Performance of the entirely subcutaneous ICD in borderline indications
ConclusionThe use of the S-ICD ™ was safe in patients with borderline or unclear indication for ICD implantation in our study. Of note, during a relatively short mean follow-up there were several appropriate therapies, especially for VF in these patients. On the other hand, oversensing also occurred in about 10% of patients, wh ile lead problems were not problematic in this collective. S-ICD™ implantation may be considered as a possible alternative in cases of borderline indications and clinical uncertainty when decision pro-ICD implantation is made. Incidence of arrhythmias was quite high and mostly consisted of VF. Nev ertheless, patient education seems even more important as there is a considerable risk for inappropriate therapies as well.Graphical abstract
CONCLUSION: The S-ICD™ seems to be a valuable option for the prevention of SCD in patients with DCM and no indication for CRT. As clinically relevant ventricular arrhythmias consisted of ventricular fibrillation or fast ventricular tachycardia in all patients in our cohort, no change to transvenous ICDs for anti-tachycardia pacing delivery was necessary. PMID: 31744658 [PubMed - as supplied by publisher]
Conclusion: Video-assisted CSD should be considered as a treatment option for patients with potentially dangerous arrhythmias that do not respond to conventional treatment, especially in recurrent ventricular tachycardia. PMID: 31588139 [PubMed - in process]
ConclusionsWnt signalling inhibits Na+ channel by direct and indirect (via Tbx3) suppression of Scn5a transcription. Strategies to block TCF4 binding to Tbx3 and Scn5a promoters would represent novel strategies for cardiac-specific inhibition of Wnt pathway to rescue INa and prevent sudden cardiac deaths.
The demonstrated effectiveness of implantable cardioverter-defibrillators (ICDs) for primary and secondary preventions of sudden cardiac death has resulted in an increasing number of patients presenting with recurrent, appropriate ICD shocks for ventricular tachycardia VT.(1) In a selected group of VT patients such as those included in the study by Bradfield and colleagues (2) in this issue of Heart Rhythm, autonomic modulation is considered as adjunctive treatment option after failed catheter-based VT ablation and anti-arrhythmic drug therapy.
The demonstrated effectiveness of implantable cardioverter-defibrillators (ICDs) for primary and secondary preventions of sudden cardiac death has resulted in an increasing number of patients presenting with recurrent, appropriate ICD shocks for ventricular tachycardia (VT).1 In a selected group of patients with VT such as those included in the study by Bradfield et al2 in this issue of HeartRhythm, autonomic modulation is considered as an adjunctive treatment option after failed catheter-based VT ablation and antiarrhythmic drug therapy.
This article reviews current knowledge regarding drug therapy for inherited arrhythmia syndromes (Brugada, early repolarization, long QT and short QT syndromes, and catecholaminergic polymorphic ventricular tachycardia), and acquired arrhythmias (idiopathic ventricular fibrillation, short-coupled torsade de pointes, outflow tract ventricular tachycardia, idiopathic left, papillary muscle and annular ventricular tachycardias). Expert opinion: In inherited arrhythmia syndromes, appropriate clinical and genetic diagnoses followed by proper selection and dosing of antiarrhythmic drugs are of utmost importance to prevent SCD, m...
AbstractIntroductionAcute hemodynamic decompensation during catheter ablation of ventricular tachycardia is associated with increased mortality. We assessed the effectiveness of mechanical circulatory support using a micro ‐axial percutaneous assist device in preventing acute hemodynamic decompensation.Methods and resultsTwenty ‐six consecutive patients with structural heart disease undergoing 28 ventricular tachycardia ablations between May 2013 and October 2017 were included. All patients presenting with left ventricular ejection fraction
Publication date: Available online 4 September 2019Source: Pharmacological ResearchAuthor(s): Enrico Paolini, Giulia Stronati, Federico Guerra, Alessandro CapucciAbstractOver the last 35 years, flecainide proved itself one of the most commonly used arrhythmic drugs, expanding its original indication for ventricular arrhythmias and results nowadays as the cornerstone of the rhythm control strategy in atrial fibrillation management of patients without structural heart disease. While the increased mortality associated with flecainide in the Cardiac Arrhythmia Suppression Trial (CAST) still casts his shadow over flecainide cli...
ConclusionStudies comparing PVR and conservative therapy exclusively in adults with rTOF are lacking. After PVR, the incidence rates of death and ventricular tachycardia are both 1 per 100 patients-years. Pooled analyses demonstrated an improved functional status and a reduction in RV volumes.
ConclusionSome noninvasive risk factors were linked to the scar areas, but few were significantly modified after ablation. Larger populations are needed to demonstrate significant differences or correlations.