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

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

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

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

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

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

Noninvasive unipolar electrogram T-wave upslope is an accurate marker of local refractoriness in explanted hearts with drug-induced repolarization dispersion
ConclusionThe moment of steepest upslope of the T-wave in a noninvasively reconstructed UEG accurately reflects end of local refractoriness in intact hearts, in case of pronounced RT dispersion. Under these circumstances, when local RT is defined by moment of re-excitability (allowing to link it to conduction block and re-entry), ECGI T-wave upslope can be taken as a truthful marker for local RT. Abstract Figure. Results (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Home fitting of electrocardiogram (ECG) ambulatory monitors during covid-19
AbstractFunding AcknowledgementsType of funding sources: None.BackgroundInterruption of health services during COVID-19 leading to increased risk to patients and a backlog for vital outpatient cardiac diagnostic services.PurposeTo safely deliver ambulatory ECG monitors whilst reducing risk to patients and staff by providing monitors to be fitted at home.MethodsA system was developed whereby monitors were set up for the patient/carer to collect a preassembled pack and fit at home using videos/written instructions. A retrospective evaluation was undertaken over four months (12/4/20 – 12/08/20) through feedback question...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Repolarization abnormalities at admission predict 30-day outcome in COVID-19
AbstractFunding AcknowledgementsType of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): BV is supported by a research grant of the Frans Van de Werf Fund for Clinical Cardiovascular Research.IntroductionCOVID-19 can be related with a poor clinical outcome. ECG abnormalities in COVID-19 have been widely described, but literature on the predictive value of a 12-lead ECG at hospital admission and normalization of these abnormalities after infection is limited.PurposeTo describe the predictive value of ECG abnormalities on admission and after recovery of COVID-19.MethodsAfter informed consent pati...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Usefulness of Goldberger"s triad to select dilated cardiomyopathy
AbstractFunding AcknowledgementsType of funding sources: None.BackgroundBackground: In 1982, Goldberger described an electrocardiographic triad (SV1 or SV2 +RV5 or RV6 ≥3.5mV, total QRS amplitude in limb leads ≤0.8mV, and R/S ratio 90% specific for detecting severe left ventricular (LV) dysfunction. The pathophysiology of this highly specific ECG triad probably relates to a number of mechanical and vectorial factors associated with congestive heart failure of a variety of etiologies. Left ventricular enlargement causes increased precordial voltage. The horizontal plane vector shifts posteriorly, orthogonal to ...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Optimum timing to assess ablation lesions with Late Gadolinium Enhancement MRl
AbstractFunding AcknowledgementsType of funding sources: Public grant(s) – National budget only. Main funding source(s): Instituto de Salud Carlos III, Spanish Government, Madrid, Spain [FIS_PI16/00435BackgroundLate gadolinium enhancement MRI (LGE-MRI) is increasingly used to detect native as well as ablation-induced atrial fibrosis in the context of atrial fibrillatio n (AF). However, cardiac fibrotic tissue including ablation lesions is subject to sustained remodeling, and neither the development of ablation-induced fibrosis over time nor the capability of LGE-MRI to detect it at different stages of scar formation ...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Clinical recurrence of palpitations following slow pathway ablation in patients with suspected paroxysmal supraventricular tachycardias but non-documented, non-inducible tachycardias
ConclusionsIn patients with high clinical suspicion of PSVT but non-documented and non-inducible arrhythmias, the presence of dual AV nodal physiology makes AVNRT a likely mechanism of the clinical tachycardia. Catheter ablation of slow pathway reduces the risk of recurrence to a level equivalent to those with inducible and ablated AVNRT. AVNRT (n  = 188)Dual nodal physiology (n = 68)p valueAge (years)48.6 ± 16.341.9 ± 14.0
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

