New Advances in Heart Failure and Atrial Fibrillation: Proceedings of the Mediterranean Cardiology Meeting (Taormina, April 10–12, 2003)

429 Pages·2003·7.12 MB·English

by  A. Rossillo

To Raffaeleand Cettina,
myfather and mother
with deep gratitude
for their life's teachings
Springer-Verlag Italia SrL
New Advances in Heart
Failure and Atrial
Fibrillation
Edited by
Michele Gulizia
Proceedingsofthe
MediterraneanCardiologyMeeting
(Taormina,April 10-12,2003)
Springer
MICHELE GULIZIA, MD
Chief of Cardiology Division
S. Luigi -S. Curro Hospital
Viale A. Fleming, 24
95126 -Catania, Italy
© Springer-V erlag Italia 2003
Originally published by Springer-Verlag Italia, Milan in 2003
Softcover reprint ofthe hardcover lst edition 2003
ISBN 978-88-470-2169-3 ISBN 978-88-470-2087-0 (eBook)
DOI 10.1007/978-88-470-2087-0
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Preface
Clinicalpractice isevolvingatarapid pace.In no placemoreso than in the field
ofcardiology,hasthischangebeensoevident.
Heart Failure and Atrial Fibrillation are two emerging pathologies where
manyinvestigators areaddressing their researches.Less than 10years ago,Heart
Failurewas consideredonlyofrelevance to internists and Atrial Fibrillation as a
common benign arrhythmia. Today, the diffusion of Heart Failure and Atrial
Fibrillation amongst the population represents one ofthe major public health
problemsatthebeginningofthethirdmillennium.
Theneedtohaveastateoftheartabouttheepidemiology,physiopathological
and electrogenetic mechanisms, diagnosis, pharmacological or electrical treat
ment, prognosis,in- and outhospital management,organizational and economi
cal implications ofHeart Failure and Atrial Fibrillation inspired us to organize a
biannualinternationalmeeting.
This book contains the Proceedings of the Mediterranean Cardiology
Meeting heldin Taormina -Italy,atVilla Diodoro on 10th-12thApril 2003.Even
though this is the first meeting, it boasts the participation ofmany nationally
and internationally renowned speakers in the field of Heart Failure and Atrial
Fibrillationwhowillinteractactivelywiththedelegates.
The book is divided into seven sections, each dedicated to a different topic:
atrialfibrillation and heartfailure: thechicken-eggdilemma;in- and outhospital
managementofheartfailure patients;currenttrendsandtreatmentsofatrialfib
rillation and flutter; 10 years ofbiventricular pacing in congestive heart failure;
atrialarrhythmias:drugs,devicesorablationfor the preventionandtreatmentof
the recurrences; new approaches in electrical treatment and management of
heart failure patients and,last but not least,the role ofICD in the prevention of
sudden death in heart failure, the brilliant lecture of my best friend Antonio
Ravielewho inspiredandincitedmein thefield ofarrhythmology.
This book is aimed at providingthe latest information about the most recent
and modern aspects concerningthe above mentioned pathologies.Itis intended
not only for cardiologists, but also for those who are actively interested in the
evidence-based approach to clinical care, such as internists, first aid clinicians,
fellows,students,nursesandtechnicians.Itmayalsobehelpfulfor thoseengaged
in the development and coordination of research strategies in biological engi-
VI Preface
neering, industry and regulatory affairs, who have a high interest in the whole
managementofthesecardiacpathologies.
AFaculty,selectedamong the Italian andforeign leadingexperts in the field,
providedthe highest qualityofthis volume.In these last years,the publications
ofmanyofthemcontributed to myscientific development and influencedmany
ofmyprofessionalconsiderations and decisions.Iam reallymostindebtedto all
theseAuthorswho havededicatedinvaluabletimeandeffortswithoutwhich this
bookwouldnothavebeencompleted.
I also wish to thank the Springer-Verlag staff and in particular Donatella
Rizza, Executive Editor, who has facilitated the publication ofthis book at the
start ofthe Mediterranean CardiologyMeeting and who has kindly assisted me
throughout. Special and deep words of thanks are addressed to Rita Reggiani,
professional, tireless and very kind Project Leader ofAdria Congrex,who has
helped and supported me in the optimal organization of this International
Meeting,togetherwithherstaffmembersSaraandSilvana.
