Arrhythmogenic right ventricular cardiomyopathy, clinical manifestations, and diagnosis
This review aims to give an update on the pathogenesis, clinical manifestations, and diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC). Arrhythmogenic right ventricular cardiomyopathy is mainly an autosomal dominant inherited disease linked to mutations in genes encoding desmosomes or desmosome-related proteins. Classic symptoms include palpitations, cardiac syncope, and aborted cardiac arrest due to ventricular arrhythmias. Heart failure may develop in later stages. Diagnosis is based on the presence of major and minor criteria from the Task Force Criteria revised in 2010 (TFC 2010), which includes evalu...
Source: Europace - June 29, 2016 Category: Cardiology Authors: Haugaa, K. H., Haland, T. F., Leren, I. S., Saberniak, J., Edvardsen, T. Tags: REVIEWS Source Type: research

Anticoagulation reversal in the era of the non-vitamin K oral anticoagulants
In recent years, non-vitamin K oral anticoagulants (NOACs) have emerged as an alternative to warfarin for the prevention and treatment of thrombo-embolic disease. Large randomized trials have demonstrated that these agents, which act by directly targeting thrombin (dabigatran) and factor Xa (rivaroxaban, apixaban, and edoxaban), are at least as effective as warfarin, with lower rates of bleeding and fewer interactions with food and drugs. In addition, NOACs have a more predictable anticoagulant effect, allowing a fixed dose regimen and obviating the need for routine anticoagulation monitoring. Since the introduction of NOA...
Source: Europace - June 29, 2016 Category: Cardiology Authors: Enriquez, A., Lip, G. Y. H., Baranchuk, A. Tags: REVIEWS Source Type: research

Arrhythmogenic right ventricular dysplasia/cardiomyopathy: arrhythmogenesis in the apparently normal heart?
(Source: Europace)
Source: Europace - June 29, 2016 Category: Cardiology Authors: Hauer, R. N. Tags: EDITORIAL Source Type: research

Impact of surround flow catheter tip irrigation in contact force ablation on the incidence of asymptomatic oesophageal lesions after atrial fibrillation ablation: a prospective comparative study
ConclusionAccording to these preliminary results, the use of an improved ablation catheter irrigation technology (surround flow) in conjunction with contact force measurement was associated with a higher but not statistically significant probability of oesophageal thermal lesions. Further studies including larger patient cohorts are needed. (Source: Europace)
Source: Europace - June 28, 2016 Category: Cardiology Source Type: research

Long-term benefit of first-line peri-implantable cardioverter –defibrillator implant ventricular tachycardia-substrate ablation in secondary prevention patients
This study assessed the benefit of peri-implantable cardioverter –defibrillator implant ventricular tachycardia (VT)-substrate ablation in patients with structural heart disease (SHD).Methods and resultsPatients with SHD and indication for secondary prevention ICD implant were prospectively included. Patients presenting with incessant and/or slow VT or frequent ( ≥2) VT episodes who underwent peri-ICD VT-substrate ablation (the scar dechannelling technique) were compared with those who received ICD alone and did not meet ablation criteria. The primary endpoint was any sustained VT/ICD therapy during follow-up. Of ...
Source: Europace - June 28, 2016 Category: Cardiology Source Type: research

Long-term outcomes after event-free cardioverter defibrillator implantation: comparison between patients discharged within 24 h and routinely hospitalized patients in the German DEVICE registry
ConclusionData from a large-scale registry reflecting current day-to-day practice in Germany suggest that most patients can be discharged safely within 24 h of successful ICD implantation if there are no procedure-related events. Follow-up data up to 1.5 years after implantation did not raise long-term safety concerns. (Source: Europace)
Source: Europace - June 28, 2016 Category: Cardiology Source Type: research

Diagnosis and management of iatrogenic cardiac perforation caused by pacemaker and defibrillator leads
ConclusionIn the setting of cardiac perforation, CT is the imaging modality of choice. Transvenous lead extraction can be recommended as a safe, efficacious, and versatile intervention. (Source: Europace)
Source: Europace - June 28, 2016 Category: Cardiology Source Type: research

