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Arrhythmia & Electrophysiology Review

journal
https://read.qxmd.com/read/30588319/haemodynamic-monitoring-devices-in-heart-failure-maximising-benefit-with-digitally-enabled-patient-centric-care
#1
REVIEW
Leah M Raj, Leslie A Saxon
ICDs and resynchronisation devices are routinely implanted in patients with heart failure for primary prevention of sudden cardiac death or to treat the condition. The addition of device features and algorithms that directly or indirectly monitor cardiac haemodynamics to assess heart failure status can provide additional benefit by treating heart failure more continuously. Established and emerging devices and sensors aimed at treating or measuring cardiac haemodynamics represent the next era of heart failure disease management...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588318/defibrillation-threshold-testing-current-status
#2
REVIEW
Justin Hayase, Duc H Do, Noel G Boyle
When the transvenous ICD initially came into use for primary and secondary prevention of sudden cardiac death, defibrillation threshold (DFT) testing was universally performed. However, DFT testing is no longer routinely recommended for transvenous ICD implantation except in certain situations. Risk scores can help guide the decision to perform DFT testing. The subcutaneous ICD represents an area of uncertainty, with limited data available regarding the role of DFT testing in these devices. Current guidelines give a class I recommendation for performing DFT testing at the time of implant...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588317/identifying-risk-and-management-of-acute-haemodynamic-decompensation-during-catheter-ablation-of-ventricular-tachycardia
#3
REVIEW
Daniele Muser, Simon A Castro, Jackson J Liang, Pasquale Santangeli
Radiofrequency catheter ablation (CA) has an established role in the management of patients with structural heart disease presenting with recurrent ventricular tachycardia (VT). Due to the complex underlying substrate, high burden of comorbidities and concomitant heart failure (HF) status, these patients may be at higher risk of periprocedural complications. The prolonged low-output state related to VT induction and mapping, as well as the fluid overload due to irrigated CA and the use of general anaesthesia, may decompensate the HF status, leading to multiple-organ failure and increase in early post-procedural mortality...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588316/catheter-ablation-of-paroxysmal-atrial-fibrillation-originating-from-non-pulmonary-vein-areas
#4
REVIEW
Satoshi Higa, Li-Wei Lo, Shih-Ann Chen
Pulmonary veins (PVs) are a major source of ectopic beats that initiate AF. PV isolation from the left atrium is an effective therapy for the majority of paroxysmal AF. However, investigators have reported that ectopy originating from non-PV areas can also initiate AF. Patients with recurrent AF after persistent PV isolation highlight the need to identify non-PV ectopy. Furthermore, adding non-PV ablation after multiple AF ablation procedures leads to lower AF recurrence and a higher AF cure rate. These findings suggest that non-PV ectopy is important in both the initiation and recurrence of AF...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588315/catheter-ablation-for-atrial-fibrillation-in-systolic-heart-failure-patients-stone-by-stone-a-castle
#5
REVIEW
Dimitrios Vrachatis, Spyridon Deftereos, Vasileios Kekeris, Styliani Tsoukala, Georgios Giannopoulos
Heart failure (HF) and AF frequently coexist and are involved in a vicious cycle of adverse pathophysiologic interactions. Applying treatment algorithms that have been validated in the general AF population to patients with AF and HF may be fraught with risks and lack effectiveness. While firm recommendations on using catheter ablation for AF do exist, the subset of patients also suffering from HF needs to be further evaluated. Observational data indicate that a significant number of ablation procedures are performed in patients with coexistent HF...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588314/arrhythmia-mechanisms-revealed-by-ripple-mapping
#6
REVIEW
George Katritsis, Vishal Luther, Prapa Kanagaratnam, Nick Wf Linton
