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, A. Raviele (auth.), Michele Gulizia MD (eds.)

To Raffaele and Cettina,
my father 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
Proceedings of the
Mediterranean Cardiology Meeting
(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
Clinical practice is evolving at a rapid pace. In no place more so than in the field
of cardiology, has this change been so evident.
Heart Failure and Atrial Fibrillation are two emerging pathologies where
many investigators are addressing their researches. Less than 10 years ago, Heart
Failure was considered only of relevance to internists and Atrial Fibrillation as a
common benign arrhythmia. Today, the diffusion of Heart Failure and Atrial
Fibrillation amongst the population represents one of the major public health
problems at the beginning of the third millennium.
The need to have a state of the art about the epidemiology, physiopathological
and electrogenetic mechanisms, diagnosis, pharmacological or electrical treat-
ment, prognosis, in- and outhospital management, organizational and economi-
cal implications of Heart Failure and Atrial Fibrillation inspired us to organize a
biannual international meeting.
This book contains the Proceedings of the Mediterranean Cardiology
Meeting held in Taormina - Italy, at Villa Diodoro on 10th-12th April 2003. Even
though this is the first meeting, it boasts the participation of many nationally
and internationally renowned speakers in the field of Heart Failure and Atrial
Fibrillation who will interact actively with the delegates.
The book is divided into seven sections, each dedicated to a different topic:
atrial fibrillation and heart failure: the chicken-egg dilemma; in- and outhospital
management of heart failure patients; current trends and treatments of atrial fib-
rillation and flutter; 10 years of biventricular pacing in congestive heart failure;
atrial arrhythmias: drugs, devices or ablation for the prevention and treatment of
the recurrences; new approaches in electrical treatment and management of
heart failure patients and, last but not least, the role of ICD in the prevention of
sudden death in heart failure, the brilliant lecture of my best friend Antonio
Raviele who inspired and incited me in the field of arrhythmology.
This book is aimed at providing the latest information about the most recent
and modern aspects concerning the above mentioned pathologies. It is 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, nurses and technicians. It may also be helpful for those engaged
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
management of these cardiac pathologies.
A Faculty, selected among the Italian and foreign leading experts in the field,
provided the highest quality of this volume. In these last years, the publications
of many of them contributed to my scientific development and influenced many
of my professional considerations and decisions. I am really most indebted to all
these Authors who have dedicated invaluable time and efforts without which this
book would not have been completed.
I also wish to thank the Springer-Verlag staff and in particular Donatella
Rizza, Executive Editor, who has facilitated the publication of this book at the
start of the Mediterranean Cardiology Meeting 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 of Adria Congrex, who has
helped and supported me in the optimal organization of this International
Meeting, together with her staff members Sara and Silvana.
I cannot forget to acknowledge the role of my two teachers Antonio Circo and
Salvatore Mangiameli who encouraged my passion for cardiology and particular-
ly for arrhythmology and cardiostimulation.
Also, I would like to thank my colleagues Cacia, Francese, Raciti, Rubino and
all the nursing staff of my Division at the "S. Luigi-S. Curro" Hospital of Catania
for their active collaboration and support during these years of work and for the
organization of this Meeting.
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
Meeting and this volume.
Michele Gulizia
Table of Contents
LECTURE
Sudden Death Prevention in Heart Failure: What Role for ICD? 3
A. Rossillo, A. Raviele
ATRIAL FIBRILLATION AND HEART FAILURE:
THE CHICKEN-EGG DILEMMA
Incidence and Diagnosis of Atrial Fibrillation in Patients
with Heart Failure 9
A.Curnis, G. Mascioli, L. Bontempi, M. Metra, L. Dei Cas
Ablation of Atrial Fibrillation in Chronic Heart Failure Patients:
Facts or Fancy? .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
F. Gaita, S. Grossi, R. Riccardi, C. Giustetto, E. Caruzzo, F. Bianchi,
L. Vivalda, E. Richiardi, G. Pistis
Drugs and Ablation in Patients with Atrial Fibrillation and Heart Failure 17
A. Bonso, A. Rossillo, R. Valente, A. Raviele
Drugs and Pacemakers in Patients with Atrial Fibrillation
and Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
R.M. Polimeni, G. Meduri, A. Amato
Can Ventricular Resynchronization Reduce Atrial Fibrillation Recurrences? 27
M.G. Bongiorni, G. Giannola, E. Soldati, G. Arena, E. Hoffmann,
M.Mariani
Management of Atrial Fibrillation Suppression in AF-HF
Comorbidity Therapy (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-Stratification in Heart Failure Patients with Varying Disease Severity 39
