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Electrical Diseases of the Heart pp 317–332Cite as

Senescence and Arrhythmogenesis

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Abstract

Cardiac arrhythmias are a major cause of morbidity and mortality, particularly in the elderly. With the rapidly changing population demographics, and increasing prevalence of cardiovascular disease, healthcare resource utilization for arrhythmia care is projected to rise exponentially. Aging is associated with electrophysiological alterations due to cardiac structural and functional remodeling, which combined with a blunted response to neurohumoral activation and hemodynamic responsiveness, results in increased propensity to brady and tachy-arrhythmias. These not only affect the quality of life but also contribute to the deterioration in myocardial function leading to heart failure, stroke and death.

Despite progress in the management of cardiovascular disease, arrhythmias in the elderly, continue to be a significant predicament. This is mainly due to limited understanding of the mechanisms and therapeutics directed against the underlying substrate that increases susceptibility of the heart to arrhythmogenesis and paucity of outcome studies in the older-elderly that limits specific practice guidelines in octo- and nona-genarians. Hence, further investigation is warranted to fully define the efficacy of anti-arrhythmic therapeutic modalities in the elderly that have proven to be effective in younger patients. This chapter summarizes the epidemiology, aging-associated cardiac structural and functional changes, basis for arrhythmogenesis, evaluation and management of elderly patients with ventricular tachyarrhythmias that increase predisposition to sudden death.

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References

  1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics – 2012 update: a report from the American Heart Association. Circulation. 2012;125:e2–220.

    Article  PubMed  Google Scholar 

  2. Lakatta EG, Sollott SJ. Perspectives on mammalian cardiovascular aging: humans to molecules. Comp Biochem Physiol A Mol Integr Physiol. 2002;132:699–721.

    Article  PubMed  Google Scholar 

  3. Chugh SS JJ, Gunson K, Stecker EC, John BT, Thompson B, Ilias N, et al. Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community. J Am Coll Cardiol. 2004;44:1268–75.

    Article  PubMed  Google Scholar 

  4. Piccini JP, Hammill BG, Sinner MF, Jensen PN, Hernandez AF, Heckbert SR, et al. Incidence and prevalence of atrial fibrillation and associated mortality among medicare beneficiaries, 1993–2007. Circ Cardiovasc Qual Outcomes. 2012;5:85–93.

    Article  PubMed  Google Scholar 

  5. Zipes DP CA, Borggrefe M, Buxton AE, Chaitman B, Fromer M, Gregoratos G, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol. 2006;48:e247–346.

    Article  PubMed  Google Scholar 

  6. Jacobs AK, Adams CD, Anderson JL, Antman EM, Hunt SA, Nishimura R, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation). Circulation. 2006;114:700–52.

    Article  Google Scholar 

  7. Kistler PM, Sanders P, Fynn SP, Stevenson IH, Spence SJ, Vohra JK, et al. Electrophysiologic and electroanatomic changes in the human atrium associated with age. J Am Coll Cardiol. 2004;44:109–16.

    Article  PubMed  Google Scholar 

  8. Preston CC, Oberlin AS, Holmuhamedov EL, Gupta A, Sagar S, Syed RH, et al. Aging-induced alterations in gene transcripts and functional activity of mitochondrial oxidative phosphorylation complexes in the heart. Mech Ageing Dev. 2008;129:304–12.

    Article  PubMed  CAS  Google Scholar 

  9. Roberts-Thomson KC, Kistler PM, Sanders P, Morton JB, Haqqani HM, Stevenson I, et al. Fractionated atrial electrograms during sinus rhythm: relationship to age, voltage, and conduction velocity. Heart Rhythm. 2009;6:587–91.

    Article  PubMed  Google Scholar 

  10. Dun W, Boyden PA. Aged atria: electrical remodeling conducive to atrial fibrillation. J Interv Card Electrophysiol. 2009;25:9–18.

    Article  PubMed  Google Scholar 

  11. Tellez JO, McZewski M, Yanni J, Sutyagin P, Mackiewicz U, Atkinson A, et al. Ageing-dependent remodelling of ion channel and Ca2+ clock genes underlying sino-atrial node pacemaking. Exp Physiol. 2011;96:1163–78.

    PubMed  CAS  Google Scholar 

  12. Lie JT, Hammond PI. Pathology of the senescent heart: anatomic observations on 237 autopsy studies of patients 90 to 105 years old. Mayo Clin Proc. 1988;63:552–64.

    Article  PubMed  CAS  Google Scholar 

  13. Cheitlin MD. Cardiovascular physiology-changes with aging. Am J Geriatr Cardiol. 2003;12:9–13.

    Article  PubMed  Google Scholar 

  14. Huang C, Ding W, Li L, Zhao D. Differences in the aging-associated trends of the monophasic action potential duration and effective refractory period of the right and left atria of the rat. Circ J. 2006;70:352–7.

    Article  PubMed  Google Scholar 

  15. Liu XK, Jahangir A, Terzic A, Gersh BJ, Hammill SC, Shen WK. Age- and sex-related atrial electrophysiologic and structural changes. Am J Cardiol. 2004;94:373–5.

    Article  PubMed  Google Scholar 

  16. Aronow WS. Heart disease and aging. Med Clin North Am. 2006;90:849–62.

    Article  PubMed  Google Scholar 

  17. Liu XK, JA, Shen WK. Cardiac arrhythmias. In: Halter JB, Ouslander JG, Tinetti ME, Studenski S, High KP, Asthana S, editors. Hazzard’s Geriatric Medicine and Gerontology, Sixth Edition. New York: McGraw-Hill; 2009. p. 951–65.

    Google Scholar 

  18. Jahangir A, Lee V, Friedman PA, Trusty JM, Hodge DO, Kopecky SL, et al. Long-term progression and outcomes with aging in patients with lone atrial fibrillation: a 30-year follow-up study. Circulation. 2007;115:3050–6.

