Cardiac psychology is a specialization of health psychology that focuses on the primary and secondary prevention of heart disease by incorporating strategies to address the emotional and behavioral barriers to lifestyle changes (e.g. smoking cessation), and that seeks to enhance recovery in cardiac patients by means of providing patients tools (e.g. stress management and psychotherapy) to cope with life and physical changes associated with their disease. Cardiac psychologists can help cardiac patients across the lifespan: prevention, pre-surgery, post-surgery, and rehabilitation of cardiac disease with a particular emphasis on achieving optimal quality of life outcomes. Cardiac psychology includes both research and clinical practice aspects.
The earliest published mention of cardiac psychology in Western medicine literature was in 1628 when William Harvey wrote that "a mental disturbance provoking pain, excessive joy, hope or anxiety extends to the heart, where it affects temper." [1] Research labs have been founded at Tilburg University, Tilburg Netherlands [2] led by Susanne Pedersen, [3] and at East Carolina University, Greenville, North Carolina [4] led by Samuel Sears, [5] that focus on psychological aspects of cardiac disease. Cardiac psychology as a term was first used by Robert Allan, PhD, and Stephen Schiedt, MD, as a title of their 1996 book, Heart and Mind: The Practice of Cardiac Psychology and launched increased attention to the clinical practice of cardiac psychology. More recently, additional texts, such as Psychotherapy with Cardiac Patients, (2008) by Ellen Dornelas, [6] have attempted to update the literature related to clinical techniques used in the care of cardiac patients. Significant research reviews have also been published spanning psychological factors in cardiac care, [7] [8] implantable electronic medical devices (pacemaker, implantable cardioverter-defibrillator, etc.) [9] [10] and congestive heart failure. [11]
An artificial cardiac pacemaker is a medical device, currently always implanted, that generates electrical pulses delivered by electrodes to one or more of the chambers of the heart, the upper atria or lower ventricles. Each pulse causes the targeted chamber(s) to contract and pump blood, thus regulating the function of the electrical conduction system of the heart.
Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current to the heart. Although not fully understood, this process depolarizes a large amount of the heart muscle, ending the arrhythmia. Subsequently, the body's natural pacemaker in the sinoatrial node of the heart is able to re-establish normal sinus rhythm. A heart which is in asystole (flatline) cannot be restarted by a defibrillator; it would be treated only by cardiopulmonary resuscitation (CPR) and medication, and then by cardioversion or defibrillation if it converts into a shockable rhythm.
An implantable cardioverter-defibrillator (ICD) or automated implantable cardioverter defibrillator (AICD) is a device implantable inside the body, able to perform defibrillation, and depending on the type, cardioversion and pacing of the heart. The ICD is the first-line treatment and prophylactic therapy for patients at risk for sudden cardiac death due to ventricular fibrillation and ventricular tachycardia.
Peripartum cardiomyopathy (PPCM) is a form of dilated cardiomyopathy that is defined as a deterioration in cardiac function presenting typically between the last month of pregnancy and up to six months postpartum. As with other forms of dilated cardiomyopathy, PPCM involves systolic dysfunction of the heart with a decrease of the left ventricular ejection fraction (EF) with associated congestive heart failure and an increased risk of atrial and ventricular arrhythmias, thromboembolism (blockage of a blood vessel by a blood clot), and even sudden cardiac death. In essence, the heart muscle cannot contract forcefully enough to pump adequate amounts of blood for the needs of the body's vital organs.
Cardiac electrophysiology is a branch of cardiology and basic science focusing on the electrical activities of the heart. The term is usually used in clinical context, to describe studies of such phenomena by invasive (intracardiac) catheter recording of spontaneous activity as well as of cardiac responses to programmed electrical stimulation - clinical cardiac electrophysiology. However, cardiac electrophysiology also encompasses basic research and translational research components. Specialists studying cardiac electrophysiology, either clinically or solely through research, are known as cardiac electrophysiologists.
T wave alternans (TWA) is a periodic beat-to-beat variation in the amplitude or shape of the T wave in an electrocardiogram TWA was first described in 1908. At that time, only large variations could be detected. Those large TWAs were associated with increased susceptibility to lethal ventricular tachycardias.
Bernard Lown was a Lithuanian-American cardiologist and inventor. Lown was the original developer of the direct current defibrillator for cardiac resuscitation, and the cardioverter for correcting rapid disordered heart rhythms. He introduced a new use for the drug lidocaine to control heartbeat disturbances.
Clinical cardiac electrophysiology, is a branch of the medical specialty of cardiology concerned with the study and treatment of rhythm disorders of the heart. Cardiologists with expertise in this area are usually referred to as electrophysiologists. Electrophysiologists are trained in the mechanism, function, and performance of the electrical activities of the heart. Electrophysiologists work closely with other cardiologists and cardiac surgeons to assist or guide therapy for heart rhythm disturbances (arrhythmias). They are trained to perform interventional and surgical procedures to treat cardiac arrhythmia.
