The wearable cardioverter-defibrillator: current technology and evolving indications
The wearable cardioverter-defibrillator has been available for over a decade and now is frequently prescribed for patients deemed at high arrhythmic risk in whom the underlying pathology is potentially reversible or who are awaiting an implantable cardioverter-defibrillator. The use of the wearable cardioverter-defibrillator is included in the new 2015 ESC guidelines for the management of ventricular arrhythmias and prevention of sudden cardiac death. The present review provides insight into the current technology and an overview of this approach. (Source: Europace)
Source: Europace - October 4, 2016 Category: Cardiology Source Type: research

Cryoballoon vs. radiofrequency ablation for paroxysmal atrial fibrillation: an updated meta-analysis of randomized and observational studies
AimsRadiofrequency (RF) ablation represents a standard of care for pulmonary vein isolation in patients with drug-refractory paroxysmal atrial fibrillation (AF). In this setting, cryoballoon (CB) ablation has emerged as alternative therapy. However, the efficacy and safety of CB vs. RF ablation in patients with paroxysmal AF remain a matter of debate.Methods and resultsWe searched electronic scientific databases for studies of CB vs. RF ablation in patients with paroxysmal AF. Aggregate data were pooled to perform a meta-analysis. The primary efficacy and safety outcomes were the recurrence of any atrial arrhythmia and pro...
Source: Europace - October 4, 2016 Category: Cardiology Source Type: research

Fluoxetine vs. placebo for the treatment of recurrent vasovagal syncope with anxiety sensitivity
AimsThe optimal medical therapy of patients with vasovagal syncope (VVS) remains controversial. Fluoxetine is effective against anxiety and panic disorders, while its use has shown promising results for VVS. Anxiety sensitivity is a personality trait observed in a considerable proportion of patients with VVS, associated with predisposition to anxiety and panic disorders. Our aim was to examine whether fluoxetine exerts beneficial effects regarding VVS prevention in the subset of patients with anxiety sensitivity.Methods and resultsWe assessed 106 patients with typical history of recurrent VVS, without other comorbidities, ...
Source: Europace - October 4, 2016 Category: Cardiology Source Type: research

Sex-dependent alterations of Ca2+ cycling in human cardiac hypertrophy and heart failure
Aims Clinical studies have shown differences in the propensity for malignant ventricular arrhythmias between women and men suffering from cardiomyopathies and heart failure (HF). This is clinically relevant as it impacts therapies like prophylactic implantable cardioverter-defibrillator implantation but the pathomechanisms are unknown. As an increased sarcoplasmic reticulum (SR) Ca2+ leak is arrhythmogenic, it could represent a cellular basis for this paradox. Methods/Results We evaluated the SR Ca2+ leak with respect to sex differences in (i) afterload-induced cardiac hypertrophy (Hy) with preserved left ventricular (LV)...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Fischer, T. H., Herting, J., Eiringhaus, J., Pabel, S., Hartmann, N. H., Ellenberger, D., Friedrich, M., Renner, A., Gummert, J., Maier, L. S., Zabel, M., Hasenfuss, G., Sossalla, S. Tags: BASIC SCIENCE Source Type: research

Implantation of subcutaneous implantable cardioverter defibrillators in Europe: results of the European Heart Rhythm Association survey
Aims The purpose of this European Heart Rhythm Association (EHRA) survey is to provide an overview of the current use of subcutaneous cardioverter defibrillators (S-ICDs) across a broad range of European centres. Methods and results A questionnaire was sent via the internet to centres participating in the EHRA electrophysiology research network. Questions included standards of care and policies used for patient management, indications, and techniques of implantation of the S-ICDs. In total, 52 centres replied to the questionnaire. More than one-fourth of the responding centres does not implant the S-ICD (n = 14, 27%). The...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Boveda, S., Lenarczyk, R., Haugaa, K., Fumagalli, S., Madrid, A. H., Defaye, P., Broadhurst, P., Dagres, N. Tags: EP WIRE Source Type: research

