<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02228083</url>
  </required_header>
  <id_info>
    <org_study_id>InsufCard</org_study_id>
    <nct_id>NCT02228083</nct_id>
  </id_info>
  <brief_title>Dental Anesthesia in Heart Failure Patients</brief_title>
  <acronym>DAHFP</acronym>
  <official_title>Occurrence of Heart Arrhythmia During Restorative Dental Procedure Under Local Anesthesia , in Heart Failure Pacients. A Double-blind Study</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of Sao Paulo General Hospital</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Fundação de Amparo à Pesquisa do Estado de São Paulo</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>University of Sao Paulo General Hospital</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      To investigate the occurrence of arrhythmias in dental treatment with local anesthetic.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Heart failure is defined as the inability of the heart to offer blood supply required to meet&#xD;
      metabolic demand of the tissues and thus exercise adequately its role as a pump. According to&#xD;
      data collected from the single health system (DATASUS), approximately 6.4 million Brazilians&#xD;
      have heart failure. This large contingent of patients will require multi-professional&#xD;
      treatment, in particular, careful with dental health heart failure is regarded as the final&#xD;
      common pathway of most cardiovascular diseases and, after installation of symptoms (mainly in&#xD;
      the stages of functional class NYHA III and IV) have poor prognosis with average survival of&#xD;
      1.7 years 3.2 years for men and for women. Dental treatment often requires application of&#xD;
      local anesthetic. The adrenaline, agent vasoconstrictor, is widely used in dental treatment&#xD;
      and aims to extend the effect of local anesthetic. Specifically in people with heart failure,&#xD;
      there shortcomings of evidence in the literature, the harmful effects of adrenaline 1:100,000&#xD;
      added to the local anaesthetic lidocaine. Among the potential complications, we can&#xD;
      highlight: arrhythmias, systemic blood pressure elevation and elevation of heart rate. The&#xD;
      main objective of this work will investigate the occurrence of arrhythmias by evaluating of&#xD;
      electrocardiographic parameters. Our secondary objectives will be assessing: variations of&#xD;
      blood pressure by ambulatory blood pressure monitoring, cardiac frequency and chest pain. We&#xD;
      will study 70 patients between 18 and 75 years with a diagnosis of congestive heart failure&#xD;
      functional class NYHA III and IV and restorative dental treatment indication. A random&#xD;
      picture in double-blind study, patients are divided into two groups, one group receives as&#xD;
      local anesthetic lidocaine 2% with adrenaline 1 in comparison with the second group that will&#xD;
      receive 2% lidocaine with vasoconstrictor.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date>September 2014</start_date>
  <completion_date type="Anticipated">September 2017</completion_date>
  <primary_completion_date type="Anticipated">September 2016</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Triple (Participant, Care Provider, Investigator)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Heart rate (bpm)</measure>
    <time_frame>24 hours</time_frame>
    <description>The continuous electrocardiogram recording for a period of 24 hours will be obtained through the Holter monitor model Seer Ligth (GE), with three channels (seven-way) cable, installed a half hour before the dental procedure. The first analysis will be done automatically by the computer system, followed by visual and manual review at which supraventricular and ventricular premature heartbeats will be filtered accurately.&#xD;
Electrocardiographic variables are: heart rate maximum, minimum and mean HR, supraventricular extrasystole (VES) and ventricular (EV) FC. The program shall provide the record in HR per minute for 24 hours. The average individual will be calculated for the period studied, to then calculate the sample mean and groups LSA and LCA. The ESV and EV will be identified in tracing obtained every minute. Consider the valid values recorded HR and ischemic episodes; analyze the occurrence of EV and ESV occurring in number&gt; 10 per hour in both groups, by study period.</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">70</enrollment>
  <condition>Heart Failure</condition>
  <arm_group>
