German Cardiac Society Working Group on Cellular Electrophysiology state-of-the-art paper: impact of molecular mechanisms on clinical arrhythmia management

Autor: Andreas Goette, Jens Kockskämper, Matthias Hammwöhner, Jordi Heijman, Katja E. Odening, Larissa Fabritz, Reza Wakili, Dierk Thomas, Niels Voigt, Dominik Linz, Patrick A. Schweizer, Torsten Christ
Rok vydání: 2018
Předmět:
medicine.medical_treatment
Medizin
Psychological intervention
Action Potentials
Arrhythmogenesis
030204 cardiovascular system & hematology
LONG-QT
Ion Channels
0302 clinical medicine
Heart Rate
030212 general & internal medicine
III ANTIARRHYTHMIC AGENT
ACTION-POTENTIAL DURATION
Cardiac electrophysiology
Atrial fibrillation
General Medicine
Patient management
Phenotype
cardiovascular system
Cardiology
NODE DYSFUNCTION
Cardiology and Cardiovascular Medicine
PLURIPOTENT STEM-CELLS
Anti-Arrhythmia Agents
medicine.medical_specialty
Cellular electrophysiology
HEART-RATE
RENAL DENERVATION
Catheter ablation
Rhythm control
BRUGADA-SYNDROME
Pathophysiology
Unmet needs
03 medical and health sciences
Quality of life (healthcare)
Heart Conduction System
Internal medicine
medicine
Animals
Humans
Genetic Predisposition to Disease
Intensive care medicine
CONDUCTION SYSTEM DISEASE
VENTRICULAR-ARRHYTHMIAS
business.industry
Arrhythmias
Cardiac
Genetic Therapy
medicine.disease
ATRIAL-FIBRILLATION
Mutation
business
Antiarrhythmic therapy
Stem Cell Transplantation
Zdroj: Clinical Research in Cardiology. 108:577-599
ISSN: 1861-0692
1861-0684
DOI: 10.1007/s00392-018-1377-1
Popis: Cardiac arrhythmias remain a common challenge and are associated with significant morbidity and mortality. Effective and safe rhythm control strategies are a primary, yet unmet need in everyday clinical practice. Despite significant pharmacological and technological advances, including catheter ablation and device-based therapies, the development of more effective alternatives is of significant interest to increase quality of life and to reduce symptom burden, hospitalizations and mortality. The mechanistic understanding of pathophysiological pathways underlying cardiac arrhythmias has advanced profoundly, opening up novel avenues for mechanism-based therapeutic approaches. Current management of arrhythmias, however, is primarily guided by clinical and demographic characteristics of patient groups as opposed to individual, patient-specific mechanisms and pheno-/genotyping. With this state-of-the-art paper, the Working Group on Cellular Electrophysiology of the German Cardiac Society aims to close the gap between advanced molecular understanding and clinical decision-making in cardiac electrophysiology. The significance of cellular electrophysiological findings for clinical arrhythmia management constitutes the main focus of this document. Clinically relevant knowledge of pathophysiological pathways of arrhythmias and cellular mechanisms of antiarrhythmic interventions are summarized. Furthermore, the specific molecular background for the initiation and perpetuation of atrial and ventricular arrhythmias and mechanism-based strategies for therapeutic interventions are highlighted. Current "hot topics" in atrial fibrillation are critically appraised. Finally, the establishment and support of cellular and translational electrophysiology programs in clinical rhythmology departments is called for to improve basic-science-guided patient management.
Databáze: OpenAIRE
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