DIAGNOSIS AND MANAGEMENT OF ARRHYTHMOGENIC CARDIOMYOPATHY. David SIU MD ( 蕭頌華醫生 ) Division of Cardiology The University of Hong Kong

Size: px
Start display at page:

Download "DIAGNOSIS AND MANAGEMENT OF ARRHYTHMOGENIC CARDIOMYOPATHY. David SIU MD ( 蕭頌華醫生 ) Division of Cardiology The University of Hong Kong"

Transcription

1 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

2 Arrhythmogenic Cardiomyopathies Arrhythmogenic Cardiomyopathy Characterized by frequent ventricular arrhythmias and increased risk of SCD typically as early manifestation before the onset of significant myocardial remodeling Channelopathies Primarily Electrical disease with no or minimal structural changes LQTS, I ks, I kr, I Na BrS, I Na Cardiomyopathies Primarily contractile disease with electrical changes in relatively late stage HCM e.g. Sarcomeric proteins DCM e.g. Lamin A/C

3 Arrhythmogenic Cardiomyopathies Ventricular arrhythmias/scd in young Prevalence in the general population: % (average 1:5,000) High prevalence in certain regions of Italy (Padua, Venice) and Greece (Island of Naxos), prevalence: % 80% ARVC is diagnosed in patients > 40 years. M/F ratio: 2.7/1.0 Focal fibrofatty infiltration of RV Primarily autosomal dominant inheritance with variable penetrance and expressivity (1/3 Familial)

4 NATURAL HISTORY OF CLASSICAL RIGHT-SIDED ACM 1 st phase: minimal or no structural abnormalities. Yet, the patient is at risk of SCD. 2 nd phase: Characterized by ventricular arrhythmias of left bundle branch block morphology and structural changes, typically confined to the RV, which can be observed using echocardiography, angiography, and/or magnetic resonance imaging. During this phase, patients might experience syncope and/or palpitations. 3 rd phase: Overt RV failure with overall preserved LV function. 4 th phase: Overt LV involvement and biventricular heart failure. Left dominant ACM is characterized by primary (but not necessarily exclusive) LV involvement, and biventricular ACM is defined by early and parallel involvement of both ventricles.

5 Genetics of Arrhythmogenic Cardiomyopathies E.T. Hoorntje. Cardiovascular Research 2017

6 Genetics of Arrhythmogenic Cardiomyopathies E.T. Hoorntje. Cardiovascular Research 2017

7 Proposed Cellular And Molecular Cascades Underlying Arrhythmogenic Cardiomyopathy E.T. Hoorntje. Cardiovascular Research 2017

8 ARVC and Brugada Syndrome The intercalated discs that connect cardiomyocytes control cell-to-cell adhesion and communication. Several macromolecular structures (desmosomes, fascia adherens junctions, gap junctions, and sodium-channel complexes) coexist in, and confer their mechanical and electrical properties to, the intercalated disc. Javier Moncayo-Arlandi and Ramon Brugada. Nature Review Cardiology 2017

9 1. Global or regional dysfunction & structural alterations 2. Tissue characterization of wall 3. Repolarization abnormalities 4. Depolarization abnormalities 5. Arrhythmias 6. Family history Circulation 2010; EHJ 2010

10 Diagnostic Criteria: 1. Global or regional dysfunction & structural alterations (ECHO) Major Criteria Regional RV akinesia, dyskinesia, or aneurysm + 1 of the following (end diastole): PLAX RVOT 32 mm (corrected for body size [PLAX/BSA] >=19 mm/m2) PSAX RVOT 36 mm (corrected for body size [PSAX/BSA] >=21 mm/m2) Fractional area change <=33% Minor Criteria Regional RV akinesia or dyskinesia + 1 of the following (end diastole): PLAX RVOT 29 to,32 mm (corrected for body size [PLAX/BSA] 16 to 19 mm/m2) PSAX RVOT 32 to,36 mm (corrected for body size [PSAX/BSA] 18 to 21 mm/m2) Fractional area change 33% to 40% Circulation 2010; EHJ 2010

11 Diagnostic Criteria: 1. Global or regional dysfunction & structural alterations (ECHO) RV R TV RVOT-Prox RVOT-Distal L LV Ao RA PA LA LA PARASTERNAL LONG AXIS PARASTERNAL LONG AXIS

12 Diagnostic Criteria: 1. Global or regional dysfunction & structural alterations (ECHO) RV RV RV Fractional Area Change (%) = 100 X (RV end diastolic area - RV end systolic area) RV end diastolic area RA RA End-diastolic End-systolic APICAL 4-CHAMBER VIEW

13 Diagnostic Criteria: 1. Global or regional dysfunction & structural alterations (MRI) Major Criteria Regional RV akinesia or dyskinesia or dyssynchronous RV contraction + 1 of the following: Ratio of RVEDV/BSA 110 ml/m 2 (male) or 100 ml/m 2 (female) RVEF <40% Minor Criteria Regional RV akinesia or dyskinesia or dyssynchronous RV contraction + 1 of the following: Ratio of RVEDV/BSA ml/m 2 (male) or ml/m 2 (female) RVEF 40-45%

14 Diagnostic Criteria: 1. Global or regional dysfunction & structural alterations (RV angiography) Major Criteria Regional RV akinesia, dyskinesia, or aneurysm

