DRS ed Aritmie Cardiache Iper ed Ipocinetiche: la clinica
|
|
- April Stafford
- 6 years ago
- Views:
Transcription
1 Corso Multidisciplinare di Aggiornamento La Sindrome delle Apnee Notturne: una sfida diagnostico terapeutica DRS ed Aritmie Cardiache Iper ed Ipocinetiche: la clinica FRANCESCO PERNA, MD, PhD Laboratorio di Elettrofisiologia Cardiaca Policlinico Gemelli, Università Cattolica del Sacro Cuore, Roma Roma, 15 Novembre 2012
2 Conflitti di interesse Nessuno
3 SDB and arrhythmias Epidemiology Important pathophysiological and epidemiological relationships have been identified between OSA and clinically significant arrhythmias, including bradyarrhythmias, SVA/atrial fibrillation (AF) and sudden cardiac death (SCD). The Sleep Heart Health Study Mehra R et al. Am J Respir Crit Care Med 2006;173:910 6
4 SDB and arrhythmias Epidemiology Sleep Heart Health Study (SHHS): Risk of AF x4 Risk of NSVT x3 Risk of complex PVCs x2 Odds of an arrhythmic event after a hypopneic or apneic episode x18 than after normal breathing 1. Mehra R et al. Am J Respir Crit Care Med 2006;173: Monahan K et al, J Am Coll Cardiol. 2009;54:
5 SDB and arrhythmias Pathophysiology Chan KH and Wilcox I, Expert Rev Cardiovasc Ther 2010;8(7):
6 Intrathoracic pressure change due to airway obstruction Atrial enlargement Ventricular remodeling Ventricular stiffness - 65 mmhg - 65 mmhg Right heart overload
7 SDB and arrhythmias Pathophysiology Acute changes Chronic changes Hypoxemia Sympathetic surge Parasympathetic surge Myocardial ischemia Intrathoracic pressure fluctuations with cardiac wall stress Increased afterload Oxidative stress, endot. dysf Chronically increased sympathetic activity Hypertension Atrial & ventricular remodeling Systemic inflammation Hypercoagulability LV syst & diast dysfunction
8 SDB and bradyarrhythmias Diving reflex Apnea-induced hypoxemia causes: Peripheral resistance (Symp) Heart rate (PS) Ludka O, Tex Heart Inst J 2011;38(4):
9 SDB and bradyarrhythmias OSA >> healthy subjects (5-50 %) Most patients: sinus bradycardia About 10%: asystole or AV block More likely with SpO2 drop 4% EP parameters: normal while awake CPAP may reverse the bradyarrhythmias
10 SDB and bradyarrhythmias OSA >> healthy subjects (5-50 %) Most patients: sinus bradycardia About 10%: asystole or AV block More likely with SpO2 drop 4% NO SAS SAS EP parameters: normal while awake CPAP may reverse the bradyarrhythmias 98 patients with pacemaker screened for SA w ESS & PSG 57 pts (59%) has SA 50% of HF pts 68% of AVB pts 58% of SND 21% had severe SA SAS should be systematically searched in these pts Whether treating SAS would have changed the need for pacing is unknown Garrigue S et al, Circ 2007;115:
11 Positive effect of CPAP on bradyarrhythmias in SDB patients N bradycardias N pauses on CPAP on CPAP % of pts with pauses and brady on CPAP Simantirakis EN, Eur Heart J 2004;25:
12 Atrial Overdrive Pacing (AOP) in the treatment of SDB This meta-analysis based on 10 randomized controlled trials indicates that AOP probably does reduce the AHI, but only by 4.65 episodes/h. This treatment effect is very modest, and is much smaller than that seen with CPAP. Baranchuk A et al, Europace (2009) 11,
13 Atrial Overdrive Pacing (AOP) in the treatment of SDB we have found no clinical benefit from pacing in SA with the purpose of improving a breathing disorder AOP should not be considered an alternative to CPAP in the treatment of patients with SA This meta-analysis based on 10 randomized controlled trials indicates that AOP probably does reduce the AHI, but only by 4.65 episodes/h. This treatment effect is very modest, and is much smaller than that seen with CPAP. Baranchuk A et al, Europace (2009) 11,
14 SDB and bradyarrhythmias Most subjects with bradyarrhythmias should be investigated for OSA (Polysomnography) The first line of treatment for bradyarrhythmias in the setting of OSA is treatment of the OSA (CPAP)
15 SDB and atrial fibrillation 1983: relationship between OSA and AF - observational study of 400 adults 1998: confirmed by 2 controlled studies More recently, prospective studies confirmed independent association Exact pathophysiological link not known SA can predict: - Lifetime risk of developing AF - Postoperative AF (CABG): x2 - AF recurrence after electrical CV - AF recurrence after cath ablation Kanagala Gami AS et al, Circulation J Am Coll Cardiol 2003;107: ;49:565.
16 SDB and atrial fibrillation 1983: relationship between OSA and AF - observational study of 400 adults 1998: confirmed by 2 controlled studies More recently, prospective studies confirmed independent association Exact pathophysiological link not known SA can predict: - Lifetime risk of developing AF - Postoperative AF (CABG): x2 - AF recurrence after electrical CV - AF recurrence after cath ablation Control: 53% No CPAP: 82% CPAP: 42% Kanagala Gami AS et al, Circulation J Am Coll Cardiol 2003;107: ;49:565.
