Palpitations Research Articles

Medieval Recipes by Al-Zahrāwī for Heart Palpitations Treatment

The Kitāb al-Taṣrīf (Book of medical arrangement) is the masterpiece of the distinguished Cordovan physician Abū l-Qāsim Khalaf Ibn ‘Abbās Al-Zahrāwī (c.936-c.1013), known among other names as Abulcasis. This book exemplifies the high level achieved by Arab science in the Middle Ages, and for this important reason it is essential to study its pages in order to make them known to researchers and academics in other areas of scientific knowledge. Its author, Abulcasis Al-Zahrāwī, was also an eminent surgeon, the first of Medieval Islam, and his influence reached as far as Renaissance Europe. The 9th treatise of his work is an interesting medieval treatise of cardiology and neurology, including the correct treatment of some of their most common ailments and diseases. It contains recipes of great value to the fields of pharmacology, cardiology and neurology. This paper is an approach to this treatise, and includes the translation to English from some of its fragments referring to recipes of remedies that are beneficial for heart palpitations treatment, according to the 502nd Arabic manuscript of the Süleymaniye Umumi Kütüphanesi from Istanbul, and the 137th manuscript of the Ṭibb Taymūr collection from the Egyptian National Library and Archives (Dār al-Kutub al-Miṣriyya) in Cairo.

Marcello Malpighi's failing health, death, and the remarkable story of his mortal remains.

Marcello Malpighi, renowned as the founder of microscopic anatomy, faced many challenges throughout his life. Among these was his frail health, which deteriorated in his early 40s when he developed kidney stones. He struggled with arthritic pain and heart palpitations, which, along with his renal condition, gradually became worse as he got older. His clinical history and autopsy findings also suggest he may have suffered from hypertension, a disease unknown in the seventeenth century. Toward the end, his declining health was complicated by cardiovascular failure. After he died from a stroke, his mortal remains lay unburied for months due to a dispute over the ownership of the burial place. They were finally entombed but relocated multiple times over the next three centuries. An examination of the bones currently housed in his memorial, conducted on the tercentenary of his birth and critically revisited years later, raised doubts about their authenticity. In this paper, I review the causes of Malpighi's poor health and death and delve into the intriguing story of his mortal remains.

Takotsubo Syndrome Following Catheter Ablation for Atrial Fibrillation: A Systematic Review and Metasummary of Case Reports/Series.

Atrial fibrillation (AF) catheter ablation is safe and effective, though rare cases of takotsubo syndrome (TTS) have been observed without proven causation. This review synthesizes TTS following AF ablation case reports and series. Until October 2024, PubMed/Medline, SCOPUS, and Google Scholar were searched for AF ablation and TTS case reports and series. This study examines TTS incidence, clinical features, and prognosis after AF catheter ablation. Thirteen articles detailing 18 patients were included in the review. The study population had a mean age of 65 ± 9.18 years and 77.77% were female. Of the 18 patients, 6 patients (33.3%) underwent radiofrequency catheter ablation and 5 patients (27.7%) underwent cryoablation. All the patients developed TTS within 4 days of the procedure. Heart palpitations and breathlessness are predominant symptoms. Eight patients had T-wave inversion. Dyskinesia was the most prevalent echocardiography finding among the reported cases. Left ventricular ejection fraction was moderately reduced in 5 cases (35.7%) and severely reduced (left ventricular ejection fraction <30%) in 6 cases (42.8%). Of the 15 patients in whom a pattern of ballooning was reported, 13 patients had apical ballooning and 2 had atypical ballooning pattern. Of the 8 cases (44.44%) with complications, 1 had ventricular fibrillation and 2 patients had pulseless electrical activity. Left ventricular function is completely recovered among 17 patients whereas one patient died due to numerous cardiac electromechanical dissociation events. This systematic investigation highlights the need for TTS vigilance after AF ablation, especially in postmenopausal women having catheter ablation. More research is required to fully understand the prevalence, etiology, and risk factors of TTS after AF ablation.

