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tachyarrhythmias guidelines

Syeda Atiqa Batul, Brian Olshansky, John D Fisher, Rakesh Gopinathannair
Ventricular arrhythmias are an important cause of cardiovascular morbidity and mortality, particularly in those with structural heart disease, inherited cardiomyopathies, and channelopathies. The goals of ventricular arrhythmia management include symptom relief, improving quality of life, reducing implantable cardioverter defibrillator shocks, preventing deterioration of left ventricular function, reducing risk of arrhythmic death, and potentially improving overall survival. Guideline-directed medical therapy and implantable cardioverter defibrillator implantation remain the mainstay of therapy to prevent sudden cardiac death in patients with ventricular arrhythmias in the setting of structural heart disease...
2017: F1000Research
Alfred E Buxton
At this time, we find ourselves with an abundance of guidelines for management of patients with manifest ventricular tachyarrhythmias, or at risk for such arrhythmias, in patients with coronary heart disease (CHD). The guidelines are focused primarily on the "appropriate use" of the implantable cardioverter/defibrillator (ICD). Unfortunately, the bulk of the guidelines have very little basis in the underlying pathophysiology responsible for sudden cardiac death (SCD) in patients with CHD. Rather, they are based primarily on the results of randomized clinical trials that merely sought to take broad populations at elevated total mortality risk and determining whether the ICD can reduce overall mortality...
June 15, 2017: International Journal of Cardiology
Roberta Pereira, Oscar Campuzano, Georgia Sarquella-Brugada, Sergi Cesar, Anna Iglesias, Josep Brugada, Fernando E S Cruz Filho, Ramon Brugada
Short QT syndrome is a malignant cardiac disease characterized by the presence of ventricular tachyarrhythmias leading to syncope and sudden cardiac death. Currently, international guidelines establish diagnostic criteria when QTc is below 340 ms. This entity is one of the main diseases responsible for sudden cardiac death in the pediatric population. In recent years, clinical, genetic and molecular advances in pathophysiological mechanisms related to short QT syndrome have improved diagnosis, risk stratification, and preventive measures...
June 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Elizabeth D Paratz, Jessie Zhao, Amanda K Sherwen, Rose-Marie Scarlato, Andrew I MacIsaac
BACKGROUND: Methamphetamine use is escalating in Australia and New Zealand, with increasing emergency department attendance and mortality. Cardiac complications play a large role in methamphetamine-related mortality, and it would be informative to assess the frequency of abnormal electrocardiograms (ECGs) amongst methamphetamine users. OBJECTIVE: To determine the frequency and severity of ECG abnormalities amongst methamphetamine users compared to a control group...
December 9, 2016: Heart, Lung & Circulation
Koichiro Ejima, Ryuta Henmi, Yuji Iwanami, Daigo Yagishita, Morio Shoda, Nobuhisa Hagiwara
INTRODUCTION: The guidelines suggest that an adjuvant substrate modification in addition to pulmonary vein isolation (PVI) may be needed for persistent atrial fibrillation (PerAF) assuming that catheter ablation is less successful for PerAF than paroxysmal AF (PAF). To revisit the above assumption, we compared the outcome of the same catheter ablation strategy between PAF and PerAF. METHODS AND RESULTS: Two hundred and thirty-three consecutive patients (mean age 60 ± 10 years, 53 PerAF and 8 long-lasting PerAF) without structural heart disease underwent catheter ablation of AF by the same strategy using an empiric thoracic vein isolation (a wide circumferential PVI plus empiric superior vena cava isolation) as a major part of the strategy without any adjuvant substrate modification...
March 2017: Journal of Cardiovascular Electrophysiology
Chien-Hua Huang, Ping-Hsun Yu, Min-Shan Tsai, Po-Ya Chuang, Tzung-Dau Wang, Chih-Yen Chiang, Wei-Tien Chang, Matthew Huei-Ming Ma, Chao-Hsiun Tang, Wen-Jone Chen
BACKGROUND: Terminating ventricular fibrillation (VF) or pulseless ventricular tachyarrhythmia (VT) is critical for successful resuscitation of patients with shockable cardiac arrest. In the event of shock-refractory VF, applicable guidelines suggest use of anti-arrhythmic agents. However, subsequent long-term outcomes remain unclear. A nationwide cohort study was therefore launched, examining 1-year survival rates in patients given amiodarone and/or lidocaine for cardiac arrest. METHODS: Medical records accruing between years 2004 and 2011 were retrieved from the Taiwan National Health Insurance Research Database (NHIRD) for review...