15 Diagnostic Criteria II. Tissue Characterization of Wall Major Criteria Residual myocytes <60% by morphometric analysis (or <50% if estimated), with fibrous replacement of RV free wall myocardium in >=1 sample, with or without fatty replacement of tissue on endomyocardial biopsy Minor Criteria Residual myocytes 60% to 75% by morphometric analysis (or 50% to 65% if estimated), with fibrous replacement of RV free wall myocardium in >=1 sample, with or without fatty replacement of tissue on endomyocardial biopsy Circulation 2010; EHJ 2010

16 Diagnostic Criteria III. Repolarization abnormalities Major Criteria Inverted T waves in right precordial leads (V1, V2 and V3) or beyond in individuals > 14 years of age (in the absence of complete RBBB QRS >=120ms) Minor Criteria Inverted T waves in V1 and V2 in individuals > 14 years of age (in the absence of complete RBBB QRS >=120ms) or in V4, V5, or V6 Inverted T waves in V1, V2, V3 and V4 in individuals > 14 years of age in the presence of complete RBBB Circulation 2010; EHJ 2010

17 Diagnostic Criteria Major Criteria IV. Depolarization & Conduction abnormalities Epsilon wave (reproducible low-amplitude signals between end of QRS complex to onset of the T wave) in the right precordial leads (V1 to V3) Minor Criteria Late potentials by SAECG in 1 of 3 parameters in the absence of a QRS duration of 110 ms on the standard ECG Filtered QRS duration (fqrs) >= 114 ms Duration of terminal QRS <40 uv (low-amplitude signal duration) >=38 ms Root-mean-square voltage of terminal 40 ms <=20 mv Terminal activation duration of QRS >=55 ms measured from the nadir of the S wave to the end of the QRS, including R, in V1, V2, or V3, in the absence of complete right bundle-branch block Circulation 2010; EHJ 2010

18 ECG from a proband with ARVC Prolongation of terminal activation >=55 ms from S to end of QRS T-wave inversion Frank I. Marcus et al. Circulation. 2010;121:

19 ECG from a proband with ARVC epsilon wave Prolongation of terminal activation >=55 ms from nadir of S to end of QRS epsilon wave T-wave inversion epsilon wave

20 Chiara Calore EHJ 2015

21 Jan Novak Europace 2017

22 Diagnostic Criteria V. Arrhythmias Major Criteria NSVT or sustained VT of LBBB morphology with superior axis (negative or indeterminate QRS in lead II, III, & avf and positive in lead avl) Minor Criteria NSVT or sustained VT of RVOT configuration, LBBB morphology with inferior axis (positive QRS in lead II, III, & avf and negative in lead avl) or of unknown axis > 500 PVC per 24 hours (Holter) Circulation 2010; EHJ 2010

23 Major Criteria Diagnostic Criteria: VI. Family History ARVC/D confirmed in a 1 st degree relative who meets current Task Force criteria ARCV/D confirmed pathologically at autopsy or surgery in a 2 nd degree relative Identification of a pathologically mutation categorized as associated or probably associated with ARVC/D in patient under evaluation Minor Criteria History of ARVC/D in a 1 st degree relative in whom it is not possible or practical to determine whether the family member meets current Task Force criteria Premature sudden death (<35 years of age) due to suspected ARVC/D in 1 st degree relative ARCV/D confirmed pathologically or by current Task Force Criteria in a 2 nd degree relative Circulation 2010; EHJ 2010

24 Diagnostic Criteria for ARVC/D Definite ARVC/D 2 major (2 x 2 points) 1 major and 2 minor criteria (2 + (2 x 1) points) or 4 minor from different categories (4 x 1 points) Borderline 1 major and 1 minor (2 + 1 points) or 3 minor criteria from different categories (3 x 1 points) Possible 1 major (2 points) or 2 minor criteria from different categories (2 x1 points) Circulation 2010; EHJ 2010

25 78 carriers Male: 46 Mean age: 44 years Regular physical activity from 10 years of age. Cynthia A. James JACC 2013

26 Impacts of Exercise on ARVC Presentation & Arrhythmic Outcomes Cynthia A. James JACC 2013

27 Threshold model for phenotypic expression of Arrhythmogenic Cardiomyopahty E.T. Hoorntje. Cardiovascular Research 2017

28 Gabriela M. Orgeron et al. JAHA 2017 Risk Stratification for Ventricular Arrhythmic events 312 patients with definite ARVC with ICD 163 men (52%) Age at presentation: 33.6±13.9 years Cumulative survival from first appropriate ICD intervention (VT/VF) Increased Risk with Inducible VT on EPS Male >= 3 TWIs >1,000PVCs/day VT at presentation Secondary prevention

29 Risk Stratification: Meta-analysis Arrhythmic outcome: Definite ARVC: 10.6%/yr Borderline ARVC: 10.0%/yr Mutation carriers: 3.7%/yr Bosman Laurens Heart Rhythm 2018

30 Risk Stratification: Meta-analysis Bosman Laurens Heart Rhythm 2018

31 Risk Factors for Arrhythmic Events Definite ARVC patients Male gender Syncope T-wave inversion >V3 RV dysfunction Prior (non) sustained VT/VF; Borderline ARVC patients All factors in Definite ARVC patients Inducibility at EPS and Inducibility during strenuous exercise Mutation carriers regardless of ARVC phenotypes All aforementioned predictors Ventricular ectopy, Multiple ARVC-related pathogenic mutations LV dysfunction Palpitations/pre-syncope determined arrhythmic risk. Bosman Laurens Heart Rhythm 2018

