A Phase Defect Framework for the Analysis of Cardiac Arrhythmia Patterns

During cardiac arrhythmias, dynamical patterns of electrical activation form and evolve, which are of interest to understand and cure heart rhythm disorders. The analysis of these patterns is commonly performed by calculating the local activation phase and searching for phase singularities (PSs), i.e., points around which all phases are present. Here we propose an alternative framework, which focuses on phase defect lines (PDLs) and surfaces (PDSs) as more general mechanisms, which include PSs as a specific case. The proposed framework enables two conceptual unifications: between the local activation time and phase description, and between conduction block lines and the central regions of linear-core rotors. A simple PDL detection method is proposed and applied to data from simulations and optical mapping experiments. Our analysis of ventricular tachycardia in rabbit hearts (n = 6) shows that nearly all detected PSs were found on PDLs, but the PDLs had a significantly longer lifespan than the detected PSs. Since the proposed framework revisits basic building blocks of cardiac activation patterns, it can become a useful tool for further theory development and experimental analysis.

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Clinical and Morphological Features of Myocardial Damage and the Course of Fulminant Myocarditis on the Background of СOVID-19, Diagnosis and Treatment Tactics

Annals of the Russian academy of medical sciences ◽

10.15690/vramn1433 ◽

2020 ◽

Vol 75 (5S) ◽

pp. 414-425

Author(s):

Olga S. Oynotkinova ◽

Evgenii L. Nikonov ◽

Oleg V. Zayratyants ◽

Elena V. Rzhevskaya ◽

Evgenii V. Krukov ◽

...

Keyword(s):

Myocardial Dysfunction ◽

Myocardial Damage ◽

Heart Rhythm ◽

Microvascular Dysfunction ◽

Symptomatic Treatment ◽

Clinical Situation ◽

Diagnosis And Treatment ◽

Screening Tests ◽

Fulminant Myocarditis ◽

Heart Rhythm Disorders

In a review article based on my own clinical experience of managing patients with acute myocardial injury and fulminant myocarditis, taking into account expert recommendations on the clinical treatment of myocardial damage associated with novel coronavirus infection a National clinical geriatric medical research center, division of cardiovascular diseases, the Chinese geriatrics society, Department of cardiology, Beijing Medical Association and European clinics discusses the pathogenesis, diagnosis and treatment of myocardial damage and FM patients, infected with SARS-CoV-2 in the context of the COVID-19 pandemic. Clinical features and diagnostic criteria are presented, including screening tests of markers of myocardial damage in the form of a highly sensitive troponin test, a natriuretic peptide. The article discusses in detail the pathogenesis and mechanisms of myocardial damage, including immune mechanisms, cytokine storm, systemic inflammation with macro- and microvascular dysfunction and the development of myocardial dysfunction with acute heart failure, hypotension, cardiogenic shock and/or life-threatening heart rhythm disorders caused by hypoxia and metabolic disorders at the cellular level. Features of the clinical course of fulminant myocarditis in infected patients (SARS-CoV-2) in the conditions of the COVID-19 pandemic are presented. For the first time, a detailed histo-morphological analysis of pathological myocardial injuries and complications is presented on the basis of unique autopsy material on post-mortem diagnostics of various pathoanatomic autopsies of those who died from COVID-19 in Moscow. Based on the clinical, functional and morphological material, the Protocol of etiopathogenetic treatment is presented. The basis of standard therapy is considered antiviral drugs, immunoglobulin G, the use of monoclonal antibodies to interleukin-6, anticoagulants, glucocorticoids, depending on the clinical situation, cardioprotectors and symptomatic treatment are recommended to maintain the heart, which in combination can achieve a certain clinical effectiveness. As adjuvant cardioprotective targeted therapy, the sodium salt of phosphocreatine is considered in order to preserve the myocardium, maintain its contractility and vital activity.

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1224A hybrid local activation time mapping model as for the ablation of premature ventricular contractions

EP Europace ◽

10.1093/ehjci/eux154.008 ◽

2017 ◽

Vol 19 (suppl_3) ◽

pp. iii254-iii255

Author(s):

T J R De Potter ◽

E. Silva Garcia ◽

T. Strisciuglio ◽

T. Bar-On ◽

S. Chatzikyriakou ◽

...

