scholarly journals An Unexpected Cause of Bradycardia in a Patient with Bacterial Meningitis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Petros Ioannou ◽  
Magdalini Velegraki ◽  
Stella Soundoulounaki ◽  
Achilleas Gikas ◽  
Diamantis P. Kofteridis
Keyword(s):  
Sick Sinus Syndrome ◽  
Beta Blockers ◽  
Sinus Bradycardia ◽  
Permanent Pacemaker ◽  
Toxic Exposure ◽  
Increased Intracranial Pressure ◽  
Electrolyte Disorders ◽  
Cardiac Disorders ◽  
Environmental Causes ◽  
Work Up

Sinus bradycardia which is a sinus rhythm with a resting heart rate of less than 60 bpm is caused by intrinsic cardiac disorders like sick sinus syndrome or inferior myocardial infarction, metabolic and environmental causes (such as hypothyroidism and electrolyte disorders), medications (such as beta-blockers and amiodarone), infection (such as myocarditis), increased intracranial pressure, and toxic exposure, while it can sometimes be a normal phenomenon, especially during sleep, in athletes, and during pregnancy. Symptomatic sinus bradycardia should warrant a thorough work-up in order to identify any reversible causes; otherwise, placement of a permanent pacemaker could be needed. We present the case of a patient who was admitted due to confusion and fever and was found to have pneumococcal meningitis and bacteremia, and during his hospital stay he developed symptomatic sinus bradycardia that was of intractable cause and persistent. Placement of a permanent pacemaker was chosen until the night staff of the hospital discovered by chance the neglected cause of his bradycardia.

APPLICATION OF PERMANENT PACEMAKERS AND OPTIMAL PROGRAMMATION IN HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 114-121
Author(s):  
Van Minh Huynh ◽  
Anh Tien Hoang ◽  
Khanh Hung Doan ◽  
Vu Phong Nguyen ◽  
Viet Lam Ngo ◽  
...  
Keyword(s):  
Sick Sinus Syndrome ◽  
Clinical Symptoms ◽  
Jugular Vein ◽  
Pacemaker Implantation ◽  
Heart Association ◽  
External Jugular Vein ◽  
Permanent Pacemaker ◽  
Male Gender ◽  
Inclusion Criteria ◽  
Underlying Diseases

Aim: To evaluate the application of permanent pacemaker and optimal programmation associated with Nora G. checklist in pacemaker implantation. Patients and methods: we analyse the 35 cases who were implanted the permanent pacemakers we analyse the 35 cases who were implanted the permanent pacemakers in 2017. For inclusion criteria, we used the recomendation of ACC/AHA/ HRS and Vietnam Heart Association. Apply the C arm fluoroscopy to perform the implantation of the permanent pacemaker. Most of patients were performed the subclavian vein and cephalic vein as the main way but some cases we choosed the external jugular vein as the alternative route. Results: male gender was 60%, mean age was 71.97±12.55. Mostly cardiac arrhythmia were sick sinus syndrome (42.86%), atrial fibrillation with slow rate response (17.14%), blocAVII nd degree Mobitz II (14.28%), bloc AV III rd (11.42%), the underlying diseases were arterial hypertension 42.86%, coronary disease (20%), diabetes mellitus (14.29%). The implanted pacemekers were predominantly one chamber VVIR type (47.5%). The complications was rare and there were a clear recovery of clinical symptoms and mortality death following the Nora checklist. Conclusion: VT technology is an integral part of the treatment of arrhythmias, especially the optimal combination of programming and the Nora checklist, which makes it more effective. Key words: permanent pacemaker, optimal programmation

scholarly journals Acute Efficacy of a Traditional Chinese Medicine for Treatment of Frequent Premature Ventricular Contractions in Patients with Concomitant Sinus Bradycardia: Results from a Double-Blind, Placebo-Controlled, Multicentre, Randomized Clinical Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Fengxiang Zhang ◽  
Jiangang Zou ◽  
Hao Yu ◽  
Xiaorong Li ◽  
Pipin Kojodjojo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Randomized Clinical Trial ◽  
Beta Blockers ◽  
Sinus Bradycardia ◽  
Antiarrhythmic Therapy ◽  
Double Blind ◽  
Premature Ventricular Contractions ◽  
Double Blind Placebo