Twiddler's syndrome with a baroreflex stimulator device
(Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Galand, V., Martins, R. P., Leclercq, C. Tags: CASE EXPRESS REPORTS Source Type: research

Standardized algorithm for cardiac pacing in older patients affected by severe unpredictable reflex syncope: 3-year insights from the Syncope Unit Project 2 (SUP 2) study
Conclusion The benefit of cardiac pacing is maintained at 3 years, irrespective of the index diagnostic test, and is maximum in patients with negative TT. Clinical trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01509534. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Brignole, M., Arabia, F., Ammirati, F., Tomaino, M., Quartieri, F., Rafanelli, M., Del Rosso, A., Rita Vecchi, M., Russo, V., Gaggioli, G., on behalf of the Syncope Unit Project 2 (SUP 2) investigators Tags: Syncope and event loop recorders Source Type: research

Novel electrocardiographic criteria for the diagnosis of arrhythmogenic right ventricular cardiomyopathy
Conclusion The terminal S wave length and area in the right precordial leads are diagnostically useful and suitable for automatic analysis in ARVC. The CF leads are diagnostically superior to the unipolar precordial leads. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Batchvarov, V. N., Bastiaenen, R., Postema, P. G., Clark, E. N., Macfarlane, P. W., Wilde, A. A. M., Behr, E. R. Tags: Channelopathies Source Type: research

Brugada syndrome: clinical presentation and genotype--correlation with magnetic resonance imaging parameters
Conclusion Brugada syndrome patients with an SCN5A mutation reveal distinct changes in RV volumes and function when compared with those without an SCN5A mutation. Furthermore, mutation-positive patients have a higher likelihood of a spontaneous type 1 BrS-ECG, which is associated with a higher incidence of clinical events. Cardiovascular magnetic resonance may provide additional insight to distinguish between SCN5A mutation-positive and -negative BrS patients. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Rudic, B., Schimpf, R., Veltmann, C., Doesch, C., Tülümen, E., Schoenberg, S. O., Borggrefe, M., Papavassiliu, T. Tags: Channelopathies Source Type: research

Evaluation of a new very low dose imaging protocol: feasibility and impact on X-ray dose levels in electrophysiology procedures
This study presents and evaluates the impact of a new lowest-dose fluoroscopy protocol (Siemens AG), especially designed for electrophysiology (EP) procedures, on X-ray dose levels. Methods and results From October 2014 to March 2015, 140 patients underwent an EP study on an Artis zee angiography system. The standard low-dose protocol was operated at 23 nGy (fluoroscopy) and at 120 nGy (cine-loop), the new lowest-dose protocol was operated at 8 nGy (fluoroscopy) and at 36 nGy (cine-loop). Procedural data, X-ray times, and doses were analysed in 100 complex left atrial and in 40 standard EP procedures. The resulting dose&n...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Bourier, F., Reents, T., Ammar-Busch, S., Buiatti, A., Kottmaier, M., Semmler, V., Telishevska, M., Brkic, A., Grebmer, C., Lennerz, C., Kolb, C., Hessling, G., Deisenhofer, I. Tags: Cardiac electrophysiology Source Type: research

Pacing and sensing optimization of permanent His-bundle pacing in cardiac resynchronization therapy/implantable cardioverter defibrillators patients: value of integrated bipolar configuration
Aims The clinical implementation of His-bundle pacing (HBP) has been limited by concern over higher capture thresholds (CTs) and lower R-wave amplitudes (RWAs), when compared with right ventricular (RV) pacing. The aim of this study was to assess the optimal pacing configuration for HBP lead when incorporated with cardiac resynchronization therapy/implantable cardioverter defibrillators (CRT-D/ICD) by testing of an integrated bipolar configuration. Methods and results HBP was achieved in 25 CRT-D and 13 ICD patients at implantation. Their RWA, CT@0.5 ms and impedance with His-bundle (HB) tip-RV coil, and HB unipolar and b...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Su, L., Xu, L., Wu, S.-j., Huang, W.-j. Tags: Pacing and resynchronization therapy Source Type: research