Cardiotoxicity of Drugs Used in the Management of the COVID-19 Patients: Single-Center Retrospective Study

Background:-Since COVID-19 was declared a pandemic by the World Health Organization (WHO), there have been many changes in treatment protocols. With the rise of COVID-19 cases globally and the absence of any approved medicine for the treatment of (COVID-19), many drugs have been experimentally administered to patients, ignoring possible side effects. Some of these drugs have a background of potential cardiotoxicity that should be evaluated. Methods:-A retrospective study will be conducted on patients’ admissions to (ICU) or (CCU) in Al-Noor Hospital in the Kingdom of Saudi Arabia to treat COVID-19. The effect of the drugs used in the management of COVID-19 on the cardiac parameters of patients will be evaluated and compared with COVID-19 medications that cause cardiotoxicity in patients. Results:-The patients were having Symptoms included arrhythmia (56.3%), murmur (43.0%), QT prolongation (54.3%), chest pain (54.3%), shortness of breath (55.0%), heart palpitation (45.7%), fluid retention (47.0%) and myocarditis (51.7%). ICU admission diagnoses in most patients were COVID exacerbation (51.7%) and pneumonia (38.4%). Different classes of antibiotics and antivirals were administered to the patients, and a high risk of cardiac manifestations was observed in patients using Ribavirin which was used in 51 patients (33.8%). Conclusion:-The study showed that cardiotoxic symptoms appear among patients using anti-COVID medications, especially Ribavirin. Therefore, there is a need to limit the use of medicines for COVID-19, which causes cardiotoxicity and change the protocol used in Saudi Arabia.

Enhanced interpretable thyroid disease diagnosis by leveraging synthetic oversampling and machine learning models

Thyroid illness encompasses a range of disorders affecting the thyroid gland, leading to either hyperthyroidism or hypothyroidism, which can significantly impact metabolism and overall health. Hypothyroidism can cause a slowdown in bodily processes, leading to symptoms such as fatigue, weight gain, depression, and cold sensitivity. Hyperthyroidism can lead to increased metabolism, causing symptoms like rapid weight loss, anxiety, irritability, and heart palpitations. Prompt diagnosis and appropriate treatment are crucial in managing thyroid disorders and improving patients’ quality of life. Thyroid illness affects millions worldwide and can significantly impact their quality of life if left untreated. This research aims to propose an effective artificial intelligence-based approach for the early diagnosis of thyroid illness. An open-access thyroid disease dataset based on 3,772 male and female patient observations is used for this research experiment. This study uses the nominal continuous synthetic minority oversampling technique (SMOTE-NC) for data balancing and a fine-tuned light gradient booster machine (LGBM) technique to diagnose thyroid illness and handle class imbalance problems. The proposed SNL (SMOTE-NC-LGBM) approach outperformed the state-of-the-art approach with high-accuracy performance scores of 0.96. We have also applied advanced machine learning and deep learning methods for comparison to evaluate performance. Hyperparameter optimizations are also conducted to enhance thyroid diagnosis performance. In addition, we have applied the explainable Artificial Intelligence (XAI) mechanism based on Shapley Additive exPlanations (SHAP) to enhance the transparency and interpretability of the proposed method by analyzing the decision-making processes. The proposed research revolutionizes the diagnosis of thyroid disorders efficiently and helps specialties overcome thyroid disorders early.