    Article  PubMed  Google Scholar 

  19. Go ASHE, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285:2370–5.

    Article  PubMed  CAS  Google Scholar 

  20. Jahangir A, Shen WK. Pacing in elderly patients. Am Heart J. 2003;146:750–3.

    Article  PubMed  Google Scholar 

  21. Jahangir A, Sagar S, Terzic A. Aging and cardioprotection. J Appl Physiol. 2007;103:2120–8.

    Article  PubMed  Google Scholar 

  22. Adabag AS, Luepker RV, Roger VL, Gersh BJ. Sudden cardiac death: epidemiology and risk factors. Nat Rev Cardiol. 2010;7:216–25.

    Article  PubMed  Google Scholar 

  23. Chugh SS, Jui J, Gunson K, Stecker EC, John BT, Thompson B, et al. Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community. J Am Coll Cardiol. 2004;44:1268–75.

    Article  PubMed  Google Scholar 

  24. Myerburg RJ, Hendel RC. Expanding risk-profiling strategies for prediction and prevention of sudden cardiac death. J Am Coll Cardiol. 2010;56:215–7.

    Article  PubMed  Google Scholar 

  25. Fishman GI, Chugh SS, Dimarco JP, Albert CM, Anderson ME, Bonow RO, et al. Sudden cardiac death prediction and prevention: report from a national heart, lung, and blood institute and heart rhythm society workshop. Circulation. 2010;122:2335–48.

    Article  PubMed  Google Scholar 

  26. Gillum RF. Geographic variation in sudden coronary death. Am Heart J. 1990;119:380–9.

    Article  PubMed  CAS  Google Scholar 

  27. Chugh SS. Early identification of risk factors for sudden cardiac death. Nat Rev Cardiol. 2010;7:318–26.

    Article  PubMed  Google Scholar 

  28. Nichol G, Thomas E, Callaway CW, Hedges J, Powell JL, Aufderheide TP, et al. Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA. 2008;300:1423–31.

    Article  PubMed  CAS  Google Scholar 

  29. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol. 2006;48:e247–346.

    Article  PubMed  Google Scholar 

  30. Myerburg RJ, Castellanos A. Emerging paradigms of the epidemiology and demographics of sudden cardiac arrest. Heart Rhythm. 2006;3:235–9.

    Article  PubMed  Google Scholar 

  31. Myerburg RJ. Sudden cardiac death: exploring the limits of our knowledge. J Cardiovasc Electrophysiol. 2001;12:369–81.

    Article  PubMed  CAS  Google Scholar 

  32. Theroux P, Fuster V. Acute coronary syndromes: unstable angina and non-q-wave myocardial infarction. Circulation. 1998;97:1195–206.

    Article  PubMed  CAS  Google Scholar 

  33. Naghavi MFE, Hecht HS, Jamieson MJ, Kaul S, Berman D, Fayad Z, et al. From vulnerable plaque to vulnerable patient – Part III: executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force Report. Am J Cardiol. 2006;17:2H–15.

    Article  Google Scholar 

  34. Farb A, Tang AL, Burke AP, Sessums L, Liang Y, Virmani R. Sudden coronary death: frequency of active coronary lesions, inactive coronary lesions, and myocardial infarction. Circulation. 1995;92:1701–9.

    Article  PubMed  CAS  Google Scholar 

  35. Hulot JS, Jouven X, Empana JP, Frank R, Fontaine G. Natural history and risk stratification of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circulation. 2004;110:1879–84.

    Article  PubMed  Google Scholar 

  36. Klein GJ, Krahn AD, Skanes AC, Yee R, Gula LJ. Primary prophylaxis of sudden death in hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and dilated cardiomyopathy. J Cardiovasc Electrophysiol. 2005;16:S28–34.

    Article  PubMed  Google Scholar 

  37. Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124:e783–831.

    Article  PubMed  Google Scholar 

  38. Maron BJ. Contemporary insights and strategies for risk stratification and prevention of sudden death in hypertrophic cardiomyopathy. Circulation. 2010;121:445–56.

    Article  PubMed  Google Scholar 

  39. Locati EH, Zareba W, Moss AJ, Schwartz PJ, Vincent GM, Lehmann MH, et al. Age- and sex-related differences in clinical manifestations in patients with congenital long-QT syndrome: findings from the International LQTS Registry. Circulation. 1998;97:2237–44.

    Article  PubMed  CAS  Google Scholar 

  40. Bjerregaard PJA, Gussak I. Targeted therapy for short qt syndrome. Expert Opin Ther Targets. 2006;10:393–400.

    Article  PubMed  CAS  Google Scholar 

  41. Friedlander Y, Siscovick DS, Weinmann S, Austin MA, Psaty BM, Lemaitre RN, et al. Family history as a risk factor for primary cardiac arrest. Circulation. 1998;97:155–60.

    Article  PubMed  CAS  Google Scholar 

  42. Jouven X, Desnos M, Guerot C, Ducimetiere P. Predicting sudden death in the population. The Paris prospective study I. Circulation. 1999;99:1978–83.

    Article  PubMed  CAS  Google Scholar 

  43. Cerrone M, Priori SG. Genetics of sudden death: focus on inherited channelopathies. Eur Heart J. 2011;32:2109–18.

    Article  PubMed  Google Scholar 

  44. Faber BCG, Cleutjens KBJM, Niessen RLJ, Aarts PLJW, Boon W, Greenberg AS, et al. Identification of genes potentially involved in rupture of human atherosclerotic plaques. Circ Res. 2001;89:547–54.

    Article  PubMed  CAS  Google Scholar 

  45. Topol EJ, McCarthy J, Gabriel S, Moliterno DJ, Rogers WJ, Newby LK, et al. Single nucleotide polymorphisms in multiple novel thrombospondin genes may be associated with familial premature myocardial infarction. Circulation. 2001;104:2641–4.

