…cholesterol and glucose levels, together with a low salt, low cholesterol diet, regular physical activity, avoidance of smoking, and adequate sleep. The process should begin…

…wide range of settings can be adjusted. These settings include the base rate of the pacemaker (the lowest heart rate allowed, which triggers the pacemaker)…

…Assessing pacemaker function Base rate The base rate is the lowest heart rate allowed by the pacemaker; intrinsic cardiac activity below the base rate will…

…arrhythmia unit. Assessment of the effect of adenosine, which can be given during the recording and unmask the atrial activity. The investigation is diagnostic, not…

…resting heart rate ≥70 beats/min; persistent symptoms despite evidence based therapy with an ACE inhibitor or ARNI, a beta blocker and a mineralocorticoid receptor…

…activity should be assessed and prescribed using the components of: Frequency Intensity Time or duration Type Progression The prescription should be individualized rather than based…

…understanding of differential diagnoses, therapeutic strategies, and evidence based interventions. Many tachyarrhythmias carry a potential risk of serious morbidity or mortality, underscoring the need for…

…without acute elevations in cardiac troponin concentrations. Based on the presenting electrocardiogram (ECG) and the presence of troponin elevation, ACS are classified into unstable angina…

…and drug induced reactions. Approximately 90% of anaphylactic cardiac arrests present with pulseless electrical activity (PEA) as the initial rhythm, while the remainder manifest ventricular…

…s perceived exertion is a way of estimating the intensity of the physical activity. It is based on the subjective physical sensations experienced during exercise…

…under baseline conditions. Raw Image Analysis : Raw images are reviewed to identify potential artifacts, extracardiac tracer activity, and assess image quality and patient motion. Alignment …

…finding in acute coronary syndromes). Between 3 8 minutes, pulseless electrical activity (PEA) develops. PEA progresses to asystole within minutes, as outlined in the studies…

…DW, Wickman LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995; 30:16975…

…for interpretation of ischemia. All available ECG criteria for acute myocardial infarction and ischemia are based on conventional 12 lead ECG. Established ECG criteria do…

…to the assessment of exercise capacity. Metabolic equivalents (METs) can be used to estimate the energy cost of physical activity. One metabolic equivalent (1 MET…

…vasodilators replicate the effects of exercise on coronary arteries, without the need for physical activity. Advantages of regadenoson over adenosine Regadenoson has advantages over adenosine…

…means that the automaticity is diminished). Chronotropic incompetence (inability of the sinoatrial node to adequately increase its automaticity during physical activity). Sinus arrest & sinus pause…

…of sinus tachycardia are as follows: Normal (physiologic) sinus tachycardia: The automaticity (rate of spontaneous depolarization) in the sinoatrial node is increased during physical activity…

…in knowledge, with some of the most critical components of current guidelines being based on observational data ( e.g compression rate and depth). With current…

…than by diabetes alone. The source material does not provide a detailed symptom profile or symptom based diagnostic algorithm for each condition. Diabetes related AF…

…DW, Wickman LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995; 30:16975…

…DW, Wickman LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995;30:16975…

…DW, Wickman LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995; 30:16975…

…parallel to definitive control of the bleeding. Activate the protocol in Activation must be based on an overall assessment, not on a single threshold value…

…prophylaxis. Deep puncture wounds , where the base cannot be inspected or irrigated clean. Wounds with retained foreign material or devitalised tissue that cannot be removed…

…risk of symptomatic intracerebral haemorrhage or death [3]. Acute overview 1. Activate the stroke call. 2. Establish the time of symptom onset or the time…

…elevated blood pressure and impaired glucose regulation. Diagnosis is based on the coexistence of defined clinical and laboratory components; the diagnostic criteria themselves are not…

…plaque. Upon such damage, the plaque exposes highly thrombogenic materials which activate circulating platelets and coagulation factors, which results in thrombus formation (Figure 1). Disruption…

…normal FEV₁/FVC. Set aside time, coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation…

…individualized within the applicable guideline framework. Combination therapy is based on the complementary mechanisms of drugs from different classes. By acting on more than one…

…is a comprehensive e resource and CME site for anasthesiologists. Site is maintained and updated actively, which means it deserves a bookmark if your into…

