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    Atrial fibrillation was changed into sinus bradycardia in a ROS1-positive advanced lung adenocarcinoma patient who achieved durable response to Crizotinib: A case report and literature review.
    Medicine (Baltimore) 2017 May;96(21):e6979
    Department of Thoracic Oncology, Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China.
    Rational: The c-ros oncogene 1 receptor tyrosine kinase (ROS1)-rearrangements represent a new and rare genetic subtype of non-small-cell lung cancer. In recent years, the use of crizotinib in ROS1-rearranged lung cancer exhibits significant clinical efficacy. Crizotinib is generally well tolerated and the most frequent adverse events include visual disorders, gastrointestinal disturbances, cardiac, and endocrine abnormalities. Read More

    Electrophysiological Testing for the Investigation of Bradycardias.
    Arrhythm Electrophysiol Rev 2017 Apr;6(1):24-28
    Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
    In this article we review the role of electrophysiological testing in patients presenting with bradycardia due to sinus node or atrioventricular node disease. In sinus bradycardia the role of electrophysiology studies is not established. In AV conduction disturbances, an electrophysiology study may be necessary both for the establishment of atrioventricular block as the main cause of symptoms, and for identification of the anatomic site of block that may dictate the potential need of permanent pacing. Read More

    A novel 'splice site' HCN4 Gene mutation, c.1737+1 G>T, causes familial bradycardia, reduced heart rate response, impaired chronotropic competence and increased short-term heart rate variability.
    Int J Cardiol 2017 Apr 20. Epub 2017 Apr 20.
    2nd Department of Internal Medicine and Cardiology Center, University of Szeged, Hungary. Electronic address:
    Background: The most important molecular determinant of heart rate regulation in sino-atrial pacemaker cells includes hyperpolarization-activated, cyclic nucleotide-gated ion channels, the major isoform of which is encoded by the HCN4 gene. Mutations affecting the HCN4 gene are associated primarily with sick sinus syndrome.

    Methods And Results: A novel c. Read More

    An unexpected presentation of sick sinus syndrome: Isolated ventricular asystole.
    Am J Emerg Med 2017 Apr 27. Epub 2017 Apr 27.
    Department of Emergency Medicine, Duzce University School of Medicine, Duzce, Turkey.
    Sick sinus syndrome is a disorder of sinus node function characterized by various dysrhythmias such as sinus bradycardia or pause, paroxysmal regular or irregular atrial tachycardia, tachycardiabradycardia attacks or atrial fibrillation with slow ventricular response. Ventricular asystole with preserved atrial electrical activity is a rarely seen presenting rhythm in the ED and an extremely rare cause of syncope. A 67-year-old male having a syncope attack was admitted to the emergency department. Read More

    Biphasic Renal Sympathetic Response to Hemorrhagic Hypotension in Mice.
    Shock 2017 Apr 28. Epub 2017 Apr 28.
    *Department of Physiology II, Kanazawa Medical University, Uchinada 920-0293, Japan †Division of Cell Signaling, Okazaki Institute for Integrative Bioscience (National Institute for Physiological Sciences), National Institutes of Natural Sciences, Okazaki, 444-8787, Japan ‡Department of Physiological Science and Molecular Biology, Fukuoka Dental College, Fukuoka, Japan §Department of Colorectal and Hernia Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China ||Department of Infectious Disease, The Sheng Jing Hospital of China Medical University, Shenyang 110009, China.
    Aim: The inhibitory responses of renal sympathetic nerve activity (RSNA) and heart rate (HR) to sustained hemorrhagic shock occurred in anesthetized rats, but have not yet been determined in mice. Here, we investigated the responses of RSNA and HR to hemorrhagic hypotension in anesthetized mice, with an emphasis on the molecule-based mechanism for roles of afferent vagal nerves.