Reduction of inappropriate anti-tachycardia pacing therapies and shocks by a novel suite of detection algorithms in heart failure patients with cardiac resynchronization therapy defibrillators: a historical comparison of a prospective database
Aims Implantable cardioverter defibrillators improve survival of patients at risk for ventricular arrhythmias, but inappropriate shocks occur in up to 30% of patients and have been associated with worse quality of life and prognosis. In heart failure patients with cardiac resynchronization therapy defibrillators (CRT-Ds), we evaluated whether a new generation of detection and discrimination algorithms reduces inappropriate shocks. Methods and results We analysed 1983 Medtronic CRT-D patients (80% male, 67 ± 10 years), 1368 with standard devices (Control CRT-D) and 615 with new generation devices (New CRT-D). Expert...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Lunati, M., Proclemer, A., Boriani, G., Landolina, M., Locati, E., Rordorf, R., Daleffe, E., Ricci, R. P., Catanzariti, D., Tomasi, L., Gulizia, M., Baccillieri, M. S., Molon, G., Gasparini, M., on behalf of the ClinicalService Cardiological Centres Tags: Pacing and resynchronization therapy Source Type: research

Serum amine-based metabolites and their association with outcomes in primary prevention implantable cardioverter-defibrillator patients
Conclusion Utilizing metabolic profiling in two independent prospective cohorts of patients undergoing ICD implantation for primary prevention of SCD, we identified several novel amine markers that were associated with appropriate shock and mortality. These findings shed insight into the potential biologic pathways leading to adverse events in ICD patients. Further studies are needed to confirm the prognostic value of these findings. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Zhang, Y., Blasco-Colmenares, E., Harms, A. C., London, B., Halder, I., Singh, M., Dudley, S. C., Gutmann, R., Guallar, E., Hankemeier, T., Tomaselli, G. F., Cheng, A. Tags: Sudden death and ICDs Source Type: research

Reduced long-term overall mortality in heart failure patients with prolonged QRS treated with CRT combined with ICD vs. heart failure patients with narrow QRS treated with ICD only
Conclusion In HF patients treated with ICD, the subgroup of patients with prolonged QRS who receive CRT-D displays better long-term survival than narrow QRS ICD recipients, owing to their reduced HF mortality. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Palmisano, P., Accogli, M., Pisano, E. C. L., Zaccaria, M., De Blasi, S., Ponzetta, M. A., Valsecchi, S., Milanese, G., Lauretti, M., Magliari, F. Tags: Sudden death and ICDs Source Type: research

Battery drain in daily practice and medium-term projections on longevity of cardioverter-defibrillators: an analysis from a remote monitoring database
Aims The longevity of generators is a crucial determinant of the cost-effectiveness of therapy with implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-D). We evaluated the trend of device-measured residual battery capacity and longevity projections over 5-year follow-up. We also investigated possible factors associated with battery drain. Methods and results Data from 4851 patients in the European LATITUDE® database who were followed up for a minimum of 3 years were analysed. The factors associated with battery drain (i.e. year-to-year decrease in residual battery ...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Boriani, G., Ritter, P., Biffi, M., Ziacchi, M., Diemberger, I., Martignani, C., Valzania, C., Valsecchi, S., Padeletti, L., Gadler, F. Tags: Sudden death and ICDs Source Type: research

Incidence and outcomes of cerebrovascular events complicating catheter ablation for atrial fibrillation
Conclusion Cerebrovascular complications related to catheter ablation of AF are relatively infrequent and typically occur early either during the procedure or within the first 24 h after AF ablation. Previous ischaemic stroke, mechanical valve replacement, and CHA2DS2-VASc score ≥3 are independent predictors of such complications. The majority of these events are ischaemic stroke with a benign clinical outcome, while ICH may correlate with poor prognosis. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Liu, Y., Zhan, X., Xue, Y., Deng, H., Fang, X., Liao, H., Huang, J., Liu, F., Liang, Y., Wei, W., Wu, S. Tags: Ablation for atrial fibrillation Source Type: research

