Neuromuscular Disease
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Worawan Limipitikul, Chin Siang Ong, Gordon F. TomaselliTeaser Cardiovascular complications of neuromuscular diseases disproportionately affect the cardiac conduction system. Cardiomyopathy and cardiac arrhythmias produce significant morbidity and mortality. Patients with neuromuscular diseases should be carefully and frequently evaluated for the presence of bradycardia, heart block, and tachyarrhythmias. Preemptive treatment with permanent pacemakers or implanted defibrillators is appropriate in patients with conduction...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Heart Failure and Sudden Cardiac Death
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Basil Saour, Bryan Smith, Clyde W. YancyTeaser The Centers for Diseases Control and Prevention estimates that 5.7 million adults in the United States suffer from heart failure and 1 in 9 deaths in 2009 cited heart failure as a contributing cause. Almost 50% of patients who are diagnosed with heart failure die within 5 years of diagnosis. Cardiovascular disease is a public health burden. The prognosis of patients with heart failure has improved significantly. However, the risk for death remains high. Managing sudden ...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Ventricular Arrhythmias and Sudden Cardiac Death
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Pok Tin Tang, Mohammad Shenasa, Noel G. BoyleTeaser Ventricular arrhythmias remain a significant cause of sudden cardiac death (SCD), and knowledge of their cause and high-risk features is important. SCD occurs when the interaction between vulnerable substrates and acute triggers results in sustained ventricular tachycardia progressing to ventricular fibrillation. Here, the authors aim to review the role of ventricular arrhythmias in SCD, first by approaching the substrates that support ventricular arrhythmias, and then ...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death in Ischemic Heart Disease
This article reviews the most recent pathophysiology and risk stratification strategies for SCD, emphasizing electrophysiologic surrogates of conduction disorder, dispersion of repolarization, and autonomic imbalance. Factors that modify arrhythmic death are addressed. (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Cardiac Innervation and the Autonomic Nervous System in Sudden Cardiac Death
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): William A. Huang, Noel G. Boyle, Marmar VaseghiTeaser Neural remodeling in the autonomic nervous system contributes to sudden cardiac death. The fabric of cardiac excitability and propagation is controlled by autonomic innervation. Heart disease predisposes to malignant ventricular arrhythmias by causing neural remodeling at the level of the myocardium, the intrinsic cardiac ganglia, extracardiac intrathoracic sympathetic ganglia, extrathoracic ganglia, spinal cord, and the brainstem, as well as the higher centers and th...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Biomarkers to Predict Cardiovascular Death
This article reviews biomarkers that have been shown to identify subjects at increased risk for cardiovascular death within the general population, in those with established coronary artery disease, and in those with heart failure. Use of biomarkers for risk stratification for sudden cardiac death continues to evolve. It seems that a multimarker strategy for risk stratification using simple measures of circulating proteins and usual clinical risk factors, particularly in patients with known coronary artery disease, can be used to identify patients at near-term risk of death. Whether similar strategies in the general popula...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Role of Cardiac Imaging in Evaluating Risk for Sudden Cardiac Death
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Constancia Macatangay, Juan F. Viles-Gonzalez, Jeffrey J. GoldbergerTeaser Sudden cardiac death (SCD) is a major cause of death from cardiovascular disease. Our ability to predict patients at the highest risk of developing lethal ventricular arrhythmias remains limited. Despite recent studies evaluating risk stratification tools, there is no optimal strategy. Cardiac imaging provides the opportunity to assess left ventricular ejection fraction, strain, fibrosis, and sympathetic innervation, all of which are pathophysiolo...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Prediction and Prevention of Sudden Cardiac Death
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Daniel P. Morin, Munther K. Homoud, N.A. Mark EstesTeaser Sudden death is a major problem, with significant impact on public health. Many conditions predispose to sudden cardiac death and sudden cardiac arrest (SCA), foremost among them coronary artery disease, and an effective therapy exists in the form of the implantable cardioverter defibrillator. Risk stratification for SCA remains imperfect, especially for patients with nonischemic cardiomyopathy. Ongoing trials may make it easier to identify those at high risk, and...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Electrocardiographic Markers of Sudden Cardiac Death (Including Left Ventricular Hypertrophy)
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Andrés Ricardo Pérez-Riera, Raimundo Barbosa-Barros, Mohammad ShenasaTeaser Although the electrocardiograph (ECG) was invented more than 100 years ago, it remains the most commonly used test in clinical medicine. It is easy to perform, relatively cheap, and results are readily available. Interpretation, however, needs expertise and knowledge. New data, phenomenon, and syndromes are continually discovered by the ECG. It is important to differentiate between normal and abnormal ECGs first and then try to...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death in Genetic Cardiomyopathies
