Arrhythmic safety of hydroxychloroquine in COVID-19 patients from different clinical settings
AbstractAimsThe aim of the study was to describe ECG modifications and arrhythmic events in COVID-19 patients undergoing hydroxychloroquine (HCQ) therapy in different clinical settings.Methods and resultsCOVID-19 patients at seven institutions receiving HCQ therapy from whom a baseline and at least one ECG at 48+ h were available were enrolled in the study. QT/QTc prolongation, QT-associated and QT-independent arrhythmic events, arrhythmic mortality, and overall mortality during HCQ therapy were assessed. A total of 649 COVID-19 patients (61.9 ± 18.7 years, 46.1% males) were enrolled. HCQ therapy was administrated a...
Source: Europace - September 24, 2020 Category: Cardiology Source Type: research

Frequency of injuries associated with syncope in the prevention of syncope trials
AbstractAimsSyncope can lead to injuries. We determined the frequency, severity, and predictors of injuries due to syncope in cohorts of syncope patients.Methods and resultsParticipants were enrolled in the POST2 (fludrocortisone) and POST4 (midodrine) vasovagal syncope (VVS) randomized trials, and POST3 enrolled patients with bifascicular block and syncope. Injury was defined as minor (bruising, abrasions), moderate (lacerations), and severe (fractures, burns, joint pain), and recorded up to 1  year after enrolment. A total of 459 patients (median 39 years) were analysed. There were 710 faints occurred in 18...
Source: Europace - September 20, 2020 Category: Cardiology Source Type: research

Corrigendum to: Contemporary management of patients with syncope in clinical practice - an EHRA physician-based survey
[Europace 2020;22:980 –987] (Source: Europace)
Source: Europace - September 19, 2020 Category: Cardiology Source Type: research

Corrigendumto: Results of the Patient Related Outcomes of Mechanical lead Extraction Techniques (PROMET) study: a multicenter retrospective study on advanced mechanical lead extraction techniques
Corrigendum to: Results of the Patient Related Outcomes of Mechanical lead Extraction Techniques (PROMET) study: a multicenter retrospective study on advanced mechanical lead extraction techniques [Europace 2020;22:1103 –1110] (Source: Europace)
Source: Europace - September 19, 2020 Category: Cardiology Source Type: research

Electrocardiographic features of 431 consecutive, critically ill COVID-19 patients: an insight into the mechanisms of cardiac involvement
ConclusionsThe ECG is abnormal in almost all critically ill COVID-19 patients and shows a large spectrum of abnormalities, with signs of acute RVPO in 30% of the patients. Rapid and simple identification of these cases with ECG at hospital admission can facilitate classification of the patients and provide pathophysiological insights. (Source: Europace)
Source: Europace - September 18, 2020 Category: Cardiology Source Type: research

Defining the normal QT interval in newborns: the natural history and reference values for the first 4 weeks of life
ConclusionDuring the 4 weeks QTcFramingham and QTcHodges showed minor changes, whereas QTcBazett and QTcFridericia were stable. The QT interval was unaffected by sex and infant size and GA only showed an effect in very premature newborns. Reference values for HR-specific uncorrected QT intervals may facilitate a more accurate diagnosis of newborns with abnormal QT intervals. (Source: Europace)
Source: Europace - September 17, 2020 Category: Cardiology Source Type: research

Long-term impact of the burden of new-onset atrial fibrillation in patients with acute myocardial infarction: results from the NOAFCAMI-SH registry
ConclusionIn patients with NOAF complicating AMI, high AF burden was strongly associated with long-term outcomes. (Source: Europace)
Source: Europace - September 15, 2020 Category: Cardiology Source Type: research

Utilization and procedural adverse outcomes associated with Watchman device implantation
Conclusion  Percutaneous LAAO with the Watchman device in the USA is associated with low in-hospital complications and a similar safety profile to a recently published EWOLUTION cohort. The complication rates were lower than those reported in the major randomized clinical trials (RCTs). We report the frequency of peri-procedural complications of the LAAO using the Watchman device from the NIS database. We also compare the frequency of peri-procedural complications with the previously published RCTs and EWOLUTION cohort. Our findings are in concordance with findings from EWOLUTION cohort and compare favourably with RCT...
Source: Europace - September 14, 2020 Category: Cardiology Source Type: research

