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Is the Adenosine Test Obsolete in the Clinical Assessment of Syncope of Unknown Origin? 在不明原因晕厥的临床评估中，腺苷试验过时了吗?
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2021-12-01 DOI: 10.15420/aer.2021.39
Melani Sotiriadou, Antonios P Antoniadis, Nikolaos Fragakis, Vassilios Vassilikos
{"title":"Is the Adenosine Test Obsolete in the Clinical Assessment of Syncope of Unknown Origin?","authors":"Melani Sotiriadou,&nbsp;Antonios P Antoniadis,&nbsp;Nikolaos Fragakis,&nbsp;Vassilios Vassilikos","doi":"10.15420/aer.2021.39","DOIUrl":"https://doi.org/10.15420/aer.2021.39","url":null,"abstract":"<p><p>Syncope is a common clinical condition affecting 50% of the general population; however, its exact pathophysiology and underlying mechanisms remain elusive. The adenosine test (ADT) has been proposed as a complementary diagnostic test in the work-up of syncope of unknown origin aiming to further elucidate the underlying pathogenetic mechanism of spontaneous syncope. Although ADT has not been endorsed by the recent European Society of Cardiology guidelines on syncope management, the use of a quick, safe and non-invasive test which can contribute to an accurate diagnosis and rationalised therapy, may deserve further consideration. This review summarises the evidence on the role of ADT in the investigation and management of syncope of unknown origin and highlights future perspectives in this area. The authors also analyse the current challenges and research targets on adenosine plasma levels and its receptors due to the involvement of the adenosine pathway in the ADT response.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":" ","pages":"230-234"},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/62/aer-10-230.PMC8785082.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39879146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Inferior Extensions of the Atrioventricular Node. 房室结的下延伸。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2021-12-01 DOI: 10.15420/aer.2021.43
Robert H Anderson, Jill Pjm Hikspoors, Justin T Tretter, Yolanda Macías, Diane E Spicer, Wouter H Lamers, Damián Sánchez-Quintana, Eduardo Back Sternick
{"title":"Inferior Extensions of the Atrioventricular Node.","authors":"Robert H Anderson,&nbsp;Jill Pjm Hikspoors,&nbsp;Justin T Tretter,&nbsp;Yolanda Macías,&nbsp;Diane E Spicer,&nbsp;Wouter H Lamers,&nbsp;Damián Sánchez-Quintana,&nbsp;Eduardo Back Sternick","doi":"10.15420/aer.2021.43","DOIUrl":"https://doi.org/10.15420/aer.2021.43","url":null,"abstract":"<p><p>The pathways for excitation of the atrioventricular node enter either superiorly, as the so-called 'fast' pathway, or inferiorly as the 'slow' pathway. However, knowledge of the specific anatomical details of these pathways is limited. Most of the experimental studies that established the existence of these pathways were conducted in mammalian hearts, which have subtle differences to human hearts. In this review, the authors summarise their recent experiences investigating human cardiac development, correlating these results with the arrangement of the connections between the atrial myocardium and the compact atrioventricular node as revealed by serial sectioning of adult human hearts. They discuss the contributions made from the atrioventricular canal myocardium, as opposed to the primary ring. Both these rings are incorporated into the atrial vestibules, albeit with the primary ring contributing only to the tricuspid vestibule. The atrial septal cardiomyocytes are relatively late contributors to the nodal inputs. Finally, they relate our findings of human cardiac development to the postnatal arrangement.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":" ","pages":"262-272"},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/54/aer-10-262.PMC8785076.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39879579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Cardiac Pacing in Cardioinhibitory Reflex Syncope: Clinical Use of Closed-loop Stimulation. 心脏抑制性反射性晕厥的心脏起搏:闭环刺激的临床应用。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2021-12-01 DOI: 10.15420/aer.2021.45
Marco Tomaino, Vincenzo Russo, Daniele Giacopelli, Alessio Gargaro, Michele Brignole
{"title":"Cardiac Pacing in Cardioinhibitory Reflex Syncope: Clinical Use of Closed-loop Stimulation.","authors":"Marco Tomaino,&nbsp;Vincenzo Russo,&nbsp;Daniele Giacopelli,&nbsp;Alessio Gargaro,&nbsp;Michele Brignole","doi":"10.15420/aer.2021.45","DOIUrl":"https://doi.org/10.15420/aer.2021.45","url":null,"abstract":"Cardiac pacing has been studied extensively in patients with reflex syncope over the past two decades. The heterogeneity of the forms and clinical manifestations of reflex syncope explain the controversial results of older randomised clinical trials. New evidence from recent trials has changed medical practice, now leading to clear indications for pacing in patients with asystolic syncope documented during carotid sinus massage, implantable cardiac monitoring or tilt testing. Given that recent trials in reflex syncope have been performed using the closed-loop stimulation algorithm, the authors will briefly discuss this pacing mode, review hypotheses about the mechanisms underlying its activation during syncope and provide practical instructions for programming and troubleshooting.","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":" ","pages":"244-249"},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/5d/aer-10-244.PMC8785081.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39879577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Obesity and Atrial Fibrillation: Epidemiology, Pathogenesis and Effect of Weight Loss. 肥胖与房颤:流行病学、发病机制和减肥效果。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2021-10-01 DOI: 10.15420/aer.2021.36
