-
European Heart Journal Oct 2023
Topics: Humans; Cardiomyopathies; Death, Sudden, Cardiac; Arrhythmogenic Right Ventricular Dysplasia; Defibrillators, Implantable
PubMed: 37622657
DOI: 10.1093/eurheartj/ehad194 -
The New England Journal of Medicine Jan 2024The Resynchronization-Defibrillation for Ambulatory Heart Failure Trial (RAFT) showed a greater benefit with respect to mortality at 5 years among patients who received... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
The Resynchronization-Defibrillation for Ambulatory Heart Failure Trial (RAFT) showed a greater benefit with respect to mortality at 5 years among patients who received cardiac-resynchronization therapy (CRT) than among those who received implantable cardioverter-defibrillators (ICDs). However, the effect of CRT on long-term survival is not known.
METHODS
We randomly assigned patients with New York Heart Association (NYHA) class II or III heart failure, a left ventricular ejection fraction of 30% or less, and an intrinsic QRS duration of 120 msec or more (or a paced QRS duration of 200 msec or more) to receive either an ICD alone or a CRT defibrillator (CRT-D). We assessed long-term outcomes among patients at the eight highest-enrolling participating sites. The primary outcome was death from any cause; the secondary outcome was a composite of death from any cause, heart transplantation, or implantation of a ventricular assist device.
RESULTS
The trial enrolled 1798 patients, of whom 1050 were included in the long-term survival trial; the median duration of follow-up for the 1050 patients was 7.7 years (interquartile range, 3.9 to 12.8), and the median duration of follow-up for those who survived was 13.9 years (interquartile range, 12.8 to 15.7). Death occurred in 405 of 530 patients (76.4%) assigned to the ICD group and in 370 of 520 patients (71.2%) assigned to the CRT-D group. The time until death appeared to be longer for those assigned to receive a CRT-D than for those assigned to receive an ICD (acceleration factor, 0.80; 95% confidence interval, 0.69 to 0.92; P = 0.002). A secondary-outcome event occurred in 412 patients (77.7%) in the ICD group and in 392 (75.4%) in the CRT-D group.
CONCLUSIONS
Among patients with a reduced ejection fraction, a widened QRS complex, and NYHA class II or III heart failure, the survival benefit associated with receipt of a CRT-D as compared with ICD appeared to be sustained during a median of nearly 14 years of follow-up. (RAFT ClinicalTrials.gov number, NCT00251251.).
Topics: Humans; Cardiac Resynchronization Therapy; Defibrillators, Implantable; Heart Failure; Kaplan-Meier Estimate; Stroke Volume; Treatment Outcome; Ventricular Function, Left; Electrocardiography; Follow-Up Studies; Time Factors
PubMed: 38231622
DOI: 10.1056/NEJMoa2304542 -
Cardiac Electrophysiology Clinics Sep 2023Short-coupled ventricular fibrillation (SCVF) is a distinct phenotype among individuals with unexplained cardiac arrest accounting for 7% to 14% of cases of idiopathic... (Review)
Review
Short-coupled ventricular fibrillation (SCVF) is a distinct phenotype among individuals with unexplained cardiac arrest accounting for 7% to 14% of cases of idiopathic ventricular fibrillation (IVF). VF is typically initiated by a trigger premature ventricular contraction with a short-coupling interval of less than 350 milliseconds. In the absence of specific electrocardiographic features or provocative tests, the diagnosis remains challenging and requires documentation of VF onset. Most cases are diagnosed during follow-up at the time of VF recurrence. SCVF is characterized by a high risk of VF recurrence. Insertion of an implantable cardioverter-defibrillator and quinidine are the keystones of SCVF management.
