Device Therapy in Heart Failure

Cover......Page p0001.djvu
Front......Page p0002.djvu
Preface......Page p0006.djvu
Contents......Page p0007.djvu
Contributors......Page p0008.djvu
1 Pathophysiology of Heart Failure......Page p0010.djvu
1.1 Normal Cardiac Function......Page p0011.djvu
1.2 The Frank--Starling Mechanism in HF......Page p0012.djvu
1.3 Chronic Ventricular Remodeling......Page p0013.djvu
1.3.1 Myocardial Hypertrophy and Remodeling......Page p0014.djvu
1.4 Neurohormones in Heart Failure......Page p0017.djvu
1.4.1 The Sympathetic Nervous System......Page p0018.djvu
1.4.2 The Renin--Angiotensin--Aldosterone System......Page p0019.djvu
1.4.4 Endothelin......Page p0021.djvu
1.4.5 Nitric Oxide......Page p0022.djvu
1.4.6 Natriuretic Peptides......Page p0023.djvu
2 Molecular Mechanisms Affecting Cardiac Arrhythmogenesis......Page p0024.djvu
2.1 Calcium Cycling in Normal and Failing Cardiac Myocytes......Page p0025.djvu
2.2 Prolongation of the Cardiac Action Potential......Page p0027.djvu
2.3 Abnormalities in Conduction......Page p0028.djvu
4 Conclusions......Page p0029.djvu
1 Introduction......Page p0037.djvu
2 Digitalis Glycosides......Page p0038.djvu
3 Diuretic Therapy for Heart Failure......Page p0041.djvu
4.1 Angiotensin-Converting Enzyme (ACE) Inhibitors......Page p0045.djvu
4.2 Angiotensin Receptor Blockers (ARBs)......Page p0050.djvu
4.3 Other Vasodilators......Page p0055.djvu
5 Aldosterone Receptor Antagonists......Page p0057.djvu
6 Beta-Adrenergic Receptor Blockers......Page p0059.djvu
7 Anticoagulation......Page p0064.djvu
8 Statins......Page p0065.djvu
9 Medications to Avoid......Page p0066.djvu
10 Consensus Statements......Page p0068.djvu
3  Device Trials in Chronic Heart Failure: Implications of Trial Design......Page p0077.djvu
2.1 The Question......Page p0078.djvu
3.1 The Endpoint: Symptom Relief in Acute DecompensatedHeart Failure......Page p0082.djvu
3.2 The Endpoint: Functional Improvement and Quality of Life......Page p0083.djvu
4 Impact of Trial Design on Outcome......Page p0091.djvu
6 Conclusions......Page p0093.djvu
4 The FDA Perspective on Heart Failure Devices......Page p0096.djvu
1 Introduction......Page p0097.djvu
2.1 Regulatory Terminology and Submission Types......Page p0098.djvu
2.2 Device Labeling......Page p0102.djvu
2.3 Product Recalls......Page p0103.djvu
3.1 Choosing a Control Group......Page p0104.djvu
3.2 Selecting the Appropriate Endpoints......Page p0106.djvu
3.3 Utilizing Quality Control Measures......Page p0110.djvu
3.5 Gender Bias......Page p0111.djvu
4.1 Cardiac Resynchronization Therapy......Page p0112.djvu
4.2 Ventricular Assist Devices and Total Artificial Hearts......Page p0113.djvu
4.3 Hemodynamic Monitoring Technologies......Page p0117.djvu
5 Role of the Circulatory System Devices Advisory Panel......Page p0118.djvu
6 Interactions with External Stakeholders and Government Partners......Page p0119.djvu
7 Conclusions......Page p0121.djvu
5 Hemodynamic Monitoring in Heart Failure......Page p0125.djvu
2.1 Symptoms......Page p0126.djvu
2.2 Physical Examination......Page p0127.djvu
3 Laboratory Evaluation of Elevated Filling Pressures......Page p0128.djvu
5.1 The Pulmonary Artery Catheter......Page p0130.djvu
5.1.1 Indications for the Use of the Pulmonary Artery Catheter......Page p0131.djvu
