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Herzschrittmachertherapie & Elektrophysiologie

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https://www.readbyqxmd.com/read/28220241/-icd-in-elderly-patients
#1
Carsten W Israel
Treatment with an implantable cardioverter-defibrillator (ICD) represents a prognostic but not symptomatic therapy. It should therefore be restricted to patients where an improvement of prognosis is possible and reasonable. ICD implantation should only be performed in patients with a life expectancy of at least 1 year at reasonable quality of life. The decision in which patient improvement of prognosis is no longer a desirable target is problematic, both medically and ethically. It is not entirely clear in which elderly patient an ICD therapy can convey prognostic benefit despite comorbidity and competitive life-threatening diseases, as it is unclear how old age should be defined...
February 20, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28204917/-ecg-score-to-predict-icd-therapies-in-patients-with-nonischemic-cardiomyopathy-and-primary-prophylactic-crt-d
#2
Martin Grett, Martin Christ, Jan-Peter Röing Gen Nölke, Hans-Joachim Trappe
BACKGROUND AND PROBLEM: Recently published results of the DANISH study raise concerns, if primary prophylactic ICD implantations in patients with nonischemic cardiomyopathy (NICM) and severe reduced left ventricular ejection fraction (LVEF) should be performed without further risk stratification. There was no significant difference in the overall mortality of patients with or without ICD and CRT defibrillator (CRT-D) or CRT pacemaker (CRT-P), respectively. Clinical risk scores to identify patients with ischemic cardiomyopathy (ICM) who benefit most from an ICD have been recommended...
February 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28204916/-remodeling-of-the-aging-heart-sinus-node-dysfunction-and-atrial-fibrillation
#3
Jörg Weirich
The incidence of both sinus node dysfunction (SND) and atrial fibrillation (AF) increases with age. SND and AF frequently coexist. Likewise, they are often associated with cardiovascular diseases. Both arrhythmias share similar pathomechanisms such as structural and functional remodeling, i. e., degenerative fibrosis and altered Ca(2+) handling, respectively. A growing body of evidence suggests an important role for the CamKII (Ca(2+)/calmodulin-dependent protein kinase II) in structural as well as in functional remodeling...
February 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28204915/-acute-chest-pain-and-new-ecg-changes-in-pacemaker-patients-a%C3%A2-clinical-challenge
#4
Matthias Hoyme, Ralf Surber, P Christian Schulze, Dirk Prochnau
We report the case of a 82-year-old woman who was admitted to our institution with acute chest pain, nausea, and vomiting. Because of atrial fibrillation with intermittent bradycardia, a single-chamber pacemaker was implanted 4 years ago. The initial 12-lead ECG showed atrial fibrillation with a heart rate of 70 bpm, narrow QRS, and T‑wave inversions in the inferolateral leads. Coronary artery disease was excluded by immediate cardiac catheterization. A subsequent ECG three hours later showed a ventricular paced rhythm...
February 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28185081/-electrophysiologic-procedure-complications-in-the-elderly
#5
Dietrich Pfeiffer, Martin Neef, Daniel Jurisch, Andreas Hagendorff
Published registries give limited information on age-dependent complication rates. There are several reasons for this, including limited numbers of patients in subgroups (e.g., contractility management), experience-dependent procedures (e.g., catheter ablation), or in changing indications (e.g., resynchronization). Finally, severely ill and very old patients with limited prognosis are often excluded from electrophysiologic procedures. Therefore, published data are difficult to interpret. Meta-analyses of randomized trials give more precise information on included patient cohorts, but do not necessarily reflect daily practice because elderly patients are often excluded from trials...
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28185080/wellens-syndrome-can-indicate-high-grade-lad-stenosis-in-case-of-left-bundle-branch-block
#6
Steffen Grautoff
Diagnosing acute myocardial infarction (AMI) in left bundle branch block (LBBB) is challenging. Modified Sgarbossa criteria are known to help detect AMI in LBBB. This is a report about an electrocardiogram (ECG) with Wellens' signs in combination with a pre-existing LBBB. The ECG of a patient with fluctuating chest pain showed very subtle and one day later more obvious Wellens'signs. A left anterior descending artery (LAD) stenosis was diagnosed and successfully treated. Wellens' syndrome can be diagnosed in a case of LBBB and help detect a high-grade LAD stenosis even if modified Sgarbossa criteria are not met...
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28185079/-a%C3%A2-life-saving-shock-from-a%C3%A2-subcutaneous-icd-during-skydiving
#7
Stefan Baumann, Susanne Roeger, Tobias Becher, Ibrahim Akin, Martin Borggrefe, Juergen Kuschyk
We report the case of a 38-year-old man who was implanted a subcutaneous implantable cardioverter-defibrillator (S-ICD) and then performed a skydive from a height of 3000 m. During the jump, he lost consciousness due to ventricular fibrillation (VF). The S‑ICD detected the VF properly and successfully shocked the arrhythmia. Our illustrative case emphasizes the S‑ICD as an appropriate therapy in patient with life-threatening arrhythmias even under extreme conditions.
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28185078/-ablation-of-av-nodal-reentrant-tachycardia-via-combined-access-through-the-medial-cubital-and-axillary-vein
#8
Tobias Schreiber, Philipp Attanasio, Frank Heinzel, Burkert Pieske, Wilhelm Haverkamp, Martin Huemer
If a transfemoral approach for catheter ablation procedures of paroxysmal supraventricular tachycardias is impossible, other access sites have to be considered. We present the case of a 78-year-old woman with an inferior vena cava (IVC) filter with symptomatic episodes of an atrioventricular nodal reentrant tachycardia (AVNRT). We used a combined cubital and axillary vein approach. The tachycardia was successfully ablated within the timeframe needed for conventional ablation.
