Cardiovascular Medicine

1 pages, 149 KB

Open AccessCommunication

2015 Guidelines Update for Performing Cardiac Implantable Electronic Device Procedures and Catheter Ablation of Arrhythmias

by Haran Burria, Christian Sticherlingb, Istvan Babotaic, Firat Durud, Vincent Ganièree, Andrea Menafogliof, Etienne Pruvotg, Sven Reekh, Marianne Zimmerli-Voegtlii and Juerg Fuhrerj

Cardiovasc. Med. 2015, 18(11), 325; https://doi.org/10.4414/cvm.2015.00372 - 18 Nov 2015

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Abstract

Guidelines defining competency for performing procedures involving cardiac implantable electronic devices and catheter ablation of arrhythmias have been published by the Working Group of Cardiac Pacing and Electrophysiology of the Swiss Society of Cardiology since 2000. These guidelines have been updated in 2005 [...] Read more.

Guidelines defining competency for performing procedures involving cardiac implantable electronic devices and catheter ablation of arrhythmias have been published by the Working Group of Cardiac Pacing and Electrophysiology of the Swiss Society of Cardiology since 2000. These guidelines have been updated in 2005 and 2011 with the evolution of procedure complexity. They define not only the requirements for baseline training, but also the procedural volume and continued medical education to maintain competency. The current update is warranted owing to the new certification standards of the European Heart Rhythm Association, publication of data on outcome linked to procedural volume, and the emergence of new technologies. Full article

1 pages, 176 KB

Open AccessInteresting Images

Ectopia Cordis

by Shailaja Chhetria, Rubina Raia and Nikesh Raj Shresthab

Cardiovasc. Med. 2015, 18(11), 324; https://doi.org/10.4414/cvm.2015.00373 - 18 Nov 2015

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Abstract

A 22-year-old primigravida presented to the antenatal clinic at 34 weeks of gestation [...] Full article

7 pages, 262 KB

Open AccessArticle

Catheter Ablation for Atrial Fibrillation in a Real-World Setting

by Laurent M. Haegeli, Fabian Jud, Chol Jun On, Christine Gstrein, Ardan M. Saguner, Jan Steffel, Stefano Benussi, Nazmi Krasniqi, Corinna Brunckhorst, Thomas F. Lüscher, Thomas Wolber and Firat Duru

Cardiovasc. Med. 2015, 18(11), 319; https://doi.org/10.4414/cvm.2015.00356 - 18 Nov 2015

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Abstract

Introduction: Several prospective multi-center randomized trials have established the efficacy of catheter ablation in patients with atrial fibrillation (AF). The aim of this study was to assess the mid-term results after AF ablation in a real-world cohort in a single tertiary care [...] Read more.

Introduction: Several prospective multi-center randomized trials have established the efficacy of catheter ablation in patients with atrial fibrillation (AF). The aim of this study was to assess the mid-term results after AF ablation in a real-world cohort in a single tertiary care center in Switzerland. Methods: This prospective registry comprised all patients with paroxysmal or persistent AF undergoing a catheter ablation procedure at the University Heart Center Zurich between June 2009 and April 2013 with a clinical follow-up including symptom assessment and long-term ECG monitoring for at least 24 hours. Results: A total of 275 consecutive ablation procedures were performed in 201 patients (mean age 62 ± 9 years, 75% men). Patients had paroxysmal AF in 62% and persistent in 38%. Left ventricular ejection fraction as assessed by transthoracic echocardiogram was 58 ± 8%, the diameter of the left atrium averaged 44 ± 7 mm. Hypertension was present in 49%, coronary artery disease in 13% of patients. Pericardial tamponade occurred in 3% of the procedures. No other major complication requiring interventions or cardiac surgery was observed. After a follow-up period of 19.1 ± 11.8 months, 84% of the patients had a significant (>90%) reduction of their arrhythmia burden. Freedom from AF was observed in 73% of all patients. Conclusion: In our cohort sinus rhythm was maintained in the majority of patients who underwent catheter ablation for paroxysmal or persistent AF after a mid-term follow-up with a very low periprocedural complication rate. Full article

9 pages, 511 KB

Open AccessReview

Update Hypertensive Herzkrankheit

by Roman Brennera, Markus Diethelmb, Hans Ricklia and Micha T. Maedera

Cardiovasc. Med. 2015, 18(11), 312; https://doi.org/10.4414/cvm.2015.00361 - 18 Nov 2015

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Abstract

An update on hypertensive heart disease. Longstanding and uncontrolled arterial hypertension is frequently associated with a hypertensive heart disease with / without heart failure. Hypertensive heart disease in its full expression is characterised by left ventricular hypertrophy, diastolic dysfunction and a mostly preserved [...] Read more.

