Ripolarizzazione precoce. Non così innocente come si pensava
|
|
- Phyllis Daniels
- 6 years ago
- Views:
Transcription
1 Brugada syndrome: tests and diagnosis. Torino, 27 ottobre 2017 Ripolarizzazione precoce. Non così innocente come si pensava Carla Giustetto Carla Giustetto Divisione di Cardiologia Divisione Università di Cardiologia Torino Ospedale S.Giovanni Battista -Università di Torino Ospedale Città della Salute e della Scienza
2 Brugada syndrome: diagnosis J point 2mm Channelopathy characterized by: Coved type ST Genetic segment mutations: elevationna + channel in 15-30% of pts; Ca ++ channel, Negative K + T channel, wave GPD1L NO structural heart disease Risk of sudden death Diagnostic ECG: typical ECG alterations (V 1 -V 2 )
3 LOOP RECORDER HIDROQUINIDINE ICD
4 Brugada Piedmont Registry 826 pts 12 diagnosed after Sudden Death total 814 pts Symptoms at presentation Asymptomatic (75%) 77 (9%) 118 (15%) asd 11 (1.4%) 1% neurally mediated Torino Asti Vercelli Orbassano Rivoli Cuneo Novara Savigliano unexplained Syncope 195 (24%)
5 A 45 years old man: traumatic syncope, which occurred after awakening at 6.30 a.m, while he was in the bathroom, with doubtful prodromes 1st ECG: sinus rhythm, normal conduction, non-significant ST-T alterations
6 Head-up tilt test (HUTT) Tilt test was negative but ST segment in V1-V2 with a type 2 Brugada pattern was recorded V1 V2
7 Pt with syncope + suspect Brugada ECG (type 2) V1 V2 Which investigations are reasonable/recommended? ECG with V1-V2 at 2 nd and 3 rd intercostal space (ICS)
8 ECG 4 th ICS ECG was recorded with V1-V2 at a higher intercostal space in this case it remained doubtful, still not diagnostic V1 2 ICS V2 2 ICS
9 Which investigations are reasonable/recommended? Pt with syncope + suspect Brugada ECG pattern (type 2) ECG with V1-V2 at 2 nd and 3 rd intercostal space type 2 Brugada ECG Drug challenge with sodium channel blockers
10 Pharmacological challenge with Na + -channel blockers was performed Basal ECG V1 Ajmaline infusion (1mg/kg in 5 min) V1 V2 V2 V3 V4 V1 - II space V1 - II space V2 - II space V2 - II space
11 Summary 45 years old man syncope of uncertain origin Drug induced type 1 Brugada ECG pattern What does literature report? What do guidelines recommend?
12 No syncope, nor type 1 Circulation 2002;105:1342 Italian Registry 200 pts Asymptomatic spontaneous type 1 Syncope + induced type 1 Syncope + spontaneous type 1 HR 6.4 for risk of cardiac arrest
13 1312 patients from 14 prospective observational studies Circulation 2016;133:
14 12-lead 24-hour Holter monitoring: intermittent spontaneous type 1 Brugada pattern V1 - II space h. 4:12 pm h. 11:44 pm h. 6:33 am h. 8:20 am h. 1:08 pm V2 - II space V1 standard V2 standard V5 V6
15 Summary 45 years old man syncope of uncertain origin drug induced type 1 Brugada ECG pattern and spontaneous type 1 documented at f-up What do guidelines recommend? What does literature report?
16 Which Brugada patients to treat: Guidelines 2015
17 Results Role of of EP-study study in in Brugada Brugada pts pts (overall (overall population) P = 0.05 Probst et al, FINGER Registry, Circulation 2010;121: 635
18 Sroubek J et al. Circulation 2016;133:
19 Annual incidence of cardiac arrest among 1312 individuals included in the analysis Sroubek J et al. Circulation 2016;133:
20 Int. J. of Cardiology2017; 241: Arrhythmic events in neurally mediated syncope versus unexplained 118 neurally-mediated vs 77 unexplained syncope Neurally mediated Unexplained 2 (0.3% person-year) f-up 62 months 6 (1.8% person-year)
21 Int. J. of Cardiology2017; 241: Role of PVS in unexplained syncope Best predictors of ventricular 7 year events mean f-upat follow-up: unexplained syncope + spontaneous type 1 + Inducibility at PVS 0 events 27% 5.2% per year
22 19 years old man, asymptomatic for syncope, no history of SD. ECG for sport eligibility: suspicious for Brugada pattern What should we do?
