Left-sided accessory pathways successfully ablated from the aortomitral continuity region: distinctive atrial activation patterns and anatomic concerns
ConclusionAMC-AP is featured by recording comparable retrograde atrial activation times at CSp, CSl, and HB with the latest recordings at the posterior CS. Stable placement and successful ablation in the AMC via retrograde aortic approach was difficult but can be achieved via transseptal approach. (Source: Europace)
Source: Europace - August 23, 2020 Category: Cardiology Source Type: research

Intra-abdominal migration of a right ventricular pacemaker lead
(Source: Europace)
Source: Europace - August 10, 2020 Category: Cardiology Source Type: research

Novel electroanatomical map for permanent his bundle pacing: the Mont Blanc approach - influence of the learning curve and procedural outcome
ConclusionElectroanatomical mapping-guided implantation of His-bundle leads can facilitate the identification of optimal pacing sites and allow to minimize procedure and fluoroscopy times even during the phase of the learning curve. (Source: Europace)
Source: Europace - August 10, 2020 Category: Cardiology Source Type: research

Prescription of oral anticoagulants and antiplatelets for stroke prophylaxis in atrial fibrillation: nationwide time series ecological analysis
AbstractAimsTo investigate trends in the prescription of oral anticoagulants (OACs) and antiplatelet agents for atrial fibrillation (AF).Methods and resultsPrescription data for 450  518 patients with AF from 3352 General Practices in England, was obtained from the GRASP-AF registry, 2009–2018. Annualized temporal trends for OAC and antiplatelet prescription were reported according to eligibility based on stroke risk (CHADS2 or CHA2DS2-VASc scores ≥1 or>2, respectively). From 2009 to 2018, the prevalence of AF increased from 1.6% [95% confidence interval (CI) 1.5 –1.7%] to 2.4% (2.3–2.5%), and ...
Source: Europace - August 10, 2020 Category: Cardiology Source Type: research

Repolarization instability and arrhythmia by IKr block in single human-induced pluripotent stem cell-derived cardiomyocytes and 2D monolayers
ConclusionTaking their ion-current characteristics and Ca2+ handling into account, Pluricyte® CMs are suitable forin vitro studies on action potentials and field potentials. Beat-to-beat variability of repolarization duration proved useful to evaluate the dynamics of repolarization instability and demonstrated its significance as proarrhythmic marker in hiPSC-CMs duringIKr block. (Source: Europace)
Source: Europace - August 8, 2020 Category: Cardiology Source Type: research

Corrigendum to: Plasma adenosine and neurally mediated syncope: ready for clinical use
[Europace 2020;22:847 –853, doi:10.1093/europace/euaa070] (Source: Europace)
Source: Europace - August 5, 2020 Category: Cardiology Source Type: research

Management of thrombus formation after electrical isolation of the left atrial appendage in patients with atrial fibrillation
ConclusionLeft atrial appendage thrombus formation is common after LAAEI. Adjustment of OAC leads to LAA thrombus resolution in most patients. Left atrial appendage closure in the presence of LAA thrombi might be a feasible option in case of failed medical treatment. (Source: Europace)
Source: Europace - August 3, 2020 Category: Cardiology Source Type: research

Remote monitoring of cardiac implanted electronic devices: legal requirements and ethical principles - ESC Regulatory Affairs Committee/EHRA joint task force report
This report from a joint Task Force of the European Heart Rhythm Association and the Regulatory Affairs Committee of the European Society of Cardiology (ESC) recommends a common legal interpretation of the GDPR. Manufacturers and hospitals should be designated as joint controllers of the data collected by remote monitoring (depending upon the system architecture) and they should have a mutual contract in place that defines their respective roles; a generic template is proposed. Alternatively, they may be two independent controllers. Self-employed cardiologists also are data controllers. Third-party providers of monitoring ...
Source: Europace - July 29, 2020 Category: Cardiology Source Type: research