Ahmed M Al-Kaisey, Jonathan M Kalman
{"title":"Obesity and Atrial Fibrillation: Epidemiology, Pathogenesis and Effect of Weight Loss.","authors":"Ahmed M Al-Kaisey,&nbsp;Jonathan M Kalman","doi":"10.15420/aer.2021.36","DOIUrl":"https://doi.org/10.15420/aer.2021.36","url":null,"abstract":"<p><p>The obesity epidemic continues its relentless advance and is paralleled by an increase in the incidence of AF. Several epidemiological studies have highlighted obesity as an independent risk factor for the development of AF. This relationship is likely multifactorial through a number of interacting mechanisms. Weight loss through lifestyle changes or surgery has been associated with reverse remodelling of the atrial substrate and subsequent reduction in AF, making it an essential pillar in the management of AF in obese patients. In this review, the epidemiological data that support the obesity-AF relationship, the current insights into the underlying pathophysiological mechanism, the impact of weight loss on reverse remodelling and AF reduction, and the strategies to achieve weight loss in patients with AF are discussed.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"10 3","pages":"159-164"},"PeriodicalIF":3.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/24/aer-10-159.PMC8576485.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39876852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Simple is Complicated. 简单就是复杂
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2021-10-01 DOI: 10.15420/aer.2021.40
Demosthenes G Katritsis
{"title":"Simple is Complicated.","authors":"Demosthenes G Katritsis","doi":"10.15420/aer.2021.40","DOIUrl":"10.15420/aer.2021.40","url":null,"abstract":"","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"10 3","pages":"131"},"PeriodicalIF":3.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/13/aer-10-131.PMC8576484.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39876847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Use of Electrocardiographic Imaging in Localising the Origin of Arrhythmias During Catheter Ablation of Ventricular Tachycardia. 心电成像在室性心动过速导管消融过程中心律失常根源定位中的应用。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2021-10-01 DOI: 10.15420/aer.2021.27
Adam J Graham, Richard J Schilling
{"title":"The Use of Electrocardiographic Imaging in Localising the Origin of Arrhythmias During Catheter Ablation of Ventricular Tachycardia.","authors":"Adam J Graham,&nbsp;Richard J Schilling","doi":"10.15420/aer.2021.27","DOIUrl":"https://doi.org/10.15420/aer.2021.27","url":null,"abstract":"<p><p>Non-invasive electrocardiographic imaging (ECGI) is a novel clinical tool for mapping ventricular arrhythmia. Using multiple body surface electrodes to collect unipolar electrograms and conventional medical imaging of the heart, an epicardial shell can be created to display calculated electrograms. This calculation is achieved by solving the inverse problem and allows activation times to be calculated from a single beat. The technology was initially pioneered in the US using an experimental torso-shaped tank. Accuracy from studies in humans has varied. Early data was promising, with more recent work suggesting only moderate accuracy when reproducing cardiac activation. Despite these limitations, the system has been successfully used in pioneering work with non-invasive cardiac radioablation to treat ventricular arrhythmia. This suggests that the resolution may be sufficient for treatment of large target areas. Although untested in a well conducted clinical study it is likely that it would not be accurate enough to guide more discreet radiofrequency ablation.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"10 3","pages":"211-217"},"PeriodicalIF":3.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/6e/aer-10-211.PMC8576495.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39891187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep Apnoea and AF: Where Do We Stand? Practical Advice for Clinicians. 睡眠呼吸暂停和心房颤动:我们在哪里?给临床医生的实用建议
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2021-10-01 DOI: 10.15420/aer.2021.05
Suneet Mittal, David Golombeck, Jacqueline Pimienta
{"title":"Sleep Apnoea and AF: Where Do We Stand? Practical Advice for Clinicians.","authors":"Suneet Mittal,&nbsp;David Golombeck,&nbsp;Jacqueline Pimienta","doi":"10.15420/aer.2021.05","DOIUrl":"https://doi.org/10.15420/aer.2021.05","url":null,"abstract":"<p><p>AF is the most common sustained arrhythmia encountered in clinical practice. Among the largest contributing factors to the rapid increase in the incidence of AF are aging and obesity within the global population. Obstructive sleep apnoea (OSA) is a risk factor for AF that is clearly linked to obesity. Guidelines have advocated interrogation for clinical signs of OSA in all AF patients. The aim of this article is to provide practical advice for clinicians seeking to manage patients with AF and OSA. The authors discuss questionnaires to screen for OSA, various types of tests available for the diagnosis of OSA and data to assess the impact of treatment of OSA after various treatment options in AF patients. Finally, they outline the many areas that warrant further investigation in this patient population.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"10 3","pages":"140-146"},"PeriodicalIF":3.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/ec/aer-10-140.PMC8576511.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39876849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Hybrid Convergent Procedure for the Treatment of Persistent and Long-standing Persistent Atrial Fibrillation. 治疗持续性和长期持续性心房颤动的混合聚合程序。
