Tachyarrhythmia Therapies: Approaches to Atrial Fibrillation and Postinfarction Ventricular Arrhythmias

2011 ◽  
pp. 349-378
Author(s):  
J. Kevin Donahue ◽  
Kenneth R. Laurita
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Arrhythmias

scholarly journals Prevalence of arrhythmias in dogs examined between 2008 and 2014

2017 ◽  
Vol 61 (1) ◽  
pp. 103-110 ◽  
Author(s):  
Agnieszka Noszczyk-Nowak ◽  
Marcin Michałek ◽  
Ewelina Kałuża ◽  
Alicja Cepiel ◽  
Urszula Pasławska
Keyword(s):  
Atrial Fibrillation ◽  
Body Weight ◽  
Retrospective Analysis ◽  
Ventricular Arrhythmias ◽  
Heart Rhythm ◽  
Supraventricular Arrhythmias ◽  
Premature Ventricular Complexes ◽  
Labrador Retrievers

Abstract Introduction: The prevalence of arrhythmias in dogs and the influence of sex, breed, age, and body weight were analysed over a seven-year span. Material and Methods: In total, 1189 referrals for cardiological examination by electrocardiography were received at one academic centre in Poland between 2008 and 2014. The largest proportion of the examined dogs were cross-breeds with body weight below 25 kg (n = 153, 12.87%), followed by German Shepherds (n = 122, 10.26%), Labrador Retrievers (n = 68, 5.72%), Yorkshire Terriers (n = 63, 5.3%), and Boxers (n = 60, 5.05%). Retrospective analysis was made of 1201 standing or right recumbent electrocardiograms without pharmacological sedation. The prevalence of arrhythmias was examined in terms of sex, age, body weight, and breed of the dogs. Results: A total of 630 (52.46%) electrocardiograms showed no signs of arrhythmia, but 96 (7.99%) and 475 (39.55%) pointed to physiological and pathological arrhythmias respectively. The most commonly diagnosed type was atrial fibrillation with 33.68% incidence, followed by ventricular arrhythmias (28%), sinus pauses (27.58%), supraventricular arrhythmias (24%), and atrioventricular blocks (22.95%). Pathological arrhythmias were most commonly found in male dogs and in German Shepherds. Conclusions: Atrial fibrillation predominated, followed by premature ventricular complexes. Male dogs were generally more prone to heart rhythm disturbances.

scholarly journals New-onset ventricular arrhythmias post radiofrequency catheter ablation for atrial fibrillation

Medicine ◽  
2016 ◽  
Vol 95 (36) ◽  
pp. e4648 ◽  
Author(s):  
Lingmin Wu ◽  
Yanlai Lu ◽  
Yan Yao ◽  
Lihui Zheng ◽  
Gang Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Radiofrequency Catheter Ablation ◽  
New Onset

scholarly journals Incidence of Ventricular Arrhythmias and 1‐Year Predictors of Mortality in Patients Treated With Implantable Cardioverter‐Defibrillator Undergoing Generator Replacement

2021 ◽  
Vol 10 (4) ◽  
Author(s):  
Andrea Demarchi ◽  
Stefano Cornara ◽  
Antonio Sanzo ◽  
Simone Savastano ◽  
Barbara Petracci ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Ventricular Arrhythmias ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cardioverter Defibrillator ◽  
Generator Replacement

Background When implantable cardioverter defibrillator (ICD) battery is depleted most patients undergo generator replacement (GR) even in the absence of persistent ICD indication. The aim of this study was to assess the incidence of ventricular arrhythmias and the overall prognosis of patients with and without persistent ICD indication undergoing GR. Predictors of 1‐year mortality were also analyzed. Methods and Results Patients with structural heart disease implanted with primary prevention ICD undergoing GR were included. Patients were stratified based on the presence/absence of persistent ICD indication (left ventricular ejection fraction ≤35% at the time of GR and/or history of appropriate ICD therapies during the first generator's life). The study included 371 patients (82% male, 40% with ischemic heart disease). One third of patients (n=121) no longer met ICD indication at the time of GR. During a median follow‐up of 34 months after GR patients without persistent ICD indication showed a significantly lower incidence of appropriate ICD shocks (1.9% versus 16.2%, P <0.001) and ICD therapies. 1‐year mortality was also significantly lower in patients without persistent ICD indication (1% versus 8.3%, P =0.009). At multivariable analysis permanent atrial fibrillation, chronic advanced renal impairment, age >80, and persistent ICD indication were found to be significant predictors of 1‐year mortality. Conclusions Patients without persistent ICD indication at the time of GR show a low incidence of appropriate ICD therapies after GR. Persistent ICD indication, atrial fibrillation, advanced chronic renal disease, and age >80 are significant predictors of 1‐year mortality. Our findings enlighten the need of performing a comprehensive clinical reevaluation of ICD patients at the time of GR.