17 SDB and atrial fibrillation Response to antiarrhythmic drugs in AF patients with SDB Monahan K et al, Am J Cardiol 2012;110(3): Chronically heightened sympathetic activity, even during the waking period, might also hinder pharmacologic rate-control strategies (Somers VK, J Clin Invest 1995;96(4): )
18 OSA as a predictor of AF recurrence after catheter ablation Patel D et al, Circ Arrhythm Electrophysiol. 2010;3: CPAP improves PVAI success rates OSA patients 25% greater risk of AF recurrence after catheter ablation Ng CY et al, Am J Cardiol 2011; 108:47 51.
19 SDB and atrial fibrillation SDB has been recognized as a predisposing factor to atrial tachyarrhythmias, especially AF Less strong association with atrial flutter OSA does not predict AFL recurrence after ablation (van Oosten E et al, J Interv Card Electrophysiol 2011) At present, there is no clear evidence for differentiating medical treatment for nighttime as compared with daytime atrial fibrillation. Individuals with nocturnal onset of atrial fibrillation should be monitored for the presence of SDB (polysomnography), which can be effectively treated by CPAP
20 SDB and ventricular arrhythmias patients with SDB patients without SDB The Sleep Heart Health Study >25% with severe SA have complex ventricular ectopy >5% NSVT during sleep. (x3 risk) Independent of related comorbidities Mehra R et al, Am J Respir Crit Care Med 2006; ;173:
21 SDB and malignant ventricular arrhythmias in heart failure patients Time to first appropriate implantable defibrillator therapy Bitter T et al, European Heart Journal 2011;32:61 74
22 Rossi V et al, European Heart Journal 2012;33: CPAP withdrawal and repolarization Subtherapeutic CPAP Therapeutic CPAP
23 Day-night pattern of SCD in OSA AHI OSA is associated with an increased risk of SCD, particularly at night Gami AS et al, N Engl J Med 2005;352:1206.
24 SDB and ventricular arrhythmias SDB may reduce/eliminate protective effects of sleep on ventricular irritability (arrhythmia suppression) Increased incidence of myocardial infarction, LV remodeling, systolic and diastolic dysfunction CPAP therapy is recommended in heart failure patients with coexisting OSA on behalf of an enhanced prognosis Studies suggest a positive effect on ventricular irritability, but conclusive evidence for a protective effect of CPAP on the occurrence of malignant arrhythmias in patients with OSA is lacking
25 Clinical case 58 yo male BMI 26 Kg/m^2 NIDCM LVEF 30% >25000 PVCs, drug-refractory Dryness of mouth Snoring Daytime sleepiness Vitulano N et al, J Cardiovasc Med 2009 Dec 7
26 Clinical case 2 Polysomnography AHI : 33/h SO 2 <90%: 18.5% of the sleeping time SO 2 <80%:5% Vitulano N et al, J Cardiovasc Med 2009 Dec 7
27 Ventricular ectopy during night time Baseline CPAP Vitulano N et al, J Cardiovasc Med 2009 Dec 7
28 Conclusions Diagnosis of SDB should be considered in patients presenting with cardiac arrhythmias, especially if: Patients have nocturnal arrhythmias Arrhythmia is refractory to standard therapy Heart Failure is present Other clinical indicators of OSA are present Polysomnography should be then performed in most patients with cardiovascular disease including cardiac arrhythmias Early treatment of OSA can reduce arrhythmias and improve symptoms and may have the potential confer a mortality benefit
29 Further considerations Whether sleep apnea treatment is capable of reducing risk for atrial and ventricular fibrillation and sudden death and for mortality has not been established definitively Future research (large scale prospective trials) is required, first, to identify patient subgroups in which OSA imparts a heightened risk of poor arrhythmic outcomes and to evaluate the role of OSA therapy in modulating such risk
FA et Apnée du Sommeil
FA et Apnée du Sommeil La Réunion Octobre 2017 Pascal Defaye CHU Grenoble-Alpes Obstructive Sleep Apnea and AF Incidence of atrial fibrillation (AF), based on presence or absence of OSA. Cumulative frequency
More informationΣύνδρομο σπνικής άπνοιας. Ποιός o ρόλος ηοσ ζηη γένεζη και ανηιμεηώπιζη ηων αρρσθμιών;
Σύνδρομο σπνικής άπνοιας. Ποιός o ρόλος ηοσ ζηη γένεζη και ανηιμεηώπιζη ηων αρρσθμιών; E.N. Σημανηηράκης MD, FESC Επίκ. Καθηγηηής Καρδιολογίας Πανεπιζηημιακό Νοζοκομείο Ηρακλείοσ Epidemiology 4% 2% 24%
More informationThe Effect of Sleep Disordered Breathing on Cardiovascular Disease
The Effect of Sleep Disordered Breathing on Cardiovascular Disease Juan G. Flores MD Pulmonary, Critical Care and Sleep Medicine Dupage Medical Group Director of Edward Sleep Lab Disclaimers or Conflicts
More informationOSA and cardiovascular disease what is the evidence? Mohan Edupuganti, MD, FACC. Baptist Health Cardiology. Disclosures: None
OSA and cardiovascular disease what is the evidence? Mohan Edupuganti, MD, FACC. Baptist Health Cardiology. Disclosures: None 1 OSA basics Affects 20-30% of males and 10-15% of females in North America