    <arm_group_label>Safety of dental anesthesia</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Application of local dental anesthesia with two cartridges (5,6 mL) of the lidocaine 2% with epinephrine 1:100.000 in heart failure patients in functional class III or IV.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Oral health profile</arm_group_label>
    <arm_group_type>Other</arm_group_type>
    <description>An oral health profile of patients with heart failure will be described based in oral clinical examination.</description>
  </arm_group>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Lidocaine with epinephrine</intervention_name>
    <description>Lidocaine without vasoconstrictor , lidocaine with epinephrine 1:100,000</description>
    <arm_group_label>Oral health profile</arm_group_label>
    <arm_group_label>Safety of dental anesthesia</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  any race,nationality,profession, single or married.&#xD;
&#xD;
          -  class II , III or IV of New York heart Association ( NYHA)&#xD;
&#xD;
          -  minimum 45% ventricular ejection fraction&#xD;
&#xD;
          -  patient must be in a clinical treatment or hospital treatment&#xD;
&#xD;
          -  patient must need dental restorative treatment , mandible or maxilla, due to caries or&#xD;
             need for substitution of a inadequate dental filling.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  patients with history of heart attack within less than three months&#xD;
&#xD;
          -  acute myocardial infarction&#xD;
&#xD;
          -  unstable angina&#xD;
&#xD;
          -  significant ventricular dysfunction&#xD;
&#xD;
          -  severe ventricular arrhythmia&#xD;
&#xD;
          -  malignant hypertension&#xD;
&#xD;
          -  neoplasms&#xD;
&#xD;
          -  sepsis&#xD;
&#xD;
          -  pregnancy&#xD;
&#xD;
          -  allergy to lidocaine and epinephrine&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>70 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Itamara LI Neves, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Instituto do Coração do HCFMUSP</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Edimar A Bocchi, Habilitation</last_name>
    <role>Study Director</role>
    <affiliation>Heart Institute of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Ricardo S Neves, PhD</last_name>
    <role>Study Chair</role>
    <affiliation>Instituto do Coração do HCFMUSP</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Sergio ET Quaresma, MS.</last_name>
    <role>Study Chair</role>
    <affiliation>Heart Institute of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Itamara LI Neves, PhD</last_name>
    <phone>55-11-26615229</phone>
    <email>itamara@incor.usp.br</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Sergio ET Quaresma, MS</last_name>
    <phone>55-11-983890099</phone>
    <email>setquaresma@uol.com.br</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Instituto do Coração HCFMUSP</name>
      <address>
        <city>São Paulo</city>
        <zip>05403000</zip>
        <country>Brazil</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Itamara LI Neves, PhD</last_name>
      <phone>1126615229</phone>
      <email>itamara@incor.usp.br</email>
    </contact>
    <contact_backup>
      <last_name>Sergio ET Quaresma, MS.</last_name>
      <phone>11983890099</phone>
      <email>setquaresma@uol.com.br</email>
    </contact_backup>
    <investigator>
      <last_name>Itamara LI Neves, PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Brazil</country>
  </location_countries>
  <reference>
    <citation>Mann DL. Mechanisms and models in heart failure: A combinatorial approach. Circulation. 1999 Aug 31;100(9):999-1008. doi: 10.1161/01.cir.100.9.999. No abstract available.</citation>
    <PMID>10468532</PMID>
  </reference>
  <reference>
    <citation>Palatini P, Frigo G, Bertolo O, Roman E, Da Corta R, Winnicki M. Validation of the A&amp;D TM-2430 device for ambulatory blood pressure monitoring and evaluation of performance according to subjects' characteristics. Blood Press Monit. 1998 Aug;3(4):255-260.</citation>
    <PMID>10212363</PMID>
  </reference>
  <reference>
    <citation>Sivaneswaran S. The oral health of adults in NSW, 2004-06. N S W Public Health Bull. 2009 Mar-Apr;20(3-4):46-51. doi: 10.1071/NB08066.</citation>
    <PMID>19401068</PMID>
  </reference>
  <reference>
    <citation>SILNESS J, LOE H. PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. Acta Odontol Scand. 1964 Feb;22:121-35. doi: 10.3109/00016356408993968. No abstract available.</citation>
