Long-term clinical outcomes in implantable cardioverter defibrillator recipients on the island of Crete

Kanoupakis, Emmanuel M.; Fanourgiakis, John; Mavrakis, Hercules E.; Kallergis, E. M.; Simantirakis, Emmanuel N.; Crysostomakis, Stavros I.; Saloustros, I.; Chlouverakis, Gregory; Vardas, Panos

doi:10.1016/j.hjc.2016.05.004

Cited by 8 publications

(2 citation statements)

References 16 publications

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“…This elevated incidence is presumably related to changes in both cardiac autonomic function (for supraventricular events) and in ion channel conduction (for ventricular events) within the myocardium. Pregnancy is also associated with substantial haemodynamic changes, which can cause myocardial stretching and may thus promote arrhythmogenic events (Kanoupakis andVardas 2005, Adamson andNelson-Piercy 2007). The ability to non-invasively assess (and act upon) an individual's risk of developing arrhythmia during pregnancy would therefore be clinically significant.…”

Section: Introductionmentioning

confidence: 99%

Changes in heart rate variability and QT variability during the first trimester of pregnancy

et al. 2015

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The risk of new-onset arrhythmia during pregnancy is high, presumably relating to changes in both haemodynamic and cardiac autonomic function. The ability to non-invasively assess an individual's risk of developing arrhythmia during pregnancy would therefore be clinically significant. We aimed to quantify electrocardiographic temporal characteristics during the first trimester of pregnancy and to compare these with non-pregnant controls. Ninety-nine pregnant women and sixty-three non-pregnant women underwent non-invasive cardiovascular and haemodynamic assessment during a protocol consisting of various physiological states (postural manoeurvres, light exercise and metronomic breathing). Variables measured included stroke volume, cardiac output, heart rate, heart rate variability, QT and QT variability and QTVI (a measure of the variability of QT relative to that of RR). Heart rate (p < 0.0005, p < 0.0005, p < 0.0005) and cardiac output (p = 0.043, p < 0.0005, p < 0.0005) were greater in pregnant women in all physiological states (respectively for the supine position, light exercise and metronomic breathing state), whilst stroke volume was lower in pregnancy only during the supine position (p < 0.0005). QTe (Q wave onset to T wave end) and QTa (T wave apex) were significantly shortened (p < 0.05) and QTeVI and QTaVI were increased in pregnancy in all physiological states (p < 0.0005). QT variability (p < 0.002) was greater in pregnant women during the supine position, whilst heart rate variability was reduced in pregnancy in all states (p < 0.0005). Early pregnancy is associated with substantial changes in heart rate variability, reflecting a reduction in parasympathetic tone and an increase in sympathetic activity. QTVI shifted to a less favourable value, reflecting a greater than normal amount of QT variability. QTVI appears to be a useful method for quantifying changes in QT variability relative to RR (or heart rate) variability, being sensitive not only to physiological state but also to gestational age. We support the use of non-invasive markers of cardiac electrical variability to evaluate the risk of arrhythmic events in pregnancy, and we recommend the use of multiple physiological states during the assessment protocol.

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Section: Introductionmentioning

confidence: 99%

Changes in heart rate variability and QT variability during the first trimester of pregnancy

et al. 2015

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“…The number of patients with a CIED in Greece based on data from the European Heart Rhythm Association (EHRA) for implants in Greece from 2008 to today 4 ( Figure 1 ) as well as the annual data of the Cardiology Clinic of the University Hospital of Heraklion from 1998 to 2006, were calculated. 5 On the basis of the historical data, the implants from 2019 to 2029, by making a 5% annual increase, were anticipated. The survival of patients with CIEDs was projected for the 10-year period (2019 to 2029) based on clinical studies assuming a 95% annual survival rate.…”

Section: Fundingmentioning

confidence: 99%

A roadmap to nationwide monitoring of Cardiovascular Implantable Electronic Devices in Greece: staying safe in the era of COVID-19 pandemic

Dilaveris¹,

Casado-Arroyo

Lumens

2020

Hellenic Journal of Cardiology

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Long-term follow-up of patients with implantable cardioverter defibrillators in Greece: The Cretan Registry

Dilaveris

Tousoulis

2016

Hellenic Journal of Cardiology

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Long-term clinical outcomes in implantable cardioverter defibrillator recipients on the island of Crete

Abstract: The long-term data related to clinical outcomes in ICD recipients in our center are in accordance with those of other international centers and confirm the high efficacy and safety of these devices in preventing sudden cardiac death.

Cited by 8 publications

References 16 publications

Changes in heart rate variability and QT variability during the first trimester of pregnancy

Changes in heart rate variability and QT variability during the first trimester of pregnancy

A roadmap to nationwide monitoring of Cardiovascular Implantable Electronic Devices in Greece: staying safe in the era of COVID-19 pandemic

Long-term follow-up of patients with implantable cardioverter defibrillators in Greece: The Cretan Registry

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