Adverse effects of amiodarone are rarely seen in pediatric patients, but may occur if amiodarone is applied for long-term treatment. Two rather rare phenomena are blue-gray skin pigmentation and pulmonary mass. They represent important differential diagnoses from more common clinical complications like pneumonia and drug-induced toxic skin lesions.

Exaggerated cardiovascular reactivity and impaired recovery to psychological stress is independently related to cardiovascular disease (CVD), and may play a causal role in its development. I examined autonomic reactivity and recovery in 136 black, white, and Hispanic women who were predisposed to CVD, as indicated by a positive family history (FH+). Pre-ejection period (PEP; sympathetic) and respiratory sinus arrhythmia (RSA; parasympathetic) were measured during public speaking, mental arithmetic, and cold pressor tasks. Overall, FH+ participants exhibited greater RSA reactivity, while black participants exhibited impaired RSA recovery. These findings suggest that a hereditary predisposition for CVD is related to altered autonomic reactivity before any differences in resting levels are observed. Further, black participants did not exhibit a RSA rebound after the stress tasks, a key component in buffering the damaging effects of exaggerated sympathetic reactivity. These findings demonstrate the importance of examining parasympathetic activity in addition to sympathetic reactivity measures.

Background: Patients with d-transposition of the great arteries after Senning or Mustard procedure are at increased risk for arrhythmias. Especially atrial arrhythmias represent a major threat in this patient population. Early detection of clinical and subclinical arrhythmias may prevent major cardiac events. Therefore, this study aimed to evaluate the ability of the Medtronic REVEAL LINQ to detect atrial arrhythmias in adult patients after atrial switch procedure and compare the effectiveness of detecting clinically relevant arrhythmias to conventional Holter monitoring. METHODS: The database of the Heart Center Leipzig, Department for pediatric cardiology was analyzed for patients after atrial switch procedure and implantation of a Medtronic REVEAL LINQ (Medtronic Inc., Minneapolis, Minnesota). After informed consent was obtained, patients were followed up for 1 year including Holter ECG tracings and device interrogation every 3 months. In addition, symptoms were determined using a standardized questionnaire completed by the patient. RESULTS: The analysis is based on 10 patients aged 34.5 years (range 27-46 years), of which 8 had a Senning - and 2 had a Mustard procedure. The comparison of the number of arrhythmia episodes detected by Holter and LINQ showed significantly more detected episodes using LINQ (p 0.014). Data showed that no therapy adjustments were recorded as a consequence of Holter ECG findings, whereas two changes in medication were documented due to arrhythmia detection via LINQ. When analyzing possible correlations between subjective symptoms reported in the standardized questionnaire and the number of episodes documented, there was a significant correlation of subjective symptoms and arrhythmia episodes in LINQ (p 0.014), whereas no correlation could be demonstrated between subjective symptoms and the number of episodes detected by Holter monitoring (p 0.394). CONCLUSION: In patients after Senning or Mustard procedure, the Medtronic REVEAL LINQ seems to be superior in the identification of subclinical arrhythmia burden in comparison to standard Holter ECG.

No description available.

