Dose adjustment based on the plasma level measurement used anti-FXa chromogenic assay on the use of non-vitamin K antagonist oral anticoagulants (NOACs) improved the overall benefit of NOACs dosing in patients with atrial fibrillation: Authors ’ reply
We thank the authors for alerting us to their recently published article on non-vitamin K antagonist oral anticoagulant (NOAC) plasma level assessments.1 Indeed, despite extensive literature review, this interesting and important article has slipped our attention.2 We like to congratulate the authors for their detailed and well-represented work. Based on our 2018 EHRA Practical Guide ’s recommendations,3 Suwaet al. measured plasma levels in both patients on rivaroxaban and apixaban and found acceptable peak plasma levels even in a substantial proportion of patients with off-label dose reductions. Especially in patien...
Source: Europace - September 22, 2021 Category: Cardiology Source Type: research

Dose adjustment based on the plasma level measurement used anti-FXa chromogenic assay on the use of non-vitamin K antagonist oral anticoagulants (NOACs) improved the overall benefit of NOACs dosing in patients with atrial fibrillation
This article indicates that anti-FXa chromogenic assays are available to measure plasma concentration of the FXa inhibitors using validated calibrators. In the section of ‘Potential indications for NOAC plasma level measurements’ of this article, the authors say that no studies have investigated if measurement of drug levels and dose adjustment based on laboratory coagulation parameters, e.g. by dose reduction in case of higher than expected levels or by dose inc rease in case of lower than expected levels, improve the overall benefit of non-vitamin K antagonist oral anticoagulants during long-term treatment in...
Source: Europace - September 22, 2021 Category: Cardiology Source Type: research

2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: comment
We have read with keen interest the updated practical guide by Steffelet al.1 For safer decision-making, we share the authors ’ view on the need for rapid assessment of anticoagulation in patients under non-vitamin K antagonist oral anticoagulant (NOAC) during emergencies such as bleeding and urgent surgical intervention. Our group has been involved in studies on point-of-care coagulation testing (POCT) in acute stroke p atients where rapid decision-making with respect to thrombolysis and anticoagulation reversal is vital. (Source: Europace)
Source: Europace - September 4, 2021 Category: Cardiology Source Type: research

2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: comment —Authors’ reply
We thank the authors for addressing this important issue.1 Indeed, the assessment of NOAC plasma levels —or potential alternatives—in special situations may represent an important element in the further refinement of non-vitamin K antagonist oral anticoagulant (NOAC) therapy. In their letter, Mbroh and Poli make a case for using point-of-care coagulation tests (POCT) to more rapidly assess the lev el of anticoagulant in patients’ blood samples. In the 2021 EHRA Practical Guide on the use of NOACs, we suggest to consider NOAC plamsa level assessment in two different types of scenarios: emergency situations...
Source: Europace - September 4, 2021 Category: Cardiology Source Type: research

Prompt recognition and successful aspiration of a left atrial thrombus under intracardiac echocardiography guidance during radiofrequency catheter ablation for atrial tachycardia
We present a case of an 80-year-old woman with persistent atrial tachycardia who underwent catheter ablation, during which continuous intracardiac echocardiography (ICE)-based monitoring of the ablation site revealed an RFA-related thrombus. (Source: Europace)
Source: Europace - September 3, 2021 Category: Cardiology Source Type: research

Outcomes after catheter ablation of ventricular tachycardia without implantable cardioverter-defibrillator in selected patients with arrhythmogenic right ventricular cardiomyopathy
Conclusion  In patients with ARVC, well-tolerated MVT without a back-up ICD did not lead to fatal arrhythmic event after RCA despite VT recurrences in some. Our data suggest that RCA may be an alternative to ICD in selected ARVC patients. (Source: Europace)
Source: Europace - August 24, 2021 Category: Cardiology Source Type: research

Corrigendum to: Complications in pulmonary vein isolation in the Netherlands Heart Registration differ with sex and ablation technique
[Europace 2020; doi:10.1093/europace/euaa255] (Source: Europace)
Source: Europace - August 6, 2021 Category: Cardiology Source Type: research

