Prognostic relevance of the interaction between short-term, metronome-paced heart rate variability, and inflammation: results from the population-based CARLA cohort study
ConclusionA change in TNF-α levels or the autonomic nervous system influences the mortality risk through both entities simultaneously. Thus, TNF-α and HRV need to be considered when predicating mortality. (Source: Europace)
Source: Europace - May 24, 2016 Category: Cardiology Source Type: research

The impact of ischaemic stroke on atrial fibrillation-related healthcare cost: a systematic review
AbstractThe aim of this study was to summarize healthcare costs incurred by patients with atrial fibrillation (AF) who developed ischaemic stroke, explore factors associated with increased cost, and highlight the importance of anticoagulation therapy for stroke prophylaxis. A systematic literature search of PubMed, EMBASE, Web of Science, and the health economic evaluation database was conducted up to December 2015. Studies focused on the cost and/or resource utilization of ischaemic stroke in patients with AF were included. Reported costs were converted to international dollars (I$) and adjusted to 2015 values. Alongside ...
Source: Europace - May 21, 2016 Category: Cardiology Source Type: research

Increased risk of stroke and mortality following new-onset atrial fibrillation during hospitalization
AbstractAimsThe outcome of patients who develop new-onset atrial fibrillation (AF) during hospitalization is unknown, and the management of this patient population is not specifically addressed by current guidelines. We investigated the incidence of death and inhospital stroke among a large cohort of hospitalized inpatients who developed new-onset AF.Methods and resultsAll patients ≥50 years of age admitted to a tertiary academic medical centre (20 April 2005 to 31 December 2011;n = 84 919) were studied. Demographic variables were compared among patients categorized as having new-onset, pre-existing, or no AF. A propens...
Source: Europace - May 20, 2016 Category: Cardiology Source Type: research

Five seconds of 50 –60 W radio frequency atrial ablations were transmural and safe: an in vitro mechanistic assessment and force-controlled in vivo validation
ConclusionHigh-power, short-duration atrial ablation was as safe and effective as the conventional ablation. Compared with the conventional 40 W/30 s setting, 50 and 60 W ablation for 5 s achieved transmurality and had fewer complications. (Source: Europace)
Source: Europace - May 20, 2016 Category: Cardiology Source Type: research

Ultrasound-guided cannulation of the femoral vein in electrophysiological procedures: a systematic review and meta-analysis
ConclusionThe use of real-time 2D ultrasound guidance for femoral vein cannulation decreases access-related bleeding rates and life-threatening vascular complications. (Source: Europace)
Source: Europace - May 20, 2016 Category: Cardiology Source Type: research

Noninvasive epicardial and endocardial mapping of premature ventricular contractions
ConclusionThe NEEES accurately identified the site of PVC/VT origin. Knowledge of the potential site of the PVC/VT origin may aid the physician in planning a successful ablation strategy. (Source: Europace)
Source: Europace - May 20, 2016 Category: Cardiology Source Type: research

Arrhythmogenic right ventricular cardiomyopathy: implications of next-generation sequencing in appropriate diagnosis
ConclusionsMost of the patients with ‘definite’ ARVC phenotype by task force 2010 host mutations in desmosomal genes. Weaker ARVC phenotypes host variants/mutations in other DCM genes and result in a disease spectrum, including DCM or phenocopies of ARVC. (Source: Europace)
Source: Europace - May 18, 2016 Category: Cardiology Source Type: research

‘Real-world’ atrial fibrillation management in Europe: observations from the 2-year follow-up of the EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase
ConclusionIn this 2-year follow-up report from EORP-AF, mortality rates with AF remain high from cardiovascular causes, despite the high prevalent use of OAC. Improved management strategies to reduce major adverse outcomes in AF patients are needed. (Source: Europace)
Source: Europace - May 18, 2016 Category: Cardiology Source Type: research

Cost effectiveness of LAA closure in patients with AF and contraindications to warfarin: comment
This study evaluated the costs of percutaneous left atrial appendage closure (LAAC) using the Watchman device (Boston Scientific, Marlborough, MA). As pointed out by the authors, procedures to implement percutaneous devices are associated with a 6.7% short-term risk of major complications (air embolism, major bleeding, and pericardial effusion). Moreover, the device and technical platform necessary for the procedure come at a significant cost (€9136). Despite these downsides, assuming a willingness-to-pay threshold of€30 000 per quality-adjusted life-year gained, the authors found that relative to both aspirin an...
Source: Europace - May 18, 2016 Category: Cardiology Source Type: research

