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    Obstetric and perinatal outcome in anti-Ro/SSA-positive pregnant women: a prospective cohort study.
    Immunol Res 2017 Jan 30. Epub 2017 Jan 30.
    Obstetric and Gynecology Department, High Risk Pregnancy Unit, Autoimmune diseases and pregnancy clinic, University Hospital La Paz, Paseo de la Castella 261, 28046, Madrid, Spain.
    Anti-Ro/SS-A is one specific type of antinuclear antibodies. They are in the majority of cases associated with primary Sjögren syndrome (SS) but also in Systemic Lupus Erythematosus (SLE), rheumatoid arthritis (RA), and in healthy people. During pregnancy, they are mainly associated to congenital heart block (CHB) and neonatal lupus (NL). Read More

    Electrocardiographic assessments and cardiac events after fingolimod first dose - a comprehensive monitoring study.
    BMC Neurol 2017 Jan 18;17(1):11. Epub 2017 Jan 18.
    Charité Universitaetsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.
    Background: First dose observation for cardiac effects is required for fingolimod, but recommendations on the extent vary. This study aims to assess cardiac safety of fingolimod first dose. Individual bradyarrhythmic episodes were evaluated to assess the relevance of continuous electrocardiogram (ECG) monitoring. Read More

    Permanent pacemaker implantation in octogenarians with unexplained syncope and positive electrophysiologic testing.
    Heart Rhythm 2017 Jan 12. Epub 2017 Jan 12.
    2nd Department of Cardiology, National and Kapodistrean University of Athens Medical School, Attikon University Hospital, Athens, Greece.
    Background: Syncope is a common problem in the elderly, and a permanent pacemaker is a therapeutic option when a bradycardic etiology is revealed. However, the benefit of pacing when no association of symptoms to bradycardia has been shown is not clear, especially in the elderly.

    Objective: The aim of this study was to evaluate the effect of pacing on syncope-free mortality in patients aged 80 years or older with unexplained syncope and "positive" invasive electrophysiologic testing (EPT). Read More

    Effects of reduced food intake for 4 weeks on physiological parameters in toxicity studies in dogs.
    J Toxicol Sci 2017 ;42(1):31-42
    Drug Safety, Drug Safety and Pharmacokinetics Laboratories, Taisho Pharmaceutical Co., Ltd.
    This study sought to clarify the effects of reduced feeding on physiological parameters in dogs to enable appropriate evaluations of the safety and toxicity of test compounds. We measured alkaline phosphatase isozymes and the circulating blood volume, as well as clinical signs, body weight, hematology, blood chemistry, electrocardiography, organ weight, and histopathology, in male beagle dogs fed a diet consisting of 300 g/day or 150 g/day for 4 weeks. There were no abnormal clinical signs in any of the dogs. Read More

    Development and impact of arrhythmias after the Norwood procedure: A report from the Pediatric Heart Network.
    J Thorac Cardiovasc Surg 2017 Mar 16;153(3):638-645.e2. Epub 2016 Nov 16.
    Division of Cardiovascular Sciences, The National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.
    Objectives: The study objective was to determine the predictors of new-onset arrhythmia among infants with single-ventricle anomalies during the post-Norwood hospitalization and the association of those arrhythmias with postoperative outcomes (ventilator time and length of stay) and interstage mortality.

    Methods: After excluding patients with preoperative arrhythmias, we used data from the Pediatric Heart Network Single Ventricle Reconstruction Trial to identify risk factors for tachyarrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, junctional ectopic tachycardia, and ventricular tachycardia) and atrioventricular block (second or third degree) among 544 eligible patients. We then determined the association of arrhythmia with outcomes during the post-Norwood hospitalization and interstage period, adjusting for identified risk factors and previously published factors. Read More

    Early safety and efficacy of fingolimod treatment in Denmark.
    Acta Neurol Scand 2017 Jan 8;135(1):129-133. Epub 2016 Mar 8.
    Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
    Background: Initiation of fingolimod treatment is associated with a transient decrease of heart rate, and atrioventricular (AV) conduction block may occur.

    Objective: To evaluate the therapeutic effect and safety of fingolimod treatment in MS patients in Denmark with focus on cardiac and pulmonary side effects at treatment onset.