Topics: Humans; Ventricular Fibrillation; Electrocardiography; Defibrillators, Implantable
PubMed: 37558303
DOI: 10.1016/j.ccep.2023.05.004 -
Circulation. Cardiovascular Quality and... Aug 2023
Topics: Humans; Defibrillators, Implantable; Death, Sudden, Cardiac
PubMed: 37492957
DOI: 10.1161/CIRCOUTCOMES.123.010266 -
Recenti Progressi in Medicina Sep 2023
Topics: Humans; Automobiles; Defibrillators; Pacemaker, Artificial
PubMed: 37530027
DOI: 10.1701/4088.40820 -
The Canadian Journal of Cardiology May 2024Obstructive hypertrophic cardiomyopathy is the most common genetically transmitted cardiomyopathy that is associated with significant morbidity and mortality. Despite... (Review)
Review
Obstructive hypertrophic cardiomyopathy is the most common genetically transmitted cardiomyopathy that is associated with significant morbidity and mortality. Despite contemporary treatments and interventions, the management of patients with obstructive hypertrophic cardiomyopathy remains poorly defined compared with other branches of cardiology. In this review, we discuss established and novel therapeutic interventions in patients with obstructive hypertrophic cardiomyopathy with a focus on percutaneous and surgical strategies including surgical myectomy, mitral valve repair or replacement, percutaneous alcohol septal ablation, pacemaker and cardioverter-defibrillator implantation, septal embolization, radiofrequency endocardial catheter ablation, and percutaneous intramyocardial septal radiofrequency ablation.
Topics: Humans; Cardiomyopathy, Hypertrophic; Catheter Ablation; Defibrillators, Implantable; Cardiac Surgical Procedures
PubMed: 38070769
DOI: 10.1016/j.cjca.2023.12.001 -
Primary Care Mar 2024Ventricular tachyarrhythmias remain a major cause of sudden cardiac arrest (SCA) that leads to sudden cardiac death (SCD). Primary prevention strategies to prevent SCD... (Review)
Review
Ventricular tachyarrhythmias remain a major cause of sudden cardiac arrest (SCA) that leads to sudden cardiac death (SCD). Primary prevention strategies to prevent SCD include promoting a healthy lifestyle, following United States Preventive Service Task Force recommendations related to cardiovascular disease, and controlling comorbid conditions. For a patient experiencing SCA, early cardiopulmonary resuscitation and defibrillation should be performed. Implantable cardioverter defibrillators are more effective at secondary prevention compared with drug therapy but medications such as amiodarone, beta-blockers, and sotalol may be helpful adjuncts to reduce the risk of SCD or improve a patient's symptoms (eg, palpitations and inappropriate defibrillator shocks).
Topics: Humans; Arrhythmias, Cardiac; Death, Sudden, Cardiac; Heart Arrest; Defibrillators, Implantable; Sotalol
PubMed: 38278568
DOI: 10.1016/j.pop.2023.07.008 -
Heart Failure Clinics Jan 2024Remote patient monitoring (RPM) in patients with heart failure (HF) involves transmitting physiological data from devices to a health-care provider via a wireless... (Review)
Review
Remote patient monitoring (RPM) in patients with heart failure (HF) involves transmitting physiological data from devices to a health-care provider via a wireless connection with targeted interventions when values exceed the preset threshold. Devices used in telemonitoring range from weighing scales, blood pressure cuffs, and pulse oximeters to devices used to measure cardiac filling pressure and intrathoracic impedance using cardiac implantable electronic devices and wearables. Accordingly, RPM devices can potentially engage patients in their cardiovascular care and reduce the burden of HF in society.
Topics: Humans; Heart Failure; Monitoring, Physiologic; Defibrillators, Implantable
PubMed: 37953016
DOI: 10.1016/j.hfc.2023.05.002 -
Revue Medicale Suisse Feb 2024
Topics: Humans; Defibrillators
PubMed: 38323769
DOI: 10.53738/REVMED.2024.20.860.318 -
The American Journal of Cardiology Sep 2023
Topics: Humans; Electric Countershock; Atrial Fibrillation; Anti-Arrhythmia Agents; Treatment Outcome
PubMed: 37516552
DOI: 10.1016/j.amjcard.2023.07.027