Humans ; Death, Sudden, Cardiac/prevention & control* ; Arrhythmias, Cardiac/therapy*

OBJECTIVE: In order to solve alarm fatigue, the algorithm optimization strategies were researched to reduce false and worthless alarms. METHODS: A four-lead arrhythmia analysis algorithm, a multiparameter fusion analysis algorithm, an intelligent threshold reminder, a refractory period delay technique were proposed and tested with collected 28 679 alarms in multi-center study. RESULTS: The sampling survey indicate that the 80.8% of arrhythmia false alarms were reduced by the four-lead analysis, the 55.9% of arrhythmia and pulse false alarms were reduced by the multi-parameter fusion analysis, the 28.0% and 29.8% of clinical worthless alarms were reduced by the intelligent threshold and refractory period delay techniques respectively. Finally, the total quantity of alarms decreased to 12 724. CONCLUSIONS To increase the dimensionality of parametric analysis and control the alarm limits and delay time are conducive to reduce alarm fatigue in intensive care units.
Alert Fatigue, Health Personnel/prevention & control* ; Arrhythmias, Cardiac/diagnosis* ; Clinical Alarms ; Humans ; Intensive Care Units ; Monitoring, Physiologic

The use of an implantable cardioverter-defibrillator (ICD) is an effective treatment strategy for patients with aborted sudden cardiac death (SCD) and ventricular tachyarrhythmias. Primary prevention of SCD is a strategy involving the use of ICDs in patients who are at high risk for but who have not had any previous events of ventricular arrhythmias or cardiac arrest. Cardiac resynchronization therapy (CRT) improves symptoms of heart failure and left ventricular systolic function when used in patients with severe heart failure symptoms, reduced left ventricular ejection, and a wide QRS complex. CRT has also been proven to reduce the rate of hospitalization due to heart failure as well as the rate of death from any cause. In this review, we discuss the clinical trials and current clinical indications for the ICD and CRT.
Arrhythmias, Cardiac ; Cardiac Resynchronization Therapy* ; Death, Sudden, Cardiac ; Defibrillators, Implantable* ; Heart Arrest ; Heart Failure ; Hospitalization ; Humans ; Primary Prevention ; Tachycardia

Implantable cardioverter-defibrillators (ICDs) are an effective treatment strategy for patients with aborted sudden cardiac death (SCD) and ventricular tachyarrhythmias. rimary prevention of SCD is a strategy involving the use of ICDs in patients who are at high risk for, but have not had, any previous events of ventricular arrhythmias or cardiac arrest. Several randomized clinical trials have demonstrated the efficacy of ICDs in the primary prevention of SCD. Therefore, ICD implantation is recommended as a standard of care by the guidelines in patients who have ischemic or nonischemic cardiomyopathy and a low left ventricular ejection fraction. However, the rates of ICD implantation as a primary prevention in Korea is quite low compared to western countries. In this review, we will summarize the results and efficacy of ICDs in the clinical trials about primary prevention of SCD, the current treatment guidelines, and the reimbursement policy of Korean health insurance. We hope that this review will help broaden the recognition of importance of ICD implantation for the primary prevention of SCD.
Arrhythmias, Cardiac ; Cardiomyopathies ; Death, Sudden, Cardiac* ; Defibrillators, Implantable* ; Heart Arrest ; Hope ; Humans ; Insurance, Health ; Korea ; Primary Prevention* ; Standard of Care ; Stroke Volume ; Tachycardia

The management of pulmonary atresia with intact ventricular septum (PA/IVS) remains controversial. The goal of separating systematic and pulmonary circulation can be achieved by biventricular or uni-ventricular (Fontan or one and a half ventricle repair) strategies. Although outcomes have been improved, these surgical procedures are still associated with high mortality and morbidity. An optimal strategy for definitive repair has yet to be defined. We searched databases for genetically randomized controlled trials (RCTs) comparing biventricular with uni-ventricular repair for patient with PA/IVS. Data extraction and quality assessment were performed following the guidelines of the Cochrane Collaboration. Primary outcome measures were overall survival, and secondary criteria included exercise function, arrhythmia-free survival and treatment-related mortality. A total number of 669 primary citations were screened for relevant studies. Detailed analysis revealed that no RCTs were found to adequately address the research question and no systematic meta-analysis would have been carried out. Nevertheless, several retrospective analyses and case series addressed the question of finding right balance between biventricular and uni-ventricular repair for patient with PA/IVS. In this review, we will discuss the currently available data.
Arrhythmias, Cardiac ; physiopathology ; prevention & control ; Cardiac Valve Annuloplasty ; methods ; mortality ; Fontan Procedure ; methods ; mortality ; Heart Defects, Congenital ; mortality ; pathology ; surgery ; Heart Ventricles ; abnormalities ; pathology ; surgery ; Humans ; Pulmonary Atresia ; mortality ; pathology ; surgery ; Retrospective Studies ; Survival Analysis ; Treatment Outcome

