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Conduction abnormalities after transcatheter aortic valve implantation

Journal of Geriatric Cardiology 2018年第1期15卷 105-112页

作者： Panagiotis Karyofillis Anna Kostopoulou Sofia Thomopoulou Martha Habibi efthimios livanis George Karavolias Vassilis Voudris Department of Invasive Cardiology Onassis Cardiac Surgery Centre Athens Greece

In the last few years, transcatheter aortic valve implantation （TAVI） has become an alternative procedure in patients with severe aortic stenosis and high risk for surgical aortic replacement. Due to the anatomic correlation between aortic valve structure and conduction system of the heart, one of the most common complications after TAVI is conduction system disturbances which including bundle branch block, complete heart block and need for permanent pacemaker implantation. Although these disturbances are usually not lethal, they may have a great influence on patients＇ state and long term-survival. Several risk factors for conduction disturbances have been identified which including age, anatomy of the heart, periprocedural factors, type of implanted valve, preexisting abnormalities and comorbidities. As this technique becomes more familiar to physicians, patients should be carefully screened for risk factors for the development of conduction abnormalities after TAVI in order to provide effective prevention and proper treatment.

关键词： Atrioventricular block Bundle branch block Pacemaker Transcatheter aortic valve implantation

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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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特发性扩张型心肌病患者不明原因晕厥的神经心源性机制

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世界核心医学期刊文摘（心脏病学分册） 2007年第7期3卷 23-24页

作者： livanis E.G. Kostopoulou A. Theodorakis G.N. 杜媛 2nd Department of Cardiology Onassis Cardiac Surgery Center Attikon Hospital Athens Greece Dr.

晕厥是严重心力衰竭患者预后不良的征象。扩张型心肌病（DC）患者出现晕厥的原因尚未完全阐明，即使标准化评估后仍不明确。本研究的目的为观察神经介导机制在DC患者晕厥发作的病理生理学中的作用。26例左室射血分数≤40％的DC患者（21... 详细信息

晕厥是严重心力衰竭患者预后不良的征象。扩张型心肌病（DC）患者出现晕厥的原因尚未完全阐明，即使标准化评估后仍不明确。本研究的目的为观察神经介导机制在DC患者晕厥发作的病理生理学中的作用。26例左室射血分数≤40％的DC患者（21例男性，5例女性，平均年龄59±2岁，极差38～79岁）人选本研究。13例发生不明原因晕厥或前晕厥的患者及13例无不明原因晕厥的患者进行氯米帕明激发直立倾斜试验。两组患者在年龄、性别和左室射血分数方面相匹配，所采用药物治疗也没有显著差别。倾斜试验过程中进行心率变异性分析和前臂血流体积描记，同时采集血样测定儿茶酚胺浓度。

关键词：扩张型心肌病患者不明原因晕厥神经心源性特发性左室射血分数直立倾斜试验心率变异性分析心力衰竭患者

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