Keyword(s):

Activation Time ◽

Premature Ventricular Contractions ◽

Mapping Model ◽

Local Activation ◽

Local Activation Time

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PLASMA CONCENTRATION OF ENDOTHELIN-1 IN PATIENTS WITH HYPERTENSION ASSOCIATED WITH OBESITY, DEPENDING ON THE LYS198ASN POLYMORPHISM OF THE ENDOTHELIN-1 GENE

Eastern Ukrainian Medical Journal ◽

10.21272/eumj.2021;9(1):87-94 ◽

2021 ◽

Vol 9 (1) ◽

pp. 87-94

Author(s):

Yu.O. Smiianova

Keyword(s):

Body Weight ◽

Heart Rhythm ◽

Pathological Process ◽

Main Group ◽

Overweight And Obesity ◽

Control Group ◽

Endothelin 1 ◽

Normal Body ◽

Heart Rhythm Disorders ◽

Normal Body Weight

Endothelial dysfunction is considered one of the main mechanisms for the further development of arterial hypertension (AH) and its complications, and endothelin-1 (ЕТ-1) plays one of the key roles in this process. Endothelium is drawn into the pathological process at the earliest stages of AH development. ЕТ-1 is currently considered as a marker and predictor of the stage and consequences of AH, chronic heart failure (CHF), coronary heart disease (CHD), in particularly, acute myocardial infarction (MI), heart rhythm disorders, pulmonary hypertension, atherosclerotic vascular injury, target vascular disorders. One factor that may influence the level of ЕТ-1 is the endothelin-1 gene Lys198Asn polymorphism, which is considered by many researchers as a possible genetic marker of AH. However, the effect of this polymorphism on the level of plasma ЕТ-1 level in patients with AH of varying severity in Ukraine is understudied. The basis of this work were the materials of a complete examination of 160 patients with a verified diagnosis of AH I, stage II of 1, 2, 3 degrees (main group) and 110 apparently healthy persons (control group). Patients of the main group were divided into three subgroups: 1st group – 75 patients with normal body weight; 2nd group – 48 overweight patients; 3rd group – 37 patients with alimentary obesity. In obese patients, the waist circumference in women was around 103 (96–115) cm, and in men – 108 (105–116) cm, which indicates an abdominal type of obesity in these patients. As a result of the study, it was found that the level of ЕТ-1 is higher in patients with AH who suffer with overweight and obesity as compared with patients with AH and normal body weight. Also, the peptide level depends on the genotype of patients and is higher in AH patients with the genotype Asn198Asn and Lys198Asn as compared to carriers of the genotype Lys198Lys.

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Feasibility of remote support for electrophysiological ablation procedures during CoVid-19 pandemics

European Heart Journal ◽

10.1093/eurheartj/ehab724.3110 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A Muessigbrodt ◽

F Demoniere ◽

S Finoly ◽

M Mommarche ◽

J Inamo

Keyword(s):

Atrial Flutter ◽

Medical Training ◽

Human Life ◽

Heart Rhythm ◽

Left Ventricular ◽

Technical Support ◽

Right Atrial ◽

Global Challenge ◽

Heart Rhythm Disorders ◽

Technical Support Staff

Abstract The COVID-19 pandemics is a global challenge with a huge impact on medicine, politics, economy, education, travel and many other aspects of human life. The treatment of heart rhythm disorders has also been affected by the disease itself and by restrictions in order to constrain the spread of the virus. Catheter ablations of cardiac arrhythmias are nowadays frequently guided by electro-anatomic mapping systems. Technical staff with medical training, or medical staff with technical training, is needed to assist the operator. Travel restrictions due to current COVID-19 pandemics have limited the in person availability for technical support staff. To overcome these limitations we explored the feasibility of remote support with an internet based communication platform. A total of 9 patients (87,5% male, mean age 66,6 years) with different arrhythmias (atrial fibrillation, left atrial flutter, typical right atrial flutter, left ventricular tachycardia), having undergone ablation procedures between October 2020 and February 2021, were included. Acute procedural success was obtained in 9 out of 9 procedures. No complications occurred. Our experience with remote support for electro-anatomic mapping for complex electrophysiological ablation procedures, show the feasibility and safety of this approach. It increases the availability of technical support at reduced costs and a reduced CO2 footprint. Remote support for electro-anatomic mapping may therefore facilitate continuous care for patients with arrhythmias during the COVID-19 pandemics. Due to its advantages beyond COVID-19 pandemics related problems, it will likely play a greater role in the future. FUNDunding Acknowledgement Type of funding sources: None.