5.1.2 Use of the Pulmonary Artery Catheter to \'\'Tailor Therapy\'\' in Heart Failure......Page p0132.djvu
5.1.3 Controversy Surrounding the Use of Pulmonary Artery Catheters......Page p0133.djvu
5.1.4 Safety and Efficacy of the Pulmonary Artery Catheter in Advanced Decompensated Heart Failure: The Escape Trial......Page p0138.djvu
5.1.5 Recommendations for the Use of Pulmonary Artery Catheters in Heart Failure......Page p0139.djvu
5.2 Implantable Hemodynamic Monitors (IHM)......Page p0140.djvu
5.2.1 The Medtronic Chronicle   ®    Implantable Hemodynamic Monitor Design......Page p0141.djvu
5.2.2 Validation of the Chronicle   ®    Implantable Hemodynamic Monitor......Page p0142.djvu
5.2.3 Clinical Trials with the Chronicle   ®    Implantable Hemodynamic Monitor in Heart Failure......Page p0144.djvu
5.3 Other Investigational Implantable Hemodynamic Monitoring Devices......Page p0146.djvu
6 Non-Invasive Methods of Hemodynamic Monitoring......Page p0147.djvu
6.2 Bioimpedance Cardiography......Page p0148.djvu
6.3 Non-invasive Measurement of Left Ventricular End-Diastolic Pressure Based on the Arterial Blood Pressure Response to the Valsalva Maneuver......Page p0153.djvu
7 Summary......Page p0155.djvu
1 Sudden Cardiac Death in Heart Failure......Page p0161.djvu
2.1 Secondary Prevention Trials......Page p0162.djvu
2.2 Primary Prevention Trials......Page p0165.djvu
2.3 Benefit of the ICD in Patients with Advanced Heart Failure......Page p0171.djvu
3.1 Treatment......Page p0177.djvu
3.2 Detection......Page p0180.djvu
3.3.1 P   rogramming       of the    ICD: B   radycardia    P   acing    ......Page p0182.djvu
3.5 Device Malfunction......Page p0183.djvu
4 Conclusions......Page p0184.djvu
7 Cardiac Resynchronization Therapy......Page p0191.djvu
1.1 Context......Page p0192.djvu
1.2 Electrical Timing......Page p0193.djvu
1.3 CRT Compared with Other Methods of Increasing Cardiac Output (Inotropes)......Page p0194.djvu
1.5 LV vs. BiV Pacing......Page p0195.djvu
2.2 Other Imaging Techniques......Page p0196.djvu
3.1 Trials......Page p0197.djvu
3.2 Patient Characteristics/Subsets......Page p0201.djvu
3.3 QRS Morphology......Page p0202.djvu
4.1 Leads and Delivery Systems......Page p0204.djvu
4.2 Technical Considerations......Page p0205.djvu
4.3.2 Maximizing LV Pacing......Page p0207.djvu
4.3.3 Other Diagnostics......Page p0209.djvu
5.1 ECG Patterns......Page p0210.djvu
5.2 AV Optimization......Page p0211.djvu
6 Guidelines......Page p0213.djvu
7 Conclusions......Page p0215.djvu
8 Pacing and Defibrillation for Atrial Arrhythmias......Page p0220.djvu
1 Mechanisms of Atrial Arrhythmias and Interaction with Electrical Pacing......Page p0221.djvu
2 Atrial Fibrillation in Patients with Pacemakers......Page p0222.djvu
3 Diagnosis of Atrial Arrhythmias in Patients with Pacemakers......Page p0224.djvu
4 Alternate Site Atrial Pacing......Page p0226.djvu
5 Pacing Algorithms to Prevent Atrial Fibrillation......Page p0229.djvu
6 Termination of Atrial Arrhythmias: Antitachycardia Pacing and Cardioversion......Page p0231.djvu
7 Conclusions......Page p0233.djvu
1 Atrial Fibrillation  Prevalence and Morbidity......Page p0240.djvu
2.1 Pharmacologic Therapy......Page p0241.djvu
