首页 > 最新文献

Arrhythmia & Electrophysiology Review最新文献

英文 中文
The Emerging Role of Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy. 左束支区起搏在心脏再同步化治疗中的新作用
IF 2.6 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-12-01 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2023.15
Juan Carlos Diaz, Mauricio Duque, Julian Aristizabal, Jorge Marin, Cesar Niño, Oriana Bastidas, Luis Miguel Ruiz, Carlos D Matos, Carolina Hoyos, Daniela Hincapie, Alejandro Velasco, Jorge E Romero

Cardiac resynchronisation therapy (CRT) reduces the risk of heart failure-related hospitalisations and all-cause mortality, as well as improving quality of life and functional status in patients with persistent heart failure symptoms despite optimal medical treatment and left bundle branch block. CRT has traditionally been delivered by implanting a lead through the coronary sinus to capture the left ventricular epicardium; however, this approach is associated with significant drawbacks, including a high rate of procedural failure, phrenic nerve stimulation, high pacing thresholds and lead dislodgement. Moreover, a significant proportion of patients fail to derive any significant benefit. Left bundle branch area pacing (LBBAP) has recently emerged as a suitable alternative to traditional CRT. By stimulating the cardiac conduction system physiologically, LBBAP can result in a more homogeneous left ventricular contraction and relaxation, thus having the potential to improve outcomes compared with conventional CRT strategies. In this article, the evidence supporting the use of LBBAP in patients with heart failure is reviewed.

心脏再同步化疗法(CRT)可降低心衰相关的住院风险和全因死亡率,还能改善尽管接受了最佳治疗但仍有心衰症状和左束支传导阻滞的患者的生活质量和功能状态。CRT 的传统方法是通过冠状窦植入导联来捕捉左心室心外膜,但这种方法存在很大的缺陷,包括手术失败率高、膈神经刺激、起搏阈值高和导联脱落。此外,相当一部分患者未能从中获得任何明显的益处。左束支区起搏(LBBAP)是最近出现的一种替代传统 CRT 的合适方法。通过生理性地刺激心脏传导系统,左束支区起搏可使左心室的收缩和舒张更加均匀,因此与传统的 CRT 策略相比,左束支区起搏具有改善预后的潜力。本文回顾了支持在心衰患者中使用 LBBAP 的证据。
{"title":"The Emerging Role of Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy.","authors":"Juan Carlos Diaz, Mauricio Duque, Julian Aristizabal, Jorge Marin, Cesar Niño, Oriana Bastidas, Luis Miguel Ruiz, Carlos D Matos, Carolina Hoyos, Daniela Hincapie, Alejandro Velasco, Jorge E Romero","doi":"10.15420/aer.2023.15","DOIUrl":"10.15420/aer.2023.15","url":null,"abstract":"<p><p>Cardiac resynchronisation therapy (CRT) reduces the risk of heart failure-related hospitalisations and all-cause mortality, as well as improving quality of life and functional status in patients with persistent heart failure symptoms despite optimal medical treatment and left bundle branch block. CRT has traditionally been delivered by implanting a lead through the coronary sinus to capture the left ventricular epicardium; however, this approach is associated with significant drawbacks, including a high rate of procedural failure, phrenic nerve stimulation, high pacing thresholds and lead dislodgement. Moreover, a significant proportion of patients fail to derive any significant benefit. Left bundle branch area pacing (LBBAP) has recently emerged as a suitable alternative to traditional CRT. By stimulating the cardiac conduction system physiologically, LBBAP can result in a more homogeneous left ventricular contraction and relaxation, thus having the potential to improve outcomes compared with conventional CRT strategies. In this article, the evidence supporting the use of LBBAP in patients with heart failure is reviewed.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e29"},"PeriodicalIF":2.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10762674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139085685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Open Window Mapping of Accessory Pathways: A Literature Review and Practical Guide. 辅助通路的开窗绘图:文献综述与实用指南》。
IF 3 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-12-01 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2023.09
Rajdip Dulai, Fatima Bangash, Ajay Sharma, Alex Cambridge, Geoff Wong, Wei Lim, David Farwell, Jason Garcia, Neil T Srinivansan

Catheter ablation is the treatment of choice for patients with symptomatic accessory pathways (APs) causing recurrent atrioventricular reciprocating tachycardia or in situations where APs conduct rapidly, posing a risk of sudden cardiac death. Conventional AP mapping relies on point-by-point assessment of local electrograms looking closely for pathway electrograms or early atrial or ventricular electrograms, which may be challenging and time consuming. Recently, open window mapping (OWM) using 3D navigational systems has emerged as a novel technique to help localise and ablate APs. OWM has significant advantages over conventional point-by-point mapping techniques. The purpose of this review is to summarise the currently available literature on the OWM technique and to highlight the technical aspects and mapping considerations for OWM, including specific cases demonstrating its utility.

