scholarly journals Bioinformation Algorithm for Selecting a Method for Premedication of Patients with Arterial Hypertension with Amiodarone-Associated Thyrotoxicosis Type I during Neurosurgical Operations

Biomeditsina ◽  
2020 ◽  
Vol 16 (3) ◽  
pp. 97-101
Author(s):  
A. V. Safronenko ◽  
S. V. Lepyavka ◽  
A. A. Demidova ◽  
S. I. Demidov ◽  
M. I. Nazheva ◽  
...  

Signs associated with adverse cardiovascular reactions after surgery were established in 46 patients with arterial hypertension, cardiac arrhythmias and type I amiodarone-associated thyrotoxicosis. These signs included an increase in the circadian index above 1.52, the presence of pauses in the heart rate for more than 3 seconds, the number of group ventricular extrasystoles per day exceeding 30, an increase in LF/HF with RR-intervalometry more than 1.3. In order to reduce the risk of cardiac arrhythmias in the postoperative period, a premedication with long-acting benzodiazepines in combination with magnesium preparations over a prolonged course is recommended.

2019 ◽  
Vol 10 (2) ◽  
pp. 37-46
Author(s):  
Eugene V. Timofeev ◽  
Eduard V. Zemtsovsky ◽  
Svetlana V. Reeva

Cardiac arrhythmias are frequent manifestations of hereditary connective tissue disorders (HCTD). Such HCTD as Marfan syndrome (MS), the primary mitral valve prolapse are characterized by frequent supraventricular and ventricular extrasystoles, prolonged PQ and QT interval, reduced heart rate variability and frequent findings of other predictors of heart arrhythmias. Cardiac arrhythmias as well as their predictors in patients of young age with marfanoid habitus (MH) were not previously evaluated. Materials and methods. A total number of 238 patients of young age were examined. All patients received phenotypic and anthropometric screening and Holter ECG. Cardiac arrhythmias, duration of QT interval (QTc), QT dispersion (QTd), heart rate variability and heart rate turbulence were estimated. Results for young people with MH as compared with the control group are characterized by frequent detection of paired (42.6% vs 9.7%, p= 0.00001), group (17.0% vs 4.2%, p = 0.01) supraventricular extrasystoles, ventricular extrasystoles in pathological quantity (10.6% vs 1.4%, p = 0.02). Pathological value of heart rate turbulence is detected significantly more frequently in individuals with MH. During evaluation of variability a significant decrease in all spectral (HF, LF, VLF), as well as most statistical (SDNN, pNN50) indicators was revealed. Patients with MH are characterized by prolonged QT interval (QTc threshold in 480 ms overcomes 21% of boys with MH, p = 0.00001) and increase the variance of the QT interval (threshold of 50 ms overcomes 37.5% of girls with MH, p = 0.0004).


2021 ◽  
Vol 28 (6) ◽  
pp. 5009-5018
Author(s):  
Karol Kaziród-Wolski ◽  
Aldona Kowalska ◽  
Janusz Sielski ◽  
Magdalena Biskup-Frużyńska ◽  
Grzegorz Piotrowski

Aim of the study: To assess the occurrence of cardiac arrhythmias caused by high doses of levothyroxine in patients with thyroid cancer with subclinical hyperthyroidism. Materials and Methods: This prospective study included 98 women divided into three groups according to plasma thyroid stimulating hormone (TSH) concentration: <0.1 µU/mL, 0.1–0.39 µU/mL, or 0.4–4.0 µU/mL (control group). All participants underwent laboratory tests and an electrocardiography (ECG) Holter test to assess their heart rate and the occurrence of arrhythmias. Statistical analysis assessed differences between groups in all clinical parameters and factors influencing the occurrence of arrhythmias. Results: There were no differences between groups in the maximum, average, or minimum heart rate or in the incidence of the studied cardiac arrhythmias. Heart rate in women with a TSH concentration of <0.1 µU/mL depended on age and the presence of arterial hypertension, and heart rate in women with a TSH concentration of 0.4–4.0 µU/mL depended on free triiodothyronine concentration and the presence of arterial hypertension; no relationship was identified for women with a TSH concentration of 0.1–0.39 µU/mL. One-way logistic regression analysis did not identify any factors influencing the occurrence of arrhythmias. Conclusions: While maintaining normal free triiodothyronine levels, the use of suppressive doses of levothyroxine after thyroidectomy for differentiated thyroid cancer does not induce clinically significant arrhythmias or affect average heart rate. None of the studied clinical parameters influenced the risk of arrhythmia.


