Remodeling Of Cardiac Passive Electrical Properties And Susceptibility To Ventricular And Atrial Arrhythmias

The effective management of cardiac arrhythmias, either of atrial or of ventricular origin, remains a major challenge. Sudden cardiac death due to ventricular tachyarrhythmias remains the leading cause of death in industrialized countries while atrial fibrillation is the most common rhythm disorder; an arrhythmia that’s prevalence is increasing and accounts for nearly one quarter of ischemic stokes the elderly population. Yet, despite the enormity of the problem, effective therapeutic interventions remain elusive. In fact, several initially promising antiarrhythmic agents were found to increase rather than decrease mortality in patients recovering from myocardial infarction. The question then is what went wrong, why have these interventions proven to be so ineffective? An obvious answer is the drugs were designed to attack the wrong therapeutic target. Clearly, targeting single ion channels (using either isolated ion channels or single myocytes preparations) has proven to be less than effective. What then is the appropriate target? It is well established that cardiac electrical properties can vary substantially between single cells and intact preparations. One obvious example is the observation that action potential duration is much longer in isolated cells as compared to multi-cellular preparations or intact hearts. Due to the low electrical resistance between adjacent myocytes, the cells act in coordinated fashion producing “electrotonic interdependence” between neighboring cells. Myocardial infarction and/or acute ischemia provoke profound changes in the passive electrical properties of cardiac muscle. In particular, electrotonic uncoupling of the myocytes disrupts the coordinated activation and repolarization of cardiac tissue. The resulting compensatory changes in ionic currents decrease cardiac electrical stability increasing the risk for life-threatening changes in the cardiac rhythm. Thus, the electrical properties of myocardial cells must be considered as a unit rather than in isolation. It is the purpose of this Research Topic to evaluate the largely neglected relationship between changes in passive electrical properties of cardiac muscle and arrhythmia formation.

The effective management of cardiac arrhythmias, either of atrial or of ventricular origin, remains a major challenge. Sudden cardiac death due to ventricular tachyarrhythmias remains the leading cause of death in industrialized countries while atrial fibrillation is the most common rhythm disorder; an arrhythmia that's prevalence is increasing and accounts for nearly one quarter of ischemic stokes the elderly population. Yet, despite the enormity of the problem, effective therapeutic interventions remain elusive. In fact, several initially promising antiarrhythmic agents were found to increase rather than decrease mortality in patients recovering from myocardial infarction. The question then is what went wrong, why have these interventions proven to be so ineffective? An obvious answer is the drugs were designed to attack the wrong therapeutic target. Clearly, targeting single ion channels (using either isolated ion channels or single myocytes preparations) has proven to be less than effective. What then is the appropriate target? It is well established that cardiac electrical properties can vary substantially between single cells and intact preparations. One obvious example is the observation that action potential duration is much longer in isolated cells as compared to multi-cellular preparations or intact hearts. Due to the low electrical resistance between adjacent myocytes, the cells act in coordinated fashion producing "electrotonic interdependence" between neighboring cells. Myocardial infarction and/or acute ischemia provoke profound changes in the passive electrical properties of cardiac muscle. In particular, electrotonic uncoupling of the myocytes disrupts the coordinated activation and repolarization of cardiac tissue. The resulting compensatory changes in ionic currents decrease cardiac electrical stability increasing the risk for life-threatening changes in the cardiac rhythm. Thus, the electrical properties of myocardial cells must be considered as a unit rather than in isolation. It is the purpose of this Research Topic to evaluate the largely neglected relationship between changes in passive electrical properties of cardiac muscle and arrhythmia formation.

Part of the highly regarded Braunwald’s family of cardiology references, Clinical Arrhythmology and Electrophysiology, 3rd Edition, offers complete coverage of the latest diagnosis and management options for patients with arrhythmias. Expanded clinical content and clear illustrations keep you fully abreast of current technologies, new syndromes and diagnostic procedures, new information on molecular genetics, advances in ablation, and much more.

Rapid advancements in cardiac electrophysiology require today’s health care scientists and practitioners to stay up to date with new information both at the bench and at the bedside. The fully revised 7th Edition of Cardiac Electrophysiology: From Cell to Bedside, by Drs. Douglas Zipes, Jose Jalife, and William Stevenson, provides the comprehensive, multidisciplinary coverage you need, including the underlying basic science and the latest clinical advances in the field. An attractive full-color design features color photos, tables, flow charts, ECGs, and more. All chapters have been significantly revised and updated by global leaders in the field, including 19 new chapters covering both basic and clinical topics. New topics include advances in basic science as well as recent clinical technology, such as leadless pacemakers; catheter ablation as a new class I recommendation for atrial fibrillation after failed medical therapy; current cardiac drugs and techniques; and a new video library covering topics that range from basic mapping (for the researcher) to clinical use (implantations). Each chapter is packed with the latest information necessary for optimal basic research as well as patient care, and additional figures, tables, and videos are readily available online. New editor William G. Stevenson, highly regarded in the EP community, brings a fresh perspective to this award-winning text. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, images, videos (including video updates), glossary, and references from the book on a variety of devices.

Your must-have bench reference for cardiac electrophysiology is now better than ever! This globally recognized gold standard text provides a complete overview of clinical EP, with in-depth, expert information that helps you deliver superior clinical outcomes. In this updated 5th Edition, you’ll find all-new material on devices, techniques, trials, and much more – all designed to help you strengthen your skills in this fast-changing area and stay on the cutting edge of today’s most successful cardiac EP techniques. Expert guidance from world authorities who contribute fresh perspectives on the challenging clinical area of cardiac electrophysiology. New focus on clinical relevance throughout, with reorganized content and 15 new chapters. New coverage of balloons, snares, venoplasty, spinal and neural stimulation, subcutaneous ICDs and leadless pacing, non-CS lead implantation, His bundle pacing, and much more. New sections on cardiac anatomy and physiology and imaging of the heart, a new chapter covering radiography of devices, and thought-provoking new information on the basic science of device implantation. State-of-the-art guidance on pacing for spinal and neural stimulation, computer simulation and modeling, biological pacemakers, perioperative and pre-procedural management of device patients, and much more.

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 volume constitutes the refereed proceedings of the 6th Workshop on Engineering Applications, WEA 2019, held in Santa Marta, Colombia, in October 2019. The 62 revised full papers and 2 short papers presented in this volume were carefully reviewed and selected from 178 submissions. The papers are organized in the following topical sections: computer science; computational intelligence; bioengineering; Internet of things; power applications; simulation systems; optimization.