PubMed Journal Database | Herzschrittmachertherapie & Elektrophysiologie 
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Showing PubMed Articles 1–25 of 82 from Herzschrittmachertherapie & Elektrophysiologie
ECG diagnostic is not only an easy to use, cost efficient, extensively available method for cardiological patients, but also a potential tool in diagnostic for other morbidities. As a well-known example, cerebral hemorrhage and ischemia can show an ECG, that resembles an acute coronary syndrome. Furthermore systemic diseases may show characteristic ECG; often as a malfunction of the conductive system (e.g., AV block). Exclusion of cardiac involvement when dealing with sarcoidosis is important, and the ECG m...
Catheter ablation for paroxysmal atrial fibrillation is a meanwhile established therapy option, which is most frequently performed using radiofrequency ablation. Mid-term success rate of 70 % are achievable with a single ablation procedure. However, the mechanistics of persistent atrial fibrillation are less well understood and catheter ablation is a far more challenging procedure. Different ablation approaches are being performed to treat persistent atrial fibrillation ranging from sole pulmonary vein is...
The implantation of a left atrial appendage (LAA) occluder has evolved into an established non-pharmacological alternative to oral anticoagulation (OAC) in the prevention of cardioembolic stroke in patients with atrial fibrillation. While 2 randomized trials investigated the LAA occluder as an alternative treatment in patients who can also undergo OAC, current guidelines recommend the LAA occluder rather as a second line therapy if permanent OAC is not possible due to contraindications. This is in line with...
Implantable Cardioverter Defibrillator.
This article aims to give an overview over important articles in the field of implantable cardioverter defibrillator (ICD) therapy in 2012. Important publications concern analyses on therapy efficacy and safety of the subcutaneous ICD, gender-specific differences in the complication rate and prognosis after ICD implantation, the necessity of intraoperative testing of the defibrillation threshold and the impact of preventive measures to reduce ICD therapies on prognosis after device implantation. The relevan...
Catheter ablation of paroxysmal atrial fibrillation: Optimal approach and result.
The gold standard in ablation of paroxysmal atrial fibrillation (PAF) is radiofrequency (RF) based point by point pulmonary vein isolation (PVI). In the majority of patients with PAF (80 %) PVI can restore stable SR even during long-term follow-up of up to 5 years. However multiple procedures are often required. Cryo-balloon based PVI is an established technique. Safety and efficacy are comparable to RF ablation. Due to the high success rates in patients with PAF and the progression rate to persistent atr...
Takotsubo cardiomyopathy (TTC) is a recently recognized clinical syndrome characterized by transient ventricular dysfunction in the absence of obstructive coronary artery disease. TTC primarily affects postmenopausal women; TTC in children and adolescents is only rarely reported. Furthermore, simultaneous occurrence of Takotsubo cardiomyopathy and primary electrical diseases has been previously reported in only four recent cases of female patients with congenital long QT syndrome. Here, we report the novel...
Cardiac embolisation in patients with atrial fibrillation accounts for the most serious complication of cerebral infarction. The left atrial appendage resembles the origin of these cardiac emboli in the majority of cases, although other anatomical areas of the left atrium might also be prerequisites for thrombus formation. Surgical closure of the left atrial appendage during an ablation therapy incorporates the theoretical possibility of reducing the rate of cardiac cerebral infarction. In order to achieve...
Implantation of the AMPLATZERTM Cardiac Plug: tips and tricks.
The AMPLATZERTM Cardiac Plug device is designed for percutaneous occlusion of the left atrial appendage (LAA) for stroke prophylaxis in patients with atrial fibrillation (AF) who are contraindicated or intolerant to oral anticoagulation. While updated guidelines start to refer to this therapy (Camm A, Eur Heart J, doi:10.1093/eurheartj/ehs253, 2012) and operators gain experience with this relatively new technique, continuing efforts are focused on maximizing the safety of the implantation procedure. This pa...
Ultrasound in the electrophysiological cardiac catheterization laboratory.
During recent years the need for intraprocedural imaging has increased. Fluoroscopy and angiography are frequently supplemented by pre-procedural magnetic resonance or computed tomography imaging as well as electroanatomic mapping techniques. However, poor real-time imaging quality of soft tissue, radiation exposure, and contrast media consumption are disadvantageous. Ultrasound techniques are characterized by high-quality imaging of soft tissue that can be obtained in real time. All relevant anatomical str...