Underdiagnosis of phrenic nerve palsy caused by cryoballoon ablation for atrial fibrillation with upright position chest radiography: usefulness of supine position dynamic chest radiography
A 77-year-old man with paroxysmal atrial fibrillation underwent pulmonary vein (PV) isolation using a 28  mm 4th-generation cryoballoon. Despite the immediate termination of cryoablation of the right superior PV upon weakened diaphragmatic motion detection, right phrenic nerve palsy (PNP) was observed fluoroscopically. (Source: Europace)
Source: Europace - August 5, 2021 Category: Cardiology Source Type: research

In Memoriam Prof. Dr sc. med. Joachim Witte (1936 –2021)
On 18th January 2021, Prof. Dr sc. med. Joachim Witte, a pioneer of pacemaker therapy in the former German Democratic Republic (GDR), dies after a brief serious illness. (Source: Europace)
Source: Europace - August 4, 2021 Category: Cardiology Source Type: research

Corrigendum to: Arrhythmogenic potential of myocardial disarray in hypertrophic cardiomyopathy: genetic basis, functional consequences and relation to sudden cardiac death [Europace 2021; doi:10.1093/europace/euaa348]
Upon the original publication of this article, the following sentence and accompanying reference were inadvertently omitted from the end of the legend of Figure 5: “Figure adapted from Arigaet al. ”. This error has now been corrected. (Source: Europace)
Source: Europace - July 30, 2021 Category: Cardiology Source Type: research

Leadless left ventricular endocardial pacing for CRT upgrades in previously failed and high-risk patients in comparison with coronary sinus CRT upgrades
AbstractAimsCardiac resynchronization therapy (CRT) upgrades may be less likely to improve following intervention. Leadless left ventricular (LV) endocardial pacing has been used for patients with previously failed CRT or high-risk upgrades. We compared procedural and long-term outcomes in patients undergoing coronary sinus (CS) CRT upgrades with high-risk and previously failed CRT upgrades undergoing LV endocardial upgrades.Method and resultsProspective consecutive CS upgrades between 2015 and 2019 were compared with those undergoing WiSE-CRT implantation. Cardiac resynchronization therapy response at 6 months was defined...
Source: Europace - July 28, 2021 Category: Cardiology Source Type: research

Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study
AbstractAimsTo assess the clinical relevance of a history of atrial fibrillation (AF) in hospitalized patients with coronavirus disease 2019 (COVID-19).Methods and resultsWe enrolled 696 consecutive patients (mean age 67.4  ± 13.2 years, 69.7% males) admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. One hundred and six patients (15%) had a history of AF and the median hospitalization length was 14 days (interquartile range 9–24). Patients with a history of AF were olde r and with a higher burden of cardiovascular risk factors. Compared to patie...
Source: Europace - July 23, 2021 Category: Cardiology Source Type: research

How simple ideas forged in the fire of adversity can change healthcare: telehealth for atrial fibrillation during the COVID 19 pandemic
This editorial refers to ‘The European TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: centre and patient experiences.’ by D. Gawalkoet al. on pages 23(7):1003--15. (Source: Europace)
Source: Europace - July 22, 2021 Category: Cardiology Source Type: research

A meta-analysis of clinical risk factors for stroke in anticoagulant-na ïve patients with atrial fibrillation
ConclusionThis study confirms age and prior stroke as the strongest predictors of stroke or systemic embolism in anticoagulant-naive AF patients. Other predictors include hypertension, diabetes, heart failure, and vascular disease. Female sex seems not to be universally associated with stroke or systemic embolism. (Source: Europace)
Source: Europace - July 19, 2021 Category: Cardiology Source Type: research

Brugada syndrome and syncope: a practical approach for diagnosis and treatment
AbstractSyncope in patients with Brugada electrocardiogram pattern may represent a conundrum in the decision algorithm because incidental benign forms, especially neurally mediated syncope, are very frequent in this syndrome similarly to the general population. Arrhythmic syncope in Brugada syndrome typically results from a self-terminating sustained ventricular tachycardia or paroxysmal ventricular fibrillation, potentially leading to sudden cardiac death. Distinguishing syncope due to malignant arrhythmias from a benign form is often difficult unless an electrocardiogram is recorded during the episode. We performed a rev...
Source: Europace - July 15, 2021 Category: Cardiology Source Type: research