OBJECTIVETo study the protected effect of Yindan Xinnaotong capsule (YDXNTC) and main components compatibility on myocardium ischemia/reperfusion injury.

METHODGlobal ischemia/reperfusion was adopted to induce myocardial ischemia/reperfusion injury (MIRI) in isolated rat heart. Sprague-Dawley (SD) rats were divided into control, model, YDXNTC, Ginkgo biloba extract (GBE) group, ethanol extract of Salvia miltiorrhiza (SM-E) group, aqueous extract of Salvia miltiorrhiza (SM-H) group, mixed compatibility of other components in YDXNTC (MC), GBE and SM-E compatibility (GSEC), GBE and SM-H compatibility (GSHC), and SM-E and SM-H compatibility (SEHC). During the experiment, electrocardiogram was recorded to observe cardiac arrest time, heart resuscitation time, regaining normal rhythm time, the incidence and duration of arrhythmias (VT/VF). At the end of reperfusion, hearts were arrested and homogenated to assay the activity of superoxide dismutase (SOD), and the content of malondialdehyde (MDA), lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), cardiac troponin I.

RESULT(1) YDXNTC, SM-E, SM-H and MC elevated cardiac arrest time, also reduced rebeating time, restoring normal rhythm time as well as the duration of arrhythmia, but no remarkable impact on VT/VF occurrence. GBE was effective for incidence of VT/VF, also achieved good effect on shortening rebeating time, restoring normal rhythm time and arrhythmia duration. Likewise, obviously reduced rebeating time, restoring normal rhythm time and arrhythmia duration, and evaluated cardiac arrest time were also exhibited in compatibility groups except that no lengthened cardiac arrest time was detected in GSHC. And the incidence of VT/VF was decreased by GSEC. (2) YDXNT, ginkgo biloba extract (GBE), ethanol extract of salvia miltiorrhiza (SM-E), GBE and SM-E compatibility (GSEC), and SM-E and aqueous extract of salvia miltiorrhiza (SM-H) compatibility (SEHC) could improved SOD and decreased MDA level SM-H, mixed compatibility of other elements in YDXNTC (MC) and GBE and SM-H compatibility (GSHC) showed a role on MDA reduction. (3) LDH was declined by YDXNT and SM-H. CK-MB was reduced by GBE, SM-E, SM-H, and GSEC. (4) The release of cTnI was only inhibited by GSEC.

CONCLUSIONYDXNTC, primary materials and main components compatibility has a certain protection effect on MIRI, its mechanism may be related to antioxidant and calcium overload reduction.

Animals ; Arrhythmias, Cardiac ; physiopathology ; prevention & control ; Capsules ; Creatine Kinase, MB Form ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Electrocardiography ; Ginkgo biloba ; chemistry ; Heart ; drug effects ; physiopathology ; In Vitro Techniques ; L-Lactate Dehydrogenase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Myocardial Reperfusion Injury ; metabolism ; physiopathology ; prevention & control ; Myocardium ; metabolism ; pathology ; Phytotherapy ; Plant Extracts ; pharmacology ; Protective Agents ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; chemistry ; Superoxide Dismutase ; metabolism ; Troponin I ; metabolism

Atrial fibrillation (AF) is the most common arrhythmia and is associated with increased cardiovascular morbidity and mortality. The anti-arrhythmic effect of statins on AF prevention appears to be highly significant in most clinical studies. However, some discrepancies do exist among different clinical studies. Different clinical settings and types of stains used may explain these differences between trials. The CHADS2 and CHA2DS2VASc scoring systems have been used for stroke risk stratification in AF patients. The recent study suggested that these scores can also be used to guide statin therapy for AF prevention. Patients with higher scores had a higher risk of developing AF and gained more benefits from statins therapy than those with lower scores. This review article focused on the ability of these scores to predict AF prevention by statins.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Coloring Agents ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Mortality ; Primary Prevention* ; Stroke