导管消融术是治疗有症状的附属通路(AP)导致复发性房室往复性心动过速患者的首选方法,也是AP快速传导导致心脏性猝死风险患者的首选方法。传统的 AP 图谱绘制依赖于逐点评估局部电图,仔细观察通路电图或早期心房或心室电图,这可能具有挑战性且耗费时间。最近,使用三维导航系统的开窗测图(OWM)已成为一种帮助定位和消融 AP 的新技术。与传统的逐点映射技术相比,开窗映射具有明显优势。本综述旨在总结目前有关 OWM 技术的文献,并重点介绍 OWM 的技术方面和绘图注意事项,包括证明其实用性的具体病例。
{"title":"Open Window Mapping of Accessory Pathways: A Literature Review and Practical Guide.","authors":"Rajdip Dulai, Fatima Bangash, Ajay Sharma, Alex Cambridge, Geoff Wong, Wei Lim, David Farwell, Jason Garcia, Neil T Srinivansan","doi":"10.15420/aer.2023.09","DOIUrl":"10.15420/aer.2023.09","url":null,"abstract":"<p><p>Catheter ablation is the treatment of choice for patients with symptomatic accessory pathways (APs) causing recurrent atrioventricular reciprocating tachycardia or in situations where APs conduct rapidly, posing a risk of sudden cardiac death. Conventional AP mapping relies on point-by-point assessment of local electrograms looking closely for pathway electrograms or early atrial or ventricular electrograms, which may be challenging and time consuming. Recently, open window mapping (OWM) using 3D navigational systems has emerged as a novel technique to help localise and ablate APs. OWM has significant advantages over conventional point-by-point mapping techniques. The purpose of this review is to summarise the currently available literature on the OWM technique and to highlight the technical aspects and mapping considerations for OWM, including specific cases demonstrating its utility.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e28"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10782422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139429255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Explaining the Unexplained: A Practical Approach to Investigating the Cardiac Arrest Survivor. 解释未解之谜:调查心脏骤停幸存者的实用方法》。
IF 3 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-11-23 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2023.06
Gonca Suna, Greg J Mellor

Sudden cardiac arrest (SCA) is a common cause of death. The majority of SCA is caused by ventricular arrhythmia due to underlying CHD. Aborted SCA with no apparent diagnosis after initial assessment with ECG, echocardiography and coronary assessment is referred to as unexplained cardiac arrest (UCA). Systematic evaluation of such patients may reveal a specific diagnosis in up to half of patients before a diagnosis of idiopathic VF is assigned. Specific diagnoses include inherited cardiac conditions, such as latent cardiomyopathies or inherited primary electrical disease. Identifying the cause of UCA is therefore not only critical for appropriate management of the SCA survivors to prevent recurrence, but also for their family members who may be at risk of the same condition. This review provides a tiered, systematic approach for the investigation of UCA.

