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The 2004 ACC/AHA Guidelines: a perspective and adaptation for Canada by the Canadian Cardiovascular Society Working Group.

https://arctichealth.org/en/permalink/ahliterature178142
Source
Can J Cardiol. 2004 Sep;20(11):1075-9
Publication Type
Article
Date
Sep-2004
Author
Paul W Armstrong
Peter Bogaty
Christopher E Buller
Paul Dorian
Blair J O'Neill
Author Affiliation
VIGOUR Centre, University of Alberta, Edmonton. paul.armstrong@ualberta.ca
Source
Can J Cardiol. 2004 Sep;20(11):1075-9
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Canada
Defibrillators, Implantable - standards
Electrocardiography
Emergency Medical Services - standards
Emergency Service, Hospital - standards
Female
Guideline Adherence
Humans
Male
Myocardial Infarction - diagnosis - therapy
Myocardial Reperfusion - standards
Severity of Illness Index
Survival Analysis
Treatment Outcome
Abstract
Major changes in acute ST elevation myocardial infarction (STEMI) management prompted a comprehensive rewriting of the American College of Cardiology/American Heart Association Guidelines. The Canadian Cardiovascular Society (CCS) participated in both the writing process and the external review. Subsequently, a Canadian Working Group (CWG), formed under the auspices of the CCS, developed a perspective and adaptation for Canada. Herein, accounting for specific realities of the Canadian cardiovascular health system, is a discussion of the implications for prehospital care and transport, optimal reperfusion therapy and an approach to decision making regarding reperfusion options and invasive therapy following fibrinolytic therapy. Major recent developments regarding indications for implantable cardioverter defibrillator(s) (ICDs) also prompted a review of indications for ICDs and the optimal timing of implantation given the potential for recovery of left ventricular function. At least a 40-day, preferably a 12-week, waiting period was judged to be optimal to evaluate left ventricular function post-STEMI. A recommended algorithm for the insertion of an ICD is provided. Implementation of the new STEMI guidelines has substantial implications for resources, organization and priorities of the Canadian health care system. While on the one hand, the necessary incremental funding to provide tertiary and quaternary care and to support revascularization and device implantation capability is desirable, it is equally or more important to develop enhanced prehospital care, including the capacity for early recognition, risk assessment, fibrinolytic therapy and/or triage to a tertiary care centre as part of an enlightened approach to improving cardiac care.
PubMed ID
15457302 View in PubMed
Less detail

Aerobic interval training in patients with heart failure and an implantable cardioverter defibrillator: a controlled study evaluating feasibility and effect.

https://arctichealth.org/en/permalink/ahliterature267640
Source
Eur J Prev Cardiol. 2015 Mar;22(3):296-303
Publication Type
Article
Date
Mar-2015
Author
Kjetil Isaksen
Peter S Munk
Torstein Valborgland
Alf I Larsen
Source
Eur J Prev Cardiol. 2015 Mar;22(3):296-303
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Aged
Brachial Artery - physiopathology
Combined Modality Therapy
Defibrillators, Implantable
Electric Countershock - adverse effects - instrumentation
Endothelium, Vascular - physiopathology
Exercise Test
Exercise Therapy - adverse effects - methods
Exercise Tolerance
Feasibility Studies
Female
Heart Failure - diagnosis - physiopathology - therapy
Humans
Male
Middle Aged
Norway
Prospective Studies
Recovery of Function
Time Factors
Treatment Outcome
Abstract
Aerobic interval training (AIT) has been shown to be superior to moderate continuous exercise training in improving exercise capacity and endothelial function in patients with both coronary artery disease and heart failure (HF). The objective of this study was to evaluate this training modality in patients with HF and an implantable cardioverter defibrillator (ICD) with regard to feasibility, safety, and effect.
We prospectively included 38 patients with an ICD: 26 patients participated in an AIT programme for 3 months, while 12 patients served as controls. At baseline and 12-week follow up, patients were assessed with a maximal ergospirometry stress test, echocardiography, endothelial function testing, and ICD interrogation.
No exercise-related adverse events occurred during or soon after the training sessions. ICD interrogation revealed no sustained arrhythmias, antitachycardia pacing, or ICD discharge related to exercise sessions. The AIT programme led to a significant increase in peak oxygen uptake, cycle ergometer workload, and endothelial function compared to the control group. The training programme was safe and not associated with any adverse events or ICD-related complications.
An AIT programme is feasible and seems safe in a well-treated, stable ICD population. Further, AIT for 3 months results in significantly increased aerobic capacity and endothelial function in this population.
PubMed ID
24403295 View in PubMed
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Age and mental health predict early device-specific quality of life in patients receiving prophylactic implantable defibrillators.