    Article  PubMed  CAS  Google Scholar 

  46. Splawski I, Timothy KW, Tateyama M, Clancy CE, Malhotra A, Beggs AH, et al. Variant of SCN5A sodium channel implicated in risk of cardiac arrhythmia. Science. 2002;297:1333–6.

    Article  PubMed  CAS  Google Scholar 

  47. Goldenberg I, Moss AJ, Bradley J, Polonsky S, Peterson DR, McNitt S, et al. Long-QT syndrome after age 40. Circulation. 2008;117:2192–201.

    Article  PubMed  Google Scholar 

  48. Kannel WB, Cupples LA, D’Agostino RB. Sudden death risk in overt coronary heart disease: the Framingham Study. Am Heart J. 1987;113:799–804.

    Article  PubMed  CAS  Google Scholar 

  49. Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001;321:225–36.

    Article  PubMed  CAS  Google Scholar 

  50. Bergner DW, Goldberger JJ. Diabetes mellitus and sudden cardiac death: what are the data? Cardiol J. 2010;17:117–29.

    PubMed  Google Scholar 

  51. Spooner PM. Sudden cardiac death: influence of diabetes. Diabetes Obes Metab. 2008;10:523–32.

    Article  PubMed  CAS  Google Scholar 

  52. Myerburg RJ, Kessler KM, Castellanos A. Sudden cardiac death: epidemiology, transient risk, and intervention assessment. Ann Intern Med. 1993;119:1187–97.

    Article  PubMed  CAS  Google Scholar 

  53. Adamson P, Barr RC, Callans DJ, Chen PS, Lathrop DA, Makielski JC, et al. The perplexing complexity of cardiac arrhythmias: beyond electrical remodeling. Heart Rhythm. 2005;2:650–9.

    Article  PubMed  Google Scholar 

  54. Juhaszova MRC, Zorov DB, Lakatta EG, Sollott SJ. Protection in the aged heart: preventing the heart-break of old age? Cardiovasc Res. 2005;66:233–44.

    Article  PubMed  CAS  Google Scholar 

  55. Vlietstra REJA, Shen WK. Choice of pacemakers in patients aged 75 years and older: ventricular pacing mode vs. dual-chamber pacing mode. Am J Geriatr Cardiol. 2005;14:35–8.

    Article  PubMed  Google Scholar 

  56. Epstein AE, DiMarco JP, Ellenbogen KA, Estes 3rd NA, Freedman RA, Gettes LS, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;51:e1–62.

    Article  PubMed  Google Scholar 

  57. Jose A. Effect of combined sympathetic and parasympathetic blockade on heart rate and cardiac function in man. Am J Cardiol. 1966;18:476–8.

    Article  PubMed  CAS  Google Scholar 

  58. Lakatta EG. Cardiovascular regulatory mechanisms in advanced age. Physiol Rev. 1993;73:413–67.

    PubMed  CAS  Google Scholar 

  59. Fleg JL, O’Connor F, Gerstenblith G, Becker LC, Clulow J, Schulman SP, et al. Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women. J Appl Physiol. 1995;78:890–900.

    PubMed  CAS  Google Scholar 

  60. Koura THM, Takeuchi S, Ota K, Okada Y, Miyoshi S, Watanabe A, et al. Anisotropic conduction properties in canine atria analyzed by high-resolution optical mapping: preferential direction of conduction block changes from longitudinal to transverse with increasing age. Circulation. 2002;105:2092–8.

    Article  PubMed  Google Scholar 

  61. de Bakker JM, van Rijen HM. Continuous and discontinuous propagation in heart muscle. J Cardiovasc Electrophysiol. 2006;17:567–73.

    Article  PubMed  Google Scholar 

  62. Hao X, Zhang Y, Zhang X, Nirmalan M, Davies L, Konstantinou D, et al. TGF-beta1-mediated fibrosis and ion channel remodeling are key mechanisms in producing the sinus node dysfunction associated with SCN5A deficiency and aging. Circ Arrhythm Electrophysiol. 2011;4:397–406.

    Article  PubMed  CAS  Google Scholar 

  63. Nerbonne JM, Kass RS. Physiology and molecular biology of ion channels contributing to ventricular repolarization. In: Gussak I, Antzelevitch C, Hammill SC, Shen WK, Bjerregaard P, editors. Cardiac repolarization: bridging basic and clinical science, Contemporary cardiology. Totowa, NJ: Humana Press; 2003. p. 25–62.

    Chapter  Google Scholar 

  64. Josephson IR, Guia A, Stern MD, Lakatta EG. Alterations in properties of L-type Ca channels in aging rat heart. J Mol Cell Cardiol. 2002;34:297–308.

    Article  PubMed  CAS  Google Scholar 

  65. Jahangir A, Holmuhamedov EL, Cabrera Aguilera CC, Oberlin AS, Ashfaque N, Alekseev AE, et al. Molecular basis for the increased ­vulnerability of the aging heart to injury. Eur Heart J. 2006;27:S875.

    Article  CAS  Google Scholar 

  66. Lakatta EG, Maltsev VA, Vinogradova TM. A coupled SYSTEM of intracellular Ca2+ clocks and surface membrane voltage clocks controls the timekeeping mechanism of the heart’s pacemaker. Circ Res. 2010;106:659–73.

    Article  PubMed  CAS  Google Scholar 

  67. Janczewski AMSH, Lakatta EG. Action potential prolongation in cardiac myocytes of old rats is an adaptation to sustain youthful intracellular Ca2+ regulation. J Mol Cell Cardiol. 2002;34:641–8.

    Article  PubMed  CAS  Google Scholar 

  68. Walker KE, Lakatta EG, Houser SR. Alterations in properties of l-type ca channels in aging rat heart. Cardiovasc Res. 2002;27:1968–77.

