Transcatheter Therapies for Structural Heart Diseases

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Self Introduction Malignant ventricular arrhythmia contributes to approximately half of the sudden cardiac deaths. In common practice, echocardiography is used to identify structural heart diseases that are the most frequent substrate of VA. Identification and prognostication of structural heart diseases are very important as they are the main determinant of poor prognosis of ventricular arrhythmia. Purpose : The objective of this study is to determine whether cardiac magnetic resonance (CMR) may identify structural heart disease (SHD) in patients with ventricular arrhythmia who had no pathology observed on echocardiography. Methods : A total of 864 consecutive patients were enrolled in this single-center prospective study with significant ventricular arrhythmia. VA was characterized as >1000 ventricular ectopic beats per 24 hours, non-sustained ventricular arrhythmia, sustained ventricular arrhythmia, and no pathological lesion on echocardiography. The primary endpoint was the detection of SHD with CMR. Secondary endpoints were a composite of CMR detection of SHD and abnormal findings not specific for a definite SHD diagnosis. Results : CMR studies were used to diagnose SHD in 212 patients (24.5%) and abnormal findings not specific for a definite SHD diagnosis in 153 patients (17.7%). Myocarditis (n = 84) was the more frequent disease, followed by arrhythmogenic cardiomyopathy (n = 51), ischemic heart disease (n = 32), dilated cardiomyopathy (n = 17), hypertrophic cardiomyopathy (n = 12), congenital cardiac disease (n = 08), left ventricle noncompaction (n = 5), and pericarditis (n = 3). The strongest univariate and multivariate predictors of SHD on CMR images were chest pain (odds ratios [OR]: 2.5 and 2.33, respectively) and sustained ventricular tachycardia (ORs: 2.62 and 2.21, respectively). Conclusion : Our study concludes that SHD was able to be identified on CMR imaging in a significant number of patients with malignant VA and completely normal echocardiography. Chest pain and sustained ventricular tachycardia were the two strongest predictors of positive CMR imaging results. Abstract Figure. Distribution of different SHD

Download Full-text

The impact of physical exercise on the occurence of arrhythmias in athletes – recommendations

In a good rythm ◽

10.5604/01.3001.0011.6478 ◽

2018 ◽

Vol 1 (46) ◽

pp. 11-15

Author(s):

Jakub Szwed ◽

Michał Kowara ◽

Marcin Grabowski

Keyword(s):

Physical Exercise ◽

Heart Diseases ◽

Sudden Cardiac Arrest ◽

Endurance Sports ◽

Endurance Sport ◽

Sport Training ◽

Negative Results ◽

Structural Heart Diseases ◽

Long Time ◽

The Impact

The aim of this article is to demonstrate the impact of physical exercise on the development of arrhytmias in athletes. The studies show that this relation exist and concerns endurance sports practiced for a long time. In addition, this article contains review of the most common arrhythmias in athletes and appropriate recommendations. The time of arrhythmias onset depends on the presence of structural heart diseases. If the cardiac disorder is absent the arrhythmias appear at the age 40-50. If the structural heart diseases exist, the arrhythmias occur in young athletes and are more dangerous (can lead to sudden cardiac arrest). The most common arrhythmia in endurance athletes is atrial fibrillation. In order to avoid negative results of endurance sports, such as cardiac arrhythmias, the reliable examinations are necessary, especially to exclude structural cardiac diseases. These examinations should be undertaken before initiation of endurance sport training and routinely later, in course of follow-up.

Download Full-text

Diagnostic value of assessment of coronary calcification in dysplastic heart

Practical medicine ◽

10.32000/2072-1757-2021-1-75-77 ◽

2021 ◽

Vol 19 (1) ◽

pp. 75-77

Author(s):

L. T. Pimenov ◽

◽

V. V. Remnyakov ◽

M. Yu. Smetanin ◽

E. N. Avdeev ◽

...

Keyword(s):

Connective Tissue ◽

System Development ◽

Heart Diseases ◽

Coronary Calcification ◽

Diagnostic Value ◽

Conduction Disorders ◽

Increased Risk ◽

Structural Heart Diseases ◽

Connective Tissue Dysplasia ◽

Functional Features

The problem of heart connective tissue dysplasia syndrome is extremely relevant due to the increased risk of rhythm and conduction disorders, infectious endocarditis, thromboembolism and sudden cardiac death (SCD). Structural heart diseases (SHD) are manifestations of minor anomalies of the cardiovascular system development. Dysplastic heart refers to the combination of constitutional, topographical, anatomical, and functional features of the heart in a patient with connective tissue dysplasia (CTD). The standard for the diagnosis of coronary calcification (CC), one of the known predictors of coronary heart disease (CHD) and complications of cardiovascular diseases (CVD), is multispiral computed tomography (MSCT).

Download Full-text

The Changing Paradigm in the Treatment of Structural Heart Disease and the Need for the Interventional Imaging Specialist

Interventional Cardiology Review ◽

10.15420/icr.2016:12:2 ◽

2016 ◽

Vol 11 (2) ◽

pp. 135

Author(s):

Nina C Wunderlich ◽

Harald Küx ◽

Felix Kreidel ◽

Ralf Birkemeyer ◽

Robert J Siegel ◽

...