Arrhythmogenic potential of myocardial disarray in hypertrophic cardiomyopathy: genetic basis, functional consequences and relation to sudden cardiac death
AbstractMyocardial disarray is defined as disorganized cardiomyocyte spatial distribution, with loss of physiological fibre alignment and orientation. Since the first pathological descriptions of hypertrophic cardiomyopathy (HCM), disarray appeared as a typical feature of this condition and sparked vivid debate regarding its specificity to the disease and clinical significance as a diagnostic marker and a risk factor for sudden death. Although much of the controversy surrounding its diagnostic value in HCM persists, it is increasingly recognized that myocardial disarray may be found in physiological contexts and in cardiac...
Source: Europace - July 15, 2021 Category: Cardiology Source Type: research

EHRA expert consensus statement and practical guide on optimal implantation technique for conventional pacemakers and implantable cardioverter-defibrillators: endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS)
AbstractWith the global increase in device implantations, there is a growing need to train physicians to implant pacemakers and implantable cardioverter-defibrillators. Although there are international recommendations for device indications and programming, there is no consensus to date regarding implantation technique. This document is founded on a systematic literature search and review, and on consensus from an international task force. It aims to fill the gap by setting standards for device implantation. (Source: Europace)
Source: Europace - July 15, 2021 Category: Cardiology Source Type: research

Erratum to: Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions. Part 2: ventricular arrhythmias, channelopathies, and implantable defibrillators: A position statement of the Section of Sports Cardiology and Exercise from the European Association of Preventive Cardiology (EAPC) and the European Heart Rhythm Association (EHRA), both associations of the European Society of Cardiology
Europace 2020;https://doi.org/10.1093/europace/euaa106 (Source: Europace)
Source: Europace - July 15, 2021 Category: Cardiology Source Type: research

Spatial characterization of the tachycardia circuit of atrioventricular nodal re-entrant tachycardia
AbstractAimsThe exact circuit of atrioventricular nodal re-entrant tachycardia (AVNRT) remains elusive. To assess the location and dimensions of the AVNRT circuit.Methods and resultsBoth typical and atypical AVNRT were induced at electrophysiology study of 14 patients. We calculated the activation time of the fast and slow pathways, and consequently, the length of the slow pathway, by assuming an average conduction velocity of 0.04  mm/ms in the nodal area. The distance between the compact atrioventricular node and the slow pathway ablating electrode was measured on three-dimensionally reconstructed fluoroscopic ima...
Source: Europace - July 8, 2021 Category: Cardiology Source Type: research

The cost of non-response to cardiac resynchronization therapy: characterizing heart failure events following cardiac resynchronization therapy
AbstractAimsThe aim of this study is to quantify healthcare resource utilization among non-responders to cardiac resynchronization therapy (CRT-NR) by heart failure (HF) events and influence of comorbidities.Methods and resultsThe ADVANCE CRT registry (2013 –2015) prospectively identified responders/CRT-NRs 6 months post-implant using the clinical composite score. Heart failure event rates and associated cost, both overall and separated for inpatient hospitalizations, office visits, emergency room visits, and observational stays, were quantified. C osts of events were imputed from payments for similar real-wor...
Source: Europace - July 1, 2021 Category: Cardiology Source Type: research

α1-adrenoceptors and takotsubo syndrome: pathophysiologic connotations
I enjoyed reading the contribution by Huanget al.,1 delving into the arrhythmogenesis generated by toxic levels of epinephrine (Epi) in human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), a model for the study of the pathogenesis of takotsubo syndrome (TTS). The authors concentrated on the α1-adrenoceptor stimulation effects of Epi and its blockade on the hiPSC-CMs, studying the responses of their preparation to phentolamine, phenylephrine, clonidine, reactive oxygen species (ROS), H2O2, N-acetyl-I-cysteine, nicotinamide adenine dinucleotide phosphate hydrogen oxidases, and a protein kinase C bloc...
Source: Europace - June 30, 2021 Category: Cardiology Source Type: research

α1-adrenoceptors and takotsubo syndrome: pathophysiologic connotations—Authors’ reply
We appreciate the interest of Dr Madias in our paper entitled ‘Alpha 1 adrenoceptor signaling contributes to toxic effects of catecholamine on electrical properties in human-induced pluripotent stem cell derived cardiomyocytes’.1 (Source: Europace)
Source: Europace - June 30, 2021 Category: Cardiology Source Type: research