    Materials & Methods: We analysed data from the first 496 fingolimod-treated Danish patients, observed for at least 3 months. Read More

    Assessment Of Sinoatrial Node Function In Patients With Persistent And Long-Standing Persistent Forms Of Atrial Fibrillation After Maze III Procedure Combined With Mitral Valve operation.
    J Atr Fibrillation 2016 Jun-Jul;9(1):1408. Epub 2016 Jun 30.
    A.N. Bakoulev Scientific Center for Cardiovascular Surgery.
    Research Objective: Assessment of sinoatrial node function after Maze III procedure combined with a mitral valve operation.

    Methods: 100 patients were included in the research with persistent and long-standing persistent forms of atrial fibrillation (AF) and need of operative treatment concerning valve disease. The following preoperative preparation methods were executed to all patients: Electrocardiogram in 12 standard assignments;Two-dimensional echocardiographic with assessment of systolic and diastolic functions of the left ventricle, size of the left atrium and grade of valve disease;Transesophageal echocardiography for exclusion of blood clots in the left atrium and left atrial appendage;Coronary angiography for exclusion of coronary heart disease;Computer tomography for examination of cardiac chambers and anatomic characteristics of pulmonary veins. Read More

    Comfrey herbal remedy causing second-degree heart block: do not be outfoxed by digitalis.
    BMJ Case Rep 2016 Dec 1;2016. Epub 2016 Dec 1.
    Department of Accident and Emergency, King's College Hospital, London, UK.
    A previously well woman aged 63 years presents to the emergency department with vomiting, palpitations and 3 presyncopal episodes. She had no previous medical or cardiac history, with the patient stating that she tried a herbal remedy of boiled comfrey leaves for insomnia 18 hours before arrival to the department. Her ECG showed multiple abnormalities, including bradycardia, second-degree atrioventricular node block, Mobitz Type 2, a shortened QT interval, downsloping ST depression and presence of U waves. Read More

    Safety of regadenoson stress testing in patients with pulmonary hypertension.
    J Nucl Cardiol 2016 Nov 28. Epub 2016 Nov 28.
    Division of Cardiovascular Medicine, Department of Internal Medicine and Frankel Cardiovascular Center, University of Michigan, 2nd Floor CVC / SPC 5853, 1500 E. Medical Center Dr.,, Ann Arbor, MI, 48109-5853, USA.
    Objectives: We sought to determine the safety of regadenoson stress testing in patients with PH.

    Background: PH is increasingly recognized at more advanced ages. As many as one-third of patients with PH have coronary artery disease. Read More

    Surviving All Odds: A Unique Case of Multiple Congenital Unruptured Sinus of Valsalva Aneurysms Involving Both Left and Right Coronary Sinuses with Biventricular Dysfunction and Heart Block.
    Case Rep Cardiol 2016 2;2016:4654031. Epub 2016 Nov 2.
    Amrita Institute of Medical Sciences (AIMS), Amrita Vishwa Vidyapeetham University, Kochi, India.
    Aneurysms of the sinus of Valsalva are very uncommon, with an incidence ranging from 0.1 to 3.5% of all congenital heart defects. Read More

    Syncope in patients paced for atrioventricular block.
    Europace 2016 Nov 6;18(11):1735-1739. Epub 2016 Feb 6.
    Arrhythmologic Centre, Department of Cardiology, Ospedali del Tigullio, Lavagna 16033, Italy
    Aims: Although syncope is the main reason for cardiac pacing in ∼40% of patients affected by atrioventricular block (AVB), very few data are available on the benefit of cardiac pacing in preventing syncopal recurrences.