More informationMCOEM Spring Chapter Meeting April 5, Sleep Apnea An Overview with Emphasis on Cardiovascular Correlations Jacques Conaway, MD
MCOEM Spring Chapter Meeting April 5, 2014 Sleep Apnea An Overview with Emphasis on Cardiovascular Correlations Jacques Conaway, MD Case Presentation History of Present Illness 57 year old man with ihh/
More informationMario Kinsella MD FAASM 10/5/2016
Mario Kinsella MD FAASM 10/5/2016 Repetitive episodes of apnea or reduced airflow Due to upper airway obstruction during sleep Patients often obese Often have hypertension or DM 1 Obstructive apneas, hypopneas,
More informationSleep and the Heart. Sleep Stages. Sleep and the Heart: non REM 8/31/2016
Sleep and the Heart Overview of sleep Hypertension Arrhythmias Ischemic events CHF Pulmonary Hypertension Cardiac Meds and Sleep Sleep Stages Non-REM sleep(75-80%) Stage 1(5%) Stage 2(50%) Stage 3-4*(15-20%)
More informationSleep and the Heart. Physiologic Changes in Cardiovascular Parameters during Sleep
Sleep and the Heart Rami N. Khayat, MD Professor of Internal Medicine Medical Director, Department of Respiratory Therapy Division of Pulmonary, Critical Care and Sleep Medicine The Ohio State University
More informationSleep and the Heart. Rami N. Khayat, MD
Sleep and the Heart Rami N. Khayat, MD Professor of Internal Medicine Medical Director, Department of Respiratory Therapy Division of Pulmonary, Critical Care and Sleep Medicine The Ohio State University
More informationSleep Apnea and Heart Failure
Sleep Apnea and Heart Failure Micha T. Maeder, MD Cardiology Division Kantonsspital St. Gallen Switzerland micha.maeder@kssg.ch Sleep Disordered Breathing (SDB) in HFrEF 700 HFrEF patients (LVEF
More informationHeart Failure and Sleep Disordered Breathing (SDB) Unhappy Bedfellows
Question Heart Failure and Sleep Disordered Breathing (SDB) Unhappy Bedfellows 1 ResMed 2012 07 2 ResMed 2012 07 Open Airway 3 ResMed 2012 07 Flow Limitation Snore 4 ResMed 2012 07 Apnoea 5 ResMed 2012
More information3/10/2014. Pearls to Remember. 1) Consequences of OSA related to both arousals and hypoxia. 2) Arousals provoke increased
Cardiovascular disease and Sleep Disorders Timothy L. Grant, M.D.,F.A.A.S.M. Medical Director Baptist Sleep Center at Sunset Medical Director Baptist Sleep Education Series Medical Director Sleep Division
More informationObstructive Sleep Apnea
Obstructive Sleep Apnea Definition: Repetitive episodes of upper airway obstruction (complete or partial) that occur during sleep and are associated with arousals or desaturations +/or daytime sleepiness.
More informationGOALS. Obstructive Sleep Apnea and Cardiovascular Disease (OVERVIEW) FINANCIAL DISCLOSURE 2/1/2017
Obstructive Sleep Apnea and Cardiovascular Disease (OVERVIEW) 19th Annual Topics in Cardiovascular Care Steven Khov, DO, FAAP Pulmonary Associates of Lancaster, Ltd February 3, 2017 skhov2@lghealth.org
More informationObstructive sleep apnoea (OSA) is a common. Effects of obstructive sleep apnoea on heart rhythm REVIEW
Eur Respir J 2013; 41: 1439 1451 DOI: 10.1183/09031936.00128412 CopyrightßERS 2013 REVIEW Effects of obstructive sleep apnoea on heart rhythm Valentina A. Rossi*, John R. Stradling # and Malcolm Kohler*,"
More information6/2/18 SLEEP APNEA AND ITS CARDIOVASCULAR CONSEQUENCE. Salim Surani, MD, MPH, MSHM, FACP, FCCP, FAASM
SLEEP APNEA AND ITS CARDIOVASCULAR CONSEQUENCE Salim Surani, MD, MPH, MSHM, FACP, FCCP, FAASM 1 2 SNORING PATIENT Sleep and wakefulness, both of them when immoderate constitutes disease hippocrates SRS
More informationA Deadly Combination: Central Sleep Apnea & Heart Failure
A Deadly Combination: Central Sleep Apnea & Heart Failure Sanjaya Gupta, MD FACC FHRS Ohio State University Symposium May 10 th, 2018 Disclosures Boston Scientific: fellowship support, speaking honoraria
More informationESC/EHRA. Guidelines on Cardiac Pacing. Panos E. Vardas Professor of Cardiology Heraklion University Hospital Crete, Greece
ESC/EHRA Guidelines on Cardiac Pacing Panos E. Vardas Professor of Cardiology Heraklion University Hospital Crete, Greece Reasons for European Guidelines? Scientific reasons Cultural and political reasons
More informationSleep Disordered Breathing and HH with Preserved Ejection Fraction:
Sleep Disordered Breathing and HH with Preserved Ejection Fraction: Pr Thibaud DAMY Heart Failure Unit Department of Cardiology CHU Mondor, Créteil, France Definition of HF-PEF The diagnosis of HF-PEF
More informationCo-Morbidities Associated with OSA
Co-Morbidities Associated with OSA Dr VK Vijayan MD (Med), PhD (Med), DSc, FCCP, FICC, FAPSR, FAMS Advisor to Director General, ICMR Bhopal Memorial Hospital and Research Centre & National Institute for
More informationProf. Samir Morcos Rafla Alexandria Univ. Cardiology Dept.