HeartMate 3- Challenges in Ventricular Tachycardia Ablation
ConclusionsVT ablation in patients with HM3 is feasible and safe when done in the appropriate setup. Long-term arrhythmia free survival is acceptable but not well predicted by non-inducibility at the end of the procedure. Abstract Figure. HeartMate3 ablation Challenges (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia using standardized voltage mapping system protocol
Conclusionsvoltage gradient mapping successfully targeted the slow pathway in most of our cases. Lesions on the voltage bridge led  to effective ablation of AVNRT and to a drastic x-ray exposure reduction in the absence of acute or long-term complications. Abstract Figure. Last lesion on low-voltage bridge. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Workflows and clinical utilization of dynamic mapping data in radiofrequency catheter ablation of cardiac arrhythmias
ConclusionsThis initial analysis demonstrated the diverse clinical utilization of LiveView dynamic display during RF catheter ablation procedures, including atrial and ventricular arrhythmias. Without causing significant changes to normal workflow, dynamic display of regional signals allows for rapid identification of ablation targets. When used during RF delivery, real-time assessment of regional activation patterns helped improve outcomes by rapidly identifying critical ablation location and ensuring successful lesion delivery. A further study that examines the impact of dynamic display on procedure efficacy may be warra...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Ablation Index guided high power (50W) short duration for anterior line and roof line ablation: feasibility, procedural data and lesion analysis
ConclusionAI guided high-power(50W) ablation appears to be a feasible, effective and fast technique for AL and RL ablation. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Antiarrhythmic effect of 9-week hybrid cardiac telerehabilitation - subanalysis of the TELEREHabilitation in Heart Failure patients - TELEREH-HF randomized clinical trial
Conclusions. Significant improvement in physical capacity after 9 weeks of HCTR did not correlate with the antiarrhythmic effect in terms of   incidence of nsVT or PVCs ≥10. An antiarrhythmic effect after the 9-week HCTR affected long term cardiovascular mortality in HF patients. Abstract Figure (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Management and perinatal outcomes of cardiac arrhythmias in pregnancy
Conclusionssupraventricular tachycardia and premature beats are common in pregnancy. Spontaneous vaginal delivery is more likely in this patients. Major maternal and fetal adverse outcomes are infrequent in pregnant women with arrhythmias. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Buccal mucosa cells as a diagnostic tool in patients with arrhythmogenic cardiomyopathy
AbstractFunding AcknowledgementsType of funding sources: Foundation. Main funding source(s): Netherlands Cardio Vascular Research Initiative (CVON): the Dutch heart foundationBackgroundArrhythmogenic cardiomyopathy (ACM) is predominantly caused by mutations in genes encoding desmosomal proteins (most often multiple different mutations in plakophilin-2), however also mutations in non-desmosomal proteins like phospholamban (PLN, PLNR14Del) are found. Previous investigations showed that plakoglobin protein levels and localization in cardiac tissue of ACM patients is disturbed and this could be a valuable additional tool to di...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Fibrosis biomarkers as a predictive tool for clinical outcome in PLNR14Del patients
ConclusionHigh PICP/ICTP ratios correlate with clinical outcome in PLN patients, such as T wave inversion and PVCs. However, the size and heterogeneity of the patient group resulted in weak to moderate correlation coefficients and might therefore currently precludes to use PICP and ICTP levels as biomarker. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Non-algorithmic approach to accessory pathway localization based on a mobile app
ConclusionsA novel method, easy to use, not requiring to remember any algorithmic steps, and based on an analysis of by far the largest cohort of over accessory pathways (in comparison with published algorithms) was developed. Prospective validation of the localization application seems warranted. Abstract Figure. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Development and validation of an algorithm to assist in the interpretation of the electrocardiogram
ConclusionsWe have validated an ECG algorithm through a rigorous development and review process in a multi-institutional and multi-national Modified Delphi study. The completed expert reviewed algorithm may be a safe, informative tool for novice users to improve ECG interpretation. However, further validation in user groups is now mandated to refine the tool. Abstract Figure 1- Algorithm one of three (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Instrumental markers of frequent symptomatic atrial fibrillation in patients with arterial hypertension
AbstractFunding AcknowledgementsType of funding sources: None.IntroductionGreat attention of researchers is focused on the study of the features of electrical and structural remodeling of the heart in patients with atrial fibrillation (AF) and arterial hypertension (AH). Holter monitoring of the electrocardiogram (HM ECG) and echocardiography are used as methods for evaluating these changes.Objectivesto determine instrumental markers of frequent symptomatic AF in patients with AH.Methods146 patients with AH stage II with AF (males 68 (46.6%)) and 26 patients with AH stage II (males 11 (42.3%)) were examined in Vinnitsa reg...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Remote operation for non-fluoroscopic navigation of complex tachycardias
ConclusionsRemote System Operation allowed full teleoperation of a non-fluoroscopic navigation system (keyboard, mouse and screen) as well as bidirectional real time audio/video feedback with the operating physician, providing a fully autonomous remote assistance in 50 complex ablation procedures. This technology ensures workflow continuity and optimal workforce flexibility and has relevant and promising implications in the field of training, teaching and resource optimization that deserves further development. Latency measurements.Hospital LocationPamplonaPamplonaPamplonaRemote operator locationBilbaoMadridTarragonaT1(s/m...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Very (70W) vs. LSI guided (5-6) high power short duration ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein vs. pulmonary vein and posterior wall isolation
AbstractFunding AcknowledgementsType of funding sources: None.Backgroundhigh power short duration (HPSD) ablation is at least as safe while reducing procedure time than radiofrequency (RF) ablation with lower power in pts undergoing pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF). Purpose: to compare safety and efficacy of 2 different: 1) RF energy set up (FlexAbility: 70W, 41 °, 6-10s, 11ml/h vs. TactiCath: 50W, 41°, LSI 5-6, 17ml/h, both Abbott), and 2) ablation strategies (posterior wall isolation (PWI) in addition to PVI vs. PVI) in pts undergoing their first ablation for paroxysmal AF. M...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Three-dimensional late gadolinium enhancement increases the diagnostic yield of cardiovascular magnetic resonance to detect low voltage in the right ventricular outflow tract
AbstractFunding AcknowledgementsType of funding sources: None.BackgroundCardiac magnetic resonance (CMR) using late gadolinium enhancement (LGE) fails to detect scar tissue in patients with electroanatomical abnormalities and biopsy-proven structural heart disease. It has shown conflicting data regarding existence of structural abnormalities in patients with idiopathic premature ventricular contractions (PVCs) from the right ventricular outflow tract (RVOT). Three- dimensional (3D) LGE enables high-spatial resolution more appropriate to the thin-walled right ventricle than two-dimensional (2D) LGE.ObjectiveOur aim was to e...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Assessment of wavefront propagation speed on the right ventricular outflow tract: deceleration zones associated with the presence of low voltage areas
AbstractFunding AcknowledgementsType of funding sources: None.Background and aimsActivation wavefront is rapid and uniform in normal myocardium. Fibrosis is associated with deceleration zones (DZ) and late activated zones. The presence of low voltage areas (LVAs) in the right ventricular outflow tract (RVOT) of patients with premature ventricular contractions (PVCs) from this origin has been described previously. The aim of this study was to evaluate in sinus rhythm, the RVOT endocardial activation duration (EAD) and the presence of DZs, in patients with PVCs and in controls.MethodsConsecutive patients with frequent (>1...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Implantable loop recorders in patients with a structural or electrical heart disease: comparison of the clinical value in patients with and without a history of syncope
Conclusion Our results show no differences in ILR yield in patients with structural or electrical heart disease who present with any suspected arrhythmia-related symptom, including those with non-syncopal symptoms. Abstract Figure. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Correlation between body mass index and electrocardiogram parameters in healthy adults
AbstractFunding AcknowledgementsType of funding sources: None.BackgroundThe electrocardiogram (ECG) is a tool to evaluate cardiac function. Its interpretation depends on age, sex and race.Aimsto evaluate the association between body mass index (BMI) and electrocardiogram parameters in healthy adults.MethodsWe conducted a prospective study that included apparently healthy volunteers aged between 18 and 65 years. Body mass index was calculated and standard 12-lead ECG was recorded for all participants. Subjects were classified into four groups according to BMI: underweight (
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

