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1.
Europace ; 12(3): 424-9, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20139118

RESUMEN

Implantable cardioverter-defibrillator (ICD) therapy is effective in primary and secondary prevention for patients who are at high risk of sudden cardiac death. However, the current risk stratification of patients who may benefit from this therapy is unsatisfactory. Single nucleotide polymorphisms (SNPs) are DNA sequence variations occurring when a single nucleotide in the genome differs among members of a species. A novel concept has emerged being that these common genetic variations might modify the susceptibility of a certain population to specific diseases. Thus, genetic factors may also modulate the risk for arrhythmias and sudden cardiac death, and identification of common variants could help to better identify patients at risk. The DISCOVERY study is an interventional, longitudinal, prospective, multi-centre diagnostic study that will enrol 1287 patients in approximately 80 European centres. In the genetic part of the DISCOVERY study, candidate gene polymorphisms involved in coding of the G-protein subunits will be correlated with the occurrence of ventricular arrhythmias in patients receiving an ICD for primary prevention. Furthermore, in order to search for additional sequence variants contributing to ventricular arrhythmias, a genome-wide association study will be conducted if sufficient a priori evidence can be gathered. In the second part of the study, associations of SNPs with ventricular arrhythmias will be sought and a search for potential new biological arrhythmic pathways will be investigated. As it is a diagnostic study, DISCOVERY will also investigate the impact of long-term device diagnostic data on the management of patients suffering from chronic cardiac disease as well as medical decisions made regarding their treatment.


Asunto(s)
Desfibriladores Implantables , Estudio de Asociación del Genoma Completo , Polimorfismo de Nucleótido Simple , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/genética , Cromograninas , Subunidades alfa de la Proteína de Unión al GTP Gq-G11/genética , Subunidades alfa de la Proteína de Unión al GTP Gs/genética , Marcadores Genéticos , Predisposición Genética a la Enfermedad/epidemiología , Pruebas Genéticas , Proteínas de Unión al GTP Heterotriméricas/genética , Humanos , Estudios Longitudinales , Estudios Multicéntricos como Asunto , Factores de Riesgo , Taquicardia Ventricular/epidemiología , Taquicardia Ventricular/terapia
2.
J Cardiovasc Electrophysiol ; 20(6): 663-6, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19175450

RESUMEN

INTRODUCTION: The purpose of this investigation is to evaluate whether a prolonged detection interval for life threatening ventricular tachyarrhythmia (VT) is able to reduce therapies (Rx) delivered by an implantable cardioverter/defibrillator (ICD). Until now, only the PREPARE trial demonstrated a reduction of ICD Rx in a cohort of primary prevention patients. METHODS AND RESULTS: The ADVANCE III study is a prospective, randomized, parallel trial with 2 arms evaluating different intervals to detect (NID), i.e., 18/24 (as currently used) versus 30/40. The primary endpoint is to demonstrate a 20% reduction of ICD Rx (antitachycardia pacing or shocks) delivered to terminate spontaneous VT with a cycle length < or =320 ms in patients with Class I-IIA indication for ICD therapy, regardless of cardiac resynchronization capabilities. The worldwide investigation started in spring 2008 and is expected to be finished in 2011. CONCLUSIONS: The ADVANCE III trial is the first randomized investigation evaluating the reduction of ICD Rx for fast VT due to a prolongation of NID in a general ICD patient cohort.


Asunto(s)
Desfibriladores Implantables , Cardioversión Eléctrica/métodos , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/prevención & control , Humanos , Proyectos de Investigación , Resultado del Tratamiento
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