scholarly journals Electrocardiographic markers for the prediction of ventricular arrhythmias in patients with systemic sclerosis

Rheumatology ◽  
2020 ◽  
Vol 59 (3) ◽  
pp. 478-486 ◽  
Author(s):  
Veronika Sebestyén ◽  
Gabriella Szűcs ◽  
Dénes Páll ◽  
Dóra Ujvárosy ◽  
Tamás Ötvös ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Cardiac Involvement ◽  
Internal Organs ◽  
Exact Role ◽  
Microvascular Damage ◽  
Increased Risk ◽  
Major Organ ◽  
Electrocardiographic Markers ◽  
Cardiac Manifestation

Abstract SSc is an autoimmune disease characterized by microvascular damage, endothelial dysfunction and fibrosis of the skin and the internal organs. Cardiac manifestation in patients with SSc is one of the major organ involvements. Approximately 20% of SSc patients suffer from primary cardiovascular disease and another 20% may have secondary cardiac involvement. Although cardiac arrhythmias are mostly linked to myocardial fibrosis, atrioventricular conduction abnormalities are secondary to the fibrosis of the pulse conduction system. Despite the severe consequences of ventricular rhythm disturbances in patients with SSc, the exact role of electrocardiographic markers in the prediction of these arrhythmias has not yet been clearly elucidated. Therefore, the question is whether certain ECG parameters reflecting ventricular repolarization may help to recognize scleroderma patients with increased risk for ventricular arrhythmias and sudden cardiac death.

Myocardial Noncompaction

2018 ◽  
Vol 69 (8) ◽  
pp. 2209-2212
Author(s):  
Alexandru Radu Mihailovici ◽  
Vlad Padureanu ◽  
Carmen Valeria Albu ◽  
Venera Cristina Dinescu ◽  
Mihai Cristian Pirlog ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Specific Treatment ◽  
Left Ventricular ◽  
Left Ventricular Noncompaction ◽  
Ventricular Noncompaction ◽  
Genetic Transmission ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
Patients With Heart Failure

Left ventricular noncompaction is a primary cardiomyopathy with genetic transmission in the vast majority of autosomal dominant cases. It is characterized by the presence of excessive myocardial trabecularities that generally affect the left ventricle. In diagnosing this condition, echocardiography is the gold standard, although this method involves an increased risk of overdiagnosis and underdiagnosis. There are also uncertain cases where echocardiography is inconclusive, a multimodal approach is needed, correlating echocardiographic results with those obtained by magnetic resonance imaging. The clinical picture may range from asymptomatic patients to patients with heart failure, supraventricular or ventricular arrhythmias, thromboembolic events and even sudden cardiac death. There is no specific treatment of left ventricular noncompaction, but the treatment is aimed at preventing and treating the complications of the disease. We will present the case of a young patient with left ventricular noncompactioncardiomyopathy and highlight the essential role of transthoracic echocardiography in diagnosing this rare heart disease.

scholarly journals Ventricular tachycardia storm management in a COVID-19 patient: a case report

2020 ◽  
Vol 4 (FI1) ◽  
pp. 1-6 ◽  
Author(s):  
Gianfranco Mitacchione ◽  
Marco Schiavone ◽  
Alessio Gasperetti ◽  
Giovanni B Forleo
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmias ◽  
Cardiac Involvement ◽  
Previous History ◽  
Left Ventricular ◽  
Electrical Storm ◽  
Increased Risk ◽  
History Of ◽  
Myocardial Involvement ◽  
Artery Disease

Abstract Background Coronavirus disease 2019 (COVID-19) has been associated with myocardial involvement. Among cardiovascular manifestations, cardiac arrhythmias seem to be fairly common, although no specifics are reported in the literature. An increased risk of malignant ventricular arrhythmias and electrical storm (ES) has to be considered. Case summary We describe a 68-year-old patient with a previous history of coronary artery disease and severe left ventricular systolic disfunction, who presented to our emergency department describing cough, dizziness, fever, and shortness of breath. She was diagnosed with COVID-19 pneumonia, confirmed after three nasopharyngeal swabs. Ventricular tachycardia (VT) storm with multiple implantable cardioverter defibrillator (ICD) shocks was the presenting manifestation of cardiac involvement during the COVID-19 clinical course. A substrate-based VT catheter ablation procedure was successfully accomplished using a remote navigation system. The patient recovered from COVID-19 and did not experience further ICD interventions. Discussion To date, COVID-19 pneumonia associated with a VT storm as the main manifestation of cardiac involvement has never been reported. This case highlights the role of COVID-19 in precipitating ventricular arrhythmias in patients with ischaemic cardiomyopathy who were previously stable.