Icannotforget to acknowledgethe roleofmytwoteachersAntonioCircoand
SalvatoreMangiameliwhoencouragedmypassionforcardiologyandparticular
lyforarrhythmologyandcardiostimulation.
Also,Iwouldlike to thank mycolleagues Cacia,Francese,Raciti,Rubino and
all the nursing staffofmyDivision at the"S.Luigi-S.Curro"HospitalofCatania
for theiractivecollaboration andsupportduringtheseyearsofworkandfor the
organizationofthisMeeting.
Finally, a special mention for my wife Luisa and my daughters Alice and
Raffaella. I am especially and deeply grateful to them. Without their love and
patience I could not have spent so many nights and weekends preparing the
Meetingandthisvolume.
MicheleGulizia
Table ofContents
LECTURE
SuddenDeathPreventioninHeartFailure:WhatRoleforICD? 3
A.Rossillo,A.Raviele
ATRIALFIBRILLATIONANDHEARTFAILURE:
THECHICKEN-EGGDILEMMA
IncidenceandDiagnosisofAtrialFibrillationinPatients
with HeartFailure 9
A.Curnis,G.Mascioli,L.Bontempi,M.Metra,L.DeiCas
AblationofAtrialFibrillationinChronicHeartFailurePatients:
FactsorFancy? ................................................... 13
F.Gaita,S.Grossi,R.Riccardi,C.Giustetto,E.Caruzzo,F.Bianchi,
L.Vivalda,E.Richiardi,G.Pistis
DrugsandAblationinPatientswithAtrialFibrillationandHeartFailure 17
A.Bonso,A.Rossillo,R.Valente,A.Raviele
DrugsandPacemakersinPatientswithAtrialFibrillation
andHeartFailure ................................................. 23
R.M.Polimeni,G.Meduri,A.Amato
CanVentricularResynchronizationReduceAtrialFibrillationRecurrences? 27
M.G.Bongiorni,G.Giannola,E.Soldati,G.Arena,E.Hoffmann,
M.Mariani
ManagementofAtrialFibrillationSuppressioninAF-HF
ComorbidityTherapy(MASCOT)Trial 33
M.G.Bongiorni,G.Giannola,G.Arena,E.Soldati,L.Padeletti,
A.Puglisi,A.Curnis,S.Favale,A.Carboni,E.Hoffmann,M.Mariani
Risk-StratificationinHeartFailurePatientswithVaryingDiseaseSeverity 39
I.Can,K.Aytemir,A.Oto
VIII TableofContents
RiskStratificationinAtrialFibrillationandCongestiveHeartFailure .... 61
G.Boriani,C.Camanini,A.Branzi,C.Rapezzi
PhysiopathologyofSuddenCardiac Death........................... 65
S.Nodari,M.Metra,N.Pezzali,C.Giovannelli,G.Milesi,L.DeiCas
DrugsandImplantableCardioverterDefibrillatorsinPatientswithAtrial
FibrillationandHeartFailure 75
P.Dini,F.Laurenzi
NewICDPerspectivesintheCongestiveHeartFailurePatient 81
H.-J.Trappe
TypeofTherapyandQualityofLifeinAtrialFibrillation............... 93
B.Liideritz
IN-ANDOUTHOSPITALMANAGEMENTOFHEARTFAILUREPATIENTS
Non-InvasiveEvaluationandEarlyTreatmentofHeartFailurePatients..... 101
M.Scherillo,F.ScottodiUccio,F.Vigorito,D.Miceli,M.G.Tesorio,
V.Monda,R.Calabro
p-
ACE-Inhibitors, Blockers,Spironolactone:
DoWeNeedManyMoreDrugstoTreatChronicHeartFailure? 117
G.Sinagra,G.Sabbadini,A.Perkan,S.Rakar,F.Longaro,L.Salvatore,
G.Lardieri,A.DiLenarda
TheProblemofRecreationalSportinPatientswith
MildtoModerateHeartFailure..................................... 123
F.Furlanello,F.Terrasi,A.Bertoldi,R.Cappato
WirelessHomeMonitoringinPermanentCardiacStimulation:
isitEspeciallySuitableinCongestiveHeartFailurePatients? 131
D.Igidbashian,M.Barbiero,E.Visentin,M.Gemelli
ElectromagneticInterferenceinBiventricularand/or