Obesity as a risk factor for Atrial Fibrillation Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept. CardioAlex 2010 smrafla@hotmail.com 1 Obesity has reached epidemic proportions in the United
More informationCardiac Arrhythmias in Sleep
Cardiac Arrhythmias in Sleep Only 53 Slides! Gauresh H Kashyap, MD, FACP, FCCP, FAASM 1 2 Cardiac Arrhythmias in Sleep Out of 400 Patients with OSA, 48% had some Arrhythmias 20% - 2 PVCs/min 7% - Bradycardia
More informationObstructive sleep apnea, CPAP treatment and bradyarrhythmias: close relationship or simple coincidence? A brief review based on case series
CASE REPORT Obstructive sleep apnea, CPAP treatment and bradyarrhythmias: close relationship or simple coincidence? A brief review based on case series Nicola Vitulano Department of Cardiovascular Disease,
More informationSleep and the Heart Reversing the Effects of Sleep Apnea to Better Manage Heart Disease
1 Sleep and the Heart Reversing the Effects of Sleep Apnea to Better Manage Heart Disease Rami Khayat, MD Professor of Internal Medicine Director, OSU Sleep Heart Program Medical Director, Department of
More informationICD THERAPIES: are they harmful or just high risk markers?
ICD THERAPIES: are they harmful or just high risk markers? Konstantinos P. Letsas, MD, PhD, FESC LAB OF CARDIAC ELECTROPHYSIOLOGY EVANGELISMOS GENERAL HOSPITAL ATHENS ICD therapies are common In a meta-analysis
More informationCircadian Variations Influential in Circulatory & Vascular Phenomena
SLEEP & STROKE 1 Circadian Variations Influential in Circulatory & Vascular Phenomena Endocrine secretions Thermo regulations Renal Functions Respiratory control Heart Rhythm Hematologic parameters Immune
More informationPVDOMICS. Sleep Core. Cleveland Clinic Cleveland, Ohio
PVDOMICS Sleep Core Rawan Nawabit, Research Coordinator and Polysomnologist Joan Aylor, Research Coordinator Dr. Reena Mehra, Co-Investigator, Sleep Core Lead Cleveland Clinic Cleveland, Ohio 1 Obstructive
More informationObstructive sleep apnea (OSA) is the periodic reduction
Obstructive Sleep Apnea and Oxygen Therapy: A Systematic Review of the Literature and Meta-Analysis 1 Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto,
More informationIn-Patient Sleep Testing/Management Boaz Markewitz, MD
In-Patient Sleep Testing/Management Boaz Markewitz, MD Objectives: Discuss inpatient sleep programs and if they provide a benefit to patients and sleep centers Identify things needed to be considered when
More informationSleep Apnea and Cardiovascular Risk. Presented by Akshay Mahadevia, M.D. Diplomate American Board of Sleep Medicine
Sleep Apnea and Cardiovascular Risk Presented by Akshay Mahadevia, M.D. Diplomate American Board of Sleep Medicine Objectives Pathogenesis of obstructive sleep apnea, central sleep apnea and Cheyne-Stokes
More informationAtrial Fibrillation Ablation in Patients with Heart Failure
Atrial Fibrillation Ablation in Patients with Heart Failure Eleftherios M. Kallergis, MD, PhD, FESC Cardiology Department, Heraklion University Hospital Since auricular fibrillation so often complicates
More informationCardiac Arrhythmias during Sleep. Each night, when I go to sleep, I die. And the next morning, when I wake up, I am reborn.
Cardiac Arrhythmias during Sleep Graeme Kirkwood SpR in Cardiology Wrightington, Wigan and Leigh NHS Foundation Trust Each night, when I go to sleep, I die. And the next morning, when I wake up, I am reborn.
More information2/19/2013. Cardiovascular Disease Prevention International Symposium. Cardiovascular Disease and Sleep Apnea. Still Controversial?
Cardiovascular Disease Prevention International Symposium Cardiovascular Disease and Sleep Apnea February 16, 2013 Jonathan A. Fialkow, M.D., FACC, FAHA Medical Director, Clinical Cardiology, Baptist Cardiac
More informationEdoardo Gronda UO cardiologia e Ricerca Dipartimento Cardiovascolare IRCCS MultiMedica
Convegno Pneumologia 2016 Milano 16-18 giugno 2016 Centro Congressi Palazzo delle Stelline Edoardo Gronda UO cardiologia e Ricerca Dipartimento Cardiovascolare IRCCS MultiMedica Central apnea 10 second
More informationAssociation of Nocturnal Cardiac Arrhythmias with Sleep- Disordered Breathing
Association of Nocturnal Cardiac Arrhythmias with Sleep- Disordered Breathing 1 ARIC Manuscript Proposal #918S PC Reviewed: 01/10/03 Status: A Priority: 2 SC Reviewed: 01/15/03 Status: A Priority: 2 SHHS
More informationCase. Case. Case. Sleep Disorders: A Case-based Approach. LeRoy Essig, MD Rami Khayat, MD ROS:
Sleep Disorders: A Case-based Approach LeRoy Essig, MD Rami Khayat, MD Case ROS: 30 Lbs wt gain/1year Fatigue Heart burn Nasal congestion, dry mouth Reduced concentration/memory Case 47 y/o male presents
More information3/23/2018. Complications of VAD Therapy: Arrhythmias. Disclosures. Agenda. I have no relevant disclosures
March 23, 2018 Complications of VAD Therapy: Arrhythmias Sandeep M. Jani, MD, MPH Associate Directory of Advanced Heart Failure and Population Health MedStar Heart and Vascular Institute - Baltimore Sandeep
More informationAre We Sure That Obstructive Sleep Apnea Is Not a Risk factor for Atrial Fibrillation in the Elderly Population?
