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Current Treatment Options of Fontan Arrhythmias: Etiology, Incidence, and Diagnosis
AbstractPurpose of the reviewPatients who undergo single ventricle palliation with a Fontan are at a high risk for developing arrhythmias. This review will address our understanding of pathophysiology, incidence, presentation, and type of arrhythmia, focusing on recent developments.Recent findingsPatients with the initially described atriopulmonary connection type of Fontan have a high incidence of arrhythmias, with severe consequences. Arrhythmias are less of a problem with the two currently used surgical techniques, the lateral tunnel and the extracardiac conduit Fontan, with the extracardiac Fontan being potentially les...
Source: Current Treatment Options in Cardiovascular Medicine - October 14, 2020 Category: Cardiology Source Type: research

Update on Bicuspid Aortic Valve Syndrome: Patient Selection and Therapies in 2020
This article highlights our current understanding of bicuspid aortic valve (BAV) syndrome and how genetics, pathology, imaging features, and clinical symptoms direct the clinical management, surveillance, and intervention of those with BAV.Recent findingsWhile randomized data and guidelines are lacking, transcatheter therapies are routinely used for BAV stenosis in medical centers throughout the world. Guidelines suggest that younger patients age less than 50  years undergo surgical aortic valve replacement (AVR) with a mechanical valve and the elderly>  70 years of age receive a bioprosthetic valve. For the age gro...
Source: Current Treatment Options in Cardiovascular Medicine - October 12, 2020 Category: Cardiology Source Type: research

Imaging and Management of Coronary Artery Anomalies
AbstractPurpose of reviewTo highlight imaging features of coronary artery anomalies, especially those that may require surgical intervention, and review various management options.Recent findingsThe clinical presentation of coronary artery anomalies ranges from clinically silent lesions to those leading to sudden cardiac death. With the evolution and increasing use of advanced imaging techniques such as computed tomography, more cases are being identified on scans either done specifically for this purpose or discovered incidentally. Management decisions can be complex and often require a multidisciplinary approach.SummaryI...
Source: Current Treatment Options in Cardiovascular Medicine - October 10, 2020 Category: Cardiology Source Type: research

Current Treatment Options of Fontan Arrhythmias: Management
AbstractPurpose of the reviewArrhythmias are a common complication of patients with single ventricle anatomy who undergo the Fontan operation. This review will address current management strategies for acute and chronic arrhythmias.Recent findingsAlterations to surgical techniques, newer antiarrhythmic medications, and improvements in catheter ablation procedures have improved the management of patients with arrhythmias following Fontan palliation.SummaryArrhythmias predict poor prognosis for Fontan patients. Early and aggressive management of arrhythmias improve patient outcomes. For bradyarrhythmias, management strategie...
Source: Current Treatment Options in Cardiovascular Medicine - October 10, 2020 Category: Cardiology Source Type: research

Cardiac Contractility Modulation in Heart Failure: Mechanisms and Clinical Evidence
AbstractPurpose of reviewDevice-based therapy utilizing cardiac contractility modulation (CCM ™) was approved by the FDA in March 2019 for patients with moderately to severely symptomatic heart failure with reduced ejection fraction between 25 and 45% on optimal guideline-directed medical therapy in normal sinus rhythm and not a candidate for cardiac resynchronization therapy. This review explores the mechanism of action behind CCM, the most recent clinical trials, and the expansion of therapy to additional patient populations.Recent findingsThe most recent trial on CCM explored a two-lead system, which was as equally ef...
Source: Current Treatment Options in Cardiovascular Medicine - October 10, 2020 Category: Cardiology Source Type: research