Mobile phone apps capable of monitoring arrhythmias and heart rate (HR) are increasingly used for screening, diagnosis, and monitoring of HR and rhythm disorders such as atrial fibrillation (AF). ...These apps involve either the use of (1) photoplethysmographic recording or (2) a handheld external electrocardiographic recording device attached to the mobile phone or wristband.
This review seeks to explore the current state of mobile phone apps in cardiac rhythmology while highlighting shortcomings for further research.
We conducted a narrative review of the use of mobile phone devices by searching PubMed and EMBASE from their inception to October 2018. Potentially relevant papers were then compared against a checklist for relevance and reviewed independently for inclusion, with focus on 4 allocated topics of (1) mobile phone monitoring, (2) AF, (3) HR, and (4) HR variability (HRV).
The findings of this narrative review suggest that there is a role for mobile phone apps in the diagnosis, monitoring, and screening for arrhythmias and HR. Photoplethysmography and handheld electrocardiograph recorders are the 2 main techniques adopted in monitoring HR, HRV, and AF.
A number of studies have demonstrated high accuracy of a number of different mobile devices for the detection of AF. However, further studies are warranted to validate their use for large scale AF screening.
Update on long QT syndrome Neira, Víctor; Enriquez, Andrés; Simpson, Chris ...
Journal of cardiovascular electrophysiology,
December 2019, Letnik:
30, Številka:
12
Journal Article
Recenzirano
Odprti dostop
Long QT syndrome (LQTS) is an inherited disorder characterized by a prolonged QT interval in the 12‐lead electrocardiogram and increased risk of malignant arrhythmias in patients with a structurally ...normal heart. Since its first description in the 1950s, advances in molecular genetics have greatly improved our understanding of the cause and mechanisms of this disease. Sixteen genes linked to LQTS have been described and genetic testing had become an integral part of the diagnosis and risk stratification. This article provides an updated review of the genetic basis, diagnosis, and clinical management of LQTS.
Lyme carditis and atrioventricular block Wan, Douglas, MD; Baranchuk, Adrian, MD
Canadian Medical Association journal (CMAJ),
05/2018, Letnik:
190, Številka:
20
Journal Article
Recenzirano
Odprti dostop
Lyme disease is a tick-borne bacterial infection (mainly Borrelia burgdorferi) with endemic regions predominantly along the Canada-US border. In 2016, 987 cases of Lyme disease were reported in ...Canada. The heart is involved in up to 10% of Lyme disease cases, with the development of cardiac tissue inflammation or Lyme carditis. Nearly all patients with Lyme carditis (90%) will have atrioventricular block, which commonly presents with breathlessness, palpitations, dizziness or syncope. Cardiac monitoring is critical, and temporary pacing may be needed to manage unstable atrioventricular block until adequate response to antibiotic treatment. An earlier diagnosis of Lyme disease provides a better chance of reducing or preventing lasting complications. Failure to treat Lyme disease in the early stages may increase the need for implantation of a permanent pacemaker. High-degree atrioventricular block usually resolves within one week of starting antibiotics.
Abstract Brugada syndrome is an inherited heart disease without structural abnormalities that is thought to arise as a result of accelerated inactivation of Na channels and predominance of transient ...outward K current ( Ito ) to generate a voltage gradient in the right ventricular layers. This gradient triggers ventricular tachycardia/ventricular fibrillation possibly through a phase 2 reentrant mechanism. The Brugada electrocardiographic (ECG) pattern, which can be dynamic and is sometimes concealed, being only recorded in upper precordial leads, is the hallmark of Brugada syndrome. Because of limitations of previous consensus documents describing the Brugada ECG pattern, especially in relation to the differences between types 2 and 3, a new consensus report to establish a set of new ECG criteria with higher accuracy has been considered necessary. In the new ECG criteria, only 2 ECG patterns are considered: pattern 1 identical to classic type 1 of other consensus (coved pattern) and pattern 2 that joins patterns 2 and 3 of previous consensus (saddle-back pattern). This consensus document describes the most important characteristics of 2 patterns and also the key points of differential diagnosis with different conditions that lead to Brugada-like pattern in the right precordial leads, especially right bundle-branch block, athletes, pectus excavatum, and arrhythmogenic right ventricular dysplasia/cardiomyopathy. Also discussed is the concept of Brugada phenocopies that are ECG patterns characteristic of Brugada pattern that may appear and disappear in relation with multiple causes but are not related with Brugada syndrome.
