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JACC. Clinical Electrophysiology Aug 2023
Topics: Humans; Arrhythmias, Cardiac; Defibrillators; Electric Countershock; Wearable Electronic Devices
PubMed: 37558290
DOI: 10.1016/j.jacep.2023.01.019 -
The New England Journal of Medicine Feb 2024
Review
Topics: Humans; Defibrillators, Implantable; Heart; Pacemaker, Artificial; Heart Diseases
PubMed: 38294976
DOI: 10.1056/NEJMra2308353 -
Cardiac Electrophysiology Clinics Dec 2023Pediatric and congenital heart disease patients may require cardiac implantable electronic device implantation, inclusive of pacemaker, ICD, and implantable cardiac... (Review)
Review
Pediatric and congenital heart disease patients may require cardiac implantable electronic device implantation, inclusive of pacemaker, ICD, and implantable cardiac monitor, for a variety of etiologies. While leads, generators, and monitors have decreased in size over the years, they remain less ideal for the smallest patients. The potential for a miniature pacemaker, fetal micropacemaker, improving leadless technology, and rechargeable devices creates hope that the development of pediatric-focused devices will increase. Further, alternative approaches that avoid the need for a transvenous or surgical approach may add more options to the toolbox for the pediatric and congenital electrophysiologist.
Topics: Humans; Child; Defibrillators, Implantable; Pacemaker, Artificial; Arrhythmias, Cardiac; Heart; Electrocardiography
PubMed: 37865523
DOI: 10.1016/j.ccep.2023.06.007 -
Europace : European Pacing,... Oct 2023
Topics: Humans; Cardiac Resynchronization Therapy; Defibrillators, Implantable; Heart Failure; Treatment Outcome
PubMed: 37713248
DOI: 10.1093/europace/euad285 -
Journal of Interventional Cardiac... Jun 2024
Topics: Humans; Defibrillators, Implantable
PubMed: 38308736
DOI: 10.1007/s10840-024-01740-y -
Journal of Interventional Cardiac... Oct 2023
Topics: Humans; Defibrillators, Implantable; Electric Countershock; Ventricular Fibrillation; Algorithms
PubMed: 36892801
DOI: 10.1007/s10840-023-01518-8 -
Polish Archives of Internal Medicine Sep 2023The choice between rhythm and rate control strategy represents one of the most intriguing dilemmas in the management of atrial fibrillation (AF). Although the advantage... (Review)
Review
The choice between rhythm and rate control strategy represents one of the most intriguing dilemmas in the management of atrial fibrillation (AF). Although the advantage of rhythm over rate control in terms of outcome has not been unequivocally proven, the initial management of patients with symptomatic episodes of AF frequently involves early cardioversion. As electrical cardioversion (EC) is challenging in terms of fasting status and involvement of an anesthesiologic team, pharmacological cardioversion (PC) is usually selected as the first step toward rhythm conversion. Qualification criteria for PC or EC are similar and should comprise assessment of hemodynamic status, estimation of arrhythmic episode duration, evaluation of anticoagulation regimen, exclusion of other supraventricular arrhythmias, and assessment of the chance of rhythm conversion and persistence of sinus rhythm. Finally, the choice of adequate antiarrhythmic drug (AAD) depends on the presence of structural heart disease (SHD) and local experience. In patients without any SHD, complications occur rarely, hence traditional (propafenone, flecainide) or nonclassical Vaughan-Williams class I (antazoline) or class III (vernakalant, ibutilide, or dofetilide) drugs are preferred. The presence of SHD consistent with any left ventricular hypertrophy, heart failure, myocardial ischemia, or valvular heart disease limits the choice of AAD to amiodarone. Given the risk of ventricular proarrhythmia of AAD, safety should always prevail over the enticing possibility of rhythm conversion. The present review aims to provide a comprehensible summary of proper qualification for PC, selection of suitable AAD, and state‑of‑the‑art periprocedural management of patients with recent‑onset AF.
