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Spontaneous Episodes (spontaneous + episode)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Comparison of Induced and Spontaneous Atrial Tachyarrhythmias in Patients with a History of Spontaneous Atrial Tachyarrhythmias

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 8 2005
CHRISTIAN G. WOLLMANN M.D.
Introduction: This retrospective study investigated whether induced episodes could be used to predict the morphology of future spontaneous atrial episodes. Methods: Eighty-two patients (64 ± 12 years; 77% male; CAD in 60%; left ventricular ejection fraction 45 ± 16%) with a history of atrial tachycardia or atrial fibrillation (AT/AF) were implanted with a dual-chamber implantable cardioverter defibrillator (ICD) and followed for 6 months. A total of 224 episodes of induced and spontaneous AT/AF were classified into type I, II, and III according to the method of Israel et al. and then compared based on average cycle length (CL) and atrial amplitude. Episodes were also grouped as "pace-terminable" or "nonpace-terminable" based on the CL definition of Gillis et al. Results: The analysis of 121 induced episodes (from 80 patients) and 103 spontaneous episodes (from 43 patients) showed that within each arrhythmia type, there were no significant differences in CL or mean amplitude between induced and spontaneous episodes. Additional analysis of patients that had both induced and spontaneous episodes (n = 41) showed 78% had at least one spontaneous episode that matched the induced episode. Fifty-seven percent of spontaneous episodes were considered to be pace-terminable based on CL. Conclusions: Our data suggest that there is no significant difference between induced and spontaneous episodes of AT/AF of the same type. The majority of patients had at least one spontaneous episode of the same type as the induced episode, showing that induced atrial arrhythmias may be useful in predicting the morphology of future spontaneous episodes and in identifying patients potentially benefiting from atrial antitachycardia pacing. [source]

Effects of Ethanol on Persistent Activity and Up-States in Excitatory and Inhibitory Neurons in Prefrontal Cortex

ALCOHOLISM, Issue 12 2009
John J. Woodward
Background:, Elucidating mechanisms that underlie the neural actions of ethanol is critical for understanding how this drug affects behavior. Increasing evidence suggests that, in addition to mid-brain dopaminergic regions, higher cortical structures play an important role in the pathophysiology associated with alcohol abuse. Previous studies from this laboratory used a novel slice co-culture system to demonstrate that ethanol reduces network-dependent patterns of activity in excitatory pyramidal neurons of the prefrontal cortex (PFC). In the present study, we examine the effect of ethanol on the activity of fast-spiking (FS) interneurons, a sub-population of neurons critically involved in shaping cortical activity. Methods:, Slices containing the dorsolateral PFC were prepared from neonatal C57 mice and maintained in culture. After 2 to 3 weeks in vitro, whole-cell patch-clamp electrophysiology was used to monitor spontaneous episodes of persistent activity in prelimbic PFC neurons. In some experiments, the use-dependent NMDA receptor blocker, MK801, was included in the pipette recording solution to assess the contribution of NMDA receptors to up-states. Results:, MK801 reduced up-state amplitude and revealed underlying fast EPSPs in excitatory pyramidal neurons while having little effect on these parameters in FS interneurons. Despite this difference, ethanol (44 mM), significantly reduced up-state duration and up-state area in both pyramidal and FS interneurons. Conclusions:, These results suggest that ethanol reduces the activity of FS interneurons due to disruption of network-dependent activity. This would be expected to further impair the ability of PFC networks to carry out their normal function and may contribute to the adverse effects of ethanol on PFC-dependent behaviors. [source]

Heart Rate Variability in Arrhythmogenic Right Ventricular Cardiomyopathy Correlation with Clinical and Prognostic Features

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2002
ANTONIO FRANCO FOLINO
FOLINO, A.F., et al.: Heart Rate Variability in Arrhythmogenic Right Ventricular Cardiomyopathy Correlation with Clinical and Prognostic Features. The identification of subjects with arrhythmogenic right ventricular cardiomyopathy (ARVC) at higher risk for sudden death is an unresolved issue. An influence of the autonomic activity on the genesis of ventricular arrhythmias was postulated. Heart rate variability (HRV) analysis provides a useful method to measure autonomic activity, and is a predictor of increased risk of death after myocardial infarction. For these reasons, the aim of the study was to evaluate HRV and its correlations with ventricular arrhythmias, heart function, and prognostic outcome in patients with ARVC. The study included 46 patients with ARVC who were not taking antiarrhythmic medications. The diagnosis was made by ECG, echocardiography, angiography, and endomyocardial biopsy. Exercise stress test and Holter monitoring were obtained in all patients. Time-domain analysis of HRV was expressed as the standard deviation of all normal to normal NN intervals (SDNN) detected during 24-hour Holter monitoring. Thirty healthy subjects represented a control group for HRV analysis. The mean follow-up was 10.8 ± 1.86 years. SDNN was reduced in patients with ARVC in comparison with the control group (151 ± 36 vs 176 ± 34, P = 0.00042). Moreover, there was a significant correlation of this index with the age of the patients (r =,0.59, P < 0.001), with the left (r = 0.44, P = 0.002) and right (r = 0.47, P = 0.001) ventricle ejection fraction, with the right ventricular end diastolic volume (r =,0.62, P < 0.001), and with the ventricular arrhythmias, detected during the same Holter record used for HRV analysis (patients with isolated ventricular ectopic beats < 1,000/24 hours, 184 ± 34; patients with isolated ventricular ectopic beats > 1,000/24 hours and/or couplets, 156 ± 25; patients with repetitive ventricular ectopic beats (,3) and/or ventricular tachycardia, 129 ± 25; P < 0.001). During follow-up two patients showed a transient but significant reduction of SDNN and a concomitant increase of the arrhythmic events. In eight patients an episode of sustained ventricular tachycardia occurred, but the mean SDNN of this subgroup did not differ from the mean value of the remaining patients (152 ± 15 vs 150 ± 39; P = NS). Only one subject died after heart transplantation during follow-up (case censored). Time-domain analysis of HRV seems to be a useful method to assess the autonomic influences in ARVC. A reduction of vagal influences correlates with the extent of the disease. The significant correlation between SDNN and ventricular arrhythmias confirmed the influences of autonomic activity in the modulation of the electrical instability in ARVC patients. However, SDNN was not predictive of spontaneous episodes of sustained ventricular tachycardia. [source]