Ripple mapping is a novel method of 3D intracardiac electrogram visualisation that allows activation of the myocardium to be tracked visually without prior assignment of local activation times and without interpolation into unmapped regions. It assists in the identification of tachycardia mechanism and optimal ablation site, without the need for an experienced computer-operating assistant. This expert opinion presents evidence demonstrating the benefit of Ripple Mapping, compared with traditional electroanatomic mapping techniques, for the diagnosis and management of atrial and ventricular tachyarrhythmias during electrophysiological procedures...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588313/percutaneous-treatment-of-non-paroxysmal-atrial-fibrillation-a-paradigm-shift-from-pulmonary-vein-to-non-pulmonary-vein-trigger-ablation
#7
REVIEW
Domenico G Della Rocca, Sanghamitra Mohanty, Chintan Trivedi, Luigi Di Biase, Andrea Natale
Pulmonary vein antrum isolation is the most effective rhythm control strategy in patients with paroxysmal AF. However, catheter ablation of non-paroxysmal AF has a lower success rate, even when persistent isolation of pulmonary veins (PVs) is achieved. As a result of arrhythmia-related electophysiological and structural changes in the atria, sites other than the PVs can harbour triggers. These non-PV triggers contribute to AF relapse. In this article, we summarise the rationale and current evidence supporting the arrhythmogenic role of non-PV triggers and our ablation approach to patients with non-paroxysmal AF...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588312/heart-rate-variability-an-old-metric-with-new-meaning-in-the-era-of-using-mhealth-technologies-for-health-and-exercise-training-guidance-part-two-prognosis-and-training
#8
REVIEW
Nikhil Singh, Kegan James Moneghetti, Jeffrey Wilcox Christle, David Hadley, Victor Froelicher, Daniel Plews
It has been demonstrated that heart rate variability (HRV) is predictive of all-cause and cardiovascular mortality using clinical ECG recordings. This is true for rest, exercise and ambulatory HRV clinical ECG device recordings in prospective cohorts. Recently, there has been a rapid increase in the use of mobile health technologies (mHealth) and commercial wearable fitness devices. Most of these devices use ECG or photo-based plethysmography and both are validated for providing accurate heart rate measurements...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588311/team-management-of-the-ventricular-tachycardia-patient
#9
REVIEW
Pok Tin Tang, Duc H Do, Anthony Li, Noel G Boyle
Ventricular tachycardia is a common arrhythmia in patients with structural heart disease and heart failure, and is now seen more frequently as these patients survive longer with modern therapies. In addition, these patients often have multiple comorbidities. While anti-arrhythmic drug therapy, implantable cardioverter-defibrillator implantation and ventricular tachycardia ablation are the mainstay of therapy, well managed by the cardiac electrophysiologist, there are many other facets in the care of these patients, such as heart failure management, treatment of comorbidities and anaesthetic interventions, where the expertise of other specialists is essential for optimal patient care...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588310/arrhythmias-and-heart-rate-mechanisms-and-significance-of-a-relationship
#10
REVIEW
Antonio Zaza, Carlotta Ronchi, Gabriella Malfatto
The occurrence of arrhythmia is often related to basic heart rate. Prognostic significance is associated with such a relationship; furthermore, heart rate modulation may result as an ancillary effect of therapy, or be considered as a therapeutic tool. This review discusses the cellular mechanisms underlying arrhythmia occurrence during tachycardia or bradycardia, considering rate changes per se or as a mirror of autonomic modulation. Besides the influence of steady-state heart rate, dynamic aspects of changes in rate and autonomic balance are considered...
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588309/catheter-ablation-of-atrioventricular-nodal-re-entrant-tachycardia-facts-and-fiction
#11
EDITORIAL
Demosthenes G Katritsis
No abstract text is available yet for this article.
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588308/-arrhythmia-electrophysiology-review-is-now-the-official-journal-of-the-british-heart-rhythm-society
#12
EDITORIAL
Demosthenes G Katritsis, Richard Schilling
No abstract text is available yet for this article.
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30588307/everything-flows-heraclitus
#13
EDITORIAL
Demosthenes G Katritsis
No abstract text is available yet for this article.
December 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30416736/letter-to-the-editor-his-bundle-pacing-a-new-frontier-in-the-treatment-of-heart-failure
#14
Zografos Theodoros
No abstract text is available yet for this article.