Wound haematoma following defibrillator implantation: incidence and predictors in the Shockless Implant Evaluation (SIMPLE) trial
This study included 2500 patients receiving an ICD in the SIMPLE trial. A clinically significant pocket haematoma was defined as a haematoma that required re-operation or interruption of oral anticoagulation (OAC) therapy. Clinically significant pocket haematoma occurred in 56 of 2500 patients (2.2%) of which 6 (10.7%) developed device-related infection. Patients who developed pocket haematoma were older (mean age 67.6 ± 8.8 years vs. 62.7 ± 11.6 years,P
Source: Europace - June 28, 2016 Category: Cardiology Source Type: research

Electrocardiographic differentiation of idiopathic right ventricular outflow tract ectopy from early arrhythmogenic right ventricular cardiomyopathy
ConclusionsIn patients with RVOT VEBs and no major electrocardiographic or echocardiographic abnormalities, the ectopic QRS morphology aids in the differential diagnosis between idiopathic RVOT arrhythmias and early ARVC. (Source: Europace)
Source: Europace - June 23, 2016 Category: Cardiology Source Type: research

Addictive drugs, arrhythmias, and cardiac inward rectifiers
In many addictive drugs including alcohol and nicotine, proarrhythmic effects were reported. This review provides an overview of the current knowledge in this field (with a focus on the inward rectifier potassium currents) to promote the lacking data and appeal for their completion, thus, to improve understanding of the proarrhythmic potential of addictive drugs. (Source: Europace)
Source: Europace - June 14, 2016 Category: Cardiology Source Type: research

Differential effects of ganglionic plexi ablation in a patient with neurally mediated syncope and intermittent atrioventricular block: a commentary
This editorial refers to ‘Differential effect of ganglionic plexi ablation in a patient with neurally mediated syncope and intermittent atrioventricular block’ by M. Fukunaga et al., on pages 119–126. (Source: Europace)
Source: Europace - June 14, 2016 Category: Cardiology Source Type: research

Conduction over and around the atrioventricular node: author's reply
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Katritsis, D. G., Josephson, M. E. Tags: LETTERS TO THE EDITOR Source Type: research

Characterizing fast pathway in typical and atypical atrioventricular nodal re-entrant tachycardia by atrial-His and His-atrial: more to consider
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Sun, H., Lakin, R., He, Y., Yang, P. Tags: LETTERS TO THE EDITOR Source Type: research

Temperature-limited applications of mini-electrode catheter: authors' reply
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Iwasawa, J., Miyazaki, S., Iesaka, Y. Tags: LETTERS TO THE EDITOR Source Type: research

Importance of anatomy in cavotricuspid isthmus
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Caldwell, J. C., Hobson, N., Redfearn, D. Tags: LETTERS TO THE EDITOR Source Type: research

Replacement of implantable cardioverter defibrillators and cardiac resynchronization therapy devices: results of the European Heart Rhythm Association survey
The aim of this EP Wire was to assess the management, indications, and techniques for implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) device replacement in Europe. A total of 24 centres in 14 European countries completed the questionnaire. All centres were members of the European Heart Rhythm Association Electrophysiology Research Network. Replacement procedures were performed by electrophysiologists in 52% of the centres, by cardiologists in 33%, and both in the remaining centres. In the majority of centres, the procedures were performed during a short hospitalization (
Source: Europace - June 13, 2016 Category: Cardiology Authors: Tilz, R., Boveda, S., Deharo, J.-C., Dobreanu, D., Haugaa, K. H., Dagres, N. Tags: EP WIRE Source Type: research

QT interval variability in body surface ECG: measurement, physiological basis, and clinical value: position statement and consensus guidance endorsed by the European Heart Rhythm Association jointly with the ESC Working Group on Cardiac Cellular Electrophysiology
This consensus guideline discusses the electrocardiographic phenomenon of beat-to-beat QT interval variability (QTV) on surface electrocardiograms. The text covers measurement principles, physiological basis, and clinical value of QTV. Technical considerations include QT interval measurement and the relation between QTV and heart rate variability. Research frontiers of QTV include understanding of QTV physiology, systematic evaluation of the link between QTV and direct measures of neural activity, modelling of the QTV dependence on the variability of other physiological variables, distinction between QTV and general T wave...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Baumert, M., Porta, A., Vos, M. A., Malik, M., Couderc, J.-P., Laguna, P., Piccirillo, G., Smith, G. L., Tereshchenko, L. G., Volders, P. G. A. Tags: EHRA POSITION PAPER Source Type: research