Pharmacological antiarrhythmic therapy such as beta-blockers in patients with frequent premature ventricular contractions (PVCs) and concomitant bradycardia is challenging. A traditional Chinese medicine, Shensong Yangxin (SSYX), has been effective in treatment of frequent PVCs and sinus bradycardia (SB) in separate patient cohorts. This double-blind, placebo-controlled, multicentre, randomized clinical trial investigates the acute efficacy of SSYX in reducing PVCs burden in patients with concomitant SB. Patients with symptomatic, frequent PVCs, and SB, defined as mean heart rate (MHR) of 45 to 59 beats per min (bpm), were recruited at 33 medical centres in mainland China and randomly assigned by computer to either SSYX or matching placebo for eight weeks. Patients, investigators, and trial personnel were masked to treatment allocation. Primary endpoints were changes in PVCs burden and MHR as assessed by 24-hour Holter monitoring relative to baseline. Secondary efficacy endpoints were subjective symptom score, ECG, and biochemical parameters. Analysis was based on intention-to-treat principles. 333 patients were randomized, of which 166 received SSYX and 167 placebo. Baseline characteristics did not differ. SSYX reduced PVCs burden by 68.2% (p < 0.001) and increased MHR by 10.9% (p < 0.001) compared to 32.2% and 4.7%, respectively, in the placebo group. SSYX group experienced greater symptomatic improvement (p < 0.001). No differences in reported adverse events were seen (20 versus 23). SSYX is an effective antiarrhythmic therapy for symptomatic, frequent PVCs uniquely suited patients with concomitant SB. Clinical trial number was NCT01750775.

ECG SIGNAL GENERATION AND HEART RATE VARIABILITY SIGNAL EXTRACTION: SIGNAL PROCESSING, FEATURES DETECTION, AND THEIR CORRELATION WITH CARDIAC DISEASES

2012 ◽  
Vol 12 (04) ◽  
pp. 1240012 ◽  
Author(s):  
GOUTHAM SWAPNA ◽  
DHANJOO N. GHISTA ◽  
ROSHAN JOY MARTIS ◽  
ALVIN P. C. ANG ◽  
SUBBHURAAM VINITHA SREE
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Sinus Bradycardia ◽  
Premature Ventricular Contraction ◽  
P Wave ◽  
Ecg Signal ◽  
Qrs Complex ◽  
T Wave ◽  
St Segment ◽  
Cardiac Disorders

The sum total of millions of cardiac cell depolarization potentials can be represented by an electrocardiogram (ECG). Inspection of the P–QRS–T wave allows for the identification of the cardiac bioelectrical health and disorders of a subject. In order to extract the important features of the ECG signal, the detection of the P wave, QRS complex, and ST segment is essential. Therefore, abnormalities of these ECG parameters are associated with cardiac disorders. In this work, an introduction to the genesis of the ECG is given, followed by a depiction of some abnormal ECG patterns and rhythms (associated with P–QRS–T wave parameters), which have come to be empirically correlated with cardiac disorders (such as sinus bradycardia, premature ventricular contraction, bundle-branch block, atrial flutter, and atrial fibrillation). We employed algorithms for ECG pattern analysis, for the accurate detection of the P wave, QRS complex, and ST segment of the ECG signal. We then catagorited and tabulated these cardiac disorders in terms of heart rate, PR interval, QRS width, and P wave amplitude. Finally, we discussed the characteristics and different methods (and their measures) of analyting the heart rate variability (HRV) signal, derived from the ECG waveform. The HRV signals are characterised in terms of these measures, then fed into classifiers for grouping into categories (for normal subjects and for disorders such as cardiac disorders and diabetes) for carrying out diagnosis.

Hormone conference at Sahlgren's University Hospital: polycythemia and inappropriately high serum erythropoietin concentration in a 62-year-old man

1994 ◽  
Vol 40 (11) ◽  
pp. 2093-2098 ◽  
Author(s):  
G Lindstedt ◽  
P A Lundberg ◽  
A Norrby ◽  
J Kutti ◽  
O Andersen ◽  
...  
Keyword(s):  
Hemoglobin Concentration ◽  
High Serum ◽  
University Hospital ◽  
Cerebellar Tumor ◽  
Increased Intracranial Pressure ◽  
Coronary Insufficiency ◽  
Abdominal Symptoms ◽  
History Of ◽  
Work Up ◽  
Serum Erythropoietin