Who is the operator, that is the question: a multicentre study of catheter ablation of atrial fibrillation
Aims A worldwide survey reported that the success rate of atrial fibrillation (AF) ablation was higher in high-volume centers compared with low-volume centers. We tested whether the procedure volume of each operator was associated with the outcome of AF ablation in high-volume centres. Methods and results We studied 471 patients with paroxysmal AF who underwent pulmonary vein (PV) isolation for the first time in three cardiovascular centers where the annual AF ablation volume was>100 procedures. We classified a total of 10 primary operators according to their operation volume on the basis of ACC/AHA/ACP CLINICAL COMPET...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Sairaku, A., Yoshida, Y., Nakano, Y., Maeda, M., Hirayama, H., Hashimoto, H., Kihara, Y. Tags: Ablation for atrial fibrillation Source Type: research

Intracardiac drifting iceberg: a worrisome incident during cryoablation
(Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Fontenla, A., Villagraz, L., Lopez-Gil, M. Tags: IMAGES IN ELECTROPHYSIOLOGY Source Type: research

Outcomes after cryoablation vs. radiofrequency in patients with paroxysmal atrial fibrillation: impact of pulmonary veins anatomy
Conclusion Our findings suggest that mid-term outcomes of cryoballoon ablation for paroxysmal AF ablation are similar to those of radiofrequency, regardless of PV anatomy. The presence of anatomical variants of PVs should not discourage the referral of patients with paroxysmal AF for cryoballoon ablation. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Khoueiry, Z., Albenque, J.- P., Providencia, R., Combes, S., Combes, N., Jourda, F., Sousa, P. A., Cardin, C., Pasquie, J.- L., Cung, T. T., Massin, F., Marijon, E., Boveda, S. Tags: Ablation for atrial fibrillation Source Type: research

High-density biatrial activation mapping during typical atrial flutter after bicavopulmonary bypass
(Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Maury, P., Capellino, S., Hascoet, S. Tags: CASE EXPRESS REPORTS Source Type: research

Five-year efficacy of pulmonary vein antrum isolation as a primary ablation strategy for atrial fibrillation: a single-centre cohort study
Conclusion Five-year freedom of atrial tachyarrhythmia could be achieved by PVAI as primary ablation strategy in 58.3% of patients. Additional substrate modification only moderately increased overall success. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Teunissen, C., Kassenberg, W., van der Heijden, J. F., Hassink, R. J., van Driel, V. J. H. M., Zuithoff, N. P. A., Doevendans, P. A., Loh, P. Tags: Ablation for atrial fibrillation Source Type: research

Cystic tumour of the atrioventricular node: can an electrophysiological study predict sudden death?
(Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Ueda, K., Tagusari, O., Kasao, M. Tags: CASE EXPRESS REPORTS Source Type: research

Von Willebrand factor is associated with atrial fibrillation development in ischaemic patients after cardiac surgery
Conclusion Plasma vWF levels are associated with tissue fibrosis in patients undergoing cardiac surgery and with post-surgical AF development in ischaemic patients. These findings suggest an association among vWF levels, atrial remodelling, and AF development. It is supported by higher vWF expression in right atrial tissue in ischaemic patients, who developed post-surgical AF. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Hernandez-Romero, D., Lahoz, A., Roldan, V., Jover, E., Romero-Aniorte, A. I., Martinez, C. M., Jara-Rubio, R., Arribas, J. M., Garcia-Alberola, A., Canovas, S., Valdes, M., Marin, F. Tags: Atrial fibrillation Source Type: research

A useful irrigated tip to cannulate distal coronary sinus
(Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Fedida, J., Lepiece, C., Knecht, S. Tags: CASE EXPRESS REPORTS Source Type: research

