scholarly journals Can Intradetrusor OnabotulinumtoxinA Injections Alter Heart Function in Patients with Cardiac Arrhythmia?

2018 ◽  
Vol 7 (9) ◽  
pp. 263
Author(s):  
Pawel Miotla ◽  
Pawel Olejniczak ◽  
Konrad Futyma ◽  
Andrzej Wrobel ◽  
Michal Tomaszewski ◽  
...  
Keyword(s):  
Heart Rate ◽  
Overactive Bladder ◽  
Cardiac Arrhythmia ◽  
Heart Function ◽  
Phone Call ◽  
Anticholinergic Drugs ◽  
Normal Range ◽  
Clinically Significant ◽  
Electrocardiogram Ecg

The prevalence of overactive bladder (OAB) increases with age and can be associated with other co-morbidities, such as cardiac arrhythmia. Unfortunately, commonly used anticholinergic drugs for OAB can affect the cardiovascular system, leading to tachycardia. However, there are no data, which consider the influence of intradetrusor onabotulinumtoxinA injections on heart function in idiopathic OAB patients. The aim of the present study was to evaluate the influence of intradetrusor onabotulinumtoxinA injections on electrocardiogram (ECG) parameters. Additionally, changes in ECG were analyzed in OAB patients without cardiac arrhythmia. Thirty-one patients with cardiac arrhythmia and 31 participants without irregular heart rate (HR) completed the study. ECG measurements were performed in supine positions 2 h before onabotulinumtoxinA injections, 1 h after treatment, and at 2 weeks of follow-up. At week 6, a phone-call survey was conducted to collect data about adverse events. OnabotulinumtoxinA injections were performed with rigid cystoscopy under local anesthesia. We did not observe any clinically significant changes in the analyzed ECG parameters between consecutive measurements. While a slight increase of HR was observed in patients without cardiac arrhythmia, it remained within normal range. Intravesical onabotulinumtoxinA injections are, hence, safe for female patients with cardiac arrhythmia and do not significantly influence changes in ECG.

scholarly journals Heart Rate Monitor Instead of Ablation? Atrioventricular Nodal Re-Entrant Tachycardia in a Leisure-Time Triathlete: 6-Year Follow-Up

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 391 ◽  
Author(s):  
Robert Gajda
Keyword(s):  
Heart Rate ◽  
Diagnostic Tool ◽  
Leisure Time ◽  
Submaximal Exercise ◽  
Training Load ◽  
Heart Rate Monitor ◽  
Heart Rate Monitors ◽  
Amateur Athlete ◽  
Electrocardiogram Ecg

This study describes a triathlete with effort-provoked atrioventricular nodal re-entrant tachycardia (AVNRT), diagnosed six years ago, who ineffectively controlled his training load via heart-rate monitors (HRM) to avoid tachyarrhythmia. Of the 1800 workouts recorded for 6 years on HRMs, we found 45 tachyarrhythmias, which forced the athlete to stop exercising. In three of them, AVNRT was simultaneously confirmed by a Holter electrocardiogram (ECG). Tachyarrhythmias occurred in different phases (after the 2nd–131st minutes, median: 29th minute) and frequencies (3–8, average: 6.5 times/year), characterized by different heart rates (HR) (150–227 beats per minute (bpm), median: 187 bpm) and duration (10–186, median: 40 s). Tachyarrhythmia appeared both unexpectedly in the initial stages of training as well as quite predictably during prolonged submaximal exercise—but without rigid rules. Tachyarrhythmias during cycling were more intensive (200 vs. 162 bpm, p = 0.0004) and occurred later (41 vs. 10 min, p = 0.0007) than those during running (only one noticed but not recorded during swimming). We noticed a tendency (p = 0.1748) towards the decreasing duration time of tachycardias (2014–2015: 60 s; 2016–2017: 50 s; 2018–later: 37 s). The amateur athlete tolerated the tachycardic episodes quite well and the ECG test and echocardiography were normal. In the studied case, the HRM was a useful diagnostic tool for detecting symptomatic arrhythmia; however, no change in the amount, phase of training, speed, or duration of exercise-stimulated tachyarrhythmia was observed.

