Adrian Baranchuk

• Professor of Medicine
• Heart Rhythm Service at Queen's University

La apnea obstructiva del sueño (AOS) es una condición caracterizada por episodios recurrentes de colapso parcial o completo de la vía respiratoria superior durante el sueño, que producen flujo aéreo disminuido (hipopnea) o ausente durante más de 10 segundos (apnea). La prevalencia estimada de la AOS en adultos hispanos es del 9,8%, en el caso de en...

Left bundle branch area pacing (LBBAP) is a type of conduction system pacing wherein the left bundle branch and/or the left side of the interventricular septum are stimulated with a permanent pacing lead to maintain physiological electrical activation of the left ventricle. As understanding grows regarding trifascicular activation in the left ventr...

The electrocardiogram (ECG) is a simple, rapid, accessible, and inexpensive diagnostic tool that continues to play a pivotal role in daily clinical activities. Through the practice of ECG interpretation, fundamental information is gathered to guide the approach of multiple cardiovascular disorders such as arrhythmias, acute coronary syndromes, cond...

Introduction: Among professional athletes, high altitude training is a popular technique due to its documented success on improving cardiovascular health and athletic performance. Nevertheless, there is little consensus on the guidelines for high altitude training and competition. This review sought to summarize existing literature for acclimatizat...

Background: In-flight cardiac arrest (IFCA) is unique due to restricted access to equipment, healthcare providers, and isolated location in the air. This review aimed to explore the complexities surrounding IFCA on commercial flights, including the prevalence, incidence, and risk factors of IFCA and the effectiveness of automated external defibrill...

Envenomation (latrodectism) with black widow spider (BWS) venom can cause dysfunction in the cardiovascular system. The pathophysiology and consequences of cardiovascular effects have not been fully elucidated. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Of 364 initial results, 22...

Background Influenza vaccination has been shown to reduce the occurrence of cardiovascular events, both in the general population and especially in individuals with cardiovascular disease. However, the extent to which cardiologists and other physicians support and prescribe influenza vaccination for patients with cardiovascular diseases is not know...

Background: Conduction disorders and arrhythmias frequently accompany cardiac amyloidosis (CA), with atrial fibrillation (AF) being the most prevalent manifestation. The prevalence of AF varies across different types of CA, with transthyretin (TTR) type showing the highest prevalence upon diagnosis. Methods: A retrospective, observational analys...

Objectives Despite the critical value of healthcare workers (HCWs) demonstrated during the COVID-19 pandemic, there remains a noted global surge in violence against this population. The present meta-analysis aimed to gather data on the prevalence of workplace violence (WPV) against HCWs and to determine if there is any difference based on gender....

Brugada Syndrome is an inherited cardiac channelopathy with a high incidence of ventricular fibrillation and sudden cardiac death in patients with structurally normal hearts. Diagnosis is based on a characteristic electrocardiographic pattern (coved type ST-segment elevation ≥2 mm followed by a negative T-wave in ≥1 in the right precordial leads V1...

The diagnostic criteria, treatments at the time of admission, and drugs used in patients with acute coronary syndrome are well defined in countless guidelines. However, there is uncertainty about the measures to recommend during patient discharge planning. This document brings together the most recent evidence and the standardized and optimal treat...

Background Mitral annular flutter (MAF) is the most common left atrial macro‐reentrant arrhythmia following catheter ablation of atrial fibrillation (AF). The best ablation approach for this arrhythmia remains unclear. Methods This single‐center, retrospective study sought to compare the acute and long‐term outcomes of patients with MAF treated wi...

Resumen Objetivos Describir las características de las diferentes residencias médicas de cardiología de Latinoamérica. Método Estudio de corte transversal que tiene como objetivo evaluar las características de las residencias de cardiología en países hispanohablantes de América Latina, mediante encuestas electrónicas autoadministradas Resultados...

Background: Rapid correction of severe hyperkalemia is mandatory to survival due to its induction of fatal cardiac arrhythmias. The electrocardiogram serves as the diagnostic tool that can provide insight into such fatal arrhythmias. We present two relevant alterations seen in an 84-year-old female patient with previous anterior myocardial infarcti...

Almost half of physicians report being uncomfortable with ECG interpretation, underscoring the need for high-quality ECG training. There are two major strategies for teaching ECG interpretation. Pattern recognition involves reading ECGs solely as graphic images, after being taught the underlying pathophysiology behind the ECG patterns. Inductive-de...

