2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary

Page, Richard L.; Joglar, José A.; Caldwell, Mary A.; Calkins, Hugh; Conti, Jamie B.; Deal, Barbara J.; Estes, N.A. Mark; Field, Michael E.; Goldberger, Zachary D.; Hammill, Stephen C.; Indik, Julia H.; Lindsay, Bruce D.; Olshansky, Brian; Russo, Andrea M.; Shen, Win‐Kuang; Tracy, Cynthia M.; Al‐Khatib, Sana M.

doi:10.1016/j.jacc.2015.09.019

Cited by 83 publications

(32 citation statements)

References 389 publications

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“…AF was diagnosed based on electrocardiogram characteristics including: absence of distinct repeating P waves, irregular RR intervals (when atrioventricular conduction is present), and irregular atrial activity. 3 In this study, we enrolled patients with AF for more than 7 days (chronic AF) instead of paroxysmal AF and new-onset AF. HF was confirmed by a cardiologist and the diagnosis was based on the patient's clinical symptoms/signs, echocardiogram, or cardiac nuclear medicine examination.…”

Section: Methodsmentioning

confidence: 99%

“…The irregular rhythm and chaotic atrial activity associated with AF can cause various potentially deleterious hemodynamic consequences that may exert a negative influence on the weaning process of mechanically ventilated patients. 3 , 14 In patients with exacerbated chronic respiratory failure, Marcelino et al 19 recently reported that patients presenting with AF on ICU admission require a significantly long length of MV. However, the influence of AF on ventilator outcomes, including successful weaning of ventilator, ventilator days, and ventilator dependence, in a medical ICU has not yet been investigated and remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Atrial Fibrillation on Intensive Care Unit Admission Independently Increases the Risk of Weaning Failure in Nonheart Failure Mechanically Ventilated Patients in a Medical Intensive Care Unit

Tseng

et al. 2016

Medicine

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Atrial fibrillation (AF) is one of the most frequent arrhythmias in clinical practice. Previous studies have reported the influence of AF on patients with heart failure (HF). The effect of AF on the non-HF critically ill patients in a medical intensive care unit (ICU) remains largely unclear. The study aimed to investigate the impact of AF presenting on ICU admission on the weaning outcome of non-HF mechanically ventilated patients in a medical ICU.A retrospective observational case–control study was conducted over a 1-year period in a medical ICU at Taipei Veterans General Hospital, a tertiary medical center in north Taiwan. Non-HF mechanically ventilated patients who were successful in their spontaneous breathing trial and underwent ventilator discontinuation were enrolled. The primary outcome measure was the ventilator status after the first episode of ventilator discontinuation.A total of 285 non-HF patients enrolled were divided into AF (n = 62) and non-AF (n = 223) groups. Compared with the non-AF patients, the AF patients were significantly associated with old age (P = 0.002), a higher rate of acute respiratory distress syndrome causing respiratory failure (P = 0.015), a higher percentage of sepsis before liberation from mechanical ventilation (MV) (P = 0.004), and a higher serum level of blood urea nitrogen on the day of liberation from MV (P = 0.003). Multivariate logistic regression analysis demonstrated that AF independently increased the risk of weaning failure [adjusted odds ratio (AOR), 3.268; 95% confidence interval (CI), 1.254–8.517; P = 0.015]. Furthermore, the AF patients were found to be independently associated with a high rate of ventilator dependence (log rank test, P = 0.026), prolonged total ventilator use (AOR, 1.979; 95% CI, 1.032–3.794; P = 0.040), increased length of ICU stay (AOR, 2.256; 95% CI, 1.049–4.849; P = 0.037), increased length of hospital stay (AOR, 2.921; 95% CI, 1.363–6.260; P = 0.006), and increased ICU mortality (AOR, 4.143; 95% CI, 1.381–12.424; P = 0.011).AF on ICU admission is an independent risk factor for weaning failure and significantly associated with poor hospital outcome in non-HF mechanically ventilated patients in a medical ICU.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Atrial Fibrillation on Intensive Care Unit Admission Independently Increases the Risk of Weaning Failure in Nonheart Failure Mechanically Ventilated Patients in a Medical Intensive Care Unit

Tseng

et al. 2016

Medicine

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“…To the best of our knowledge, this is the first study reporting the prevalence of Danon disease in patients with coexistent LVH and electrocardiographic preexcitation. Ventricular preexcitation is a common clinical finding, the majority of which arises from failure of the annulus fibrosus to fully insulate the atrial and ventricular chambers due to the presence of accessory pathways, and also termed Wolff-Parkinson-White (WPW) syndrome if associated with paroxysmal supraventricular tachycardia (Page et al, 2016). It is usually sporadic and of unknown etiology in most F I G U R E 2 Sanger sequencing validated three LAMP2 mutations.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical characteristics of Danon disease among patients with left ventricular hypertrophy and concomitant electrocardiographic preexcitation