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LEVELS OF ESSENTIAL AND CONDITIONALLY ESSENTIAL NUTRIENTS IN THE INTRAOPERATIVE BIOPSY SPECIMENS OF CHILDREN WITH CONGENITAL HEART DISEASE AND HEART RHYTHM DISORDERS

Complex Issues of Cardiovascular Diseases ◽

10.17802/2306-1278-2018-7-2-112-120 ◽

2018 ◽

Vol 7 (2) ◽

pp. 112-120 ◽

Cited By ~ 1

Author(s):

A. V. Dubovaya ◽

G. E. Sukhareva

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Strong Correlation ◽

Congenital Heart ◽

Heart Rhythm ◽

Mineral Nutrients ◽

Emission Spectrometry ◽

Essential Nutrients ◽

Biopsy Specimens ◽

Heart Rhythm Disorders

Background. Despite recent numerous studies, etiopathogenesis, treatment and rehabilitation of children with heart rhythm disorders haven’t been studied well. We paid attention to the significant impact of mineral nutrients on cardiac activity, while addressing to the viable solutions. Aim. To measure the levels of essential and conditionally essential mineral nutrients and to determine any relationships between their concentrations in hair and in the intraoperative biopsy specimens obtained from children with congenital heart disease and heart rhythm disorders. Methods 55 children (34 boys and 21 girls) aged 6 to 17 years with different heart rhythm disorders and congenital heart disease were included in the study. Levels of 15 essential mineral nutrients (calcium, potassium, magnesium, sodium, phosphorus, sulfur, chromium, copper, iron, iodine, cobalt, manganese, molybdenum, selenium, zinc) and 3 conditionally essential nutrients (boron, silicon, vanadium) were measured in hair and in the intraoperative biopsy specimens obtained from children with congenital heart disease using inductively coupled plasma atomic emission spectrometry and electrothermal atomization atomic absorption spectrometry. The results of the study were processed using variational and alternative statistic methods with the commercially available software “MedStat”. Results The lack of essential nutrients (K, Mn, Se, Cr, P, Co, S, Cu, Na, Mo) and conditionally essential mineral, Si, in the intraoperative biopsy specimens of the heart and great arteries has been found. The direct strong correlation between the levels of essential (K, Mn, Se, Cr, Co) and conditionally essential (Si) minerals in hair and heart tissues of children with congenital heart disease and heart rhythm disorders has been determined. Conclusion The deficit of essential (potassium, manganese, selenium, chromium, phosphorus, cobalt, sulfur, copper, sodium, molybdenum) and conditionally essential (silicon) mineral nutrients, and the direct strong correlation between their levels in hair and heart tissues of children with congenital heart disease and heart rhythm disorders allows using hair as a biosubstrate, which is highly informative for the measurement of nutrients in the human body.

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Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia

Zaporozhye Medical Journal ◽

10.14739/2310-1210.2021.6.235435 ◽

2021 ◽

Vol 23 (6) ◽

pp. 766-771

Author(s):

T. O. Kulynych ◽

O. O. Lisova ◽

O. V. Shershnova ◽

A. V. Hrytsai

Keyword(s):

Heart Rate ◽

Total Duration ◽

Heart Rhythm ◽

Main Group ◽

Autonomic Regulation ◽

Control Group ◽

Ecg Monitoring ◽

Coronary Syndrome ◽

St Segment ◽

Heart Rhythm Disorders

Pneumonia presents a considerable challenge in patients with cardiovascular disease due to an increase in the incidence, difficulties of diagnosis and treatment, high mortality. Aim: to study the characteristics of cardiac arrhythmias and heart rhythm autonomic regulation in patients with chronic coronary syndrome (CCS) and community-acquired pneumonia (CAP), and to define their relationship with the clinical features of the disease. Materials and methods. A monocenter cross-sectional study analyzed 90 patients with CCS in parallel groups. The main group included 60 CCS patients with CAP; the control group consisted of 30 patients without concomitant CAP. A complex clinical examination of patients was performed on 1–3 days of hospital stay in accordance with the National Recommendations. Holter ECG monitoring was performed using a CARDIOSENS K device (XAI-MEDICA, Ukraine). Results. Based on the results of 24-hour ECG monitoring, heart rhythm disorders, increased duration of myocardial ischemia and ST-segment depression depth with an increase in the total duration of tachycardia episodes within 24 hours were more common in the main group patients. The severity of CAP on the PSI/PORT scale was correlated with the 24-hour mean heart rate (r = +0.31, P < 0.05), the number of ventricular extrasystoles – with respiratory rate (r = +0.29, P < 0.05), supraventricular extrasystoles – with the duration of ST-segment depression (r = +0.57, P < 0.05). In patients with CCS and CAP, there was a decrease in the total heart rate variability (HRV), mainly in the passive period, combined with an increase in the LF/HF ratio and stress index (SI), which was directly correlated with the severity of CAP and intoxication syndrome. Conclusions. Patients with CCS and CAP are characterized by the increased 24-hour heart rate, duration of ST-segment depression, frequency of supraventricular and ventricular arrhythmias on 24-hour Holter monitoring, paroxysms of atrial fibrillation with the decreased total HRV combined with significantly increased activity of the sympathetic autonomic nervous system.