Chagas disease poses a public health problem in Latin America, and the electrocardiogram is a crucial tool in the diagnosis and monitoring of this pathology. In this context, the aim of this study was to quantify the change in the ability to detect electrocardiographic patterns among healthcare professionals after completing a virtual course. Mater...

Objective Chagas disease poses a public health problem in Latin America, and the electrocardiogram is a crucial tool in the diagnosis and monitoring of this pathology. In this context, the aim of this study was to quantify the change in the ability to detect electrocardiographic patterns among healthcare professionals after completing a virtual cou...

Background: Humans and mammals have sex-specific differences in cardiac electrophysiology, linked to the action of sex hormones in the cardiac muscle. These hormones can either increase or decrease the expression of ionic channels modulating the cardiac cycle through genomic and non-genomic interactions. Methods: Systematic search in PubMed, Medlin...

Ramchandani, Rashi, Ioana Tereza Florica, Zier Zhou, Aziz Alemi, and Adrian Baranchuk. Review of athletic guidelines for high-altitude training and acclimatization. High Alt Med Biol. 00:000-000, 2024. Introduction: Exposure to high altitude results in hypobaric hypoxia with physiological acclimatization changes that are thought to influence athlet...

Introducción: La violencia contra el personal de salud es un problema complejo, que parece haberse incrementado por la pandemia de COVID-19. Nos propusimos explorar las diferencias de estos hechos entre cardiólogos y otros médicos de Latinoamérica. Método: Encuesta electrónica con un muestreo no probabilístico por conveniencia al personal médico y...

Background: Accurate ECG interpretation is vital, but variations in skills exist among healthcare professionals. This study aims to identify factors contributing to ECG interpretation proficiency. Methods: Survey data and ECG test scores from participants in the EDUCATE Trial were analyzed. The dependent variable was the test score for interpreting...

Background: The impact of computer ECG interpretation (CEI) on medical professionals’ performance is understudied. This study aims to assess the interpretation proficiency of diverse medical professionals with and without access to CEI reports. Methods: Medical professionals from diverse backgrounds interpreted 60 12-lead ECGs with urgent and non-u...

Background: ECG interpretation is crucial in medical practice, but professionals struggle with achieving and maintaining competency. Identifying proficiency gaps aids in designing educational interventions. Methods: Medical professionals from various disciplines interpreted 30 12-lead ECGs containing commonly taught urgent and non-urgent findings....

Background: Gaps in ECG interpretation competency among medical professionals exist, with a need for practical, evidence-based, and accessible learning solutions. We conducted an international, prospective, randomized controlled trial to assess the effectiveness of web-based, self-directed ECG learning. Methods: A total of 1206 diverse medical lear...

Resumen La necesidad de mejorar el acceso a servicios de salud para la comunidad transgénero se ha vuelto evidente, especialmente en relación con el riesgo cardiovascular, que es más alto en comparación con la población general. Los procedimientos quirúrgicos y las terapias hormonales son comunes en esta población para reafirmar la identidad de gén...

Lyme disease is mainly present in humid peri-urban zones or rural areas of several countries in North America, Europe, and Asia. Most cases occur in the in the summer months of June and July (within the North hemisphere). The season in which ticks are most active corresponds to the time when people are typically outdoors. People of any age can suff...

The development of Lyme carditis is largely mediated by the direct invasion of the myocardial tissue and the subsequent triggering of pro-inflammatory changes. Borrelia spp. modulates the expression of proteins, including outer surface adhesins and complement inhibitor proteins, to facilitate pathogenesis; causing the common manifestations of Lyme...

Permanent pacemakers should not be part of the treatment algorithm for Lyme carditis (LC), as LC is a transient cause of high-degree atrioventricular (AV) block that should resolve after 5–10 days of intravenous antibiotics. If LC is not suspected by the treating physicians, the patient may undergo the unnecessary implantation of a permanent pacema...

A positive association between dilated cardiomyopathy (DCM) and Lyme disease (LD) has been shown in several small observational studies in Europe but has not been replicated in North America. In previous studies, serological testing has been a limiting factor in establishing a causal link between LD and DCM. Many trials have relied on the more accu...

Lyme carditis commonly presents with high degree atrioventricular block, but most conduction abnormalities will resolve with appropriate antibiotic therapy. Most patients with treated Lyme carditis remain symptom-free without lasting or recurrent conduction abnormalities in long term follow-up of greater than 12 months after initial presentation.

