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Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, Charron P, Corrado D, Dagres N, de Chillou C, Eckardt L, Friede T, Haugaa KH, Hocini M, Lambiase PD, Marijon E, Merino JL, Peichl P, Priori SG, Reichlin T, Schulz-Menger J, Sticherling C, Tzeis S, Verstrael A, Volterrani M. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022; 43:3997-4126. [PMID: 36017572 DOI: 10.1093/eurheartj/ehac262] [Citation(s) in RCA: 770] [Impact Index Per Article: 385.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Nishii N, Noda T, Nitta T, Aizawa Y, Ohe T, Kurita T. Risk factors for the first and second inappropriate implantable cardioverter-defibrillator therapy. IJC HEART & VASCULATURE 2021; 34:100779. [PMID: 33997254 PMCID: PMC8100615 DOI: 10.1016/j.ijcha.2021.100779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/24/2022]
Abstract
Introduction Various risk factors for the first inappropriate implantable cardioverter-defibrillator (ICD) therapy event have been reported, including a history of atrial fibrillation/atrial flutter (AF/AFL), younger age, and multiple zones. Nonetheless, which factors are concordant with real-world data has not been clarified, and risk factors for the second inappropriate ICD therapy event have not been well examined. This study aimed to clarify the risk factors for the first and second inappropriate ICD therapy events. Methods We conducted a post-hoc secondary analysis of data from a multicenter, prospective observational study (the Nippon Storm Study) designed to clarify the risk factors for electrical storm. Results The analysis included data from 1549 patients who received ICD or cardiac resynchronization therapy with defibrillator (CRT-D). Over a median follow-up of 28 months, 293 inappropriate ICD therapy events occurred in 153 (10.0%) patients. On multivariate Cox regression analysis, the risk factors for the first inappropriate ICD therapy event were younger age (hazard ratio [HR], 0.986; p = 0.028), AF/AFL (HR, 2.324; p = 0.002), ICD without CRT implantation (HR, 2.377; p = 0.004), and multiple zones (HR, 1.852; p = 0.010). “No-intervention” after the first inappropriate ICD therapy event was the sole risk factor for the second inappropriate ICD therapy event. Conclusions Risk factors for the first inappropriate ICD therapy event were similar to those previously reported. Immediate intervention after the first inappropriate ICD therapy event could reduce the risk of the second inappropriate event.
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Affiliation(s)
- Nobuhiro Nishii
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takashi Nitta
- Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan
| | - Yoshifusa Aizawa
- Department of Research and Development, Tachikawa Medical Center, Niigata, Japan
| | - Tohru Ohe
- Okayama City Hospital, Okayama, Japan
| | - Takashi Kurita
- Department of Internal Medicine, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
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Mugnai G, Hünük B, Ströker E, Ruggiero D, Coutino-Moreno HE, Takarada K, De Regibus V, Choudhury R, Abugattas de Torres JP, Moran D, Iacopino S, Filannino P, Conte G, Sieira J, Poelaert J, Beckers S, Brugada P, de Asmundis C, Chierchia GB. Long-term outcome of pulmonary vein isolation in patients with paroxysmal atrial fibrillation and Brugada syndrome. Europace 2018; 20:548-554. [PMID: 28340057 DOI: 10.1093/europace/euw428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/07/2016] [Indexed: 11/13/2022] Open
Abstract
Aims The therapeutical management of atrial fibrillation (AF) in the setting of Brugada syndrome (BS) might be challenging as many antiarrhythmic drugs (AADs) with sodium channel blocking properties might lead to to the development of ventricular arrhythmias. This study sought to evaluate the clinical outcome in a consecutive series of patients with BS having undergone pulmonary vein (PV) isolation by means of radiofrequency (RF) or cryoballoon (CB) ablation and the efficacy of catheter ablation for preventing inappropriate interventions delivered by implantable cardioverter defibrillators (ICD) on a 3-year follow up. Methods and results Twenty-three consecutive patients with BS (13 males; mean age was 47 ± 18 years) having undergone PV isolation for drug-resistant paroxysmal AF were enrolled. Eleven patients (48%) had an ICD implanted of whom four had inappropriate shocks secondary to rapid AF. Over a mean follow-up period of 35.0 ± 25.4 months (median 36 months) the freedom from AF recurrence after the index PV isolation procedure was 74% without AADs. Patients with inappropriate ICD interventions for AF did not present futher ICD shocks after AF ablation. No major complications occurred. Conclusion Catheter ablation is a valid therapeutic choice for patients with BS and paroxysmal AF considering the high success rates, the limitations of the AADs and the safety of the procedure, and it should be taken into consideration especially in those patients presenting inappropriate ICD shocks due to rapid AF.