    Article  Google Scholar 

  69. Walker KE, Lakatta EG, Houser SR. Age associated changes in membrane currents in rat ventricular myocytes. Cardiovasc Res. 1993;27:1968–77.

    Article  PubMed  CAS  Google Scholar 

  70. Jahangir A, Terzic A. K(ATP) channel therapeutics at the bedside. J Mol Cell Cardiol. 2005;39:99–112.

    Article  PubMed  CAS  Google Scholar 

  71. Toro LMJ, Nishimaru K, Tanaka Y, Song M, Stefani E. Aging, ion channel expression, and vascular function. Vascul Pharmacol. 2002;38:73–80.

    Article  PubMed  CAS  Google Scholar 

  72. Zhou YY, Lakatta EG, Xiao RP. Age-associated alterations in calcium current and its modulation in cardiac myocytes. Drugs Aging. 1998;13:159–71.

    Article  PubMed  CAS  Google Scholar 

  73. Xiao R-P, Zhu W, Zheng M, Cao C, Zhang Y, Lakatta EG, et al. Subtype-specific [alpha]1- and [beta]-adrenoceptor signaling in the heart. Trends Pharmacol Sci. 2006;27:330–7.

    Article  PubMed  CAS  Google Scholar 

  74. Morita N, Lee JH, Bapat A, Fishbein MC, Mandel WJ, Chen PS, et al. Glycolytic inhibition causes spontaneous ventricular fibrillation in aged hearts. Am J Physiol Heart Circ Physiol. 2011;301:H180–91.

    Article  PubMed  CAS  Google Scholar 

  75. Lompre AM, Lambert F, Lakatta EG, Schwartz K. Expression of sarcoplasmic reticulum Ca(2+). ATPase and calsequestrin genes in rat heart during ontogenic development and aging. Circ Res. 1991;69:1380–8.

    Article  PubMed  CAS  Google Scholar 

  76. Taffet GE, Tate CA. CaATPase content is lower in cardiac sarcoplasmic reticulum isolated from old rats. Am J Physiol. 1993;264:H1609–14.

    PubMed  CAS  Google Scholar 

  77. Koban MU, Moorman AF, Holtz J, Yacoub MH, Boheler KR. Expressional analysis of the cardiac Na-Ca exchanger in rat development and senescence. Cardiovasc Res. 1998;37:405–23.

    Article  PubMed  CAS  Google Scholar 

  78. Xu A, Narayanan N. Effects of aging on sarcoplasmic reticulum Ca2+-cycling proteins and their phosphorylation in rat myocardium. Am J Physiol. 1998;275:H2087–94.

    PubMed  CAS  Google Scholar 

  79. Jahangir A, Ozcan C, Holmuhamedov EL, Terzic A. Increased calcium vulnerability of senescent cardiac mitochondria: protective role for a mitochondrial potassium channel opener. Mech Ageing Dev. 2001;122:1073–86.

    Article  PubMed  CAS  Google Scholar 

  80. Fleg JL, Kennedy HL. Cardiac arrhythmias in a healthy elderly population: detection by 24-hour ambulatory electrocardiography. Chest. 1982;81:302–7.

    Article  PubMed  CAS  Google Scholar 

  81. Kennedy HL, Whitlock JA, Sprague MK, Kennedy LJ, Buckingham TA, Goldberg RJ. Long-term follow-up of asymptomatic healthy subjects with frequent and complex ventricular ectopy. N Engl J Med. 1985;312:193–7.

    Article  PubMed  CAS  Google Scholar 

  82. Hinkle Jr LE, Carver ST, Stevens M. The frequency of asymptomatic disturbances of cardiac rhythm and conduction in middle-aged men. Am J Cardiol. 1969;24:629–50.

    Article  PubMed  Google Scholar 

  83. Jouven X, Zureik M, Desnos M, Courbon D, Ducimetiere P. Long-term outcome in asymptomatic men with exercise-induced premature ventricular depolarizations. N Engl J Med. 2000;343:826–33.

    Article  PubMed  CAS  Google Scholar 

  84. Frolkis JP, Pothier CE, Blackstone EH, Lauer MS. Frequent ventricular ectopy after exercise as a predictor of death. N Engl J Med. 2003;348:781–90.

    Article  PubMed  Google Scholar 

  85. Messerli FH, Ventura HO, Elizardi DJ, Dunn FG, Frohlich ED. Hypertension and sudden death: increased ventricular ectopic activity in left ventricular hypertrophy. Am J Med. 1984;77:18–22.

    Article  PubMed  CAS  Google Scholar 

  86. Bigger Jr JT, Fleiss JL, Kleiger R, et al. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation. 1984;69:250–8.

    Article  PubMed  Google Scholar 

  87. Huikuri HV, Makikallio TH, Raatikainen MJP, Perkiomaki J, Castellanos A, Myerburg RJ. Prediction of sudden cardiac death: appraisal of the studies and methods assessing the risk of sudden arrhythmic death. Circulation. 2003;108:110–5.

    Article  PubMed  Google Scholar 

  88. Stevenson WG, Stevenson LW, Middlekauff HR, Saxon LA. Sudden death prevention in patients with advanced ventricular dysfunction. Circula­tion. 1993;88:2953–61.

    Article  PubMed  CAS  Google Scholar 

  89. Aronow WS, Ahn C, Mercando AD, Epstein S, Kronzon I. Prevalence and association of ventricular tachycardia and complex ventricular arrhythmias with new coronary events in older men and women with and without cardiovascular disease. J Gerontol A Biol Sci Med Sci. 2002;57:M178–80.

    Article  PubMed  Google Scholar 

  90. Volpi A, Cavalli A, Turato R, Barlera S, Santoro E, Negri E. Incidence and short-term prognosis of late sustained ventricular tachycardia after myocardial infarction: results of the Gruppo Italiano per lo Studio Della Sopravvivenza nell’Infarto Miocardico (GISSI-3) Data Base. Am Heart J. 2001;142:87–92.