Corrigendum to: 2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation
Europace 2021;23:1612 –76. (Source: Europace)
Source: Europace - June 28, 2021 Category: Cardiology Source Type: research

Prevention of cardiac implantable electronic device infections: guidelines and conventional prophylaxis
AbstractCardiac implantable electronic devices (CIED) are potentially life-saving treatments for several cardiac conditions, but are not without risk. Despite dissemination of recommended strategies for prevention of device infections, such as administration of antibiotics before implantation, infection rates continue to rise resulting in escalating health care costs. New trials conveying important steps for better prevention of device infection and an EHRA consensus paper were recently published. This document will review the role of various preventive measures for CIED infection, emphasizing the importance of adhering to...
Source: Europace - June 23, 2021 Category: Cardiology Source Type: research

Epidemiology of cardiac implantable electronic device infections: incidence and risk factors
AbstractCardiac implantable electronic device (CIED) infection is a potentially devastating complication of CIED procedures, causing significant morbidity and mortality for patients. Of all CIED complications, infection has the greatest impact on mortality, requirement for re-intervention and additional hospital treatment days. Based on large prospective studies, the infection rate at 12-months after a CIED procedure is approximately 1%. The risk of CIED infection may be related to several factors which should be considered with regards to risk minimization. These include technical factors, patient factors, and periprocedu...
Source: Europace - June 23, 2021 Category: Cardiology Source Type: research

Antibiotic eluting envelopes: evidence, technology, and defining high-risk populations
AbstractCardiovascular implantable electronic devices (CIED) are effective and important components of modern cardiovascular care. Despite the dramatic improvements in the functionality and reliability of these devices, over time patients are at risk for developing several morbidities, the most feared of which are local and systemic infections. Despite significant financial investment and aggressive therapy with hospitalization, intravenous antibiotics, and transvenous lead extraction, the outcomes include a 1-year mortality rate as high as 25%. This risk of infection has increased over time, likely due to the increased co...
Source: Europace - June 23, 2021 Category: Cardiology Source Type: research

Infections of cardiac implantable electronic devices: still a cause of high mortality
Cardiac implantable electronic devices (CIEDs) are increasingly used around the globe (Figure 1).1 However, CIEDs may carry a risk of adverse events, which are classifiable as access-related, lead-related, generator-related, and infections. Thus, CIED infections may require system removal, whereas superficial or incisional infections at the pocket site might be handled conservatively. Studies reported an infection rateup to 4.9% over 5  years of follow-up.2 Serious device infections defined as requiring lead extraction or lifelong antibiotic treatment or causing death occurred in 2.7%.2 (Source: Europace)
Source: Europace - June 23, 2021 Category: Cardiology Source Type: research

Therapy and outcomes of cardiac implantable electronic devices infections
AbstractCardiac implantable electronic device (CIED) infection causes significant morbidity and mortality without appropriate treatment. It can present as incisional infection, pocket infection, systemic CIED infection, or occult bacteraemia. Complete percutaneous CIED extraction (excepted in case of incisional infection) and appropriate antibiotic therapy are the two main pillars of therapy. Device reimplantation, if needed, should be delayed sufficiently to allow control of the infection. Here, we address the differences in prognosis according to the clinical scenario and the different treatment options. (Source: Europace)
Source: Europace - June 23, 2021 Category: Cardiology Source Type: research

Infections associated with cardiac electronic implantable devices: economic perspectives and impact of the TYRX ™ antibacterial envelope
AbstractThe occurrence of cardiac implantable electronic devices (CIED) infections and related adverse outcomes have an important financial impact on the healthcare system, with hospitalization length of stay (2 –3 weeks on average) being the largest cost driver, including the cost of device system extraction and device replacement accounting for more than half of total costs. In the recent literature, the economic profile of the TYRX™ absorbable antibacterial envelope was analysed taking into account both randomized and non-randomized trial data. Economic analysis found that the envelope is associated w...
Source: Europace - June 23, 2021 Category: Cardiology Source Type: research