Predictors of recurrence of atrial fibrillation within the first 3 months after ablation
ConclusionHalf of all early AF recurrences within the first 3 months post-ablation occurred within the first 14  days post-ablation. Vascular disease and cardioversion during the procedure are strong predictors of recurrent AF. P-wave duration at follow-up was longer in patients with recurrent AF.Trial registrationClinicaltrials.gov identifier NCT02227550 (Source: Europace)
Source: Europace - July 28, 2020 Category: Cardiology Source Type: research

The effect of centre volume and procedure location on major complications and mortality from transvenous lead extraction: an ESC EHRA EORP European Lead Extraction ConTRolled ELECTRa registry subanalysis
AbstractAims  Transvenous lead extraction (TLE) should ideally be undertaken by experienced operators in a setting that allows urgent surgical intervention. In this analysis of the ELECTRa registry, we sought to determine whether there was a significant difference in procedure complications and mortality depending on centre volume and extraction location.Methods and results  Analysis of the ESC EORP European Lead Extraction ConTRolled ELECTRa registry was conducted. Low-volume (LoV) centres were defined as
Source: Europace - July 20, 2020 Category: Cardiology Source Type: research

A pacemaker lead wedged into the chest
An 88-year-old man with atrial fibrillation and slow ventricular rate was referred for pacemaker implantation. A single-chamber pacemaker was successfully placed with the active fixation lead supposedly implanted into the anterior free wall of the right ventricle. At the 48-h follow-up, the pacemaker resulted unable to capture the myocardium. The stimulus induced by magnet application was not able to get a myocardial capture. A chest computed tomography revealed the perforation of the myocardial wall by the ventricular lead which crossed the pericardium and the pleural leaflets, ‘wedging’ into the intercostal s...
Source: Europace - July 20, 2020 Category: Cardiology Source Type: research

Pregnancies, ventricular arrhythmias, and substrate progression in women with arrhythmogenic right ventricular cardiomyopathy in the Nordic ARVC Registry
AbstractAimsWomen with arrhythmogenic right ventricular cardiomyopathy (ARVC) are at relatively lower risk of ventricular arrhythmias (VAs) than men, but the physical burden associated with pregnancy on VA risk remains insufficiently studied. We aimed to assess the risk of VA in relation to pregnancies in women with ARVC.Methods and resultsWe included 199 females with definite ARVC (n = 121) and mutation-positive family members without ascertained ARVC diagnosis (n = 78), of whom 120 had at least one childbirth. Ventricular arrhythmia-free survival after the latest childbirth was compared betwee...
Source: Europace - July 18, 2020 Category: Cardiology Source Type: research

Safety and efficacy of transvenous mechanical lead extraction in patients with abandoned leads
AbstractAimsOptimal management of redundant or malfunctioning leads is controversial. We aimed to assess safety and efficacy of mechanical transvenous lead extraction (TLE) in patients with abandoned leads.Methods and resultsConsecutive TLE procedures performed in our centre from January 2009 to December 2017 were considered. We evaluated the safety and efficacy of mechanical TLE in patients with abandoned (Group 1) compared to non-abandoned (Group 2) leads. We analysed 1210 consecutive patients that required transvenous removal of 2343 leads. Group 1 accounted for 250 patients (21%) with a total of 617 abandoned leads (26...
Source: Europace - July 18, 2020 Category: Cardiology Source Type: research

The PRAETORIAN score: guardian against subcutaneous implantable cardioverter-defibrillator shock failure?
This editorial refers to ‘Implantation technique and optimal subcutaneous defibrillator chest position: a PRAETORIAN score-based study’ by P. Franciaet al., on pages 1822--1829. (Source: Europace)
Source: Europace - July 17, 2020 Category: Cardiology Source Type: research

Electrophysiological effects of non-vitamin K antagonist oral anticoagulants on atrial repolarizing potassium channels
Conclusion  Apixaban, dabigatran, edoxaban, and rivaroxaban did not exhibit direct functional interactions with human atrial K+ channels underlyingIKr,IKur,Ito,IK1, andIK2P currents that could account for beneficial clinical outcome associated with the drugs. Indirect or chronic effects and potential underlying signalling mechanisms remain to be investigated. (Source: Europace)
Source: Europace - July 17, 2020 Category: Cardiology Source Type: research

