China
Africa
Explore chapters and articles related to this topic
Statistical Approaches in the Development of Digital Therapeutics
Published in Oleksandr Sverdlov, Joris van Dam, Digital Therapeutics, 2023
Oleksandr Sverdlov, Yevgen Ryeznik, Sergei Leonov, Valerii Fedorov
For example, the cardiac pacemaker is a remarkable invention with an about 300-year history, which has been a critical driver of many developments in cardiac science and medicine (Ward et al., 2013). Its development started with the experiments of electrophysiology in the 18th century, creation of initial machines in the 1920s and external stimulators designed and built in the 1950s, subsequent miniaturization and the transition to microprocessor-controlled implantable pacemakers in the 1990s, and continued new developments in the early 21st century. Most recent pacemakers aim to reduce mortality and improve morbidity (Ward et al., 2013).
Ventricular Arrhythmias in Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Antonis S. Manolis, Antonis A. Manolis, Theodora A. Manolis
A high proportion of HF patients (40–80%) will manifest runs of NSVT.7 Although some studies suggested that patients who died suddenly had significantly more episodes of NSVT compared with survivors and those who died from HF,8 many studies have indicated that asymptomatic runs of NSVT on a Holter monitor may not predict SCD in moderate-to-severe HF,9,10 and are not an independent predictor of mortality,7 implying that suppression of these arrhythmias may not improve survival. Rather, patients with NSVT have worse left ventricular (LV) function.10 When in doubt about the clinical significance of NSVT, an electrophysiology study with programmed ventricular stimulation may help in risk stratification;11 in patients with inducible sustained VT, an implantable cardioverter defibrillator (ICD) should be offered.
Minimally Invasive Atrial Ablation Surgery
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
Hybrid (epicardial and endocardial) ablation, either simultaneous or staged, offers significant improvements to a standalone epicardial approach. Fundamentally, catheter-based ablation has the advantage of mapping techniques to ensure bidirectional electrical isolation of pulmonary veins or other linear ablation. In addition, certain areas of the atria (e.g. mitral isthmus, cavotricuspid isthmus) are more accessible from an endocardial approach. Catheter ablation techniques also offer the opportunity for detailed mapping of atypical flutters or atrial tachycardia. However, point-by-point ablation can be cumbersome and may not be durable. Surgical ablation offers an anatomic approach with direct visual guidance but no electrophysiologic guidance. Overall, patients undergoing hybrid ablation had better outcomes. However, no cost-effectiveness study has yet been performed to justify the significant additive cost of the hybrid procedure.
Impact of biomimetic electrical stimulation combined with Femoston on pregnancy rate and endometrium characteristics in infertility patients with thin endometrium: a prospective observational study
Published in Gynecological Endocrinology, 2023
Yilinuer Shabiti, Shaadaiti Wufuer, Remila Tuohuti, Tan Yun, Jing Lu
Bioelectricity is a kind of physicochemical change in life activities, a basic feature of living organisms, and a manifestation of normal physiological activities. Electrophysiology has developed rapidly in different disciplines in recent years. Electrophysiology research can help understand the functional status of the body. It can be used to diagnose diseases (e.g. electrocardiogram), but it can also help intervene for function regulation intervention, and it is possible to use it for disease prevention and treatment clinically. Biomimetic electrical stimulation acts on pelvic floor muscles and nerves through low-frequency currents, promotes lymphatic and blood circulation by stimulating the nerve-muscle-visceral reflex axis, improves endometrial blood flow and tissue nutrition, accelerates the healing of damaged tissue, and promotes endometrial repair [23,24]. A study enrolled 41 patients with a thin endometrium (≤ 7 mm) and undergoing assisted reproductive technology; they received intermittent vaginal electrical stimulation for 20–30 min on treatment days. The results showed that pelvic floor nerve stimulation significantly increased uterine endometrial thickness in patients with a thin endometrium [14]. By stimulating the repeated contraction and relaxation of uterine smooth muscle, the blood supply to the entire endometrial and subendometrial region can be increased, resulting in better nourishment of the endometrial tissues [14].
Management of congenitally corrected transposition from fetal diagnosis to adulthood
Published in Expert Review of Cardiovascular Therapy, 2023
Due to abnormal position of the atrioventricular node and its connection to the atrioventricular bundle in ccTGA, cardiac conduction disorders are common and permanent pacemaker therapy is frequently required [27]. Unless contraindicated (patient’s size, unrepaired associated lesions), the transvenous system can be implanted. Subpulmonary univentricular pacing was shown to be associated with deterioration of sRV and exacerbation of tricuspid valve regurgitation [59,60]. Study on 53 patients with dual-chamber univentricular pacemakers revealed an improvement after upgrading to biventricular pacing [60]. However, some observations provided different results [61]. Transvenous implantation of an sRV lead is possible in ccTGA patients with suitable anatomy assessed by advanced cardiac imaging [62]. Alternatively, surgical placement of ventricular pacing leads or a hybrid approach can be performed. According to Pediatric and Congenital Electrophysiology Society (PACES) and Heart Rhythm Society guidelines, cardiac resynchronization therapy (CRT) can be useful for adults with sRV function ≤35%, sinus rhythm, complete right bundle branch block with QRS ≥150 ms (spontaneous or paced) and NYHA class II-IV [63]. The benefit of CRT in patients with sRV dysfunction without conduction disturbances is unclear.
Treatment of brief episodes of highly symptomatic supraventricular and ventricular arrhythmias: a methodological review
Published in Expert Review of Medical Devices, 2021
Rita B. Gagyi, Mark Hoogendijk, Sing-Chien Yap, Tamas Szili-Torok
The diagnosis of short-lived arrhythmias is difficult; therefore, it can be established with certainty only by an electrophysiology (EP) study. The current mapping approaches are described in the next section. Data for an evidence-based choice of drugs for the pharmacological therapy of supraventricular arrhythmias are deficient. However, current guidelines recommend initiation of therapy with beta-blockers or calcium channel blockers. In the case of nonsustained or short-lived arrhythmias guidelines recommend no drug therapy but targeted CA [10]. At the ventricular level, guidelines recommend beta-blocker therapy for PVCs and nonsustained VTs as pharmacological approach. Catheter ablation, however, is an important treatment option for patients with ventricular arrhythmias when antiarrhythmic medication is ineffective, not tolerated or not desired by the patient [11].