Article (Scientific journals)
Arrhythmias in Patients With Valvular Heart Disease: Gaps in Knowledge and the Way Forward.
Kubala, Maciej; de Chillou, Christian; Bohbot, Yohann et al.
2022In Frontiers in Cardiovascular Medicine, 9, p. 792559
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Keywords :
aortic stenosis; arrhythmic mitral valve prolapse; atrial arrhythmia; postoperative atrial fibrillation; valvular heart disease; ventricular arrhythmia
Abstract :
[en] The prevalence of both organic valvular heart disease (VHD) and cardiac arrhythmias is high in the general population, and their coexistence is common. Both VHD and arrhythmias in the elderly lead to an elevated risk of hospitalization and use of health services. However, the relationships of the two conditions is not fully understood and our understanding of their coexistence in terms of contemporary management and prognosis is still limited. VHD-induced left ventricular dysfunction/hypertrophy and left atrial dilation lead to both atrial and ventricular arrhythmias. On the other hand, arrhythmias can be considered as an independent condition resulting from a coexisting ischemic or non-ischemic substrate or idiopathic ectopy. Both atrial and ventricular VHD-induced arrhythmias may contribute to clinical worsening and be a turning point in the natural history of VHD. Symptoms developed in patients with VHD are not specific and may be attributable to hemodynamical consequences of valve disease but also to other cardiac conditions including arrhythmias which are notably prevalent in this population. The issue how to distinguish symptoms related to VHD from those related to atrial fibrillation (AF) during decision making process remains challenging. Moreover, AF is a traditional limit of echocardiography and an important source of errors in assessment of the severity of VHD. Despite recent progress in understanding the pathophysiology and prognosis of postoperative AF, many questions remain regarding its prevention and management. Furthermore, life-threatening ventricular arrhythmias can predispose patients with VHD to sudden cardiac death. Evidence for a putative link between arrhythmias and outcome in VHD is growing but available data on targeted therapies for VHD-related arrhythmias, including monitoring and catheter ablation, is scarce. Despite growing evidences, more research focused on the prognosis and optimal management of VHD-related arrhythmias is still required. We aimed to review the current evidence and identify gaps in knowledge about the prevalence, prognostic considerations, and treatment of atrial and ventricular arrhythmias in common subtypes of organic VHD.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Kubala, Maciej;  Department of Cardiology, Amiens University Hospital, Amiens, France. ; Jules Verne University of Picardie, Amiens, France.
de Chillou, Christian;  Department of Cardiology, University Hospital Nancy, Vandœuvre lès Nancy, France.
Bohbot, Yohann;  Department of Cardiology, Amiens University Hospital, Amiens, France. ; Jules Verne University of Picardie, Amiens, France.
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Enriquez-Sarano, Maurice;  Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic,
Tribouilloy, Christophe;  Department of Cardiology, Amiens University Hospital, Amiens, France. ; Jules Verne University of Picardie, Amiens, France.
Language :
English
Title :
Arrhythmias in Patients With Valvular Heart Disease: Gaps in Knowledge and the Way Forward.
Publication date :
2022
Journal title :
Frontiers in Cardiovascular Medicine
eISSN :
2297-055X
Publisher :
Frontiers Research Foundation, Lausanne, Ch
Volume :
9
Pages :
792559
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright © 2022 Kubala, de Chillou, Bohbot, Lancellotti, Enriquez-Sarano and Tribouilloy.
Available on ORBi :
since 18 May 2022

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