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Predictors and Novel Pathophysiological Aspects of Ventricular Arrhythmias and Sudden...
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Predictors and Novel Pathophysiological Aspects of Ventricular Arrhythmias and Sudden Cardiac Death

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 7338

Special Issue Editor

Dr. Lukas Jaroslaw Motloch

E-Mail Website
Guest Editor
Clinic II for Internal Medicine, Paracelsus Medical University, Salzburg, Austria
Interests: arrhythmias; ventricular arrhythmias; cardiac electrophysiology; sudden cardiac death; cardiac ion channel; heart failure; cardiac device therapy

Special Issue Information

Dear Colleagues,

Ventricular arrhythmias constitute a major public health burden worldwide. Both ventricular fibrillation and tachycardia are responsible for sudden cardiac death, which, according to the World Health Organization, is one of the major causes of cardiovascular death worldwide. While coronary artery disease remains the leading cause of ventricular tachyarrhythmias, other pathologies like cardiomyopathies and, especially in the younger population, genetic disorders, are linked to arrhythmia-related mortality. These pathologies promote an arrhythmogenic substrate that is still not fully understood. Consequently, effective pharmacological therapies are still lacking. Even in high-risk populations, which are prone to develop ventricular arrhythmias, antiarrhythmic drug therapy often increases, or, at best, has a neutral effect on cardiac-related mortality. Since the advent of the implantable cardiac defibrillator era, an effective therapeutic tool is available, yet this therapy is also associated with various complications. Therefore, a better understanding of associated pathophysiology with consequent improvement in risk stratification and therapeutic strategies is needed.

This Special Issue will discuss new therapeutic and risk assessment strategies for ventricular tachyarrhythmias and sudden cardiac death. We also want to consider new epidemiological and pathophysiological aspects of these relevant pathologies. We invite both clinical and translational research articles dealing with this relevant issue. Together we will elucidate novel pathophysiological as well as therapeutic aspects of ventricular arrhythmic disease.

Dr. Lukas Jaroslaw Motloch
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ventricular arrhythmia
  • ventricular tachycardia
  • ventricular fibrillation
  • sudden cardiac death
  • implantable cardiac defibrillator
  • cardiac electrophysiology
  • antiarrhythmic drug
  • cardiac ion channel
  • cardiac electrophysiology
  • electrophysiological remodeling

Published Papers (3 papers)

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Research

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9 pages, 657 KiB  
Article
Cardiac Arrhythmias in Survivors of Sudden Cardiac Death Requiring Impella Assist Device Therapy
by Khaled Q. A. Abdullah, Jana V. Roedler, Juergen vom Dahl, Istvan Szendey, Dimitrios Dimitroulis, Lars Eckardt, Albert Topf, Bernhard Ohnewein, Lorenz Fritsch, Fabian Föttinger, Mathias C. Brandt, Bernhard Wernly, Lukas J. Motloch and Robert Larbig
J. Clin. Med. 2021, 10(7), 1393; https://doi.org/10.3390/jcm10071393 - 31 Mar 2021
Cited by 1 | Viewed by 1730
Abstract
In this retrospective single-center trial, we analyze 109 consecutive patients (female: 27.5%, median age: 69 years, median left ventricular ejection fraction: 20%) who survived sudden cardiac death (SCD) and needed hemodynamic support from an Impella assist device between 2008 and 2018. Rhythm monitoring [...] Read more.
In this retrospective single-center trial, we analyze 109 consecutive patients (female: 27.5%, median age: 69 years, median left ventricular ejection fraction: 20%) who survived sudden cardiac death (SCD) and needed hemodynamic support from an Impella assist device between 2008 and 2018. Rhythm monitoring is investigated in this population and associations with hospital survival are analyzed. Hospital mortality is high, at 83.5%. Diverse cardiac arrhythmias are frequently registered during Impella treatment. These include atrial fibrillation (AF, 21.1%) and ventricular tachycardia (VT, 18.3%), as well as AV block II°/III° (AVB, 7.3%), while intermittent asystole (ASY) is the most frequently observed arrhythmia (42.2%). Nevertheless, neither ventricular nor supraventricular tachycardias are associated with patients’ survival. In patients who experience intermittent asystole, a trend towards a fatal outcome is noted (p = 0.06). Conclusions: Mortality is high in these severely sick patients. While cardiac arrhythmias were frequent, they did not predict hospital mortality in this population. The hemodynamic support of the pump seems to counterbalance the adverse effects of these events. Full article
(This article belongs to the Special Issue Predictors and Novel Pathophysiological Aspects of Ventricular Arrhythmias and Sudden Cardiac Death)
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13 pages, 580 KiB  
Article
Laboratory and Instrumental Risk Factors Associated with a Sudden Cardiac Death Prone ECG Pattern in the General Population: Data from the Brisighella Heart Study
by Pierangelo Coppola, Arrigo Francesco Giusepp Cicero, Federica Fogacci, Sergio D’Addato, Stefano Bacchelli, Claudio Borghi and on behalf of the Brisighella Heart Study Group
J. Clin. Med. 2021, 10(4), 640; https://doi.org/10.3390/jcm10040640 - 8 Feb 2021
Cited by 5 | Viewed by 2375
Abstract
Sudden cardiac death (SCD) remains a daunting problem and a major public health issue. We applied the validated Electrocardiogram (ECG) score to the Brisighella Heart Study (BHS) cohort, in order to verify if there were also other recognized laboratory and instrumental risk factors [...] Read more.
Sudden cardiac death (SCD) remains a daunting problem and a major public health issue. We applied the validated Electrocardiogram (ECG) score to the Brisighella Heart Study (BHS) cohort, in order to verify if there were also other recognized laboratory and instrumental risk factors for cardiovascular disease associated with a sudden death risk-prone pattern. We examined the ECG traces of 1377 participants of the 2016 BHS survey and identified 33 subjects at high risk for SCD (while 1344 subjects had no cumulative ECG abnormalities). Serum uric acid (SUA) and carotid-femoral pulse wave velocity (cfPWV) values were significantly higher in the high-risk cohort (p < 0.05) and were both independently associated with the presence of ECG abnormalities [Odd ratio (OR) = 2.14, p < 0.05–OR = 1.23, p < 0.05, respectively]. A similar independent correlation was found with long-term non-steroid anti-inflammatory drugs (NSAIDs) use, more widespread among high-risk subjects (OR = 1.19, p < 0.05). Conversely, the analysis did not show any significant association with impaired renal function (p = 0.09). This study showed that long-term NSAID use and high SUA and cfPWV values are independent risk factors for ECG abnormalities predictive of SCD. These findings herald the need for further prospective research to identify the optimal combination of SCD risk markers in order to prevent fatal events. Full article
(This article belongs to the Special Issue Predictors and Novel Pathophysiological Aspects of Ventricular Arrhythmias and Sudden Cardiac Death)
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Review

