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There exists no clear method to distinguish between potentially useful or harmful drugs in the setting of excitable cardiac disease. Computational modeling, however, can be utilized to predict interactions and consequences of antiarrhythmics. One application of this approach is in exploring the mechanism of action of the antiarrhythmic drug flecainide, once condemned for causing an increased incidence of sudden cardiac death, which has been shown to demonstrate efficacy in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). In addition to its classic effects on sodium current, flecainide has been shown to interact with the ryanodine receptor. This work first gives an introduction to computer modeling, cardiac electrophysiology, and their intersection. A detailed background on CPVT then follows this introduction, including the genetic basis, experimental models, and options for treatment of CPVT. An initial study utilizes a computational approach to predict the mechanism of efficacy of the drug flecainide in the setting of CPVT. The models are then expanded upon in a second study in order to predict alternate therapy to rectify electrical abnormalities in the setting of CPVT. These two studies highlight the emerging applications of computational modeling as a tool to direct the development of novel therapeutic treatments and strategies for cardiac rhythm pathologies.
Technological advances in generated molecular and cell biological data are transforming biomedical research. Sequencing, multi-omics and imaging technologies are likely to have deep impact on the future of medical practice. In parallel to technological developments, methodologies to gather, integrate, visualize and analyze heterogeneous and large-scale data sets are needed to develop new approaches for diagnosis, prognosis and therapy. Systems Medicine: Integrative, Qualitative and Computational Approaches is an innovative, interdisciplinary and integrative approach that extends the concept of systems biology and the unprecedented insights that computational methods and mathematical modeling offer of the interactions and network behavior of complex biological systems, to novel clinically relevant applications for the design of more successful prognostic, diagnostic and therapeutic approaches. This 3 volume work features 132 entries from renowned experts in the fields and covers the tools, methods, algorithms and data analysis workflows used for integrating and analyzing multi-dimensional data routinely generated in clinical settings with the aim of providing medical practitioners with robust clinical decision support systems. Importantly the work delves into the applications of systems medicine in areas such as tumor systems biology, metabolic and cardiovascular diseases as well as immunology and infectious diseases amongst others. This is a fundamental resource for biomedical students and researchers as well as medical practitioners who need to need to adopt advances in computational tools and methods into the clinical practice. Encyclopedic coverage: ‘one-stop’ resource for access to information written by world-leading scholars in the field of Systems Biology and Systems Medicine, with easy cross-referencing of related articles to promote understanding and further research Authoritative: the whole work is authored and edited by recognized experts in the field, with a range of different expertise, ensuring a high quality standard Digitally innovative: Hyperlinked references and further readings, cross-references and diagrams/images will allow readers to easily navigate a wealth of information
Fully updated from cover to cover, Zipes and Jalife’s Cardiac Electrophysiology: From Cell to Bedside, 8th Edition, provides the comprehensive, multidisciplinary coverage you need—from new knowledge in basic science to the latest clinical advances in the field. Drs. José Jalife and William Gregory Stevenson lead a team of global experts who provide cutting-edge content and step-by-step instructions for all aspects of cardiac electrophysiology. Packs each chapter with the latest information necessary for optimal basic research as well as patient care. Covers new technologies such as CRISPR, protein research, improved cardiac imaging, optical mapping, and wearable devices. Contains significant updates in the areas of molecular biology and genetics, iPSCs (induced pluripotent stem cells), embryonic stem cells, precision medicine, antiarrhythmic drug therapy, cardiac mapping with advanced techniques, and ablation technologies including stereotactic radioablation. Includes 47 new standalone chapters that are organized into discrete topics for improved access. Discusses extensive recent progress in the understanding, diagnosis, and management of arrhythmias, including new clinical insights on atrial fibrillation and stroke prevention, new advances in the understanding of ventricular arrythmias in genetic disease, and advances in implantable devises and infection management. Features 1,600 high-quality photographs, anatomic and radiographic images, electrocardiograms, tables, algorithms, and more., with additional figures, tables, and videos online. Recipient of a 2018 Highly Commended award from the British Medical Association.
