Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of t...Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of the general population,even when the various types are combined.Coronary anomalies are practically challenging when the left and right coronary ostium are not found around their normal positions during coronary angiography with a catheter.If there is atherosclerotic stenosis of the coronary artery with an anomaly and percutaneous coronary intervention(PCI)is required,the suitability of the guiding catheter at the entrance and the adequate back up force of the guiding catheter are issues.The level of PCI risk itself should also be considered on a caseby-case basis.In this case,emission computed tomography in the R-1 subtype single coronary artery proved that ischemia occurred in an area where the coronary artery was not visible to the naked eye.Meticulous follow-up would be crucial,because sudden death may occur in single coronary arteries.To prevent atherosclerosis with full efforts is also important,as the authors indicated admirably.展开更多
The role of the autopsy: 1) Whether the death is ascribable to a natural or unnatural cause and when natural, if cardiac or extra-cardiac;2) The nosology of the cardiac diseases and the mechanism of cardiac death, whe...The role of the autopsy: 1) Whether the death is ascribable to a natural or unnatural cause and when natural, if cardiac or extra-cardiac;2) The nosology of the cardiac diseases and the mechanism of cardiac death, whether arrhythmic or mechanical;3) If the cardiac disease is inherited, screening and counselling of the next of kin is required. About 30% of sudden deaths is ascribable to genetically determined morbid entities, mostly transmissible with the autosomal dominant pattern of inheritance, so that 50% of the first degree relatives are genetically affected (“carriers”) and exposed at risk;4) If toxic or illicit drug abuse was involved.展开更多
BACKGROUND Sudden death is unanticipated,non-violent death taking place within the first 24 h after the onset of symptoms.It is a major public health problem worldwide.Moreover,the effects of living at moderate altitu...BACKGROUND Sudden death is unanticipated,non-violent death taking place within the first 24 h after the onset of symptoms.It is a major public health problem worldwide.Moreover,the effects of living at moderate altitude on mortality are poorly understood.AIM To retrospectively report the frequency and the main causes of sudden deaths in relation to total deaths at Asir Central Hospital,2255 m above sea level,in the southern region of Saudi Arabia over a period of 4 years from 2013 to 2016.METHODS The medical records of 1821 deaths were examined and showed 353 cases(19.4%)of sudden death.RESULTS The highest incidence of sudden death was among the elderly(51%),whereas,the lowest was among children and adolescents(6.5%).With regard to gender,the incidence of sudden death was higher in males(54.4%)compared to 45.6% in females.In this study,we found that the most common direct causes of sudden death were cardiovascular diseases(29.2%),respiratory disease(22.7%),infectious disease(12.2%),cancer(9.4%)and hematological diseases(6.2%).With respect to seasonal variation,the highest incidence was during winter(31.32%)followed by summer(25.8%).CONCLUSION The results of this study will help emergency physicians and health care providers to exercise due care to reduce the incidence of sudden death and raise public awareness about the impact of sudden death.展开更多
Early repolarization syndrome(ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considera...Early repolarization syndrome(ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considerable risk of life- threatening arrhythmias and sudden cardiac death(SCD). Early repolarization characteristics associated with SCD include high-amplitude J-point elevation, horizontal and/or downslopping ST segments, and inferior and/or lateral leads location. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation(0.05 m V vs 0.1 m V) being the main determinants.ERS patients are sporadic and they are at a higher risk of having recurrent cardiac events. Implantable cardioverter-defibrillator implantation and isoproterenol are the suggested therapies in this set of patients. On the other hand, asymptomatic patients with ERS are common and have a better prognosis. The risk stratification in asymptomatic patients with ERS still remains a grey area. This review provides an outline of the up-to-date evidence associated with ERS and the risk of life- threatening arrhythmias. Further prospective studies are required to elucidate the mechanisms of ventricular arrhythmogenesis in patients with ERS.展开更多
We report an acute case of a native man from Bolivia suffered from cephalalgia which rapidly worsened and ended in his sudden and unexpected death.Magnetic resonance imaging(MRI) of the brain was obtained.Features dem...We report an acute case of a native man from Bolivia suffered from cephalalgia which rapidly worsened and ended in his sudden and unexpected death.Magnetic resonance imaging(MRI) of the brain was obtained.Features demonstrated on brain MRI scan were consistent with a diagnosis of neurocysticercosis(NCC).An autopsy showed the presence of intraventricular Taenia solium(T.solium) cysts which caused blockage of cerebrospinal fluid and secondary hydrocephalus.Due to the increasing travel movements of people neurocysticercosis must be considered as a cause of unexplained sudden death.展开更多