心脏骤停(SCA)是一种常见的死亡原因。大多数 SCA 是由潜在的心脏病导致的室性心律失常引起的。在使用心电图、超声心动图和冠状动脉评估进行初步评估后仍无明显诊断的中止型 SCA 被称为原因不明的心脏骤停(UCA)。对此类患者进行系统评估后,最多可发现半数患者有明确诊断,然后再做出特发性室颤的诊断。具体诊断包括遗传性心脏病,如潜伏性心肌病或遗传性原发性心电疾病。因此,确定 UCA 的病因不仅对适当管理 SCA 幸存者以防止复发至关重要,而且对可能面临同样病情风险的家庭成员也至关重要。本综述为 UCA 的调查提供了一种分层、系统的方法。
{"title":"Explaining the Unexplained: A Practical Approach to Investigating the Cardiac Arrest Survivor.","authors":"Gonca Suna, Greg J Mellor","doi":"10.15420/aer.2023.06","DOIUrl":"https://doi.org/10.15420/aer.2023.06","url":null,"abstract":"<p><p>Sudden cardiac arrest (SCA) is a common cause of death. The majority of SCA is caused by ventricular arrhythmia due to underlying CHD. Aborted SCA with no apparent diagnosis after initial assessment with ECG, echocardiography and coronary assessment is referred to as unexplained cardiac arrest (UCA). Systematic evaluation of such patients may reveal a specific diagnosis in up to half of patients before a diagnosis of idiopathic VF is assigned. Specific diagnoses include inherited cardiac conditions, such as latent cardiomyopathies or inherited primary electrical disease. Identifying the cause of UCA is therefore not only critical for appropriate management of the SCA survivors to prevent recurrence, but also for their family members who may be at risk of the same condition. This review provides a tiered, systematic approach for the investigation of UCA.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e27"},"PeriodicalIF":3.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138827912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Catheter Ablation for Ventricular Tachycardia After MI: A Reconstructed Individual Patient Data Meta-analysis of Randomised Controlled Trials. 心肌梗死后室性心动过速的导管消融:随机对照试验的个体患者数据 Meta 分析。
IF 2.6 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2023.07
Rohin K Reddy, James P Howard, Yousif Ahmad, Matthew J Shun-Shin, Florentina A Simader, Alejandra A Miyazawa, Keenan Saleh, Akriti Naraen, Jack W Samways, George Katritsis, Jagdeep S Mohal, Nandita Kaza, Bradley Porter, Daniel Keene, Nicholas Wf Linton, Darrel P Francis, Zachary I Whinnett, Vishal Luther, Prapa Kanagaratnam, Ahran D Arnold

Background: The prognostic impact of ventricular tachycardia (VT) catheter ablation is an important outstanding research question. We undertook a reconstructed individual patient data meta-analysis of randomised controlled trials comparing ablation to medical therapy in patients developing VT after MI.

Methods: We systematically identified all trials comparing catheter ablation to medical therapy in patients with VT and prior MI. The prespecified primary endpoint was reconstructed individual patient assessment of all-cause mortality. Prespecified secondary endpoints included trial-level assessment of all-cause mortality, VT recurrence or defibrillator shocks and all-cause hospitalisations. Prespecified subgroup analysis was performed for ablation approaches involving only substrate modification without VT activation mapping. Sensitivity analyses were performed depending on the proportion of patients with prior MI included.

Results: Eight trials, recruiting a total of 874 patients, were included. Of these 874 patients, 430 were randomised to catheter ablation and 444 were randomised to medical therapy. Catheter ablation reduced all-cause mortality compared with medical therapy when synthesising individual patient data (HR 0.63; 95% CI [0.41-0.96]; p=0.03), but not in trial-level analysis (RR 0.91; 95% CI [0.67-1.23]; p=0.53; I2=0%). Catheter ablation significantly reduced VT recurrence, defibrillator shocks and hospitalisations compared with medical therapy. Sensitivity analyses were consistent with the primary analyses.

Conclusion: In patients with postinfarct VT, catheter ablation reduces mortality.

