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Cardiac Electrophysiology Clinics

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https://www.readbyqxmd.com/read/29173420/sudden-cardiac-death-contemporary-challenges
#1
EDITORIAL
Mohammad Shenasa, N A Mark Estes, Gordon F Tomaselli
No abstract text is available yet for this article.
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173419/sudden-cardiac-death-back-to-the-future
#2
EDITORIAL
Ranjan K Thakur, Andrea Natale
No abstract text is available yet for this article.
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173418/future-directions-management-of-sudden-cardiac-death
#3
REVIEW
Robert W Neumar
There will always be a need to optimize early recognition and treatment of sudden cardiac arrest. For out-of-hospital cardiac arrest, this requires a complex system of care involving bystanders, 911 dispatchers, and emergency medical service and hospital-based providers. Optimizing this system is fundamental to improving outcomes. In addition, personnel and resources are needed to develop and sustain a research pipeline that will bring new scientific discoveries and technologies to the field. The 2015 Institute of Medicine report, "Strategies to Improve Cardiac Arrest Survival: A Time to Act," provides a roadmap...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173417/the-subcutaneous-defibrillator
#4
REVIEW
Jonathan Weinstock, Christopher Madias
The transvenous implantable cardioverter-defibrillator (ICD) has been shown in multiple studies to be effective in the prevention of sudden cardiac death in select populations. The Achilles heel of traditional ICD technology has been the transvenous lead. The subcutaneous ICD provides effective sudden death protection while avoiding lead-related complications of traditional transvenous systems. The subcutaneous ICD is a reasonable option for patients with an ICD indication who do not need bradycardia pacing or cardiac resynchronization therapy...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173416/primary-prevention-implantable-cardiac-defibrillator-trials-what-have-we-learned
#5
REVIEW
Jakub Sroubek, Alfred E Buxton
Patients with impaired left ventricular systolic function frequently die suddenly because of arrhythmic and nonarrhythmic causes. Nine trials have evaluated the utility of implantable cardioverter-defibrillator (ICDs) primary prevention of sudden cardiac death. Individuals with stable ischemic heart disease (no recent myocardial infarction), especially those with inducible arrhythmias, seem to derive the highest mortality benefit from prophylactic ICD use. The role of ICDs in other patient populations is much less clear and may even be harmful...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173415/sudden-cardiac-death-lessons-learned-from-cardiac-implantable-rhythm-devices
#6
REVIEW
Pasquale Santangeli, Andrew E Epstein
Trials have demonstrated that implantable-cardioverter defibrillators (ICDs) are effective in preventing sudden cardiac death (SCD). The degree of left ventricular dysfunction is the only parameter to identify primary prevention populations at higher risk of SCD in which ICDs may reduce longitudinal mortality risk. Clinical application of current stratification approaches based on left ventricular ejection fraction (LVEF) alone has failed to prevent most SCD in the general population. This lack of specificity has resulted in a significant number of potentially unnecessary ICDs...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173414/neuromuscular-disease-cardiac-manifestations-and-sudden-death-risk
#7
REVIEW
Worawan Limipitikul, Chin Siang Ong, Gordon F Tomaselli
Cardiovascular complications of neuromuscular diseases disproportionately affect the cardiac conduction system. Cardiomyopathy and cardiac arrhythmias produce significant morbidity and mortality. Patients with neuromuscular diseases should be carefully and frequently evaluated for the presence of bradycardia, heart block, and tachyarrhythmias. Preemptive treatment with permanent pacemakers or implanted defibrillators is appropriate in patients with conduction system disease or who are at risk for ventricular arrhythmias...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173413/sudden-cardiac-death-in-acute-coronary-syndromes
#8
REVIEW
Nikolaos Dagres, Gerhard Hindricks
Sudden cardiac death in acute coronary syndromes mostly results from complex ventricular arrhythmias. Although the incidence has fallen with contemporary management, they still pose a threat for many patients. Treatment consists of immediate termination by electrical cardioversion and prompt coronary revascularization for relief of ischemia. Beta-blockers administered prophylactically have a protective effect. For recurrent episodes, pharmacologic treatment consists of beta-blockers and amiodarone, or, in nonresponsive patients, lidocaine...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173412/heart-failure-and-sudden-cardiac-death
