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Prevalence of Atrial Fibrillation as a Risk Factor in Patients after Circulatory Arrest for Ventricular Fibrillation
Šmíd, Jiří ; Vančura, Vlastimil (advisor) ; Mayer, Otto (referee) ; Skalická, Hana (referee)
Atrial fibrillation is the most common arrhythmia occurring in the adult population. Sudden cardiac death is one of the most common causes of cardiovascular death, accounting for up to 50% of all cardiovascular deaths. A number of trials have investigated the association between atrial fibrillation and other heart diseases, including sudden cardiac death. Atrial fibrillation is increasing in prevalence and incidence in the population and is associated with higher morbidity and mortality in patients. The pathophysiological mechanisms in atrial fibrillation are very complex and are linked to a number of other diseases. With these diseases they may share a common background and may interact together. A higher incidence of atrial fibrillation is described especially in patients with coronary artery disease, heart failure, and arterial hypertension. Increased mortality or higher incidence of ventricular arrhythmias, including ventricular fibrillation, has been described in studies in ICD carriers, but also in the general population, where atrial fibrillation has been shown to be an independent risk factor associated with up to a 3-fold increased risk of AF. This paper want to provide a comprehensive picture of the relationship between atrial fibrillation and sudden cardiac death. It provides information...
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Study of morphological and functional alternations of autonomic cardiac and vessels innervation and its causes in chronic diseases
Mistrová, Eliška ; Chottová Dvořáková, Magdaléna (advisor) ; Vančura, Vlastimil (referee) ; Adamcová, Michaela (referee)
Within the span of few decades, there has been a significant increase in diabetes mellitus and chronic stress in developed countries, such as the Czech Republic. These conditions have a significant negative effect on physical and mental health. Repeated and long-term exposure to raised levels of glucose, overactivity of the sympathetic nervous system and the increase in plasma levels of stress hormones affects most of the organs in the body, including the heart. The cardiovascular system is regulated by a broad number of neurotransmitters, hormones and neuropeptides. Alterations in the innervation of the cardiovascular system, as a result of both diseases, can affect its physiological functions. The present thesis focuses not only on the role of the classic, but primarily on the peptidergic innervation of the heart. The aim was to contribute to the explanation of the impact of neuropeptides and their shared receptor systems on the genesis and the development of heart damage due to diabetes mellitus and/or exposure to stressors. Knowledge of the physiological characteristics of neuropeptides and their involvement in the pathogenesis of both diseases and related complications could be helpful in determining the optimal treatment method or alternatively allow us to use the cardio protective effect of...
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Use of spectral analysis for the treatment of paroxysmal or persistent atrial fibrillation
Veselá, Jana ; Rosina, Jozef (advisor) ; Hána, Karel (referee) ; Vančura, Vlastimil (referee)
Introduction: Atrial fibrillation is most common sustained cardiac arrhythmia characterized by rapid, unorganized atrial electrical activation. Its incidence in- creases with age and comorbidities. The presence of AF has been demonstrated to be independently associated with increased morbidity and mortality. The tre- atment of AF remains challenging. The aim of the present work is to use the analysis of heart rate variability in prediction of AF occurrence, and during tre- atment procedures of AF for better understanding of physiology of AF. Results of time-, frequency- and non-linear analyses were used in two present studies. The first study was study of patients undergoing hybrid ablation of atrial fib- rillation. Hybrid ablation consists of surgical epicardial thoracoscopic procedure, followed by electrophysiological catheter ablation. The second part is done 1-3 months after the surgical part. The aim was to establish the coincidental damage of ganglionated plex during the first, surgical procedure, using the analysis of heart rate variability during the electrophysiological procedure. The aim of the second study was the prediction of post-operative AF in pa- tients undergoing open-chest cardiac surgery, using the pre-operative heart rate variability analysis. Methods: Study 1: Patients with...
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Cardiac Pacing Hemodynamics
Ulč, Ivan ; Vančura, Vlastimil (advisor) ; Mayer, Otto (referee) ; Ošťádal, Petr (referee)
(EN) Cardiac pacing is the only established treatment method of bradyarrhythmias. Most patients indicated for cardiac pacing need to have one lead implanted in the right ventricle. Activation sequence of the left ventricle during right ventricular pacing resembles the activation sequence in patients with left bundle branch block. When the proportion of paced cycles in the right ventricle reaches significant level, 10-20 % of patients develop pacing induced cardiomyopathy. Direct causal relationship with right ventricular pacing is supported by the improvement of subjective symptoms and objective parameters of the left ventricular function after the upgrade to cardiac resynchronization therapy (CRT). In patients with preexisting heart failure with reduced left ventricular ejection fraction, the best prevention of heart failure worsening is to implant CRT when antibradycardic indication to the right ventricular pacing occurs. In patients with normal or near normal left ventricular function, the situation is more problematic. CRT implantation in all patients with supposed high proportion of right ventricular paced cycles is not only more expensive, but also imposes higher demands on implanting centers and increases the occurrence of immediate as well as long-term complications which do not outweigh...
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Study of morphological and functional alternations of autonomic cardiac and vessels innervation and its causes in chronic diseases
Mistrová, Eliška ; Chottová Dvořáková, Magdaléna (advisor) ; Vančura, Vlastimil (referee) ; Adamcová, Michaela (referee)
Within the span of few decades, there has been a significant increase in diabetes mellitus and chronic stress in developed countries, such as the Czech Republic. These conditions have a significant negative effect on physical and mental health. Repeated and long-term exposure to raised levels of glucose, overactivity of the sympathetic nervous system and the increase in plasma levels of stress hormones affects most of the organs in the body, including the heart. The cardiovascular system is regulated by a broad number of neurotransmitters, hormones and neuropeptides. Alterations in the innervation of the cardiovascular system, as a result of both diseases, can affect its physiological functions. The present thesis focuses not only on the role of the classic, but primarily on the peptidergic innervation of the heart. The aim was to contribute to the explanation of the impact of neuropeptides and their shared receptor systems on the genesis and the development of heart damage due to diabetes mellitus and/or exposure to stressors. Knowledge of the physiological characteristics of neuropeptides and their involvement in the pathogenesis of both diseases and related complications could be helpful in determining the optimal treatment method or alternatively allow us to use the cardio protective effect of...
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