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The main factors of an unfavorable prognosis, are life-threatening heart rhythm disorders which determine the severity of the clinical course of myocarditis, in addition to impaired contractility and dilatation of the left ventricle (LV). The aim of the study was to assess the frequency and nature of arrhythmias and establish predictors of their long-term persistence, assess the severity of anxiety and depression, changes in heart rate variability in combatants on the background of changes in the structural and functional state of the left ventricle during a 6-month follow-up. The study included 52 male servicemen (combatants) with acute myocarditis (AM) with an average age of 33.4±2.5 years. All patients were assessed by Questionnaire according to the Hospital Anxiety and Depression Scale (HADS) and underwent 24 hour ECG monitoring, transthoracic echocardiography and cardiac magnetic resonance (CMR) with late enhancement using gadovist. At the onset of AM frequent supraventricular (30.7% of cases) and frequent ventricular (42.3% of cases) extrasystolic arrhythmia, as well as paroxysms of non-sustained ventricular tachycardia (26.9% of cases) on the background of heart rhythm variability disorders were recorded. After 6 months, there was an improvement in the structural and functional state of the heart, which was characterized by a decrease in dilatation and an improvement of LV systolic function, a decrease in the volume of the inflammatory lesion and the total number of affected LV segments revealed on cardiac MRI, which was associated with a decrease in the number of ventricular rhythm disorders and reduction of clinical manifestations of anxiety according to the HADS scale. The obtained data indicate that the persistence of supraventricular rhythm disorders is associated with the long-term presence of anxiety and low values of standard deviation of RR intervals (SDNN) and root mean square of successive differences between normal heartbeats (RMSSD). Also predictors of persistence of non-sustained ventricular tachycardia paroxysms were established – SDNN value ≤80.0 ms, LV end-diastolic volume index ≥95 ml/m2, total number of affected LV segments ≥6 segments, presence of delayed contrasting in ≥3 LV segments, pre­sence of ≥12 points on the HADS scale and predictors of atrial fibrillation – SDNN value ≤80.0 ms, RMSSD value ≤12.0 ms, total number of affected segments of LV≥6 seg. and ≥12 points on the HADS anxiety scale, determined at the onset of AM.

Background. Pompe disease is a rare, severe, autosomal recessive genetic disorder caused by GAA gene mutations, which cause α-1,4-glucosidase enzyme deficiency. There are two forms of Pompe disease based on the age of onset, the infantile and the adult form (LOPD). Cardiac involvement, previously recognized only in infantile cases, is now also reported in adults. Cardiomyopathy remains an exceptional finding while heart rhythm disorders appear to be more frequent. Methods. We retrospectively evaluated cardiac involvement in 12 patients with late-onset Pompe disease (LOPD) followed for an overall period of 143 years (mean 12.7 ± 7.7) using ECG, Holter ECG, and echocardiography. Results. The mean age of patients (M8:F4) at the first visit was 40.7 ± 16.1 (range 14–63) and 53.7 ± 16.9 (range 21–76) at last visit. Conduction delay was present in three patients; one patient developed ascending aorta ectasia but had a history of hypertension, and one patient showed right heart enlargement on echocardiography, probably due to pulmonary hypertension. No patient died during the FU, nor developed cardiomyopathy. Ectopic supraventricular beats and repeated episodes of ablation-resistant atrial fibrillation were observed in only one patient (8.3%) who required PMK implantation. Conclusions. Benefitting from the long follow-up, this study allows us to state that primary myocardial involvement is rare in patients with LOPD, while rhythm disorders are more frequent and require monitoring to avoid the risk of possible life-threatening complications. [ABSTRACT FROM AUTHOR]