背景:室性心动过速(VT)导管消融对预后的影响是一个尚未解决的重要研究问题。我们对心肌梗死后发生室速的患者进行了随机对照试验,比较了消融与药物治疗,并对这些试验的单个患者数据进行了重建荟萃分析:我们系统地确定了所有对既往有心肌梗死的 VT 患者进行导管消融与药物治疗比较的试验。预设的主要终点是患者个人对全因死亡率的重建评估。预设的次要终点包括全因死亡率、VT 复发或除颤器电击以及全因住院的试验水平评估。对于只涉及基质改变而不涉及 VT 激活图谱的消融方法,进行了预先指定的亚组分析。根据纳入的既往有心肌梗死的患者比例进行了敏感性分析:结果:共纳入了八项试验,招募了 874 名患者。在这874名患者中,430人被随机分配接受导管消融治疗,444人被随机分配接受药物治疗。与药物治疗相比,导管消融术降低了全因死亡率(HR 0.63;95% CI [0.41-0.96];P=0.03),但在试验层面的分析中却没有降低(RR 0.91;95% CI [0.67-1.23];P=0.53;I2=0%)。与药物治疗相比,导管消融大大降低了VT复发率、除颤器电击率和住院率。敏感性分析结果与主要分析结果一致:导管消融术可降低梗死后 VT 患者的死亡率。
{"title":"Catheter Ablation for Ventricular Tachycardia After MI: A Reconstructed Individual Patient Data Meta-analysis of Randomised Controlled Trials.","authors":"Rohin K Reddy, James P Howard, Yousif Ahmad, Matthew J Shun-Shin, Florentina A Simader, Alejandra A Miyazawa, Keenan Saleh, Akriti Naraen, Jack W Samways, George Katritsis, Jagdeep S Mohal, Nandita Kaza, Bradley Porter, Daniel Keene, Nicholas Wf Linton, Darrel P Francis, Zachary I Whinnett, Vishal Luther, Prapa Kanagaratnam, Ahran D Arnold","doi":"10.15420/aer.2023.07","DOIUrl":"10.15420/aer.2023.07","url":null,"abstract":"<p><strong>Background: </strong>The prognostic impact of ventricular tachycardia (VT) catheter ablation is an important outstanding research question. We undertook a reconstructed individual patient data meta-analysis of randomised controlled trials comparing ablation to medical therapy in patients developing VT after MI.</p><p><strong>Methods: </strong>We systematically identified all trials comparing catheter ablation to medical therapy in patients with VT and prior MI. The prespecified primary endpoint was reconstructed individual patient assessment of all-cause mortality. Prespecified secondary endpoints included trial-level assessment of all-cause mortality, VT recurrence or defibrillator shocks and all-cause hospitalisations. Prespecified subgroup analysis was performed for ablation approaches involving only substrate modification without VT activation mapping. Sensitivity analyses were performed depending on the proportion of patients with prior MI included.</p><p><strong>Results: </strong>Eight trials, recruiting a total of 874 patients, were included. Of these 874 patients, 430 were randomised to catheter ablation and 444 were randomised to medical therapy. Catheter ablation reduced all-cause mortality compared with medical therapy when synthesising individual patient data (HR 0.63; 95% CI [0.41-0.96]; p=0.03), but not in trial-level analysis (RR 0.91; 95% CI [0.67-1.23]; p=0.53; I<sup>2</sup>=0%). Catheter ablation significantly reduced VT recurrence, defibrillator shocks and hospitalisations compared with medical therapy. Sensitivity analyses were consistent with the primary analyses.</p><p><strong>Conclusion: </strong>In patients with postinfarct VT, catheter ablation reduces mortality.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e26"},"PeriodicalIF":2.6,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138827911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Septal and Conduction System Pacing. 间隔和传导系统起搏。
IF 2.6 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-09-26 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2023.14
Demosthenes G Katritsis, Hugh Calkins
{"title":"Septal and Conduction System Pacing.","authors":"Demosthenes G Katritsis, Hugh Calkins","doi":"10.15420/aer.2023.14","DOIUrl":"10.15420/aer.2023.14","url":null,"abstract":"","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e25"},"PeriodicalIF":2.6,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/17/aer-12-e25.PMC10583155.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heart Failure and Cardiac Device Therapy: A Review of Current National Institute of Health and Care Excellence and European Society of Cardiology Guidelines. 心力衰竭与心脏设备治疗:美国国家健康与护理卓越研究所和欧洲心脏病学会现行指南回顾。
IF 2.6 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-06-30 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2022.35
Akriti Naraen, Dileep Duvva, Archana Rao

Guidelines help clinicians to deliver high-quality care with therapies based on up-to-date evidence. There has been significant progress in the management of heart failure with regards to both medication and cardiac device therapy. These advances have been incorporated into national and international guidelines with varying degrees of success. This article reviews current guidance from the National Institute of Health and Care Excellence in the UK and compares this with European Society of Cardiology guidelines, and evaluates how differences between them may impact on clinical practice.