A giant parathyroid adenoma: a case report

BackgroundPrimary hyperparathyroidism is an endocrine disease and a common cause of nonmalignant hypercalcemia, often discovered incidentally in asymptomatic patients. The case reported herein illustrates that significant hormonal imbalances can present with unexpectedly mild clinical manifestations.Case presentationWe describe a 47-year-old Caucasian male with two episodes of kidney stones and otherwise no symptoms of severe hypercalcemia. In our case, fasting emerged as a potential risk factor for the development of renal stones. The diagnosis was primary hyperparathyroidism. The intervention consisted of preoperative fluids and cinacalcet while awaiting surgery. Despite initial stability, the patient experienced a subsequent increase in ionized calcium and parathyroid hormone levels, becoming symptomatic with fatigue, tremors, and heart palpitations. This progression led to a diagnosis of a hypercalcemic crisis, and the plan was accelerated. An acute parathyroid scintigraphy and an ultrasound was performed and revealed a giant intrathoracic parathyroid adenoma. After surgical removal of the adenoma, he developed hungry bones and biochemical remission. The patient has received three extracorporeal shock wave lithotripsy treatments for a stone in the upper left kidney, but as of a computed tomography scan on 9 February 2024, the stone remains unchanged. Owing to the stone’s resistance to extracorporeal shock wave lithotripsy and the absence of symptoms, no further treatment is planned. Endoscopic laser treatment (retrograde intrarenal surgery) is an option, but for now, the situation will be monitored.ConclusionThis case report underscores that extremely elevated levels of calcium and parathyroid hormone along with a rare giant parathyroid adenoma may not necessarily present with symptoms indicative of a calcium crisis. Additionally, management of such rare giant parathyroid adenomas requires careful monitoring and a tailored approach to address potential postsurgical complications such as hungry bone syndrome.

Variations in Adverse Events Typology Following E-Cigarette Use: The Role of Preexisting Medical Conditions

Background Electronic cigarettes (e-cigarettes) are often marketed as safer alternatives to traditional smoking, yet evidence suggests potential health risks, especially among vulnerable populations. This study examines the immediate adverse events following e-cigarette use in individuals with preexisting health conditions to better understand these risks. Methods We conducted a STROBE-compliant observational study to identify specific preexisting medical conditions that may increase the risk of adverse events following e-cigarette use. A cross-sectional survey was deployed from January 3rd to March 3rd, 2023. A total of 4695 current and former e-cigarette users completed the survey. Logistic regression models were utilized to examine associations between 23 distinct preexisting conditions and 48 adverse events, adjusting for age, sex, race/ethnicity, education level, and income. Results The analysis encompassed 4,421 respondents, demonstrating that individuals with solid organ transplants faced notably pronounced risks, with odds ratios indicating a seven-fold increase in mouth/tongue blisters (OR = 7.05), nearly five-fold for heart palpitations (OR = 4.92), and heartburn (OR = 4.79). Stem cell transplantation recipients also showed significantly heightened risks for similar adverse events, including mouth/tongue blisters (OR = 5.53) and heart palpitations (OR = 4.65). Metabolic diseases were linked to substantially increased odds of mouth/tongue blisters (OR = 5.63), hair loss (OR = 4.09), and migraine (OR = 3.50), highlighting a specific vulnerability to e-cigarette aerosol exposure among these groups. Conclusion The findings highlight the acute health risks associated with e-cigarette use in individuals with certain preexisting conditions. These results challenge the notion that e-cigarette use poses limited harm to human health and highlight the need for tailored public health strategies to protect vulnerable populations.

Evaluation of risk factor profiles for acute coronary syndrome among Indian adults

Acute coronary syndrome (ACS) refers to a group of conditions that include ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina. Therefore, it is of interest to assess the risk factor (R/F) of ACS. 67 patients underwent investigation with the help of history and clinical examination test like electrocardiogram (ECG), blood sugar and lipid level. Data shows R/F was seen more for males than females with 30-40 years of age range. Thus, we conclude that, multiple complications like chest pain (CP), palpitation (PP), sweating (SW), vomiting (VM) and giddiness (GD) should not be overlooked.