Cost comparison of two implantable cardiac monitors in two different settings: Reveal XT in a catheterization laboratory vs. Reveal LINQ in a procedure room
Conclusion Inserting the miniaturized version of the ICM is simpler and faster, and the procedure can take place outside the cath lab in a less resource intensive environment. Hospitals save resources when the higher price of the Reveal LINQ does not outweigh these savings. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Kanters, T. A., Wolff, C., Boyson, D., Kouakam, C., Dinh, T., Hakkaart, L., Rutten-Van Mölken, M. P. M. H. Tags: Syncope and event loop recorders Source Type: research

The benefit of a remotely monitored implantable loop recorder as a first line investigation in unexplained syncope: the EaSyAS II trial
Conclusions Implantable loop recorder monitoring achieved a more rapid diagnosis in unexplained syncope than usual care. Conventional management of syncope failed to achieve an ECG diagnosis despite a large number of investigative tests. Syncope Clinic and provocative tilt testing delivered a rapid ECG diagnosis, but did not prevent recurrent syncope. Implantable loop recorders offered rapid diagnosis, increased the likelihood of syncope being reported, demonstrated a high rate of intermittent bradycardia requiring pacing, and reduced recurrent syncope. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Sulke, N., Sugihara, C., Hong, P., Patel, N., Freemantle, N. Tags: Electrocardiology and risk stratification Source Type: research

Novel SCN10A variants associated with Brugada syndrome
Conclusion In six BrS probands who carried SCN10A variants, most experienced severe arrhythmic attacks. It is of clinical importance to screen SCN10A mutations in BrS, although the functional significance of these variants remains unclear. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Fukuyama, M., Ohno, S., Makiyama, T., Horie, M. Tags: Channelopathies Source Type: research

A Brugada syndrome proband with compound heterozygote SCN5A mutations identified from a Chinese family in Singapore
Aims Brugada syndrome (BrS) is a rare heritable ventricular arrhythmia. Genetic defects in SCN5A, a gene that encodes the α-subunit of the sodium ion channel Nav1.5, are present in 15–30% of BrS cases. SCN5A remains by far, the highest yielding gene for BrS. We studied a young male who presented with syncope at age 11. This proband was screened for possible disease causing SCN5A mutations. The inheritance pattern was also examined amongst his first-degree family members. Methods and results The proband had a baseline electrocardiogram that showed Type 2 BrS changes, which escalated to a characteristic Type I B...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Tan, B. Y., Yong, R. Y. Y., Barajas-Martinez, H., Dumaine, R., Chew, Y. X., Wasan, P. S., Ching, C. K., Ho, K. L., Gan, L. S. H., Morin, N., Chong, A. P. L., Yap, S. H., Neo, J. L., Yap, E. P. H., Moochhala, S., Chong, D. T. T., Chow, W., Seow, S. C., Hu, Tags: Channelopathies Source Type: research

Purkinje-related ventricular fibrillation associated with a homozygous H558R polymorphism in the sodium channel SCN5A gene
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Reithmann, C., Beckmann, B.-M., Kääb, S. Tags: EP CASE EXPRESS Source Type: research

Diagnostic yield of molecular autopsy in patients with sudden arrhythmic death syndrome using targeted exome sequencing
Aims The targeted genetic screening of Sudden Arrhythmic Death Syndrome (SADS) probands in a molecular autopsy has a diagnostic yield of up to 35%. Exome sequencing has the potential to improve this yield. The primary aim of this study is to examine the feasibility and diagnostic utility of targeted exome screening in SADS victims, utilizing familial clinical screening whenever possible. Methods and results To determine the feasibility and diagnostic yield of targeted exome sequencing deoxyribonucleic acid (DNA) was isolated from 59 SADS victims (mean age 25 years, range 1–51 years). Targeted exome sequencing of 135...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Nunn, L. M., Lopes, L. R., Syrris, P., Murphy, C., Plagnol, V., Firman, E., Dalageorgou, C., Zorio, E., Domingo, D., Murday, V., Findlay, I., Duncan, A., Carr-White, G., Robert, L., Bueser, T., Langman, C., Fynn, S. P., Goddard, M., White, A., Bundgaard, Tags: Channelopathies Source Type: research