    Methods And Results: We retrospectively evaluated 229 consecutive patients (124 males, age 80 ± 10 years) who had received a permanent pacemaker from January 2009 to December 2013 for AVB and syncope (94 patients, 41%) or AVB without syncope (135 patients, 59%). In patients with AVB and syncope, a third-degree or Mobitz II second-degree AVB had been documented in 73 and was only suspected in another 21, all of whom had bundle branch block. Read More

    Long-term effects of frequent maximal breath-holding on the cardiac health of elite freedivers.
    Scand J Med Sci Sports 2016 Nov 22;26(11):1283-1286. Epub 2015 Dec 22.
    Department of Cardiology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
    Cardiac arrhythmias are commonly reported in freedivers during maximal voluntary breath-holds, but their influence on the cardiological status and their long-term effects on the cardiac health of these athletes have not been investigated. Here we present the results of a study on 32 healthy young men (mean age 32.6 ± 1. Read More

    Twenty-four hour Holter monitoring in finishing cattle housed outdoors.
    J Vet Cardiol 2016 Oct 6. Epub 2016 Oct 6.
    Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave., Manhattan, KS 66506, USA.
    Introduction: Atrial premature complexes have been reported to be the most common arrhythmia in cattle and is suspected to be secondary to systemic disease, especially gastrointestinal disease. In order to properly identify pathologic arrhythmia in cattle, the normal rhythm and arrhythmia prevalence should be defined. The objective of this study was to determine the normal heart rate, rhythm, number of ventricular premature complexes (VPCs), and atrial premature complexes (APCs) in unrestrained Angus steers. Read More

    Safety and Tolerability of Neladenoson Bialanate, a Novel Oral Partial Adenosine A1 Receptor Agonist, in Patients With Chronic Heart Failure.
    J Clin Pharmacol 2016 Sep 14. Epub 2016 Sep 14.
    Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
    We studied safety and tolerability of neladenoson bialanate, a novel oral selective partial adenosine A1 receptor agonist that maintains the cardioprotective effects of adenosine without the undesired side effects of a full agonist, in 2 pilot studies in patients with heart failure with reduced ejection fraction (HFrEF). The β-blocker interaction study was a single-blind, placebo-controlled study on the effects of a 30-mg single dose of neladenoson bialanate on atrioventricular (AV) conduction in 11 patients with HFrEF treated with β-blockers. The PARSiFAL pilot study was a double-blind, placebo-controlled study on the effects of a 7-day treatment with 10 or 20 mg neladenoson bialanate or placebo in 31 patients with HFrEF on β-blocker therapy. Read More

    Transient Trifascicular Block in Severe Hyperkalemia.
    J Assoc Physicians India 2015 Sep;63(9):74-5
    Resident, Department of Medicine, MLB Medical College, Jhansi, Uttar Pradesh.
    Hyperkalemia is a commonly encountered electrolyte abnormality that can significantly alter normal cardiac conduction. Potentially lethal dysrhythmias associated with hyperkalemia include complete heart block and Mobitz Type II second-degree AV block. We report a case of trifascicular block, due to hyperkalemia. Read More

    Atrioventricular block after ASD closure.
    Heart Asia 2016 1;8(2):26-31. Epub 2016 Aug 1.
    Department of Cardiology, Royal Children's Hospital, Heart Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia.
    Objective: Secundum atrial septal defect (ASD) is a common congenital heart defect. There is limited data on both early and late atrioventricular (AV) block post ASD closure. The aim of this study was to determine the incidence and risk factors of AV block associated with ASD closure. Read More

    [Anesthetic Management of a Patient who Developed Intraoperative Paroxysmal Supraventricular Tachycardia with Pulseless Electric Activity].
    Masui 2016 Jun;65(6):636-9
    A 75-year-old woman was scheduled to undergo an ileus operation under general combined with epidural anesthesia. Preoperative electrocardiogram (ECG) showed first-degree atrioventricular block. The patient received no preoperative antiarrhythmic medication. Read More

    Long-Term Follow-Up of Children with Heart Block Born from Mothers with Systemic Lupus Erythematosus: A Retrospective Study from the Database Pediatric and Congenital Heart Disease in University Hospitals Leuven.
    Pacing Clin Electrophysiol 2016 Sep 2;39(9):935-43. Epub 2016 Aug 2.
    Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium.
    Background: Children from mothers with systemic lupus erythematosus are frequently born with congenital heart block. This study aimed at evaluating long-term outcome because long-term data are scarce.