    Methods: RSNA, HR, and mean systemic arterial pressure (MAP) were continuously measured in male pentobarbital-anesthetized C57BL/6N mice. Read More

    Chronic lithium intoxication: Varying electrocardiogram manifestations.
    Indian J Pharmacol 2017 Jan-Feb;49(1):127-129
    Department of Cardiology, KMC, Manipal University, Manipal, Udupi, Karnataka, India.
    Lithium is a commonly used drug in psychiatric practice. It is used in the treatment of depression and bipolar disorder. It has a narrow therapeutic index with documented adverse effects even near therapeutic levels. Read More

    Clinical characteristics associated with bradycardia and asystole in patients with syncope undergoing long-term electrocardiographic monitoring with implantable loop recorder.
    Wien Klin Wochenschr 2017 Apr 27. Epub 2017 Apr 27.
    Cardiology Clinic, Safarik University, VUSCH, Ondavská 8, 04001, Kosice, Slovakia.
    Background: The aim of this retrospective single center cohort study was to assess the occurrence of bradycardia during implantable loop recorder (ILR) monitoring in patients with unexplained syncope and negative conventional testing and to identify clinical predictors of bradycardia and pacemaker implantation.

    Methods: An ILR was implanted in 112 patients (31 men, 81 women, mean age 64 ±13 years) with syncope which was not explained after conventional diagnostic work-up. Clinical variables were compared between patients with and without pacemaker implantation. Read More

    Trigemino-Cardiac Reflex: A Phenomenon Neglected in Maxillofacial Surgery?
    J Maxillofac Oral Surg 2017 Jun 10;16(2):181-185. Epub 2016 Sep 10.
    Department of Oral and Maxillofacial Surgery, HKES S. Nijalingappa Institute of Dental Science and Research, Gulbarga, India.
    Background: Trigemino-cardiac reflex is a physiologic response of the body to pressure effects in the region of distribution of the trigeminal nerve. Oral and maxillofacial surgical procedures can induce the development of this reflex, which leads to significant changes in the heart rate and sinus rhythms. This study intends to evaluate the effects of this reflex in patients with facial fractures and its subsequent management. Read More

    Perioperative Outcomes and Safety of Atrial Fibrillation Catheter Ablation in Octogenarians: A Retrospective Study and Review of the Benefits of Rhythm Control.
    Cardiology 2017 Apr 21;137(3):173-178. Epub 2017 Apr 21.
    University of Miami/JFK Medical Center Palm Beach Regional GME Consortium, Atlantis, FL, USA.
    Objectives: Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control.

    Methods: Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified. Read More

    [The relationship between preoperative anxiety levels and vasovagal incidents during the administration of spinal anesthesia].
    Rev Bras Anestesiol 2017 Apr 12. Epub 2017 Apr 12.
    Kafkas University School of Medicine, Department of Anesthesiology and Reanimation, Kars, Turquia.
    Background: It was aimed to investigate the relationship between preoperative anxiety and vasovagal symptoms observed during the administration of spinal anesthesia in patients undergoing surgery in the perianal and inguinal regions.

    Methods: The study included patients with planned surgery for inguinal hernia repair, anal fissure, hemorrhoid and pilonidal sinus excision. The study included a total of 210 patients of ASA I-II, aged 18-65 years. Read More

    Pacemaker Placement in Patients with Stroke-Mediated Autonomic Dysregulation.
    Case Rep Med 2017 16;2017:6301430. Epub 2017 Mar 16.
    Department of Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.
    Lateral medullary syndrome (LMS) is an ischemic disease of the medulla oblongata, which involves the territory of the posterior inferior cerebellar artery. Lateral medullary syndrome is often missed as the cause of autonomic dysregulation in patients with recent brain stem stroke. Due to the location of the baroreceptor regulatory center in the lateral medulla oblongata, patients with LMS occasionally have autonomic dysregulation-associated clinical manifestations. Read More

    REFRACTORY BRADYCARDIA--A RARE COMPLICATION OF CARBOPROST TROMETHAMINE FOR INDUCTION OF ABORTION
    Acta Clin Croat 2016 Jun;55(2):323-5
    We report a first case of refractory several-hour sinus bradycardia, a rare but already described side effect of intramuscular administration of carboprost tromethamine to induce abortion for medical indication in a patient without cardiovascular and other diseases. After administration of atropine sulfate 3x0.5 mg intravenously without effect, the patient‘s sinus rhythm spontaneously normalized as carboprost was eliminated from the body (it has a 3-hour half-life). Read More