scholarly journals Arrhythmic Sudden Cardiac Death and the Role of Implantable Cardioverter-Defibrillator in Patients with Cardiac Amyloidosis—A Narrative Literature Review

2021 ◽  
Vol 10 (9) ◽  
pp. 1858
Author(s):  
Aleksandra Liżewska-Springer ◽  
Grzegorz Sławiński ◽  
Ewa Lewicka
Keyword(s):  
Sudden Cardiac Death ◽  
Implantable Cardioverter Defibrillator ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Cardiac Amyloidosis ◽  
Cardioverter Defibrillator ◽  
Increased Risk ◽  
Narrative Literature ◽  
Narrative Literature Review

Cardiac amyloidosis (CA) is considered to be associated with an increased risk of sudden cardiac death (SCD) due to ventricular tachyarrhythmias and electromechanical dissociation. However, current arrhythmic risk stratification and the role of an implantable cardioverter-defibrillator (ICD) for primary prevention of SCD remains unclear. This article provides a narrative review of the literature on electrophysiological abnormalities in the context of ventricular arrhythmias in patients with CA and the role of ICD in terms of survival benefit in this group of patients.

scholarly journals Management of Cardiac Sarcoidosis in 2020

2020 ◽  
Vol 9 (4) ◽  
pp. 182-188
Author(s):  
Nisha Gilotra ◽  
David Okada ◽  
Apurva Sharma ◽  
Jonathan Chrispin
Keyword(s):  
Heart Failure ◽  
Heart Block ◽  
Ventricular Arrhythmias ◽  
Cardiac Involvement ◽  
Cardiac Sarcoidosis ◽  
Management Strategies ◽  
Clinical Manifestations ◽  
Future Directions ◽  
Inflammatory Phase

Sarcoidosis is an inflammatory granulomatous disease that can affect any organ. Up to one-quarter of patients with systemic sarcoidosis may have evidence of cardiac involvement. The clinical manifestations of cardiac sarcoidosis (CS) include heart block, atrial arrhythmias, ventricular arrhythmias and heart failure. The diagnosis of CS can be challenging given the patchy infiltration of the myocardium but, with the increased availability of advanced cardiac imaging, more cases of CS are being identified. Immunosuppression with corticosteroids remains the standard therapy for the acute inflammatory phase of CS, but there is an evolving role of steroid-sparing agents. In this article, the authors provide an update on the diagnosis of CS, including the role of imaging; review the clinical manifestations of CS, namely heart block, atrial and ventricular arrhythmias and heart failure; discuss updated management strategies, including immunosuppression, electrophysiological and heart failure therapies; and identify the current gaps in knowledge and future directions for cardiac sarcoidosis.

scholarly journals Tissue-resident Sca1+ PDGFRα+ mesenchymal progenitors are the cellular source of fibrofatty infiltration in arrhythmogenic cardiomyopathy

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 141 ◽  
Author(s):  
Ben Paylor ◽  
Justin Fernandes ◽  
Bruce McManus ◽  
Fabio Rossi
Keyword(s):  
Ventricular Arrhythmias ◽  
Pathological Process ◽  
Mesenchymal Progenitor Cells ◽  
Arrhythmogenic Cardiomyopathy ◽  
Mesenchymal Progenitors ◽  
Increased Risk ◽  
Cellular Source ◽  
Myocardial Dystrophy ◽  
The Right

Arrhythmogenic cardiomyopathy (AC) is a disease of the heart involving myocardial dystrophy leading to fibrofatty scarring of the myocardium and is associated with an increased risk of both ventricular arrhythmias and sudden cardiac death. It often affects the right ventricle but may also involve the left. Although there has been significant progress in understanding the role of underlying desmosomal genetic defects in AC, there is still a lack of data regarding the cellular processes involved in its progression. The development of cardiac fibrofatty scarring is known to be a principal pathological process associated with ventricular arrhythmias, and it is vital that we elucidate the role of various cell populations involved in the disease if targeted therapeutics are to be developed. The known role of mesenchymal progenitor cells in the reparative process of both the heart and skeletal muscle has provided inspiration for the identification of the cellular basis of fibrofatty infiltration in AC. Here we hypothesize that reparative processes triggered by myocardial degeneration lead to the differentiation of tissue-resident Sca1+ PDGFRα+ mesenchymal progenitors into adipocytes and fibroblasts, which compose the fibrofatty lesions characteristic of AC.

scholarly journals Early Repolarization, Fragmented QRS and Tpeak-Tend Interval as Electrocardiographic Markers in Patients with Idiopathic Ventricular Arrhythmias: a Brief Review