Atrial ectopy and N-terminal pro-B-type natriuretic peptide as predictors of atrial fibrillation: a population-based cohort study
ConclusionAtrial fibrillation risk discrimination was significantly improved by the addition of PAC to the Framingham AF risk model, but not by the addition of NT-proBNP. (Source: Europace)
Source: Europace - May 18, 2016 Category: Cardiology Source Type: research

Plasma homocysteine levels predict early recurrence after catheter ablation of persistent atrial fibrillation
AimsTo assess the association and the predictive value of plasma homocysteine (Hcy) with early recurrence in persistent atrial fibrillation patients after a single ablation procedure.Methods and resultsTwo hundred and fifty-seven consecutive patients with persistent atrial fibrillation who underwent successful catheter ablation were enrolled. Early recurrence of atrial tachyarrhythmia was documented within 3 months after ablation. The logistic regression analysis and Kaplan–Meier curve analysis were used to evaluate the association of Hcy with early recurrence. During the 3-month follow-up, 75 (29.2%) patients experi...
Source: Europace - May 18, 2016 Category: Cardiology Source Type: research

Differential effect of ganglionic plexi ablation in a patient with neurally mediated syncope and intermittent atrioventricular block
ConclusionThis is the first clinical case showing the differential effect of GP ablation on SA and AV nodal function, and critical importance of targeting the GP at the postero-inferior left atrium. The successful procedure corroborates clinical utility of ablation treatment instead of pacemaker implantation in selected patients with cardio-inhibitory NMS. (Source: Europace)
Source: Europace - May 18, 2016 Category: Cardiology Source Type: research

Fluconazole-induced long QT syndrome via impaired human ether-a-go-go-related gene (hERG) protein trafficking in rabbits
AbstractAimshERG protein trafficking deficiency has long been known in drug-induced long QT syndrome (LQTS). However, validated evidence fromin vivo data kept scanty. Our goal was to investigate the proarrhythmic action of fluconazole and its underlying mechanism in an animal model.Methods and resultsTwenty female Japanese long-eared white rabbits were randomly distributed into a control group and a fluconazole group for a chronic 2-week treatment. The control group was treated with 0.5% sodium carboxymethylcellulose (CMCNa), and the fluconazole group was treated with fluconazole. Electrocardiograms (ECGs) were recorded du...
Source: Europace - May 17, 2016 Category: Cardiology Source Type: research

Multipoint pacing via a quadripolar left-ventricular lead: preliminary results from the Italian registry on multipoint left-ventricular pacing in cardiac resynchronization therapy (IRON-MPP)
AbstractAimsThis registry was created to describe the experience of 76 Italian centres with a large cohort of recipients of multipoint pacing (MPP) capable cardiac resynchronization therapy (CRT) devices.Methods and resultsA total of 507 patients in whom these devices had been successfully implanted were enrolled between August 2013 and May 2015. We analysed: (i) current clinical practices for the management of such patients, and (ii) the impact of MPP on heart failure clinical composite response and on the absolute change in ejection fraction (EF) at 6 months. Multipoint pacing was programmed to ‘ON’ in 46% of...
Source: Europace - May 17, 2016 Category: Cardiology Source Type: research

High prevalence of arrhythmic and myocardial complications in patients with cardiac glycogenosis due to PRKAG2 mutations
ConclusionThis study of patients withPRKAG2 mutations provides a more comprehensive view of the natural history of this disease and demonstrates a high risk of cardiac complications. Early recognition of this disease appears important to allow an appropriate management. (Source: Europace)
Source: Europace - May 17, 2016 Category: Cardiology Source Type: research