32 Flow chart of risk stratification and indications to ICD implantation in ARVC/D High Risk >10%/yr arrhythmic events Intermediate Risk 1-10%/yr arrhythmic events Low Risk <1%/yr arrhythmic events - Aborted SCD due to VF - Sustained VT - Severe RV dysfunction (RVEF <36%) - Severe LV dysfunction (LVEF <36%) >=1 major risk factors - Syncope - NSVT - Moderate RV dysfunction (RVEF 36-46%) - Moderate LV dysfunction (LVEF ) >= 1 minor risk factors: complex genotype, male sex, proband, positive EPS, T-wave inversion in 2/3 inferior leads, and T- wave inversion in >=V3 - No risk factors - Healthy gene carriers ICD indicated (Class I) ICD should be considered (Class IIa) ICD May be considered (Class IIb) ICD not indicated (Class III) Corrado Domenico, Circulation

33 Management: AAD AADs are recommended as an adjunct therapy to ICD in ARVC/D patients with frequent appropriate device discharges (class I). The use of AADs should be considered to improve symptoms in patients with frequent premature ventricular beats and/or nonsustained VT (class IIa).

34 Management: Beta-blocker Beta-blocker therapy is recommended in ARVC/D patients with recurrent VT, appropriate ICD therapies, or inappropriate ICD interventions resulting from sinus tachycardia, supraventricular tachycardia, or atrial fibrillation/flutter with high-ventricular rate (class I). Beta-blocker therapy should be considered in all patients with ARVD/C irrespective of arrhythmias (class IIa). The prophylactic use of β-blockers in healthy gene carriers is not recommended (class III).

35 Management: Ablation Catheter ablation of VT is recommended in ARVC/D patients with incessant VT or frequent appropriate ICD interventions on VT despite maximal pharmacological therapy, including amiodarone (class I). Catheter ablation of VT should be considered in ARVC/D patients with incessant VT or frequent appropriate ICD interventions on VT who have failed pharmacological therapy other than amiodarone (class IIa).

36 Conclusions ARVC is associated with risk of SCD in young adult The arrhythmic risk ranges from % per years Common factors for arrhythmic risk have been identified including gender, presentation, symptom, cardiac function, ECG features, and so on Strenuous exercise hastens development of cardiac phenotype, therefor should be avoided For high risk patients, ICD should be considered Future studies are needed to develop risk models to tailor individual patient management.

FANS ARVC (Arrhythmogenic Right Ventricular Cardiomyopathy) Investigation Protocol

FANS ARVC (Arrhythmogenic Right Ventricular Cardiomyopathy) Investigation Protocol Clinical Features FANS ARVC (Arrhythmogenic Right Ventricular Cardiomyopathy) Investigation Protocol History: Progressive disease, characterised by the following clinical stages: o Early concealed phase

More information

BMR Medicine. Case Study YOUNG PATIENT WITH RECURRENT PRESYNCOPE: A CASE REPORT

BMR Medicine. Case Study YOUNG PATIENT WITH RECURRENT PRESYNCOPE: A CASE REPORT www.bmrjournals.com Open Access Scientific Publisher Case Study YOUNG PATIENT WITH RECURRENT PRESYNCOPE: A CASE REPORT ABSTRACT Manish Ruhela *, Vijay Pathak, Anoop Jain, Department of Cardiology, Sawai

More information

Arrhythmogenic Right Ventricular Dysplasia: An Under-recognized Form of Inherited Cardiomyopathy

Arrhythmogenic Right Ventricular Dysplasia: An Under-recognized Form of Inherited Cardiomyopathy Case Review Arrhythmogenic Right Ventricular Dysplasia: An Under-recognized Form of Inherited Cardiomyopathy George O. Adesina, MD, Shelly A. Hall, MD, Jose C. Mendez, MD, Susan M. Joseph, MD, Robert L.

More information

Arrhythmogenic Right Ventricular Cardiomyopathy. Europace June 28,2011

Arrhythmogenic Right Ventricular Cardiomyopathy. Europace June 28,2011 Arrhythmogenic Right Ventricular Cardiomyopathy Europace June 28,2011 Right Ventricular Cardiomyopathy Classical ARVC is defined as a cardiac disease mainly involving the right ventricle, characterized

More information

Arrhythmogenic Cardiomyopathy cases. Δέσποινα Παρχαρίδου Καρδιολόγος Επιστημονικός Συνεργάτης Α Καρδιολογική κλινική ΑΧΕΠΑ

Arrhythmogenic Cardiomyopathy cases. Δέσποινα Παρχαρίδου Καρδιολόγος Επιστημονικός Συνεργάτης Α Καρδιολογική κλινική ΑΧΕΠΑ Arrhythmogenic Cardiomyopathy cases Δέσποινα Παρχαρίδου Καρδιολόγος Επιστημονικός Συνεργάτης Α Καρδιολογική κλινική ΑΧΕΠΑ Definition ARVD (Arrhythmogenic Right Ventricular Dysplasia) Progressive loss of

More information

Update on use of cardiac MRI in ARVC/D. Stefan L. Zimmerman, MD Johns Hopkins University Department of Radiology

Update on use of cardiac MRI in ARVC/D. Stefan L. Zimmerman, MD Johns Hopkins University Department of Radiology Update on use of cardiac MRI in ARVC/D Stefan L. Zimmerman, MD Johns Hopkins University Department of Radiology Outline Background Diagnosis Characteristic imaging findings Genetics of ARVC Genotype phenotype

More information

Prevention of Sudden Death in ARVC

Prevention 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 information

Implications of the new diagnostic criteria for ARVC

Implications of the new diagnostic criteria for ARVC EUROECHO 2010 Echocardiographic assessment of cardiomyopathies Implications of the new diagnostic criteria for ARVC Barbara Bauce, MD, PhD Department of Cardiac, Thoracic and Vascular Sciences University

More information

Biventricular Arrhythmogenic Cardiomyopathy: A New Paradigm?