指南有助于临床医生根据最新证据提供高质量的治疗。在药物和心脏设备治疗方面,心力衰竭的管理取得了重大进展。这些进展已被纳入国家和国际指南,并取得了不同程度的成功。本文回顾了英国国家健康与护理卓越研究所(National Institute of Health and Care Excellence)的现行指南,并将其与欧洲心脏病学会(European Society of Cardiology)的指南进行了比较,评估了两者之间的差异可能对临床实践产生的影响。
{"title":"Heart Failure and Cardiac Device Therapy: A Review of Current National Institute of Health and Care Excellence and European Society of Cardiology Guidelines.","authors":"Akriti Naraen, Dileep Duvva, Archana Rao","doi":"10.15420/aer.2022.35","DOIUrl":"10.15420/aer.2022.35","url":null,"abstract":"<p><p>Guidelines help clinicians to deliver high-quality care with therapies based on up-to-date evidence. There has been significant progress in the management of heart failure with regards to both medication and cardiac device therapy. These advances have been incorporated into national and international guidelines with varying degrees of success. This article reviews current guidance from the National Institute of Health and Care Excellence in the UK and compares this with European Society of Cardiology guidelines, and evaluates how differences between them may impact on clinical practice.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e21"},"PeriodicalIF":2.6,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/d0/aer-12-e21.PMC10345955.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Pathways Guided by Remotely Monitoring Cardiac Device Data: The Future of Device Heart Failure Management? 远程监测心脏设备数据指导下的临床路径:设备心力衰竭管理的未来?
IF 3 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-04-24 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2022.13
Joanne K Taylor, Fozia Zahir Ahmed

Research examining the utility of cardiac device data to manage patients with heart failure (HF) is rapidly evolving. COVID-19 has reignited interest in remote monitoring, with manufacturers each developing and testing new ways to detect acute HF episodes, risk stratify patients and support self-care. As standalone diagnostic tools, individual physiological metrics and algorithm-based systems have demonstrated utility in predicting future events, but the integration of remote monitoring data with existing clinical care pathways for device HF patients is not well described. This narrative review provides an overview of device-based HF diagnostics available to care providers in the UK, and describes the current state of play with regard to how these systems fit in with current HF management.

研究心脏设备数据在管理心力衰竭(HF)患者中的效用的研究正在迅速发展。新冠肺炎重新激发了人们对远程监测的兴趣,制造商各自开发并测试了检测急性HF发作、对患者进行风险分层和支持自我护理的新方法。作为独立的诊断工具,个体生理指标和基于算法的系统在预测未来事件方面已经证明了实用性,但远程监测数据与设备HF患者现有临床护理途径的集成尚未得到很好的描述。这篇叙述性综述概述了英国护理提供者可获得的基于设备的HF诊断,并描述了这些系统如何适应当前HF管理的现状。
{"title":"Clinical Pathways Guided by Remotely Monitoring Cardiac Device Data: The Future of Device Heart Failure Management?","authors":"Joanne K Taylor,&nbsp;Fozia Zahir Ahmed","doi":"10.15420/aer.2022.13","DOIUrl":"10.15420/aer.2022.13","url":null,"abstract":"<p><p>Research examining the utility of cardiac device data to manage patients with heart failure (HF) is rapidly evolving. COVID-19 has reignited interest in remote monitoring, with manufacturers each developing and testing new ways to detect acute HF episodes, risk stratify patients and support self-care. As standalone diagnostic tools, individual physiological metrics and algorithm-based systems have demonstrated utility in predicting future events, but the integration of remote monitoring data with existing clinical care pathways for device HF patients is not well described. This narrative review provides an overview of device-based HF diagnostics available to care providers in the UK, and describes the current state of play with regard to how these systems fit in with current HF management.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e15"},"PeriodicalIF":3.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/88/aer-12-e15.PMC10326671.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Leadless Pacing: Therapy, Challenges and Novelties. 无导线起搏:治疗、挑战和创新。
IF 2.6 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-04-13 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2022.41
Nadeev Wijesuriya, Felicity De Vere, Vishal Mehta, Steven Niederer, Christopher A Rinaldi, Jonathan M Behar

Leadless pacing is a rapidly growing field. Initially designed to provide right ventricular pacing for those who were contraindicated for conventional devices, the technology is growing to explore the potential benefit of avoiding long-term transvenous leads in any patient who requires pacing. In this review, we first examine the safety and performance of leadless pacing devices. We then review the evidence for their use in special populations, such as patients with high risk of device infection, patients on haemodialysis, and patients with vasovagal syncope who represent a younger population who may wish to avoid transvenous pacing. We also summarise the evidence for leadless cardiac resynchronisation therapy and conduction system pacing and discuss the challenges of managing issues, such as system revisions, end of battery life and extractions. Finally, we discuss future directions in the field, such as completely leadless cardiac resynchronisation therapy-defibrillator devices and whether leadless pacing has the potential to become a first-line therapy in the near future.

