently on precipitations, while organic compounds show a more seasonal trend. The statistical analysis showed that the site in the northern Lagoon has lower and almost homogeneous fluxes of pollutants, while the other sites registered more variable concentrations. The study also provided important information about the annual trend of pollutants and their evolution over a period of about five years, from 2005 to 2010.

  8. Dress as Civic Celebration in Late Sixteenth-Century Venice: The Woodcuts of Cesare Vecellio’s Habiti antichi et moderni and the Paintings of Paolo Veronese

    OpenAIRE

    Jones, Ann; Rosenthal, Margaret

    2014-01-01

    In this essay, we discuss words and images in sixteenth-century Venice in two forms: the prose commentary and woodcuts in Cesare Vecellio's Degli habiti antichi et moderni di diverse parti del mondo (Venice, 1590), and the paintings of Paulo Veronese from 1550 to 1578. Our theoretical framework is the analysis of ideology as it is materialized in the making, wearing and representation of clothing. We study three kinds of dress in Venice: the red silks worn by wealthy merchants, the black wool...

  9. "I Could Teach You How to Choose Right": Using Holocaust Memoir to Teach Shakespeare's "The Merchant of Venice"

    Science.gov (United States)

    Whaley, Annemarie Koning

    2011-01-01

    The article examines the problems of teaching William Shakespeare's "The Merchant of Venice" after the Holocaust, arguing that even though the play is anti-Semitic, it can become a valuable teaching tool when placed in the context of the Holocaust memoirs "Dry Tears" by Nechama Tec and "The Nazi Officer's Wife" by…

  10. Introduction of human papillomavirus (HPV) vaccination into national immunisation schedules in Europe: Results of the VENICE 2007 survey.

    Science.gov (United States)

    King, L A; Lévy-Bruhl, D; O'Flanagan, D; Bacci, S; Lopalco, P L; Kudjawu, Y; Salmaso, S

    2008-08-14

    The European Union Member States are simultaneously considering introducing HPV vaccination into their national immunisation schedules. The Vaccine European New Integrated Collaboration Effort (VENICE) project aims to develop a collaborative European vaccination network. A survey was undertaken to describe the decision status and the decision-making process regarding the potential introduction of human papillomavirus (HPV) vaccination in to their national immunisation schedules. A web-based questionnaire was developed and completed online in 2007 by 28 countries participating in VENICE. As of 31 October 2007,five countries had decided to introduce HPV vaccination into the national immunisation schedule, while another seven had started the decision-making process with a recommendation favouring introduction. Varying target populations were selected by the five countries which had introduced the vaccination. Half of the surveyed countries had undertaken at least one ad hoc study to support the decision-making process. According to an update of the decision-status from January 2008, the number of countries which had made a decision or recommendation changed to 10 and 5 respectively. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe and the existence of expertise and experience among EU Member States. The VENICE network is capable of following this process and supporting countries in making vaccine introduction decisions. A VENICE collaborative web-space is being developed as a European resource for the decision-making process for vaccine introduction.

  11. Pre-School Education--Aims, Methods and Problems. Report of a Symposium (Venice, Italy, October 11-16, 1971).

    Science.gov (United States)

    Council of Europe, Strasbourg (France). Committee for General and Technical Education.

    This report provides a summary of the proceedings and recommendations of the Council of Europe symposium on preschool education held in Venice, Italy in 1971. The report is divided into three major areas: (1) historical background information; (2) summaries of general lectures, especially dealing with the functions, aims, methods, and problems of…

  12. Pupil Exchange in the European Community Venice Colloquium (October 24-28, 1977). Collection Studies. Education Series No. 5.

    Science.gov (United States)

    Commission des Communautes Europeennes (Luxembourg).

    This publication contains the papers of the Venice Colloquium held in October, 1977 by educators from European countries to discuss the topic of visits and exchanges for pupils. There are seven chapters. Chapter one discusses the context and objectives of the colloquium. Chapter two describes pupil visits and exchanges in the European community.…

  13. Left ventricular function in patients with ventricular arrhythmias and aortic valve disease

    International Nuclear Information System (INIS)

    Santinga, J.T.; Kirsh, M.M.; Brady, T.J.; Thrall, J.; Pitt, B.