    Article  PubMed  CAS  Google Scholar 

  91. Trusty JM, Beinborn DS, Jahangir A. Dysrhythmias and the athlete. AACN Clin Issues. 2004;15:432–48.

    Article  PubMed  Google Scholar 

  92. Ornato JP, Peberdy MA, Tadler SC, Strobos NC. Factors associated with the occurrence of cardiac arrest during hospitalization for acute myocardial infarction in the second national registry of myocardial infarction in the US. Resuscitation. 2001;48:117–23.

    Article  PubMed  CAS  Google Scholar 

  93. Behar S, Goldbourt U, Reicher-Reiss H, Kaplinsky E, The Principal Investigators of the SPRINT Study. Prognosis of acute myocardial infarction complicated by primary ventricular fibrillation. Am J Cardiol. 1990;66:1208–11.

    Article  PubMed  CAS  Google Scholar 

  94. Huikuri HV, Castellanos A, Myerburg RJ. Medical progress: sudden death due to cardiac arrhythmias. N Engl J Med. 2001;345:1473–82.

    Article  PubMed  CAS  Google Scholar 

  95. Luu M, Stevenson WG, Stevenson LW, Baron K, Walden J. Diverse mechanisms of unexpected cardiac arrest in advanced heart failure. Circulation. 1989;80:1675–80.

    Article  PubMed  CAS  Google Scholar 

  96. Bayes de Luna A, Coumel P, Leclercq JF. Ambulatory sudden cardiac death: mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J. 1989;117:151–9.

    Article  PubMed  CAS  Google Scholar 

  97. Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK. Changing incidence of out-of-hospital ventricular fibrillation, 1980–2000. JAMA. 2002;288:3008–13.

    Article  PubMed  Google Scholar 

  98. Herlitz J, Andersson E, Bang A, Engdahl J, Holmberg M, Lindqvist J, et al. Experiences from treatment of out-of-hospital cardiac arrest during 17 years in Goteborg. Eur Heart J. 2000;21:1251–8.

    Article  PubMed  CAS  Google Scholar 

  99. Schouten EG, Dekker JM, Meppelink P, Kok FJ, Vandenbroucke JP, Pool J. QT interval prolongation predicts cardiovascular mortality in an apparently healthy population. Circulation. 1991;84:1516–23.

    Article  PubMed  CAS  Google Scholar 

  100. Steinberg JS, Berbari EJ. The signal-averaged electrocardiogram: update on clinical applications. J Cardiovasc Electrophysiol. 1996;7:972–88.

    Article  PubMed  CAS  Google Scholar 

  101. Cook JR, Flack JE, Gregori CA, Deaton DW, Rousou JA, Engelman RM. The CABG Patch Trial. Influence of the preoperative signal-averaged electrocardiogram on left ventricular function after coronary artery bypass graft surgery in patients with left ventricular dysfunction. Am J Cardiol. 1998;82:285–9.

    Article  PubMed  CAS  Google Scholar 

  102. Podrid PJ, Graboys TB. Exercise stress testing in the management of cardiac rhythm disorders. Med Clin North Am. 1984;68:1139–52.

    PubMed  CAS  Google Scholar 

  103. Couderc JP, Zareba W, McNitt S, Maison-Blanche P, Moss AJ. Repolarization variability in the risk stratification of MADIT II patients. Europace. 2007;9:717–23.

    Article  PubMed  Google Scholar 

  104. Bloomfield DM, Bigger JT, Steinman RC, Namerow PB, Parides MK, Curtis AB, et al. Microvolt t-wave alternans and the risk of death or sustained ventricular arrhythmias in patients with left ventricular dysfunction. J Am Coll Cardiol. 2006;47:456–63.

    Article  PubMed  Google Scholar 

  105. Chow T, Kereiakes DJ, Bartone C, Booth T, Schloss EJ, Waller T, et al. Prognostic utility of microvolt T-wave alternans in risk stratification of patients with ischemic cardiomyopathy. J Am Coll Cardiol. 2006;47:1820–7.

    Article  PubMed  Google Scholar 

  106. Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: Summary article: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). J Am Coll Cardiol. 2003;42:954–70.

    Article  PubMed  Google Scholar 

  107. Azaouagh A, Churzidse S, Konorza T, Erbel R. Arrhythmogenic right ventricular cardiomyopathy/dysplasia: a review and update. Clin Res cardiol. 2011;100:383–94.

    Article  PubMed  CAS  Google Scholar 

  108. Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria. Circulation. 2010;121:1533–41.

    Article  PubMed  Google Scholar 

  109. Klocke FJ, Baird MG, Lorell BH, Bateman TM, Messer JV, Berman DS, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging–executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). J Am Coll Cardiol. 2003;42:1318–33.

    Article  PubMed  Google Scholar 

  110. Wilber DJ, Garan H, Finkelstein D, Kelly E, Newell J, McGovern B, et al. Out-of-hospital ­cardiac arrest. Use of electrophysiologic testing in the prediction of long-term outcome. N Engl J Med. 1988;318:19–24.

    Article  PubMed  CAS  Google Scholar 

  111. Bachinsky WB, Linzer M, Weld L, Estes I, Mark NA. Usefulness of clinical characteristics in predicting the outcome of electrophysiologic studies in unexplained syncope. Am J Cardiol. 1992;69:1044–9.

    Article  PubMed  CAS  Google Scholar 

  112. Chen LYJA, Decker WW, Smars PA, Wieling W, Hodge DO, Gersh BJ, et al. Score indices for predicting electrophysiologic outcomes in patients with unexplained syncope. J Interv Card Electrophysiol. 2005;14:99–105.