The optimal anaesthetic management of neonates with complete congenital heart block (CCHB) is unknown, as there is a low incidence of such cases. Neonates with CCHB often require surgery for the initiation of electronic pacing. In addition to the challenges of anaesthetising a neonate, this procedure is risky due to the potential for hypotension, arrhythmias and cardiac arrest. We herein present the case of a premature low-birth-weight neonate with antibody-related CCHB and normal heart structure who underwent anaesthesia and surgery for epicardial pacing wire insertion on Day 1 of life. We also compare our patient's anaesthetic conduct and outcome with similar previously reported cases.
Adult ; Anesthetics ; therapeutic use ; Arrhythmias, Cardiac ; prevention & control ; Female ; Heart Block ; congenital ; therapy ; Hemodynamics ; Humans ; Hypotension ; prevention & control ; Infant, Newborn ; Infant, Very Low Birth Weight ; Pacemaker, Artificial ; Treatment Outcome

Abnormal enhanced transmural dispersion of repolarization (TDR) plays an important role in the maintaining of the severe ventricular arrhythmias such as torsades de pointes (TDP) which can be induced in long-QT (LQT) syndrome. Taking advantage of an in vitro rabbit model of LQT2, we detected the effects of KN-93, a CaM-dependent kinase (CaMK) II inhibitor on repolarization heterogeneity of ventricular myocardium. Using the monophasic action potential recording technique, the action potentials of epicardium and endocardium were recorded in rabbit cardiac wedge infused with hypokalemic, hypomagnesaemic Tyrode's solution. At a basic length (BCL) of 2000 ms, LQT2 model was successfully mimicked with the perfusion of 0.5 μmol/L E-4031, QT intervals and the interval from the peak of T wave to the end of T wave (Tp-e) were prolonged, and Tp-e/QT increased. Besides, TDR was increased and the occurrence rate of arrhythmias like EAD, R-on-T extrasystole, and TDP increased under the above condition. Pretreatment with KN-93 (0.5 μmol/L) could inhibit EAD, R-on-T extrasystole, and TDP induced by E-4031 without affecting QT interval, Tp-e, and Tp-e/QT. This study demonstrated KN-93, a CaMKII inhibitor, can inhibit EADs which are the triggers of TDP, resulting in the suppression of TDP induced by LQT2 without affecting TDR.
Action Potentials ; drug effects ; Animals ; Anti-Arrhythmia Agents ; pharmacology ; Arrhythmias, Cardiac ; etiology ; physiopathology ; prevention & control ; Benzylamines ; pharmacology ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; antagonists & inhibitors ; metabolism ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Endocardium ; drug effects ; physiopathology ; Heart ; drug effects ; physiopathology ; In Vitro Techniques ; Long QT Syndrome ; complications ; Pericardium ; drug effects ; physiopathology ; Piperidines ; pharmacology ; Protein Kinase Inhibitors ; pharmacology ; Pyridines ; pharmacology ; Rabbits ; Sulfonamides ; pharmacology ; Torsades de Pointes ; etiology ; physiopathology ; prevention & control

Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases (CVD) are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People's Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China (2010), including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk factors, as well as health resources for CVD, and a profile of medical expenditure, with the aim of providing evidence for decision-making in CVD prevention and control programs in China, and of delivering the most authoritative information on CVD prevention and control for all citizens.
Arrhythmias, Cardiac ; epidemiology ; prevention & control ; China ; epidemiology ; Coronary Disease ; epidemiology ; mortality ; prevention & control ; Diabetes Complications ; epidemiology ; Diet ; Dyslipidemias ; complications ; epidemiology ; Epidemics ; Heart Failure ; epidemiology ; mortality ; prevention & control ; Humans ; Hypertension ; complications ; epidemiology ; Kidney Failure, Chronic ; epidemiology ; mortality ; prevention & control ; Metabolic Syndrome ; Motor Activity ; Nutritional Physiological Phenomena ; Overweight ; complications ; epidemiology ; Peripheral Arterial Disease ; epidemiology ; prevention & control ; Risk Factors ; Smoking ; adverse effects ; Stroke ; epidemiology ; mortality ; prevention & control