The influences of dipole-dipole interaction and detuning on the entanglement between two atoms with different initial tripartite entangled W-like states in the Tavis Cummings model have been investigated by means of W...The influences of dipole-dipole interaction and detuning on the entanglement between two atoms with different initial tripartite entangled W-like states in the Tavis Cummings model have been investigated by means of Wootters＇ concurrence, respectively. The results show that the entanglement between the two atoms can be enhanced via appropriately tuning the strength of dipole-dipole interaction of two atoms or the detunings between atom and cavity, and the so-called sudden death effect can he weakened simultaneously.展开更多
Most heart failure （HF） related mortality is due to sudden cardiac death （SCD） and worsening HF, particularly in the case of reduced ejection fraction. Predicting and preventing SCD is an important goal but most w...Most heart failure （HF） related mortality is due to sudden cardiac death （SCD） and worsening HF, particularly in the case of reduced ejection fraction. Predicting and preventing SCD is an important goal but most works include no or few patients with advanced age, and the prevention of SCD in elderly patients with HF is still controversial. A recent reduction in the annual rate of SCD has been recently described but it is not clear if this is also true in advanced age patients. Age is associated with SCD, although physicians frequently have the perception that elderly patients with HF die mainly of pump failure, underestimating the importance of SCD. Other clinical variables that have been associated to SCD are symptoms, New York Heart Association functional class, ischemic cause, and comorbidities （chronic obstructive pulmonary disease, renal dysfunction and diabetes）. Some test results that should also be considered are left ventricular ejection fraction and diameters, natriuretic peptides, non-sustained ventricular tachycardias and autonomic abnormalities. The combination of all these markers is probably the best option to predict SCD. Different risk scores have been described and, although there are no specific ones for elderly populations, most include age as a risk predictor and some were developed in populations with mean age 〉 65 years. Finally, it is important to stress that these scores should be able to predict any type of SCD as, although most are due to tachyarrhythmias, bradyarrhythmias also play a role, particularly in the case of the elderly.展开更多
BACKGROUND There is a high risk for sudden cardiac death(SCD) in certain patient groups that would not meet criteria for implantable cardioverter defibrillator(ICD) therapy.In conditions such as hypertrophic cardiomyo...BACKGROUND There is a high risk for sudden cardiac death(SCD) in certain patient groups that would not meet criteria for implantable cardioverter defibrillator(ICD) therapy.In conditions such as hypertrophic cardiomyopathy(HCM) there are clear risk scores that help define patients who are high risk for SCD and would benefit from ICD therapy. There are however many areas of uncertainty such as certain patients post myocardial infarction(MI). These patients are high risk for SCD but there is no clear tool for risk stratifying such patients.AIM To assess risk factors for sudden cardiac death in major cardiac disorders and to help select patients who might benefit from Wearable cardiac defibrillators(WCD).METHODS A literature search was performed looking for risk factors for SCD in patients post-MI, patients with left ventricular systolic dysfunction(LVSD), HCM, long QT syndrome(LQTS). There were 41 studies included and risk factors and the relative risks for SCD were compiled in table form.RESULTS We extracted data on relative risk for SCD of specific variables such as age,gender, ejection fraction. The greatest risk factors for SCD in post MI patients was the presence of diabetes [Hazard ratio(HR) 1.90-3.80], in patient with LVSD was ventricular tachycardia(Relative risk 3.50), in LQTS was a prolonged QTc(HR36.53) and in patients with HCM was LVH greater than 20 mm(HR 3.10). A proportion of patients currently not suitable for ICD might benefit from a WCDCONCLUSION There is a very high risk of SCD post MI, in patients with LVSD, HCM and LQTS even in those who do not meet criteria for ICD implantation. These patients may be candidates for a WCD. The development of more sensitive risk calculators to predict SCD is necessary in these patients to help guide treatment.展开更多
In this paper the so-called sudden death effect of entanglement is investigated in a quantum model. The results show that one can expect the resurrection of the original entanglement to occur in a periodic way followi...In this paper the so-called sudden death effect of entanglement is investigated in a quantum model. The results show that one can expect the resurrection of the original entanglement to occur in a periodic way following each sudden death event. The length of the time interval for the zero entanglement depends not only on the degree of entanglement of the initial state but also on the initial state.展开更多
We investigate the properties of entanglement between an isolated atom and a Jaynes-Cummings atom in the presence of transient effects. These effects are due to the modulation of the atom-field coupling whose explicit...We investigate the properties of entanglement between an isolated atom and a Jaynes-Cummings atom in the presence of transient effects. These effects are due to the modulation of the atom-field coupling whose explicit time-dependence is considered for the case of the linear sweep. We show that the sudden death of entanglement can be controlled by the transient effects. These effects can suppress the sudden death of entanglement in time.展开更多