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Gourg Atteya, Rachel LampertTeaser Sudden cardiac death (SCD) caused by ventricular arrhythmias is common in patients with genetic cardiomyopathies (CMs) including dilated CM, hypertrophic CM, and arrhythmogenic right ventricular CM (ARVC). Phenotypic features can identify individuals at high enough risk to warrant placement of an implantable cardioverter-defibrillator, although risk stratification schemes remain imperfect. Genetic testing is valuable for family cascade screening but with few exceptions (eg, LMNA mutatio...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death in Children and Adolescents
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Elizabeth D. Sherwin, Charles I. BerulTeaser Sudden cardiac death (SCD) is a rare but devastating event in children and adolescents. Etiologies include congenital heart disease, cardiomyopathies, primary arrhythmia syndromes, and miscellaneous conditions. Challenges in the diagnosis and prevention of SCD in the young are reviewed. (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death During Sports Activities in the General Population
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Kumar Narayanan, Wulfran Bougouin, Ardalan Sharifzadehgan, Victor Waldmann, Nicole Karam, Eloi Marijon, Xavier JouvenTeaser Regular exercise reduces cardiovascular and overall mortality. Participation in sports is an important determinant of cardiovascular health and fitness. Regular sports activity is associated with a smaller risk of sudden cardiac death (SCD). However, there is a small risk of sports-related SCD. Sports-related SCD accounts for approximately 5% of total SCD. SCD among athletes comprises only a fractio...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Public Access Defibrillation
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Myron L. Weisfeldt, Ross A. PollackTeaser Public access defibrillation is particularly valuable in witnessed cardiac arrests that occur in public places. Bystander and police use of automated external defibrillators (AEDs) has increased over the past 15 years, resulting in improved survival with normal or near-normal neurologic function. There is great promise for increasing bystander use of defibrillators as the technology is applied to linking patients with shockable arrests to volunteers committed to bringing AED...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Channelopathies as Causes of Sudden Cardiac Death
This article reviews the main clinical aspects of 3 channelopathies: the long QT syndrome, the catecholaminergic polymorphic ventricular tachycardia, and the Brugada syndrome. The text summarizes our views on clinical presentation and diagnosis, on risk stratification, and on therapy. Special attention is given to the progress in the understanding of the genetic bases and on the growing impact of genetics on therapy, which, at least in the case of long QT syndrome, now allows gene-specific management. (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Basic Electrophysiologic Mechanisms of Sudden Cardiac Death Caused by Acute Myocardial Ischemia and Infarction
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Andrew L. WitTeaser Sudden cardiac death caused by acute ischemia results from electrophysiologic changes in myocardium deprived of its blood supply. These changes include a reduction in resting potential and phase 0 depolarization and an increase in intercellular resistivity that slow conduction, cause conduction block, and lead to reentrant excitation and ventricular fibrillation. Reperfusion of a coronary artery after a short period of occlusion leads to similar changes. (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Robert J. MyerburgTeaser The population incidence of sudden cardiac arrest (SCA) and sudden cardiac death have not changed appreciably during the decades of improvement in general outcomes from cardiovascular diseases, but the age, clinical circumstances, and pathophysiologic mechanisms have. The epidemiology and pathophysiology of SCA are linked, in that mechanisms of SCA can be modeled based on substrate and expression characteristics. The goal for the future is to expand pathophysiologic and epidemiologic interactions...
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death: Contemporary Challenges
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Mohammad Shenasa, N.A. Mark Estes, Gordon F. Tomaselli (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death: Back to the Future
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Ranjan K. Thakur, Andrea Natale (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Contemporary Challenges in Sudden Cardiac Death
Publication date: December 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 4 Author(s): Mohammad Shenasa, N.A. Mark Estes, Gordon F. Tomaselli (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - November 22, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death in Acute Coronary Syndromes
Publication date: Available online 28 September 2017 Source:Cardiac Electrophysiology Clinics Author(s): Nikolaos Dagres, Gerhard HindricksTeaser Sudden cardiac death in acute coronary syndromes mostly results from complex ventricular arrhythmias. Although the incidence has fallen with contemporary management, they still pose a threat for many patients. Treatment consists of immediate termination by electrical cardioversion and prompt coronary revascularization for relief of ischemia. Beta-blockers administered prophylactically have a protective effect. For recurrent episodes, pharmacologic treatment consists of beta-bloc...
Source: Cardiac Electrophysiology Clinics - September 29, 2017 Category: Cardiology Source Type: research