Introduction SARS-CoV-2 represents one of the most extensively researched pathogens in the last decade due to its major impact on humanity. Not only does this viral infection cause respiratory disturbances, but it also generates cardiovascular injury. Cardiac arrhythmias represent one of the main consequences of SARS-CoV-2 infection, but they can also occur in the context of antiviral treatment. Furthermore, arrhythmias do not always seem to be correlated with the severity of the lung injury. However, they represent a poor prognostic factor in terms of mortality, increasing the need for intensive care and the length of hospitalization. Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses 2020 Statement, from September 2022 to October 2023, we conducted this study by examining the literature through the PubMed database using the following keywords: COVID-19, cardiac arrhythmias, and, in terms of study design, observational studies. Results We initially identified 266 studies across PubMed. After applying the inclusion/exclusion criteria, we managed to include 22 studies in our review. Conclusions Deducing the pathophysiological mechanisms behind SARS-CoV-2's ability to disrupt the electrical activity of the heart, as well as identifying associated risk factors in patients with SARS-CoV- 2 infection, could allow targeted therapeutic interventions to decrease the risk of mortality in hospitalized patients. [ABSTRACT FROM AUTHOR]

The global burden caused by cardiovascular disease is substantial, with heart disease representing the most common cause of death around the world. There remains a need to develop better mechanistic models of cardiac function in order to combat this health concern. Heart rhythm disorders, or arrhythmias, are one particular type of disease which has been amenable to quantitative investigation. Here we review the application of quantitative methodologies to explore dynamical questions pertaining to arrhythmias. We begin by describing single-cell models of cardiac myocytes, from which two and three dimensional models can be constructed. Special focus is placed on results relating to pattern formation across these spatially-distributed systems, especially the formation of spiral waves of activation. Next, we discuss mechanisms which can lead to the initiation of arrhythmias, focusing on the dynamical state of spatially discordant alternans, and outline proposed mechanisms perpetuating arrhythmias such as fibrillation. We then review experimental and clinical results related to the spatio-temporal mapping of heart rhythm disorders. Finally, we describe treatment options for heart rhythm disorders and demonstrate how statistical physics tools can provide insights into the dynamics of heart rhythm disorders.

Background. Pompe disease is a rare, severe, autosomal recessive genetic disorder caused by GAA gene mutations, which cause α-1,4-glucosidase enzyme deficiency. There are two forms of Pompe disease based on the age of onset, the infantile and the adult form (LOPD). Cardiac involvement, previously recognized only in infantile cases, is now also reported in adults. Cardiomyopathy remains an exceptional finding while heart rhythm disorders appear to be more frequent. Methods. We retrospectively evaluated cardiac involvement in 12 patients with late-onset Pompe disease (LOPD) followed for an overall period of 143 years (mean 12.7 ± 7.7) using ECG, Holter ECG, and echocardiography. Results. The mean age of patients (M8:F4) at the first visit was 40.7 ± 16.1 (range 14–63) and 53.7 ± 16.9 (range 21–76) at last visit. Conduction delay was present in three patients; one patient developed ascending aorta ectasia but had a history of hypertension, and one patient showed right heart enlargement on echocardiography, probably due to pulmonary hypertension. No patient died during the FU, nor developed cardiomyopathy. Ectopic supraventricular beats and repeated episodes of ablation-resistant atrial fibrillation were observed in only one patient (8.3%) who required PMK implantation. Conclusions. Benefitting from the long follow-up, this study allows us to state that primary myocardial involvement is rare in patients with LOPD, while rhythm disorders are more frequent and require monitoring to avoid the risk of possible life-threatening complications.