    Methods: In the database of pediatric and congenital heart disease (University Hospitals Leuven), 19 children from systemic lupus erythematosus mothers and who were born with or developed atrioventricular block were identified. Read More

    Heart block following stage 1 palliation of hypoplastic left heart syndrome.
    J Thorac Cardiovasc Surg 2016 Jul 11;152(1):189-94. Epub 2016 Apr 11.
    Department of Cardiology, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
    Objectives: Publicly available data from the Pediatric Heart Network's Single Ventricle Reconstruction Trial was analyzed to determine the prevalence, timing, risk factors for, and impact of second- and third-degree heart block (HB) on outcomes in patients who underwent stage 1 palliation (S1P) for hypoplastic left heart syndrome (HLHS).

    Methods: The presence and date of onset of post-S1P HB occurring within the first year of life, potential risk factors for HB, and factors known to predict poor outcomes after S1P were extracted. Multivariable logistic and Cox regression analyses were performed to identify risk factors for HB and to determine the effect of HB on 3-year transplantation-free survival. Read More

    Electrophysiological Mechanisms of Bayés Syndrome: Insights from Clinical and Mouse Studies.
    Front Physiol 2016 31;7:188. Epub 2016 May 31.
    Department of Medicine and Therapeutics, The Chinese University of Hong KongHong Kong, China; Department of Epidemiology and Preventive Medicine, Monash UniversityMelbourne, VIC, Australia.
    Bayés syndrome is an under-recognized clinical condition characterized by inter-atrial block (IAB). This is defined electrocardiographically as P-wave duration > 120 ms and can be categorized into first, second and third degree IAB. It can be caused by inflammatory conditions such as systemic sclerosis and rheumatoid arthritis, abnormal protein deposition in cardiac amyloidosis, or neoplastic processes invading the inter-atrial conduction system, such as primary cardiac lymphoma. Read More

    Mobitz type I and II atrioventricular blocks during fingolimod therapy.
    Neurol Sci 2016 Sep 25;37(9):1557-9. Epub 2016 May 25.
    Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini, 5, 80131, Naples, Italy.
    We investigated patients who showed a second-degree atrioventricular block (S-AVB) after the first fingolimod administration. We observed six patients with S-AVB, three Mobitz type I, and three type II. Monitoring continued on the second day for all patients. Read More

    A case of advanced second-degree atrioventricular block in a ferret secondary to lymphoma.
    Open Vet J 2016 15;6(1):68-70. Epub 2016 Apr 15.
    SAFU, Regina Elena Cancer Institute, Via delle Messi d' Oro 156, 00158 Rome, Italy.
    A female ferret was referred as an emergency for severe respiratory distress symptoms. At presentation, the patient was listlessness, dyspnoeic, and hyper-responsive. The clinical examination evidenced dyspnea with cyanosis, altered cardiac rhythm, and hepatomegaly. Read More

    Novel mutations in LMNA A/C gene and associated phenotypes.
    Acta Myol 2015 Dec;34(2-3):116-9
    Cardiomyology and Medical Genetics, Department of Experimental Medicine;
    Mutations in the lamin A/C gene (LMNA) have been associated with several phenotypes ranging from systemic to prevalent of muscle, heart, skin, nerve etc. More recently they have been associated with dilated cardiomyopathy (DCM) and severe forms of arrhythmogenic right ventricular cardiomyopathy (ARVC). We report four novel mutations - 3 missense and 1 deletion - in 4 unrelated patients showing different phenotypes, ranging from the early onset congenital form of laminopathy to classical LGMD phenotype, to LGMD and heart involvement. Read More

    Incidence and characteristics of heart block after heart surgery in pediatric patients: A multicenter study.
    J Thorac Cardiovasc Surg 2016 Jul 7;152(1):197-202. Epub 2016 May 7.
    Division of Pediatric Cardiology, Department of Pediatrics, New York-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY.
    Background: Advanced second- or third-degree heart block has been reported with variable incidence after surgery for congenital heart disease in children. We report the incidence of heart block requiring a pacemaker and describe the risk factors for this complication in a large multicenter study.

