scholarly journals Modern treatment of supraventricular tachycardia

2020 ◽  
Vol 19 (5) ◽  
pp. 2694
Author(s):  
A. I. Tarzimanova ◽  
V. I. Podzolkov

Supraventricular tachycardia (SVT) is one of the most common arrhythmias. The prevalence of SVT varies widely in different countries and is 2,25 per 1,000 people in the general population. SVT reduce the quality of life of patients, and in some cases can worsen the prognosis. In patients with cardiovascular disease, the risk of SVT increases. Therapy of SVT is selected depending on the stability of hemodynamic and the QRS width. Until now, the treatment of SVT remains an urgent issue of modern cardiology, since despite the high effectiveness of catheter ablation, antiarrhythmic therapy plays an important role.

Author(s):  
M. Meshkova ◽  
A. Doronin

Atrial fibrillation (AF) is a worldwide epidemic that has hit about 33 million people. In clinical studies, the efficacy of antiarrhythmic therapy and catheter ablation in the treatment of AF was compared, and controversial results were obtained. Objective. To analyze three advanced publications in recent years, which, according to the authors, are of fundamental importance for the choice of radiofrequency catheter ablation as a treatment option for AF. Results and discussion. In the CABANA study catheter ablation was compared with antiarrhythmic therapy and showed significant improvement in the quality of life. Within 3 years, AF recurrence rate was 69% in the group of antiarrhythmic treatment and 50% in the catheter ablation group. The proportion of patients with non-paroxysmal AF decreased from 57% to 26% with antiarrhythmic treatment and up to 16% with catheter ablation. Among the serious complications in the catheter ablation group were tamponades (0.8%), minor hematomas (2.3%) and pseudoaneurysms (1.1%). Thyroid dysfunction (1.6%) and proarrhythmogenic effect (0.8%) were observed in the group of antiarrhythmic therapy. In the CASTLE-AF (HF) study, 179 patients were randomly selected for catheter ablation, and 184 for antiarrhythmic therapy. All of them were in NYHA class II, III or IV, had left ventricular ejection fraction 35% or less, and used implantable defibrillator. In the mean follow-up of 37.8 months, significantly less patients died after catheter ablation (24 [13.4%] versus 46 [25.0%]), and less were hospitalized due to worsening heart failure (37 [20.7%] versus 66 [35.9%]). ATTEST is the first randomized controlled trial that has demonstrated slowing down of the progression of AF after catheter ablation. Radiofrequency ablation was performed in 128 patients, antiarrhythmic therapy was applied in 127 patients. Within 3 years, the incidence of persistent AF or atrial tachycardia was lower in patients treated with ablation compared with patients on antiarrhythmic therapy (2.4% vs. 17.5%; P = 0.0009). Conclusions. The expected benefit of catheter ablation of AF in comparison with drug therapy is as follows: increase in the probability of maintaining sinus rhythm, improvement of the quality of life, decrease in the number of hospitalizations and all-cause mortality in patients with heart failure, decrease in fatigue.


Author(s):  
Katja Leuteritz ◽  
Diana Richter ◽  
Anja Mehnert-Theuerkauf ◽  
Jens-Uwe Stolzenburg ◽  
Andreas Hinz

Abstract Purpose Quality of life (QoL) has been the subject of increasing interest in oncology. Most examinations of QoL have focused on health-related QoL, while other factors often remain unconsidered. Moreover, QoL questionnaires implicitly assume that the subjective importance of the various QoL domains is identical from one patient to the next. The aim of this study was to analyze QoL in a broader sense, considering the subjective importance of the QoL components. Methods A sample of 173 male urologic patients was surveyed twice: once while hospitalized (t1) and once again 3 months later (t2). Patients completed the Questions on Life Satisfaction questionnaire (FLZ-M), which includes satisfaction and importance ratings for eight dimensions of QoL. A control group was taken from the general population (n = 477). Results Health was the most important QoL dimension for both the patient and the general population groups. While satisfaction with health was low in the patient group, the satisfaction ratings of the other seven domains were higher in the patient group than in the general population. The satisfaction with the domain partnership/sexuality showed a significant decline from t1 to t2. Multiple regression analyses showed that the domains health and income contributed most strongly to the global QoL score at t2 in the patient group. Conclusion Health is not the only relevant category when assessing QoL in cancer patients; social relationships and finances are pertinent as well. Importance ratings contribute to a better understanding of the relevance of the QoL dimensions for the patients.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine Arnaud ◽  
Carine Duffaut ◽  
Jérôme Fauconnier ◽  
Silke Schmidt ◽  
Kate Himmelmann ◽  
...  

Abstract Background Effective inclusion in society for young people with disabilities is increasingly seen as generating opportunities for self-development, and improving well-being. However, significant barriers remain in the vast majority of activities meaningful for young adults. Research argues that various personal (disabilities, health) and environmental (access to the resources needed, accessible environment, discrimination, lack of personal economic independence) factors contribute to limited participation. However, previous studies conducted in young people with cerebral palsy (CP) mainly investigated the transition period to adulthood, and did not fully consider the whole range of impairment severity profiles or environmental barriers. In this study, we will use the follow-up of the SPARCLE cohort and a comparison group from the general population (1) to investigate the impact of the environment on participation and quality of life of young adults with CP, (2) to determine predictors of a successful young adulthood in educational, professional, health and social fields, (3) to compare quality of life and frequency of participation in social, work and recreational activities with the general population, (4) to document on participation and quality of life in those with severe disabilities. Methods The SPARCLE3 study has a combined longitudinal and cross-sectional design. Young adults with CP aged 22 to 27 years in 6 European regions previously enrolled in the SPARCLE cohort or newly recruited will be invited to self-complete a comprehensive set of questionnaires exploring participation (daily life and discretionary activities), health-related quality of life, body function, personal factors (health, personal resources), and contextual factors (availability of needed environmental items, family environment, services provision) during home visits supervised by trained researchers. Proxy-reports or adapted questionnaires will be used for those with the most severe impairments. The recruitment of a large group from the general population (online survey) will enable to identify life areas where the discrepancies between young people with CP and their able-bodied peers are the most significant. Discussion This study will help identify to what extent disabilities and barriers in environment negatively affect participation and quality of life, and how previous valued experiences during childhood or adolescence might modulate these effects.


2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
K Nakajima ◽  
T Kimura ◽  
T Fujisawa ◽  
Y Katsumata ◽  
T Nishiyama ◽  
...  

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