HRS/EHRA/APHRS/LAHRS/ACC/AHA worldwide practice update for telehealth and arrhythmia monitoring during and after a pandemicDeveloped in partnership with and endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), the European Heart Rhythm Association (EHRA), the Heart Rhythm Society (HRS), and the Latin American Heart Rhythm Society (LAHRS).
COVID-19PandemicArrhythmiasQT intervalRemote monitoringTelemedicinePosition paper (Source: Europace)
Source: Europace - September 10, 2020 Category: Cardiology Source Type: research

Ventricular arrhythmia risk is associated with myocardial scar but not with response to cardiac resynchronization therapy
ConclusionMalignant arrhythmic events and SCD depend on the presence of myocardial scar but not on CRT response. All-cause mortality improved only with the combined absence of myocardial scar and CRT response. (Source: Europace)
Source: Europace - September 8, 2020 Category: Cardiology Source Type: research

An unusual atrial tachycardia resulting from two levels of conduction block within the arrhythmogenic superior vena cava
A 60-year-old woman underwent catheter ablation for atrial tachycardia (AT) [cycle length (CL), 260 ms]. The site of earliest activation was identified in the high superior vena cava (SVC) where a rapid tachycardia (CL, 130 ms) was observed, suggesting 2:1 block between the SVC and right atrium. The constant P-wave morphology and atrial activation sequence indicated a single electrical connection in the cavoatrial junction (CAJ). The atrial CL spontaneously became prolonged from 260 to 520 ms (Panel A). In the low SVC (LSVC), activation sequence was unidirectional and there were two different sites of 2:1 block in the late...
Source: Europace - September 7, 2020 Category: Cardiology Source Type: research

Perimitral flutter with a long epicardial bypass tract successfully treated by selective ethanol infusion to a branch of the vein of Marshall
We present a 83-year-old woman suffering from paroxysmal AT after three AF procedures including isolation of pulmonary veins (PVs) and posterior left atrium (LA), linear lines for the cavotricuspid isthmus and anterior LA. The activation map during left atrial appendage (LAA) pacing showed extensive scar in the posterior and anterior walls with activation appearing at the septal edge of the large anterior scar (Panel A). Although no EGMs were identified in this area and low-output pacing did not capture the LA, high-output did. The activation map of an induced clinical AT (cycle length = 409 ms) showed a centrifugal activa...
Source: Europace - September 7, 2020 Category: Cardiology Source Type: research

Myocardial infarction or acute coronary syndrome with non-obstructive coronary arteries and sudden cardiac death: a missing connection
AbstractMyocardial infarction with non-obstructive coronary arteries or any acute coronary syndrome (ACS) with normal or near-normal (non-obstructive) coronary arteries (ACS-NNOCA) is an heterogeneous clinical entity, which includes different pathophysiology mechanisms and is challenging to treat. Sudden cardiac death (SCD) is a catastrophic manifestation of ACS that is crucial to prevent and treat urgently. The concurrence of the two conditions has not been adequately studied. This narrative review focuses on the existing literature concerning ACS-NNOCA pathophysiology, with an emphasis on SCD, together with risk and outc...
Source: Europace - September 7, 2020 Category: Cardiology Source Type: research

Right-sided accessory pathway visualized using intracardiac echocardiography
A 57-year-old woman with a right-sided accessory pathway (AP) presented with frequent palpitations and underwent radiofrequency (RF) catheter ablation. Transthoracic echocardiography showed no structural heart disease, including Ebstein ’s anomaly. A three-dimensional electroanatomical mapping system was used to map the ventricular and atrial activation during sinus rhythm and right ventricular (RV) pacing. The AP had no decremental property, and the earliest atrial activation site was located at 9 o’clock to the tricuspid annu lus (TA). A SOUNDSTAR® catheter (Biosense Webster, Diamond Bar, CA, USA) reveale...
Source: Europace - September 5, 2020 Category: Cardiology Source Type: research

QRS complex axis deviation changing in catheter ablation of left fascicular ventricular tachycardia
ConclusionThe axis deviation changing of QRS complex in FVT may be attributed to the different exit sites of the reentry. (Source: Europace)
Source: Europace - September 5, 2020 Category: Cardiology Source Type: research

Usefulness of post-procedural heart rate response to predict syncope recurrence or positive head up tilt table testing after cardioneuroablation
ConclusionThis pilot study shows that CNA can effectively prevent recurrent syncopal episodes in patients with refractory VVS. Head-up tilt testing seems as a valuable diagnostic tool not only to select suitable candidates and but also to evaluate success of CNA. (Source: Europace)
Source: Europace - September 4, 2020 Category: Cardiology Source Type: research