Abstract Approximately 1-2 percent of the world population lives with various heart rhythm disorders of supraventricular nature. These arrhythmias can alter the patient's lifestyle and negatively affect the balance between the demands of daily life and functional abilities. To diagnose paroxysmal supraventricular tachycardia (PSVT) can be difficult due to spontaneity of the episodes and the transience nature of the symptoms. Finding the right treatment can also pose a challenge because some of the medicines used are associated with increased toxic risks and requires close monitoring of the patient through regular blood tests. Some patients experience recurrence of symptoms despite optimal treatment measures and adherence to treatment and self-care recommendations.  Studies have shown that patients’ prior knowledge regarding these diagnoses is low. The nurse has a crucial role of informing and making sure that patients receive education in among other things self-care as well as information regarding disease and drugs related complications etc. There is a mutual interaction between daily life and functional health status where daily life makes demands on functional abilities at the same time as these affect how an individual lives their daily lives. In order to experience quality of life and health, the balance between these two must be maintained. The nurse has a pivot role in assisting the patient maintain the balance.  The study’s aim was to highlight the effects of living with supraventricular tachycardia (SVT) on the patient's daily life. The method chosen was literature review. Original articles were obtained from established databases such as PubMed and CINAHL, and the results from 17 articles were analyzed using content analysis. This means that the text was read several times in order to familiarize with the content. Different units were identified and the categories as well as sub-categories were coded. These formed the basis of the headings and subheading used to present the results. Four categories and ten sub-categories were identified from the studies.  Studies show that SVT has negative effects on the patients’ daily life. Symptoms cause anxieties and uncertainties that lead to mental and emotional stress. Some patients withdraw from participating in the social activities for fear of provoking the attacks whereas others are forced to give up participation due to among other things fatigue that results from symptoms attacks. Family life is sometimes disrupted since the symptoms can lead to fatigue that negatively affects family life in that patients do not have the energy to participate in activities in their home or to live up to other requirements of their daily lives.  The diagnosis can even affect economy since patients are forced to cut down on working hours or go into early retirement. Other patients lost their employment due to frequent hos-pital visits or inability to fulfill their duties. Physical activities as well as well-being are negatively affected too in that some patients show signs of impaired physical activities. Patients use different coping strategies such as planning their daily lives around the symp-tomatic periods. In conclusion it is suffice to state that SVT has negative effects on the patients’ daily life. The Patients would benefit from a well-structured and person centered patient education.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a stress-induced arrhythmia, caused by genetic defects in sarcoplasmic reticulum (SR) Ca-release channel RyR2, or its accessory proteins. Our previous studies demonstrated that CPVT mitochondria can absorb RyR2-mediated aberrant Ca release (ACR) and behave as an efficient Ca buffer which is critical in mitigating harmful consequences of ACR. In this study, we test the hypothesis that modulating mitochondrial phosphate (Pi) transport or the tethering between SR-mitochondria, known as Mitochondria-associated-membrane (MAMs), impacts arrhythmogenesis in CPVT. We found that inhibiting mitochondrial Pi carrier (PiC) exacerbated cellular arrhythmias whereas overexpressing PiC in CPVT alleviated both cellular and in vivo arrhythmias. In parallel, disrupting MAMs exacerbated arrhythmogenesis in CPVT, but promoting MAMs by overexpressing mitofusin2 tethering protein reduced cellular arrhythmias. Our study provided both pharmacological and genetic evidence that directing more Ca to mitochondria by enhancing mitochondrial Pi transport or targeting MAMs could be promising therapeutic strategies to reduce CPVT arrhythmia.

To determine whether children with selective mutism (SM) withhold speech to regulate their emotional arousal and decrease automatic distress, the current study examines the behavioral and physiological responses of children with SM in comparison to children with social phobia (SP) and children with no psychiatric disorder (TD) as they participate in two social situations. A single case design strategy is used to compare behavioral and physiological responses both within and across groups. Examining the temporal sequencing of behaviors and physiology provides a direct test of the utility of emotion regulation theory as it pertains to children with social phobia/selective mutism. The results indicate that children with SM show elevated arousal and emotional reactivity across all interaction segments relative to other children. Unique affective, behavioral and physiological responses occur between and within groups in relation to situational demands. The temporal sequencing of behavioral and physiological responses suggests that behavioral deficits may be related to underutilized and/or deficient physiological response systems and that not speaking represents a primitive avoidance strategy by children with SM to regulate extreme physiological arousal.

No description available.

Gross' emotion regulation model, Porges' polyvagal theory, and other existing research suggest that regulation of emotions, tactics used to handle conflict, and certain physiological processes that occur within the autonomic nervous system (ANS) in response to stress are significantly related, especially in relational contexts. However, despite their pervasiveness and negative impacts, there is a noticeable lack of research on predictors of violent, aggressive, or abusive conflict tactics in couples. In the current study, the predictive role of emotion regulation in relation to conflict tactics was examined, in addition to the role of respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) as mediators for these variables. Thirty-eight participants (19 couples) completed self-report measures of emotion regulation and conflict tactics, and RSA and PEP were measured during a three-minute baseline and 20-minute conflict discussion. Results showed no significant relationships between emotion regulation and conflict tactics, and no significant relationships between these variables and RSA or PEP were found. These findings may suggest that other variables aside from measures of ANS activity better explain the relationship between emotional and behavioral regulation skills, though additional research is necessary to confirm these findings. Clinical implications of this research point to the exploration of other contributors to violence and aggression aside from poor emotion regulation as it was measured in this study. Future research may benefit from investigating the impact of other variables such as sleep and exercise on ANS reactivity in relation to the use of maladaptive conflict tactics in married couples.

No description available.