Relative value of exercise electrocardiography, long-term electrocardiographic monitoring and programmed electrical stimulation of the heart in the treatment of cardiac arrhythmias.

The article analyzes modern methods of diagnosis and treatment of cardiac arrhythmias – atrial fibrillation. The author primarily focuses on the fact that the most important thing for atrial fibrillation is administering an anticoagulant, since failure to follow this recommendation can lead to negative consequences, such as stroke. The article also says on the effectiveness of taking antianrhythmic agents that is proven and recommended. Atrial fibrillation is a kind of pandemic of the 21st century, since, as of 2023, it was found in 43.6 million people worldwide. Particularly, there is a dynamic increase in the frequency of AF after the COVID-19 pandemic. Therefore, updated studies on the follow-up examination and treatment of this arrhythmia are quite relevant.

Objective To summarize and investigate the incidence,reason,diagnosis and treatment of postoperative early cardiac arrhythmia after orthotopic liver transplantation(OLT).Method A retrospective study was made for the incidence,dignosis and treatment of cardiac arrhythmia (two weeks after OLT) following OLT from June 2004 to January 2012 in the Beijing You-An Hospital.Results In 500 patients who received OLT,Cardiac arrhythmia developed in 82 patients (16.4％).Among these cardiac arrhythmia,35(7.0 ％) were sick sinus syndrome (including severe sinus bradycardia ),18 (3.6 ％ ) were paroxysmal supraventricular tachycardia,21(4.2 ％) were atrial fibrillation,8(1.6 ％,including 2 patients with torsades de pointes) were ventricular tachycardia and 4 (0.8 ％ )were cardiac arrest.Mortality rate after OLT relate to cardiac arrhythmia was 0.4％ (2 patients).Cardiac arrhythmia was mainly correlated with four factors:(1)whether patient had heart disease before OLT or not(x2 =15.82,P＜0.01),(2)Prolonged QT interval in patients with end-stage liver disease before OLT(x2 =11.00,P＜0.01).Conclusions Cardiac arrhythmia was common complication after OLT,and it can lead to death of recipients.Careful evaluation to recipients before OLT,controlling fluid load after OLT,keeping the balance of the electrolyte,acidity and alkalescence,giving intensive monitor to patients with heart disease before OLT and prolonged QT interval are the key factor to reduce incidence and mortality of cardiac arrhythmia.Application of medication and cardiac pacemaker can prevent cardiovascular accident after OLT. Key words: Liver transplantation; Arrhythmia; Causality

