Invasive Risk Stratification: When is it needed?
|
|
- Elwin Fox
- 6 years ago
- Views:
Transcription
1 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 Hong Kong Queen Mary Hospital Hong Kong
2 Inherited channelopathies Long QT Syndrome Short QT Syndrome Catecholaminergic polymorphic ventricular tachycardia Brugada Syndrome
3 Inherited channelopathies Long QT Syndrome Short QT Syndrome Catecholaminergic polymorphic ventricular tachycardia Brugada Syndrome
4 Long QT Syndrome 15 pts with LQTS with syncope or cardiac arrest Neither the inducibility of non-sustained VT nor the results of drug testing with beta- blockers proved to be of any prognostic value Spontaneous and Inducible VF in patients with LQTS Conclusion: EPS are of limited value in the diagnosis and treatment of pts with LQTS Bhandari AK, et al. Circulation 1985;71: 63-71
5 Short QT Syndrome 18 pts with SQTS presented with syncope/scd or Dx during family screening underwent EPS mean vent ERP 155ms (CL ms) and 150ms (CL ), and inducible VF in 11/18 (61%). In 6 pts with VF and SCD, only 3 pts (50%) had inducible VF on EPS. Conclusion: EPS are of limited value in the diagnosis and treatment of pts with SQTS Giustetto C, et al. Eur Heart J 2006;27:
6 Inherited channelopathies Long QT Syndrome Short QT Syndrome Catecholaminergic polymorphic ventricular tachycardia Brugada Syndrome
7 Catecholaminergic polymorphic ventricular tachycardia 19 pts with CPVT underwent EPS Polymorphic non-sustained VT was induced by EPS in 2/19 (11%) pts and 6 pts (31%) with polymorphic non-sustained VTwas induced during isoproterenol infusion 11/19 pts (58%) were not inducible. Conclusions: Low sensitivity and specificity of EPS for symptomatic CPVT pts Priori SG, et al. Circulation 2002;106;
8 Inherited channelopathies Long QT Syndrome Short QT Syndrome Catecholaminergic polymorphic ventricular tachycardia Brugada Syndrome
9 Brugada Syndrome Benito B, et al. Prog Cardiovas Dis 2008;51:1-22
10 Variation of ECG Pattern in Brugada Syndrome Richter S, et al. Eur Heart J 2010
11 PHARMACOLOGICAL TESTS Suspicion of Brugada Syndrome and a nondiagnostic ECG Drug challenge tests Drug Dosage and Administration (3) Ajmaline 1 mg/kg over 5 min, IV Flecainide 2 mg/kg over 10 min, IV (400 mg, PO) Procainamide 10 mg/kg over 10 min, IV Plisicainide 1 mg/kg over 10 min, IV Never forget to place V 1 and V 2 in 2 nd And 3 rd intercostal space!!! 1. Hong et al. Circ Meregalli et al JCE Antzelevich et al. Circ Mivamoto et al. Am J Cardiol. 2007
12 Brugada Syndrome Benito B, et al. Prog Cardiovas Dis 2008;51:1-22
13 Benito B, et al. Prog Cardiovas Dis 2008;51:1-22
14 Brugada Series Patients Without Prior Cardiac Arrest Multivariate analysis (Independent predictors of events) HR 95% CI P Inducibility in EPS Syncope Basal ECG Inducible Non inducible ECG+syncope ECG+asymptomatic ECG-syncope ECG - asymptomatic Berruezo AJ. HRS 2010
15 Brugada Series Probability of SCD During Life-Time 45, ,5 23,4 4, Inducible Non inducible 11 7,6 ECG - male ECG - female ECG + male ECG + female Berruezo AJ. HRS 2010
16 Brugada Series: ICD Pts SYMPTOMS Yes : sudden death 79 patients Events : 37/79 (47%) HIGH RISK Yes : syncope 81 patients Events : 21/81 (26%) HIGH RISK No (asymptomatic) 98 patients Events : 11/98 (11%) INTERMEDICATE RISK BASAL ECG Abnormal 83 patients Events : 11/83 (13%) INTERMEDICATE RISK Normal 15 patients Events : 0/15 (0%) LOW RISK Yes 68 patients Events : 11/68 (16%) INTERMEDICATE RISK INDUCIBILITY ON EPS No 15 patients Events : 0/15 (0%) LOW RISK Berruezo AJ. HRS 2010
17 Number of Patients with EPS Electrophysiological Study in Brugada Syndrome % % 250 Brugada series % 23% Others % 23% Cardiac Arrest Syncope Asymptomatic Paul M, et al. Eur Heart J 2007; 28:
18 Asymptomatic Brugada Syndrome Paul M, et al. Eur Heart J 2007; 28:
19 % of Patients Asymptomatic Brugada Syndrome 2% VF % VF % VF 4% VF Others 10 0 EPS -ve EPS +ve Brugada series Paul M, et al. Eur Heart J 2007; 28:
20 Asymptomatic Brugada Syndrome Japanese Probands N=330, mean age pts underwent EPS 57% of asymptomatic pt (n=154, 63%) with inducible VF Mean FU 4 yrs European Probands N=1029, mean age pts underwent EPS 37% of asymptomatic pt (n=654, 64%) with inducible VF Mean FU 3 yrs Kamakura S, et al. Circ Arrhythm EP 2009 Probst et al. Circulation 2009
21 Asymptomatic Brugada Syndrome 100 Japanese Study Europe (FINGER) Study Arrhythmia free survival Asymptomatic Arrhythmia free survival Asymptomatic 100 Syncope Syncope 80% Cardiac arrest 80% Cardiac arrest 60% 60% Months follow-up Drug-induced Type I Months follow-up 100 Drug-induced Type I 80% Spontaneous Type I 80% Spontaneous Type I p= Months follow-up 70 Kamakura S, et al. Circ Arrhythm EP 2009 p= Months follow-up Probst et al. Circulation 2009
22 Asymptomatic Brugada Syndrome Data on outcome of asymptomatic patients with type I Brugada ECG with INDCIBLE VF Japanese Study Spontaneous Type I 57 Inducible VF Drug-induced type I (56%) 20 (58%) Spontaneous VF at 4 years 1/32 = 3% 0/20 = 0 1/52 = 2% Europe FINGER Study Spontaneous Type I 172 Inducible VF Drug-induced type I (37%) 74 (37%) Spontaneous VF at 5 years 1/63 = 2% 3/74 = 4% 4/137 = 3% Kamakura S, et al. Circ Arrhythm EP 2009 Probst et al. Circulation 2009
23 Asymptomatic Brugada Syndrome Japanese Study Arrhythmia free survival Europe (FINGER) Study Arrhythmia free survival 100 Negative EPS 100 Negative EPS 80% Inducible VF 80% Inducible VF p=0.16 p= % 60% 40% Follow-up (months) 40% Follow-up (months)
24 Data on outcome of asymptomatic patients with type I Brugada ECG with INDUCIBLE VF Data on the Japanese Study and the European FINGER study combined This risk for arrhythmic events -- at 4-5 years -- for asymptomatic patients with inducible VT is : 1/52 + 4/137 = 5/189 = 2.6% Upper limit of the 95% confidence interval = 6% Japanese Study Europe FINGER Study Brugada Series 6% 1/52 + 4/ /68 = 16/257 Viskin S. HRS 2010
25 Data on outcome of asymptomatic patients with type I Brugada ECG with NEGATIVE EPS Data on the Japanese Study and the European FINGER study combined This risk for arrhythmic events -- at 4-5 years -- for asymptomatic patients who are NOT inducible 2/39 + 2/76 = 4/115 = 3.5% Upper limit of the 95% confidence interval = 8% And for asymptomatic patients with spontaneous Type I who are NOT inducible : 2/25 + 2/109 = 4/134 = 3% Upper limit of the 95% confidence interval = 7% Viskin S. HRS 2010
26 Current ACC/AHA/ESC Guideline Long QTS/ CPVT No recommendation for EP testing Brugada Syndrome Class IIb. EP testing may be considered for risk assessment for SCD in pts with ARVC/D (level of evidence C)
27 Inherited Cardiomyopathy Hypertrophic Cardiomyopathy Arrhythmogenic Right Ventricular Cardiomyopathy Maron BJ. Cardiovas Path 2010 Buja G, et al. Prog Cardiovas Dis 2008
28 Hypertrophic Cardiomyopathy Asymptomatic Symptomatic Pts with inducible VT on EPS had higher event rate But, predictive accuracy is very low Fananapazir L, et al. Circulation 1992
29 Arrhythmogenic Right Ventricular Cardiomyopathy The prognostic role of EPS in patients with ARVC/D is controversial. Majority of data are based on retrospective analysis of ARVD pts who underwent ICD implant low predictive accuracy of EPS in pts with definite ARVC/D Pts with probable ARVC/D and ve EP study may represent a low risk group Roguin A, et al. JACC 2004 Piccini JP, et al. Heart Rhythm 2005
30 Current ACC/AHA/ESC Guideline Hypertrophic Cardiomyopathy Class IIb. EP testing may be considered for risk assessment for SCD in pts with HCM (level of evidence C) Arrhythmogenic Right Ventricular Cardiomyopathy Class IIb. EP testing may be considered for risk assessment for SCD in pts with ARVC/D (level of evidence C)
31 Conclusions Risk stratification for SCD with EP study in subjects with inherited channelopathy and cardiomyopathy remain challenging No role for invasive EP study in symptomatic pts with LQTS/SQTS/CPVT, but role in asymptomatic subjects unclear? Controversy over the role of EP study in asymptomatic Brugada syndrome/hocm and ARVD role in uncertain case?