ICDPacedPatients................................................ 139
M.Santomauro,L.Ottaviano,D.DaPrato,A.Borrelli, M.Chiariello
OrganizationalandEconomicAspectsoftheManagement
ofCongestiveHeartFailure 151
R.F.E.Pedretti
TableofContents IX
CURRENTTRENDSANDTREATMENTS
OFATRIALFIBRILLATIONANDFLUTTER
AtrialFibrillation:NewInsightsintoElectrophysiologicMechanisms 157
E.N.Prystowsky,B.J.Padanilam
PharmacologicalTherapyofAtrial FibrillationandFlutter:
AdvancesandLimitationsofSpecificAntiarrhythmicDrugs. ........... 167
P.Alboni
Rhythm ControlVersus Rate Control:
UnresolvedRiddleinDailyClinicalPractice 173
F.Gaita,S.Grossi,R.Riccardi,C.Giustetto,E.Caruzzo,F.Bianchi,
1.Vivalda,E.Richiardi,G.Pistis
TheAFFIRMStudyandItsImplicationsforthePharmacological
TreatmentofAtrialFibrillation 179
A.Capucci,G.Q.Villani
AmiodaroneintheTreatmentofAtrialFibrillation:
NewPerspectivesfrom ClinicalTrials. ............................... 183
G.M.DeFerrari,B.Petracci
DrugsasPretreatmentbeforeElectricalCardioversion................. 191
G.1.Botto,M.Luzi,A.Sagone
AtrialFibrillationandFlutter:the Latestfrom thePlanetofRight
RadiofrequencyCatheterAblation 197
M.Lunati,G.Magenta,G.Cattafi,R.Vecchi,M.Paolucci,T.DiCamillo
ImpactofLocaLisaonAblationManagement ......................... 201
F.Atienza,J.Almendral,A.Arenal,E.G.Torrecilla,J.Jimenez,M.Ortiz
PacinginAtrialFibrillation:Therapiesfor RhythmControl 205
A.Carboni
PacinginAtrialFibrillation:Therapiesfor RateControl. ............... 209
A.Schuchert
DeviceTherapyforAtrialArrhythmias:
LatestTopicsfrom theAT500ItalianRegistry. ........................ 215
G.1.Botto,M.Santini,1.Padeletti,A.Sagone,G.Boriani,G.Inama,
A.Capucci,M.Gulizia,P.DellaBella,F.Solimene,M.Vimercati,M.Disertori,
onbehalfoftheAT500ItalianRegistryInvestigators
x TableofContents
AntiarrhythmicAgentsinAtrialFibrillation:
ANewRoleintheContextofaHybridApproach? ..................... 223
G.Boriani,M.Biffi,C.Martignani,C.Camanini,C.Valzania,
I.Diemberger,C.Greco,G.Cakagnini,P.Bartolini,A.Branzi
10YEARSOFBIVENTRICULARPACINGINCONGESTIVEHEARTFAILURE
TheElectrophysiologicalAspect 229
E.Bertaglia
PharmacologicalTrialsonHeartFailure:
WhatCanWeTranslateintoDailyClinicalPractice? 233
G.Fabbri,A.P.Maggioni
SelectionofPatientsforCardiacResynchronizationTherapy 237
D.Gras,J.P.Cebron,P.BruneI,B.Leurent,Y.Banus
ThePerspectiveoftheEmergencyDepartment 243
L.Zulli
VentricularPacinginCongestiveHeartFailure:
TheRoleoftheInternist. .......................................... 247
M.Pagani,F.LoPresti
RoleofElectricalTherapyinPatientswithLeftVentricular
Dysfunction:TheClinicalCardiologist'sExperience ................... 249
F.Nacci,F.Fino,V.F.Napoli.S.Favale
EchocardiographyintheIdentificationofResponders:
TheNovelRoleofTissueDopplerImagingandStrainImaging 257
S.Carerj,C.Zito
Howto FollowResynchronizedPacedPatients ........................ 263
G.DeMartino,T.Chiriaco,G.Pelargonio,A.DelIoRusso,T.Sanna,
C.Ierardi,D.Gabrielli,L.Messano,P.Zecchi,F.Bellocci
WhichCongestiveHeartFailurePatientNeedstobeStudied
inHaemodynamicLaboratoryandWhen? 267
C.Vassanelli,G.Menegatti
BiventricularPacingwithICDBackup:ALuxuryoraNecessity? 277
S.Nisam,C.Duby