Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Feb 1996
ReviewRisk assessment and prevention of sudden cardiac death in hypertrophic cardiomyopathy.
One of the principle aims in the assessment of the patient with hypertrophic cardiomyopathy is assessment of risk for sudden cardiac death. Conventional risk stratification is reviewed together with other non-invasive techniques such as exercise physiology; the signal averaged electrocardiogram and heart rate variability. ⋯ A novel electrophysiological technique is described in detail which aims to measure the electrophysiological effects of myocardial disarray and seems safer and more sensitive and specific than conventional electrophysiological techniques. Current therapeutic strategies are discussed including the role of drugs, the implantable cardioverter defibrillator, surgery and dual chamber pacing.
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Arch Mal Coeur Vaiss · Feb 1996
New generations of implantable pacemaker defibrillators for ventricular and atrial tachyarrhythmias.
Implantable defibrillation devices have now been extensively applied to patients requiring cardioversion and defibrillation of sustained ventricular tachyarrhythmias. The focus of new developments is in improving technology, achieving physiologic operation in the atrium and ventricle, seeking new indications and identifying patient populations amenable to this therapy. Ventricular application technology is focusing on simplifying and improving robustness of lead systems yet seeking lower defibrillation thresholds. ⋯ New applications include atrial defibrillation combined with atrial pacing in future devices. These devices are planned to have capabilities of ventricular defibrillation as a backup to address proarrhythmia concerns. It can be anticipated that implantable cardioverter defibrillator devices will be used for arrhythmia reversion in an expanding group of patients in the future.