The main factors of an unfavorable prognosis, are life-threatening heart rhythm disorders which determine the severity of the clinical course of myocarditis, in addition to impaired contractility and dilatation of the left ventricle (LV). The aim of the study was to assess the frequency and nature of arrhythmias and establish predictors of their long-term persistence, assess the severity of anxiety and depression, changes in heart rate variability in combatants on the background of changes in the structural and functional state of the left ventricle during a 6-month follow-up. The study included 52 male servicemen (combatants) with acute myocarditis (AM) with an average age of 33.4±2.5 years. All patients were assessed by Questionnaire according to the Hospital Anxiety and Depression Scale (HADS) and underwent 24 hour ECG monitoring, transthoracic echocardiography and cardiac magnetic resonance (CMR) with late enhancement using gadovist. At the onset of AM frequent supraventricular (30.7% of cases) and frequent ventricular (42.3% of cases) extrasystolic arrhythmia, as well as paroxysms of non-sustained ventricular tachycardia (26.9% of cases) on the background of heart rhythm variability disorders were recorded. After 6 months, there was an improvement in the structural and functional state of the heart, which was characterized by a decrease in dilatation and an improvement of LV systolic function, a decrease in the volume of the inflammatory lesion and the total number of affected LV segments revealed on cardiac MRI, which was associated with a decrease in the number of ventricular rhythm disorders and reduction of clinical manifestations of anxiety according to the HADS scale. The obtained data indicate that the persistence of supraventricular rhythm disorders is associated with the long-term presence of anxiety and low values of standard deviation of RR intervals (SDNN) and root mean square of successive differences between normal heartbeats (RMSSD). Also predictors of persistence of non-sustained ventricular tachycardia paroxysms were established – SDNN value ≤80.0 ms, LV end-diastolic volume index ≥95 ml/m2, total number of affected LV segments ≥6 segments, presence of delayed contrasting in ≥3 LV segments, presence of ≥12 points on the HADS scale and predictors of atrial fibrillation – SDNN value ≤80.0 ms, RMSSD value ≤12.0 ms, total number of affected segments of LV≥6 seg. and ≥12 points on the HADS anxiety scale, determined at the onset of AM. [ABSTRACT FROM AUTHOR]

Optical mapping is a high-resolution fluorescence imaging technique, which provides highly detailed visualizations of the electrophysiological wave phenomena, which trigger the beating of the heart. Recent advancements in optical mapping have demonstrated that the technique can now be performed with moving and contracting hearts and that motion and motion artifacts, once a major limitation, can now be overcome by numerically tracking and stabilizing the hearts motion. As a result, the optical measurement of electrical activity can be obtained from the moving heart surface in a co-moving frame of reference and motion artifacts can be reduced substantially. The aim of this study is to assess and validate the performance of a 2D marker-free motion tracking algorithm, which tracks motion and non-rigid deformations in video images. Because the tracking algorithm does not require markers to be attached to the tissue, it is necessary to verify that it accurately tracks the displacements of the cardiac tissue surface, which not only contracts and deforms, but also fluoresces and exhibits spatio-temporal physiology-related intensity changes. We used computer simulations to generate synthetic optical mapping videos, which show the contracting and fluorescing ventricular heart surface. The synthetic data reproduces experimental data as closely as possible and shows electrical waves propagating across the deforming tissue surface, as seen during voltage-sensitive imaging. We then tested the motion tracking and motion-stabilization algorithm on the synthetic as well as on experimental data. The motion tracking and motion-stabilization algorithm decreases motion artifacts approximately by 80% and achieves sub-pixel precision when tracking motion of 1-10 pixels (in a video image with 100 by 100 pixels), effectively inhibiting motion such that little residual motion remains after tracking and motion-stabilization. To demonstrate the performance of the algorithm, we present optical maps with a substantial reduction in motion artifacts showing action potential waves propagating across the moving and strongly deforming ventricular heart surface. The tracking algorithm reliably tracks motion if the tissue surface is illuminated homogeneously and shows sufficient contrast or texture which can be tracked or if the contrast is artificially or numerically enhanced. In this study, we also show how a reduction in dissociation-related motion artifacts can be quantified and linked to tracking precision. Our results can be used to advance optical mapping techniques, enabling them to image contracting hearts, with the ultimate goal of studying the mutual coupling of electrical and mechanical phenomena in healthy and diseased hearts.

