Heart Rhythm

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Giuseppe Boriani - One of the best experts on this subject based on the ideXlab platform.

Gregory Y H Lip - One of the best experts on this subject based on the ideXlab platform.

  • european Heart Rhythm association ehra position paper on arRhythmia management and device therapies in endocrine disorders endorsed by asia pacific Heart Rhythm society aphrs and latin american Heart Rhythm society lahrs
    Europace, 2018
    Co-Authors: Bulent Gorenek, Giuseppe Boriani, Laurent Fauchier, Guilherme Fenelon, Gregory Y H Lip, Gheorge Andrei Dan, He Huang, Gulmira Kudaiberdieva, Rajiv Mahajan
    Abstract:

    Endocrine disorders are associated with various tachyarRhythmias, including atrial fibrillation (AF), ventricular tachycardia (VT), ventricular fibrillation (VF), and bradyarRhythmias. Along with underlying arRhythmia substrate, electrolyte disturbances, glucose, and hormone levels, accompanying endocrine disorders contribute to development of arRhythmia. ArRhythmias may be life-threatening, facilitate cardiogenic shock development and increase mortality. The knowledge on the incidence of tachy- and bradyarRhythmias, clinical and prognostic significance as well as their management is limited; it is represented in observational studies and mostly in case reports on management of challenging cases. It should be also emphasized, that the topic is not covered in detail in current guidelines. Therefore, cardiologists and multidisciplinary teams participating in care of such patients do need the evidence-based, or in case of limited evidence expert-opinion based recommendations, how to treat arRhythmias using contemporary approaches, prevent their complications and recurrence in patients with endocrine disorders. In recognizing this close relationship between endocrine disorders and arRhythmias, the European Heart Rhythm Association (EHRA) convened a Task Force, with representation from Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE), with the remit of comprehensively reviewing the available evidence and publishing a joint consensus document on endocrine disorders and cardiac arRhythmias, and providing up-to-date consensus recommendations for use in clinical practice.

  • occupational radiation exposure in the electrophysiology laboratory with a focus on personnel with reproductive potential and during pregnancy a european Heart Rhythm association ehra consensus document endorsed by the Heart Rhythm society hrs
    Europace, 2017
    Co-Authors: Andrea Sarkozy, Hein Heidbuchel, Tom De Potter, Sabine Ernst, Jedrzej Kosiuk, E Vano, Eugenio Picano, Elena Arbelo, Usha B Tedrow, Gregory Y H Lip
    Abstract:

    Occupational radiation exposure in the electrophysiology laboratory with a focus on personnel with reproductive potential and during pregnancy : A European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS).

  • hypertension and cardiac arRhythmias executive summary of a consensus document from the european Heart Rhythm association ehra and esc council on hypertension endorsed by the Heart Rhythm society hrs asia pacific Heart Rhythm society aphrs and sociedad latinoamericana de estimulacion cardiaca y electrofisiologia soleace
    Europace, 2017
    Co-Authors: Giuseppe Boriani, Gregory Y H Lip, Antonio Coca, Thomas Kahan, Antonis S Manolis, Michael H Olsen, Ali Oto, Tatjana S Potpara, Jan Steffel
    Abstract:

    Hypertension is a common cardiovascular risk factor leading to Heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive Heart disease can manifest as many cardiac arRhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arRhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnesemia), further contributing to arRhythmias, whereas effective control of blood pressure may prevent the development of the arRhythmias such as AF. In recognizing this close relationship between hypertension and arRhythmias, the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE), with the remit to comprehensively review the available evidence to publish a joint consensus document on hypertension and cardiac arRhythmias, and to provide up-to-date consensus recommendations for use in clinical practice. The ultimate judgment regarding care of a particular patient must be made by the healthcare provider and the patient in light of all of the circumstances presented by that patient.