Research on Lyme disease and Lyme carditis is rapidly evolving, with new evidence constantly emerging on the diagnosis and treatment of LC. Future areas of research include prevention of Lyme complications, potential vaccine development for Lyme disease, and studies on the long-term effects of Lyme carditis. Interprofessional collaboration and pati...

The incidence of Lyme carditis is expected to increase due to human migration, reforestation, and climate mediated improvement. Autoantibody biomarkers of Lyme carditis can: (a) stratify affected individuals based on their risk of a sustained immune response and cardiac involvement, thereby facilitating proactive treatment regimens; and (b) be targ...

The development of Lyme disease-dilated cardiomyopathy likely involves three pathophysiological processes, including direct spirochetal invasion, dysfunctional immune response, and autoimmune processes. The association between Lyme disease and dilated cardiomyopathy remains tentative due to heterogenous results of existing studies. Further high-qua...

Most high degree atrioventricular block due to Lyme carditis will resolve with appropriate antibiotic therapy over the course of days to weeks. Lyme carditis patients with atrioventricular block require continuous cardiac monitoring. For patients with Lyme carditis with symptomatic heart block, temporary-permanent pacing is the preferred strategy f...

Standard reporting definitions of Lyme carditis do not adequately define the true prevalence of Lyme carditis. Asymptomatic patients with Lyme carditis require increased monitoring and follow-up to ensure resolution of cardiac inflammation. Future epidemiological research should include asymptomatic cases of Lyme carditis to determine the true prev...

Atrioventricular conduction abnormalities are the most common presentation of early disseminated Lyme carditis. Up to two-thirds of patients with Lyme carditis will progress to a high-degree atrioventricular block; however, it can reverse completely when early antibiotic treatment is provided. A systematic approach to early disseminated Lyme cardit...

Due to the presence of extra-cellular proteins, the myocardium possesses a very inviting environment for B. burgdorferi to adhere. This allows for a mechanism of direct invasion into the myocardial tissue, leading to cardiovascular manifestations such as myocarditis. An exaggerated inflammatory response can be seen through elevated levels of proinf...

Lyme carditis most commonly manifests as cardiac conduction abnormalities, specifically high-degree atrioventricular block, which may require temporary pacing in conjunction with early intravenous antibiotic therapy. The Suspicious Index in Lyme Carditis (SILC) score has been developed to assess the likelihood that a patient with atrioventricular b...

Introduction During the Coronavirus (COVID‐19) pandemic, healthcare providers have overcome difficult experiences such as workplace violence. Nurses are particularly vulnerable to workplace violence. The objective of this study was to characterize violence and aggression against nurses during the COVID‐19 pandemic in Latin America. Methods An elec...

Dear Editors, We thank Dr. McLean for his insightful comments 1 on our recent publication reporting our experience in virtual international medical research mentorship. 2 We agree that despite technological advances, virtual meetings cannot serve to replace face to face meetings completely. Indeed, we recognise the benefits of building in-person re...

Background Cavotricuspid isthmus (CTI) ablation requires permanent bidirectional block to prevent recurrence of typical atrial flutter (AFL). Catheter irrigation with half-normal saline (HNS) produces larger and deeper lesions in experimental models compared with normal saline (NS). This study was performed to compare the clinical efficacy and safe...

Introduction: Accurate ECG interpretation is vital, but variations in skills exist among healthcare professionals. This study aims to identify factors contributing to ECG interpretation proficiency. Methods: Survey data and ECG interpretation test scores from participants in the EDUCATE Trial were analyzed to identify predictors of performance f...

Introduction: Interatrial block (IAB) is defined as prolonged P-wave duration (≥ 120 ms) due to delayed conduction in the Bachmann bundle. This is readily identifiable using surface electrocardiogram (ECG). Advanced IAB can be classified as typical and atypical. Atypical IAB can be further categorized by (i) duration or (ii) morphology. In this re...

Comparación de la violencia y agresiones sufridas por el personal de salud durante la pandemia de COVID-19 en Argentina y el resto de Latinoamérica. ÍNDICE Encuesta utilizada durante el estudio Tabla S1: Definiciones de violencia (basadas en las guías de la Organización Mundial de la Salud) Tabla S2: Distribución de los participantes por países...

Introduction: The interpretation of electrocardiograms (ECGs) involves dynamic interplay between computerized ECG interpretation (CEI) software and human overread. However, the impact of computer ECG interpretation on the performance of healthcare professionals remains largely unexplored. The aim of this study was to evaluate the interpretation pr...

