Laparoscopic repositioning of a dislocated pacemaker into the rectovesical pouch.

Dislocation of the epicardial pacemaker into the peritoneal cavity is an uncommon but potentially life-threatening complication. We report a case of a 74 year old with an abdominally implanted epicardial pacemaker that migrated through the peritoneum to the excavatio rectovesicalis. The laparoscopic approach was chosen because of the increased risks of perioperative morbidity and decreased survival.

Ambulatory respiratory rate trends identify patients at higher risk of worsening heart failure in implantable cardioverter defibrillator and biventricular device recipients: a novel ambulatory parameter to optimize heart failure management.

Purpose: Respiratory distress is the primary driver for heart failure (HF) hospitalization. Implantable pacemakers and defibrillators are capable of monitoring respiratory rate (RR) in ambulatory HF patients. We investigated changes in RR prior to HF hospitalizations and its near-term risk stratification power.

Three-dimensional rotational venography of the coronary sinus tree facilitates left ventricular lead implantation for CRT.

Background: Precise knowledge of the coronary sinus (CS) tree anatomy facilitates catheter-based intubation of the CS, target vein and lead selection and reduces the need for fluoroscopy, contrast medium and overall procedure time in cardiac resynchronization therapy (CRT). Three-dimensional rotational angiography (3DRA) provides a new means of multiangle imaging of the CS tree that can be applied preoperatively.

Purpose And Methods: Our study aims to investigate the feasibility of preoperative rotational CS venography and its implications for CRT device implantation procedures.

Phrenic nerve stimulation in CRT patients and benefits of electronic lead repositioning: the ERACE trial.

Purpose: Despite novel left ventricular (LV) lead technologies, phrenic nerve stimulation (PNS) remains an adverse effect observed in many patients with cardiac resynchronization therapy (CRT). Beyond anatomic repositioning, modern CRT devices allow avoidance of PNS also by software-based adaption of the pacing configuration. The Electronic Repositioning With Acuity and Easytrak Leads study evaluated the incidence of PNS in a CRT population and examined how often LV lead relocation can be avoided by "electronic repositioning" (ER).

Electromagnetic interference of avalanche transceivers with cardiac pacemakers and implantable cardioverter defibrillators.

Background: Avalanche transceivers are essentials tools in locating persons who were buried by an avalanche. In the past few years, avalanche transceivers have become widely available and affordable, but it is largely unknown whether they are a source of electromagnetic interference for implanted cardiac devices. We aimed to determine the potential interaction between avalanche transceivers and pacemakers or implantable cardioverter defibrillators (ICDs).

Combined use of three-dimensional rotational angiogram of left atrium and circular multi-electrode ablation catheter for pulmonary vein isolation.

Background: A novel circular pulmonary vein ablation catheter (PVAC) has been introduced for pulmonary vein isolation (PVI). Accurate delineation of left atrium-pulmonary vein (LA-PV) anatomy is important for this technique. The aim of this study was to test whether the 3-dimensional rotational angiography (3D RTA) of the left atrium can facilitate PVI using PVAC technique.

Chronic CRP-exposure inhibits VEGF-induced endothelial cell migration.

Unlabelled: C-reactive protein (CRP) is a pluripotent mediator of inflammation and is present at sites of vascular injury and in atherosclerotic lesions. CRP stimulates endothelial cell adhesion molecule expression and monocyte migration, thereby contributing to the development and progression of vascular lesion formation. In addition, chronic exposure to CRP is known to inhibit angiogenesis and endothelial cell (EC) proliferation.

Performance evaluation of a right atrial automatic capture verification algorithm using two different sensing configurations.

Background: This acute data collection study evaluated the performance of a right atrial (RA) automatic capture verification (ACV) algorithm based on evoked response sensing from two electrode configurations during independent unipolar pacing.

Methods: RA automatic threshold tests were conducted. Evoked response signals were simultaneously recorded between the RA(Ring) electrode and an empty pacemaker housing electrode (RA(Ring)-->Can) and the electrically isolated Indifferent header electrode (RA(Ring)-->Ind).

Rapid ventricular pacing to optimize rotational angiography in atrial fibrillation ablation.

Background: Conventional pulmonary vein (PV) angiography cannot precisely delineate the left atrium (LA)-PV anatomy, which is essential for the ablation of atrial fibrillation (AF). The aim of the study was to test the feasibility of a novel method of rotational angiography for the AF ablation.

Methods And Results: Forty-one patients were enrolled in this study.

Clinical evaluation of two different evoked response sensing methods for automatic capture detection in the left ventricle.

Background: This acute feasibility study compared two different automatic capture detection methodologies, the reduced coupling capacitor (RCC) and the independent pace/sense (IPS) methods, for the left ventricle (LV).

Methods: LV threshold tests were performed in DDD mode, with LV-only and bi-ventricular (BiV) pacing using an external cardiac resynchronization therapy (CRT) defibrillator. Evoked response (ER) signals from LV leads were recorded using the LV(Tip) (LV(Tip)-->Can) and LV(Ring) (LV(Ring)-->Can) to empty pulse generator (Can) housing sensing vectors to evaluate the two methodologies.

Endoproteolytic activation of alpha(v) integrin by proprotein convertase PC5 is required for vascular smooth muscle cell adhesion to vitronectin and integrin-dependent signaling.

Background: Integrins play an important role for vascular smooth muscle cell (VSMC) migration during the development of atherosclerosis and restenosis. Integrin alpha(v)-subunit consists of disulphide-bound 125-kDa heavy and 25-kDa light chains, which are generated by endoproteolytic cleavage. This type of activation requires the presence of suitable proprotein convertases (PCs).