  • antithrombotic therapy in atrial fibrillation associated with valvular Heart disease executive summary of a joint consensus document fromthe european Heart Rhythm association ehra and european society of cardiologyworking group on thrombosis endorsed by the esc working group on valvular Heart disease cardiac arRhythmia society of southern africa cassa Heart Rhythm society hrs asia pacific Heart Rhythm society aphrs south african Heart sa Heart association and sociedad latinoameri
    Thrombosis and Haemostasis, 2017
    Co-Authors: Gregory Y H Lip, Francisco Marin, Deirdre A Lane, Laurent Fauchier, Jeanphilippe Collet, Raffaele De Caterina, Torben Larsen, Joao Morais, Calambur Narasimhan, Brian Olshansky
    Abstract:

    Management strategies for patients with atrial fibrillation (AF) in association with valvular Heart disease (VHD) have been less informed by randomized trials, which have largely focused on ‘non-valvular AF’ patients. Thromboembolic risk also varies according to valve lesion and may also be associated with CHA2DS2-VASc score risk factor components, rather than only the valve disease being causal. Given the need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD, a task force was convened by the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group (WG) on Thrombosis, with representation from the ESC WG on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE) with the remit to comprehensively review the published evidence, and to produce a consensus document on the management of patients with AF and associated VHD, with up-to-date consensus statements for clinical practice for different forms of VHD, based on the principles of evidence-based medicine. This is an executive summary of a consensus document which proposes that the term ‘valvular AF’ is outdated and given that any definition ultimately relates to the evaluated practical use of oral anticoagulation (OAC) type, we propose a functional EHRA (Evaluated Heartvalves, Rheumatic or Artificial) categorization in relation to the type of OAC use in patients with AF, as follows: EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type 1 VHD, which refers to AF patients with ‘VHD needing therapy with a vitamin K antagonist (VKA)’ and EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type 2 VHD, which refers to AF patients with ‘VHD needing therapy with a VKA or a non-VKA oral anticoagulant also taking into consideration CHA2DS2-VASc score risk factor components.

  • cardiac tachyarRhythmias and patient values and preferences for their management the european Heart Rhythm association ehra consensus document endorsed by the Heart Rhythm society hrs asia pacific Heart Rhythm society aphrs and sociedad latinoamericana de estimulacion cardiaca y electrofisiologia soleace
    Europace, 2015
    Co-Authors: Deirdre A Lane, Giuseppe Boriani, Luis Aguinaga, Gregory Y H Lip, Carina Blomstromlundqvist, Gheorge Andrei Dan, Mellanie True Hills, Elaine M Hylek, Stephen A Lahaye, Trudie Lobban
    Abstract:

    Cardiac tachyarRhythmias are recurrent or chronic and in some cases life-threatening conditions. Heart Rhythm disturbances are often highly symptomatic and the psychological impact of the disease can be significant. Patients' beliefs and knowledge about their health (and illness), medications, and healthcare they receive are important determinants of whether or not they accept recommended treatments; influence their coping responses to their illness and treatment; adherence to recommended therapy; and ultimately affects health outcomes. Incorporation of patients' values and preferences for therapy should now be considered as an integral part of the decision-making process and treatment strategy. It is important to acknowledge and understand the impact of cardiac tachyarRhythmias on the patient. To address this issue, a Task Force was convened by the European Heart Rhythm Association (EHRA), and endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE), with the remit to comprehensively review the published evidence available, to publish a joint consensus document on patient values and preferences for the management of cardiac tachyarRhythmias, and to provide up-to-date consensus recommendations for use in clinical practice. Hence this unique consensus document focuses on patients, summarizing the available literature on patients' experiences of living with various cardiac tachyarRhythmias and their treatment preferences, and identifies gaps in knowledge which will help to inform clinical practice and future research. The document will also summarize key points for discussions with patients during consultations regarding their condition, treatment options, disease trajectory, treatment goals, and outcomes. Finally, this document provides links to useful resources and patient advocacy groups and organizations and professional societies relevant to each group of cardiac tachyarRhythmias. ### Patients' experiences of living with atrial fibrillation The experience of living with atrial fibrillation (AF) has been investigated from several perspectives. Quantitative studies reveal that patients with AF generally report lower health-related quality …

Deirdre A Lane - One of the best experts on this subject based on the ideXlab platform.

Carina Blomstromlundqvist - One of the best experts on this subject based on the ideXlab platform.