Biventricular Arrhythmogenic Cardiomyopathy: A New Paradigm? International Journal of Cardiovascular Sciences. 2018;31(6)667-671 667 CASE REPORT Biventricular Arrhythmogenic Cardiomyopathy: A New Paradigm? João Augusto, 1 João Abecasis, 2 Victor Gil 2 Service of

More information

Arrhythmogenic right ventricular

Arrhythmogenic right ventricular case report Oman Medical Journal [2017], Vol. 32, No. 4: 339-343 First Reported Case of Arrhythmogenic Right Ventricular Cardiomyopathy in Oman Hatim Al Lawati 1 * and Humoud Al Dhuhli 2 1 Division of

More information

Name of Presenter: Marwan Refaat, MD

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 information

ARVC when TO IMPLANT THE ASYMPTOMATIC PERSON

ARVC 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 information

Benign RVOT Ectopy and RV dysplasia

Benign RVOT Ectopy and RV dysplasia Heart Rhythm Congress Birmingham October 2009 How to distinguish between... Benign RVOT Ectopy and RV dysplasia in the child... Dr Graham Stuart 14yr old boy asymptomatic irregular pulse picked up by GP

More information

Unusual Serial Electrocardiographic Changes which Progressed to Arrhythmogenic Right Ventricular Cardiomyopathy

Unusual Serial Electrocardiographic Changes which Progressed to Arrhythmogenic Right Ventricular Cardiomyopathy CASE REPORT Unusual Serial Electrocardiographic Changes which Progressed to Arrhythmogenic Right Ventricular Cardiomyopathy Shu Yoshihara 1,2, Masaki Matsunaga 2, Taku Yaegashi 3, Shioto Suzuki 4, Masaaki

More information

Arrhythmias (II) Ventricular Arrhythmias. Disclosures

Arrhythmias (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 information

Managing Hypertrophic Cardiomyopathy with Imaging. Gisela C. Mueller University of Michigan Department of Radiology

Managing Hypertrophic Cardiomyopathy with Imaging. Gisela C. Mueller University of Michigan Department of Radiology Managing Hypertrophic Cardiomyopathy with Imaging Gisela C. Mueller University of Michigan Department of Radiology Disclosures Gadolinium contrast material for cardiac MRI Acronyms Afib CAD Atrial fibrillation

More information

Urgent VT Ablation in a Patient with Presumed ARVC

Urgent VT Ablation in a Patient with Presumed ARVC Urgent VT Ablation in a Patient with Presumed ARVC Mr Alex Cambridge, Chief Cardiac Physiologist, St. Barts Hospital, London, UK The patient, a 52 year-old male, attended the ICD clinic without an appointment

More information

Exercise guidelines in athletes with isolated repolarisation abnormalities and structurally normal heart.

Exercise 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 information

Tachycardia Devices Indications and Basic Trouble Shooting

Tachycardia 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 information

Clinical aspects of Arrhythmogenic Cardiomyopathies

Clinical aspects of Arrhythmogenic Cardiomyopathies Clinical aspects of Arrhythmogenic Cardiomyopathies INTERNATIONAL CLINICAL CARDIOVASCULAR GENETICS CONFERENCE 25 May 2018 Dr Hari Raju MBChB PhD ECES FRACP Clinical Associate Professor, Macquarie University,

More information

Sudden cardiac death: Primary and secondary prevention

Sudden 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 information

Echocardiography for the Electrophysiologist: Day-to-day practice. Emmanuel Fares, MD

Echocardiography for the Electrophysiologist: Day-to-day practice. Emmanuel Fares, MD Echocardiography for the Electrophysiologist: Day-to-day practice Emmanuel Fares, MD EP and pacing service, Department of Cardiovascular Medicine, Cairo University Agenda Role of echo in arrhythmia management:

More information

Tachycardias II. Štěpán Havránek

Tachycardias 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 information

Arrhythmogenic right ventricular dysplasia: a rare case report from tribal zone of Central India

Arrhythmogenic right ventricular dysplasia: a rare case report from tribal zone of Central India International Journal of Research in Medical Sciences Khunte P et al. Int J Res Med Sci. 2015 Apr;3(4):1025-1029 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Case Report DOI: 10.5455/2320-6012.ijrms20150445

More information

at least 4 8 hours per week

at least 4 8 hours per week ECG IN ATHLETS An athlete is defined as an individual who engages in regular exercise or training for sport or general fitness, typically with a premium on performance, and often engaged in individual

More information

High Arrhythmic Burden but Low Mortality during Long-term Follow-up in Arrhythmogenic Right Ventricular Cardiomyopathy

