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Implantable Cardioverter Defibrillators

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https://www.readbyqxmd.com/read/28316104/implantable-cardioverter-defibrillators-for-primary-prevention-of-mortality-in-patients-with-non-ischemic-cardiomyopathy-a-meta-analysis-of-randomized-controlled-trials
#1
Stavros Stavrakis, Zain Asad, Dwight Reynolds
BACKGROUND: Implantable cardioverter defibrillators (ICDs) improve survival in patients with heart failure due to ischemic cardiomyopathy, but their benefit in non-ischemic cardiomyopathy (NICM) has been recently questioned. We performed a meta-analysis of randomized clinical trials to examine the effect of ICDs on total mortality and arrhythmic death in patients with NICM. We also examined the impact of age and cardiac resynchronization therapy (CRT) on the relative effect of ICD compared to control...
March 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28314849/prognostic-implications-of-nonsustained-ventricular-tachycardia-in-high-risk-patients-with-hypertrophic-cardiomyopathy
#2
Weijia Wang, Zhesi Lian, Ethan J Rowin, Barry J Maron, Martin S Maron, Mark S Link
BACKGROUND: The prognostic significance of nonsustained ventricular tachycardia (NSVT) in patients with hypertrophic cardiomyopathy is incompletely resolved. METHODS AND RESULTS: The study group comprised 160 patients with implantable cardioverter defibrillators (ICDs), of whom 94 patients had 24- to 48-hour ambulatory monitoring preimplant. ICDs were interrogated and ambulatory ECGs monitored for NSVT episodes, with associations between NSVT- and ICD-treated ventricular arrhythmias examined...
March 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28299956/remote-monitoring-to-improve-long-term-prognosis-in-heart-failure-patients-with-implantable-cardioverter-defibrillators
#3
Maki Ono, Niraj Varma
Strong evidence exists for the utility of remote monitoring in cardiac implantable electronic devices for early detection of arrhythmias and evaluation of system performance. The application of remote monitoring for the management of chronic disease such as heart failure has been an active area of research. Areas covered: This review aims to cover the latest evidence of remote monitoring of implantable cardiac defibrillators in terms of heart failure prognosis. This article also update the current technology relating to the method and discuss key factors to be addressed in order to better use the approach...
March 16, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28292754/cardiac-resynchronization-therapy-reduces-ventricular-arrhythmias-in-primary-but-not-secondary-prophylactic-implantable-cardioverter-defibrillator-patients-insight-from-the-resynchronization-in-ambulatory-heart-failure-trial
#4
John L Sapp, Ratika Parkash, George A Wells, Elizabeth Yetisir, Martin J Gardner, Jeffrey S Healey, Bernard Thibault, Laurence D Sterns, David Birnie, Pablo B Nery, Soori Sivakumaran, Vidal Essebag, Paul Dorian, Anthony S L Tang
BACKGROUND: The RAFT (Resynchronization in Ambulatory Heart Failure Trial) demonstrated that cardiac resynchronization therapy (CRT) reduced both mortality and heart failure hospitalizations in patients with functional class II or III heart failure and widened QRS. We examined the influence of CRT on ventricular arrhythmias in patients with primary versus secondary prophylaxis defibrillator indications. METHODS AND RESULTS: All ventricular arrhythmias among RAFT study participants were downloaded and adjudicated by 2 blinded reviewers with an overreader for disagreements and committee review for remaining discrepancies...
March 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28292751/impact-of-substrate-modification-by-catheter-ablation-on-implantable-cardioverter-defibrillator-interventions-in-patients-with-unstable-ventricular-arrhythmias-and-coronary-artery-disease-results-from-the-multicenter-randomized-controlled-sms-substrate-modification
#5
Karl-Heinz Kuck, Roland Richard Tilz, Thomas Deneke, Boris A Hoffmann, Rodolfo Ventura, Peter Steen Hansen, Markus Zarse, Stefan H Hohnloser, Josef Kautzner, Stephan Willems
BACKGROUND: The implantable cardioverter-defibrillator (ICD) is the standard therapy to prevent sudden cardiac death in patients with coronary artery disease and unstable ventricular tachyarrhythmias. The prospective multinational SMS (Substrate Modification Study) was designed to assess whether prophylactic ablation of the arrhythmogenic substrate reduces or prevents the recurrence of ventricular tachycardia/ventricular fibrillation in such patients. METHODS AND RESULTS: Of 111 patients included in an intention-to-treat analysis, 54 were randomly assigned catheter ablation plus ICD implantation (ablation group: 68±8 years; 47 men), whereas 57 were assigned ICD implantation without catheter ablation (ICD-only group: 66±8 years; 46 men)...
