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Arrhythmias in women : diagnosis and management PDF

297 Pages·2014·10.75 MB·English
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ARRHYTHMIAS IN WOMEN Diagnosis and Management MAYO CLINIC SCIENTIFIC PRESS Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade Edited by James R. Hebl, MD, and Robert L. Lennon, DO Mayo Clinic Preventive Medicine and Public Health Board Review Edited by Prathibha Varkey, MBBS, MPH, MHPE Mayo Clinic Challenging Images for Pulmonary Board Review Edward C. Rosenow III, MD Mayo Clinic Gastroenterology and Hepatology Board Review, Fourth Edition Edited by Stephen C. Hauser, MD Mayo Clinic Infectious Diseases Board Review Edited by Zelalem Temesgen, MD Mayo Clinic Antimicrobial Handbook: Quick Guide, Second Edition Edited by John W. Wilson, MD, and Lynn L. Estes, PharmD Just Enough Physiology James R. Munis, MD, PhD Mayo Clinic Cardiology: Concise Textbook, Fourth Edition Edited by Joseph G. Murphy, MD, and Margaret A. Lloyd, MD, MBA Mayo Clinic Internal Medicine Board Review, Tenth Edition Edited by Robert D. Ficalora, MD Mayo Clinic Internal Medicine Board Review: Questions and Answers Edited by Robert D. Ficalora, MD Mayo Clinic Electrophysiology Manual Edited by Samuel J. Asirvatham, MD Mayo Clinic Gastrointestinal Imaging Review, Second Edition C. Daniel Johnson, MD ARRHYTHMIAS IN WOMEN Diagnosis and Management - - editors in chief Yong-Mei Cha, MD Consultant and Co-Director, Implantable Cardiac Device Service, Division of Cardiovascular Diseases Mayo Clinic, Rochester, Minnesota Professor of Medicine Mayo Clinic College of Medicine Margaret A. Lloyd, MD, MBA Consultant, Division of Cardiovascular Diseases Mayo Clinic, Rochester, Minnesota Assistant Professor of Medicine Mayo Clinic College of Medicine Ulrika M. Birgersdotter-Green, MD Director, Pacemaker and ICD Services UC–San Diego Health Sciences, San Diego, California Professor of Medicine UC–San Diego School of Medicine MAYO CLINIC SCIENTIFIC PRESS OXFORD UNIVERSITY PRESS The triple-shield Mayo logo and the words MAYO, MAYO CLINIC, and MAYO CLINIC SCIENTIFIC PRESS are marks of Mayo Foundation for Medical Education and Research. 3 Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trademark of Oxford University Press in the UK and certain other countries. Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016 © Mayo Foundation for Medical Education and Research 2014 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Mayo Clinic, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to Scientific Publications, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905. You must not circulate this work in any other form and you must impose this same condition on any acquirer. Library of Congress Cataloging-in-Publication Data Arrhythmias in women : diagnosis and management / edited by Yong-Mei Cha, Margaret A. Lloyd, Ulrika M. Birgersdotter-Green. p. ; cm.—(Mayo Clinic scientific press) Includes bibliographical references. ISBN 978–0–19–932197–1 (alk. paper) I. Cha, Yong-Mei, editor of compilation. II. Lloyd, Margaret A., editor of compilation. III. Birgersdotter-Green, Ulrika M., editor of compilation. IV. Series: Mayo Clinic scientific press (Series) [DNLM: 1. Arrhythmias, Cardiac—diagnosis. 2. Arrhythmias, Cardiac—therapy. 3. Women’s Health. WG 330] RC685.A65 616.1′280082—dc23 2013047125 Mayo Foundation does not endorse any particular products or services, and the reference to any products or services in this book is for informational purposes only and should not be taken as an endorsement by the authors or Mayo Foundation. Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, express or implied, with respect to the contents of the publication. This book should not be relied on apart from the advice of a qualified health care provider. The authors, editors, and publisher have exerted efforts to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, readers are urged to check the package insert for each drug for any change in indications and dosage and for added wordings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have US Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care providers to ascertain the FDA status of each drug or device planned for use in their clinical practice. 