Browsing by Subject "arrhythmia"

Now showing 1 - 4 of 4
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    The role of exercise in atrial fibrillation prevention and promotion: Finding optimal ranges for health
    (Elsevier, 2017) Elliott, Adrian D.; Maatman, Benjamin; Emery, Michael S.; Sanders, Prashanthan; Department of Medicine, School of Medicine
    The cardiovascular benefits of regular exercise have been well described, including a significant reduction in cardiovascular morbidity and mortality for those meeting recommended guidelines. Yet the impact of physical activity on the incidence of atrial fibrillation (AF) has been less clear. This review seeks to define the optimal dose and duration for the prevention and treatment of AF. In doing so, we review the evidence that supports a decline in AF risk for those who achieve a weekly physical activity dose slightly above the current recommended guidelines. Furthermore, we identify the reduced AF incidence in those individuals who attain a cardiorespiratory fitness of 8 METs (metabolic equivalents of task) or more during maximal exercise testing. Finally, we review the evidence that shows an excess of AF among regular participants of endurance exercise.
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    Simultaneous Recordings of Intrinsic Cardiac Nerve Activities and Skin Sympathetic Nerve Activities From Human Patients During the Postoperative Period
    (Elsevier, 2017) Shen, Mark J.; Coffey, Arthur C.; Straka, Susan; Adams, David E.; Wagner, David B.; Kovacs, Richard J.; Clark, Michael; Shen, Changyu; Chen, Lan S.; Everett, Thomas H., IV; Lin, Shien-Fong; Chen, Peng-Sheng; Department of Medicine, IU School of Medicine
    Background Intrinsic cardiac nerve activity (ICNA) and skin nerve activity (SKNA) are both associated with cardiac arrhythmias in dogs. Objective The purpose of this study was to test the hypothesis that ICNA and SKNA correlate with postoperative cardiac arrhythmias in humans. Methods Eleven patients (mean age 60 ± 13 years; 4 women) were enrolled in this study. Electrical signals were simultaneously recorded from electrocardiogram (ECG) patch electrodes on the chest wall and from 2 temporary pacing wires placed during open heart surgery on the left atrial epicardial fat pad. The signals were filtered to display SKNA and ICNA. Premature atrial contractions (PACs) and premature ventricular contractions were determined manually. The SKNA and ICNA of the first 300 minutes of each patient were calculated minute by minute to determine baseline average amplitudes of nerve activities and to determine their correlation with arrhythmia burden. Results We processed 1365 ± 973 minutes of recording per patient. Low-amplitude SKNA and ICNA were present at all time, while the burst discharges were observed much less frequently. Both SKNA and burst ICNA were significantly associated with the onset of PACs and premature ventricular contractions. Baseline average ICNA (aICNA), but not average SKNA, had a significant association with PAC burden. The correlation coefficient (r) between aICNA and PAC burden was 0.78 (P < .01). A patient with the greatest aICNA developed postoperative atrial fibrillation. Conclusion ICNA and SKNA can be recorded from human patients in the postoperative period. The baseline magnitude of ICNA correlates with PAC burden and development of postoperative atrial fibrillation.
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    Skin sympathetic nerve activity precedes the onset and termination of paroxysmal atrial tachycardia and fibrillation
    (Elsevier, 2017) Uradu, Andrea; Wan, Juyi; Doytchinova, Anisiia; Wright, Keith C.; Lin, Andrew Y. T.; Chen, Lan S.; Shen, Changyu; Lin, Shien-Fong; Everett, Thomas H., IV; Chen, Peng-Sheng; Department of Medicine, IU School of Medicine
    Background Skin sympathetic nerve activity (SKNA) is useful for estimating sympathetic tone in humans. Objective The purpose of this study was to test the hypotheses that (1) increased SKNA is associated with the onset and termination of paroxysmal atrial tachycardia (AT) and atrial fibrillation (AF) and (2) sinoatrial node response to SKNA is reduced in patients with more frequent AT or AF episodes. Methods SKNA and electrocardiogram were recorded in 11 patients (4 men and 7 women; average age 66 ± 10 years), including 3 patients with AT (11 ± 18 episodes per patient) and 8 patients with AF (24 ± 26 episodes per patient). Results The average SKNA (aSKNA) 10 seconds before AT onset was 1.07 ± 0.10 μV and 10 seconds after termination was 1.27 ± 0.10 μV; both were significantly (P = .032 and P < .0001) higher than that during sinus rhythm (0.97 ± 0.09 μV). The aSKNA 10 seconds before AF onset was 1.34 ± 0.07 μV and 10 seconds after termination was 1.31 ± 0.07 μV; both were significantly (P < .0001) higher than that during sinus rhythm (1.04 ± 0.07 μV). The aSKNA before onset (P < .0001) and after termination (P = .0011) was higher in AF than in AT. The sinus rate correlated (P < .0001) with aSKNA in each patient (average r = 0.74; 95% confidence interval 0.65–0.84). The r value in each patient negatively correlated with the number of AT and AF episodes (r = −0.6493; 95% confidence interval −0.8990 to −0.08073; P = .0306). Conclusion Increased SKNA was observed both at the onset and termination of AT and AF. Patients with more frequent AT and AF episodes had a weak correlation between sinus rate and aSKNA, suggesting sinoatrial node remodeling by tachycardia.
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    Unstable wide complex tachycardia: Consider hyperkalemia while preparing for cardioversion
    (Elsevier, 2016-10) Leech, Lindsay; Welch, Julie; Department of Emergency Medicine, IU School of Medicine