Transseptal puncture and catheter ablation via the superior vena cava approach for persistent atrial fibrillation in a patient with polysplenia syndrome and interruption of the inferior vena cava: contact force –guided pulmonary vein isolation
ConclusionsWe successfully performed transseptal puncture in a patient with persistent AF, polysplenia syndrome, and complete interruption of the IVC using the superior route through the internal jugular vein. We also accomplished PV isolation using a deflectable guiding sheath and real-time monitoring of the contact force of the ablation catheter. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Source Type: research

Catheter ablation vs. antiarrhythmic drug therapy in patients with symptomatic atrioventricular nodal re-entrant tachycardia: a randomized, controlled trial
AimsTo conduct a randomized trial in order to guide the optimum therapy of symptomatic atrioventricular nodal re-entrant tachycardia (AVNRT).Methods and ResultsPatients with at least one symptomatic episode of tachycardia per month and an electrophysiologic diagnosis of AVNRT were randomly assigned to catheter ablation or chronic antiarrhythmic drug (AAD) therapy with bisoprolol (5 mg od) and/or diltiazem (120 –300 mg od). All patients were properly educated to treat subsequent tachycardia episodes with autonomic manoeuvres or a ‘pill in the pocket’ approach. The primary endpoint of the study was hospital...
Source: Europace - May 12, 2016 Category: Cardiology Source Type: research

Interpretation of discrete potential in idiopathic outflow tract ventricular arrhythmia: more consideration
(Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Sun, H., Lakin, R., Yang, P. Tags: LETTERS TO THE EDITOR Source Type: research

Leadless pacemakers and MRI compatibility: authors' reply
(Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Sperzel, J. Tags: LETTERS TO THE EDITOR Source Type: research

Valvular atrial fibrillation: rheumatic mitral valve disease
(Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Garcia-Villarreal, O. A. Tags: LETTERS TO THE EDITOR Source Type: research

The contact force and continuity index parameters in pulmonary vein ablation: reply
(Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Kautzner, J., on behalf of the co-authors Tags: LETTERS TO THE EDITOR Source Type: research

The contact force and continuity index parameters in pulmonary vein ablation
(Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Pietro, T. Tags: LETTERS TO THE EDITOR Source Type: research

An important advantage of the leadless pacemakers: magnetic resonance imaging compatibility
(Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Cay, S., Ozeke, O., Ozcan, F., Topaloglu, S., Aras, D. Tags: LETTERS TO THE EDITOR Source Type: research

The role of the Arrhythmia Team, an integrated, multidisciplinary approach to treatment of patients with cardiac arrhythmias: results of the European Heart Rhythm Association survey
Management of patients with cardiac arrhythmias is increasingly complex because of continuous technological advance and multifaceted clinical conditions associated with ageing of the population, the presence of co-morbidities and the need for polypharmacy. The aim of this European Heart Rhythm Association Scientific Initiatives Committee survey was to provide an insight into the role of the Arrhythmia Team, an integrated, multidisciplinary approach to management of patients with cardiac arrhythmias. Forty-eight centres from 18 European countries replied to the Web-based questionnaire. The presence of an Arrhythmia Team was...
Source: Europace - May 12, 2016 Category: Cardiology Authors: Fumagalli, S., Chen, J., Dobreanu, D., Madrid, A. H., Tilz, R., Dagres, N. Tags: EP WIRE Source Type: research

A novel lamin A/C gene missense mutation (445 V > E) in immunoglobulin-like fold associated with left ventricular non-compaction
Conclusion Our data associated a novel lamin A/C mutation (V445E) with a sudden death form of familial LVNC. The reduced sodium current in mutant LMNA may account for the advent of malignant ventricular arrhythmias. The altered structures of three β sheets and side chains may partially explain the aggregation of lamin A/C protein subjacent to the nuclear envelope. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Liu, Z., Shan, H., Huang, J., Li, N., Hou, C., Pu, J. Tags: Channelopathies Source Type: research

Arrhythmic risk assessment in genotyped families with arrhythmogenic right ventricular cardiomyopathy
Conclusion Male gender, independently of genotype is an arrhythmic risk predictor in ARVC-associated desmosomal-mutation carriers. Repolarization abnormalities and left-ventricular dysfunction are important components of the first event-associated clinical disease profile. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Protonotarios, A., Anastasakis, A., Panagiotakos, D. B., Antoniades, L., Syrris, P., Vouliotis, A., Stefanadis, C., Tsatsopoulou, A., McKenna, W. J., Protonotarios, N. Tags: Channelopathies Source Type: research