First-line treatment of persistent and long-standing persistent atrial fibrillation with single-stage hybrid ablation: a 2-year follow-up study
ConclusionFirst-line single-stage hybrid AF ablation is an effective treatment strategy for patients with persistent and long-standing persistent AF with an acceptable rate of major complications. Recurrences are predominantly AFL/AT that can be successfully ablated percutaneously. Hybrid ablation seems a feasible approach for first-line ablation of (long-standing) persistent AF. (Source: Europace)
Source: Europace - June 18, 2021 Category: Cardiology Source Type: research

Cardiac magnetic resonance to predict recurrences after ventricular tachycardia ablation: septal involvement, transmural channels, and left ventricular mass
AbstractAimsVentricular tachycardia (VT) substrate-based ablation has an increasing role in patients with structural heart disease-related VT. VT is linked to re-entry in relation to myocardial scarring with areas of conduction block (core scar) and areas of slow conduction [border zone (BZ)]. VT substrate can be analysed by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Our study aims to analyse the role of LGE-CMR in identifying predictors of VT recurrence after ablation.Methods and resultsWe analysed 110 consecutive patients who underwent VT ablation from 2013 to 2018. All patients underwent a preproc...
Source: Europace - June 18, 2021 Category: Cardiology Source Type: research

The Atrial Fibrillation Better Care pathway for managing atrial fibrillation: a review
AbstractThe 2020 European Society of Cardiology guidelines endorse the Atrial Fibrillation Better Care (ABC) pathway as a structured approach for the management of atrial fibrillation (AF), addressing three principal elements: ‘A’ – avoid stroke (with oral anticoagulation), ‘B’ – patient-focused better symptom management, and ‘C’ – cardiovascular and comorbidity risk factor reduction and management. This review summarizes the definitions used for the ABC criteria in different studies and the impact of ad herence/non-adherence on clinical outcomes, from 12 studies on sev...
Source: Europace - June 14, 2021 Category: Cardiology Source Type: research

Predictors of sinus rhythm 6 weeks after cardioversion of atrial fibrillation: a pre-planned post hoc analysis of the X-VeRT trial
AbstractAimsUsing a pre-plannedpost hoc analysis of patients included in X-VeRT, we evaluated predictors of sinus rhythm at 6  weeks after planned cardioversion.Methods and resultsReceiver operating characteristic curves and logistic regression models were used to evaluate continuous and categorical variables as predictors of sinus rhythm 6 at weeks from cardioversion (end of study). The primary analysis was performed in successfully cardioverted patients with an evaluable electrocardiogram at end of study. A second analysis evaluated additional patients who spontaneously restored sinus rhythm before planned cardiov...
Source: Europace - June 13, 2021 Category: Cardiology Source Type: research

Current perspectives on wearable rhythm recordings for clinical decision-making: the wEHRAbles 2 survey
AbstractNovel wearable devices for heart rhythm analysis using either photoplethysmography (PPG) or electrocardiogram (ECG) are in daily clinical practice. This survey aimed to assess impact of these technologies on physicians ’ clinical decision-making and to define, how data from these devices should be presented and integrated into clinical practice. The online survey included 22 questions, focusing on the diagnosis of atrial fibrillation (AF) based on wearable rhythm device recordings, suitable indications for weara ble rhythm devices, data presentation and processing, reimbursement, and future perspectives. A to...
Source: Europace - June 11, 2021 Category: Cardiology Source Type: research

Marijuana use disorder and arrhythmias: what were they smoking?
This editorial refers to ‘Prevalence of cardiac arrhythmias in cannabis use disorder related hospitalizations in teenagers from 2003 to 2016 in the United States’ by K.K. Umapathiet al., on pages 1302 –1309. (Source: Europace)
Source: Europace - June 10, 2021 Category: Cardiology Source Type: research

‘Close’ cardiac monitoring: life-threatening complication of a loop recorder implant
A 76-year-old man with previous coronary bypass surgery, diabetes, and hypertension was admitted following a ‘collapse’. All investigations including cardiac telemetry were unremarkable. A loop recorder (BIOMONITOR III, BIOTRONIK, Germany) was implanted using the standard ‘one-step’ injection technique without apparent complication. He was re-admitted with syncope after 2 weeks; device interrogatio n demonstrated sinus pauses requiring a pacemaker implantation. (Source: Europace)
Source: Europace - June 7, 2021 Category: Cardiology Source Type: research