Name 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 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 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 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 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 informationRipolarizzazione precoce. Non così innocente come si pensava
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
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 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 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 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 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 informationAsymptomatic Long QT. Prof. Dr. Martin Borggrefe Mannheim
Asymptomatic Long QT Prof. Dr. Martin Borggrefe Mannheim QT interval Distribution of QTc intervals in large population-based studies Viskin S, Heart Rhythm 2009; 6: 711-715 QT interval Distribution of
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 informationRipolarizzazione 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 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 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 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 informationSudden Cardiac Death What an electrophysiologist thinks a cardiologist should know
Sudden Cardiac Death What an electrophysiologist thinks a cardiologist should know Steven J. Kalbfleisch, M.D. Medical Director Electrophysiology Laboratory Ross Heart Hospital Wexner Medical Center Sudden
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 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 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 informationARVC when TO IMPLANT THE ASYMPTOMATIC PERSON
EUROPACE 2011 INHERITED ELECTRICAL CARDIAC DISORDERS ARVC when TO IMPLANT THE ASYMPTOMATIC PERSON June 26 th 2011 Robert Lemery MD CONFLICTS of INTEREST None ASYMPTOMATIC ARVC 1. ECG 2. ASYMPTOMATIC PVC
More informationSEMINAIRES IRIS. Sudden cardiac death in the adult. Gian Battista Chierchia. Heart Rhythm Management Center, UZ Brussel. 20% 25% Cancers !
Sudden cardiac death in the adult Gian Battista Chierchia. Heart Rhythm Management Center, UZ Brussel.! " # $ % Cancers National Vital Statistics Report, Vol 49 (11), Oct. 12, 2001. 20% 25% State-specific
More informationWhat is New in CPVT? Diagnosis Genetics Arrhythmia Mechanism Treatment. Andreas Pflaumer
What is New in CPVT? Diagnosis Genetics Arrhythmia Mechanism Treatment Andreas Pflaumer Diagnosis of CPVT Induction of different types of VES or VT by exercise or catecholamines AND exclusion of of other
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 informationWhat Every Physician Should Know:
What Every Physician Should Know: The Canadian Heart Rhythm Society estimates that, in Canada, sudden cardiac death (SCD) is responsible for about 40,000 deaths annually; more than AIDS, breast cancer
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 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 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 informationDrugs Controlling Myocyte Excitability and Conduction at the AV node Singh and Vaughan-Williams Classification
Drugs Controlling Myocyte Excitability and Conduction at the AV node Singh and Vaughan-Williams Classification Class I Na Channel Blockers Flecainide Propafenone Class III K channel Blockers Dofetilide,
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 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 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 informationSUDDEN CARDIAC DEATH(SCD): Definition
SUDDEN CARDIAC DEATH EPIDEMIOLOGY, PATHOPHYSIOLOGY, PREVENTION & THERAPY Hasan Garan, M.D. Columbia University Medical Center SUDDEN CARDIAC DEATH(SCD): Definition DEATH DUE TO A CARDIAC CAUSE IN A CLINICALLY
More informationJean François Leclercq Department of Rythmology Private Hospital of Parly 2 - Le Chesnay F
SECONDARY PREVENTION of Sudden Death: in which patients? Jean François Leclercq Department of Rythmology Private Hospital of Parly 2 - Le Chesnay F Why an AID is effective? Because it stoppes a VT very
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 informationSUDDEN CARDIAC DEATH(SCD): Definition