Dual LQT1 and HCM phenotypes associated with tetrad heterozygous mutations in KCNQ1, MYH7, MYLK2, and TMEM70 genes in a three-generation Chinese family
Aims Hypertrophic cardiomyopathy (HCM) mainly results from autosomal-dominant inherited single heterozygous mutations in cardiac sarcomere genes. Contributions of multiple gene mutations to disease heterogeneity in a three-generation family were investigated. Methods Clinical, electrocardiographic (ECG), and echocardiographic examination in members of a three-generation Chinese family was followed by exon and boarding intron analysis of 96 genes in the proband using second-generation sequencing. The identified mutations were confirmed by bi-directional Sanger sequencing in all family members and 300 healthy controls. Res...
Source: Europace - May 12, 2016 Category: Cardiology Authors: Wang, L., Zuo, L., Hu, J., Shao, H., Lei, C., Qi, W., Liu, Y., Miao, Y., Ma, X., Huang, C. L.- H., Wang, B., Zhou, X., Zhang, Y., Liu, L. Tags: Channelopathies Source Type: research

Improving usual care after sudden death in the young with focus on inherited cardiac diseases (the CAREFUL study): a community-based intervention study
Conclusions The autopsy rate in young SD cases in the Netherlands is low and few families undergo cardiogenetic evaluation to detect inherited cardiac diseases. Two different interventions did not improve this suboptimal situation substantially. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: van der Werf, C., Hendrix, A., Birnie, E., Bots, M. L., Vink, A., Bardai, A., Blom, M. T., Bosch, J., Bruins, W., Das, C., Koster, R. W., Naujocks, T., Schaap, B., Tan, H. L., de Vos, R., de Vries, P., Woonink, F., Doevendans, P. A., van Weert, H. C., Wil Tags: Channelopathies Source Type: research

Ambulatory cardiac arrhythmias in relation to mild hypokalaemia and prognosis in community dwelling middle-aged and elderly subjects
Conclusion In middle-aged and elderly subjects with no manifest heart disease, mild hypokalaemia is associated with increased rate of ventricular but not supraventricular arrhythmias. Hypokalaemia interacts synergistically with increased ventricular ectopy to increase the risk of adverse events. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Mattsson, N., Sadjadieh, G., Kumarathurai, P., Nielsen, O. W., Kober, L., Sajadieh, A. Tags: Cardiac electrophysiology Source Type: research

The ventricular tachycardia score: a novel approach to electrocardiographic diagnosis of ventricular tachycardia
Conclusion The new ECG-based method provides a certain diagnosis of VT in the majority of patients with VT, identifies unequivocal ECGs, and has superior overall diagnostic accuracy to other ECG methods. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Jastrzebski, M., Sasaki, K., Kukla, P., Fijorek, K., Stec, S., Czarnecka, D. Tags: Cardiac electrophysiology Source Type: research

Real-time magnetic resonance-guided ablation of typical right atrial flutter using a combination of active catheter tracking and passive catheter visualization in man: initial results from a consecutive patient series
Conclusion The combination of active catheter tracking and passive real-time visualization in CMR-guided electrophysiologic (EP) studies using advanced interventional hardware and software was safe and enabled efficient navigation, mapping, and ablation. These cases demonstrate significant progress in the development of MR-guided EP procedures. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Hilbert, S., Sommer, P., Gutberlet, M., Gaspar, T., Foldyna, B., Piorkowski, C., Weiss, S., Lloyd, T., Schnackenburg, B., Krueger, S., Fleiter, C., Paetsch, I., Jahnke, C., Hindricks, G., Grothoff, M. Tags: Cardiac electrophysiology Source Type: research

Propafenone shows class Ic and class II antiarrhythmic effects
Aims Propafenone is a well-known Class Ic antiarrhythmic agent. It has the typical chemical structure of a beta-blocker, but human studies on its beta-blocking effects revealed conflicting results. Methods and results Twelve healthy males received single oral doses of 600 mg propafenone and placebo according to a randomized, double-blind, placebo-controlled, cross-over protocol. Four hours following drug intake, heart rate and blood pressure were measured, and plasma concentrations of propafenone were determined at rest, during exercise and after recovery. At exercise, propafenone significantly decreased heart rate (–6%, P
Source: Europace - May 12, 2016 Category: Cardiology Authors: Stoschitzky, K., Stoschitzky, G., Lercher, P., Brussee, H., Lamprecht, G., Lindner, W. Tags: Cardiac electrophysiology Source Type: research