Post-acute sequelae of SARS-CoV-2 cardiovascular symptoms are associated with trace-level cytokines that affect cardiomyocyte function

An estimated 65 million people globally suffer from post-acute sequelae of COVID-19 (PASC), with many experiencing cardiovascular symptoms (PASC-CVS) like chest pain and heart palpitations. This study examines the role of chronic inflammation in PASC-CVS, particularly in individuals with symptoms persisting over a year after infection. Blood samples from three groups—recovered individuals, those with prolonged PASC-CVS and SARS-CoV-2-negative individuals—revealed that those with PASC-CVS had a blood signature linked to inflammation. Trace-level pro-inflammatory cytokines were detected in the plasma from donors with PASC-CVS 18 months post infection using nanotechnology. Importantly, these trace-level cytokines affected the function of primary human cardiomyocytes. Plasma proteomics also demonstrated higher levels of complement and coagulation proteins in the plasma from patients with PASC-CVS. This study highlights chronic inflammation’s role in the symptoms of PASC-CVS.

Knowledge, attitude, and practice toward sleep hygiene and cardiovascular health: a cross-sectional survey among healthcare workers.

Healthcare workers grapple with distinct challenges, inherent to their profession, making them susceptible to irregular sleep patterns and insufficient sleep, which may further impact their cardiovascular health. This study aimed to investigate the knowledge, attitude and practice (KAP) of healthcare workers concerning sleep hygiene and cardiovascular health. A cross-sectional survey was conducted at Yancheng TCM Hospital Affiliated with Nanjing University of Chinese Medicine between July, 2023 and September, 2023. Demographic characteristics, KAP scores, sleep health awareness and habits, and sleep quality were assessed through the questionnaires. A total of 423 valid questionnaires were included in the study. Among these, 215 (50.83%) were aged 35 or below, and 128 (30.26%) reported suffering from chronic insomnia. The mean knowledge, attitude, and practice scores were 43.23 ± 5.67 (possible range: 10-50), 24.53 ± 4.59 (possible range: 9-45), and 20.22 ± 4.46 (possible range: 6-30), respectively. Multivariate analyses indicated that attitude score (OR = 0.890, 95% CI: [0.807-0.981], p = 0.019), sleep health awareness & habits score (OR = 1.847, 95% CI: [1.284-2.656], p = 0.001), experienced chest tightness or heart palpitations (OR = 6.084, 95% CI: [2.172-17.042], p = 0.001), and the presence of chronic insomnia (OR = 5.017, 95% CI: [2.428-10.368], p < 0.001) were independently associated with sleep quality. Healthcare workers had adequate knowledge, negative attitude and moderate practice toward sleep hygiene and cardiovascular health. The findings highlight the need for targeted interventions to address the observed gaps in attitudes and practices, aiming to enhance overall awareness and promote healthier sleep habits among healthcare professionals.

Deep Learning for Time Series Anomaly Detection: A Survey

Time series anomaly detection is important for a wide range of research fields and applications, including financial markets, economics, earth sciences, manufacturing, and healthcare. The presence of anomalies can indicate novel or unexpected events, such as production faults, system defects, and heart palpitations, and is therefore of particular interest. The large size and complexity of patterns in time series data have led researchers to develop specialised deep learning models for detecting anomalous patterns. This survey provides a structured and comprehensive overview of state-of-the-art deep learning for time series anomaly detection. It provides a taxonomy based on anomaly detection strategies and deep learning models. Aside from describing the basic anomaly detection techniques in each category, their advantages and limitations are also discussed. Furthermore, this study includes examples of deep anomaly detection in time series across various application domains in recent years. Finally, it summarises open issues in research and challenges faced while adopting deep anomaly detection models to time series data.

Anxiety in Pregnancy: Comparing High-Risk and Normal Pregnant Women through the Beck Anxiety Inventory