无导联起搏是一个快速发展的领域。该技术最初的设计目的是为那些有传统装置禁忌症的患者提供右心室起搏,现在该技术正在不断发展,以探索在任何需要起搏的患者身上避免长期经静脉导联的潜在益处。在这篇综述中,我们首先探讨了无导联起搏设备的安全性和性能。然后,我们回顾了在特殊人群中使用无导联起搏设备的证据,如设备感染风险高的患者、血液透析患者以及血管迷走性晕厥患者,这些患者是希望避免经静脉起搏的年轻群体。我们还总结了无导联心脏再同步治疗和传导系统起搏的证据,并讨论了管理问题所面临的挑战,如系统改造、电池寿命终止和拔出。最后,我们讨论了该领域的未来发展方向,如完全无导联心脏再同步治疗-除颤器设备,以及无导联起搏是否有可能在不久的将来成为一线疗法。
{"title":"Leadless Pacing: Therapy, Challenges and Novelties.","authors":"Nadeev Wijesuriya, Felicity De Vere, Vishal Mehta, Steven Niederer, Christopher A Rinaldi, Jonathan M Behar","doi":"10.15420/aer.2022.41","DOIUrl":"10.15420/aer.2022.41","url":null,"abstract":"<p><p>Leadless pacing is a rapidly growing field. Initially designed to provide right ventricular pacing for those who were contraindicated for conventional devices, the technology is growing to explore the potential benefit of avoiding long-term transvenous leads in any patient who requires pacing. In this review, we first examine the safety and performance of leadless pacing devices. We then review the evidence for their use in special populations, such as patients with high risk of device infection, patients on haemodialysis, and patients with vasovagal syncope who represent a younger population who may wish to avoid transvenous pacing. We also summarise the evidence for leadless cardiac resynchronisation therapy and conduction system pacing and discuss the challenges of managing issues, such as system revisions, end of battery life and extractions. Finally, we discuss future directions in the field, such as completely leadless cardiac resynchronisation therapy-defibrillator devices and whether leadless pacing has the potential to become a first-line therapy in the near future.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e09"},"PeriodicalIF":2.6,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/44/aer-12-e09.PMC10326662.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Machine Learning and the Conundrum of Stroke Risk Prediction. 机器学习与中风风险预测难题。
IF 2.6 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-04-12 eCollection Date: 2023-01-01 DOI: 10.15420/aer.2022.34
Yaacoub Chahine, Matthew J Magoon, Bahetihazi Maidu, Juan C Del Álamo, Patrick M Boyle, Nazem Akoum

Stroke is a leading cause of death worldwide. With escalating healthcare costs, early non-invasive stroke risk stratification is vital. The current paradigm of stroke risk assessment and mitigation is focused on clinical risk factors and comorbidities. Standard algorithms predict risk using regression-based statistical associations, which, while useful and easy to use, have moderate predictive accuracy. This review summarises recent efforts to deploy machine learning (ML) to predict stroke risk and enrich the understanding of the mechanisms underlying stroke. The surveyed body of literature includes studies comparing ML algorithms with conventional statistical models for predicting cardiovascular disease and, in particular, different stroke subtypes. Another avenue of research explored is ML as a means of enriching multiscale computational modelling, which holds great promise for revealing thrombogenesis mechanisms. Overall, ML offers a new approach to stroke risk stratification that accounts for subtle physiologic variants between patients, potentially leading to more reliable and personalised predictions than standard regression-based statistical associations.

