Pregnancy in Seronegative Myasthenia Gravis: A Single-Center Case Series.

Introduction: The course of double-seronegative myasthenia gravis (DSNMG) during and after pregnancy has not been well described.

Objective: To assess the course of DSNMG during pregnancy and within 6 months postpartum.

Methods: A retrospective cohort study of women with DSNMG seen in the Duke Myasthenia gravis (MG) Clinic after 2003.

Pregnancy in MuSK-positive myasthenia gravis: A single-center case series.

Introduction/aims: Myasthenia gravis (MG) with muscle-specific tyrosine kinase (MuSK) antibodies (MMG) is predominantly seen in women of childbearing age. Our objective in this study was to describe the course of MMG during pregnancy and within 6 months postpartum, and to document any effect on fetal health.

Methods: A retrospective review was performed of medical records of patients with MMG seen in the Duke Myasthenia Gravis Clinic from 2003 to 2022.

Initial antihypertensive agent effects on acute blood pressure after intracerebral haemorrhage.

Introduction: Current guidelines recommend blood pressure (BP) lowering in patients after acute intracerebral haemorrhage (ICH) without guidance on initial choice of antihypertensive class. This study sought to determine if initial antihypertensive class differentially effects acute BP lowering in a large multiethnic ICH cohort.

Methods: Subjects enrolled in the Ethnic/Racial Variations in ICH study between August 2010 and August 2017 with elevated admission BP and who received labetalol, nicardipine or hydralazine monotherapy as initial antihypertensive were analysed.

Delayed occurrence of an accelerated idioventricular rhythm with alternating bundle branch block after myocardial infarction as predictor of sudden cardiac arrest: a case report.

Background: Accelerated idioventricular rhythm (AIVR) is known as reperfusion arrhythmia in the setting of acute myocardial infarction (AMI). In healthy individuals, it is usually considered to be benign. Alternating bundle branch block (ABBB) often progresses to complete atrioventricular block requiring permanent pacemaker implantation.

Anti-Neurofascin-Associated Nephrotic-Range Proteinuria in Chronic Inflammatory Demyelinating Polyneuropathy.

There are few case reports of concomitant chronic inflammatory demyelinating polyneuropathy (CIDP) and focal segmental glomerulosclerosis. A rare autoantibody to a neuronal and podocyte structural component, neurofascin, may be contributory. A Black man in his 40s presented with worsening polyneuropathy requiring mechanical ventilation and initially acute inflammatory demyelinating polyneuropathy was diagnosed.

Combining Imaging and Genetics to Predict Recurrence of Anticoagulation-Associated Intracerebral Hemorrhage.

Background And Purpose: For survivors of oral anticoagulation therapy (OAT)-associated intracerebral hemorrhage (OAT-ICH) who are at high risk for thromboembolism, the benefits of OAT resumption must be weighed against increased risk of recurrent hemorrhagic stroke. The ε2/ε4 alleles of the () gene, MRI-defined cortical superficial siderosis, and cerebral microbleeds are the most potent risk factors for recurrent ICH. We sought to determine whether combining MRI markers and genotype could have clinical impact by identifying ICH survivors in whom the risks of OAT resumption are highest.

Novel collaborative cardiology and maternal fetal medicine practice - experience at the heart and pregnancy program.

Purpose: The Heart and Pregnancy Program (HPP) was created to evaluate and manage pregnant women with cardiac conditions simultaneously by cardiology and maternal-fetal medicine (MFM). The objective of our study was to describe the experience at this multidisciplinary program.

Methods: This is a retrospective review of women managed at HPP for over 4.

Feasibility of entirely subcutaneous ICD™ systems in patients with coronary artery disease.

Background: The subcutaneous ICD (S-ICD™) is an important advance in device therapy for the prevention of sudden cardiac death (SCD). Although current guidelines recommend S-ICD™ use, long-term data are still limited, especially in subgroups. Among several cardiac diseases that prone to SCD, coronary artery disease (CAD) carries several peculiarities that may hamper S-ICD™ therapy in this cohort.

Device updates successfully reduce T‑wave oversensing and inappropriate shocks in subcutaneous ICD patients.

Aims: To analyse the impact of device and software updates on the prevention of T‑wave oversensing (TWOS) and inappropriate shocks (IS) in subcutaneous ICD (S-ICD) patients.

Background: TWOS is a feared complication after implantation. It may lead to harmful IS.

Extended ECG monitoring with an implantable loop recorder in patients with cryptogenic stroke: time schedule, reasons for explantation and incidental findings (results from the TRACK-AF trial).

Background: Implantable loop recorders (ILR) may be used to detect occult atrial fibrillation (AF) in patients with cryptogenic stroke. At present, there has been no description on the incidental findings of stored episodes in these patients. Furthermore, no standard practice has been established with respect to the duration of continued ECG monitoring in these patients.

Follow-up of the first patients with a totally subcutaneous ICD in Germany from implantation till battery depletion.

Background: The subcutaneous ICD is a promising treatment option in patients at risk for sudden cardiac death. Approved in 2009, the first S-ICD in Germany was implanted in June 2010. Although large prospective registry studies have shown safety and efficacy of the system, there is a lack of long-term data with regard to battery longevity of the S-ICD.

Long-term single-center experience of defibrillator therapy in children and adolescents.