Effectiveness and safety of dabigatran versus acenocoumarol in 'real-world patients with atrial fibrillation
Conclusion In ‘real-world’ patients with AF, dabigatran appears to be as effective, but significantly safer than acenocoumarol. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Korenstra, J., Wijtvliet, E. P. J., Veeger, N. J. G. M., Geluk, C. A., Bartels, G. L., Posma, J. L., Piersma-Wichers, M., Van Gelder, I. C., Rienstra, M., Tieleman, R. G. Tags: Atrial fibrillation Source Type: research

Antithrombotic therapy use in patients with atrial fibrillation before the era of non-vitamin K antagonist oral anticoagulants: the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) Phase I cohort
Conclusion Phase I of GLORIA-AF shows that VKAs were mostly used in patients with persistent/permanent (vs. paroxysmal) AF and in those with high stroke risk. Furthermore, there were meaningful geographical differences in the use of VKA therapy in the era before the availability of NOACs, including a much lower use of VKAs in China, where most patients either received antiplatelet agents or no antithrombotic treatment. (Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Huisman, M. V., Ma, C. S., Diener, H.-C., Dubner, S. J., Halperin, J. L., Rothman, K. J., Teutsch, C., Schoof, N., Kleine, E., Bartels, D. B., Lip, G. Y. H., for the GLORIA-AF Investigators Tags: Atrial fibrillation Source Type: research

Extra-cardiac stimulators: what do cardiologists need to know?
For several decades, treating patients with pacemakers has been the privilege of cardiologists. However, in the last 30 years, researchers have found new targets for electrical stimulation in different clinical subspecialities, such as deep brain stimulation (for the treatment of Parkinson's disease, essential tremor, dystonia, and some psychiatric illnesses); spinal cord stimulation (for refractory angina, chronic pain, and peripheral artery disease); and sacral (for diverse urologic and proctologic conditions), vagal (for epilepsy), and phrenic nerve stimulation (for sleep apnoea). The purpose of this article is to famil...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Guinand, A., Noble, S., Frei, A., Renard, J., Tramer, M. R., Burri, H. Tags: REVIEWS Source Type: research

Human-based approaches to pharmacology and cardiology: an interdisciplinary and intersectorial workshop
Both biomedical research and clinical practice rely on complex datasets for the physiological and genetic characterization of human hearts in health and disease. Given the complexity and variety of approaches and recordings, there is now growing recognition of the need to embed computational methods in cardiovascular medicine and science for analysis, integration and prediction. This paper describes a Workshop on Computational Cardiovascular Science that created an international, interdisciplinary and inter-sectorial forum to define the next steps for a human-based approach to disease supported by computational methodologi...
Source: Europace - August 31, 2016 Category: Cardiology Authors: Rodriguez, B., Carusi, A., Abi-Gerges, N., Ariga, R., Britton, O., Bub, G., Bueno-Orovio, A., Burton, R. A. B., Carapella, V., Cardone-Noott, L., Daniels, M. J., Davies, M. R., Dutta, S., Ghetti, A., Grau, V., Harmer, S., Kopljar, I., Lambiase, P., Lu, H. Tags: REVIEWS Source Type: research

Longevity of implantable cardioverter-defibrillators: still a long way to go
(Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Johansen, J. B., Nielsen, J. C., Sandgaard, N. C. F. Tags: EDITORIALS Source Type: research

Pharmacoepidemiological comparisons between acenocoumarol and dabigatran: interpretation of data reflecting clinical practice
(Source: Europace)
Source: Europace - August 31, 2016 Category: Cardiology Authors: Nielsen, P. B. Tags: EDITORIALS Source Type: research

Incidence of asymptomatic oesophageal lesions after atrial fibrillation ablation using an oesophageal temperature probe with insulated thermocouples: a comparative controlled study
ConclusionAccording to these preliminary results, the use of oesophageal temperature probes with insulated thermocouples seems to be feasible in patients undergoing AF RF catheter ablation. The incidence of post-procedural EDEL when using a cut-off of 39°C is comparable to the incidence of EDEL without using a temperature probe. (Source: Europace)
Source: Europace - August 18, 2016 Category: Cardiology Source Type: research

Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints, and data collection requirements for clinical studies
The increasing interest in left atrial appendage occlusion (LAAO) for ischaemic stroke prevention in atrial fibrillation (AF) fuels the need for more clinical data on the safety and effectiveness of this therapy. Besides an assessment of the effectiveness of the therapy in specific patients groups, comparisons with pharmacological stroke prophylaxis, surgical approaches, and other device-based therapies are warranted. This paper documents the consensus reached among clinical experts in relevant disciplines from Europe and North America, European cardiology professional societies, and representatives from the medical device...
Source: Europace - August 18, 2016 Category: Cardiology Source Type: research

Assessing cardiac autonomic function via heart rate variability analysis requires monitoring respiration: reply
(Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Malik, M., Sassi, R., Cerutti, S., Lombardi, F., Huikuri, H. V., Peng, C.-K., Schmidt, G., Yamamoto, Y. Tags: LETTERS TO THE EDITOR Source Type: research

Assessing cardiac autonomic function via heart rate variability analysis requires monitoring respiration
(Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Wessel, N., Sidorenko, L., Kraemer, J. F., Schoebel, C., Baumann, G. Tags: LETTERS TO THE EDITOR Source Type: research

Combining an subcutaneous ICD and a pacemaker with abdominal device location and bipolar epicardial left ventricular lead: first-in-man approach
(Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Gemein, C., Haj, M., Schmitt, J. Tags: CASE EXPRESS REPORTS Source Type: research

Diagnostic role of head-up tilt test in patients with cough syncope
Conclusion Syncope during coughing is a result of hypotension, rather than bradycardia. Coughing during HUT is a useful test in patients suspected to have cough syncope but in whom the history is not conclusive. (Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Mereu, R., Taraborrelli, P., Sau, A., Di Toro, A., Halim, S., Hayat, S., Bernardi, L., Francis, D. P., Sutton, R., Lim, P. B. Tags: Syncope and event loop recorders Source Type: research

External prolonged electrocardiogram monitoring in unexplained syncope and palpitations: results of the SYNARR-Flash study
Aims SYNARR-Flash study (Monitoring of SYNcopes and/or sustained palpitations of suspected ARRhythmic origin) is an international, multicentre, observational, prospective trial designed to evaluate the role of external 4-week electrocardiogram (ECG) monitoring in clinical work-up of unexplained syncope and/or sustained palpitations of suspected arrhythmic origin. Methods and results Consecutive patients were enrolled within 1 month after unexplained syncope or palpitations (index event) after being discharged from emergency room or hospitalization without a conclusive diagnosis. A 4-week ECG monitoring was obtained by ext...
Source: Europace - August 5, 2016 Category: Cardiology Authors: Locati, E. T., Moya, A., Oliveira, M., Tanner, H., Willems, R., Lunati, M., Brignole, M. Tags: Syncope and event loop recorders Source Type: research

Novel electrophysiological characteristics of atrioventricular nodal continuous conduction curves in atrioventricular nodal re-entrant tachycardia with concomitant cavotricuspid isthmus-dependent atrial flutter
Conclusion Atrioventricular nodal re-entrant tachycardia patients with concomitant CTI-dependent AFL had more continuous AV node function curves. Forty-one per cent of these patients had non-inducible AFL after the SP ablation, indicating a slow conduction isthmus in the triangle of Koch area. (Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Lin, C.-H., Lin, Y.-J., Chang, S.-L., Lo, L.-W., Huang, H.-K., Chiang, C.-H., Allamsetty, S., Liao, J.-N., Chung, F.-P., Chang, Y.-T., Lin, C.-Y., Chen, S.-A. Tags: Cardiac electrophysiology Source Type: research