1 3 5 7 9 8 6 4 2 Printed in China on acid-free paper With this book, the editors wish to honor Doris J. W. Escher, MD, Nora F. Goldschlager, MD, Anne B. Curtis, MD, and Anne M. Gillis, MD—past presidents of the North American Society of Pacing and Electrophysiology and its successor, the Heart Rhythm Society—who have provided inspirational leadership with integrity, compassion, and good cheer. Foreword SEX MATTERS Sex matters—more and differently than was ever believed, especially as it relates to cardiovascular disease. But the fact that sex should be considered when car- ing for patients with arrhythmias is a relatively new concept and one for which there is a substantial gap between its recognition and the realization of health benefits. The Institute of Medicine in its landmark 2001 report, Exploring the Biological Contributions to Human Health: Does Sex Matter?, answered its own question with a resounding yes; sex must be taken into consideration “from womb to tomb” when it comes to the science of medicine and caring for women and men. Evidence of important sex differences affecting every aspect of cardiovascu- lar disease is mounting, and arrhythmias are no exception. Aside from the obvi- ous differences associated with gonadal hormones, differences in natural history, symptoms, accuracy of diagnostic tests, response to therapy, prevalence and rela- tive risk of risk factors, and social and behavioral issues have been identified, each of which has the potential to impact treatment and outcomes. Therein is the challenge. While discoveries and advances in the diagnosis and treatment of heart disease have come at apparent lightning speed over the past few decades, compared with men, women have not experienced the same decrease in cardiovascular mortality, and until the past decade, they were largely ignored as a population worthy of separate study or consideration. Previously, women and their physicians were told that heart disease did not develop in women, or vii viii FOREWORD if it did, it did not develop until women were elderly. When and if women ulti- mately received a diagnosis of heart disease, it was not felt to be as serious a health threat as it was in men. Women’s symptoms are sometimes challenging to address, and both women and their physicians can be quick to attribute manifestations of cardiovascular disease to menopause, mental health issues, or aging. In stud- ies of several arrhythmias and related conditions, compared with men, women have received a diagnosis and treatment at a more advanced stage of disease and received delayed or less-intensive therapy. These practices have likely contributed to women’s higher cardiovascular-related total mortality. Compounding these historical practices, physicians and patients have been faced with insufficient sex-specific scientific evidence to confidently manage women with cardiac arrhythmias. The lack of relevant cardiovascular research on women and inadequate enrollment of women in clinical trials, compounded by the absence of sex-specific data analysis or reporting, have led to a substan- tial and persistent sex-based knowledge gap in care for women with suspected or diagnosed arrhythmias. These care and knowledge gaps include key issues such as symptoms and the effects, side effects, risks, and benefits of commonly used diagnostic tests and therapies. Without sex-specific evidence to guide them, clinicians are left with the option of either withholding therapies from women when there is no sex-specific proof of benefit, or alternatively, treating women in a “sex-blind” manner using data from studies on men as a means to guide their treatment. Neither approach is evidence-based, and both have the potential for harm, overtreatment, or undertreatment. While cardiac arrhythmias continue to be responsible for substantial morbid- ity and mortality in women, progress is being made. Over the past decade there has been exponential growth in the availability of evidence-based and sex-specific data and strategies for optimal arrhythmia diagnosis, risk assessment and modifi- cation, and clinical management. Many of these discoveries have informed impor- tant changes in recommended practice and have affirmed the need for a sex-based approach to arrhythmia management in order to optimize practice and outcomes for women. An important next step in bridging the sex gap in care is to provide to medical practitioners and the women they care for a practical, comprehensive, and acces- sible source of this new information. For that reason, I celebrate the publication Foreword ix of this superb textbook, in which the very experts who have made the most sig- nificant contributions to the field of electrophysiology in women synthesize their knowledge into a practical work that will be a valuable reference for anyone who provides medical care to women. On behalf of women who are living with or are at risk for heart disease, I wish to thank the editors and authors for providing this resource to the health care community. Sharonne N. Hayes, MD Consultant, Division of Cardiovascular Diseases Founder, Women’s Heart Clinic Professor of Medicine, Mayo Clinic College of Medicine Mayo Clinic, Rochester Minnesota

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Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.