The incidence of Lyme disease, a tick-borne bacterial infection, is dramatically increasing in North America. The diagnosis of Lyme carditis (LC), an early disseminated manifestation of Lyme disease, ...has important implications for patient management and preventing further extracutaneous complications. High-degree atrioventricular block is the most common presentation of LC, and usually resolves with antibiotic therapy. A systematic approach to the diagnosis of LC in patients with high-degree atrioventricular block will facilitate the identification of this usually transient condition, thus preventing unnecessary implantation of permanent pacemakers in otherwise healthy young individuals.
Frailty has been identified as a risk factor for mortality. However, whether frailty increases mortality risk in patients undergoing percutaneous coronary intervention (PCI) has been controversial. ...Therefore, we conducted a systematic review and meta-analysis of the frailty measures and mortality outcomes in this setting.
PubMed and EMBASE were searched until July 23, 2017 for studies evaluating the association between frailty measures and mortality in individuals who have undergone PCI.
A total of 141 entries were retrieved from our search strategy. A total of 8 studies involving 2332 patients were included in the final meta-analysis (mean age: 69 years; 68% male, follow-up duration was 30 ± 28 months). Frailty was a significant predictor of all-cause mortality after PCI, with a hazard ratio (HR) of 2.97 95% confidence interval (CI) 1.56-5.66, P = .001. This was substantial heterogeneity present (I
: 79%). Subgroup analysis using the Fried score reduced I
to 68% without altering the pooled HR (2.78, 95% CI 1.02-7.76; P < .05). Using the Canadian Study of Health and Aging Clinical Frailty Scale reduced I
to 0% while preserving the pooled HR (5.99, 95% CI 2.77-12.95, P < .001).
Frailty leads to significantly higher mortality rates in patients who have undergone PCI. Both the Fried score and Canadian Study of Health and Aging Clinical Frailty Scale are powerful predictors of mortality. These findings may support the notion that an alternative to invasive strategy should be considered in frail patients who are indicated for revascularization.
The coexistence of atrial fibrillation and heart failure significantly increases the risk of all-cause mortality and heart failure hospitalizations. Sex-related differences in all patients undergoing ...atrial fibrillation catheter ablation include the referral of fewer women for catheter ablation (15-25%), older age of women at ablation, and higher risk of post-ablation recurrence of atrial fibrillation. We searched the existing literature for sex-related differences in patients undergoing atrial fibrillation catheter ablation with a focus on heart failure. Randomized controlled trials assessing atrial fibrillation catheter ablation in patients with heart failure have demonstrated a significant reduction in all-cause mortality and heart failure hospitalizations. Within the eight existing randomized controlled trials on heart failure with reduced ejection fraction, women composed a small proportion of the study population. Only two studies (CASTLE-AF and AATAC-HF) specifically assessed the effect of gender on outcome and showed no difference in post-ablation outcomes. Registry data-based studies assessing sex-related differences in atrial fibrillation catheter ablation in heart failure reveal that women are half as likely as men to undergo ablation. Conflicting data exist on the interaction of gender and heart failure as they may affect peri-ablation and post-ablation long-term outcomes such as atrial fibrillation recurrence or heart failure hospitalizations. In conclusion, existing studies provide insight into the gender-based differences in patients undergoing catheter ablation for atrial fibrillation as it pertains to heart failure. Further prospective studies with higher proportions of female participants are required to accurately determine gender-based differences in this population.
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