Botulinum toxin therapy for nonneurogenic overactive bladder: first experience

2011 ◽  
Vol 18 (3) ◽  
pp. 120-126
Author(s):  
Aušra ČERNIAUSKIENĖ ◽  
Feliksas JANKEVIČIUS
Keyword(s):  
Botulinum Toxin ◽  
Overactive Bladder ◽  
Botulinum Toxin A ◽  
Urine Volume ◽  
Bladder Capacity ◽  
Anticholinergic Drugs ◽  
Detrusor Muscle ◽  
Residual Urine Volume ◽  
Toxin A

The paper presents early experience in the treatment of 20 patients with botulinum toxin injections into the detrusor muscle for the treatment of non-neurogenic overactive bladder (OAB) resistant to anticholinergic drugs. Background. Botulinum toxin, a presynaptic neuromuscular blocking agent, reduces the involuntary bladder contractions that cause urgency, frequency and urge incontinence. We present our early experience with Dysport® injections into the detrusor for the treatment of non–neurogenic overactive bladder (OAB) resistant to anticholinergic drugs. Materials and methods. Using intravenous anaesthesia, 20 patients (18 female and 2 male) with non-neurogenic OAB were injected with botulinum toxin A (Dysport®250 IU diluted in 4 ml normal saline) under cystoscopic visualization in 20 sites in the detrusor muscle, sparing the trigone. The urethral catheter was removed 24 hours after the procedure. Follow-up at 3 and 6 months after the injection included the Urogenital Distress Inventory UDI-6, the Incontinence Impact Questionnaire IIQ-7, clinical parameters and ultrasound measurement of bladder capacity and post-void residual urine volume. Results. All 20 patients completed questionnaires and were examined after 3 and 6 months. At the 3-month follow-up, the median daytime micturation frequency decreased from 10.4 to 4.6 times (p < 0.0001) and at the 6 months follow-up 5 times (p < 0.0001), while nocturia decreased from 4.2 to 1.3 times after 3 months (p < 0.0001) and after 6 months to 2 times (p < 0.0001). Urgency decreased from 6 to 1.5 times after 3 months (p < 0.0001) and to 2 times after 6 months (p < 0.0001), and incontinence decreased from 4.2 times to 1.5 times after 3 months (p < 0.0001) and to 2.1 times after 6 months (p < 0.0001). The median maximum bladder capacity increased from 250 to 420 ml after 3 months (p < 0.0001) and decreased to 350 ml after 6 months (p < 0.0001). The post-void median residual urine volume was 10 ml. Only one patient mentioned a post-operative obstructive voiding difficulty. Eighteen (90%) patients were satisfied with the treatment. In two patients (10%), the amelioration of symptoms lasted for one month only, and later OAB symptoms reappeared. Analysis of the UDI-6 and IIQ-7 questionnaires revealed that botulinum toxin A intradetrusor injection had decreased discomfort for patients and ameliorated their quality of life. Conclusions. Botulinum toxin A injections in the detrusor are effective for the treatment of non-neurogenic OAB. Botulinum toxin A injections are a minimally invasive therapy and offer an alternative treatment for non–neurogenic OAB dysfunction resistant to conservative treatment. The durability of the treatment effect is the objective of the further investigation. Keywords: botulinum toxin, overactive bladder, urinary incontinence

scholarly journals A case report of cardiac toxicity from barracuda ingestion in Mexico