The use of multisite left ventricular pacing via quadripolar lead improves acute haemodynamics and mechanical dyssynchrony assessed by radial strain speckle tracking: initial results
The objective of the present study was to evaluate the effect of multipoint pacing (MPP) on acute haemodynamics, cardiac contractility, and left ventricle (LV) dyssynchrony, in comparison with conventional cardiac resynchronization therapy (CRT). Methods and results An open-label, non-randomized, single-centre, prospective study was designed. Twenty-seven consecutive patients were included. Evaluation of pacing configurations was performed in a random order. Transthoracic echocardiography was used to obtain haemodynamic and dyssynchrony parameters. Left ventricular ejection fraction (LVEF) was significantly superior in MP...
Source: Europace - May 12, 2016 Category: Cardiology Authors: Osca, J., Alonso, P., Cano, O., Andres, A., Miro, V., Tello, M. J. S., Olague, J., Martinez, L., Salvador, A. Tags: Pacing and resynchronization therapy Source Type: research

Longer right to left ventricular activation delay at cardiac resynchronization therapy implantation is associated with improved clinical outcome in left bundle branch block patients
Aims Data on longer right to left ventricular activation delay (RV-LV AD) predicting clinical outcome after cardiac resynchronization therapy (CRT) by left bundle branch block (LBBB) are limited. We aimed to evaluate the impact of RV-LV AD on N-terminal pro–B-type natriuretic peptide (NT-proBNP), ejection fraction (EF), and clinical outcome in patients implanted with CRT, stratified by LBBB at baseline. Methods and results Heart failure (HF) patients undergoing CRT implantation with EF ≤ 35% and QRS ≥ 120 ms were evaluated based on their RV-LV AD at implantation. Baseline and 6-month clinical parameters, EF, a...
Source: Europace - May 12, 2016 Category: Cardiology Authors: Kosztin, A., Kutyifa, V., Nagy, V. K., Geller, L., Zima, E., Molnar, L., Szilagyi, S., Ozcan, E. E., Szeplaki, G., Merkely, B. Tags: Pacing and resynchronization therapy Source Type: research

Ablation of atrial fibrillation in patients >=75 years: long-term clinical outcome and safety
Conclusions Catheter ablation in patients ≥75 years is associated with a favourable clinical long-term outcome in patients with PAF, while results are less promising in persistent or long-standing persistent patients. The safety profile of AF ablation in patients ≥75 years is comparable with patients of younger age. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Metzner, I., Wissner, E., Tilz, R. R., Rillig, A., Mathew, S., Schmidt, B., Chun, J., Wohlmuth, P., Deiss, S., Lemes, C., Maurer, T., Fink, T., Heeger, C., Ouyang, F., Kuck, K.-H., Metzner, A. Tags: Ablation for atrial fibrillation Source Type: research

Visually guided pulmonary vein isolation in patients with persistent atrial fibrillation
Conclusion A subset of patients with drug-refractory persistent AF of short duration benefit from pure PVI without additional substrate modification. A LB-based strategy showed similar outcomes as an irrigated RF-guided circumferential PVI and may be considered an alternative option for the index ablation. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Bordignon, S., Boehmer, M.-C., Klostermann, A., Fuernkranz, A., Perrotta, L., Dugo, D., Chun, K. R. J., Schmidt, B. Tags: Ablation for atrial fibrillation Source Type: research

