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Arrhythmia, defibrillator, heart failure, sudden cardiac death

Sérgio Barra, Rui Providência, Rudolf Duehmke, Serge Boveda, Eloi Marijon, Christian Reitan, Rasmus Borgquist, Didier Klug, Pascal Defaye, Nicolas Sadoul, Jean-Claude Deharo, Iannish Sadien, Kiran Patel, Khang-Li Looi, David Begley, Anthony W Chow, Jean-Yves Le Heuzey, Sharad Agarwal
OBJECTIVE: Among primary prevention patients with heart failure receiving cardiac resynchronisation therapy (CRT), the impact of additional implantable cardioverter defibrillator (ICD) treatment on outcomes and its interaction with sex remains uncertain. We aim to assess whether the addition of the ICD functionality to CRT devices offers a more pronounced survival benefit in men compared with women, as previous research has suggested. METHODS: Observational multicentre cohort study of 5307 consecutive patients with ischaemic or non-ischaemic dilated cardiomyopathy and no history of sustained ventricular arrhythmias having CRT implantation with (cardiac resynchronisation therapy defibrillator (CRT-D), n=4037) or without (cardiac resynchronisation therapy pacemaker (CRT-P), n=1270) defibrillator functionality...
January 19, 2017: Heart: Official Journal of the British Cardiac Society
Josef Finsterer, Claudia Stöllberger, Jeffrey A Towbin
Left ventricular hypertrabeculation (LVHT) or noncompaction is a myocardial abnormality of unknown aetiology, frequently associated with monogenic disorders, particularly neuromuscular disorders, or with chromosomal defects. LVHT is diagnosed usually by echocardiography by the presence of a bilayered myocardium consisting of a thick, spongy, noncompacted endocardial layer and a thin, compacted, epicardial layer. The pathogenesis of LVHT is unsolved, and the diagnostic criteria, prognosis, and optimal treatment of patients with LVHT are under debate...
January 12, 2017: Nature Reviews. Cardiology
Sergio Barra, Rudolf Duehmke, Rui Providencia, Eloi Marijon, Serge Boveda, Munmohan Virdee, Patrick Heck, Simon Fynn, David Begley, Andrew Grace, Sharad Agarwal
AIMS: Upgrade to cardiac resynchronization therapy (CRT) should be offered to patients who have developed pacing-induced cardiomyopathy with conventional right ventricular pacing. The extent to which these patients would also benefit from defibrillator back-up at the time of CRT upgrade is, however, unknown. METHODS AND RESULTS: Retrospective observational cohort study of 199 patients with pacing-induced cardiomyopathy and no history of sustained ventricular arrhythmia, including 104 upgraded to CRT-Pacemaker (CRT-P) and 95 upgraded to CRT-Defibrillator (CRT-D)...
December 28, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Saurabh Kumar, Samuel H Baldinger, Estelle Gandjbakhch, Philippe Maury, Jean-Marc Sellal, Alexander F A Androulakis, Xavier Waintraub, Philippe Charron, Anne Rollin, Pascale Richard, William G Stevenson, Ciorsti J Macintyre, Carolyn Y Ho, Tina Thompson, Jitendra K Vohra, Jonathan M Kalman, Katja Zeppenfeld, Frederic Sacher, Usha B Tedrow, Neal K Lakdawala
BACKGROUND: Mutations in LMNA are variably expressed and may cause cardiomyopathy, atrioventricular block (AVB), or atrial arrhythmias (AAs) and ventricular arrhythmias (VA). Detailed natural history studies of LMNA-associated arrhythmic and nonarrhythmic outcomes are limited, and the prognostic significance of the index cardiac phenotype remains uncertain. OBJECTIVES: This study sought to describe the arrhythmic and nonarrhythmic outcomes of LMNA mutation carriers and to assess the prognostic significance of the index cardiac phenotype...
November 29, 2016: Journal of the American College of Cardiology
Paul Khairy
PURPOSE OF REVIEW: The literature on sudden death in transposition of the great arteries (D-TGA) with atrial switch surgery is reviewed and a pathophysiological mechanism is proposed. RECENT FINDINGS: Over 80% of sudden deaths in patients with D-TGA and Mustard or Senning baffles occur during exercise. Factors most consistently associated with ventricular arrhythmias and sudden death include heart failure parameters and atrial arrhythmias. Atrial arrhythmias have been observed to trigger malignant ventricular arrhythmias...
January 2017: Current Opinion in Cardiology
Thomas A Mavrakanas, David M Charytan
PURPOSE OF REVIEW: This review article focuses on the most significant cardiovascular complications in dialysis patients [sudden cardiac death (SCD), acute coronary syndromes, heart failure, and atrial fibrillation]. RECENT FINDINGS: Current and ongoing research aims to quantify the rate and pattern of significant arrhythmia in dialysis patients and to determine the predominant mechanism of SCD. Preliminary findings from these studies suggest a high rate of atrial fibrillation and that bradycardia and asystole may be more frequent than ventricular arrhythmia as a cause of sudden death...
