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Circulation Research Jan 2021
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Humans
PubMed: 33476206
DOI: 10.1161/CIRCRESAHA.120.318576 -
Hellenic Journal of Cardiology : HJC =... 2018Cardiac arrhythmias refer to any abnormality or disturbance in the normal activation sequence of the myocardium and may be indicative of structural heart disease and the... (Review)
Review
Cardiac arrhythmias refer to any abnormality or disturbance in the normal activation sequence of the myocardium and may be indicative of structural heart disease and the cause of significant cardiovascular complications and sudden cardiac death. The following review summarizes the current state-of-the-art knowledge on the role of echocardiography in the management of cardiac arrhythmias and focuses on atrial fibrillation and ventricular arrhythmias where echocardiography presents a particular diagnostic and prognostic interest. Moreover, a brief reference is made to the effect of cardiac arrhythmias and conduction abnormalities on echocardiographic examination.
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Echocardiography; Humans; Patient Care Management
PubMed: 29203161
DOI: 10.1016/j.hjc.2017.11.017 -
Trends in Cardiovascular Medicine Aug 2022Among the inherited ion channelopathies associated with potentially life-threatening ventricular arrhythmia syndromes in nominally structurally normal hearts are the J... (Review)
Review
Among the inherited ion channelopathies associated with potentially life-threatening ventricular arrhythmia syndromes in nominally structurally normal hearts are the J wave syndromes, which include the Brugada (BrS) and early repolarization (ERS) syndromes. These ion channelopathies are responsible for sudden cardiac death (SCD), most often in young adults in the third and fourth decade of life. Our principal goal in this review is to briefly outline the clinical characteristics, as well as the molecular, ionic, cellular, and genetic mechanisms underlying these primary electrical diseases that have challenged the cardiology community over the past two decades. In addition, we discuss our recently developed whole-heart experimental model of BrS, providing compelling evidence in support of the repolarization hypothesis for the BrS phenotype as well as novel findings demonstrating that voltage-gated sodium and transient outward current channels can modulate each other's function via trafficking and gating mechanisms with implications for improved understanding of the genetics of both cardiac and neuronal syndromes.
Topics: Arrhythmias, Cardiac; Brugada Syndrome; Channelopathies; Death, Sudden, Cardiac; Electrocardiography; Humans
PubMed: 34256120
DOI: 10.1016/j.tcm.2021.07.001 -
Frontiers in Bioscience (Landmark... Nov 2021The heart, like most mammalian organs, is influenced by circadian patterns. The suprachiasmatic nucleus in the hypothalamus has a key role in this influence, via various... (Review)
Review
The heart, like most mammalian organs, is influenced by circadian patterns. The suprachiasmatic nucleus in the hypothalamus has a key role in this influence, via various neurohumoral factors, particularly the autonomic nervous system. In addition, a local cardiac peripheral clock might drive a circadian rhythm related to the expression of ion channels. Several myocardial functions are influenced by these circadian cycles including activity/rest, regeneration, nutrient storage, growth, and myocardial repair. Numerous circadian genes have been identified in basic studies, and both biological factors and environmental features (including epigenetic) influence the human circadian rhythm. A normal circadian rhythm is important to maintain a normal heart rhythm and circadian rhythm disturbances can predispose to the development of cardiac arrhythmias. The normal heart rate presents a daily variability with a morning peak and nocturnal bradycardization. Ventricular arrhythmias and sudden death are more likely to occur in the morning after waking, while atrial fibrillation and heart blocks most commonly occur at night. Drugs such as beta-blockers might modify the chronobiology of some of these arrhythmias. On the other hand, drugs that influence circadian rhythm, like the circadian hormone melatonin, have demonstrated pleiotropic properties and show promising results as antiarrhythmics. This review is focused on the current understanding of the basic mechanism and clinical implications of the association circadian rhythms-cardiac arrhythmias/sudden death. The close relationship between circadian patterns and arrhythmias may provide us with the possibility of novel interventions to decrease the arrhythmic risk in some patients.
Topics: Animals; Arrhythmias, Cardiac; Circadian Rhythm; Death, Sudden, Cardiac; Heart; Humans; Ion Channels
PubMed: 34856769
DOI: 10.52586/5025 -
Turk Kardiyoloji Dernegi Arsivi : Turk... Mar 2022Brugada syndrome was first described in 1992 as right precordial ST-segment elevation in patients with structurally normal hearts and sudden cardiac death. Brugada... (Review)
Review
Brugada syndrome was first described in 1992 as right precordial ST-segment elevation in patients with structurally normal hearts and sudden cardiac death. Brugada Syndrome is one of the most common reasons for sudden cardiac death (4-12%) and is a hereditary disease with an autosomal dominant pattern of transmission with nearly 300 pathogenic variants in 19 responsible genes published. The present review focuses on the diagnosis, genetics, risk stratification, and management of patients with Brugada Syndrome.
Topics: Brugada Syndrome; Death, Sudden, Cardiac; Electrocardiography; Humans
PubMed: 35400636
DOI: 10.5543/tkda.2022.21020 -
Methodist DeBakey Cardiovascular Journal 2016There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience... (Review)
Review
There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). This article reviews the epidemiology and common causes of SCD in specific athlete populations. There is ongoing debate about the optimal mechanism for SCD prevention, specifically regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation. This controversy and contemporary screening recommendations are also reviewed.
