Isorhythmic atrioventricular dissociation in an adult with levo-transposition of the great arteries

A 36-year-old woman with levo-transposition of the great arteries presented for a programmed visit. She was asymptomatic and the clinical examination showed no signs of decompensated heart failure. Standard 12-lead ECG showed isorhythmic atrioventricular dissociation. A 24-hour ambulatory recording demonstrated sinus rhythm with intermittent periods of isorhythmic dissociation. This case highlights the association between two rare conditions.

Motionwatch8 Wrist Actimetry Data Analysis: from ambulatory recording to real life monitoring.

On the National Sleep Research Resource (NSRR) platform, there's a year's worth in real-life wrist actigraphy data using a Motionwatch8. The data analysis suggested in this paper reveals a data structure that allows the design of parameters to be used in real life monitoring and may drive the developments of devices. The analysis is totally data driven and connects in a quantitative way the wrist movements (time base seconds) to the circadian rhythms (time base days). A simple example of parameters is described

P1189OFFICE AND AMBULATORY RECORDING OF CENTRAL AORTIC PRESSURES, WAVE REFLECTION AND ARTERIAL STIFFNESS INDICES IN PERITONEAL DIALYSIS PATIENTS

Background and Aims Among peritoneal dialysis (PD) patients, aortic blood pressure (BP) and arterial stiffness indices are independent predictors of cardiovascular morbidity and mortality. Previous studies in PD patients recorded these parameters only in the office. The present study provides comparisons between office and ambulatory recordings of these parameters and explores the association of demographic, clinical and hemodynamic variables with high arterial stiffness. Method In 81 stable PD patients (mean age: 61.3±16.3 years; male gender: 64.2%), brachial and aortic BP, heart rate-adjusted augmentation index (AIx75) and pulse wave velocity (PWV) were recorded after a 5-minute seated rest in the office using the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). Subsequently, all patients underwent ambulatory recording of these parameters with the same device for 24 hours. Logistic regression analysis was performed to identify factors independently associated with high ambulatory PWV. Results As expected, office brachial systolic BP (SBP) was higher than 24-hour brachial SBP (134.2±22.7 vs. 129.0±18.0 mmHg, P<0.01). Similarly, office aortic SBP was higher than 24-hour aortic SBP (122.5±20.1 vs. 117.1±16.1 mmHg, P=0.001). By contrast, office AIx75 did not differ from 24-hour AIx75 (23.4%±11.7% vs. 23.9%±9.3%, P=0.602), whereas office PWV was only slightly higher than 24-hour PWV (9.2±2.3 vs. 9.0±2.2m/sec, P=0.001). Participants stratified in the high PWV tertile were older, had higher 24-hour mean BP (MBP) and had more commonly history of diabetes, dyslipidemia and coronary heart disease. In multivariate analysis, older age (OR: 4.23; 95% CI: 1.59-11.24) and higher 24-hour MBP (OR: 1.31; 95% CI: 1.03-1.67) were the only independent determinants of high PWV. Conclusion Among patients on PD, brachial and central aortic pressures recorded in the office were higher than 24-hour ambulatory pressures, whereas this variation between office and ambulatory recordings was diminished for AIx75 and PWV. Future studies are warranted to explore the prognostic significance of these parameters in the PD population.