Aim: Pregnancy is a critical life event that necessitates adaptation to numerous physical and psychological changes. While it often brings positive emotions, it can also induce significant stress and anxiety, especially in high-risk scenarios with potential maternal and fetal health concerns. This study aims to investigate whether there is a difference in anxiety levels between pregnant women under routine obstetric care and those under perinatology care for high-risk pregnancies. Material and Method: This cross-sectional survey was conducted at the Giresun Training and Research Hospital Obstetrics and Gynecology Hospital. Ninety pregnant women aged 18-40 were divided into two groups: 45 women receiving routine obstetric care (Group I) and 45 women receiving perinatology care for high-risk pregnancies (Group II). Data were collected using a 20-question socio-demographic and medical characteristics questionnaire, along with the Beck Anxiety Inventory. Results: The study found no significant difference in socio-demographic characteristics such as education, employment, and income status between the two groups (p&gt;0.05). The Beck Anxiety Inventory scores indicated that both groups predominantly experienced low-level anxiety: 82.2% in Group I and 86.7% in Group II. Moderate anxiety was reported by 15.6% of Group I and 11.1% of Group II. Only 2.2% of participants in each group experienced severe anxiety. There was no significant difference in the overall anxiety levels between the two groups (p&gt;0.05), although Group I reported higher heart palpitations (p

Sosyal Kaygı Bozukluğunda Bilişsel Davranışçı Terapi Olgu Sunumu

In this study, the client's symptoms were characterized as social anxiety disorder based on dsm5 diagnostic criteria. The client is a 24-year-old female university student. The client stated that she had fears of failing, being stupid and being disgraced and mentioned physical symptoms such as hand and voice tremors, nausea and heart palpitations due to these fears. The client, who has beliefs such as inadequate, worthless and I must be successful, shows excessive anxiety and avoidance behaviors in situations such as eating in front of people, speaking in public, making presentations and mixing with people. The client realized that his academic success was jeopardized and his functionality was decreasing and applied for therapy. Cognitive behavioral therapy was used with the client. First, the client was psychoeducated about the therapy and its progress and a therapeutic relationship was developed. In the first stage of the treatment, cognitive processes were emphasized, automatic negative thoughts and core beliefs were identified and questioned, and cognitive restructuring was performed. Then behavioral techniques were practiced. Key words: Social anxiety disorder, anxiety, cognitive behavioral therapy.

(049) FIRST TIME ROBOTIC ASSISTED LAPAROSCOPIC BILATERAL VESICULECTOMY FOR POST ORGASMIC ILLNESS SYNDROME: A CASE REPORT

Abstract Introduction Post Orgasmic Illness Syndrome (POIS) is a rare disorder characterized by feeling ill after ejaculation. Many people experience flu-like or allergy symptoms that last 2-7 days, on average. POIS was first described in the literature in 2002 by Dr. Waldinger, who described the 5 diagnostic criteria and 7 clusters of symptoms. Currently, it is most widely believed that this syndrome is an autoimmune or allergic reaction to semen or seminal fluid. However, with recent case-reports, various proposed mechanisms have sprouted in the literature including that it is an opioid receptor disorder, cytokine and neuroendocrine response disorder, hormonal imbalance or sympathetic dysregulation. Various treatment options have been suggested in the literature including antihistamines, anti-depressants, prednisone, NSAIDs, hormone replacement, and alpha agonists. Overall, the literature that exists is composed of case reports without a clear-cut understanding of pathophysiology or the best treatment modality for POIS. Objective To describe a difficult to manage POIS case in a patient that opted to pursue bilateral vesiculectomy for treatment without success after failing conservative measures. Methods A 44-year-old man presented to our institution with intermittent symptoms of POIS since the age of 20. His symptoms were as follows: about 5-6 hours after orgasm, he had tachycardia, chest wall pain, cough, myalgia, runny nose, and muscle aches that could last about 7 days. He denied any history of genital trauma or surgery, erythrocytosis, VTE, MI, erectile dysfunction, or stroke. He did have a history of hypogonadism. He is a former smoker with 10 pack years and was not currently consuming alcohol. He did not have any pertinent family history. His physical exam was overall normal and unremarkable. Prior to visiting our institution, he had tried buspirone and clonazepam without success. Initially, he started on Claritin daily and precoital Diphenhydramine which was partially helpful. He was also prescribed hydroxyzine, Tamsulosin and prednisone in later visits, in addition to his current regimen, but his symptoms persisted. His POIS symptoms were causing him extreme depression and anxiety and the patient wanted to escalate his treatment efforts. The patient was counseled extensively on a bilateral vesiculectomy, including that he may not see benefits from the procedure and that this would be the first time this procedure would be carried out as treatment for POIS. Results The patient decided to undergo a robotic assisted laparoscopic bilateral vesiculectomy. His seminal vesicles were sent to pathology and overall were unremarkable bilaterally. At his 1-month follow-up, the patient continued to have POIS symptoms with sneezing, chest pain and heart palpitations. He was diagnosed with epididymoorchitis and was prescribed Bactrim. A follow up at 8 months was scheduled. Conclusions This study suggests that pathophysiology for POIS is not necessarily an allergic reaction to seminal fluid for all patients. POIS continues to be poorly understood with some patients exhausting their options. Given the impact POIS can have on quality of life, it is important for physicians to gain a better understanding of this syndrome to spare patients unnecessary distress and invasive procedures. Disclosure No.

