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Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues
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Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues

A special issue of Hearts (ISSN 2673-3846).

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 30958

Special Issue Editor

Dr. Cristian Martignani

E-Mail Website
Guest Editor
Institute of Cardiology, S. Orsola University Hospital, 40138 Bologna, Italy
Interests: electrophysiology; congestive heart failure; arrhythmias; ablation; pacemakers; implantable cardioverter defibrillators; channellopathies; ARVD; CMPI

Special Issue Information

The purpose of this Special Issue is to present the state-of-the-art developments in the most important cardiac and vascular pathologies, providing readers with an updated vision of how new technologies offer concrete support in the diagnosis and therapy of these diseases.

Dear Colleagues,

This Special Issue of Hearts focuses on the use of devices in cardiovascular diseases.

More and more often, new tools are increasingly used alongside traditional ones in the diagnosis and therapy of old and new cardiovascular diseases: for example, the increasing use of percutaneous valves, implantable defibrillators, instruments for the control of heart failure, the use of implantable vascular prostheses. At the same time, an increasing number of implantable and wearable instruments provide increasingly accurate clinical information: just think of how much cardiology has changed with the advent of telemedicine and remote monitoring and how timely therapeutic interventions have become today thanks to this.

The purpose of this Special Issue is to present the state-of-the-art developments in the most important cardiac and vascular pathologies, providing readers with an updated vision of how new technologies offer concrete support in the diagnosis and therapy of these pathologies.

Dr. Cristian Martignani
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. Hearts is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. 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

  • congestive heart failure 
  • cardiac implantable electronic devices
  • remote monitoring 
  • prostetic valves 
  • vascular prostheses

Published Papers (8 papers)

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Research

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8 pages, 210 KiB  
Article
Outcomes of Patients Who Have Incidental Non-Sustained Ventricular Tachycardia Identified on Cardiac Implantable Electronic Device Interrogation
by Aditya Narain, Chun Shing Kwok, Caterina Liggett-Wright, Joseph Mayer, Daniel Darlington, Fozia Z. Ahmed, Thanh Phan and Diane Barker
Hearts 2021, 2(3), 294-301; https://doi.org/10.3390/hearts2030024 - 24 Jun 2021
Viewed by 5768
Abstract
Background: Non-sustained ventricular tachycardia (NSVT) is an arrhythmia prevalent in both structurally normal and abnormal hearts. Methods: We conducted a single-center retrospective clinical audit of patients followed-up in a device clinic with one or more incidental NSVT episodes recorded on their device between [...] Read more.
Background: Non-sustained ventricular tachycardia (NSVT) is an arrhythmia prevalent in both structurally normal and abnormal hearts. Methods: We conducted a single-center retrospective clinical audit of patients followed-up in a device clinic with one or more incidental NSVT episodes recorded on their device between November 2017 and August 2018 and followed up patients for outcomes until January 2019. Results: A total of 83 patients were included in the analysis with one or more episodes of NSVT on device interrogation. Those identified to have NSVT were more likely to be male (74.7%) and there was a mean of 14.2 beats per episode and a mean of 3.7 episodes for each patient. Only 24.7% of patients had electrolytes checked within 4 weeks of episode detection and 18.3% had an echocardiogram post-episode. The majority of patients (73.5%) were followed up again in the pacing clinic but had no changes in medication, or other management implemented. In terms of outcomes, 81.7% of patients had no admission to hospital, mortality, or shock during the follow-up period. Conclusions: Most patients who developed NSVT did not have an extra follow-up, medication review, or investigation. Despite this, outcomes such as admission, shock, or death were uncommon. Full article
(This article belongs to the Special Issue Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues)
9 pages, 848 KiB  
Article
Heart Rate Variability Relates with Competition Performance in Professional Soccer Players
by Michele Malagù, Francesco Vitali, Ugo Rizzo, Alessandro Brieda, Ottavio Zucchetti, Filippo Maria Verardi, Gabriele Guardigli and Matteo Bertini
Hearts 2021, 2(1), 36-44; https://doi.org/10.3390/hearts2010004 - 10 Jan 2021
Cited by 2 | Viewed by 3119
Abstract
Background: Heart rate variability (HRV) is widely used in professional soccer players as a tool to assess individual response to training load. Different devices and methods are available for HRV assessment. The relationship between HRV and competitive soccer matches performance is not documented. [...] Read more.
Background: Heart rate variability (HRV) is widely used in professional soccer players as a tool to assess individual response to training load. Different devices and methods are available for HRV assessment. The relationship between HRV and competitive soccer matches performance is not documented. Methods: We monitored HRV in professional soccer players throughout a game season. Measurements were performed with a portable lightweight device in weekly 5 min sessions from which we obtained the value of the square root of the mean squared differences of successive beat-to-beat intervals (rMSSD). Game parameters of run and velocity were collected. Results: Twenty-seven players were monitored with a total of 121 observations. The rMSSD significantly related with the total distance covered (p = 0.036) and with the distance covered running at >15 km/h (p = 0.039) during soccer games. Conclusions: HRV was associated with competition performance in professional soccer players. Full article
(This article belongs to the Special Issue Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues)
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Review