Topics: Humans; Atrial Fibrillation; Electric Countershock; Anti-Arrhythmia Agents; Propafenone; Heart Failure; Heart Diseases; Treatment Outcome
PubMed: 37622443
DOI: 10.20452/pamw.16547 -
Cardiac Electrophysiology Clinics Dec 2023Epicardial cardiac implantable electronic device implant remains a common option in pediatric patients and certain patients with congenital heart disease due to patient... (Review)
Review
Epicardial cardiac implantable electronic device implant remains a common option in pediatric patients and certain patients with congenital heart disease due to patient size, complex anatomy, residual intracardiac shunts, and prior surgery precluding transvenous implant. Advantages include the lack of thromboembolic and vascular risks and ability to implant during concomitant surgery. Significant disadvantages include the occurrence of lead dysfunction that can result in bradycardia events in pacemaker patients, inappropriate shocks in implantable cardiac defibrillator patients, and overall a more invasive procedure.
Topics: Humans; Child; Treatment Outcome; Defibrillators, Implantable; Pacemaker, Artificial; Heart Defects, Congenital; Electric Countershock
PubMed: 37865520
DOI: 10.1016/j.ccep.2023.07.006 -
Journal of the American College of... Jul 2023Implantable cardioverter-defibrillators (ICDs) represent transformational technology, arguably the most significant advance in cardiovascular medicine in 50 years. The... (Review)
Review
Implantable cardioverter-defibrillators (ICDs) represent transformational technology, arguably the most significant advance in cardiovascular medicine in 50 years. The vision and determination of pioneers Mirowski and Mower was fundamental to this monumental achievement, working with limited resources and confronted by skepticism/criticism from medical establishment. The inventors were followed >35 years in which a multitude of innovative clinical scientists and engineers introduced technological advances leading to the sophisticated devices in practice today. A pivotal patient experiment with automated termination of ventricular fibrillation (1980) led to U.S. Food and Drug Administration approval. Transvenous lead systems converted ICDs from thoracotomy-based secondary prevention to primary prevention of sudden death devices in countless patients worldwide. ICD acceptance was solidified by prospective randomized controlled trials showing reduced mortality superior to antiarrhythmic drugs. ICDs eventually expanded from coronary disease to inherited arrhythmia conditions (eg, hypertrophic cardiomyopathy). The ICD breakthrough story demonstrates how significant progress is possible in medicine against all odds, given fearless imagination to pursue novel ideas that conflict with accepted wisdom.
Topics: Humans; Defibrillators, Implantable; Prospective Studies; Death, Sudden, Cardiac; Ventricular Fibrillation; Arrhythmias, Cardiac
PubMed: 37468191
DOI: 10.1016/j.jacc.2023.04.056 -
Trends in Cardiovascular Medicine May 2024Cardiac amyloidosis (CA) has diverse and deleterious effects on the conductive system. Atrial fibrillation is by far the most common electrophysiological manifestation... (Review)
Review
Cardiac amyloidosis (CA) has diverse and deleterious effects on the conductive system. Atrial fibrillation is by far the most common electrophysiological manifestation of CA and is associated with more mortality, morbidity, and hospitalizations. While AF increases the risk of thrombosis regardless of the CHADS-VASc score, the risk of thromboembolism seems to be high even in CA patients without AF. AV Nodal disease is prevalent and may precede the diagnosis of CA. The incidence of ventricular arrhythmias remains disputed, and the role of implantable cardioverter defibrillator devices in CA patients is controversial. Newer therapies targeted against specific types of CA have been developed, but their effects on conductive system disease are not well studied.
Topics: Humans; Action Potentials; Amyloidosis; Atrial Fibrillation; Cardiac Conduction System Disease; Cardiomyopathies; Defibrillators, Implantable; Electric Countershock; Heart Conduction System; Heart Rate; Prognosis; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 36804858
DOI: 10.1016/j.tcm.2023.02.004