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Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia

Sudden cardiac death due to arrhythmias, such as atrial fibrillation or ventricular tachycardia, account for 15–20% of all deaths. Myocardial infarction increases the burden of atrial fibrillation and ventricular tachycardia by structural and electrical remodeling of the heart. The current managemen...

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Autores principales: Mircea, Andrei Alexandru, Rusu, Mihaela, Liehn, Elisa Anamaria, Bucur, Octavian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604396/
https://www.ncbi.nlm.nih.gov/pubmed/36293490
http://dx.doi.org/10.3390/ijms232012612
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author Mircea, Andrei Alexandru
Rusu, Mihaela
Liehn, Elisa Anamaria
Bucur, Octavian
author_facet Mircea, Andrei Alexandru
Rusu, Mihaela
Liehn, Elisa Anamaria
Bucur, Octavian
author_sort Mircea, Andrei Alexandru
collection PubMed
description Sudden cardiac death due to arrhythmias, such as atrial fibrillation or ventricular tachycardia, account for 15–20% of all deaths. Myocardial infarction increases the burden of atrial fibrillation and ventricular tachycardia by structural and electrical remodeling of the heart. The current management of new-onset atrial fibrillation includes electric cardioversion with very high conversion rates and pharmacologic cardioversion, with less a than 50% conversion rate. If atrial fibrillation cannot be converted, the focus becomes the control of the symptoms ensuring a constant rhythm and rate control, without considering other contributory factors such as autonomic imbalance. Recently, a huge success was obtained by developing ablation techniques or addressing the vagal nerve stimulation. On the other hand, ventricular tachycardia is more sensitive to drug therapies. However, in cases of non-responsiveness to drugs, the usual therapeutic choice is represented by stereotactic ablative therapy or catheter ablation. This review focuses on these newly developed strategies for treatment of arrhythmias in clinical practice, specifically on vernakalant and low-level tragus stimulation for atrial fibrillation and stereotactic ablative therapy for drug-refractory ventricular tachycardia. These therapies are important for the significant improvement of the management of atrial fibrillation and ventricular tachycardia, providing: (1) a safer profile than current therapies, (2) higher success rate than current solutions, (3) low cost of delivery.
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spelling pubmed-96043962022-10-27 Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia Mircea, Andrei Alexandru Rusu, Mihaela Liehn, Elisa Anamaria Bucur, Octavian Int J Mol Sci Review Sudden cardiac death due to arrhythmias, such as atrial fibrillation or ventricular tachycardia, account for 15–20% of all deaths. Myocardial infarction increases the burden of atrial fibrillation and ventricular tachycardia by structural and electrical remodeling of the heart. The current management of new-onset atrial fibrillation includes electric cardioversion with very high conversion rates and pharmacologic cardioversion, with less a than 50% conversion rate. If atrial fibrillation cannot be converted, the focus becomes the control of the symptoms ensuring a constant rhythm and rate control, without considering other contributory factors such as autonomic imbalance. Recently, a huge success was obtained by developing ablation techniques or addressing the vagal nerve stimulation. On the other hand, ventricular tachycardia is more sensitive to drug therapies. However, in cases of non-responsiveness to drugs, the usual therapeutic choice is represented by stereotactic ablative therapy or catheter ablation. This review focuses on these newly developed strategies for treatment of arrhythmias in clinical practice, specifically on vernakalant and low-level tragus stimulation for atrial fibrillation and stereotactic ablative therapy for drug-refractory ventricular tachycardia. These therapies are important for the significant improvement of the management of atrial fibrillation and ventricular tachycardia, providing: (1) a safer profile than current therapies, (2) higher success rate than current solutions, (3) low cost of delivery. MDPI 2022-10-20 /pmc/articles/PMC9604396/ /pubmed/36293490 http://dx.doi.org/10.3390/ijms232012612 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mircea, Andrei Alexandru
Rusu, Mihaela
Liehn, Elisa Anamaria
Bucur, Octavian
Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia
title Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia
title_full Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia
title_fullStr Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia
title_full_unstemmed Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia
title_short Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia
title_sort promising therapies for atrial fibrillation and ventricular tachycardia
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604396/
https://www.ncbi.nlm.nih.gov/pubmed/36293490
http://dx.doi.org/10.3390/ijms232012612
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