How to estimate the potential clinical benefit associated with left atrial appendage closure? Authors ’ reply
In response to the letter by Fauchier et al.,1 we wish to highlight numerous erroneous statements they have made with regards the data and analysis in our published article2 Firstly Fauchieret al. claim that ‘8% of patients still had oral anticoagulation (OAC) at 2-year follow-up, with no information on OAC use in the preceding follow-up visits’. However, the article states that 94% of patients stopped OAC at the first follow-up visit (2–3 months post-procedure) and patients who were recommenced on OAC during follow-up are individually described in the results leading to 8% of patients taking OAC a...
Source: Europace - July 16, 2020 Category: Cardiology Source Type: research

Avulsion of coronary sinus after mapping in the great cardiac vein
A 21-year-old woman was referred for catheter ablation of a symptomatic premature ventricular contraction (PVC). Twelve-lead electrocardiography of outflow tract PVC showed with an R wave pattern break in the precordial leads V2 suggesting an origin close to the anterior interventricular sulcus. Mapping and ablation were initially performed in right ventricular outflow tract and left coronary cusp using a 3.5-mm tip catheter (ThermoCool SmartTouch; Biosense Webster, Diamond Bar, CA, USA) but had no effect on the PVCs. Then the great cardiac vein (GCV) mapping was performed, the catheter was wedged into the distal GCV and f...
Source: Europace - July 13, 2020 Category: Cardiology Source Type: research

Pentaray contraindicated for use with mechanical valves
We recently reviewed the EP Case Express article ‘How to release PentaRay catheter entrapped in the hinge point of mechanical mitral valve?’ by Kawajiet al.1 Per the Instructions For Use (IFU)2 of the PENTARAY® Catheter, the catheter is contraindicated for use in patients with prosthetic valves as the splines of the catheter may become entangled in the valves. If this happens, the physician could have difficulty withdrawing the catheter from the patient and may apply excessive force against the resistance, which may cause part of the catheter spline to detach and potentially embolize inside the patient &rsq...
Source: Europace - July 13, 2020 Category: Cardiology Source Type: research

Pentaray contraindicated for use with mechanical valves: Authors ’ reply
We thank Dr Thomas for commenting on our recent case report,1 which described PentaRay mapping catheter (Biosense Webster, Inc., Diamond Bar, CA, USA) entrapped in mechanical mitral valve and find ways to handle the trouble. He emphasized the contraindication for PentaRay use in patients with mechanical valves.2 (Source: Europace)
Source: Europace - July 13, 2020 Category: Cardiology Source Type: research

The harm of delayed diagnosis of arrhythmogenic cardiac sarcoidosis: a case series
AbstractAimsCardiac sarcoidosis (CS) is a known cause of ventricular tachycardia (VT). However, an arrhythmogenic presentation may not prompt immediate comprehensive evaluation. We aimed to assess the diagnostic and disease course of patients with arrhythmogenic cardiac sarcoidosis (ACS).Methods and resultsFrom the Leiden VT-ablation-registry, consecutive patients with CS as underlying aetiology were retrospectively included. Data on clinical presentation, time-to-diagnosis, cardiac function, and clinical outcomes were collected. Patients were divided in early (
Source: Europace - July 10, 2020 Category: Cardiology Source Type: research

Arrhythmia documented in a suicide attempt
A 69-year-old patient with no history of cardiovascular disease or arrhythmias and with an implantable loop recorder (Medtronic Reveal® XT 9529) for a prior unexplained syncope was referred to the emergency department after an aborted suicide attempt. He hanged himself and a witness discovered him. Resuscitation manoeuvres where immediately started and he recovered consciousness, and haemodynamic stability. (Source: Europace)
Source: Europace - July 8, 2020 Category: Cardiology Source Type: research

How to estimate the potential clinical benefit associated with left atrial appendage closure?
We read the article by Phillipset al. about combined left atrial appendage (LAA) closure and catheter ablation for atrial fibrillation (AF) and its related editorial.1,2 The rate of ischaemic stroke was 0.36% per year which would represent a 93% relative risk reduction (RRR) vs. predicted rate by the CHA2DS2-VASc score without oral anticoagulation (OAC). For non-procedural major bleeding rate, estimated RRR was 70% when compared to the expected bleeding risk on warfarin according to the HAS-BLED score. (Source: Europace)
Source: Europace - July 2, 2020 Category: Cardiology Source Type: research

