Posts Tagged ‘AFib’

Fielding Facts About Sudden Cardiac Arrest in Youth Sports

Posted by Michael Gralinski, Chief Executive Officer at CorDynamics on December 10th, 2011

 

Sudden Cardiac Arrest is the leading cause of death in youth sports, according to the recent Youth Sports Safety Summit. It’s a frightening reality that many parents and coaches fear, but don’t necessarily understand.

Sudden Cardiac Arrest occurs when the heart’s normal rhythm becomes severely abnormal, compromising cardiac output. These arrhythmias can be generated by a number of triggers, including direct blunt trauma to the chest or exertion stress upon a previously unrecognized vulnerable heart.

Blunt trauma is often the result of an object such as a baseball or hockey puck striking a child in the chest during the very brief period of electrical vulnerability associated with each normal heartbeat—resulting in ‘commotio cordis’, a life threatening arrhythmia that often degenerates into fatal ventricular fibrillation. Appropriate protection equipment or alternate types of baseballs/pucks can reduce the morbidity and mortality of chest trauma in young athletes.

When sports participants experience arrhythmias during exertion stress, it is often associated with previously unrecognized conditions such as hypertrophic cardiomyopathy (a thickened left ventricle usually present via congenital route). Since the cardiomyopathy results in some compromised left ventricular function, an increase in hemodynamic demand places an extra burden on the abnormal heart muscle substrate. This extra burden renders the heart vulnerable to disturbances in electrophysiology, with an increased risk of severe arrhythmias. Hypertrophic cardiomyopathy can be detected by ECG screening, with follow up echocardiography where warranted.

Since screening all children for heart pathophysiology is not practiced in our current health care system, directives from the summit encourage Coaches, teams and schools to implement a strong cardiac chain of survival:

  • Recognize a cardiac emergency and call 911
  • Early CPR
  • Early defibrillation
  • Early advanced cardiac life support

While we run electrophysiology studies to make sure drugs are safe and do not cause sudden cardiac death, we continue to learn more about the condition along the way.

You want may want to checkout www.parentheartwatch.org for more information.

 

 

Filed under: Atrial Fibrillation, Electrophysiology, Hemodynamics | No Comments

American Heart Association Take-Away: Still Seeking Truth About AFib

Posted by Michael Gralinski, Chief Executive Officer at CorDynamics on November 17th, 2011

As we’ve discussed in a previous blog, Investigating the Truth About AFib, the path toward targeted efficacy is fraught with hurdles. The reports coming out of the American Heart Association’s Annual Meeting are confirming just that.

Clearly, AFib, AF, Atrial Fibrillation, while being the most common cardiac arrhythmia affecting millions of individuals, is still not commonly understood from a drug development standpoint. Dronedarone, one of the big AHA headliners, is a drug we have used in preclinical investigations as well. In fact, our abstract that was presented at the 2012 Safety Pharmacology Society meeting in Innsbruck featured the use of chronically instrumented dogs to demonstrate the doses of both flecainide and dronedarone that result in changes with atrial, but not ventricular, refractoriness.

Through these types of studies, we are finding one of the long-standing AF roadblocks has been the selectivity of compounds on atrial vs. ventricular electrophysiology. Usually, the goal is to specifically alter the electrical properties of the heart’s upper chambers (atria) while leaving the lower chambers (ventricles) alone. Not nearly enough new chemical entities have this property—thus, the limited good treatment options in this area.

I find much of drug development news features on the negative headlines of drugs that “fail.” As researchers, we learn important discoveries from each study. This ultimately leads us to more effective compounds and gives physicians, a better indication of which medications to prescribe to which patients on a case-by-case basis. Sometimes knowing what doesn’t work, is just as important as knowing what does.

Filed under: Atrial Fibrillation, Drug Discovery Services, Telemetry | No Comments

Investigating the Truth About Afib

Posted by Michael Gralinski, Chief Executive Officer at CorDynamics on September 29th, 2011

AFib, AF, Atrial Fibrillation, — It’s the most common cardiac arrhythmia, affecting millions of individuals. Patients with AF rarely exhibit symptoms and are at a five-fold increased risk of stroke due to thrombosis from stagnant flow in the atrium. With such a target profile, the condition is a hot area for drug developers.

As with many disease states, the path toward targeted efficacy is fraught with hurdles. With AF, one of the long-standing roadblocks has been the selectivity of compounds on atrial vs. ventricular electrophysiology. Usually, the goal is to specifically alter the electrical properties of the heart’s upper chambers (atria) while leaving the lower chambers (ventricles) alone. Not nearly enough new chemical entities have this property—thus, the limited good treatment options in this area.

One way of investigating test articles from both a safety and discovery perspective is to use an instrumented animal equipped to provide information on complete cardiac electrophysiology. These models are effective since they provide a detailed interrogation on these parameters, alongside tolerability and PK/PD information.

For a more in-depth look at how an in vivo model can provide a comprehensive safety and discovery investigation in one experiment, check out our abstract to be presented at the 2012 Safety Pharmacology Society meeting in Innsbruck. We used chronically instrumented dogs to demonstrate the doses of both flecainide and dronedarone that result in changes with atrial, but not ventricular, refractoriness.

Getting to the heart of atrial fibrillation will go a long way in helping researchers make good scientific decisions and drug companies make good business decisions so physicans can guide patients in making the best health decisions.

 

Filed under: Atrial Fibrillation, Drug Discovery Services, Drug Safety Services, Electrophysiology, Telemetry | No Comments