Multi-phase post-mortem CT-angiography （MPMCTA） has the great potential to increase the quality of the postmortem investigation, especially in the area of sudden death; however, its role as routine complement to the...Multi-phase post-mortem CT-angiography （MPMCTA） has the great potential to increase the quality of the postmortem investigation, especially in the area of sudden death; however, its role as routine complement to the pathology toolbox is still questioned as it needs to be further standardized. The aim of this study is to investigate the contribution of MPMCTA in cases of sudden unexplained death in adults and in particular in sudden cardiovascular death. Sixty-eight sudden unexpected deaths of adults were investigated at our institution between 2012 and 2013. Ten cases underwent MPMCTA and autopsy and were included in the study. Before the angiographic step by complete filling of the vascular system, prior to any manipulation of the body, a non-contrast CT-scan was carried out. Image reconstructions were performed on a CT workstation （Vitrea） and two radiologists experienced with post mortem imaging interpreted the MPMCTA findings. In all 10 cases, we could state a good correlation between combination of post-mortem CT and MPMCTA and autopsy procedures, confirming a high diagnostic sensitivity. With this case series we want to illustrate the advantages offered by performing MPMCTA when facing a sudden death, regardless of specific suspicion for acute coronary syndrome or other vascular or ischemic disease.展开更多
Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease that affects the left ventricle. HCM can appear at any age, with the majority of the patients remaining clinically stable. When patients com...Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease that affects the left ventricle. HCM can appear at any age, with the majority of the patients remaining clinically stable. When patients complain of symptoms, these include: dyspnea, dizziness, syncope and angina. HCM can lead to sudden cardiac death (SCD), mainly due to ventricular tachyarrhythmia or ventricular tachycardia. High-risk patients benefit from implantable cardioverter-defibrillators. Left ventricular outflow tract obstruction is not a rare feature in HCM, especially in symptomatic patients, and procedures that abolish that obstruction provide positive and consistent results that can improve longterm survival. HCM is the most common cause of sudden death in young competitive athletes and preparticipation screening programs have to be implemented to avoid these tragic fatalities. The structure of these programs is a matter of large debate. Worldwide registries are necessary to identify the full extent of HCMrelated SCD.展开更多
Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators(ICD), after an efficient risk stratificat...Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators(ICD), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity meaning that a significant number of victims will remain undetectable by this risk stratification approach because they have a preserved left ventricular systolic function. Current risk stratification strategies focus on combinations of non invasive methods like T wave alternans, late potentials, heart rate turbulence, deceleration capacity and others, with invasive methods like the electrophysiologic study. In the presence of an electrically impaired substrate with formed post myocardial infarction fibrotic zones, programmed ventricular stimulation provides important prognostic information for the selection of the patients expected to benefit from an ICD implantation, while due to its high negative predictive value, patients at low risk level may also be detected. Clustering evidence from different research groups and electrophysiologic labs support an electrophysiologic testing guided risk stratification approach for sudden cardiac death.展开更多
An increased cardiovascular morbidity and mortality, including the risk of sudden cardiac death(SCD), has been shown in patients with rheumatoid arthritis(RA). Abnormalities in autonomic markers such as heart rate var...An increased cardiovascular morbidity and mortality, including the risk of sudden cardiac death(SCD), has been shown in patients with rheumatoid arthritis(RA). Abnormalities in autonomic markers such as heart rate variability and ventricular repolarization parameters, such as QTc interval and QT dispersion, have been associated with sudden death in patients with RA. The interplay between these parameters and inflammation that is known to exist with RA is of growing interest. In this article, we review the prevalence and predictors of SCD in patients with RA and describe the potential underlying mechanisms, which may contribute to this. We also review the impact of biologic agents on arrhythmic risk as well as cardiovascular morbidity and mortality.展开更多
Early detection of sudden cardiac death may be used for surviving the life of cardiac patients. In this paper we have investigated an algorithm to detect and predict sudden cardiac death, by processing of heart rate v...Early detection of sudden cardiac death may be used for surviving the life of cardiac patients. In this paper we have investigated an algorithm to detect and predict sudden cardiac death, by processing of heart rate variability signal through the classical and time-frequency methods. At first, one minute of ECG signals, just before the cardiac death event are extracted and used to compute heart rate variability (HRV) signal. Five features in time domain and four features in frequency domain are extracted from the HRV signal and used as classical linear features. Then the Wigner Ville transform is applied to the HRV signal, and 11 extra features in the time-frequency (TF) domain are obtained. In order to improve the performance of classification, the principal component analysis (PCA) is applied to the obtained features vector. Finally a neural network classifier is applied to the reduced features. The obtained results show that the TF method can classify normal and SCD subjects, more efficiently than the classical methods. A MIT-BIH ECG database was used to evaluate the proposed method. The proposed method was implemented using MLP classifier and had 74.36% and 99.16% correct detection rate (accuracy) for classical features and TF method, respectively. Also, the accuracy of the KNN classifier were 73.87% and 96.04%.展开更多
