Device Therapy and Arrhythmia Management in Left Ventricular Assist Device Recipients: A Scientific Statement From the American Heart Association.

Device Therapy and Arrhythmia Management in Left Ventricular Assist Device Recipients: A Scientific Statement From the American Heart Association. Circulation. 2019 Apr 04;:CIR0000000000000673 Authors: Gopinathannair R, Cornwell WK, Dukes JW, Ellis CR, Hickey KT, Joglar JA, Pagani FD, Roukoz H, Slaughter MS, Patton KK, American Heart Association Electrocardiography and Arrhythmias Committee; Heart Failure and Transplantation Committee of the Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing Abstract Left ventricular assist devices (LVADs) are an increasingly used strategy for the management of patients with advanced heart failure with reduced ejection fraction. Although these devices effectively improve survival, atrial and ventricular arrhythmias are common, predispose these patients to additional risk, and complicate patient management. However, there is no consensus on best practices for the medical management of these arrhythmias or on the optimal timing for procedural interventions in patients with refractory arrhythmias. Although the vast majority of these patients have preexisting cardiovascular implantable electronic devices or cardiac resynchronization therapy, given the natural history of heart failure, it is common practice to maintain cardiovascular implantable electronic device detection and therapies after LVAD implantation. Available data, however, are conflicting on the efficacy of and optimal device program...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research

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This article provides a concise overview of the medical management of LVAD patients aimed for non-expert clinicians. Our presentation includes the basics of LVAD physiology, design and operation, patient selection, patient assessment, medical management, adverse event identification and management, multidisciplinary care, and management of special circumstances such as non-cardiac surgery, cardiac arrest, and end-of-life care. The clinical examination of LVAD patients is unique in terms of blood-pressure and heart-rate assessment, LVAD ‘hum’ auscultation, driveline/insertion-site inspection, and device-paramete...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
ConclusionsA high incidence of CV events, with no apparent correlation with CV comorbidities or risk factors, was observed. Prompt identification and treatment of CV events allowed most pts to complete the treatment with FP.Clinical trial identificationNCT02665312.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureM. Aglietta: Advisory / Consultancy: Bristol-Myers Squibb; Advisory / Consultancy: Merck; Advisory / Consultancy: Roche. All other authors have declared no conflicts of interest.
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: Neither LVADs nor IABP improves short or long-term survival in hr-PCI patients. LVADs are more likely to reduce repeat revascularization after PCI, but to increase the risk of bleeding events than IABP.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
Hypertension is the most common cardiovascular risk factor and underlies heart failure, coronary artery disease, stroke, and chronic kidney disease. Hypertensive heart disease can manifest as cardiac arrhythmias. Supraventricular and ventricular arrhythmias may occur in the hypertensive patients. Atrial fibrillation and hypertension contribute to an increased risk of stroke. Some antihypertensive drugs predispose to electrolyte abnormalities, which may result in atrial and ventricular arrhythmias. A multipronged strategy involving appropriate screening, aggressive lifestyle modifications, and optimal pharmacotherapy can re...
Source: Heart Failure Clinics - Category: Cardiology Authors: Source Type: research
In this study, we used large-scale electronic health records data from multiple linked UK databases to address these evidence gaps.MethodsFor this population-based cohort study, we used linked primary care, hospital, and cancer registry data from the UK Clinical Practice Research Datalink to identify cohorts of survivors of the 20 most common cancers who were 18 years or older and alive 12 months after diagnosis and controls without history of cancer, matched for age, sex, and general practice. We compared risks for a range of cardiovascular disease outcomes using crude and adjusted Cox models. We fitted interactions to in...
Source: The Lancet - Category: General Medicine Source Type: research
Abstract Atrial fibrillation (AF) is the most common arrhythmia and its management may be organized into risk stratification and/or treatment of heart failure, stroke prevention, and symptom control. At the core of symptom control, treatment is tailored to either allow AF continue with controlled heart rates, so-called rate control, versus restoring and maintaining sinus rhythm or rhythm control. Rate control strategies mainly use rate-modulating medications, whereas rhythm control treatment includes therapy aimed at restoring sinus rhythm, including pharmacologic and direct current cardioversion, as well as maint...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Med Clin North Am Source Type: research
Authors: Mavrogeni S, Koutsogeorgopoulou L, Dimitroulas T, Markousis-Mavrogenis G, Boki K, Katsifis G, Vartela V, Kallenberg CG, Kolovou G, Kitas G Abstract Cardiovascular disease (CVD) in systemic lupus erythematosus (SLE) and neuropsychiatric SLE (NPSLE) have an estimated prevalence of 50% and 40% respectively and both constitute major causes death among SLE patients. In this review, we propose a combined brain/heart magnetic resonance imaging (MRI) for SLE risk stratification. The pathophysiologic background of NPSLE includes microangiopathy, macroscopic infarcts and accelerated atherosclerosis. Classic brain MR...
Source: Current Cardiology Reviews - Category: Cardiology Tags: Curr Cardiol Rev Source Type: research
AbstractSelf-terminating atrial arrhythmias are commonly detected on continuous rhythm monitoring, e.g. by pacemakers or defibrillators. It is unclear whether the presence of these arrhythmias has therapeutic consequences. We sought to summarize evidence on the prevalence of atrial high-rate episodes (AHREs) and their impact on risk of stroke. We performed a comprehensive, tabulated review of published literature on the prevalence of AHRE. In patients with AHRE, but without atrial fibrillation (AF), we reviewed the stroke risk and the potential risk/benefit of oral anticoagulation. Atrial high-rate episodes are found in 10...
Source: Europace - Category: Cardiology Source Type: research
ConclusionMediacalcosis is a severe complication since it increases the risk of cardiovascular morbidity and mortality in hemodialysis patients, to this end, the individualization of entangled factors involved in its pathophysiology, will slow down or prevent its progression in the future.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Publication date: Available online 24 July 2019Source: Archives of Cardiovascular Diseases SupplementsAuthor(s): Djamila-Djahida Batouche, Kheireddine Kerboua, Nadia-Faiza benatta, Samia Benouaz, Rabia Okbani, Wahiba Berrachdi, Miloud Lahmer, Lynda Sadaoui, Fadela Benhamed, Z. MentouriObjectivesCardiovascular complications are the leading cause of death and morbidity in chronic hemodialysis patients. The purpose of this study was to identify the factors associated with major cardiovascular events in hemodialysis children.MethodsBi-centric study was carried out during in 2016 into two hemodialysis departments. We included h...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
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