High Arrhythmic Burden but Low Mortality during Long-term Follow-up in Arrhythmogenic Right Ventricular Cardiomyopathy Heart, Lung and Circulation (2016) 25, 275 281 1443-9506/04/$36.00 http://dx.doi.org/10.1016/j.hlc.2015.08.019 ORIGINAL ARTICLE High Arrhythmic Burden but Low Mortality during Long-term Follow-up in Arrhythmogenic

More information

Ablative Therapy for Ventricular Tachycardia

Ablative Therapy for Ventricular Tachycardia Ablative Therapy for Ventricular Tachycardia Nitish Badhwar, MD, FACC, FHRS 2 nd Annual UC Davis Heart and Vascular Center Cardiovascular Nurse / Technologist Symposium May 5, 2012 Disclosures Research

More information

Εμφύτευση 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 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 information

ECG Underwriting Puzzler Dr. Regina Rosace AVP & Medical Director

ECG Underwriting Puzzler Dr. Regina Rosace AVP & Medical Director December 2018 ECG Underwriting Puzzler Dr. Regina Rosace AVP & Medical Director To obtain best results Select Slide Show from the ribbon at the top of your PowerPoint screen Select From Beginning on the

More information

Prevalence of Modified ARVC Task Force Criteria in Elite Male Athletes

Prevalence of Modified ARVC Task Force Criteria in Elite Male Athletes ESC Congress Paris 2011 Prevalence of Modified ARVC Task Force Criteria in Elite Male Athletes A Zaidi, N Sheikh, S Gati, S Ghani, R Howes, S Sharma St George s, University of London, United Kingdom Conflict

More information

6/19/2018. Background Athlete s heart. Ultimate question. Applying the International Criteria for ECG

6/19/2018. Background Athlete s heart. Ultimate question. Applying the International Criteria for ECG Applying the International Criteria for ECG Interpretation in Athletes to a preparticipation screening program DAVE SIEBERT, MD, CAQSM ASSISTANT PROFESSOR DEPARTMENT OF FAMILY MEDICINE UNIVERSITY OF WASHINGTON

More information

Advances in Ablation Therapy for Ventricular Tachycardia

Advances in Ablation Therapy for Ventricular Tachycardia Advances in Ablation Therapy for Ventricular Tachycardia Nitish Badhwar, MD, FACC, FHRS Director, Cardiac Electrophysiology Training Program University of California, San Francisco For those of you who

More information

Ventricular Tachycardia Ablation. Saverio Iacopino, MD, FACC, FESC

Ventricular Tachycardia Ablation. Saverio Iacopino, MD, FACC, FESC Ventricular Tachycardia Ablation Saverio Iacopino, MD, FACC, FESC ü Ventricular arrhythmias, both symptomatic and asymptomatic, are common, but syncope and SCD are infrequent initial manifestations of

More information

Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Three Decades of Progress Hugh Calkins, MD FOCUS

More information

ECG Workshop. Carolyn Shepherd And Anya Horne UWE Principles of Cardiac Care

ECG Workshop. Carolyn Shepherd And Anya Horne UWE Principles of Cardiac Care ECG Workshop Carolyn Shepherd And Anya Horne UWE Principles of Cardiac Care ECG workshop case study1 44 Year old male. Reports SOB, Lethargy, tiredness. PMH: Hypertension, nil else. What tests? What treatment?

More information

Office ECG Interpretation

Office ECG Interpretation Office ECG Interpretation Jason Evanchan, DO Assistant Professor of Medicine Division of Cardiovascular Medicine The Ohio State University Wexner Medical Center Outline of topics High risk ischemia T wave

More information

Treatment of VT of Purkinje fiber origin: ablation targets and outcome

Treatment 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 information

La valutazione dell atleta: è una strategia salva-vita e costo-efficace?

La 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 information

Normal ECG And ECHO Findings in Athletes

Normal ECG And ECHO Findings in Athletes Normal ECG And ECHO Findings in Athletes Dr.Yahya Kiwan Consultant Interventional Cardiologist Head Of Departement Of Cardiology Canadian Specialist Hospital Sinus Bradycardia The normal heartbeat is initiated

More information

The 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 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 information

Pearls of the ESC/ERS Guidelines 2015 Channelopathies

Pearls 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 information

The Role of Defibrillator Therapy in Genetic Arrhythmia Syndromes

The 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 information

Isolated Cardiac Sarcoidosis Mimicking Arrhythmogenic Right Ventricular Cardiomyopathy

Isolated Cardiac Sarcoidosis Mimicking Arrhythmogenic Right Ventricular Cardiomyopathy doi: 10.2169/internalmedicine.9395-17 Intern Med Advance Publication http://internmed.jp CASE REPORT Isolated Cardiac Sarcoidosis Mimicking Arrhythmogenic Right Ventricular Cardiomyopathy Hirotaka Waki

More information

Arrhythmogenic right ventricular dysplasia masquerading as right ventricular outflow tract tachycardia

Arrhythmogenic right ventricular dysplasia masquerading as right ventricular outflow tract tachycardia Pop-Mandru et al. 314 case in images OPEN ACCESS Arrhythmogenic right ventricular dysplasia masquerading as right ventricular outflow tract tachycardia Daniel Pop-Mandru, Gabriel Cismaru, Dana Pop, Dumitru