The dynamics of distillability entanglement between qutrit-qutrit systems interacting with a thermal reservoir is investigated in this paper. We discovered an interesting phenomenon that under a thermal reservoir cert...The dynamics of distillability entanglement between qutrit-qutrit systems interacting with a thermal reservoir is investigated in this paper. We discovered an interesting phenomenon that under a thermal reservoir certain initially prepared free=entangled states become bound-entangled states in a finite time, which is called distillability sudden death （DSD）. We use a realignment criterion to measure the nine-dimensional density matrix of the entanglement. Moreover, we analyze some other parameters to investigate the effects to the systems. Explanations are then given.展开更多
Tis paper demonstrates that multipartite Bell-inequality violations can be fully destroyed in a finite time in three- qubit states coupled to a general XY spin-chain with a three-site interaction environment. The Merm...Tis paper demonstrates that multipartite Bell-inequality violations can be fully destroyed in a finite time in three- qubit states coupled to a general XY spin-chain with a three-site interaction environment. The Mermin Ardehali- Belinksii-Klyshko inequality is used to detect the degree of nonlocality, as measured by the extent of their violations. The effects of system-environment couplings, the size of degrees of freedom of the environment and the strength of the three-site interaction on the Bell-inequality violations are given. The results indicate that the Bell-inequality violations of the tripartite states will be completely destroyed by decoherence under certain conditions for the GHZ state. The decoherence-free subspaces of our model are identified and the entanglement of quantum states is also discussed.展开更多
Background: The potential benefits of implantable cardioverter-defibrillator (ICD) therapy in patients with sudden cardiac death (SCD) treated with therapeutic hypothermia (TH) have not been well studied. Methods: Inc...Background: The potential benefits of implantable cardioverter-defibrillator (ICD) therapy in patients with sudden cardiac death (SCD) treated with therapeutic hypothermia (TH) have not been well studied. Methods: Incidence of recurrent non-sustained ventricular arrhythmia, ICD therapy, and death were ascertained in 64 consecutive survivors of SCD due to ventricular fibrillation or tachycardia, who were treated with TH. Follow-up was 31.5 +/- 3.3 months in 41 ICD recipients and 36.3 +/- 3.9 months in 23 patients who did not receive an ICD due to the presence of a reversible cause of cardiac arrest, an acute myocardial infarction in 87%. Results: Combined incidence of ventricular arrhythmia, ICD therapy, or death in patients who underwent ICD placement (21.9%) were similar to overall mortality in the patients who did not receive an ICD (21.7%, p = 0.752). ICD placement was associated with a significant mortality benefit;95.1% survival in ICD recipients vs. 78.3% in the no-ICD group (p = 0.038). Electrocardiographic findings of ST segment elevation on admission were associated with increased event rate in ICD recipients (p = 0.039) and increased mortality in SCD patients who did not receive an ICD (p Conclusions: SCD survivors treated with TH are at increased risk for recurrent arrhythmic events and derive significant mortality benefit from ICD implantation. Increased mortality in revascularized SCD patients with acute coronary syndrome, thought to have a reversible cause of cardiac arrest, calls for prospective trials investigating utility of ICD in this vulnerable patient population.展开更多
BACKGROUND：As the regulators of cytokines, suppressors of cytokine signaling （SOCS） play an important role in the inflammation reaction. Some studies found that SOCS-1 and SOCS-3 were involved in the pathogenesis o...BACKGROUND：As the regulators of cytokines, suppressors of cytokine signaling （SOCS） play an important role in the inflammation reaction. Some studies found that SOCS-1 and SOCS-3 were involved in the pathogenesis of some inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease. But the expressions of SOCS in coronary heart disease have not yet been reported. This study aimed to investigate the expression and clinical significance of SOCS-1 and SOCS-3 in the myocardium of patients with sudden cardiac death （SCD）.METHODS： Myocardial autopsy specimens were collected from 24 patients at the Forensic Medicine Department of Sun Yat-Sen University, Guangzhou, China between 2005 and 2006. Of them, 9 patients had autopsy findings consistent with coronary atherosclerosis （non-myocardial infarction） leading to SCD （non-MI group）, 7 died of acute myocardial infaction （MI group）, and 8 died from traffic accidents and trauma （control group）. The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of the non-MI, MI and control groups were detected using RT-PCR. The levels of SOCS-1 and SOCS-3 proteins were detected using immunohistochemistry. Statistical analyses were performed using SPSS version 13.0 sottware and the data were analyzed by ANOVA.RESULTS： The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the non-MI and MI groups were significantly higher than those in the control group[（0.788±0.101）, （0.741±0.111） vs. （0.436±0.044）, （P〈0.01）; （0.841±0.092）, （0.776±0.070） vs. （0.454±0.076）, （P〈0.01）] respectively. The antibody-positive cells of SOCS-1 protein in the myocardium of the non-MI and MI groups were significantly higher than those in the myocardium of the control group[（320.00±48.48）, （347.14±70.88） vs. （42.50±10.35）, （P〈0.01）] respectively. The antibody-positive cells of SOCS-3 protein in the myocardium of the non-MI and MI groups were significantly higher than those in the myocardium of the control group[（381.11 ±59.25） vs. （40.00±10.69）, （P〈0.01）] and[（332.86±111.91） vs. （40.00±10.69）, （P=0.001）].CONCLUSION： The expressions of SOCS-1 and SOCS-3 in the myocardium of patients with SCD from coronary heart disease are significantly increased and contribute to the pathogenesis of SCD.展开更多
