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https://www.readbyqxmd.com/read/27886932/newer-echocardiographic-techniques-in-cardiac-resynchronization-therapy
#1
REVIEW
John Gorcsan, Bhupendar Tayal
Echocardiographic imaging plays a major role in patient selection for cardiac resynchronization therapy (CRT). One-third of patients do not respond; there is interest in advanced echocardiographic imaging to improve response. Current guidelines favor CRT for patients with electrocardiographic (ECG) QRS width of 150 milliseconds or greater and left bundle branch block. ECG criteria are imperfect; there is interest in advanced echocardiographic imaging to improve patient selection. This discussion focuses on newer echocardiographic methods to improve patient selection, improve delivery, and identify patients at risk for poor outcomes and serious ventricular arrhythmias...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27844191/-indications-for-implantable-loop-recorders-in-patients-with-channelopathies-and-ventricular-tachycardias
#2
Julia Köbe, Kristina Wasmer, Florian Reinke, Lars Eckardt
Implantable loop recorders (ILR) do not play a pivotal role in the current guidelines on ventricular arrhythmias except in identifying rhythm-symptom correlations if ventricular arrhythmias are assumed. Before a decision for a pure diagnostic implantable device is made, a thorough arrhythmic risk assessment is of major importance due to the potential lethal outcome of ventricular arrhythmias. Nevertheless, some clinical circumstances exist where long-term monitoring by an ILR may add significant information in electrical heart diseases, in patients with ventricular arrhythmias, or structural heart diseases and a potential risk of ventricular arrhythmias...
November 14, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27836307/early-detection-of-cardiac-involvement-in-sarcoidosis-with-2-dimensional-speckle-tracking-echocardiography
#3
Elie-Dan Schouver, Pamela Moceri, Denis Doyen, Nathalie Tieulie, Viviane Queyrel, Delphine Baudouy, Pierre Cerboni, Pierre Gibelin, Sylvie Leroy, Jean-Gabriel Fuzibet, Emile Ferrari
BACKGROUND/OBJECTIVES: Cardiac sarcoidosis (CS) is associated with high morbidity and sudden death. The absence of specific symptoms and lack of diagnostic gold standard technique is challenging. New imaging methods could improve the diagnosis of CS. The aim of our study was to assess the role of left ventricular (LV) longitudinal and circumferential strain as estimated by 2D speckle-tracking imaging in patients with diagnosed sarcoidosis without cardiac involvement according to the current guidelines...
October 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27754006/js-ish-esh-2-update-on-the-detection-and-follow-up-of-early-hypertensive-heart-disease
#4
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27749559/cardiac-device-implantation-in-fabry-disease-a-retrospective-monocentric-study
#5
Thomas Sené, Olivier Lidove, Joel Sebbah, Jean-Marc Darondel, Hervé Picard, Laurent Aaron, Olivier Fain, Thierry Zenone, Dominique Joly, Philippe Charron, Jean-Marc Ziza
The incidence and predictive factors of arrhythmias and/or conduction abnormalities (ACAs) requiring cardiac device (CD) implantation are poorly characterized in Fabry disease (FD). The aim of our retrospective study was to determine the prevalence, incidence, and factors associated with ACA requiring CD implantation in a monocentric cohort of patients with confirmed FD who were followed up in a department of internal medicine and reference center for FD.Forty-nine patients (20M, 29F) were included. Nine patients (4M, 5F; 18%) had at least one episode of ACA leading to device therapy...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27711072/numerous-brugada-syndrome-associated-genetic-variants-have-no-effect-on-j-point-elevation-syncope-susceptibility-malignant-cardiac-arrhythmia-and-all-cause-mortality
#6
Jonas Ghouse, Christian T Have, Morten W Skov, Laura Andreasen, Gustav Ahlberg, Jonas B Nielsen, Tea Skaaby, Søren-Peter Olesen, Niels Grarup, Allan Linneberg, Oluf Pedersen, Henrik Vestergaard, Stig Haunsø, Jesper H Svendsen, Torben Hansen, Jørgen K Kanters, Morten S Olesen
PURPOSE: We investigated whether Brugada syndrome (BrS)-associated variants identified in the general population have an effect on J-point elevation as well as whether carriers of BrS variants were more prone to experience syncope and malignant ventricular arrhythmia and had increased mortality compared with noncarriers. METHODS: All BrS-associated variants were identified using the Human Gene Mutation Database (HGMD). Individuals were randomly selected from a general population study using whole-exome sequencing data (n = 870) and genotype array data (n = 6,161) and screened for BrS-associated variants...
