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Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or other cardiac arrhythmia is converted to a normal rhythm using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle, restoring the activity of the electrical conduction system of the heart. Pharmacologic cardioversion, also called chemical cardioversion, uses antiarrhythmia medication instead of an electrical shock.
Short QT syndrome (SQT) is a very rare genetic disease of the electrical system of the heart, and is associated with an increased risk of abnormal heart rhythms and sudden cardiac death. The syndrome gets its name from a characteristic feature seen on an electrocardiogram (ECG) – a shortening of the QT interval. It is caused by mutations in genes encoding ion channels that shorten the cardiac action potential, and appears to be inherited in an autosomal dominant pattern. The condition is diagnosed using a 12-lead ECG. Short QT syndrome can be treated using an implantable cardioverter-defibrillator or medications including quinidine. Short QT syndrome was first described in 2000, and the first genetic mutation associated with the condition was identified in 2004.
Cardiac electrophysiology is a branch of cardiology and basic science focusing on the electrical activities of the heart. The term is usually used in clinical context, to describe studies of such phenomena by invasive (intracardiac) catheter recording of spontaneous activity as well as of cardiac responses to programmed electrical stimulation - clinical cardiac electrophysiology. However, cardiac electrophysiology also encompasses basic research and translational research components. Specialists studying cardiac electrophysiology, either clinically or solely through research, are known as cardiac electrophysiologists.
Dronedarone, sold under the brand name Multaq, is a medication by Sanofi-Aventis, mainly for the indication of cardiac arrhythmias. It was approved by the FDA on July 2, 2009. It was recommended as an alternative to amiodarone for the treatment of atrial fibrillation and atrial flutter in people whose hearts have either returned to normal rhythm or who undergo drug therapy or electric shock treatment i.e. direct current cardioversion (DCCV) to maintain normal rhythm. It is a class III antiarrhythmic drug. In the United States, the FDA approved label includes a claim for reducing hospitalization, but not for reducing mortality, as a reduction in mortality was not demonstrated in the clinical development program. A trial of the drug in heart failure was stopped as an interim analysis showed a possible increase in heart failure deaths, in patients with moderate to severe CHF.
The Libin Cardiovascular Institute is an entity of Alberta Health Services and the University of Calgary. It connects all cardiovascular research, education and clinical care in Southern Alberta. The Institute coordinates the activities of over 1,500 individuals in Southern Alberta. Of its more than 175 research and clinician members, over 75 are cardiologists, making it the largest heart or cardiovascular institute in Western Canada by that measure.
Tedisamil (3,7-dicyclopropylmethyl-9,9-tetramethylene-3,7-diazabicyclo-3,3,1-nonane) is an experimental class III antiarrhythmic agent currently being investigated for the treatment of atrial fibrillation. Tedisamil blocks multiple types of potassium channels in the heart resulting in slowed heart rate. While the effects of tedisamil have been demonstrated in both atrial and ventricular muscle, repolarization is prolonged more efficiently in the atria. Tedisamil is administered intravenously and has a half-life of approximately 8 –13 hours in circulation. Tedisamil is being developed as an alternative to other antiarrhythmics as incidence of additional arrhythmic events is lower compared to other class III agents. Tedisamil also has significant anti-ischemic properties and was initially investigated as a potential treatment for angina until its antiarrhythmic effects were discovered. Tedisamil is manufactured by Solvay Pharmaceuticals Inc. under the proposed trade name Pulzium.
Pilsicainide (INN) is an antiarrhythmic agent. It is marketed in Japan as サンリズム (Sunrythm). It was developed by Suntory Holdings Limited and first released in 1991. The JAN applies to the hydrochloride salt, pilsicainide hydrochloride.
Michel Haïssaguerre is a French cardiologist and electrophysiologist. His investigations have been the basis for development of new markers and therapies for atrial and ventricular fibrillation.
Atrial fibrillation is an abnormal heart rhythm (arrhythmia) characterized by rapid and irregular beating of the atrial chambers of the heart. It often begins as short periods of abnormal beating, which become longer or continuous over time. It may also start as other forms of arrhythmia such as atrial flutter that then transform into AF. Episodes can be asymptomatic. Symptomatic episodes may involve heart palpitations, fainting, lightheadedness, shortness of breath, or chest pain. Atrial fibrillation is associated with an increased risk of heart failure, dementia, and stroke. It is a type of supraventricular tachycardia.
Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be lightheadedness, passing out, shortness of breath or chest pain. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in sudden death.
James L. Cox is an American cardiothoracic surgeon and medical innovator best known for the development of the Cox maze procedure for treatment of atrial fibrillation in 1987.
Celivarone is an experimental drug being tested for use in pharmacological antiarrhythmic therapy. Cardiac arrhythmia is any abnormality in the electrical activity of the heart. Arrhythmias range from mild to severe, sometimes causing symptoms like palpitations, dizziness, fainting, and even death. They can manifest as slow (bradycardia) or fast (tachycardia) heart rate, and may have a regular or irregular rhythm.
