mixed-reality-technology-three-dimensional-printing-teaching-heart

Mixed Reality Technology and Three-Dimensional Printing in Teaching: Heart Anatomy as an Example

Mixed reality technology and three-dimensional (3D) printing are becoming more and morecommon in the field of medicine. During the COVID-19 pandemic and ...

Medical University of Silesia in Katowice

Flecainide, similar to encainide and propafenone, is IC class antiarrhythmic, inhibiting Nav1.5 sodium channels in heart muscle cells and modulates cardiac conduction. Despite its over 40-year presence in clinical practice, strong evidence and well-known safety profile, flecainide distribution in Europe has not always been equal. In Poland, the drug has been available in pharmacies only since October this year, and previously it had to be imported on request. Flecainide can be used successfully in both the acute and chronic treatment of cardiac arrhythmias. The main indication for flecainide is the treatment of paroxysmal supraventricular tachycardias, including atrial fibrillation, atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia and ventricular arrhythmias in patients without structural heart disease. Beyond that, it may be used in some supraventricular tachycardia in children and for sustained fetal tachycardia. Many studies indicate its efficacy comparable to or better than previously used drugs such as propafenone and amiodarone, depending on the indication. This review aims to highlight the most important clinical uses of flecainide in the light of the latest scientific evidence and to provide an overview of the practical aspects of treatment, including indications, off-label use, contraindications, areas of use, monitoring of treatment and most common complications, taking into account special populations: children and pregnant women.

Flecainide in clinical practice.

Most current algorithms for detecting atrial fibrillation (AF) rely on heart rate variability (HRV), and only a few studies analyse the variability of photopletysmography (PPG) waveform. This study aimed to compare morphological features of the PPG curve in patients with AF to those presenting a normal sinus rhythm (NSR) and evaluate their usefulness in AF detection.10 min PPG signals were obtained from patients with persistent/paroxysmal AF and NSR. Nine morphological parameters (1/Δ), Pulse Width [PW], augmentation index [AI], b/a, e/a, [b-e]/a, crest time [CT], inflection point area [IPA], Area and five HRV parameters (heart rate [HR], Shannon entropy [ShE], root mean square of the successive differences [RMSSD], number of pairs of consecutive systolic peaks [-] that differ by more than 50 ms [NN50], standard deviation of the-intervals [SDNN]) were calculated.Eighty subjects, including 33 with AF and 47 with NSR were recruited. In univariate analysis five morphological features (1/Δ,< 0.001; b/a,< 0.001; [b-e]/a,< 0.001; CT,= 0.011 and Area,< 0.001) and all HRV parameters (= 0.01 for HR and< 0.001 for others) were significantly different between the study groups. In the stepwise multivariate model (Area under the curve [AUC] = 0.988 [0.974-1.000]), three morphological parameters (PW,< 0.001; e/a,= 0.011; (b-e)/a,< 0.001) and three of HRV parameters (ShE,= 0.01; NN50,< 0.001, HR,= 0.01) were significant.There are significant differences between AF and NSR, PPG waveform, which are useful in AF detection algorithm. Moreover adding those features to HRV-based algorithms may improve their specificity and sensitivity.

Article	Year
Flecainide in clinical practice. Cardiology journal\| PubMed ID: 36908162	2023
Photoplethysmography wave morphology in patients with atrial fibrillation. Physiological measurement\| PubMed ID: 36958052	2023

Wojciech Bojanowicz

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