October 6, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/27702851/the-wearable-cardioverter-defibrillator-current-technology-and-evolving-indications
#7
Sven Reek, Haran Burri, Paul R Roberts, Christian Perings, Andrew E Epstein, Helmut U Klein
The wearable cardioverter-defibrillator has been available for over a decade and now is frequently prescribed for patients deemed at high arrhythmic risk in whom the underlying pathology is potentially reversible or who are awaiting an implantable cardioverter-defibrillator. The use of the wearable cardioverter-defibrillator is included in the new 2015 ESC guidelines for the management of ventricular arrhythmias and prevention of sudden cardiac death. The present review provides insight into the current technology and an overview of this approach...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27629507/pathogenesis-and-management-of-brugada-syndrome
#8
Juan Sieira, Gregory Dendramis, Pedro Brugada
Brugada syndrome is an inherited disease characterized by an increased risk of sudden cardiac death owing to ventricular arrhythmias in the absence of structural heart disease. Since the first description of the syndrome >20 years ago, considerable advances have been made in our understanding of the underlying mechanisms involved and the strategies to stratify at-risk patients. The development of repolarization-depolarization abnormalities in patients with Brugada syndrome can involve genetic alterations, abnormal neural crest cell migration, improper gap junctional communication, or connexome abnormalities...
September 15, 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27581243/-updated-esc-guideline-innovations-for-the-treatment-of-ventricular-arrhythmias-and-recommendations-for-prevention-of-sudden-cardiac-death
#9
L Eckardt, T Deneke
The 2015 European Society of Cardiology Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death is an update of the former 2006 European/American guidelines. This new consensus document gives a detailed overview on prevention and therapy of ventricular arrhythmias and sudden cardiac death. This includes detailed discussion of channelopathies and various cardiomyopathies. Gaps in evidence are identified and also discussed. DNA analysis and postmortem assessment in sudden cardiac death victims is for the first time part of these new recommendations...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27560278/rhythm-control-in-atrial-fibrillation
#10
REVIEW
Jonathan P Piccini, Laurent Fauchier
Many patients with atrial fibrillation have substantial symptoms despite ventricular rate control and require restoration of sinus rhythm to improve their quality of life. Acute restoration (ie, cardioversion) and maintenance of sinus rhythm in patients with atrial fibrillation are referred to as rhythm control. The decision to pursue rhythm control is based on symptoms, the type of atrial fibrillation (paroxysmal, persistent, or long-standing persistent), patient comorbidities, general health status, and anticoagulation status...
August 20, 2016: Lancet
https://www.readbyqxmd.com/read/27538377/integration-of-60-000-exomes-and-acmg-guidelines-question-the-role-of-catecholaminergic-polymorphic-ventricular-tachycardia-associated-variants
#11
C Paludan-Müller, G Ahlberg, J Ghouse, C Herfelt, J H Svendsen, S Haunsø, J K Kanters, M S Olesen
Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) is a highly lethal cardiac arrhythmia disease occurring during exercise or psychological stress. CPVT has an estimated prevalence of 1:10,000 and has mainly been associated with variants in calcium-regulating genes. Identification of potential false-positive pathogenic variants was conducted by searching the Exome Aggregation Consortium (ExAC) database (n = 60,706) for variants reported to be associated with CPVT. The pathogenicity of the interrogated variants was assessed using guidelines from the American College of Medical Genetics and Genomics (ACMG) and in silico prediction tools...
August 19, 2016: Clinical Genetics
https://www.readbyqxmd.com/read/27443438/cardiac-sarcoidosis
#12
REVIEW
David H Birnie, Pablo B Nery, Andrew C Ha, Rob S B Beanlands
Clinically manifest cardiac involvement occurs in perhaps 5% of patients with sarcoidosis. The 3 principal manifestations of cardiac sarcoidosis (CS) are conduction abnormalities, ventricular arrhythmias, and heart failure. An estimated 20% to 25% of patients with pulmonary/systemic sarcoidosis have asymptomatic cardiac involvement (clinically silent disease). In 2014, the first international guideline for the diagnosis and management of CS was published. In patients with clinically manifest CS, the extent of left ventricular dysfunction seems to be the most important predictor of prognosis...
July 26, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27276869/electrocardiography-in-pre-participation-screening-and-current-guidelines-for-participation-in-competitive-sports
#13
Ljubica Georgijević, Lana Andrić
Electrocardiography (ECG) is especially significant in pre-participation screening due to its ability to discover or to rise a suspicion for certain cardiovascular diseases and conditions that represent a serious health risk in athletes. Common, conditionally benign and training related ECG changes are sinus bradycardia and sinus arrhythmia, first degree atrioventricular block, incomplete right bundle branch block, benign early repolarization, and isolated QRS voltage criteria for left ventricular enlargement...
January 2016: Srpski Arhiv za Celokupno Lekarstvo
https://www.readbyqxmd.com/read/27272896/assessing-utility-of-exercise-test-in-determining-exercise-prescription-in-adolescent-and-adult-patients-with-repaired-tetralogy-of-fallot
#14
Ming-Chun Yang, Chun-An Chen, Hsin-Hui Chiu, Jou-Kou Wang, Ming-Tai Lin, Shuenn-Nan Chiu, Chun-Wei Lu, Shu-Chien Huang, Mei-Hwan Wu
Parameters from cardiopulmonary exercise test (CPET) are useful prognostic factors for patients with repaired tetralogy of fallot (TOF). Its application in exercise prescription remains unclear. This study sought to define its role. We made current exercise recommendations in repaired TOF patients according to European Society of Cardiology (ESC) guideline, which were based on ventricular function, pressure/volume load, pulmonary artery pressure, hypoxemia and arrhythmic burden both at rest and during exercise...