The human ether-a-go-go-related gene (hERG) encodes for the pore-forming subunit of the channel that conducts the rapidly activating delayed K+ current (IKr) in the heart. The hERG channel is important for cardiac repolarization, and reduction of its expression in the plasma membrane due to mutations causes long-QT syndrome type 2 (LQT2). As such,...

Background: Electrocardiogram (ECG) interpretation training is a fundamental component of medical education across disciplines. However, the skill of interpreting ECGs is not universal among medical graduates, and numerous barriers and challenges exist in medical training and clinical practice. An evidence-based and widely accessible learning solu...

Introduction: ECG interpretation is essential in modern medicine, yet achieving and maintaining competency can be challenging for healthcare professionals. Quantifying proficiency gaps can inform educational interventions for addressing these challenges. Methods: Medical professionals from diverse disciplines and training levels interpreted 30 1...

Objetivos. Explorar la frecuencia e impacto de la violencia contra los trabajadores de salud de Argentina y compararlo con el resto de sus pares de Latinoamérica en el contexto de la pandemia por COVID-19. Materiales y métodos. Estudio de corte transversal a través de una encuesta electrónica al personal médico y no médico de Latinoamérica que dese...

Background: Medical research is important for professional advancement, and mentoring is a key means by which students and early-career doctors can engage in research. Contrasting international research collaborations, research mentoring programmes are often geographically limited. As the COVID-19 pandemic has led to increased use of online techno...

Purpose of review The goal of this review is to assess recent literature regarding the risk of sudden cardiac death (SCD) in athletes with Brugada syndrome (BrS) and critically evaluate the current sporting recommendations. Recent findings Historically, exercise limitation in patients with BrS has been the main cornerstone of preventive therapy. C...

Introduction: The electrocardiogram (ECG) is a crucial diagnostic tool in medicine with concerns about its interpretation proficiency across various medical disciplines. Our study aimed to explore potential causes of these issues and identify areas requiring improvement. Methods: A survey was conducted among medical professionals to understand t...

Introduction: The risk of typical atrial flutter (AFL) is increased proportionately to right atrial (RA) size or right atrial scarring that results in reduced conduction velocity. These characteristics result in propagation of a flutter wave by ensuring the macro re-entrant wave front does not meet its refractory tail. The time taken to traverse t...

Recent studies suggest that up to a quarter of physicians in training suffer from burnout and psychological disorders. Scientist-physicians, cardiologists, cardiology residents, and first-year medical residents seem to be more prone to developing varying degrees of emotional distress. Concerned about the new generations of clinicians and researcher...

Aims: Ablation of outflow tract ventricular arrhythmias may be limited by a deep intramural location of the arrhythmogenic source. This study evaluates the acute and long-term outcomes of patients undergoing ablation of intramural outflow tract premature ventricular complexes (PVCs). Methods and results: This multicenter series included patients...

Background It is estimated that over 60 million individuals regularly use opioids globally, with opioid use disorder increasing substantially in the past decade. Several reports have linked sudden cardiac death, QTc prolongation, and other adverse cardiovascular outcomes with opioid use through their inhibitory effect on the human ether-a-go-go-rel...

Background: Influenza is a major cause of morbidity and mortality in patients with cardiovascular disease (CVD). The aim of this updated systematic review and meta-analysis was to evaluate the effect of influenza vaccination (IV) on morbidity and morbidity in adult patients with CVD. Methods: We conducted a systematic review and meta-analysis (Pub...

Swallowing is an uncommon trigger of reflex situational syncope. We discuss the case of a 61-year-old woman who presented without a prior cardiac history complaining of 15 years of dizzy spells and hot facial flushing provoked by the swallowing of solid foods.

Introducción : La influenza es una causa importante de morbilidad y mortalidad en pacientes con enfermedades cardiovasculares (ECV). El objetivo de esta revisión sistemática actualizada y metaanálisis fue evaluar los efectos de la vacunación contra la influenza (VI) sobre la mortalidad y morbilidad en pacientes adultos con ECV. Métodos : Se realiz...

Sexually transmitted infections (STIs) have substantial morbidity and mortality worldwide, with over one million new infections occurring daily. Similarly, cardiovascular (CV) disease is the leading global cause of death and has tremendous impact on disability as well as quality of life. Several STIs have potential CV consequences and may precipita...