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Cardiovascular PET-CT
Published in Yi-Hwa Liu, Albert J. Sinusas, Hybrid Imaging in Cardiovascular Medicine, 2017
Etienne Croteau, Ran Klein, Jennifer M. Renaud, Manuja Premaratne, Robert A. Dekemp
The role of revascularization with either coronary artery bypass surgery (CABG) or PCI in patients with ischemic cardiomyopathy has been an area of controversy in recent years following the publication of the surgical treatment for ischemic heart failure (STICH) trial (Velasquez et al. 2011), where the primary analysis failed to show a significant benefit for CABG over optimal medical therapy. The viability substudy also failed to show an association between the degree of viable myocardium and subsequent outcomes following revascularization (Bonow et al. 2011). These results were in stark contrast to a wealth of observational evidence (Nam et al. 2011), and it is noteworthy that FDG PET-CT was not used for viability testing in the STICH trial (Allman et al. 2002).
inHEART Models software – novel 3D cardiac modeling solution
Published in Expert Review of Medical Devices, 2023
Leah A. John, Brett Tomashitis, Zain Gowani, Dan Levin, Chau Vo, Ian John, Jeffrey R. Winterfield
Cardiovascular disease is a leading cause of mortality worldwide, accounting for approximately 30% of all deaths globally. Roughly half of all cardiovascular deaths are due to sudden cardiac death (SCD), and 80% of these deaths result from ventricular arrhythmias (VA) [1,2]. VA often occurs in patients with structural heart disease, including those with ischemic (ICM) and/or non-ischemic cardiomyopathy (NICM), or in those with genetic predispositions. Clinical presentation can vary from syncope, electrical storm, cardiogenic shock, cardiac arrest, and SCD [1]. Treatment strategies for prevention of SCD and reduction of VA risk include implantation of implantable-cardioverter defibrillators (ICDs), anti-arrhythmic drug therapy, and radiofrequency catheter ablation (RFCA) for ventricular tachycardia (VT). These therapies, however, are not without inherent risks including adverse drug effects, procedural risks, and inadequate efficacy [3]. Efforts aimed at improving the efficacy of such therapies are essential in optimizing patient safety and treatment success. In those requiring RFCA, advanced cardiac imaging is becoming an increasingly integral component in pre-procedural planning to guide ablation strategy.
Comparison of methods for delivering cardiac resynchronization therapy: electrical treatment targets and mechanisms of action
Published in Expert Review of Medical Devices, 2023
Florentina Simader, Ahran Arnold, Zachary Whinnett
In response to the challenges with HBP, Huang et al. developed a technique for passing a lead deep into the interventricular septum, with the aim of directly capturing the proximal left bundle [45]. Data from observational studies suggest that left bundle branch area pacing (LBBAP) is a promising method for delivering CRT to patients with LBBB [46]. Impressive reductions in QRS duration and improvements in left ventricular function and volumes have been reported [47]. Encouragingly, capture thresholds appear to be low and stable during follow-up, which is a potential advantage over His-CRT. Implant success rates and successful correction of LBBB have been reported to be high, particularly in patients with non-ischemic cardiomyopathy [47]. However, lead implantation appears to be more challenging in patients with ischemic heart disease, LV dilatation, and septal fibrosis [48].
Continuous-flow left ventricular assist device implantation in patients with preexisting mechanical mitral valves: a systematic review
Published in Expert Review of Medical Devices, 2020
Jonathan S. Gordon, Thomas J. O’Malley, Elizabeth J. Maynes, Chelsey T. Wood, Neal Kalantri, Rohinton J. Morris, Louis E. Samuels, H. Todd Massey, Vakhtang Tchantchaleishvili
Five studies, comprising seven patients who underwent CF-LVAD with preexisting MMVs, were included. Study specifics are available in Table 1. The median age of patients was 54 [42, 61] years and 71.4% (5/7) were male. Baseline patient characteristics are available in Table 2. Nonischemic cardiomyopathy was the predominant etiology for heart failure in 83.3% (5/7) of patients, and ischemic cardiomyopathy was present in 16.7% (1/7) of patients. The majority (85%, 6/7) of patients received CF-LVAD as a bridge-to-transplant, with only one patient indicated for destination therapy. The MMVs were implanted a median of 6 [1, 15] years before CF-LVAD. The types of mechanical mitral valves in place were St Jude in 28.6% (2/7), On-X in 14.3% (1/7), Carbomedics in 14.3% (1/7), Starr Edwards in 14.3% (1/7), and 28.6% (2/7) were unspecified. Aortic valve prosthetics were present in 42.9% (3/7), of which two (66.7%) were mechanical valves and one (33.3%) was a bioprosthetic valve. Aortic valve replacement occurred a median of 13 [10, 17] years before CF-LVAD implantation.