August 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30416735/transvenous-lead-extractions-current-approaches-and-future-trends
#15
REVIEW
Adryan A Perez, Frank W Woo, Darren C Tsang, Roger G Carrillo
The use of cardiac implantable electronic devices (CIEDs) has continued to rise along with indications for their removal. When confronted with challenging clinical scenarios such as device infection, malfunction or vessel occlusion, patients often require the prompt removal of CIED hardware, including associated leads. Recent advancements in percutaneous methods have enabled physicians to face a myriad of complex lead extractions with efficiency and safety. Looking ahead, emerging technologies hold great promise in making extractions safer and more accessible for patients worldwide...
August 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30416734/mechanisms-underlying-the-actions-of-antidepressant-and-antipsychotic-drugs-that-cause-sudden-cardiac-arrest
#16
REVIEW
Serge Sicouri, Charles Antzelevitch
A number of antipsychotic and antidepressant drugs are known to increase the risk of ventricular arrhythmias and sudden cardiac death. Based largely on a concern over the development of life-threatening arrhythmias, a number of antipsychotic drugs have been temporarily or permanently withdrawn from the market or their use restricted. While many antidepressants and antipsychotics have been linked to QT prolongation and the development of torsade de pointes arrhythmias, some have been associated with a Brugada syndrome phenotype and the development of polymorphic ventricular arrhythmias...
August 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30416733/heart-rate-variability-an-old-metric-with-new-meaning-in-the-era-of-using-mhealth-technologies-for-health-and-exercise-training-guidance-part-one-physiology-and-methods
#17
REVIEW
Nikhil Singh, Kegan James Moneghetti, Jeffrey Wilcox Christle, David Hadley, Daniel Plews, Victor Froelicher
The autonomic nervous system plays a major role in optimising function of the cardiovascular (CV) system, which in turn has important implications for CV health. Heart rate variability (HRV) is a measurable reflection of this balance between sympathetic and parasympathetic tone and has been used as a marker for cardiac status and predicting CV outcomes. Recently, the availability of commercially available heart rate (HR) monitoring systems has had important CV health implications and permits ambulatory CV monitoring on a scale not achievable with traditional cardiac diagnostics...
August 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30416732/long-qt-syndrome-and-competitive-sports
#18
REVIEW
Frédéric Schnell, Nathalie Behar, François Carré
Long QT syndrome (LQTS) is an inherited channelopathy which exposes athletes to a risk of sudden cardiac death. Diagnosis is more difficult in this population because: the QT interval is prolonged by training; and the extreme bradycardia frequently observed in athletes makes the QT correction formula less accurate. Based on limited clinical data which tend to demonstrate that exercise, especially swimming, is a trigger for cardiac events, participation in any competitive sports practice is not supported by 2005 European guidelines...
August 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30416731/arrhythmogenic-inflammatory-cardiomyopathy-a-review
#19
REVIEW
Brenton S Bauer, Anthony Li, Jason S Bradfield
Arrhythmogenic inflammatory cardiomyopathy is a recent clinical description of a subgroup of patients with non-ischaemic cardiomyopathy who are referred to electrophysiologists for evaluation and management of ventricular arrhythmias and are found to have evidence of active cardiac inflammation. The identification of these patients is key, since the aetiology of their arrhythmic burden is likely both related to scar-mediated and direct inflammatory mechanisms, which may have different treatment approaches. Evaluation of these patients starts with a full clinical history and physical examination along with echocardiography, as with most patients with cardiomyopathy, however, additional imaging with fluorodeoxyglucose PET-CT and cardiac MRI is crucial...
August 2018: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/30416730/the-impact-of-advances-in-atrial-fibrillation-ablation-devices-on-the-incidence-and-prevention-of-complications
#20
REVIEW
Fehmi Keçe, Katja Zeppenfeld, Serge A Trines
The number of patients with atrial fibrillation currently referred for catheter ablation is increasing. However, the number of trained operators and the capacity of many electrophysiology labs are limited. Accordingly, a steeper learning curve and technical advances for efficient and safe ablation are desirable. During the last decades several catheter-based ablation devices have been developed and adapted to improve not only lesion durability, but also safety profiles, to shorten procedure time and to reduce radiation exposure...
August 2018: Arrhythmia & Electrophysiology Review
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