Introduction. Internet electrocardiography (internet-ECG) is becoming one of the most demanded areas of telemedicine; it becomes especially important in conditions of remoteness from medical and diagnostic institutions and impossibility of real consulting assistance of specialists. The general principle of operation of the internet-ECG devices is transferring the record to a server with subsequent processing and obtaining an automatic conclusion on the rhythm and morphology of the atrial-ventricular complex. At present, internet-ECG is widely used in adult network, while its possibilities in pediatrics are poorly covered. Materials and methods. The archive of children's ECGs recorded using the Cardiometer-MT system in the period from 2013 to 2021 has been analyzed. 3 groups of children were identified. 1st — screening of practically healthy children of primary school age (2153 children), 2nd group — school-age children examined in children's city polyclinics, who underwent stress and vegetative tests (2500 children), 3rd group — 200 healthy full-term newborn children who had a standard resting ECG on 1-2 days of life. Results. The advantages of using such systems in the mass examination of children of various ages in the framework of screening programs are shown. The results of an ECG examination of 2153 healthy children of primary school age are presented. The results of the automatic and medical conclusion are compared, sensitivity and specificity in the detection of cardiac arrhythmias and conduction are determined. The advantages of internet-ECG in carrying out vegetative and stress tests in the examination of adolescent children are substantiated. Performance of functional (including vegetative) and stress tests using internet-ECG systems allows to estimate reliably the functional state of the cardiovascular system, to determine adaptive capabilities of the vegetative nervous system, to reveal hypertension at early stages. Conclusion. The internet-ECG makes it possible to significantly simplify and streamline the ECG examination of children, forming an electronic archive of records, which is relevant for field examinations in children's groups and in conditions of a shortage of qualified specialists in functional diagnostics.

A major problem in arrhythmology is supraventricular arrhythmias atrial fibrillation. Remodeling of the myocardium and the formation of fibrosis zones are the cause of cardiac arrhythmias. Violations of the extracellular framework of myocardiocytes with the formation of zones of sclerotically altered areas lead to violations of the pulse from the sinoatrial node. The inflammatory reaction, which results in fibrosis, has been repeatedly confirmed by the results of histological examination of lung vein and myocardial tissue samples in patients with rhythm disorders atrial fibrillation. The paper considers the possibility of determining in the blood of patients with atrial fibrillation a highly sensitive C-reactive protein, widely used in clinical practice, as an indicator of the activity of sluggish inflammation in the myocardium with simultaneous determination of the level of vitamin D (25-OH), known, among other things, for its anti-inflammatory effects. The data of the pilot study are presented.

Arterial hypertension (AH) is a leading risk factor for cardiovascular disease as well as it is the most common, independent and potentially reversible risk factor for atrial fibrillation (AF). AH contributes to the occurrence and maintenance of AF due to hemodynamic disorders, alterations in cardiomyocyte electrophysiological properties and structural remodeling in the atria. AF, which is also associated with an increased risk of cardiovascular events, is the most common arrhythmia. AH and AF often coexist, and their prevalence increases with age. This consensus provides the key features of the management of patients with these nosological units. The pathogenesis, risk stratification, and features of the selection of antihypertensive, antiarrhythmic and antithrombotic therapy are described in detail.

To reduce a burden of circulatory diseases (CD) is among primary tasks the state has to solve. There are available data on a contribution made by chronic inflammation on occurrence of heart and vascular diseases. Given that, it seems especially interesting to examine impacts exerted by Epstein-Barr virus infection on CD development. The paper focuses on analyzing morbidity with infectious mononucleosis and CD in the Russian Federation over 1995–2018. 103 patients with heart rhythm disorders and 92 blood donors were examined to determine whether they had immu-noglobulins to EBV antigens. The results were statistically processed involving calculation of Pearson’s linear correlation coefficient, error of correlation coefficient, validity coefficient, determination coefficient, and frequencies of EBV markers detection per 100 examined people and their confidence intervals. Differences were considered to be authentic when confidence probability was equal to 95 % and confidence significance was p