Reduced residual conduction gaps and favourable outcome in contact force-guided circumferential pulmonary vein isolation
Aims Although contact force (CF)-guided circumferential pulmonary vein isolation (CPVI) for paroxysmal atrial fibrillation (PAF) is useful, AF recurrence at long-term follow-up still remains to be resolved. The purpose of this study was to assess safety and efficacy of CF-guided CPVI and to compare residual conduction gaps during CPVI and long-term outcome between the conventional (non-CF-guided) and the CF-guided CPVI. Methods and results We studied the 50 consecutive PAF patients undergoing CPVI by a ThermoCool EZ Steer catheter (conventional group, mean age 61 ± 10 years) and the other 50 consecutive PAF patient...
Source: Europace - May 12, 2016 Category: Cardiology Authors: Itoh, T., Kimura, M., Tomita, H., Sasaki, S., Owada, S., Horiuchi, D., Sasaki, K., Ishida, Y., Kinjo, T., Okumura, K. Tags: Ablation for atrial fibrillation Source Type: research

A pacemaker lead implantation: what if we go through the stent strut cell?
(Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Riahi, L., Gabeler, E. E. E., Prisecaru, R., Schwagten, B. Tags: CASE EXPRESS REPORTS Source Type: research

Incidence and risk factors for symptomatic heart failure after catheter ablation of atrial fibrillation and atrial flutter
Aims To determine the incidence and risk factors for development of symptomatic heart failure (HF) following catheter ablation for atrial fibrillation (AF) and atrial flutter. Methods and results We prospectively enrolled consecutive patients undergoing pulmonary vein isolation (PVI) or cavotricuspid isthmus (CTI) ablation between November 2013 and June 2014. Post-discharge symptoms were assessed via telephone follow-up and clinic visits. The primary outcome was symptomatic HF requiring treatment with new/increased diuretic dosing. Secondary outcomes were prolonged index hospitalization and readmission for HF ≤30 days....
Source: Europace - May 12, 2016 Category: Cardiology Authors: Huang, H. D., Waks, J. W., Contreras-Valdes, F. M., Haffajee, C., Buxton, A. E., Josephson, M. E. Tags: Ablation for atrial fibrillation Source Type: research

Outcomes of catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy: a systematic review and meta-analysis
Conclusions Catheter ablation of AF in patients with HCM is feasible, although more repeat procedures and AAD are needed to prevent AF recurrence. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Zhao, D.-S., Shen, Y., Zhang, Q., Lin, G., Lu, Y.-H., Chen, B.-T., Shi, L.-S., Huang, J.-F., Lu, H.-H. Tags: Ablation for atrial fibrillation Source Type: research

Burden of stroke and other cardiovascular complications in patients with atrial fibrillation hospitalized in France
Conclusion Half a million patients with AF were hospitalized in France in 2012. Cardiovascular-related hospitalizations involved half of these admissions, for a global burden of almost 2 billion, equivalent to 2.6% of total expenditure in French hospitals. Among these hospitalizations stroke/TIA/SE represented costly, but potentially preventable, complications. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Cotte, F.-E., Chaize, G., Gaudin, A.-F., Samson, A., Vainchtock, A., Fauchier, L. Tags: Atrial fibrillation Source Type: research

Endocardial biventricular defibrillator implantation in a patient with superior vena cava obstruction
(Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Finlay, M. C., Lall, K., Hunter, R. J., Schilling, R. J. Tags: CASE EXPRESS REPORTS Source Type: research

Substantial differences in initiation of oral anticoagulant therapy and clinical outcome among non-valvular atrial fibrillation patients treated in inpatient and outpatient settings
Conclusion In a nationwide cohort of non-valvular AF patients, outpatients were much more likely to receive OAC therapy and had a significantly lower risk of stroke/TE compared with inpatients and ED patients. However, across all settings investigated, OAC therapy was far from optimal. (Source: Europace)
Source: Europace - May 12, 2016 Category: Cardiology Authors: Mikkelsen, A. P., Hansen, M. L., Olesen, J. B., Hvidtfeldt, M. W., Karasoy, D., Husted, S., Johnsen, S. P., Brandes, A., Gislason, G., Torp-Pedersen, C., Lamberts, M. Tags: Atrial fibrillation Source Type: research