Rotigaptide (ZP-123) is a drug under clinical investigation for the treatment of cardiac arrhythmias – specifically atrial fibrillation. It is a peptide analog that has been shown to increase gap junction intercellular conductance in cardiac muscle cells. Gap junctions are protein channels that are responsible for conducting electrical impulses between cells in the heart to maintain normal rhythm. Gap junction modulation is a promising and novel mechanism of action for the treatment of cardiovascular disorders. Its peptide sequence is Ac-D-Tyr-D-Pro-D-Hyp-Gly-D-Ala-Gly-NH2.
Budiodarone (ATI-2042) is an antiarrhythmic agent and chemical analog of amiodarone that is currently being studied in clinical trials. Amiodarone is considered the most effective antiarrhythmic drug available, but its adverse side effects, including hepatic, pulmonary and thyroid toxicity as well as multiple drug interactions, are discouraging its use. Budiodarone only differs in structure from amiodarone through the presence of a sec-butyl acetate side chain at position 2 of the benzofuran moiety. This side chain allows for budiodarone to have a shorter half-life in the body than amiodarone which allows it to have a faster onset of action and metabolism while still maintaining similar electrophysiological activity. The faster metabolism of budiodarone allows for fewer adverse side effects than amiodarone principally due to decreased levels of toxicity in the body.
Andrea Natale is an Italian-born American cardiologist and electrophysiologist, i.e. a heart rhythm specialist. Natale is known for his work in atrial fibrillation ablation, and he is currently the executive director at the Texas Cardiac Arrhythmia Institute.
Peter R. Kowey is an American cardiologist and medical researcher. He is Professor of Medicine and Clinical Pharmacology at Jefferson Medical College of Thomas Jefferson University and holds the William Wikoff Smith Chair in Cardiovascular Research at Lankenau Institute for Medical Research.
Yaariv Khaykin is a Canadian cardiologist and a clinical researcher in the area of electrophysiology. He is the director of the Newmarket Electrophysiology Research Group at the Southlake Regional Health Centre. He has published research into complex ablation and pioneered cardiac ablation methods.
Bruce B. Lerman is a cardiologist. He is the Hilda Altschul Master Professor of Medicine at Weill Cornell Medical College, and is chief of the Division of Cardiology and director of the Cardiac Electrophysiology Laboratory at Weill Cornell Medicine and the New York Presbyterian Hospital.
Sanjiv M. Narayan is a British-born American physician, biomedical engineer, and academic researcher. He is a Professor of Medicine at Stanford University. Narayan's work is focused on treating patients with heart rhythm disorders, particularly those with atrial fibrillation. His research applies bioengineering and computational methods to develop improved diagnostic tools and therapy.
Günter Breithardt is a German physician, cardiologist and emeritus university professor. He is known for his research in the field of rhythmology, especially the diagnosis and pharmacological and non-pharmacological therapy of cardiac arrhythmias and acute cardiac death, in particular the identification of arrhythmia-triggering gene mutations. For 21 years he headed the Medical Clinic and Polyclinic C at Münster University Hospital. A number of his academic students hold university management and chief physician positions.
References
- ↑ International Experts Advisory Committee Archived 2008-06-07 at the Wayback Machine - Libin Cardiovascular Institute of Alberta
- ↑ Press Release Archived 2012-09-22 at the Wayback Machine - Lecture to Seniors
- ↑ May 12, 2007 edition of Heart Rhythm Daily Archived May 19, 2011, at the Wayback Machine - a publication of the Heart Rhythm Society
- ↑ Wyse D, Waldo A, DiMarco J, Domanski M, Rosenberg Y, Schron E, Kellen J, Greene H, Mickel M, Dalquist J, Corley S (2002). "A comparison of rate control and rhythm control in patients with atrial fibrillation". N Engl J Med. 347 (23): 1825–33. doi: 10.1056/NEJMoa021328 . PMID 12466506.
- ↑ Wyse DG, Morganroth J, Ledingham R, Denes P, Hallstrom A, Mitchell LB, Epstein AE, Woosley RL, Capone R (1994). "New insights into the definition and meaning of proarrhythmia during initiation of antiarrhythmic drug therapy from the Cardiac Arrhythmia Suppression Trial and its pilot study. The CAST and CAPS Investigators". J Am Coll Cardiol. 23 (5): 1130–40. doi: 10.1016/0735-1097(94)90601-7 . PMID 8144779.
- ↑ "Dr. D. George Wyse - antiarrhythmic drugs". Archived from the original on August 23, 2007. Retrieved 2008-08-27.
- ↑ Citation Archived 2011-06-06 at the Wayback Machine - Distinguished Alumni
- ↑ Distinguished Scientist Archived 2008-09-17 at the Wayback Machine - Heart Rhythm Society
- ↑ Citation Archived 2016-09-17 at the Wayback Machine - Top 40 Alumni
- ↑ Citation Archived 2009-02-03 at the Wayback Machine - CCS Annual Achievement Award
- ↑ "George Wyse to speak at 2017 Lecture of a Lifetime". 19 April 2017.