Fieldsmaddox2941

Fetal tachyarrhythmia is a condition that may lead to cardiac dysfunction, hydrops, and death. Despite a transplacental treatment, failure to obtain or maintain sinus rhythm may occur.

We aimed to analyze the perinatal outcomes of sustained fetal tachyarrhythmias after in utero treatment.

We performed a retrospective evaluation of 69 cases with sustained fetal tachyarrhythmia. We compared the perinatal and long-term outcomes of prenatally converted and drug-resistant fetuses. Tachyarrhythmia subtypes were also evaluated.

Conversion to sinus rhythm was obtained in 74% of cases; 26% of cases were drug-resistant and delivered arrhythmic. Three perinatal deaths occurred in both groups (6.7% vs 17%,

= .34). Neonates delivered arrhythmic were more frequently admitted to neonatal intensive care units (75% vs 31%,

< .01), and their hospital stay was longer (20.9 vs 6.64 days,

< .001). Multiple neonatal recurrences (81% vs 11%,

< .001), temporary hemodynamic dysfunction or heart failure (5 overrepresentation of PJRT in the drug-resistant population.

Adult long QT syndrome (LQTS) patients have inadequate corrected QT interval (QTc) shortening and an abnormal T-wave response to the sudden heart rate acceleration provoked by standing. In adults, this knowledge can be used to aid an LQTS diagnosis and, possibly, for risk stratification. However, data on the diagnostic value of the standing test in children are currently limited.

To determine the potential value of the standing test to aid LQTS diagnostics in children.

In a prospective cohort including children (≤18 years) who had a standing test, comprehensive analyses were performed including manual and automated QT interval assessments and determination of T-wave morphology changes.

We included 47 LQTS children and 86 control children. At baseline, the QTc that identified LQTS children with a 90% sensitivity was 435 ms, which yielded a 65% specificity. A QTc ≥ 490 ms after standing only slightly increased sensitivity (91%, 95% confidence interval [CI] 80%-98%) and slightly decreased specificity (58additional value. The standing test for LQTS should only be used with caution in children.

Ectopic cycle length (ECL) and the distribution patterns of ventricular bigeminy and trigeminy, expressed as their postextrasystolic intervals (PEIs) and interectopic intervals (IEIs), have been poorly pursued.

Based on modulation theory, we hypothesized that the PEIs of bigeminy and trigeminy determine their IEIs and ECL.

Ambulatory electrocardiograms of 1290 patients with ventricular premature complexes (≥3000/day) were studied. To quantify their distribution pattern on the PEI vs IEI curve (PIC), we introduced the following 2 ratios PEI of trigeminy to PEI of bigeminy ratio (T/B-PEI) and IEI of trigeminy to IEI of bigeminy ratio (T/B-IEI). Distribution patterns were divided into 3 types by T/B-PEI standard type (<0.90), intermediate type (between 0.90 and 1.20), and reverse type (>1.20). ECL was defined as the average of the bigeminy and trigeminy intervals in the standard type, and bigeminy intervals in the other 2 types.

T/B-IEI disclosed significant linear relationship with T/B-PEI (

< .0001). ECLs were longest in the standard type (1905 ± 347 ms; n = 426), followed by the intermediate type (1520 ± 239 ms; n = 607) and reverse type (1317 ± 227 ms; n= 227) (

< .0001). Trigeminy PEI/ECL in the standard type (0.450 ± 0.074) was significantly shorter than that of the other 2 types (

< .0001).

We confirmed that T/B-PEI determines T/B-IEI and ECL by discriminating the 3 distribution patterns. Among them, trigeminy PEI/ECL decided the 2 types of modulation by the first sinus QRS, starting at the early delay phase or the later acceleration phase.

We confirmed that T/B-PEI determines T/B-IEI and ECL by discriminating the 3 distribution patterns. Among them, trigeminy PEI/ECL decided the 2 types of modulation by the first sinus QRS, starting at the early delay phase or the later acceleration phase.

Cardiac implantable electronic devices (CIED)-ie, pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices-have recently been designed to allow for patients to safely undergo magnetic resonance imaging (MRI) when specific programming is implemented. MRI AutoDetect is a feature that automatically switches CIED's programming into and out of an MR safe mode when exposed to an MRI environment.

The purpose was to analyze de-identified daily remote transmission data to characterize the utilization of the MRI AutoDetect feature.

Home Monitoring transmission data collected from MRI AutoDetect-capable devices were retrospectively analyzed to determine the workflow and usage in patients experiencing an MRI using the MRI AutoDetect feature.

Among 48,756 capable systems, 2197 devices underwent an MRI using the MRI AutoDetect feature. In these 2197 devices, the MRI AutoDetect feature was used a total of 2806 times with an average MRI exposure of 40.83 minutes. The majority (88.9%) of MRI exposures occurred on the same day as the MRI AutoDetect programming. A same day post-MRI exposure follow-up device interrogation was performed 8.6% of the time. A device-related complaint occurred within 30 days of the MRI exposure in 0.25% of MRI exposures using MRI AutoDetect but with no adverse clinical outcome.

As a result of automation in device programming, the MRI AutoDetect feature eliminated post-MRI device reprogramming in 91.4% of MRI exposures and, while less frequent, allowed for pre-MRI interrogations prior to the day of the MRI exposure-reducing resource utilization and creating workflow flexibility.

As a result of automation in device programming, the MRI AutoDetect feature eliminated post-MRI device reprogramming in 91.4% of MRI exposures and, while less frequent, allowed for pre-MRI interrogations prior to the day of the MRI exposure-reducing resource utilization and creating workflow flexibility.

Heart rate score (HrSc) ≥70% in cardiac resynchronization therapy defibrillator and implantable cardioverter-defibrillator subjects predicts 5-year mortality risk. A high HrSc suggests few sensed cardiac cycles above the programmed lower rate.

To determine if HrSc is related to chronotropic incompetence (CI) in pacemaker (PM) subjects.

HrSc is the percentage of all atrial-paced and sensed events in the single tallest 10 beats/min histogram bin programmed to DDD 60/min. The prospective LIFE study of PM subjects examined multiple treadmill-based measures of CI. α-D-Glucose anhydrous cost The 1-month postimplant DDD 60/min PM rate histogram prior to treadmill was retrospectively analyzed for HrSc. Measures of CI were applied to submaximal treadmill data in the DDD mode. HrSc was compared to these CI measures and to clinical indications for PM.

The 1-month histogram demonstrated HrSc ≥70% in 43% of subjects. HrSc ≥70% correlated with a clinical diagnosis of sick sinus syndrome (

< .001). CI was present in 34%-88% of subjects by treadmill-based measures.