    Article  PubMed  Google Scholar 

  113. Priori SG, Schwartz PJ, Napolitano C, Bloise R, Ronchetti E, Grillo M, et al. Risk stratification in the long-QT syndrome. N Engl J Med. 2003;348:1866–74.

    Article  PubMed  Google Scholar 

  114. Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J. 2009;30:2631–71.

    Article  PubMed  Google Scholar 

  115. Priori SG, Napolitano C, Gasparini M, Pappone C, Della Bella P, Giordano U, et al. Natural history of Brugada syndrome: insights for risk stratification and management. Circulation. 2002;105:1342–7.

    Article  PubMed  Google Scholar 

  116. Brugada J, Brugada R, Brugada P. Determinants of sudden cardiac death in individuals with the electrocardiographic pattern of Brugada syndrome and no previous cardiac arrest. Circulation. 2003;108:3092–6.

    Article  PubMed  Google Scholar 

  117. Nienaber CA, Hiller S, Spielmann RP, Geiger M, Kuck KH. Syncope in hypertrophic cardiomyopathy: multivariate analysis of prognostic determinants. J Am Coll Cardiol. 1990;15:948–55.

    Article  PubMed  CAS  Google Scholar 

  118. Schmitt C, Barthel P, Ndrepepa G, Schreieck J, Plewan A, Schomig A, et al. Value of programmed ventricular stimulation for prophylactic internal cardioverter-defibrillator implantation in postinfarction patients preselected by noninvasive risk stratifiers. J Am Coll Cardiol. 2001;37:1901–7.

    Article  PubMed  CAS  Google Scholar 

  119. Buxton AE, Lee KL, Hafley GE, Wyse DG, Fisher JD, Lehmann MH, et al. Relation of ejection fraction and inducible ventricular tachycardia to mode of death in patients with coronary artery disease: an analysis of patients enrolled in the multicenter unsustained tachycardia trial. Circula­tion. 2002;106:2466–72.

    Article  PubMed  CAS  Google Scholar 

  120. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EU, Hafley G. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med. 1999;341:1882–90.

    Article  PubMed  CAS  Google Scholar 

  121. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med. 1996;335:1933–40.

    Article  PubMed  CAS  Google Scholar 

  122. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877–83.

    Article  PubMed  Google Scholar 

  123. Connolly SJ, Hallstrom AP, Cappato R, Schron EB, Kuck KH, Zipes DP, et al. Meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. AVID, CASH and CIDS studies. Antiarrhythmics vs Implantable Defibrillator study. Cardiac Arrest Study Hamburg. Canadian Implantable Defibrillator Study. Eur Heart J. 2000;21:2071–8.

    Article  PubMed  CAS  Google Scholar 

  124. Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med. 2004;350:1013–22.

    Article  PubMed  CAS  Google Scholar 

  125. Jahangir A, Terzic A, Shen WK. Antiarrhythmic drugs and future direction. In: Gussak I, Antzelevitch C, Hammill SC, Shen WK, Bjerregaard P, editors. Cardiac repolarization: bridging basic and clinical science, Contem­porary cardiology. Totowa, NJ: Humana Press; 2003. p. 387–404.

    Chapter  Google Scholar 

  126. Williams BR, Kim J. Cardiovascular drug therapy in the elderly: theoretical and practical considerations. Drugs Aging. 2003;20:445–63.

    Article  PubMed  CAS  Google Scholar 

  127. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med. 1989;321:406–12.

    Article  Google Scholar 

  128. Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF, et al. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. Lancet. 1996;348:7–12.

    Article  PubMed  CAS  Google Scholar 

  129. Fleg JL, Aronow WS, Frishman WH. Cardiovascular drug therapy in the elderly: benefits and challenges. Nat Rev Cardiol. 2011;8:13–28.

    Article  PubMed  CAS  Google Scholar 

  130. Hellestrand KJ, Burnett PJ, Milne JR, et al. Effect of the antiarrhythmic agent flecainide acetate on acute and chronic pacing thresholds. Pacing Clin Electrophysiol. 1983;6:892–9.

    Article  PubMed  CAS  Google Scholar 

  131. Echt DS, Black JN, Barbey JT, Coxe DR, Cato E. Evaluation of antiarrhythmic drugs on defibrilla­tion energy requirements in dogs. Sodium channel block and action potential prolongation. Circulation. 1989;79:1106–17.

    Article  PubMed  CAS  Google Scholar 

  132. Connolly SJ, Dorian P, Roberts RS, Gent M, Bailin S, Fain ES, et al. Comparison of [beta]-blockers, amiodarone plus [beta]-blockers, or sotalol for prevention of shocks from implantable cardioverter defibrillators – the optic study: a randomized trial. J Am Med Assoc. 2006;295:165–71.

    Article  CAS  Google Scholar 

  133. Pacifico A, Hohnloser SH, Williams JH, Tao B, Saksena S, Henry PD, et al. Prevention of implantable-defibrillator shocks by treatment with sotalol. N Engl J Med. 1999;340:1855–62.

    Article  PubMed  CAS  Google Scholar 

  134. Connolly SJ. Meta-analysis of antiarrhythmic drug trials. Am J Cardiol. 1999;84:90R–3.

    Article  PubMed  CAS  Google Scholar 

  135. Farre J, Romero J, Rubio JM, Ayala R, Castro-Dorticos J. Amiodarone and ‘primary’ prevention of sudden death: critical review of a decade of clinical trials. Am J Cardiol. 1999;83:55D–63.

    Article  PubMed  CAS  Google Scholar 

  136. Steinberg JS, Martins J, Sadanandan S, Goldner B, Menchavez E, Domanski M, et al. Antiarrhythmic drug use in the implantable defibrillator arm of the Antiarrhythmics Versus Implantable Defibrillators (AVID) study. Am Heart J. 2001;142:520–9.

    Article  PubMed  CAS  Google Scholar 

  137. Piccini JP, Berger JS, O’Connor CM. Amiodarone for the prevention of sudden cardiac death: a meta-analysis of randomized controlled trials. Eur Heart J. 2009;30:1245–53.