This book delineates the state of the art of the diagnosis and treatment of J wave syndromes, as well as where future research needs to be directed. It covers basic science, translational and clinical aspects of these syndromes. The authors are leading experts in their respective fields, who have contributed prominently to the literature concerning these topics. J wave syndromes are one of the hottest topics in cardiology today. Cardiac arrhythmias associated with Brugada syndrome (BrS) or an early repolarization (ER) pattern in the inferior or infero-lateral ECG leads are thought to be mechanistically linked to accentuation of transient outward current (Ito)-mediated J waves. Although BrS and ER syndrome (ERS) differ with respect to magnitude and lead location of abnormal J waves, they are thought to represent a continuous spectrum of phenotypic expression termed J wave syndromes. ERS is divided into three subtypes with the most severe, Type 3, displaying an ER pattern globally in the inferior, lateral and right precordial leads. BrS has been linked to mutations in 19 different genes, whereas ERS has been associated with mutations in 7 different genes. There is a great deal of confusion as to how to properly diagnose and treat the J wave syndromes as well as confusion about the underlying mechanisms. The demonstration of successful epicardial ablation of BrS has provided new therapeutic options for the management of this syndrome for which treatment alternatives are currently very limited, particularly in the case of electrical storms caused by otherwise uncontrollable recurrent VT/VF. An early repolarization pattern is observed in 2-5% of the US population. While it is clear that the vast majority of individuals exhibiting an ER pattern are not at risk for sudden cardiac death, the challenge moving forward is to identify those individuals who truly are at risk and to design safe and effective treatments.
The 6th edition of the textbook Ellestad's Stress Testing: Principles and Practice was written for the new and veteran clinician alike performing stress testing. Thoroughly updated, referenced and interspersed with case examples, the book reviews how to get the most out exercise testing, without and with ancillary imaging. In addition to evaluation of ST segment depression, other powerful tools to detect ischemia and forecast the future are reviewed to increase the diagnostic accuracy and prognostic ability of exercise testing. The recognition and significance of exercise induced arrhythmias and conduction defects are examined. When to convert to pharmacologic stress or add ancillary imaging, including myocardial perfusion imaging, echocardiography, coronary calcium scoring, and magnetic reference imaging are reviewed. The use of stress testing in the management of obstructive and non-obstructive coronary artery disease (CAD), heart failure, cardiac rehabilitation, peripheral vascular disease, congenital heart and other cardiovascular diseases (CVD) is examined. Options to optimize the diagnostic capabilities of exercise and other diagnostic testing for women are highlighted. Strategic use of exercise testing in the face of a decreasing burden of CAD in the developed world, as well as the opportunity to rely on exercise testing as the first test to evaluate CVD in the developing world, are reviewed. The fundamentals of exercise physiology and myocardial ischemia that serve as the foundation for exercise testing in health and disease are --
Der Bereich der pädiatrischen Herz- und Gefäßchirurgie umfasst nicht nur die Herzchirurgie bei Säuglingen und Kindern, sondern auch die Herzchirurgie bei Erwachsenen zur Korrektur von angeborenen Herzfehlern. Da die Kindersterblichkeit aufgrund von Herzfehlern zurückgeht und Patienten mit angeborenen Herzfehlern zunehmend ein langes, gesundes Leben führen, ergeben sich neue Herausforderungen. Somit war der Bedarf an Einführungen in diesen lebensrettenden Bereich noch nie so groß. Pediatric Cardiac Surgery ist ein gut verständliches, umfassendes Lehrbuch, das diesen Bedarf seit über dreißig Jahren erfüllt und von Fachleuten auf allen Ebenen genutzt wird. Das Lehrwerk, das zahlreiche farbige Abbildungen enthält, bietet zunächst eine wissenschaftliche Einführung in die kardiovaskuläre Entwicklung und dann detaillierte Analysen von Defekten in verschiedenen Bereichen des Herzens mit den entsprechenden Verfahren zur Korrektur dieser Defekte. Die aktualisierte fünfte Auflage berücksichtigt die neuesten wissenschaftlichen Erkenntnisse und bleibt damit ein unverzichtbares Werk zu diesem Thema. Die fünfte Auflage von Pediatric Cardiac Surgery enthält unter anderem: * Beiträge von über 75 nationalen und internationalen Experten auf dem Gebiet * Beeindruckende anatomische Illustrationen von Rachid Idriss * Neue Kapitel, in denen der neueste Stand der Forschung dargestellt wird, sowie neue Inhalte in Bezug auf die kardiale Bildgebung und die medizinische Ausbildung Pediactric Cardiac Surgery ist ein wichtiges Nachschlagewerk für Herzchirurgen, die sich auf Kinder und Erwachsene spezialisiert haben, Kardiologen und alle medizinischen Fachkräfte, die mit pädiatrischen oder erwachsenen Herzpatienten arbeiten.