    Methods: We performed a retrospective cohort study, using the Pediatric Health Information System database from 45 hospitals in the United States, for all children aged 18 years, discharged between January 1, 2004, and December 31, 2013, who underwent open surgery for congenital heart disease. Read More

    Continuous intraoperative monitoring of vagus and recurrent laryngeal nerve function in patients with advanced atrioventricular block.
    Langenbecks Arch Surg 2016 Jun 30;401(4):551-6. Epub 2016 Apr 30.
    Department of General, Visceral, and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany.
    Purpose: Intraoperative neuromonitoring of recurrent laryngeal nerve function after stimulation of the vagus nerve has been embraced as a risk minimization tool in thyroid surgery to prevent recurrent laryngeal nerve injury. Because this technology is increasingly used in an elderly and sicker population, the present study was conducted to determine the safety of this method in patients with second- or third-degree atrioventricular block.

    Methods: This study aimed at evaluating the feasibility and safety of continuous intraoperative neuromonitoring (CIONM) in patients with second- or third-degree atrioventricular block. Read More

    Repair of Partial Atrioventricular Septal Defect: Age and Outcomes.
    Ann Thorac Surg 2016 Jul 25;102(1):170-7. Epub 2016 Apr 25.
    Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
    Background: We evaluated the outcomes of patients undergoing surgical repair of partial atrioventricular septal defect (AVSD) and analyzed the effect of age on outcome.

    Methods: In this single-center retrospective study, we included all children who underwent repair of partial AVSD between 1990 and 2014. We divided the patients into 4 age quartiles (first quartile: 0-0. Read More

    Diagnostic and Prognostic Implications of Surface Recordings from Patients with Atrioventricular Block.
    Card Electrophysiol Clin 2016 Mar;8(1):25-35
    The atrioventricular (AV) bridge is vulnerable to many circumstances that depress conduction. Abnormal impulse transmission may be caused by drugs, autonomic effects, or destructive processes. Type 1 (Wenckebach) AV block is owing to depressed AV nodal conduction and is recognized by a prolonging PR interval ending in a "dropped beat. Read More

    A Heart too Drunk to Drive; AV Block following Acute Alcohol Intoxication.
    Chin J Physiol 2016 Feb;59(1):1-8
    Department of Medical Physiology, Division of Heart & Lungs, University Medical Center Utrecht, Yalelaan 50, 3584 CM Utrecht, The Netherlands.
    Acute excessive alcohol consumption is associated with heart rhythm disorders like atrial fibrillation but also premature ventricular contractions, collectively known as the "holiday heart syndrome". More rarely but clinically significant are reports of atrioventricular (AV) conduction disturbances in binge drinkers with no underlying heart disease or chronic alcohol consumption. To obtain better insights into common denominators and the potential underlying mechanisms we collected and compared individual case reports of AV block following acute alcohol intoxication in otherwise healthy people. Read More

    The management and outcomes of fingolimod first dose cardiac monitoring in UK patients with relapsing-remitting multiple sclerosis.
    Mult Scler Relat Disord 2016 Jan 3;5:40-6. Epub 2015 Nov 3.
    Regent's Park Heart Clinics (RPHC), 52 Brook Street, Mayfair, London, United Kingdom. Electronic address:
    Background: Patients initiated on Gilenya (fingolimod) require cardiovascular monitoring for 6h after the first dose. Novartis has engaged an independent provider (Regent's Park Heart Clinics [RPHC]) to provide a first dose observation (FDO) service to UK neurologists.

    Objectives: To describe routinely-documented clinical observations (heart rate [HR], blood pressure [BP], cardiac rhythm [CR]) and outcomes from the RPHC fingolimod FDO service. Read More

    Short-term pacemaker dependency after transcatheter aortic valve implantation.
    Wien Klin Wochenschr 2016 Mar 8;128(5-6):198-203. Epub 2016 Jan 8.
    Department of Cardiology, Paracelsus Medical University, Salzburger Landeskliniken, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.
    Background: Transcatheter aortic valve implantation (TAVI) is a less invasive technique for the treatment of severe aortic stenosis in high-risk patients. Occurrence of conduction disturbances requiring permanent pacemaker (PPM) implantation after TAVI is frequently observed.