BLOOD PRESSURE PROFILE AND DIETARY INTAKE OF STUDENTS EXEMPTED FROM PUBLIC GENERAL EDUCATION COLLEGES IN THE COMMUNE OF MISSERETE

Physical education is part of the compulsory curriculum in secondary schools in Benin. Despite being compulsory, it is observed that some students claim to be exempted from it in the first weeks of the school year. The main reasons cited, supported either rightly or wrongly by medical authority, include chest pains during exertion, heart palpitations, dizziness, high blood pressure, health conditions incompatible with physical education for a duration of one year or indefinite, etc.. Thus, faced with an increasingly high rate of exempted students, the dietary consumption of 126 exempted students, including 79 girls and 47 boys from public secondary schools in the commune of Misserete, was analyzed to establish a link with their blood pressure profile. The results revealed that none of the surveyed exempted students from these schools were hypertensive because they have good dietary habits. 45.2% are underweight and 12.6% are overweight or obese. Regarding dietary consumption, none of them consume alcoholic beverages or tobacco. 86.5% walk 2 to more than 3km to school, while 10.3% and 3.2% respectively come by bicycle and motorcycle. In conclusion, the study raised concerns about the sincerity of the statements of all exempted students as well as the certificates issued by medical authority. However, further research is needed to confirm or refute these results.

Electrochemical sensor based on mesoporous g-C3N4/N-CNO/gold nanoparticles for measuring oxycodone

Oxycodone, often used as an analgesic, is a potent opioid. While its effectiveness has been proven in the control of moderate to acute pain, excessive use of oxycodone imposes heart failure, heart palpitations, reduction of red blood cells, bone pain, and even death. Therefore, monitoring the oxycodone concentration in blood is vital for emergency care. For this purpose, a novel electrochemical sensor was designed based on a glassy carbon electrode modified with mesoporous g-C3N4 (M-C3N4), carbon nano-onions doped with nitrogen (N-CNO), and gold nanoparticles. At first, the SEM and XRD techniques were employed to characterize prepared M-C3N4 and N-CNO samples. The electro-oxidation behavior of the oxycodone was evaluated by cyclic and differential pulse voltammetric methods. Based on the influence of the potential scanning rate and solution pH on the voltammetric response of oxycodone oxidation, a redox mechanism was proposed. A 16 nM detection limit was acquired for the oxycodone analysis with a linear response in the 0.05–150 µM range. This sensor showed a remarkable ability for oxycodone detection in plasma samples. The long-term stability, superior selectivity, and reproducibility of this sensor prove its ability to measure oxycodone accurately and precisely in authentic spices.

