Stimulace srdečního převodního systému (conduction system pacing, CSP) se "vynořila" jako fyziologičtější alternativa stimulace pravé komory a ve vybraných případech se používá i pro srdeční resynchronizační terapii. Stimulace Hisova svazku byla zavedena před více než dvěma desítkami let a v posledních pěti letech se začala používat ve větší míře poté, co se na trhu objevilo instrumentarium usnadňující implantaci elektrod. Stimulace oblasti levého Tawarova raménka je novější strategií, která získává vzhledem k větší cílové oblasti a vynikajícím elektrickým parametrům rychle oblibu. Nicméně stejně jako v případě jakékoli intervence je předpokladem bezpečné a účinné léčby její správné provádění. Cílem tohoto dokumentu je standardizovat způsob provádění daného výkonu a nabídnout jistý rámcový přehled lékařům, kteří by rádi implantovali elektrody pro CSP, případně kteří si přejí zdokonalit svoji techniku implantace.
Conduction system pacing (CSP) has emerged as a more physiological alternative to right ventricular pacing and is also being used in selected cases for cardiac resynchronization therapy. His bundle pacing was first introduced over two decades ago and its use has risen over the last five years with the advent of tools which have facilitated implantation. Left bundle branch area pacing is more recent but its adoption is growing fast due to a wider target area and excellent electrical parameters. Nevertheless, as with any intervention, proper technique is a prerequisite for safe and effective delivery of therapy. This document aims to stan- dardize the procedure and to provide a framework for physicians who wish to start CSP implantation, or who wish to improve their technique.
- MeSH
- Hisův svazek MeSH
- lidé MeSH
- nemoci převodního systému srdečního MeSH
- převodní systém srdeční * MeSH
- srdeční resynchronizační terapie * MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Kanada MeSH
- Latinská Amerika MeSH
Conduction system pacing (CSP) has emerged as a more physiological alternative to right ventricular pacing and is also being used in selected cases for cardiac resynchronization therapy. His bundle pacing was first introduced over two decades ago and its use has risen over the last five years with the advent of tools which have facilitated implantation. Left bundle branch area pacing is more recent but its adoption is growing fast due to a wider target area and excellent electrical parameters. Nevertheless, as with any intervention, proper technique is a prerequisite for safe and effective delivery of therapy. This document aims to standardize the procedure and to provide a framework for physicians who wish to start CSP implantation, or who wish to improve their technique.
- MeSH
- Hisův svazek MeSH
- lidé MeSH
- nemoci převodního systému srdečního MeSH
- převodní systém srdeční * MeSH
- srdeční resynchronizační terapie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Kanada MeSH
- Latinská Amerika MeSH
- MeSH
- diabetes mellitus * prevence a kontrola MeSH
- lidé MeSH
- mobilní aplikace MeSH
- oblast s nedostatečnou zdravotní péčí MeSH
- telemedicína * MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Latinská Amerika MeSH
- Mexiko MeSH
- MeSH
- fibrilace síní * MeSH
- genetické testování MeSH
- konsensus MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Asie MeSH
- Latinská Amerika MeSH
- MeSH
- fibrilace síní * MeSH
- genetické testování MeSH
- konsensus MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
- Geografické názvy
- Asie MeSH
- Latinská Amerika MeSH
- MeSH
- konsensus MeSH
- lidé MeSH
- mitrální chlopeň diagnostické zobrazování MeSH
- nemoci srdečních chlopní * MeSH
- prolaps mitrální chlopně * komplikace diagnostické zobrazování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Latinská Amerika MeSH
In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients.
- MeSH
- Americká kardiologická asociace MeSH
- defibrilátory implantabilní * MeSH
- dítě MeSH
- dospělí MeSH
- elektronika MeSH
- kardiologie * MeSH
- lidé MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
- Geografické názvy
- Latinská Amerika MeSH
- Spojené státy americké MeSH
ABSTRACT: Cronobacter is a bacterial genus that includes seven species, and the species Cronobacter sakazakii is most related to meningitis and septicemia in infants associated with powdered infant formula (PIF). The objectives of this study were to evaluate the presence of C. sakazakii and to determine the microbiological quality of PIF for infant consumption. To do this, a total of 128 PIF samples were analyzed in four brands and countries (Chile, Mexico, Holland, and Brazil), considering three types of PIF: premature (PIF1), infant (PIF2), and follow-up (PIF3). Aerobic plate counts (APC) and Enterobacteriaceae (ENT) were assessed in accordance with Chilean official standards. The outer membrane protein A (ompA) gene was amplified to detect Cronobacter spp. and the fusA gene was amplified to identify C. sakazakii by using the PubMLST Web site and BLAST (NCBI). The antibiotic resistance profile was performed according to the Clinical and Laboratory Standards Institute standards. The pathogen was quantified by the most probable number (MPN). The results showed that APC median values for PIF1, PIF2, and PIF3 were 3.2, 4.9, and 4.8 log CFU g-1, respectively. The APC were higher in PIF2 (P < 0.01) from Holland (P < 0.01) in the commercial brand 4 (P < 0.01). The ENT median values in PIF1, PIF2, and PIF3 were 1.8, 1.5, and 1.7 log CFU g-1, respectively. Five strains of C. sakazakii and one strain of Cronobacter malonaticus were identified as having values between 0.023 and 2.3 MPN/g. All strains (100%) harbored the ompA, plasminogen activator (cpa), and hemolysin (hly) virulence genes. To conclude, C. sakazakii was found in four PIF samples from four Chilean products and one from Mexico, which is distributed throughout America. C. sakazakii strains exhibit virulence factors and resistance to ampicillin, thus posing a risk when PIFs are consumed by infants. HIGHLIGHTS:
- MeSH
- Cronobacter sakazakii * MeSH
- Cronobacter MeSH
- kojenec MeSH
- kontaminace potravin analýza MeSH
- lidé MeSH
- náhražky mateřského mléka * mikrobiologie normy MeSH
- potravinářská mikrobiologie MeSH
- prášky, zásypy, pudry MeSH
- spotřebitelská bezpečnost produktů MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Brazílie MeSH
- Chile MeSH
- Latinská Amerika MeSH
- Mexiko MeSH
- Nizozemsko MeSH