    <PMID>14158464</PMID>
  </reference>
  <results_reference>
    <citation>[Guidelines of the Brazilian Cardiology Society to the diagnosis and treatment of heart failure]. Arq Bras Cardiol. 1999 Feb;72 Suppl 1:1-30. No abstract available. Portuguese.</citation>
    <PMID>10488571</PMID>
  </results_reference>
  <results_reference>
    <citation>Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20;112(12):e154-235. doi: 10.1161/CIRCULATIONAHA.105.167586. Epub 2005 Sep 13. No abstract available.</citation>
    <PMID>16160202</PMID>
  </results_reference>
  <results_reference>
    <citation>Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, Ganiats TG, Goldstein S, Gregoratos G, Jessup ML, Noble RJ, Packer M, Silver MA, Stevenson LW, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Jacobs AK, Hiratzka LF, Russell RO, Smith SC Jr; American College of Cardiology/American Heart Association. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. 2001 Dec;38(7):2101-13. doi: 10.1016/s0735-1097(01)01683-7. No abstract available.</citation>
    <PMID>11738322</PMID>
  </results_reference>
  <results_reference>
    <citation>Hempenstall PD, Campbell JP, Bajurnow AT, Reade PC, McGrath B, Harrison LC. Cardiovascular, biochemical, and hormonal responses to intravenous sedation with local analgesia versus general anesthesia in patients undergoing oral surgery. J Oral Maxillofac Surg. 1986 Jun;44(6):441-6. doi: 10.1016/s0278-2391(86)80008-8.</citation>
    <PMID>3009759</PMID>
  </results_reference>
  <results_reference>
    <citation>Brand HS, Gortzak RA, Abraham-Inpijn L. Anxiety and heart rate correlation prior to dental checkup. Int Dent J. 1995 Dec;45(6):347-51.</citation>
    <PMID>8666460</PMID>
  </results_reference>
  <results_reference>
    <citation>Hasse AL, Heng MK, Garrett NR. Blood pressure and electrocardiographic response to dental treatment with use of local anesthesia. J Am Dent Assoc. 1986 Oct;113(4):639-42. doi: 10.14219/jada.archive.1986.0245. Erratum In: J Am Dent Assoc 1986 Dec;113(6):868.</citation>
    <PMID>2945853</PMID>
  </results_reference>
  <results_reference>
    <citation>Hill CM, Mostafa P, Stuart AG, Thomas DW, Walker RV. ECG variations in patients pre- and post-local anaesthesia and analgesia. Br Dent J. 2009 Dec 19;207(12):E23. doi: 10.1038/sj.bdj.2009.978. Epub 2009 Nov 6.</citation>
    <PMID>19893562</PMID>
  </results_reference>
  <results_reference>
    <citation>Neves RS, Neves IL, Giorgi DM, Grupi CJ, Cesar LA, Hueb W, Grinberg M. Effects of epinephrine in local dental anesthesia in patients with coronary artery disease. Arq Bras Cardiol. 2007 May;88(5):545-51. doi: 10.1590/s0066-782x2007000500008. English, Portuguese.</citation>
    <PMID>17589629</PMID>
  </results_reference>
  <results_reference>
    <citation>Perusse R, Goulet JP, Turcotte JY. Contraindications to vasoconstrictors in dentistry: Part I. Cardiovascular diseases. Oral Surg Oral Med Oral Pathol. 1992 Nov;74(5):679-86. doi: 10.1016/0030-4220(92)90365-w.</citation>
    <PMID>1437073</PMID>
  </results_reference>
  <results_reference>
    <citation>Rhodus NL, Falace DA. Management of the dental patient with congestive heart failure. Gen Dent. 2002 May-Jun;50(3):260-5, quiz 266-7.</citation>
    <PMID>12116514</PMID>
  </results_reference>
  <results_reference>
    <citation>Blinder D, Manor Y, Shemesh J, Taicher S. Electrocardiographic changes in cardiac patients having dental extractions under a local anesthetic containing a vasopressor. J Oral Maxillofac Surg. 1998 Dec;56(12):1399-402; discussion 1402-3. doi: 10.1016/s0278-2391(98)90403-7.</citation>
    <PMID>9846537</PMID>
  </results_reference>
  <results_reference>
    <citation>Caceres MT, Ludovice AC, Brito FS, Darrieux FC, Neves RS, Scanavacca MI, Sosa EA, Hachul DT. Effect of local anesthetics with and without vasoconstrictor agent in patients with ventricular arrhythmias. Arq Bras Cardiol. 2008 Sep;91(3):128-33, 142-7. doi: 10.1590/s0066-782x2008001500002. English, Portuguese.</citation>
    <PMID>18853053</PMID>
  </results_reference>
  <results_reference>
    <citation>Dajani AS, Taubert KA, Wilson W, Bolger AF, Bayer A, Ferrieri P, Gewitz MH, Shulman ST, Nouri S, Newburger JW, Hutto C, Pallasch TJ, Gage TW, Levison ME, Peter G, Zuccaro G Jr. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. Circulation. 1997 Jul 1;96(1):358-66. doi: 10.1161/01.cir.96.1.358.</citation>
    <PMID>9236458</PMID>
  </results_reference>
  <verification_date>October 2015</verification_date>
  <study_first_submitted>August 26, 2014</study_first_submitted>