Failure to shock due to misdiagnosis of polymorphic ventricular tachycardia: to bin or not to bin?
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Lim, T. W., Kojodjojo, P., Seow, S.-C. Tags: EP CASE EXPRESS Source Type: research

Asymptomatic ventricular premature depolarizations are not necessarily benign
Aims Most patients with idiopathic ventricular premature depolarizations (VPDs) complain of symptoms related to this arrhythmia, but some patients are asymptomatic even with a high VPD burden. Our understanding of the relationship between symptoms and cardiomyopathy related to this arrhythmia remains limited. Methods and Results We evaluated 801 subjects (381 men; mean age, 55 ± 17 years) who visited our outpatient clinic. All subjects were diagnosed with frequent VPDs (1% or>1000 beats/day). The patients were divided into two groups according to the presence or absence of typical VPD symptoms (palpitations or s...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Park, K.-M., Im, S. I., Chun, K. J., Hwang, J. K., Park, S.-J., Kim, J. S., On, Y. K. Tags: Cardiac electrophysiology Source Type: research

Impact of previous cardiac surgery on long-term outcome of cavotricuspid isthmus-dependent atrial flutter ablation
Conclusion Radiofrequency catheter ablation of CTI-AFL after surgical correction of AHD and CHD is associated with high acute success rates. The severity of the structural alterations of the underlying heart disease and consequently the type of surgical correction correlates with higher risk for recurrence. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Dallaglio, P. D., Anguera, I., Jimenez-Candil, J., Peinado, R., Garcia-Seara, J., Arcocha, M. F., Macias, R., Herreros, B., Quesada, A., Hernandez-Madrid, A., Alvarez, M., Di Marco, A., Filgueiras, D., Matia, R., Cequier, A., Sabate, X. Tags: Cardiac electrophysiology Source Type: research

Cavotricuspid isthmus ablation using a catheter equipped with mini electrodes on the 8 mm tip: a prospective comparison with an 8 mm dumbbell-shaped tip catheter and 8 mm tip cryothermal catheter
Aims The mini electrodes (ME) placed on the tip of the ablation electrode provide more precise local signal. We evaluated whether ME catheter was effective for the ablation of cavotricuspid isthmus (CTI)-dependent atrial flutter. Methods and results Eighty-five consecutive patients (68 men; 62 ± 10 years) underwent CTI ablation either using a catheter equipped with ME on the 8 mm tip (ME catheter) in 25 patients (Group A), 8 mm dumbbell-shaped (DS) tip catheter (DS catheter) in 30 patients (Group B), or 8 mm tip cryothermal catheter (Cryo catheter) in 30 patients (Group C). In cases of failed isthmus block, the cat...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Iwasawa, J., Miyazaki, S., Takagi, T., Taniguchi, H., Nakamura, H., Hachiya, H., Iesaka, Y. Tags: Cardiac electrophysiology Source Type: research

Radiofrequency ablation of left atrial appendage accessory pathway
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Mollazadeh, R., Eslami, M. Tags: EP CASE EXPRESS Source Type: research

Bundled preparation of skin antisepsis decreases the risk of cardiac implantable electronic device-related infection
Conclusion Pocket haematoma was the most important risk factor for CIED infection. The bundled skin antiseptic preparation strategy significantly reduced the risk of minor CIED infection. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Chen, H.-C., Chen, M.-C., Chen, Y.-L., Tsai, T.-H., Pan, K.-L., Lin, Y.-S. Tags: Pacing and resynchronization therapy Source Type: research

