&lt;p&gt;Cardiac Electronic Devices: Future Directions and Challenges&lt;/p&gt;

Kotalczyk, Agnieszka; Kalarus, Zbigniew; Wright, David J.; Boriani, Giuseppe; Lip, Gregory Y.H.

doi:10.2147/mder.s245625

Cited by 19 publications

(18 citation statements)

References 115 publications

(173 reference statements)

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“…Among the mAFA group, lower rates of OAC‐related bleeding (due to the mitigation of modifiable bleeding risk factors) and an increase in the use of OAC (from 63.4% to 70.2%) was observed as compared to standard care 45 . Indeed, implementing digital healthcare models into holistic care pathways of patients with AF may improve patients awareness and treatment acceptance, resulting in better outcomes and OACs compliance 46‐48 …”

Section: Discussionmentioning

confidence: 99%

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One‐year Follow‐up Results of the Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry

Guo

Wang

Kotalczyk

et al. 2021

Journal of Arrhythmia

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Background The high prevalence of atrial fibrillation (AF) in the very elderly population (aged >80 years) might be underestimated. The elderly are at increased risk of both fatal stroke and bleeding. The Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry provides contemporary management strategies among the elderly Chinese patients in the new era of non‐vitamin K antagonists. Objective To present the 1‐year follow‐up data from the ChiOTEAF registry, focusing on the use of antithrombotic therapy, rate vs. rhythm control strategies, and determinants of mortality and stroke. Methods The ChiOTEAF registry analyzed consecutive AF patients presenting in 44 centers from 20 Chinese provinces from October 2014 to December 2018. Endpoints of interest were mortality, thromboembolism, major bleedings, cardiovascular comorbidities, and hospital re‐admissions. Results Of the 7077 patients enrolled at baseline, 657 patients (9.3%) were lost to the follow‐up and 435 deaths (6.8%) occurred. The overall use of anticoagulants remains low, approximately 38% of the entire cohort at follow‐up, with similar proportions of vitamin K antagonists (VKA) and non‐vitamin K antagonists (NOACs). Antiplatelet therapy was used in 38% of the entire cohort at follow‐up, and more commonly among high‐risk patients (41%). Among those on a NOAC at baseline, 22.4% switched to antiplatelet therapy alone after one year. Independent predictors of stroke/transient ischemic attack/peripheral embolism and/or mortality were age, heart failure, chronic kidney disease, prior ischemic stroke, dementia, and chronic obstructive pulmonary disease. Conclusions The ChiOTEAF registry provides contemporary data on AF management, including stroke prevention. The poor adherence of NOACs and common use of antiplatelet in these high‐risk elderly population calls for multiple comorbidities management.

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Section: Discussionmentioning

confidence: 99%

“… 45 Indeed, implementing digital healthcare models into holistic care pathways of patients with AF may improve patients awareness and treatment acceptance, resulting in better outcomes and OACs compliance. 46 , 47 , 48 …”

Section: Discussionmentioning

confidence: 99%

One‐year Follow‐up Results of the Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry

Guo

Wang

Kotalczyk

et al. 2021

Journal of Arrhythmia

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“…Over 1,000,000 permanent pacemakers (PPMs) and 300,000 implantable cardioverter‐defibrillators (ICDs) are implanted annually worldwide 1 . Due to an expanding list of indications for cardiac implantable electrical devices (CIEDs) and the increasing incidence of conduction disorders and congestive heart failure, CIED use is expected to grow considerably throughout the next decade 2 . Since the first CIED was used in the 1950′s, commercially available devices have undergone significant technological refinement, size reduction, and the introduction of dual chamber pacing and rate‐adaptive capabilities.…”

Section: Introductionmentioning

confidence: 99%

Tricuspid regurgitation associated with implantable electrical device insertion: A systematic review and meta‐analysis

