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heart failure device therapy

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https://www.readbyqxmd.com/read/28525417/assessing-frailty-in-patients-undergoing-destination-therapy-left-ventricular-assist-device-observations-from-interagency-registry-for-mechanically-assisted-circulatory-support
#1
Lauren B Cooper, Bradley G Hammill, Larry A Allen, JoAnn Lindenfeld, Robert J Mentz, Joseph G Rogers, Carmelo A Milano, Chetan B Patel, Karen P Alexander, Adrian F Hernandez
Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data of destination therapy (DT) LVAD patients from January 1, 2012, to March 31, 2014, we examined preimplantation provider-assessed frailty and gait speed testing and the association with 1 year postimplantation outcomes. Of 2,469 patients, 227 (9...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28523441/progress-in-the-presence-of-failure-updates-in-chronic-systolic-heart-failure-management
#2
REVIEW
Katie M Murphy, Julie L Rosenthal
The therapeutic heart failure armamentarium has evolved from drugs to transplantation to devices through further understanding of its complex pathophysiology and pathogenesis. Current medications capitalize on our evolving understanding of the sympathetic and renin-angiotensin-aldosterone systems that subsequently promote both beneficial and maladaptive responses that ultimately yield a decrease in cardiac function. Despite these advancements, the prevalence of heart failure continues to rise and carries a significant burden on our patients and health care system...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28522783/splenic-abcesses-as-infectious-complication-following-127-implantation-of-left-ventricular-asssist-device-case-report
#3
Sławomir Gajda, Anna M Szczepanik, Grzegorz Religa, Andrzej Misiak, Andrzej B Szczepanik
Left ventricular assist device (LVAD) is one of the modern management therapies in patients with advanced heart failure, and it serves as a bridge to heart transplantation or even as destination therapy. However, it is burdened with a high risk of thromboembolic, hemorrhagic, and infectious complications despite prophylactic management. Splenic abscesses, as septic complications following implantation of mechanical ventricular support, have not yet been described in the literature. We report of a patient with severe left ventricular insufficiency (NYHA II/III), pulmonary hypertension, and arrhythmia who underwent implantation of the Heart Ware® pump for left ventricular support with simultaneous tricuspidvalvoplasty, as a bridge therapy to heart transplantation...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28520449/-novelties-in-the-treatment-of-heart-failure
#4
Filip Souček, Jan Novak
Heart failure (HF) is a complex clinical syndrome which is manifested by characteristic symptoms and objective signs of cardiac insufficiency. The incidence of HF, particularly its chronic form, is estimated 0.4-2 % in the central and western Europe, with an increase in higher age groups, affecting 10-20 % of the population aged over 80. With respect to its growing incidence and prevalence, novel modalities of pharmacological and non-pharmacological treatment are being developed in order to improve quality of life and survival of the affected patients...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28512680/a-novel-idea-to-improve-cardiac-output-of-mechanical-circulatory-support-devices-by-optimizing-kinetic-energy-transfer-available-in-forward-moving-aortic-blood-flow
#5
Muhammad B Qureshi, Jacob Glower, Daniel L Ewert, Steven C Koenig
Mechanical circulatory support devices (MCSDs) have gained widespread clinical acceptance as an effective heart failure (HF) therapy. The concept of harnessing the kinetic energy (KE) available in the forward aortic flow (AOF) is proposed as a novel control strategy to further increase the cardiac output (CO) provided by MCSDs. A complete mathematical development of the proposed theory and its application to an example MCSDs (two-segment extra-aortic cuff) are presented. To achieve improved device performance and physiologic benefit, the example MCSD timing is regulated to maximize the forward AOF KE and minimize retrograde flow...
