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Continuous internal counterpulsation as a bridge to recovery in acute and chronic heart failure

World Journal of Transplantation 2016年第1期6卷 115-124页

作者： christos D kontogiannis Konstantinos Malliaras Chris J Kapelios Jay W Mason John N Nanas 3~(rd) Department of Cardiology University of Athens School of Medicine Cardiology Division University of Utah

Cardiac recovery from cardiogenic shock(CS) and end-stage chronic heart failure(HF) remains anoften insurmountable therapeutic challenge. The counterpulsation technique exerts numerous beneficial effects on systemic hemodynamics and left ventricular mechanoenergetics, rendering it attractive for promoting myocardial recovery in both acute and chronic HF. Although a recent clinical trial has questioned the clinical effectiveness of short-term hemodynamic support with intra-aortic balloon pump(IABP, the main representative of the counterpulsation technique) in CS complicating myocardial infarction, the issue remains open to further investigation. Moreover, preliminary data suggest that long-term IABP support in patients with end-stage HF is safe and may mediate recovery of left- or/and right-sided cardiac function, facilitating long-term weaning from mechanical support or enabling the application of other permanent, life-saving solutions. The potential of long-term counterpulsation could possibly be enhanced by implementation of novel, fully implantable counterpulsation devices.

关键词： Counterpulsation Recovery Intra-aortic balloon pump Heart failure Cardiac remodeling Reverse remodeling

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Novel approaches for the treatment of ventricular tachycardia

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World Journal of Cardiology 2018年第7期10卷 52-59页

作者： Michael Spartalis Eleftherios Spartalis Eleni Tzatzaki Diamantis I Tsilimigras Demetrios Moris christos kontogiannis Efthimios Livanis Dimitrios C Iliopoulos Vassilis Voudris George N Theodorakis ESC Working Group on Cardiac Cellular Electrophysiology Sophia Antipolis Cedex 06903France Division of Cardiology Onassis Cardiac Surgery CenterAthens 17674Greece Laboratory of Experimental Surgery and Surgical Research University of Athens Medical SchoolAthens 11527Greece Department of Surgery Duke UniversityDurhamNC 27710United States Department of Clinical Therapeutics “Alexandra”HospitalUniversity of AthensAthens 11528Greece

Ventricular tachycardia(VT) is a crucial cause of sudden cardiac death(SCD) and a primary cause of mortality and morbidity in patients with structural cardiac disease. VT includes clinical disorders varying from benign to lifethreatening. Most life-threatening episodes are correlated with coronary artery disease, but the risk of SCD varies in certain populations, with various underlying heart conditions, specific family history, and genetic variants. The targets of VT management are symptom alleviation, improved quality of life, reduced implantable cardioverter defibrillator shocks, prevention of reduction of left ventricular function, reduced risk of SCD, and improved overall survival. Antiarrhythmic drug therapy and endocardial catheter ablation remains the cornerstone of guideline-endorsed VT treatment strategies in patients with structural cardiac abnormalities. Novel strategies such as epicardial ablation, surgical cryoablation, transcoronary alcohol ablation, pre-procedural imaging, and stereotactic ablative radiotherapy are an appealing area of res-earch. In this review, we gathered all recent advances in innovative therapies as well as experimental evidence focusing on different aspects of VT treatment that could be significant for future favorable clinical applications.

关键词： Ventricular tachycardia Catheter ablation Epicardial Sudden cardiac death Novel techniques Substrate

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