Clustering of Ventricular Tachyarrhythmias in Heart Failure Patients Implanted with a Biventricular Cardioverter Defibrillator

Lunati, Maurizio; Gasparini, Maurizio; Bocchiardo, Mario; Curnis, Antonio; Landolina, Maurizio; Carboni, Angelo; Luzzi, G; Zanotto, Gabriele; Ravazzi, P. A.; Magenta, G.; Denaro, Alessandra; Distefano, Paola; Grammatico, Andrea

doi:10.1111/j.1540-8167.2006.00618.x

Cited by 16 publications

(6 citation statements)

References 42 publications

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“…Local, lead-related proarrhythmia may partly explain a higher incidence of a first VT/VF event in the first year after a prophylactic ICD implant than in the second or later years as was observed in some ICD trials11 and one single centre experience 82. Although cardiac resynchronisation therapy (CRT) devices can reduce VT/VF occurrence in LBBB patients83 the effect is not always noted,84 and there are numerous anecdotal cases of proarrhythmia attributed to biventricular pacing 85 86…”

Section: Acute Complicationsmentioning

confidence: 99%

Implantable cardioverter defibrillators: risks accompany the life-saving benefits

Atwater

Daubert

2012

Heart

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Sudden cardiac arrest is the one of the most common causes of death in developed countries and accounts for between 180,000 and over 450,000 per year in the USA. Antiarrhythmic drug approaches to prevention of sudden cardiac death have been resoundingly ineffective. The implantable cardioverter defibrillator (ICD) constitutes one of the most important and well validated therapeutic advances in modern cardiovascular medicine. Consequently, ICD use has increased exponentially, although implementation has been quite variable geographically and with respect to other measures. In view of the expanded use of ICDs, the potential shortcomings and risks of ICD therapy have attracted attention. This commentary summarises the weaknesses, disadvantages and risks of the ICD in a balanced fashion in light of their proven life-saving benefits.

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Section: Acute Complicationsmentioning

confidence: 99%

Implantable cardioverter defibrillators: risks accompany the life-saving benefits

Atwater

Daubert

2012

Heart

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“…While earlier studies described the occurrence of cardiac arrhythmias as random events, data from implanted devices showed strong evidence of temporal clustering of the cardiac arrhythmia episodes (1)(2)(3). A more recent study analyzed more than a million paroxysmal atrial fibrillation (AF) episodes (4).…”

Section: Introductionmentioning

confidence: 99%

Skin sympathetic nerve activity and the temporal clustering of cardiac arrhythmias

Kusayama¹,

Jiang²,

Doytchinova³

et al. 2019

JCI Insight

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“…1 It occurs frequently in patients with heart failure (HF) and is an important reason for rehospitalization. 2-4 In addition, recurrent SVF occurs in roughly half of the patients undergoing cardiopulmonary resuscitation, and may be associated with significant morbidity and mortality. 3, 4 The mechanisms of electrical storm remain unclear.…”

Section: Introductionmentioning

confidence: 99%

“…2-4 In addition, recurrent SVF occurs in roughly half of the patients undergoing cardiopulmonary resuscitation, and may be associated with significant morbidity and mortality. 3, 4 The mechanisms of electrical storm remain unclear. We recently developed a rabbit model of electrical storm with pacing-induced HF.…”

Section: Introductionmentioning

confidence: 99%

Small-Conductance Calcium-Activated Potassium Channel and Recurrent Ventricular Fibrillation in Failing Rabbit Ventricles

Chua

Chang

Maruyama

et al. 2011

Circulation Research

156

204

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Rationale Fibrillation-defibrillation episodes in failing ventricles may be followed by action potential duration (APD) shortening and recurrent spontaneous ventricular fibrillation (SVF). Objective We hypothesized that activation of apamin-sensitive small-conductance Ca2+-activated K+ (SK) channels are responsible for the postshock APD shortening in failing ventricles. Methods and Results A rabbit model of tachycardia-induced heart failure was used. Simultaneous optical mapping of intracellular Ca2+ and membrane potential (Vm) was performed in failing and non-failing ventricles. Three failing ventricles developed SVF (SVF group), 9 did not (no-SVF group). None of the 10 non-failing ventricles developed SVF. Increased pacing rate and duration augmented the magnitude of APD shortening. Apamin (1 μmol/L) eliminated recurrent SVF, increased postshock APD80 in SVF group from 126±5 ms to 153±4 ms (p<0.05), in no-SVF group from147±2 ms to 162±3 ms (p<0.05) but did not change of APD80 in non-failing group. Whole cell patch-clamp studies at 36°C showed that the apamin-sensitive K+ current (IKAS) density was significantly larger in the failing than in the normal ventricular epicardial myocytes, and epicardial IKAS density is significantly higher than midmyocardial and endocardial myocytes. Steady-state Ca2+ response of IKAS was leftward-shifted in the failing cells compared with the normal control cells, indicating increased Ca2+ sensitivity of IKAS in failing ventricles. The Kd was 232 ± 5 nM for failing myocytes and 553 ± 78 nM for normal myocytes (p = 0.002). Conclusions Heart failure heterogeneously increases the sensitivity of IKAS to intracellular Ca2+, leading to upregulation of IKAS, postshock APD shortening and recurrent SVF.

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Clustering of Ventricular Tachyarrhythmias in Heart Failure Patients Implanted with a Biventricular Cardioverter Defibrillator

Abstract: In HF patients with biventricular ICDs, VT/VF clusters may be regarded as the epiphenomenon of HF deterioration or as a marker of suboptimal response to cardiac resynchronization therapy.

Cited by 16 publications

References 42 publications

Implantable cardioverter defibrillators: risks accompany the life-saving benefits

Implantable cardioverter defibrillators: risks accompany the life-saving benefits

Skin sympathetic nerve activity and the temporal clustering of cardiac arrhythmias

Small-Conductance Calcium-Activated Potassium Channel and Recurrent Ventricular Fibrillation in Failing Rabbit Ventricles

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