    Methods: The retrospective analysis comprised 153 patients (96 women, aged from 65 to 97 years) who underwent TAVI due to high-grade aortic stenosis. Read More

    Subcutaneous nerve activity and mechanisms of sudden death in a rat model of chronic kidney disease.
    Heart Rhythm 2016 May 29;13(5):1105-12. Epub 2015 Dec 29.
    Krannert Institute of Cardiology, Division of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address:
    Background: The mechanisms of sudden death in chronic kidney disease (CKD) remain unclear.

    Objective: The purpose of this study was to test the hypotheses that subcutaneous nerve activity (SCNA) can be used to estimate sympathetic tone in ambulatory rats and that abrupt reduction of SCNA precedes the spontaneous arrhythmic death of Cy/+ rats.

    Methods: Radiotransmitters were implanted in ambulatory normal (N = 6) and Cy/+ (CKD; N = 6) rats to record electrocardiogram and SCNA. Read More

    Feasibility and safety of adenosine cardiovascular magnetic resonance in patients with MR conditional pacemaker systems at 1.5 Tesla.
    J Cardiovasc Magn Reson 2015 Dec 22;17:112. Epub 2015 Dec 22.
    Deptartment of Cardiology, Katholisches Klinikum Essen, University of Witten/Herdecke, Hülsmannstraße 17, 45355, Essen, Germany.
    Background: Cardiovascular Magnetic Resonance (CMR) with adenosine stress is a valuable diagnostic tool in coronary artery disease (CAD). However, despite the development of MR conditional pacemakers CMR is not yet established in clinical routine for pacemaker patients with known or suspected CAD. A possible reason is that adenosine stress perfusion for ischemia detection in CMR has not been studied in patients with cardiac conduction disease requiring pacemaker therapy. Read More

    Large doses of uterotonic drugs caused type II second degree sinoatrial block during cesarean section.
    Int J Clin Pharmacol Ther 2016 Jan;54(1):62-4
    In China, it is a routine procedure to inject 250 μg of hemabate (sterile solution, an oxytocic, contains the tromethamine salt of the (I5S)-15 methyl analogue of naturally occurring prostaglandin F2α in a solution suitable for intramuscular injection) into the myometrium of patients experiencing uterine inertia after delivery, with an additional dose given in the event that the efficacy is not obvious. Although hemabate is prohibited from being used in patients with active liver disease, there are no restrictions regarding the application of hemabate in positive hepatitis B surface antigen (HbsAg)-positive subjects with normal liver function. Here we report adverse effects of hemabate in 1 HbsAg-positive subject with normal liver function. Read More

    Apheresis in high risk antiphospholipid syndrome pregnancy and autoimmune congenital heart block.
    Transfus Apher Sci 2015 Dec 25;53(3):269-78. Epub 2015 Nov 25.
    Blood Transfusion Unit, University-Hospital of Padua, Padua, Italy.
    In the first part a prospective cohort study was reported to evaluate the efficacy and safety of a treatment protocol including plasma exchange (PE) or PE plus intravenous immunoglobulins (IVIG) or immunoadsorption (IA) plus IVIG administered in addition to conventional therapy to 22 pregnant women with high-risk APS. The results indicate that PE or IA treatments administered along with IVIG and conventional antithrombotic therapy could be a valuable and safe therapeutic option in pregnant APS women with triple antiphospholipid antibody positivity along with a history of thrombosis and/or one or more severe pregnancy complications. In the second part the efficacy and safety of PE combined with IVIG and steroids were evaluated for the treatment of 10 patients with autoimmune congenital heart block (CHB) by comparing maternal features, pregnancy outcome and side effects with those of 24 CHB patients treated with steroids only. Read More

    Arrhythmias Seen in Baseline 24-Hour Holter ECG Recordings in Healthy Normal Volunteers During Phase 1 Clinical Trials.
    J Clin Pharmacol 2016 Jul 11;56(7):885-93. Epub 2016 Jan 11.
    Quintiles Cardiac Safety Services, Mumbai, India.
    Regulatory agencies encourage sponsors to submit 24-hour ambulatory ECG data for assessing cardiac safety of new drugs, and some arrhythmias, hitherto considered rare, have been observed in some early-phase studies. Interpretation of these observations is difficult given the dearth of published data on the prevalence of cardiac arrhythmias seen during 24-hour continuous ECG monitoring in healthy volunteers (HV) from clinical trials. We analyzed drug-free ambulatory ECG recordings from 1273 HV (1000 males, 273 females; age 18-65 years) from 22 phase 1 studies that were analyzed in a core ECG laboratory; all subjects had normal screening ECGs. Read More