Quantitative assessment of cardiac mechanical dyssynchrony and prediction of response to cardiac resynchronization therapy in patients with non-ischaemic dilated cardiomyopathy using equilibrium radionuclide angiography
Conclusion Baseline SD LVmPA and LV–RVmPA derived from ERNA are useful for prediction of response to CRT in non-ischaemic DCM patients. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Mukherjee, A., Patel, C. D., Naik, N., Sharma, G., Roy, A. Tags: Pacing and resynchronization therapy Source Type: research

Mid-term clinical and echocardiographic evaluation of super responders with and without pacing: the preliminary results of a prospective, randomized, single-centre study
Conclusion Super responders without pacing had poor clinical and echocardiographic outcomes at the mid-term follow-up. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Cay, S., Ozeke, O., Ozcan, F., Aras, D., Topaloglu, S. Tags: Pacing and resynchronization therapy Source Type: research

Clinical features and changes in epidemiology of infective endocarditis on pacemaker devices over a 27-year period (1987-2013)
Aims Use of cardiac pacing devices has grown in recent years. Our aim was to evaluate changes in epidemiology and clinical features of infective endocarditis (IE) involving pacemaker devices in a large series of IE over the last 27 years (1987–2013). Methods and results From 1987 to December 2013, 413 consecutive IE cases were diagnosed in our hospital. During this period, 7424 pacemaker devices were implanted (6917 pacemakers, 239 implantable cardiac defibrillators, 158 resynchronization devices, and 110 resynchronization/defibrillator devices). All consecutive cases of IE on pacemaker devices were included and ana...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Carrasco, F., Anguita, M., Ruiz, M., Castillo, J. C., Delgado, M., Mesa, D., Romo, E., Pan, M., Suarez de Lezo, J. Tags: Pacing and resynchronization therapy Source Type: research

Concerns about implantable cardioverter-defibrillator shocks mediate the relationship between actual shocks and psychological distress
Conclusion Implantable cardioverter-defibrillator-related concerns have a bigger impact on psychological distress than receipt of an actual shock. Assessing ICD-related concerns in clinical practice can identify patients at risk for psychological distress. Further research on assessment of, and interventions targeting, ICD-related concerns is warranted. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Thylen, I., Moser, D. K., Strömberg, A., Dekker, R. A., Chung, M. L. Tags: Sudden death and ICDs Source Type: research

Impact of remote monitoring on reducing the burden of inappropriate shocks related to implantable cardioverter-defibrillator lead fractures: insights from a French single-centre registry
Conclusion Remote monitoring helps to reduce the burden of ISs related to ICD lead fractures. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Souissi, Z., Guedon-Moreau, L., Boule, S., Kouakam, C., Finat, L., Marquie, C., Brigadeau, F., Wissocque, L., Mouton, S., Montaigne, D., Klug, D., Kacet, S., Lacroix, D. Tags: Sudden death and ICDs Source Type: research

Ratchet syndrome in complex congenital heart disease
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Shoda, M., Takeuchi, D., Manaka, T. Tags: IMAGES IN ELECTROPHYSIOLOGY Source Type: research

Feasibility and safety of temporary subcutaneous venous figure-of-eight suture to achieve haemostasis after ablation of atrial fibrillation
Conclusion Figure-of-eight suture is a fast closure technique that can be used as an efficient alternative to usual compression methods to prevent bleeding during high-intensity anticoagulation and the use of large-diameter venous sheaths and multiple femoral venous accesses. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Traulle, S., Kubala, M., Doucy, A., Quenum, S., Hermida, J.-S. Tags: Ablation for atrial fibrillation Source Type: research

Combined remote magnetic navigation and ultra-high-density mapping (Rhythmia™) in slow pathway ablation
(Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Latcu, D. G., Bun, S.-S., Saoudi, N. Tags: EP CASE EXPRESS Source Type: research

