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J Forensic Sci 2021 May 7. Epub 2021 May 7.

Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Milano, Italy.

Blunt chest trauma (BCT) often results in blunt cardiac injuries of little clinical concern, but cases of severe heart damage with high mortality rates have also been described. In particular, BCT should never be underestimated, especially when it is located in the anterior thoracic region. Among traffic accidents, motorcyclists are the most vulnerable and at the greatest risk. Read More

J Am Heart Assoc 2021 May 7:e020033. Epub 2021 May 7.

Department of Cardiovascular Medicine Mayo Clinic Rochester MN.

Background The temporal incidence of high-grade atrioventricular block (HAVB) after transcatheter aortic valve replacement (TAVR) is uncertain. As a result, periprocedural monitoring and pacing strategies remain controversial. This study aimed to describe the temporal incidence of initial episode of HAVB stratified by pre- and post-TAVR conduction and identify predictors of delayed events. Read More

J Nucl Cardiol 2021 May 6. Epub 2021 May 6.

Heart and Vascular Institute, Henry Ford West Bloomfield Hospital, 6777 West Maple, West Bloomfield, MI, 48322, USA.

Front Pharmacol 2021 20;12:667254. Epub 2021 Apr 20.

Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.

The renin-angiotensin-aldosterone system (RAAS) firstly considered as a cardiovascular circulating hormonal system, it is now accepted as a local tissue system that works synergistically or independently with the circulating one. Evidence states that tissue RAAS locally generates mediators with regulatory homeostatic functions, thus contributing, at some extent, to organ dysfunction or disease. Specifically, RAAS can be divided into the traditional RAAS pathway (or classic RAAS) mediated by angiotensin II (AII), and the non-classic RAAS pathway mediated by angiotensin 1-7. Read More

JACC Cardiovasc Interv 2021 May;14(9):981-991

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address:

Objectives: The aim of this study was to validate the 2019 consensus algorithm in a large cohort of contemporary transcatheter aortic valve replacement (TAVR) patients.

Background: The optimal management of patients with atrioventricular conduction disturbances after TAVR is unknown. Guidance was consolidated in an expert consensus algorithm in 2019. Read More

J Am Coll Cardiol 2021 May;77(18):2263-2273

Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.

Background: Permanent pacemaker implantation (PPI) remains one of the main drawbacks of transcatheter aortic valve replacement (TAVR), but scarce data exist on PPI after valve-in-valve (ViV) TAVR, particularly with the use of newer-generation transcatheter heart valves (THVs).

Objectives: The goal of this study was to determine the incidence, factors associated with, and clinical impact of PPI in a large series of ViV-TAVR procedures.

Methods: Data were obtained from the multicenter VIVID Registry and included the main baseline and procedural characteristics, in-hospital and late (median follow-up: 13 months [interquartile range: 3 to 41 months]) outcomes analyzed according to the need of periprocedural PPI. Read More

Heart Rhythm 2021 May 3. Epub 2021 May 3.

Department of Cardiology, Willem Einthoven Center of Arrhythmia research and Management, Leiden University Medical Center, The Netherlands. Electronic address:

Background: Cardiac sarcoidosis (CS) with right ventricular (RV) involvement can mimic arrhythmogenic right ventricular cardiomyopathy (ARVC). Histopathological differences may result in disease-specific RV activation patterns, detectable on the 12-lead electrocardiogram (ECG). Dominant subepicardial scar in ARVC leads to delayed activation of areas with reduced voltages, translating into terminal activation delay and occasionally (epsilon) waves with small amplitude. Read More

Heart Rhythm 2021 May 3. Epub 2021 May 3.

Section of Cardiac Electrophysiology, Division of Cardiology, University of California San Francisco, CA. Electronic address:

Herzschrittmacherther Elektrophysiol 2021 May 6. Epub 2021 May 6.

The Heart Center and University of Nairobi, Nairobi, Kenia.