More information

ΤΙ ΠΡΕΠΕΙ ΝΑ ΓΝΩΡΙΖΕΙ ΟΓΕΝΙΚΟΣ ΚΑΡΔΙΟΛΟΓΟΣ ΓΙΑ ΤΙΣ ΔΙΑΥΛΟΠΑΘΕΙΕΣ

ΤΙ 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 information

Silvia G Priori MD PhD

Silvia 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 information

FANS Paediatric Pathway for Inherited Arrhythmias*

FANS 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 information

Arrhythmogenic right ventricular cardiomyopathy/dysplasia. Analysis based on six cases

Arrhythmogenic right ventricular cardiomyopathy/dysplasia. Analysis based on six cases ORIGINAL ARTICLE Cardiology Journal 2007, Vol. 14, No. 4, pp. 396 401 Copyright 2007 Via Medica ISSN 1897 5593 Arrhythmogenic right ventricular cardiomyopathy/dysplasia: Analysis based on six cases Radosław

More information

INTRODUCTION. left ventricular non-compaction is a sporadic or familial cardiomyopathy characterized by

INTRODUCTION. left ventricular non-compaction is a sporadic or familial cardiomyopathy characterized by A Rare Case of Arrhythmogenic Right Ventricular Cardiomyopathy Co-existing with Isolated Left Ventricular Non-compaction NS Yelgeç, AT Alper, Aİ Tekkeşin, C Türkkan INTRODUCTION Arrhythmogenic right ventricular

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE

NATIONAL 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 information

ECG Cases and Questions. Ashish Sadhu, MD, FHRS, FACC Electrophysiology/Cardiology

ECG Cases and Questions. Ashish Sadhu, MD, FHRS, FACC Electrophysiology/Cardiology ECG Cases and Questions Ashish Sadhu, MD, FHRS, FACC Electrophysiology/Cardiology 32 yo female Life Insurance Physical 56 yo male with chest pain Terminology Injury ST elevation Ischemia T wave inversion

More information

Cardiomyopathies. Andre Keren, MD

Cardiomyopathies. Andre Keren, MD Cardiomyopathies Andre Keren, MD Cardiomyopathies Heart muscle disease of unknown etiology Elliott P et al. Eur Heart J 2008;29:270-276 Definition of Cardiomyopathies Elliott P et al. Eur Heart J 2008;29:270-276

More information

Study methodology for screening candidates to athletes risk

Study methodology for screening candidates to athletes risk 1. Periodical Evaluations: each 2 years. Study methodology for screening candidates to athletes risk 2. Personal history: Personal history of murmur in childhood; dizziness, syncope, palpitations, intolerance

More information

Outflow Tract Ventricular Tachycardia Always Benign?

Outflow 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 information

SUDDEN CARDIAC DEATH(SCD): Definition

SUDDEN 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 information

Inherited Arrhythmia Syndromes

Inherited Arrhythmia Syndromes Inherited Arrhythmia Syndromes When to perform Genetic testing? Arthur AM Wilde February 4, 2017 Which pts should undergo genetic testing? SCD victims with a likely diagnosis Pts diagnosed with an inherited

More information

SUDDEN CARDIAC DEATH(SCD): Definition

SUDDEN 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 information

Echocardiographic Evaluation of the Cardiomyopathies. Stephanie Coulter, MD, FACC, FASE April, 2016

Echocardiographic Evaluation of the Cardiomyopathies. Stephanie Coulter, MD, FACC, FASE April, 2016 Echocardiographic Evaluation of the Cardiomyopathies Stephanie Coulter, MD, FACC, FASE April, 2016 Cardiomyopathies (CMP) primary disease intrinsic to cardiac muscle Dilated CMP Hypertrophic CMP Infiltrative

More information

Impact of the Revision of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia Task Force Criteria on Its Prevalence by CMR Criteria

Impact of the Revision of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia Task Force Criteria on Its Prevalence by CMR Criteria JACC: CARDIOVASCULAR IMAGING VOL. 4, NO. 3, 2011 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-878X/$36.00 PUBLISHED BY ELSEVIER INC. DOI:10.1016/j.jcmg.2011.01.005 Impact of the Revision

More information

SEMINAIRES IRIS. Sudden cardiac death in the adult. Gian Battista Chierchia. Heart Rhythm Management Center, UZ Brussel. 20% 25% Cancers !

SEMINAIRES 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 information

27-year-old professionnal rugby player: asymptomatic

27-year-old professionnal rugby player: asymptomatic 27-year-old professionnal rugby player: asymptomatic Benefits and limits of cardiac MRI in the young athlete with a suspected heart disease. Philippe PAULE Service de Cardiologie, HIA Clermont Tonnerre,

More information

Acute Coronary Syndromes Unstable Angina Non ST segment Elevation MI (NSTEMI) ST segment Elevation MI (STEMI)

Acute Coronary Syndromes Unstable Angina Non ST segment Elevation MI (NSTEMI) ST segment Elevation MI (STEMI) Leanna R. Miller, RN, MN, CCRN-CSC, PCCN-CMC, CEN, CNRN, CMSRN, NP Education Specialist LRM Consulting Nashville, TN Objectives Evaluate common abnormalities that mimic myocardial infarction. Identify

More information

DELAYED ENHANCEMENT IMAGING IN CHILDREN

DELAYED ENHANCEMENT IMAGING IN CHILDREN NASCI 38 TH ANNUAL MEENG, SEATLE October 3-5, 21 1. DELAYED ENHANCEMENT IN CHILDREN Shi-Joon Yoo, MD Lars Grosse-Wortmann, MD University of Toronto Canada -1. 1. 1. Magnitude image Magnitude images -1.

