201: Are QT intervals correlated to apnea-hypopnea index in obstructive sleep apnea?

IntroductionSeveral studies proved that obstructive sleep apnea (OSA) is associated with cardio-vascular diseases such as cardiac arrhythmia. QT duration and dispersion reflect the heterogeinity of ventricular repolarization and are considered as precursors of ventricular arrhythmiaAimThe aim of this study is to assess the relation between the severity of OSA parameters as apnea hypopnea index and QT intervals.MethodsForty patients (18 men and 22 women) who were diagnosed with OSA by overnight polysomnography were included in this prospective study. The mean age was 56±10 years old. They were all in sinus rhythm. Before initiating continuous positive airway pressure therapy, we calculated on a 12 lead ECG : QT duration (QTend) corrected to Bazett formula and QT dispersion (QT end max -QT end min).ResultsTwenty four patients had severe OSA (AHI >30), 4 had moderate OSA (AHI between 15 and 30) and 12 had a mild OSA (AHI between 5 and 15). There was a significant positive correlation between QT dispersion and AHI (r=0.48, p=0.001)ConclusionThe severity of OSA seems to be correlated with ventricular repolarization heterogeinity These results suggest that the higher is the AHI the higher is the risk of ventricular arrhythmia occurence. Further studies are needed to validate these results

Drug Abuse-Induced Cardiac Arrhythmias: Mechanisms and Management

Toxicomania is a worldwide emerging problem threatening young population. Several reports highlighted its hazardous cardiovascular effects. Sudden cardiac death secondary to cardiac arrhythmias is the most occupying issue. Different forms of cardiac rhythm disorders may be induced by illicit drug abuse according to the type of drug and the mechanism involved. In this review, we exposed the main ventricular and supraventricular arrhythmia complicating the common recreational drugs, and we explained their different mechanisms as well as the particularities of management

SEMRAchain: A Secure Electronic Medical Record Based on Blockchain Technology

A medical record is an important part of a patient’s follow-up. It comprises healthcare professionals’ views, prescriptions, analyses, and all information about the patient. Several players, including the patient, the doctor, and the pharmacist, are involved in the process of sharing, and managing this file. Any authorized individual can access the electronic medical record (EMR) from anywhere, and the data are shared among various health service providers. Sharing the EMR requires various conditions, such as security and confidentiality. However, existing medical systems may be exposed to system failure and malicious intrusions, making it difficult to deliver dependable services. Additionally, the features of these systems represent a challenge for centralized access control methods. This paper presents SEMRAchain a system based on Access control (Role-Based Access Control (RBAC), Attribute-Based Access Control (ABAC)) and a smart contract approach. This fusion enables decentralized, fine-grained, and dynamic access control management for EMR management. Together, blockchain technology as a secure distributed ledger and access control provides such a solution, providing system stakeholders with not just visibility but also trustworthiness, credibility, and immutability

Cardiomyopathy induced by incessant ventricular tachycardia originating in the vicinity of the His bundle

A 04-year-old boy was referred to our institution with severe, progressive heart failure of 4-months duration associated with a persistent wide QRS tachycardia with left bundle branch block and severe left ventricular dysfunction. Because of incessant wide QRS tachycardia refractory to antiarrhythmic drugs, he was referred for electrophysiological study. The ECG was suggestive of VT arising from the right ventricle near the His area. Electrophysiological study revealed that origin of tachycardia was septum of the right ventricle, near His bundle, however the procedure was not successful and an inadvertent complete atrioventricular conduction block occurred. The same ventricular tachycardia recurred. A second procedure was performed with a retrograd aortic approach to map the left side of the interventricular septum. The earliest endocardial site for ablation was localized in the anterobasal region of left ventricle near His bundle. In this location, one radiofrequency pulse interrupted VT and rendered it not inducible. The echocardiographic evaluation showed partial reversal of left ventricular function in the first 3 months. The diagnosis was idiopathic parahisian left ventricular tachycardia leading to a tachycardia mediated cardiomyopathy, an extremely rare clinical picture in children. Keywords: Parahisian ventricular tachycardia, Tachycardia mediated cardiomyopathy, Radiofrequency catheter ablation, Childre

Epidemiology of heart failure and long-term follow-up outcomes in a north-African population: Results from the NAtional TUnisian REgistry of Heart Failure (NATURE-HF)

International audienceThe NATURE-HF registry was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). This is a prospective, multicenter, observational survey conducted in Tunisian Cardiology centers. A total of 2040 patients were included in the study. Of these, 1632 (80%) were outpatients with chronic HF (CHF). The mean hospital stay was 8.7 ± 8.2 days. The mortality rate during the initial hospitalization event for AHF was 7.4%. The all-cause 1-year mortality rate was 22.8% among AHF patients and 10.6% among CHF patients. Among CHF patients, the older age, diabetes, anemia, reduced EF, ischemic etiology, residual congestion and the absence of ACEI/ ARBs treatment were independent predictors of 1-year cumulative rates of rehospitalization and mortality. The female sex and the functional status were independent predictors of 1-year all-cause mortality and rehospitalization in AHF patients. This study confirmed that acute HF is still associated with a poor prognosis, while the mid-term outcomes in patients with chronic HF seems to be improved. Some differences across countries may be due to different clinical characteristics and differences in healthcare systems