Abstract A 62-year-old man with a history of coronary insufficiency complained at his scheduled visit to the outpatient clinic of symptoms suggestive of gastritis. His blood hemoglobin concentration, however, was markedly increased. Results of a hematological work-up suggested an erythropoietin-producing tumor. Signs of increased intracranial pressure then led to the finding of a cerebellar tumor, which could explain his vertigo and abdominal symptoms. This cystic capillary hemangioblastoma probably was responsible for the erythropoietin production and also seemed to produce basic fibroblast growth factor. The clinical evaluation of polycythemia as well as erythropoietin biochemistry and clinical application are reviewed.

scholarly journals Efficacy of Catheter Ablation for Atrial Fibrillation in Patients with a Permanent Pacemaker for Sick Sinus Syndrome

2013 ◽  
Vol 52 (20) ◽  
pp. 2305-2310 ◽  
Author(s):  
Jin-Tao Wu ◽  
Jian-Zeng Dong ◽  
Cai-Hua Sang ◽  
Ri-Bo Tang ◽  
Xiao-Hong Li ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Sick Sinus Syndrome ◽  
Permanent Pacemaker

His Bundle Pacing with Recruitment of Right Bundle Branch after Orthotopic Heart Transplant

2021 ◽  
Vol 4 (3) ◽  
pp. 01-05
Author(s):  
Kristin Ellison
Keyword(s):  
Heart Transplant ◽  
Ventricular Dysfunction ◽  
Complete Heart Block ◽  
Sinus Bradycardia ◽  
Right Ventricular Dysfunction ◽  
Permanent Pacemaker ◽  
Orthotopic Heart Transplant ◽  
Bundle Branch Block ◽  
His Bundle ◽  
His Bundle Pacing

The incidence of permanent pacemaker implant after orthotopic heart transplant is between 2-24%. We present a 63-year-old male with ischemic cardiomyopathy who underwent orthotopic heart transplant. His post-operative course was complicated by recurrent asystole from sinus bradycardia and complete heart block. He had baseline right bundle branch block and right ventricular dysfunction. The decision was made to proceed with His-bundle pacing to provide physiologic cardiac activation, and provide anatomical benefit for subsequent endomyocardial biopsy. He did well after receiving a His bundle pacemaker with recruitment of his right bundle branch.

Abstract 17124: Severe Bradycardia in Critically Ill Patients With COVID-19

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Julie Larue ◽  
Patrick De Jode ◽  
Jean-François Timsit ◽  
Guillaume Franchineau ◽  
Fabrice Extramiana ◽  
...  
Keyword(s):  
Heart Rate ◽  
Beta Blockers ◽  
Sinus Bradycardia ◽  
Sinus Node ◽  
Cardiac Pacing ◽  
Multiple Organ ◽  
Physical Stimulation ◽  
Node Disease ◽  
Cardiac Manifestations ◽  
Mean Heart Rate

Cardiac manifestations of severe Covid19 infection are still poorly understood. From January to May 2020, 113 consecutive patients were admitted in intensive care units for severe Covid19 and 10 out of them presented an episode of bradycardia. Patients had a median age of 63 years, 6/10 were men, 7/10 were under mechanical ventilation for severe acute respiratory distress syndrome and 4/10 received a veno-venous extracorporeal membrane oxygenation. All bradycardias were due to sinus node bradycardia with a median heart rate of 36 bpm (range 10 - 45 bpm). For 6 patients, bradycardia was persistent and 3 required continuous isoprenaline infusion (Figure, patient A). Bradycardia was sudden for 4 patients and required brief resuscitation maneuvers for one (Figure, patient B) . Patients had normal baseline ECG and echocardiography, except for two patients who were under beta-blockers. For those two patients beta blockers were interrupted several days before bradycardia. A comprehensive review of patient’s files ruled out bradycardia due to drug-drug interactions, myocarditis, hyperkalemia, hypoxia or vagal physical stimulation. Holter ECG was performed for 7 patients: 3 recordings evoked vagal hyperactivity (low mean heart rate and elevated pNN50 / RMSSD, Figure Patient A), 3 others cardiac dysautonomia (SDNN<100ms, Figure Patient B). Amongst these 10 patients, 5 were discharged from ICU among which 2 returned home and five died from covid-19 associated multiple-organ failure. None of them required temporary or permanent cardiac pacing. To conclude, sinus bradycardia occurred commonly in severe Covid19 infection. This highlights the need to monitor cardiac rhythm. Even if the pathophysiology remains unclear, cardiac dysautonomia and vagal hyperactivity could be hypothesized rather than an intrinsic sinus node disease.

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