  <study_first_submitted_qc>August 27, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">August 28, 2014</study_first_posted>
  <last_update_submitted>October 15, 2015</last_update_submitted>
  <last_update_submitted_qc>October 15, 2015</last_update_submitted_qc>
  <last_update_posted type="Estimate">October 19, 2015</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>dental</keyword>
  <keyword>epinephrine</keyword>
  <keyword>local anesthetic</keyword>
  <keyword>lidocaine</keyword>
  <keyword>cardiac arrhythmias</keyword>
  <keyword>procedure</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Heart Failure</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Lidocaine</mesh_term>
    <mesh_term>Epinephrine</mesh_term>
  </intervention_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02228083
org study id: InsufCard
nct id: NCT02228083
lead sponsor: 
collaborator: 
has dmc: Yes
To investigate the occurrence of arrhythmias in dental treatment with local anesthetic.
Heart failure is defined as the inability of the heart to offer blood supply required to meet
      metabolic demand of the tissues and thus exercise adequately its role as a pump. According to
      data collected from the single health system (DATASUS), approximately 6.4 million Brazilians
      have heart failure. This large contingent of patients will require multi-professional
      treatment, in particular, careful with dental health heart failure is regarded as the final
      common pathway of most cardiovascular diseases and, after installation of symptoms (mainly in
      the stages of functional class NYHA III and IV) have poor prognosis with average survival of
      1.7 years 3.2 years for men and for women. Dental treatment often requires application of
      local anesthetic. The adrenaline, agent vasoconstrictor, is widely used in dental treatment
      and aims to extend the effect of local anesthetic. Specifically in people with heart failure,
      there shortcomings of evidence in the literature, the harmful effects of adrenaline 1:100,000
      added to the local anaesthetic lidocaine. Among the potential complications, we can
      highlight: arrhythmias, systemic blood pressure elevation and elevation of heart rate. The
      main objective of this work will investigate the occurrence of arrhythmias by evaluating of
      electrocardiographic parameters. Our secondary objectives will be assessing: variations of
      blood pressure by ambulatory blood pressure monitoring, cardiac frequency and chest pain. We
      will study 70 patients between 18 and 75 years with a diagnosis of congestive heart failure
      functional class NYHA III and IV and restorative dental treatment indication. A random
      picture in double-blind study, patients are divided into two groups, one group receives as
      local anesthetic lidocaine 2% with adrenaline 1 in comparison with the second group that will
      receive 2% lidocaine with vasoconstrictor.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Triple (Participant, Care Provider, Investigator)
measure: Heart rate (bpm)
time frame: 24 hours
description: The continuous electrocardiogram recording for a period of 24 hours will be obtained through the Holter monitor model Seer Ligth (GE), with three channels (seven-way) cable, installed a half hour before the dental procedure. The first analysis will be done automatically by the computer system, followed by visual and manual review at which supraventricular and ventricular premature heartbeats will be filtered accurately.
Electrocardiographic variables are: heart rate maximum, minimum and mean HR, supraventricular extrasystole (VES) and ventricular (EV) FC. The program shall provide the record in HR per minute for 24 hours. The average individual will be calculated for the period studied, to then calculate the sample mean and groups LSA and LCA. The ESV and EV will be identified in tracing obtained every minute. Consider the valid values recorded HR and ischemic episodes; analyze the occurrence of EV and ESV occurring in number> 10 per hour in both groups, by study period.
arm group label: Safety of dental anesthesia
arm group type: Active Comparator
description: Application of local dental anesthesia with two cartridges (5,6 mL) of the lidocaine 2% with epinephrine 1:100.000 in heart failure patients in functional class III or IV.
arm group label: Oral health profile
arm group type: Other
description: An oral health profile of patients with heart failure will be described based in oral clinical examination.