Background: Implantable cardioverter-defibrillator (ICD) systems are established therapy for prevention of sudden cardiac death. Long-term data on ICD systems in children and adolescents is rare. The present study displays a long-term single-center follow-up of children and adolescents with ICD systems.

Change of sensing vector in the subcutaneous ICD during follow-up and after device replacement.

Background: The subcutaneous implantable cardioverter defibrillator (S-ICD) has been established as a valuable alternative to transvenous ICD for prevention of sudden cardiac death. The system automatically chooses the optimal sensing vector. However, during follow-up and especially after device replacement we observed a change of the suggested sensing vector in automatic setup.

Long-Term Experience With the Subcutaneous Implantable Cardioverter-Defibrillator in Teenagers and Young Adults.

Objectives: This study sought to examine the use of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in teenagers and young adults.

Background: The S-ICD is an important advance in device therapy for the prevention of sudden cardiac death. Although guidelines recommend S-ICD use, long-term data are still limited, especially in subgroups.

Postoperative ergometry-guided programming does not prevent T-wave oversensing and inappropriate shocks in S-ICD patients.

Background: T-wave oversensing (TWOS) is a feared complication after subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation, potentially leading to inappropriate shocks (IS) with tremendous impact on quality of life.

Hypothesis: Postoperative ergometry facilitates primary and secondary prevention of TWOS or other potential causes of IS and optimizes S-ICD programming.

Methods: We analyze the impact of ergometry guided-programming (EMGP) on primary and secondary prevention of TWOS/IS in S-ICD patients, we screened 146 patients implanted in our center (2010-2016) for the incidence of TWOS/IS during postoperative ergometry.

[Management of inappropriate shocks/T-wave-oversensing in S-ICD®-patients].

Inappropriate shocks are a feared complication after implantable cardioverter-defibrillator (ICD) implantation and have a tremendous impact on quality of life. Inappropriate shocks in patients with subcutaneous ICD (S-ICD®, Boston Scientific, Marlborough, MA, USA) have various underlying causes. This review summarizes the current literature on this topic and lists possible treatment options.

Sensitive Detection of Atrial Fibrillation in Acute Stroke Patients by Short-Term Bedside Electrocardiography Monitoring Software Analysis.

Background: Atrial fibrillation (AF) is an important cause of stroke. Continuous electrocardiography (ECG) monitoring with software-based analysis algorithms has been suggested to enhance the AF detection rate. We investigated the ability of stroke risk analysis (SRA) in the detection of AF in acute stroke patients.

Right versus left parasternal electrode position in the entirely subcutaneous ICD.

Objectives: The subcutaneous implantable cardioverter defibrillator (S-ICD) has been established as an alternative to conventional transvenous ICD for the prevention of sudden cardiac death. Initial studies have shown safety and efficacy of the system with a left parasternal (LP) electrode. However, several case studies reported a right parasternal (RP) position.

Refinement of detecting atrial fibrillation in stroke patients: results from the TRACK-AF Study.

Background And Purpose: Detection of occult atrial fibrillation (AF) is crucial for optimal secondary prevention in stroke patients. The AF detection rate was determined by implantable cardiac monitor (ICM) and compared to the prediction rate of the probability of incident AF by software based analysis of a continuously monitored electrocardiogram at follow-up (stroke risk analysis, SRA); an optimized AF detection algorithm is proposed by combining both tools.

Methods: In a monocentric prospective study 105 out of 389 patients with cryptogenic stroke despite extensive diagnostic workup were investigated with two additional cardiac monitoring tools: (a) 20 months' monitoring by ICM and (b) SRA during hospitalization at the stroke unit.

Posttraumatic stress and quality of life with the totally subcutaneous compared to conventional cardioverter-defibrillator systems.

Background: For prevention of sudden cardiac death, the transvenously implantable cardioverter-defibrillator therapy (tv-ICD) is well accepted. The subcutaneous system (S-ICD) is promising in terms of reducing ICD complications. Nevertheless, the impact of the novel generator position on patients' quality of life (QoL) is yet unknown.

Long-time "real-life" performance of the subcutaneous ICD in patients with electrical heart disease or idiopathic ventricular fibrillation.

Backgrounds: The totally subcutaneous implantable defibrillator (S-ICD) has been designed as a new alternative to conventional implantable defibrillators. This system is especially attractive for young patients. However, long-term experience is not yet available.

Intraoperative Defibrillation Testing of Subcutaneous Implantable Cardioverter-Defibrillator Systems-A Simple Issue?

Background: The results of the recently published randomized SIMPLE trial question the role of routine intraoperative defibrillation testing. However, testing is still recommended during implantation of the entirely subcutaneous implantable cardioverter-defibrillator (S-ICD) system. To address the question of whether defibrillation testing in S-ICD systems is still necessary, we analyzed the data of a large, standard-of-care prospective single-center S-ICD registry.

IFRD1 gene polymorphisms are associated with nasal polyposis in cystic fibrosis patients.

Background: Nasal polyposis (NP) is an inflammatory disease of the upper nasal airways frequently present in CF patients. Interferon-Related Developmental Regulator 1 (IFRD1) gene was reported as a possible modifier of CF lung disease severity. Three IFRD1 SNPs were analyzed to investigate a possible effect on the development of NP in CF patients.