POSTER PRESENTATIONS

Beta-blockers for the treatment of arrhythmias: Bisoprolol – a systematic review

ORAL PRESENTATION

Noninvasive atrial fibrillation (AF) therapies are based on 2 separate strategies: rate or rhythm control aiming to slow ventricular rate to normal or to restore sinus rhythm, respectively.Hence, in rate control, AF itself is not resolved, whereas the curtailment of ventricular frequency reduces exercise tolerance.Rhythm control, on the other hand, is hampered by adverse effects such as ventricular proarrhythmia.Therefore, better insight into the contribution of ion channels, present in the atria but not the ventricles, to AF and the concordant exploration of possible atrium-specific therapies are essential if we are to diminish the burden of adverse effects in AF treatment.Previous studies showed that the acetylcholine-dependent potassium current (I K,ACh ), governed by the atrium-specific Kir3.x channels, can become constitutively active (I K,ACh-C ) in patients with AF.In the present study, we demonstrate the contribution of I K,ACh-C and Kir3.x to the initiation, maintenance, and termination of AF.We show for the first time that I K,ACh-C increases the chance of AF initiation through its steepening effects on the action potential duration and conduction velocity restitution curves, causing action potential duration and amplitude alternans.In addition, I K,ACh-C is shown to facilitate AF maintenance by stabilizing rotor dynamics, whereas AF termination can be elicited by blockade of I K,ACh-C , causing alternans-mediated rotor destabilization.Our findings provide evidence for a causal relationship between I K,ACh-C , alternans, and the initiation, maintenance, and termination of AF.Thus, not only I K,ACh-C or Kir3.x but also its consequent alternans might be an interesting atrium-specific target for future AF rhythm control or pharmacological cardioversion.Conclusions-Atrium-specific Kir3.x controls the induction, dynamics, and termination of fibrillation by modulating APD and APD/conduction velocity restitution slopes in atrial tissue with I K,ACh-c .This study provides new molecular and mechanistic insights into atrial tachyarrhythmias and identifies Kir3.x as a promising atrium-specific target for antiarrhythmic strategies. 1 Incident Atrial Fibrillation Among Asians, Hispanics, Blacks, and WhitesSummary-Although atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice, the underlying mechanisms responsible for its induction and perpetuation remain incompletely understood.Blacks experience a substantially lower rate of AF compared with whites, and the relative strength of this association suggests the mechanism responsible for the race-AF association plays an important role in disease pathogenesis.Because AF rates have only been rigorously compared between black and white patients, it is unclear whether white race confers elevated AF risk or black race affords arrhythmia protection.The present investigation compared incident AF between whites, blacks, Hispanics, and Asians receiving hospital-based medical care in California.A significantly lower hazard of AF was observed among blacks, Hispanics, and Asians compared with whites both before and after controlling for established risk factors.These findings argue against a protective effect unique to black race and instead suggest an unidentified characteristic inherent to white race increases AF risk.In addition, the difference in AF risk between whites and nonwhites was most pronounced in the absence of established AF risk factors.This further suggests that an unknown, alternative disease mechanism is driving these racial differences.As nonwhite racial and ethnic populations within the United States continue to grow, clinicians should be aware of the importance of race in AF prediction and incorporate this knowledge into their care of patients at risk for this frequently encountered disease.Conclusions-In a large hospital-based cohort, whites have an increased risk of AF whether compared with blacks, Asians, or Hispanics.The heightened AF risk among whites is most pronounced in the absence of cardiovascular comorbidities. 2 Intramyocardial Adiposity After Myocardial Infarction: New Implications of a Substrate for Ventricular TachycardiaSummary-The prevalence of intramyocardial adipose tissue (IMAT) in patients after myocardial infarction is ≈15% to 89%, depending on disease progression and assessment modality.To date, the electrophysiological influence of IMAT in this setting has been undefined.In this large-animal study, we have provided histological and electrophysiological evidence that IMAT is associated with ventricular tachycardia in the chronic phase of myocardial infarction.If these findings are confirmed clinically, noninvasive identification of IMAT within infarct borders may be applied to predict the propensity for ventricular tachycardia and mortality.The "gray zone"

ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities

The clinical use of diphenylhydantoin (Dilantin) in the treatment and prevention of cardiac arrhythmias

Intravenous amiodarone and off-pump coronary artery bypass graft procedures: A new role for intraoperative antiarrhythmic therapy?

Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter

The rapid growth in computational power, sensor technology, and wearable devices has provided a solid foundation for all aspects of cardiac arrhythmia care. Artificial intelligence (AI) has been instrumental in bringing about significant changes in the prevention, risk assessment, diagnosis, and treatment of arrhythmia. This review examines the current state of AI in the diagnosis and treatment of atrial fibrillation, supraventricular arrhythmia, ventricular arrhythmia, hereditary channelopathies, and cardiac pacing. Furthermore, ChatGPT, which has gained attention recently, is addressed in this paper along with its potential applications in the field of arrhythmia. Additionally, the accuracy of arrhythmia diagnosis can be improved by identifying electrode misplacement or erroneous swapping of electrode position using AI. Remote monitoring has expanded greatly due to the emergence of contactless monitoring technology as wearable devices continue to develop and flourish. Parallel advances in AI computing power, ChatGPT, availability of large data sets, and more have greatly expanded applications in arrhythmia diagnosis, risk assessment, and treatment. More precise algorithms based on big data, personalized risk assessment, telemedicine and mobile health, smart hardware and wearables, and the exploration of rare or complex types of arrhythmia are the future direction.

Unforeseen consequences: Class III antiarrhythmic amiodarone stimulated increase in prostate-specific antigen

Use of temporarily placed epicardial atrial wire electrodes for the diagnosis and treatment of cardiac arrhythmias following open-heart surgery

Chapter 26 - The Sexually Dimorphic Characteristics of the Pathophysiology and Treatment of Atrial Fibrillation

Cardiac arrhythmias are an important clinical problem since it increases risk of stroke, heart failure, and overall morbidity. Treatment of arrhythmias may include blood thinners, rhythm control, as well as surgical ablation. In this review, we discuss the differences in diagnosis, prognosis and treatment of cardiac arrhythmias in men and women. Further understanding of the gender specific differences of cardiac arrhythmias may be helpful to achieve success and more delivery of more personalized medicine.