Liu

Chen

Wang

et al. 2019

Molec Gen & Gen Med

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Background Cardiac involvement in Danon disease typically manifests as left ventricular hypertrophy (LVH) and ventricular preexcitation. This study aimed to identify patients with Danon disease among patients with LVH and concurrent electrocardiographic preexcitation. Methods Electrocardiographic preexcitation was identified in 10 of 197 patients with unexplained LVH in whom genetic testing was performed using next‐generation sequencing. Results Three (3/10, 30%) patients with Danon disease were found in association with different mutations in the gene of lysosome‐associated membrane protein 2 ( LAMP2 ). Compared to seven patients without Danon disease, these three patients presented with distinctive clinical phenotypes, including onset at an earlier age (20 ± 2 years vs. 53 ± 9 years, p < 0.001), more neurological involvements (100% vs. 0, p = 0.008), higher electrocardiographic voltages (10 ± 1 mV vs. 5 ± 1 mV, p < 0.001), wider QRS complexes (163 ± 5 ms vs. 115 ± 20 ms, p = 0.006), less common asymmetric hypertrophy (0% vs. 86%, p = 0.033), and more frequent elevation of three serum enzymes (creatine kinase, aspartate aminotransferase, and lactate dehydrogenase). Intracellular vacuoles accumulation with deficiencies of LAMP2 protein was found in both cardiac and skeletal myocytes of patients with Danon disease. Conclusion In patients with coexistent LVH and ventricular preexcitation, Danon disease is common with distinctive clinical presentations. Comprehensive assessment of these resemble patients can provide valuable findings for early identification and clinical decision making of patients with Danon disease.

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“…It is commonly held that the major complication rate in AP ablation is 2-3%, and that this number should be weighed against the benefits of ablation [3,5,16]. However, this view is mostly based on the results of early studies.…”

Section: Periprocedural Complicationsmentioning

confidence: 99%

“…Indications for this procedure are based not only on the tachyarrhythmia-related symptoms and the risk of serious consequences of untreated AP, but they also take into account the risks of the ablation procedure [3,4]. The issue of serious complications of AP ablation is probably the most common reason for the failure to perform this usually curative procedure in asymptomatic or mildly symptomatic patients with overt pre-excitation.…”

Section: Introductionmentioning

confidence: 99%

Contemporary outcomes of catheter ablation of accessory pathways: complications and learning curve

Jastrzębski¹,

Moskal

Pitak

et al. 2017

Kardiol Pol

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A b s t r a c t Background and aim:The aim of this study was to examine contemporary results of accessory pathway (AP) ablation in a sizeable number of patients, focusing on periprocedural complications and the learning curve. Methods:We performed a retrospective cohort study of consecutive AP ablation procedures at three centres by the same operator. In total 629 electrophysiological studies and 610 AP ablation procedures were performed in 570 patients (age: 33 ± 18.9 years).Results: There was one (0.16%) serious and there were 14 (2.3%) minor periprocedural complications. Five hundred and ninety APs were successfully ablated: single/multiple procedure success was 93.4%/96.7%, while the average fluoroscopy time was 13.5 min. There was significantly higher success and less fluoroscopy use with increased experience, while periprocedural complications seemed evenly distributed over the years. The learning was most pronounced for the first 120 cases. However, the learning curve fully flattened only after approximately 400 ablations. Conclusions:This study suggests that in the modern era AP ablation is safer than it was in the first two decades after the introduction of catheter ablation of APs. Perhaps, in experienced centres there should be a lower threshold for referring asymptomatic/mildly symptomatic patients with pre-excitation for electrophysiological study.

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2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary

Cited by 83 publications

References 389 publications

Atrial Fibrillation on Intensive Care Unit Admission Independently Increases the Risk of Weaning Failure in Nonheart Failure Mechanically Ventilated Patients in a Medical Intensive Care Unit

Atrial Fibrillation on Intensive Care Unit Admission Independently Increases the Risk of Weaning Failure in Nonheart Failure Mechanically Ventilated Patients in a Medical Intensive Care Unit

Prevalence and clinical characteristics of Danon disease among patients with left ventricular hypertrophy and concomitant electrocardiographic preexcitation

Contemporary outcomes of catheter ablation of accessory pathways: complications and learning curve

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