intervention type: Drug
intervention name: Lidocaine with epinephrine
description: Lidocaine without vasoconstrictor , lidocaine with epinephrine 1:100,000
arm group label: Oral health profile
arm group label: Safety of dental anesthesia
criteria: 
gender: All
minimum age: 18 Years
maximum age: 70 Years
healthy volunteers: No
last name: Itamara LI Neves, PhD
role: Principal Investigator
affiliation: Instituto do Coração do HCFMUSP
last name: Edimar A Bocchi, Habilitation
role: Study Director
affiliation: Heart Institute of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
last name: Ricardo S Neves, PhD
role: Study Chair
affiliation: Instituto do Coração do HCFMUSP
last name: Sergio ET Quaresma, MS.
role: Study Chair
affiliation: Heart Institute of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
last name: Itamara LI Neves, PhD
phone: 55-11-26615229
email: itamara@incor.usp.br
last name: Sergio ET Quaresma, MS
phone: 55-11-983890099
email: setquaresma@uol.com.br
facility: 
status: Recruiting
contact: 
contact backup: 
investigator: 
country: Brazil
citation: Mann DL. Mechanisms and models in heart failure: A combinatorial approach. Circulation. 1999 Aug 31;100(9):999-1008. doi: 10.1161/01.cir.100.9.999. No abstract available.
PMID: 10468532
citation: Palatini P, Frigo G, Bertolo O, Roman E, Da Corta R, Winnicki M. Validation of the A&D TM-2430 device for ambulatory blood pressure monitoring and evaluation of performance according to subjects' characteristics. Blood Press Monit. 1998 Aug;3(4):255-260.
PMID: 10212363
citation: Sivaneswaran S. The oral health of adults in NSW, 2004-06. N S W Public Health Bull. 2009 Mar-Apr;20(3-4):46-51. doi: 10.1071/NB08066.
PMID: 19401068
citation: SILNESS J, LOE H. PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. Acta Odontol Scand. 1964 Feb;22:121-35. doi: 10.3109/00016356408993968. No abstract available.
PMID: 14158464
citation: [Guidelines of the Brazilian Cardiology Society to the diagnosis and treatment of heart failure]. Arq Bras Cardiol. 1999 Feb;72 Suppl 1:1-30. No abstract available. Portuguese.
PMID: 10488571
citation: Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20;112(12):e154-235. doi: 10.1161/CIRCULATIONAHA.105.167586. Epub 2005 Sep 13. No abstract available.
PMID: 16160202
citation: Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, Ganiats TG, Goldstein S, Gregoratos G, Jessup ML, Noble RJ, Packer M, Silver MA, Stevenson LW, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Jacobs AK, Hiratzka LF, Russell RO, Smith SC Jr; American College of Cardiology/American Heart Association. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. 2001 Dec;38(7):2101-13. doi: 10.1016/s0735-1097(01)01683-7. No abstract available.
PMID: 11738322
citation: Hempenstall PD, Campbell JP, Bajurnow AT, Reade PC, McGrath B, Harrison LC. Cardiovascular, biochemical, and hormonal responses to intravenous sedation with local analgesia versus general anesthesia in patients undergoing oral surgery. J Oral Maxillofac Surg. 1986 Jun;44(6):441-6. doi: 10.1016/s0278-2391(86)80008-8.
PMID: 3009759
citation: Brand HS, Gortzak RA, Abraham-Inpijn L. Anxiety and heart rate correlation prior to dental checkup. Int Dent J. 1995 Dec;45(6):347-51.
PMID: 8666460
citation: Hasse AL, Heng MK, Garrett NR. Blood pressure and electrocardiographic response to dental treatment with use of local anesthesia. J Am Dent Assoc. 1986 Oct;113(4):639-42. doi: 10.14219/jada.archive.1986.0245. Erratum In: J Am Dent Assoc 1986 Dec;113(6):868.
PMID: 2945853
citation: Hill CM, Mostafa P, Stuart AG, Thomas DW, Walker RV. ECG variations in patients pre- and post-local anaesthesia and analgesia. Br Dent J. 2009 Dec 19;207(12):E23. doi: 10.1038/sj.bdj.2009.978. Epub 2009 Nov 6.
PMID: 19893562
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responsible party type: Sponsor
mesh term: Heart Failure
mesh term: Lidocaine
mesh term: Epinephrine