Real-time measurement of ICD lead motion during stereotactic body radiotherapy of ventricular tachycardia

Background: Here we aimed to evaluate the respiratory and cardiac-induced motion of a ICD lead used as surrogate in the heart during stereotactic body radiotherapy (SBRT) of ventricular tachycardia (VT). Data provides insight regarding motion and motion variations during treatment. Materials and methods: We analyzed the log files of surrogate motion during SBRT of ventricular tachycardia performed in 20 patients. Evaluated parameters included the ICD lead motion amplitudes; intrafraction amplitude variability; correlation error between the ICD lead and external markers; and margin expansion in the superior-inferior (SI), latero-lateral (LL), and anterior-posterior (AP) directions to cover 90% or 95% of all amplitudes. Results: In the SI, LL, and AP directions, respectively, the mean motion amplitudes were 5.0 +/- 2.6, 3.4. +/- 1.9, and 3.1 +/- 1.6 mm. The mean intrafraction amplitude variability was 2.6 +/- 0.9, 1.9 +/- 1.3, and 1.6 +/- 0.8 mm in the SI, LL, and AP directions, respectively. The margins required to cover 95% of ICD lead motion amplitudes were 9.5, 6.7, and 5.5 mm in the SI, LL, and AP directions, respectively. The mean correlation error was 2.2 +/- 0.9 mm. Conclusions: Data from online tracking indicated motion irregularities and correlation errors, necessitating an increased CTV-PTV margin of 3 mm. In 35% of cases, the motion variability exceeded 3 mm in one or more directions. We recommend verifying the correlation between CTV and surrogate individually for every patient, especially for targets with posterobasal localization where we observed the highest difference between the lead and CTV motion.Web of Science26113712

Preparticipation screening of athletes: The prevalence of positive family history

Sudden cardiac death (SCD) is a leading cause of death among athletes, and those with a positive family history (FH) of SCD and/or cardiovascular disease (CVD) may be at increased risk. The primary objective of this study was to assess the prevalence and predictors of positive FH of SCD and CVD in athletes using four widely used preparticipation screening (PPS) systems. The secondary objective was to compare the functionality of the screening systems. In a cohort of 13,876 athletes, 1.28% had a positive FH in at least one PPS system. Multivariate logistic regression analysis identified the maximum heart rate as significantly associated with positive FH (OR = 1.042, 95% CI = 1.027–1.056, p < 0.001). The highest prevalence of positive FH was found using the PPE-4 system (1.20%), followed by FIFA, AHA, and IOC systems (1.11%, 0.89%, and 0.71%, respectively). In conclusion, the prevalence of positive FH for SCD and CVD in Czech athletes was found to be 1.28%. Furthermore, positive FH was associated with a higher maximum heart rate at the peak of the exercise test. The findings of this study revealed significant differences in detection rates between PPS protocols, so further research is needed to determine the optimal method of FH collection.Web of Science104art. no. 18

Vliv elektráren ČEZ, a.s. situovaných v okrese Chomutov na imise SO2 a polétavého prachu před a po odsíření

Import 20/04/2006Prezenční výpůjčkaVŠB - Technická univerzita Ostrava. Fakulta hornicko-geologická. Institut matematiky a deskriptivní geometrie (514

Analiza w czasie rzeczywistym QRS bazująca na transformacie falkowej

The pacing for permanent pacing in bradyarrhytmias can influence ventricular activation and can contribute to marked asynchrony in extremity. In this work, we search the optimal position for right ventricular pacing according the QRS duration. We evaluate the system for detection of QRS boundaries based on wavelet transform and adaptive threshold. The system is used during pacemaker implantations in Department of Cardiology, Heart Center, Hospital Podlesí Třinec.W artykule zaprezentowano system do detekcji QRS bazujący na transformacie falkowej. System sprawdzono w Klinice serca w Tryncu podczas implantacji rozrusznika serca.Web of Science879a31531

The influence of catheter-based renal sympathetic denervation on renal function and renal arteries

AbstractObjectiveCurrently investigated non-pharmacological minimally invasive method for the treatment of resistant hypertension is percutaneous denervation of renal sympathetic nerve fibres by radiofrequency catheter-based ablation. We assessed its influence on renal function and renal arteries.MethodsThe first 38 patients treated with catheter-based renal denervation at our centre between September 2011 and December 2012 were included in the study. Changes in renal function and changes in renal artery morphology at 12 months after the procedure have been analyzed.ResultsMean age was 57.6±11 years, the majority (63.9%) were men. Average estimated glomerular filtration rates (eGF) were 1.25ml/s/1,73m2 before denervation and 1.30ml/s−1/1.73m−2 12 months after intervention. Changes in eGF did not reach statistical significance. New haemodynamically non-significant renal artery stenosis (40%) has occurred in only one case after procedure.ConclusionIn agreement with the results of several studies, our findings suggest that renal denervation (RDN) appears to be a safe therapeutic approach

Early ganglion stellate blockade as part of two-step treatment algorithm suppresses electrical storm and need for intubation

Background: For the treatment of patients with electrical storm (ES), we established a two-step algo rithm comprising standard anti-arrhythmic measures and early ultrasound-guided stellate ganglion blockade (SGB). In this single-center study, we evaluated the short-term efficacy of the algorithm and tested the hypothesis that early SGB might prevent the need for intubations. Methods: Overall, we analyzed data for 70 ES events in 59 patients requiring SGB (mean age 67.7 ± 12.4 years, 80% males, left ventricular ejection fraction 30.0% ± 9.1%), all with implantable cardioverter-defibrillators (ICDs). Results: The mean time from ES onset to SGB was 13.2 ± 12.3 hours. Percentage and mean absolute reduction in shocks at 48 hours after SGB reached 86.8% ( 6.3 shocks), and anti-tachycardiac pacing (ATP) declined by 65.9% ( 51.1 ATPs; all P < 0.001). Patients with the highest sustained ventricular arrhythmia (VA) burden (shocks 10/48 h; ATPs 10e99/48 h and 100/48 h) experienced the highest percentage decrease in ICD therapy (shocks 99.1%; ATPs 92.1% and 100.0%, respectively). For clinical response by defined criteria and two outcome periods (1/no sustained VA 48 hours post SGB, and 2/no ICD shock or <3 ATPs/day from day 3 to discharge/catheter ablation/day 8), 75.7% and 76.1% experienced complete response, respectively. Catecholamine support, no/low-dose b-blocker therapy, polymorphic/ mixed-type VA, and baseline sinus rhythm versus atrial fibrillation were more frequent in patients with early arrhythmia recurrence. Temporary Horner's syndrome occurred in 67.1%, and no other adverse events were recorded. Intubation and general anesthesia during and after SGB were not needed. Conclusion: The presented two-step algorithm for treating ES proved efficacious and safe. The results support implementation of early SGB in routine ES management.Web of Science73352