    Description of 214 cases of autoimmune congenital heart block: Results of the French neonatal lupus syndrome.
    Autoimmun Rev 2015 Dec 15;14(12):1154-60. Epub 2015 Aug 15.
    AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France. Electronic address:
    Background: Cardiac neonatal lupus syndrome is due to anti-SSA or SSB antibodies and mainly includes congenital heart block (CHB) and dilated cardiomyopathy (DCM). Its optimal management is still debated. We report a large series of autoimmune high degree CHB. Read More

    First-dose effects of fingolimod: Pooled safety data from three phase 3 studies.
    Mult Scler Relat Disord 2014 Sep 17;3(5):629-38. Epub 2014 Jun 17.
    Neurology, Departments of Medicine, Clinical Research and Biomedicine, University Hospital, Petersgraben 4, CH-4031 Basel, Switzerland. Electronic address:
    Fingolimod treatment initiation is associated with a transient slowing of heart rate and atrioventricular conduction. This report presents first-dose fingolimod effects (0.5mg or 1. Read More

    Temporal distribution of arrhythmic events in chronic kidney disease: Highest incidence in the long interdialytic period.
    Heart Rhythm 2015 Oct 22;12(10):2047-55. Epub 2015 Jun 22.
    Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia. Electronic address:
    Background: Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) have a high risk of sudden cardiac death (SCD). A unique risk factor may be a longer interval between HD sessions (interdialytic period). Inherent in conventional HD (thrice-weekly) are two 48-hour short breaks (SIDP) and one 72-hour long break (LIDP) between HD sessions. Read More

    The frequency of type 2 second-degree and third-degree atrioventricular block induced by blunt chest trauma in the emergency department: A multicenter study.
    Ulus Travma Acil Cerrahi Derg 2015 May;21(3):193-6
    Department of Cardiology, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.
    Background: Conduction disturbances including type 2 second-degree atrioventricular block (Mobitz II) and third-degree atrioventricular block following blunt chest trauma are probably rare. Moreover, the pathophysiological mechanisms responsible for this rare dysrhythmia following trauma are not well understood yet. In this study, it was aimed to identify the frequency of this dysrhythmia associated with trauma. Read More

    Ventricular tachycardias in patients with pulmonary hypertension: an underestimated prevalence? A prospective clinical study.
    Herzschrittmacherther Elektrophysiol 2015 Jun 2;26(2):155-62. Epub 2015 Jun 2.
    University of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany,
    Background: Sudden cardiac death (SCD) accounts for approximately 30 % in patients with pulmonary arterial hypertension (PAH). The exact circumference for SCD in this patient population is still unclear. Malignant cardiac arrhythmias are reported to be rarely present. Read More

    Trazodone and omeprazole interaction causing frequent second-degree Mobitz type 1 atrioventricular (AV) block (Wenckebach phenomenon) and syncope: a case report and literature review.
    Am J Case Rep 2015 May 27;16:319-21. Epub 2015 May 27.
    Department of Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, Jamaica, NY, USA.
    Background: This case report highlights serious cardiovascular adverse effects with a conventional dose of trazodone as a result of its potential interaction with omeprazole.

    Case Report: A 54-year-old man who was a former smoker, with dyslipidemia, coronary artery disease, and anxiety disorder developed lightheadedness and syncope the morning of admission. He was taking trazodone 50 mg daily, omeprazole 20 mg daily, and simvastatin 20 mg at bedtime. Read More

    Second degree AV block and severely impaired contractility in cardiac myxedema: a case report.
    Thyroid Res 2015 19;8. Epub 2015 May 19.
    Department of Endocrinology and Diabetes, Medical Hospital I, Bergmannsheil University Hospitals, Ruhr University of Bochum, Bochum, NRW Germany.
    The heart is a major target organ for thyroid hormone action. Severe overt hypothyroidism can result in diastolic hypertension, lowered cardiac output, impaired left ventricular contractility and diastolic relaxation, pericardial effusion and bradycardia. However, the function of the atrial pacemaker is usually normal and the degree by which the heart rate slows down is often modest. Read More