Use of a snare to aid implanting leadless pacemaker in a patient with severely dilated atria
One key factor in successful implantation of the Medtronic Micra Transcatheter Pacemaker System (TPS) is to obtain sufficient force on the tip of the delivery system at the time of device deployment. In structurally fairly normal hearts, this is usually not a problem once the delivery system is deflected and the tip is in the right ventricle (RV). The tricuspid valve acts as an anatomical barrier for cranial dislodgement of the system during forward movement of the delivery system and hence, the force will transmit sufficiently to the distal end. (Source: Europace)
Source: Europace - September 3, 2020 Category: Cardiology Source Type: research

Standardized pulmonary vein isolation workflow to enclose veins with contiguous lesions: the multicentre VISTAX trial
ConclusionsThe VISTAX trial demonstrated that a standardized PAF ablation workflow aiming for contiguous lesions leads to low rates of PAEs, high acute first-pass isolation rates, and 12-month freedom from arrhythmias approaching 80%. Further research is needed to improve the reproducibility of the outcomes across a wider range of centres.Clinical trial registration: ClinicalTrials.gov, number NCT03062046,https://clinicaltrials.gov/ct2/show/NCT03062046. (Source: Europace)
Source: Europace - September 3, 2020 Category: Cardiology Source Type: research

Machine learning does not improve upon traditional regression in predicting outcomes in atrial fibrillation: an analysis of the ORBIT-AF and GARFIELD-AF registries
ConclusionWhen developed from two large, community-based AF registries, ML techniques did not improve prediction modelling of death, major bleeding, or stroke. (Source: Europace)
Source: Europace - September 3, 2020 Category: Cardiology Source Type: research

Competing risk analysis of ventricular arrhythmia events in heart failure patients with moderately compromised renal dysfunction
AbstractAimsPatients with impaired renal function were shown to have an attenuated benefit from implantable cardioverter-defibrillator. However, there are limited data on the competing risk of ventricular arrhythmia events and death by renal function in patients without severe disease. Therefore, we aimed to assess the competing risk of ventricular arrhythmia events and death by renal function.Methods and resultsWe analysed 1782 patients (99%) enrolled in Multicenter Automatic Defibrillator Implantation Trial –Cardiac Resynchronization Therapy (MADIT–CRT) with glomerular filtration rate (GFR) data available. Cu...
Source: Europace - September 1, 2020 Category: Cardiology Source Type: research

Hein Wellens, a two-way translational cardiologist, and a memorable teacher
Hein Wellens used to say, ‘never repeat a successful experiment’, meaning that a single observation should not be generalized. He stated ‘this is too complicated for me’ when a slide had too much information.Hein Wellens unfortunately died on 9 June 2020, after a long professional life as a physician, teacher, mentor, scientist, and innovator. In his personal life, Hein has been a beloved husband, father, and grandfather, a constant friend for many people, a good poker player, a soccer enthusiast, a thriller ’s lover, a wine connoisseur, a gourmand under the wise guidance of his wife Inez, a g...
Source: Europace - September 1, 2020 Category: Cardiology Source Type: research

Efficacy and safety of ablation index-guided catheter ablation for atrial fibrillation: an updated meta-analysis
AbstractAims  Despite recent advances in catheter ablation for atrial fibrillation (AF), pulmonary vein reconnection (PVR), and AF recurrence remain significantly high. Ablation index (AI) is a new method incorporating contact force, time, and power that should optimize procedural outcomes. We aimed to evaluate the efficacy and safety of AI-guided catheter ablation compared to a non-AI-guided approach.Methods and results  A systematic search was performed on MEDLINE (via PubMED), EMBASE, COCHRANE, and European Society of Cardiology (ESC) databases (from inception to 1 July 2019). We included only studies that com...
Source: Europace - August 30, 2020 Category: Cardiology Source Type: research

Cardiogenetic screening amongst families of sudden cardiac death victims: Authors ’ reply
Thank you for the interest in our recently published article on cardio-genetic screening in sudden cardiac death (SCD) families.1 (Source: Europace)
Source: Europace - August 25, 2020 Category: Cardiology Source Type: research

Cardiogenetic screening amongst families of sudden cardiac death victims
We were interested to read the article by Hansenet al.1 on investigating thediagnostic yield of cardiogenetic screening in families with all types of sudden cardiac death (SCD). The study yielded a diagnosis of inherited cardiac disease in 47% of families participating and found a low rate of serious cardiac events in relatives who were offered early treatment. (Source: Europace)
Source: Europace - August 25, 2020 Category: Cardiology Source Type: research