June 6, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27261837/guidelines-for-potassium-channel-blocker-use
#15
REVIEW
Anne M Gillis
This article summarizes recommendations for the clinical use of antiarrhythmic drugs for the treatment and prevention of atrial and ventricular arrhythmias based on current guideline and consensus documents. The choice of antiarrhythmic drug is based on the efficacy and safety profile and influenced by the presence or absence of structural heart disease. Because of its adverse side-effect profile, amiodarone is recommended for the management of atrial fibrillation only when other agents have failed or are contraindicated...
June 2016: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/27250216/ventricular-arrhythmias-and-sudden-cardiac-death-in-adults-with-congenital-heart-disease
#16
Paul Khairy
Remarkable gains in survival have led to an unprecedented number of adults with congenital heart disease. Arrhythmias collectively comprise the most common complication encountered. Recognising the unique issues and challenges involved in managing arrhythmias in adults with congenital heart disease and the consequential decisions surrounding sudden death prevention, expert societies have proposed evidence-based recommendations. On the whole, acute ventricular arrhythmias are managed according to general cardiology guidelines, while taking into consideration congenital heart disease-specific issues, such as positioning of patches or paddles according to location of the heart...
November 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27235787/human-ex-vivo-action-potential-model-for-pro-arrhythmia-risk-assessment
#17
Guy Page, Phachareeya Ratchada, Yannick Miron, Guido Steiner, Andre Ghetti, Paul E Miller, Jack A Reynolds, Ken Wang, Andrea Greiter-Wilke, Liudmila Polonchuk, Martin Traebert, Gary A Gintant, Najah Abi-Gerges
While current S7B/E14 guidelines have succeeded in protecting patients from QT-prolonging drugs, the absence of a predictive paradigm identifying pro-arrhythmic risks has limited the development of valuable drug programs. We investigated if a human ex-vivo action potential (AP)-based model could provide a more predictive approach for assessing pro-arrhythmic risk in man. Human ventricular trabeculae from ethically consented organ donors were used to evaluate the effects of dofetilide, d,l-sotalol, quinidine, paracetamol and verapamil on AP duration (APD) and recognized pro-arrhythmia predictors (short-term variability of APD at 90% repolarization (STV(APD90)), triangulation (ADP90-APD30) and incidence of early afterdepolarizations at 1 and 2Hz to quantitatively identify the pro-arrhythmic risk...
September 2016: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/27234868/long-term-follow-up-of-implantable-cardioverter-defibrillators-in-adult-congenital-heart-disease-patients-indications-and-outcomes
#18
Sandhya Santharam, Lucy Hudsmith, Sara Thorne, Paul Clift, Howard Marshall, Joseph De Bono
AIMS: Ventricular arrhythmias are a major cause of mortality in adult congenital heart disease (ACHD) patients. The European Society of Cardiology guidelines state that implantable cardioverter-defibrillators (ICD) should be considered in patients with congenital heart disease following spontaneous sustained ventricular tachycardia (VT) or cardiac arrest and in patients at presumed high risk. This study sought to analyse the circumstances in which ACHD patients received ICD and to assess outcomes of ICD implantation, including therapies delivered and the rate of complications...
May 26, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27221084/-antibradycardia-therapy-indication-and-implementation
#19
Peter Zartner
Pacemaker therapy (PMT) in grown-up congenital heart disease (GUCH) must meet the demands of a young, dynamic and heterogeneous group of patients. The duration of the therapy has to be planned for several decades and should be accompanied by an invasive procedure at the very least. Most of the patients enter adulthood with their pacemaker (PM) already implanted; for others the indications can be derived from the published guidelines for GUCH and PMT, but need to be adjusted to the individual situation of the patient...
June 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27208697/rabbit-models-as-tools-for-preclinical-cardiac-electrophysiological-safety-testing-importance-of-repolarization-reserve
#20
REVIEW
István Baczkó, Norbert Jost, László Virág, Zsuzsanna Bősze, András Varró
It is essential to more reliably assess the pro-arrhythmic liability of compounds in development. Current guidelines for pre-clinical and clinical testing of drug candidates advocate the use of healthy animals/tissues and healthy individuals and focus on the test compound's ability to block the hERG current and prolong cardiac ventricular repolarization. Also, pre-clinical safety tests utilize several species commonly used in cardiac electrophysiological studies. In this review, important species differences in cardiac ventricular repolarizing ion currents are considered, followed by the discussion on electrical remodeling associated with chronic cardiovascular diseases that leads to altered ion channel and transporter expression and densities in pathological settings...
July 2016: Progress in Biophysics and Molecular Biology
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