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11 pages, 2362 KiB  
Review
A Historical Perspective of Cardiac Implantable Electronic Device Infection: How a Menace Can Drive Technological and Clinical Improvement
by Giulia Massaro, Igor Diemberger, Matteo Ziacchi, Andrea Angeletti, Giovanni Statuto, Nazzareno Galiè and Mauro Biffi
Hearts 2021, 2(2), 202-212; https://doi.org/10.3390/hearts2020016 - 30 Mar 2021
Viewed by 2759
Abstract
In recent decades there has been a relevant increase in the implantation rate of cardiac implantable electronic devices (CIEDs), albeit with relevant geographical inhomogeneities. Despite the positive impact on clinical outcomes, the possibility of major complications is not negligible, particularly with respect to [...] Read more.
In recent decades there has been a relevant increase in the implantation rate of cardiac implantable electronic devices (CIEDs), albeit with relevant geographical inhomogeneities. Despite the positive impact on clinical outcomes, the possibility of major complications is not negligible, particularly with respect to CIED infections. CIED infections significantly affect morbidity and mortality, especially in instances of delayed diagnosis and appropriate treatment. In the present review, we will start to depict the factors underlying the development of CIED infection as well as the difficulties related to its diagnosis and treatment. We will explain the reasons underlying the need to focus on prophylaxis rather than treatment, in view of the poor outcomes despite improvements in lead extraction procedures. This will lead to the consideration of management of this complication in a hub-spoke manner, and to our analysis of the several technological and procedural improvements developed to minimize this complication. These include prolongation of CIED longevity, the development of leadless devices, and integrated prophylactic approaches. We will conclude with a discussion regarding new devices and strategies under development. This complete excursus will provide the reader with a new perspective on how a major complication can drive technological improvements. Full article
(This article belongs to the Special Issue Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues)
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14 pages, 391 KiB  
Review
Cardiac Contractility Modulation in Patients with Heart Failure with Reduced Left Ventricular Ejection Fraction
by Francesco Giallauria, Alessandro Parlato, Anna Di Lorenzo, Crescenzo Testa, Antonio D’Onofrio, Gianfranco Sinagra, Mauro Biffi, Carlo Vigorito and Andrew J. S. Coats
Hearts 2021, 2(1), 156-169; https://doi.org/10.3390/hearts2010013 - 22 Mar 2021
Cited by 5 | Viewed by 3147
Abstract
Cardiac contractility modulation is an innovative therapy conceived for the treatment of heart failure. It is a device-based therapy, employing multiple electrodes to deliver relatively high-voltage (~7.5 V) biphasic signals to the endocardium of the right ventricular septum, in order to [...] Read more.
Cardiac contractility modulation is an innovative therapy conceived for the treatment of heart failure. It is a device-based therapy, employing multiple electrodes to deliver relatively high-voltage (~7.5 V) biphasic signals to the endocardium of the right ventricular septum, in order to improve heart failure symptoms, exercise capacity and quality of life. Multiple clinical and mechanistic studies have been conducted to investigate the potential usefulness of this technology and, as of now, they suggest that it could have a place in therapy and meet a relevant medical need for a specific sub-category of underserved heart failure patients with reduced left ventricular ejection fraction. More studies are needed to further investigate its effect on outcomes such as mortality and rate of hospitalizations. Full article
(This article belongs to the Special Issue Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues)
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12 pages, 1279 KiB  
Review
Durable Continuous-Flow Mechanical Circulatory Support: State of the Art
