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Herzschrittmachertherapie & Elektrophysiologie

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https://www.readbyqxmd.com/read/29992405/non-contact-mapping-in-cardiac-electrophysiology
#1
REVIEW
Marcus Wieczorek
Catheter ablation of atrial and ventricular arrhythmias is now considered a standard technology for selected patients. In some patients, however, cure of the arrhythmia is hampered by the complexity of the arrhythmia or the way the arrhythmia presents in the electrophysiological laboratory: some focal atrial and ventricular arrhythmias are difficult to induce using electrical stimulation or medical provocation. Precise mapping of these arrhythmias is challenging or even impossible by contact mapping, while other arrhythmias are poorly tolerated and need early termination...
July 10, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29946891/-epicardial-vt-ablation-in-whom-when-how-and-why
#2
REVIEW
E Ene, P Halbfaß, K Nentwich, K Sonne, A Berkovitz, A-K Wolf, T Deneke
Ventricular tachycardia (VT) is a leading cause of cardiovascular death and remains the main cause of sudden cardiac death. Implanted cardiac defibrillators (ICD) improve survival but the recurrent ICD therapies, mostly ICD shocks, are associated with an increased mortality and deleterious psychological effects. In this regard and based on the results of multicenter studies, the current European guidelines recommend early referral for catheter ablation. The ablation strategy (isolated endocardial approach or combined epi-/endocardial) depends mostly on the underlying myocardial disease...
June 26, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29946890/-mapping-and-ablation-of-cardiac-arrhythmias-never-forget-where-you-are-coming-from
#3
REVIEW
Henning Jansen, Jürgen Siebels, Rodolfo Ventura, Joachim Hebe, Christian Sohns
With the rapid development of new mapping and imaging technologies as well as catheter ablation technologies, it is increasingly important to understand the basic concepts of conventional mapping and ablation of cardiac arrhythmias. Prerequisite for successful ablation is the exact identification of the tachycardia mechanism and subsequent localization of the origin or tachycardic substrate. Only intracardiac electrograms provide decisive information regarding activation time and signal morphology. In some arrhythmias, it is necessary to supplement conventional mapping with so-called pace and/or entrainment mapping...
June 26, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29946889/-modern-mapping-technologies-technical-background-and-clinical-use
#4
REVIEW
Felix Bourier, Frédéric Sacher
Successful mapping and ablation of arrhythmias can be a challenging clinical task. For many years, conventional pacing maneuvers and activation mapping were the gold standard to identify underlying arrhythmia mechanisms in ablation procedures. In the last decade, technology has dramatically improved. In parallel to high-density automated mapping, cardiac imaging and image integration tools are increasingly used to assess the arrhythmia substrate and identify reentrant circuits. The aim of this review is to describe the technologies underlying these new mapping systems and to discuss their possible role in providing new insights into identification and visualization of arrhythmia mechanisms...
June 26, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29876875/bradycardia-in-a-newborn
#5
Ismail Al Abri, Ghaliah Al Mohani, Carsten W Israel
No abstract text is available yet for this article.
June 6, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29766267/-syncopes-and-channelopathies
#6
REVIEW
Johanna Müller-Leisse, Christos Zormpas, Thorben König, David Duncker, Christian Veltmann
Syncope can be the first manifestation of cardiac channelopathies, namely Brugada syndrome, long QT syndrome, short QT syndrome and catecholaminergic polymorphic ventricular tachycardia (CPVT). Patients affected by these rare diseases are at increased risk for sudden cardiac death due to ventricular tachyarrhythmias and require specific therapy and follow-up. As syncope is common in the general population, only few cases are caused by an underlying channelopathy. Nevertheless, the diagnosis should be considered in young patients with structurally normal hearts, especially if the history of syncope is typical for an arrhythmogenic cause, in the presence of characteristic echocardiogram (ECG) patterns, and if there is a family history of channelopathies or sudden cardiac death...