Early repolarization pattern and its day-to-day dynamic change as markers for ventricular fibrillation in patients with vasospastic angina
This study aimed to clarify the relation between ER and VF in patients with VSA and to investigate the long-term outcomes of ICD therapy. Methods and results This retrospective, observational survey evaluated 265 consecutive VSA patients, including 21 with VF. Their electrocardiogram findings and clinical course were analysed over a mean follow-up of 5.5 ± 3.3 years. Early repolarization was observed in 64 patients (24.2%) and was more frequent in patients with VF history than those without (P = 0.001). Early repolarization was independently associated with VF history. During follow-up, four patients had VF recurre...
Source: Europace - August 5, 2016 Category: Cardiology Authors: Kitamura, T., Fukamizu, S., Hojo, R., Aoyama, Y., Komiyama, K., Nishizaki, M., Sakurada, H., Hiraoka, M. Tags: Cardiac electrophysiology Source Type: research

The limbus of the fossa ovalis: an unusual location for incessant focal atrial tachycardia in children
(Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Di Pino, A., Caruso, E., Gitto, P. Tags: CASE EXPRESS REPORTS Source Type: research

Propofol sedation administered by cardiologists for patients undergoing catheter ablation for ventricular tachycardia
Aims Propofol sedation has been shown to be safe for atrial fibrillation ablation and internal cardioverter-defibrillator implantation but its use for catheter ablation (CA) of ventricular tachycardia (VT) has yet to be evaluated. Here, we tested the hypothesis that VT ablation can be performed using propofol sedation administered by trained nurses under a cardiologist's supervision. Methods and results Data of 205 procedures (157 patients, 1.3 procedures/patient) undergoing CA for sustained VT under propofol sedation were analysed. The primary endpoint was change of sedation and/or discontinuation of propofol sedation du...
Source: Europace - August 5, 2016 Category: Cardiology Authors: Servatius, H., Höfeler, T., Hoffmann, B. A., Sultan, A., Lüker, J., Schäffer, B., Willems, S., Steven, D. Tags: Cardiac electrophysiology Source Type: research

Solvent-facilitated lead disconnection for battery replacement in patients with pacemakers or implantable cardioverter defibrillators
Conclusion Ethanol has utility as a simple and inexpensive modality for lead disconnection from ICD or PM headers. (Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Erne, P., Kobza, R., Lehner, M., Resink, T. J. Tags: Leads and lead extraction Source Type: research

Inappropriate high-rate pacing with maximal output due to runaway pacemaker malfunction in a temporary device
(Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Park, S. M., Son, J.-W., Hong, K.-S. Tags: CASE EXPRESS REPORTS Source Type: research

Active fixation of a thin transvenous left-ventricular lead by a side helix facilitates targeted and stable placement in cardiac resynchronization therapy
Conclusion Active fixation of this 4Fr LV lead by using a side helix, offers flexibility to place the lead precisely in targeted vein segments over a wide range of vein anatomies. The average LV pacing threshold was low at implantation and follow-ups. The lead seems to be extractable and no late dislodgements have been observed. (Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Keilegavlen, H., Hovstad, T., Faerestrand, S. Tags: Leads and lead extraction Source Type: research

Haemodynamic effects of cardiac resynchronization therapy using single-vein, three-pole, multipoint left ventricular pacing in patients with ischaemic cardiomyopathy and a left ventricular free wall scar: the MAESTRO study
Aims The clinical response to cardiac resynchronization therapy (CRT) is variable. Multipoint left ventricular (LV) pacing could achieve more effective haemodynamic response than single-point LV pacing. Deployment of an LV lead over myocardial scar is associated with a poor haemodynamic response to and clinical outcome of CRT. We sought to determine whether the acute haemodynamic response to CRT using three-pole LV multipoint pacing (CRT3P-MPP) is superior to that to conventional CRT using single-site LV pacing (CRTSP) in patients with ischaemic cardiomyopathy and an LV free wall scar. Methods and results Sixteen patients...
Source: Europace - August 5, 2016 Category: Cardiology Authors: Umar, F., Taylor, R. J., Stegemann, B., Marshall, H., Flannigan, S., Lencioni, M., De Bono, J., Griffith, M., Leyva, F. Tags: Pacing and resynchronization therapy Source Type: research