    Article  PubMed  CAS  Google Scholar 

  138. Kuhlkamp V, Mewis C, Mermi J, Bosch RF, Seipel L. Suppression of sustained ventricular tachyarrhythmias: a comparison of d, l-sotalol with no antiarrhythmic drug treatment. J Am Coll Cardiol. 1999;33:46–52.

    Article  PubMed  CAS  Google Scholar 

  139. Alberte C, Zipes DP. Use of nonantiarrhythmic drugs for prevention of sudden cardiac death. J Cardiovasc Electrophysiol. 2003;14:S87–95.

    Article  PubMed  Google Scholar 

  140. Woods KL, Ketley D, Lowy A, Agusti A, Hagn C, Kala R, et al. Beta-blockers and antithrombotic treatment for secondary prevention after acute myocardial infarction. Towards an understanding of factors influencing clinical practice. Eur Heart J. 1998;19:74–9.

    Article  PubMed  CAS  Google Scholar 

  141. Cairns JA, Connolly SJ, Roberts R, Gent M. Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Lancet. 1997;349:675–82.

    Article  PubMed  CAS  Google Scholar 

  142. Julian D, Camm A, Frangin G, Janse M, Munoz A, Schwartz P, et al. Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. Lancet. 1997;349:667–74.

    Article  PubMed  CAS  Google Scholar 

  143. Wilber DJ, Zareba W, Hall WJ, Brown MW, Lin AC, Andrews ML, et al. Time dependence of mortality risk and defibrillator benefit after myocardial infarction. Circulation. 2004;109:1082–4.

    Article  PubMed  Google Scholar 

  144. Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R, et al. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med. 2004;351:2481–8.

    Article  PubMed  CAS  Google Scholar 

  145. Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS, et al. Canadian Implantable Defibrillator Study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation. 2000;101:1297–302.

    Article  PubMed  CAS  Google Scholar 

  146. Lee KL, Hafley G, Fisher JD, Gold MR, Prystowsky EN, Talajic M, et al. Effect of implantable defibrillators on arrhythmic events and mortality in the multicenter unsustained tachycardia trial. Circulation. 2002;106:233–8. doi:10.1161/01.Cir.0000021920.73149.C3.

    Article  PubMed  Google Scholar 

  147. Kuck K-H, Cappato R, Siebels J, Ruppel R. Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest: the Cardiac Arrest Study Hamburg (CASH). Circulation. 2000;102:748–54.

    Article  PubMed  CAS  Google Scholar 

  148. Trappe H-J, Pfitzner P, Achtelik M, Fieguth H-G. Age dependent efficacy of implantable cardioverter-defibrillator treatment: observations in 450 patients over an 11 year period. Heart. 1997;78:364–70.

    PubMed  CAS  Google Scholar 

  149. Duray G, Richter S, Manegold J, Israel CW, Grönefeld G, Hohnloser SH. Efficacy and safety of ICD therapy in a population of elderly patients treated with optimal background medication. J Interv Card Electrophysiol. 2005;V14:169–73.

    Article  Google Scholar 

  150. Daubert J, Sesselberg H, Huang D. Implantable cardioverter-defibrillators for primary prevention: how do the data pertain to the aged? Am J Geriatr Cardiol. 2006;15:88–92.

    Article  PubMed  Google Scholar 

  151. Penn J, Goldenberg I, Moss AJ, McNitt S, Zareba W, Klein HU, et al. Improved outcome with preventive cardiac resynchronization therapy in the elderly: a MADIT-CRT substudy. J Cardiovasc Electrophysiol. 2011;22:892–7.

    Article  PubMed  Google Scholar 

  152. Bardy GH, Lee KL, Mark DB, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352:225–37.

    Article  PubMed  CAS  Google Scholar 

  153. Cleland JGF, Daubert J-C, Erdmann E, Freemantle N, Gras D, Kappenberger L, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539–49.

    Article  PubMed  CAS  Google Scholar 

  154. van Rees JB, Borleffs CJ, Thijssen J, de Bie MK, van Erven L, Cannegieter SC, et al. Prophylactic implantable cardioverter-defibrillator treatment in the elderly: therapy, adverse events, and survival gain. Europace. 2012;14:66–73.

    Article  PubMed  Google Scholar 

  155. Jahangir ASW, Neubauer SA, Ballard DJ, Hammill SC, Hodge DO, Lohse CM, et al. Relation between mode of pacing and long-term survival in the very elderly. J Am Coll Cardiol. 1999;33:1208–16.

    Article  PubMed  CAS  Google Scholar 

  156. Krahn AD, Connolly SJ, Roberts RS, Gent M. Diminishing proportional risk of sudden death with advancing age: implications for prevention of sudden death. Am Heart J. 2004;147:837–40.

    Article  PubMed  Google Scholar 

  157. Geelen P, Lorga Filho A, Primo J, Wellens F, Brugada P. Experience with implantable cardioverter defibrillator therapy in elderly patients. Eur Heart J. 1997;18:1339–42.

    Article  PubMed  CAS  Google Scholar 

  158. Panotopoulos PT, Axtell K, Anderson AJ, Sra J, Blanck Z. Efficacy of the implantable cardioverter-defibrillator in the elderly. J Am Coll Cardiol. 1997;29:556–60.

    Article  PubMed  CAS  Google Scholar 

  159. Saksena S, Mathew P, Giorgberidze I, Krol RB, Kaushik R. Implantable defibrillator therapy for the elderly. Am J Geriatr Cardiol. 1998;7:11–3.

    PubMed  Google Scholar 

  160. Wilkoff BL, Cook JR, Epstein AE, Greene L, Hallstrom AP, Hsia H, et al. Dual-chamber pacing-or ventricular backup pacing in patients with an implantable defibrillator: the Dual Chamber and VVI Implantable Defibrillator (DAVID) trial. J Am Med Assoc. 2002;288:3115–23.