23 Am J Cardiol 2015; 115: Brugada Piedmont Registry 684 patients 12 Lead - 24 hour Holter 251 patients % 70% 30% Persistent type 1 Intermittent type 1 No type % spontaneous type 1 at basal ECG (group 1) % 31% 20% drug-induced type 1 (group 2) 0 group 1 group 2
24 12-lead Holter ECG: NO spontaneous type 1
25 Asymptomatic 19 years old pt evaluated for sport eligibility Basal ECG Positive ajmaline test IV space II space IV space II space
26 J Am Coll Cardiol 2010;56: Exercise test 93 Brugada pts 102 controls yes no augmentation of STsegment elevationat early recovery? 37% 63% none
27 Makimoto, J Am Coll Cardiol 2010;56:
28 pre-exercise test Peak exercise
29 Which investigations are reasonable/recommended? Asymptomatic pt + suspect Brugada ECG pattern (type 2) Negative 12-lead-Holter monitoring Type 1 Brugada ECG at exercise test programmed ventricular stimulation
30 Freedom from arrhythmic events Brugada Registry of the Piedmont region: arrhythmic events at follow-up 1 0,95 0,9 0,85 0,8 0,75 0,7 0,65 0,6 G1 vs Unexplained G2, p=0.02 syncope vs G1 vs Asympt, p=0.58 Mean follow-up of 62±48 months G2 vs Asympt, p < neurally-mediated Group1 Group2 asymptomatic neurally-mediated unexplained time (years) G G Asympt % (0.2% person-year) 2% (0.3% person-year) 9% (1.8% person-year)
31 Am J Cardiol 2015;116:98e prospective observational studies mean f-up months 3,536 asymptomatic subjects (2,820 men) 1,398 with spontaneous type 1 ECG Asymptomatic pts with spontaneous type 1 ECG exhibit an increased risk of arrhythmic events
32 Am J Cardiol 2015;116:98e103 Inducible ventricular arrhythmias at PVS were predictive of arrhythmic events
33 In summary: 1. asd ICD 2. unexplained SYNCOPE PVS + PVS - ICD loop recorder if still arrhythmic events or ICD refusal: add HQ/ablation Spontaneous type 1 ECG PVS + HQ PVS + PVS - ICD F-up YES 3. neurally mediated SYNCOPE / ASYMPTOMATIC Drug-induced type 1 12 lead Holter: Spontaneous type 1 NO F-up
34 Thank you for your attention!
Ripolarizzazione precoce.
Controversia: impianto di defibrillatore in prevenzione primaria Caso clinico: Ripolarizzazione precoce. Sindrome di Brugada Non così innocente come si pensava Torino, 31 marzo 2017 Carla Giustetto Carla
More informationRipolarizzazione precoce. Non così innocente come si pensava
La sincope nel paziente con ECG Brugada-like Stresa, 9 giugno 2017 Ripolarizzazione precoce. Non così innocente come si pensava Carla Giustetto Carla Giustetto Divisione di Cardiologia Divisione Università
More informationRipolarizzazione precoce. Torino, 24th October Non così innocente come si pensava
Asymptomatic inherited arrhythmia syndromes: Drug induced Brugada Syndrome: when a prophylactic ICD is indicated? how high (or low) is QT the risk? Asymptomatic short Ripolarizzazione precoce. Torino,
More informationWPW and Brugada syndrome: what do they have in common?
Ripolarizzazione precoce. Non così innocente come si pensava WPW and Brugada syndrome: what do they have in common? Carla Giustetto Prof. Divisione Fiorenzo di Cardiologia Gaita Ospedale S.Giovanni Battista
More informationInvasive Risk Stratification: When is it needed?
Inherited Cardiomyopathies and Channelopathies: Who is at risk for Sudden Cardiac Death? Invasive Risk Stratification: When is it needed? Hung-Fat Tse, MD, PhD Department of Medicine The University of
More informationHow to manage a patient with short QT syndrome?
How to manage a patient with short QT syndrome? Torino, 27 ottobre2012 Carla Giustetto Division of Cardiology University of Torino QT 280 ms QTc 260 ms Narrow, tall and peaked T waves High incidence of
More informationHow agressively should we treat asymptomatic patients with Brugada syndrome. Josep Brugada Medical Director Hospital Clínic, University of Barcelona
How agressively should we treat asymptomatic patients with Brugada syndrome Josep Brugada Medical Director Hospital Clínic, University of Barcelona The ECG in Brugada syndrome - Prolonged PR - RBBB - ST
More informationICD in a young patient with syncope
ICD in a young patient with syncope Konstantinos P. Letsas, MD, FESC Second Department of Cardiology Evangelismos General Hospital of Athens Athens, Greece Case presentation A 17-year-old apparently healthy
More information13/09/2018. The ISSUE Studies. International (Italy & Spain) Study of Syncope of Uncertain Etiology. ISSUE study Pre-defined inclusion cathegories
The Studies Jean-Claude Deharo Aix-Marseille Université, France In Cardiac Electrophysiology Methods and Models Editors: Daniel C. Sigg, Paul A. Iaizzo, Yong-Fu Xiao, Bin He Springer 2010 study Pre-defined
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 informationThe impact of clinical and genetic findings on the management of young Brugada Syndrome patients
12 ème Congrès Médico-Chirugical de la FCPC 21 au 24 novembre 2015 Schoelcher, Martinique The impact of clinical and genetic findings on the management of young Brugada Syndrome patients Institut du Thorax,
More informationAre there low risk patients in Brugada syndrome?