    1983-01-01

    Forty patients having aortic valve replacement were evaluated preoperatively for ventricular arrhythmia and left ventricular ejection fraction. Arrhythmias were classified as complex or simple using the Lown criteria on the 24-hour ambulatory electrocardiogram; ejection fractions were determined by radionuclide gated blood pool analysis and contrast angiography. The ejection fractions determined by radionuclide angiography were 59.1 +/- 13.1% for 26 patients with simple or no ventricular arrhythmias, and 43.9 +/- 20.3% for 14 patients with complex ventricular arrhythmias (p less than 0.01). Ejection fractions determined by angiography, available for 31 patients, were also lower in patients with complex ventricular arrhythmias (61.1 +/- 16.3% versus 51.4 +/- 13.4%; p less than 0.05). Seven of 9 patients showing conduction abnormalities on the electrocardiogram had complex ventricular arrhythmias. Eight of 20 patients with aortic stenosis had complex ventricular arrhythmias, while 2 of 13 patients with aortic insufficiency had such arrhythmias. It is concluded that decreased left ventricular ejection fraction, intraventricular conduction abnormalities, and aortic stenosis are associated with an increased frequency of complex ventricular arrhythmias in patients with aortic valve disease

  14. Ketamine infusion for refractory status epilepticus: A case report of cardiac arrest.

    Science.gov (United States)

    Koffman, Lauren; Yan Yiu, Ho; Farrokh, Salia; Lewin, John; Geocadin, Romergryko; Ziai, Wendy

    2018-01-01

    Refractory status epilepticus (RSE) has a high mortality rate and is often difficult to treat. When traditional therapies fail ketamine may be considered. There are limited reports of adverse cardiac events with the use of ketamine for RSE and no reports of cardiac arrest in this context. Evaluate the occurrence of cardiac arrhythmias associated with the use of ketamine for RSE. Retrospective chart review of nine patients who underwent ketamine infusion for RSE. Etiology of refractory status epilepticus included autoimmune/infectious process (Zeiler et al., 2014), ischemic stroke (Bleck, 2005) and subarachnoid hemorrhage (Bleck, 2005). Of the nine patients who received ketamine, two had documented cardiac events; one remained clinically stable and the other developed multiple arrhythmias, including recurrent episodes of asystole. Once ketamine was discontinued the latter patient stabilized with the addition of anti arrhythmic therapy. Ketamine is utilized to treat refractory status epilepticus, but should be used with caution in patients with subarachnoid hemorrhage, as there may be an increased risk of life threatening arrhythmias and cardiac arrest. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. [Ventricular tachycardia in a patient with rate-responsive cardiac pacemaker].

    Science.gov (United States)

    Himbert, C; Lascault, G; Tonet, J; Coutte, R; Busquet, P; Frank, R; Grosgogeat, Y

    1992-11-01

    The authors report a case of syncopal ventricular tachycardia in a patient with a respiratory-dependent rate responsive pacemaker, followed-up for valvular heart disease with severe left ventricular dysfunction and sustained atrial and ventricular arrhythmias. The introduction of low dose betablocker therapy with reinforcement of the treatment of cardiac failure controlled the ventricular arrhythmia, after suppression of the data responsive function had been shown to be ineffective. The authors discuss the role of the rate responsive function in the triggering of the ventricular tachycardias.

  16. Cardiac CT

    International Nuclear Information System (INIS)

    Dewey, Marc

    2011-01-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  17. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  18. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  19. Intracardiac echo-facilitated 3D electroanatomical mapping of ventricular arrhythmias from the papillary muscles: assessing the 'fourth dimension' during ablation.

    Science.gov (United States)

    Proietti, Riccardo; Rivera, Santiago; Dussault, Charles; Essebag, Vidal; Bernier, Martin L; Ayala-Paredes, Felix; Badra-Verdu, Mariano; Roux, Jean-François

    2017-01-01

    Ventricular arrhythmias (VA) originating from a papillary muscle (PM) have recently been described as a distinct clinical entity with peculiar features that make its treatment with catheter ablation challenging. Here, we report our experience using an intracardiac echo-facilitated 3D electroanatomical mapping approach in a case series of patients undergoing ablation for PM VA. Sixteen patients who underwent catheter ablation for ventricular tachycardia (VT) or symptomatic premature ventricular contractions originating from left ventricular PMs were included in the study. A total of 24 procedures (mean 1.5 per patient) were performed: 15 using a retrograde aortic approach and 9 using a transseptal approach. Integrated intracardiac ultrasound for 3D electroanatomical mapping was used in 15 of the 24 procedures. The posteromedial PM was the most frequent culprit for the clinical arrhythmia, and the body was the part of the PM most likely to be the successful site for ablation. The site of ablation was identified based on the best pace map matching the clinical arrhythmia and the site of earliest the activation. At a mean follow-up of 10.5 ± 7 months, only two patients had recurrent arrhythmias following a repeat ablation procedure. An echo-facilitated 3D electroanatomical mapping allows for real-time creation of precise geometries of cardiac chambers and endocavitary structures. This is useful during procedures such as catheter ablation of VAs originating from PMs, which require detailed representation of anatomical landmarks. Routine adoption of this technique should be considered to improve outcomes of PM VA ablation. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  20. Bile acids induce arrhythmias in human atrial myocardium--implications for altered serum bile acid composition in patients with atrial fibrillation.

