scholarly journals Atrial Fibrillation in Congenital Heart Disease

2021 ◽  
Vol 16 ◽  
Author(s):  
Irene Martín de Miguel ◽  
Pablo Ávila

The increasing prevalence of AF in a growing population of adults with congenital heart disease (CHD) poses new challenges to clinicians involved in the management of these patients. Distinctive underlying anatomies, unique physiological aspects, a high diversity of corrective surgeries and associated comorbidities can complicate clinical decision-making. In this review, the authors provide an overview of the current knowledge on epidemiology and pathophysiology, with a special focus on the differences to the non-CHD population and the clinical impact of AF in adults with CHD. Acute and long-term management strategies are summarised, including the use of antiarrhythmic drugs, catheter or surgical ablation and prophylaxis of thromboembolism. Finally, gaps of knowledge and potential areas of future research are highlighted.

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
G Wheeler ◽  
S Deng ◽  
K Pushparajah ◽  
J A Schnabel ◽  
J M Simpson ◽  
...  

Abstract Funding Acknowledgements Work supported by the NIHR i4i funded 3D Heart project [II-LA-0716-20001] Background/Introduction Virtual Reality (VR) has recently gained great interest for examining 3D images from congenital heart disease (CHD) patients. Currently, 3D printed models of the heart may be used for particularly complex cases. These have been found to be intuitive and to positively impact clinical decision-making. Although positively received, such printed models must be segmented from the image data, generally only CT/MR may be used, the prints are static, and models do not allow for cropping / slicing or easy manipulation. Our VR system is designed to address these issues, as well as providing a simple interface compared to standard software. Building such a VR system, one with intuitive interaction which is clinically useful, requires studying user acceptance and requirements. Purpose: We evaluate the usability of our VR system can a prototype VR system be easily learned and used by clinicians unfamiliar with VR. Method We tested a VR system which can display 3D echo images and enables the user to interact with them, for instance by translating, rotating and cropping. Our system is tested on a transoesophageal echocardiogram from a patient with aortic valve disease. 13 clinicians evaluated the system including 5 imaging cardiologists, 5 physiologists, 2 surgeons and an interventionist, with their clinical experience ranging from trainee to more than 5 years’ of experience. None had used VR regularly in the past. After a brief training session, they were asked to place three anatomical landmarks and identify a particular cardiac view. They then completed a questionnaire on system ease of learning and image manipulation. Results: Results are shown in the figure below. Learning to use the system was perceived as easy for all but one participant, who rated it as ‘Somewhat difficult’. However, once trained, all users found the system easy to use. Participants found the interaction, where objects in the scene are picked up using the controller and then track the controller’s motion in a 1:1 way, to be particularly easy to learn and use. Conclusion Our VR system was accepted by the vast majority of clinicians, both for ease of learning and use. Intuitiveness and the ability to interact with images in a natural way were highlighted as most useful - suggesting that such a system could become accepted for routine clinical use in the future. Abstract P1417 Figure. VR system evaluation participant feedbac


2021 ◽  
Vol 5 (2) ◽  
pp. 1-5
Author(s):  
Lauren Johnston ◽  
Maria Boumpouli ◽  
Asimina Kazakidi

Congenital heart disease, which affects more than one million newborns globally each year, contributes to an increased risk of cardiovascular disease and ultimately reduced life expectancy. Computational fluid dynamics (CFD) enables detailed, non-invasive characterization of complex physiological pressure and flow fields, thus improving our understanding of congenital heart disease hemodynamics. In recent years, this has driven clinical decision-making, surgical planning, and the evaluation of innovative surgical techniques. In this mini review, CFD methods applied to the study of congenital abnormalities, with a focus on the aorta and pulmonary bifurcation, are discussed. The clinical relevance and future directions of CFD modelling are also reviewed.


2021 ◽  
Vol 126 (3) ◽  
pp. 365-379
Author(s):  
Gianluca Pontone ◽  
Ernesto Di Cesare ◽  
Silvia Castelletti ◽  
Francesco De Cobelli ◽  
Manuel De Lazzari ◽  
...  

AbstractCardiac magnetic resonance (CMR) has emerged as new mainstream technique for the evaluation of patients with cardiac diseases, providing unique information to support clinical decision-making. This document has been developed by a joined group of experts of the Italian Society of Cardiology and Italian society of Radiology and aims to produce an updated consensus statement about the current state of technology and clinical applications of CMR. The writing committee consisted of members and experts of both societies who worked jointly to develop a more integrated approach in the field of cardiac radiology. Part 1 of the document will cover ischemic heart disease, congenital heart disease, cardio-oncology, cardiac masses and heart transplant.