Are there low risk patients in Brugada syndrome? Pedro Brugada MD, PhD Andrea Sarkozy MD Risk stratification in Brugada syndrome In the last years risk stratification in Brugada syndrome has become the
More informationState of the Art: Brugada Syndrome Novel diagnostic approaches and risk stratification
State of the Art: Brugada Syndrome Novel diagnostic approaches and risk stratification Lars Eckardt Division Electrophysiology Department of Cardiovascular Medicine University of Münster, Germany I have
More informationFANS Paediatric Pathway for Inherited Arrhythmias*
FANS Paediatric Pathway for Inherited Arrhythmias* The pathway is based on the HRS/EHRA/APHRS Expert Consensus Statement on the Diagnosis and Management of Patients with Inherited Primary Arrhythmia Syndromes
More informationName of Presenter: Marwan Refaat, MD
NAAMA s 24 th International Medical Convention Medicine in the Next Decade: Challenges and Opportunities Beirut, Lebanon June 26 July 2, 2010 I have no actual or potential conflict of interest in relation
More informationSyncope in patients with inherited arrhythmogenic syndromes. Is it enough to justify ICD implantation?
Innovations in Interventional Cardiology and Electrophysiology Thessaloniki 2014 Syncope in patients with inherited arrhythmogenic syndromes. Is it enough to justify ICD implantation? K. Letsas, MD, FESC
More informationBrugada Syndrome: An Update
Brugada Syndrome: An Update Osama Diab Associate professor of Cardiology Ain Shams university, Cairo, Egypt Updates Mechanism and Genetics Risk stratification Treatment 1 Brugada syndrome causes 4 12%
More informationShort QT Syndrome: Pharmacological Treatment
Journal of the American College of Cardiology Vol. 43, No. 8, 2004 2004 by the American College of Cardiology Foundation ISSN 0735-1097/04/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2004.02.034
More informationTailored treatment in Brugada syndrome
Tailored treatment in Brugada syndrome Lars Eckardt Department of Cardiology and Angiology Division of Experimental and Clinical Electrophysiology University of Münster, Germany 45 yr old male preoperative
More informationAdult Complexities of the Channelopathies
Adult Complexities of the Channelopathies Andrew Krahn MD FHRS Sauder Family and Heart and Stroke Foundation Chair in Cardiology Paul Brunes Chair in Heart Rhythm Disorders University of British Columbia
More informationΔιαχείρηση Ασυμπτωματικού ασθενούς με ΗΚΓ τύπου Brugada
Διαχείρηση Ασυμπτωματικού ασθενούς με ΗΚΓ τύπου Brugada Άννα Κωστοπούλου Επιμελήτρια Α Ωνάσειο Καρδιοχειρουργικό Κέντρο Τμήμα Ηλεκτροφυσιολογίας και Βηματοδότησης BrS: Diagnosis 5:10000 First described
More informationCaso clinico: Palpitazioni, Sincope e Brugada Diana Solari Centro Aritmologico e Syncope Unit, Lavagna. Santa Margherita Ligure, 4 aprile 2014
Caso clinico: Palpitazioni, Sincope e Brugada Diana Solari Centro Aritmologico e Syncope Unit, Lavagna Santa Margherita Ligure, 4 aprile 2014 Anamnesi Uomo di 48 anni Pattern ECG tipo 2 Brugada Consigliato
More informationLee Chee Wan. Senior Consultant Pacing and Cardiac Electrophysiology. GP Symposium 2 nd April 2016
Lee Chee Wan Senior Consultant Pacing and Cardiac Electrophysiology GP Symposium 2 nd April 2016 Objectives Definition of syncope Common causes of syncope & impacts How to clinically assess patient with
More informationBrugada Syndrome: Age is just a number
Brugada Syndrome: Age is just a number 1 Deepthi Kagolanu, MD, 2 Cynthia Pacas, 1 Usman Jilani, DO, 1 Ebisa Bekele, MD, 3 Christopher Henessey, 4 Kent Stephenson MD 1 Nassau University Medical Center,
More informationRemote Monitoring & the Smart Home of the 21 Century
Cardiostim EHRA Europace 2016, Nice - June 8-11, 2016 Remote Monitoring & the Smart Home of the 21 Century Antonio Raviele, MD, FESC, FHRS President ALFA -Alliance to Fight Atrial fibrillation- Venezia
More informationExercise guidelines in athletes with isolated repolarisation abnormalities and structurally normal heart.