    Microvasculature and incident atrioventricular conduction abnormalities in the Multi-Ethnic Study of Atherosclerosis (MESA).
    Vasc Med 2015 Oct 21;20(5):417-23. Epub 2015 May 21.
    Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology, Division of Public Health, Wake Forest School of Medicine, Winston-Salem, NC, USA.
    Abnormalities of the microvasculature are linked to major cardiac events, but their role in the development of atrioventricular conduction abnormalities (AVCA) is unknown. We examined the association between central retinal arteriolar equivalent (CRAE), a measure of the microvasculature, and incident AVCA. This analysis included 3975 participants free of AVCA at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA). Read More

    ECG Case of the Month: Unexpected Atrioventricular Conduction in High-Grade Atrioventricular Block. Sinus rhythm; high-grade second degree atrioventricular block with a junctional escape rhythm and three capture complexes, each with right bundle branch block aberration; possible septal myocardial infarct of indeterminate age; ST-T and U wave changes suggesting hypokalemia.
    J La State Med Soc 2015 Mar-Apr;167(2):97-9. Epub 2015 Apr 15.
    Emeritus Professor of Medicine in the Cardiology Section of the LSUHSC New Orleans, LA.
    A 90-year-old man with a history of high blood pressure, a cerebrovascular accident without focal residua, dementia, and stage 3 chronic kidney disease went to the emergency department because of dizziness and near syncope. His medications were aspirin 81 mg qd, clopidogrel 75 mg qod, escitalopram oxalate 10 mg qd, Seroquel 25 mg qd, and memantine hydrochloride 10 mg qd. He had orthostatic hypotension with supine blood pressure of 173/77 mm Hg falling to 116/68 on standing, while pulse increased from 66 to 84 beats/ min. Read More

    Lacosamide cardiac safety: clinical trials in patients with partial-onset seizures.
    Acta Neurol Scand 2015 Nov 30;132(5):355-63. Epub 2015 Apr 30.
    Consulting Early Development, Bonn, Germany.
    Objective: To evaluate the cardiac safety of adjunctive lacosamide in a large pool of adults with partial-onset seizures (POS).

    Methods: Post-randomization changes from baseline for electrocardiographic (ECG) measurements, diagnostic findings, and relevant adverse events (AEs) were compared for pooled data from three randomized, placebo-controlled trials of adjunctive lacosamide for the treatment of POS.

    Results: Lacosamide did not prolong the QTc interval or affect heart rate as determined by an analysis of data from patients randomized to lacosamide 200, 400, or 600 mg/day (n = 944) compared with placebo (n = 364). Read More

    Lacosamide cardiac safety: a thorough QT/QTc trial in healthy volunteers.
    Acta Neurol Scand 2015 Nov 30;132(5):346-54. Epub 2015 Apr 30.
    Consulting Early Development, Bonn, Germany.
    Objective: To determine whether lacosamide prolongs the corrected QT interval (QTc).

    Materials And Methods: In this randomized, double-blind, positive- and placebo-controlled, parallel-design trial, healthy volunteers were randomized to lacosamide 400 mg/day (maximum-recommended daily dose, 6 days), lacosamide 800 mg/day (supratherapeutic dose, 6 days), placebo (6 days), or moxifloxacin 400 mg/day (3 days). Variables included maximum time-matched change from baseline in QT interval individually corrected for heart rate ([HR] QTcI), other ECG parameters, pharmacokinetics (PK), and safety/tolerability. Read More

    Long-term cardiac safety and tolerability of fingolimod in multiple sclerosis: A postmarketing study.
    J Clin Pharmacol 2015 Oct 17;55(10):1131-6. Epub 2015 Jun 17.
    Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Bari, Italy.
    Fingolimod is the first oral disease-modifying therapy approved for multiple sclerosis (MS). The risks associated with the use of fingolimod include cardiovascular adverse events (AEs). First-dose observation (FDO) is required for all patients for at least 6 hours. Read More

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