May 16, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28509888/cardiac-contractility-modulation-a-technical-guide-for-device-implantation
#6
Jürgen Kuschyk, Axel Kloppe, Stephan Schmidt-Schweda, Hendrik Bonnemeier, Benny Rousso, Susanne Röger
This article provides a technical description of common implant practice for delivery of cardiac contractility modulation (CCM) therapy to heart failure patients. As of September 2016, the authors of this article collectively have been involved with more than 400 system implantations in five medical centers, beginning with the advent of CCM therapy approximately 12 years ago. CCM therapy has been evaluated in a variety of studies, and was shown to be safe and effective and of benefit to patient quality of life and exercise capacity...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28508801/adaptive-pump-speed-algorithms-to-improve-exercise-capacity-in-patients-supported-with-a-left-ventricular-assist-device
#7
Thomas Schmidt, Nils Reiss, Ezin Deniz, Christina Feldmann, Andreas Hein, Jan-Dirk Hoffmann, Jenny Inge Röbesaat, Jan Dieter Schmitto, Detlev Willemsen, Frerk Müller-von Aschwege
For the treatment of terminal heart failure, the therapy with left-ventricular assist devices has already been established. In the systems used today, pump speed does not adjust during physical activity so that cardiac output and exercise capacity remain markedly limited. It is the aim of this study to develop an automatic pump speed control based on filling pressure values in order to improve exercise capacity and quality of life in these patients. Different approaches are planned, to be tested in an in vitro patient simulator...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28506978/addition-of-blood-pressure-and-weight-transmissions-to-standard-remote-monitoring-of-implantable-defibrillators-and-its-association-with-mortality-and-rehospitalization
#8
M Obadah Al-Chekakie, Haikun Bao, Paul W Jones, Kenneth M Stein, Lucas Marzec, Paul D Varosy, Frederick A Masoudi, Jeptha P Curtis, Joseph G Akar
BACKGROUND: Among patients with implantable defibrillators (ICD), use of remote patient monitoring (RPM) is associated with lower risk of death and rehospitalization. Standard ICD RPM can be supplemented with weight and blood pressure data. It is not known whether standard RPM plus routine weight and blood pressure transmission (RPM+) is associated with better outcomes. METHODS AND RESULTS: RPM+ patients (n=4106) were compared with patients who only transmitted standard ICD RPM data (n=14 183)...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28501337/late-in-hospital-management-of-patients-hospitalized-with-acute-heart-failure
#9
REVIEW
Nicole B Cyrille, Snehal R Patel
Acute Heart Failure (AHF) hospitalization presents a significant financial burden and portends a poor prognosis following discharge. As such, there has been significant emphasis on the late inpatient management of patients hospitalized with AHF to ensure successful transition to the outpatient setting and to reduce overall readmission and mortality rates. Thorough discharge planning and a multidisciplinary team approach are essential and as outlined in this review should focus on four key elements: the assessment of patients' readiness for discharge, optimization of goal directed medical therapy and appropriate device therapy, patient education and transition to the outpatient care...
May 10, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28500136/percutaneous-mechanical-circulatory-support-devices-in-cardiogenic-shock
#10
REVIEW
Aditya Mandawat, Sunil V Rao
Despite a high rate of early revascularization and use of intra-aortic balloon pump counterpulsation therapy, the prognosis of patients with cardiogenic shock has remained poor. In the hopes of improving outcomes, clinicians are increasingly turning to percutaneous left and right mechanical circulatory support devices. Until recently, the evidence base for these devices had consisted only of observational data, meta-analyses, and small feasibility trials. In this article, we describe the contemporary outcomes of patients with cardiogenic shock, the hemodynamics of cardiogenic shock, and hemodynamic effects of percutaneous mechanical circulatory support devices...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28499668/a-multicenter-feasibility-study-on-ultrafiltration-via-a-single-peripheral-venous-access-in-acute-heart-failure-with-overt-fluid-overload
#11
Marco Morpurgo, Mario Pasqualini, Maria Cristiana Brunazzi, Gabriele Vianello, Roberto Valle, Loris Roncon, Fulvio Fiorini, Nadia Aspromonte, Mario Barbiero, Marco Goldoni, Giancarlo Marenzi
OBJECTIVES: The need for a central venous catheter has limited the widespread use of ultrafiltration in daily clinical practice for the treatment of acute heart failure (AHF) with overt fluid overload. We evaluated the feasibility of a new ultrafiltration device, the CHIARA (Congestive Heart Impairment Advanced Removal Approach) system, that utilizes a single-lumen cannula (17G, multi-hole) inserted in a peripheral vein of the arm. METHODS: In this multicenter, prospective, feasibility study, consecutive ultrafiltration treatments (lasting ≥6 hours and with an ultrafiltration rate ≥100ml/h) with the CHIARA device and a single peripheral venous approach were performed at 6 Italian hospitals...