SUDDEN CARDIAC DEATH EPIDEMIOLOGY, PATHOPHYSIOLOGY, PREVENTION & THERAPY Hasan Garan, M.D. Columbia University Medical Center SUDDEN CARDIAC DEATH(SCD): Definition DEATH DUE TO A CARDIAC CAUSE IN A CLINICALLY
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 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 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 informationSudden Cardiac Death in Sports: Causes and Current Screening Recommendations
Sports Cardiology Sudden Cardiac Death in Sports: Causes and Current Screening Recommendations Domenico Corrado, MD, PhD Inherited Arrhytmogenic Cardiomyopathy Unit Department of Cardiac, Thoracic and
More informationCorporate Medical Policy
Corporate Medical Policy Genetic Testing for Cardiac Ion Channelopathies File Name: Origination: Last CAP Review: Next CAP Review: Last Review: genetic_testing_for_cardiac_ion_channelopathies 10/2008 4/2018
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 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 informationRisk Factors for Sudden cardiac Death
Risk Factors for Sudden cardiac Death A. Arenal Arrhythmias in competitive sports Disclosure Conflict of interest Advisory board: Medtronic, Boston Scientific Research grants: Medtronic, Boston Scientific,
More informationProfessor Eric Schulze-Bahr
No CoI. Professor Eric Schulze-Bahr Institute for Genetics of Heart Diseases Department of Cardiology and Angiology University Hospital Münster / Germany ICD therapy in asymptomatic or borderline LQTS
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 informationPlotse hartdood & genetica
Onder spanning inspannen Utrecht, 17 April 2018 Plotse hartdood & genetica N. Hofman, PhD Academic Medical Centre Amsterdam, the Netherlands European Reference Network Network of centres in Europe sharing
More informationSPORTS AND EXERCISE ADVICE IN PATIENTS WITH ICD AND PPM
SPORTS AND EXERCISE ADVICE IN PATIENTS WITH ICD AND PPM Rio De Janeiro 2016 Sport and Exercise Cardiology Symposium SBC/SOCERJ ACC Sharlene M. Day, MD Associate Professor, Cardiovascular Medicine Director,
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 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 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 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 informationAsaad Khoury 2,3 MD, Monther Boulos 1,3 MD, Mahmoud Suleiman 1,3 MD, Miry Blich 1,3 MD, Michael Eldar 4 MD, Ibrahim Marai 1,3 MD,
Flecainide therapy suppresses exercise induced ventricular arrhythmias in patients with CASQ2 associated catecholaminergic polymorphic ventricular tachycardia Asaad Khoury 2,3 MD, Monther Boulos 1,3 MD,
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 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 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 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 informationIHCP bulletin INDIANA HEALTH COVERAGE PROGRAMS BT JANUARY 24, 2012
IHCP bulletin INDIANA HEALTH COVERAGE PROGRAMS BT201203 JANUARY 24, 2012 The IHCP to reimburse implantable cardioverter defibrillators separately from outpatient implantation Effective March 1, 2012, the
More informationVentricular arrhythmias
Ventricular arrhythmias Assoc.Prof. Lucie Riedlbauchová, MD, PhD Department of Cardiology University HospitalMotol and2nd FacultyofMedicine, Charles University in Prague Definition and classification Ventricular
More informationExercise-induced ventricular arrhythmias in CPVT patients occur at lower heart rate on beta-blocker therapy
Exercise-induced ventricular arrhythmias in CPVT patients occur at lower heart rate on beta-blocker therapy Leren IS, Haugaa KH, Berge KE, Bathen J, Loennechen JP, Anfinsen OG, Früh A, Edvardsen T, Kongsgård
More informationPreventing Sudden Death in Young Athletes. Outline. Scope of the Problem. Causes of SCD in Young Athletes. Sudden death in the young athlete
Preventing Sudden Death in Young Athletes Ronn E. Tanel, MD Director, Pediatric Arrhythmia Service UCSF Children s Hospital Associate Professor of Pediatrics UCSF School of Medicine Outline Sudden death
More informationLa valutazione dell atleta: è una strategia salva-vita e costo-efficace?