IF 2.6
Arrhythmia & Electrophysiology Review Pub Date : 2021-10-01 DOI: 10.15420/aer.2021.24
David B DeLurgio, Jaswinder S Gill, Syed Ahsan, Riyaz A Kaba, Kristen M Plasseraud, Michael E Halkos
{"title":"Hybrid Convergent Procedure for the Treatment of Persistent and Long-standing Persistent Atrial Fibrillation.","authors":"David B DeLurgio, Jaswinder S Gill, Syed Ahsan, Riyaz A Kaba, Kristen M Plasseraud, Michael E Halkos","doi":"10.15420/aer.2021.24","DOIUrl":"10.15420/aer.2021.24","url":null,"abstract":"<p><p>Recent advances have been made in AF treatment, including the role of early rhythm control and landmark clinical trials using ablation therapy. However, some treatment gaps remain, including the creation of durable lesions outside the pulmonary veins and effective treatment of longstanding persistent AF. A novel epicardial-endocardial ablation approach - the hybrid convergent procedure - was developed to combine surgical and catheter ablation techniques into a collaborative, multidisciplinary approach to managing AF. In this review, the authors discuss recently published data on hybrid convergent ablation, including results of the CONVERGE clinical trial, in the context of current challenges to treatment of persistent and long-standing persistent AF. The review also aims to provide perspective on outstanding questions and future directions in this area.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"10 3","pages":"198-204"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/16/aer-10-198.PMC8576514.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39891185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Catheter Ablation on Stroke, Cognitive Decline and Dementia. 导管消融对脑卒中、认知能力下降和痴呆的影响。
IF 3
Arrhythmia & Electrophysiology Review Pub Date : 2021-10-01 DOI: 10.15420/aer.2021.42
Tyson S Burnham, Monte L Scott, Benjamin A Steinberg, Daniel L Varela, Brian Zenger, T Jared Bunch
{"title":"Impact of Catheter Ablation on Stroke, Cognitive Decline and Dementia.","authors":"Tyson S Burnham,&nbsp;Monte L Scott,&nbsp;Benjamin A Steinberg,&nbsp;Daniel L Varela,&nbsp;Brian Zenger,&nbsp;T Jared Bunch","doi":"10.15420/aer.2021.42","DOIUrl":"https://doi.org/10.15420/aer.2021.42","url":null,"abstract":"<p><p>AF has been consistently associated with multiple forms of dementia, including idiopathic dementia. Outcomes after catheter ablation for AF are favourable and patients experience a better quality of life, arrhythmia-free survival, and lower rates of hospitalisation compared to patients treated with antiarrhythmic drugs. Catheter ablation is consistently associated with lower rates of stroke compared to AF management without ablation in large national and healthcare system databases. Multiple observational trials have shown that catheter ablation is also associated with a lower risk of cognitive decline, dementia and improved cognitive testing that can be explained through a variety of pathways. Long-term, adequately powered, randomised trials are required to define the role of catheter ablation in the management of AF as a means to lower the risk of cognitive decline, stroke and dementia.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"10 3","pages":"205-210"},"PeriodicalIF":3.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/da/aer-10-205.PMC8576494.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39891186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The DAPA Trial in the Context of Previous Prophylactic ICD Landmark Trials. 从先前的预防性 ICD 标志性试验看 DAPA 试验。
IF 2.6
Arrhythmia & Electrophysiology Review Pub Date : 2021-10-01 DOI: 10.15420/aer.2021.23
Danielle Haanschoten, Arif Elvan
{"title":"The DAPA Trial in the Context of Previous Prophylactic ICD Landmark Trials.","authors":"Danielle Haanschoten, Arif Elvan","doi":"10.15420/aer.2021.23","DOIUrl":"10.15420/aer.2021.23","url":null,"abstract":"<p><p>In patients with ischaemic cardiomyopathy and severely reduced left ventricular ejection fraction (LVEF), an arrhythmogenic milieu is created by a complex interplay between myocardial scarring (assessed by cardiac MRI) and multiple other factors (ventricular ectopy, ischaemia and autonomic imbalance), favouring the occurrence of arrhythmic sudden cardiac death (SCD). Currently, a dynamic and robust model of dichotomised SCD risk assessment after primary percutaneous coronary intervention (PCI) is lacking, underlining the urgent need for further refinement of the widely accepted and guidelines-based criteria (ischaemic cardiomyopathy, LVEF ≤35%) for primary prevention. This review addresses the potential additional value of the recently published Defibrillator After Primary Angioplasty (DAPA) trial results. The DAPA trial conveys important messages and provides novel perspectives regarding left ventricular function post-primary PCI as an (early) risk marker for SCD and the impact of prophylactic ICD implantation on survival in this cohort. In the context of other previous primary prevention trials, DAPA was the first trial including only ST-elevation MI patients all treated with acute PCI.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"10 3","pages":"154-158"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/c6/aer-10-154.PMC8576491.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39876851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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