May 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28495061/high-risk-cardiac-surgery-as-an-alternative-to-transplant-or-mechanical-support-in-patients-with-end-stage-heart-failure
#12
Hiroyuki Kawajiri, Cedric Manlhiot, Heather Ross, Diego Delgado, Filio Billia, Michael McDonald, Vivek Rao
OBJECTIVE: Although the results of cardiac surgery in patients with poor left ventricular function have been widely published, the outcomes in patients with end-stage heart failure who meet criteria for advanced therapies are not well investigated. As access to transplantation and ventricular assist device therapy remains limited, we explored the possibility of conventional surgery as an alternative option for highly selected patients with end-stage heart failure. METHODS: We identified patients with left ventricular ejection fraction <20% and VO2 max <14 mL/min/m(2), who were initially referred for advanced therapies but were instead offered a conventional procedure from 2002 to 2012...
March 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28494980/extracorporeal-ultrafiltration-for-fluid%C3%A2-overload-in-heart-failure-current-status-and-prospects-for-further-research
#13
REVIEW
Maria Rosa Costanzo, Claudio Ronco, William T Abraham, Piergiuseppe Agostoni, Jonathan Barasch, Gregg C Fonarow, Stephen S Gottlieb, Brian E Jaski, Amir Kazory, Allison P Levin, Howard R Levin, Giancarlo Marenzi, Wilfried Mullens, Dan Negoianu, Margaret M Redfield, W H Wilson Tang, Jeffrey M Testani, Adriaan A Voors
More than 1 million heart failure hospitalizations occur annually, and congestion is the predominant cause. Rehospitalizations for recurrent congestion portend poor outcomes independently of age and renal function. Persistent congestion trumps serum creatinine increases in predicting adverse heart failure outcomes. No decongestive pharmacological therapy has reduced these harmful consequences. Simplified ultrafiltration devices permit fluid removal in lower-acuity hospital settings, but with conflicting results regarding safety and efficacy...
May 16, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28483550/efficacy-and-safety-of-inter-atrial-shunt-devices-for-heart-failure-with-reduced-or-preserved-ejection-fraction-early-experiences
#14
Dasheng Lu, Jing Zhu, Bin Liao
BACKGROUND: Elevated left atrial (LA) pressure is thought to be the common final pathological way in decompensated heart failure (HF). We aimed to gather currently available clinical evidence to evaluate the feasibility of inter-atrial shunt devices in HF patients. METHODS: We searched PubMed and Cochrane Library databases through 23rd April 23, 2016. Data were extracted by two investigators independently. We pooled outcomes of interest in Revman 5.2 (The Cochrane Collaboration, Oxford, United Kingdom)...
April 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28471759/advancing-the-science-of-myocardial-recovery-with-mechanical-circulatory-support-a-working-group-of-the-national-heart-lung-and-blood-institute
#15
Stavros G Drakos, Francis D Pagani, Martha S Lundberg, J Timothy Baldwin
The medical burden of heart failure (HF) has spurred interest in clinicians and scientists to develop therapies to restore the function of a failing heart. To advance this agenda, the National Heart, Lung, and Blood Institute (NHLBI) convened a Working Group of experts from June 2 to 3, 2016, in Bethesda, Maryland, to develop NHLBI recommendations aimed at advancing the science of cardiac recovery in the setting of mechanical circulatory support (MCS). MCS devices effectively reduce volume and pressure overload that drives the cycle of progressive myocardial dysfunction, thereby triggering structural and functional reverse remodeling...