    Electrocardiographic changes mimicking acute coronary syndrome in a large intracranial tumour: A diagnostic dilemma.
    BMC Cardiovasc Disord 2017 Apr 4;17(1):91. Epub 2017 Apr 4.
    National Hospital, Colombo, Sri Lanka.
    Background: ST elevation Myocardial infarction is a medical emergency. A variety of noncardiac conditions had been known to mimic the ECG changes that are seen in acute coronary syndrome. Although the common ECG changes that are documented with raised intracranial pressure are T inversions, prolongation of QT interval and sinus bradycardia, ST elevation or depression, arrhythmias and prominent U waves have also been recognized. Read More

    Tachyarrhythmias and Bradyarrhythmias: Differential Diagnosis and Initial Management in the Primary Care Office.
    Med Clin North Am 2017 May 6;101(3):495-506. Epub 2017 Mar 6.
    SummaHealth Heart and Vascular Institute, North East Ohio Medical University, 95 Arch Street, Suite 350, Akron, OH 44304, USA. Electronic address:
    Tachyarrhythmias and bradyarrhythmias are often seen in the outpatient setting. Patients can present minimally symptomatic or in extremis. Accurate diagnosis of the rhythm, plus a detailed clinical history, are critical for best management and optimal outcome. Read More

    Timed sequential therapy of the selective T-type calcium channel blocker mibefradil and temozolomide in patients with recurrent high-grade gliomas.
    Neuro Oncol 2017 Jun;19(6):845-852
    The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (M.H., X.Y., J.D.F., S.D., S.A.G.); Massachusetts General Hospital, Boston, Massachusetts (J.G.S.); University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama (L.B.N.); University of Pennsylvania, Philadelphia, Pennsylvania (A.S.D.); Henry Ford Health System, Detroit, Michigan (T.W.); Wake Forest University, School of Medicine, Winston-Salem, North Carolina (G.J.L.); Emory University, Atlanta, Georgia (W.L.R.); University of Pittsburgh, Pittsburgh, Pennsylvania (F.S.L.); The Johns Hopkins University School of Medicine, Baltimore, Maryland (M.A.L., J.L.); Washington University School of Medicine, St. Louis, Missouri (R.L.W.); University of Virginia Medical Center, Charlottesville, Virginia (D.S.).
    Background: Mibefradil (MIB), previously approved for treatment of hypertension, is a selective T-type calcium channel blocker with preclinical activity in high-grade gliomas (HGGs). To exploit its presumed mechanism of impacting cell cycle activity (G1 arrest), we designed a phase I study to determine safety and the maximum tolerated dose (MTD) of MIB when given sequentially with temozolomide (TMZ) in recurrent (r)HGG.

    Methods: Adult patients with rHGG ≥3 months from TMZ for initial therapy received MIB in 4 daily doses (q. Read More

    Tachycardia-bradycardia syndrome: Electrophysiological mechanisms and future therapeutic approaches (Review).
    Int J Mol Med 2017 Feb 6. Epub 2017 Feb 6.
    Li Dak‑Sum Research Centre‑HKU‑Karolinska Institutet Collaboration on Regenerative Medicine, University of Hong Kong, Hong Kong, SAR, P.R. China.
    Sick sinus syndrome (SSS) encompasses a group of disorders whereby the heart is unable to perform its pacemaker function, due to genetic and acquired causes. Tachycardia‑bradycardia syndrome (TBS) is a complication of SSS characterized by alternating tachycardia and bradycardia. Techniques such as genetic screening and molecular diagnostics together with the use of pre-clinical models have elucidated the electrophysiological mechanisms of this condition. Read More

    Bradycardia during Transradial Cardiac Catheterization due to Catheter Manipulation: Resolved by Catheter Removal.
    Case Rep Vasc Med 2017 1;2017:8538149. Epub 2017 Mar 1.
    Sanford Cardiovascular Institute, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA.
    Purpose. To report the resolution of bradycardia encountered during transradial cardiac catheterization through the catheter pullback technique in two cases. Case Report. Read More

    Electrocardiographic abnormalities in treatment-naïve HIV subjects in south-east Nigeria.
    Cardiovasc J Afr 2017 Mar 23;28:1-5. Epub 2017 Mar 23.
    Imo State University, Orlu, Nigeria. Email:
    Background: Cardiac complications of human immunodeficiency virus (HIV) infection are important causes of morbidity and mortality. We set out to determine the electrocardiographic (ECG) abnormalities in treatment-naïve HIV-positive patients in Enugu, south-east Nigeria.