    Science.gov (United States)

    Rainer, Peter P; Primessnig, Uwe; Harenkamp, Sandra; Doleschal, Bernhard; Wallner, Markus; Fauler, Guenter; Stojakovic, Tatjana; Wachter, Rolf; Yates, Ameli; Groschner, Klaus; Trauner, Michael; Pieske, Burkert M; von Lewinski, Dirk

    2013-11-01

    High bile acid serum concentrations have been implicated in cardiac disease, particularly in arrhythmias. Most data originate from in vitro studies and animal models. We tested the hypotheses that (1) high bile acid concentrations are arrhythmogenic in adult human myocardium, (2) serum bile acid concentrations and composition are altered in patients with atrial fibrillation (AF) and (3) the therapeutically used ursodeoxycholic acid has different effects than other potentially toxic bile acids. Multicellular human atrial preparations ('trabeculae') were exposed to primary bile acids and the incidence of arrhythmic events was assessed. Bile acid concentrations were measured in serum samples from 250 patients and their association with AF and ECG parameters analysed. Additionally, we conducted electrophysiological studies in murine myocytes. Taurocholic acid (TCA) concentration-dependently induced arrhythmias in atrial trabeculae (14/28 at 300 µM TCA, pursodeoxycholic acid did not. Patients with AF had significantly decreased serum levels of ursodeoxycholic acid conjugates and increased levels of non-ursodeoxycholic bile acids. In isolated myocytes, TCA depolarised the resting membrane potential, enhanced Na(+)/Ca(2+) exchanger (NCX) tail current density and induced afterdepolarisations. Inhibition of NCX prevented arrhythmias in atrial trabeculae. High TCA concentrations induce arrhythmias in adult human atria while ursodeoxycholic acid does not. AF is associated with higher serum levels of non-ursodeoxycholic bile acid conjugates and low levels of ursodeoxycholic acid conjugates. These data suggest that higher levels of toxic (arrhythmogenic) and low levels of protective bile acids create a milieu with a decreased arrhythmic threshold and thus may facilitate arrhythmic events.

  1. Arrhythmias and conduction abnormalities in children after repair of tetralogy of Fallot

    Directory of Open Access Journals (Sweden)

    Kuzevska-Maneva Konstandina

    2005-01-01

    Full Text Available Aim. To find out types and frequency of cardiac arrhythmias and conduction abnormalities in the group of children who underwent surgery for tetralogy of Fallot (TOF. Methods. Fortysix pedicatric patients who underwent a complete repair of TOF at the age of 1 to 13 (mean 2.89 ± 2.36 were studied. Thirty-eight (82.60% had total correction and 8 (17.40% had palliative operation first, and total correction afterwards. Twenty-four-hour Holter ECG monitoring was performed in all 46 pediatric patients aged from 1 to 16 yrs (mean 6.48 ± 4.04 after surgery as follows: in 1 patient (2.17% after a year, in 20 patients (43.47% after 2 to 5 years and in 25 patients (54.34% after 5 years. Mean age of patients on Holter monitoring was 9.25 ± 4.39 (range 4−19. Twenty of them (43.47% were girls and 28 (56.53% were boys. All the patients were evaluated by standard methods (clinical signs, clinical findings, ECG before surgery, ECG before Holter monitoring and 2D Doppler echocardiography. Results. Types of heart rhythm found out by Holter monitoring were: sinus nodus dysfunction in 1 child (2.17%, significant premature atrial contraction (PAC in 8 (17.39%, supraventricular paroxysmal tachycardia in 3 (6.53%, transient nodal rhythm in 2 (4.34%, premature ventricular contraction (PVC Lown grade I-III in 9 (19.56% and Lown grade IV in 2 (4.34, atrioventricular (AV block grade I in 2, right bundle branch block (RBBB in all 46 (100% and RBBB + left anterior hemiblock (LAH in 4 (8.96%. There was no presence of atrial flutter, ventricular tachycardia or complete AV block. None of them experienced sudden death. Using cross procedure statistical methods, it was found that all the patients with PVC had right ventricular dilatation. There was no relation of other types of arrhythmia found on Holter monitoring to the other parameters from echocardiography, neither to the other standard methods. Children did not need the pace-maker, but 36.95% of the them required

  2. Sudden cardiac arrest as a rare presentation of myxedema coma: case report.

    Science.gov (United States)

    Salhan, Divya; Sapkota, Deepak; Verma, Prakash; Kandel, Saroj; Abdulfattah, Omar; Lixon, Antony; Zwenge, Deribe; Schmidt, Frances

    2017-01-01

    Myxedema coma is a decompensated hypothyroidism which occurs due to long-standing, undiagnosed, or untreated hypothyroidism. Untreated hypothyroidism is known to affect almost all organs including the heart. It is associated with a decrease in cardiac output, stroke volume due to decreased myocardial contractility, and an increase in systemic vascular resistance. It can cause cardiac arrhythmias and the most commonly seen conduction abnormalities are sinus bradycardia, heart block, ventricular tachycardia, and torsade de pointes. The authors report a case of an elderly man who presented with sudden cardiac arrest and myxedema coma and who was successfully revived.

