Electrophysiological changes in heart failure and their implications for arrhythmogenesis

Coronel, Ruben; Wilders, Ronald; Verkerk, Arie O.; Wiegerinck, Rob F.; Benoist, David; Bernus, Olivier

doi:10.1016/j.bbadis.2013.04.002

Cited by 95 publications

(96 citation statements)

References 94 publications

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Section: Reviewmentioning

confidence: 99%

“…There are multiple mechanisms that contribute to the generation of these arrhythmias including scar formation, fibrosis, ion channel remodelling, alteration of calcium handling and alterations of cell:cell coupling [25]. These mechanisms are well described within the left ventricle however there is less information with regards to the secondary effects on the right ventricle due to the development of pulmonary hypertension [25]. In a study of explanted hearts from patients undergoing cardiac transplantation for left heart failure there was significant alterations in the action potential, ion channel expression, calcium handling proteins expression and cell:cell coupling within the right ventricle [26].…”

Section: Reviewmentioning

confidence: 99%

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Arrhythmias in pulmonary arterial hypertension

Temple¹

2017

J Congenit Heart Dis

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Pulmonary arterial hypertension is a condition associated with raised right heart pressures and subsequent remodelling of the right atrium and ventricle with relative preservation of left heart function. There is a high incidence of arrhythmias including atrial fibrillation, atrial flutter and atrioventricular nodal re-entrant tachycardia. Despite recent advances in medical therapy for pulmonary arterial hypertension arrhythmias continue to have a high morbidity and mortality. Treatment includes medical therapy, cardioversion and catheter ablation.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Arrhythmias in pulmonary arterial hypertension

Temple¹

2017

J Congenit Heart Dis

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“…Fibrosis, di lation, changes in ion currents, and other structural changes in the myocardium are proposed mechanisms of arrhythmias. 300 In patients with nonischemic cardio myopathy, female sex, lack of statin therapy, and el evated creatinine were independent risk factors for ma lignant ventricular arrhythmias. 301 Benza et al 302 reviewed the OPTIMECHF (Outcomes of a Prospective Trial of Intravenous Milrinone for Ex acerbations of Chronic Heart Failure) registry and con cluded that new arrhythmias during an exacerbation of heart failure were associated with both higher inpatient and 60day morbidity and mortality.…”

Section: Other Cardiac Conditionsmentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

201

214

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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“…HF, amongst others, is characterized by an action potential prolongation due to remodeling the repolarizing currents I to and I Ks (reviewed in Ref. 88). The reduction in I to is due to the reduction of K V 4.3 channels (202).…”

Section: B Strategies For Treatment Of Vfmentioning

confidence: 99%

Cardiac Potassium Channel Subtypes: New Roles in Repolarization and Arrhythmia

Schmitt

Grunnet

Olesen

2014

Physiological Reviews

196

197

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About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K+ channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K+ channels drive the late repolarization of the ventricle with some redundancy, and in atria this repolarization reserve is supplemented by the fairly atrial-specific KV1.5, Kir3, KCa, and K2P channels. The role of the latter two subtypes in atria is currently being clarified, and several findings indicate that they could constitute targets for new pharmacological treatment of atrial fibrillation. The interplay between the different K+ channel subtypes in both atria and ventricle is dynamic, and a significant up- and downregulation occurs in disease states such as atrial fibrillation or heart failure. The underlying posttranscriptional and posttranslational remodeling of the individual K+ channels changes their activity and significance relative to each other, and they must be viewed together to understand their role in keeping a stable heart rhythm, also under menacing conditions like attacks of reentry arrhythmia.

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Electrophysiological changes in heart failure and their implications for arrhythmogenesis

Cited by 95 publications

References 94 publications

Arrhythmias in pulmonary arterial hypertension

Arrhythmias in pulmonary arterial hypertension

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Cardiac Potassium Channel Subtypes: New Roles in Repolarization and Arrhythmia

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