I. Can, K. Aytemir, A. Oto
VIII Table of Contents
Risk Stratification in Atrial Fibrillation and Congestive Heart Failure .... 61
G. Boriani, C. Camanini, A. Branzi, C. Rapezzi
Physiopathology of Sudden Cardiac Death........................... 65
S. Nodari, M. Metra, N. Pezzali, C. Giovannelli, G. Milesi, L. Dei Cas
Drugs and Implantable Cardioverter Defibrillators in Patients with Atrial
Fibrillation and Heart Failure 75
P. Dini, F. Laurenzi
New ICD Perspectives in the Congestive Heart Failure Patient 81
H.-J. Trappe
Type of Therapy and Quality of Life in Atrial Fibrillation. . . . . . . . . . . . . . . 93
B. Liideritz
IN- AND OUTHOSPITAL MANAGEMENT OF HEART FAILURE PATIENTS
Non-Invasive Evaluation and Early Treatment of Heart Failure Patients. . . . . 101
M. Scherillo, F. Scotto di Uccio, F. Vigorito, D. Miceli, M.G. Tesorio,
V. Monda, R. Calabro
ACE-Inhibitors, p-Blockers, Spironolactone:
Do We Need Many More Drugs to Treat Chronic Heart Failure? 117
G. Sinagra, G. Sabbadini, A. Perkan, S. Rakar, F. Longaro, L. Salvatore,
G. Lardieri, A. Di Lenarda
The Problem of Recreational Sport in Patients with
Mild to Moderate Heart Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
F. Furlanello, F. Terrasi, A. Bertoldi, R. Cappato
Wireless Home Monitoring in Permanent Cardiac Stimulation:
is it Especially Suitable in Congestive Heart Failure Patients? 131
D. Igidbashian, M. Barbiero, E. Visentin, M. Gemelli
Electromagnetic Interference in Biventricular and/or
ICD Paced Patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
M. Santomauro, L. Ottaviano, D. Da Prato, A. Borrelli, M. Chiariello
Organizational and Economic Aspects of the Management
of Congestive Heart Failure 151
R.F.E. Pedretti
Table of Contents IX
CURRENT TRENDS AND TREATMENTS
OF ATRIAL FIBRILLATION AND FLUTTER
Atrial Fibrillation: New Insights into Electrophysiologic Mechanisms 157
E.N. Prystowsky, B.J. Padanilam
Pharmacological Therapy of Atrial Fibrillation and Flutter:
Advances and Limitations of Specific Antiarrhythmic Drugs. . . . . . . . . . . . 167
P.Alboni
Rhythm Control Versus Rate Control:
Unresolved Riddle in Daily Clinical Practice 173
F. Gaita, S. Grossi, R. Riccardi, C. Giustetto, E. Caruzzo, F. Bianchi,
1. Vivalda, E. Richiardi, G. Pistis
The AFFIRM Study and Its Implications for the Pharmacological
Treatment of Atrial Fibrillation 179
A. Capucci, G.Q. Villani
Amiodarone in the Treatment of Atrial Fibrillation:
New Perspectives from Clinical Trials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
G.M. De Ferrari, B. Petracci
Drugs as Pretreatment before Electrical Cardioversion . . . . . . . . . . . . . . . . . 191
G.1. Botto, M. Luzi, A. Sagone
Atrial Fibrillation and Flutter: the Latest from the Planet of Right
Radiofrequency Catheter Ablation 197
M. Lunati, G. Magenta, G. Cattafi, R. Vecchi, M. Paolucci, T. Di Camillo
Impact of LocaLisa on Ablation Management . . . . . . . . . . . . . . . . . . . . . . . . . 201
F. Atienza, J. Almendral, A. Arenal, E.G. Torrecilla, J. Jimenez, M. Ortiz
Pacing in Atrial Fibrillation: Therapies for Rhythm Control 205
A.Carboni
Pacing in Atrial Fibrillation: Therapies for Rate Control. . . . . . . . . . . . . . . . 209
A. Schuchert
Device Therapy for Atrial Arrhythmias:
Latest Topics from the AT500 Italian Registry. . . . . . . . . . . . . . . . . . . . . . . . . 215
G.1. Botto, M. Santini, 1. Padeletti, A. Sagone, G. Boriani, G. Inama,
A. Capucci, M. Gulizia, P. Della Bella, F. Solimene, M. Vimercati, M. Disertori,
on behalf of the AT500 Italian Registry Investigators
x Table ofContents
Antiarrhythmic Agents in Atrial Fibrillation:
A New Role in the Context of a Hybrid Approach? . . . . . . . . . . . . . . . . . . . . . 223
G. Boriani, M. Biffi, C. Martignani, C. Camanini, C. Valzania,
I. Diemberger, C. Greco, G. Cakagnini, P. Bartolini, A. Branzi
10 YEARS OF BIVENTRICULAR PACING IN CONGESTIVE HEART FAILURE
The Electrophysiological Aspect 229
E. Bertaglia
Pharmacological Trials on Heart Failure:
What Can We Translate into Daily Clinical Practice? 233
G. Fabbri, A.P. Maggioni
Selection of Patients for Cardiac Resynchronization Therapy 237
D. Gras, J.P. Cebron, P. BruneI, B. Leurent, Y. Banus
The Perspective of the Emergency Department 243
L.Zulli
Ventricular Pacing in Congestive Heart Failure:
The Role of the Internist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
M. Pagani, F. Lo Presti
Role of Electrical Therapy in Patients with Left Ventricular
Dysfunction: The Clinical Cardiologist's Experience . . . . . . . . . . . . . . . . . . . 249
F. Nacci, F. Fino, V.F. Napoli. S. Favale
Echocardiography in the Identification of Responders:
The Novel Role of Tissue Doppler Imaging and Strain Imaging 257
S. Carerj, C. Zito
How to Follow Resynchronized Paced Patients . . . . . . . . . . . . . . . . . . . . . . . . 263
G. De Martino, T. Chiriaco, G. Pelargonio, A. DelIo Russo, T. Sanna,
C. Ierardi, D. Gabrielli, L. Messano, P. Zecchi, F. Bellocci
Which Congestive Heart Failure Patient Needs to be Studied
in Haemodynamic Laboratory and When? 267
C. Vassanelli, G. Menegatti
Biventricular Pacing with ICD Backup: A Luxury or a Necessity? 277
S. Nisam, C. Duby