scholarly journals Gain-of-function mutation in SCN5A causes ventricular arrhythmias and early onset atrial fibrillation

2017 ◽  
Vol 236 ◽  
pp. 187-193 ◽  
Author(s):  
Krystien V. Lieve ◽  
Arie O. Verkerk ◽  
Svitlana Podliesna ◽  
Christian van der Werf ◽  
Michael W. Tanck ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Early Onset ◽  
Ventricular Arrhythmias ◽  
Gain Of Function ◽  
Onset Atrial Fibrillation

Classification of tachyarrhythmias, mechanisms of arrhythmogenesis, and acute management

2013 ◽  
Author(s):  
Demosthenes G. Katritsis ◽  
Bernard J. Gersh ◽  
A. John Camm
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Arrhythmias ◽  
Acute Management ◽  
Acute Therapy

Tachyarrhythmias are considered as atrial tachycardias, AVNRT and other junctional arrhythmias, AVRT, atrial fibrillation, and ventricular arrhythmias. The classification, electrophysiological mechanisms, and acute therapy of arrhythmias are presented.

scholarly journals Rates of Cardiac Rhythm Abnormalities in Patients with CKD and Diabetes

2019 ◽  
Vol 14 (4) ◽  
pp. 549-556 ◽  
Author(s):  
Nazem Akoum ◽  
Leila R. Zelnick ◽  
Ian H. de Boer ◽  
Irl B. Hirsch ◽  
Dace Trence ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Arrhythmias ◽  
Ventricular Arrhythmias ◽  
Cardiac Rhythm ◽  
Cardiac Monitoring ◽  
Premature Ventricular Contractions ◽  
Mortality And Morbidity ◽  
Conduction Abnormalities ◽  
Patients With Diabetes ◽  
New Diagnosis

Background and objectivesCardiac arrhythmias increase mortality and morbidity in CKD. We evaluated the rates of subclinical arrhythmias in a population with type 2 diabetes and patients with moderate to severe CKD who were not on dialysis.Design, setting, participants & measurementsThis is a prospective observational study, using continuous ambulatory cardiac monitors to determine the rate of atrial and ventricular arrhythmias, as well as conduction abnormalities in this group.ResultsA total of 38 patients (34% women), with mean eGFR of 38±13 ml/min per 1.73 m2, underwent ambulatory cardiac monitoring for 11.2±3.9 days. The overall mean rate of any cardiac arrhythmia was 88.8 (95% confidence interval [95% CI], 27.1 to 184.6) episodes per person-year (PY). A history of cardiovascular disease was associated with a higher rate of detected arrhythmia (rate ratio, 5.87; 95% CI, 1.37 to 25.21; P<0.001). The most common arrhythmia was atrial fibrillation, which was observed in two participants with known atrial fibrillation and was a new diagnosis in four patients (11%), none of whom experienced symptoms. Overall, atrial fibrillation episodes occurred at a rate of 37.6 (95% CI, 2.4 to 112.3) per PY. Conduction abnormalities were found in eight patients (21%), a rate of 26.5 (95% CI, 4.2 to 65.5) per PY. Rates of ventricular arrhythmias were low (14.5 per PY; 95% CI, 4.3 to 32.0) and driven by premature ventricular contractions.ConclusionsCardiac rhythm abnormalities are common in patients with diabetes with moderate to severe CKD not requiring dialysis. Rates of atrial fibrillation are high and episodes are asymptomatic. Future studies are needed to determine the role of screening and upstream therapy of cardiac arrhythmias in this group.