An update on hypertensive heart disease. Longstanding and uncontrolled arterial hypertension is frequently associated with a hypertensive heart disease with / without heart failure. Hypertensive heart disease in its full expression is characterised by left ventricular hypertrophy, diastolic dysfunction and a mostly preserved ejection fraction. Several ECG criteria have been suggested for the detection of left ventricular hypertrophy. All these criteria have in common poor sensitivity, while the specificity is relatively high. The search for atrial fibrillation, which is frequently asymptomatic, is a key indication for an ECG in patients with arterial hypertension. This arrhythmia is a major consequence of hypertensive heart disease, and its detection has important clinical consequences, in particular prophylaxis of thromboembolic events. Transthoracic echocardiography is much more sensitive than the ECG for the detection of left ventricular hypertrophy and also allows determination of diastolic and systolic left ventricular function and exclusion of important differential diagnoses of left ventricular hypertrophy. As a consequence of the impaired ventricular filling (diastolic dysfunction), heart failure may evolve which, in the case of preserved ejection fraction, is referred to as heart failure with preserved ejection fraction (HFpEF). In this situation, consequent control of blood pressure (and rate control in the case of rapidly conducted atrial fibrillation) play a pivotal role. No largescale, randomised study with a specific drug has shown a relevant reduction of hard clinical endpoints in HFpEF patients up to the present day. Full article

8 pages, 235 KB

Open AccessReview

Preparticipation Screening of Elite and Recreational Athletes

by Philipp Bohm, Tim Meyer and Jürgen Scharhag

Cardiovasc. Med. 2015, 18(11), 306; https://doi.org/10.4414/cvm.2015.00339 - 18 Nov 2015

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Abstract

Regular physical activity is associated with appreciable cardiovascular benefits but, paradoxically, vigorous exertion increases the risk of sudden cardiac death (SCD) in athletes by 2- to 3-fold compared with nonathletes. The exact incidence of sports-related SCD remains unclear owing to differing methodology and [...] Read more.

Regular physical activity is associated with appreciable cardiovascular benefits but, paradoxically, vigorous exertion increases the risk of sudden cardiac death (SCD) in athletes by 2- to 3-fold compared with nonathletes. The exact incidence of sports-related SCD remains unclear owing to differing methodology and heterogeneous population comparisons. Younger athletes are most commonly affected by underlying inherited/congenital cardiac disease whereas in older athletes aged >35 years coronary artery disease (CAD) predominates by far. However, different regional distribution patterns of cardiac diseases as a result of heterogeneous ethnic population compositions have to be taken into account. Preparticipation Screening with personal/family history, physical examination and resting electrocardiogram has the potential to detect many causes of SCD, which reduces its incidence. However, in older athletes, this screening modality is of limited value because of the high prevalence of CAD. Therefore, an individualised screening approach is adopted for athletes aged >35 years according to their risk profile and the intended level of physical activity. As cardiovascular screening cannot detect all individuals at risk, particular focus should be put upon secondary prevention measures, including education about adequate cardiopulmonary resuscitation and availability of automated external defibrillators at sporting facilities. In this review, we summarise the current state of knowledge of SCD in athletes of different age groups with regard to epidemiology. Furthermore, we discuss primary and secondary prevention strategies such as cardiovascular screening recommendations and on-site prevention. Full article

11 pages, 1885 KB

Open AccessReview

Cardiovascular Risk-Benefit Ratio of Alpine Skiing in Recreational Skiers

by David Niederseera, Christian Schmieda and Josef Niebauerb

Cardiovasc. Med. 2015, 18(11), 298; https://doi.org/10.4414/cvm.2015.00360 - 18 Nov 2015

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Abstract

Worldwide, but especially in western countries, there is an epidemic of physical inactivity with its known detrimental health-related effects. Physical activity and regular physical exercise remain difficult to implement especially in sedentary elderly subjects, often because of a lack of appealing physical activities. [...] Read more.

Worldwide, but especially in western countries, there is an epidemic of physical inactivity with its known detrimental health-related effects. Physical activity and regular physical exercise remain difficult to implement especially in sedentary elderly subjects, often because of a lack of appealing physical activities. Gaining the attraction of these target groups is a prerequisite in order to improve adherence. Alpine skiing is performed by millions of recreational subjects in the Alps alone and may be an attractive mode of physical activity for many local citizens and tourists alike. Besides the well-known positive effects of exercise on cardiovascular and other health-related outcomes, the risks also need to be considered. Indeed, myocardial infarction and sudden cardiac death during alpine skiing in recreational skiers are the leading causes of death in the Alps during the winter and exceed the number of fatalities due to avalanches or traumatic deaths. It is the aim of this article to provide an up-to-date evaluation of the potential cardiovascular risks of recreational alpine skiing as well as the known benefit s thereof. In the first section a general cardiovascular risk–benefit evalua tion of physical activity is provided. Thereafter the current knowledge of the cardiovascular benefits and risks of alpine skiing are summarized, followed by a discussion and conclusion. Full article

1 pages, 65 KB

Open AccessEditorial

Es lebe der Sport

by Christian Marc Schmied

Cardiovasc. Med. 2015, 18(11), 297; https://doi.org/10.4414/cvm.2015.00374 - 18 Nov 2015

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Abstract

«Es lebe der Sport» hiess in den 80er Jahren einer der bekanntesten Hits des österreichischen Chansonniers Rainhard Fendrich. Er besang in diesem ironischen Liedtext die Unfallgefahren in diversen Fernsehsportarten bzw. die Sensationslust der Zuschauer vor den Bildschirmen [...] Full article

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Cardiovasc. Med., Volume 18, Issue 11 (11 2015) – 7 articles

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