Background: Electrocardiogram (ECG) offers a valuable resource easily available in the emergency setting. Objective: Aim of the study was to describe ECG alterations on emergency department (ED) presentation or that developed during hospitalization in SARS-CoV-2-infected patients and their association with 28-day mortality. Methods: A retrospective, single-center study including hospitalized patients with SARS-CoV-2 was conducted. ECG was recorded on ED admission to determine: heart rhythm, rate, and cycle; atrio-ventricular and intra-ventricular conduction; right ventricular strain; and ventricular repolarization. A specialized cardiologist blinded for the outcomes performed all 12-lead ECG analyses and their interpretation. Results: 190 patients were included, with a total of 24 deaths (12.6%). Age (p < 0.0001) and comorbidity burden were significantly higher in non-survivors (p < 0.0001). Atrial fibrillation (AF) was more frequent in non-survivors (p < 0.0001), alongside a longer QTc interval (p = 0.0002), a lower Tp-e/QTc ratio (p = 0.0003), and right ventricular strain (p = 0.013). Remdesivir administration was associated with bradycardia development (p = 0.0005) but no increase in mortality rates. In a Cox regression model, AF (aHR 3.02 (95% CI 1.03–8.81); p = 0.042), QTc interval above 451 ms (aHR 3.24 (95% CI 1.09–9.62); p = 0.033), and right ventricular strain (aHR 2.94 (95% CI 1.01–8.55); p = 0.047) were associated with higher 28-day mortality risk. Conclusions: QTc interval > 451 ms, right ventricular strain, and AF are associated with higher mortality risk in SARS-CoV-2 hospitalized patients. ECG recording and its appropriate analysis offers a simple, quick, non-expensive, and validated approach in the emergency setting to guide COVID-19 patients' stratification. [ABSTRACT FROM AUTHOR]

Obesity is a chronic disease, which has significant health consequences and is a staggering burden to health care systems. Obesity can have harmful effects on the cardiovascular system, including heart failure, hypertension, coronary heart disease, and atrial fibrillation (AF). One of the possible substrates might be epicardial adipose tissue (EAT), which can be the link between AF and obesity. EAT is a fat deposit located between the myocardium and the visceral pericardium. Numerous studies have demonstrated that EAT plays a pivotal role in this relationship regarding atrial fibrillation. This review will focus on the role of obesity and the occurrence of atrial fibrillation (AF) and examine the connection between these and epicardial adipose tissue (EAT). The first part of this review will explain the pathophysiology of EAT and its association with the occurrence of AF. Secondly, we will review bariatric and metabolic surgery and its effects on EAT and AF. In this review, the epidemiology, pathophysiology, and treatment methods of AF are explained. Secondly, the effects on EAT were elucidated. Due to the complex pathophysiological link between EAT, AF, and obesity, it is still uncertain which treatment strategy is superior. [ABSTRACT FROM AUTHOR]

Background and objective An arrhythmia is a disorder of the heart rate or rhythm. An implantable cardioverter defibrillator (ICD) is a small electronic device connected to the heart to continuously keep track of and help control rapid and sometimes life-threatening electrical problems with the heart. However, it may result in psychological tension in patients' lives, eventually affecting their quality of life (QoL). In light of this, we aimed to assess the QoL of patients with ICD at the Vilnius University Hospital, Lithuania. Methods We employed the following three questionnaires in this study: an originally prepared questionnaire including sociodemographic and health factors; the 36-item Short Form Health Survey questionnaire (SF-36); and the Hospital Anxiety and Depression Scale (HADS) to assess depression and anxiety. Data analysis was performed using SPSS Statistics v. 13.00 (IBM Corp., Armonk, NY). Results Of the patients evaluated in all areas of QoL, males demonstrated higher scores compared to females. A statistically significant difference was found when assessing the domains of physical activity, social function, pain, and physical and mental health QoL. Conclusions Based on our findings, the majority of ICD patients can achieve their desired QoL and psychosocial outcomes. Our results show that patients with ICDs have the potential to return to a normal life. Depression and anxiety manifested more commonly in respondents with a disease duration of up to five years., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board of the Faculty of Medicine, University of Vilnius issued approval 57. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Nedzinskiene et al.)