Keyword(s):

Heart Disease ◽

Heart Diseases ◽

Three Dimensional ◽

Structural Heart Disease ◽

Percutaneous Treatment ◽

Interventional Imaging ◽

Key Factor ◽

Structural Heart Diseases ◽

Specialist Standard ◽

Contrast Ventriculography

Percutaneous interventions in structural heart diseases are emerging rapidly. The variety of novel percutaneous treatment approaches and the increasing complexity of interventional procedures are associated with new challenges and demands on the imaging specialist. Standard catheterisation laboratory imaging modalities such as fluoroscopy and contrast ventriculography provide inadequate visualisation of the soft tissue or three-dimensional delineation of the heart. Consequently, additional advanced imaging technology is needed to diagnose and precisely identify structural heart diseases, to properly select patients for specific interventions and to support fluoroscopy in guiding procedures. As imaging expertise constitutes a key factor in the decision-making process and in the management of patients with structural heart disease, the sub-speciality of interventional imaging will likely develop out of an increased need for high-quality imaging.

Download Full-text

Predictors of appropriate ICD therapy in Japanese patients with structural heart diseases: A major role of prior sustained ventricular tachycardia in secondary prevention

Journal of Arrhythmia ◽

10.1002/joa3.12086 ◽

2018 ◽

Vol 34 (5) ◽

pp. 527-535

Author(s):

Daigo Nagahara ◽

Takefumi Fujito ◽

Atsushi Mochizuki ◽

Shinya Shimoshige ◽

Akiyoshi Hashimoto ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Secondary Prevention ◽

Heart Diseases ◽

Japanese Patients ◽

Sustained Ventricular Tachycardia ◽

Icd Therapy ◽

Structural Heart Diseases

Download Full-text

Role of a schematic figure of echocardiography in congenital heart diseasessurgery: which method of reporting do you prefer?

Journal of Surgery and Trauma ◽

10.32592/jsurgery.2020.8.2.100 ◽

2019 ◽

pp. 50-51

Keyword(s):

Congenital Heart ◽

Heart Diseases ◽

Diagnostic Technique ◽

Final Decision ◽

Ultrasound Waves ◽

Pediatric Cardiologist ◽

Complete Treatment ◽

Structural Heart Diseases ◽

Cardiac Surgeon ◽

Dimensional Echocardiography

Congenital structural heart diseases are the most commonly reported fatal anomalies in children. These anatomical disorders often can be corrected surgically .Today, echocardiography is the best and most important diagnostic technique for anatomical abnormalities in the heart. In this method, by using the ultrasound waves (sonography), anatomical details, and hemodynamic examination of the heart can be determined . Most pediatric cardiologists provide echocardiographic reports in the form of handwriting or typed text. This method of reporting is sometimes unable to understand the structural anomalies precisely and accurately for the final decision. Nowadays, 2-dimensional echocardiography is acceptable for the diagnosis of some structural heart abnormalities accurately. Even there is no necessary to angiography for surgical planning .2 But sometimes lack matching echocardiographic findings with surgical reports, it seems that adding a schematic figure base on echocardiography findings from the viewpoint of pediatric cardiologist will be the helper to the congenital cardiac surgeon. This proposed method of reporting will lead to the promotion of surgical treatment in congenital heart diseases. The history of the schematic picture in the anatomical textbook for a better understanding of subjects and also diseases has been shown previously by famous painters like Leonardo Davin chi. This suggestion shows that mapping can be viewed as a common language for better understanding of echocardiographic reports and more adaptation between comments of a pediatric cardiologist with designing congenital cardiac surgeon for more precise and complete treatment.

Download Full-text

Atrial tachycardias: macroreentrant atrial tachycardias, CTI-dependent atrial flutter (clockwise, anticlockwise), and non-CTI-dependent macroreentrant atrial tachycardia

ESC CardioMed ◽

10.1093/med/9780198784906.003.0485 ◽

2018 ◽

pp. 2075-2082

Author(s):

Jose L. Merino

Keyword(s):

Atrial Flutter ◽

Atrial Tachycardia ◽

Heart Diseases ◽

Vena Cava ◽

Common Type ◽

Tricuspid Annulus ◽

Significant Morbidity ◽

Structural Heart Diseases ◽

The Right ◽

Invasive Evaluation

Macroreentrant atrial tachycardia is, after atrial fibrillation, the most common sustained form of supraventricular tachycardia. It is often associated with significant morbidity and mortality. Originally, atrial flutter was the most used term but has been discouraged in favour of the most generally applied macroreentrant atrial tachycardia and the definition and diagnosis changed from an electrocardiogram-based to an electrophysiological one after invasive evaluation. The most common type of macroreentrant atrial tachycardia is cavotricuspid isthmus (CTI)-dependent atrial flutter. The reentrant circuit of CTI-atrial flutter revolves around the tricuspid annulus in the counterclockwise or the less common clockwise direction. The treatment of choice for most presentations of CTI-dependent flutter is catheter ablation by linear radiofrequency application of the isthmus between the tricuspid annulus and the inferior vena cava. Different reentrant circuits of non-CTI-dependent macroreentrant atrial tachycardia have been reported in both the right and the left atrium. They are often associated with different structural heart diseases.

Download Full-text