May 15, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29766266/-syncope-and-fitness-to-drive
#7
REVIEW
Hermann H Klein
Although medical students are rarely instructed in traffic medicine in Germany, they are obliged to inform their patients about their fitness to drive after having become a medical doctor. This article gives an overview on the fitness to drive for patients with syncope by referring to the driving license regulation and the current guidelines released by the department of traffic. The driving license regulation distinguishes between group 1 and group 2 drivers. Group 1 drivers drive vehicles with a total weight less than 3...
May 15, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29761339/-syncope-in-hypertrophic-obstructive-cardiomyopathy
#8
REVIEW
Hubert Seggewiß, Angelika Koljaja-Batzner, Kornelia Seggewiß, Malte Meesmann
Hypertrophic cardiomyopathy is the most common genetic cardiac disease. The most important pathophysiological finding is dynamic (outflow tract) obstruction of the left ventricle in about 70% of affected patients. Especially in younger patients, an increased risk of sudden cardiac death has been observed. Syncope and presyncope-in addition to extremely variable cardiac symptoms (dyspnea and angina)-are common. The etiology of syncope is complex. The most important aspect for diagnosis is a detailed history regarding the accompanying circumstances of the syncope...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29761338/-journey-of-the-s%C3%A2-icd-to-first-line-therapy
#9
REVIEW
Elif Kaya, Reza Wakili, Tienush Rassaf
The subcutaneous implantable cardioverter-defibrillator (S-ICD®, Boston Scientific, Marlborough, MA, USA, previously Cameron Health, San Clemente, CA, USA) represents an important milestone in ICD therapy for prevention of sudden cardiac death (SCD). Since the introduction of the S‑ICD in 2010, the device has undergone further development. Based on the unique feature of an entirely extracardiac implantation, the S‑ICD is able to reduce the common perioperative and long-term complications of the usual endovascular implanted ICD systems...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29761337/-psychogenic-non-epileptic-seizures-differential-diagnostic-features
#10
REVIEW
Philipp S Reif, Laurent M Willems, Adam Strzelczyk, Karl Martin Klein, Felix Rosenow
Psychogenic nonepileptic seizures (PNES) are to be considered in the differential diagnosis of a transient loss of consciousness. Their discrimination from syncope, epileptic seizures or vascular events can be difficult and requires profound knowledge about the semiology and clinical presentation of PNES and their differential diagnoses. Erroneous diagnoses and the resulting therapies lead to elevated morbidity, elevated costs and a poorer outcome. The aim of the present article is to provide an overview on PNES and their delineation from the clinical pictures of epilepsy and syncope...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29761336/-syncope-in-children-and-adolescents
#11
REVIEW
Matthias J Müller, Thomas Paul
Syncope is common in children and adolescents. Neurally mediated syncope including pallid and cyanotic breath holding spells, vagovasal syncope and neurocardiogenic syncope is based on a common pathomechanism and accounts for approximately 75% of cases. A potentially life-threatening cardiac cause of syncope may be present in up to 6%. Detailed history, physical examination and 12-lead electrocardiogram (ECG) allow discrimination between benign and serious syncope in the majority of pediatric patients. Tilt-testing can be useful when diagnosis is unclear...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29761335/-biomarkers-and-atrial-fibrillation-prediction-of-recurrences-and-thromboembolic-events-after-rhythm-control-management
#12
REVIEW
Jelena Kornej, Katja Schumacher, Daniela Husser, Gerhard Hindricks
Atrial fibrillation (AF) is the most common arrhythmia in clinical praxis and is associated with an increased risk for cardio- and cerebrovascular complications leading to an increased mortality. Catheter ablation represents one of the most important and efficient therapy strategies in AF patients. Nevertheless, the high incidence of arrhythmia recurrences after catheter ablation leads to repeated procedures and higher treatment costs. Recently, several scores had been developed to predict rhythm outcomes after catheter ablation...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29761334/-do-we-need-syncope-units-experience-from-bolzano-south-tyrol-italy
#13
REVIEW
Matthias Unterhuber, Marco Tomaino, Michele Brignole
Syncope is a common cause for presentation to the emergency department. Because of the numerous differential diagnoses which can be life-threatening, it can be a challenging work-up for the physician. This often results in admission rates that are too high and hospital stays that are too long with consequent high costs. Several studies have shown the inferiority of best-clinical practice to an evidence-based approach in syncope work-up, which results in underdiagnosis and often incorrect diagnosis of syncope...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29904794/-syncope-update-2018
#14
EDITORIAL
Carsten W Israel, Malte Meesmann
No abstract text is available yet for this article.