#9
REVIEW
Basil Saour, Bryan Smith, Clyde W Yancy
The Centers for Diseases Control and Prevention estimates that 5.7 million adults in the United States suffer from heart failure and 1 in 9 deaths in 2009 cited heart failure as a contributing cause. Almost 50% of patients who are diagnosed with heart failure die within 5 years of diagnosis. Cardiovascular disease is a public health burden. The prognosis of patients with heart failure has improved significantly. However, the risk for death remains high. Managing sudden death risk and intervening appropriately with primary or secondary prevention strategies are of paramount importance...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173411/ventricular-arrhythmias-and-sudden-cardiac-death
#10
REVIEW
Pok Tin Tang, Mohammad Shenasa, Noel G Boyle
Ventricular arrhythmias remain a significant cause of sudden cardiac death (SCD), and knowledge of their cause and high-risk features is important. SCD occurs when the interaction between vulnerable substrates and acute triggers results in sustained ventricular tachycardia progressing to ventricular fibrillation. Here, the authors aim to review the role of ventricular arrhythmias in SCD, first by approaching the substrates that support ventricular arrhythmias, and then by exploring features of these substrates and the acute triggers that may lead to SCD...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173410/sudden-cardiac-death-in-ischemic-heart-disease-pathophysiology-and-risk-stratification
#11
REVIEW
Nabil El-Sherif, Mohamed Boutjdir, Gioia Turitto
Sudden cardiac death (SCD) accounts for approximately 360,000 deaths annually in the United States. Ischemic heart disease is the major cause of death in the general adult population. SCD can be due to arrhythmic or nonarrhythmic cardiac causes. Arrhythmic SCD may be caused by ventricular tachyarrhythmia or pulseless electrical activity/asystole. This article reviews the most recent pathophysiology and risk stratification strategies for SCD, emphasizing electrophysiologic surrogates of conduction disorder, dispersion of repolarization, and autonomic imbalance...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173409/cardiac-innervation-and-the-autonomic-nervous-system-in-sudden-cardiac-death
#12
REVIEW
William A Huang, Noel G Boyle, Marmar Vaseghi
Neural remodeling in the autonomic nervous system contributes to sudden cardiac death. The fabric of cardiac excitability and propagation is controlled by autonomic innervation. Heart disease predisposes to malignant ventricular arrhythmias by causing neural remodeling at the level of the myocardium, the intrinsic cardiac ganglia, extracardiac intrathoracic sympathetic ganglia, extrathoracic ganglia, spinal cord, and the brainstem, as well as the higher centers and the cortex. Therapeutic strategies at each of these levels aim to restore the balance between the sympathetic and parasympathetic branches...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173408/biomarkers-to-predict-cardiovascular-death
#13
REVIEW
Devinder S Dhindsa, Jay Khambhati, Pratik B Sandesara, Danny J Eapen, Arshed A Quyyumi
This article reviews biomarkers that have been shown to identify subjects at increased risk for cardiovascular death within the general population, in those with established coronary artery disease, and in those with heart failure. Use of biomarkers for risk stratification for sudden cardiac death continues to evolve. It seems that a multimarker strategy for risk stratification using simple measures of circulating proteins and usual clinical risk factors, particularly in patients with known coronary artery disease, can be used to identify patients at near-term risk of death...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173407/role-of-cardiac-imaging-in-evaluating-risk-for-sudden-cardiac-death
#14
REVIEW
Constancia Macatangay, Juan F Viles-Gonzalez, Jeffrey J Goldberger
Sudden cardiac death (SCD) is a major cause of death from cardiovascular disease. Our ability to predict patients at the highest risk of developing lethal ventricular arrhythmias remains limited. Despite recent studies evaluating risk stratification tools, there is no optimal strategy. Cardiac imaging provides the opportunity to assess left ventricular ejection fraction, strain, fibrosis, and sympathetic innervation, all of which are pathophysiologically related to SCD risk. These modalities may play a role in the identification of vulnerable anatomic substrates that provide the pathophysiologic basis for SCD...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173406/prediction-and-prevention-of-sudden-cardiac-death
