Category: Reviews

Expert Speakers Confirmed for the 29th Great Wall International Cardiology Conference (GW-ICC)

May 2018: The GW-ICC board are delighted to announce the expert speakers for China’s premier cardiology congress. The 29th Great Wall International Cardiology Conference (GW-ICC) takes place from October 11-14, 2018 in Beijing, China.

The conference is jointly organized by more than 20 domestic and international cardiovascular academic organizations and will include 13 academic fields, 18 kinds of sessions, nearly 60 professional categories, more than 400 academic exchange activities, seminars, training workshops, exhibitions and joint forums run with nearly 20 well-known international academic organizations. It is expected that the conference will welcome more than 1,000 scholars from nearly 40 countries and regions, more than 2,000 experts across China and over 18,000 guests and representatives, who will share and learn the latest progress, knowledge and innovation in cardiology and related fields.

Valentine-C-Michael

C. Michael Valentine, MD, FACC, ACC President

Notable speakers will include:

C. Michael Valentine, MD, FACC, ACC President

Dr. Valentine is a senior cardiologist at the Stroobants Cardiovascular Center of Centra Health in Lynchburg, Virginia, USA and has previously served on the ACC’s board of trustees and advocacy committee and as the Virginia chapter governor and board of governors’ chair. He graduated from the University of Virginia School of Medicine. Dr. Valentine has special training and interest in pacing, electrophysiology and interventional cardiology.

Barbara Casadei

Barbara Casadei, MD DPhil FRCP FMedSci FESC

Barbara Casadei, MD DPhil FRCP FMedSci FESC, President Elect of the European Society of Cardiology

Professor Casadei is currently Deputy Head of Division of Cardiovascular Medicine in Oxford. Professor Casadei provides a clinical service at the Oxford University Hospitals NHS Trust’s John Radcliffe Hospital and leads a bench-to-bedside translational research programme focussed on atrial fibrillation, which spans from clinical trials to bench-based investigation in human tissue and cells.

Dr.Ivor-Benjamin

Ivor J. Benjamin, MD, FACC, FAHA

Ivor J. Benjamin, MD, FACC, FAHA, President Elect of the AHA

Dr. Ivor J. Benjamin, is currently professor of medicine and director of the Cardiovascular Center at Froedtert Hospital and the Medical College of Wisconsin, USA. Dr Benjamin received his medical degree from Johns Hopkins University School of Medicine and has been in practice for more than 20 years.

David Wood

David Wood, MB ChB, MSc, FRCP, FRCPE, FFPHM, FESC

David Wood, MB ChB, MSc, FRCP, FRCPE, FFPHM, FESC, President World Heart Federation

Professor Wood is currently Garfield Weston Professor of Cardiovascular Medicine and Honorary Consultant Cardiologist, National Heart and Lung Institute, Imperial College London, United Kingdom. Professor Wood has contributed to international policy and guidelines on cardiovascular disease (CVD) prevention through the World Health Organization, World Heart Federation and the European Society of Cardiology. He was a founder and President of the European Association for Cardiovascular Prevention and Rehabilitation and a Board member of the European Society of Cardiology.

valentin fuster

Valentin Fuster, MD, PhD

Valentin Fuster, MD, PhD, Editor-in-Chief of Journal of the American College of Cardiology

After qualifying in medicine at the University of Barcelona, Dr Fuster continued his studies in the United States. Currently he serves The Mount Sinai Medical Hospital as Physician-in-Chief, as well as Director of Mount Sinai Heart, the Zena and Michael A. Wiener Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health and is CEO of the National Center for Cardiovascular Research (CNIC). He is also the Richard Gorlin, MD/Heart Research Foundation Professor, Icahn School of Medicine at Mount Sinai. Dr Fuster has made significant contributions throughout his professional career to the advancement of cardiology research, the prevention and treatment of cardiovascular disease, particularly coronary artery disease, atherosclerosis and thrombosis.