  • european Heart Rhythm association ehra international consensus document on how to prevent diagnose and treat cardiac implantable electronic device infections endorsed by the Heart Rhythm society hrs the asia pacific Heart Rhythm society aphrs the latin american Heart Rhythm society lahrs international society for cardiovascular infectious diseases iscvid and the european society of clinical microbiology and infectious diseases escmid in collaboration with the european association for cardio thor
    European Heart Journal, 2020
    Co-Authors: Carina Blomstromlundqvist, Giuseppe Boriani, Jens Cosedis Nielsen, Maria Grazia Bongiorni, Vassil Traykov, Paola Anna Erba, Haran Burri, Jeanne E Poole, Roberto Costa
    Abstract:

    Pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy devices are potentially lifesaving treatments for a number of cardiac conditions but are not without risk. Most concerning is the risk of a cardiac implantable electronic device (CIED) infection, which is associated with significant morbidity, increased hospitalizations, reduced survival, and increased health care costs. Recommended preventive strategies such as administration of intravenous antibiotics before implantation are well-recognized. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, antibacterial envelopes, prolonged antibiotics post-implantation, and others. When compared with previous guidelines or consensus statements, the present consensus document gives guidance on the use of novel device alternatives, novel oral anticoagulants, antibacterial envelopes, prolonged antibiotics post-implantation, as well as definitions on minimum quality requirements for centres and operators and volumes. The recognition that an international consensus document focused on management of CIED infections is lacking, the dissemination of results from new important randomized trials focusing on prevention of CIED infections, and observed divergences in managing device-related infections as found in an European Heart Rhythm Association worldwide survey, provided a strong incentive for a Novel 2019 International State-of-the-art Consensus document on risk assessment, prevention, diagnosis, and treatment of CIED infections.

  • a roadmap to improve the quality of atrial fibrillation management proceedings from the fifth atrial fibrillation network european Heart Rhythm association consensus conference
    Europace, 2016
    Co-Authors: Paulus Kirchhof, Giuseppe Boriani, Carina Blomstromlundqvist, Jeroen J Bax, Gunter Breithardt, Gerlinde Benninger, Axel Brandes, Helen Brown, Martina Brueckmann
    Abstract:

    At least 30 million people worldwide carry a diagnosis of atrial fibrillation (AF), and many more suffer from undiagnosed, subclinical, or 'silent' AF. Atrial fibrillation-related cardiovascular mortality and morbidity, including cardiovascular deaths, Heart failure, stroke, and hospitalizations, remain unacceptably high, even when evidence-based therapies such as anticoagulation and rate control are used. Furthermore, it is still necessary to define how best to prevent AF, largely due to a lack of clinical measures that would allow identification of treatable causes of AF in any given patient. Hence, there are important unmet clinical and research needs in the evaluation and management of AF patients. The ensuing needs and opportunities for improving the quality of AF care were discussed during the fifth Atrial Fibrillation Network/European Heart Rhythm Association consensus conference in Nice, France, on 22 and 23 January 2015. Here, we report the outcome of this conference, with a focus on (i) learning from our 'neighbours' to improve AF care, (ii) patient-centred approaches to AF management, (iii) structured care of AF patients, (iv) improving the quality of AF treatment, and (v) personalization of AF management. This report ends with a list of priorities for research in AF patients.

  • cardiac tachyarRhythmias and patient values and preferences for their management the european Heart Rhythm association ehra consensus document endorsed by the Heart Rhythm society hrs asia pacific Heart Rhythm society aphrs and sociedad latinoamericana de estimulacion cardiaca y electrofisiologia soleace
    Europace, 2015
    Co-Authors: Deirdre A Lane, Giuseppe Boriani, Luis Aguinaga, Gregory Y H Lip, Carina Blomstromlundqvist, Gheorge Andrei Dan, Mellanie True Hills, Elaine M Hylek, Stephen A Lahaye, Trudie Lobban
    Abstract:

    Cardiac tachyarRhythmias are recurrent or chronic and in some cases life-threatening conditions. Heart Rhythm disturbances are often highly symptomatic and the psychological impact of the disease can be significant. Patients' beliefs and knowledge about their health (and illness), medications, and healthcare they receive are important determinants of whether or not they accept recommended treatments; influence their coping responses to their illness and treatment; adherence to recommended therapy; and ultimately affects health outcomes. Incorporation of patients' values and preferences for therapy should now be considered as an integral part of the decision-making process and treatment strategy. It is important to acknowledge and understand the impact of cardiac tachyarRhythmias on the patient. To address this issue, a Task Force was convened by the European Heart Rhythm Association (EHRA), and endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE), with the remit to comprehensively review the published evidence available, to publish a joint consensus document on patient values and preferences for the management of cardiac tachyarRhythmias, and to provide up-to-date consensus recommendations for use in clinical practice. Hence this unique consensus document focuses on patients, summarizing the available literature on patients' experiences of living with various cardiac tachyarRhythmias and their treatment preferences, and identifies gaps in knowledge which will help to inform clinical practice and future research. The document will also summarize key points for discussions with patients during consultations regarding their condition, treatment options, disease trajectory, treatment goals, and outcomes. Finally, this document provides links to useful resources and patient advocacy groups and organizations and professional societies relevant to each group of cardiac tachyarRhythmias. ### Patients' experiences of living with atrial fibrillation The experience of living with atrial fibrillation (AF) has been investigated from several perspectives. Quantitative studies reveal that patients with AF generally report lower health-related quality …

  • use of fluoroscopy in clinical electrophysiology in europe results of the european Heart Rhythm association survey
    Europace, 2015
    Co-Authors: Heidi L Estner, Nikolaos Dagres, Maria Grazia Bongiorni, Jian Chen, Antonio Hernandezmadrid, Carina Blomstromlundqvist
    Abstract:

    Despite the advent of non-fluoroscopic technologies, fluoroscopy remains the cornerstone of imaging in most interventional electrophysiological procedures, from diagnostic studies to ablation interventions and device implantation. The purpose of the European Heart Rhythm Association survey was to provide an insight into regulatory policies and physicians' clinical practice when using fluoroscopy during ablation procedures and device implantation. The survey has shown that only 50% of the participating centres worked with low frame rates (3-6 frames per second) and that the left anterior oblique projection, with higher radiation exposure for the physician, is used for nearly every ablation target. Although three-dimensional imaging systems may reduce the radiation exposure, most centres never used these systems for standard ablation procedures and a trend is that non-fluoroscopy technologies are even less frequently used than in 2012, when the use of robotic systems was still rare. Even less costly equipment such as lead gloves, lead glass cabins, or radiation absorbing pads are still not routinely used.

  • left atrial appendage closure indications techniques and outcomes results of the european Heart Rhythm association survey
    Europace, 2015
    Co-Authors: Laurent Pison, Torben Bjerregaard Larsen, Tatjana S Potpara, Maria Grazia Bongiorni, Jian Chen, Carina Blomstromlundqvist
    Abstract:

    The purpose of this EP Wire was to assess the indications, techniques, and outcomes of left atrial appendage occlusion (LAAO) in Europe. Thirty-three European centres, all members of the European Heart Rhythm Association electrophysiology (EP) research network, responded to this survey by completing the questionnaire. The major indication for LAAO (94%) was the prevention of stroke in patients at high thrombo-embolic risk (CHA2DS2-VASc ≥ 2) and contraindications to oral anticoagulants (OACs). Twenty-one (64%) of the responding centres perform LAAO in their own institution and 80% implanted 30 or less LAAO devices in 2014. Two-dimensional transoesophageal echocardiography was the preferred imaging technique to visualize LAA before, during, and after LAAO in 79, 58, and 62% of the participating centres, respectively. Following LAAO, 49% of the centres prescribe vitamin K antagonists or novel OACs. Twenty-five per cent of the centres combine LAAO with pulmonary vein isolation. The periprocedural complications included death (range, 0-3%), ischaemic or haemorrhagic stroke (0-25%), tamponade (0-25%), and device embolization (0-20%). In conclusion, this EP Wire has demonstrated that LAAO is most commonly employed in patients at high thrombo-embolic risk in whom OAC is contraindicated. The technique is not yet very widespread and the complication rates remain significant.

Hein Heidbuchel - One of the best experts on this subject based on the ideXlab platform.

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