We Have Come a Long Way with Device Therapy: Historical Perspectives on Antiarrhythmic Electrotherapy

Historical Perspectives on Antiarrhythmic Electrotherapy. The history of device therapies is long and fascinating. In the beginning, there is not simply the anatomy and physiology of the heart, but also analysis of the pulse, which indicates the activity of the heart. The analysis of the (peripheral) pulse as a mechanical expression of heart activity goes back several millennia. In China, in 280 BC, Wang Shu He wrote 10 books about the pulse. The Greeks called the pulse “sphygmos”; thus, sphygmology deals with a theory of this natural occurrence. In Roman times, Galen interpreted the various types of pulse according to the widespread presumption of the time that each organ in every disease has its own form of pulse. The growing clinical importance of electrical cardiac stimulation was recognized and renewed as Zoll in 1952 described a successful resuscitation in cardiac standstill by external stimulation. Meanwhile, millions of patients with cardiac arrhythmias worldwide have been treated with pacemakers in the last 40 years. The concept of a fully automatic implantable cardioverter defibrillator system for recognition and treatment of ventricular tachyarrhythmias was first suggested in 1970. The first implantation of the device in a human being was performed in February 1980. Further developments involved atrial and atrioventricular defibrillators, radiofrequency ablation, laser therapy, and advanced antiarrhythmic surgery. Since 1990, there has been a growing interest in using cardiac pacing as additional treatment in severe cardiac failure. Recent reports have suggested that intervention with left ventricular or biventricular pacing may be helpful for a subgroup of patients with congestive heart failure. Despite encouraging (preliminary) acute and short‐term results, pacing strategies for heart failure still are limited and currently regarded as investigational. Advances in the field of therapeutic application of pharmacologic and electrical tools as well as alternative methods will continue as rapidly as before and provide us further significant aid in taking care of patients.     

抑制内膜增生,任重而道远

对于动脉粥样硬化病变血管,诸如球囊血管成形术、支架植入及冠状动脉搭桥等血运重建术后的再狭窄仍是制约心血管介入治疗技术的最主要瓶颈之一。再狭窄主要由新生内膜增生和血管的缩窄性重构导致的结果,而新生内膜增生则是对血管损伤及低血流动力学状态下的一种血管性反应,包括一系列复杂的信号通路和生物效应过程,如炎症、血栓形成、血管平滑肌细胞增殖迁移等。因此,我们应该分阶段、多方向的预防再狭窄的发生。     

A Blue Baby Grows Up

This report describes the history of a 41‐year‐old female patient born with atresia of the right atrioventricular valve, hypoplasia of the right ventricle, an atrial septal defect, and malposed great arteries. The patient underwent surgical pulmonary artery banding in infancy but did not undergo corrective surgery due to the development of pulmonary arterial hypertension. This report touches on several important clinical issues that may arise when caring for the adult with complex palliated cyanotic congenital heart disease, including the development and treatment of pulmonary arterial hypertension.     

The Long Baby Boom: An Optimistic Vision for a Graying Generation,by Jeff Goldsmith

Experience Corps^® places teams of trained volunteers in elementary school classrooms to promote academic achievement in children and serves as a health-promotion intervention for older adults. Prior to randomization, individuals reported participation in several activities of varying cognitive, physical, and social demands. Maintaining an active lifestyle, particularly in intellectually demanding activities, was associated with physical, mental, and cognitive health in adulthood. Establishing how individuals allocated their time before randomization to this program provides insight into prevalent health behaviors for at-risk older adults, and can provide the basis for examining intervention-related changes in lifestyle as a result of volunteer participation.