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... HRV was measured as the rMSSD of the inter-beat interval (IBI). rMSSD is a time domain measure of HRV and reflects parasympathetic activity [28]. The rMSSD data were log transformed prior to analysis [28]. ...
... rMSSD is a time domain measure of HRV and reflects parasympathetic activity [28]. The rMSSD data were log transformed prior to analysis [28]. ...
The aim of the present study was to investigate the effects of Atlantic salmon consumption on underlying biological mechanisms associated with anxiety such as heart rate variability (HRV) and heart rate (HR) as well as a measure of self-reported anxiety. Moreover, these biological and self-reported outcome measures were investigated in relation to specific nutrients; vitamin D status, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Ninety-five male forensic inpatients were randomly assigned into a Fish (Atlantic salmon three times per week from September to February) or a Control group (alternative meal, e.g., chicken, pork, or beef three times per week during the same period). HRV measured as the root mean square of successive differences (rMSSD), HR, state- and trait-anxiety (STAI), were assessed before (pre-test) and at the end of the 23 weeks dietary intervention period (post-test). The Fish group showed significant improvements in both rMSSD and HR. The Fish group also showed significant decreases in state-anxiety. Finally, there was a positive relationship between rMSSD and vitamin D status. The findings suggest that Atlantic salmon consumption may have an impact on mental health related variables such as underlying mechanisms playing a key role in emotion-regulation and state-anxiety.
... One such curriculum, adapted from the 2003 NASPE (North American Society of Pacing and Electrophysiology) curriculum, can be found in Table 1 of the Appendix. 7 Equally important is the selection of proper candidates. Training should be prioritized for committed individuals who are supported by committed institutions. ...
The burden of cardiovascular disease is increasing globally, with low- and middle-income countries (LMICs) absorbing most of the burden while lacking the necessary healthcare infrastructure to combat the increase. In particular, the disparity in pacemaker implants between high-income countries and LMICs is glaring, partially spurned by reduced numbers of physicians and supporting staff who are trained in pacemaker implant technique. Herein, we will discuss current pacemaker implant training models, outline training frameworks that can be applied to underserved regions, and review adjunctive training techniques that can help supplement traditional training models in LMICs.
... Reference ranges for the assessment of abnormal electrocardiograms and cardiac conduction disorders in patients have long been established and are regularly adopted by expert bodies, such as the North American Society of Pacing and Electrophysiology (GURA et al. 2003) and the European Society of Cardiology (Blomström-Lundqvist et al. 2003;Camm et al. 2010). For mouse models, however, there are no such reference ranges. ...
Reference ranges provide a powerful tool for diagnostic decision-making in clinical medicine and are enormously valuable for understanding normality in pre-clinical scientific research that uses in vivo models. As yet, there are no published reference ranges for electrocardiography (ECG) in the laboratory mouse. The first mouse-specific reference ranges for the assessment of electrical conduction are reported herein generated from an ECG dataset of unprecedented scale. International Mouse Phenotyping Consortium data from over 26,000 conscious or anesthetized C57BL/6N wildtype control mice were stratified by sex and age to develop robust ECG reference ranges. Interesting findings include that heart rate and key elements from the ECG waveform (RR-, PR-, ST-, QT-interval, QT corrected, and QRS complex) demonstrate minimal sexual dimorphism. As expected, anesthesia induces a decrease in heart rate and was shown for both inhalation (isoflurane) and injectable (tribromoethanol) anesthesia. In the absence of pharmacological, environmental, or genetic challenges, we did not observe major age-related ECG changes in C57BL/6N-inbred mice as the differences in the reference ranges of 12-week-old compared to 62-week-old mice were negligible. The generalizability of the C57BL/6N substrain reference ranges was demonstrated by comparison with ECG data from a wide range of non-IMPC studies. The close overlap in data from a wide range of mouse strains suggests that the C57BL/6N-based reference ranges can be used as a robust and comprehensive indicator of normality. We report a unique ECG reference resource of fundamental importance for any experimental study of cardiac function in mice.
... If the assumption of sphericity was not met (Mauchlys Sphericity Test: p o0.05), degrees of freedom for dependent variables were corrected conservatively by Greenhouse-Geisser. Being exceedingly robust against violation of normality (Tabachnick and Fidell, 2007), ANOVAs and t-tests if feasible (all twotailed) were also adopted for variables not normal in distribution. Mahalanobis' distance was applied separately on physiological and self-report data with p o0.001. ...
The present study wanted to test the course of the urge for non-suicidal self-injury (UNSSI) and the urge for self-punishment (USP) when suppressing or accepting upcoming emotions in response to a sadness-inducing film clip in female participants with borderline personality disorder (BPD). Thirty-six women with BPD were allocated either to a condition in which they were asked to engage in expressive suppression or acceptance while watching a sadness-inducing film clip. Ratings of UNSSI, USP, and positive and negative emotions were assessed prior to the clip (baseline), immediately after it (t1) and after a 5min waiting period (t2), during which participants viewed landscape pictures. Additionally, physiological measures were obtained. Main results revealed a significant increase in UNSSI from baseline to t2 in the acceptance, but not in the suppression group. Furthermore, USP scores significantly increased from baseline to t2 in the acceptance, but not in the suppression condition. However, there was no differential impact on the sympathetic and parasympathetic branch depending on strategy. The results are in line with recent literature showing that expressive suppression in BPD may also have an adaptive function.