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13 pages, 553 KiB  
Review
Management of Implantable Cardioverter-Defibrillators during Pregnancy—A Systematic Review
by Albert Topf, Nina Bacher, Kristen Kopp, Moritz Mirna, Robert Larbig, Mathias C. Brandt, Johannes Kraus, Uta C. Hoppe, Lukas J. Motloch and Michael Lichtenauer
J. Clin. Med. 2021, 10(8), 1675; https://doi.org/10.3390/jcm10081675 - 14 Apr 2021
Cited by 5 | Viewed by 2701
Abstract
Background: With the advent of implantable cardioverter-defibrillator (ICD) technology in recent decades, patients with inherited or congenital cardiomyopathy have a greater chance of survival into adulthood. Women with ICDs in this group are now more likely to reach reproductive age. However, pregnancy represents [...] Read more.
Background: With the advent of implantable cardioverter-defibrillator (ICD) technology in recent decades, patients with inherited or congenital cardiomyopathy have a greater chance of survival into adulthood. Women with ICDs in this group are now more likely to reach reproductive age. However, pregnancy represents a challenge for clinicians, as no guidelines for the treatment of pregnant women with an ICD are currently available. Methods: To analyze this issue, we performed a systematic screening of the literature using the keywords: pregnancy with ICD, lead fracture in pregnancy, lead thrombi in pregnancy, ventricular tachycardia in pregnancy, inappropriate shocks in pregnancy, ICD discharge in pregnancy and ICD shock in pregnancy. Of 1101 publications found, 27 publications were eligible for further analysis (four retrospective trials and 23 case reports). Results: According to physiological changes in pregnancy, resulting in an increase in heart rate and cardiac output, a vulnerability for malignant arrhythmias and device-related complications in ICD carriers might be suspected. While the literature is limited on this issue, maternal complications including arrhythmia burden with following ICD therapies, thromboembolic events and lead complications as well as inappropriate shock therapy have been reported. According to the limited available studies, associated risk seems not to be more frequent than in the general population and depends on the underlying cardiac pathology. Furthermore, worsening of heart failure and related cardiovascular disease have been reported with associated risk of preterm delivery. These observations are exaggerated by restricted applications of diagnostics and treatment due to the risk of fetal harm in this population. Conclusions: Due to limited data on management of ICDs during pregnancy, further scientific investigations are required. Consequently, careful risk assessment with individual risk evaluation and close follow ups with interdisciplinary treatment are recommended in pregnant ICD carriers. Full article
(This article belongs to the Special Issue Predictors and Novel Pathophysiological Aspects of Ventricular Arrhythmias and Sudden Cardiac Death)
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