    Methods: This was a cross-sectional study involving 250 HIV-positive and 200 HIV-negative subjects. Read More

    Cardiac iodine-123-metaiodobenzylguanidine scintigraphy may be useful to identify pathologic from physiologic sinus bradycardia.
    Pacing Clin Electrophysiol 2017 Mar 27. Epub 2017 Mar 27.
    Kansai Rosai Hospital Cardiovascular Center, Hyogo, Japan.
    Background: Sinus bradycardia includes pathologic sick sinus syndrome (SSS) and physiologic bradycardia such as athletes' heart. Pacemaker implantation is indicated for patients with symptomatic SSS; however, the indication remains difficult to determine in those with mild and/or unspecific symptoms. The sympathetic tone is increased in response to reduced cardiac output in SSS, whereas excessive vagal tone has been seen in physiological bradycardia. Read More

    Swallow-induced syncope and carotid sinus hypersensitivity: Coincident or associated conditions?
    J Electrocardiol 2017 Mar 14. Epub 2017 Mar 14.
    Department of Cardiology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Swallow induced syncope is a rare clinical condition which is thought to result from an abnormal vagal reflex leading to bradycardia and cerebral hypoperfusion. It mostly occurs in patients with organic or functional disorders of the esophagus, and often requires permanent pacemaker implantation, along with treatment of the underlying esophageal pathology. In the following case, we report of a 71-year-old male with achalasia post per oral endoscopic myectomy, who presented with syncope and documented AV-block while eating solid food. Read More

    Sinus Bradycardia in Habitual Cocaine Users.
    Am J Cardiol 2017 May 1;119(10):1611-1615. Epub 2017 Mar 1.
    Electrophysiology Section, Division of Cardiology, Drexel University College of Medicine, Philadelphia, Pennsylvania. Electronic address:
    Common physiological manifestations of cocaine are related to its adrenergic effects, due to inhibition of dopamine and norepinephrine uptake at the postsynaptic terminal. Few studies have documented bradycardia secondary to cocaine use, representing the antithesis of its adrenergic effects. We assessed the prevalence of sinus bradycardia (SB) in habitual cocaine users and postulated a mechanism for this effect. Read More

    Pacemaker Use Following Heart Transplantation.
    Ochsner J 2017 ;17(1):20-24
    Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA ; Department of Surgery, Harvard University, Cambridge, MA.
    Background: The incidence of permanent pacemaker implantation after orthotopic heart transplantation has been reported to be 2%-24%. Transplanted hearts usually exhibit sinus rhythm in the operating room following reperfusion, and most patients do not exhibit significant arrhythmias during the postoperative period. However, among the patients who do exhibit abnormalities, pacemakers may be implanted for early sinus node dysfunction but are rarely used after 6 months. Read More

    [Efficacy and safety analysis of ivabradine hydrochloride treatment of Chinese patients with chronic heart failure: subgroup analysis of Chinese patients in the SHIFT study].
    Zhonghua Xin Xue Guan Bing Za Zhi 2017 Mar;45(3):190-197
    Department of Cardiology, Peking University People's Hospital, Beijing 100044, China.
    Objective: To evaluate the efficacy and safety of ivabradine for the treatment of Chinese patients with chronic heart failure based on the Chinese subgroup data of the systolic heart failure treatment with the I(f) inhibitor ivabradine trial (SHIFT). Method: A total of 6 558 stable outpatients who presented symptoms of heart failure, with a left ventricular ejection fraction (LVEF) ≤35%, sinus rhythms with a heart rate ≥70 bpm participated in the randomized, double-blind, placebo-controlled, international multicenter clinical study.The subset of Chinese patients with heart rate ≥75 bpm was enrolled in the post-hoc subgroup analyses. Read More