joseph hill

Joseph Hill, MD, PhD

Joseph Hill, MD, PhD, Editor-in-Chief of Circulation

Dr Joseph Hill is Chief of UT Southwestern Medical Center’s Division of Cardiology and Director of the Harry S. Moss Heart Center, Dallas, TX, USA. Dr Hill’s research focuses on molecular mechanisms of structural, functional, and electrophysiological remodeling in cardiac hypertrophy and heart failure. He earned his medical and doctoral (pharmacology) degrees at Duke University, completed fellowships with the Institut Pasteur in Paris and the Brigham and Women’s Hospital, Harvard Medical School.

thomas luscher

Thomas F. Lüscher, MD, FRCP

Thomas F. Lüscher, MD, FRCP, Editor-in-Chief of European Heart Journal

Professor Thomas F. Lüscher is the Director of Research, Education & Development and Consultant of Cardiology at Royal Brompton & Harefield Hospital Trust and Imperial College, London, United Kingdom and Director of the Center for Molecular Cardiology at the University Zurich, Switzerland. Professor Lüscher is a board certified internist and cardiologist with training in internal medicine at the University Hospital Zurich, cardiovascular physiology and cardiology at the Mayo Clinic, Rochester, MN, USA and in cardiology and clinical pharmacology at the University Hospital Basel, Switzerland. Prior to his current position he was Professor of Pharmacotherapy at the University of Basel, then Professor and vice-chairman of cardiology at the Inselspital of the University of Berne, Switzerland.

More information is available at http://en.gw-icc2017.org/en/jsp/login.jsp

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Current Management of Ventricular Tachycardia: Approaches and Timing

Current Management of Ventricular Tachycardia: Approaches and Timing

Authors: John, Roy M.; Stevenson, William

Ventricular tachycardia (VT) in the presence of structural heart disease is associated with sudden cardiac death and warrants prompt attention. Implantable cardioverter defibrillators (ICDs) while highly effective in terminating sustained ventricular arrhythmias and reducing mortality, have no effect on the arrhythmia substrate and recurrent shocks for VT termination occur in approximately 20% of patients. Shocks worsen quality of life and are associated with progression of heart failure and increased mortality. Antiarrhythmic drugs, mainly in the form of beta-blockers or amiodarone, are moderately effective in reducing ICD therapies but drug intolerance and serious toxicities of amiodarone necessitate drug cessation in a quarter of patients. Catheter ablation has emerged as an effective treatment for control of frequent VT episodes and can be life saving in cases of incessant VT or VT storm. As experience increases, it is being used increasingly earlier, rather than a last resort therapy. Efficacy varies with the nature of the underlying heart disease. Intramural arrhythmia substrate and failure to create permanent ablation lesions remain challenges and repeat procedures are necessary in a third to a half of patients. For idiopathic VTs or PVCs that are symptomatic or worsen LV function, catheter ablation is often an effective therapy.

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Principles of Arrhythmia Management During Pregnancy

Principles of Arrhythmia Management During Pregnancy

Authors: Burkart, Thomas Adam; Miles, William M.; Conti, Jamie Beth

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.

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Stroke Prevention in Atrial Fibrillation: Current Strategies and Recommendations

Stroke Prevention in Atrial Fibrillation: Current Strategies and Recommendations

Authors: Naccarelli, Gerald V.; Caputo, Gregory; Abendroth, Thomas; Faber, Samuel; Sendra-Ferrer, Mauricio; Wolbrette, Deborah; Samii, Soraya; Hussain, Sarah; Gonzalez, Mario

Stroke is the most common complication of atrial fibrillation (AF). Guidelines recommend anticoagulant treatment in patients with CHA2DS2VASc scores of >2. Registry data suggests that almost half of patients who should be on therapeutic anticoagulation for stroke prevention in AF (SPAF) are not. Warfarin and more recently developed agents, the “novel anticoagulants” (NOACs) reduce the risk of embolic strokes. In addition, the NOACs also reduce intracranial hemorrhage (ICH) by over 50% compared to warfarin. Anticoagulation and bridging strategies involving cardioversion, catheter ablation, and invasive/surgical procedures are reviewed. The development of reversal agents for NOACs and the introduction of left atrial appendage occluding devices will evolve the use of newer strategies for preventing stroke in high risk AF patients.

