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Archives of Cardiovascular Diseases 2018Investigation and catheter ablation of cardiac arrhythmias are currently still based on optimal knowledge of arrhythmia mechanisms in relation to the cardiac anatomy... (Review)
Review
Investigation and catheter ablation of cardiac arrhythmias are currently still based on optimal knowledge of arrhythmia mechanisms in relation to the cardiac anatomy involved, in order to target their crucial components. Currently, most complex arrhythmias are investigated using three-dimensional electroanatomical navigation systems, because these are felt to optimally integrate both the anatomical and electrophysiological features of a given arrhythmia in a given patient. In this article, we review the technical background of available three-dimensional electroanatomical navigation systems, and their potential use in complex ablations.
Topics: Action Potentials; Arrhythmias, Cardiac; Catheter Ablation; Electrophysiologic Techniques, Cardiac; Equipment Design; Heart Conduction System; Heart Rate; Humans; Imaging, Three-Dimensional; Predictive Value of Tests; Treatment Outcome
PubMed: 29887403
DOI: 10.1016/j.acvd.2018.03.013 -
Heart Rhythm Aug 2015A prominent J wave is encountered in a number of life-threatening cardiac arrhythmia syndromes, including the Brugada syndrome and early repolarization syndromes.... (Review)
Review
A prominent J wave is encountered in a number of life-threatening cardiac arrhythmia syndromes, including the Brugada syndrome and early repolarization syndromes. Brugada syndrome and early repolarization syndromes differ with respect to the magnitude and lead location of abnormal J waves and are thought to represent a continuous spectrum of phenotypic expression termed J-wave syndromes. Despite two decades of intensive research, risk stratification and the approach to therapy of these 2 inherited cardiac arrhythmia syndromes are still undergoing rapid evolution. Our objective in this review is to provide an integrated synopsis of the clinical characteristics, risk stratifiers, and molecular, ionic, cellular, and genetic mechanisms underlying these 2 fascinating syndromes that have captured the interest and attention of the cardiology community in recent years.
Topics: Arrhythmias, Cardiac; Brugada Syndrome; Cardiac Conduction System Disease; Electrocardiography; Genetic Predisposition to Disease; Heart Conduction System; Heart Ventricles; Humans; Risk Factors; Syndrome
PubMed: 25869754
DOI: 10.1016/j.hrthm.2015.04.014 -
Journal of Cardiovascular... Feb 2020Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) can be attributed to cardiac, respiratory, metabolic, and toxicologic etiologies. Most cases of SCD are caused... (Review)
Review
Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) can be attributed to cardiac, respiratory, metabolic, and toxicologic etiologies. Most cases of SCD are caused by coronary artery disease and approximately 40% of cardiac arrests are unexplained. Inherited arrythmias and cardiomyopathies are important contributors to SCA and SCD. Identifying an inherited condition after such an event not only has important ramifications for the individual, but also for relatives who may be at risk for the familial condition. This review will provide an overview of inherited cardiovascular disorders than can predispose to SCA/SCD, review the diagnostic evaluation for an individual and/or family after an SCA/SCD, and discuss the role of genetic testing.
Topics: Arrhythmias, Cardiac; Cardiomyopathies; DNA Mutational Analysis; Death, Sudden, Cardiac; Electrocardiography; Female; Genetic Predisposition to Disease; Heredity; Humans; Male; Middle Aged; Mutation; Pedigree; Phenotype; Predictive Value of Tests; Prognosis; Risk Assessment; Risk Factors; Young Adult
PubMed: 31909521
DOI: 10.1111/jce.14333 -
Internal Medicine Journal Jun 2023Ventricular arrhythmias (VAs) are a group of heart rhythm disorders that can be life-threatening and cause significant morbidity. VA in the presence of structural heart... (Review)
Review
Ventricular arrhythmias (VAs) are a group of heart rhythm disorders that can be life-threatening and cause significant morbidity. VA in the presence of structural heart disease (SHD) has distinct prognostic implications and requires a comprehensive and multifaceted approach for investigation and management. Early specialist referral should be considered for all patients with VA. Particular urgency is recommended in patients with syncope, nonsustained/sustained VA on Holter monitor and SHD on cardiac imaging because of the heightened risk of sudden cardiac death. Comprehensive phenotyping is recommended for most patients with VA, encompassing noninvasive cardiac functional testing, multimodality imaging and genetic testing in select circumstances. Management of idiopathic VA is guided heavily by symptom burden and the presence of ventricular systolic impairment. In SHD, guideline-directed heart failure therapy and device implantation are critical considerations. Whilst commonly used and well-established, antiarrhythmic drugs can be hampered by toxicity and failure of adequate arrhythmia control. Catheter ablation is increasingly being considered a feasible first-line alternative to medical therapy, where outcomes are influenced by disease aetiology and scar burden in SHD. Catheter ablation is associated with reduced arrhythmia recurrence and burden and improved quality of life at follow-up.
Topics: Humans; Tachycardia, Ventricular; Quality of Life; Arrhythmias, Cardiac; Heart Diseases; Anti-Arrhythmia Agents; Catheter Ablation
PubMed: 36369893
DOI: 10.1111/imj.15976 -
The Korean Journal of Internal Medicine May 2021Inherited arrhythmia (IA) is one of the main causes of sudden cardiac death (SCD) in young people, and is reported to be a more prevalent cause of SCD in Asia than in... (Review)
Review
Inherited arrhythmia (IA) is one of the main causes of sudden cardiac death (SCD) in young people, and is reported to be a more prevalent cause of SCD in Asia than in Western countries. IAs are a group of genetic disorders caused by mutations in genes encoding cardiac ion channels, leading to electrophysiological characteristics that often occur in the absence of structural abnormalities. Channelopathies, such as long QT syndrome and Brugada syndrome, carry a potential risk of life-threatening ventricular tachyarrhythmias that predispose to SCD, although early prediction and prevention of the risk remain challenging. Recent advances in genetic testing have facilitated risk stratification as well as a precise diagnosis for IA, despite ongoing debates about the implications. Herein, we provide epidemiological data, a pathophysiological overview, and the current clinical approach to IAs related to SCD. In addition, we review the general issues arising from genetic testing for IAs.