Atrial fibrillation burden during the coronavirus disease 2019 pandemic
AbstractAimsThe aim of this study is to determine the association between the coronavirus disease 2019 (COVID-19) pandemic and atrial fibrillation (AF) occurrence in individuals with cardiac implantable electronic devices (CIEDs).Method and resultsMulti-centre, observational, cohort study over a 100-day period during the COVID-19 pandemic (COVID-19) in the USA. Remote monitoring was used to assess AF episodes in patients with a CIED (pacemaker or defibrillator; 20 centres, 13 states). For comparison, the identical 100-day period in 2019 was used (Control). The primary outcomes were the AF burden during the COVID-19 pandemi...
Source: Europace - June 2, 2021 Category: Cardiology Source Type: research

Ablation of incisional re-entrant atrial tachycardia via superior approach in heterotaxy syndrome
(Source: Europace)
Source: Europace - June 2, 2021 Category: Cardiology Source Type: research

Real-time multielectrode mapping of pulmonary vein gap closure
A 59-year-old female patient underwent pulmonary vein isolation (PVI) reprocedure for recurrent atrial fibrillation. A high-density map performed with Advisor HD Grid catheter (Abbot St Paul, MN, USA) revealed a high-voltage area in the right superior pulmonary vein (PV) (Figure). In order to identify the gap responsible for the PV reconnection, a real-time activation map (RTAM) of the PV potential was performed using LiveView module (Abbott, St Paul, MN, USA). At many points it was observed an incorrect annotation of the local activation time (LAT) on the far-field signal of the left atrium. In order to correct this, the ...
Source: Europace - June 2, 2021 Category: Cardiology Source Type: research

Sex differences in disease progression and arrhythmic risk in patients with arrhythmogenic cardiomyopathy
AbstractAimsWe aimed to assess sex-specific phenotypes and disease progression, and their relation to exercise, in arrhythmogenic cardiomyopathy (AC) patients.Methods and resultsIn this longitudinal cohort study, we included consecutive patients with AC from a referral centre. We performed echocardiography at baseline and repeatedly during follow-up. Patients ’ exercise dose at inclusion was expressed as metabolic equivalents of task (MET)-h/week. Ventricular arrhythmia (VA) was defined as aborted cardiac arrest, sustained ventricular tachycardia, or appropriate therapy by implantable cardioverter-defibrillator. We i...
Source: Europace - June 2, 2021 Category: Cardiology Source Type: research

SARS-CoV-2 and electrocardiography: is electrocardiography a predictor of mortality?
We have read with great interest the article by Lanzaet al. named ‘Electrocardiographic findings at presentation and clinical outcome in patients with SARS-CoV-2 infection’.1 In this issue, We want to underline few issues that need careful consideration. (Source: Europace)
Source: Europace - June 2, 2021 Category: Cardiology Source Type: research

SARS-CoV-2 and electrocardiography: is electrocardiography a predictor of mortality? —Authors’ reply
We appreciate the interest of Babayi ğitet al. in our study assessing the relation of the electrocardiogram (ECG) with clinical outcome in patients with SARS-CoV-2 infection.1 They make some critical observations to our article, concluding that the reported association of ECG abnormalities with mortality in these patients is in fact doubtful.2 It seems, however, that Babayi ğitet al. failed to catch the substance of our study. As already detectable from the title, we aimed to assess whether the presence of abnormal findings at the ECG recorded at presentation in the emergency room (ER) identified patients with increased ...
Source: Europace - June 2, 2021 Category: Cardiology Source Type: research

His bundle pacing after Senning baffle operation
We present a patient with dextro-transposition of the great arteries (D-TGA) and a Senning baffle repair with sinus node dysfunction and intermittent heart block with non-selective His bundle pacemaker placement. (Source: Europace)
Source: Europace - May 25, 2021 Category: Cardiology Source Type: research

Long-term survival following upgrade compared with de novo cardiac resynchronization therapy implantation: a single-centre, high-volume experience
AbstractAimsPatients with a pacemaker or implantable cardioverter-defibrillator are often considered for cardiac resynchronization therapy (CRT). However, limited comprehensive data are available regarding their long-term outcomes.Methods and resultsOur retrospective registry included 2524 patients [1977 (78%)de novo, 547 (22%) upgrade patients] with mild to severe symptoms, left ventricular ejection fraction ≤35%, and QRS ≥ 130ms. The primary outcome was the composite of all-cause mortality, heart transplantation (HTX), or left ventricular assist device (LVAD) implantation; secondary endpoints were dea...
Source: Europace - May 25, 2021 Category: Cardiology Source Type: research

