scholarly journals Value of implantable loop recorders in patients with structural or electrical heart disease

2018 ◽  
Vol 52 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Rafi Sakhi ◽  
Dominic A. M. J. Theuns ◽  
Rohit E. Bhagwandien ◽  
Michelle Michels ◽  
Arend F. L. Schinkel ◽  
...  
Keyword(s):  
Heart Disease ◽  
Electrical Heart Disease ◽  
Implantable Loop Recorders

scholarly journals Monomorphic Ventricular Arrhythmias in Athletes

2019 ◽  
Vol 8 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Jeffrey J Hsu ◽  
Ali Nsair ◽  
Jamil A Aboulhosn ◽  
Tamara B Horwich ◽  
Ravi H Dave ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Arrhythmias ◽  
Comprehensive Evaluation ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Sports Participation ◽  
Structural Heart Disease ◽  
Competitive Sports ◽  
Ventricular Cardiomyopathy ◽  
Electrical Heart Disease ◽  
Increase Risk

Ventricular arrhythmias are challenging to manage in athletes with concern for an elevated risk of sudden cardiac death (SCD) during sports competition. Monomorphic ventricular arrhythmias (MMVA), while often benign in athletes with a structurally normal heart, are also associated with a unique subset of idiopathic and malignant substrates that must be clearly defined. A comprehensive evaluation for structural and/or electrical heart disease is required in order to exclude cardiac conditions that increase risk of SCD with exercise, such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy. Unique issues for physicians who manage this population include navigating athletes through the decision of whether they can safely continue their chosen sport. In the absence of structural heart disease, therapies such as radiofrequency catheter ablation are very effective for certain arrhythmias and may allow for return to competitive sports participation. In this comprehensive review, we summarise the recommendations for evaluating and managing athletes with MMVA.

scholarly journals Single-centre use of implantable loop recorders in patients with congenital heart disease

EP Europace ◽  
2009 ◽  
Vol 11 (3) ◽  
pp. 303-307 ◽  
Author(s):  
D. Kenny ◽  
S. Chakrabarti ◽  
A. Ranasinghe ◽  
A. Chambers ◽  
R. Martin ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Single Centre ◽  
Implantable Loop Recorders

scholarly journals A NovelSCN5AMutation in a Patient with Coexistence of Brugada Syndrome Traits and Ischaemic Heart Disease

2009 ◽  
Vol 2009 ◽  
pp. 1-4
Author(s):  
Anders G. Holst ◽  
Kirstine Calloe ◽  
Thomas Jespersen ◽  
Pernille Cedergreen ◽  
Bo G. Winkel ◽  
...  
Keyword(s):  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Ischaemic Heart Disease ◽  
Brugada Syndrome ◽  
Cardiac Death ◽  
Novel Mutation ◽  
Index Patient ◽  
Proarrhythmic Effect ◽  
Electrical Heart Disease ◽  
Disease Entities

Brugada syndrome (BrS) is a primary electrical heart disease, which can lead to sudden cardiac death. In older patients with BrS, the disease may coexist with ischaemic heart disease (IHD) and recent studies support a synergistic proarrhythmic effect of the two disease entities. We report a case that illustrates this. The index patient was a middle-aged patient with BrS traits, IHD, and aborted sudden cardiac death. Mutation analysis discovered a novel mutation P468L in theNaV1.5 sodium channel. Surprisingly, voltage-clamp experiments on the wild-type and mutantNaV1.5 channels expressed in HEK cells revealed no functional effect of the mutation. In a patient like ours, the distinction between IHD and BrS as the cause of an aborted sudden cardiac death is hard to establish and mounting evidence shows that coexistence of the two may have a synergistic proarrhythmic effect.

scholarly journals Exercise-induced neurocardiogenic syncope

EP Europace ◽  
2000 ◽  
Vol 2 (1) ◽  
pp. 77-82 ◽  
Author(s):  
D. Kosinski ◽  
B.P. Grubb ◽  
B.J. Karas ◽  
S. Frederick
Keyword(s):  
Heart Disease ◽  
Neurocardiogenic Syncope ◽  
Diagnostic Challenge ◽  
Electrical Heart Disease ◽  
Life Threatening ◽  
Qt Syndrome ◽  
Exercise Induced ◽  
Anomalous Coronary ◽  
Upright Tilt

Abstract The evaluation of syncope occurring during exercise or occurring spontaneously in highly trained individuals presents a unique diagnostic challenge. It is of critical importance to exclude potential life-threatening disorders such as hypertrophic cardiomyopathy, long QT syndrome, right ventricular dysplasia, anomalous coronary artery distribution, valvular heart disease, myocarditis, or exercise-induced arrhythmia. This review is not directed towards identifying, treating, or determining athletic eligibility of individuals with such disorders. Rather, we endeavour to discuss the pathophysiology of exercise-induced neurocardiogenic syncope and to address the role of head upright tilt testing in evaluating syncope in athletic individuals in whom proper evaluation has excluded the presence of ischaemic heart disease or primary structural or electrical heart disease.