Morton Maimon Mower was an American cardiologist specializing in electrophysiology and the co-inventor of the automatic implantable cardioverter defibrillator. He served in several professional capacities at Sinai Hospital and Cardiac Pacemakers Inc. In 1996, he became the chairman and chief executive officer of Mower Research Associates. He was inducted into the National Inventors Hall of Fame in 2002 for the development of the automatic implantable cardioverter defibrillator with Michel Mirowski in the 1970s. He continued his research in the biomechanical engineering laboratories at Johns Hopkins University.
Marlin Stephen "Doc" Heilman is an American physician, entrepreneur and inventor. He is credited with inventions in the fields of contrast enhanced medical imaging, the first implantable cardioverter defibrillator or ICD, the first wearable defibrillator or LifeVest defibrillator, and heart assist devices. His first inventions, a flow controlled angiographic injector and pressure tolerant disposable angiographic syringes, advanced the fields of radiology and cardiology by improving the diagnostic image quality and eliminating the imaging risk of blood borne disease transmission from patient to patient. He founded Medrad Inc, now part of Bayer Healthcare, to manufacture and supply these imaging devices on a worldwide basis. In 2013, an estimated 65 million medical imaging procedures were performed using Medrad products.
Cardiac resynchronisation therapy is the insertion of electrodes in the left and right ventricles of the heart, as well as on occasion the right atrium, to treat heart failure by coordinating the function of the left and right ventricles via a pacemaker, a small device inserted into the anterior chest wall.
Management of heart failure requires a multimodal approach. It involves a combination of lifestyle modifications, medications, and possibly the use of devices or surgery.
A wearable cardioverter defibrillator (WCD) is a non-invasive, external device for patients at risk of sudden cardiac arrest (SCA). It allows physicians time to assess their patient's arrhythmic risk and see if their ejection fraction improves before determining the next steps in patient care. It is a leased device. A summary of the device, its technology and indications was published in 2017 and reviewed by the EHRA Scientific Documents Committee.
Jonathan L. Halperin is an American cardiologist and the author of Bypass (ISBN 0-89586-509-2), among the most comprehensive works on the subject of coronary artery bypass surgery. In addition, he is the Robert and Harriet Heilbrunn Professor of Medicine at The Mount Sinai School of Medicine as well as Director of Clinical Cardiology in the Zena and Michael A. Wierner Cardiovascular Institute at The Mount Sinai Medical Center, both in New York City. Halperin was the principal cardiologist responsible for both the design and execution of the multi-center Stroke Prevention in Atrial Fibrillation (SPAF) clinical trials, funded by the National Institutes of Health, which helped develop antithrombotic strategies to prevent stroke, and he subsequently directed the SPORTIF clinical trials, which evaluated the first oral direct thrombin inhibitor for prevention of stroke in patients with atrial fibrillation.
Frederick A. Masoudi is an American cardiologist with expertise in cardiovascular outcomes research, clinical registries and quality measurement.
Cardiac contractility modulation is a therapy which is intended for the treatment of patients with moderate to severe heart failure with symptoms despite optimal medical therapy who can benefit from an improvement in cardiac output. The short- and long-term use of this therapy enhances the strength of ventricular contraction and therefore the heart's pumping capacity by modulating (adjusting) the myocardial contractility. This is provided by a pacemaker-like device that applies non-excitatory electrical signals adjusted to and synchronized with the electrical action in the cardiac cycle.
Yaariv Khaykin is a Canadian cardiologist and a clinical researcher in the area of electrophysiology. He is the director of the Newmarket Electrophysiology Research Group at the Southlake Regional Health Centre. He has published research into complex ablation and pioneered cardiac ablation methods.
Subcutaneous implantable cardioverter defibrillator, or S-ICD, is an implantable medical device for detecting and terminating ventricular tachycardia and ventricular fibrillation in patients at risk of sudden cardiac arrest. It is a type of implantable cardioverter defibrillator but unlike the transvenous ICD, the S-ICD lead is placed just under the skin, leaving the heart and veins untouched.
Ischemic cardiomyopathy is a type of cardiomyopathy caused by a narrowing of the coronary arteries which supply blood to the heart. Typically, patients with ischemic cardiomyopathy have a history of acute myocardial infarction, however, it may occur in patients with coronary artery disease, but without a past history of acute myocardial infarction. This cardiomyopathy is one of the leading causes of sudden cardiac death. The adjective ischemic means characteristic of, or accompanied by, ischemia — local anemia due to mechanical obstruction of the blood supply.
Iqbal Mahmoud Al Assad is a physician pursuing a pediatric cardiology fellowship at Boston Children's Hospital. She was recognized as one of the youngest doctors in the world when she completed her medical training at age 20. Her name is also seen as Iqbal El-Assaad in some sources.