Optimized implementation of cardiac resynchronization therapy: a call for action for referral and optimization of careA joint position statement from the Heart Failure Association (HFA), European Heart Rhythm Association (EHRA), and European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology
AbstractCardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and all ‐cause mortality. Nevertheless, up to two‐thirds of eligible patients are not referred for CRT. Furthermore, post‐implantation follow‐up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three European Society of Cardiolo gy Associations, Heart Failure Association (HFA), European Heart Rhythm Association (EHRA) and E...
Source: Europace - May 25, 2021 Category: Cardiology Source Type: research

Benefits of catheter ablation of typical cavotricuspid isthmus-dependent atrial flutter using half-normal saline
Conclusions RFA of AFL using HNS is an effective and safe procedure. In patients with unfavorable anatomy who required a greater number of applications, the radiofrequency time was significantly shorter using HNS. Baseline characteristicsHNS (19 p)NS(19 p)pAge56 ± 12.3 years61 ± 10.8 years.22Male16 p (84%)1 6 p (84%)1Heart Disease7 p (36.8%)5 p (26.3%).68Ejection Fraction57.1 ± 11%56 ± 14.3%.49Ejection Fraction
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Cognitive outcomes post-catheter ablation for atrial fibrillation: a systematic review and meta-analysis
AbstractFunding AcknowledgementsType of funding sources: None.BackgroundAtrial fibrillation (AF) is a known risk factor for cognitive impairment and dementia. Recent data suggests that successful restoration of sinus rhythm by catheter ablation improves cognitive outcomes. Purpose: Our aim was to perform a systematic review and meta-analysis of the available data regarding the effectiveness of AF catheter ablation on neurocognitive outcomes. Methods: A comprehensive literature search was performed through December 1, 2020, for all eligible studies comparing neurocognitive outcomes in AF patients with or without AF catheter...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

A minimally fluoroscopic approach in AVNRT ablation reduces radiation exposure and number of RF applications without compromising safety, effectiveness and procedural time
AbstractFunding AcknowledgementsType of funding sources: None.IntroductionRadiofrequency ablation (RF) of atrioventricular nodal reentry tachycardia (AVNRT) using conventional fluoroscopy is associated with a significant radiation exposure to both patients and operators. 3D electro-anatomical mapping systems (EAMS) can reduce radiation exposure, but specific clinical studies on their use in AVNRT ablation still lack.PurposeThe aim of this study was to determine if EAMS use in AVNRT ablation can reduce radiation exposure and to analyse its effects on clinical and procedural outcomes.MethodsWe selected 277 patients who under...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Predictive value of early AF recurrence after cryoballoon ablation
AbstractFunding AcknowledgementsType of funding sources: None.BackgroundEarly recurrence of atrial fibrillation (ERAF) during a blanking period of 90 days after radiofrequency ablation has been associated with worse long-term outcome. However, the impact of ERAF after cryoballoon pulmonary vein isolation (cryoPVI) is less clear.ObjectiveA prospective comparison of long-term ablation success after cryoPVI between patients who had ERAF during the blanking period and patients who remained free of AF recurrence during this period.MethodsWe analyzed consecutive patients who underwent cryoPVI in a single-center cohort between 20...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

A novel non-invasive electrocardiographic imaging technique facilitates the preprocedural diagnostic workup of patients with infrequent ventricular arrhythmias
AbstractFunding AcknowledgementsType of funding sources: None.BackgroundCatheter ablation (CA) fails in considerable numbers of patients with ventricular arrhythmias (VAs). Possible reasons include absence and non-inducibility, multifocal origin and anatomically difficult locations of premature ventricular complexes (PVCs) and ventricular tachycardias (VTs). A novel non-invasive electrocardiographic imaging (ECGI) diagnostic tool may help to determine the best treatment strategy of these patients.PurposeTo evaluate outpatient ECGI (VIVO, View Into Ventricular Onset, Catheter Precision, NJ) to tailor treatment of patients w...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research