Usefulness of implantable loop recorders in office-based practice for evaluation of syncope in patients with and without structural heart disease

2003 ◽  
Vol 92 (9) ◽  
pp. 1127-1129 ◽  
Author(s):  
Pamela K Mason ◽  
Mark A Wood ◽  
Daniel B Reese ◽  
John H Lobban ◽  
Mark A Mitchell ◽  
...  
Keyword(s):  
Heart Disease ◽  
Structural Heart Disease ◽  
Implantable Loop Recorders

scholarly journals Implantable loop recorders in patients with a structural or electrical heart disease: comparison of the clinical value in patients with and without a history of syncope

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Assaf ◽  
R Sakhi ◽  
M Michels ◽  
JW Roos-Hesselink ◽  
JMA Verhagen ◽  
...  
Keyword(s):  
Heart Disease ◽  
Primary Endpoint ◽  
Clinical Value ◽  
Loop Recorder ◽  
Increased Risk ◽  
Significant Difference ◽  
Electrical Heart Disease ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Funding Acknowledgements Type of funding sources: None. Background Patients with structural and electrical heart disease are at increased risk for sudden cardiac death. Guidelines recommend the use of an implantable loop recorder (ILR) in symptomatic patients when symptoms are sporadic and suspected to be related to arrhythmias. In clinical practice, an ILR is mainly used in patients with unexplained syncope. Purpose To compare the clinical value of an ILR in patients with a heart disease and a history of syncope versus those with non-syncopal suspected arrhythmia-related symptoms. Methods In this observational single-center study we included symptomatic patients with structural or electrical heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to implantation of a pacemaker or implantable cardioverter-defibrillator (ICD). Results A total of 120 patients (mean age 47 ± 17 years, 49% men) were included. Underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%), and other structural heart disease (18%).There were 43 patients with a history of syncope (group A) and 77 patients with non-syncopal symptoms (group B) such as palpitations, dizziness and/or near-syncope at baseline. During a median follow-up of 19 months (IQR 8-36), a primary endpoint was reached in 14 patients (33%) of group A, and in 28 patients (36%) of group B (logrank P = 0.54, Figure A). There was also no significant difference in the cumulative rate of cardiac device implantation between group A and B, 14% versus 10%, respectively (logrank P = 0.97, Figure B). Conclusion Our results show no differences in ILR yield in patients with structural or electrical heart disease who present with any suspected arrhythmia-related symptom, including those with non-syncopal symptoms. Abstract Figure.

P988Implantable cardioverter defibrillators in patients with electrical heart disease and hypertrophic cardiomyopathy - data from the German device Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Frommeyer ◽  
F Reinke ◽  
D Andresen ◽  
T Klemann ◽  
S G Spitzer ◽  
...  
Keyword(s):  
Heart Disease ◽  
Hypertrophic Cardiomyopathy ◽  
Secondary Prevention ◽  
Real Life ◽  
Control Group ◽  
Icd Implantation ◽  
Large Patient ◽  
Electrical Heart Disease ◽  
One Year

Abstract Background Implantable cardioverter- defibrillator (ICD) therapy is established for prevention of sudden cardiac death (SCD) in different entities. However, data from large patient cohorts on patients with electrical heart disease of hypertrophic cardiomyopathy (HCM) is rare. Therefore, we investigated these patients by analysing registry data from a multi-center “real-life” registry. Methods The German Device Registry (DEVICE) is a nationwide, prospective registry with one-year follow-up investigating 5450 patients receiving device implantations in 50 German centres. The present analysis of DEVICE focussed on patients with electrical heart disease or HCM who received an ICD for primary or secondary prevention. Results 174 patients with HCM and 112 patients with electrical heart disease were compared with 5164 other ICD patients. Median follow-up was 17.0 months. Patients in the control group were significantly older. Of note, overall mortality after one year was 1.8% in HCM patients, 6.6% in patients with electrical heart disease and 7.3% in the control group. Patients in the control group presented significantly more severe comorbidities. In contrast to HCM patients and the control group where primary prevention was the major indication for ICD implantation 77.5% of patients with electrical heart disease received an ICD for secondary prevention. The number of surgical revisions was higher in patients with electrical heart disease. Conclusion Data from the present registry display a surprisingly high mortality in patients with electrical heart disease equivalent to the control group. A high proportion of patients who received an ICD for secondary prevention may be regarded as a major determinant for these results while severe comorbidities such as diabetes, hypertension and renal failure are major determinants for mortality in the control cohort.

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