BACKGROUND AND OBJECTIVE: Theophylline has been used for decades in human medicine for its psychostimulant, anti-inflammatory, and bronchodilator effects. Historically, in pulmonary medicine, theophylline has been used in the treatment of obstructive pulmonary diseases such as bronchial asthma (BA) or chronic obstructive pulmonary disease (COPD). This review aims to determine whether theophylline still has its place in the therapy of obstructive pulmonary diseases or whether we can even extend its use to other diagnoses such as atropine-resistant cardiac arrests, apnea of prematurity, or others. Moreover, we also aim to determine if there is a rationale for using low-dose theophylline due to its immunomodulatory and anti-inflammatory effect, or if the future of methylxanthines lies in newly synthesized derivates of theophylline such as bamifylline, or doxofylline. METHODS: The narrative review is based on a literature search of the articles indexed in the PubMed database in 2023. We searched the database since the year 2009 using the MeSH terms "theophylline", "aminophylline", and "methylxanthines" and we included original articles in the English language. KEY CONTENT AND FINDINGS: Theophylline has a number of adverse drug reactions (ADRs), the most serious of which is its effect on the cardiovascular system. It can cause severe arrhythmias or even cardiac arrest when overdosed. On the other hand, there is still a substantial amount of its applications in current clinical practice. CONCLUSIONS: There is considerable controversy associated with its use in current medicine, which can be attributed both to its narrow therapeutic range and its mentioned cardiotoxic effect. Herein, we summarize the current state-of-art of theophylline and its use in human medicine.

• Klíčová slova
• Theophylline, aminophylline, bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), methylxanthines,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

AIMS: The field of conduction system pacing (CSP) is evolving, and our aim was to obtain a contemporary picture of European CSP practice. METHODS AND RESULTS: A survey was devised by a European CSP Expert Group and sent electronically to cardiologists utilizing CSP. A total of 284 physicians were invited to contribute of which 171 physicians (60.2%; 85% electrophysiologists) responded. Most (77%) had experience with both His-bundle pacing (HBP) and left bundle branch area pacing (LBBAP). Pacing indications ranked highest for CSP were atrioventricular block (irrespective of left ventricular ejection fraction) and when coronary sinus lead implantation failed. For patients with left bundle branch block (LBBB) and heart failure (HF), conventional biventricular pacing remained first-line treatment. For most indications, operators preferred LBBAP over HBP as a first-line approach. When HBP was attempted as an initial approach, reasons reported for transitioning to utilizing LBBAP were: (i) high threshold (reported as >2 V at 1 ms), (ii) failure to reverse bundle branch block, or (iii) > 30 min attempting to implant at His-bundle sites. Backup right ventricular lead use for HBP was low (median 20%) and predominated in pace-and-ablate scenarios. Twelve-lead electrocardiogram assessment was deemed highly important during follow-up. This, coupled with limitations from current capture management algorithms, limits remote monitoring for CSP patients. CONCLUSIONS: This survey provides a snapshot of CSP implementation in Europe. Currently, CSP is predominantly used for bradycardia indications. For HF patients with LBBB, most operators reserve CSP for biventricular implant failures. Left bundle branch area pacing ostensibly has practical advantages over HBP and is therefore preferred by many operators. Practical limitations remain, and large randomized clinical trial data are currently lacking.

• Klíčová slova
• CSP, HBP, LBBAP, Survey,
• MeSH
• blokáda Tawarova raménka diagnóza   terapie   MeSH
• funkce levé komory srdeční MeSH
• lidé MeSH
• převodní systém srdeční MeSH
• srdeční arytmie terapie   MeSH
• srdeční resynchronizační terapie * MeSH
• srdeční selhání * diagnóza   terapie   MeSH
• tepový objem fyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

• Klíčová slova
• Ambulatory ECG monitoring, Antiarrhythmic drug therapy, Antitachycardia pacing, Arrhythmogenic cardiomyopathy, Asystole, Atrioventricular block, Bradycardia, Brugada syndrome, Cardiac channelopathies, Cardiac transplantation, Cardiomyopathy, Cardiovascular implantable electronic devices, Catecholaminergic polymorphic ventricular tachycardia, Children, Congenital heart disease, Coronary artery compression, ECG, Echocardiography, Endocardial lead, Epicardial lead, Expert consensus statement, Genetic arrhythmias, Heart block, Heart failure, Hypertrophic cardiomyopathy, Implantable cardioverter defibrillator, Insertable cardiac monitor, Lead extraction, Lead removal, Long QT syndrome, Low- and middle-income countries, MR imaging, Neuromuscular disease, PACES, Pacemaker, Pediatrics, Postoperative, Remote monitoring, Shared decision-making, Sick sinus syndrome, Sports and physical activity, Sudden cardiac arrest, Sudden cardiac death, Syncope, Transvenous, Ventricular fibrillation, Ventricular tachycardia,
• Publikační typ
• časopisecké články 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