2020 ◽  
Vol 33 (3) ◽  
pp. 142-146
Author(s):  
Javier Pinos Vásquez ◽  
Tiago Luiz Luz Leiria ◽  
Clóvis Froemming Jr ◽  
Bruno Schaaf Finkler ◽  
Danilo Barros Zanotta ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Randomized Clinical Trials ◽  
Early Repolarization ◽  
Specific Patient ◽  
Patient Profile ◽  
Published Evidence ◽  
Increased Risk ◽  
Electrocardiographic Markers

Introduction: Idiopathic ventricular tachycardia and ventricular fibrillation, as causes of sudden cardiac death, are entities with mechanisms poorly studied and understood to date. The electrocardiogram (ECG) is a simple tool, but with great diagnostic and prognostic value, which has allowed the identification of certain markers associated with increased risk of development of malignant ventricular arrhythmias and sudden cardiac death. Methods: To identify the electrocardiographic markers related to the risk of developing idiopathic malignant ventricular arrhythmias, a review of the literature was performed, looking for the most recent articles with the greatest scientific impact on the topic. Outcome: Although the number of studies published to date is scarce, the published evidence has shown three electrocardiographic risk markers that have emerged in recent years and which have been related to the development of idiopathic malignant ventricular arrhythmias: the early repolarization (ER) pattern, QRS fragmentation (QRSF) and the Tpeak-Tend (Tp-Te) interval. The ECG marker that has shown most evidence to date is the pattern of ER, as a cause of changes in both ventricular depolarization and repolarization. The QRSF and the Tp-Te interval have also been related to the development of idiopathic ventricular arrhythmias, although with less evidence in this regard. Conclusion: In the last years, three electrocardiographic markers have appeared as variables related to the development of malignant ventricular arrhythmias, as is the case of ER, QRSF and Tp-Te interval. However, evidence is scarce in this specific patient profile and further randomized clinical trials are necessary to demonstrate its true relationship and usefulness.

Fragmented QRS complex – an important prognostic risk factor?

2017 ◽  
Vol 3 (44) ◽  
pp. 9-14
Author(s):  
Anna Kucharz ◽  
Piotr Kułakowski
Keyword(s):  
Risk Factor ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Potential Role ◽  
Current Knowledge ◽  
Qrs Complex ◽  
Non Invasive ◽  
Fragmented Qrs ◽  
Increased Risk

Fragmentation of the QRS complex is caused by the presence of myocardial scarring and prolonged, non-homogenous conduction. These areas are the source of dangerous ventricular arrhythmias. The potential role of fragmented QRS as a non-invasive marker of increased risk of sudden cardiac death is under investigation. The present article summarises the current knowledge on this topic.

Advanced imaging for risk stratification of sudden death in hypertrophic cardiomyopathy

Heart ◽  
2020 ◽  
Vol 106 (11) ◽  
pp. 793-801 ◽  
Author(s):  
Jay Ramchand ◽  
Agostina M Fava ◽  
Michael Chetrit ◽  
Milind Y Desai
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Risk Stratification ◽  
Ventricular Arrhythmias ◽  
Left Ventricular ◽  
Small Subset ◽  
Imaging Features ◽  
Icd Implantation ◽  
Increased Risk ◽  
Cardiac Condition

Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac condition, which typically manifests as left ventricular hypertrophy. A small subset of patients with HCM have an increased risk of sudden cardiac death (SCD) from ventricular arrhythmias. Risk of SCD can be effectively reduced following implantation of implantable cardiac defibrillators (ICD), although this treatment carries a risk of complications such as inappropriate shocks. With this in mind, we turn to advances in cardiac imaging to guide risk stratification for SCD and to select the appropriate individual who may benefit from ICD implantation. In this review, we have taken the opportunity to briefly summarise the role of imaging in the diagnosis of HCM before focusing on how specific imaging features influence risk of SCD in patients with HCM.

Vitamin A: dietologist’s position

2020 ◽  
pp. 49-57
Author(s):  
S. V. Orlova ◽  
E. A. Nikitina ◽  
L. I. Karushina ◽  
Yu. A. Pigaryova ◽  
O. E. Pronina
Keyword(s):  
Immune Response ◽  
Urinary Tract ◽  
Gastrointestinal Tract ◽  
Vitamin A ◽  
Developed Countries ◽  
Therapeutic Practice ◽  
The Past ◽  
Increased Risk ◽  
Mucous Membranes

Vitamin A (retinol) is one of the key elements for regulating the immune response and controls the division and differentiation of epithelial cells of the mucous membranes of the bronchopulmonary system, gastrointestinal tract, urinary tract, eyes, etc. Its significance in the context of the COVID‑19 pandemic is difficult to overestimate. However, a number of studies conducted in the past have associated the additional intake of vitamin A with an increased risk of developing cancer, as a result of which vitamin A was practically excluded from therapeutic practice in developed countries. Our review highlights the role of vitamin A in maintaining human health and the latest data on its effect on the development mechanisms of somatic pathology.

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