A candidate genetic modifier and autosomal recessive cause of Brugada syndrome that may alter the circadian expression of SCN5A
AbstractFunding AcknowledgementsType of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): This work was supported by a generous grant from the Newnham College Senior Members Research Support fund.IntroductionInherited cardiac arrhythmias (ICAs) are a major cause of sudden cardiac death (SCD) in the young. ICAs are caused by variants in genes encoding ion channels that predispose individuals to life-threatening arrhythmic events. Early diagnosis to facilitate implementation of effective clinical interventions that greatly reduce SCD risk is critical.ICAs have traditionally been considered monogen...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Comparative effectiveness of ventricular tachycardia ablation versus escalated antiarrhythmic drug therapy by location of myocardial infarction: A sub-study of the VANISH trial
CONCLUSIONThe effectiveness of VT ablation versus escalated pharmacological therapy varies based on the location of the MI. Patients with MI scars located only in non-inferior regions of the ventricles derive greater benefit from VT ablation in reducing VT-related events. Further studies are required to explore reasons for this finding and to assess the impact of VT treatment strategies based on MI location in optimizing outcomes. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Remote magnetic navigation shows superior long-term outcomes in pediatric atrioventricular (nodal) tachycardia ablation compared to manual radiofrequency and cryoablation
AbstractFunding AcknowledgementsType of funding sources: None.Introduction– Catheter ablation (CA) is a first-choice treatment for tachyarrhythmia in pediatric patients. The currently available CA techniques differ in manner of catheter steering technique and energy sources. There are no large studies comparing long-term outcomes between the available CA techniques in p ediatric patients with atrioventricular reentry (also known as accessory pathway mediated) tachycardia (AVRT) or atrioventricular nodal reentry tachycardia (AVNRT) mechanisms.Objective– The aim of this study was to compare procedural parame...
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

The efficacy and safety of non-fluoroscopic catheter ablation of arrhythmias in pregnancy after mid-long-term follow-up: a single- center experience
Conclusionsnon-fluoroscopic catheter ablation of arrhythmias is feasible and can be safety performed in pregnancy. Our data suggests that these pregnancies were with good perinatal and neonatal outcomes. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research

Minimal fluoroscopic approaches and factors associated with radiation dose when high-definition mapping is used for supraventricular tachycardia ablation: insight from the CHARISMA registry
ConclusionsIn our experience, arrhythmias ablation through minimal fluoroscopy approach with the use of a novel ablation technology is safe, feasible, and effective in common right atrial arrhythmias. High-dose exposure occurred in a very limited number of cases, without any reduction of the safety and acute and long-term effectiveness profile. (Source: Europace)
Source: Europace - May 24, 2021 Category: Cardiology Source Type: research