Outcome and incidence of appropriate implantable cardioverter-defibrillator therapy in patients with cardiac amyloidosis

Hamon, David; Algalarrondo, Vincent; Gandjbakhch, Estelle; Extramiana, Fabrice; Marijon, Éloi; Elbaz, Nathalie; Selhane, D.; Jl, Dubois-Randé; Teiger, Emmanuel; Planté‐Bordeneuve, Violaine; Damy, Thibaud; Lellouche, Nicolas

doi:10.1016/s1878-6480(17)30248-3

Cited by 13 publications

(20 citation statements)

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“…63 The role of intracardiac defi brillators is controversial, but may be warranted in selected patients with AL-CA. 64,65 AL treatment Risk stratifi cation and prognostication for AL. The most important determinant of clinical outcome in AL is the extent of cardiac involvement, as congestive heart failure and sudden cardiac death are the most common causes of death.…”

Section: Management Of Heart Failure In Cardiac Amyloidosismentioning

confidence: 99%

Cardiac amyloidosis: An update on diagnosis and treatment

Donnelly

Hanna

2017

CCJM

158

213

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Cardiac amyloidosis (CA), once thought to be a rare disease, is increasingly recognized due to enhanced clinical awareness and better diagnostic imaging. CA is becoming of heightened interest to the cardiology community given more effective treatment strategies for light chain amyloidosis (AL), as well as emerging therapies for transthyretin amyloidosis (ATTR). Furthermore, reversing amyloid deposition in affected organs using monoclonal antibodies is actively being tested in clinical trials. A high index of suspicion and a systematic approach to the diagnosis of CA can lead to referral to a center of expertise for timely treatment.

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Section: Management Of Heart Failure In Cardiac Amyloidosismentioning

confidence: 99%

Cardiac amyloidosis: An update on diagnosis and treatment

Donnelly

Hanna

2017

CCJM

158

213

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“…We identified 163 citations of which 22 studies met the inclusion criteria (Figure and Table ) . The studies were undertaken between 1982 and 2015 with 23,600 participants.…”

Section: Resultsmentioning

confidence: 99%

“…ICD interrogation was performed in all deaths in three studies . In nine other studies, the use of device interrogation ranged from 39% to 89% of total deaths or 20–100% of sudden deaths (Table ) . Three studies did not report the precise number of postmortem recordings obtained .…”

Section: Resultsmentioning

confidence: 99%

Postmortem ICD interrogation in mode of death classification

Nikolaidou

Johnson

Ghosh

et al. 2018

Cardiovasc electrophysiol

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“…However, overall survival was not impacted by the burden of ventricular arrhythmias. 49 In another study, ICD therapy was not associated with prolonged survival in patients with CA when compared to patients without ICD therapy (44 vs 40 months, P = 0.76). Compared to patients without CA, patients with the disease had a significantly higher mortality (40.5 vs 26.2%, P < 0.045), despite ICD therapy.…”

Section: Device Therapymentioning

confidence: 91%

Ventricular Arrhythmias in Cardiac Amyloidosis: A Review of Current Literature

Khanna

Cho

et al. 2020

Clin Med Insights Cardiol

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Cardiac Amyloidosis is an infiltrative cardiomyopathy which occurs secondary to deposition of mis-folded protein in the myocardium, with the two most common subtypes being AL amyloidosis and TTR amyloidosis. The pathogenesis of the disease is multifaceted and involves a variety of mechanisms including an inflammatory response cascade, oxidative stress and subsequent separation of myocyte fibrils. Cardiac Amyloidosis frequently results in congestive cardiac failure and arrhythmias, from a disruption in cardiac substrate with subsequent electro-mechanical remodelling. Disease progression is usually demonstrated by development of progressive pump failure, which may be seen with a high arrhythmic burden, usually portending a poor prognosis. There is a paucity of literature on the clinical implications of ventricular arrhythmias in the context of cardiac amyloidosis. The important diagnostic investigations for these patients include transthoracic echocardiography, cardiac magnetic resonance imaging and an electrophysiology study. Whilst there are no robust management guidelines, studies have indicated benefits from contemporary pharmacological therapy and case-by-case catheter ablation. There are novel directed therapies available for TTR amyloidosis that have shown to improve overall survival. The role of ICD therapy in cardiac amyloidosis is controversial, with benefits seen predominantly in early phases of the disease process. The only definitive surgical therapy includes heart transplantation, but is largely indicated for progressive decompensated heart failure (Figure 1). Further large-scale studies are required to better outline management paradigms for treating ventricular arrhythmias in cardiac amyloidosis.

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Outcome and incidence of appropriate implantable cardioverter-defibrillator therapy in patients with cardiac amyloidosis

Cited by 13 publications

References 0 publications

Cardiac amyloidosis: An update on diagnosis and treatment

Cardiac amyloidosis: An update on diagnosis and treatment

Postmortem ICD interrogation in mode of death classification

Ventricular Arrhythmias in Cardiac Amyloidosis: A Review of Current Literature

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