Effective teamwork in pediatric electrophysiology (EP) is the key to providing high quality and patient-focused care. Individuals function optimally when they work as part of a high functioning team which encompasses respect, communication, trust, collaboration, and fosters creativity among the team members. During the past several decades the care of children and adolescents with arrhythmias has significantly improved. These advances are largely technological, including catheter ablation as first-line therapy for many childhood arrhythmias as well as the use of implantable cardioverter-defibrillators (ICDs) for life-threatening ventricular arrhythmias, often genetically mediated or occurring in adolescents and young adults who have survived complex congenital heart surgery. The complex technologies involved in the diagnosis and treatment of pediatric arrhythmias necessitates a multidisciplinary approach and a skilled, knowledgeable electrophysiology team. Effective, competent allied professionals are essential to the function of the EP team. The many different roles of allied professional team include EP technicians, nurses, and advance practice nurses.
The Cardiac Electrophysiology Clinics, published four times per year in textbook format, provides the clinician with practical, hands-on advice regarding the evaluation and management of patients with heart rhythm disorders. The June 2014 publication, Implantable Devices: Design, Manufacturing and Malfunction: Editors: Kenneth A. Ellenbogen, Charles J. Love, Consulting Editors: Ranjan K. Thakur, Andrea Natale is a comprehensive yet practical text that focuses on the issues related to design, manufacturing, and malfunction of cardiac implantable electronic devices (CIEDs). This volume is most welcome to all clinicians who deal with patients with CIEDs but especially to the allied professional cardiac device specialist. The editors have gathered international experts to provide insight into key evolving matters related to CIEDs and patient management.This article is protected by copyright. All rights reserved
Remote monitoring of cardiac implantable electronic devices improves device surveillance and patient clinical management. The greatest challenge in implementing remote monitoring in standard practice is the need to develop new organizational models, capable of combining clinical effectiveness, low resource consumption, and patient acceptance. Since 2005, we developed a new model based on 'Primary Nursing' in which each patient is assigned to a nurse responsible for continuity of care. The model is essentially based on a cooperative interaction between the roles of an expert reference nurse and a responsible physician with an agreed list of respective tasks and responsibilities. After a pilot experience, the model was tested in a wide registry, the HomeGuide Registry, in which 1650 patients were enrolled. In this setting, remote monitoring sensitivity in detecting major cardiovascular events was very high (84%) with a positive predictive value of 97%. Overall, 95% of asymptomatic and 73% of actionable events were detected during remote monitoring sessions with a median reaction time of 3 days. Manpower was remarkably low: 55.5 min per health personnel per month every 100 patients. The strongest points of this model include strict definition of workflow, early reaction, traceability, continuity of care, maintaining human relationship with the patient. This model has been tested successfully even in a multicentre setting in the Model Project Monitor Centre study, in which one monitor centre screened daily remote monitoring data from nine satellite clinics. Published on behalf of the European Society of Cardiology. All rights reserved.
Nurse-patient-family interactions afford key opportunities for education, support, and interventions aimed at facilitating
positive child and family adjustments for children with arrhythmias. While some situations are relatively minor requiring
minimal nursing intervention, others are very demanding requiring an intensive, long-term level of care. As the complexity
of care advances, the need for collaboration amongst all care providers involved increases.
Allied professionals with diverse backgrounds and training are essential to the delivery of quality care to patients with heart rhythm disorders. There is a growing worldwide demand for defined educational requirements and certification pathways to ensure uniformity of knowledge and competence of those practicing in electrophysiology. The present viewpoint article reviews the current deficiencies of education and training, and advocates for the establishment of certification pathways by professional societies.
Sudden cardiac death (SCD) is a major healthcare problem worldwide. The majority of SCD events occur in patients with clinically recognized heart disease and most episodes result from ventricular tachyarrhythmias. Implantable cardioverter defibrillator (ICD) therapy prevents SCD in specific patient populations. Significant progress in the design and technology has been made since the Food and Drug Administration first approved the ICD in 1985. First-generation ICDs were large, were implanted in the abdomen, required a thoracotomy for placing epicardial defibrillation patches, and were nonprogrammable. Contemporary ICDs have been substantially downsized, are implanted via a transvenous approach, and are multiprogrammable. Device implantation has been simplified to be similar to that of a permanent pacemaker. In addition to treating life-threatening ventricular arrhythmias, ICDs now treat bradyarrhythmias, atrial arrhythmias, and congestive heart failure. The purpose of this article is to describe the evidence supporting the use of ICD therapy and to explain the current devices used in clinical practice.