Primary Prevention Implantable Cardiac Defibrillator Trials
Publication date: Available online 28 September 2017 Source:Cardiac Electrophysiology Clinics Author(s): Jakub Sroubek, Alfred E. BuxtonTeaser Patients with impaired left ventricular systolic function frequently die suddenly because of arrhythmic and nonarrhythmic causes. Nine trials have evaluated the utility of implantable cardioverter-defibrillator (ICDs) primary prevention of sudden cardiac death. Individuals with stable ischemic heart disease (no recent myocardial infarction), especially those with inducible arrhythmias, seem to derive the highest mortality benefit from prophylactic ICD use. The role of ICDs in other...
Source: Cardiac Electrophysiology Clinics - September 29, 2017 Category: Cardiology Source Type: research

Normal Ventricular Repolarization and QT Interval
Publication date: September 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 3 Author(s): Emanuela T. Locati, Giuseppe Bagliani, Luigi PadelettiTeaser The QT interval on surface electrocardiogram represents the sum of depolarization and repolarization process of the ventricles. The ventricular recovery process, reflected by ST segment and T wave, mainly depends on the transmembrane outward transport of potassium ions to reestablish the endocellular electronegativity. Outward potassium channels represent a heterogeneous family of ionic carriers, whose global kinetics is modulated by heart rate and autonomic n...
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

General Approach to a Wide QRS Complex
Publication date: September 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 3 Author(s): Roberto De Ponti, Giuseppe Bagliani, Luigi Padeletti, Andrea NataleTeaser Wide QRS complex is present when the normal activation pattern is modified by various mechanisms and clinical conditions. Correct interpretation is crucial for appropriate decision making. When approaching an electrocardiogram (ECG) with wide complex tachycardia, one must differentiate between ventricular tachycardia and supraventricular tachycardia conducted with aberrancy. ECG criteria are used and algorithms developed to aid in differential dia...
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

Arrhythmias Involving the Atrioventricular Junction
Publication date: September 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 3 Author(s): Luigi Di Biase, Carola Gianni, Giuseppe Bagliani, Luigi PadelettiTeaser The atrioventricular junction has a central role in electrophysiology, responsible for reentrant and automatic forms of supraventricular tachycardia. During atrioventricular nodal reentry tachycardia, the circuit involves 2 electrophysiologically separate pathways located in the vicinity of the atrioventricular node. Atrioventricular reentry tachycardia is caused by the presence of an accessory pathway located almost anywhere along the atrioventricu...
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

PR Interval and Junctional Zone
This article reviews the main anatomic and electrophysiologic features of the atrioventricular junction, with a focus on cardiac preexcitation. (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

Arrhythmias Originating in the Atria
Publication date: September 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 3 Author(s): Fabio Leonelli, Giuseppe Bagliani, Giuseppe Boriani, Luigi PadelettiTeaser Atrial flutter, atrial tachycardias, and atrial fibrillation are the main sustained atrial tachycardias. Reentry, increased automaticity, and triggered activity are atrial arrhythmia’s main mechanisms. Atrial flutter is the clinical and theoretical model of reentry. Its classification is based on the atrial chamber involved and the arrhythmia’s anatomic path. Ablative procedures for atrial fibrillation have created several new reentra...
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

P Wave and the Substrates of Arrhythmias Originating in  the Atria
Publication date: September 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 3 Author(s): Giuseppe Bagliani, Fabio Leonelli, Luigi PadelettiTeaser The sinus node is the primary cardiac pacemaker from which the wavefront of activation proceeds through bundles of atrial fibers to the atrioventricular node. Left atrial activation proceeds along the Bachmann bundle and lower right atrium, determining P-wave morphology. Electrocardiogram reveals ectopic or retrograde atrial activation, wandering pacemaker activity, or artificial pacemaker-mediated atrial depolarization. Vectorcardiography and transesophageal reco...
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

Normal Electrophysiology, Substrates, and the Electrocardiographic Diagnosis of Cardiac Arrhythmias
Publication date: September 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 3 Author(s): Luigi Padeletti, Giuseppe Bagliani (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

On the Shoulder of Giants
Publication date: September 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 3 Author(s): Ranjan K. Thakur, Andrea Natale (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

