First‐in‐man case of non‐invasive proton radiotherapy for the treatment of refractory ventricular tachycardia in advanced heart failure

2020 ◽  
Author(s):  
Veronica Dusi ◽  
Viviana Vitolo ◽  
Laura Frigerio ◽  
Rossana Totaro ◽  
Adele Valentini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Advanced Heart Failure ◽  
Proton Radiotherapy ◽  
Non Invasive

The Characteristics and Distribution of the Scar Tissue Predict Ventricular Tachycardia in Patients with Advanced Heart Failure

2009 ◽  
Vol 32 (3) ◽  
pp. 314-322 ◽  
Author(s):  
MIKI YOKOKAWA ◽  
HIROSHI TADA ◽  
KEIKO KOYAMA ◽  
TOSHIHIKO INO ◽  
SHIGEKI HIRAMATSU ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Scar Tissue ◽  
Advanced Heart Failure

Significance of aborted cardiac arrest and sustained ventricular tachycardia in patients referred for treatment therapy of advanced heart failure

1992 ◽  
Vol 124 (1) ◽  
pp. 123-130 ◽  
Author(s):  
William G. Stevenson ◽  
Holly R. Middlekauff ◽  
Lynne W. Stevenson ◽  
Leslie A. Saxon ◽  
Mary A. Woo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Advanced Heart Failure ◽  
Sustained Ventricular Tachycardia

Comparison of invasive and non-invasive measurements of haemodynamic parameters in patients with advanced heart failure

2011 ◽  
Vol 12 (11) ◽  
pp. 773-778 ◽  
Author(s):  
Mateusz Sokolski ◽  
Agnieszka Rydlewska ◽  
Bartosz Krakowiak ◽  
Jan Biegus ◽  
Robert Zymlinski ◽  
...  
Keyword(s):  
Heart Failure ◽  
Advanced Heart Failure ◽  
Non Invasive ◽  
Haemodynamic Parameters

scholarly journals Relation of primary and secondary cardiac arrests or sustained ventricular tachycardia to sudden death risk in advanced heart failure

1991 ◽  
Vol 17 (2) ◽  
pp. A92 ◽  
Author(s):  
William G. Stevenson ◽  
Holly R. Middlekauff ◽  
Lynne W. Stevenson ◽  
Leslie A. Saxon ◽  
Mary Woo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Sudden Death ◽  
Advanced Heart Failure ◽  
Sustained Ventricular Tachycardia ◽  
Death Risk

scholarly journals 568 Echocardiography and impedance cardiography as determinants of successful slow Levosimendan infusion in patients with acute advanced heart failure

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Gaetano Ruocco ◽  
Guido Pastorini ◽  
Mauro Feola
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Impedance Cardiography ◽  
Global Longitudinal Strain ◽  
Advanced Heart Failure ◽  
Non Invasive ◽  
Dimensional Echocardiography ◽  
Invasive Measurement

Abstract Aims Despite new therapeutic options, patients with heart failure (HF) still progress to advanced stage. Among new therapeutic options, Levosimendan was recently approved in order to treat patients hospitalized for acute decompensated heart failure (ADHF) with severe systolic dysfunction. The pharmacological effects of Levosimendan consist of inotropy, vasodilatation, and cardioprotection through the increase of calcium sensitivity. These effects should be monitored with echocardiography and in particular with speckle tracking and tri-dimensional echocardiography which appear to be useful in LV systolic function detection and monitoring. In this study we aim to evaluate the effect of slow infusion of Levosimendan on the non-invasive measurement of cardiac output, the speckle tracking parameters and the tri-dimensional echocardiography measurements in advanced ADHF patients. Methods and results This is a prospective observational study evaluating Levosimendan efficacy through advanced echocardiography. We enrolled 11 patients with diagnosis of ADHF who respect the recent ESC criteria of ‘advanced heart failure’. Patients underwent to blood sample examination to measure electrolytes, creatinine, and NTproBNP. Patients underwent to advanced echocardiography examination (performed for each patient pre- and post-Levosimendan infusion) with tri-dimensional echocardiography and global longitudinal strain assessment. Furthermore patients underwent to non-invasive cardiac output and cardiac index collection through impedance cardiography pre- and post-Levosimendan infusion. All patients were followed for 30 days after discharge for all cause of mortality and HF re-hospitalization. A total of 11 patients affected by advanced ADHF were included in this study. Mean age was 73.8 ± 4.7 years. 72.7% (n 8) patients were men. 81.9% (n 9) of patients recognize ischaemic heart disease as HF etiology. At admission mean systolic arterial pressure was 100 ± 17 mmHg, mean NTproBNP was 24 445 ± 12 194 pg/ml and mean serum creatinine was 1.55 ± 0.84 mg/dl. At tri-dimensional echocardiography mean LV ejection fraction (LVEF) was 19.7 ± 5.7% and at bi-dimensional echocardiography mean tricuspid anular plane systolic excursion (TAPSE) and pulmonary arterial systolic pressure (PASP) were, respectively, 12.5 ± 2.7 mm and 48 ± 16 mmHg. Mean LV global longitudinal strain (GLS) was −3.0 ± 1.8. Mean furosemide in-hospital infusion was 306 ± 102 mg/die and mean urine output 1436 ± 496 ml. None developed significant ventricular or supraventricular arrhythmias. All patients were treated with betablockers during infusion. At 30 days of follow-up two patients died and 1 patient was re-hospitalized. Evaluating the differences among our variables pre- and post-Levosimendan infusion, we found that NTproBNP was significantly reduced post-Levosimendan infusion (P = 0.01). Among ICG non-invasive measurement, we found significant differences in stroke volume (SV) and cardiac output (CO) in terms of significant improvement (P = 0.001 for both). Analysing tri-dimensional echocardiography variables, we observed a significant improvement of LVEF (P = 0.003), SV (P = 0.03) and 3-D LV GLS (P = 0.002). Furthermore, we observed a significant reduction in end-systolic volume (ESV) post-Levosimendan infusion (P = 0.02). Among bi-dimensional echocardiography measurements, there was a significant reduction in end-diastolic diameter of right ventricle (EDDRV) and in B-lines count (respectively, P = 0.02 and P = 0.002). Moreover, we observed a significant improvement in TAPSE (P = 0.003) and in LV GLS (P = 0.004). Conclusions Our study showed that slow Levosimendan infusion (12.5 mg at velocity of 0.05–1 mcg/kg/min) without bolus could be considered in advanced ADHF patients to improve cardiac performance without severe adverse events. ICG and echocardiography in-hospital evaluation seemed to be necessary to understand treatment success and patients status improvement as well as cardiac function benefit.