  3. Life-threatening Arrhythmias in a Becker Muscular Dystrophy Family due to the Duplication of Exons 3-4 of the Dystrophin Gene.

    Science.gov (United States)

    Ishizaki, Masatoshi; Fujimoto, Akiko; Ueyama, Hidetsugu; Nishida, Yasuto; Imamura, Shigehiro; Uchino, Makoto; Ando, Yukio

    2015-01-01

    We herein present a report of three patients with Becker muscular dystrophy in the same family who developed complete atrioventricular block or ventricular tachycardia with severe cardiomyopathy. Our cases became unable to walk in their teens, and were introduced to mechanical ventilation due to respiratory muscle weakness in their twenties and thirties. In all three cases, a medical device such as a permanent cardiac pacemaker or an implantable cardiac defibrillator was considered to be necessary. The duplication of exons 3-4 in the dystrophin gene was detected in two of the patients. In patients with Becker muscular dystrophy, complete atrioventricular block or ventricular tachycardia within a family has rarely been reported. Thus attention should be paid to the possibility of severe arrhythmias in the severe phenotype of Becker muscular dystrophy.

  4. C.A.U.S.E.: Cardiac arrest ultra-sound exam--a better approach to managing patients in primary non-arrhythmogenic cardiac arrest.

    Science.gov (United States)

    Hernandez, Caleb; Shuler, Klaus; Hannan, Hashibul; Sonyika, Chionesu; Likourezos, Antonios; Marshall, John

    2008-02-01

    Cardiac arrest is a condition frequently encountered by physicians in the hospital setting including the Emergency Department, Intensive Care Unit and medical/surgical wards. This paper reviews the current literature involving the use of ultrasound in resuscitation and proposes an algorithmic approach for the use of ultrasound during cardiac arrest. At present there is the need for a means of differentiating between various causes of cardiac arrest, which are not a direct result of a primary ventricular arrhythmia. Identifying the cause of pulseless electrical activity or asystole is important as the underlying cause is what guides management in such cases. This approach, incorporating ultrasound to manage cardiac arrest aids in the diagnosis of the most common and easily reversible causes of cardiac arrest not caused by primary ventricular arrhythmia, namely; severe hypovolemia, tension pneumothorax, cardiac tamponade, and massive pulmonary embolus. These four conditions are addressed in this paper using four accepted emergency ultrasound applications to be performed during resuscitation of a cardiac arrest patient with the aim of determining the underlying cause of a cardiac arrest. Identifying the underlying cause of cardiac arrest represents the one of the greatest challenges of managing patients with asystole or PEA and accurate determination has the potential to improve management by guiding therapeutic decisions. We include several clinical images demonstrating examples of cardiac tamponade, massive pulmonary embolus, and severe hypovolemia secondary to abdominal aortic aneurysm. In conclusion, this protocol has the potential to reduce the time required to determine the etiology of a cardiac arrest and thus decrease the time between arrest and appropriate therapy.

  5. Automated testing of arrhythmia monitors using annotated databases.

    Science.gov (United States)

    Elghazzawi, Z; Murray, W; Porter, M; Ezekiel, E; Goodall, M; Staats, S; Geheb, F

    1992-01-01

    Arrhythmia-algorithm performance is typically tested using the AHA and MIT/BIH databases. The tools for this test are simulation software programs. While these simulations provide rapid results, they neglect hardware and software effects in the monitor. To provide a more accurate measure of performance in the actual monitor, a system has been developed for automated arrhythmia testing. The testing system incorporates an IBM-compatible personal computer, a digital-to-analog converter, an RS232 board, a patient-simulator interface to the monitor, and a multi-tasking software package for data conversion and communication with the monitor. This system "plays" patient data files into the monitor and saves beat classifications in detection files. Tests were performed using the MIT/BIH and AHA databases. Statistics were generated by comparing the detection files with the annotation files. These statistics were marginally different from those that resulted from the simulation. Differences were then examined. As expected, the differences were related to monitor hardware effects.