January 15, 2017: International Journal of Cardiology
Stephan Willems, Paul Khairy, Jason G Andrade, Boris A Hoffmann, Sylvie Levesque, Atul Verma, Rukshen Weerasooriya, Paul Novak, Thomas Arentz, Isabel Deisenhofer, Thomas Rostock, Daniel Steven, Lena Rivard, Peter G Guerra, Katia Dyrda, Blandine Mondesert, Marc Dubuc, Bernard Thibault, Mario Talajic, Denis Roy, Stanley Nattel, Laurent Macle
BACKGROUND: Early recurrences (ERs) of atrial tachyarrhythmia are common after catheter ablation of atrial fibrillation. A 3-month blanking period is recommended by current guidelines. This study sought to investigate the significance of ER during the first 3 months post ablation in predicting late recurrences and determine whether it varies according to timing. METHODS AND RESULTS: A total of 401 patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation were followed for 12 months with transtelephonic monitoring in the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) trial...
August 2016: Circulation. Arrhythmia and Electrophysiology
Lars Eckardt, Julia Köbe, Kristina Wasmer
The 2016 ESC guideline on prevention and therapy of ventricular tachyarrhythmias and sudden cardiac death present an excellent recommendation and summary for all forms of ventricular tachyarrhythmias in patients with and without structural or electrical heart disease. This includes cardiomyopathies as well as conditions such as proarrhythmia, neurologic/psychaitric disorders, or pregnancy. Some aspects are novel; (1) the guideline emphasizes for the first time genetic work-up in sudden cardiac death victims; (2) for prevention of sudden cardiac death systematic re-evaluation 6-12 weeks after myocardial infarction is recommended; (3) subcutaneous ICD as well as the wearable cardioverter/defibrillator are for the first time included in the guidelines; (4) automatic external defibrillators are recommended for public places; (5) for patients with recurrent ventricular tachyarrhythmias the role of catheter ablation has been upgraded...
August 2016: Deutsche Medizinische Wochenschrift
D Duncker, J Bauersachs, C Veltmann
In the majority of cases sudden cardiac death (SCD) is caused by ventricular tachyarrhythmia. Implantable cardioverter-defibrillators (ICD) represent an evidence-based and established method for prevention of SCD. For patients who do not fulfill the criteria for guideline-conform implantation of an ICD but still have an increased, e.g. transient risk for SCD, a wearable cardioverter-defibrillator (WCD) vest was developed to temporarily prevent SCD. Numerous studies have shown the safety and efficacy of the WCD, although there is still a gap in evidence concerning a reduction in overall mortality and improvement in prognosis...
September 2016: Der Internist
Henry Chubb, Mark O'Neill, Eric Rosenthal
Device therapy in the complex congenital heart disease (CHD) population is a challenging field. There is a myriad of devices available, but none designed specifically for the CHD patient group, and a scarcity of prospective studies to guide best practice. Baseline cardiac anatomy, prior surgical and interventional procedures, existing tachyarrhythmias and the requirement for future intervention all play a substantial role in decision making. For both pacing systems and implantable cardioverter defibrillators, numerous factors impact on the merits of system location (endovascular versus non-endovascular), lead positioning, device selection and device programming...
May 2016: Arrhythmia & Electrophysiology Review
Alon Barsheshet, Theodora Vamvouris, Ilan Goldenberg
INTRODUCTION: Ventricular tachyarrhythmias (ventricular tachycardia and ventricular fibrillation) can lead to aborted cardiac arrest or sudden cardiac death in patients with poor left ventricular function early after acute myocardial infarction (AMI). Although it has been shown that the implantable cardioverter defibrillator (ICD) can treat ventricular tachyarrhythmias and save lives in patients with ischemic cardiomyopathy, it's use during the early phase post AMI has not been shown to reduce mortality...
July 2016: Expert Review of Medical Devices
Alessandro Zorzi, Ilaria Rigato, Barbara Bauce, Kalliopi Pilichou, Cristina Basso, Gaetano Thiene, Sabino Iliceto, Domenico Corrado
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically determined disease which predisposes to life-threatening ventricular arrhythmias. The main goal of ARVC therapy is prevention of sudden cardiac death (SCD). Implantable cardioverter defibrillator (ICD) is the most effective therapy for interruption of potentially lethal ventricular tachyarrhythmias. Despite its life-saving potential, ICD implantation is associated with a high rate of complications and significant impact on quality of life...
June 2016: Current Cardiology Reports
Wilhelm Haverkamp
INTRODUCTION: Cardiopulmonary resuscitation represents a therapeutic challenge. Evidence-based guidelines, which were updated in 2015, give detailed advice on how to treat the patient. METHODS: Basic life support consists of cardiopulmonary resuscitation (30 chest compressions interrupted briefly to provide to 2 ventilations) and, if ventricular tachyarrhythmia is present, urgent cardiac defibrillation. Administration of drugs is one of the aspects of advanced life support...