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The article is devoted to the influence of magnesium on the homeostasis of the body and, in particular, on the cardiovascular system. It describes the importance of the presence and effects of magnesium on various key processes and functions occurring in the body. The reasons for the lack of magnesium and ways to replenish it both in the natural way (eating, certain foods) and magnesium preparations are considered. The article provides examples of large randomized studies that prove the importance of the influence of normal magnesium levels on human health in general and on the state of the cardiovascular system. These studies show how magnesium deficiency increases the risk of cardiovascular diseases and how it can be reduced. It is also shown which trace elements and vitamins are closely related to magnesium metabolism, and how they (in particular, potassium and vitamin B6) improve and facilitate the normalization of magnesium levels. It is noted how comorbidity decreases with the normalization of magnesium level – the higher the magnesium level in the blood plasma (closer to the upper limit and more), the less comorbidity and longer life expectancy. Magnesium is an absolutely essential ion and a good medicine. Magnesium deficiency and hypomagnesemia are quite common, difficult to diagnose (due to underestimation and rare level control) and accompany many diseases of the cardiovascular system and beyond. The widespread use of organic magnesium salts would improve the situation as a whole, due to their universal multiple effect on many processes in the body. This is an integral part of therapeutic and preventive measures in patients with already existing diseases and in people who do not have diseases, but who are at risk due to existing hypomagnesemia.

Abstract The Asia Pacific Heart Rhythm Society (APHRS) has grown very rapidly and efficiently after its founding in 2008. The success of our organization and rapid growth was due to the enthusiastic support by pioneer electrophysiologists and efforts by many physicians to cure heart rhythm disorders. With the experience of preceding arrhythmia symposia of inter‐cities or international basis in the region, the organization could quickly grow to become APHRS. The mission of APHRS is to promote basic research and improve clinical practice, optimize care of patients with heart rhythm disorders, and to train and encourage young physicians to actively participate and promote the activity of our society.

The aim of this systematic review is to provide an overview of the literature on the effects of bariatric surgery on obesity-associated electrocardiogram (ECG) abnormalities and cardiac arrhythmias. Fourteen studies were included with a methodological quality ranging from poor to good. Majority of the studies showed a significant decrease of QT interval and related measures after bariatric surgery. Seven studies were included in the meta-analysis on effects of bariatric surgery on QTc interval and a significant decrease in QTc interval of − 33.6 ms, 95%CI [− 49.8 to − 17.4] was seen. Bariatric surgery results in significant decrease in QTc interval and P-wave dispersion, i.e., a normalization of initial pathology. The effects on atrial fibrillation are conflicting and not yet fully understood. [ABSTRACT FROM AUTHOR]

Sex differences in heart rhythm disorders have been described, especially due to differences of hormone status in women and men. In general, women do have a higher baseline heart rate than men and shorter refractory periods of most structures in the conduction system, except the ventricles. This is particularly apparent in paroxysmal supraventricular tachycardias. The incidence of a dual AV nodal physiology is the same in both sexes. However, an AV-nodal reentry tachycardia is much more frequent in women than in men. The embryonal disposition for an accessory pathway, as well as the resultant AV reentry tachycardia is more common in men than in women. Focal atrial tachycardias do not reveal a clear dominance between the sexes. Knowledge about sex-related differences in heart rhythm disorders are relevant for its diagnostics. Therefore, important aspects will be discussed in this article. [ABSTRACT FROM AUTHOR]

Torsade de pointes tachycardia is a potentially life-threatening heart rhythm disorder, caused by prolongation of the QT interval resulting in triggered activity. This QT prolongation can be congenital or acquired. If acquired, it is mainly caused by pharmacological therapy. The hallmark of torsade de pointes is an undulating QRS axis with a twist of the QRS complex around the ECG's baseline. Often, this polymorphic ventricular tachycardia is self-limiting, but degeneration into ventricular fibrillation is possible, which makes torsade de pointes tachycardia dangerous. This article aims to provide insights into etiology, diagnostics, prevention and management of this heart rhythm disorder. [ABSTRACT FROM AUTHOR]

Lightning injuries are one of the rarest types of injuries admitted to the ER. They are accompanied by a wide spectrum of symptoms with less or more dangerous evolutions. The most severe of them are rhabdomyolysis, acute kidney injury, and danger cardiac arrhythmias. Treatment of those patients is challenging for the whole personnel of the emergency ward. In this paper, we present a case of a 34-year-old male who suffered a lightning injury during a family fest organized at a public square. Over time, the patient's status was changing from almost a lack of symptoms to severe complications, including rhabdomyolysis, compartment syndrome, hyperkaliemia, and cardiac arrhythmias. The treatment process lasted for 18 days and included ER, ICU, Operating Room, and Internal Medicine Ward. In the discussion, the author analyses the diagnostic process retrospectively and is posing questions about an improvement of the methods for dealing with this kind of "unusual" cases at the ER. [ABSTRACT FROM AUTHOR]

