Tag Archives: arrhythmia

Background Ambulatory electrocardiogram (AECG) monitoring is a common investigation performed as part of the assessment of patients with known or suspected cardiac arrhythmias. This normally requires the patient to attend a face-to-face hospital appointment. The role of patient-led collection and self-fitting of AECG within the National Health Service (NHS) has not previously been investigated. In order to reduce patient contact during the COVID-19 pandemic, and in order to maintain AECG services while other non-urgent diagnostics were suspended, we sought to assess the feasibility, reliability, and patient acceptability of a drive-by collect

NICE heart failure guidelines The latest National Institute for Health and Care Excellence (NICE) guidelines for management of chronic heart failure (NG 106)1 were presented by Dr Abdallah Al-Mohammed (Sheffield Teaching Hospitals). It was fascinating to hear Dr Al-Mohammed describe his work on producing the guidelines with respect to what recommendations the authors are permitted to include and how recommendations may be presented. Key changes include the removal of a history of a previous myocardial infarction from the initial assessment of a patient with suspected chronic heart failure. Other changes include the guidelines now using the te

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Nanoparticles, inhaled from sources such as vehicle exhausts, have been shown to cross from the lungs into the blood stream. They can then accumulate in areas susceptible to heart problems, according to research part-funded by the British Heart Foundation.  Previous studies have identified a correlation but not a causal link between nanoparticles and strokes or cardiovascular disease. It is not currently possible to measure environmental nanoparticles in the blood. So, researchers from the University of Edinburgh, and the National Institute for Public Health and the Environment in the Netherlands, used a variety of specialist techniques to t

Introduction Cardiac sarcoidosis can present in a broad spectrum of entities ranging from a benign condition, which is diagnosed incidentally, to a potentially serious disease leading to sudden cardiac death, which only becomes apparent at autopsy, as is the case in 5% of the affected population.1 Due to its subtle, but also sometimes fatal presentation, cardiac sarcoid is hugely underdiagnosed, and awareness of such cases should be brought to light whenever possible. This case report highlights the importance of being aware of the potential presentations of cardiac involvement in patients with sarcoidosis and the general investigations and m

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Case report A 51-year-old Asian woman presented with intermittent presyncope and profound breathlessness. She had no significant past medical history of note and was not receiving any regular medication. A resting 12-lead electrocardiogram (ECG) revealed a second-degree atrioventricular block. She subsequently underwent insertion of a dual-chamber permanent pacemaker. Further investigations at that time revealed unobstructed coronary arteries on angiography and normal ventricular function on transthoracic echocardiography. Figure 1. 12-lead electrocardiogram (ECG) demonstrates ventricular tachycardia of varying morphology Her symptoms initial

Introduction Temporary transvenous pacing (TTVP) has been used to treat life-threatening bradycardic, and tachycardic emergencies for 50 years. We present a retrospective analysis of TTVP in an outer London hospital between July 2003 and March 2009. Results The results from 51 patients, undergoing a total of 58 procedures were identified. The mean age was 77 years. Almost two-thirds (62%) of all procedures were performed within working hours. The majority (74%) were performed within four hours of an identified indication. Of the patients delayed up to four hours, half were maintained on external pacing. Table 1. Acute complications of tempora

The evidence The utility of cardioversion was originally explored in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study,2 which recruited over 4,000 patients aged 65 and over with atrial fibrillation and one additional risk factor for stroke. Patients were randomised to either rhythm control, using electrical cardioversion and medication as necessary, or to rate control using drugs, such as beta blockers or digoxin. To the surprise of the investigators the primary outcome, mortality, was worse in the rhythm control group, as were secondary outcomes such as hospitalisation and serious arrhythmias. Importantly,