Radiotherapy in patients with pacemakers and implantable cardioverter defibrillators: a literature review
An increasing number of patients with implantable cardiac rhythm devices undergo radiotherapy (RT) for cancer and are thereby exposed to the risk of device failure. Current safety recommendations seem to have limitations by not accounting for the risk of pacemakers and implantable cardioverter defibrillators malfunctioning at low radiation doses. Besides scant knowledge about optimal safety measures, only little is known about the exact prevalence of patients with devices undergoing RT. In this review, we provide a short overview of the principles of RT and present the current evidence on the predictors and mechanisms of d...
Source: Europace - May 12, 2016 Category: Cardiology Authors: Zaremba, T., Jakobsen, A. R., Sogaard, M., Thogersen, A. M., Riahi, S. Tags: REVIEWS Source Type: research

Infection control in implantation of cardiac implantable electronic devices: current evidence, controversial points, and unresolved issues
A significant increase in the implantation of cardiac implantable electronic devices (CIEDs) is evident over the past years, while there is evidence for a disproportionate increase in CIED-related infections. The cumulative probability of device infection seems to be higher in implantable cardioverter defibrillator and in cardiac resynchronization therapy patients compared with permanent pacemaker patients. Given that more than a half of CIED infections are possibly related to the operative procedure, there is a need for effective periprocedural infection control. However, many of the current recommendations are empirical ...
Source: Europace - May 12, 2016 Category: Cardiology Authors: Korantzopoulos, P., Sideris, S., Dilaveris, P., Gatzoulis, K., Goudevenos, J. A. Tags: REVIEWS Source Type: research

Activation of N -methyl- d -aspartate receptors reduces heart rate variability and facilitates atrial fibrillation in rats
AbstractAimsThe goal of this study was to assess the effects ofN-methyl-d-aspartate (NMDA) receptors activation on heart rate variability (HRV) and susceptibility to atrial fibrillation (AF).Methods and resultsRats were randomized for treatment with saline, NMDA (agonist of NMDA receptors), or NMDA plus MK-801 (antagonist of NMDA receptors) for 2 weeks. Heart rate variability was evaluated by using implantable electrocardiogram telemeters. Atrial fibrillation susceptibility was assessed with programmed stimulation in isolated hearts. Compared with the controls, the NMDA-treated rats displayed a decrease in the standard dev...
Source: Europace - May 11, 2016 Category: Cardiology Source Type: research

Is mortality a useful parameter for public reporting in pacemaker implantation? Results of an obligatory external quality control programme
AimsTo evaluate if public reporting of pacemaker implantation-associated mortality is meaningful in a large contemporary patient cohort.Methods and ResultsThe database of the obligatory external quality control programme in the Federal State of Hessen, Germany, of patients undergoing permanent pacemaker (PPM) implantation was evaluated retrospectively. We compared the baseline features of patients who died compared with those who did not during hospitalization after PPM. Of 5079 patients who underwent PPM implantation in 2009, 74 (1.5%) died during the hospital stay. Cause of death was available in 70/74 patients (94.6%) w...
Source: Europace - May 11, 2016 Category: Cardiology Source Type: research

CHA 2 DS 2 -VASc score and blood biomarkers to identify patients with atrial high-rate episodes and paroxysmal atrial fibrillation
ConclusionTIMP-4, NT-proANP, NT-proBNP were strongest associated with PAF and AHRE. The discriminatory performance of CHADS2-VASc for PAF was increased by addition of selected biomarkers. (Source: Europace)
Source: Europace - May 11, 2016 Category: Cardiology Source Type: research

Presence of ‘ghosts’ and mortality after transvenous lead extraction
AimsThe number of cardiovascular implantable electronic devices has increased progressively, leading to an increased need for transvenous lead extraction (TLE) due to device infections. Previous studies described ‘ghost’ as a post-removal, new, tubular, mobile mass detected by echocardiography following the lead's intracardiac route in the right-sided heart chambers, associated with diagnosis of cardiac device-related infective endocarditis. We aimed to analyse the association between ‘ghosts’ assessed by transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) and mortality in...
Source: Europace - March 29, 2016 Category: Cardiology Source Type: research

Quantitative analysis of PKP2 and neighbouring genes in a patient with arrhythmogenic right ventricular cardiomyopathy caused by heterozygous PKP2 deletion
ConclusionScreening for CNVs in desmosome genes is useful to identify the genetic basis of disease in clinically suspected ARVC patients. (Source: Europace)
Source: Europace - March 22, 2016 Category: Cardiology Source Type: research