Slow right atrial appendage tachycardia mimicking sinus rhythm
A 57-year-old man was referred for treatment of incessant regular palpitations. The 12-lead electrocardiogram (ECG) revealed a slow narrow QRS complex tachycardia with a cycle length of 680  ms (Panel A) and P-wave morphology similar to that recorded during sinus rhythm (Panel B). Electroanatomical mapping of the right atrium defined the earliest endocardial activation (white colour) to the apex of the right atrial appendage, where radiofrequency catheter ablation successfully terminated the focal arrhythmia (Panel C, right anterior oblique view, yellow dot). The activation map during sinus rhythm is shown inPanel D...
Source: Europace - July 2, 2020 Category: Cardiology Source Type: research

In silico pace-mapping: prediction of left vs. right outflow tract origin in idiopathic ventricular arrhythmias with patient-specific electrophysiological simulations
AbstractAimsA pre-operative non-invasive identification of the site of origin (SOO) of outflow tract ventricular arrhythmias (OTVAs) is important to properly plan radiofrequency ablation procedures. Although some algorithms based on electrocardiograms (ECGs) have been developed to predict left vs. right ventricular origins, their accuracy is still limited, especially in complex anatomies. The aim of this work is to use patient-specific electrophysiological simulations of the heart to predict the SOO in OTVA patients.Methods and resultsAnin silico pace-mapping procedure was designed and used on 11 heart geometries, generati...
Source: Europace - July 1, 2020 Category: Cardiology Source Type: research

Sex differences in atrial fibrillation ablation outcomes: insights from a large-scale multicentre registry
AbstractAimThe impact of sex differences on the clinical outcomes of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is controversial. We investigated the sex differences regarding the efficacy and clinical outcomes of RFCA of AF.Methods and resultsWe conducted a large-scale, prospective, multicentre, observational study (Kansai Plus Atrial Fibrillation Registry). We enrolled 5010 consecutive patients who underwent an initial RFCA of AF at 26 centres (64  ± 10 years; non-paroxysmal AF, 35.7%). The median follow-up duration was 2.9 years. Female patients (n =&thi...
Source: Europace - June 17, 2020 Category: Cardiology Source Type: research

Is the sympathetic hyperactivity a confounding factor for the outcomes of atrial fibrillation ablation?
In their elegant study ‘Safety and outcome of very high-power short-duration ablation using 70 W for pulmonary vein isolation in patients with paroxysmal atrial fibrillation’ Kottmaieret al.1 reported that patients who underwent a high-power short-duration (HPSD) pulmonary vein isolation (PVI) ablation to treat paroxysmal atrial fibrillation (AF) had 18% fewer arrhythmia recurrences in comparison to those who were subjected to a conventional power protocol ablation after 1-year follow-up. This was mostly assigned to the fact that the HPSD technique limited the radiofrequency application time and thereby ...
Source: Europace - June 12, 2020 Category: Cardiology Source Type: research

Is the sympathetic hyperactivity a confounding factor for the outcomes of atrial fibrillation ablation and do we simply need to crank up the energy? Author ’s reply
We thank Denekeet al.1 for the editorial commentary as well as Kiuchiet al.2 for the letter regarding our recently published study Kottmaieret al.3 and would like to take the opportunity and clarify the raised issues. (Source: Europace)
Source: Europace - June 12, 2020 Category: Cardiology Source Type: research

Implication of the distinctive bipolar intracardiac electrograms for ventricular arrhythmias arising from different regions of ventricular outflow tract
AbstractAimsTo investigate the characteristics of bipolar intracardiac electrograms (bi-EGMs) in target sites of ventricular arrhythmias (VAs) originating from different regions of ventricular outflow tract (VOT).Methods and resultsTwo hundred and seventy patients undergoing first-time ablation for VAs originated from distal great cardiac vein (DGCV), aortic sinus cusps (ASCs), or pulmonary sinus cusps (PSCs) were enrolled in present study. Local intracardiac bipolar recordings on 243 successful sites and 506 attempted but unsuccessful ablation sites were analysed. Specific potentials in bi-EGMs on successful sites were mo...
Source: Europace - May 25, 2020 Category: Cardiology Source Type: research