Tatum

Maynes

Wood

et al. 2021

Pacing Clinical Electrophis

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Background Implantable cardioverter defibrillator (ICD) and permanent pacemaker (PPM) lead placement may worsen or result in tricuspid regurgitation (TR). While the association between lead placement and the incidence of TR has been established, current understanding of this problem remains incomplete. This systematic review and meta‐analysis sought to pool the existing evidence to better understand the occurrence and severity of TR associated with cardiac implantable electrical device (CIED) insertion. Methods An electronic search was performed to identify all relevant studies published from 2000 to 2018. Overall, 15 studies were selected for the analysis comprising 4019 patients with data reported on TR development following ICD or PPM lead placement. Demographic information, perioperative clinical variables, and clinical outcome measures, including pre and postoperative echocardiographic TR grade changes, were extracted and pooled for systematic review. Results Mean patient age was 69 years [95% CI: 64.62‐73.59], and 63% [95% CI: 57‐68] were male. Devices implanted included ICD in 57% [95%CI: 43‐70] and PPM in 41% [95%CI: 31‐52]. The most common indications for pacemaker implantation were sick sinus syndrome in 22% [95% CI: 22‐37] and AV block in 21% [95%CI:12‐34. The commonest indications for ICD implantation were primary and secondary prevention of sudden cardiac death. Atrial fibrillation was present in 37% [95%CI: 28‐46] and congestive heart failure in 15% [95%CI: 2‐57]. Baseline distribution of TR grades were as follows: grade 0/1 TR in 89% [95%CI: 82‐93], grade 2 TR in 8% [95%CI: 5‐13], grade 3 TR in 2% [95%CI: 0‐7] and grade 4 TR in 2% [95%CI: 1‐4]. Post‐procedure, grade 0/ 1 TR decreased to 68% [95% CI: 51‐81] (p < 0.01), grade 2 TR increased to 21% [15‐28] (p < 0.01), grade 3 TR increased to 13% [95%CI: 5‐32] (p = 0.02), and grade 4 TR increased to 7% [95%CI: 5‐9] (p < 0.01). Conclusion ICD and PPM lead placement is associated with increased TR post‐procedure. Further studies are warranted to evaluate changes in TR grade in the long term.

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“…During 14.9 ± 5.4 months of follow-up, 29% of patients in the access arm and 20% of patients in the control arm reached the composite endpoint of all-cause mortality and HF hospitalizations (HR 1.52; 95% CI 0.97-2.37), showing that the use of the monitoring tool was not beneficial. Additional algorithms incorporating multiple HF related indexes such as thoracic impedance, heart sounds (S1, S3), respiratory rate and relative tidal volume, activity response and heart rate have been developed to overcome the limited efficacy of single parameters [73]. In the study by Boehmer et al [10], the device-based diagnostic algorithm combining these indexes showed 70% sensitivity in predicting impending HF decompensation.…”

Section: Heart Failure: a Major Public Health Threatmentioning

confidence: 99%

Remote monitoring and telemedicine in heart failure: implementation and benefits

et al. 2021

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Purpose of review Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is recommended as part of the individualized multidisciplinary follow-up of heart failure (HF) patients. Aim of this article is to critically review recent findings on RM, highlighting potential benefits and barriers to its implementation. Recent findings Device-based RM is useful in the early detection of CIEDs technical issues and cardiac arrhythmias. Moreover, RM allows the continuous monitoring of several patients' clinical parameters associated with impending HF decompensation, but there is still uncertainty regarding its effectiveness in reducing mortality and hospitalizations. Summary Implementation of RM strategies, together with a proactive physicians' attitude towards clinical actions in response to RM data reception, will make RM a more valuable tool, potentially leading to better outcomes.

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<p>Cardiac Electronic Devices: Future Directions and Challenges</p>

Cited by 19 publications

References 115 publications

One‐year Follow‐up Results of the Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry

One‐year Follow‐up Results of the Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry

Tricuspid regurgitation associated with implantable electrical device insertion: A systematic review and meta‐analysis

Remote monitoring and telemedicine in heart failure: implementation and benefits

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