  6. Privacy-Preserving Electrocardiogram Monitoring for Intelligent Arrhythmia Detection.

    Science.gov (United States)

    Son, Junggab; Park, Juyoung; Oh, Heekuck; Bhuiyan, Md Zakirul Alam; Hur, Junbeom; Kang, Kyungtae

    2017-06-12

    Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components. The decision support server analyzes the heart activity, using the Pan-Tompkins algorithm to detect heartbeats and a decision tree to classify them. Our system protects sensing data and user privacy, which is an essential attribute of dependability, by adopting signal scrambling and anonymous identity schemes. We also employ a public key cryptosystem to enable secure communication between the entities. Simulations using data from the MIT-BIH arrhythmia database demonstrate that our system achieves a 95.74% success rate in heartbeat detection and almost a 96.63% accuracy in heartbeat classification, while successfully preserving privacy and securing communications among the involved entities.

  7. Privacy-Preserving Electrocardiogram Monitoring for Intelligent Arrhythmia Detection †

    Science.gov (United States)

    Son, Junggab; Park, Juyoung; Oh, Heekuck; Bhuiyan, Md Zakirul Alam; Hur, Junbeom; Kang, Kyungtae

    2017-01-01

    Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components. The decision support server analyzes the heart activity, using the Pan–Tompkins algorithm to detect heartbeats and a decision tree to classify them. Our system protects sensing data and user privacy, which is an essential attribute of dependability, by adopting signal scrambling and anonymous identity schemes. We also employ a public key cryptosystem to enable secure communication between the entities. Simulations using data from the MIT-BIH arrhythmia database demonstrate that our system achieves a 95.74% success rate in heartbeat detection and almost a 96.63% accuracy in heartbeat classification, while successfully preserving privacy and securing communications among the involved entities. PMID:28604628

  8. Calmodulin is essential for cardiac IKS channel gating and assembly: impaired function in long-QT mutations

    DEFF Research Database (Denmark)

    Shamgar, Liora; Ma, Lijuan; Schmitt, Nicole

    2006-01-01

    The slow IKS K+ channel plays a major role in repolarizing the cardiac action potential and consists of the assembly of KCNQ1 and KCNE1 subunits. Mutations in either KCNQ1 or KCNE1 genes produce the long-QT syndrome, a life-threatening ventricular arrhythmia. Here, we show that long-QT mutations ...

  9. Guidelines for autopsy investigation of sudden cardiac death: 2017 update from the Association for European Cardiovascular Pathology

    NARCIS (Netherlands)

    Basso, Cristina; Aguilera, Beatriz; Banner, Jytte; Cohle, Stephan; d'Amati, Giulia; de Gouveia, Rosa Henriques; di Gioia, Cira; Fabre, Aurelie; Gallagher, Patrick J.; Leone, Ornella; Lucena, Joaquin; Mitrofanova, Lubov; Molina, Pilar; Parsons, Sarah; Rizzo, Stefania; Sheppard, Mary N.; Mier, Maria Paz Suárez; Kim Suvarna, S.; Thiene, Gaetano; van der Wal, Allard; Vink, Aryan; Michaud, Katarzyna

    2017-01-01

    Although sudden cardiac death (SCD) is one of the most important modes of death in Western countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed and the accurate

  10. Inhalation of diluted diesel engine emission impacts heart rate variability and arrhythmia occurrence in a rat model of chronic ischemic heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Anselme, Frederic [Rouen University Hospital, Service de Cardiologie, Rouen (France); Loriot, Stephane; Henry, Jean-Paul; Thuillez, Christian; Morin, Jean-Paul [University of Rouen France, INSERM U644, School of Medicine-Pharmacy, Rouen, Cedex (France); Dionnet, Frederic [Centre d' Etudes et de Recherches Technologiques en Aerothermique et Moteurs, Saint Etienne du Rouvray (France); Napoleoni, Jean-Gerard [EMKA Technologies, Paris (France)

    2007-04-15

    Both increase in cardiac arrhythmia incidence and decrease in heart rate variability (HRV) have been described following human and experimental animal exposures to air pollutants. However, the potential causal relationship between these two factors remains unclear. Incidence of ventricular arrhythmia and HRV were evaluated during and after a 3 h period of Diesel engine exhaust exposure in ten healthy and ten chronic ischemic heart failure (CHF, 3 months after coronary ligation) Wistar rats using implantable ECG telemetry. Air pollutants were delivered to specifically designed whole body individual exposure chambers at particulate matter concentrations similar to those measured inside cabins of cars inserted in congested urban traffic. Recordings were obtained from unrestraint and unsedated vigil rats. Immediate decrease in RMSSD was observed in both healthy (6.64 {+-} 2.62 vs. 4.89 {+-} 1.67 ms, P < 0.05) and CHF rats (8.01 {+-} 0.89 vs. 6.6 {+-} 1.37 ms, P < 0.05) following exposure. An immediate 200-500% increase in ventricular premature beats was observed in CHF rats only. Whereas HRV progressively returned to baseline values within 2.5 h after exposure start, the proarrhythmic effect persisted as late as 5 h after exposure termination in CHF rats. Persistence of ventricular proarrhythmic effects after HRV normalization suggests that HRV reduction is not the mechanism of cardiac arrhythmias in this model. Our methodological approach, closely reflecting the real clinical situations, appeared to be a unique tool to provide further insight into the pathophysiological mechanisms of traffic related airborne pollution health impact. (orig.)