scholarly journals A missense mutation in the RSRSP stretch of Rbm20 causes dilated cardiomyopathy and atrial fibrillation in mice

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Kensuke Ihara ◽  
Tetsuo Sasano ◽  
Yuichi Hiraoka ◽  
Marina Togo-Ohno ◽  
Yurie Soejima ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Dilated Cardiomyopathy ◽  
Missense Mutation ◽  
Cardiac Dysfunction ◽  
Ventricular Arrhythmias ◽  
Left Ventricular ◽  
Mutant Mice ◽  
Clinical State ◽  
Missense Mutations ◽  
Nuclear Localization Signals

Abstract Dilated cardiomyopathy (DCM) is a fatal heart disease characterized by left ventricular dilatation and cardiac dysfunction. Recent genetic studies on DCM have identified causative mutations in over 60 genes, including RBM20, which encodes a regulator of heart-specific splicing. DCM patients with RBM20 mutations have been reported to present with more severe cardiac phenotypes, including impaired cardiac function, atrial fibrillation (AF), and ventricular arrhythmias leading to sudden cardiac death, compared to those with mutations in the other genes. An RSRSP stretch of RBM20, a hotspot of missense mutations found in patients with idiopathic DCM, functions as a crucial part of its nuclear localization signals. However, the relationship between mutations in the RSRSP stretch and cardiac phenotypes has never been assessed in an animal model. Here, we show that Rbm20 mutant mice harboring a missense mutation S637A in the RSRSP stretch, mimicking that in a DCM patient, demonstrated severe cardiac dysfunction and spontaneous AF and ventricular arrhythmias mimicking the clinical state in patients. In contrast, Rbm20 mutant mice with frame-shifting deletion demonstrated less severe phenotypes, although loss of RBM20-dependent alternative splicing was indistinguishable. RBM20S637A protein cannot be localized to the nuclear speckles, but accumulated in cytoplasmic, perinuclear granule-like structures in cardiomyocytes, which might contribute to the more severe cardiac phenotypes.

scholarly journals Expanding Spectrum of Human RYR2 -Related Disease

Circulation ◽  
2007 ◽  
Vol 116 (14) ◽  
pp. 1569-1576 ◽  
Author(s):  
Zahurul A. Bhuiyan ◽  
Maarten P. van den Berg ◽  
J. Peter van Tintelen ◽  
Margreet T.E. Bink-Boelkens ◽  
Ans C.P. Wiesfeld ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Polymerase Chain Reaction ◽  
Ventricular Arrhythmias ◽  
Sinoatrial Node ◽  
Atrioventricular Node ◽  
Left Ventricular ◽  
Polymorphic Ventricular Tachycardia ◽  
Chain Reaction ◽  
Genomic Deletion ◽  
Polymerase Chain

Background— Catecholaminergic polymorphic ventricular tachycardia is a disease characterized by ventricular arrhythmias elicited exclusively under adrenergic stress. Additional features include baseline bradycardia and, in some patients, right ventricular fatty displacement. The clinical spectrum is expanded by the 2 families described here. Methods and Results— Sixteen members from 2 separate families have been clinically evaluated and followed over the last 15 years. In addition to exercise-related ventricular arrhythmias, they showed abnormalities in sinoatrial node function, as well as atrioventricular nodal function, atrial fibrillation, and atrial standstill. Left ventricular dysfunction and dilatation was present in several affected individuals. Linkage analysis mapped the disease phenotype to a 4-cM region on chromosome 1q42-q43. Conventional polymerase chain reaction–based screening did not reveal a mutation in either the Ryanodine receptor 2 gene ( RYR2 ) or ACTN2 , the most plausible candidate genes in the region of interest. Multiplex ligation-dependent probe amplification and long-range polymerase chain reaction identified a genomic deletion that involved RYR2 exon-3, segregated in all the affected family members (n=16) in these 2 unlinked families. Further investigation revealed that the genomic deletion occurred in both families as a result of Alu repeat–mediated polymerase slippage. Conclusions— This is the first report on a large genomic deletion in RYR2 , which leads to extended clinical phenotypes (eg, sinoatrial node and atrioventricular node dysfunction, atrial fibrillation, atrial standstill, and dilated cardiomyopathy). These features have not previously been linked to RYR2 .

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