November 2016: Current Opinion in Nephrology and Hypertension
Jaber Abboud, Joachim R Ehrlich
Implantable cardioverter defibrillators (ICDs) are effective in the prevention of arrhythmic sudden cardiac death. Many patients receiving an ICD are affected by heart failure and are at risk of ventricular arrhythmias, which may lead to appropriate shocks. On the other hand, in this population the incidence of atrial fibrillation, giving rise to inappropriate ICD shocks, is high. Accordingly, ICD discharges occur frequently and many patients with an ICD will need concomitant antiarrhythmic drug therapy to avoid or reduce the frequency of shocks...
August 2016: Arrhythmia & Electrophysiology Review
Andrew D Krahn, Jeffrey S Healey, Brenda Gerull, Paul Angaran, Santabhanu Chakrabarti, Shubhayan Sanatani, Laura Arbour, Zachary W M Laksman, Sandra L Carroll, Colette Seifer, Martin Green, Jason D Roberts, Mario Talajic, Robert Hamilton, Martin Gardner
BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a complex and clinically heterogeneous arrhythmic condition. Incomplete penetrance and variable expressivity are particularly evident in ARVC, making clinical decision-making challenging. METHODS: Pediatric and adult cardiologists, geneticists, genetic counsellors, ethicists, nurses, and qualitative researchers are collaborating to create the Canadian ARVC registry using a web-based clinical database...
April 21, 2016: Canadian Journal of Cardiology
Antti Eranti, Aapo L Aro, Tuomas Kenttä, Arttu Holkeri, Jani T Tikkanen, M Juhani Junttila, Heikki V Huikuri
Sudden cardiac death (SCD) causes a high burden of premature deaths in the population affecting subjects of all ages. The identification of subjects at high risk for SCD is of great importance as the prevention of many of these events would be possible with the treatment of underlying cardiac diseases and the use of implantable cardioverter-defibrillators (ICD). However, the current selection of patients for ICD therapy is based solely on left ventricular ejection fraction, and thus a substantial portion of patients at high risk does not qualify for the therapy...
August 10, 2016: Scandinavian Cardiovascular Journal: SCJ
John Sabu, Kalyani Regeti, Mary Mallappallil, John Kassotis, Hamidul Islam, Shoaib Zafar, Rafay Khan, Hiyam Ibrahim, Romana Kanta, Shuvendu Sen, Abdalla Yousif, Qiang Nai
It is important but difficult to distinguish convulsive syncope from epileptic seizure in many patients. We report a case of a man who presented to emergency department after several witnessed seizure-like episodes. He had a previous medical history of systolic heart failure and automated implantable converter defibrillator (AICD) in situ. The differential diagnoses raised were epileptic seizures and convulsive syncope secondary to cardiac arrhythmia. Subsequent AICD interrogation revealed ventricular tachycardia and fibrillation (v-tach/fib)...
August 2016: Journal of Clinical Medicine Research
Jacek Lelakowski, Joanna Pudło, Maria Lelakowska-Pieła, Anna Rydlewska, Justyna Piekarz, Donat Domaracki
UNLABELLED: Ambulatory follow-up of patients with implanted cardioverter-defibrillator (ICD) with/without resynchronisation therapy (CRTD) requires regular visits to assess arrhythmias, device interventions and mortality. AIM: The aim of the study was to examine arrhythmia prevalence, device interventions and mortality in patients with dilative cardiomyopathy with ICD/CRTD implanted in primary sudden cardiac death (SCD) prevention. MATERIALS AND METHODS: The study consisted of patients with ICD and/or CRTD implanted between 2010-2011...
April 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Muhammad Umar Kamal, Irbaz Bin Riaz, Rajesh Janardhanan
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy with a prevalence of 1:500 (0.2%) in the general population. Sudden cardiac death (SCD) is the most feared presentation of HCM. Therefore, it is essential to identify individuals at high risk in order to prevent SCD. The absence of conventional risk factors does not nullify the risk of HCM related SCD. Although echocardiography is currently the most widely used imaging modality, cardiac magnetic resonance (CMR) allows detailed characterization of the HCM phenotype, which makes it possible to differentiate HCM from other causes of left ventricular hypertrophy...
2016: Cardiology Journal
Ting-Yan Zhu, Shu-En Teng, Yan-Yu Chen, Shen-Rong Liu, Su-Rong Meng, Jian Peng
OBJECTIVE: To investigate whether Tpeak-Tend interval (Tp-e) and Tp-e/QT ratio are associated with malignant ventricular arrhythmia in patients with implantable cardioverter-defibrillator (ICD) for primary prevention. METHODS: A cohort of 68 consecutive patients with chronic heart failure undergoing standard ICD for primary prevention indications (NYHA function class II-III, left ventricular ejection fraction ≤35%, systolic cardiomyopathy without prior malignant ventricular arrhythmia) were enrolled in this study...
