A J Camm

..quot;Atrial" turbulence slope (TSA) moderately correlates with "ventricular" turbulence slope (TSV). This study investigated the value of TSA assessed in 24-hour Holter recordings for postinfarction risk stratification...

..It also delves into the potential benefits and limitations of 5-HT4 antagonists in the prevention and management of this arrhythmia...

..Arrhythmology guidelines now must be funded, implemented, value tested, and regularly revised...

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..Long-term goals of antiarrhythmic therapy include upstream approaches, such as identification of the biochemical intermediaries of the process and, eventually, of molecular and genetic lesions involved in arrhythmogenesis...

..Azimilide, a novel class III antiarrhythmic drug, was investigated for its effects on mortality in patients with depressed LVF after recent MI and in a subpopulation of patients with low HRV...

..The safety profile of ivabradine was also investigated...

..Despite the lack of formal studies there is a very substantial clinical experience which testifies to the value of hybrid therapy for the management of both atrial fibrillation and ventricular tachycardia/fibrillation...

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..However, QTd may be largely due to projections of the repolarization dipole rather than "nondipolar" signals...

..Newer concepts evaluating spatial and temporal irregularity of ventricular repolarization are still needed to reliably detect the effects of autonomic activity on ventricular repolarization...

..This substudy tested a prospective hypothesis that European Myocardial Infarct Amiodarone Trial (EMIAT) patients with depressed heart rate variability (HRV) benefit from amiodarone treatment...

..Thus in patients with paroxysmal AF, digoxin leads to more reproducible patterns of ventricular cycles that may be better tolerated clinically...

..02), respectively. CONCLUSIONS: An innovative analysis of frequency-domain HRV, which characterizes the distribution of spectral power within the low-frequency band, is a potent and independent risk stratifier in postinfarction patients...

..There is individual variation in the pacing site that leads to the greatest improvement. In the group as a whole, biventricular and LV pacing produced only modest improvements compared to RV pacing...

..During a mean follow-up period of 13 months (range, 2 to 24 months), there were three cases of recurrent VT (in all patients VT remained inducible) and no sudden deaths.(ABSTRACT TRUNCATED AT 250 WORDS)..

..Exercise tolerance was significantly greater during treatment with xamoterol/amiodarone than during treatment with metoprolol/amiodarone or with amiodarone alone...

..The study showed a satisfactory short- and long-term reproducibility of Ptot in the atrial SAECG in healthy subjects. However, low reproducibility of the voltage parameters should be considered in clinical applications...

..These new temporal and wavefront direction descriptors are sensitive and rapid detectors of autonomic effects on ventricular repolarization...

..To assess the changes in quality of life, arrhythmia symptoms, and hospital resource utilisation following catheter ablation of typical atrial flutter...

..The selection of patients for prophylactic implantable cardioverter-defibrilator (ICD) treatment after myocardial infarction (MI) remains controversial...

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..Current therapeutic strategies are discussed including the role of drugs, the implantable cardioverter defibrillator, surgery and dual chamber pacing...

..This article will review both the established and the new methods of risk stratification for the post MI patient, with particular attention to antiarrhythmic therapy...

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..Contemporary information is lacking on the effect of demographic features and clinical features on the specific mode of mortality after myocardial infarction (MI) in the thrombolytic era...

..By combining HR turbulence, BRS, and SDNN, a comprehensive assessment of cardiac autonomic reflexes and modulation can be obtained...

..This contradicts the finding of decreased transmural repolarization heterogeneity by amiodarone and the appreciated antiarrhythmic efficacy of this drug...

..In the meantime the pendulum of clinical opinion has begun to swing towards a rhythm control strategy...

..Most recently, in addition to the conventional two leads used for pacing, a third lead to pace the left ventricle has been advocated in some patients with heart failure. We review the evidence for pacing in heart failure...

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..Increased QT dispersion may be both a substrate for sudden cardiac death and a marker of risk in patients with Prinzmetal's variant angina...

..The purpose of this study was to design a more efficient protocol for the electrical cardioversion of atrial arrhythmias...

..A proven association could have important implications for public health worldwide, potentially leading to novel and relatively inexpensive therapeutic measures in the secondary prevention of CHD--broad-spectrum antibiotics...

..Initial results are encouraging, particularly for atrial flutter. However, the drug has the potential for proarrhythmic effects and physicians who use it will need to be aware of these...

..The evolution of hybrid therapy, in which two or more different strategies are employed in the same patient, may be the most effective approach to management of AF...

..The prognostic value of blood pressure measured during hospitalization after acute myocardial infarction (MI) has not been investigated, particularly with regard to arrhythmic death...

..Ivabradine has been associated with a good safety profile during its clinical development and its safety will be further assessed by postmarketing surveillance and during on-going clinical trials...

..To investigate the use of ambulatory electrocardiogram (ECG) monitoring in atrial fibrillation (AF) to predict recurrence after electrical cardioversion (ECV)...

..To prospectively determine whether ventricular rate and regularity are significant determinants of the velocity and magnitude of left atrial appendage (LAA) flow...

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..The regulatory perspective includes careful adaptation of new research findings...

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..Their definitions, clinical features, diagnostic criteria, pathophysiologic mechanisms, and optimum management are discussed in this review...

..Current consensus documents on Brugada syndrome recommend the diagnostic intravenous administration of a Na-channel blocker to be stopped when the QRS prolongs to > or =130% of baseline, presumably because of increased arrhythmic risk...

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..g., three complexes in one lead only)...

..Previously, we have shown that higher expression of heat shock protein (HSP) 70 was associated with decreased incidence of postoperative AF (PoAF), suggestive of an antiarrhythmic role...

