The impact of socioeconomic status and race on the outcomes of congenital heart disease
Purpose of review
Studying the outcomes of congenital heart disease and their associations allows paediatric cardiologists and intensivists to improve the care and health equity of their patients. This review presents the most recent literature discussing the socioeconomic and racial disparities that pervade the outcomes of patients with congenital heart disease in every facet of treatment. The outcomes of congenital heart disease discussed are prenatal detection, maintenance of care, quality of life, neurodevelopment and mortality.
Recent findings
Historically, it has been documented that patients with congenit...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research
Brugada syndrome – minimizing overdiagnosis and over treatment in children
Purpose of review
Is to summarise the new contributions toward the understanding of the broad spectrum of manifestations of Brugada syndrome (BrS) during the first years of life. The review encompasses the screening of the asymptomatic patient referred due to family history in one extreme of the spectrum, and also the rare child with early clinical expression of the disease on the opposite side.
Recent findings
Involve specific features of pediatric BrS including the risk related to a positive family history of sudden cardiac death, the risk of presenting with syncope and the multiple diagnostic challenges of th...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: PEDIATRICS: Edited by Mitchell I. Cohen Source Type: research
Current evidence on the safety and efficacy of combined atrial fibrillation ablation and left atrial appendage closure
In conclusion, combined AF ablation and LAAC serve as a promising option for patients with symptomatic AF and high risk of stroke and/or bleeding. (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Cryoballoon atrial fibrillation ablation experience in Japan
Purpose of review
In Japan, cryoballoon ablation has been widely accepted and more than 70 000 patients have undergone pulmonary vein isolation using this novel technology since the introduction. This review focused on the current status of cryoballoon ablation in Japan and clarified the characteristics as compared to Europe and the United States.
Recent findings
The number of atrial fibrillation patients undergoing cryoballon ablation has rapidly increased over the last 6 years. Most of the Japanese physicians consider the indication of cryoballoon ablation based on the anatomy of the pulmonary veins and left...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
A tale of two balloons: technical and procedural difference between cryoballoon systems
Purpose of review
The cryoballoon catheter has been an option for the treatment of atrial fibrillation for over a decade. The most widely used device is the Medtronic Arctic Advance cryoballoon catheter. Recently, Boston Scientific has released the POLARx cryoballoon catheter. Here we review the major changes in the catheter system's design and its implications for procedural practice.
Recent findings
The POLARx cryoballoon catheter has been approved for use in Europe. Some studies have been published detailing the first clinical experiences in vivo with this newest technology.
Summary
The changes to the ...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Posterior left atrial epicardial adipose tissue: scope of the problem and impact of new technology
Purpose of review
Patients with persistent forms of atrial fibrillation are seeking treatments based on the promise of better restoration of sinus rhythm with newer therapies. Successful catheter ablation and maintenance of atrial fibrillation in this subgroup is negatively impacted by the presence of epicardial adipose tissue (EAT) associated with the posterior left atrium.
Recent findings
EAT is now understood to be hormonally active and promotes adverse atrial remodelling, including fibrosis and myopathy. Despite being dominantly adipose tissue, it is known to be electrically active, comprising ganglia, neura...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Ablation of intra-atrial reentrant tachycardias in adults with congenital heart disease: islands, isthmuses, channels, and walls
Purpose of review
The adult congenital heart patient population is rapidly growing due to increasing survival rates, and they often face chronic physiologic challenges as sequalae of both their defects and repairs. Among the most common sequalae are arrhythmias. Here we describe intra-atrial reentrant tachycardia (IART), one of the most commonly seen arrhythmias in the adult congenital heart population, and the approaches to successful ablation in adult congenital heart patients.
Recent findings
IART has increasing ablation success rates due to the increasing exposure of electrophysiologists to congenital cases,...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Atypical atrial flutter: review of mechanisms, advances in mapping and ablation outcomes
Purpose of review
Atrial flutter (AFL) is the second most prevalent arrhythmia after atrial fibrillation (AF). It is a macro-reentrant tachycardia that is either cavotricuspid isthmus dependent (typical) or independent (atypical). This review aims at highlighting mechanism, diagnosis and treatment of atypical AFL and the recent developments in electroanatomic mapping.
