Differential effects of ganglionic plexi ablation in a patient with neurally mediated syncope and intermittent atrioventricular block: a commentary

M, José Carlos Pachon; M, Enrique I. Pachon

doi:10.1093/europace/euw133

Cited by 9 publications

(15 citation statements)

References 12 publications

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“…Given small and closely spaced electrodes, these multi‐electrode catheters, such as the Livewire duodecapolar catheter (St. Jude Medical, Saint Paul, MN), Orion mapping catheter (Boston Scientific, Marlborough, MA), and Pentaray mapping catheter (Biosense Webster, Diamond Bar, CA), not only increase the speed and point acquisition of electroanatomic mapping, but also improve the resolution of the scar and provide better discrimination of late potentials (Figure 4). 65, 66, 67 Ablation guided through high‐density multi‐electrode mapping can also result in a shorter radiofrequency ablation time 66, 67, 68…”

Section: Management Of Vt In Nicmmentioning

confidence: 99%

Ventricular arrhythmias in nonischemic cardiomyopathy

Chung

Lin

et al. 2018

Journal of Arrhythmia

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Nonischemic cardiomyopathies (NICMs) are composed of variable disease entities, including primary and secondary cardiomyopathies. Determining the etiology of NICM provides pivotal roles of not only the understanding of the individual pathogenesis, but also the clinical management, such as risk stratification, pharmacological treatment, and intervention therapies. Despite the diverse causes of NICM, these cases mostly require clinical attention owing to progressive myocardial injury, resulting in ventricular dysfunction and heart failure. The interaction between the diseased ventricular substrates and systemic/neurophysiological factors contributes to the cornerstones responsible for ventricular arrhythmogenesis and sudden cardiac death (SCD). Prevention of SCD and diminishing ventricular tachyarrhythmias are the important mainstays for the management of NICM patients. Given the understanding of the abnormal ventricular substrates and advancement of navigation systems, radiofrequency catheter ablation (RFCA) has become an adjunctive or alternative strategy for NICM patients who experience drug‐refractory ventricular tachycardias (VTs). Successful ablation can frequently be achieved at the expense of an epicardial intervention. A recent study has proven the survival benefits for NICM patients who are free from recurrent VTs after a successful RFCA, regardless of the New York Heart Association (NYHA) functional class status or left ventricular ejection fraction. Additionally, recent evidence has highlighted the better delineation of a diseased myocardium through the incorporation of cardiovascular magnetic resonance imaging (CMRI) and 3D mapping systems, which can facilitate the identification of critical ventricular arrhythmogenic substrates in NICM patients.

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Section: Management Of Vt In Nicmmentioning

confidence: 99%

Ventricular arrhythmias in nonischemic cardiomyopathy

Chung

Lin

et al. 2018

Journal of Arrhythmia

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“…Population aging is associated with a progressive accumulation of cardiovascular risk factors, an increased prevalence of degenerative and involutional disorders, and alterations in the way the central nervous system, and consequently the entire body, is functioning. 1 Atrial fibrillation (AF) and frailty syndrome (FS) are a part of this process, 2 though these disorders by no means exhaust the long list of comorbidities. 3 All these factors affect patients’ quality of life (QoL), but FS significantly modifies the diagnosis and treatment of other diseases, and AF is a perfect example of that.…”

Section: Introductionmentioning

confidence: 99%

<p>Quality of Life and Frailty Syndrome in Patients with Atrial Fibrillation</p>

Sławuta¹,

Polański²,

Mazur³

et al. 2020

CIA

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Introduction: Atrial fibrillation (AF) and frailty syndrome (FS) are a part of the aging process. Both are still of great importance in the assessment of quality of life (QoL). There is definitely a lack of research clarifying the association between FS and QoL in AF patients. Objective: The aim of this study was to evaluate the influence of FS on QoL in AF patients. Materials and Methods: The retrospective and observational study included 158 inpatients with mean age 69.8±7.1 years, treated for AF in the cardiac department from 1 April 2019 to 31 June 2019. The following instruments were used: the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) and the Edmonton Frail Scale (EFS). Results: The mean level of frailty in the study group was 8.5±5.0. In 25.9% of patients, the level of frailty was mild, in 10.1% moderate, and in 17.1% severe. Patients were divided into two groups based on their frailty status. In comparative analysis of the QoL, there were significant differences between the groups: the frail group had more intense symptoms of arrhythmia than the non-frail group (14.9±4.1 vs 11.9±4.9; p<0.001). In the analysis of the total score impact of arrhythmia on QoL, the frail group had a significantly higher score than the non-frail group (23.5±5.2 vs 14.5±5.5), which confirmed the stronger negative impact of arrhythmia on QoL. In the regression coefficient analysis, the independent predictor of symptom severity and QoL was FS. However, we observed a negative impact of diabetes, which increased the impact of arrhythmia on QoL, and physical activity, which improved QoL and decreased the impact of symptoms on everyday life. Conclusion: Patients in the frail group have worse QoL and higher impact of arrhythmia on QoL in comparison to patients in the non-frail group. Frailty is an independent predictor of higher intensity of symptoms of arrhythmia and worse QoL. Diabetes and physical activity are predictors of QoL for patients with AF.

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“…Initial descriptions pointed to very aggressive clinical manifestations in SQTS patients, with up to 60% experiencing syncope and 31% SCD in follow-up, frequently at young age [ 62 , 63 ]. More recent publications highlight a great variability of phenotypes, with more than half patients remaining asymptomatic despite showing continuous short QTc on the ECG [ 64 ]. Other arrhythmias, such as atrial fibrillation, are common in SQTS patients [ 65 ].…”

Section: Short Qt Syndromementioning

confidence: 99%

Ion Channel Disorders and Sudden Cardiac Death

García-Elías

Benito

2018

IJMS

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Long QT syndrome, short QT syndrome, Brugada syndrome and catecholaminergic polymorphic ventricular tachycardia are inherited primary electrical disorders that predispose to sudden cardiac death in the absence of structural heart disease. Also known as cardiac channelopathies, primary electrical disorders respond to mutations in genes encoding cardiac ion channels and/or their regulatory proteins, which result in modifications in the cardiac action potential or in the intracellular calcium handling that lead to electrical instability and life-threatening ventricular arrhythmias. These disorders may have low penetrance and expressivity, making clinical diagnosis often challenging. However, because sudden cardiac death might be the first presenting symptom of the disease, early diagnosis becomes essential. Genetic testing might be helpful in this regard, providing a definite diagnosis in some patients. Yet important limitations still exist, with a significant proportion of patients remaining with no causative mutation identifiable after genetic testing. This review aims to provide the latest knowledge on the genetic basis of cardiac channelopathies and discuss the role of the affected proteins in the pathophysiology of each one of these diseases.

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Differential effects of ganglionic plexi ablation in a patient with neurally mediated syncope and intermittent atrioventricular block: a commentary

Cited by 9 publications

References 12 publications

Ventricular arrhythmias in nonischemic cardiomyopathy

Ventricular arrhythmias in nonischemic cardiomyopathy

<p>Quality of Life and Frailty Syndrome in Patients with Atrial Fibrillation</p>

Ion Channel Disorders and Sudden Cardiac Death

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