https://arctichealth.org/en/permalink/ahliterature126084
Source
Can J Cardiol. 2012 Jul-Aug;28(4):502-7
Publication Type
Article
Author
Sandra L Carroll
Maureen Markle-Reid
Donna Ciliska
Stuart J Connolly
Heather M Arthur
Author Affiliation
School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. carroll@mcmaster.ca
Source
Can J Cardiol. 2012 Jul-Aug;28(4):502-7
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Character
Cohort Studies
Defibrillators, Implantable - psychology
Depressive Disorder - psychology
Female
Heart Failure - complications - psychology
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Ischemia - complications - psychology
Ontario
Patient Acceptance of Health Care - psychology
Prospective Studies
Quality of Life - psychology
Socioeconomic Factors
Treatment Outcome
Ventricular Fibrillation - prevention & control - psychology
Abstract
Ventricular arrhythmia is a significant cause of sudden death. Implantable cardioverter-defibrillators (ICDs) offer at-risk patients a prophylactic treatment option. This prophylaxis is largely responsible for growth in utilization of ICDs. Identification of factors that may impact device-specific quality of life (QOL) is warranted. The influence of preimplant patient variables on postimplant device-specific QOL is unknown. The study aimed to determine whether preimplant psychosocial, generic health-related quality of life (HRQOL), personality disposition, or demographic factors predicted early postimplant device-specific QOL.
A prospective cohort study design was employed in 70 adults receiving an ICD for primary prevention. Preimplant, we measured generic HRQOL, personality disposition, depressive symptoms, age, and sex. The primary outcome was 3-month ICD device-specific QOL as measured by the Florida Patient Acceptance Scale (FPAS). We applied hierarchical multivariate regression analysis.
Mean age was 64.8 ± 9.4 years; 12.9% were women. Most had ischemic heart disease (77%) and a heart failure history (54.3%). Preimplant prevalence of elevated depressive symptoms was 30%. Three months post implant, the mean adjusted FPAS score was 76.8 ± 12.98. Of the variance in FPAS scores, 37% was explained by the independent variables. Younger age and poor preimplant mental HRQOL contributed most to lower FPAS scores.
Patient support and psychosocial interventions should target younger ICD candidates and those reporting poor preimplant mental HRQOL; these patients may be at risk for poor postimplant device-specific QOL.
PubMed ID
22425267 View in PubMed
Less detail

Aging and heart failure: changing demographics and implications for therapy in the elderly.

https://arctichealth.org/en/permalink/ahliterature144487
Source
Heart Fail Rev. 2010 Sep;15(5):401-5
Publication Type
Article
Date
Sep-2010
Author
Bodh I Jugdutt
Author Affiliation
Division of Cardiology, Department of Medicine and Cardiovascular Research Group, Faculty of Medicine, 2C2 Walter MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB T6G 2R7, Canada. bjugdutt@ualberta.ca
Source
Heart Fail Rev. 2010 Sep;15(5):401-5
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging - physiology
Alberta - epidemiology
Antihypertensive Agents - therapeutic use
Cardiac Pacing, Artificial
Defibrillators, Implantable
Demography
Disease Progression
Female
Heart Failure - drug therapy - epidemiology - mortality - therapy
Humans
Male
Stroke Volume
Ventricular Dysfunction, Left - epidemiology - mortality
Ventricular Function, Left
Abstract
The elderly population (age > or =65) is increasing and with it morbidity, hospitalizations, costs and mortality due to heart failure (HF). HF is a progressive disorder that is superimposed on an on-going aging process. The two broad categories of HF, HF with left ventricular (LV) systolic dysfunction or low ejection fraction (HF/low-EF) and HF with preserved ejection fraction (HF/PEF) are equally prevalent in the elderly. Trials of therapy for HF/low-EF in primarily non-elderly patients showed mortality benefit in elderly patients. In contrast, trials for HF/PEF have not shown mortality benefit in elderly or non-elderly patients. HF pharmacotherapy in the elderly is challenging and needs to be individualized and consider several aging-related changes. More research into the biology of aging and more clinical trials in elderly patients are needed to improve morbidity and mortality in elderly HF patients.
PubMed ID
20364319 View in PubMed
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Air pollution and cardiac arrhythmias in patients with implantable cardioverter defibrillators.

