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Titolo:
Advances in cardiac electrophysiology and pacing
Autore:
Fei, L; Trohman, RG;
Indirizzi:
Rush Presbyterian St Lukes Med Ctr, Div Cardiovasc Dis & Crit Care Med, Chicago, IL 60612 USA Rush Presbyterian St Lukes Med Ctr Chicago IL USA 60612 ago, IL 60612 USA
Titolo Testata:
CRITICAL CARE CLINICS
fascicolo: 2, volume: 17, anno: 2001,
pagine: 337 -
SICI:
0749-0704(200104)17:2<337:AICEAP>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
RADIOFREQUENCY CATHETER ABLATION; CONGESTIVE-HEART-FAILURE; PAROXYSMAL ATRIAL-FIBRILLATION; SICK SINUS SYNDROME; QUALITY-OF-LIFE; INTRACARDIAC ECHOCARDIOGRAPHIC GUIDANCE; OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY; ELECTROANATOMICAL MAPPING SYSTEM; PRACTICE GUIDELINES COMMITTEE; CORONARY-ARTERY DISEASE;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
130
Recensione:
Indirizzi per estratti:
Indirizzo: Trohman, RG Rush Presbyterian St Lukes Med Ctr, Cardiol Sect, Electrophysiol Arrhythmia & Pacemaker Serv, Room 1091 Jelke,1653 W Congress Pkwy, Chicago, IL 60612USA Rush Presbyterian St Lukes Med Ctr Room 1091 Jelke,1653 W Congress Pkwy Chicago IL USA 60612
Citazione:
L. Fei e R.G. Trohman, "Advances in cardiac electrophysiology and pacing", CRIT CARE C, 17(2), 2001, pp. 337

Abstract

New technologies such as intracardiac echocardiography, nonfluoroscopic electroanatomic mapping, and noncontact endocardial activation mapping have contributed significantly to the advancements in interventional cardiac electrophysiology. Radiofrequency ablation is now consistently effective treatment for typical atrial flutter in addition to atrioventricular (AV) nodal and AV reentrant tachycardias. Although atrioventricular junctional ablationplus pacemaker implantation is reported to be superior to drug therapy in controlling symptoms caused by atrial fibrillation, some investigators havereported no significant improvement in cardiac performance or disease progression. These limitations have spurred efforts toward curative therapy. Catheter-based radiofrequency ablative approaches, designed to create linear lesions or aimed at focal sources, are exciting new approaches for drug-refractory atrial fibrillation patients. (17 44) (45, 68. 122) In experienced hands, radiofrequency catheter ablation is able to eliminate spontaneous episodes of ventricular tachycardia (VT) in up to two thirds of patients after myocardial infarction.(116) At present, catheter ablation of VT is largely adjunctive to amiodarone and the implantable cardioverter defibrillator (ICD). Advances also have been made in device therapy. Clinical trials have demonstrated that the ICD is more effective than antiarrhythmic drugs in primaryand secondary prevention of sudden cardiac death in several clinical settings. Modern ICDs provide sophisticated algorithms for tachyarrhythmia therapy and dual-chamber, rate-responsive pacing.(91) A low-energy (less than 6 J) atrial defibrillator (InControl METRIX Atrioverter, Redmond, WA) also has emerged. Initial studies indicate that the atrial defibrillator is able to recognize episodes of atrial fibrillation accurately and to restore sinusrhythm safely and effectively(126) There is increasing interest in multisite ventricular pacing in patients with congestive heart failure. Preliminary experience has shown that biventricular pacing significantly improves cardiac function and quality of life in patients with congestive heart failureand electrocardiographic (ECG) evidence of widened QRS duration. Noninvasive techniques such as assessment of heart rate variability(32). (33) and T wave alternans(22) have been documented to be useful tools for sudden cardiac death risk stratification. Abnormal heart rate variability(32)(33) and T wave alternans(38) have been shown to be strong independent predictors of arrhythmic death.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 21:31:51