BACKGROUND：There have been numerous reports of sudden cardiac death attributable to the condition of commotio cordis. Primarily, these are reports from the USA. Although three Australian cases have been mentioned in ...BACKGROUND：There have been numerous reports of sudden cardiac death attributable to the condition of commotio cordis. Primarily, these are reports from the USA. Although three Australian cases have been mentioned in the published literature, the present case appears to be the first described Australian case. METHODS：A man was brought to the Emergency Department after sudden collapse while playing cricket. His medical history was suggestive of hitting by a cricket ball while batting. RESULTS：The epidemiology and mechanism of arrhythmia induction in commofio cordis are discussed. The emergency management of commotio cordis is outlined. CONCLUSIONS： Commofio cordis is rare in sports （and Emergency Medicine）. However it has a high mortality rate, and rapid recognition of the condition allows early defibrillation, generally with a good outcome. The improvement of participant care is recommended at community and other sport events.展开更多
文摘Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of the general population,even when the various types are combined.Coronary anomalies are practically challenging when the left and right coronary ostium are not found around their normal positions during coronary angiography with a catheter.If there is atherosclerotic stenosis of the coronary artery with an anomaly and percutaneous coronary intervention(PCI)is required,the suitability of the guiding catheter at the entrance and the adequate back up force of the guiding catheter are issues.The level of PCI risk itself should also be considered on a caseby-case basis.In this case,emission computed tomography in the R-1 subtype single coronary artery proved that ischemia occurred in an area where the coronary artery was not visible to the naked eye.Meticulous follow-up would be crucial,because sudden death may occur in single coronary arteries.To prevent atherosclerosis with full efforts is also important,as the authors indicated admirably.
文摘The role of the autopsy: 1) Whether the death is ascribable to a natural or unnatural cause and when natural, if cardiac or extra-cardiac;2) The nosology of the cardiac diseases and the mechanism of cardiac death, whether arrhythmic or mechanical;3) If the cardiac disease is inherited, screening and counselling of the next of kin is required. About 30% of sudden deaths is ascribable to genetically determined morbid entities, mostly transmissible with the autosomal dominant pattern of inheritance, so that 50% of the first degree relatives are genetically affected (“carriers”) and exposed at risk;4) If toxic or illicit drug abuse was involved.
文摘BACKGROUND Sudden death is unanticipated,non-violent death taking place within the first 24 h after the onset of symptoms.It is a major public health problem worldwide.Moreover,the effects of living at moderate altitude on mortality are poorly understood.AIM To retrospectively report the frequency and the main causes of sudden deaths in relation to total deaths at Asir Central Hospital,2255 m above sea level,in the southern region of Saudi Arabia over a period of 4 years from 2013 to 2016.METHODS The medical records of 1821 deaths were examined and showed 353 cases(19.4%)of sudden death.RESULTS The highest incidence of sudden death was among the elderly(51%),whereas,the lowest was among children and adolescents(6.5%).With regard to gender,the incidence of sudden death was higher in males(54.4%)compared to 45.6% in females.In this study,we found that the most common direct causes of sudden death were cardiovascular diseases(29.2%),respiratory disease(22.7%),infectious disease(12.2%),cancer(9.4%)and hematological diseases(6.2%).With respect to seasonal variation,the highest incidence was during winter(31.32%)followed by summer(25.8%).CONCLUSION The results of this study will help emergency physicians and health care providers to exercise due care to reduce the incidence of sudden death and raise public awareness about the impact of sudden death.
文摘Early repolarization syndrome(ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considerable risk of life- threatening arrhythmias and sudden cardiac death(SCD). Early repolarization characteristics associated with SCD include high-amplitude J-point elevation, horizontal and/or downslopping ST segments, and inferior and/or lateral leads location. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation(0.05 m V vs 0.1 m V) being the main determinants.ERS patients are sporadic and they are at a higher risk of having recurrent cardiac events. Implantable cardioverter-defibrillator implantation and isoproterenol are the suggested therapies in this set of patients. On the other hand, asymptomatic patients with ERS are common and have a better prognosis. The risk stratification in asymptomatic patients with ERS still remains a grey area. This review provides an outline of the up-to-date evidence associated with ERS and the risk of life- threatening arrhythmias. Further prospective studies are required to elucidate the mechanisms of ventricular arrhythmogenesis in patients with ERS.