A significantly expanded third edition, this book provides a comprehensive and concise overview of cardiac arrhythmias and their ECG/telemetry manifestations, including the principles of cardiac electrophysiology, current concepts of pharmacology, clinical features, diagnoses, and state-of-the-art treatments. Additionally, the book emphasizes decision-making strategies in approaching each individual patient and the application of technical innovations in specific clinical situations. Organized into eight parts, beginning chapters introduce the concepts and principles of cardiac electrophysiology, unique rhythms, and ECG waves/signs. These chapters are designed to integrate emerging knowledge in basic science and clinical medicine. Subsequent chapters focus on the diagnosis of a variety of cardiac arrhythmias using non-invasive methodology. Throughout the book, chapters continue to analyze pharmacological and other approaches to therapy of specific arrhythmias, including supraventricular tachycardias, atrial fibrillation and flutter, ventricular arrhythmias, and bradyarrhythmias. Finally, the book closes with coverage on inherited cardiac arrhythmia syndromes including the long, short QT, and J-wave syndromes, catecholaminergic polymorphic ventricular tachycardia, and arrhythmogenic right ventricular cardiomyopathy. The third edition of Management of Cardiac Arrhythmias, is an essential resource for physicians, residents, fellows, and medical students in cardiology, cardiac surgery, vascular surgery, cardiac electrophysiology, and cardiac radiology.
The purpose of this book is to present a focused approach to the pathophysiology, diagnosis, and management of the most common autonomic disorders that may present to the clinical neurologist. Autonomic Neurology is divided into 3 sections. The first section includes 5 chapters reviewing the anatomical and biochemical mechanisms of central and peripheral nervous system control of autonomic function, principles of autonomic pharmacology, and a clinical and laboratory approach to the diagnosis of autonomic disorders. The second section focuses on the pathophysiology and management of orthostatic hypotension, postural tachycardia, baroreflex failure; syncope, disorders of sweating, neurogenic bladder and sexual dysfunction, gastrointestinal dysmotility, and autonomic hyperactivity. The final section is devoted to specific autonomic disorders, including central neurodegenerative disorders; common peripheral neuropathies with prominent autonomic failure; painful small fiber neuropathies; autoimmune autonomic ganglionopathies and neuropathies; focal brain disorders; focal spinal cord disorders; and chronic pain disorders with autonomic manifestations. This book is the product of the extensive experience of its contributors in the evaluation and management of the many patients with autonomic symptoms who are referred for neurologic consultation at Mayo Clinic in Rochester, Minnesota. Autonomic Neurology focuses on clinical scenarios and presentation of clinical cases and includes several figures showing the results of normal and abnormal autonomic testing in typical conditions. Its abundance of tables summarizing the differential diagnosis, testing, and management of autonomic disorders also help set this book apart from other books focused on the autonomic nervous system.
In recent years there has been considerable interest in the diagnosis and understanding of ventricular repolarisation, particularly the QT interval prolongation and abnormal T and T/U wave morphology associated with torsades de pointes. Advances in ion channel cloning have greatly improved our understanding of the role of ionic channels in mediating cardiac repolarisation. Unfortunately, it is increasingly recognised that a number of drugs, both those associated with altering repolarisation, and others for non-cardiac conditions can increase the propensity for polymorphic ventricular tachycardia, syncope and even ventricular fibrillation and sudden death. In this volume, arrhythmia specialists from St. George’s Hospital Medical School, London discuss the mechanisms behind QT prolongation and torsades de pointes. They focus particularly on the risk of individual cardiac and non-cardiac drugs in provoking long QT syndrome, providing a comprehensive review which will be useful for all electrophysiologists treating polymorphic ventricular tachycardias, and will expose important regulatory issues for pharmaceutical authorities and for the wider medical community.