scholarly journals Is Doppler echo a non-invasive alternative to Swan-Ganz catheterization in patients with advanced heart failure?

1996 ◽  
Vol 27 (2) ◽  
pp. 173
Author(s):  
James H. Stein ◽  
Alex Neumann ◽  
Lynn M. Preston ◽  
Jeffrey S. Soble ◽  
Susan M. Quinn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Advanced Heart Failure ◽  
Non Invasive

Abstract 1976: Characteristics and Distribution of the Scar Tissue Detected by Magnetic Resonance Imaging may Predict Ventricular Tachycardia in Patients with Advanced Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Miki Yokokawa ◽  
Hiroshi Tada ◽  
Keiko Koyama ◽  
Shigeto Naito ◽  
Shigeki Hiramatsu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Magnetic Resonance ◽  
Scar Tissue ◽  
Wall Layer ◽  
Advanced Heart Failure ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Potential Substrate

Introduction: Contrast-enhanced magnetic resonance imaging (CMR) reveals scar tissue as an enhanced area. Non-transmural scar regions may link to a scar-related reentrant ventricular tachycardia (VT). Methods: CMR was performed in 46 patients with advanced heart failure (dilated cardiomyopathy [DCM]-30, ischemic cardiomyopathy [ICM]-16; 36 males, 65±12 yrs; EF 28±12 %). Twenty-one patients (46 %) had documented sustained VTs. The scar volume (%; the percentage of the total scar volume) was obtained using MRI software. CMR images were also scored visually according to a 17-segment model (transmural score: 0= no damage, 4= transmural scar). The total number (No.) of segments with a transmural score of 4 (transmural scar) and transmural score of 1–3 (non-transmural scar), and the percentage of segments with non-transmural scar were obtained. The CMR parameters and clinical arrhythmic events were compared between the patients with DCM (DCM-Gr) and ICM (ICM-Gr). Results ( Table ): In the DCM-Gr, the scar was usually non-transmural, which presented mainly in the mid-wall layer and was characterized by a patchy distribution. The scar volume and total No. of segments with non-transmural scar were greater in DCM patients with VT than in those without. In contrast, patients in the ICM-Gr had transmural or subendocardial enhancement in the territory of coronary arteries, and the scar volume was smaller in ICM patients with VT than in those without. However, the total No. of segments with non-transmural scar and percentage of segments with non-transmural scar were greater in ICM patients with VT than in those without. In the VT patients in both Grs, non-transmural scar was always found at the VT exit site. Conclusions: CMR is useful for assessing the characteristics and distribution of myocardial scar. A wider and greater distribution of the non-transmural scar may provide the potential substrate for reentrant VTs in patients with advanced heart failure. Table: CMR-parameters in Patients with DCM and ICM

Clinical experience of stereotactic body radiation for refractory ventricular tachycardia in advanced heart failure patients

Heart Rhythm ◽  
2020 ◽  
Vol 17 (3) ◽  
pp. 415-422 ◽  
Author(s):  
Michael S. Lloyd ◽  
John Wight ◽  
Frank Schneider ◽  
Michael Hoskins ◽  
Tamer Attia ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Clinical Experience ◽  
Advanced Heart Failure ◽  
Heart Failure Patients ◽  
Stereotactic Body Radiation
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