文摘We report an acute case of a native man from Bolivia suffered from cephalalgia which rapidly worsened and ended in his sudden and unexpected death.Magnetic resonance imaging(MRI) of the brain was obtained.Features demonstrated on brain MRI scan were consistent with a diagnosis of neurocysticercosis(NCC).An autopsy showed the presence of intraventricular Taenia solium(T.solium) cysts which caused blockage of cerebrospinal fluid and secondary hydrocephalus.Due to the increasing travel movements of people neurocysticercosis must be considered as a cause of unexplained sudden death.
基金supported by the National Natural Science Foundation of China (Grant No 60667001)
文摘The influences of dipole-dipole interaction and detuning on the entanglement between two atoms with different initial tripartite entangled W-like states in the Tavis Cummings model have been investigated by means of Wootters＇ concurrence, respectively. The results show that the entanglement between the two atoms can be enhanced via appropriately tuning the strength of dipole-dipole interaction of two atoms or the detunings between atom and cavity, and the so-called sudden death effect can he weakened simultaneously.
文摘Most heart failure （HF） related mortality is due to sudden cardiac death （SCD） and worsening HF, particularly in the case of reduced ejection fraction. Predicting and preventing SCD is an important goal but most works include no or few patients with advanced age, and the prevention of SCD in elderly patients with HF is still controversial. A recent reduction in the annual rate of SCD has been recently described but it is not clear if this is also true in advanced age patients. Age is associated with SCD, although physicians frequently have the perception that elderly patients with HF die mainly of pump failure, underestimating the importance of SCD. Other clinical variables that have been associated to SCD are symptoms, New York Heart Association functional class, ischemic cause, and comorbidities （chronic obstructive pulmonary disease, renal dysfunction and diabetes）. Some test results that should also be considered are left ventricular ejection fraction and diameters, natriuretic peptides, non-sustained ventricular tachycardias and autonomic abnormalities. The combination of all these markers is probably the best option to predict SCD. Different risk scores have been described and, although there are no specific ones for elderly populations, most include age as a risk predictor and some were developed in populations with mean age 〉 65 years. Finally, it is important to stress that these scores should be able to predict any type of SCD as, although most are due to tachyarrhythmias, bradyarrhythmias also play a role, particularly in the case of the elderly.
文摘BACKGROUND There is a high risk for sudden cardiac death(SCD) in certain patient groups that would not meet criteria for implantable cardioverter defibrillator(ICD) therapy.In conditions such as hypertrophic cardiomyopathy(HCM) there are clear risk scores that help define patients who are high risk for SCD and would benefit from ICD therapy. There are however many areas of uncertainty such as certain patients post myocardial infarction(MI). These patients are high risk for SCD but there is no clear tool for risk stratifying such patients.AIM To assess risk factors for sudden cardiac death in major cardiac disorders and to help select patients who might benefit from Wearable cardiac defibrillators(WCD).METHODS A literature search was performed looking for risk factors for SCD in patients post-MI, patients with left ventricular systolic dysfunction(LVSD), HCM, long QT syndrome(LQTS). There were 41 studies included and risk factors and the relative risks for SCD were compiled in table form.RESULTS We extracted data on relative risk for SCD of specific variables such as age,gender, ejection fraction. The greatest risk factors for SCD in post MI patients was the presence of diabetes [Hazard ratio(HR) 1.90-3.80], in patient with LVSD was ventricular tachycardia(Relative risk 3.50), in LQTS was a prolonged QTc(HR36.53) and in patients with HCM was LVH greater than 20 mm(HR 3.10). A proportion of patients currently not suitable for ICD might benefit from a WCDCONCLUSION There is a very high risk of SCD post MI, in patients with LVSD, HCM and LQTS even in those who do not meet criteria for ICD implantation. These patients may be candidates for a WCD. The development of more sensitive risk calculators to predict SCD is necessary in these patients to help guide treatment.
基金Project supported by National Natural Science Foundation of China （Grant No 10604053）.
文摘In this paper the so-called sudden death effect of entanglement is investigated in a quantum model. The results show that one can expect the resurrection of the original entanglement to occur in a periodic way following each sudden death event. The length of the time interval for the zero entanglement depends not only on the degree of entanglement of the initial state but also on the initial state.
文摘We investigate the properties of entanglement between an isolated atom and a Jaynes-Cummings atom in the presence of transient effects. These effects are due to the modulation of the atom-field coupling whose explicit time-dependence is considered for the case of the linear sweep. We show that the sudden death of entanglement can be controlled by the transient effects. These effects can suppress the sudden death of entanglement in time.