March 2016: Herzschrittmachertherapie & Elektrophysiologie
Peter Marstrand, Anna Axelsson, Jens Jakob Thune, Niels Vejlstrup, Henning Bundgaard, Juliane Theilade
AIMS: Guidelines recommend evaluation of family members of sudden cardiac death victims. However, initiation of cascade screening in families with uncertain diagnoses is not cost-effective and may cause unnecessary concern. For these reasons, we set out to assess to what extent cardiac magnetic resonance imaging (CMR) would increase the diagnostic precision and thereby possibly change the indication for family screening in patients with ventricular tachyarrhythmias. METHODS AND RESULTS: We retrospectively collected data from 79 patients hospitalized with aborted cardiac arrest (resuscitated from a cardiac arrest), ventricular tachycardia (VT), or syncope who underwent a CMR at the Copenhagen University Hospital, Rigshospitalet, Denmark...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Alessandro Zorzi, Francesco Peruzza, Federica Stella, Alvise Del Monte, Federico Migliore, Nicola Gasparetto, Luigi Badano, Sabino Iliceto, Domenico Corrado
BACKGROUND: in-hospital life-threatening ventricular arrhythmias (LT-VA) may complicate the course of cardiovascular patients. We aimed to assess the incidence, circumstances, determinants, and outcome of in-hospital LT-VA in order to help clinicians in prescribing appropriate levels of monitoring. METHODS: the study population consisted of all 10,741 consecutive patients (65 ± 15 years, 67.7% males) admitted to a cardiology department in 2009-2014. Terminally ill patients and those with primary arrhythmia diagnosis were excluded...
April 2016: Resuscitation
Alban-Elouen Baruteau, James C Perry, Shubhayan Sanatani, Minoru Horie, Anne M Dubin
UNLABELLED: Heart rate is commonly used in pediatric early warning scores. Age-related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiogram features that differ from adults and vary with age. Bradycardia is defined as a heart rate below the lowest normal value for age. Pediatric bradycardia most commonly manifests as sinus bradycardia, junctional bradycardia, or atrioventricular block. As a result of several different etiologies, it may occur in an entirely structurally normal heart or in association with concomitant congenital heart disease...
February 2016: European Journal of Pediatrics
Sara Santacesaria, Stefania Cataldo, Giuseppe A Annoni, Paola Corbella, Stefano Fiocchi, Gabriele M Vignati
AIMS: The aim of the present study is to determine pregnancy outcome with regard to the risk class and the modality way of referral to our joint Cardiac Obstetric Clinic. METHODS: This is a prospective observational study. Patients referred to our clinic between 2011 and 2014 were included. Reason and timing for referral were recorded. Two groups were identified: women who were known to have cardiac disease before referral (group I) and women who were not (group II)...
October 2016: Journal of Cardiovascular Medicine
Ravi B Patel, Sara Tannenbaum, Ana Viana-Tejedor, Jianping Guo, KyungAh Im, David A Morrow, Benjamin M Scirica
BACKGROUND: In acute coronary syndrome (ACS), potassium levels <3.5 mEq/L are associated with ventricular arrhythmias. Current guidelines therefore recommend a potassium target >4.0 mEq/L in ACS. Our study evaluated the association between potassium levels, cardiac arrhythmias, and cardiovascular death in patients with non-ST-segment elevation myocardial infarction or unstable angina. METHODS: Potassium levels were measured in 6515 patients prior to randomization to receive either ranolazine or a placebo in the MERLIN-TIMI 36 trial...
February 2017: European Heart Journal. Acute Cardiovascular Care
Ralph J Damiano, Christopher P Lawrance, Lindsey L Saint, Matthew C Henn, Laurie A Sinn, Jane Kruse, Marye J Gleva, Hersh S Maniar, Patrick M McCarthy, Richard Lee
BACKGROUND: Current guidelines recommend at least 24-hour Holter monitoring at 6-month intervals to evaluate the recurrence of atrial fibrillation (AF) after surgical ablation. In this prospective multicenter study, conventional intermittent methods of AF monitoring were compared with continuous monitoring using an implantable loop recorder (ILR). METHODS: From August 2011 to January 2014, 47 patients receiving surgical treatment for AF at 2 institutions had an ILR placed at the time of operation...
January 2016: Annals of Thoracic Surgery
Misato Chimura, Kunihiko Kiuchi, Katsunori Okajima, Akira Shimane, Takahiro Sawada, Tetsuari Onishi, Shinichiro Yamada, Yasuyo Taniguchi, Yoshinori Yasaka, Hiroya Kawai
BACKGROUND: Current guidelines recommend the implantation of an implantable cardioverter-defibrillator (ICD) for primary prevention of sudden cardiac death (SCD) in a subgroup of patients with nonishcemic cardiomyopathy (NICM) who have a left ventricular ejection fraction (LVEF) ≤30% to 35%, and are NYHA functional class Ⅱ or Ⅲ. However, the majority of patients with an ICD implantation for primary prevention did not receive appropriate ICD therapy. The purpose of this study was to evaluate the association between myocardial fibrosis detected by cardiovascular magnetic resonance (CMR) imaging and life-threatening ventricular arrhythmic events in NICM patients...
July 29, 2015: Journal of Cardiovascular Electrophysiology
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