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28175981/-catheter-ablation-of-ventricular-extrasystoles-and-ventricular-tachycardia-in-the-elderly
#9
Philipp Halbfaß, Karin Nentwich, Kai Sonne, Elena Ene, Franziska Fochler, Andreas Mügge, Bernhard Schieffer, Thomas Deneke
BACKGROUND: The prevalence of structural heart disease increases with higher age, and thereby the basis for ventricular arrhythmias is created. Catheter ablation has been shown to be an effective therapy option that is very safe and achieves good long-term results in patients with recurrent ventricular tachycardia (VT). Data regarding ablation in patients older than 75 years is sparse, although this patient group was included as a minority in most published VT ablation studies. Data from younger patient collectives may not be transferable to older patient cohorts due to differences in patient comorbidities and baseline characteristics...
February 7, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28138764/-ablation-for-atrial-fibrillation-in-the-elderly
#10
Clemens Jilek, Thorsten Lewalter
Atrial fibrillation is mainly an arrhythmia among the elderly. The current ESC guideline determines that there is no justification to deny atrial fibrillation ablation to any age group; however, the guideline does not provide specific scientific data. Thus, the goal of this article is to summarize the data on efficacy and safety of atrial fibrillation ablation among elderly people and give treatment recommendations: (1) The success of atrial fibrillation ablation is the same between elderly and younger patients...
January 30, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28083643/jahresbericht-2014-des-deutschen-herzschrittmacher-und-defibrillatorregisters-teil%C3%A2-2-%C3%A2-implantierbare-kardioverter-defibrillatoren-icd-fachgruppe-herzschrittmacher-und-aqua-%C3%A2-institut-f%C3%A3-r-angewandte-qualit%C3%A3-tsf%C3%A3-rderung-und-forschung-im-gesundheitswesen-gmbh
#11
EDITORIAL
https://www.readbyqxmd.com/read/28083642/jahresbericht-2014-des-deutschen-herzschrittmacher-und-defibrillatorregisters-teil%C3%A2-1-%C3%A2-herzschrittmacher-fachgruppe-herzschrittmacher-und-aqua-%C3%A2-institut-f%C3%A3-r-angewandte-qualit%C3%A3-tsf%C3%A3-rderung-und-forschung-im-gesundheitswesen-gmbh
#12
EDITORIAL
https://www.readbyqxmd.com/read/27957586/erratum-to-mismanagement-oder-misunderstanding
#13
Helmut U Klein
No abstract text is available yet for this article.
December 12, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27896455/erratum-to-tachycardia-detection-in-modern-implantable-cardioverter-defibrillators
#14
Thomas Brüggemann, Daniel Dahlke, Amin Chebbo, Ilka Neumann
No abstract text is available yet for this article.
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27878365/-implantable-loop-recorders-of-the-reveal-family-medtronic
#15
Frederik Voss
This review explains the implantable loop recorders Medtronic Reveal XT and Medtronic Reveal LINQ. Technical specifications of the two devices are described in great detail. Additional tips for implantation as well as device programming are given including specific considerations of follow-up.
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27878364/-av-reentrant-tachycardia-and-wolff-parkinson-white-syndrome-diagnosis-and-treatment
#16
Frederik Voss, Lars Eckardt, Sonia Busch, Heidi L Estner, Daniel Steven, Philipp Sommer, Christian von Bary, Hans-Ruprecht Neuberger
The AV-reentrant tachycardia (AVRT) is a supraventricular tachycardia with an incidence of 1-3/1000. The pathophysiological basis is an accessory atrioventricular pathway (AP). Patients with AVRT typically present with palpitations, an on-off characteristic, anxiety, dyspnea, and polyuria. This type of tachycardia may often be terminated by vagal maneuvers. Although the clinical presentation of AVRT is quite similar to AV-nodal reentrant tachycardias, the correct diagnosis is often facilitated by analyzing a standard 12-lead ECG at normal heart rate showing ventricular preexcitation...
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27873022/current-rare-indications-and-future-directions-for-implantable-loop-recorders
#17
Simon Wechselberger, Christopher Piorkowski, Matthias Pohl
The scope of application for implantable loop recorders has shifted away from the evaluation of unclear palpitations and syncope episodes to more complex conditions. This article focuses on rare indications of growing importance such as rhythm monitoring after ablation of atrial fibrillation or after cryptogenic stroke. Furthermore, forthcoming applications in various clinical settings are described, e. g., arrhythmia detection after myocardial infarction, after catheter-based valve interventions, in heart failure, and in cardiomyopathies...
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27873021/hugo-von-ziemssen-posterpreis
#18
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27848030/-implantable-loop-recorder-biomonitor%C3%A2-2-biotronik
#19
Thorsten Lewalter, Clemens Jilek
The implantable loop recorder BioMonitor 2 is available with an emphasis on syncope and one on detection of atrial tachycardias. The BioMonitor 2 can be easily implanted. The BioMonitor 2 pilot study showed a high and over time stable signal and the telemetric performance was above average.
December 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27844195/-event-recorder-in-cryptogenic-stroke-accepted-and-feasible-indications
#20
J Brachmann, M Held
It was proven in multiple studies that about 30 % of cryptogenic strokes are related to clinically silent atrial fibrillation (AF). There is an opportunity for prolonged ECG monitoring mainly through an implanted event recorder after completion of conventional diagnostic methods in an unidentified stroke source. The Crystal AF study has proven, together with other results, improved AF detection through prolonged monitoring for up to 36 months. An implanted event recorder for 2-3 years is suitable for this particular purpose...
December 2016: Herzschrittmachertherapie & Elektrophysiologie
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