Pacemakers and Defibrillators: Recent and Ongoing Studies That Impact the Elderly

Martinez, Claudia; Tzur, Assaf; Hrachian, Hakop H.; Zebede, Joseph; Lamas, Gervasio A.

doi:10.1111/j.1076-7460.2006.04883.x

Cited by 7 publications

(5 citation statements)

References 33 publications

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“…Pacing of the right ventricular apex alters the normal ventricular activation leading to dyssynchronous ventricular contraction (73–76). Delayed and abnormal activation of the left ventricle is responsible for a less efficient heart pump.…”

Section: Pacemakers and Defibrillatorsmentioning

confidence: 99%

“…On this basis, available evidence supports the use of ICD with standard indications for elderly patients with HF and without major comorbid conditions (83). However, when multiple comorbidities or possible competing causes of death are present, the clinician must use judicious rules to decide for or against the use of ICD in elderly patients (76).…”

Section: Pacemakers and Defibrillatorsmentioning

confidence: 99%

See 1 more Smart Citation

Management of heart failure in elderly people

Imazio

Cotroneo²,

Gaschino

et al. 2007

International Journal of Clinical Practice

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Heart failure is the commonest reason for hospitalisation and readmission among older adults. HF shows peculiar features in elderly people, and is usually complicated by comorbidities, presenting a significant financial burden worldwide, nevertheless elderly people have been generally excluded from clinical trials, and thus management largely remains empiric and based on evidence from younger age groups.

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Section: Pacemakers and Defibrillatorsmentioning

confidence: 99%

Section: Pacemakers and Defibrillatorsmentioning

confidence: 99%

Management of heart failure in elderly people

Imazio

Cotroneo²,

Gaschino

et al. 2007

International Journal of Clinical Practice

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“…Pharmacological therapeutics can reduce the heart's work load via diuretics, nitrates, and humoral factor blockers such as ACE inhibitors or B‐blockers (Doughty et al, 1997; Sharpe et al, 1991). Interventional therapy, such as implanting pacing devices can be performed to control electrical/mechanical asynchrony (Martinez et al, 2007). Nonetheless, pharmaceutics and surgery fall short from preventing progression to end stage heart failure (Packer, 2002).…”

Section: Introductionmentioning

confidence: 99%

Functional 3‐D cardiac co‐culture model using bioactive chitosan nanofiber scaffolds

Hussain

Collins

Yip

et al. 2012

Biotech & Bioengineering

120

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The in vitro generation of a three-dimensional (3-D) myocardial tissue-like construct employing cells, biomaterials, and biomolecules is a promising strategy in cardiac tissue regeneration, drug testing, and tissue engineering applications. Despite significant progress in this field, current cardiac tissue models are not yet able to stably maintain functional characteristics of cardiomyocytes for long-term culture and therapeutic purposes. The objective of this study was to fabricate bioactive 3-D chitosan nanofiber scaffolds using an electrospinning technique and exploring its potential for long-term cardiac function in the 3-D co-culture model. Chitosan is a natural polysaccharide biomaterial that is biocompatible, biodegradable, non-toxic, and cost effective. Electrospun chitosan was utilized to provide structural scaffolding characterized by scale and architectural resemblance to the extracellular matrix (ECM) in vivo. The chitosan fibers were coated with fibronectin via adsorption in order to enhance cellular adhesion to the fibers and migration into the interfibrous milieu. Ventricular cardiomyocytes were harvested from neonatal rats and studied in various culture conditions (i.e., mono- and co-cultures) for their viability and function. Cellular morphology and functionality were examined using immunofluorescent staining for alpha-sarcomeric actin (SM-actin) and gap junction protein, Connexin-43 (Cx43). Scanning electron microscopy (SEM) and light microscopy were used to investigate cellular morphology, spatial organization, and contractions. Calcium indicator was used to monitor calcium ion flux of beating cardiomyocytes. The results demonstrate that the chitosan nanofibers retained their cylindrical morphology in long-term cell cultures and exhibited good cellular attachment and spreading in the presence of adhesion molecule, fibronectin. Cardiomyocyte mono-cultures resulted in loss of cardiomyocyte polarity and islands of non-coherent contractions. However, the cardiomyocyte-fibroblast co-cultures resulted in polarized cardiomyocyte morphology and retained their morphology and function for long-term culture. The Cx43 expression in the fibroblast co-culture was higher than the cardiomyocytes mono-culture and endothelial cells co-culture. In addition, fibroblast co-cultures demonstrated synchronized contractions involving large tissue-like cellular networks. To our knowledge, this is the first attempt to test chitosan nanofiber scaffolds as a 3-D cardiac co-culture model. Our results demonstrate that chitosan nanofibers can serve as a potential scaffold that can retain cardiac structure and function. These studies will provide useful information to develop a strategy that allows us to generate engineered 3-D cardiac tissue constructs using biocompatible and biodegradable chitosan nanofiber scaffolds for many tissue engineering applications.

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“…The third letter indicates what the pacemaker does in response to a sensed event. [1][2][3][4] An example of a single chamber pacemaker is a P-triggered ventricular pacemaker with a VAT pacemaker code. The last 2 letters refer to other programmable features on pacemakers including rate modulation and antitachycardic function.…”

Section: Pacing Codes and Types Of Pacemakersmentioning

confidence: 99%

“…The use of pacemakers has increased considerably with the most common indications for placement of a permanent pacemaker being (1) a heart rate that is too slow (symptomatic bradycardia); (2) a heart rate that fails to increase appropriately with exercise (chrontropic incompetence); or (3) an electric pathway that is blocked resulting in atrioventricular delays or bundle branch blocks. 1 Heart blocks may cause a loss of AV synchrony, a term that refers to the sequence and timing of the atria and ventricles.…”

Section: Introduction To Pacemakersmentioning

confidence: 99%