    Ventricular Parasystole in a Neonatal Rhesus Macaque (Macaca mulatta).
    Comp Med 2016 Dec;66(6):489-493
    Division of Comparative Medicine, Oregon National Primate Research Center, Beaverton, Oregon.
    A 6-d-old Indian-origin female rhesus macaque (Macaca mulatta) presented with bradycardia shortly after sedation with ketamine. No other cardiac abnormalities were apparent. Approximately 2 wk after the initial presentation, the macaque was again bradycardic and exhibited a regularly irregular arrhythmia on a prestudy examination. Read More

    [The Pacemaker and Implantable Cardioverter-Defibrillator Registry of the Italian Association of Arrhythmology and Cardiac Pacing - Annual report 2015].
    G Ital Cardiol (Rome) 2017 Jan;18(1):67-79
    Dipartimento di Medicina Ambientale e Salute Pubblica, Università degli Studi, Padova.
    Background: The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2015 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers.

    Methods: The Registry collects prospectively national PM and ICD implantation activity on the basis of European cards. Read More

    Guillain-Barré Syndrome Presenting with Sinus Node Dysfunction and Refractory Shock.
    Am J Case Rep 2017 Mar 11;18:251-254. Epub 2017 Mar 11.
    Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, NY, USA.
    BACKGROUND Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy that is usually associated with preceding respiratory or gastrointestinal infection and has the hallmark manifestation of ascending flaccid paralysis. We report an atypical presentation of GBS. CASE REPORT A 76-year-old male presented with acute onset of diaphoresis and altered mental status. Read More

    Efficacy of Intravenous Sotalol for Treatment of Incessant Tachyarrhythmias in Children.
    Am J Cardiol 2017 May 10;119(9):1366-1370. Epub 2017 Feb 10.
    Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University, Medical Center, Tsinghua University, Beijing, People's Republic of China.
    Our objective was to evaluate the efficacy and safety of intravenous (IV) sotalol in the treatment of incessant tachyarrhythmias in children with normal cardiac function. Eighty-three children admitted to hospital from October 2011 to December 2014 were treated with IV sotalol or IV sotalol plus IV propafenone. The time to conversion to sinus rhythm and maintaining sinus rhythm were evaluated. Read More

    Insufficient efficacy and safety of intravenous ribavirin in treatment of haemorrhagic fever with renal syndrome caused by Puumala virus.
    Infect Dis (Lond) 2017 Jul 3;49(7):514-520. Epub 2017 Mar 3.
    b Laboratory for Zoonoses , Central Research Institute of Epidemiology , Moscow , Russia.
    Background: Intravenous ribavirin has been reported to be an effective treatment for haemorrhagic fever with renal syndrome (HFRS) caused by Hantaan virus in Asia. However, its therapeutic benefits for HFRS caused by Puumala virus (PUUV) in Europe are still unknown.

    Methods: A randomized, open-label study of efficacy and safety of intravenous ribavirin in the treatment of HFRS was conducted in the European part of Russia. Read More

    Amplitude based beat detection for atrial fibrillation in pacemaker.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:2757-2759
    Bradycardia is defined as a sinus rhythm of less than 60 beats per minute and atrial tachyarrhythmia including atrial fibrillation (AF) is frequently associated with bradycardia. Pacemaker is the only effective treatment for symptomatic bradycardia and automatic mode switching (AMS) function is built in pacemaker to switch mode in the presence of atrial tachyarrhythmia. AMS algorithms consider appropriate mode switching in case of undersensing or oversensing and this consideration makes their onset time and resynchronization time late. Read More

    Cardiovascular Disease Update: Bradyarrhythmias.
    FP Essent 2017 Mar;454:18-23
    Naval Hospital Jacksonville, 2080 Child St, Jacksonville, FL 32212.
    Bradyarrhythmia (bradycardia) is a heart rate lower than 60 beats/min. It can be due to sinus, atrial, or junctional bradycardia or to a problem with the conduction system (eg, an atrioventricular block). Asymptomatic bradycardia is common, especially among trained athletes or during sleep. Read More