by Antonio Loforte, Luca Botta, Silvia Boschi, Gregorio Gliozzi, Giulio Giovanni Cavalli, Carlo Mariani, Sofia Martin Suarez and Davide Pacini
Hearts 2021, 2(1), 127-138; https://doi.org/10.3390/hearts2010010 - 12 Feb 2021
Viewed by 4587
Abstract
Implantable mechanical circulatory support (MCS) systems for ventricular assist device (VAD) therapy have emerged as an important strategy due to a shortage of donor organs for heart transplantation. A growing number of patients are receiving permanent assist devices, while fewer are undergoing heart [...] Read more.
Implantable mechanical circulatory support (MCS) systems for ventricular assist device (VAD) therapy have emerged as an important strategy due to a shortage of donor organs for heart transplantation. A growing number of patients are receiving permanent assist devices, while fewer are undergoing heart transplantation (Htx). Continuous-flow (CF) pumps, as devices that can be permanently implanted, show promise for the treatment of both young and old patients with heart failure (HF). Further improvement of these devices will decrease adverse events, enable pulse modulation of continuous blood flow, and improve automatic remote monitoring. Ease of use for patients could also be improved. We herein report on the current state of the art regarding implantable CF pumps for use as MCS systems in the treatment of advanced refractory HF. Full article
(This article belongs to the Special Issue Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues)
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13 pages, 5327 KiB  
Review
Percutaneous Mitral Valve Repair with the MitraClip System in the Current Clinical Practice
by Sergio Sorrentino, Alessandra Berardini, Giovanni Statuto, Andrea Angeletti, Giulia Massaro, Claudio Capobianco, Giuseppe Pio Piemontese, Alberto Spadotto, Sebastiano Toniolo, Angelo Giuseppe Caponetti, Raffaello Ditaranto, Vanda Parisi, Matteo Minnucci, Valentina Ferrara, Nazzareno Galiè and Elena Biagini
Hearts 2021, 2(1), 74-86; https://doi.org/10.3390/hearts2010007 - 22 Jan 2021
Cited by 2 | Viewed by 4042
Abstract
Severe mitral valve regurgitation (MR) carries a significant burden both in prognosis and quality of life of patients, as well as on healthcare systems, with high rates of hospitalization for heart failure. While mitral valve surgery constitutes the first-line treatment option for primary [...] Read more.
Severe mitral valve regurgitation (MR) carries a significant burden both in prognosis and quality of life of patients, as well as on healthcare systems, with high rates of hospitalization for heart failure. While mitral valve surgery constitutes the first-line treatment option for primary MR in suitable patients, surgical treatment for secondary severe MR remains controversial, with a substantial lack of evidence on a survival benefit. In recent decades, percutaneous mitral valve repair has emerged as an alternative treatment for patients deemed not suitable for surgery. Among several devices under development or evaluation, the MitraClip system is the most widespread and is supported by the strongest evidence. While the role of MitraClip in patients with chronic primary MR who are not deemed suitable for surgery is well established, with consistent data showing improvement in both prognosis and quality of life, MitraClip treatment in secondary MR is a rapidly evolving field. Two recent randomized clinical trials generated apparently controversial results but actually provided an interesting pathophysiologic frame that could help discerning patients who will benefit from the procedure versus patients who will not. In this review, we will discuss current treatment options for mitral regurgitation, focusing on percutaneous mitral valve repair with the MitraClip system. Full article
(This article belongs to the Special Issue Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues)
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21 pages, 8598 KiB  
Review
Cardiac Stimulation in the Third Millennium: Where Do We Head from Here?