https://arctichealth.org/en/permalink/ahliterature179578
Source
Inhal Toxicol. 2004 Jun;16(6-7):353-62
Publication Type
Article
Date
Jun-2004
Author
Sverre Vedal
Kira Rich
Michael Brauer
Rick White
John Petkau
Author Affiliation
National Jewish Medical and Research Center, Denver, Colorado 80246, USA. vedals@njc.org
Source
Inhal Toxicol. 2004 Jun;16(6-7):353-62
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Air Pollutants - adverse effects
Air Pollution - adverse effects
Arrhythmias, Cardiac - epidemiology - etiology - therapy
British Columbia - epidemiology
Child
Defibrillators, Implantable
Electric Countershock - instrumentation
Female
Humans
Inhalation Exposure - adverse effects
Logistic Models
Longitudinal Studies
Male
Meteorological Concepts
Middle Aged
Retrospective Studies
Sulfur Dioxide - adverse effects
Abstract
Epidemiological studies have demonstrated associations between short-term increases in outdoor air pollution concentrations and adverse cardiovascular effects, including cardiac mortality and hospitalizations. One possible mechanism behind this association is that air pollution exposure increases the risk of developing a cardiac arrhythmia. To investigate this hypothesis, dates of implantable cardioverter defibrillator (ICD) discharges were abstracted from patient records in patients attending the two ICD clinics in Vancouver, BC, for the years 1997-2000. Daily outdoor air pollutant concentrations and daily meteorological data from the Vancouver region were obtained for the same 4-yr period. Generalized estimating equations were used to assess the association between short-term increases in air pollutant concentrations and ICD discharges while controlling for temporal trends, meteorology, and serial correlation in the data. Air pollution concentrations in the Vancouver region were relatively low from 1997 to 2000, as expected. In the 50 patients who resided within the Vancouver region and who experienced at least 1 ICD discharge during the period of follow-up, no significant associations between increased air pollution concentrations and increased ICD discharges were present. When the patient sample was restricted to the 16 patients who had at least 6 months of follow-up and experienced a rate of at least 2 days with ICD discharges per year, there was a statistically significant association between increased sulfur dioxide (SO(2)) concentration and ICD discharge 2 days after the SO(2) increase. When stratified by season, no associations between increased air pollutant concentrations and increased risk of ICD discharge were observed in the summer, although for several pollutants, concentration increases were associated with a decrease in ICD discharges. In the winter, increased SO(2) concentrations again were seen to be associated with increased risk of ICD discharge, at both 2 and 3 days following increases in SO(2) concentrations. These findings provide no compelling evidence that short-term increases in relatively low concentrations of outdoor air pollutants have an adverse effect on individuals at risk of cardiac arrhythmias. The findings regarding SO(2) are difficult to interpret. They may be chance findings. Alternatively, given the very low concentrations of SO(2) that were present in Vancouver, SO(2) may have been serving as a surrogate measure of other environmental or meteorological factors.
PubMed ID
15204751 View in PubMed
Less detail

Anxiety predicts mortality in ICD patients: results from the cross-sectional national CopenHeartICD survey with register follow-up.

https://arctichealth.org/en/permalink/ahliterature265218
Source
Pacing Clin Electrophysiol. 2014 Dec;37(12):1641-50
Publication Type
Article
Date
Dec-2014
Author
Selina Kikkenborg Berg
Lau Caspar Thygesen
Jesper Hastrup Svendsen
Anne Vinggaard Christensen
Ann-Dorthe Zwisler
Source
Pacing Clin Electrophysiol. 2014 Dec;37(12):1641-50
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Anxiety - complications
Cross-Sectional Studies
Defibrillators, Implantable - psychology
Denmark
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications - etiology - mortality
Prognosis
Questionnaires
Registries
Abstract
Although highly effective in preventing arrhythmic death, patients receiving an implantable cardioverter defibrillator (ICD) may still experience psychological difficulties such as anxiety, depression, and reduced quality of life. The objectives of this study were to describe patient-reported outcomes among ICD patients: (1) compared to a matched healthy population, (2) compared by ICD indication, (3) factors predicting patient-reported outcomes, and (4) if patient-reported outcomes predicted mortality.
The study was a mailed survey to an unselected group of patients 18+ years old receiving ICD between January 1, 2011 and June 30, 2011 (n = 499). The following instruments were used: SF-36, Hospital Anxiety and Depression Scale, HeartQoL, EQ-5D, and the Multidimensional Fatigue Inventory.
The response rate was 72%. Mean age was 65.5 years and 82% patients were males. Fifty-three percent of patients had primary prevention indication ICD. Compared to an age- and gender-matched population without disease, the ICD population had worse mental health (55.0 vs 51.7 points) and physical health (52.6 vs 41.9 points). Patients with primary prevention indication had lower levels of perceived health, quality of life, and fatigue; for example, physical health 39.8 versus 44.3 points, compared to secondary prevention indication. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality, anxiety being the strongest with an adjusted odds ratio of 4.17 (1.49; 11.66).
Patients with primary prevention ICD had lower levels of perceived health, quality of life, and more fatigue. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality.
PubMed ID
25196176 View in PubMed
Less detail

Appropriate use of the implantable cardioverter defibrillator: a Canadian perspective. Canadian Working Group on Cardiac Pacing.