文摘Multi-phase post-mortem CT-angiography （MPMCTA） has the great potential to increase the quality of the postmortem investigation, especially in the area of sudden death; however, its role as routine complement to the pathology toolbox is still questioned as it needs to be further standardized. The aim of this study is to investigate the contribution of MPMCTA in cases of sudden unexplained death in adults and in particular in sudden cardiovascular death. Sixty-eight sudden unexpected deaths of adults were investigated at our institution between 2012 and 2013. Ten cases underwent MPMCTA and autopsy and were included in the study. Before the angiographic step by complete filling of the vascular system, prior to any manipulation of the body, a non-contrast CT-scan was carried out. Image reconstructions were performed on a CT workstation （Vitrea） and two radiologists experienced with post mortem imaging interpreted the MPMCTA findings. In all 10 cases, we could state a good correlation between combination of post-mortem CT and MPMCTA and autopsy procedures, confirming a high diagnostic sensitivity. With this case series we want to illustrate the advantages offered by performing MPMCTA when facing a sudden death, regardless of specific suspicion for acute coronary syndrome or other vascular or ischemic disease.
文摘Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease that affects the left ventricle. HCM can appear at any age, with the majority of the patients remaining clinically stable. When patients complain of symptoms, these include: dyspnea, dizziness, syncope and angina. HCM can lead to sudden cardiac death (SCD), mainly due to ventricular tachyarrhythmia or ventricular tachycardia. High-risk patients benefit from implantable cardioverter-defibrillators. Left ventricular outflow tract obstruction is not a rare feature in HCM, especially in symptomatic patients, and procedures that abolish that obstruction provide positive and consistent results that can improve longterm survival. HCM is the most common cause of sudden death in young competitive athletes and preparticipation screening programs have to be implemented to avoid these tragic fatalities. The structure of these programs is a matter of large debate. Worldwide registries are necessary to identify the full extent of HCMrelated SCD.
文摘Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators(ICD), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity meaning that a significant number of victims will remain undetectable by this risk stratification approach because they have a preserved left ventricular systolic function. Current risk stratification strategies focus on combinations of non invasive methods like T wave alternans, late potentials, heart rate turbulence, deceleration capacity and others, with invasive methods like the electrophysiologic study. In the presence of an electrically impaired substrate with formed post myocardial infarction fibrotic zones, programmed ventricular stimulation provides important prognostic information for the selection of the patients expected to benefit from an ICD implantation, while due to its high negative predictive value, patients at low risk level may also be detected. Clustering evidence from different research groups and electrophysiologic labs support an electrophysiologic testing guided risk stratification approach for sudden cardiac death.
文摘An increased cardiovascular morbidity and mortality, including the risk of sudden cardiac death(SCD), has been shown in patients with rheumatoid arthritis(RA). Abnormalities in autonomic markers such as heart rate variability and ventricular repolarization parameters, such as QTc interval and QT dispersion, have been associated with sudden death in patients with RA. The interplay between these parameters and inflammation that is known to exist with RA is of growing interest. In this article, we review the prevalence and predictors of SCD in patients with RA and describe the potential underlying mechanisms, which may contribute to this. We also review the impact of biologic agents on arrhythmic risk as well as cardiovascular morbidity and mortality.
文摘Early detection of sudden cardiac death may be used for surviving the life of cardiac patients. In this paper we have investigated an algorithm to detect and predict sudden cardiac death, by processing of heart rate variability signal through the classical and time-frequency methods. At first, one minute of ECG signals, just before the cardiac death event are extracted and used to compute heart rate variability (HRV) signal. Five features in time domain and four features in frequency domain are extracted from the HRV signal and used as classical linear features. Then the Wigner Ville transform is applied to the HRV signal, and 11 extra features in the time-frequency (TF) domain are obtained. In order to improve the performance of classification, the principal component analysis (PCA) is applied to the obtained features vector. Finally a neural network classifier is applied to the reduced features. The obtained results show that the TF method can classify normal and SCD subjects, more efficiently than the classical methods. A MIT-BIH ECG database was used to evaluate the proposed method. The proposed method was implemented using MLP classifier and had 74.36% and 99.16% correct detection rate (accuracy) for classical features and TF method, respectively. Also, the accuracy of the KNN classifier were 73.87% and 96.04%.
基金Project supported by the National Natural Science Foundation of China (Grant No. 11074072)
文摘The dynamics of distillability entanglement between qutrit-qutrit systems interacting with a thermal reservoir is investigated in this paper. We discovered an interesting phenomenon that under a thermal reservoir certain initially prepared free=entangled states become bound-entangled states in a finite time, which is called distillability sudden death （DSD）. We use a realignment criterion to measure the nine-dimensional density matrix of the entanglement. Moreover, we analyze some other parameters to investigate the effects to the systems. Explanations are then given.
基金Project supported by the National Natural Science Foundation of China (Grant No.11004050)the Scientific Research Fund of Hunan Provincial Education Department of China (Grant Nos.+3 种基金 09A013 and 10B013)the Science and Technology Research Foundation of Hunan Province of China (Grant No.2010FJ4120)the Excellent Talents Program of Hengyang Normal University of China (Grant No.2010YCJH01)the Science Foundation of Hengyang Normal University of China (Grant Nos.10A46 and 10B69)
文摘Tis paper demonstrates that multipartite Bell-inequality violations can be fully destroyed in a finite time in three- qubit states coupled to a general XY spin-chain with a three-site interaction environment. The Mermin Ardehali- Belinksii-Klyshko inequality is used to detect the degree of nonlocality, as measured by the extent of their violations. The effects of system-environment couplings, the size of degrees of freedom of the environment and the strength of the three-site interaction on the Bell-inequality violations are given. The results indicate that the Bell-inequality violations of the tripartite states will be completely destroyed by decoherence under certain conditions for the GHZ state. The decoherence-free subspaces of our model are identified and the entanglement of quantum states is also discussed.