Recent findings
Incidence of left AFL is at an exponential rise presently with increase in AF ablation rates. The mechanism of left AFL is most often peri-mitral, roof-dependent or within pulmonary veins in preablated, in contrast to posterior or a...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
The emerging role of cardiac contractility modulation in heart failure treatment
Purpose of review
Heart failure often progresses despite optimal medical and device therapies, and advanced mechanical circulatory support has limited availability and substantial associated morbidity. Cardiac contractility modulation (CCM) provides nonexcitatory stimulation to ventricular myocardium which increases cardiac contractility without increasing oxygen demand. This review describes the emerging role of CCM in heart failure treatment.
Recent findings
The FIX-HF-5C2 study demonstrated similar safety and efficacy profile of the two-lead Optimizer device in comparison with the prior three-lead system, the...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Economics and laboratory efficiency of atrial fibrillation ablation
This article summarizes the recently published studies evaluating the economic impact of atrial fibrillation treatment. Catheter ablation have shown to be the most successful strategy for treatment of defibrillation. However, repeat ablation is associated with higher costs, over and above any subsequent procedural costs, compared with a single ablation procedure for atrial fibrillation. Cryoballoon ablation has been shown to have fewer repeat ablations than radiofrequency ablations, which resulted in overall cost reduction. Improvement in laboratory efficiency, better utilization of laboratory resources and same-day discha...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Risk factors of sudden cardiac death in hypertrophic cardiomyopathy
Purpose of review
Hypertrophic cardiomyopathy (HCM) is one of the leading causes of sudden cardiac death (SCD) in younger people and athletes. It is crucial to identify the risk factors for SCD in individuals with HCM. This review, based on recent systematic literature studies, will focus on the risk factors for SCD in patients with HCM.
Recent findings
An increasing number of studies have further explored the risk factors for SCD in patients with HCM, and new risk markers have emerged accordingly. In addition, more accurate SCD risk estimation and stratification methods have been proposed and continuously impro...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Exclusion of left atrial appendage: effects beyond thromboembolic prevention
Purpose of review
This review aims to summarize the nonthromboembolic prevention effects of left atrial appendage exclusion (LAAE).
Recent findings
Left atrial appendage (LAA) secretes multiple hormones; regulates blood volume and pressure; and generates trigger activities. Exclusion of the LAA by different techniques may lead to downstream effects including changes in blood pressure and cardiac performance, improvement of outcome of atrial fibrillation (AF) ablation, and alteration of metabolism.
Summary
LAAE procedures not only prevent thromboembolic events in patients with AF, but rather may bring addi...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Mobile health technologies in the diagnosis and management of atrial fibrillation
Purpose of review
Atrial fibrillation is the most common sustained rhythm abnormality and is associated with stroke, heart failure, cognitive decline, and premature death. Digital health technologies using consumer-grade mobile technologies (i.e. mHealth) capable of recording heart rate and rhythm can now reliably detect atrial fibrillation using single lead or multilead ECG or photoplethysmography (PPG). This review will discuss how these developments are being used to detect and manage atrial fibrillation.
Recent findings
Studies have established the accuracy of mHealth devices for atrial fibrillation detectio...
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: ARRHYTHMIAS: Edited by Wilber W. Su Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Cardiology)
Source: Current Opinion in Cardiology - December 9, 2021 Category: Cardiology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Recent clinical trials in atrial fibrillation
Purpose of review
Management of atrial fibrillation can be overwhelming with the amount of information and treatment options available today. This review discusses landmark and other clinically relevant trials published in the last 18 months.
Recent findings
There have been several recent key clinical trials and subanalyses in the field of atrial fibrillation. Early rhythm control with ablation or antiarrhythmic medications has upended the previous practice of rate control for patients with atrial fibrillation. Vein of Marshall alcohol ablation in combination with endocardial mitral annular ablation and a hybrid...
Source: Current Opinion in Cardiology - October 21, 2021 Category: Cardiology Tags: SPECIAL COMMENTARY Source Type: research