Exercise guidelines in athletes with isolated repolarisation abnormalities and structurally normal heart. Hanne Rasmusen Consultant cardiologist, PhD Dept. of Cardiology Bispebjerg University Hospital
More informationImplantable loop recorders Michele Brignole Arrhythmologic Center, Lavagna, Italy
Implantable loop recorders Michele Brignole Arrhythmologic Center, Lavagna, Italy DECLARATION OF CONFLICT OF INTEREST Medtronic, minimal ILR: available devices Reveal DX/XT, Medtronic Confirm, St Jude
More information2018 ESC Guidelines for the diagnosis and management of syncope
2018 ESC Guidelines for the diagnosis and management of syncope Michele Brignole (Chairperson) (Italy); Angel Moya (Co-chairperson) (Spain); Jean-Claude Deharo (France); Frederik de Lange (The Netherlands);
More informationLow Prevalence of Risk Markers in Cases of Sudden Death Due to Brugada Syndrome
Journal of the American College of Cardiology Vol. 57, No. 23, 2011 2011 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2010.11.067
More informationAmbulatory Cardiac Monitoring Modalities
Ambulatory Cardiac Monitoring Modalities NAVIGATING THE CHOICES MKT0390.03 LEARNING OBJECTIVES Identify the Clinical Applications for Each Modality Define and Distinguish Between the Various Monitoring
More informationCase Presentation. Asaad Khan University College Hospital Galway Rep of Ireland
Case Presentation Asaad Khan University College Hospital Galway Rep of Ireland Case History 32 male Married Working as a chartered accountant P/C:Admitted to a Regional hospital to be investigated for
More informationCME Article Brugada pattern masking anterior myocardial infarction
Electrocardiography Series Singapore Med J 2011; 52(9) : 647 CME Article Brugada pattern masking anterior myocardial infarction Seow S C, Omar A R, Hong E C T Cardiology Department, National University
More informationPrevention of Sudden Death in ARVC
ESC Munich, August 29, 2012 Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): Prevention of Sudden Death in ARVC Thomas Wichter, MD, FESC Professor of Medicine - Cardiology Marienhospital Osnabrück
More informationPearls of the ESC/ERS Guidelines 2015 Channelopathies
Pearls of the ESC/ERS Guidelines 2015 Channelopathies Carina Blomstrom Lundqvist Dept Cardiology, Uppsala, Sweden Content 2015 ESC Guidelines for the Management of Patients with Ventricular Arrhythmias
More informationIndex. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Adenosine in idiopathic AV block, 445 446 Adolescent(s) syncope in, 397 409. See also Syncope, in children and adolescents AECG monitoring.
More informationWhen the rhythm of life is disturbed
Brugada Syndrome has the capacity to cause abnormal heart rhythms originating in the upper chambers of the heart When the rhythm of life is disturbed Cardiovascular disease continues to be a leading cause
More informationClinical Case 1 A patient with a syncope Panos E. Vardas President Elect of the ESC, Prof of Cardiology, University Hospital of Crete
Clinical Case 1 A patient with a syncope Panos E. Vardas President Elect of the ESC, Prof. of Cardiology, University Hospital of Crete Case presentation A 64-year-old male smoker, with arterial hypertension
More informationManagement of Syncope in Heart Failure. University of Iowa
Management of Syncope in Heart Failure Brian Olshansky University of Iowa 1 Syncope Transient loss of consciousness, with rapid, usually complete, recovery, with or without prodrome A common, non-specific,
More informationA case of convulsion: Brugada syndrome
Hong Kong Journal of Emergency Medicine A case of convulsion: Brugada syndrome CK Shum, ML Tse, FL Lau, WK Chan A healthy 28-year-old man presented with multiple brief episodes of convulsion. He was found
More informationWhen VF is the endpoint, wait and see is not always the best option.
Being free of symptoms does not necessarily mean free of arrhythmias. This Holter is from a asymptomatic 48 years old female with LQT2 When VF is the endpoint, wait and see is not always the best option.