ISPUB.COM The Internet Journal of Geriatrics and Gerontology Volume 6 Number 1 Are We Sure That Obstructive Sleep Apnea Is Not a Risk factor for Atrial Fibrillation in the Elderly H Ganga, Y Thangaraj,
More informationAHA Sleep Apnea and Cardiovascular Disease. Slide Set
AHA 2008 Sleep Apnea and Cardiovascular Disease Slide Set Based on the AHA 2008 Scientific Statement Sleep Apnea and Cardiovascular Disease Virend K. Somers, MD, DPhil, FAHA, FACC Mayo Clinic and Mayo
More informationHigh Risk OSA n = 5,359
Table S1 Prevalence of atrial fibrillation (AF) identified using different methods in participants with high and low risk obstructive sleep apnea (). High Risk n = 5,359 Low Risk n = 14,992 SR-AF (%) 467
More informationChronic NIV in heart failure patients: ASV, NIV and CPAP
Chronic NIV in heart failure patients: ASV, NIV and CPAP João C. Winck, Marta Drummond, Miguel Gonçalves and Tiago Pinto Sleep disordered breathing (SDB), including OSA and central sleep apnoea (CSA),
More informationThe most accurate predictors of arterial hypertension in patients with Obstructive Sleep Apnea Syndrome
The most accurate predictors of arterial hypertension in patients with Obstructive Sleep Apnea Syndrome Natsios Georgios University Hospital of Larissa, Greece Definitions Obstructive Sleep Apnea (OSA)
More informationTachycardia-induced heart failure - Does it exist?
Tachycardia-induced heart failure - Does it exist? PD Dr Etienne Delacrétaz Clinique Cecil et Hôpital de Fribourg SSC Cardiology meeting 2015 Zürich Rapid atrial fibrillation is a common cause of heart
More informationSynopsis of Management on Ventricular arrhythmias. M. Soni MD Interventional Cardiologist
Synopsis of Management on Ventricular arrhythmias M. Soni MD Interventional Cardiologist No financial disclosure Premature Ventricular Contraction (PVC) Ventricular Bigeminy Ventricular Trigeminy Multifocal
More informationSleep Apnea and chronic Heart Failure
ESC CONGRESS 2012 Sleep Apnea and chronic Heart Failure Prof. Dr. med. Michael Arzt Schlafmedizinisches Zentrum Klinik und Poliklinik für Innere Medizin II Universitätsklinikum Regensburg michael.arzt@klinik.uni-regensburg.de
More informationSystemic manifestations of Sleep Apnea. Karan Madan Department of Pulmonary medicine PGIMER, Chandigarh
Systemic manifestations of Sleep Apnea Karan Madan Department of Pulmonary medicine PGIMER, Chandigarh Introduction Growing epidemic of obesity in an aging population. Obstructive sleep apnea (OSA) is
More informationPVCs: Do they cause Cardiomyopathy? Raed Abu Sham a, M.D.
PVCs: Do they cause Cardiomyopathy? Raed Abu Sham a, M.D. Cardiologist and Electrophysiologist No conflict of interest related to this presentation Objectives 1. PVCs are benign. What is the Evidence?
More informationApnea-Hypopnea- Index The new old biomarker for Sleep-Disordered Breathing. Alan S Maisel MD
Apnea-Hypopnea- Index The new old biomarker for Sleep-Disordered Breathing Alan S Maisel MD Triumvirate of Health-public awareness 1.8% Sleep Physical Fitness Nutrition 91.3% 99.9% Sleep is important to
More informationObstructive Sleep Apnea and Co-Morbidities
Obstructive Sleep Apnea and Co-Morbidities Susan Redline, MD, MPH Peter C Farrell Professor of Sleep Medicine Harvard Medical School Director, Program in Sleep and Cardiovascular Medicine Brigham and Women
More informationAtrial Fibrillation Ablation in Patients with Heart Failure
Atrial Fibrillation Ablation in Patients with Heart Failure Eleftherios M. Kallergis, MD, PhD, FESC Cardiology Department, Heraklion University Hospital Since auricular fibrillation so often complicates
More informationDialysis-Dependent Cardiomyopathy Patients Demonstrate Poor Survival Despite Reverse Remodeling With Cardiac Resynchronization Therapy
Dialysis-Dependent Cardiomyopathy Patients Demonstrate Poor Survival Despite Reverse Remodeling With Cardiac Resynchronization Therapy Evan Adelstein, MD, FHRS John Gorcsan III, MD Samir Saba, MD, FHRS
More informationEHRA/EUROPACE 2011 Madrid, Spain June
EHRA/EUROPACE 2011 Madrid, Spain June 26.-29.2011 Implementing modern management in atrial fibrillation patients Proceedings from the 3rd AFNet/EHRA consensus conference EHRA Special Session Different
More informationWhen to ablate patients with premature ventricular complexes?