March 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28292197/sudden-death-risk-stratification-in-non-ischemic-dilated-cardiomyopathy-using-old-and-new-tools-a-clinical-challenge
#6
Antonis S Manolis
Risk stratification for sudden cardiac death in non-ischemic dilated cardiomyopathy (NIDCM) remains a clinical challenge. Areas Covered: Currently, left ventricular ejection fraction (LVEF), severity of heart failure symptoms according to NYHA classification, and morphology and duration of the QRS complex guide device management in these patients with implantation of a cardioverter defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices. Recently, the results of a randomized trial stirred some controversy regarding the utility of ICD in NIDCM patients, however, a subsequent meta-analysis confirmed prior findings of the survival-prolonging benefit of device therapy...
March 15, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28291831/t-wave-loop-area-from-a-pre-implant-12-lead-ecg-is-associated-with-appropriate-icd-shocks
#7
Joachim Seegers, Katerina Hnatkova, Tim Friede, Marek Malik, Markus Zabel
AIMS: In implantable cardioverter-defibrillator (ICD) patients, predictors of ICD shocks and mortality are needed to improve patient selection. Electrocardiographic (ECG) markers are simple to obtain and have been demonstrated to predict mortality. We aimed to assess the association of T-wave loop area and circularity with ICD shocks. METHODS: The study investigated patients with ICDs implanted between 1998 and 2010 for whom digital 12-lead ECGs (Schiller CS200 ECG-Network) of sufficient quality were obtained within 1 month prior to the implantation...
2017: PloS One
https://www.readbyqxmd.com/read/28290897/-the-brugada-syndrome-as-a-cause-of-sudden-death-diagnostics-and-clinical-manifestations-in-children
#8
I M Miklashevich, M A Shkolnikova
The Brugada syndrome is a hereditary potentially arrhythmogenic disease related to the category of channelopathies. It is manifested as syncopal states and sudden death in young people in the absence of structural cardiac disease. The basis of the disease is genetically determined abnormality of function of ionic channels of cardiomyocytes (sodium, potassium, calcium) phenotypically manifesting as sustained or transitory segment-ST elevation and high risk of polymorphic ventricular tachycardia, fibrillation, and sudden death...
October 2016: Kardiologiia
https://www.readbyqxmd.com/read/28289531/critical-analysis-of-ineffective-post-implantation-implantable-cardioverter-defibrillator-testing
#9
Markus Roos, J Christoph Geller, Marc-Alexander Ohlow
AIM: To test of the implantable-cardioverter-defibrillator is done at the time of implantation. We investigate if any testing should be performed. METHODS: All consecutive patients between January 2006 and December 2008 undergoing implantable cardioverter-defibrillator (ICD) implantation/replacement (a total of 634 patients) were included in the retrospective study. RESULTS: Sixteen patients (2.5%) were not tested (9 with LA/LV-thrombus, 7 due to operator's decision)...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28287212/-the-pacemaker-and-implantable-cardioverter-defibrillator-registry-of-the-italian-association-of-arrhythmology-and-cardiac-pacing-annual-report-2015
#10
Alessandro Proclemer, Massimo Zecchin, Antonio D'Onofrio, Giuseppe Boriani, Giovanni Luca Botto, Domenico Facchin, Luca Rebellato, Marco Ghidina, Giulia Bianco, Emanuela Bernardelli, Elsa Pucher, Dario Gregori
BACKGROUND: The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2015 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers. METHODS: The Registry collects prospectively national PM and ICD implantation activity on the basis of European cards...