Normal Electrophysiology, Substrates, and the Electrocardiographic Diagnosis of Cardiac Arrhythmias: Part I
Publication date: September 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 3 Author(s): Luigi Padeletti, Giuseppe Bagliani (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - August 25, 2017 Category: Cardiology Source Type: research

General Introduction, Classification, and Electrocardiographic Diagnosis of Cardiac Arrhythmias
Publication date: Available online 14 July 2017 Source:Cardiac Electrophysiology Clinics Author(s): Luigi Padeletti, Giuseppe BaglianiTeaser The conduction system includes a primary pacemaker, the internodal tracts, the atrioventricular node, and the His bundle with the right and left branches. In “emergency” conditions, accessory pacemakers may be triggered. The conduction system produces very low-intensity currents; a surface electrocardiogram (ECG) detects only the big myocardial masses. Electrogenetic mechanisms are reduced automaticity and/or impaired conduction at the base of bradycardias. An increased a...
Source: Cardiac Electrophysiology Clinics - July 15, 2017 Category: Cardiology Source Type: research

The QRS Complex
This article reviews the main electroanatomical features of the ventricular conduction system and the effects of its delay on the QRS. (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - June 27, 2017 Category: Cardiology Source Type: research

Arrhythmias in the History
Publication date: Available online 12 June 2017 Source:Cardiac Electrophysiology Clinics Author(s): Donatella LippiTeaser Lovesickness has been termed a real disorder, with a specific cause, pathogenesis, and cure: it has been attested to in medical literature since classical times, and may still have a place in current medicine in the frame of psychiatry and humoral disorders. Although in different cultures there is a general agreement on the symptoms, including fever, agitation, loss of appetite, headache, rapid breathing, and palpitations, the treatments vary greatly in the various cultural contexts. (Source: Cardiac E...
Source: Cardiac Electrophysiology Clinics - June 13, 2017 Category: Cardiology Source Type: research

Arrhythmia Surgery for Adults with Congenital Heart Disease
Publication date: June 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 2 Author(s): Barbara J. Deal, Constantine MavroudisTeaser Patients with repaired or unrepaired congenital heart anomalies are at increased risk for arrhythmia development throughout their lives, often paralleling the need for reoperations for hemodynamic residua. The ability to incorporate arrhythmia surgery into reoperations can result in improvement in functional class and decreased need for antiarrhythmic medications. Every reoperation for congenital heart disease can be viewed as an opportunity to assess the electrical and arrhythmia...
Source: Cardiac Electrophysiology Clinics - April 28, 2017 Category: Cardiology Source Type: research

Catheter Ablation
Publication date: June 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 2 Author(s): Sabine ErnstTeaser Besides antiarrhythmic medication, there are now very good options for a potentially curative therapy by catheter ablation targeting the origin of the underlying arrhythmias in patients with complex congenital heart disease. Three-dimensional (3D) reconstruction of tomographic imaging (MRI or computed tomography) is helpful to understand the underlying cardiac anatomy, identify the most likely target chamber, and help with planning access. Use of the available 3D mapping systems (sequential or simultaneous...
Source: Cardiac Electrophysiology Clinics - April 28, 2017 Category: Cardiology Source Type: research

Drug Therapy in Adult Congenital Heart Disease
Publication date: June 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 2 Author(s): Tahmeed Contractor, Vadim Levin, Ravi MandapatiTeaser Adults with congenital heart disease are at risk for atrial and ventricular arrhythmias that can lead to an increased morbidity as well as mortality. When catheter ablation is not an option or unsuccessful, antiarrhythmic drugs are the mainstay of treatment. There is limited data on the use of antiarrhythmics in this population. The purpose of this article is to discuss the practical aspects of the use of antiarrhythmics in adults with congenital heart disease. Several ta...
Source: Cardiac Electrophysiology Clinics - April 28, 2017 Category: Cardiology Source Type: research

Ebstein Anomaly
Publication date: June 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 2 Author(s): Elizabeth D. Sherwin, Dominic J. AbramsTeaser Ebstein anomaly is a rare form of congenital heart disease with a uniquely high prevalence of arrhythmias. The most prevalent arrhythmia mechanisms are intrinsic to the underlying embryologic defects and may manifest at any stage. Current electrophysiological and surgical strategies are well equipped to address these arrhythmia mechanisms, yet despite available technology and a robust understanding of the mechanisms, these cases remain challenging. Surgical techniques that render...
Source: Cardiac Electrophysiology Clinics - April 28, 2017 Category: Cardiology Source Type: research

