Why Does CRT Reduce the Risk of Arrhythmias?

Cleland, John G.F.; Pellicori, Pierpaolo; Dicken, Benjamin

doi:10.1016/j.jcmg.2013.02.003

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…These new modalities consist of ICDs, cardiac resynchronization therapy systems, and neurohormonal inhibitor medications, which also help to prevent arrhythmias by themselves. 42 Strategies like these that remain in continued development could further lower the effective dose of amiodarone to control arrhythmia-related problems. Lower doses and improved surveillance would, in theory, result in fewer side effects and improvements in quality of life.…”

Section: Safety Of Low-dose Amiodaronementioning

confidence: 99%

Low-dose Amiodarone Is Safe: A Systematic Review and Meta-analysis

Chokesuwattanaskul

Shah

Chokesuwattanaskul

et al. 2020

J Innov Cardiac Rhythm Manage

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Amiodarone is commonly used for a variety of arrhythmias and, in some parts of the world, is the only available antiarrhythmic drug (AAD). Yet, amiodarone is known to have a wide range of potential side effects, many of which are dose-and duration-dependent. We sought to study the incidence of side effects leading to the discontinuation of low-dose amiodarone, arbitrarily defined as 200 mg/day or less, and very-low-dose amiodarone, defined as 100 mg/ day or less. In this study, literature databases were searched through June 2019. Studies that reported the incidence or prevalence of side effects of amiodarone were included. Effect estimates from individual studies were extracted and combined using the random-effects generic inverse variance method of DerSimonian and Laird. A total of 10 observational cohort studies involving 901 patients were included in the analysis. The pooled estimated incidence of overall side effects for low-dose amiodarone was 0.17 [95% confidence interval (CI): 0.12-0.22]. In addition, the pooled estimated incidence of side effects requiring medication discontinuation was 0.06 (95% CI: 0.03-0.11). As compared with 200 mg/day of amiodarone, the pooled estimated incidence of overall side effects was 0.11 (95% CI: 0.04-0.27), while the incidence of side effects requiring medication discontinuation was 0.02 (95% CI: 0.01-0.06) for the dose of 100 mg/day. In conclusion, verylow-dose amiodarone displays a low incidence of significant side effects requiring medication discontinuation.

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Section: Safety Of Low-dose Amiodaronementioning

confidence: 99%

Low-dose Amiodarone Is Safe: A Systematic Review and Meta-analysis

Chokesuwattanaskul

Shah

Chokesuwattanaskul

et al. 2020

J Innov Cardiac Rhythm Manage

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Mechanical Dyssynchrony after Cardiac Resynchronization Therapy for Severely Symptomatic Heart Failure Is Associated with Risk for Ventricular Arrhythmias

Haugaa¹,

Marek²,

Ahmed³

et al. 2014

Journal of the American Society of Echocardiography

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Cardiac imaging in evaluating patients prone to sudden death

Tamene

Tholakanahalli

Chandrashekhar

2014

Indian Heart Journal

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Identifying subjects who are at risk for SCD and stratifying them correctly into low or high-risk groups is the holy grail of Cardiology. While imaging shows a lot of promise, it is plagued by the fact that most SCD occurs in relatively healthy subjects, a massive group who would not ordinarily be subjected to imaging. Left ventricular ejection fraction (LVEF) currently is our primary parameter for risk stratification for sudden cardiac death but is a poor marker with low sensitivity and specificity. Current data shows that sophisticated imaging with techniques, mainly Cardiac magnetic resonance Imaging (CMR), have the potential to identify novel high-risk markers underlying SCD, beyond ejection fraction. Imaging seems to further refine risk in patients with low LVEF as well as in those with normal EF; this is a major strength of advanced imaging. Clinical application has been slow and not fully prime time. It is important to remember that while promising, imaging techniques including CMR, have not been tested in rigorous prospective studies and thus have not as yet replaced EF as the gatekeeper to ICD implantation.

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Why Does CRT Reduce the Risk of Arrhythmias?

Cited by 5 publications

References 13 publications

Low-dose Amiodarone Is Safe: A Systematic Review and Meta-analysis

Low-dose Amiodarone Is Safe: A Systematic Review and Meta-analysis

Mechanical Dyssynchrony after Cardiac Resynchronization Therapy for Severely Symptomatic Heart Failure Is Associated with Risk for Ventricular Arrhythmias

Cardiac imaging in evaluating patients prone to sudden death

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