More informationAbbreviation List: 2017 by the American Heart Association, Inc. and the American College of Cardiology Foundation. 1
2017 AHA/ACC/HRS Systematic Review for the Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Data Supplement Table of Contents Part 1. For Asymptomatic
More informationΤΙ ΠΡΕΠΕΙ ΝΑ ΓΝΩΡΙΖΕΙ ΟΓΕΝΙΚΟΣ ΚΑΡΔΙΟΛΟΓΟΣ ΓΙΑ ΤΙΣ ΔΙΑΥΛΟΠΑΘΕΙΕΣ
ΤΙ ΠΡΕΠΕΙ ΝΑ ΓΝΩΡΙΖΕΙ ΟΓΕΝΙΚΟΣ ΚΑΡΔΙΟΛΟΓΟΣ ΓΙΑ ΤΙΣ ΔΙΑΥΛΟΠΑΘΕΙΕΣ ΣΤΕΛΙΟΣ ΠΑΡΑΣΚΕΥΑÏΔΗΣ ΔΙΕΥΘΥΝΤΗΣ ΕΣΥ Α Καρδιολογική Κλινική ΑΠΘ, Νοσοκομείο ΑΧΕΠΑ, Θεσσαλονίκη NO CONFLICT OF INTEREST Sudden Cardiac Death
More informationA case of Brugada syndrome coexisting with vasospastic angina: Caution should be taken when using calcium channel blockers
Journal of Cardiology Cases (2011) 4, e143 e147 Available online at www.sciencedirect.com jou rn al h om epa g e: www.elsevier.com/locate/jccase Case Report A case of Brugada syndrome coexisting with vasospastic
More informationManagement of Arrhythmias The General Practitioners role
Management of Arrhythmias The General Practitioners role Rohan Gunawardena MD, FRCP, FCCP, FACC Consultant Cardiac Electrophysiologist National Hospital of Sri Lanka Arrhythmias not common Palpitations
More informationSyncope: Evaluation of the Weak and Dizzy
Syncope: Evaluation of the Weak and Dizzy William M. Miles, MD, FACC, FHRS Professor of Medicine Silverstein Chair for Cardiovascular Education University of Florida College of Medicine Disclosures Medtronic,
More informationSyncope: Evaluation of the Weak and Dizzy
Syncope: Evaluation of the Weak and Dizzy William M. Miles, MD, FACC, FHRS Professor of Medicine Silverstein Chair for Cardiovascular Education University of Florida College of Medicine Disclosures Medtronic,
More information2018 ESC SYNCOPE GUIDELINES SUMMARY
208 ESC SYNCOPE GUIDELINES SUMMARY NEW GUIDELINES OVERVIEW OF UPDATED RECOMMENDATIONS SINCE 2009 208 EUROPEAN SOCIETY OF CARDIOLOGY SYNCOPE GUIDELINES Goals of 208 Task Force Reducing Cost & Admissions:
More informationSyncope evaluation: the role of syncope clinics Michele Brignole Arrhythmologic Centre, Lavagna, Italy
Syncope evaluation: the role of syncope clinics Michele Brignole Arrhythmologic Centre, Lavagna, Italy Why should we need a Syncope Management Unit? We are not happy with current strategies: - not standardized
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 informationIN THE NAME OF GOD. Dr.Sima Sayah
IN THE NAME OF GOD Dr.Sima Sayah Epidemiology: Prevalence: ranging from 0.14% in the japanese to 0.61% in europeans & may reach to 3% in southeast Asia. In up to 60% of patients,the disease can be sporadic.
More informationAn Approach to the Patient with Syncope. Guy Amit MD, MPH Soroka University Medical Center Beer-Sheva
An Approach to the Patient with Syncope Guy Amit MD, MPH Soroka University Medical Center Beer-Sheva Case presentation A 23 y.o. man presented with 2 episodes of syncope One during exercise,one at rest
More informationTachycardia Devices Indications and Basic Trouble Shooting
Tachycardia Devices Indications and Basic Trouble Shooting Peter A. Brady, MD., FRCP Cardiology Review Course London, March 6 th, 2014 2011 MFMER 3134946-1 Tachycardia Devices ICD Indications Primary and
More informationOptimal management of Brugada syndrome
Optimal management of Brugada syndrome Cristian Stătescu 1,2, Teodor Vasilcu 1,2, Ioana Mădălina Chiorescu*,1,2, Grigore Tinică 1,2, Cătălina Arsenescu-Georgescu 1,2, Radu Sascău 1,2 1 "Grigore T. Popa"
More informationWINDLAND SMITH RICE SUDDEN DEATH GENOMICS LABORATORY
Learning Objectives to Disclose: To CRITIQUE the ICD and its role in the treatment of BrS, CPVT, and LQTS WINDLAND SMITH RICE SUDDEN DEATH GENOMICS LABORATORY Conflicts of Interest to Disclose: Consultant
More informationClinical and Electrocardiographic Characteristics of Patients with Brugada Syndrome: Report of Five Cases of Documented Ventricular Fibrillation
J Arrhythmia Vol 25 No 1 2009 Original Article Clinical and Electrocardiographic Characteristics of Patients with Brugada Syndrome: Report of Five Cases of Documented Ventricular Fibrillation Seiji Takashio
More informationDiagnostic and therapeutic management of the patient with syncope M. Brignole Arrhythmologic Centre and Syncope Unit Lavagna, Italy
Diagnostic and therapeutic management of the patient with syncope M. Brignole Arrhythmologic Centre and Syncope Unit Lavagna, Italy Eur Heart J. 2009 Nov;30(21):2631-71 Available on www.escardio.org/guidelines
More informationThe Role of Defibrillator Therapy in Genetic Arrhythmia Syndromes
The Role of Defibrillator Therapy in Genetic Arrhythmia Syndromes RHEA C. PIMENTEL, MD, FACC, FHRS UNIVERSITY OF KANSAS HOSPITAL MID AMERICA CARDIOLOGY AUGUST 19, 2012 Monogenic Arrhythmia Syndromes Mendelian
More informationPre-Participation Athletic Cardiac Screening
Pre-Participation Athletic Cardiac Screening Kimberly A Krabill, MD Pediatric and Fetal Cardiologist Northwest Congenital Heart Care, Division of MedNax Cardiology Update for Primary Care Symposium July
More informationAntony French Consultant Cardiologist & Electrophysiologist
Antony French Consultant Cardiologist & Electrophysiologist Palpitations Unpleasant awareness of rapid or forceful heart beat Not all tachycardias cause palpitations, and not all palpitations are due to
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 informationGenetic Testing for Cardiac Ion Channelopathies
Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided
More informationAsymptomatic patient with WPW
Asymptomatic patient with WPW Dimosthenis Avramidis, MD. Arrythmiologist Mitera Children s Hospital Athens Greece Scientific Associate 1st Cardiology Dpt Evangelismos Hospital Athens Greece Preexcitation
More informationHeart Rhythm Disorders. How do you quantify risk?