    A single center's experience with pacemaker implantation after the Cox maze procedure for atrial fibrillation.
    J Thorac Cardiovasc Surg 2017 Feb 9. Epub 2017 Feb 9.
    Department of Cardiac Research, Inova Fairfax Hospital, Falls Church, Va.
    Objective: The Cox maze procedure (CM) is safe and effective for all atrial fibrillation (AF) types. A recent randomized trial found alarming rates of pacemaker implantation (PMI) during hospitalization after CM. The purpose of this study was to assess the rate of PMI and its impact on outcomes after CM. Read More

    Electrocardiographic characteristics in individuals with cocaine use disorder.
    Am J Addict 2017 Apr 1;26(3):221-227. Epub 2017 Mar 1.
    Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas.
    Background And Objectives: Chronic cocaine use has been linked to several abnormalities in cardiac functioning. The objective of this study was to further characterize baseline heart rate and electrocardiograph (ECG) profiles of individuals with cocaine use disorder (CUD) by evaluating demographic and drug use variables that may impact cardiovascular profiles.

    Methods: Participants with CUD (n = 335, primarily African-American males) provided demographic and drug use data and ECG profiles (eg, heart rate, PR Interval, QRS, and QTc) were obtained via 12-lead ECG. Read More

    Effect of alectinib on cardiac electrophysiology: results from intensive electrocardiogram monitoring from the pivotal phase II NP28761 and NP28673 studies.
    Cancer Chemother Pharmacol 2017 Mar 27;79(3):559-568. Epub 2017 Feb 27.
    F. Hoffmann-La Roche Ltd, Basel, Switzerland.
    Purpose: Alectinib, a central nervous system (CNS)-active ALK inhibitor, has demonstrated efficacy and safety in ALK+ non-small-cell lung cancer that has progressed following crizotinib treatment. Other ALK inhibitors have shown concentration-dependent QTc prolongation and treatment-related bradycardia. Therefore, this analysis evaluated alectinib safety in terms of electrophysiologic parameters. Read More

    Inappropriate Shocks and Power Delivery Using Adult Automatic External Defibrillator Pads in a Pediatric Patient.
    Pediatr Emerg Care 2017 Feb 21. Epub 2017 Feb 21.
    From the *Edmond J. Safra International Center for Congenital Heart Diseases, and †Davidai Arrhythmia Center, Leviev Heart Center, Sheba Medical Center, Ramat Gan; ‡The Hatzalah Organization, Jerusalem, Israel; and §St George's University of London-University of Nicosia, Nicosia, Cyprus.
    The use of automatic external defibrillators (AEDs) during pulseless resuscitations is considered safe and reliable, and was established as part of the guidelines in out-of-hospital events. Based on extensive studies, the use of the standard AED is now indicated in every age group with a preference of pediatric pad application for small children and babies. If unavailable, adult pads are recommended. Read More

    A Mutation in the G-Protein Gene GNB2 Causes Familial Sinus Node and Atrioventricular Conduction Dysfunction.
    Circ Res 2017 May 20;120(10):e33-e44. Epub 2017 Feb 20.
    From the Institute for Genetics of Heart Diseases, Department of Cardiology and Angiology, University Hospital Muenster, Germany (B.S., J.K., S.Z., C.F., E.S.-B., G.S., E.S.-B.); Department of Pediatric Cardiology (S.K.) and Department of General Pediatrics (S.R.), University Children's Hospital Muenster, Germany; and Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps University of Marburg, Germany (K.V., S.R., L.A.M., N.D.).
    Rationale: Familial sinus node and atrioventricular conduction dysfunction is a rare disorder that leads to paroxysmal dizziness, fatigue, and syncope because of a temporarily or permanently reduced heart rate. To date, only a few genes for familial sinus and atrioventricular conduction dysfunction are known, and the majority of cases remain pathogenically unresolved.