We report the case of a pregnant woman with complete heart block during her first trimester who presented with dyspnea at the East African Heart Rhythm Project in Nairobi. There was no evidence of an acute cause (e.g. Read More

Biomed Res Int 2021 16;2021:6693221. Epub 2021 Apr 16.

Department of Anesthesiology, Bengbu Medical College, Bengbu, China.

Background: Although video-assisted thoracoscopy has a smaller incision than traditional surgery, the postoperative pain is still severe. Ultrasound-guided pectoral nerve block (PECS) II is a new technique that can reduce pain in patients, and it had not been reported in the analgesia after thoracoscopic lobectomy.

Methods: 40 patients scheduled for thoracoscopic lobectomy were randomly divided into two groups. Read More

Proc (Bayl Univ Med Cent) 2021 Jan 28;34(3):405-406. Epub 2021 Jan 28.

Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.

Seckel syndrome is a rare autosomal recessive disorder characterized by facial dysmorphic features known as bird-headed dwarfism. Only about 100 cases have been reported. Cardiac anomalies have been described as a potential association with Seckel syndrome. Read More

Sci Rep 2021 May 5;11(1):9565. Epub 2021 May 5.

Department of Physiology, Faculty of Medicine, University of Debrecen, Nagyerdei krt 98, 4012, Debrecen, Hungary.

Enhancement of the late Na current (I) increases arrhythmia propensity in the heart, while suppression of the current is antiarrhythmic. GS967 is an agent considered as a selective blocker of I. In the present study, effects of GS967 on I and action potential (AP) morphology were studied in canine ventricular myocytes by using conventional voltage clamp, action potential voltage clamp and sharp microelectrode techniques. Read More

Pediatrics 2021 May 5. Epub 2021 May 5.

Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii; and.

Acute rheumatic fever (ARF) is an acute inflammatory process resulting in rheumatic carditis, one of the most common acquired heart diseases in youth. Among the clinical manifestations of carditis, pathologic valve regurgitation and atrioventricular block are included in the criteria for the diagnosis of ARF. Besides atrioventricular block, ARF may often present with other arrhythmias, such as junctional tachycardia (JT). Read More

BMJ Open 2021 May 5;11(5):e044374. Epub 2021 May 5.

Medical Psychology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, Germany.

Introduction: Self-management (SM) may facilitate patient participation and involvement to become active and knowledgeable partners in the care of complex chronic conditions such as ventricular assist device (VAD) therapy. The 'SM model for patients on VAD support' will serve to distinguish between SM components, and will guide the development, implementation and evaluation of an evidence-based curriculum.

Methods And Analysis: This is a 3-phase, multicentre study. Read More

N Z Vet J 2021 May 5:1-27. Epub 2021 May 5.

School of Veterinary Science, Massey University, Palmerston North, New Zealand.

Aims: To compare the analgesic effect of morphine combined with maropitant and/or dexmedetomidine to morphine alone given at a higher dose, and to evaluate the pharmacokinetics of the drug combinations, in dogs undergoing ovariohysterectomy (OHE).

Methods: Forty client owned-dogs were randomised into four treatment groups (n=10 per group) each to receive a different analgesic protocol. After premedication with I/M acepromazine anaesthesia was induced with propofol to effect and maintained with isoflurane in 100% oxygen delivered via a circle system. Read More

Cardiovasc J Afr 2021 Apr 19;32:1-5. Epub 2021 Apr 19.

Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town; Cardiac Clinic, Groote Schuur Hospital, Cape Town, South Africa.

Background: The rate of cardiac implantable electronic device (CIED) implantation in low- and middle-income countries is increasing. Patients recieving these devices are frequently older and with multiple co-morbidities, which may later lead to complications requiring CIED removal. CIED removals are associated with life-threatening complications. Read More

Trials 2021 May 4;22(1):321. Epub 2021 May 4.

Department of Anesthesiology and Pain Medicine, Catharina Hospital, Michelangelolaan 2, Eindhoven, 5623 EJ, The Netherlands.