Heart Rhythm Disorders How do you quantify risk? Heart Rhythm Disorders Scale of the Problem 1/2 population will have an episode of transient loss of consciousness (T-LOC) at some stage in their life.
More informationJOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL. 65, NO. 9, 2015 ª 2015 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN /$36.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL. 65, NO. 9, 2015 ª 2015 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 0735-1097/$36.00 PUBLISHED BY ELSEVIER INC. http://dx.doi.org/10.1016/j.jacc.2014.12.031
More informationΕμφύτευση απινιδωτών για πρωτογενή πρόληψη σε ασθενείς που δεν περιλαμβάνονται στις κλινικές μελέτες
Εμφύτευση απινιδωτών για πρωτογενή πρόληψη σε ασθενείς που δεν περιλαμβάνονται στις κλινικές μελέτες Δημήτριος M. Κωνσταντίνου Ειδικός Καρδιολόγος, MD, MSc, PhD, CCDS Πανεπιστημιακός Υπότροφος Dr. Konstantinou
More informationΠαναγιώτης Ιωαννίδης. Διευθυντής Τμήματος Αρρυθμιών & Επεμβατικής Ηλεκτροφυσιολογίας Βιοκλινικής Αθηνών
Διαστρωμάτωση κινδύνου για αιφνίδιο καρδιακό θάνατο σε ασθενείς που δεν συμπεριλαμβάνονται σε μεγάλες κλινικές μελέτες «Ασθενείς με ηλεκτρικά νοσήματα» Παναγιώτης Ιωαννίδης Διευθυντής Τμήματος Αρρυθμιών
More informationSupraventricular arrhythmias in Brugada syndrome. Prof. Dr. Martin Borggrefe Mannheim
Supraventricular arrhythmias in Brugada syndrome Prof. Dr. Martin Borggrefe Mannheim Brugada syndrome 1992-2012 Time interval between description of the disease and discovery of first causal gene Brugada
More informationDeath after Syncope: Can we predict it? Daniel Zamarripa, MD Senior Medical Director December 2013
Death after Syncope: Can we predict it? Daniel Zamarripa, MD Senior Medical Director December 2013 Death after Syncope: Can we predict it? Those who suffer from frequent and severe fainting often die suddenly
More informationThe pill-in-the-pocket strategy for paroxysmal atrial fibrillation
The pill-in-the-pocket strategy for paroxysmal atrial fibrillation KONSTANTINOS P. LETSAS, MD, FEHRA LABORATORY OF CARDIAC ELECTROPHYSIOLOGY EVANGELISMOS GENERAL HOSPITAL OF ATHENS ARRHYTHMIAS UPDATE,
More informationManagement of Arrhythmia Syndromes in the Newborn and Very Young Child: Unique Risks & Barriers in this Age Population
Management of Arrhythmia Syndromes in the Newborn and Very Young Child: Unique Risks & Barriers in this Age Population Mitchell Cohen, MD FACC FHRS Co-Director Heart Center Chief of Pediatric Cardiology
More informationElectrophysiologic investigation in Brugada syndrome
European Heart Journal (2002) 23, 1394 1401 doi:10.1053/euhj.2002.3256, available online at http://www.idealibrary.com on Electrophysiologic investigation in Brugada syndrome Yield of programmed ventricular
More informationSincopi ricorrenti: diagnosi differenziale e management. Alessandro Proclemer SOC Cardiologia Az. Osp.-Univ. Udine
Sincopi ricorrenti: diagnosi differenziale e management Alessandro Proclemer SOC Cardiologia Az. Osp.-Univ. Udine DISCLOSURE INFORMATION Dr. Alessandro Proclemer negli ultimi due anni ho avuto i seguenti
More informationApproximately 5% of patients who experience sudden death
Sodium Channel Blockers Identify Risk for Sudden Death in Patients With ST-Segment Elevation and Right Bundle Branch Block but Structurally Normal Hearts Ramon Brugada, MD; Josep Brugada, MD; Charles Antzelevitch,
More informationWPW in Athletes Should we treat all? age? RAMI FOGELMAN SCHNEIDER CHILDREN MEDICAL CENTER OF ISRAEL
WPW in Athletes Should we treat all? age? RAMI FOGELMAN SCHNEIDER CHILDREN MEDICAL CENTER OF ISRAEL W.P.W Clues in sinus rhythm No Q in Lt chest leads (WPW 88%, control 5%) PR < 100msec (WPW 80%, control
