Heart rhythm : the official journal of the Heart Rhythm Society
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Comparative Study
Antipsychotic drugs are associated with pulseless electrical activity: the Oregon Sudden Unexpected Death Study.
There has been a paradigm shift in the manifestation of sudden cardiac arrest (SCA), with steadily decreasing rates of ventricular fibrillation/tachycardia (VF/VT) and a significant increase in the proportion of pulseless electrical activity (PEA) and asystole. ⋯ When drugs modifying myocardial contractility were evaluated in a comprehensive analysis of patients who suffered SCA, use of antipsychotic agents was a significant and independent predictor of manifestation with PEA.
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Comparative Study
Sympathetic nerve fibers and ganglia in canine cervical vagus nerves: localization and quantitation.
Cervical vagal nerve (CVN) stimulation may improve left ventricular ejection fraction in patients with heart failure. ⋯ Sympathetic nerve fibers are invariably present in the CVNs of normal dogs and occupy in average up to 2.8% of the cross-sectional area. Because sympathetic nerve fibers are present in the periphery of the CVNs, they may be susceptible to activation by electrical stimulation. Spontaneous activation of the sympathetic component of the vagal nerve may accelerate the heart rate.
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Recent studies have suggested an emerging link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Patients with OSA are less likely to remain in sinus rhythm after radiofrequency catheter ablation of AF. ⋯ Patients with untreated OSA have a higher recurrence of AF after ablation. Appropriate treatment with CPAP in patients with OSA is associated with a lower recurrence of AF.
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Sudden death (SD) in young competitive athletes due to cardiovascular disease is an important community issue with relevance to designing effective screening initiatives. However, the frequency with which these tragic events occur importantly affects considerations for selecting the most appropriate screening strategy. ⋯ In this high school athlete population, risk of cardiovascular SD was small, in the range of 1:150,000 participants/year. Based on autopsy data, only about 30% of the SDs were due to diseases that could be reliably detected by preparticipation screening, even with 12-lead electrocardiograms.
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We studied the effects of transcutaneous electrical stimulation at the tragus, the anterior protuberance of the outer ear, for inhibiting atrial fibrillation (AF). ⋯ LL-TS can reverse RAP-induced atrial remodeling and inhibit AF inducibility, suggesting a potential noninvasive treatment of AF.