Arrhythmias in Patients with Atrial Defects
Publication date: June 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 2 Author(s): Tahmeed Contractor, Ravi MandapatiTeaser Atrial arrhythmias are common in patients with atrial septal defects. A myriad of factors are responsible for these that include remodeling related to the defect and scar created by the repair or closure. An understanding of potential arrhythmias, along with entrainment and high-density activation mapping can result in accurate diagnosis and successful ablation. Atrial fibrillation is being seen increasingly after patent foramen ovale closure and may be the primary etiology of recurre...
Source: Cardiac Electrophysiology Clinics - April 28, 2017 Category: Cardiology Source Type: research

Supraventricular Tachycardia in Adult Congenital Heart Disease
Publication date: June 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 2 Author(s): Christopher M. Janson, Maully J. ShahTeaser Supraventricular arrhythmias represent a major source of morbidity in adults with congenital heart disease (ACHD). Anatomic variants and post-operative changes contribute to a unique electrophysiologic milieu ripe for the development of supraventricular tachycardia. Intra-atrial reentrant tachycardia is the most prevalent mechanism. Atrioventricular reciprocating tachycardia is common in lesions associated with accessory pathways. Abnormal anatomy complicates the management of atri...
Source: Cardiac Electrophysiology Clinics - April 28, 2017 Category: Cardiology Source Type: research

Cardiac Arrhythmias in Adults with Congenital Heart Disease
Publication date: Available online 31 March 2017 Source:Cardiac Electrophysiology Clinics Author(s): Frank Cecchin, Daniel G. HalpernTeaser Implanting cardiac rhythm medical devices in adults with congenital heart disease requires training in congenital heart disease. The techniques and indications for device implantation are specific to the anatomic diagnosis and state of disease progression. It often requires a team of physicians and is best performed at a specialized adult congenital heart center. (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - April 1, 2017 Category: Cardiology Source Type: research

Development of Tachyarrhythmias Late After the Fontan Procedure
Publication date: Available online 28 March 2017 Source:Cardiac Electrophysiology Clinics Author(s): Natasja M.S. de Groot, Ad J.J.C. BogersTeaser Patients with a Fontan circulation are at a high risk of developing a variety of cardiac dysrhythmias after cardiac surgery. These dysrhythmias are most often supraventricular tachyarrhythmias (SVT), but ventricular tachyarrhythmias (VT) may also occur. Mechanisms underlying SVT are variable, including both ectopic activity and reentry. Over time, successive SVT may be caused by different mechanisms. The acute success rate of ablative therapy of AT is considerable high yet duri...
Source: Cardiac Electrophysiology Clinics - March 29, 2017 Category: Cardiology Source Type: research

Arrhythmias Following the Mustard and Senning Operations for Dextro-Transposition of the Great Arteries
Publication date: Available online 22 March 2017 Source:Cardiac Electrophysiology Clinics Author(s): Sherrie Joy Baysa, Melissa Olen, Ronald J. KanterTeaser The atrial switch operations, the Mustard and Senning procedures, performed for dextro-transposition of the great arteries, have largely been supplanted by the arterial switch operation. As such, affected patients will only exist for approximately 30 more years. The main arrhythmias in these patients include sinoatrial node dysfunction, intraatrial reentry tachycardia, and sudden death. Device therapy for these patients is well-established, and catheter ablation for a...
Source: Cardiac Electrophysiology Clinics - March 23, 2017 Category: Cardiology Source Type: research

Bradyarrhythmias in Congenital Heart Disease
Publication date: Available online 22 March 2017 Source:Cardiac Electrophysiology Clinics Author(s): Steven K. Carlson, Akash R. Patel, Philip M. ChangTeaser Bradyarrhythmias in adults with congenital heart disease (CHD) comprise a complex group of arrhythmia disorders with congenital and acquired origins, highly variable long-term sequelae, and complicated treatment options. They can develop across the spectrum of CHD defects and can be encountered at all ages. Although permanent pacing is effective in treating bradyarrhythmias, it is associated with many complications and morbidity, where it is often used early in life....
Source: Cardiac Electrophysiology Clinics - March 23, 2017 Category: Cardiology Source Type: research

Sudden Cardiac Death in Adult Congenital Heart Disease
Publication date: Available online 18 March 2017 Source:Cardiac Electrophysiology Clinics Author(s): Pablo Ávila, Marie-A. Chaix, Blandine Mondésert, Paul KhairyTeaser Sudden death of presumed arrhythmic etiology is a leading cause of mortality in adults with congenital heart disease. Anticipated benefits of the implantable cardioverter-defibrillator (ICD) must be weighed against high complication rates. Without robust evidence from randomized trials, caregivers face difficult decisions in selecting appropriate candidates. Although secondary prevention indications are often clear-cut, risk stratification for...
Source: Cardiac Electrophysiology Clinics - March 18, 2017 Category: Cardiology Source Type: research

