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Cardiac Electrophysiology Clinics

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https://www.readbyqxmd.com/read/28457248/cardiac-arrhythmias-in-adults-with-congenital-heart-disease
#1
EDITORIAL
Seshadri Balaji, Ravi Mandapati, Kalyanam Shivkumar
No abstract text is available yet for this article.
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457247/foreword
#2
EDITORIAL
Ranjan K Thakur, Andrea Natale
No abstract text is available yet for this article.
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457246/arrhythmia-surgery-for-adults-with-congenital-heart-disease
#3
REVIEW
Barbara J Deal, Constantine Mavroudis
Patients with repaired or unrepaired congenital heart anomalies are at increased risk for arrhythmia development throughout their lives, often paralleling the need for reoperations for hemodynamic residua. The ability to incorporate arrhythmia surgery into reoperations can result in improvement in functional class and decreased need for antiarrhythmic medications. Every reoperation for congenital heart disease can be viewed as an opportunity to assess the electrical and arrhythmia substrates and to intervene to improve the arrhythmias and the hemodynamic condition of the patient...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457245/cardiac-arrhythmias-in-adults-with-congenital-heart-disease-pacemakers-implantable-cardiac-defibrillators-and-cardiac-resynchronization-therapy-devices
#4
REVIEW
Frank Cecchin, Daniel G Halpern
Implanting cardiac rhythm medical devices in adults with congenital heart disease requires training in congenital heart disease. The techniques and indications for device implantation are specific to the anatomic diagnosis and state of disease progression. It often requires a team of physicians and is best performed at a specialized adult congenital heart center.
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457244/catheter-ablation-general-principles-and-advances
#5
REVIEW
Sabine Ernst
Besides antiarrhythmic medication, there are now very good options for a potentially curative therapy by catheter ablation targeting the origin of the underlying arrhythmias in patients with complex congenital heart disease. Three-dimensional (3D) reconstruction of tomographic imaging (MRI or computed tomography) is helpful to understand the underlying cardiac anatomy, identify the most likely target chamber, and help with planning access. Use of the available 3D mapping systems (sequential or simultaneous acquisition) and (if available) more advanced navigation systems, such as remote magnetic navigation, can improve the acute and long-term outcomes of catheter ablation in congenital heart disease...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457243/drug-therapy-in-adult-congenital-heart-disease
#6
REVIEW
Tahmeed Contractor, Vadim Levin, Ravi Mandapati
Adults with congenital heart disease are at risk for atrial and ventricular arrhythmias that can lead to an increased morbidity as well as mortality. When catheter ablation is not an option or unsuccessful, antiarrhythmic drugs are the mainstay of treatment. There is limited data on the use of antiarrhythmics in this population. The purpose of this article is to discuss the practical aspects of the use of antiarrhythmics in adults with congenital heart disease. Several tables have been provided to provide clinicians a reference for daily use...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457242/clinical-aspects-and-ablation-of-ventricular-arrhythmias-in-tetralogy-of-fallot
#7
REVIEW
Katja Zeppenfeld, Adrianus P Wijnmaalen
Life expectancy of patients with rToF has considerably improved due to refined surgical interventions. Monomorphic fast VTs are frequently encountered in adult patients with rToF. The dominant substrate of VT is anatomical isthmuses bordered by surgical incisions, patch material and valve annuli. Substrate based ablation strategies aim to transect all slow conducting anatomical isthmuses (SCAI) as identified by electroanatomical mapping. Procedural success is defined as non-inducibility of VT and confirmed conduction block over the SCAI resulting in long-term VT free survival in most patients...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457241/development-of-tachyarrhythmias-late-after-the-fontan-procedure-the-role-of-ablative-therapy
#8
REVIEW
Natasja M S de Groot, Ad J J C Bogers
Patients with a Fontan circulation are at a high risk of developing a variety of cardiac dysrhythmias after cardiac surgery. These dysrhythmias are most often supraventricular tachyarrhythmias (SVT), but ventricular tachyarrhythmias (VT) may also occur. Mechanisms underlying SVT are variable, including both ectopic activity and reentry. Over time, successive SVT may be caused by different mechanisms. The acute success rate of ablative therapy of atrial tachyarrhythmias is considerably high yet during long-term follow-up 'recurrences' frequently occur...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457240/arrhythmias-following-the-mustard-and-senning-operations-for-dextro-transposition-of-the-great-arteries-clinical-aspects-and-catheter-ablation
#9
REVIEW
Sherrie Joy Baysa, Melissa Olen, Ronald J Kanter
The atrial switch operations, the Mustard and Senning procedures, performed for dextro-transposition of the great arteries, have largely been supplanted by the arterial switch operation. As such, affected patients will only exist for approximately 30 more years. The main arrhythmias in these patients include sinoatrial node dysfunction, intraatrial reentry tachycardia, and sudden death. Device therapy for these patients is well-established, and catheter ablation for atrial tachycardias is highly efficacious...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457239/ebstein-anomaly
#10
REVIEW
Elizabeth D Sherwin, Dominic J Abrams
Ebstein anomaly is a rare form of congenital heart disease with a uniquely high prevalence of arrhythmias. The most prevalent arrhythmia mechanisms are intrinsic to the underlying embryologic defects and may manifest at any stage. Current electrophysiological and surgical strategies are well equipped to address these arrhythmia mechanisms, yet despite available technology and a robust understanding of the mechanisms, these cases remain challenging. Surgical techniques that render arrhythmia substrates unreachable mandate comprehensive presurgical electrophysiological assessment and potential ablation...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457238/arrhythmias-in-patients-with-atrial-defects
#11
REVIEW
Tahmeed Contractor, Ravi Mandapati
