1,721,258 research outputs found
A closer look into the complexity of our practice: Outcome research for transvenous temporary cardiac pacing
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Farmaci antiaritmici
No full textUn libro di Farmacologia originale e tutto italiano: i capitoli rispecchiano le linee guida internazionali rispetto ai farmaci e alla terapia farmacologica così come sono interpretate e applicate dalle società scientifiche italiane.
I vari capitoli sono stati assegnati a esperti degli argomenti trattati con formazione di un team autoriale qualificato e variegato. Molta cura si è posta poi nell'opera di revisione affinché il testo risultasse omogeneo.
Il libro è suddiviso in più sezioni. In quella di carattere generale, la prima, che tratta dell'appropriatezza terapeutica, dei farmaci equivalenti, dei biosimilari, della farmacosorveglianza ecc., si offrono al lettore gli strumenti culturali per affrontare temi che sono attuali e dibattuti, tuttavia risulta evidente che gli autori hanno espresso una posizione e non si sono limitati a scrivere un distaccato documento accademico.
Un'attenzione quasi maniacale è stata posta alla lunghezza dei singoli capitoli per fare del volume un'agile opera di riferimento per la farmacologia e non un'enciclopedia. Importanti parti di testo, più adatte all'approfondimento che non allo studio, sono state pubblicate sul sito web che accompagna il volume cartaceo, sul quale si ritrovano anche la bibliografia e i test di autovalutazione.
I test di autovalutazione, pensati per ogni capitolo e disponibili online su my.zanichelli.it, serviranno allo studente per valutare la propria preparazione in modo interattivo
Cardiac resynchronization therapy in the real world: need to focus on implant rates, patient selection, co-morbidities, type of devices, and complications
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Cardiac resynchronization therapy in the real world: need to upgrade outcome research
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Pharmacological cardioversion of atrial fibrillation : current management and treatment options.
No full textAtrial fibrillation (AF) is the most common form of arrhythmia, carrying high social costs. It is usually first seen by general practitioners or in emergency departments. Despite the availability of consensus guidelines, considerable variations exist in treatment practice, especially outside specialised cardiological settings. Cardioversion to sinus rhythm aims to: (i) restore the atrial contribution to ventricular filling/output; (ii) regularise ventricular rate; and (iii) interrupt atrial remodelling. Cardioversion always requires careful assessment of potential proarrhythmic and thromboembolic risks, and this translates into the need to personalise treatment decisions. Among the many clinical variables that affect strategy selection, time from onset is crucial. In selected patients, pharmacological cardioversion of recent-onset AF can be a safely used, feasible and effective approach, even in internal medicine and emergency departments. In most cases of recent-onset AF, pharmacological cardioversion provides an important--and probably more cost effective--alternative to electrical cardioversion, which can then be employed as a second-line therapy for nonresponders. Class IC agents (flecainide or propafenone), which can be safely used in hospitalised patients with recent-onset AF without left ventricular dysfunction, can provide rapid conversion to sinus rhythm after either intravenous administration or oral loading. Although intravenous amiodarone requires longer conversion times, it is still the standard treatment for patients with heart failure. Ibutilide also provides good conversion rates and could be used for AF patients with left ventricular dysfunction (were it not for high costs). For long-lasting AF most pharmacological treatments have only limited efficacy and electrical cardioversion remains the gold standard in this setting. However, a widely used strategy involves pretreatment with amiodarone in the weeks before planned electrical cardioversion: this provides optimal prophylaxis and can sometimes even restore sinus rhythm. Dofetilide may also be capable of restoring sinus rhythm in up to 25-30% of patients and can be used in patients with heart failure. The potential risk of proarrhythmia increases the need for careful therapeutic decision making and management of pharmacological cardioversion. The results of recent trials (AFFIRM [Atrial Fibrillation Follow-up Investigation of Rhythm Management] and RACE [Rate Control versus Electrical Cardioversion for Persistent Atrial Fibrillation]) on rate versus rhythm control strategies in the long term have led to a generalised shift in interest towards rate control. Although carefully designed studies are required to better define the role of pharmacological rhythm control in specific AF settings, this alternative option remains a recommendable strategy for many patients, especially those in acute care
Authors’ Reply to Robert P. Giugliano and Colleagues’ Comment on: “Direct Oral Anticoagulants and Interstitial Lung Disease: Emerging Clues from Pharmacovigilance”
No full textLeadless left ventricular endocardial pacing: A real alternative or a luxury for a few?
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The struggle against infections of cardiac implantable electrical devices: the burden of costs requires new personalized solutions
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