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Clinical Advances in Ventricular Arrhythmia and Cardiac Arrest
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Clinical Advances in Ventricular Arrhythmia and Cardiac Arrest

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

Deadline for manuscript submissions: closed (20 December 2023) | Viewed by 8523

Special Issue Editor

Dr. Simone Savastano

E-Mail Website
Guest Editor
Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
Interests: cardiac arrest; sudden death; ventricular arrhythmias
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The treatment of ventricular arrhythmias and cardiac arrest is a real challenge for cardiologists, intensivists, and emergency physicians. Many progresses have been done during the last years both in understanding the underlying mechanisms and in developing new treatments but a great work is still to be done. The more we study about this topic the more we improve the chance of survival of our patients.

So, please submit your science about this challenging issue focusing on new techniques, new therapeutical algorithms and new strategy to fight ventricular arrhythmias and cardiac arrest.

Dr. Simone Savastano
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 arrhythmias
  • cardiac arrest
  • heart rhythms
  • heart attack
  • sudden death

Published Papers (4 papers)

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Research

13 pages, 4483 KiB  
Article
Safety and Performance of the Subcutaneous Implantable Cardioverter Defibrillator Detection Algorithm INSIGHTTM in Pacemaker Patients
by Kay F. Weipert, Srdjan Kostic, Timur Gökyildirim, Victoria Johnson, Ritvan Chasan, Christopher Gemein, Josef Rosenbauer, Damir Erkapic and Jörn Schmitt
J. Clin. Med. 2024, 13(1), 129; https://doi.org/10.3390/jcm13010129 - 26 Dec 2023
Cited by 1 | Viewed by 754
Abstract
Background: The use of the S-ICD is limited by its inability to provide backup pacing. Combined use of the S-ICD with a pacemaker may be a good choice in certain situations, yet current experience concerning the compatibility is limited. The goal of this [...] Read more.
Background: The use of the S-ICD is limited by its inability to provide backup pacing. Combined use of the S-ICD with a pacemaker may be a good choice in certain situations, yet current experience concerning the compatibility is limited. The goal of this study was to determine the safety and efficacy of the S-ICD in patients with a pacemaker. Methods: A total of 74 consecutive patients with a bipolar pacemaker were prospectively enrolled. First, surface rhythm strips were recorded in all possible pacemaker stimulation modes, to screen for T-wave oversensing (TWOS). Second, a S-ICD functional dummy was placed epicutaneously on the patient in the typical implant position. The same standardized pacing protocol was used as mentioned above, and every stimulation mode was recorded via S-ECG in all vectors. Results: In 16 patients (21.6%), programmed stimulation would have led to VT/VF detection. Triggered episodes were due to counting of the pacing spike(s), QRS complex, premature ventricular contractions, and/or additional TWOS. Three cases triggered in the bipolar stimulation mode. Oversensing was associated with lung emphysema and a reduced QRS amplitude in the S-ECG. Conclusion: The combination of an S-ICD and a pacemaker may lead to inadequate shock delivery due to oversensing, even under programmed bipolar stimulation. Oversensing cannot be sufficiently predicted by the screening tool in pacemaker patients. Testing with an epicutaneous S-ICD dummy in all vectors and stimulation settings is recommended in patients with pre-existing pacemakers. Full article
(This article belongs to the Special Issue Clinical Advances in Ventricular Arrhythmia and Cardiac Arrest)
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14 pages, 1798 KiB  
Article
Appropriate Implantable Cardioverter-Defibrillator Therapy in Patients with Ventricular Arrhythmia of Unclear Cause in Secondary Prevention of Sudden Cardiac Death
by Alwin B. P. Noordman, Michiel Rienstra, Yuri Blaauw, Bart A. Mulder and Alexander H. Maass
J. Clin. Med. 2023, 12(13), 4479; https://doi.org/10.3390/jcm12134479 - 04 Jul 2023
Cited by 2 | Viewed by 841
Abstract
In this study, we sought to investigate the occurrence of appropriate implantable cardioverter-defibrillator (ICD) therapies and inappropriate shocks in secondary prevention ICD recipients with ventricular arrhythmia of unclear cause and ventricular arrhythmia in the context of underlying heart disease. In this retrospective study, [...] Read more.
In this study, we sought to investigate the occurrence of appropriate implantable cardioverter-defibrillator (ICD) therapies and inappropriate shocks in secondary prevention ICD recipients with ventricular arrhythmia of unclear cause and ventricular arrhythmia in the context of underlying heart disease. In this retrospective study, consecutive patients with an ICD implanted for secondary prevention in the University Medical Center Groningen (UMCG), the Netherlands between 1 January 2012 and 31 December 2018 were included. Patients were classified as having ventricular arrhythmia of unclear cause if no clear cause was found which could explain the index ventricular arrhythmia. The primary outcome was appropriate ICD therapy. The study population consisted of 257 patients. In 220 patients, an underlying heart disease could be identified as the cause of ventricular arrhythmia, while 37 patients had an unclear cause of ventricular arrhythmia. The median age was 64 years (interquartile range (IQR) 53–72 years). Forty-five (18%) patients were women. During a median duration of follow-up of 6.2 years (IQR 4.8–7.8 years), appropriate ICD therapy occurred in 95 (37%) patients. This number was 90 (41%) in the group with a clear etiology and 5 (14%) in the group with an unclear etiology. In multivariable analysis, index ventricular arrhythmia of unclear cause was associated with fewer appropriate ICD therapies (HR 0.37 [95% CI 0.14–0.99]; p = 0.048), as well as an increased risk of inappropriate ICD shocks (HR 3.71 [95% CI 1.17–11.80]; p = 0.026). Index ventricular arrhythmia of unclear cause was significantly associated with fewer appropriate ICD therapies. Full article
(This article belongs to the Special Issue Clinical Advances in Ventricular Arrhythmia and Cardiac Arrest)
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14 pages, 1385 KiB  
Article
Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest—Device Matters: A Propensity-Score-Based Match Analysis
by Roberto Primi, Sara Bendotti, Alessia Currao, Giuseppe Maria Sechi, Gianluca Marconi, Greta Pamploni, Gianluca Panni, Davide Sgotti, Ettore Zorzi, Marco Cazzaniga, Umberto Piccolo, Daniele Bussi, Simone Ruggeri, Fabio Facchin, Edoardo Soffiato, Vincenza Ronchi, Enrico Contri, Paola Centineo, Francesca Reali, Luigi Sfolcini, Francesca Romana Gentile, Enrico Baldi, Sara Compagnoni, Federico Quilico, Luca Vicini Scajola, Clara Lopiano, Alessandro Fasolino, Simone Savastano and all the Lombardia CARe Researchersadd Show full author list remove Hide full author list
J. Clin. Med. 2023, 12(13), 4429; https://doi.org/10.3390/jcm12134429 - 30 Jun 2023
Cited by 1 | Viewed by 3462
Abstract
Background. Devices for mechanical cardiopulmonary resuscitation (CPR) are recommended when high quality CPR cannot be provided. Different devices are available, but the literature is poor in direct comparison studies. Our aim was to assess whether the type of mechanical chest compressor could affect [...] Read more.
Background. Devices for mechanical cardiopulmonary resuscitation (CPR) are recommended when high quality CPR cannot be provided. Different devices are available, but the literature is poor in direct comparison studies. Our aim was to assess whether the type of mechanical chest compressor could affect the probability of return of spontaneous circulation (ROSC) and 30-day survival in Out-of-Hospital Cardiac Arrest (OHCA) patients as compared to manual standard CPR. Methods. We considered all OHCAs that occurred from 1 January 2015 to 31 December 2022 in seven provinces of the Lombardy region equipped with three different types of mechanical compressor: Autopulse®(ZOLL Medical, MA), LUCAS® (Stryker, MI), and Easy Pulse® (Schiller, Switzerland). Results. Two groups, 2146 patients each (manual and mechanical CPR), were identified by propensity-score-based random matching. The rates of ROSC (15% vs. 23%, p < 0.001) and 30-day survival (6% vs. 14%, p < 0.001) were lower in the mechanical CPR group. After correction for confounders, Autopulse® [OR 2.1, 95%CI (1.6–2.8), p < 0.001] and LUCAS® [OR 2.5, 95%CI (1.7–3.6), p < 0.001] significantly increased the probability of ROSC, and Autopulse® significantly increased the probability of 30-day survival compared to manual CPR [HR 0.9, 95%CI (0.8–0.9), p = 0.005]. Conclusion. Mechanical chest compressors could increase the rate of ROSC, especially in case of prolonged resuscitation. The devices were dissimilar, and their different performances could significantly influence patient outcomes. The load-distributing-band device was the only mechanical chest able to favorably affect 30-day survival. Full article
(This article belongs to the Special Issue Clinical Advances in Ventricular Arrhythmia and Cardiac Arrest)
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Graphical abstract