Restoration of sinus rhythm by pulmonary vein isolation improves heart failure with preserved ejection fraction in atrial fibrillation patients
AbstractAimsAtrial fibrillation (AF) in patients suffering from heart failure with preserved ejection fraction (HFpEF) is associated with increased symptoms and higher morbidity and mortality. Effective treatment strategies for this patient population have not yet been established.Methods and resultsWe analysed clinical outcomes and echocardiographic parameters of patients with AF and HFpEF who underwent pulmonary vein isolation (PVI). Out of 374 PVI patients, we identified 35 patients suffering from concomitant HFpEF. Freedom from atrial tachyarrhythmia (AT) after 1 year was 80%. Heart failure symptoms assessed by New Yor...
Source: Europace - May 25, 2020 Category: Cardiology Source Type: research

Cryoablation of atrial fibrillation using computed tomography overlay
During cryoablation of atrial fibrillation, guidance to target the pulmonary veins (PV) and visualize the anatomical shape of the region of interest is critical. Using an automated computed tomography (CT) software (Valve ASSIST 2, General Electric, Boston, MA, USA), the anatomic volumes (left atrium, PV, appendage …) obtained from the pre-procedural CT are fused on real‐time fluoroscopy screen. After merging, the transparent CT overlay rotates following the C-arm. The additional anatomical landmarks facilitate the navigation to reach and stabilize the cryoballoon at the PV ostium. Further studies are need ed to e...
Source: Europace - May 3, 2020 Category: Cardiology Source Type: research

Cardioneuroablation for the treatment of recurrent swallow syncope
We present a 62-year-old male with recurrent neurally mediated syncope with falls and many injuries. Syncopal spells were triggered by swallowing of fluid. Structural cardiac and oesophageal abnormalities were excluded. Idiopathic deglutition (swallow) syncope was confirmed by a provocation test with a cold carbonated beverage that induced sinus arrest of 7-s duration. (Source: Europace)
Source: Europace - April 24, 2020 Category: Cardiology Source Type: research

Wearable cardioverter-defibrillator in patients at risk of sudden cardiac death: consensus document from Kalarus et al. contradicts current guideline recommendations —Authors’ reply
We appreciate the response to the EHRA consensus document on arrhythmias in the setting of acute coronary syndrome.1 The letter concerns the recommendation that a wearable cardioverter-defibrillator (WCD) is not indicated in post-myocardial infarction (MI) patients with reduced left ventricular ejection fraction. Our consensus document was written after publication of the VEST trial,2 which is the only randomized controlled trial (RCT) on WCD, and the VEST trial was published after the current sudden cardiac death (SCD) guidelines.3 The VEST trial was a well-powered RCT investigating the benefit of WCD in post-MI patients ...
Source: Europace - March 27, 2020 Category: Cardiology Source Type: research

Wearable cardioverter-defibrillator in patients at risk of sudden cardiac death: consensus document contradicts current guideline recommendations
Kalaruset al.1 present their consensus document as written in ‘Cardiac arrhythmias in the emergency settings of acute coronary syndrome and revascularization’. (Source: Europace)
Source: Europace - March 6, 2020 Category: Cardiology Source Type: research

Sex-related differences in risk factors, outcome, and quality of life in patients with permanent atrial fibrillation: results from the RACE II study
AbstractAimsAtrial fibrillation (AF) risk factors translate into disease progression. Whether this affects women and men differently is unclear. We aimed to investigate sex differences in risk factors, outcome, and quality of life (QoL) in permanent AF patients.Methods and resultsThe Rate Control Efficacy in Permanent Atrial Fibrillation (RACE II) randomized 614 patients, 211 women and 403 men, to lenient or strict rate control. In thispost hoc analysis risk factors, cardiovascular events during 3-year follow-up (cardiovascular death, heart failure hospitalization, stroke, systemic embolism, bleeding, and life-threatening ...
Source: Europace - November 20, 2019 Category: Cardiology Source Type: research

