Prevalence of Arrhythmias During 24-Hour Electrocardiographic Monitoring in Patients with Dilative Cardiomyopathy

Exercise training (ET) is now recommended as an important component of a comprehensive approach to patients with heart failure (HF). Despite the existence of proven benefits of ET, many HF patients remain physically inactive. Introducing telerehabilitation (TR) may eliminate most of the factors that result in the currently low number of patients undergoing outpatient-based rehabilitation programmes and thus increase the percentage of those who will undergo cardiac rehabilitation. Despite the fact that TR is highly applicable and effective, there are few papers dedicated to the study of TR in HF patients. Until recently, only a couple of home rehabilitation-monitoring models have been presented, from the simplest, i.e. heart rate monitoring and transtelephonic electrocardiographic monitoring, through to the more advanced tele-electocardiogram (tele-ECG) monitoring (via a remote device) and realtime electrocardiographic and voice transtelephonic monitoring. It seems the last two are the most useful and reliable. Based on published studies, TR in HF patients could be equally effective as and provide similar improvements in health-related quality of life to standard outpatient cardiac rehabilitation. In addition, adherence to cardiac rehabilitation seems to be better during TR. Due to disease-related limitations, TR seems to be a viable alternative for comprehensive cardiac rehabilitation in HF patients. Further studies are needed to confirm the utility of this type of rehabilitation in routine clinical practice, including its cost-effectiveness. Because of the diversity of technological systems, it is necessary to create a platform to ensure compatibility between the devices used in telemedicine.

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Role of implantable loop recorder in the clinical diagnosis of syncope: Results of the introduction of an effective diagnostic tool

Orvosi Hetilap ◽

10.1556/oh.2015.30124 ◽

2015 ◽

Vol 156 (15) ◽

pp. 609-613

Author(s):

Miklós Somlói ◽

Emil Toldy-Schedel ◽

Zoltán Nényei ◽

Róbert Böszörményi ◽

János Tomcsányi

Keyword(s):

Clinical Practice ◽

Diagnostic Yield ◽

Diagnostic Algorithm ◽

Definitive Treatment ◽

Implantable Loop Recorder ◽

Everyday Clinical Practice ◽

Loop Recorder ◽

Early Application ◽

Electrocardiographic Monitoring ◽

The Everyday

Introduction: Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. Aim: In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. Method: The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. Results: There were 52 loop recorder implantations within the study period. During the 167 (±136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. Conclusions: The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope. Orv. Hetil., 2015, 156(15), 609–613.

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Is hypertensive left ventricular hypertrophy a cause of sustained ventricular arrhythmias in humans?

Journal of Human Hypertension ◽

10.1038/s41371-021-00503-w ◽

2021 ◽

Author(s):

R. Nadarajah ◽

P. A. Patel ◽

M. H. Tayebjee

Keyword(s):

Left Ventricular Hypertrophy ◽

Ventricular Arrhythmias ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Systemic Hypertension ◽

Electrolyte Disturbance ◽

Electrocardiographic Monitoring ◽

Homogenous Distribution ◽

Artery Disease ◽

Asymptomatic Coronary Artery Disease

AbstractSudden cardiac death (SCD) is most commonly secondary to sustained ventricular arrhythmias (VAs). This review aimed to evaluate if left ventricular hypertrophy (LVH) secondary to systemic hypertension in humans is an isolated risk factor for ventricular arrhythmogenesis. Animal models of hypertensive LVH have shown changes in ion channel function and distribution, gap junction re-distribution and fibrotic deposition. Clinical data has consistently exhibited an increase in prevalence and complexity of non-sustained VAs on electrocardiographic monitoring. However, there is a dearth of trials suggesting progression to sustained VAs and SCD, with extrapolations being confounded by presence of co-existent asymptomatic coronary artery disease (CAD). Putatively, this lack of data may be due to the presence of more homogenous distribution of pathophysiological changes seen in those with hypertensive LVH versus known pro-arrhythmic conditions such as HCM and myocardial infarction. The overall impression is that sustained VAs in the context of hypertensive LVH are most likely to be precipitated by other causes such as CAD or electrolyte disturbance.

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