Background: Thoracic epidural analgesia is considered the gold standard for pain relief in video-assisted thoracoscopic surgery. This neuraxial technique blocks pain sensation by injecting a local anesthetic agent in the epidural space near the spinal cord to block spinal nerve roots. Recently, the erector spinae plane block has been introduced as a practical alternative to the thoracic epidural. Read More

J Vet Cardiol 2021 Apr 2;35:121-123. Epub 2021 Apr 2.

Department Small Animal Clinical Science, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA, USA.

A 3-year-old female spayed indoor/outdoor Siamese cat was diagnosed with cytauxzoonosis and irregular heart rhythm was appreciated during a physical examination. On electrocardiogram, the cat had an average ventricular rate of 144 beats/min with Wenckebach type (Mobitz type I) atrioventricular block. The QRS complexes of sinus conducted beats had left anterior fascicular block morphology, they were followed by two subsequent beats presented with a prolonged P-R interval and QRS conducted with a left bundle branch block. Read More

Med Gas Res 2021 Jul-Sep;11(3):88-93

School of Health, Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran.

Postoperative pain control is recognized as a challenging surgical issue receiving high priority in the healthcare system, and opioids are routinely prescribed for anesthesia and pain relief. This study aimed to investigate the effects of ropivacaine administered intraperitoneally alone or combined with dexmedetomidine or fentanyl on postoperative pain control following laparoscopic cholecystectomy. This randomized double-blind clinical trial recruited three equal-size block-randomized groups of patients (n = 138) scheduled for elective laparoscopic cholecystectomy at Valiasr Hospital, Arak, Iran, in 2019-2020 who received ropivacaine (40 mL/0. Read More

Eur J Clin Pharmacol 2021 May 3. Epub 2021 May 3.

Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Purpose: Empagliflozin, dapagliflozin, canagliflozin, and ertugliflozin have been shown in randomized controlled trials to improve cardiovascular, metabolic, and renal outcomes in heart failure patients. To date, there has not been any meta-analysis examining the differences in clinical outcomes across different SGLT2 inhibitors in heart failure patients.

Methods: Four electronic databases (PubMed, Embase, Cochrane, SCOPUS) were searched on 13 September 2020 for articles published from 1 January 2000 to 13 September 2020 examining the effect of SGLT2 inhibitors on cardiovascular, renal, and metabolic outcomes in heart failure patients. Read More

PLoS One 2021 3;16(5):e0251124. Epub 2021 May 3.

Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan.

Background: High-degree atrioventricular block (HAVB) is a prognostic factor for survival in patients with inferior ST-segment elevation myocardial infarction (STEMI). However, there is little information about factors associated with temporary pacing (TP). The aim of this study was to find factors associated with TP in patients with inferior STEMI. Read More

Minerva Anestesiol 2021 May 3. Epub 2021 May 3.

Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Background: The posterior Quadratus Lumborum Block (pQLB) has been used in postoperative pain management after Cesarean Section (CS). However, clinicians have no data about pQLB safety in pregnants, at increased risk of local anesthetic systemic toxicity (LAST). The purpose of the present study was to explore the efficacy and the safety of adding epinephrine to ropivacaine for bilateral pQLB vs. Read More

J Am Heart Assoc 2021 May 3:e016676. Epub 2021 May 3.

Department of Emergency Medicine and The Heart and Vascular Research Center MetroHealth Campus Case Western Reserve University Cleveland OH.

Background Amiodarone is administered during resuscitation, but its antiarrhythmic effects during targeted temperature management are unknown. The purpose of this study was to determine the effect of both therapeutic hypothermia and amiodarone on arrhythmia substrates during resuscitation from cardiac arrest. Methods and Results We utilized 2 complementary models: (1) In vitro no-flow global ischemia canine left ventricular transmural wedge preparation. Read More

Arrhythm Electrophysiol Rev 2021 Apr;10(1):51-58

Geisinger Heart Institute, Wilkes-Barre, PA, US.