    Article  Google Scholar 

  161. Grimm W. Outcomes of elderly heart failure recipients of ICD and CRT. Int J Cardiol. 2008;125:154–60.

    Article  PubMed  Google Scholar 

  162. Kocovic DZ. Cardiac resynchronization therapy and other new approaches for the treatment of heart failure in the elderly. Am J Geriatr Cardiol. 2006;15:108–13.

    Article  PubMed  Google Scholar 

  163. Foley PW, Chalil S, Khadjooi K, Smith RE, Frenneaux MP, Leyva F. Long-term effects of cardiac resynchronization therapy in octogenarians: a comparative study with a younger population. Europace. 2008;10:1302–7.

    Article  PubMed  Google Scholar 

  164. Silva RMFL, Mont L, Nava S, Rojel U, Matas M, Brugada J. Radiofrequency catheter ablation for arrhythmic storm in patients with an implantable cardioverter defibrillator. Pacing Clin Electrophysiol. 2004;27:971–5.

    Article  PubMed  Google Scholar 

  165. Scheinman MM. Naspe survey on catheter ablation. Pacing Clin Electrophysiol. 1995;18:1474–8.

    Article  PubMed  CAS  Google Scholar 

  166. Tchou P, Jazayeri M, Denker S, Dongas J, Caceres J, Akhtar M. Transcatheter electrical ablation of right bundle branch. A method of treating macroreentrant ventricular tachycardia attributed to bundle branch reentry. Circulation. 1988;78:246–57.

    Article  PubMed  CAS  Google Scholar 

  167. Stevenson WG, Khan H, Sager P, Saxon LA, Middlekauff HR, Natterson PD, et al. Identification of reentry circuit sites during catheter mapping and radiofrequency ablation of ventricular tachycardia late after myocardial infarction. Circulation. 1993;88:1647–70.

    Article  PubMed  CAS  Google Scholar 

  168. Gurevitz OTGM, Asirvatham S, Kester TA, Grice SK, Munger TM, Rea RF, et al. Use of advanced mapping systems to guide ablation in complex cases: experience with noncontact mapping and electroanatomic mapping systems. Pacing Clin Electrophysiol. 2005;28:316–23.

    Article  PubMed  Google Scholar 

  169. Joshi S, Wilber DJ. Ablation of idiopathic right ventricular outflow tract tachycardia: current perspectives. J Cardiovasc Electrophysiol. 2005;16:S52–8. doi:10.1111/j.1540-8167.2005.50163.X.

    Article  PubMed  Google Scholar 

  170. Pedrinazzi C, Durin O, Agricola P, Romagnoli P, Inama G. Efficacy and safety of radiofrequency catheter ablation in the elderly. J Interv Card Electrophysiol. 2007;19:179–85.

    Article  PubMed  Google Scholar 

  171. Inada K, Roberts-Thomson KC, Seiler J, Steven D, Tedrow UB, Koplan BA, et al. Mortality and safety of catheter ablation for antiarrhythmic drug-refractory ventricular tachycardia in elderly patients with coronary artery disease. Heart Rhythm. 2010;7:740–4.

    Article  PubMed  Google Scholar 

  172. Kelly P, Ruskin JN, Vlahakes GJ, Buckley Jr MJ, Freeman CS, Garan H. Surgical coronary revascularization in survivors of prehospital cardiac arrest: its effect on inducible ventricular arrhythmias and long-term survival. J Am Coll Cardiol. 1990;15:267–73.

    Article  PubMed  CAS  Google Scholar 

  173. Brugada J, Aguinaga L, Mont L, Betriu A, Mulet J, Sanz G. Coronary artery revascularization in patients with sustained ventricular arrhythmias in the chronic phase of a myocardial infarction: effects on the electrophysiologic substrate and outcome. J Am Coll Cardiol. 2001;37:529–33.

    Article  PubMed  CAS  Google Scholar 

  174. Natale A, Sra J, Axtell K, Maglio C, Dhala A, Blanck Z, et al. Ventricular fibrillation and polymorphic ventricular tachycardia with critical coronary artery stenosis: does bypass surgery suffice? J Card Electrophysiol. 1994;5:988–94.

    Article  CAS  Google Scholar 

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Acknowledgement.

Drs. Jahangir and Mirza’s research effort was in part supported by the National Heart, Lung, and Blood Institute grants RO1 HL101240-02 and R01 HL089542-04.

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Authors and Affiliations

  1. Center for Integrative Research on Cardiovascular Aging (CIRCA), Aurora University of Wisconsin Medical Group, Aurora Health Care, Milwaukee, WI, USA

    Mahek Mirza MD

  2. Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA

    Win-Kuang Shen MD

  3. Center for Integrative Research on Cardiovascular Aging (CIRCA), Aurora University of Wisconsin Medical Group, Aurora Health Care, 3033 South 27th Street, Suite 201, Milwaukee, WI, 53215, USA

    Arshad Jahangir MD

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  1. Mahek Mirza MD
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  3. Arshad Jahangir MD
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Correspondence to Arshad Jahangir MD .

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  1. , Department of Internal Medicine, UMDNJ-RWJ Medical School, Robert Wood Johnson Pl. 1, New Brunswick, 08903-0019, New Jersey, USA

    Ihor Gussak

  2. , Gordon K. Moe Scholar, Masonic Medical Research Laboratory, Bleecker Street, Utica, 13501-1787, New York, USA

    Charles Antzelevitch

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Mirza, M., Shen, WK., Jahangir, A. (2013). Senescence and Arrhythmogenesis. In: Gussak, I., Antzelevitch, C. (eds) Electrical Diseases of the Heart. Springer, London. https://doi.org/10.1007/978-1-4471-4881-4_19

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