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HAS-BLED scor system for the assessment of risk of breathing of patients on oral anticoagulant therapy // HAS-BLED skor sistem bodovanja za procjenu rizika od krvarenja pacijenata na oralnoj antikoagulantnoj terapiji

SESTRINSKI ŽURNAL ◽

10.7251/sez0118011d ◽

2018 ◽

Vol 5 (1) ◽

pp. 11

Author(s):

Daniela Dobrovoljski

Keyword(s):

Atrial Fibrillation ◽

Oral Anticoagulant ◽

Oral Anticoagulant Therapy ◽

Vitamin K Antagonists ◽

Oral Anticoagulants ◽

Heart Rhythm ◽

Clinical Problem ◽

Coagulation Factors ◽

Heart Rhythm Disorders ◽

Anticoagulant Drugs

Oral anticoagulant drugs (OALs) are effective agents in the prevention and treatment of thromboembolic complications. However, despite standardization and application progression, OALs represent a significant clinical problem because they are small-therapeutic medicines that easily interact with food and medicine, which can substantially affect the increased or weakened therapeutic effect. Oral anticoagulants are 4-hydroxycoumarin derivatives and vitamin K antagonists, and their pharmacological activity is based on inhibition of the synthesis of coagulation factors in the liver. These drugs are effective in the prevention of venous thromboembolism, acute myocardial infarction (AIM), heart rhythm disorders by type of atrial fibrillation, stroke prevention, and the like. The most important and clinically commonly undesirable effect of OAL is bleeding. The risk of bleeding is greatest during the introduction of the drug in therapy and for the first few months of the onset of therapy. HAS-BLED scor is a skoring system developed to estimate the 1-year risk of major bleeding in patients with atrial fibrillation and is also used for other indications.

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Problem of prescribing anticoagulant therapy in patients with atrial fibrillation on the regional level

Medical Council ◽

10.21518/2079-701x-2020-11-19-25 ◽

2020 ◽

pp. 19-25

Author(s):

M. G. Nazarkina ◽

V. V. Stolyarova ◽

D. A. Karpova

Keyword(s):

Atrial Fibrillation ◽

Anticoagulant Therapy ◽

Oral Anticoagulants ◽

Significant Proportion ◽

Heart Rhythm ◽

Regional Level ◽

Thromboembolic Complications ◽

Constant Form ◽

Heart Rhythm Disorders ◽

The Republic

Introduction. Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, with heart rhythm disorders accounting for a significant proportion of them. Atrial fibrillation (AF) is an arrhythmia that poses a risk of thromboembolic complications and is difficult to treat with ongoing preventive anticoagulant therapy. Aim of the study. To analyze the prescription of anticoagulant therapy to patients with AF on the regional level. Methods and results. The study included 72 patients with the nonvalvular form of AF (from 41 to 82 years old) of the Department of Rhythm and Conductivity Abnormalities of the State Budgetary Institution of the Republic of Mordovia RCH № 4 for 2019. Three groups were singled out depending on the AF form: the first one – patients with the constant form (n = 22), the second one (n = 24) – with the persistent form, the third one (n = 24) – with the paroxysmal form. The risk of thromboembolic complications was assessed using the CHA2DS2-VASc scale and hemorrhagic complications using the HAS-BLED scale. All patients had a high risk of thromboembolism (index above 2 points), which reflects multiple risk factors and indicates the need for oral anticoagulants (OAC). According to HAS-BLED scale calculations, the risk of haemorrhagic complications was low in most patients (2 or less points) – there was no significant increase in the risk of bleeding, but careful monitoring is required. Analysis of the results revealed that only 54% of patients took OAC, despite the fact that all patients were shown anticoagulant therapy. When analyzing the cases of patients who did not take anticoagulants, it was found that 23% of patients, despite the doctor’s recommendations, refused to take the drugs, 47% of patients justified the inability to control IHR and 30% were unable to purchase expensive new OAC. Conclusion. Despite the recommendations for the management of patients with atrial fibrillation, only 54% were prescribed oral anticoagulants.

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