Abstract:
BACKGROUND:AV delay optimisation of biventricular pacing devices (cardiac resynchronisation therapy, CRT) is performed in trials and recommended by current guidelines. The Doppler echocardiographic iterative method is the most commonly recommended. Yet whether it can be executed reliably has never been tested formally. METHODS:36 multinational specialists, familiar with using the echocardiographic iterative method of CRT optimisation, were shown 20-40 sets of transmitral Doppler traces at 6-8 AV settings and asked to select the optimal AV delay. Unknown to the specialists, some Doppler datasets appeared in duplicate, allowing assessment of both inter and intra-specialist interpretation. RESULTS:On the Kappa scale of agreement (1 = perfect agreement, 0 = chance alone), the agreement regarding optimal AV delay between specialists was poor (kappa=0.12 ± 0.08). More importantly, agreement of specialists with themselves (i.e. viewing identical sets of traces, twice) was also poor, with Kappa=0.23 ± 0.07 and mean absolute difference in optimum AV delay of 83 ms between first and second viewing of the same traces. CONCLUSION:Iterative AV optimisation is not executed reliably by experts, even in an artificially simplified context where biological variability and variation in image acquisition are eliminated by use of identical traces. This cannot be blamed on insufficient skills of some experts or discordant methods of selecting the optimum, because operators also showed poor agreement with themselves when assessing the same trace. Instead, guidelines should retract any recommendation for this algorithm. Guideline-development processes might usefully begin with a rudimentary check on proposed algorithms, to establish at least minimal credibility.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Raphael CE,Kyriacou A,Jones S,Pabari P,Cole G,Baruah R,Hughes AD,Francis DPdoi
10.1016/j.ijcard.2012.09.097subject
Has Abstractpub_date
2013-09-20 00:00:00pages
407-13issue
1eissn
0167-5273issn
1874-1754pii
S0167-5273(12)01203-Xjournal_volume
168pub_type
杂志文章abstract::Patent foramen ovale (PFO) is a remnant of the foetal circulation, found in about a quarter of the population. PFO is an asymptomatic condition and the high prevalence infers that it is in most cases of no or only limited clinical significance. However, recent research has found an increased prevalence of PFO in crypt...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2009.01.049
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Dofetilide is a class III antiarrhythmic drug that has been reported to be safe and efficacious in the treatment of atrial dysrhythmias with a known initial risk of QT prolongation and torsades de pointes (TdP). As a result, the Federal Drug Administration (FDA) mandated in-hospital dofetilide initiation and...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.01.157
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Lipid ratios are clinically useful markers of coronary artery disease (CAD) risk. The effects of rosuvastatin, atorvastatin, simvastatin, and pravastatin on lipid ratios were investigated in the Measuring Effective Reductions in Cholesterol Using Rosuvastatin TherapY (MERCURY) I trial. METHODS:This trial wa...
journal_title:International journal of cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ijcard.2004.12.011
更新日期:2005-04-20 00:00:00
abstract:OBJECTIVE:We investigated a full energetic profile of pressure and volume loaded right ventricle (RV) in porcine models by evaluating kinetic energy (KE), stroke power, power output and power loss across pulmonary valves with stenosis (PS) or with regurgitation (PR). METHODS:Fifteen pigs (6 PS and 6 PR, 3 unoperated c...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2018.03.136
更新日期:2018-07-15 00:00:00
abstract::The relationship between autonomic nerve system and the onset of paroxysmal atrial fibrillation (PAF) is still controversial. Furthermore, no prior studies have compared heart rate variability (HRV) between PAF patients with (organic) or without (idiopathic) underlying cardiac diseases. The purpose of this study was t...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(98)00241-1
更新日期:1998-10-30 00:00:00
abstract:BACKGROUND:Several studies have indicated that treatment with angiotensin converting enzyme (ACE) inhibitors and angiotensin II type 1 receptor blockers (ARBs) may reduce the incidence of atrial fibrillation (AF) in hypertensive patients and patients with left ventricular dysfunction. However, there is limited data on ...
