67 Does non-specialist care mean under treatment with antiarrhythmic drugs and poor DC cardioversion outcome for persistent atrial fibrillation - a single centre study
Introduction: Atrial fibrillation (AF) remains one of the major causes of cardiovascular morbidity and mortality worldwide. The number of patients with AF is predicted to rise as we live longer lives with more complex predisposing comorbidities, and therefore good evidence-based care is essential for optimal outcomes.  Rhythm control therapy with either electrical or chemical cardioversion is currently recommended for patients with symptomatic persistent AF, and pretreatment with antiarrhythmic drugs should be considered to optimise cardioversion results and reduce the risk of AF recurrence.  We wa...
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

66 How well do London ambulance assess potential T-LOC patients in comparison to nice guidance
Transient loss of consciousness is common, affecting up to 40% of the population at some point. Its assessment can be very complex because of the potential diagnoses, the inexperience of the front-line staff making the assessment and their concerns relating to risk. Literature  is available to suggest that assessment is often incomplete, with risk over-estimated, leading to unnecessary admissions and investigations. NICE, in 2010, detailed guidance on the management of this condition and EHRA have suggested methods to develop more efficient syncope clinics. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

6 A novel mapping system for panoramic mapping of the left atrium: validation and application to detect and characterise localised sources maintaining AF
This study sought to validate a novel panoramic mapping system (CARTOFINDER, Biosense Webster) and apply it to detect and characterise drivers in persistent AF. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

5 Characteristics of ablated rotors in terminating persistent atrial fibrillation using non-contact mapping
Introduction: Early data has shown beneficial outcomes after rotor-guided catheter ablation in persistent atrial fibrillation (persAF). We aim to investigate the rotor characteristics at ablation sites that terminated AF (terminators) compared to those at sites that did not (non-terminators). (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

65 Improving access to arrhythmia services: the role of the cardiac rhythm management specialist nurses
Introduction: Cardiac Rhythm Management (CRM) specialist nurses fulfil a range of differing roles in different arrhythmia centres. In our tertiary centre, CRM nurses run a nurse led arrhythmia clinic, seeing patients with atrial fibrillation and uncharacterised palpitations, discussing each case with a consultant electrophysiologist (EP) at a weekly review meeting. We performed a retrospective review of the service to assess how many patients can be managed in this nurse led setting. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

64 Cryoablation for persistent and long standing persistent atrial fibrillation: a single centre experience
We examined the procedural success and long-term outcomes of cryoablation in persistent AF and long standing persistent AF. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

63 How good are new ELRS in AF monitoring?
Introduction: Novel external ECG recording external loop recorders (ELRs) have been developed including the Zio patch (ZP), NUUBO ’s shirt-based ELR, the Bardy patch (BP) and the Qardio Belt (QB) . We compared patient (pt) satisfaction, accuracy of atrial fibrillation (AF) detection and cost efficacy of ZP, NUUBO vest (NV), BP and QB with Novacor ‘R’ test, our clinical standard. All pts had dual chamber DDDR pacemakers ( PPMs) implanted allowing continuous assessment of positive and negative predictive accuracy of the ELRs, throughout the study period. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

62 Long term success rates following pulmonary vein isolation with 2nd generation cryoballoon ablation for paroxysmal atrial fibrillation; 3.5 year follow up
Introduction: Pulmonary vein isolation (PVI) using the 2nd generation cryoballoon (Arctic Front Advance (AFA)) is an effective treatment for paroxysmal atrial fibrillation (PAF). However, outcome data beyond 12 months post ablation is not well documented. The aim of this study was to document the recurrence rates of atrial fibrillation beyond 12 months (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

61 Prevalence and spectrum of genetic variants in a single-centre cohort of Brugada syndrome
Background: Brugada syndrome is an inherited cardiac condition predisposing to life-threatening arrhythmias. It is characterised by the presence of a typical ECG pattern with J-point elevation, coved-type ST segment and negative T wave in the right precordial leads, either spontaneously or with provocation by a sodium channel blocker. Pathogenic genetic variants have been identified in around 30% of individuals and SCN5A variants make up the majority of those associated with the condition. We sought to characterise the prevalence and spectrum of genetic variants in our cohort of patients diagnosed with Brugada syndrome. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

60 Is this the beginning of the end for warfarin?
Introduction: The European Society of Cardiology guidelines on the management of atrial fibrillation (AF) advocate the use of direct oral anticoagulants (DOACs) in preference to warfarin. DOACs are also licensed for the treatment of pulmonary embolus and deep venous thrombosis. DOACs are easier to use, result in fewer intracranial haemorrhages and are just as efficacious, if not more so, in reducing the incidence of ischaemic strokes as warfarin. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

59 Can high volume tertiary centres with 24/7 device implanting service provide improved efficacy and outcomes compared to a large district general hospital model?
Background: There is a need to provide improvements in acute device service delivery for patients requiring cardiac implantable devices with measurable cost and clinical outcomes. We compared the model of a large tertiary centre with a 24/7 on call inter-hospital transfer (IHT) service compared to a large district hospital (DGH) cardiac department with catheter lab facilities for delivering urgent inpatient device therapy. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

58 Screen, EAARN, or valid-CRT score, which one best predicts CRT response and long-term survival?
Background: Up to a third of heart failure (HF) patients do not respond to cardiac resynchronization therapy (CRT). Recently, 3 scores have been developed to predict outcomes of CRT patients following implantation, but comparisons among the 3 are still absent. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