The combined novel KCNQ1 frameshift I145Sfs*92 and nonsense W392X variants caused Jervell and Lange-Nielsen syndrome in a Chinese infant presenting with sustained foetal bradycardia
ConclusionWe report the novel frameshift KCNQ1-I145Sfs*92 and nonsense KCNQ1-W392X compound variants in autosomal recessive inheritance that caused JLNS presenting as sustained foetal bradycardia for the first time. Meanwhile, KCNQ1-I145Sfs*92 heterozygous variant demonstrated LQT1 phenotype in autosomal dominant inheritance with incomplete penetrance. (Source: Europace)
Source: Europace - August 23, 2020 Category: Cardiology Source Type: research

Left atrial fibrosis predicts left ventricular ejection fraction response after atrial fibrillation ablation in heart failure patients: the Fibrosis-HF Study
This study investigated the correlation between left atrial (LA) fibrosis extent and LV ejection fraction (LVEF) recovery after AF ablation.Methods and resultsIn this study, 103 patients [64  years, 69% men, 79% persistent AF, LVEF 33% interquartile range (IQR) (25–38)] undergoing first time AF ablation were investigated. Identification of LA fibrosis and selection of ablation strategy were based on sinus rhythm voltage mapping. Continuous rhythm monitoring was used to assess ablati on success. Improvement in post-ablation LVEF was measured as primary study endpoint. An absolute increase in post-ablation LVEF ...
Source: Europace - August 23, 2020 Category: Cardiology Source Type: research

Arrhythmia exacerbation after post-infarction ventricular tachycardia ablation: prevalence and prognostic significance
Conclusion  Arrhythmia exacerbation after ablation of infarct-related VT is infrequent but is independently associated with an adverse long-term outcome among patients who experience a VT recurrence. The mechanisms and mitigation strategies of AE after catheter ablation require further investigation. (Source: Europace)
Source: Europace - August 23, 2020 Category: Cardiology Source Type: research

High-density mapping in patients undergoing ablation of atrial fibrillation with the fourth-generation cryoballoon and the new spiral mapping catheter
ConclusionHigh-density mapping after cryoballoon ablation using CB4G and the new SMC identifies incomplete PVI, not detected by the new SMC, in a significantly lower proportion of veins compared to HDM performed after the other generation CB ablation. (Source: Europace)
Source: Europace - August 23, 2020 Category: Cardiology Source Type: research

Predictors of long-term mortality after catheter ablation of ventricular tachycardia in a contemporary cohort of patients with structural heart disease
AbstractAimsAblation of ventricular tachycardias (VTs) in patients with structural heart disease has been established in the past decades as an effective and safe treatment. However, the prognosis and long-term outcome remains poor.Methods and resultsWe investigated 309 patients with ischaemic cardiomyopathy (ICM) and non-ischaemic cardiomyopathy (NICM) (186 ICM, 123 NICM; 271 males; mean age 64.1  ± 12 years; ejection fraction 34 ± 13%) after ≥1 VT ablations over a mean follow-up period of 34 ± 28 months. Electrical storm was the indication fo...
Source: Europace - August 23, 2020 Category: Cardiology Source Type: research

Atrial fibrillation detection by the subcutaneous defibrillator: real-world clinical performances and implications from a multicentre study
ConclusionThe S-ICD AF detection algorithm yields a high sensitivity for AF diagnosis. Low specificity and positive predictive value contribute to a high remote monitoring-notification workload and underline the necessity of a manual analysis. Atrial fibrillation diagnosis by the S-ICD AF detection algorithm might lead to significant therapeutic adjustments. (Source: Europace)
Source: Europace - August 23, 2020 Category: Cardiology Source Type: research

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

Giant left atrial calcified myxoma-induced premature atrial contractions
A 73-year-old woman with palpitations for 3  months was referred for a diastolic murmur and frequent premature atrial contractions (PACs) (21,544 PACs/day). During the PACs, the P-wave morphology was negative/positive in lead V1 and positive in lead aVL (Panel A), suggesting their origin in the septal left atrium (LA). Transthoracic echocardiography showed a mass in the LA; cardiac computed tomography demonstrated a giant calcified mass with a stalk to the LA septum (Panel B). After surgical resection of the mass, histopathology confirmed a rare calcified myxoma, and the PACs were disappeared. At 18 months of follow...
Source: Europace - August 13, 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