    Objective: We aim to identify the disease gene in a large 3-generation family (n=25) with autosomal dominant sinus node dysfunction (SND) and atrioventricular block (AVB) and to characterize the mutation-related pathomechanisms in familial SND+AVB. Read More

    Crizotinib Inhibits Hyperpolarization-activated Cyclic Nucleotide-Gated Channel 4 Activity.
    Cardiooncology 2017 19;3. Epub 2017 Jan 19.
    Department of Medicine, Duke University Medical Center, Durham, NC USA 27710.
    Background: Sinus bradycardia is frequently observed in patients treated with crizotinib, a receptor tyrosine kinase inhibitor used for the treatment of anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC). We investigated whether crizotinib could influence heart rate (HR) through direct cardiac effects.

    Methods: The direct effect of crizotinib on HR was studied using ECG analysis of Langendorff-perfused mouse hearts. Read More

    Cardiac electrophysiology of patients with spinal cord injury.
    Heart Rhythm 2017 Jun 12;14(6):920-927. Epub 2017 Feb 12.
    Cardiac Electrophysiology Department, Emory University Hospital, Atlanta, Georgia.
    Spinal cord injury is a clinical syndrome encountered frequently in trauma centers and is accompanied by both acute and chronic heart rhythm abnormalities. The injury is characterized by sympathetic nervous system impairment with preservation of parasympathetic output via the vagus nerve. Severe bradycardia in the form of life-threatening sinus arrest or complete heart block may be observed in the acute recovery phase. Read More

    Clinical Profile of Cardiac Arrhythmias in Children Attending the Out Patient Department of a Tertiary Paediatric Care Centre in Chennai.
    J Clin Diagn Res 2016 Dec 1;10(12):SC06-SC08. Epub 2016 Dec 1.
    Director, Department of Pediatrics, Mehta Hospitals , Nungamabakkam, Chennai, Tamil Nadu, India .
    Introduction: The presentation of symptoms of paediatric arrhythmias vary depending on the age and underlying heart disease. Physical examination of children with important arrhythmias may be entirely normal.

    Aim: Aim is to study the characteristics of cardiac arrhythmias in paediatric patients in a tertiary paediatric care centre in Chennai, India. Read More

    Knockdown of cardiac Kir3.1 gene with siRNA can improve bradycardia in an experimental sinus bradycardia rat model.
    Mol Cell Biochem 2017 May 15;429(1-2):103-111. Epub 2017 Feb 15.
    Department of Cardiology, The First Affiliated Hospital of China Medical University, Nanjing north street, No. 155, Heping District, Shenyang, 110001, China.
    The objective of this study was to explore whether the inhibition of potassium inwardly rectifying channel (Kir3.1) with short interfering RNA (siRNA) can improve bradycardia in an experimental sinus bradycardia rat model. 54 Sprague Dawley (SD) rats were randomly divided into three groups: experimental group, control group, and sham group. Read More

    Tachycardia-bradycardia syndrome: Electrophysiological mechanisms and future therapeutic approaches (Review).
    Int J Mol Med 2017 Mar 6;39(3):519-526. Epub 2017 Feb 6.
    Li Dak‑Sum Research Centre‑HKU‑Karolinska Institutet Collaboration on Regenerative Medicine, University of Hong Kong, Hong Kong, SAR, P.R. China.
    Sick sinus syndrome (SSS) encompasses a group of disorders whereby the heart is unable to perform its pacemaker function, due to genetic and acquired causes. Tachycardia‑bradycardia syndrome (TBS) is a complication of SSS characterized by alternating tachycardia and bradycardia. Techniques such as genetic screening and molecular diagnostics together with the use of pre-clinical models have elucidated the electrophysiological mechanisms of this condition. Read More

    Targets and End Points in Cardiac Autonomic Denervation Procedures.
    Circ Arrhythm Electrophysiol 2017 Feb;10(2):e004638
    From the Unidade Clínica de Arritmia, Heart Institute, University of São Paulo Medical School, Brazil.
    Background: Autonomic denervation is an alternative approach for patients with symptomatic bradycardia. No consensus exists on the critical targets and end points of the procedure. The aim of this study was to identify immediate end points and critical atrial regions responsible for vagal denervation. Read More