January 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28284506/sudden-cardiac-death-the-role-of-imaging
#11
Pieter van der Bijl, Victoria Delgado, Jeroen J Bax
Sudden cardiac death (SCD) is defined as "a non-traumatic, unexpected, fatal event occurring within one hour of the onset of symptoms in an apparently healthy subject", and it causes a fifth of all deaths worldwide. It often occurs in individuals not previously known with cardiac disease, which makes prevention challenging. The mechanism underlying SCD is thought to be a trigger (e.g. ischemia) acting upon a substrate (e.g. scar), causing a lethal arrhythmia. Primary prevention refers to patients at high risk of SCD and secondary prevention to those who have had an aborted episode of SCD...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28275941/what-is-the-role-of-cardiac-sympathetic-denervation-for-recurrent-ventricular-tachycardia
#12
REVIEW
Jonathan C Hong, Todd Crawford, Harikrishna Tandri, Kaushik Mandal
There is a subset of patients who have recurrent ventricular tachycardia despite optimal medical management with pharmacologic therapy and catheter ablation. The cardiac sympathetic nervous system is responsible for triggering and perpetuating ventricular arrhythmias, and surgery can reduce the sympathetic stimulation to the heart. Evidence supports the use of left cardiac sympathetic denervation in recurrent ventricular arrhythmias for long QT syndrome and catecholaminergic polymorphic ventricular tachycardia...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28268889/low-energy-defibrillation-research-using-a-rabbit-ventricular-model-optimizing-the-potential-gradient-distribution-using-multiple-epicardial-electrodes
#13
Jianfei Wang, Lian Jin, Xiaomei Wu, Biao Song, Li Qian, Weiqi Wang
Cardiac potential gradient distribution directly affects defibrillation efficacy, and the electrode configuration that ensures optimal distribution is yet to be determined. In this study, a rabbit ventricular finite element conductor model containing blood perfusion in ventricular cavities was developed. The electric field was solved on the model by using 95% myocardial volume potential gradient higher than 5 V/cm as the successful defibrillation threshold (DFT). Multiple epicardial electrodes (MEE) protocols and a SCAN protocol were used to identify the optimum defibrillation method...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268306/in-silico-pre-clinical-trials-for-implantable-cardioverter-defibrillators
#14
Zhihao Jiang, Houssam Abbas, Kuk Jin Jang, Marco Beccani, Jackson Liang, Sanjay Dixit, Rahul Mangharam
Regulatory authorities require that the safety and efficacy of a new high-risk medical device be proven in a Clinical Trial (CT), in which the effects of the device on a group of patients are compared to the effects of the current standard of care. Phase III trials can run for several years, cost millions of dollars, and expose patients to an unproven device. In this paper, we demonstrate how to use a large group of synthetic patients based on computer modeling to improve the planning of a CT so as to increase the chances of a successful trial for implantable cardioverter defibrillators (ICDs)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267958/comparison-of-multivariate-risk-estimation-models-to-predict-prognosis-in-patients-with-implantable-cardioverter-defibrillators-with-or-without-cardiac-resynchronization-therapy
#15
Salima Akoudad, Lara Dabiri Abkenari, Beat A Schaer, Christian Sticherling, Wayne C Levy, Luc Jordaens, Dominic A M J Theuns
Several multivariate risk score models were developed to predict prognosis of patients with heart failure (HF). We compared 3 models with regard to prediction of mortality in patients with HF who received an implantable defibrillator (ICD) or a cardiac resynchronization therapy defibrillator (CRT-D), as primary prevention of sudden death. The study cohort consisted of 823 patients (ICD = 410; CRT-D = 413). The evaluated models were the Seattle Heart Failure Model (SHFM), the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) score, and an adjusted Charlson Comorbidity Index (aCCI)...
