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tachyarrhythmias guidelines

Emin Evren Özcan, Bülent Görenek
Although various cardiac monitoring methods were developed to detect subclinical arrhythmias, guidelines do not address in detail the management of subclinical atrial fibrillation and tachyarrhythmias. The European Heart Rhythm Association recently published a consensus document that addresses the clinical importance, implications, and management of device-detected subclinical atrial tachyarrhythmias. This paper comprehensively reviews the diagnostic tools to detect subclinical atrial arrhythmias and discusses the pathophysiologic link between devicedetected subclinical atrial fibrillation and stroke...
February 2018: Anatolian Journal of Cardiology
Jonathan W Waks, Alfred E Buxton
Sudden cardiac death (SCD) accounts for ∼50% of mortality after myocardial infarction (MI). Most SCDs result from ventricular tachyarrhythmias, and the tachycardias that precipitate cardiac arrest result from multiple mechanisms. As a result, it is highly unlikely that any single test will identify all patients at risk for SCD. Current guidelines for use of implantable cardioverter-defibrillators (ICDs) to prevent SCD are based primarily on measurement of left ventricular ejection fraction (LVEF). Although reduced LVEF is associated with increased total cardiac mortality after MI, the focus of current guidelines on LVEF omits ∼50% of patients who die suddenly...
January 29, 2018: Annual Review of Medicine
Marwan M Refaat, Jad Ballout, Moussa Mansour
With improved surgical techniques and medical management for patients with congenital heart diseases, more patients are living longer and well into adulthood. This improved survival comes with a price of increased morbidity, mainly secondary to increased risk of tachyarrhythmias. One of the major arrhythmias commonly encountered in this subset of cardiac patients is AF. Similar to the general population, the risk of AF increases with advancing age, and is mainly secondary to the abnormal anatomy, abnormal pressure and volume parameters in the hearts of these patients and to the increased scarring and inflammation seen in the left atrium following multiple surgical procedures...
December 2017: Arrhythmia & Electrophysiology Review
Nikhil Mehta, Robert Vannozzi
Lithium has been used for the treatment of bipolar disorder for more than 6 decades. Reports of cardiac side effects resulting in both benign electrocardiographic (ECG) changes and near fatal arrhythmias have been reported in the literature. A systematic literature search was conducted on 2 electronic databases-PubMed and Medline-for the time period between January 1970 and March 2016 using the key word "lithium," along with "electrocardiography" or "ECG." All articles and their references were then screened by title for relevance by 2 authors and a librarian...
December 16, 2017: Clinical Cardiology
A Schlitt, M Guha, M Noutsias, H H Klein, H U Klein
Assessment of a permanent risk of life-threatening ventricular arrhythmia in patients with severely reduced left ventricular ejection fraction (LVEF <35%), e. g. after myocarditis, dilated cardiomyopathy, acute myocardial infarction, in patients with postpartum cardiomyopathy or implantable cardioverter-defibrillator (ICD) and cardiac resynchronization treatment plus defibrillator (CRT-D) infection with temporary explantation of the system is a medical challenge. This is time-consuming and unsafe because life-threatening ventricular arrhythmias may occur during the time of risk assessment...
December 12, 2017: Herz
J J Xu, L J Gao, D Chang, X J Xiao, R F Zhang, J Lin, Z M Zhao, H Zhang, Y L Xia, X M Yin, Y Z Yang
Objective: To compare the outcome of radiofrequency catheter ablation under local anesthesia/sedation (S) or general anesthesia(GA) in atrial fibrillation patients. Methods: Data of 498 patients with atrial fibrillation undergoing radiofrequency catheter ablation in our departmentfrom January 2014 to December 2015 were retrospectively analyzed. Two hundred and twenty patients assigned to the GA group, the other 278 patients to the S group. Patients were followed clinically every 3 months within one year after procedure...
November 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
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
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