Illness presentation and quality of life in myalgic encephalomyelitis/chronic fatigue syndrome and post COVID-19 condition: a pilot Australian cross-sectional study

PurposePost COVID-19 Condition (PCC), being persistent COVID-19 symptoms, is reminiscent of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—a chronic multi-systemic illness characterised by neurocognitive, autonomic, endocrinological and immunological disturbances. This novel cross-sectional investigation aims to: (1) compare symptoms among people with ME/CFS (pwME/CFS) and people with PCC (pwPCC) to inform developing PCC diagnostic criteria; and (2) compare health outcomes between patients and people without acute or chronic illness (controls) to highlight the illness burdens of ME/CFS and PCC.MethodsSociodemographic and health outcome data were collected from n = 61 pwME/CFS, n = 31 pwPCC and n = 54 controls via validated, self-administered questionnaires, including the 36-Item Short-Form Health Survey version 2 (SF-36v2) and World Health Organization Disability Assessment Schedule version 2.0 (WHODAS 2.0). PwME/CFS and pwPCC also provided self-reported severity and frequency of symptoms derived from the Canadian and International Consensus Criteria for ME/CFS and the World Health Organization case definition for PCC.ResultsBoth illness cohorts similarly experienced key ME/CFS symptoms. Few differences in symptoms were observed, with memory disturbances, muscle weakness, lymphadenopathy and nausea more prevalent, light-headedness more severe, unrefreshed sleep more frequent, and heart palpitations less frequent among pwME/CFS (all p < 0.05). The ME/CFS and PCC participants’ SF-36v2 or WHODAS 2.0 scores were comparable (all p > 0.05); however, both cohorts returned significantly lower scores in all SF-36v2 and WHODAS 2.0 domains when compared with controls (all p < 0.001).ConclusionThis Australian-first investigation demonstrates the congruent and debilitating nature of ME/CFS and PCC, thereby emphasising the need for multidisciplinary care to maximise patient health outcomes.

Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia.

Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta-blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation. This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation. The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate(HR) on a 24-h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24-h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm. This is the first case series reporting the acute and long-term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge(AR) under intracardiac echography(ICE) guidance. The novel anatomic ICE-guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions towardits septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.

Postural orthostatic tachycardia syndrome during pregnancy, labor, and post-delivery: A case series

Postural orthostatic tachycardia syndrome (POTS) is an autonomic condition characterized by the presence of a &gt;30 bpm increase in heart rate, accompanied by orthostatic symptoms, including heart palpitations, light-headedness, weakness, blurred vision, nausea, and headache. Females are commonly affected by POTS at childbearing age. This case series aims to compare the clinical presentations, autonomic dysfunction management, and pregnancy outcomes of four women with POTS. In our autonomic neurology clinic, the goal for our patients is consistent blood pressure during pregnancy. The patients were all interviewed retrospectively to determine pregnancy outcomes. Our study indicates the need for neurologists to collaborate with a team of maternal-fetal medicine specialists with advanced training in high-risk pregnancies to optimize autonomic function throughout the course of pregnancy. In addition, our results suggest that reducing medications to minimize harm can be achieved through regular monitoring at 1 &amp;ndash; 3 month intervals during pregnancy, with a 6-week postpartum evaluation.

Reduced serum CLCF1 levels in hyperthyroidism patients and T3-treated mice.

Characteristic symptoms of hyperthyroidism include weight loss, heart palpitation, and sweating. Thyroid hormones (TH) can stimulate thermogenesis through central and peripheral mechanisms. Previous studies have shown an association between dysfunction of cardiotrophin-like cytokine factor 1 (CLCF1) and cold-induced sweating syndrome, with recent research also indicating a link between CLCF1 and brown adipose tissue thermogenesis. However, it remains unclear whether CLCF1 and TH have synergistic or antagonistic effects on thermogenesis. This study aims to investigate the influence of thyroid hormone on circulating CLCF1 levels in humans and explore the potential possibilities of thyroid hormone in regulating energy metabolism by modulating Clcf1 in mice. By recruiting hyperthyroid patients and healthy subjects, we observed significantly lower serum CLCF1 levels in hyperthyroid patients compared to healthy subjects, with serum CLCF1 levels independently associated with hyperthyroidism after adjusting for potential confounders. Tissue analysis from mice treated with T3 revealed a decrease in CLCF1 expression in BAT and iWAT of C57BL/6 mice. These findings suggest that TH may play a role in regulating CLCF1 expression in adipose tissue.