March 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Deeptankar DeMazumder, Worawan B Limpitikul, Miguel Dorante, Swati Dey, Bhasha Mukhopadhyay, Yiyi Zhang, J Randall Moorman, Alan Cheng, Ronald D Berger, Eliseo Guallar, Steven R Jones, Gordon F Tomaselli
AIMS: The need for a readily available, inexpensive, non-invasive method for improved risk stratification of heart failure (HF) patients is paramount. Prior studies have proposed that distinct fluctuation patterns underlying the variability of physiological signals have unique prognostic value. We tested this hypothesis in an extensively phenotyped cohort of HF patients using EntropyXQT, a novel non-linear measure of cardiac repolarization dynamics. METHODS AND RESULTS: In a prospective, multicentre, observational study of 852 patients in sinus rhythm undergoing clinically indicated primary prevention implantable cardioverter-defibrillator (ICD) implantation (2003-10), exposures included demographics, history, physical examination, medications, laboratory results, serum biomarkers, ejection fraction, conventional electrocardiographic (ECG) analyses of heart rate and QT variability, and EntropyXQT...
April 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Kalliopi Pilichou, Gaetano Thiene, Barbara Bauce, Ilaria Rigato, Elisabetta Lazzarini, Federico Migliore, Martina Perazzolo Marra, Stefania Rizzo, Alessandro Zorzi, Luciano Daliento, Domenico Corrado, Cristina Basso
Arrhythmogenic cardiomyopathy (AC) is a heart muscle disease clinically characterized by life-threatening ventricular arrhythmias and pathologically by an acquired and progressive dystrophy of the ventricular myocardium with fibro-fatty replacement. Due to an estimated prevalence of 1:2000-1:5000, AC is listed among rare diseases. A familial background consistent with an autosomal-dominant trait of inheritance is present in most of AC patients; recessive variants have also been reported, either or not associated with palmoplantar keratoderma and woolly hair...
2016: Orphanet Journal of Rare Diseases
Luisa Zanolla, Paola Guarise, Luca Tomasi, Corrado Vassanelli, Nicola Cicorella, Roberto Zanini, Simonetta Guarrera, Giovanni Fiorito, Giuseppe Matullo
BACKGROUND: Sympathetic activation in heart failure patients favors the development of ventricular arrhythmias, thus leading to an increased risk of sudden cardiac death. β1 - and β2 -adrenergic receptor polymorphisms have been linked to the risk of sudden death. Implantable cardioverter-defibrillators (ICD) are implanted in a large percentage of heart failure patients, and beyond preventing sudden cardiac death they provide a continuous monitoring of major ventricular arrhythmias and of their own interventions...
June 2016: Pacing and Clinical Electrophysiology: PACE
Phillip A Weeks, Adam Sieg, Jennifer Ann Gass, Indranee Rajapreyar
Sudden cardiac death remains a significant threat to the survival of patients with heart failure. Long-term cardiac remodeling predisposes these patients to develop malignant ventricular arrhythmias. Permanent implantable and temporary external defibrillators remain a mainstay for the prevention of sudden cardiac death in this population. For decades, researchers have attempted to identify reliable drug therapies to avoid such arrhythmias; however, to date, success has been inconsistent. This review aims to explore the evidence defining the role of drug therapies for direct and indirect suppression of arrhythmias that may cause sudden cardiac death in patients with heart failure...
July 2016: Heart Failure Reviews
Yitschak Biton, Jayson R Baman, Bronislava Polonsky
Implantable devices are indicated in the primary and secondary prevention of potentially life-threatening ventricular tachyarrhythmias in patients with heart failure. Early studies, including the landmark MADIT trials, showed that implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy (CRT) devices can play a significant role in aborting and preventing ventricular arrhythmias, respectively, that can cause sudden cardiac death. To this day, there have been a number of randomized controlled trials, with respective substudy analyses, that have attempted to better understand the indications for these interventions in patient care...
July 2016: Heart Failure Reviews
Francesca Galati, Antonio Galati, Serafina Massari
Ventricular arrhythmias are one of the most common causes of death in developed countries. The use of implantable cardiac defibrillators is the most effective treatment to prevent sudden cardiac death. To date, the ejection fraction is the only approved clinical variable used to determine suitability for defibrillator placement in subjects with heart failure. The purpose of this study was to assess whether genetic polymorphisms found in the ryanodine receptor type 2 (Q2958R) and histidine-rich calcium-binding protein (S96A) might serve as markers for arrhythmias...
2016: Cardiology Research and Practice
Shih-Chuan Tsai, Yu-Cheng Chang, Kuo-Feng Chiang, Wan-Yu Lin, Jin-Long Huang, Guang-Uei Hung, Chia-Hung Kao, Ji Chen
For patients with coronary artery disease, larger scar burdens are associated with higher risk of ventricular arrhythmia. Left ventricular (LV) dyssynchrony is associated with increased risk of sudden cardiac death in patients with heart failure. The purpose of this study was to assess the values of LV dyssynchrony and myocardial scar assessed by myocardial perfusion SPECT (MPS) in predicting the development of ventricular arrhythmia in ischemic cardiomyopathy. Twenty-two patients (16 males, mean age: 66 ± 13) with irreversible ischemic cardiomyopathy received cardiac resynchronization therapy (CRT) for at least 12 months were enrolled for MPS...
February 2016: Medicine (Baltimore)
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