Acute myocardial infarction is a potential life threatening disease spread all over the world. The continuing progress of medical and interventional therapies requires a comprehensive understanding of the underlying pathophysiology. Moreover, the potential development of heart failure or/and arrhythmias in either acute or chronic setting, demand a deep knowledge of their molecular mechanisms in order to provide adequate treatments. This review aims to summarize the current data regarding the etiopathogenesis of acute myocardial infarction and the heart rhythm disorders associated with this clinical condition. [ABSTRACT FROM AUTHOR]

L'hypotension intradialytique est la complication la plus fréquente en hémodialyse. Cependant, la baisse isolée de la pression diastolique chez l'hémodialysé est asymptomatique et sa détection nécessite une surveillance répétée de la pression artérielle au cours des séances de dialyse. Pour étudier ce phénomène, nous avons mené une étude prospective sur une période de 5 ans chez 45 patients hémodialysés chroniques. L'HDI était notée dans 42 % des cas à l'inclusion et dans 59,5 % des cas l'issue de l'étude. L'HDI était associé à l'âge avancé, le sexe féminin, le volume sanguin relatif critique élevé, les troubles du rythme cardiaque et la dysfonction diastolique du ventricule gauche. L'HDI était également significativement associée aux complications cardiovasculaires de novo (p = 0,004) et à la mortalité toute cause confondue (p = 0,038). L'hypotension diastolique isolée est un phénomène particulièrement répandu chez l'hémodialysé. L'ensemble de nos données incite à une réflexion approfondie sur ce sujet en hémodialyse. De plus, notre étude souligne l'intérêt du dépistage de l'HDI par une surveillance rapprochée des paramètres hémodynamiques, et invite à une prise en charge dialytique personnalisée basée sur l'analyse des facteurs de risque démontrés et sur l'étude des comorbidités associées. Intra dialytic hypotension is the most common complication in hemodialysis. However, isolated diastolic hypotension (IDH) in hemodialysis is asymptomatic and its detection requires repeated monitoring of blood pressure during dialysis sessions. To study this phenomenon, we conducted a prospective study over a period of 5 years in 45 chronic hemodialysis patients. The IDH, was noted in 42% at inclusion, and in 59,5% of the cases at the end of the study. IDH was associated with advanced age, female gender, high relative critical blood volume, cardiac arrhythmias and diastolic dysfunction of the left ventricle. IDH was also significantly associated with novel cardiovascular complications (P = 0.004) and all-cause mortality (P = 0.038). Isolated diastolic hypotension is a particularly common phenomenon in hemodialysis. Our data encourage in-depth reflection on this subject in hemodialysis. In addition, our study highlights the value of screening for IDH by close monitoring of hemodynamic parameters, and calls for personalized dialysis management based on the analysis of the demonstrated risk factors and on the study of the associated comorbidities. [ABSTRACT FROM AUTHOR]

Introduction: Obesity, defined as a Body Mass Index (BMI) of ≥30 kg/m2, is the most common chronic metabolic disease worldwide and its prevalence has been strongly increasing. Obesity is associated with various diseases such as cardiovascular disease, type 2 diabetes, and hypertension. Regarding heart rhythm disorders, obesity is associated with an increase in atrial fibrillation (AF), the most common arrhythmia in clinical practice. AF is associated with increased cardiovascular morbidity and mortality. Obesity, a novel risk factor, is responsible for a 50%-increased incidence of AF. Areas covered: We will briefly discuss the obesity paradox and its mechanisms regarding cardiac and hemodynamic function changes. In the first main part of this review, we will be discussing risk assessment studies, pathophysiology, genetic predisposition, epicardial adipose tissue, and ventricular adaptation in relation to obesity and development of AF. In the second part, we will discuss treatment strategies like conservative management and the effect of bariatric and metabolic surgery. Expert opinion: Cardiac arrhythmias, in particular, AF, in patients with obesity comprise complex pathophysiological mechanisms that remain poorly understood. In recent literature, there has been increased interest in the role of epicardial adipose tissue and structural remodeling in obese hearts. [ABSTRACT FROM AUTHOR]