Corrigendum to: Kalarus Z, et al. Cardiac arrhythmias in the emergency settings of acute coronary syndrome and revascularization: an European Heart Rhythm Association (EHRA) consensus document, endorsed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Acute Cardiovascular Care Association (ACCA)
[Europace 2019;21:1603 –1604] (Source: Europace)
Source: Europace - September 23, 2019 Category: Cardiology Source Type: research

Corrigendum to: Gorenek B, et al. Cardiac arrhythmias in acute coronary syndromes: position paper from the joint EHRA, ACCA, and EAPCI task force
[Europace 2014;16:1655 –1673] (Source: Europace)
Source: Europace - August 29, 2019 Category: Cardiology Source Type: research

Rising prevalence of atrial fibrillation in the elderly population: new challenges of geriatric cardiology
This editorial refers to ‘Prevalence of atrial fibrillation in the Italian elderly population and projections from 2020 to 2060 for Italy and the European Union: the FAI Project’, by A. Di Carloet al., on pages 1468--1475. (Source: Europace)
Source: Europace - August 19, 2019 Category: Cardiology Source Type: research

Restitution and adaptation measurements for the estimate of short-term cardiac action potential memory: comparison of five human ventricular models
ConclusiondER, as we define it and together with other approaches described in the study, provides an univocal way to measure STM under extreme cardiac pacing conditions. Given the relevance of AP memory for repolarization dynamics and stability, STM should be considered, among other usual biomarkers, to validate and tune cardiac AP models. The possibility of extending the method to in vivo cellular and whole organ models can also be profitably explored. (Source: Europace)
Source: Europace - August 16, 2019 Category: Cardiology Source Type: research

Arrhythmia development during inhibition of small-conductance calcium-activated potassium channels in acute myocardial infarction in a porcine model
Conclusion  Inhibition of SK channels was neither beneficial nor detrimental to ventricular arrhythmia development in the setting of AMI in this porcine model. (Source: Europace)
Source: Europace - August 13, 2019 Category: Cardiology Source Type: research

Normal and abnormal QT interval duration and its changes in preadolescents and adolescents practicing sport
AbstractAimsTwelve-lead electrocardiogram (ECG) is an established tool in the evaluation of athletes, providing information about life-threatening cardiovascular diseases, such as long QT syndrome. However, the interpretation of ECG is sometimes challenging in children, particularly for the repolarization phase. The aim of this prospective, longitudinal study was to determinate the distribution of QT interval in children practicing sport and to evaluate changes in QT duration overtime.Methods and resultsA population of 1473 preadolescents practising sport (12.0  ± 1.8 years, 7–15 ye...
Source: Europace - August 7, 2019 Category: Cardiology Source Type: research

Monitoring of cerebral oximetry in patients with postural orthostatic tachycardia syndrome
Conclusion  Postural orthostatic tachycardia syndrome patients have lower cerebral tissue saturation during orthostatic provocation compared with those subjects having normal haemodynamic response to tilt. Orthostatic decrease in cerebral saturation only weakly correlates with HR increase and does not predict vasovagal reflex in POTS. Other hitherto unknown factors may affect cerebral tissue saturation in POTS. (Source: Europace)
Source: Europace - August 5, 2019 Category: Cardiology Source Type: research

Atrial high-rate episodes: prevalence, stroke risk, implications for management, and clinical gaps in evidence
AbstractSelf-terminating atrial arrhythmias are commonly detected on continuous rhythm monitoring, e.g. by pacemakers or defibrillators. It is unclear whether the presence of these arrhythmias has therapeutic consequences. We sought to summarize evidence on the prevalence of atrial high-rate episodes (AHREs) and their impact on risk of stroke. We performed a comprehensive, tabulated review of published literature on the prevalence of AHRE. In patients with AHRE, but without atrial fibrillation (AF), we reviewed the stroke risk and the potential risk/benefit of oral anticoagulation. Atrial high-rate episodes are found in 10...
Source: Europace - August 3, 2019 Category: Cardiology Source Type: research