When to ablate patients with premature ventricular complexes? Nikolaos Fragakis Assistant Professor, FESC 3rd University Cardiology Department Hippokration Hospital, Thessaloniki 58 year-old female Case
More informationAF Ablation in Patients with Heart Failure
AF Ablation in Patients with Heart Failure Christian de Chillou, MD, PhD Department of Cardiology University Hospital Nancy, France 28ème Journée Internationale du Centre Cardio-Thoracique de Monaco Monaco,
More informationInterventional solutions for atrial fibrillation in patients with heart failure
Interventional solutions for atrial fibrillation in patients with heart failure Advances in Cardiovascular Arrhythmias Great Innovations in Cardiology Matteo Anselmino, MD PhD Division of Cardiology Department
More informationHow We Breathe During Sleep Affects Health, Wellness and Longevity
How We Breathe During Sleep Affects Health, Wellness and Longevity Susan Redline, MD, MPH Peter C. Farrell Professor of Sleep Medicine Program Director- Sleep Medicine Epidemiology Harvard Medical School
More informationObservations on Sleep Apnoea and Cardiac disease
Observations on Sleep Apnoea and Cardiac disease Tim Sutton, Cardiologist Middlemore Hospital What is sleep? a naturally recurring state of relatively suspended sensory and motor activity, characterized
More informationRate and Rhythm Control of Atrial Fibrillation
Rate and Rhythm Control of Atrial Fibrillation April 21, 2017 춘계심혈관통합학술대회 Jaemin Shim, MD, PhD Arrhythmia Center Korea University Anam Hospital Treatment of AF Goal Reducing symptoms Preventing complication
More informationRal Antic Director Thoracic Medicine Head of Sleep Service Royal Adelaide Hospital. Visiting Respiratory and Sleep Physician Alice Springs Hospital
Ral Antic Director Thoracic Medicine Head of Sleep Service Royal Adelaide Hospital Visiting Respiratory and Sleep Physician Alice Springs Hospital Conflict of Interest Past member of ResMed Medical Board
More informationRecurrent Implantable Defibrillator Discharges (ICD) Discharges ICD Storm
Recurrent Implantable Defibrillator Discharges (ICD) Discharges ICD Storm Guy Amit, MD, MPH Soroka University Medical Center Ben-Gurion University of the Negev Beer-Sheva, Israel Disclosures Consultant:
More informationABLATION OF CHRONIC AF
ABLATION OF CHRONIC AF A PISAPIA ST JOSEPH HOSPITAL MARSEILLE MEET 2008 Atrial Fibrillation The most common significant heart rhythm disturbance Incidence increases with age and the development of structural
More informationAdvances in Cardiac Arrhythmias and Great innovations in Cardiology Turin October 2016
University of Brescia School of Medicine Division of cardiologiy Director: Prof Marco Metra, MD, FESC Advances in Cardiac Arrhythmias and Great innovations in Cardiology Turin 13-15 October 2016 Arrhythmias
More informationManagement of new-onset AF: Initial rate control treatment
Geneva Acute Crdiovascular Care Congress 2014 - October 18-20, 2014 Management of new-onset AF: Initial rate control treatment Antonio Raviele, MD, FESC, FHRS ALFA Alliance to Fight Atrial fibrillation,
More informationThe 5 Most Important Things You Need to Know About Atrial Fibrillation. John D. Day, MD
The 5 Most Important Things You Need to Know About Atrial Fibrillation John D. Day, MD Disclosures Consulting with St. Jude Medical, Boston Scientific, and Biotronik The 5 Most Important Things You Need
More informationAcquired conduction disturbance in structurally normal heart in children. Mi Young Han, M.D.,PhD. Kyung Hee University Hospital
Acquired conduction disturbance in structurally normal heart in children Mi Young Han, M.D.,PhD. Kyung Hee University Hospital 1 Incidence Cardiac conduction disturbances detected in a pediatric population
More informationSymposium 27. Protagonist. sleep disordered breathing ,3 MV TV RR TV. Ela Talent 3 3 CPAP. Therapeutic Research vol. 28 no.