journal_title:International journal of cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijcard.2006.08.086
更新日期:2007-08-09 00:00:00
abstract:BACKGROUND:Chronic endoplasmic reticulum (ER) stress contributes to the apoptotic cell death in the myocardium, thereby playing a critical role in the development of cardiomyopathy. ER stress has been reported to be induced after high-fat diet feeding in mice and also after saturated fatty acid treatment in vitro. Ther...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.03.176
更新日期:2014-06-01 00:00:00
abstract::To assess whether additional aneurysmectomy and/or bypass grafting influence prognosis we studied 97 patients with recurrent sustained monomorphic ventricular tachycardia after an old myocardial infarction. All patients underwent subendocardial resection due to drug-refractory ventricular tachycardia. There were 41 pa...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(92)90022-u
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Adult patients with congenital heart disease under follow-up often need to undergo diagnostic procedures which expose them to radiation. AIM:To evaluate radiation doses in adult patients with congenital heart disease during follow-up. METHODS:Data on diagnostic procedures were used from the European Heart ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2006.07.012
更新日期:2007-05-31 00:00:00
abstract:BACKGROUND:The 12-lead electrocardiogram (ECG) represents an important diagnostic tool for detecting heart disease, but the "normal" ECG in those of African descent has yet to be definitively described. METHODS:We systematically analysed 12-lead ECGs from 387 urban South Africans determined to be heart disease free (u...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2012.06.005
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Insertable cardiac monitors (ICMs) are increasingly utilized for diagnosis of unexplained syncope and arrhythmia monitoring. The Reveal LINQ is a novel miniaturized ICM with improved algorithms. The feasibility and safety of insertion outside the traditional electrophysiology laboratory is unknown. Here we c...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.08.113
更新日期:2016-11-15 00:00:00
abstract:BACKGROUND:Although combined supine and prone acquisitions improve the detection of inferolateral obstructive coronary artery disease (CAD), the predictors of inaccurate detection of inferolateral ischemia have not been reported by using cadmium zinc telluride (CZT) myocardial perfusion imaging (MPI). METHODS AND RESU...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.04.069
更新日期:2014-06-15 00:00:00
abstract::Aneurysmal coronary artery disease occurring in the absence of stenotic atherosclerotic plaques is extremely rare and the pathophysiology of focal aneurysm formation is poorly understood. Whilst clinical-histological correlates exist linking spontaneous coronary artery dissection and perivascular eosinophilic infiltra...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2007.08.136
更新日期:2009-03-20 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is the most common sustained cardiac tachyarrhythmia and is often an occasional diagnosis in the absence of known cardiac disease. The aim of this study is to describe an Italian patient population with AF followed by their General Practitioners (GPs) using a telecardiology service. ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2003.12.005
更新日期:2005-02-15 00:00:00
abstract:BACKGROUND:This study aimed to evaluate real-world clinical outcome of patients needing short dual antiplatelet therapy (S-DAPT) following PCI with Ultimaster® thin-strut, biodegradable polymer sirolimus-eluting stent (BP-SES), which was supposed to induce faster stent endothelialization and reduce device thrombogenici...
journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ijcard.2019.03.030
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Pregnancy is associated with an increased risk of aortic pathology. We sought to assess the feasibility of performing non-contrast 3D steady-state free-precession (SSFP) magnetic resonance angiography (MRA) in pregnant subjects with inherited aortopathy. METHODS:Fifteen pregnant subjects (age 27±4yr) with p...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.05.125
更新日期:2017-10-01 00:00:00
abstract::With the tremendous advances in cardiac pacing during the past four decades, cardiac pacemaker implantation is now a common clinical procedure. In recent years, the indications for permanent pacemakers have expanded. This increase in reasons for pacing and shift in mode of pacing have been caused by the evolution of p...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2004.10.011
更新日期:2005-07-20 00:00:00
abstract:BACKGROUND:A negative interaction has been shown to exist between aspirin and angiotensin-converting enzyme inhibitors (ACE-I) in subjects with heart failure. We explored the effect of combined ACE-I and aspirin therapy compared to ACE-I without aspirin on clinical outcomes in patients with heart failure. METHODS:430 ...
journal_title:International journal of cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/s0167-5273(02)00401-1
更新日期:2003-04-01 00:00:00
abstract::The ratio between maximal and minimal R-R intervals measured during the Valsalva maneuver is an adequate means of studying the functional state of the cardiac parasympathetic nervous system. We studied the changes in heart rate evoked during the Valsalva maneuver in 49 asymptomatic Chagasic patients with different deg...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(88)90053-8
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2007.10.005
更新日期:2008-04-10 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2009.07.013
更新日期:2011-02-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(94)90005-1
更新日期:1994-02-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2011.12.016
更新日期:2013-07-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/s0167-5273(98)00003-5
更新日期:1999-01-01 00:00:00
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pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(85)90261-x
更新日期:1985-05-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2016.04.027
更新日期:2016-07-15 00:00:00
abstract::Chorea is a rare complication of major cardiac surgery, which has been related to profound hypothermia and circulatory arrest. We describe a case of choreic syndrome in a child which followed normothermic cardiac bypass and only became apparent clinically when the child was treated with captopril. ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(91)90104-w
更新日期:1991-02-01 00:00:00