…or suspected variceal bleeding, also contact a gastroenterologist with hepatology expertise 9 Activate the local major haemorrhage protocol in uncontrolled bleeding, shock or a rapid…

…in the case of left bundle branch block should lead the clinician to activate the catheterization laboratory (discussed in Left bundle branch block and ischemia…

…ECG Ventricular fibrillation, pulseless electrical activity (PEA) and sudden cardiac arrest This chapter will focus on ventricular fibrillation and pulseless electrical activity (PEA). These are…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and Pathophysiology Sotalol is a nonselective beta adrenoceptor blocker devoid of intrinsic sympathomimetic activity that also prolongs cardiac repolarization…

…minutes is the practical threshold for treatment, known as t1. After about 30 minutes of continuous convulsive activity, t2, the risk of permanent neuronal injury…

…crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction…

…organized, continuous atrial electrical activity. This activity most commonly presents as a characteristic saw tooth pattern at rates typically exceeding 200 beats per minute. While…

…with cardiovascular disease, including those recovering from myocardial infarction. It extends beyond exercise training to incorporate individualized physical activity counselling, risk factor modification, nutritional care…

…clearance of circulating LDL cholesterol (LDL C). Increased PCSK9 activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic…

…VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include all bradyarrhythmias, pulse less electrical activity (PEA), and asystole. Bradyarrhythmias are discussed in the chapter Management…

…may precede the full tachycardia. It is characterized by short, rapid bursts of atrial activity. In the majority of cases, the arrhythmia is self limiting…

…spontaneous cardiac rhythm. The likelihood of achieving spontaneous cardiac activity is a function of the duration of circulatory standstill and the underlying cause, as elaborated…

…electrical currents. An ECG lead is a graphical description of the electrical activity of the heart and it is created by analyzing several electrodes. In…

…alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the…

…while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive pacing in bradycardia dependent torsades de pointes…

…The hypotensive effect of enalaprilat depends on plasma volume and plasma renin activity. Volume depletion and high plasma renin activity increase the effect of enalaprilat…

…organ hypoperfusion. In severe cases, bradycardia may progress to bradyarrhythmic arrest or pulseless electrical activity (PEA), presenting as cardiovascular collapse and cardiac arrest. Evaluation and…

…pressure or other conventional risk factors. Colchicine is an established anti inflammatory drug that may inhibit inflammasome activity, reduce interleukin 1β and interleukin 6…

…via the autonomic nervous system. It attenuates carotid sinus baroreceptor activity and acts centrally and peripherally to enhance vagal tone. These sympatho inhibitory effects decrease…

…vasodilation. Although primarily defined by these mechanisms, levosimendan also exhibits some type 3 phosphodiesterase inhibitor (PDEI) activity, which may contribute to its inotropic profile. The…

…nervous system activity Improvement in cardiac metabolic efficiency, including increased oxygen delivery and beta hydroxybutyrate oxidation Reduced sodium hydrogen exchanger subtype 3 activity Attenuation of…

…plaque stability, thrombogenic responses and immune activity. Statin intolerance refers to adverse effects attributed to statin treatment that improve or resolve after reducing the dose…

…thrombus formation and sympathetic activation. Rho kinase may increase vascular smooth muscle sensitivity to calcium by inhibiting myosin phosphatase activity. Patients with VA are generally…

…it is exhaled. The final partial pressure of carbon dioxide in exhaled air represents the sum of ventilation, metabolic activity, and perfusion. Increased aerobic metabolism…

…small to be detected by skin electrodes; the ECG presents the electrical activity of the atrial and ventricular myocardium. Automaticity of pacemaker cells The automaticity…

…The battery is used to deliver pacing pulses, sensing (analyzing electrical activity in the heart) and store electrocardiograms. The pacemaker is powered by a lithium…

…of the heart rate is due to increased Vagus nerve activity caused by digoxin. Increased Vagus activity diminishes the automaticity in the sinoatrial node (which…

…the myocardium). Thus, increased sympathetic activity results in increased heart rate and stronger contractions. Physical exercise increases the venous return to the heart, which results…

…These age variations in heart rate are due to variations in the activity of the autonomic nervous system and changes in the automaticity of the…