Symposium 27 Protagonist sleep disordered breathing SDB 1 5 4 2 1 50 80 2,3 4 CPAP 1 5 1 MV TV RR TV Ela Talent 3 3 1 119 Symposium 27 2 10 60 2 8 10 60 50 AHI apnea hypopnea index AHI r 0.869 6 Garrigue
More informationעדכונים באלקטרופיזיולוגיה Electrophysiology Unit Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev
עדכונים באלקטרופיזיולוגיה 2014 Electrophysiology Unit Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev 1 מבנה הצגת היחידה פעילות ביחידה סקירה על הטיפול באלקטרופיזיולוגיה
More informationThe Therapeutic Role of the Implantable Cardioverter Defibrillator in Arrhythmogenic Right Ventricular Dysplasia
The Therapeutic Role of the Implantable Cardioverter Defibrillator in Arrhythmogenic Right Ventricular Dysplasia By Sandeep Joshi, MD and Jonathan S. Steinberg, MD Arrhythmia Service, Division of Cardiology
More informationLa strategia diagnostica: il monitoraggio ecg prolungato. Michele Brignole
La strategia diagnostica: il monitoraggio ecg prolungato Michele Brignole ECG monitoring and syncope In-hospital monitoring Holter Monitoring External loop recorder Remote (at home) telemetry Implantable
More informationArrhythmias and Heart Failure Dr Chris Lang Consultant Cardiologist and Electrophysiologist Royal Infirmary of Edinburgh
Arrhythmias and Heart Failure Dr Chris Lang Consultant Cardiologist and Electrophysiologist Royal Infirmary of Edinburgh Arrhythmias and Heart Failure Ventricular Supraventricular VT/VF Primary prevention
More informationPortable Sleep Testing in Hospitalized Patients
1 Portable Sleep Testing in Hospitalized Patients Rami Khayat, MD Heart Failure AND Public Health 6 million Americans with heart failure (>2% population 20 million people with asymptomatic cardiac impairment
More informationSleep Disordered Breathing: Beware Snoring! Dr T A McDonagh Consultant Cardiologist Royal Brompton Hospital London. UK
Sleep Disordered Breathing: Beware Snoring! Dr T A McDonagh Consultant Cardiologist Royal Brompton Hospital London. UK Sleep Disordered Breathing in CHF Erratic breathing during sleep known for years e.g.
More informationCardiovascular disease and obstructive sleep apnoea
Cardiovascular disease and obstructive sleep apnoea Dr. Raymond J.B. Massay M.B.B.S., F.R.C.P(London)., F.E.S.C., F.A.C.C Four basic drives in life 1. Eat 2. Drink 3. Reproduce 4. Sleep Sleep is the biggest
More informationΤεχνολογικές εξελίξεις & καινοτοµίες στις συσκευές βηµατοδότησης & απινίδωσης
Τεχνολογικές εξελίξεις & καινοτοµίες στις συσκευές βηµατοδότησης & απινίδωσης Georgios Giannopoulos, MD, FESC Cardiology Dept., Athens General Hospital G. Gennimatas, Athens, Greece Adj. Asst. Professor
More informationAtrial Fibrillation: Rate vs. Rhythm. Michael Curley, MD Cardiac Electrophysiology
Atrial Fibrillation: Rate vs. Rhythm Michael Curley, MD Cardiac Electrophysiology I have no relevant financial disclosures pertaining to this topic. A Fib Epidemiology #1 Most common heart rhythm disturbance
More informationArticles. Obesity, Sleep Apnea Syndrome, and Rhythmogenic Risk. Wolfram Grimm, 1 and Heinrich F. Becker 2. Obesity and Obstructive Sleep Apnea
Obesity, Sleep Apnea Syndrome, and Rhythmogenic Risk Wolfram Grimm, 1 and Heinrich F. Becker 2 Abstract Obstructive sleep apnea is a common disorder and affects approximately 4% of middle-aged men and
More informationCatheter Ablation for Atrial Fibrillation: Patient Selection and Outcomes
Catheter Ablation for Atrial Fibrillation: Patient Selection and Outcomes Francis Marchlinski, MD Richard T and Angela Clark President s Distinguished Professor Director Cardiac Electrophysiolgy University
More informationRESEARCH PACKET DENTAL SLEEP MEDICINE
RESEARCH PACKET DENTAL SLEEP MEDICINE American Academy of Dental Sleep Medicine Dental Sleep Medicine Research Packet Page 1 Table of Contents Research: Oral Appliance Therapy vs. Continuous Positive Airway
More informationThe implantable cardioverter defibrillator is not enough: Ventricular Tachycardia Catheter Ablation in Patients with Structural Heart Disease
The implantable cardioverter defibrillator is not enough: Ventricular Tachycardia Catheter Ablation in Patients with Structural Heart Disease Paolo Della Bella, MD Arrhythmia Department and Clinical Electrophysiology
More informationImpact of pulmonary vein isolation on obstructive sleep apnea in patients with atrial fibrillation
ORIGINAL ARTICLE Cardiology Journal 2014, Vol. 21, No. 4, pp. 392 396 DOI: 10.5603/CJ.a2013.0122 Copyright 2014 Via Medica ISSN 1897 5593 Impact of pulmonary vein isolation on obstructive sleep apnea in
More informationUP TO 25% SLEEP DISORDERED BREATHING AND STROKE OSA. Prevalence 11/12/2015. Young et al. NEJM 1993
SLEEP DISORDERED BREATHING AND STROKE Daniel Shade, Jr., MD FCCP, ABSM, D Medical Director, AHN Sleep Medicine OSA Prevalence Young et al. NEJM 1993 Middle aged cohort (30-60years) Diagnosed by PSG, in
More informationIndex. cardiacep.theclinics.com. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A AEDs. See Automated external defibrillators (AEDs) AF. See Atrial fibrillation (AF) Age as factor in SD in marathon runners, 45 Antiarrhythmic
More informationNovel pathophysiological concepts for the development and impact of sleep apnea in CHF.