More information

Invasive Risk Stratification: When is it needed?

Invasive 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 information

CLINICAL PROFILE OF ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC) Lubna Noor, Yasir Adnan, Mohammad Faheem, Shahab Ud Din, 5 6 7

CLINICAL PROFILE OF ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC) Lubna Noor, Yasir Adnan, Mohammad Faheem, Shahab Ud Din, 5 6 7 Pak Heart J ORIGINAL ARTICLE CLINICAL PROFILE OF ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC) 1 2 3 4 Lubna Noor, Yasir Adnan, Mohammad Faheem, Shahab Ud Din, 5 6 7 Amina, Kamran Bangash, Zahid

More information

Το ΗΚΓ στις Μυοκαρδιοπάθειες και στην Περικαρδίτιδα

Το ΗΚΓ στις Μυοκαρδιοπάθειες και στην Περικαρδίτιδα 4 ο ΠΑΝΕΛΛΗΝΙΟ ΑΡΡΥΘΜΙΟΛΟΓΙΚΟ ΣΥΝΕΔΡΙΟ Φροντιστηριακό Μάθημα ΗΚΓ Το ΗΚΓ στις Μυοκαρδιοπάθειες και στην Περικαρδίτιδα Γ.Ν.Α. «Ο Ευαγγελισμός» Ξυδώνας Σωτήριος, MD, PhD, FESC Εργαστήριο Ηλεκτροφυσιολογίας

More information

Arrhythmogenic right ventricular cardiomyopathy/dysplasia

Arrhythmogenic right ventricular cardiomyopathy/dysplasia ORIGINAL ARTICLE Cardiology Journal 2010, Vol. 17, No. 2, pp. 172 178 Copyright 2010 Via Medica ISSN 1897 5593 Arrhythmogenic right ventricular cardiomyopathy/dysplasia in Iraq Amar Al-Hamdi 1, 2, Tahseen

More information

How to manage a patient with short QT syndrome?

How 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 information

Sudden Cardiac Death What an electrophysiologist thinks a cardiologist should know

Sudden 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 information

PVCs: Do they cause Cardiomyopathy? Raed Abu Sham a, M.D.

PVCs: 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 information

EVALUATION OF ELECTROCARDIOGRAPHIC FINDINGS IN ATHLETES

EVALUATION OF ELECTROCARDIOGRAPHIC FINDINGS IN ATHLETES EVALUATION OF ELECTROCARDIOGRAPHIC FINDINGS IN ATHLETES UNIT OF INHERITED CV DISEASES HEART CENTER OF THE YOUNG AND ATHLETES A DPT OF CARDIOLOGY UNIVERSITY OF ATHENS EVALUATION OF ELECTROCARDIOGRAPHIC

More information

Apical Hypertrophic Cardiomyopathy With Hemodynamically Unstable Ventricular Arrhythmia Atypical Presentation

Apical Hypertrophic Cardiomyopathy With Hemodynamically Unstable Ventricular Arrhythmia Atypical Presentation Cronicon OPEN ACCESS Hemant Chaturvedi* Department of Cardiology, Non-Invasive Cardiology, Eternal Heart Care Center & research Institute, Rajasthan, India Received: September 15, 2015; Published: October

More information

Clinical study of 39 Chinese patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy

Clinical study of 39 Chinese patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy Chinese Medical Journal 2009;122(10):1133-1138 1133 Original article Clinical study of 39 Chinese patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy MA Ke-juan, LI Ning, WANG Hong-tao,

More information

Tachycardia-induced heart failure - Does it exist?

Tachycardia-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 information

Current ECG interpretation guidelines in the screening of athletes

Current ECG interpretation guidelines in the screening of athletes REVIEW ARTICLE 7 How to differentiate physiological adaptation to intensive physical exercise from pathologies Current ECG interpretation guidelines in the screening of athletes Gemma Parry-Williams, Sanjay

More information

Synopsis of Management on Ventricular arrhythmias. M. Soni MD Interventional Cardiologist

Synopsis 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 information

4/14/15. The Electrocardiogram. In jeopardy more than a century after its introduction by Willem Einthoven? Time for a revival. by Hein J.

4/14/15. The Electrocardiogram. In jeopardy more than a century after its introduction by Willem Einthoven? Time for a revival. by Hein J. The Electrocardiogram. In jeopardy more than a century after its introduction by Willem Einthoven? Time for a revival. by Hein J. Wellens MD 1 Einthoven, 1905 The ECG! Everywhere available! Easy and rapid

More information

SUDDEN CARDIAC DEATH IN ATHLETES

SUDDEN CARDIAC DEATH IN ATHLETES SUDDEN CARDIAC DEATH IN ATHLETES Alix Dufresne, MD, FACP, FACC, FESC Cardiology Division Chief, Interfaith Medical Center Director Cardiology Clinic, Kingsbrook Jewish Center PURPOSE AND OBJECTIVES PURPOSE

More information

Arrhythmogenic right ventricular cardiomyopathy

Arrhythmogenic right ventricular cardiomyopathy Heart 2000;83:588 595 588 CARDIOMYOPATHY Arrhythmogenic right ventricular cardiomyopathy: diagnosis, prognosis, and treatment Domenico Corrado, Cristina Basso, Gaetano Thiene Departments of Cardiology

More information

Antony French Consultant Cardiologist & Electrophysiologist

Antony 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 information

Do All Patients With An ICD Indication Need A BiV Pacing Device?