Prevalence and predictor factors of severe venous obstruction after cardiovascular electronic device implantation
Conclusion In patients with implantable devices, severe venous obstruction prevalence is not negligible and the lack of symptoms does not exclude it. The presence of three leads and sudden cardiac death as indication for implantable devices seem to be associated with the presence of severe venous obstruction/occlusion. (Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Santini, M., Di Fusco, S. A., Santini, A., Magris, B., Pignalberi, C., Aquilani, S., Colivicchi, F., Gargaro, A., Ricci, R. P. Tags: Pacing and resynchronization therapy Source Type: research

Atrial reverse remodelling is associated with outcome of cardiac resynchronization therapy
Conclusion Patients without atrial and ventricular reverse remodelling have the worst outcome. Patients with only atrial reverse remodelling have improved left ventricular diastolic filling during follow-up and demonstrate a comparable outcome with patients with both atrial and ventricular reverse remodelling. Assessment of atrial reverse remodelling may provide additional prognostic information in determining CRT outcome. (Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Kloosterman, M., Rienstra, M., Mulder, B. A., Van Gelder, I. C., Maass, A. H. Tags: Pacing and resynchronization therapy Source Type: research

Primary prevention implantable cardioverter-defibrillator and cardiac resynchronization therapy-defibrillator in elderly patients: results of a Spanish multicentre study
Aims Currently, there continues to be a lack of evidence regarding outcomes associated with device-based therapy for ventricular arrhythmias in elderly patients, even more in primary-prevention indications. We aimed to describe the follow-up in terms of efficacy and safety of implantable cardioverter-defibrillator (ICD) therapy in a large cohort of elderly patients. Methods and results Retrospective multicentre study performed in 15 Spanish hospitals. Consecutive patients referred for ICD implantation before 2011 were included. One hundred and sixty-two of 1174 patients (13.8%) ≥75 years were considered as ‘elder...
Source: Europace - August 5, 2016 Category: Cardiology Authors: Exposito, V., Rodriguez-Manero, M., Gonzalez-Enriquez, S., Arias, M. A., Sanchez-Gomez, J. M., Andres La Huerta, A., Bertomeu-Gonzalez, V., Arce-Leon, A., Barrio-Lopez, M. T., Arguedas-Jimenez, H., Seara, J. G., Rodriguez-Entem, F. Tags: Sudden death and ICDs Source Type: research

Retrieval of Medtronic Micra Transcatheter Pacing System after tether removal
(Source: Europace)
Source: Europace - August 5, 2016 Category: Cardiology Authors: Gerdes, C., Nielsen, J. C. Tags: CASE EXPRESS REPORTS Source Type: research

Sex difference in appropriate shocks but not mortality during long-term follow-up in patients with implantable cardioverter-defibrillators
Aims Implantable cardioverter-defibrillators (ICDs) have been shown to improve survival, although a considerable number of patients never receive therapy. Implantable cardioverter-defibrillators are routinely implanted regardless of sex. There is continuing controversy whether major outcomes differ between men and women. Methods and results In this retrospective single-centre study, 1151 consecutive patients (19% women) undergoing ICD implantation between 1998 and 2010 were followed for mortality and first appropriate ICD shock over 4.9 ± 2.7 years. Sex-related differences were investigated using multivariable Cox ...
Source: Europace - August 5, 2016 Category: Cardiology Authors: Seegers, J., Conen, D., Jung, K., Bergau, L., Dorenkamp, M., Lüthje, L., Sohns, C., Sossalla, S. T., Fischer, T. H., Hasenfuss, G., Friede, T., Zabel, M. Tags: Sudden death and ICDs Source Type: research