Ventricular Arrhythmias in Adult Congenital Heart Disease
Publication date: Available online 18 March 2017 Source:Cardiac Electrophysiology Clinics Author(s): Gnalini Sathananthan, Louise Harris, Krishnakumar NairTeaser The risk of ventricular arrhythmias in the adult congenital heart disease population increases with age. The mechanism, type, and frequency vary depending on the complexity of the defect, whether it has been repaired, and the type and timing of repair. Risk stratification for sudden death in patients with congenital heart disease is often challenging. Current recommendations provide a useful guide for management of these patients and risk stratification continues...
Source: Cardiac Electrophysiology Clinics - March 17, 2017 Category: Cardiology Source Type: research

Clinical Aspects and Ablation of Ventricular Arrhythmias in Tetralogy of Fallot
Publication date: Available online 13 March 2017 Source:Cardiac Electrophysiology Clinics Author(s): Katja Zeppenfeld, Adrianus P. WijnmaalenTeaser Life expectancy of patients with rToF has considerably improved due to refined surgical interventions. Monomorphic fast VTs are frequently encountered in adult patients with rToF. The dominant substrate of VT is anatomical isthmuses bordered by surgical incisions, patch material and valve annuli. Substrate based ablation strategies aim to transect all slow conducting anatomical isthmuses (SCAI) as identified by electroanatomical mapping. Procedural success is defined as non-in...
Source: Cardiac Electrophysiology Clinics - March 13, 2017 Category: Cardiology Source Type: research

Introduction to the Congenital Heart Defects
This article summarizes the body of literature by retaining original classical concepts and by attempting to translate the available knowledge into useful points for the congenital heart disease specialist. This discussion spans the entire spectrum of simple to complex congenital heart disease. (Source: Cardiac Electrophysiology Clinics)
Source: Cardiac Electrophysiology Clinics - March 13, 2017 Category: Cardiology Source Type: research

Catheter Ablation (General Principles and Advances)
Publication date: Available online 14 March 2017 Source:Cardiac Electrophysiology Clinics Author(s): Sabine ErnstTeaser Besides antiarrhythmic medication, there are now very good options for a potentially curative therapy by catheter ablation targeting the origin of the underlying arrhythmias in patients with complex congenital heart disease. Three-dimensional (3D) reconstruction of tomographic imaging (MRI or computed tomography) is helpful to understand the underlying cardiac anatomy, identify the most likely target chamber, and help with planning access. Use of the available 3D mapping systems (sequential or simultaneo...
Source: Cardiac Electrophysiology Clinics - March 13, 2017 Category: Cardiology Source Type: research

Substrate Ablation of Ventricular Tachycardia: Late Potentials, Scar Dechanneling, Local Abnormal Ventricular Activities, Core Isolation, and Homogenization
Publication date: March 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 1 Author(s): David F. Briceño, Jorge Romero, Carola Gianni, Sanghamitra Mohanty, Pedro A. Villablanca, Andrea Natale, Luigi Di BiaseTeaser Ventricular arrhythmias are a frequent cause of mortality in patients with ischemic cardiomyopathy and nonischemic cardiomyopathy. Scar-related reentry represents the most common arrhythmia substrate in patients with recurrent episodes of sustained ventricular tachycardia (VT). Initial mapping of scar-related VT circuits is focused on identifying arrhythmogenic tissue. The substrate-based stra...
Source: Cardiac Electrophysiology Clinics - February 3, 2017 Category: Cardiology Source Type: research

Entrainment Mapping
Publication date: March 2017 Source:Cardiac Electrophysiology Clinics, Volume 9, Issue 1 Author(s): Saurabh Kumar, Usha B. Tedrow, William G. StevensonTeaser Mapping during ventricular tachycardia (VT) aims to elucidate mechanism, describe myocardial propagation, and identify the origin and critical regions of VT that can be targeted for ablation, most commonly with radiofrequency ablation. Most VTs in structural heart disease are due to macro-reentry in and around scar. A combination of mapping techniques, including mapping to identify the arrhythmia substrate, activation sequence mapping, pace-mapping, and entrainment m...
Source: Cardiac Electrophysiology Clinics - February 3, 2017 Category: Cardiology Source Type: research