Do All Patients With An ICD Indication Need A BiV Pacing Device? Do All Patients With An ICD Indication Need A BiV Pacing Device? Muhammad A. Hammouda, MD Electrophysiology Laboratory Department of Critical Care Medicine Cairo University Etiology and Pathophysiology

More information

Ventricular tachycardia Ventricular fibrillation and ICD

Ventricular tachycardia Ventricular fibrillation and ICD EKG Conference Ventricular tachycardia Ventricular fibrillation and ICD Samsung Medical Center CCU D.I. Hur Ji Won 2006.05.20 Ventricular tachyarrhythmia ventricular tachycardia ventricular fibrillation

More information

Abnormal electrocardiographic findings in athletes: recognising changes suggestive of cardiomyopathy

Abnormal electrocardiographic findings in athletes: recognising changes suggestive of cardiomyopathy Scan to access more free content For numbered affiliations see end of article Correspondence to Jonathan A Drezner, Department of Family Medicine, University of Washington, 1959 NE Pacific Street, Box

More information

Improving 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 Suneet Mittal, MD Improving Patient Outcomes with a Syncope Center: Early Risk Stratification of Patients who Require Device Therapy Suneet Mittal, MD Director,

More information

2017 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 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 information

Secondary prevention of sudden cardiac death

Secondary 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 information

Index. cardiacep.theclinics.com. Note: Page numbers of article titles are in boldface type.

Index. 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 information

Pattarapong 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 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 information

Clinical Genetics in Cardiomyopathies

Clinical Genetics in Cardiomyopathies Clinical Genetics in Cardiomyopathies Γεώργιος Κ Ευθυμιάδης Αναπληρωτής Καθηγητής Καρδιολογίας ΑΠΘ No conflict of interest Genetic terms Proband: The first individual diagnosed in a family Mutation: A

More information

Ventricular arrhythmias

Ventricular 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 information

What Every Physician Should Know:

What 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 information

Thoranis Chantrarat MD

Thoranis Chantrarat MD Device Therapy in Heart Failure Thoranis Chantrarat MD 1 Scope of presentation Natural history of heart failure Primary and secondary prevention ICD and its indication CRT and its indication 2 Severity

More information

When to ablate patients with premature ventricular complexes?

When 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 information

Cardiac Devices CRT,ICD: Who is and is not a Candidate? Who Decides

Cardiac Devices CRT,ICD: Who is and is not a Candidate? Who Decides Cardiac Devices CRT,ICD: Who is and is not a Candidate? Who Decides Colette Seifer MB(Hons) FRCP(UK) Associate Professor, University of Manitoba, Cardiologist, Cardiac Sciences Program, St Boniface Hospital

More information

Arrhythmias 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 Dr Chris Lang Consultant Cardiologist and Electrophysiologist Royal Infirmary of Edinburgh Arrhythmias and Heart Failure Ventricular Supraventricular VT/VF Primary prevention

More information

Aνταλένα Τσατσοπούλου ΝΙΚΟΣ ΠΡΩΤΟΝΟΤΑΡΙΟΣ ΙΑΤΡΙΚΟ ΚΕΝΤΡΟ - ΝΑΞΟΣ. Arrhythmogenic Cardiomyopathy

Aνταλένα Τσατσοπούλου ΝΙΚΟΣ ΠΡΩΤΟΝΟΤΑΡΙΟΣ ΙΑΤΡΙΚΟ ΚΕΝΤΡΟ - ΝΑΞΟΣ. Arrhythmogenic Cardiomyopathy Aνταλένα Τσατσοπούλου ΝΙΚΟΣ ΠΡΩΤΟΝΟΤΑΡΙΟΣ ΙΑΤΡΙΚΟ ΚΕΝΤΡΟ - ΝΑΞΟΣ Arrhythmogenic Cardiomyopathy Aνταλένα Τσατσοπούλου ΝΙΚΟΣ ΠΡΩΤΟΝΟΤΑΡΙΟΣ ΙΑΤΡΙΚΟ ΚΕΝΤΡΟ - ΝΑΞΟΣ There is no conflict of interest Arrhythmogenic

More information

ARVD/C and the athlete s heart: Application of revised Task Force Criteria

ARVD/C and the athlete s heart: Application of revised Task Force Criteria ARVD/C and the athlete s heart: Application of revised Task Force Criteria T. Luijkx MD, B.K. Velthuis MD PhD, N.H.J. Prakken MD PhD, M.G.P.J. Cox MD, R.N.W. Hauer MD PhD, M.J.M. Cramer MD PhD Stockholm,

More information

Syncope in patients with inherited arrhythmogenic syndromes. Is it enough to justify ICD implantation?

Syncope 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 information

Etiology, Classification & Management. Sheba Medical Center Cardiology Department Matthew Wright St. George s University of London

Etiology, Classification & Management. Sheba Medical Center Cardiology Department Matthew Wright St. George s University of London Etiology, Classification & Management Sheba Medical Center Cardiology Department Matthew Wright St. George s University of London Introduction World Health Organization (1995): Diseases of myocardium (heart

More information