Cardiac computed tomography and ablation of atrial fibrillation.
Both cardiac computed tomography (CT) and interventional electrophysiology (EP) have evolved considerably in recent years. Technical improvements in CT have significantly reduced the radiation dose in cardiac applications. This imaging technology plays an important role in preprocedural planning and guidance of the procedures in many EP centers worldwide. Furthermore, CT is the imaging modality of choice to diagnose relevant complications in ablation of atrial fibrillation, e.g. pulmonary vein stenosis or a...
Three-dimensional mapping systems.
Three-dimensional (3-D) mapping systems are of great value for the diagnosis and ablation of cardiac arrhythmias. If applied appropriately, 3-D mapping systems (3DM) can reduce fluoroscopy and procedural time. In general, two advanced mapping systems are currently in use: the CARTO™ system (Biosense Webster) uses ultralow-intensity magnetic fields to locate specially designed catheters in the heart chamber. Both, the activation sequence (activation map) and the local potential amplitude (voltage map) can...
Use of cardiac MRI in the field of electrophysiology : Present status and future aspects.
In recent years, ablation therapy has become the first-line treatment of modern electrophysiology in patients with cardiac arrhythmias. Today, cardiac magnetic resonance imaging (cMRI) is an important supportive imaging technique in the implementation of complex electrophysiological investigations and ablation therapy. In clinical routine, cMRI is used not only to generate accurate three-dimensional (3D) models of cavities of the heart but also for visualization of complex anatomical structures. The develop...
Dilated cardiomyopathy (DCM) has a familial accumulation in 20-50% of cases and, therefore, frequently has a genetic cause. Currently, numerous mutations are known in more than 40 genes, which account for around 20% of familial cases. The structured evaluation of family history with recording of a family tree is an obligatory part of the initial diagnosis of DCM. By evaluation of family members other persons at risk can be identified. With the exception of the lamin A/C gene (LMNA), genetic testing does no...
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy accounting for life-threatening ventricular tachyarrhythmias and sudden death in young individuals and athletes. Over the past years, mutations in desmosomal genes have been identified as disease-causative. However, genetic heterogeneity and variable phenotypic expression alongside with diverse disease progression still render the evaluation of its prognostic implication difficult. ARVC was initially entered into the canon...
Isolated noncompaction cardiomyopathy with special emphasis on arrhythmia complications.
Isolated noncompaction cardiomyopathy (NCCM) is a rare genetically determined myocardial disease caused by abnormal fetal development of the myocardium resulting in a thin compacted and a thicker noncompacted layer of the affected left ventricular (LV) wall. The genetic basis of NCCM is heterogenous. Diagnosis can be made using echocardiography or magnetic resonance imaging. The diagnostic criteria for NCCM are still under discussion. Afflicted patients may present with various symptoms caused by arrhythmia...
Insights and challenges in hypertrophic cardiomyopathy, 2012.
We present a contemporary overview of hypertrophic cardiomyopathy (HCM), incorporating recent thinking on disease mechanisms and advances in therapy. Clinical, pathological, genetic, and mechanistic definitions of HCM are discussed. The genetic profile of HCM in both adults and children is explored to the extent of present knowledge. The spectrum of morphological and histological abnormalities in HCM is reviewed, including involvement of the right ventricle, which is less widely recognised. Morbidity and mo...
Inherited long QT syndrome : Clinical manifestation, genetic diagnostics, and therapy.
Inherited long QT syndrome (LQTS) is characterized by a prolonged ventricular repolarization (QTc interval) and symptoms (syncope, sudden cardiac arrest) due to polymorphic ventricular arrhythmias. As of today, 13 different cardiac ion channel genes have been associated with congenital LQTS. The most common ones are due to KCNQ1 (LQT-1), KCNH2 (LQT-2), and SCN5A (LQT-3) gene mutations and account for up to 75 % of cases. Typical clinical findings are an increased QT interval on the surface electrocardiogra...
The molecular autopsy: an indispensable step following sudden cardiac death in the young?
Annually thousands of sudden deaths involving young individuals (
Sudden cardiac death (SCD) in young patients (