Conduction system pacing (CSP) is a technique of pacing that involves implantation of permanent pacing leads along different sites of the cardiac conduction system and includes His bundle pacing and left bundle branch pacing. There is an emerging role for CSP to achieve cardiac resynchronisation in patients with heart failure with reduced ejection fraction and inter-ventricular dyssynchrony. In this article, the authors review these strategies for resynchronisation and the available data on the use of CSP in overcoming dyssynchrony. Read More

Local Reg Anesth 2021 23;14:75-83. Epub 2021 Apr 23.

Department of Orthopaedics, The 960th Hospital of the People's Liberation Army Joint Logistical Support Force, Jinan, Shandong, People's Republic of China.

Background: The aim of this study is to evaluate the effect of ultrasound-guided bilateral cervical plexus block on general anesthesia, postoperative analgesia, and surgical outcomes in patients undergoing total parathyroidectomy with autotransplantation.

Patients And Methods: Forty-eight ASA III-IV patients with hyperparathyroidism secondary to renal failure were included: 24 patients received ultrasound-guided bilateral superficial and deep cervical plexus block combined with general anesthesia (group A), and 24 patients received general anesthesia alone (group B). Postoperative patient-controlled intravenous analgesia was provided with sufentanil 2 μg/kg. Read More

Heart Rhythm 2021 May;18(5):835-836

Division of Cardiology, University of California San Francisco, San Francisco, California. Electronic address:

JACC Clin Electrophysiol 2021 Apr 22. Epub 2021 Apr 22.

Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China. Electronic address:

Objectives: This study sought to assess the predictive value of the proposed electrocardiogram and intracardiac electrogram characteristics for confirmation of left bundle branch (LBB) capture.

Background: Previously proposed criteria to distinguish left bundle branch pacing (LBBP) and left ventricular septum (LVS) pacing (LVSP) have not been fully validated.

Methods: A His bundle pacing lead, an LBBP lead, and a multielectrode catheter at the LVS were placed. Read More

Ultrasound Med Biol 2021 Apr 27. Epub 2021 Apr 27.

Department of Bioengineering, University of Pittsburgh School of Engineering, Pittsburgh, Pennsylvania, USA; Center for Ultrasound Molecular Imaging and Therapeutics, Department of Medicine, University of Pittsburgh School of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; Department of Mechanical Engineering and Materials Science, University of Pittsburgh School of Engineering, Pittsburgh, Pennsylvania, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address:

Thermal strain imaging (TSI) is an ultrasound-based imaging technique intended primarily for diseases in which lipid accumulation is the main biomarker. The goal of the research described here was to successfully implement TSI on a single, commercially available curved linear array transducer for heating and imaging of organs at a deeper depth. For an effective temperature rise of the tissue over a large area, which is key to TSI performance, an innovative multifocus beamforming approach was applied. Read More

Neth Heart J 2021 Apr 30. Epub 2021 Apr 30.

Department of Cardiology, University Hospital Ghent, Ghent, Belgium.

Introduction: New-onset left bundle branch block (LBBB) following transcatheter or surgical aortic valve replacement (LBBB) implies a proximal pathogenesis of LBBB. This study compares electrocardiographic characteristics and concordance with LBBB definitions between LBBB and non-procedure-induced LBBB controls (LBBB).

Methods: All LBBB patients at Ghent University Hospital between 2013 and 2019 were enrolled in the study. Read More

J Cardiovasc Electrophysiol 2021 Apr 29. Epub 2021 Apr 29.

Kepler University Hospital, Medical Faculty, Johannes Kepler University, Linz, Austria.

Introduction: MARVEL 2 assessed the efficacy of mechanical atrial sensing by a ventricular leadless pacemaker, enabling a VDD pacing mode. The behavior of the enhanced MARVEL 2 algorithm during variable atrio-ventricular conduction (AVC) and/or arrhythmias has not been characterized and is the focus of this study.

Methods: Of the 75 patients enrolled in the MARVEL 2 study, 73 had a rhythm assessment and were included in the analysis. Read More