2021 ◽  
Vol 7 (4) ◽  
pp. 55-62
Author(s):  
Andrey V. Safronenko ◽  
Sergey V. Lepyavka ◽  
Igor A. Demidov ◽  
Marina I. Nazheva ◽  
Yuri S. Maklyakov

Introduction: The effectiveness of premedication of patients with arterial hypertension and severe ventricular rhythm disturbances against the background of Amiodarone-associated thyrotoxicosis, high anxiety and cyclothymiae disorders should be based on the pharmacological positions of the need to reduce the risk of dangerous adverse cardiovascular reactions. Materials and methods: During the research, a clinical group of 114 patients with arterial hypertension, severe ventricular arrhythmias and Amiodarone-associated type I thyrotoxicosis was formed: four subgroups were identified. In Subgroup 1 (n=22), no premedication was given. In Subgroup 2 (n=32), premedication was given with Diazepam and magnesium sulfate in a prolonged mode. In Subgroup 3 (n=30), the patients received Diazepam the day before surgery. In Subgroup 4 (n=30), premedication was given with Midazolam. A dynamic assessment of the severity of anxiety, depression, sedation and daily monitoring of blood pressure and ECG were carried out. Results and discussion: After surgery, in Subgroup 1, the level of anxiety and depression increased. In all other Subgroups, regardless of the type of premedication, the use of benzodiazepines was accompanied by a decrease in the level of anxiety after surgery. A decrease in pressure load and an increase in the stability of the parameters of systemic hemodynamics were registered in Subgroup 2 of patients, whereas in Subgroup 4 of patients, the pressure load increased while limiting the differences in blood pressure values during the day. After surgery, in Subgroup 2, cardiac rhythm disturbances were less common; in Subgroup 3, the structure of rhythmogenesis disturbances in the heart almost did not change, and in Subgroup 4, there was an unfavorable trend of an increase in the frequency of supraventricular, single and group ventricular extrasystoles. Conclusion: The prolonged premedication with long-acting benzodiazepines and magnesium preparations in patients with arterial hypertension, ventricular rhythm disturbances against the background of Amiodarone-associated thyrotoxicosis reduces the level of anxiety, as well as the risk of developing cardiovascular complications and instability of systemic hemodynamics.


1975 ◽  
Vol 43 (5) ◽  
pp. 548-555 ◽  
Author(s):  
J. Zink ◽  
B. I. Sasyniuk ◽  
P. E. Dresel

2014 ◽  
Vol 8 (10) ◽  
pp. 699-708 ◽  
Author(s):  
Marijana Tadic ◽  
Cesare Cuspidi ◽  
Biljana Pencic ◽  
Tamara Marjanovic ◽  
Vera Celic

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
O. Radchenko ◽  
N. Bek ◽  
V. Potapov

An examination of 103 patients with essential hypertension and obesity showed the dependence of autonomic cardioregulation, electrical ventricular systole, and prediction of adverse cardiovascular events on the serum leptin concentration (hyper-, normo – or hypoleptinemia).


2021 ◽  
Author(s):  
Mohammed Ali

BACKGROUND cardiovascular diseases (CVDs) have become prevalent in the world. They cause millions of deaths globally with the World Health Organization putting the figure at 17.9 million people every year. These statistics indicate the need for healthcare systems to leverage contemporary advanced technology to detect and diagnose CVDs and provide appropriate and timely care to reduce mortality rates. OBJECTIVE To conduct a scoping review exploring individual use of smartwatches with self-monitoring ECG functionality for diagnosing arrhythmias. METHODS Source were selected from six credible bibliographic databases: PubMed, Medline, EMBASE, PsycInfo, CINAHL, and Google Scholar. Intervention-related terms were used to identify relevant sources. Additionally, a forward search strategy was used to search the databases and identify appropriate peer-reviewed journals. RESULTS The research returned 230 sources, out of which 40 met the inclusion criterion. The studies revealed that increased research, development, and adoption of smartwatches and other wearable devices have intensified in the past two decades. The studies showed that using smartwatches can detect cardiac arrhythmias although this depends on the algorithms and biometric sensors utilized in the smartwatches. Watches with advanced algorithms, PPG, and EKG functionalities exhibit high accuracy, sensitivity, and specificity, detecting AFib and other arrhythmias with high efficacy. Therefore, the best way for technology companies to improve their watches’ accuracy is to design and use advanced algorithms and combine PPG, EKG, activity, and biochemical sensors. Conclusion: The contemporary healthcare space is replete with wearable and non-wearable ¬systems and devices central to detecting health conditions and informing the relevant stakeholders to take corrective actions. Smartwatches are wearable devices used chiefly by patients, health, and fitness enthusiasts to detect and monitor a series of conditions, such as heart rate. Their use has fostered timely detection of cardiac arrhythmias, and therefore, caregivers and policy-makers should emphasize their use. CONCLUSIONS Technological systems have proliferated many human spaces in the last three decades, including education, healthcare, and entertainment. Their use has improved operational efficiency, reduced costs, saved lives, and increased organizations’ bottom lines. Healthcare systems use technological devices and appliances to diagnose patients, perform surgeries, improve pharmacy operations, and reduce medical errors. That way, most healthcare facilities provide quality care, attaining positive clinical outcomes. The contemporary healthcare space is replete with wearable and non-wearable ¬systems and devices central to detecting health conditions and informing the relevant stakeholders – caregivers, patients, and family members – to take corrective actions. Smartwatches are wearable devices used chiefly by patients, health, and fitness enthusiasts to detect and monitor a series of conditions, such as heart rate. They are highly effective in detecting cardiac arrhythmias, and therefore, caregivers and policy-makers should emphasize their use.


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