  11. Heart rate variability alters cardiac repolarization and electromechanical dynamics.

    Science.gov (United States)

    Phadumdeo, Vrishti M; Weinberg, Seth H

    2018-04-07

    Heart rate continuously varies due to autonomic regulation, stochasticity in pacemaking, and circadian rhythm, collectively termed heart rate variability (HRV), during normal physiological conditions. Low HRV is clinically associated with an elevated risk of cardiac arrhythmias. Alternans, a beat-to-beat alternation in action potential duration (APD) and/or intracellular calcium (Ca) transient, is a well-known risk factor associated with cardiac arrhythmias that is typically studied under conditions of a constant pacing rate, i.e., the absence of HRV. In this study, we investigate the effects of HRV on the interplay between APD, Ca, and electromechanical properties, employing a nonlinear discrete-time map model that governs APD and intracellular Ca cycling with a stochastic pacing period. We find that HRV can decrease variation in APD and peak Ca at fast pacing rates for which alternans is present. Further, increased HRV typically disrupts the alternating pattern for both APD and peak Ca and weakens the correlation between APD and peak Ca, thus decoupling Ca-mediated instabilities from repolarization alternation. We find that the efficacy of these effects is regulated by the sarcoplasmic reticulum Ca uptake rate. Overall, these results demonstrate that HRV disrupts arrhythmogenic alternans and suggests that HRV may be a significant factor in preventing life-threatening arrhythmias. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Role of Pre-incision, Intravenous Prophylactic Amiodarone to Control Arrhythmias in Patients with Rheumatic Valvular Heart Disease undergoing Mitral Valve Replacement

    International Nuclear Information System (INIS)

    Ahmad, K.; Naqvi, S.

    2013-01-01

    Objective: To evaluate the effect of intra-operative single intra venous dose of amiodarone on post operative cardiac arrhythmias in patients undergoing valvular heart surgery. Study Design: Randomized controlled trials. Place and Duration of surgery: This study was performed at Armed forces Institute of Cardiology Rawalpindi from Jan 01, 2011 to Dec 31, 2011. Patients and Methods: In this study 80 patients with rheumatic valvular heart disease and undergoing elective mitral valve replacement were randomly divided into two groups. Group I, n = 40 (Amiodarone group) was given single intravenous dose of amiodarone (5 mg/kg in 100 ml of saline over 30 min) before sternotomy incision. Group II, n = 40(control / placebo group) was given 100 ml of saline over 30 min. Result: In the amiodarone group, after removal of aortic cross clamp 75% patients had sinus rhythm compared to 47.5% in control group. p=0.045. Similarly 15% had AF, 5% JR and 5% VT/VF in amiodarone group in contrast to 32.5% with AF, 12.5% JR and 7.5% Vt/VF in control group. (p=0.045). Response to cardioversion was positive in 75% of the patients requiring shocks in amiodarone group as against 43.75% in the control group. (p=0.044). Conclusion: A single intravenous bolus dose of amiodarone is effective in decreasing the incidence of cardiac arrhythmias after mitral valve replacement in patients with rheumatic MVD. (author)

  13. Chagas disease as a cause of heart failure and ventricular arrhythmias in patients long removed from endemic areas: an emerging problem in Europe.

    Science.gov (United States)

    Vannucchi, Vieri; Tomberli, Benedetta; Zammarchi, Lorenzo; Fornaro, Alessandra; Castelli, Gabriele; Pieralli, Filippo; Berni, Andrea; Yacoub, Sophie; Bartoloni, Alessandro; Olivotto, Iacopo

    2015-12-01

    Chagas disease is a parasitic disease caused by the protozoan Trypanosoma cruzi. In endemic areas (South and Central America), Chagas disease represents a relevant public health issue, and is the most frequent cause of cardiomyopathy. In nonendemic areas, such as Europe, Chagas disease represents an emerging problem following the establishment of sizeable communities from Brazil and Bolivia. Chagas cardiomyopathy represents the most frequent and serious complication of chronic Chagas disease, affecting about 20-30% of patients, potentially leading to heart failure, arrhythmias, thromboembolism, stroke and sudden death. Because late complications of Chagas disease may develop several years or even decades after the acute infection, it may be extremely challenging to reach the correct diagnosis in patients long removed from the countries of origin. We report two examples of Chagas cardiomyopathy in South American women permanently residing in Italy for more than 20 years, presenting with cardiac manifestations ranging from left ventricular dysfunction and heart failure to isolated ventricular arrhythmias. The present review emphasizes that Chagas disease should be considered as a potential diagnosis in patients from endemic areas presenting with 'idiopathic' cardiac manifestations, even when long removed from their country of origin, with potential implications for treatment and control of Chagas disease transmission.