Keywords: anticoagulants; atrial fibrillation; stroke

Document Type: Research Article

DOI: http://dx.doi.org/10.15212/CVIA.2016.0005

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Atrial Fibrillation Ablation: Indications, New Advances, and Complications

Atrial Fibrillation Ablation: Indications, New Advances, and Complications

 Author: Ma, Chang-Sheng
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting millions of people worldwide with increasing incidence and prevalence. Radiofrequency catheter ablation has evolved as the treatment of choice for both paroxysmal and persistent AF. Several studies have been reported on catheter ablation as the first-line treatment for paroxysmal AF and different strategies for persistent AF. New technologies such as contact-force sensing catheters and cryoballoon have been recently used and the procedure carries the risk of complications like hematoma, arteriovenous fistula, cardiac tamponade, pulmonary vein stenosis, atrio-esophageal fistula and death.

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Changing the Way We “See” Scar: How Multimodality Imaging Fits in the Electrophysiology Laboratory

Changing the Way We “See” Scar: How Multimodality Imaging Fits in the Electrophysiology Laboratory

Author: Wokhlu, Anita

Substrate characterization is the mainstay of ablation for ventricular tachycardia (VT). Although the use of electroanatomic voltage mapping (EAVM) in the electrophysiology (EP) laboratory has enabled real-time approximation of myocardial scar, it has limitations. This is related to the subjective and tedious nature of voltage mapping and the challenges of defining the transmurality of scar. Various noninvasive methods of scar assessment have emerged, with magnetic resonance imaging (MRI) being the most accurate. Integrated MRI and electroanatomic voltage mapping studies demonstrate good correlation. Nonetheless, MRI has advantages. These include (1) preprocedure identification of epicardial and intramural scar, (2) assessment of ablative lesion formation after unsuccessful ablations, (3) identification of heterogeneous regions of scar, where critical conducting channels are likely to occur, and (4) predictive value in the assessment of sudden cardiac death (SCD). Integration of scar imaging in ventricular tachycardia ablation and risk stratification has great potential to advance the practice of arrhythmia management.

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Syncope and Early Repolarization: A Benign or Dangerous ECG Finding?

Syncope and Early Repolarization: A Benign or Dangerous ECG Finding?

Authors: McKillop, Matthew; Miles, William M.

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 significant 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 stratification when early repolarization change is observed on ECG.

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Inherited Wolff‐Parkinson‐White Syndrome

Inherited Wolff‐Parkinson‐White Syndrome

Authors: Liu, Yang; Xue, Yumei; Wu, Shulin; Hu, Dan

Wolff‐Parkinson‐White (WPW) syndrome is a congenital disorder of cardiac conduction system characterized by electrocardiographic preexcitation and episodes of paroxysmal supraventricular tachycardia. It is caused by a cardiac developmental defect in the electrical insulation between the atria and the ventricles due to the presence of an accessory pathway. WPW syndrome is a common cause of supraventricular tachycardia with benign prognosis. However, this clinical entity also predisposes patients to an increased risk of sudden cardiac death, especially in the setting of preexcited atrial fibrillation. WPW syndrome is usually sporadic and of unknown etiology in most cases. During the past 10 years, a significant heritable factor is increasingly recognized. Identification of the genetic basis among patients with WPW syndrome has important implications for understanding the molecular mechanism of ventricular preexcitation and the development of therapeutic strategies for risk stratification and management. The goal of this review is to examine the previous studies on hereditary variants, as well as to outline potential future avenues toward defining the heritability of WPW syndrome.

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Subcutaneous Implantable Cardioverter-Defibrillator

The Subcutaneous Implantable Cardioverter-Defibrillator: A Practical Review and Real-World Use and Application

Authors: Panna, Mark E.; Miles, William M.

The subcutaneous implantable cardioverter-defibrillator (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 benefit 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.

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Athletes and Arrhythmias

Athletes and Arrhythmias

Authors: Jansen, Michael J.; Burke, Floyd W.

Sudden cardiac death related to athletic competition is a rare but tragic event. The victims are typically young with no previous cardiovascular symptoms or limitations. The majority of sudden cardiac death events in athletes are due to ventricular arrhythmias as a result of underlying molecular and/or structural level pathologic substrate. In this article, we will review the physiologic cardiac adaptations to exercise along with arrhythmias seen in athletes with a focus on those commonly associated with sudden cardiac death.

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