The Asia Pacific Heart Rhythm Society (APHRS) has grown very rapidly and efficiently after its founding in 2008. The success of our organization and rapid growth was due to the enthusiastic support by pioneer electrophysiologists and efforts by many physicians to cure heart rhythm disorders. With the experience of preceding arrhythmia symposia of inter‐cities or international basis in the region, the organization could quickly grow to become APHRS. The mission of APHRS is to promote basic research and improve clinical practice, optimize care of patients with heart rhythm disorders, and to train and encourage young physicians to actively participate and promote the activity of our society. [ABSTRACT FROM AUTHOR]

Introduction: The Jozef Stefan Institute developed a personal portable electrocardiogram (ECG) sensor Savvy that works with a smartphone, and this was used in our study. This study aimed to analyze the usefulness of telecardiology at the primary healthcare level using an ECG personal sensor. Methods: We included 400 patients with a history of suspected rhythm disturbance who visited their family physician at the Healthcare Center Ljubljana and Healthcare Center Murska Sobota from October 2016 to January 2018. Results: The study found that there was no statistically significant difference between the test and control groups in the number of present rhythm disorders and actions taken to treat patients with either observation or administration of a new drug. However, in the test group, there were significantly fewer patients being referred to a cardiologist than in the control group (p < 0.001). Discussion: The use of an ECG sensor helps family physicians to distinguish between patients who need to be referred to a cardiologist and those who can be treated by them. This method is useful for both physicians and patients because it shortens the time taken to start treatment, can be used during pandemics such as COVID-19, and reduces unnecessary cost.

Heart rhythm disorders during pregnancy sifnificantly increase the risk of the cardioembolism in terms of the hypercoaguability state of pregnant women. The presence of atrial fibrillation during pregnancy in conditions of additional risk factors, inculding history of stroke and thromboembolic attacks, artifial heart valves, arterial hypertension, diabetes mellitus, ischemic disease or heart failure require anticoagulant therapy during all pregnancy. Acquired or genetic forms of thrombophilia also can increase the risk of thromboembolism in women with cardiac arrhythmias during pregnancy.

Aim. To compare effects of monotherapy with magnesium and combined therapy with magnesium and β-blocker on primary mitral valve prolapse (MVP) with heart rhythm disorders.Material and methods. 71 patients with primary MVP 1-2 degree and heart rhythm disorders were involved in the study. The patients were split into three groups. Group I (25 persons) received monotherapy with magnesium orotate at a dose of 1-3 g per day; group II (28 persons) received combined therapy with magnesium orotate and betaxolol. The control group (18 persons) received no therapy. Initially and after 12 weeks of observation all the patients underwent electrocardiography (ECG), ECG-Holter monitoring, echocardiography and autonomic balance assessment by A.M. Vein’s questionnaire.Results. In 12 weeks of treatment groups I and II showed positive dynamics in the MVP manifestations, including significant reduction in severity of the autonomic dysfunction syndrome, ECG positive dynamics, antiarrhythmic effect, decrease in the degree of prolapse, diminution of mitral regurgitation and left auricle volumes. More substantial hemodynamic effects were found in the group of patients who received combination therapy.Conclusion. Combined therapy has proven advantages in comparison with magnesium monotherapy in terms of daily quantity of extrasystoles, reduction in heart rate, decrease in autonomic disfunction and normalization of intracardiac hemodynamics.

The review focuses on the data of alcohol influence on cardiovascular health. The recommended and safe prevention dosages are discussed. The data summarized on the risk estimation, of development and progression of ischemic heart damage, heart rhythm disorders, stroke and other vascular complications in long-term alcohol consumption in various dosages. The article should be of interest for physicians, general practitioners, cardiologists, neurologists