..Accurate diagnosis and appropriate therapy of the sinus tachycardias not only prevents multiple consultations but might also have important long-term prognostic implications...

..We hypothesised that more powerful shocks would exceed the upper limit of vulnerability for inducing ventricular fibrillation. The initial use of higher energy could therefore reduce arrhythmic complications...

..52), underlying disease ( P =0.94), medication and gender (2.84+/-0.72 in females vs 2.97+/-0.67 in males; P =0.431). In conclusion, our findings do not indicate any role of mtDNA in the pathophysiology of AF...

..Whereas in women at all heart rates the sequence of repolarization more closely replicates the sequence of depolarization, localized repolarization is more heterogeneous than in men especially at fast heart rates...

..0028) and created a significant difference between the two slopes (P = 0.0004). The evolution of P-SAECG parameters after ECV differs in patients whose AF recurs versus patients who remain in SR...

..Its predictive power did not differ significantly between the sexes. The role of TCRT as a risk-stratifier in post-MI patients deserves further prospective assessment in multivariate models with established risk factors...

..In conclusion, increased QT dispersion is not associated with increased mortality in patients with heart failure, and is not suitable to examine drug efficacy in these patients...

..Heart rate turbulence (HRT) represents a biphasic chronotropic response of the sinus node to a single ventricular premature beat (VPB)...

..Dynamics of AV delay has little impact on the accuracy of HRT assessment from surface ECG. The significant temporal dissociation of R-R and AV interval dynamics after a VPB remains unexplained...

..Total R T cosine (TCRT) is a new descriptor of repolarization heterogeneity that quantifies the deviation between the directions of ventricular depolarization and repolarization. It revives the old concept of ventricular gradient (VG)...

..This has practical implications for a precise estimation of the heart rate-corrected QT interval in which optimized subject-specific rate correction formulas should be used...

..Dual chamber cardioverter-defibrillators with capacity to prevent and interrupt AF may offer more comprehensive and successful treatment for patients with advanced heart disease, frequent paroxysms of AF, and the risk of proarrhythmia...

..The specific bradycardic agents, by the very nature of their mode of action, may prove ideal therapies for the management of the sinus tachyarrhythmias, and this is explored at every stage...

..We aimed to test whether lowering the heart rate with ivabradine reduces cardiovascular death and morbidity in patients with coronary artery disease and left-ventricular systolic dysfunction...

..The results from large scale, prospective antibiotic trials in CHD, currently in progress, should help to clarify these important issues...

..Controlled clinical studies are still required, however, to establish a firm, evidence-based foundation for the use of LMWHs in AF...

..Furthermore, the cost of this form of therapy is very high and its prophylactic use has not been established...

..Digoxin is commonly prescribed in symptomatic paroxysmal atrial fibrillation (AF) but has never been evaluated in this condition...

..A sex difference was also observed for HR and QTc interval; however, the circadian patterns of the repolarization homogeneity descriptors were different from those of HR and QTc intervals...

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..Despite this progress, no single modality confers benefit for all patients. Strategies to combine these treatment modalities in a hybrid approach has shown increasing promise for subgroups of AF patients...

..The presence of AF is associated with increased morbidity and mortality from stroke and heart failure, particularly in patients with structural heart disease...

..LQTS may cause sudden cardiac death (SCD), but the mechanisms linking gene mutations to ventricular fibrillation (VF) are unclear...

..To compare the QT/RR relation in healthy subjects in order to investigate the differences in optimum heart rate correction of the QT interval...

..To determine the effect of multisite pacing on left ventricular function...

..Biventricular function assessment should be added to the aortic root evaluation, so that appropriate treatment may be offered to support myocardial function...

..Thus, QT dispersion appears to reflect merely the presence of more complex repolarization patterns in patients at risk of arrhythmias...

..The safety of ivabradine will be further assessed by postmarketing surveillance and during on-going clinical trials...

..Notwithstanding these considerations, most patients with AF can be considered for rhythm control, provided there is adequate pre-treatment assessment and protocols for initiation, dosing and monitoring are followed with care...

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..93). CONCLUSIONS: Intracellular, but not serum, HSP70 level is negatively correlated with postoperative atrial fibrillation. This suggests a cardioprotective and an antiarrhythmic role for intracellular HSP70...

..CONCLUSIONS: Antibiotic treatment significantly reduced adverse cardiac events in patients with acute coronary syndromes, but the effect was independent of H pylori or C pneumoniae seropositivity...

..Patients with mild left ventricular hypertrophy (LVH) are not free of events. Regional heterogeneity of LVH may contribute to arrhythmic vulnerability...

..The goal of this study was to identify the factors responsible for embolic complications of direct current (DC) cardioversion of atrial arrhythmias...

..We sought to decipher metabolic processes servicing the increased energy demand during persistent atrial fibrillation (AF) and to ascertain whether metabolic derangements might instigate this arrhythmia...

..Leads V(1) and V(2) recorded from the standard position (fourth intercostal space) have insufficient sensitivity to detect the diagnostic type 1 Brugada ECG pattern...

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..Risk stratification after myocardial infarction (MI) remains expensive and disappointing. We designed a prognostic indicator using demographic information to select patients at risk of dying after MI...

..Although cases of Brugada-type electrocardiographic (ECG) pattern in peripheral (limb) leads have been reported ("atypical" Brugada syndrome [BS]), their incidence in patients investigated for BS is unknown...

..In both subjects, T-wave complexity of the first post-VPB beat was significantly increased compared to the beats preceding the VPB...

..However, the benefits and risks of this approach have not been adequately studied...

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