14 pages, 1295 KiB  
Article
Optimal Timing of Targeted Temperature Management for Post-Cardiac Arrest Syndrome: Is Sooner Better?
by I-Ting Wang, Chieh-Jen Wang, Chao-Hsien Chen, Sheng-Hsiung Yang, Chun-Yen Chen, Yen-Chun Huang, Chang-Yi Lin and Chien-Liang Wu
J. Clin. Med. 2023, 12(7), 2628; https://doi.org/10.3390/jcm12072628 - 31 Mar 2023
Cited by 1 | Viewed by 2865
Abstract
Targeted temperature management (TTM) is often considered to improve post-cardiac arrest patients’ outcomes. However, the optimal timing to initiate cooling remained uncertain. This retrospective analysis enrolled all non-traumatic post-cardiac arrest adult patients with either out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) [...] Read more.
Targeted temperature management (TTM) is often considered to improve post-cardiac arrest patients’ outcomes. However, the optimal timing to initiate cooling remained uncertain. This retrospective analysis enrolled all non-traumatic post-cardiac arrest adult patients with either out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) who received TTM from July 2015 to July 2021 at our hospital. The values of time delay before TTM and time to target temperature were divided into three periods according to optimal cut-off values identified using receiver operating characteristic curve analysis. A total of 177 patients were enrolled. A shorter time delay before TTM (pre-induction time) was associated with a lower survival chance at 28 days (32.00% vs. 54.00%, p = 0.0279). Patients with a longer cooling induction time (>440 minis) had better neurological outcomes (1.58% vs. 1.05%; p = 0.001) and survival at 28 days (58.06% vs. 29.25%; p = 0.006). After COX regression analysis, the influence of pre-induction time on survival became insignificant, but patients who cooled slowest still had a better chance of survival at 28 days. In conclusion, a shorter delay before TTM was not associated with better clinical outcomes. However, patients who took longer to reach the target temperature had better hospital survival and neurological outcomes than those who were cooled more rapidly. A further prospective study was warranted to evaluate the appropriate time window of TTM. Full article
(This article belongs to the Special Issue Clinical Advances in Ventricular Arrhythmia and Cardiac Arrest)
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