  14. Environmental quality of transitional waters: the lagoon of Venice case study.

    Science.gov (United States)

    Micheletti, C; Gottardo, S; Critto, A; Chiarato, S; Marcomini, A

    2011-01-01

    The health status of European aquatic environments, including transitional waters such as coastal lagoons, is regulated by the Water Framework Directive (WFD), which requires the classification of the water bodies' environmental quality and the achievement of a good ecological status by 2015. In the Venice lagoon, a transitional water body located in the northeastern part of Italy, the achievement of a good ecological status is hampered by several anthropogenic and natural pressures, such as sediment and water chemical contamination, and sediment erosion. In order to evaluate the lagoon's environmental quality according to the WFD (i.e. 5 quality classes, from High to Bad), an integrated Weight-of-Evidence methodology was developed and applied to classify the quality of the lagoon water bodies, integrating biological, physico-chemical, chemical, ecotoxicological, and hydromorphological data (i.e. Lines of Evidence, LOE). The quality assessment was carried out in two lagoon habitat typologies (previously defined on the basis of morphological, sediment, and hydrodynamic characteristics) which were selected taking into account the ecological gradient from sea to land, and the differences in anthropogenic pressure and contamination levels. The LOE classification was carried out by using indicators scored by comparing site specific conditions to reference conditions measured in lagoon reference sites, or provided by local, national or European regulations (e.g. Environmental Quality Standards, EQS, for chemicals). Finally, the overall quality status for each water body was calculated by a probabilistic approach, i.e. by reporting the final result as the frequency distribution of quality classes. The developed procedure was applied by using data and information concerning selected LOE and collected from monitoring programs and research studies carried out in the last 15 years in the lagoon of Venice. A set of sampling stations characterized by spatially and temporally

  15. Global change and relative sea level rise at Venice: what impact in term of flooding

    Energy Technology Data Exchange (ETDEWEB)

    Carbognin, Laura; Tosi, Luigi [Institute of Marine Sciences, National Research Council, Venice (Italy); Teatini, Pietro [Institute of Marine Sciences, National Research Council, Venice (Italy); University of Padova, Department of Mathematical Methods and Models for Scientific Applications, Padua (Italy); Tomasin, Alberto [Institute of Marine Sciences, National Research Council, Venice (Italy); University Ca' Foscari in Venice, Venice (Italy)

    2010-11-15

    Relative sea level rise (RSLR) due to climate change and geodynamics represents the main threat for the survival of Venice, emerging today only 90 cm above the Northern Adriatic mean sea level (msl). The 25 cm RSLR occurred over the 20th century, consisting of about 12 cm of land subsidence and 13 cm of sea level rise, has increased the flood frequency by more than seven times with severe damages to the urban heritage. Reasonable forecasts of the RSLR expected to the century end must be investigated to assess the suitability of the Mo.S.E. project planned for the city safeguarding, i.e., the closure of the lagoon inlets by mobile barriers. Here we consider three RSLR scenarios as resulting from the past sea level rise recorded in the Northern Adriatic Sea, the IPCC mid-range A1B scenario, and the expected land subsidence. Available sea level measurements show that more than 5 decades are required to compute a meaningful eustatic trend, due to pseudo-cyclic 7-8 year long fluctuations. The period from 1890 to 2007 is characterized by an average rate of 0.12 {+-} 0.01 cm/year. We demonstrate that linear regression is the most suitable model to represent the eustatic process over these 117 year. Concerning subsidence, at present Venice is sinking due to natural causes at 0.05 cm/year. The RSLR is expected to range between 17 and 53 cm by 2100, and its repercussions in terms of flooding frequency are associated here to each scenario. In particular, the frequency of tides higher than 110 cm, i.e., the value above which the gates would close the lagoon to the sea, will increase from the nowadays 4 times per year to a range between 20 and 250. These projections provide a large spread of possible conditions concerning the survival of Venice, from a moderate nuisance to an intolerable aggression. Hence, complementary solutions to Mo.S.E. may well be investigated. (orig.)