• Publikační typ
• časopisecké články MeSH

Guidelines for the implantation of cardiac implantable electronic devices (CIEDs) have evolved since publication of the initial ACC/AHA pacemaker guidelines in 1984 [1]. CIEDs have evolved to include novel forms of cardiac pacing, the development of implantable cardioverter defibrillators (ICDs) and the introduction of devices for long term monitoring of heart rhythm and other physiologic parameters. In view of the increasing complexity of both devices and patients, practice guidelines, by necessity, have become increasingly specific. In 2018, the ACC/AHA/HRS published Guidelines on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay [2], which were specific recommendations for patients >18 years of age. This age-specific threshold was established in view of the differing indications for CIEDs in young patients as well as size-specific technology factors. Therefore, the following document was developed to update and further delineate indications for the use and management of CIEDs in pediatric patients, defined as ≤21 years of age, with recognition that there is often overlap in the care of patents between 18 and 21 years of age. This document is an abbreviated expert consensus statement (ECS) intended to focus primarily on the indications for CIEDs in the setting of specific disease/diagnostic categories. This document will also provide guidance regarding the management of lead systems and follow-up evaluation for pediatric patients with CIEDs. The recommendations are presented in an abbreviated modular format, with each section including the complete table of recommendations along with a brief synopsis of supportive text and select references to provide some context for the recommendations. This document is not intended to provide an exhaustive discussion of the basis for each of the recommendations, which are further addressed in the comprehensive PACES-CIED document [3], with further data easily accessible in electronic searches or textbooks.

• Klíčová slova
• Ambulatory ECG monitoring, Antiarrhythmic drug therapy, Antitachycardia pacing, Arrhythmogenic cardiomyopathy, Asystole, Atrioventricular block, Bradycardia, Brugada syndrome, Cardiac channelopathies, Cardiac transplantation, Cardiomyopathy, Cardiovascular implantable electronic devices, Catecholaminergic polymorphic ventricular tachycardia, Children, Congenital heart disease, Coronary artery compression, ECG, Echocardiography, Endocardial lead, Epicardial lead, Expert consensus statement, Genetic arrhythmias, Heart block, Heart failure, Hypertrophic cardiomyopathy, Implantable cardioverter defibrillator, Insertable cardiac monitor, Lead extraction, Lead removal, Long QT syndrome, Low- and middle-income countries, MR imaging, Neuromuscular disease, PACES, Pacemaker, Pediatrics, Postoperative, Remote monitoring, Shared decision-making, Sick sinus syndrome, Sports and physical activity, Sudden cardiac arrest, Sudden cardiac death, Syncope, Transvenous, Ventricular fibrillation, Ventricular tachycardia,
• Publikační typ
• časopisecké články 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.

• Klíčová slova
• Ambulatory ECG monitoring, Antiarrhythmic drug therapy, Antitachycardia pacing, Arrhythmogenic cardiomyopathy, Arrhythmogenic right ventricular cardiomyopathy, Asystole, Atrioventricular block, Bradycardia, Brugada syndrome, Cardiac channelopathies, Cardiac transplantation, Cardiomyopathy, Cardiovascular implantable electronic devices, Catecholaminergic polymorphic ventricular tachycardia, Children, Congenital heart disease, Coronary artery compression, ECG, Echocardiography, Endocardial lead, Epicardial lead, Expert consensus statement, Genetic arrhythmias, Heart block, Heart failure, Hypertrophic cardiomyopathy, Implantable cardioverter defibrillator, Insertable cardiac monitor, Lead extraction, Lead removal, Long QT syndrome, Low- and middle-income countries, MR imaging, Neuromuscular disease, PACES, Pacemaker, Pediatrics, Postoperative, Remote monitoring, Shared decision-making, Sick sinus syndrome, Sports and physical activity, Sudden cardiac arrest, Sudden cardiac death, Syncope, Transvenous, Ventricular fibrillation, Ventricular tachycardia,
• Publikační typ
• časopisecké články MeSH