Cardiac Device Therapy: 2nd Edition

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Electrophysiology and Cardiovascular Physiology".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 1757

Special Issue Editor


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Guest Editor
3rd Department of Cardiology, National and Kapodistrian University of Athens, 17674 Athens, Greece
Interests: cardiac electrophysiology; device therapy; atrial fibrillation; ventricular arrhythmias; sudden cardiac death; catheter ablation
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Special Issue Information

Dear Colleagues,

The implantation of a cardiac device in patients with rhythm disturbances and heart failure is associated with a significant survival benefit and an improvement in cardiopulmonary exercise capacity, depending on the type of device. Because of technological advancements over the last two decades, there is a wide range of implantable cardiac device options for a wide range of clinical situations and indications. They range from pacemaker implantations for bradycardia and subsequent asymptomatic ventricular stimulation to implantable cardioverter–defibrillator (ICD) shock deliveries to heart-assisted devices (LVADs) that completely arrogate cardiac functions.

This Special Issue focuses on cardiac device therapy in a variety of interest areas: conduction system pacing in everyday clinical practice; implantable cardioverter defibrillator for the primary prevention of sudden cardiac death among patients with cancer; leadless pacemaker–defibrillator systems; the efficacy and safety of extravascular ICDs; the status of enabling strategies for patients with heart failure with a reduced ejection fraction; and left bundle branch pacing versus biventricular pacing in cardiac resynchronization therapy.

Dr. Michael Spartalis
Guest Editor

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Keywords

  • device therapy
  • ICD
  • leadless
  • conduction
  • CRT
  • heart failure
  • arrhythmia
  • pacing

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Published Papers (2 papers)

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Research

9 pages, 838 KiB  
Article
Gender Differences for His Bundle Pacing Long-Term Performance in the Elderly Population
by Catalin Pestrea, Ecaterina Cicala, Dragos Lovin, Adrian Gheorghe, Florin Ortan and Rosana Manea
J. Cardiovasc. Dev. Dis. 2025, 12(3), 88; https://doi.org/10.3390/jcdd12030088 - 26 Feb 2025
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Abstract
Background and aims: His bundle pacing (HBP) is considered the most physiological form of cardiac pacing. Although feasibility studies have included older patients, specific data for HBP in this population are scarce. This study aimed to evaluate gender differences in HBP long-term performance [...] Read more.
Background and aims: His bundle pacing (HBP) is considered the most physiological form of cardiac pacing. Although feasibility studies have included older patients, specific data for HBP in this population are scarce. This study aimed to evaluate gender differences in HBP long-term performance in elderly patients with atrioventricular (AV) block. Methods: This retrospective study included 73 patients aged over 65 years with successful HBP and at least 2 years of follow-up. The patients’ baseline and follow-up clinical and procedural characteristics were recorded. Results: The mean age of the cohort was 72.8 ± 6.3 years, with 43 males and 30 females. The paced QRS complex was significantly narrower than the baseline value for both genders. Females had a narrower-paced QRS complex without differences in detection, type of His bundle capture, impedance, or fluoroscopy time. The pacing threshold increased progressively, reaching statistical significance compared to the baseline values at the two-year follow-up. The pacing threshold increased by more than 1 V over the follow-up period in twenty-four patients (32.9%) and by more than 2 V in six patients (8.2%), with no significant difference between genders. The pacing threshold increase occurred within the first year for most patients, without gender differences. Multivariate Cox regression analysis demonstrated that the paced QRS duration, left ventricular ejection fraction, and ischemic cardiomyopathy were significantly associated with the pacing threshold increase over time. Conclusion: In elderly patients with AV block, HBP remains a feasible pacing method, without significant gender differences, over a long-term follow-up period. Pacing threshold increases are expected in up to one-third of the patients, requiring regular follow-ups to adjust the programmed parameters and optimize battery longevity. Full article
(This article belongs to the Special Issue Cardiac Device Therapy: 2nd Edition)
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14 pages, 2947 KiB  
Article
Arrhythmia Detection in Atrioventricular, Single-Lead, Floating Atrial Dipole ICD Systems Compared with Conventional Single- and Dual-Chamber Defibrillators
by Flora Diana Gausz, Kom Nangob Manuela Lena, Paul Emmanuel Gedeon, Marton Miklos, Attila Benak, Gabor Bencsik, Attila Makai, Dora Kranyak, Rita Beata Gagyi, Robert Pap, Laszlo Saghy, Tamas Szili-Torok and Mate Vamos
J. Cardiovasc. Dev. Dis. 2024, 11(12), 386; https://doi.org/10.3390/jcdd11120386 - 1 Dec 2024
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Abstract
Background: An atrioventricular defibrillator system with a floating atrial dipole (VDD ICD) can provide atrial sensing by a single lead. Our aim was to compare the arrhythmia detection efficacy of VDD ICDs with conventional single- (VVI) and dual-chamber (DDD) defibrillators. Methods: Data from [...] Read more.
Background: An atrioventricular defibrillator system with a floating atrial dipole (VDD ICD) can provide atrial sensing by a single lead. Our aim was to compare the arrhythmia detection efficacy of VDD ICDs with conventional single- (VVI) and dual-chamber (DDD) defibrillators. Methods: Data from consecutive patients undergoing ICD implantation were retrospectively analyzed. The primary endpoint was the incidence of device-detected, new-onset atrial arrhythmias, while secondary endpoints were sensing parameters, complication rates, incidence of appropriate/inappropriate ICD therapy, arrhythmic/heart failure-related hospitalizations, and all-cause mortality. Results: A total of 256 patients (mean age 64 ± 12 years, male 75%, primary prophylaxis 28%, mean follow-up 3.7 ± 2.4 years) were included (VVI: 93, VDD: 94, DDD: 69). Atrial arrhythmia episodes were detected more frequently by VDD systems compared to VVI ICDs (aHR 7.087; 95% CI 2.371–21.183; p < 0.001), and at a rate similar to that of DDD ICDs (aHR 1.781; 95% CI 0.737–4.301; p = 0.200). The rate of inappropriate shocks was not different among the three ICD systems. Conclusion: VDD devices revealed an advantage in atrial arrhythmia detection compared to VVI ICDs and were non-inferior to DDD systems. Their main indication may be closer monitoring in high-risk patients with atrial arrhythmias to help therapy optimization and not the improvement of tachycardia discrimination. Full article
(This article belongs to the Special Issue Cardiac Device Therapy: 2nd Edition)
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