https://arctichealth.org/en/permalink/ahliterature203131
Source
Pacing Clin Electrophysiol. 1999 Jan;22(1 Pt 1):1-4
Publication Type
Article
Date
Jan-1999

Arrhythmia characterization and long-term outcomes in catecholaminergic polymorphic ventricular tachycardia.

https://arctichealth.org/en/permalink/ahliterature137113
Source
Heart Rhythm. 2011 Jun;8(6):864-71
Publication Type
Article
Date
Jun-2011
Author
Raymond W Sy
Michael H Gollob
George J Klein
Raymond Yee
Allan C Skanes
Lorne J Gula
Peter Leong-Sit
Robert M Gow
Martin S Green
David H Birnie
Andrew D Krahn
Author Affiliation
University of Western Ontario, Ontario, Canada.
Source
Heart Rhythm. 2011 Jun;8(6):864-71
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adrenergic beta-Antagonists - therapeutic use
Adult
Aged
Catecholamines - metabolism
Child
Child, Preschool
DNA - genetics
Death, Sudden, Cardiac - epidemiology - etiology - prevention & control
Defibrillators, Implantable
Electrocardiography
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Mutation
Ontario - epidemiology
Risk factors
Ryanodine Receptor Calcium Release Channel - genetics
Survival Rate - trends
Syncope - epidemiology - etiology - prevention & control
Tachycardia, Ventricular - complications - genetics - metabolism
Time Factors
Young Adult
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by adrenergically induced ventricular tachycardia (VT) associated with syncope and sudden death.
This study sought to characterize arrhythmias associated with CPVT with respect to provocation by exercise and drugs, electrocardiographic characteristics, and association with long-term outcomes; and to explore the relation between age and clinical presentation.
Seventy patients from 16 families were evaluated with exercise and selective adrenaline challenge, and screened for RyR2 mutations. CPVT was diagnosed in probands with symptoms and stress- or adrenaline-provoked VT, or in asymptomatic relatives with provoked VT or RyR2 mutations. Patients were followed up for recurrent syncope, VT, and sudden death.
Twenty-seven patients including 16 probands were identified (median age 35 years, 67% female). Presentation was cardiac arrest in 33% and syncope in 56%, and 11% were asymptomatic. Polymorphic or bidirectional VT was provoked with exercise in 63% and adrenaline in 82%. The initiating beat of VT was late-coupled and wide (coupling interval 418 ± 42 ms; QRSd 131 ± 17 ms), and QRS morphology suggested an outflow tract origin in 59%. During follow-up of 6.2 ± 5.7 years, 2 patients died despite an implantable cardioverter-defibrillator (ICD), 4 patients received ICD therapy for VT, and 5 patients had inappropriate therapy for supraventricular tachycardia. Patients presenting with late-onset CPVT (age > 21; n = 10) were often female (80%) and less likely to have RyR2 (Ryanodine receptor type 2) mutations (33%), and fatal events were not observed during follow-up (4.1 ± 3.6 years).
Ventricular arrhythmia in CPVT is often initiated from the outflow tract region. Despite ß-blocker therapy and selective ICD implantation, breakthrough arrhythmias occur and may be associated with adverse outcomes.
Notes
Comment In: Heart Rhythm. 2011 Jun;8(6):872-321338709
PubMed ID
21315846 View in PubMed
Less detail

Association between usage of beta-blocking medication and benefit from implantable cardioverter therapy.

https://arctichealth.org/en/permalink/ahliterature80124
Source
Am J Cardiol. 2006 Nov 1;98(9):1245-7
Publication Type
Article
Date
Nov-1-2006
Author
Mäkikallio Timo H
Huikuri Heikki V
Author Affiliation
Division of Cardiology, Department of Internal Medicine, University of Oulu, Oulu, Finland. timo.makikallio@oulu.fi
Source
Am J Cardiol. 2006 Nov 1;98(9):1245-7
Date
Nov-1-2006
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Defibrillators, Implantable
Humans
Randomized Controlled Trials
Risk assessment
Stroke Volume
Ventricular Dysfunction, Left - mortality - therapy
Abstract
The mortality benefit of implantable cardioverter defibrillator (ICD) therapy in primary and secondary prevention has been shown in various studies in patients with depressed left ventricular systolic function. This study determined the association between the mortality benefit of ICD therapy and the use of beta-blocking medication in randomized ICD trials. Eligible studies were randomized controlled trials of ICD therapy compared with conventional medical treatment reporting mortality as an outcome (Medline from May 1995 to May 2005). Ten randomized trials were included. Included studies were reviewed to determine the number of patients, follow-up, and the mortality of ICD and control groups. The analysis of these trials showed a strong negative association between the use of beta-blocking medication and the 2-year mortality benefit of ICD therapy (r = -0.81, p
PubMed ID
17056339 View in PubMed
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216 records – page 1 of 22.