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29904793/-tips-for-taking-the-medical-history-in-patients-with-syncope
#15
REVIEW
Carsten W Israel
Transient loss of consciousness represents one of the most frequent reasons for patients to present in the emergency room. Already at the very beginning, the diagnostic work-up is faced with fundamental questions: (1) Was it really a loss of consciousness? (2) Which department (neurology, cardiology, or others) should check the patient? (3) Is an in-hospital diagnostic work-up required? These questions can be answered from a meticulous patient history which needs to be adjusted to the individual case but also has to systematically go through a list of questions...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29845316/adenosine-hypersensitivity-and-atrioventricular-block
#16
REVIEW
Jean-Claude Deharo, Michele Brignole, Régis Guieu
Adenosine is a ubiquitous substance that is released under several physiological and pathological conditions and has cardiovascular effects including cardioinhibition and vasodilation. It has been shown to be an important modulator implicated in several forms of syncope. In patients with chronic low plasma levels of adenosine, a transient release of endogenous adenosine can be sufficient to block conduction in the atrioventricular node and induce prolonged asystole; conversely, when plasma adenosine levels are chronically high, adenosine release is responsible for vasodepression...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29802445/pacing-in-neurocardiogenic-vasovagal-syncope
#17
REVIEW
Richard Sutton
Pacing for neurocardiogenic or vasovagal syncope (VVS) has been practised for five decades, but the 1986 advent of tilt testing provided a means of diagnosis frequently revealing, in the early days, asystole caused by VVS. This was the basis for pacing these patients and the first studies created enthusiasm followed by randomised controlled trials, which were imperfectly designed, "confirming" benefit. When better trial design was employed, there was no obvious benefit. However, some cardiologists had seen patients experience a huge positive difference with pacing, so they set out to identify them...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29796760/true-vs-pseudo-electrical-ventricular-alternans-sustained-by-ventricular-premature-complexes
#18
S S Barold, K Rajamani, A Kucher
This report describes a form of electrical ventricular alternans sustained by ventricular premature complexes (VPC). Alternans was associated with a constant heart rate (RR interval) and was therefore considered to be either a form of classic or true alternans or a mimic of the configuration seen in true alternans from other causes. In contrast, VPC-induced pseudo-alternans is characterized by an inconstant heart rate (RR interval). It is surprising that the incidence of true VPC-induced alternans is unappreciated and virtually unreported, most probably since the measurement of the RR intervals involving late VPCs is ignored...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29721651/-indications-for-loop-recorder-implantation-for-syncope
#19
REVIEW
Andreas Schuchert
Implantable loop recorder with discontinuous ECG recording enables monitoring of heart rhythm over several years. Consequently, in patients with recurrent syncope it is possible to record an ECG during the next syncopal event to obtain symptom-ECG correlations. In patients with recurrent syncope of unknown origin, the implantation of a loop recorder leads to an earlier diagnosis and an asystole is more often detected as the cause of the recurrent syncope. In addition, the loop recorder identifies patients who will benefit from pacemaker implantation...
June 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29696347/syncope-and-bundle-branch-block-diagnostic-approach
#20
REVIEW
Angel Moya, Nuria Rivas-Gandara, Jordi Perez-Rodón, Jaume Franciso-Pascual, Alba Santos-Ortega, Patricia Fumero, Ivo Roca-Luque
Syncope and bundle branch block are reviewed, addressing their specific clinical characteristics, natural history, initial diagnostic approach and the role and limitations of different diagnostic tests with a special focus on electrophysiological studies and implantable loop recorders. A critical review of the different published strategies to be followed in these patients is made and finally an algorithm of how to manage these patients is proposed.
June 2018: Herzschrittmachertherapie & Elektrophysiologie
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