  16. The Lido as Venice's refuse tip: Dalmatian sheep and the 1819 elephant.

    Science.gov (United States)

    Giormani, Virgilio

    2004-01-01

    The Lido of Venice is an island twelve kilometers long and between a hundred and one thousand meters wide. The citizans of Venice and many turists can't imagine today, what Lido was some centuries ago Initially totally sandy, it was fertilized by means of a continuous supply of Venice's garbage (the "scoasse"). In addition to the "scoasse", damaged foodstuffs and the waste of the vegetable market were also sent to the Lido. Other fertilisers originated from the dung of the cattle and sheep arriving by ship from Dalmatia, which were landed on the Lido, where they could pasture before slaughter to regain weight lost during their voyage. The sheep dung, especially, was important for the proto-industrial production of saltpetre, a material of the greatest strategic importance, like uranium at the present time. Saltpetre is the most important component of gun powder, which was the only explosive known up to the second half of 19th century. There were plans to establish an "artificial nitriary" in the Lido, making use of the garbage and of the animal waste. In all probability, the most bulky item ever buried in the Lido is the corpse of an enraged elephant, which escaped from its cage on the Riva degli Schiavoni where it was performing during the 1819 carnival, and was killed by a cannon shot in a church where it took refuge. The original title of the paper, published in Italian is: V. Giormani, II Lido di Venezia "scoassera" della città. I montoni dalmati e l'elefante del 1819, in Atti del III Convegno nazionale di storia della medicina veterinaria, Lastra a Signa (Firenze), 23-24 settembre 2000, a cura di Alba Veggetti, Brescia, 2001, pp. 333-339. Other information has been added in order to facilitate non-italians readers and articles appearing after the publication of the Proceedings of the Third National Congress for the History of Veterinary Medicine, Lastra a Signa, (Florence), Italy, have also been used. I am deeply grateful to Mrs. Mary Moors for the

  17. [Cardiac cachexia].

    Science.gov (United States)

    Miján, Alberto; Martín, Elvira; de Mateo, Beatriz

    2006-05-01

    Chronic heart failure (CHF), especially affecting the right heart, frequently leads to malnutrition. If the latter is severe and is combined to other factors, it may lead to cardiac cachexia. This one is associated to increased mortality and lower survival of patients suffering from it. The causes of cardiac cachexia are diverse, generally associated to maintenance of a negative energy balance, with increasing evidence of its multifactorial origin. Neurohumoral, inflammatory, immunological, and metabolic factors, among others, are superimposed in the patient with CHF, leading to involvement and deterioration of several organs and systems, since this condition affects both lean (or active cellular) mass and adipose and bone tissue osteoporosis. Among all, the most pronounced deterioration may be seen at skeletal muscle tissue, at both structural and functional levels, the heart not being spared. As for treatment, it should be based on available scientific evidence. Assessment of nutritional status of any patient with CHF is a must, with the requirement of nutritional intervention in case of malnutrition. In this situation, especially if accompanied by cardiac cachexia, it is required to modify energy intake and oral diet quality, and to consider the indication of specific complementary or alternative artificial nutrition. Besides, the causal relationship of the beneficial role of moderate physical exertion is increasing, as well as modulation of metabolic and inflammatory impairments observed in cardiac cachexia with several drugs, leading to a favorable functional and structural response in CHF patients.

  18. Cardiac Pacemakers

    International Nuclear Information System (INIS)

    Fiandra, O.; Espasandin, W.; Fiandra, H.

    1984-01-01

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control

  19. The review of constitutional norms concerning local public administration in the view of the European Commission for Democracy through Law (Venice Commission)

    OpenAIRE

    Apostolache, Mihai

    2015-01-01

    The proposals of the Commission to review the Constitution of Romania were subject to the analysis of experts from the European Commission for Democracy through Law (the Venice Commission), who expressed their opinion in a report adopted at the 98th plenary session of the European body. The article analyzes the recommendations of the Venice Commission regarding the proposed changes to the constitutional norms governing local public administration, comprising some general aspects concern...

  20. Cardiac complications of intravenous digital subtraction angiography

    International Nuclear Information System (INIS)

    Neergaard, K.; Dirksen, K.L.; Andersen, I.; Galloee, A.M.; Madsen, E.B.

    1989-01-01

    In a prospective study of 103 patients the incidence of cardiac events during intravenous digital subtraction angiography (i.v. DSA) was investigated. Of 103 patients 17 had known ischaemic heart disease. The examination was performed with an ionic contrast medium, Urografin 76% (sodium megluminediatrizoate), administered by bolus injection into the right atrium. Patients with severe cardiac disease were examined only if the procedure was considered of vital importance. Cardiac events were defined as ST-segment changes of more than 0.1 mV, changes in heart rate of more than 20%, arrhythmias and such symptoms as chest pain and dyspnoea. Ischaemic ST-segment changes during i.v. DSA were observed in approximately 20% of the patients and were not related to the presence of known ischaemic heart disease. Three patients developed angina during the procedure. Among 12 patients with known angina only one patient developed angina during the procedure. In this study chest pain was infrequent (3%), but there was a relative high frequency of ECG changes (20%) not related to patients with ischaemic heart disease only. It is concluded that there is a risk of cardiac events during i.v. DSA, but the risk is not increased in patients with known ischaemic heart disease (if they do not suffer from congestive heart failure) as compared with other patients without known ischaemic heart disease. (orig.)