Heart failure (HF) is a complex clinical syndrome characterized by symptoms such as dyspnea and fatigue resulting from any structural or functional impairment of ventricular filling or ejection of blood necessary to meet the body's needs. The etiologies of HF are various, but autonomic dysfunction is the hallmark and contributor to HF's detrimental progression. HF's most common causes are ischemic heart disease, systemic inflammation, immune system-mediated infections (e.g., COVID-19 virus myocarditis), hypertension, valvular disorders, along with genetically inherited cardiomyopathies. It is estimated that about 38 million people worldwide are diagnosed with HF, 6.5 million in the United States of America (USA) alone, with 1.000.000 new HF cases every year. HF is far more prevalent in older age groups, reaching 4.3% among persons aged 65 to 70 years old and projected to increase steadily through the year 2030 when the prevalence of HF could get 8.5%. Consequently, HF is associated with impaired quality of life (QOL), which is reflected in the significant number of hospitalizations and increased healthcare costs. The survival rate in patients diagnosed with HF has improved in recent history; however, the death rate remains unacceptably high (with >30% of patients dying within 5 years of an HF diagnosis) despite widespread efforts to implement guideline-directed disease-modifying therapies.
The high morbidity and mortality rates of patients with HF highlight the urgent need to identify new axes of disease pathogenesis for developing novel therapeutical opportunities. Electrical disorders are frequent in patients with HF and, in this complex scenario, may have a crucial role as a primary or contributory cause of HF evolution, shaping new specific entities denominated "electrical cardiomyopathies." The main electrical cardiomyopathies can be resumed in these groups: -Tachycardiomyopathy: reversible cardiac dysfunction secondary to increased ventricular rates occurring during atrial or ventricular tachycardias (VTs). -Irregulopathies: cardiac impairment determined by irregular heartbeats occurring during atrial fibrillation (AF) and frequent atrial (PACs) or ventricular (PVCs) premature contractions. -Atrioventricular (AV) and inter-ventricular dyssynchrony: cardiac systolic and diastolic dysfunction caused by atrioventricular dissociation with lack of atrial contribution to ventricular filling (e.g., during advanced AV blocks, VTs) or non-synchronous ventricular activation and contraction as occurred in bundle branch blocks, chronic right ventricular pacing (RVP), PVCs and VTs. Electrical disorders have an undoubtedly worrisome intersection with HF in these different ways. Therefore, it is essential to know the underlying pathophysiological mechanisms of that link to offer these patients a potential resolutive remedy. Indeed, the continuous progress of diagnostic and catheter ablation instruments and new devices for cardiac resynchronization targeted to electrical abnormalities may become essential in the armamentarium of cures for HF.
This Research Topic aims to assemble evidence on the most updated options available for managing patients with electrical conditions entailing HF. At the same time, we seek to shape the integrated role of modern arrhythmias specialists in the HF team, as long as the electrical management of HF still represents a challenging unmet clinical need but the near future of cardiac pacing and electrophysiology.
The Topic Editors encourage the submission of papers in the following areas:
1) Devices and wearable technologies for diagnosing and remote monitoring arrhythmias in HF patients (e.g., smartwatches).
2) Catheter ablations tools to handle atrial, ventricular arrhythmias, and imbalanced autonomic nervous system in HF patients (e.g., electroporation, electro-anatomic mapping systems, cardio-neuromodulation).
3) Pacemakers/defibrillators tools and physiological pacing strategies to treat atrioventricular and inter-ventricular dyssynchrony disturbances and prevent pacing-induced cardiomyopathy (e.g., conduction system pacing and cardiac contractility modulation).
Heart failure (HF) is a complex clinical syndrome characterized by symptoms such as dyspnea and fatigue resulting from any structural or functional impairment of ventricular filling or ejection of blood necessary to meet the body's needs. The etiologies of HF are various, but autonomic dysfunction is the hallmark and contributor to HF's detrimental progression. HF's most common causes are ischemic heart disease, systemic inflammation, immune system-mediated infections (e.g., COVID-19 virus myocarditis), hypertension, valvular disorders, along with genetically inherited cardiomyopathies. It is estimated that about 38 million people worldwide are diagnosed with HF, 6.5 million in the United States of America (USA) alone, with 1.000.000 new HF cases every year. HF is far more prevalent in older age groups, reaching 4.3% among persons aged 65 to 70 years old and projected to increase steadily through the year 2030 when the prevalence of HF could get 8.5%. Consequently, HF is associated with impaired quality of life (QOL), which is reflected in the significant number of hospitalizations and increased healthcare costs. The survival rate in patients diagnosed with HF has improved in recent history; however, the death rate remains unacceptably high (with >30% of patients dying within 5 years of an HF diagnosis) despite widespread efforts to implement guideline-directed disease-modifying therapies.
The high morbidity and mortality rates of patients with HF highlight the urgent need to identify new axes of disease pathogenesis for developing novel therapeutical opportunities. Electrical disorders are frequent in patients with HF and, in this complex scenario, may have a crucial role as a primary or contributory cause of HF evolution, shaping new specific entities denominated "electrical cardiomyopathies." The main electrical cardiomyopathies can be resumed in these groups: -Tachycardiomyopathy: reversible cardiac dysfunction secondary to increased ventricular rates occurring during atrial or ventricular tachycardias (VTs). -Irregulopathies: cardiac impairment determined by irregular heartbeats occurring during atrial fibrillation (AF) and frequent atrial (PACs) or ventricular (PVCs) premature contractions. -Atrioventricular (AV) and inter-ventricular dyssynchrony: cardiac systolic and diastolic dysfunction caused by atrioventricular dissociation with lack of atrial contribution to ventricular filling (e.g., during advanced AV blocks, VTs) or non-synchronous ventricular activation and contraction as occurred in bundle branch blocks, chronic right ventricular pacing (RVP), PVCs and VTs. Electrical disorders have an undoubtedly worrisome intersection with HF in these different ways. Therefore, it is essential to know the underlying pathophysiological mechanisms of that link to offer these patients a potential resolutive remedy. Indeed, the continuous progress of diagnostic and catheter ablation instruments and new devices for cardiac resynchronization targeted to electrical abnormalities may become essential in the armamentarium of cures for HF.
This Research Topic aims to assemble evidence on the most updated options available for managing patients with electrical conditions entailing HF. At the same time, we seek to shape the integrated role of modern arrhythmias specialists in the HF team, as long as the electrical management of HF still represents a challenging unmet clinical need but the near future of cardiac pacing and electrophysiology.
The Topic Editors encourage the submission of papers in the following areas:
1) Devices and wearable technologies for diagnosing and remote monitoring arrhythmias in HF patients (e.g., smartwatches).
2) Catheter ablations tools to handle atrial, ventricular arrhythmias, and imbalanced autonomic nervous system in HF patients (e.g., electroporation, electro-anatomic mapping systems, cardio-neuromodulation).
3) Pacemakers/defibrillators tools and physiological pacing strategies to treat atrioventricular and inter-ventricular dyssynchrony disturbances and prevent pacing-induced cardiomyopathy (e.g., conduction system pacing and cardiac contractility modulation).