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(Targeted) Diagnosis of Arrhythmias and Sudden Cardiac Death
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(Targeted) Diagnosis of 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 March 2024) | Viewed by 3870

Special Issue Editor

Dr. Yitschak Biton

E-Mail Website
Guest Editor
Department of Cardiology, Hadassah University Hospital, 91120 Jerusalem, Israel
Interests: heart failure; pacemakers; cardiac electrophysiology; atrial fibrillation; electrocardiography; cardiomyopathies; clinical cardiology; chronic heart failure; interventional cardiology; cardiovascular medicine

Special Issue Information

Dear Colleagues,

Arrhythmias and sudden cardiac death are major causes of mortality worldwide. Early and accurate diagnosis of these conditions is crucial for effective management and prevention of fatal outcomes.

This Special Issue of the Journal of Clinical Medicine focuses on the targeted diagnosis of arrhythmias and sudden cardiac death, highlighting recent advances in the field. It covers a wide range of topics, including novel imaging techniques, non-invasive electrophysiology testing, and advanced genetic analysis. These cutting-edge approaches provide new insights into the pathophysiology of arrhythmias, facilitating personalized diagnosis and treatment. The use of artificial intelligence and machine learning in arrhythmia diagnosis and risk stratification, improving accuracy and efficiency, will also be discussed.

This Special Issue will be an invaluable resource for cardiologists, electrophysiologists, and researchers involved in the diagnosis and management of arrhythmias and sudden cardiac death, providing a comprehensive overview of the latest developments and trends in arrhythmia diagnosis, as well as practical guidance for clinicians. The high-quality content, provided by internationally renowned experts from various institutions, will make this Special Issue a must-read for anyone interested in the field.

Dr. Yitschak Biton
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

  • arrhythmia
  • sudden cardiac death
  • diagnosis targeted therapy
  • risk stratification
  • electrocardiography (ECG)
  • electrophysiology
  • implantable cardiac devices
  • personalized medicine
  • precision medicine
  • cardiac imaging

Published Papers (4 papers)

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Research

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16 pages, 2252 KiB  
Article
Trends in Atrial Fibrillation Management—Results from a National Multi-Center Urgent Care Network Registry
by Shalom Lebovitz, Menachem Estryk, Deena R. Zimmerman, Arthur Pollak, David Luria, Offer Amir and Yitschak Biton
J. Clin. Med. 2023, 12(21), 6704; https://doi.org/10.3390/jcm12216704 - 24 Oct 2023
Viewed by 846
Abstract
Background: Atrial fibrillation (AF) is a common diagnosis in patients presenting to urgent care centers (UCCs), yet there is scant research regarding treatment in these centers. While some of these patients are managed within UCCs, some are referred for further care in an [...] Read more.
Background: Atrial fibrillation (AF) is a common diagnosis in patients presenting to urgent care centers (UCCs), yet there is scant research regarding treatment in these centers. While some of these patients are managed within UCCs, some are referred for further care in an emergency department (ED). Objectives: We aimed to identify the rate of patients referred to an ED and define predictors for this outcome. We analyzed the rates of AF diagnosis and hospital referral over the years. Finally, we described trends in patient anticoagulation (AC) medication use. Methods: This retrospective study included 5873 visits of patients over age 18 visiting the TEREM UCC network with a diagnosis of AF over 11 years. Multivariate analysis was used to identify predictors for ED referral. Results: In a multivariate model, predictors of referral to an ED included vascular disease (OR 1.88 (95% CI 1.43–2.45), p < 0.001), evening or night shifts (OR 1.31 (95% CI 1.11–1.55), p < 0.001; OR 1.68 (95% CI 1.32–2.15), p < 0.001; respectively), previously diagnosed AF (OR 0.31 (95% CI 0.26–0.37), p < 0.001), prior treatment with AC (OR 0.56 (95% CI 0.46–0.67), p < 0.001), beta blockers (OR 0.63 (95% CI 0.52–0.76), p < 0.001), and antiarrhythmic medication (OR 0.58 (95% CI 0.48–0.69), p < 0.001). Visits diagnosed with AF increased over the years (p = 0.030), while referrals to an ED decreased over the years (p = 0.050). The rate of novel oral anticoagulant prescriptions increased over the years. Conclusions: The rate of referral to an ED from a UCC over the years is declining but remains high. Referrals may be predicted using simple clinical variables. This knowledge may help to reduce the burden of hospitalizations. Full article
(This article belongs to the Special Issue (Targeted) Diagnosis of Arrhythmias and Sudden Cardiac Death)
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Review

