Abstract:
:Implantable cardioverter-defibrillators (ICDs) improve survival in patients who have left ventricular dysfunction; however, they are associated with numerous problems at implant and during follow-up. The diagnosis and management of these problems is usually straightforward, but more difficult problems may include the management of patients who have elevated energy requirements to terminate ventricular fibrillation or of those who have postoperative device infections. Long-term issues in ICD patients include the occurrence of inappropriate or frequent appropriate shocks. ICD generators and leads are more prone to failures than are pacing systems alone; management of patients potentially dependent on "recalled" devices to deliver life-saving therapy is a particularly complex issue. The purpose of this article is to review the diagnosis and management of these more troublesome ICD problems.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Kowalski M,Huizar JF,Kaszala K,Wood MAdoi
10.1016/j.ccl.2008.03.012subject
Has Abstractpub_date
2008-08-01 00:00:00pages
441-58, viiissue
3eissn
0733-8651issn
1558-2264pii
S0733-8651(08)00046-5journal_volume
26pub_type
杂志文章,评审abstract::The fundamental requirements for a meaningful biomarker have not been met in the prediction of the aneurysm trait, the progression of the aneurysm disease state, or the prevention of catastrophic aortic complications. Aortic aneurysm is a worthy opponent on all fronts, and clinicians should continue actively to evalua...
journal_title:Cardiology clinics
pub_type: 评论,杂志文章,评审
doi:10.1016/j.ccl.2010.01.018
更新日期:2010-05-01 00:00:00
abstract::ACC Stage C heart failure includes those patients with prior or current symptoms of heart failure in the context of an underlying structural heart problem who are primarily managed with medical therapy. Although there is guideline-based medical therapy for those with heart failure with reduced ejection fraction (HFrEF...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2013.09.012
更新日期:2014-02-01 00:00:00
abstract::Thoracoabdominal aortic aneurysms are increasing in incidence. Rupture is associated with a high rate of morbidity and mortality. The historic gold standard of open repair can be performed with low rates of complications at centers of excellence. However, these results are not universally achievable, with significantl...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.03.008
更新日期:2017-08-01 00:00:00
abstract::Dilated cardiomyopathy is a heterogeneous disease, both clinically and genetically. Two genes responsible for X-linked DCM have been identified. Five genetic loci responsible for X-linked DCM have been identified. Five genetic loci responsible for autosomal dominant DCM have also been mapped but no genes identified so...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70037-0
更新日期:1998-11-01 00:00:00
abstract::Optimum arrhythmia management has evolved to couple ICD therapy with catheter ablative and drug therapy to attempt to eliminate or reduce arrhythmia risk. No longer should the clinician approach such therapy as a choice among single alternative strategies only. Optimum patient management includes not only recognition ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70148-x
更新日期:2000-05-01 00:00:00
abstract::Quality of life is discussed with focus on the importance of individual patient perspectives. Eight studies including at least one aspect of quality of life in patients with atrial fibrillation are reviewed with three approaches evident in assessing quality of life: patient interview, self-reported symptoms, and multi...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70307-6
更新日期:1996-11-01 00:00:00
abstract::The cardiologist and internist can make a major contribution to the care of patients with neurologic disease, both in terms of treating patients with symptomatic cardiac involvement and reducing mortality. This article highlights the need to recognize ECG abnormalities that may represent purely neurologic disease as w...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract::Although the long-term durability of stent grafts is still a concern, stent-graft treatment is already the best option in a large number of patients with descending thoracic aortic diseases who are poor candidates for surgical repair, or in an acute setting. With improved capability to recognize proper anatomy and sel...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2010.01.011
更新日期:2010-05-01 00:00:00
abstract::The overall management and prognosis of patients with acute myocardial infarction must take into account not only infarct size but also the site and locus of involvement as determined by electrocardiography. Transmural versus nontransmural infarction is discussed in relation to therapy and prognosis. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1984-02-01 00:00:00
abstract::Valvular heart disease (VHD) is generally well tolerated during pregnancy; however, the dramatic changes in hemodynamics that occur during pregnancy can lead to clinical decompensation in high-risk women. Women with VHD considering pregnancy should undergo preconception counseling with a high-risk obstetrician and car...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2020.09.010
更新日期:2021-02-01 00:00:00
abstract::Addressing the psychosocial concerns of the growing population of adults with congenital heart disease presents a unique challenge to health care providers. These patients frequently need information about their disease with emphasis on how it may affect their sexuality, childbearing, and risk of having children with ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract::Cardiovascular drugs are often used in pregnancy for the treatment of maternal and fetal conditions. The complex physiologic changes occurring during pregnancy may significantly affect the pharmacokinetics of many drugs and, consequently, the toxicity and therapeutic response. Of special concern are the effects of mat...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-11-01 00:00:00
abstract::There has been heightened interest in the design and role of preparticipation screening for high school and college athletes. An American Heart Association consensus panel, composed of cardiovascular specialists and other physician experts having extensive clinical experience with athletes of all ages as well as a leg...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70353-2
更新日期:1997-08-01 00:00:00
abstract::The treatment of cardiorenal syndrome is as complex as the various mechanisms underlying its pathophysiology. Randomized controlled data typically focus on the treatment of heart failure with cardiac specific endpoints and a lack of worsening renal function used as a surrogate for efficacy. When heart failure is consi...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2019.04.002