Safety, efficacy, and clinical applicability of pulmonary vein isolation with circular multi-electrode ablation systems: PVAC(R) vs. nMARQ™ for atrial fibrillation ablation
Aims We compare our experience with available circular multi-electrode catheters for atrial fibrillation (AF) ablation: PVAC®, a phased radiofrequency system, and nMARQ™, an irrigated tip-CARTO-based technology. Methods and results Prospective observational study of 175 consecutive patients with follow-up duration of at least 5 months who underwent pulmonary vein isolation (PVI) for symptomatic AF using PVAC® (n = 93, age 61.4 ± 9.8 years; 60% male, 13% persistent AF) vs. nMARQ™ (n = 82, age 63.2 ± 10.6 years; 67% male, 24% persistent AF). Procedure and radiation times were 94 ± 27...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Laish-Farkash, A., Khalameizer, V., Fishman, E., Cohen, O., Yosefy, C., Cohen, I., Katz, A. Tags: Ablation for atrial fibrillation Source Type: research

Role of insertable cardiac monitors in anticoagulation therapy in patients with atrial fibrillation at high risk of bleeding
Conclusion In AF patients with high bleeding risk, ICM-guided rhythm control with AADs and assessment of AF burden may allow safe discontinuation of OACs. (Source: Europace)
Source: Europace - June 13, 2016 Category: Cardiology Authors: Mascarenhas, D. A. N., Farooq, M. U., Ziegler, P. D., Kantharia, B. K. Tags: Atrial fibrillation Source Type: research

Peripheral arterial disease is associated with an increased risk of atrial fibrillation in the elderly
We examined the relationship between PAD and AF in 5143 participants (85% white, 43% male) in the Cardiovascular Health Study (CHS), a longitudinal, observational study of adults aged 65 years and older. Peripheral arterial disease was defined by abnormal ankle-brachial index (ABI) values (1.4). Incident AF events were ascertained by self-reported history, study electrocardiograms, and hospitalization discharge records. Cox regression was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between PAD and AF. Over a median follow-up of 11.7 years, a total of 1521 participants develope...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Griffin, W. F., Salahuddin, T., O'Neal, W. T., Soliman, E. Z. Tags: Atrial fibrillation Source Type: research

Smart-watches: a potential challenger to the implantable loop recorder?
The newest generation of smart-watches offer heart rate monitoring technology via photoplethysmography, a technology shown to demonstrate impressive ability in diagnosing arrhythmias including atrial fibrillation. Combining such technology with the portability, connectivity and other location and activity tracking features smart-watches could represent a powerful new tool in extended non-invasive arrhythmia detection. The technology itself, including potential uses and limitations, is discussed. There is a need for further software development but crucially, further work into clarifying the diagnostic accuracy of such tech...
Source: Europace - June 13, 2016 Category: Cardiology Authors: Carpenter, A., Frontera, A. Tags: REVIEW Source Type: research

Results from a multicentre comparison of cryoballoon vs. radiofrequency ablation for paroxysmal atrial fibrillation: is cryoablation more reproducible?
AimCryoballoon ablation (Cryoballoon) has emerged as a new alternative for the treatment of symptomatic drug-refractory atrial fibrillation (AF). Whether the results of Cryoballoon are more reproducible than those of radiofrequency (RF) ablation remains to be proved.Methods and resultsA total of 860 consecutive patients undergoing a first ablation procedure for paroxysmal AF (467 treated with RF and 393 treated with Cryoballoon) were selected from a prospective multicentre survey of AF ablation (FrenchAF). Radiofrequency and Cryoballoon were compared regarding mid-term efficacy and safety. During a median follow-up of 14 m...
Source: Europace - June 5, 2016 Category: Cardiology Source Type: research

Living with an implantable cardioverter defibrillator: patients' preferences and needs for information provision and care options
ConclusionDespite a high satisfaction level with information provision, particular topics are not broached with patients (e.g. device activation) and patients have unmet needs that are not met in current clinical practice. (Source: Europace)
Source: Europace - June 4, 2016 Category: Cardiology Source Type: research