Olaf Oldenburg Novel pathophysiological concepts for the development and impact of sleep apnea in CHF. Sleep apnea the need to synchronize the heart, the lung and the brain. Heart Failure 2011 Gothenburg,
More informationCardiac arrhythmias. Janusz Witowski. Department of Pathophysiology Poznan University of Medical Sciences. J. Witowski
Cardiac arrhythmias Janusz Witowski Department of Pathophysiology Poznan University of Medical Sciences A 68-year old man presents to the emergency department late one evening complaining of increasing
More informationRisk prediction in inherited conditions Laminopathies
Risk prediction in inherited conditions Laminopathies Karim Wahbi Cochin hospital, Paris karim.wahbi@aphp.fr Risk prediction in laminopathies Current approach for risk stratification A new score to predict
More informationSilvia G Priori MD PhD
The approach to the cardiac arrest survivor Silvia G Priori MD PhD Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri Pavia, Italy AND Leon Charney Division of Cardiology, Cardiovascular Genetics
More informationInteresting EP Cases Catheter ablation to treat congestive heart failure (CHF)
Interesting EP Cases Catheter ablation to treat congestive heart failure (CHF) Yiming WU, MD, PhD. Alaska heart and vascular institute. ywu@alaskaheart.com 907-561-3211 19 yo man transferred for out side
More informationSupplementary Online Content. Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and
1 Supplementary Online Content 2 3 4 5 6 Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and cardiometabolic risk factor management on sympton burden and severity in patients with atrial
More informationThe Sleep-Stroke Connection: An Under-recognized Entity. Simin Khavandgar MD UPMC Neurology Department
The Sleep-Stroke Connection: An Under-recognized Entity Simin Khavandgar MD UPMC Neurology Department Sleep Disordered Breathing (SDB) Obstructive Sleep Apnea (OSA): -Transient cessation of airflow, duration
More informationΚέντρο Υπέρτασης STRIDE-7 Γ Παθολογική Κλινική Πανεπιστημίου Αθηνών Νοσοκομείο Σωτηρία. Υπέρταση και ΣΑΥ. ΓΣ Στεργίου
Κέντρο Υπέρτασης STRIDE-7 Γ Παθολογική Κλινική Πανεπιστημίου Αθηνών Νοσοκομείο Σωτηρία Υπέρταση και ΣΑΥ ΓΣ Στεργίου Search results Items: 4480 14/04/2016 1990 N=35 2000 N=106 2015 N=338 Pages 130 Ref:
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Implantable cardioverter defibrillators for the treatment of arrhythmias and cardiac resynchronisation therapy for the treatment of heart failure (review
More informationLong-term Preservation of Left Ventricular Function and Heart Failure Incidence with Ablate and Pace Therapy Utilizing Biventricular Pacing
The Journal of Innovations in Cardiac Rhythm Management, 3 (2012), 976 981 HEART FAILURE RESEARCH ARTICLE Long-term Preservation of Left Ventricular Function and Heart Failure Incidence with Ablate and
More informationObstructive sleep apnea (OSA) has been associated with
S C I E N T I F I C I N V E S T I G A T I O N S background: Both obstructive sleep apnea (OSA) and prolonged QRS duration are associated with hypertension, heart failure, and sudden cardiac death. However,
More informationAPSR RESPIRATORY UPDATES
APSR RESPIRATORY UPDATES Volume 6, Issue 7 Newsletter Date: July 2014 APSR EDUCATION PUBLICATION Inside this issue: Sleep Medicine Upper Airway Stimulation for Obstructive Sleep Apnoea 2 Comparison of
More informationPrognosis of Patients With Heart Failure and Obstructive Sleep Apnea Treated With Continuous Positive Airway Pressure*
Original Research SLEEP MEDICINE Prognosis of With Heart Failure and Obstructive Sleep Apnea Treated With Continuous Positive Airway Pressure* Takatoshi Kasai, MD, PhD; Koji Narui, MD; Tomotaka Dohi, MD;
More informationProgression of atrial fibrillation: can we prevent it? Early catheter ablation will stop progression of atrial fibrillation pro
Progression of atrial fibrillation: can we prevent it? Early catheter ablation will stop progression of atrial fibrillation pro Jerónimo Farré MD, Madrid, ES AF: the kingdom of wishful thinking In AF we
More informationConsensus document: Screening and Prevention of Atrial Fibrillation
Consensus document: Screening and Prevention of Atrial Fibrillation Yong-Seog Oh, M.D.,Ph.D. Division of Cardiology, Department of Internal Medicine, Seoul St. Mary s Hospital, College of Medicine, The
More informationRebuttal. Jerónimo Farré MD 2010
Rebuttal 1.We do not know what are the types of AF in which ablation is worthless or most effective 2.Waiting implies to consider the ablation at an older age and when the duration of the history of AF
More informationSleep Apnea induced Endothelial Dysfunction: could it be reversible?
Orofacial Pain and Oral Medicine Course: OFPM #723 Motor/Sleep Disorders and Oral Physiology in OFPOM Lecture #3a Dr. Glenn Clark Professor of Diagnostic Sciences Assistant Dean of Distance Education Director
More informationPediatric Sleep-Disordered Breathing
Pediatric Sleep-Disordered Breathing OSA in infants and young children is generally characterized by partial, persistent obstruction of the upper airway Continuum Benign primary snoring Upper-airway resistance
More information