April 29, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28471545/eleven-year-trends-of-inpatient-pacemaker-implantation-in-patients-diagnosed-with-sick-sinus-syndrome
#16
Avirup Guha, Xiao Xiang, Devin Haddad, Benjamin Buck, Xu Gao, Michael Dunleavy, Ellen Liu, Dilesh Patel, Vadim V Fedorov, Emile G Daoud
BACKGROUND: Pacemakers (PM) are used for managing sick sinus syndrome (SSS). This study evaluates predictors and trends of PM implantation for SSS. METHODS: Patients were identified from the National Inpatient Sample dataset (2003-13). Included patients were ≥18 years old, had a diagnosis of sinus node dysfunction and atrial arrhythmia (i.e., SSS). Patients who died, transferred out, who had prior device or had a defibrillator or resynchronization therapy device implanted were excluded...
May 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28469691/cardiac-resynchronization-therapy-device-implantation-in-a-patient-with-congenitally-corrected-transposition-of-great-vessels
#17
Reza Mollazadeh, Masoud Eslami
A 29-year-old woman was referred to our hospital due to exacerbation in dyspnea on exertion and easy fatigability. A known case of congenitally corrected transposition of the great vessels and congenital complete heart block, she had already received a permanent single-chamber pacemaker. Decision was made to implant a biventricular pacemaker for the treatment of the failing heart. Excellent coronary sinus lead implantation was done, conferring amelioration of symptoms, QRS narrowing in the electrocardiogram, and improvement of systemic ventricular systolic function in echocardiography...
January 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28461796/is-diabetes-mellitus-a-risk-factor-for-poor-outcomes-after-left-ventricular-assist-device-placement
#18
Burhan Mohamedali, Gardner Yost, Geetha Bhat
Diabetes mellitus is associated with adverse outcomes in patients with cardiovascular diseases, including heart failure. Left ventricular assist devices (LVADs) are increasingly used as life-saving therapy for advanced heart failure. The effects of pre-LVAD diabetes on long-term outcomes after LVAD implantation are not well understood. In this study, we retrospectively evaluated the effect of existing diabetes on post-LVAD outcomes. Data on 288 LVAD recipients from 2006 through 2013 were reviewed. Patients were stratified in accordance with their histories of diabetes...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28460828/the-future-of-atrial-fibrillation-management-integrated-care-and-stratified-therapy
#19
REVIEW
Paulus Kirchhof
Atrial fibrillation is one of the major cardiovascular health problems: it is a common, chronic condition, affecting 2-3% of the population in Europe and the USA and requiring 1-3% of health-care expenditure as a result of stroke, sudden death, heart failure, unplanned hospital admissions, and other complications. Early diagnosis of atrial fibrillation, ideally before the first complication occurs, remains a challenge, as shown by patients who are only diagnosed with the condition when admitted to hospital for acute cardiac decompensation or stroke...
April 28, 2017: Lancet
https://www.readbyqxmd.com/read/28460827/heart-failure
#20
REVIEW
Marco Metra, John R Teerlink
Heart failure is common in adults, accounting for substantial morbidity and mortality worldwide. Its prevalence is increasing because of ageing of the population and improved treatment of acute cardiovascular events, despite the efficacy of many therapies for patients with heart failure with reduced ejection fraction, such as angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), β blockers, and mineralocorticoid receptor antagonists, and advanced device therapies. Combined angiotensin receptor blocker neprilysin inhibitors (ARNIs) have been associated with improvements in hospital admissions and mortality from heart failure compared with enalapril, and guidelines now recommend substitution of ACE inhibitors or ARBs with ARNIs in appropriate patients...
April 28, 2017: Lancet
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