Left-ventricular geometry and risk of sudden cardiac arrest in patients with preserved or moderately reduced left-ventricular ejection fraction
AbstractAimsThe majority of sudden cardiac arrests (SCAs) occur in patients with left-ventricular (LV) ejection fraction (LVEF)>35%, yet there are no methods for effective risk stratification in this sub-group. Since abnormalities of LV geometry can be identified even with preserved LVEF, we investigated the potential impact of LV geometry as a novel risk marker for this patient population.Methods and resultsIn the ongoing Oregon Sudden Unexpected Death Study, SCA cases with archived echocardiographic data available were prospectively identified during 2002 –15, and compared with geographical controls. Analysis wa...
Source: Europace - June 2, 2016 Category: Cardiology Source Type: research

Prognosis of high sinus heart rate after catheter ablation for atrial fibrillation
AbstractAimsAlthough atrial fibrillation (AF) catheter ablation increases sinus heart rate (HR), its mechanism and prognosis have not yet been clearly elucidated. We hypothesize that post-AF ablation high sinus HR (PA-HSR) is associated with a better clinical outcome of AF ablation without adverse cardiac effects.Methods and resultsWe studied 991 AF patients (75% male, 58 ± 11 years old, 70% paroxysmal AF) with HR variability (HRV) at 3 months and 1 year after catheter ablation, and pre- and post-1-year echocardiograms. Post-AF ablation high sinus HR was defined as an average HR greater than 2 SD (≥92 bpm) as mea...
Source: Europace - June 2, 2016 Category: Cardiology Source Type: research

Venous thromboembolism in patients with implantable cardioverter-defibrillators
ConclusionThree-month risk of VTE following ICD implantation was 0.3% regardless of comorbidity level. Five-year risk of VTE following ICD implantation was 1.9% and more than twice as high for patients with severe comorbidity as for patients without comorbidity. (Source: Europace)
Source: Europace - June 2, 2016 Category: Cardiology Source Type: research

Pulmonary vein reconnection predicts good clinical outcome after second catheter ablation for atrial fibrillation
AbstractAimsAlthough electrically reconnected pulmonary veins (PV) are the main mechanism of atrial fibrillation (AF) recurrence, PV isolation (PVI) is well-preserved in certain patients who undergo a repeat procedure. We explored the association between PV reconnection and clinical outcomes after a second ablation.Methods and resultsThis observational cohort study included 143 patients (79.0% male, 56.1 ± 10.0 years old, 65.0% paroxysmal AF) who underwent a second procedure. Pulmonary vein isolation was well-maintained in 52 patients (PVP− group, 36.4%), although the remaining 91 patients showed PV reconnecti...
Source: Europace - June 2, 2016 Category: Cardiology Source Type: research

Reduction of radiation exposure in cryoballoon ablation procedures: a single-centre study applying intracardiac echocardiography and other radioprotective measures
AbstractAimsThe population treated with cryoballoon (CB) ablation is relatively young, and radiation protection is of major importance. We aimed to demonstrate that radiation exposure can be markedly reduced by intracardiac echocardiography (ICE) and optimized settings of the X-ray system.Methods and resultsWe analysed 100 patients undergoing CB pulmonary vein isolation (PVI) for treatment of paroxysmal atrial fibrillation. In 50 consecutive patients (25 male, 59 ± 13 years; Group 1), we used ICE, skipped PV angiography prior to CB inflation, and avoided fluoroscopy whenever possible. Furthermore, we reduced the fra...
Source: Europace - June 2, 2016 Category: Cardiology Source Type: research

Exome sequencing in arrhythmogenic right ventricular cardiomyopathy: a new diagnostic tool?
This editorial refers to ‘Arrhythmogenic right ventricular cardiomyopathy: implications of next-generation sequencing in appropriate diagnosis, by A. Medeiros-Domingoet al., on pages 1063 –1069. (Source: Europace)
Source: Europace - June 2, 2016 Category: Cardiology Source Type: research

Magnetic resonance imaging in patients with cardiac implanted electronic devices: focus on contraindications to magnetic resonance imaging protocols
ConclusionUsing a pre-specified protocol, cardiac and non-cardiac MRIs were performed in CIED patients with pacemaker dependency, abandoned leads, or depleted batteries without occurrence of major adverse events. Patients with devices on advisory need to be monitored carefully during MRI, especially if they are pacemaker dependent. (Source: Europace)
Source: Europace - June 2, 2016 Category: Cardiology Source Type: research