Conduction system disease in cardiac amyloidosis

Assaf, Ala; Mekhael, Mario; Noujaim, Charbel; Chouman, Nour; Younes, Hadi; Kreidieh, Omar; Marrouche, Nassir F.; Donnellan, Eoin

doi:10.1016/j.tcm.2023.02.004

Cited by 6 publications

(6 citation statements)

References 37 publications

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“…ECG changes in CA reflect the multifaceted nature of this disease process [17], including myocardial infiltration, fibrosis, and conduction system dysfunction [18]. Arrhythmias and severe conduction abnormalities are prevalent in patients with CA, present in up to 40% of cases [19], with atrial fibrillation (AF) being the most frequent arrhythmia [20].…”

Section: Ai Applications To Electrocardiogram (Ecg) In Cardiac Amyloi...mentioning

confidence: 99%

How Artificial Intelligence Can Enhance the Diagnosis of Cardiac Amyloidosis: A Review of Recent Advances and Challenges

Kamel,

Abbas,

Kanaan

et al. 2024

JCDD

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Cardiac amyloidosis (CA) is an underdiagnosed form of infiltrative cardiomyopathy caused by abnormal amyloid fibrils deposited extracellularly in the myocardium and cardiac structures. There can be high variability in its clinical manifestations, and diagnosing CA requires expertise and often thorough evaluation; as such, the diagnosis of CA can be challenging and is often delayed. The application of artificial intelligence (AI) to different diagnostic modalities is rapidly expanding and transforming cardiovascular medicine. Advanced AI methods such as deep-learning convolutional neural networks (CNNs) may enhance the diagnostic process for CA by identifying patients at higher risk and potentially expediting the diagnosis of CA. In this review, we summarize the current state of AI applications to different diagnostic modalities used for the evaluation of CA, including their diagnostic and prognostic potential, and current challenges and limitations.

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Section: Ai Applications To Electrocardiogram (Ecg) In Cardiac Amyloi...mentioning

confidence: 99%

How Artificial Intelligence Can Enhance the Diagnosis of Cardiac Amyloidosis: A Review of Recent Advances and Challenges

Kamel,

Abbas,

Kanaan

et al. 2024

JCDD

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“…The prevalence of atrial arrhythmias in cardiac amyloidosis surpasses that of the general population [ 14 ]. Notably, wtATTR-CM carries the highest risk of comorbid AF, with prevalence estimates reaching up to 44% [ 15 ].…”

Section: Atrial Arrhythmias In Cardiac Amyloidosismentioning

confidence: 99%

Management of Arrhythmias and Conduction Disorders in Amyloid Cardiomyopathy

Holcman,

Ząbek,

Boczar

et al. 2024

JCM

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Cardiac amyloidosis, a condition characterized by abnormal protein deposition in the heart, leads to restrictive cardiomyopathy and is notably associated with an increased risk of arrhythmias and conduction disorders. This article reviews the current understanding and management strategies for these cardiac complications, with a focus on recent advancements and clinical challenges. The prevalence and impact of atrial arrhythmias, particularly atrial fibrillation, are examined, along with considerations for stroke risk and anticoagulation therapy. The article also addresses the complexities of managing rate and rhythm control, outlining the utility and limitations of pharmacological agents and interventions such as catheter ablation. Furthermore, it reviews the challenges in the treatment of ventricular arrhythmias, including the contentious use of implantable cardioverter-defibrillators for primary and secondary prevention. Individualized approaches, considering the unique characteristics of cardiac amyloidosis, are paramount. Continuous research and clinical exploration are essential to refine treatment strategies and improve outcomes in this challenging patient population.

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“…Due to the high amyloid protein deposition, the left atrium (LA) presents significant structural and electrical remodeling, leading to chronic elevation of LA pressures, dilation, and dysfunction [ 7 , 14 ]. As a result, the prevalence of AF is higher in amyloidosis with increased mortality rates and length of stay [ 7 , 14 ]. Moreover, due to AF, thromboembolic events are also frequent in these patients [ 7 , 14 ].…”

Section: Types Of Arrhythmiasmentioning

confidence: 99%

“…As a result, the prevalence of AF is higher in amyloidosis with increased mortality rates and length of stay [ 7 , 14 ]. Moreover, due to AF, thromboembolic events are also frequent in these patients [ 7 , 14 ]. AL amyloidosis as a single unity may increase thrombogenicity and thromboembolism without the presence of AF [ 7 , 14 ].…”

Section: Types Of Arrhythmiasmentioning

confidence: 99%

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Arrhythmias in Patients with Cardiac Amyloidosis: A Comprehensive Review on Clinical Management and Devices

Briasoulis

Kourek

Papamichail

et al. 2023

JCDD

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Cardiac amyloidosis (CA) is a rare but potentially life-threatening disease in which misfolded proteins accumulate in the cardiac wall tissue. Heart rhythm disorders in CA, including supraventricular arrhythmias, conduction system disturbances, or ventricular arrhythmias, play a major role in CA morbidity and mortality, and thus require supplementary management. Among them, AF is the most frequent arrhythmia during CA hospitalizations and is associated with significantly higher mortality, while ventricular arrhythmias are also common and are usually associated with poor prognosis. Early diagnosis of potential arrythmias could be performed through ECG, Holter monitoring, and/or electrophysiology study. Clinical management of these patients is quite significant, and it usually includes initiation of amiodarone and/or digoxin in patients with AF, potential electrical cardioversion, or ablation in specific patients with indication, as well as initiation of anticoagulants in all patients, independent of AF and CHADS-VASc score, for potential intracardiac thrombus. Moreover, identification of patients with conduction disorders that could benefit from prophylactic pacemaker implantation and/or CRT as well as identification of patients with life-threatening ventricular arrythmias that could benefit from ICD could both increase the survival rates of these patients and improve their quality of life.

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Conduction system disease in cardiac amyloidosis

Cited by 6 publications

References 37 publications

How Artificial Intelligence Can Enhance the Diagnosis of Cardiac Amyloidosis: A Review of Recent Advances and Challenges

How Artificial Intelligence Can Enhance the Diagnosis of Cardiac Amyloidosis: A Review of Recent Advances and Challenges

Management of Arrhythmias and Conduction Disorders in Amyloid Cardiomyopathy

Arrhythmias in Patients with Cardiac Amyloidosis: A Comprehensive Review on Clinical Management and Devices

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