Topics: Adolescent; Arrhythmias, Cardiac; Asia; Brugada Syndrome; Channelopathies; Death, Sudden, Cardiac; Humans
PubMed: 33092314
DOI: 10.3904/kjim.2020.481 -
JACC. Clinical Electrophysiology Jun 2022
Topics: Arrhythmias, Cardiac; Humans; Ranolazine; Tachycardia, Ventricular
PubMed: 35738853
DOI: 10.1016/j.jacep.2022.04.010 -
Journal of the American College of... May 2021In the initial 3 papers in this Focus Seminar series, the fundamentals and key concepts of precision medicine were reviewed, followed by a focus on precision medicine in... (Review)
Review
In the initial 3 papers in this Focus Seminar series, the fundamentals and key concepts of precision medicine were reviewed, followed by a focus on precision medicine in the context of vascular disease and cardiomyopathy. For the remaining 2 papers, we focus on precision medicine in the context of arrhythmias. Specifically, in this fourth paper we focus on long QT syndrome, Brugada syndrome, and atrial fibrillation. The final (fifth) paper will deal with catecholaminergic polymorphic ventricular tachycardia. These arrhythmias represent a spectrum of disease ranging from common to relatively rare, with very different genetic and environmental causative factors, and with differing clinical manifestations that range from almost no consequences to lethality in childhood or adolescence if untreated. Accordingly, the emerging precision medicine approaches to these arrhythmias vary significantly, but several common themes include increased use of genetic testing, avoidance of triggers, and personalized risk stratification to guide the use of arrhythmia-specific therapies.
Topics: Arrhythmias, Cardiac; Humans; Precision Medicine
PubMed: 34016268
DOI: 10.1016/j.jacc.2021.03.325 -
PloS One 2021The health-related quality of life (HRQOL) of patients with tachyarrhythmia can be negatively influenced by the clinical manifestations. The evaluation of HRQOL with...
A Brazilian Portuguese translation, cultural adaptation and validation of the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) health-related quality of life (HRQOL) scale.
INTRODUCTION
The health-related quality of life (HRQOL) of patients with tachyarrhythmia can be negatively influenced by the clinical manifestations. The evaluation of HRQOL with validated instruments can provide valuable information that will contribute to clinical decision-making and treatment. In Brazil, however, there is no available scale that evaluates HRQOL in different types of arrhythmia. The purpose of this study was to adapt the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia-HRQOL scale (ASTA-HRQOL scale) to the Brazilian culture, and to assess the psychometric properties of the adapted questionnaire.
METHODS
The study used a methodological process of cultural adaptation based on international literature guidelines. The analyses were performed with 172 participants, 32 for cultural adaptation and 140 for psychometric validation. Calculation included analysis of reliability by Cronbach's α coefficient, construct validity with convergent validity using the WHOQOL-BREF questionnaire and by the Spearman correlation coefficient, Average Variance Extracted, and assessment of confirmatory factor analysis.
RESULTS
The translation and adaptation processes showed a satisfactory degree of comprehension and applicability (93% reported them to be easy to understand). Confirmatory factor analysis indicated exclusion of one item from the mental scale, but after qualitative analysis the item was retained. The items presented adequate internal consistency (Cronbach's alpha coefficient = 0.88), and an inverse correlation of moderate magnitude with the physical domain (rho = -0.63) and with the mental domain (rho = -0.58) of the WHOQOL-BREF.
CONCLUSIONS
The Brazilian Portuguese version of the ASTA-HRQOL scale, the ASTA-Br-HRQOL scale, can be a valuable tool for use in clinical practice and research.
Topics: Arrhythmias, Cardiac; Brazil; Humans; Language; Quality of Life; Surveys and Questionnaires; Tachycardia
PubMed: 34449831
DOI: 10.1371/journal.pone.0256851 -
Cardiovascular Research Jul 2020
Topics: Action Potentials; Animals; Arrhythmias, Cardiac; Genetic Predisposition to Disease; Heart Rate; Heredity; Humans; Ion Channels; Mutation; Pedigree; Phenotype; Prognosis; Risk Assessment; Risk Factors; Translational Research, Biomedical
PubMed: 32449748
DOI: 10.1093/cvr/cvaa150 -
Clinical Medicine (London, England) Apr 2008Cardiac arrhythmia management has advanced substantially and many patients are now being offered curative treatment. There is still much to do and therefore substantial... (Review)
Review
Cardiac arrhythmia management has advanced substantially and many patients are now being offered curative treatment. There is still much to do and therefore substantial research opportunities. Technical advances with better imaging and mapping datasets, improved ablation catheters and new devices to protect against SCD are all on the horizon. The genetic contribution to arrhythmias is now firmly established and preclinical functional studies will lead to more detailed phenotyping of patients leading to more rational targeting of drugs, catheter ablation and devices.
Topics: Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Catheter Ablation; Death, Sudden, Cardiac; Defibrillators, Implantable; Humans; Risk Assessment
PubMed: 18478865
DOI: No ID Found