Early repolarization is a well-described,common electrocardiographic variant.It was initially felt to be benign,but in the last twenty years a suggested a link between specific types of early repolarization and sudden...Early repolarization is a well-described,common electrocardiographic variant.It was initially felt to be benign,but in the last twenty years a suggested a link between specific types of early repolarization and sudden cardiac death has emerged.This association was has been termed the J wave syndrome and includes both the high risk early repolarization and Brugada ECG patterns.The odds of early repolarization change being associated with poor outcomes are still exceedingly small.Nevertheless,the association of a fairly ubiquitous ECG finding with fatal or near fatal clinical outcomes has raised concern.How can we identify the truly high-risk patients?If a patient has a signifi cant clinical event with a concerning ECG repolarization pattern,what should be done next?The authors of this review present current information regarding the Early Repolarization and Brugada Syndromes and how to proceed with diagnosis,management,and risk stratifi cation when early repolarization change is observed on ECG.展开更多
The subcutaneous implantable cardioverter-defi brillator(ICD)is a novel technology using a subcutaneous(extrathoracic)system for treatment of potential lethal ventricular arrhythmias.It avoids many of the risks of tra...The subcutaneous implantable cardioverter-defi brillator(ICD)is a novel technology using a subcutaneous(extrathoracic)system for treatment of potential lethal ventricular arrhythmias.It avoids many of the risks of transvenous ICD implantation.It may be considered in patients having an ICD indication who do not have a pacing and/or cardiac resynchronization therapy indication,and who are unlikely to benefi t from antitachycardia pacing therapy.We review patient selection,system components,the implantation technique,and screening considerations for subcutaneous ICD implantation.Its uses in specific patient populations,including children,patients with congenital heart disease,hypertrophic cardiomyopathy,or end-stage renal disease,and patients with preexisting pacemakers,are highlighted.Areas of future investigation are reviewed,including potential use with leadless pacing and magnetic resonance imaging.展开更多
This paper reviews current recommendations on the appropriate evaluation and management of cardiac arrhythmias in the pregnant patient.Most arrhythmias during pregnancy are benign and require no intervention.When requ...This paper reviews current recommendations on the appropriate evaluation and management of cardiac arrhythmias in the pregnant patient.Most arrhythmias during pregnancy are benign and require no intervention.When required,the decision to treat should be based on symptom severity and the associated risk to mother and fetus posed by potentially recurring arrhythmia episodes throughout the pregnancy.Any treatment strategy in this patient population has inherent risk to both mother and unborn child.Before the initiation of any intervention,documentation of a clinical arrhythmia and correlation with clinical symptoms should be obtained.There is no role for empiric therapy.展开更多
文摘Early repolarization is a well-described,common electrocardiographic variant.It was initially felt to be benign,but in the last twenty years a suggested a link between specific types of early repolarization and sudden cardiac death has emerged.This association was has been termed the J wave syndrome and includes both the high risk early repolarization and Brugada ECG patterns.The odds of early repolarization change being associated with poor outcomes are still exceedingly small.Nevertheless,the association of a fairly ubiquitous ECG finding with fatal or near fatal clinical outcomes has raised concern.How can we identify the truly high-risk patients?If a patient has a signifi cant clinical event with a concerning ECG repolarization pattern,what should be done next?The authors of this review present current information regarding the Early Repolarization and Brugada Syndromes and how to proceed with diagnosis,management,and risk stratifi cation when early repolarization change is observed on ECG.
文摘The subcutaneous implantable cardioverter-defi brillator(ICD)is a novel technology using a subcutaneous(extrathoracic)system for treatment of potential lethal ventricular arrhythmias.It avoids many of the risks of transvenous ICD implantation.It may be considered in patients having an ICD indication who do not have a pacing and/or cardiac resynchronization therapy indication,and who are unlikely to benefi t from antitachycardia pacing therapy.We review patient selection,system components,the implantation technique,and screening considerations for subcutaneous ICD implantation.Its uses in specific patient populations,including children,patients with congenital heart disease,hypertrophic cardiomyopathy,or end-stage renal disease,and patients with preexisting pacemakers,are highlighted.Areas of future investigation are reviewed,including potential use with leadless pacing and magnetic resonance imaging.
文摘This paper reviews current recommendations on the appropriate evaluation and management of cardiac arrhythmias in the pregnant patient.Most arrhythmias during pregnancy are benign and require no intervention.When required,the decision to treat should be based on symptom severity and the associated risk to mother and fetus posed by potentially recurring arrhythmia episodes throughout the pregnancy.Any treatment strategy in this patient population has inherent risk to both mother and unborn child.Before the initiation of any intervention,documentation of a clinical arrhythmia and correlation with clinical symptoms should be obtained.There is no role for empiric therapy.
