On the nature of delays allowing anatomical re-entry involving the Purkinje network: a simulation study
ConclusionFormation of anatomical re-entry using the Purkinje network is possible through highly reduced gap junctional coupling leading to slowed conduction. (Source: Europace)
Source: Europace - January 27, 2021 Category: Cardiology Source Type: research

Risk of ventricular arrhythmia in cardiac resynchronization therapy responders and super-responders: a systematic review and meta-analysis
ConclusionsCardiac resynchronization therapy super-responders have low absolute risk of VA and all-cause mortality. However, there remains a non-trivial residual absolute risk of these adverse outcomes in CRT responders. These findings suggest that among CRT responders, there may be a continued clinical benefit of defibrillators. (Source: Europace)
Source: Europace - January 26, 2021 Category: Cardiology Source Type: research

Stereotactic ventricular tachycardia radioablation aided by CT-channels analysis in a patient with inaccessible transmural substrate
(Source: Europace)
Source: Europace - January 19, 2021 Category: Cardiology Source Type: research

Alpha 1-adrenoceptor signalling contributes to toxic effects of catecholamine on electrical properties in cardiomyocytes
ConclusionsAlpha 1-adrenoceptor signalling plays important roles for arrhythmogenesis of TTS. Alpha-adrenoceptor blockers might be clinically helpful for treating arrhythmias in patients with TTS. (Source: Europace)
Source: Europace - January 19, 2021 Category: Cardiology Source Type: research

Corner fracture: an unexpected lead complication in subcutaneous implantable cardioverter-defibrillator
We received for a routine visit a 41-year-old man with a history of dilated cardiomyopathy 18  months after a subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation for primary prevention (Emblem S-ICD; Boston Scientific, lead 3501 batch 135186, 25 February 2019). (Source: Europace)
Source: Europace - January 17, 2021 Category: Cardiology Source Type: research

Using machine learning to identify local cellular properties that support re-entrant activation in patient-specific models of atrial fibrillation
ConclusionIn a virtual patient cohort, local tissue properties, that can be measured (CV) or estimated (APD; using effective refractory period as a surrogate) clinically, identified regions of tissue that tether phase singularities. Combing CV and APD with atrial surface area further improved the accuracy in identifying regions that tether phase singularities. (Source: Europace)
Source: Europace - January 12, 2021 Category: Cardiology Source Type: research

Use of high-density activation and voltage mapping in combination with entrainment to delineate gap-related atrial tachycardias post atrial fibrillation ablation
Conclusion  High-resolution activation mapping in combination with high-density voltage and entrainment mapping is the ideal strategy to delineate the critical part of the circuit in endocardial gap-related re-entrant AT after AF ablation. (Source: Europace)
Source: Europace - January 10, 2021 Category: Cardiology Source Type: research

Quantitative collagen assessment in right ventricular myectomies from patients with tetralogy of Fallot
ConclusionGiven the high intra-individual heterogeneity, fibrosis quantification should not be conducted on single sections of TOF RVOT myectomies. We provide an analysis algorithm for fibrosis quantification in histological images, which enables the required extended volume analyses in these patients. (Source: Europace)
Source: Europace - January 6, 2021 Category: Cardiology Source Type: research

Long-term oral anticoagulant after catheter ablation for atrial fibrillation
AbstractCatheter ablation is superior to antiarrhythmic therapy for the reduction of symptomatic atrial fibrillation (AF), recurrence, and burden. The possibility of a true ‘rhythm’ control strategy with catheter ablation has re-opened the debate on rate vs. rhythm control and the subsequent impact on stroke risk. Some observation studies suggest that successful AF catheter ablation and maintenance of sinus rhythm are associated with a decrease in stroke risk, whil e the CABANA trial had demonstrated no apparent reduction. Other observational studies have demonstrated increased stroke risk when oral anticoagulation (OA...
Source: Europace - January 5, 2021 Category: Cardiology Source Type: research

Interatrial electrical dissociation with concealed atypical atrial flutter during catheter ablation
A 69-year-old man with a prior history of mitral valvuloplasty and recurrent symptomatic multidrug-resistant atypical atrial flutter (AFL) was referred to our institute for a third catheter ablation procedure after previous atrial fibrillation and typical AFL ablation procedure. The electrophysiological study documented a macroreentry circuit with a critical isthmus between the upper septal scar and the mitral annulus. Subsequent radiofrequency ablation in this region interrupted the arrhythmia. After burst pacing, an atypical AFL with 300 ms atrial cycle was induced. The electroanatomical mapping showed a complex activati...
Source: Europace - January 5, 2021 Category: Cardiology Source Type: research

Mechanical circulatory support in the management of life-threatening arrhythmia
AbstractLife-threatening refractory unstable ventricular arrhythmias in presence of advanced heart failure (HF) may determine haemodynamic impairment. Haemodynamic mechanical support (HMS) in this setting has a relevant role to restore end-organ perfusion. Catheter ablation (CA) of ventricular tachycardia (VT) is effective at achieving rhythm stabilization, allowing patient ’s weaning from HMS, or bridging to permanent HF treatments. Acute heart decompensation during CA at anaesthesia induction in presence of advanced heart disease, in selected cases requires a preemptive HMS to prevent periprocedure adverse outcomes. Su...
Source: Europace - December 31, 2020 Category: Cardiology Source Type: research

A simple and practical criterion for determining a failed His-bundle pacing
ConclusionA failed HBP can be easily and reliably determined solely by ‘S-QRSend> H-QRSend ’ in more than 30% pacing tests. (Source: Europace)
Source: Europace - December 28, 2020 Category: Cardiology Source Type: research

Left bundle branch pacing through direct puncture of superior vena cava
A 71-year-old man on haemodialysis over 2  years for chronic renal dysfunction needed pacemaker for paroxysmal atrial fibrillation and intermittent third-degree atrioventricular block with a long PR interval. Echocardiography illustrated decreased left ventricular ejection fraction. Left bundle branch pacing (LBBP) from the right subclavi an vein was planned considering the left cephalic vein-radial artery fistula. However, procedural angiography revealed the right subclavian vein and right internal jugular vein occlusion which failed to be opened after repeated attempts. Leadless pacing was not available at that time in...
Source: Europace - December 28, 2020 Category: Cardiology Source Type: research

The feasibility and safety of left bundle branch pacing vs. right ventricular pacing after mid-long-term follow-up: a single-centre experience
ConclusionLeft bundle branch pacing was feasible in bradycardia patients associated with stable pacing parameters during 18 months follow-up. Paced QRS duration was significantly narrower than that of RVP. Though cTnT elevation was more significant in LBBP within 2  days post-procedure, the complications, and cardiac outcomes were not significantly different between two groups. (Source: Europace)
Source: Europace - December 28, 2020 Category: Cardiology Source Type: research

The implantation technique in His-bundle pacing: evolution and perspectives
This editorial refers to ‘Electrical characteristics of pacing different portions of the His bundle in bradycardia patients’, by Y. Huet al., on pages ii27--ii35. (Source: Europace)
Source: Europace - December 28, 2020 Category: Cardiology Source Type: research