by Mauro Biffi, Alberto Spadotto, Giuseppe Pio Piemontese, Sebastiano Toniolo, Lorenzo Bartoli, Sergio Sorrentino, Alessandro Minguzzi, Giulia Massaro, Claudio Capobianco and Giovanni Statuto
Hearts 2021, 2(1), 15-35; https://doi.org/10.3390/hearts2010003 - 06 Jan 2021
Cited by 2 | Viewed by 4283
Abstract
Over the years, pacemakers have evolved from a life-saving tool to prevent asystole to a device to treat heart rhythm disorders and heart failure, aiming at improving both cardiac function and clinical outcomes. Cardiac stimulation nowadays aims to correct the electrophysiologic roots of [...] Read more.
Over the years, pacemakers have evolved from a life-saving tool to prevent asystole to a device to treat heart rhythm disorders and heart failure, aiming at improving both cardiac function and clinical outcomes. Cardiac stimulation nowadays aims to correct the electrophysiologic roots of mechanical inefficiency in different structural heart diseases. This has led to awareness of the concealed risks of customary cardiac pacing that can inadvertently cause atrioventricular and inter-/intra-ventricular dyssynchrony, and has promoted the development of new pacing modalities and the use of stimulation sites different from the right atrial appendage and the right ventricular apex. The perspective of truly physiologic pacing is the leading concept of the continued research in the past 30 years, which has made cardiac stimulation procedure more sophisticated and challenging. In this article, we analyze the emerging evidence in favor of the available strategies to achieve an individualized physiologic setting in bradycardia pacing. Full article
(This article belongs to the Special Issue Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues)
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15 pages, 3104 KiB  
Review
Cardiovascular Imaging Applications in Clinical Management of Patients Treated with Cardiac Resynchronization Therapy
by Cinzia Valzania, Fredrik Gadler, Eva Maret and Maria J. Eriksson
Hearts 2020, 1(3), 166-180; https://doi.org/10.3390/hearts1030017 - 19 Dec 2020
Cited by 2 | Viewed by 2232
Abstract
Cardiovascular imaging techniques, including echocardiography, nuclear cardiology, multi-slice computed tomography, and cardiac magnetic resonance, have wide applications in cardiac resynchronization therapy (CRT). Our aim was to provide an update of cardiovascular imaging applications before, during, and after implantation of a CRT device. Before [...] Read more.
Cardiovascular imaging techniques, including echocardiography, nuclear cardiology, multi-slice computed tomography, and cardiac magnetic resonance, have wide applications in cardiac resynchronization therapy (CRT). Our aim was to provide an update of cardiovascular imaging applications before, during, and after implantation of a CRT device. Before CRT implantation, cardiovascular imaging techniques may integrate current clinical and electrocardiographic selection criteria in the identification of patients who may most likely benefit from CRT. Assessment of myocardial viability by ultrasound, nuclear cardiology, or cardiac magnetic resonance may guide optimal left ventricular (LV) lead positioning and help to predict LV function improvement by CRT. During implantation, echocardiographic techniques may guide in the identification of the best site of LV pacing. After CRT implantation, cardiovascular imaging plays an important role in the assessment of CRT response, which can be defined according to LV reverse remodeling, function and dyssynchrony indices. Furthermore, imaging techniques may be used for CRT programming optimization during follow-up, especially in patients who turn out to be non-responders. However, in the clinical settings, the use of proposed functional indices for different imaging techniques is still debated, due to their suboptimal feasibility and reproducibility. Moreover, identifying CRT responders before implantation and turning non-responders into responders at follow-up remain challenging issues. Full article
(This article belongs to the Special Issue Devices in Cardiovascular Diseases: Diagnostic, Therapeutic, Prognostic Issues)
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