2020 ◽  
Author(s):  
Alice Haouzi ◽  
Haitham Khraishah ◽  
Jamie Diamond ◽  
Duane S Pinto
Keyword(s):  
Heart Rate ◽  
Gastrointestinal Symptoms ◽  
Neurological Symptoms ◽  
Cardiac Complications ◽  
Permanent Pacing ◽  
Temporary Treatment ◽  
Symptomatic Bradycardia ◽  
Cardiac Manifestations ◽  
Electrocardiogram Ecg

Abstract Background Ciguatera toxicity is a fish-borne illness that initially manifests with gastrointestinal symptoms, followed by bizarre neurological symptoms including heat-cold sensation alteration, peculiar feeling of loose teeth, and peripheral neuropathy. However, cardiac manifestations are rare and underreported in the literature. Case summary A 73-year-old man presented with symptomatic bradycardia and hypotension after ingestion of barracuda fish in Mexico. He received atropine and dopamine with subsequent improvement in his symptoms, but continued to experience peripheral neuropathic and other odd sensations. Four of his family members ingested the same fish and had similar symptoms. He was managed conservatively and did not require temporary or permanent pacing. Within 1 week from toxin exposure, bradycardia had improved. Heart rate was 40–50 b.p.m. at rest, and he was discharged with an ambulatory monitor. Heart rate had increased to 77 b.p.m. at 1-month follow-up on repeat electrocardiogram (ECG). Discussion Although the predominant manifestations of ciguatera toxicity are neurological, cardiac complications tend to be more acute and require attention. Unlike neurological symptoms, bradycardia and hypotension are short-lived, often resolving within a week. Treatment continues to be largely supportive, and patients may require temporary treatment with positive chronotropic agents such as atropine or dopamine.

scholarly journals Limbal Approach Phacovitrectomy to Treat Cataract with Clinically Significant Asteroid Hyalosis—Presentation of the Technique and Preliminary Results

2021 ◽  
Vol 10 (15) ◽  
pp. 3338
Author(s):  
Agnieszka Rozegnał-Madej ◽  
Aleksandra Wlaź ◽  
Tomasz Żarnowski
Keyword(s):  
Surgical Technique ◽  
Case Series ◽  
Normal Range ◽  
Corrected Visual Acuity ◽  
Retinal Tears ◽  
Asteroid Hyalosis ◽  
The Mean ◽  
Clinically Significant ◽  
New Surgical Technique

Purpose: To assess preliminarily the efficacy and safety of a relatively new surgical modification of phacovitrectomy in eyes with cataract and visually significant asteroid hyalosis (AH). Materials and methods: Prospective, noncomparative, interventional case series of six eyes of six patients (mean age 75.6 years; 1 woman, 5 men) with cataract and visually significant AH treated with a novel surgical technique—a phacoemulsification with anterior vitrectomy through posterior capsulorhexis and intraocular lens (IOL) implantation. Main outcome measures were: best-corrected visual acuity (BCVA), intraocular pressure (IOP), IOL centration, complications. Mean follow-up was 39.17 ± 4.31 months. Results: The mean BCVA (Snellen) improved from 0.26 ± 0.18 to 0.73 ± 0.33 at the end of the follow-up. IOP was in the normal range, and no problems with IOL fixation were observed at the end of the follow-up. No post-operative complications, retinal detachment, retinal tears, macular edema or prolonged inflammation were observed. Conclusions: The presented new surgical technique seems to be a safe and efficacious method to treat cataract with visually significant asteroid hyalosis.

scholarly journals EFFICACY OF ANTICHLONERGIC DRUGS IN IDIOPATHIC OVERACTIVE BLADDER.