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Affiliation(s)
- Giacomo Mugnai
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Burak Hünük
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Erwin Ströker
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Diego Ruggiero
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | | | - Ken Takarada
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Valentina De Regibus
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Rajin Choudhury
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | | | - Darragh Moran
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Saverio Iacopino
- Electrophysiology Unit, Maria Cecilia Hospital, via Corriera 1, 48033 Cotignola (RA), Italy
| | - Pasquale Filannino
- Electrophysiology Unit, Maria Cecilia Hospital, via Corriera 1, 48033 Cotignola (RA), Italy
| | - Giulio Conte
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Juan Sieira
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Jan Poelaert
- Department of Anaesthesiology, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Stefan Beckers
- Department of Anaesthesiology, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Pedro Brugada
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
| | - Carlo de Asmundis
- Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium
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Henmi R, Ejima K, Yagishita D, Iwanami Y, Nishimura T, Takeuchi D, Toyohara K, Shoda M, Hagiwara N. Long-Term Efficacy of Implantable Cardioverter Defibrillator in Repaired Tetralogy of Fallot - Role of Anti-tachycardia Pacing. Circ J 2016; 81:165-171. [PMID: 27941299 DOI: 10.1253/circj.cj-16-0932] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tetralogy of Fallot (TOF) is one of the common congenital heart diseases (CHD) in implantable cardioverter defibrillator (ICD) recipients, but few studies have reported the long-term outcomes of and the anti-tachycardia pacing (ATP) efficacy in repaired TOF.Methods and Results:Twenty-one repaired TOF patients with an ICD implanted between April 2003 and March 2015 were investigated retrospectively. ICD therapy and clinical outcome were analyzed. Mean patient age was 39±11 years; 62% were male; and mean age at repair surgery was 9.4±6.8 years. During a median follow-up of 5.6 years (range, 2.6-8.4 years), no patients died. Appropriate ATP were delivered in 11 patients (52%), with appropriate shocks in 5 patients (24%) and inappropriate shocks in 5 patients (24%). The success rate of ATP was 98% for fast ventricular tachycardia (VT; cycle length ≤320 ms) and 98% for slow VT (cycle length >320 ms). ATP effectiveness increased from 81.5% with the first ATP attempt to 93.7% with the second ATP attempt, to 97.5% with the third ATP attempt, and to 98.6% with the fourth or successive ATP attempt (P<0.0001, Cochran-Armitage trend test). CONCLUSIONS ATP was highly effective in repaired TOF regardless of VT cycle length. Multiple ATP attempts could have an important role in VT termination, and the novel subcutaneous ICD without ATP capability should be used carefully.
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Affiliation(s)
- Ryuta Henmi
- Department of Cardiology, Tokyo Women's Medical University
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Müssigbrodt A, Knopp H, Seewöster T, Hilbert S, Lucas J, Nowotnick K, Dinov B, Hindricks G, Arya A, Richter S. Implanted defibrillators in trouble: initial device misclassification leads to correct diagnosis—a case series. Europace 2016; 19:795-801. [DOI: 10.1093/europace/euw082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/05/2016] [Indexed: 11/14/2022] Open
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ENRIQUEZ ANDRES, ELLENBOGEN KENNETHA, BOLES USAMA, BARANCHUK ADRIAN. Atrioventricular Nodal Reentrant Tachycardia in Implantable Cardioverter Defibrillators: Diagnosis and Troubleshooting. J Cardiovasc Electrophysiol 2015; 26:1282-1288. [DOI: 10.1111/jce.12772] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 07/07/2015] [Accepted: 08/31/2015] [Indexed: 11/26/2022]
Affiliation(s)
- ANDRES ENRIQUEZ
- Division of Cardiology; Queen's University; Kingston Ontario Canada
| | - KENNETH A. ELLENBOGEN
- Department of Medicine; Virginia Commonwealth University School of Medicine; Richmond Virginia USA
| | - USAMA BOLES
- Division of Cardiology; Queen's University; Kingston Ontario Canada
| | - ADRIAN BARANCHUK
- Division of Cardiology; Queen's University; Kingston Ontario Canada
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Banchs JE, Scher DL. Emerging role of digital technology and remote monitoring in the care of cardiac patients. Med Clin North Am 2015; 99:877-96. [PMID: 26042888 DOI: 10.1016/j.mcna.2015.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Current available mobile health technologies make possible earlier diagnosis and long-term monitoring of patients with cardiovascular diseases. Remote monitoring of patients with implantable devices and chronic diseases has resulted in better outcomes reducing health care costs and hospital admissions. New care models, which shift point of care to the outpatient setting and the patient's home, necessitate innovations in technology.
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Affiliation(s)
- Javier E Banchs
- Department of Medicine, Division of Cardiology, Section of Cardiac Electrophysiology and Pacing, 2401 South 31st Street, Temple, TX 76508, USA.
| | - David Lee Scher
- Department of Medicine, Division of Cardiology, Penn State Hershey Heart & Vascular Institute, 500 University Drive, H047, Hershey, PA 17033, USA
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