Topics: Athletes; Death, Sudden, Cardiac; Electrocardiography; Exercise Tolerance; Global Health; Humans; Incidence; Risk Assessment; Risk Factors
PubMed: 27486488
DOI: 10.14797/mdcj-12-2-76 -
Biomedical Papers of the Medical... Sep 2022Sudden cardiac death (SCD) is a major medical, economic and social problem. The estimated annual number of SCDs is approximately 4 million cases worldwide. Approximately... (Review)
Review
Sudden cardiac death (SCD) is a major medical, economic and social problem. The estimated annual number of SCDs is approximately 4 million cases worldwide. Approximately 50% of SCDs are unexpected first manifestations of cardiac disease. The survival rate after out-of-hospital cardiac arrest is low even in countries with the most advanced health care systems. It all emphasizes the importance of prevention, in which implantable cardioverter-defibrillators play a dominant role. However, our ability to recognize high-risk patients remains insufficient. Moreover, a declining rate of shockable rhythm as the initial recording has been reported in the last decades. Despite numerous SCD studies and undisputed progress, there are still many unanswered questions.
Topics: Death, Sudden, Cardiac; Defibrillators, Implantable; Humans; Out-of-Hospital Cardiac Arrest; Survival Rate
PubMed: 34782798
DOI: 10.5507/bp.2021.065 -
The American Journal of Cardiology Feb 2024Hypertrophic cardiomyopathy (HCM) is a complex, heterogeneous disorder that affects approximately 1 in every 500 persons worldwide and about 750,000 Americans. It is... (Review)
Review
Hypertrophic cardiomyopathy (HCM) is a complex, heterogeneous disorder that affects approximately 1 in every 500 persons worldwide and about 750,000 Americans. It is characterized by left ventricular hypertrophy that is usually asymmetric, with enlarged myocytes in disarray, unexplained by loading conditions. Obstruction to left ventricular outflow occurs in approximately 60% of patients. The natural history and cardiac morphology of HCM are quite heterogeneous. Although most patients with HCM are asymptomatic or mildly symptomatic, a minority are disabled by dyspnea, angina, or syncope, develop advanced heart failure, or die suddenly.
Topics: Humans; Cardiomyopathy, Hypertrophic; Death, Sudden, Cardiac; Heart Failure; Heart Ventricles; Hypertrophy, Left Ventricular; Syncope
PubMed: 38368032
DOI: 10.1016/j.amjcard.2023.10.075 -
The American Journal of Cardiology Feb 2024Hypertrophic cardiomyopathy (HCM) is a heterogeneous genetic heart disease inherited in an autosomal dominant pattern with an estimated prevalence of 0.6% in the general... (Review)
Review
Hypertrophic cardiomyopathy (HCM) is a heterogeneous genetic heart disease inherited in an autosomal dominant pattern with an estimated prevalence of 0.6% in the general population. Clinical manifestations of HCM vary considerably, with symptoms ranging from none or mild exercise intolerance to severe lifestyle-limiting symptoms, advanced heart failure, and sudden cardiac death. Current management options for HCM include lifestyle modifications, familial screening with genetic counseling, pharmacotherapy for symptom control, sudden cardiac death risk stratification with or without defibrillator implantation, septal reduction therapy, and, in some cases, heart transplantation. Only recently have strongly targeted medical therapies for HCM, such as myosin inhibitors, been studied in multicenter randomized controlled trials. In this report, we review the currently available medical treatments for HCM and the future directions of HCM pharmacotherapy, and we highlight important unmet needs in this population.
Topics: Humans; Cardiomyopathy, Hypertrophic; Heart Failure; Death, Sudden, Cardiac; Genetic Counseling; Multicenter Studies as Topic
PubMed: 38368034
DOI: 10.1016/j.amjcard.2023.10.074 -
Circulation Research Jun 2015Arrhythmic sudden cardiac death (SCD) may be caused by ventricular tachycardia/fibrillation or pulseless electric activity/asystole. Effective risk stratification to... (Review)
Review
Arrhythmic sudden cardiac death (SCD) may be caused by ventricular tachycardia/fibrillation or pulseless electric activity/asystole. Effective risk stratification to identify patients at risk of arrhythmic SCD is essential for targeting our healthcare and research resources to tackle this important public health issue. Although our understanding of SCD because of pulseless electric activity/asystole is growing, the overwhelming majority of research in risk stratification has focused on SCD-ventricular tachycardia/ventricular fibrillation. This review focuses on existing and novel risk stratification tools for SCD-ventricular tachycardia/ventricular fibrillation. For patients with left ventricular dysfunction or myocardial infarction, advances in imaging, measures of cardiac autonomic function, and measures of repolarization have shown considerable promise in refining risk. Yet the majority of SCD-ventricular tachycardia/ventricular fibrillation occurs in patients without known cardiac disease. Biomarkers and novel imaging techniques may provide further risk stratification in the general population beyond traditional risk stratification for coronary artery disease alone. Despite these advances, significant challenges in risk stratification remain that must be overcome before a meaningful impact on SCD can be realized.
Topics: Arrhythmias, Cardiac; Autonomic Nervous System; Biomarkers; Coronary Disease; Death, Sudden, Cardiac; Diagnostic Techniques, Cardiovascular; Disease Susceptibility; Forecasting; Heart Rate; Humans; Risk Assessment
PubMed: 26044247
DOI: 10.1161/CIRCRESAHA.116.304493