More informationThe Brugada syndrome is an arrhythmogenic disease
Value of Electrocardiographic Parameters and Ajmaline Test in the Diagnosis of Brugada Syndrome Caused by SCN5A Mutations Kui Hong, MD, PhD; Josep Brugada, MD, PhD; Antonio Oliva, MD; Antonio Berruezo-Sanchez,
More informationPatient Resources: Cardiac Channelopathies
Patient Resources: Cardiac Channelopathies Overview of Cardiac Channelopathies: CPVT, Long QT Syndrome and Brugada Syndrome Heart muscle cells contract because of movement of certain molecules (called
More informationValutazione iniziale e stratificazione del rischio
Valutazione iniziale e stratificazione del rischio Paolo Alboni Sezione di Cardiologia Ospedale Privato Quisisana Ferrara DEFINITION OF SYNCOPE Syncope is a transient loss of consciousness due to global
More informationBrugada syndrome is a cardiac disease caused by an
Efficacy of Quinidine in High-Risk Patients With Brugada Syndrome Bernard Belhassen, MD; Aharon Glick, MD; Sami Viskin, MD Background Automatic implantable cardioverter-defibrillator therapy is considered
More informationMedical Policy An Independent Licensee of the Blue Cross and Blue Shield Association
Genetic Testing for Page 1 of 23 Medical Policy An Independent Licensee of the Blue Cross and Blue Shield Association Title: Genetic Testing for Professional Institutional Original Effective Date: August
More informationSeek and Ye Shall Find: Surprising Findings When Using the ILR-LINQ
Seek and Ye Shall Find: Surprising Findings When Using the ILR-LINQ Suneet Mittal, MD, FACC, FHRS Director, Electrophysiology Laboratory Valley Health System www.arrhythmia.org; @drsuneet October 31, 2015
More informationPattarapong Makarawate MD, FHRS Assistant Professor. Division Of Cardiology Faculty of Medicine, Khon Kaen University
Pattarapong Makarawate MD, FHRS Assistant Professor. Division Of Cardiology Faculty of Medicine, Khon Kaen University 1. Important and impact of ICD in primary prevention 2. Risk stratification for ICD
More informationGender Differences in Clinical Manifestations of Brugada Syndrome
Journal of the American College of Cardiology Vol. 52, No. 19, 2008 2008 by the American College of Cardiology Foundation ISSN 0735-1097/08/$34.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2008.07.052
More informationP. Brugada 1, R. Brugada 2 and J. Brugada 3. Introduction. U.S.A.; 3 Unitat d Arritmias, Hospital Clinic, Barcelona, Spain
European Heart Journal (2000) 21, 321 326 Article No. euhj.1999.1751, available online at http://www.idealibrary.com on Sudden death in patients and relatives with the syndrome of right bundle branch block,
More informationImproving Patient Outcomes with a Syncope Center. Suneet Mittal, MD
Improving Patient Outcomes with a Syncope Center Suneet Mittal, MD Improving Patient Outcomes with a Syncope Center: Early Risk Stratification of Patients who Require Device Therapy Suneet Mittal, MD Director,
More informationSyncope Guidelines: What s New?
Syncope Guidelines: What s New? Dr. Samuel Asirvatham Professor of Medicine and Pediatrics Mayo Clinic College of Medicine Medical Director, Electrophysiology Laboratory Program Director, EP Fellowship
More informationArrhythmias (II) Ventricular Arrhythmias. Disclosures
Arrhythmias (II) Ventricular Arrhythmias Amy Leigh Miller, MD, PhD Cardiovascular Electrophysiology, Brigham & Women s Hospital Disclosures None Rhythms and Mortality Implantable loop recorder post-mi
More informationSincope e bradicardia sinusale: quale è la terapia appropriata?