Corrigendum to: Kyriakopoulou M, et al. Evaluation of a simple technique aiming at optimizing point-by-point isolation of the left pulmonary veins: a randomized study
[Europace 2019;21:1185 –1192] (Source: Europace)
Source: Europace - August 3, 2019 Category: Cardiology Source Type: research

Cardiac arrhythmias in the emergency settings of acute coronary syndrome and revascularization: an European Heart Rhythm Association (EHRA) consensus document, endorsed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Acute Cardiovascular Care Association (ACCA)
AbstractDespite major therapeutic advances over the last decades, complex supraventricular and ventricular arrhythmias (VAs), particularly in the emergency setting or during revascularization for acute myocardial infarction (AMI), remain an important clinical problem. Although the incidence of VAs has declined in the hospital phase of acute coronary syndromes (ACS), mainly due to prompt revascularization and optimal medical therapy, still up to 6% patients with ACS develop ventricular tachycardia and/or ventricular fibrillation within the first hours of ACS symptoms. Despite sustained VAs being perceived predictors of wors...
Source: Europace - July 29, 2019 Category: Cardiology Source Type: research

Management of arrhythmia recurrence in patients with pulmonary vein stenosis following atrial fibrillation ablation
ConclusionsPulmonary vein reconnection is the major driver of arrhythmia recurrence in PVS patients. Repeat PVI is feasible and does not lead to progression of PVS or restenosis if the procedure is carefully performed. (Source: Europace)
Source: Europace - July 21, 2019 Category: Cardiology Source Type: research

Let ’s get down to the nitty-gritty in persistent atrial fibrillation: the continuous critical mass of the atria—Authors’ reply
We would like to thank the author for making this excellent point regarding the possible mechanistic implications of our study.1 While we did find that linear ablation, posterior wall isolation (PWI), and complex fractionated atrial electrogram (CFAE) ablation was associated with increased intraprocedural atrial fibrillation (AF) termination, importantly only PWI and left atrial appendage (LAA) isolation was associated with improved freedom from AF. Intraprocedural AF termination was not associated with improved long-term freedom from AF.2 (Source: Europace)
Source: Europace - July 20, 2019 Category: Cardiology Source Type: research

Let ’s get down to the nitty-gritty in persistent atrial fibrillation: the continuous critical mass of the atria
I should like to express my hearty congratulations to the authors for this interesting article by Sauet al.1 They conclude that linear ablation, posterior wall isolation, complex fractionated atrial electrogram ablation improves intraprocedural atrial fibrillation (AF) termination. Moreover, left atrial (LA) size directly affects final outcome for AF ablation, by dropping down at a rate of 4% for every 1  mm increase in diameter for freedom from AF.1 Nevertheless, I should like to draw attention to the nitty-gritty. (Source: Europace)
Source: Europace - July 20, 2019 Category: Cardiology Source Type: research

Clinical outcomes after implantation of quadripolar compared to bipolar left ventricular leads in patients undergoing cardiac resynchronization therapy: a systematic review and meta-analysis
AbstractAimsSome retrospective and prospective studies in heart failure patients with indication for cardiac resynchronization therapy (CRT) suggest better clinical outcomes for quadripolar (QP) left ventricular (LV) leads over bipolar (BP) leads. Although, lead failure remains an important safety concern, when using these more complex, novel electrodes. To evaluate safety and efficacy outcomes for QP vs. BP LV leads in patients receiving CRT.Methods and resultsWe performed a comprehensive literature search through 2018 in PubMed, Cochrane Library, and Google Scholar databases to identify studies comparing patients with QP...
Source: Europace - July 19, 2019 Category: Cardiology Source Type: research

Lead extraction for cardiac implantable electronic device infection: comparable complication rates with or without abandoned leads
ConclusionDespite longer implant times, patients with abandoned leads did not have more major complications during lead extraction. Therefore, preventive extraction of non-functional leads to avoid complications at a later stage is not warranted. (Source: Europace)
Source: Europace - July 19, 2019 Category: Cardiology Source Type: research