2019 ◽  
Vol 26 (07) ◽  
pp. 1183-1186
Author(s):  
Muhammad Zahid
Keyword(s):  
Overactive Bladder ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
Anticholinergic Drugs ◽  
Cross Sectional ◽  
International Consultation ◽  
Bladder Retraining ◽  
Solifenacin Succinate ◽  
Safe Side

Background: Symptoms of overactive bladder include urgency, frequency, and urge incontinence, with or without noctiuria. Symptoms are common in adults. The two main treatment options for overactive bladder syndrome are bladder retraining and anticholinergic drugs. Study Design: Cross sectional study. Setting: Urology Department, Kot Khawaja Saeed Hospital, Lahore. Period: January to June 2017. Methodology: Eighty patients were enrolled after informed consent. All patients were subjected to 5mg solifenacin succinate for three months. International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) was utilized to assess patient symptoms. Results: There 56 males (70%) and 24 female (30%) with mean age of 43 ± 1.6 years. Efficacy of solifenacin was found in 61 cases out of 80 patients. On first visit 19 (31%) patients were cured, 17 (28%) on second month follow up and 25 (41%) were cured on third month follow up. Conclusion: Solifenacin has significant role in managing patients with overactive bladder. It has a relatively safe side effect profile.

Immunologic Assessment of Patients Treated with Bovine Fibrin as a Hemostatic Agent

1996 ◽  
Vol 76 (06) ◽  
pp. 0925-0931 ◽  
Author(s):  
John F Carroll ◽  
Keith A Moskowitz ◽  
Niloo M Edwards ◽  
Thomas J Hickey ◽  
Eric A Rose ◽  
...  
Keyword(s):  
Coagulation Factors ◽  
Allergic Reactions ◽  
Factor V ◽  
Normal Range ◽  
Serum Samples ◽  
Human Fibrinogen ◽  
Bovine Thrombin ◽  
Thrombotic Complications ◽  
The Mean ◽  
Clinically Significant

SummaryTwenty-one cardiothoracic surgical patients have been treated with fibrin as a topical hemostatic/sealing agent, prepared from bovine fibrinogen clotted with bovine thrombin. Serum samples have been collected before treatment with fibrin and postoperatively between 1 and 9 days, 3 and 12 weeks, and 6 and 8 months. The titers of anti-bovine fibrinogen antibodies, measured by ELISA specific for immunoglobulins IgG or IgM, increased to maximal values after about 8 or 6 weeks, respectively. After 8 months, IgG titers were on average 20-fold lower than the mean maximal value, while IgM titers returned to the normal range. IgG was the predominant anti-bovine fibrinogen immunoglobulin as documented by ELISA, affinity chromatography and electrophoresis. Anti-bovine fibrinogen antibodies present in patients reacted readily with bovine fibrinogen, but did not cross-react with human fibrinogen as measured by ELISA or by immunoelectrophoresis. A significant amount of antibodies against bovine thrombin and factor V has been found, many cross-reacting with the human counterparts. No hemorrhagic or thrombotic complications, or clinically significant allergic reactions, occurred in any patient, in spite of antibody presence against some bovine and human coagulation factors. The treatment of patients with bovine fibrin, without induction of immunologic response against human fibrinogen, appeared to be an effective topical hemostatic/sealing measure.

Effect of amiodarone on heart rate variability in patients with newly diagnosed atrial fibrillation (clinical observation)

2020 ◽  
pp. 81-85
Author(s):  
E. P. Popova ◽  
O. T. Bogova ◽  
S. N. Puzin ◽  
D. A. Sychyov ◽  
V. P. Fisenko
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Drug Therapy ◽  
Heart Function ◽  
Newly Diagnosed ◽  
Class Iii ◽  
Spectral Parameters ◽  
Patient Will ◽  
The Individual

Spectral analysis of heart rate variability gives an idea of the role of the autonomic nervous system in the regulation of chronotropic heart function. This method can be used to evaluate the effectiveness of drug therapy. Drug therapy should be carried out taking into account the individual clinical form of atrial fibrillation. Information about the vegetative status of the patient will undoubtedly increase the effectiveness of treatment. In this study, spectral parameters were studied in patients with newly diagnosed atrial fibrillation. The effect of antiarrhythmic drug class III amiodarone on the spectral parameters of heart rate variability was studied.

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