更新日期:2019-08-01 00:00:00
abstract::As the incidence of valvular disease in the elderly is increasing, understanding of its pathogenesis and natural progression as well as surgical approaches and device technologies are improving. Future studies are needed to develop medical interventions that slow or halt the degenerative valvular processes associated ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70061-8
更新日期:1999-02-01 00:00:00
abstract::Cardiac implantable electronic devices (CIEDs) store clinically valuable, time-sensitive information regarding system integrity, arrhythmias, and heart failure parameters. Remote monitoring has impacted clinical practice by reducing scheduled office visits, providing protocols for device recalls and advisories, and fa...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2014.01.001
更新日期:2014-05-01 00:00:00
abstract::Exercise therapy is a valid therapeutic modality in patients with hyperlipoproteinemia (HLP). In combination with appropriate dietary modification, it can be a powerful therapeutic tool and may allow a reduction in hyperlipidemic medication doses. Improved triglyceride values and lipoprotein profiles can be obtained. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-05-01 00:00:00
abstract::Coronary thrombosis is now recognized as the most common proximate cause of acute myocardial infarction, and thrombolysis is evolving as an accepted therapeutic approach to patients presenting in the early stages of myocardial infarction. The ascent of thrombolysis in treatment hierarchies reflects multiple factors, i...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-02-01 00:00:00
abstract::Atrial fibrillation (AF) is the most prevalent heart rhythm disorder. AF accounts for a great proportion of deaths because it independently increases all-cause mortality and cardiovascular mortality risks. Ischemic stroke is the most common cardiovascular adverse event in AF patients. Oral anticoagulation (OAC) therap...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2015.12.006
更新日期:2016-05-01 00:00:00
abstract::This article discusses the epidemiology of cardiovascular (CV) events in end-stage and early renal disease, summarizes the profile of classic and nonclassic CV risk factors in renal patients, highlights recent evidence documenting accelerated atherogenesis in renal disease, and provides information on the central arte...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2005.03.002
更新日期:2005-08-01 00:00:00
abstract::Atrial fibrillation (AF), an escalating dysrhythmia, is accountable for extensive population morbidity and mortality. In the United States, approximately 2.3 million people are presently diagnosed with AF and it is estimated that this prevalence may increase to 5.6 million by 2050. Foremost predisposing risk factors f...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2008.09.015
更新日期:2009-02-01 00:00:00
abstract::A syncope evaluation should start by identifying potentially life-threatening causes, including valvular heart disease, cardiomyopathies, and arrhythmias. Most patients who present with syncope, however, have the more benign vasovagal (reflex) syncope. A busy syncope practice often also sees patients with neurogenic o...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.09.003
更新日期:2013-02-01 00:00:00
abstract::The major adaptations of the maternal cardiovascular system that progress throughout gestation may unmask previously unrecognized heart disease and result in significant morbidity and mortality. Most of these changes are almost fully reversed in the weeks and months after delivery. Hemodynamic changes during pregnancy...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.05.004
更新日期:2012-08-01 00:00:00
abstract::Following the development of the first automated methods in the 1980s, quantitative coronary angiography (QCA) has undergone substantial evolution from simplistic computer-assisted methods of visual interpretation of coronary angiograms to recently introduced three-dimensional reconstruction and quantitative analysis ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:10.1016/j.ccl.2009.03.008
更新日期:2009-08-01 00:00:00
abstract::Although the growing use of continuous-flow left ventricular assist devices (LVADs) has improved the survival and quality of life of patients with stage D heart failure, ischemic and hemorrhagic cerebrovascular accidents remain one of the most-feared complications of this therapy and a significant source of disability...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2018.06.007
更新日期:2018-11-01 00:00:00
abstract::Percutaneous left atrial appendage (LAA) closure is being increasingly used as a treatment strategy to prevent stroke in patients with atrial fibrillation (AF) who have contraindications to anticoagulants. Several approaches and devices have been developed in the last few years, each with their own unique set of advan...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2014.07.006
更新日期:2014-11-01 00:00:00
abstract::The electrocardiographic diagnosis of myocardial infarction (MI) in the presence of left bundle branch block (LBBB) has long been considered problematic or even almost impossible. Many proposed ECG markers in the old literature have now been discarded. However, the advent of reperfusion therapy has generated greater i...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2006.05.002
更新日期:2006-08-01 00:00:00
abstract::The most important factor in the interpretation of any heart lesion is the radiographic appearance of the pulmonary vessels (vascularity) and lung parenchyma. The author discusses several abnormalities; he focuses particularly on pulmonary venous hypertension. ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::Concurrent, independent clinical series at Yale University and the University of Virginia demonstrate an important role for CABG in patients with advanced ischemic cardiomyopathy. It is found that CABG can be performed safely in these patients, both angina and congestive heart failure states improve, ejection fraction...
journal_title:Cardiology clinics
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::Catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction is associated with improvement in patient-centered outcomes, such as mortality, heart failure readmission, and atrial fibrillation recurrence, compared with standard medical therapy with or without device therapy. T...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2019.01.004
更新日期:2019-05-01 00:00:00