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26 pages, 3287 KiB  
Review
Catecholaminergic Polymorphic Ventricular Tachycardia: Clinical Characteristics, Diagnostic Evaluation and Therapeutic Strategies
by Abhinav Aggarwal, Anton Stolear, Md Mashiul Alam, Swarnima Vardhan, Maxim Dulgher, Sun-Joo Jang and Stuart W. Zarich
J. Clin. Med. 2024, 13(6), 1781; https://doi.org/10.3390/jcm13061781 - 20 Mar 2024
Viewed by 933
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a severe hereditary arrhythmia syndrome predominantly affecting children and young adults. It manifests through bidirectional or polymorphic ventricular arrhythmia, often culminating in syncope triggered by physical exertion or emotional stress which can lead to sudden cardiac death. [...] Read more.
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a severe hereditary arrhythmia syndrome predominantly affecting children and young adults. It manifests through bidirectional or polymorphic ventricular arrhythmia, often culminating in syncope triggered by physical exertion or emotional stress which can lead to sudden cardiac death. Most cases stem from mutations in the gene responsible for encoding the cardiac ryanodine receptor (RyR2), or in the Calsequestrin 2 gene (CASQ2), disrupting the handling of calcium ions within the cardiac myocyte sarcoplasmic reticulum. Diagnosing CPVT typically involves unmasking the arrhythmia through exercise stress testing. This diagnosis emerges in the absence of structural heart disease by cardiac imaging and with a normal baseline electrocardiogram. Traditional first-line treatment primarily involves β-blocker therapy, significantly reducing CPVT-associated mortality. Adjunctive therapies such as moderate exercise training, flecainide, left cardiac sympathetic denervation and implantable cardioverter-defibrillators have been utilized with reasonable success. However, the spectrum of options for managing CPVT has expanded over time, demonstrating decreased rates of arrhythmic events. Furthermore, ongoing research into potential new therapies including gene therapies has the potential to further enhance treatment paradigms. This review aims to succinctly encapsulate the contemporary understanding of the clinical characteristics, diagnostic approach, established therapeutic interventions and the promising future directions in managing CPVT. Full article
(This article belongs to the Special Issue (Targeted) Diagnosis of Arrhythmias and Sudden Cardiac Death)
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14 pages, 1226 KiB  
Review
Exercise Stress Echocardiography in Athletes: Applications, Methodology, and Challenges
by Stefano Palermi, Simona Sperlongano, Giulia Elena Mandoli, Maria Concetta Pastore, Matteo Lisi, Giovanni Benfari, Federica Ilardi, Alessandro Malagoli, Vincenzo Russo, Quirino Ciampi, Matteo Cameli and Antonello D’Andrea
J. Clin. Med. 2023, 12(24), 7678; https://doi.org/10.3390/jcm12247678 - 14 Dec 2023
Viewed by 984
Abstract
This comprehensive review explores the role of exercise stress echocardiography (ESE) in assessing cardiovascular health in athletes. Athletes often exhibit cardiovascular adaptations because of rigorous physical training, making the differentiation between physiological changes and potential pathological conditions challenging. ESE is a crucial diagnostic [...] Read more.
This comprehensive review explores the role of exercise stress echocardiography (ESE) in assessing cardiovascular health in athletes. Athletes often exhibit cardiovascular adaptations because of rigorous physical training, making the differentiation between physiological changes and potential pathological conditions challenging. ESE is a crucial diagnostic tool, offering detailed insights into an athlete’s cardiac function, reserve, and possible arrhythmias. This review highlights the methodology of ESE, emphasizing its significance in detecting exercise-induced anomalies and its application in distinguishing between athlete’s heart and other cardiovascular diseases. Recent advancements, such as LV global longitudinal strain (GLS) and myocardial work (MW), are introduced as innovative tools for the early detection of latent cardiac dysfunctions. However, the use of ESE also subsumes limitations and possible pitfalls, particularly in interpretation and potential false results, as explained in this article. Full article
(This article belongs to the Special Issue (Targeted) Diagnosis of Arrhythmias and Sudden Cardiac Death)
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Other

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8 pages, 650 KiB  
Brief Report
Intrinsic Sinus Node/Atrioventricular Node Dysfunction Requiring Pacemaker Implantation: Role of Former Professional Sport Activity
by Sergei Bondarev, Evgeny Achkasov, Alessandro Zorzi, Alexandr Safaryan, Francesca Graziano and Alexey Sizov
J. Clin. Med. 2024, 13(1), 203; https://doi.org/10.3390/jcm13010203 - 29 Dec 2023
Cited by 1 | Viewed by 569
Abstract
Background: Sinus bradycardia and first degree or second degree Mobitz type I atrioventricular (AV) block in an athlete are considered adaptive and reversible phenomena; however, some evidence suggests that they may persist after detraining and become pathological. The aim of the study was [...] Read more.
Background: Sinus bradycardia and first degree or second degree Mobitz type I atrioventricular (AV) block in an athlete are considered adaptive and reversible phenomena; however, some evidence suggests that they may persist after detraining and become pathological. The aim of the study was to investigate the characteristics of a group of former professional athletes who required pacemaker (PM) implantation for intrinsic (idiopathic) sinus node (SN) dysfunction or AV block in comparison to control groups of sedentary individuals. Methods: We included all patients who underwent PM implantation during 2022. Three groups were compared: group 1 including 18 former professional athletes who received a PM for SN dysfunction/AV block in the absence of heart disease; group 2 including the first 20 sedentary individuals without heart disease who underwent PM implantation; and group 3 including all other 323 patients who received PM, the majority with underlying heart diseases. Results: Compared to the non-athlete control group 2, the mean age at diagnosis and at the time of PM implantation of former professional athletes did not show statistically significant differences. However, subgroup analysis revealed significant differences depending on the type of sports discipline: the age at diagnosis and at PM implantation was significantly lower in former endurance athletes than former strength/mixed athletes, control non-athletes, and all other patients. Moreover, former endurance professional athletes exhibited a higher prevalence of second or third degree AV block (78%) as the reason for PM implantation compared to power/mixed athletes (44%). The other clinical characteristics, including echocardiographic parameters, did not differ between former athletes and non-athletes. Conclusions: Former professional endurance athletes with idiopathic SN dysfunction/AV block manifested the disease earlier in the life course compared to former power/mixed athletes and non-athletes. This suggests that bradycardia/AV block caused by intense and prolonged endurance sports may not always be benign and adaptive phenomena. Full article
(This article belongs to the Special Issue (Targeted) Diagnosis of Arrhythmias and Sudden Cardiac Death)
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