文摘Background: The potential benefits of implantable cardioverter-defibrillator (ICD) therapy in patients with sudden cardiac death (SCD) treated with therapeutic hypothermia (TH) have not been well studied. Methods: Incidence of recurrent non-sustained ventricular arrhythmia, ICD therapy, and death were ascertained in 64 consecutive survivors of SCD due to ventricular fibrillation or tachycardia, who were treated with TH. Follow-up was 31.5 +/- 3.3 months in 41 ICD recipients and 36.3 +/- 3.9 months in 23 patients who did not receive an ICD due to the presence of a reversible cause of cardiac arrest, an acute myocardial infarction in 87%. Results: Combined incidence of ventricular arrhythmia, ICD therapy, or death in patients who underwent ICD placement (21.9%) were similar to overall mortality in the patients who did not receive an ICD (21.7%, p = 0.752). ICD placement was associated with a significant mortality benefit;95.1% survival in ICD recipients vs. 78.3% in the no-ICD group (p = 0.038). Electrocardiographic findings of ST segment elevation on admission were associated with increased event rate in ICD recipients (p = 0.039) and increased mortality in SCD patients who did not receive an ICD (p Conclusions: SCD survivors treated with TH are at increased risk for recurrent arrhythmic events and derive significant mortality benefit from ICD implantation. Increased mortality in revascularized SCD patients with acute coronary syndrome, thought to have a reversible cause of cardiac arrest, calls for prospective trials investigating utility of ICD in this vulnerable patient population.
文摘BACKGROUND：As the regulators of cytokines, suppressors of cytokine signaling （SOCS） play an important role in the inflammation reaction. Some studies found that SOCS-1 and SOCS-3 were involved in the pathogenesis of some inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease. But the expressions of SOCS in coronary heart disease have not yet been reported. This study aimed to investigate the expression and clinical significance of SOCS-1 and SOCS-3 in the myocardium of patients with sudden cardiac death （SCD）.METHODS： Myocardial autopsy specimens were collected from 24 patients at the Forensic Medicine Department of Sun Yat-Sen University, Guangzhou, China between 2005 and 2006. Of them, 9 patients had autopsy findings consistent with coronary atherosclerosis （non-myocardial infarction） leading to SCD （non-MI group）, 7 died of acute myocardial infaction （MI group）, and 8 died from traffic accidents and trauma （control group）. The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of the non-MI, MI and control groups were detected using RT-PCR. The levels of SOCS-1 and SOCS-3 proteins were detected using immunohistochemistry. Statistical analyses were performed using SPSS version 13.0 sottware and the data were analyzed by ANOVA.RESULTS： The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the non-MI and MI groups were significantly higher than those in the control group[（0.788±0.101）, （0.741±0.111） vs. （0.436±0.044）, （P〈0.01）; （0.841±0.092）, （0.776±0.070） vs. （0.454±0.076）, （P〈0.01）] respectively. The antibody-positive cells of SOCS-1 protein in the myocardium of the non-MI and MI groups were significantly higher than those in the myocardium of the control group[（320.00±48.48）, （347.14±70.88） vs. （42.50±10.35）, （P〈0.01）] respectively. The antibody-positive cells of SOCS-3 protein in the myocardium of the non-MI and MI groups were significantly higher than those in the myocardium of the control group[（381.11 ±59.25） vs. （40.00±10.69）, （P〈0.01）] and[（332.86±111.91） vs. （40.00±10.69）, （P=0.001）].CONCLUSION： The expressions of SOCS-1 and SOCS-3 in the myocardium of patients with SCD from coronary heart disease are significantly increased and contribute to the pathogenesis of SCD.
文摘BACKGROUND：There have been numerous reports of sudden cardiac death attributable to the condition of commotio cordis. Primarily, these are reports from the USA. Although three Australian cases have been mentioned in the published literature, the present case appears to be the first described Australian case. METHODS：A man was brought to the Emergency Department after sudden collapse while playing cricket. His medical history was suggestive of hitting by a cricket ball while batting. RESULTS：The epidemiology and mechanism of arrhythmia induction in commofio cordis are discussed. The emergency management of commotio cordis is outlined. CONCLUSIONS： Commofio cordis is rare in sports （and Emergency Medicine）. However it has a high mortality rate, and rapid recognition of the condition allows early defibrillation, generally with a good outcome. The improvement of participant care is recommended at community and other sport events.