Coordinated regulation and colocalization of alphav integrin and its activating enzyme proprotein convertase PC5 in vivo.

Integrin alphav is involved in intracellular-extracellular signaling important for cytoskeleton alterations and control of cell movement. In vitro experiments indicate that the integrin alphav-subunit undergoes post-translational endoproteolytic cleavage. This type of activation requires the presence of suitable kexin/subtilisin-like proprotein convertases.

LPS regulate ERK1/2-dependent signaling in cardiac fibroblasts via PKC-mediated MKP-1 induction.

Activation of MAPK pathways by angiotensin II (Ang II) is important for cardiac fibroblast (CFB) proliferation and migration. Activity of MAP-kinases is closely controlled by a group of dual-specific MAP kinase phosphatases (MKPs). Lipopolysaccharides (LPS) and cytokines are elevated in patients with heart failure and may contribute to disease progression.

Statins regulate alpha2beta1-integrin expression and collagen I-dependent functions in human vascular smooth muscle cells.

HMG-CoA reductase inhibitors have direct vascular effects that contribute to plaque stability. In the current study, the authors demonstrate that the HMG-CoA reductase inhibitors atorvastatin and pravastatin augment the adhesion of human (HSMCs) and rat aortic smooth muscle cells (RASMCs) to collagen I via induction of alpha2beta1-integrin receptors. Atorvastatin (0.

PPARalpha inhibits TGF-beta-induced beta5 integrin transcription in vascular smooth muscle cells by interacting with Smad4.

Integrins play an important role in vascular smooth muscle cell (VSMC) migration, a crucial event in the development of restenosis and atherosclerosis. Transforming growth factor-beta (TGF-beta) is highly expressed in restenotic and atherosclerotic lesions, and known to induce integrin expression. Peroxisome proliferator-activated receptor alpha (PPARalpha), a member of the nuclear receptor superfamily, regulates gene expression in a variety of vascular cells.

Leptin induces endothelial cell migration through Akt, which is inhibited by PPARgamma-ligands.

Migration of endothelial cells (EC) is a key event in angiogenesis that contributes to neovascularization in diabetic vasculopathy. Leptin induces angiogenesis and is elevated in obesity and hyperinsulinemia. The antidiabetic thiazolidinediones (TZD) inhibit leptin gene expression and vascular smooth muscle cell migration through activation of the peroxisome proliferator-activated receptor-gamma (PPARgamma).

TGF-beta(1) induces peroxisome proliferator-activated receptor gamma1 and gamma2 expression in human THP-1 monocytes.

The nuclear hormone receptor peroxisome proliferator-activated gamma (PPARgamma) is expressed as two isoforms (PPARgamma1 and gamma2), and is an important modulator of monocyte gene regulation and function. TGF-beta(1) is an essential and potent immune modulator and we therefore examined its effect on PPARgamma expression in human THP-1 monocytes. TGF-beta(1) strongly induced PPARgamma2 mRNA and protein expression with a lesser effect on PPARgamma1.

Hypoxia activates beta(1)-integrin via ERK 1/2 and p38 MAP kinase in human vascular smooth muscle cells.

Hypoxia plays an important role in vascular remodeling and directly affects vascular smooth muscle cell (VSMC) functions. VSMC adhesion participates in changes of vascular structure; however, little is known about VSMC adhesion under hypoxic conditions. It was the aim of the present study to investigate the effects of hypoxia on adhesion mechanisms in human VSMCs.

Angiotensin II-augmented migration of VSMCs towards PDGF-BB involves Pyk2 and ERK 1/2 activation.

Activation of the local and systemic renin-angiotensin system is directly and indirectly involved in mechanisms of vascular remodeling during chronic hypertension. This study investigated the effect of angiotensin II (AII) on rat vascular smooth muscle cell (VSMC) migration towards platelet-derived growth factor-BB (PDGF-BB) in vitro. Pre-treatment with AII (1 microM) for 48 or 72 h induced a significant increase in PDGF-BB-directed migration by 77 +/- 21 % and 58 +/- 24 %, respectively (both p < 0.

PPAR activators inhibit endothelial cell migration by targeting Akt.

Peroxisome proliferator-activated receptors (PPARs) regulate lipid and glucose metabolism and exert several vascular effects that may provide a dual benefit of these receptors on metabolic disorders and atherosclerotic vascular disease. Endothelial cell migration is a key event in the pathogenesis of atherosclerosis. We therefore investigated the effects of lipid-lowering PPARalpha-activators (fenofibrate, WY14643) and antidiabetic PPARgamma-activators (troglitazone, ciglitazone) on this endothelial cell function.

Increased myocardial expression of osteopontin in patients with advanced heart failure.

The expression of the adhesion protein osteopontin (OP) is associated with cardiac hypertrophy and is significantly increased after transition to heart failure in experimental animal models. We, therefore, hypothesized that OP could be upregulated in heart failure in humans. In the present study, we investigated the expression of OP in myocardial biopsies obtained from patients with heart failure due to dilated cardiomyopathy (mean LVEF=30.

Proprotein convertase PC5 regulation by PDGF-BB involves PI3-kinase/p70(s6)-kinase activation in vascular smooth muscle cells.

We have recently demonstrated that furin, PC5, and PC7, members of the subtilisin/kexin-like mammalian proprotein convertases (PCs), are found in rodent aorta. These PCs have been identified to activate several growth factors, adhesion molecules and extracellular matrix compounds by endoproteolytic cleavage. In the present study, we investigated the regulation of PC5 in vascular smooth muscle cells (VSMCs) in vitro and in vivo.