中风是世界范围内的主要死亡原因。随着医疗成本的不断上升,早期非侵入性卒中风险分层至关重要。目前卒中风险评估和缓解的范式主要集中在临床风险因素和合并症上。标准算法使用基于回归的统计关联来预测风险,这种方法虽然有用且易于使用,但预测准确性不高。这篇综述总结了最近在利用机器学习(ML)预测中风风险和丰富对中风机制的理解方面所做的努力。所调查的文献包括比较ML算法与传统统计模型预测心血管疾病,特别是不同中风亚型的研究。研究探索的另一个途径是ML作为丰富多尺度计算模型的手段,这对揭示血栓形成机制具有很大的希望。总的来说,ML提供了一种新的中风风险分层方法,可以解释患者之间微妙的生理变异,可能比基于标准回归的统计关联更可靠和个性化的预测。
{"title":"Machine Learning and the Conundrum of Stroke Risk Prediction.","authors":"Yaacoub Chahine, Matthew J Magoon, Bahetihazi Maidu, Juan C Del Álamo, Patrick M Boyle, Nazem Akoum","doi":"10.15420/aer.2022.34","DOIUrl":"10.15420/aer.2022.34","url":null,"abstract":"<p><p>Stroke is a leading cause of death worldwide. With escalating healthcare costs, early non-invasive stroke risk stratification is vital. The current paradigm of stroke risk assessment and mitigation is focused on clinical risk factors and comorbidities. Standard algorithms predict risk using regression-based statistical associations, which, while useful and easy to use, have moderate predictive accuracy. This review summarises recent efforts to deploy machine learning (ML) to predict stroke risk and enrich the understanding of the mechanisms underlying stroke. The surveyed body of literature includes studies comparing ML algorithms with conventional statistical models for predicting cardiovascular disease and, in particular, different stroke subtypes. Another avenue of research explored is ML as a means of enriching multiscale computational modelling, which holds great promise for revealing thrombogenesis mechanisms. Overall, ML offers a new approach to stroke risk stratification that accounts for subtle physiologic variants between patients, potentially leading to more reliable and personalised predictions than standard regression-based statistical associations.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e07"},"PeriodicalIF":2.6,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/9f/aer-12-e07.PMC10326666.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiation-associated Arrhythmias: Putative Pathophysiological Mechanisms, Prevalence, Screening and Management Strategies. 辐射相关心律失常:假定的病理生理机制、患病率、筛查和管理策略。
IF 3 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.15420/aer.2022.44
Rohil Bedi, Ali Ahmad, Piotr Horbal, Philip L Mar

Radiation-associated cardiovascular disease, an increasingly recognised disease process, is a significant adverse effect of radiation therapy for common malignancies that involve the chest, and include lymphomas, lung, mediastinal and breast cancers. Two factors contribute to the increasing incidence of radiation-associated cardiovascular disease: advances in malignancy detection and the improved survival of cancer patients, by which many symptoms of radiation-associated cardiovascular disease, specifically radiation-associated arrhythmias, present years and/or decades following initial radiotherapy. We present a focused overview of the currently understood pathophysiology, prevalence and management strategies of radiation-associated arrhythmias, which include bradyarrhythmias, tachyarrhythmias and autonomic dysfunction.

与辐射相关的心血管疾病是一种日益被认识到的疾病过程,是放射治疗涉及胸部的常见恶性肿瘤(包括淋巴瘤、肺癌、纵隔癌和乳腺癌)的一个重大不利影响。有两个因素导致与辐射有关的心血管疾病的发病率增加:恶性肿瘤检测的进展和癌症患者生存率的提高,由此可见,与辐射有关的心血管疾病的许多症状,特别是与辐射有关的心律失常,在最初放射治疗后的这几年和/或几十年出现。我们重点概述了目前了解的辐射相关心律失常的病理生理学、患病率和管理策略,包括慢速心律失常、快速心律失常和自主神经功能障碍。
{"title":"Radiation-associated Arrhythmias: Putative Pathophysiological Mechanisms, Prevalence, Screening and Management Strategies.","authors":"Rohil Bedi,&nbsp;Ali Ahmad,&nbsp;Piotr Horbal,&nbsp;Philip L Mar","doi":"10.15420/aer.2022.44","DOIUrl":"https://doi.org/10.15420/aer.2022.44","url":null,"abstract":"<p><p>Radiation-associated cardiovascular disease, an increasingly recognised disease process, is a significant adverse effect of radiation therapy for common malignancies that involve the chest, and include lymphomas, lung, mediastinal and breast cancers. Two factors contribute to the increasing incidence of radiation-associated cardiovascular disease: advances in malignancy detection and the improved survival of cancer patients, by which many symptoms of radiation-associated cardiovascular disease, specifically radiation-associated arrhythmias, present years and/or decades following initial radiotherapy. We present a focused overview of the currently understood pathophysiology, prevalence and management strategies of radiation-associated arrhythmias, which include bradyarrhythmias, tachyarrhythmias and autonomic dysfunction.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e24"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/48/aer-12-e24.PMC10481379.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10189110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
期刊
Arrhythmia & Electrophysiology Review
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1