Atrial arrhythmias are common in patients with atrial septal defects. A myriad of factors are responsible for these that include remodeling related to the defect and scar created by the repair or closure. An understanding of potential arrhythmias, along with entrainment and high-density activation mapping can result in accurate diagnosis and successful ablation. Atrial fibrillation is being seen increasingly after patent foramen ovale closure and may be the primary etiology of recurrent stroke in these patients...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457237/sudden-cardiac-death-in-adult-congenital-heart-disease
#12
REVIEW
Pablo Ávila, Marie-A Chaix, Blandine Mondésert, Paul Khairy
Sudden death of presumed arrhythmic etiology is a leading cause of mortality in adults with congenital heart disease. Anticipated benefits of the implantable cardioverter-defibrillator (ICD) must be weighed against high complication rates. Without robust evidence from randomized trials, caregivers face difficult decisions in selecting appropriate candidates. Although secondary prevention indications are often clear-cut, risk stratification for primary prevention ICDs is more challenging. Factors associated with sudden death in patients with tetralogy of Fallot are reasonably consistent across studies...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457236/ventricular-arrhythmias-in-adult-congenital-heart-disease-mechanisms-diagnosis-and-clinical-aspects
#13
REVIEW
Gnalini Sathananthan, Louise Harris, Krishnakumar Nair
The risk of ventricular arrhythmias in the adult congenital heart disease population increases with age. The mechanism, type, and frequency vary depending on the complexity of the defect, whether it has been repaired, and the type and timing of repair. Risk stratification for sudden death in patients with congenital heart disease is often challenging. Current recommendations provide a useful guide for management of these patients and risk stratification continues to evolve. Internal cardiac defibrillator implantation is often challenging due to limited transvenous access, often resulting in the need for epicardial or subcutaneous devices...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457235/supraventricular-tachycardia-in-adult-congenital-heart-disease-mechanisms-diagnosis-and-clinical-aspects
#14
REVIEW
Christopher M Janson, Maully J Shah
Supraventricular arrhythmias represent a major source of morbidity in adults with congenital heart disease (ACHD). Anatomic variants and post-operative changes contribute to a unique electrophysiologic milieu ripe for the development of supraventricular tachycardia. Intra-atrial reentrant tachycardia is the most prevalent mechanism. Atrioventricular reciprocating tachycardia is common in lesions associated with accessory pathways. Abnormal anatomy complicates the management of atrioventricular nodal reentrant tachycardia...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457234/bradyarrhythmias-in-congenital-heart-disease
#15
REVIEW
Steven K Carlson, Akash R Patel, Philip M Chang
Bradyarrhythmias in adults with congenital heart disease (CHD) comprise a complex group of arrhythmia disorders with congenital and acquired origins, highly variable long-term sequelae, and complicated treatment options. They can develop across the spectrum of CHD defects and can be encountered at all ages. Although permanent pacing is effective in treating bradyarrhythmias, it is associated with many complications and morbidity, where it is often used early in life. This section discusses the incidence and prevalence of bradyarrhythmias in the CHD population, their timing of occurrence with respect to specific disease entities and interventions, and their short- and long-term clinical sequelae...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457233/introduction-to-the-congenital-heart-defects-anatomy-of-the-conduction-system
#16
REVIEW
Jeremy P Moore, Jamil A Aboulhosn
The position and course of the conduction system in congenital heart disease are intricately tied to the underlying congenital malformation. Although only subtle differences exist between the anatomy of the conduction axis for simple congenital heart lesions and normal anatomy, almost every patient with congenital heart disease harbors some important anatomic variation. This article summarizes the body of literature by retaining original classical concepts and by attempting to translate the available knowledge into useful points for the congenital heart disease specialist...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167092/ventricular-tachycardia-in-structural-heart-disease
#17
EDITORIAL
Amin Al-Ahmad, Francis E Marchlinski
No abstract text is available yet for this article.
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167091/ventricular-tachycardia-ablation
#18
EDITORIAL
Ranjan K Thakur, Andrea Natale
No abstract text is available yet for this article.
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167090/ablation-of-ventricular-tachycardia-in-arrhythmogenic-right-ventricular-dysplasia
#19
REVIEW
Rajeev K Pathak, Fermin C Garcia
Endocardial and epicardial electroanatomical mapping and ablation is a safe and effective therapy in the treatment of right ventricle arrhythmias occurring in the setting of arrhythmogenic right ventricular cardiomyopathy (ARVD). Careful mapping and ablation plans must be tailored for each patient based on comorbidities and ventricular tachycardia morphologies. This review focuses on the catheter ablation for ventricular arrhythmias in patients with ARVD.
March 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28167089/alternative-approaches-for-ablation-of-resistant-ventricular-tachycardia
#20
REVIEW
Carola Gianni, Sanghamitra Mohanty, Chintan Trivedi, Luigi Di Biase, Amin Al-Ahmad, Andrea Natale, J David Burkhardt
Ventricular tachycardia (VT) ablation is usually performed with an ablation catheter that delivers unipolar radiofrequency (RF) energy to eliminate the re-entry circuit responsible for VT. However, there are some instances when unipolar RF ablation fails, notably in VTs with a deep intramural origin, or cases in which epicardial access is not attainable due to prior cardiac surgery. To overcome these limitations, several alternative approaches have been used in clinical practice, including alcohol ablation or coil embolization, simultaneous unipolar or bipolar RF ablation, surgical ablation, or noninvasive ablation with stereotactic radiosurgery...
March 2017: Cardiac Electrophysiology Clinics
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