Sincope e bradicardia sinusale: quale è la terapia appropriata? Paolo Alboni, Key points: 1 Fisiopatologia della sincope nei pz con BS 2 Diagnosi del tipo of sincope nei pz con BS 3 Trattamento della syncope
More informationCHANNELOPATHIES IS GENETIC TESTING ESSENTIAL IN PTS MANAGEMENT
CHANNELOPATHIES IS GENETIC TESTING ESSENTIAL IN PTS MANAGEMENT Inherited and Rare Cardiac Diseases Unit Heart Center for the Young and Athletes ONASSIS CARDIAC SURGERY CENTRE DIAGNOSIS ION CHANNEL DISEASE
More informationJ Wave Syndromes. Osama Diab Lecturer of Cardiology Ain Shams University
J Wave Syndromes Osama Diab Lecturer of Cardiology Ain Shams University J Wave Syndromes Group of electric disorders characterized by > 1 mm elevation of the J point or prominent J wave with or without
More informationAsymptomatic WPW Syndrome; Observation or Ablation? 전남대학교병원순환기내과 박형욱
Asymptomatic WPW Syndrome; Observation or Ablation? 전남대학교병원순환기내과 박형욱 Let It Be? Vs. Just Do It? Natural history of asymptomatic WPW Incidence of sudden cardiac death in natural history studies involving
More informationCase Demonstrations in Congenital and Acquired Long QT Syndrome
Case Demonstrations in Congenital and Acquired Long QT Syndrome Can You Make A Correct ECG Interpretation? Li Zhang, MD; 1-2 G. Michael Vincent, MD 1 1. LQTS Studies, Department t of Medicine i LDS Hospital,
More informationLe linee guida Sincope 2018 della Società Europea di Cardiologia La Syncope Unit Multidisciplinare. Andrea Ungar, MD, PhD, FESC
Le linee guida Sincope 2018 della Società Europea di Cardiologia La Syncope Unit Multidisciplinare Andrea Ungar, MD, PhD, FESC Syncope Unit, Hypertension Centre Geriatric and Intensive care Medicine University
More informationPECTUS EXCAVATUM WITH SPONTANEOUS TYPE 1 ECG BRUGADA PATTERN OR BRUGADA LIKE PHENOTYPE: ANOTHER BRUGADA ECG PHENOCOPY
PECTUS EXCAVATUM WITH SPONTANEOUS TYPE 1 ECG BRUGADA PATTERN OR BRUGADA LIKE PHENOTYPE: ANOTHER BRUGADA ECG PHENOCOPY ANDRÉS RICARDO PÉREZ RIERA MD Chief of the Sector of Electro-Vectocardiography of the
More informationCase Report Accelerated Idioventricular Rhythm During Ajmaline Test: a Case Report
www.ipej.org 474 Case Report Accelerated Idioventricular Rhythm During Ajmaline Test: a Case Report Antonio Sorgente, MD 1,2, Yoshinao Yazaki, MD 1, Lucio Capulzini, MD 1, Andrea Sarkozy, MD 1, Carlo de
More informationSection: Effective Date: Subsection: Original Policy Date: Subject: Page: Last Review Status/Date: Background
Genetic Testing for Cardiac Ion Last Review Status/Date: March 2014 Genetic Testing for Cardiac Ion Description Page: 1 of 22 Genetic testing is available for patients suspected of having cardiac ion channelopathies
More informationGenetic Testing for Cardiac Ion Channelopathies
Genetic Testing for Cardiac Ion Channelopathies Policy Number: 2.04.43 Last Review: 11/2018 Origination: 6/2007 Next Review: 11/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide
More informationThe ajmaline challenge in Brugada syndrome: Diagnostic impact, safety, and recommended protocol
European Heart Journal (2003) 24, 1104 1112 The ajmaline challenge in Brugada syndrome: Diagnostic impact, safety, and recommended protocol Sascha Rolf*, Hans-Jürgen Bruns, Thomas Wichter, Paulus Kirchhof,
More informationSyncope Cardiac or not? Dr Jaycen Cruickshank Emergency Physician Director of Clinical Training BHS
Syncope Cardiac or not? Dr Jaycen Cruickshank Emergency Physician Director of Clinical Training BHS Syncope( (cardiac(or(not?( What(is(syncope?( Syncope( is( a( brief( loss( of( consciousness( that( resolves(
More information3/17/2014. NCDR-14 ICD Registry WS # 24 Case Scenarios Including Syndromes w/ Risk of Sudden Death. Objectives
NCDR-14 ICD Registry WS # 24 Case Scenarios Including Syndromes w/ Risk of Sudden Death Denise Pond BSN, RN The following relationships exist related to this presentation: No Disclosures Objectives Discuss
More informationIn 1992, Brugada and Brugada 1 reported 8 patients resuscitated
Clinical and Genetic Heterogeneity of Right Bundle Branch Block and ST-Segment Elevation Syndrome A Prospective Evaluation of 52 Families Silvia G. Priori, MD, PhD; Carlo Napolitano, MD, PhD; Maurizio
More information