La valutazione dell atleta: è una strategia salva-vita e costo-efficace? Primo trattato di Medicina Wilson and Jungner s criteria In the 1960s the World Health Organization adopted the Wilson and Jungner
More informationPrimary Therapy for High Risk LQT Patients Should Be an ICD
Primary Therapy for High Risk LQT Patients Should Be an ICD Raul Weiss MD, FAHA, FACC, FHRS, CCDS Director, Electrophysiology Fellowship Program Associate Professor of Medicine The Ohio State University
More informationWojciech Szczepański, MD, PhD Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division Medical University of Bialystok
Channelopathies: - Long QT syndrome - Short QT syndrome - Brugada syndrome - Early repolarization syndrome - Catecholaminergic polymorphic ventricular tachycardia Wojciech Szczepański, MD, PhD Department
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 informationTreatment of VT of Purkinje fiber origin: ablation targets and outcome
Treatment of VT of Purkinje fiber origin: ablation targets and outcome Ch. Piorkowski University Leipzig - Heart Center - Dept. of Electrophysiology Leipzig, Germany Presenter Disclosure Information Gerhard
More informationSecondary prevention of sudden cardiac death
Secondary prevention of sudden cardiac death Balbir Singh, MD, DM; Lakshmi N. Kottu, MBBS, Dip Card, PGPCard Department of Cardiology, Medanta Medcity Hospital, Gurgaon, India Abstract All randomised secondary
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 informationOutflow Tract Ventricular Tachycardia Always Benign?
Outflow Tract Ventricular Tachycardia Always Benign? Arash Arya, M.D. Department of Interventional Electrophysiology Heart Center University of Leipzig Disclosures: NONE Outflow Ventricular Tachycardia
More informationΕνδείξεισ εμφύτευςησ απινιδωτή ςτην «γκρίζα ζώνη» Γεώργιοσ Ανδρικόπουλοσ, MD, PhD, Αν. Δ/ντήσ Καρδιολογικήσ Κλινικήσ ΓΝΑ «Ερρίκοσ Ντυνάν»
Ενδείξεισ εμφύτευςησ απινιδωτή ςτην «γκρίζα ζώνη» Γεώργιοσ Ανδρικόπουλοσ, MD, PhD, Αν. Δ/ντήσ Καρδιολογικήσ Κλινικήσ ΓΝΑ «Ερρίκοσ Ντυνάν» Major Implantable Cardioverter-Defibrillator Trials for Prevention
More informationTachycardias II. Štěpán Havránek
Tachycardias II Štěpán Havránek Summary 1) Supraventricular (supraventricular rhythms) Atrial fibrillation and flutter Atrial ectopic tachycardia / extrabeats AV nodal reentrant a AV reentrant tachycardia
More informationInvestigating the family after a sudden cardiac death. Dr Catherine Mercer Consultant Clinical Geneticist, Wessex
Investigating the family after a sudden cardiac death Dr Catherine Mercer Consultant Clinical Geneticist, Wessex Sudden adult deaths subdivided Sudden Adult Death Sudden Cardiac Death Sudden Arrhythmic
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 informationSubcutaneous Implantable Cardioverter Defibrillator (ICD) System
Subcutaneous Implantable Cardioverter Defibrillator (ICD) System Policy Number: Original Effective Date: MM.06.025 07/01/2015 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 3/24/201701/01/2019
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 informationThe patient with (without) an ICD and heart failure: Management of electrical storm
ISHNE Heart Failure Virtual Symposium April 2008 The patient with (without) an ICD and heart failure: Management of electrical storm Westfälische Wilhelms-Universität Münster Günter Breithardt, MD, FESC,
More informationBasics of Structure/Function of Sodium and Potassium Channels Barry London, MD PhD
Basics of Structure/Function of Sodium and Potassium Channels Barry London, MD PhD University of Pittsburgh Medical Center Pittsburgh, PA International Symposium of Inherited Arrhythmia Disorders and Hypertrophic
More informationDescription. Page: 1 of 31. Genetic Testing for Cardiac Ion Channelopathies. Last Review Status/Date: December 2015
Genetic Testing for Cardiac Ion Last Review Status/Date: December 2015 Genetic Testing for Cardiac Ion Description Page: 1 of 31 Genetic testing is available for patients suspected of having cardiac ion
More informationSyncope in Heart Failure Patients How to judge and treat? Jean-Claude Deharo, MD, FESC Marseilles, France
Syncope in Heart Failure Patients How to judge and treat? Jean-Claude Deharo, MD, FESC Marseilles, France Syncope in advanced heart failure: high risk of sudden death N = 491 patients with HF (NYHA III-IV)
More informationActive Cascade Screening in Primary Inherited Arrhythmia Syndromes
Journal of the American College of Cardiology Vol. 55, No. 23, 2010 2010 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.12.063
More informationStrength and weakness of genetic testing in clinical routine.