February 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28267474/results-of-a-curtailed-randomized-controlled-trial-evaluating-the-efficacy-and-safety-of-azimilide-in-patients-with-implantable-cardioverter-defibrillators-the-shield-2-trial
#16
Victoria M Robinson, David B Bharucha, Kenneth W Mahaffey, Paul Dorian, Peter R Kowey
BACKGROUND: Frequent hospital attendances in patients with implantable cardioverter-defibrillators (ICDs) result in significant morbidity and health care costs. Current drugs to reduce ICD shocks and hospital visits have limited efficacy and considerable toxicity. We evaluated the efficacy and safety of azimilide, a novel oral class III antiarrhythmic, for use in ICD patients. METHODS: A total of 240 patients were enrolled in a prospective, randomized, double-blind, placebo-controlled trial to evaluate the effect of oral azimilide 75 mg daily in ICD patients with previously documented ventricular tachycardia or ventricular fibrillation, and a left ventricular ejection fraction ≤40%...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28265207/clinical-risk-factors-for-infective-endocarditis-in-staphylococcus-aureus-bacteremia
#17
Vincent Bryan D Salvador, Bikash Chapagain, Astha Joshi, Debra J Brennessel
Crucial to the management of staphylococcal bacteremia is an accurate evaluation of associated endocarditis, which has both therapeutic and prognostic implications. Because the clinical presentation of endocarditis can be nonspecific, the judicious use of echocardiography is important in distinguishing patients at high risk of developing endocarditis. In the presence of high-risk clinical features, an early transesophageal echocardiogram is warranted without prior transthoracic echocardiography. The purpose of this study was to investigate the clinical risk factors for staphylococcal infective endocarditis that might warrant earlier transesophageal echocardiography and to describe the incidence of endocarditis in cases of methicillin-resistant and methicillin-sensitive Staphylococcus aureus bacteremia...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28264059/biomarker-based-diagnosis-of-pacemaker-and-implantable-cardioverter-defibrillator-pocket-infections-a-prospective-multicentre-case-control-evaluation
#18
Carsten Lennerz, Hrvoje Vrazic, Bernhard Haller, Siegmund Braun, Tobias Petzold, Ilka Ott, Agnes Lennerz, Jonathan Michel, Patrick Blažek, Isabel Deisenhofer, Peter Whittaker, Christof Kolb
BACKGROUND: The use of cardiac implantable electronic devices (CIED) has risen steadily, yet the rate of cardiac device infections (CDI) has disproportionately increased. Amongst all cardiac device infections, the pocket infection is the most challenging diagnosis. Therefore, we aimed to improve diagnosis of such pocket infection by identifying relevant biomarkers. METHODS: We enrolled 25 consecutive patients with invasively and microbiologically confirmed pocket infection...
2017: PloS One
https://www.readbyqxmd.com/read/28262437/myocardial-fibrosis-predicts-ventricular-tachyarrhythmias
#19
REVIEW
Marcello Disertori, Michela Masè, Flavia Ravelli
Myocardial fibrosis is a common pattern in the setting of different heart diseases, and promotes ventricular tachyarrhythmias by creating a vulnerable substrate for reentrant activity and by favoring the emergence of triggers. Currently, late gadolinium enhancement (LGE) cardiac magnetic resonance is considered the reference method for the noninvasive assessment of ventricular fibrosis. Several studies and meta-analyses have shown that ventricular fibrosis detected by LGE is a powerful predictor of ventricular tachyarrhythmic events in ischemic, non-ischemic dilated cardiomyopathy and hypertrophic cardiomyopathy patients...
February 2, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28261825/electrical-storm-in-icd-recipients-with-arrhythmogenic-right-ventricular-cardiomyopathy
#20
Kang Yin, Ligang Ding, Wei Hua, Shu Zhang
BACKGROUND: Implantable cardioverter defibrillator (ICD) is the most important management for prevention of sudden cardiac death (SCD) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). However, some patients may receive multiple ICD therapies in a short period, a condition referred as "electrical storm". OBJECTIVES: This study aimed to determine the prevalence, therapeutic options, and prognostic implications of ES in ARVC patients with an ICD...
March 6, 2017: Pacing and Clinical Electrophysiology: PACE
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