#15
REVIEW
Daniel P Morin, Munther K Homoud, N A Mark Estes
Sudden death is a major problem, with significant impact on public health. Many conditions predispose to sudden cardiac death and sudden cardiac arrest (SCA), foremost among them coronary artery disease, and an effective therapy exists in the form of the implantable cardioverter defibrillator. Risk stratification for SCA remains imperfect, especially for patients with nonischemic cardiomyopathy. Ongoing trials may make it easier to identify those at high risk, and potentially those at very low risk, in the future...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173405/electrocardiographic-markers-of-sudden-cardiac-death-including-left-ventricular-hypertrophy
#16
REVIEW
Andrés Ricardo Pérez-Riera, Raimundo Barbosa-Barros, Mohammad Shenasa
Although the electrocardiograph (ECG) was invented more than 100 years ago, it remains the most commonly used test in clinical medicine. It is easy to perform, relatively cheap, and results are readily available. Interpretation, however, needs expertise and knowledge. New data, phenomenon, and syndromes are continually discovered by the ECG. It is important to differentiate between normal and abnormal ECGs first and then try to correlate the findings with clinical pathologies. Furthermore, the ECG is an integral part of the screening model for a variety of conditions such as channelopathies, athletes, preoperative risk profile, and remains the cardiologist's best friend...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173404/sudden-cardiac-death-in-genetic-cardiomyopathies
#17
REVIEW
Gourg Atteya, Rachel Lampert
Sudden cardiac death (SCD) caused by ventricular arrhythmias is common in patients with genetic cardiomyopathies (CMs) including dilated CM, hypertrophic CM, and arrhythmogenic right ventricular CM (ARVC). Phenotypic features can identify individuals at high enough risk to warrant placement of an implantable cardioverter-defibrillator, although risk stratification schemes remain imperfect. Genetic testing is valuable for family cascade screening but with few exceptions (eg, LMNA mutations) do not identify higher risk for SCD...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173403/sudden-cardiac-death-in-children-and-adolescents
#18
REVIEW
Elizabeth D Sherwin, Charles I Berul
Sudden cardiac death (SCD) is a rare but devastating event in children and adolescents. Etiologies include congenital heart disease, cardiomyopathies, primary arrhythmia syndromes, and miscellaneous conditions. Challenges in the diagnosis and prevention of SCD in the young are reviewed.
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173402/sudden-cardiac-death-during-sports-activities-in-the-general-population
#19
REVIEW
Kumar Narayanan, Wulfran Bougouin, Ardalan Sharifzadehgan, Victor Waldmann, Nicole Karam, Eloi Marijon, Xavier Jouven
Regular exercise reduces cardiovascular and overall mortality. Participation in sports is an important determinant of cardiovascular health and fitness. Regular sports activity is associated with a smaller risk of sudden cardiac death (SCD). However, there is a small risk of sports-related SCD. Sports-related SCD accounts for approximately 5% of total SCD. SCD among athletes comprises only a fraction of all sports-related SCD. Sport-related SCD has a male predominance and an average age of affliction of 45 to 50 years...
December 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/29173401/public-access-defibrillation-is-this-making-any-difference-controversial-issues-in-resuscitation-from-cardiac-arrest
#20
REVIEW
Myron L Weisfeldt, Ross A Pollack
Public access defibrillation is particularly valuable in witnessed cardiac arrests that occur in public places. Bystander and police use of automated external defibrillators (AEDs) has increased over the past 15 years, resulting in improved survival with normal or near-normal neurologic function. There is great promise for increasing bystander use of defibrillators as the technology is applied to linking patients with shockable arrests to volunteers committed to bringing AEDs to the patients. There continues to be controversy as to the value of epinephrine, antiarrhythmic drugs, hypothermia, and mechanical chest compression in resuscitative efforts...
December 2017: Cardiac Electrophysiology Clinics
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