3 Catheter Ablation of Atrial Fibrillation......Page p0242.djvu
3.2 Devices Used for Catheter Ablation of AF......Page p0244.djvu
3.2.1 I   ntracardiac    E   chocardiography    ......Page p0245.djvu
3.2.3 Transseptal Sheaths......Page p0247.djvu
3.2.5 Carto......Page p0249.djvu
3.2.6 EnSite NavX......Page p0252.djvu
3.2.8 Remote Magnetic Catheter Navigation......Page p0254.djvu
3.2.9 Multielectrode Catheters for Electrical Mapping of the Pulmonary Veins......Page p0256.djvu
3.2.10 Ablation Catheters......Page p0258.djvu
4 Conclusion......Page p0262.djvu
1 A Historical Perspective......Page p0267.djvu
2 Balloon Angioplasty......Page p0268.djvu
3 Stenting......Page p0269.djvu
4 Drug-Eluting Stents......Page p0270.djvu
4.1 Cypher Stent......Page p0272.djvu
4.2 TAXUS Stent......Page p0273.djvu
5 The Controversy of Des......Page p0274.djvu
6 Coronary Artery Disease And Heart Failure......Page p0275.djvu
7 No-option Patients......Page p0277.djvu
7.2 Enhanced External Counterpulsation (EECP)......Page p0278.djvu
8 Conclusions......Page p0279.djvu
1 Introduction......Page p0291.djvu
2 Lower Extremity......Page p0292.djvu
2.1 Aortoiliac Disease......Page p0293.djvu
2.2 Femoropopliteal......Page p0295.djvu
2.3 Infrapopliteal......Page p0298.djvu
3 Renal Artery......Page p0299.djvu
4 Carotid Artery......Page p0301.djvu
5 Conclusion ......Page p0303.djvu
12 Percutaneous Management of Valvular Heart Disease......Page p0308.djvu
2.1 Balloon Valvotomy......Page p0309.djvu
2.2.3 Clinical Outcome of Percutaneous Pulmonary Valve Implantation......Page p0310.djvu
2.2.4 Limitations of the Approach and Future Directions......Page p0313.djvu
3.2 Indications for Intervention......Page p0314.djvu
3.3 Balloon Aortic Valvuloplasty (BAV)......Page p0315.djvu
3.4.1 Aortic Percutaneous Valve Designs and Preliminary Clinical Results......Page p0316.djvu
3.4.2 Limitations and Future Direction......Page p0319.djvu
4.1 Mitral Stenosis and Valvuloplasty......Page p0321.djvu
4.2.1 Primary Versus Secondary Mitral Regurgitation and Indications for Intervention......Page p0322.djvu
4.2.3 Approaches to Repair of Primary Valvular Pathology......Page p0323.djvu
5 Percutaneous Atrioventricular Valve Replacement  Preliminary Results......Page p0332.djvu
7 Future Directions and Challenges......Page p0333.djvu
13 Ventricular Assist Dvices and Total Artificial Hearts......Page p0341.djvu
1. Background......Page p0342.djvu
2. Physiological Considerations......Page p0343.djvu
3. The Devices......Page p0345.djvu
4. Short-Term Devices......Page p0346.djvu
5. Long-Term Devices......Page p0349.djvu
6. Second-Generation Devices......Page p0352.djvu
7. Third-Generation Devices......Page p0354.djvu
8. Total Artificial Hearts......Page p0355.djvu
9. Patient and Device Selection......Page p0356.djvu
10. Clinical Experiences......Page p0357.djvu
11. Conclusions......Page p0368.djvu
1 Introduction......Page p0374.djvu
2 History of Left Ventricular Remodeling Surgery......Page p0377.djvu
3 Left Ventricular Device Therapies......Page p0378.djvu
3.2 Socks......Page p0379.djvu
3.3 Cardiac Support Devices......Page p0380.djvu
3.4 Mitral Valve Interventions......Page p0382.djvu
4 A Regulatory Perspective......Page p0385.djvu
5 Conclusions......Page p0386.djvu
Subject Index......Page p0389.djvu