    Free energy landscape remodeling of the cardiac pacemaker channel explains the molecular basis of familial sinus bradycardia.
    J Biol Chem 2017 Apr 7;292(15):6414-6428. Epub 2017 Feb 7.
    From the Departments of Biochemistry and Biomedical Sciences and
    The hyperpolarization-activated and cyclic nucleotide-modulated ion channel (HCN) drives the pacemaker activity in the heart, and its malfunction can result in heart disorders. One such disorder, familial sinus bradycardia, is caused by the S672R mutation in HCN, whose electrophysiological phenotypes include a negative shift in the channel activation voltage and an accelerated HCN deactivation. The outcomes of these changes are abnormally low resting heart rates. Read More

    Sinus Node Dysfunction and Atrial Fibrillation: A Reversible Phenomenon?
    Pacing Clin Electrophysiol 2017 Apr 8;40(4):442-450. Epub 2017 Mar 8.
    Duke Clinical Research Institute.
    Background: Symptomatic sinus node dysfunction (SND) consists of a variety of manifestations, including tachycardia-bradycardia syndrome. Atrial fibrillation (AF) is commonly associated with SND, which complicates the management of both conditions. This paper reviews the epidemiology, pathophysiology, and clinical trial data investigating therapeutic approaches for treatment of patients with both SND and AF. Read More

    Symptomatic, Inspiration-Induced Atrioventricular Block: Treated with Pacemaker Implant.
    Pacing Clin Electrophysiol 2017 Feb 3. Epub 2017 Feb 3.
    Cardiology Division, Juan A. Fernandez Hospital, Ciudad Autonoma de Buenos Aires, Argentina.
    Background: The respiratory sinus arrhythmia is the most common cardiac arrhythmia. It consists of phasic variations of sinus cycle length produced by an autonomic reflex, and is characterized by increased heart rate during inspiration and decline in expiration. This phenomenon is due to a reduction of the parasympathetic tone during inspiration, causing a rise in the heart rate, while during expiration the opposite phenomenon occurs. Read More

    Sinus bradycardia after intravenous pulse methylprednisolone therapy in patients with systemic lupus erythematosus.
    Mod Rheumatol 2017 Feb 1:1-4. Epub 2017 Feb 1.
    a Department of Allergy and Rheumatology , University of Tokyo , Tokyo , Japan.
    Sinus bradycardia is reported as an adverse effect of high-dose glucocorticoid therapy. We report three cases of systemic lupus erythematosus, wherein intravenous pulse methylprednisolone was administered. The patients' average baseline heart rate was 72 beats/min, which decreased 30% from baseline at 61 h after beginning the therapy. Read More

    Permanent pacemaker implantation in octogenarians with unexplained syncope and positive electrophysiologic testing.
    Heart Rhythm 2017 May 12;14(5):694-699. 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

    Integrity of the Ganglionated Plexi Is Essential to Parasympathetic Innervation of the Atrioventricular Node by the Right Vagus Nerve.
    J Cardiovasc Electrophysiol 2017 Apr 31;28(4):432-437. Epub 2017 Jan 31.
    Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Centre for Cardiovascular Diseases, Brussels, Belgium.
    Introduction: Radiofrequency isolation of pulmonary vein can be accompanied by transient sinus bradycardia or atrioventricular nodal (AVN) block, suggesting an influence on vagal cardiac innervation. However, the importance of the atrial fat pads in relation with the vagal innervation of AVN in humans remains largely unknown. The aim of this study was to evaluate the role of ganglionated plexi (GP) in the innervation of the AVN by the right vagus nerve. Read More

    Ictal sinus pause and myoclonic seizure in a child.
    Korean J Pediatr 2016 Nov 30;59(Suppl 1):S129-S132. Epub 2016 Nov 30.
    Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
    Ictal tachycardia and bradycardia are common arrhythmias; however, ictal sinus pause and asystole are rare. Ictal arrhythmia is mostly reported in adults with temporal lobe epilepsy. Recently, ictal arrhythmia was recognized as a major warning sign of sudden unexpected death in epilepsy. Read More

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