Strength and weakness of genetic testing in clinical routine. Silvia G Priori MD PhD Molecular Cardiology, IRCCS Fondazione Maugeri Pavia, Italy AND Leon Charney Division of Cardiology, Cardiovascular
More informationSudden Cardiac Death and Asians Disclosures
Sudden Cardiac Death and Asians Disclosures 7 February 2009 Asian Heart and Vascular Symposium None Zian H. Tseng, M.D., M.A.S. Assistant Professor of Medicine Cardiac Electrophysiology Section University
More informationDIAGNOSIS AND MANAGEMENT OF ARRHYTHMOGENIC CARDIOMYOPATHY. David SIU MD ( 蕭頌華醫生 ) Division of Cardiology The University of Hong Kong
APHRS Summit 2018 in conjunction with HKCC Heart Rhythm Refresher Course DIAGNOSIS AND MANAGEMENT OF ARRHYTHMOGENIC CARDIOMYOPATHY David SIU MD ( 蕭頌華醫生 ) Division of Cardiology The University of Hong Kong
More informationSudden cardiac death: Primary and secondary prevention
Sudden cardiac death: Primary and secondary prevention By Kai Chi Chan Penultimate Year Medical Student St George s University of London at UNic Sheba Medical Centre Definition Sudden cardiac arrest (SCA)
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 informationSpontaneous type 1 pattern, ventricular arrhythmias and sudden cardiac death in Brugada Syndrome: an updated systematic review and meta-analysis
Journal of Geriatric Cardiology (2017) 14: 639 643 2017 JGC All rights reserved; www.jgc301.com Letter to the Editor Open Access Spontaneous type 1 pattern, ventricular arrhythmias and sudden cardiac death
More informationGenetic Testing for Cardiac Ion Channelopathies. Description
Genetic Testing for Cardiac Ion Page: 1 of 30 Last Review Status/Date: March 2017 Genetic Testing for Cardiac Ion Description Genetic testing is available for patients suspected of having cardiac ion channelopathies
More informationHA Convention 2010 Dr Liz YP Yuen Department of Chemical Pathology Prince of Wales Hospital
HA Convention 2010 Dr Liz YP Yuen Department of Chemical Pathology Prince of Wales Hospital 1 2 Sudden death an unexpected natural death within a short time period, generally 1 hour or less from the onset
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Implantable Cardioverter Defibrillators Page 1 of 44 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: See also: Implantable Cardioverter Defibrillators Wearable Cardioverter
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 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 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 informationHYPERTROPHIC CARDIOMYOPATHY RISK STRATIFICATION WHAT IS NEW?
HYPERTROPHIC CARDIOMYOPATHY RISK STRATIFICATION WHAT IS NEW? Division of Inherited Cardiac Diseases Heart Center for the Young and Athletes A Dpt of Cardiology University of Athens LANCET 2013 ESC HCM
More informationWhat You Should Know About Subcutaneous and Transvenous ICD
What You Should Know About Subcutaneous and Transvenous ICD N. A. Mark Estes III MD Professor of Medicine Tufts University School of Medicine Director, New England Cardiac Arrhythmia Center Tufts Medical
More information2017 AHA/ACC/HRS Ventricular Arrhythmias and Sudden Cardiac Death Guideline. Top Ten Messages. Eleftherios M Kallergis, MD, PhD, FESC
2017 AHA/ACC/HRS Ventricular Arrhythmias and Sudden Cardiac Death Guideline Top Ten Messages Eleftherios M Kallergis, MD, PhD, FESC Cadiology Department - Heraklion University Hospital No actual or potential
More informationWho does not need a primary preventive ICD?
Who does not need a primary preventive ICD? Hildegard Tanner, Bern Universitätsklinik für Kardiologie Disclosure of potential conflicts of interest Travel grants for educational purposes from: Biosense
More informationSudden Cardiac Death in the Young: Advances in Risk-stratification and Treatment
PEDIATRIC CARDIOLOGY and CARDIAC SURGERY VOL. 25 NO. 1 (8 15) Sudden Cardiac Death in the Young: Advances in Risk-stratification and Treatment Michael J. Silka and Yaniv Bar-Cohen Division of Cardiology,
More information