2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Radha O Joshi ◽  
Subramanian Chellappan ◽  
Prachi Kukshal

ABSTRACT Congenital heart disease (CHD) is one of the major debilitating birth defects resulting in significant impact on neonatal and child mortality globally. The etiology of CHD is complex and multifactorial. Many causative genes responsible for CHDs have been identified from the familial forms previously. Still, the non-Mendelian inheritance and predominant sporadic cases have stimulated research to understand the epigenetic basis and environmental impact on the incidence of CHD. The fetal epigenetic programming affecting cardiac development is susceptible to the availability of key dietary factors during the crucial periconceptional period. This article highlights the need and importance of in-depth research in the new emerging area of maternal nutritional epigenetics and CHD. It summarizes the current research and underlines the limitations in these types of studies. This review will benefit the future research on nutrition as a modifiable environmental factor to decrease the incidence of CHD.


2012 ◽  
Vol 197 (3) ◽  
pp. 155-159 ◽  
Author(s):  
Gillian M Blue ◽  
Edwin P Kirk ◽  
Gary F Sholler ◽  
Richard P Harvey ◽  
David S Winlaw

2019 ◽  
Vol 8 (4) ◽  
pp. 522 ◽  
Author(s):  
Sun ◽  
Lau ◽  
Wong ◽  
Yeong

Patient-specific three-dimensional (3D) printed models have been increasingly used in cardiology and cardiac surgery, in particular, showing great value in the domain of congenital heart disease (CHD). CHD is characterized by complex cardiac anomalies with disease variations between individuals; thus, it is difficult to obtain comprehensive spatial conceptualization of the cardiac structures based on the current imaging visualizations. 3D printed models derived from patient’s cardiac imaging data overcome this limitation by creating personalized 3D heart models, which not only improve spatial visualization, but also assist preoperative planning and simulation of cardiac procedures, serve as a useful tool in medical education and training, and improve doctor–patient communication. This review article provides an overall view of the clinical applications and usefulness of 3D printed models in CHD. Current limitations and future research directions of 3D printed heart models are highlighted.


2020 ◽  
Vol 22 (12) ◽  
Author(s):  
Benjamin Kelly ◽  
Sheyanth Mohanakumar ◽  
Vibeke Elisabeth Hjortdal

Abstract Purpose of Review Lymphatic disorders have received an increasing amount of attention over the last decade. Sparked primarily by improved imaging modalities and the dawn of lymphatic interventions, understanding, diagnostics, and treatment of lymphatic complications have undergone considerable improvements. Thus, the current review aims to summarize understanding, diagnostics, and treatment of lymphatic complications in individuals with congenital heart disease. Recent Findings The altered hemodynamics of individuals with congenital heart disease has been found to profoundly affect morphology and function of the lymphatic system, rendering this population especially prone to the development of lymphatic complications such as chylous and serous effusions, protein-losing enteropathy and plastic bronchitis. Summary Although improved, a full understanding of the pathophysiology and targeted treatment for lymphatic complications is still wanting. Future research into pharmacological improvement of lymphatic function and continued implementation of lymphatic imaging and interventions may improve knowledge, treatment options, and outcome for affected individuals.


2020 ◽  
pp. 1-8
Author(s):  
Ana Alina Haiduc ◽  
Michael Ogunjimi ◽  
Rohma Shammus ◽  
Saira Mahmood ◽  
Ramesh Kutty ◽  
...  

Abstract Objective: We aimed to examine the literature to determine if both paediatric and adult patients diagnosed with congenital heart disease (CHD) are at a higher risk of poor outcomes if they have the coronavirus disease 2019 (COVID-19), compared to those without CHD. Methods: A systematic review was executed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. To identify articles related to COVID-19 and CHD, an extensive literature search was performed on EMBASE, Medline, Scopus, and Global Health databases using keywords and MeSH terms. Results: A total of 12 articles met the inclusion criteria and were included for analysis in this systematic review. Two themes were identified for data extraction: evidence supporting higher risks in CHD patients and evidence against higher risks in CHD patients. After combining the data, there were 99 patients with CHDs out of which 12 required admissions to ICU. Conclusion: This systematic review suggests that CHD may increase the risk of poor outcomes for those with COVID-19, but also highlights the necessity for more research with larger sample sizes in order to make a more justified conclusion, as the majority of papers that were analysed were case series and case reports. Future research should aim to quantify the risks if possible whilst accounting for various confounding factors such as age and treatment history.


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