57 Day- case implant of complex pacing devices is safe and preferred by patients
We report our experience of Day-Case Implant of complex devices, with focus on acceptability to patients. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

56 The changing trends in new ICD and CRT-D implants over the last 20 years at a single large tertiary cardiology centre
Introduction: Since their introduction to standard clinical practice, implantable cardioverter defibrillators (ICD) have been shown in a number of clinical trials to improve survival.  We review the changes seen in the numbers and demographics of patients receiving ICD or CRT-D implants at one large tertiary cardiology centre (Glenfield Hospital) with a catchment population of approximately 2 million. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

55 Impact of open audit on procedural performance in electrophysiology catheter laboratory
Background: Clinical audit has played a key role in cardiac electrophysiology (EP) practice. However, it often fails to bring about expected improvement as summative institutional data alone are insufficient to drive change. We hypothesised that the practice of open audit wherein each individual ’s procedural performance is discussed will have an immediate impact on improving clinical practice. This hypothesis was tested by examining the fluoroscopy times for AF ablation performed by experienced EP consultants from two tertiary centres. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

54 How multinational community pharmacists worked with AF Association and Arrhythmia Alliance pulse rhythm check campaign Know Your Pulse) to raise awareness of and identify people at risk of AF
Background: Global AF Aware Week is run on an annual basis by the AF Association during which a 'Know Your Pulse campaign' is held in multiple settings where the general public can receive a free manual pulse rhythm check. Settings have included GP surgeries, Hospital reception areas, Community Pharmacy and public places with a high footfall of the general public, such as railway stations and shopping malls. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

53 Generation of the first functional map of left atrial ganglionated plexus sites that induce AV nodal bradycardia
Background: Previously, ganglionated plexus (GP) sites have been located via histological studies. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

52 HF-RADD - heart failure risk according to device diagnostics: a prospective observational study
Introduction: Many HF patients have a therapeutic indication for Implantable Electronic Device (IED). The diagnostic capability of IEDs is increasingly being considered in clinical practice. Recent studies have found no impact on outcome associated with routine monitoring of device diagnostics in an unselected population. There is evidence that routine remote monitoring of IEDs is more cost efficient than face to face surveillance1. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

51 Cardiac arrest in the absence of an acute coronary artery occlusion: characteristics and outcomes of patients with primary arrhythmic arrest in a UK tertiary centre
Background: In the UK there are approximately 60,000 out of hospital cardiac arrests (OOHCA) per year, of which 30,000 are treated by the emergency services. The majority have a cardiac cause, primarily coronary artery disease. Our centre adopts an early invasive strategy for OOHCA patients with all cases undergoing immediate coronary angiography. We sought to evaluate the characteristics, investigations and follow up of OOHCA patients receiving immediate coronary angiography, in whom no coronary culprit was identified. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

50 Modification in head up tilt test protocol increases diagnostic yield and better-elucidates the mechanism of situational syncope
Introduction: Situational syncope is a common condition resulting in syncope secondary to clear provoking (situational) factors. The Italian head up tilt test (HUTT) is a standardised protocol which utilises sublingual nitroglycerine (GTN) for provocation but may not be adequate to assess provoking factors in inducing situational syncope. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

49 Patients on novel oral anticoagulants require higher doses of unfractionated heparin than those on warfarin to achieve a target act value during ablation of left atrial tachyarrhythmias
Background: The administration of unfractionated heparin (UFH)  during ablation of left atrial tachyarrhythmias has been recommended to achieve an activated clotting time (ACT) of greater than 300s. It has been recommended that warfarin therapy is uninterrupted and that novel oral anticoagulant (NOAC) therapy may be interrupted or uninterrupted at the time of ablation. We investigated whether the dose of UFH required to achieve an ACT>300s is influenced by the type of concurrent oral anticoagulant (OAC) therapy given. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

48 Catheter ablation for atrial fibrillation on uninterrupted NOACs: a safe approach?
This study investigates the safety of CA for AF on uninterrupted NOACs by comparing the outcomes to patients undergoing CA on warfarin. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

47 Radiofrequency balloon catheter ablation for paroxysmal atrial fibrillation, RADIANCE STUDY –a UK experience
Introduction: Catheter ablation for paroxysmal atrial fibrillation (AF) is a widely used treatment strategy. However, success rate are still variable with a large proportion of patients requiring redo procedures. Point-by-point radiofrequency ablation can be time-consuming. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

46 Smartphone apps for the detection of AF
Background: Improving availability of screening methods of AF,   could reduce the number of thromboemobilc strokes. Commercially available smartphone applications that utilise the smartphones intrinsic function without the need for a peripheral device, are available for consumer use. However, there is limited information on their reliability. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

45 Atrial tachyarrhythmia ablation in lateral tunnel fontan patients: a case series
We present our experience of RFA in patients with univentricular physiology who have undergone a lateral tunnel procedure. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

44 Early experience of intra-operative use of ECGI during VT ablation
We describe our initial experience using ECGi intra-operatively to guide catheter ablation of VT. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

43 Long-term clinical outcomes of cardiac resynchronization therapy with or without defibrillation: impact of the etiology of cardiomyopathy
Background: There is a continuing debate as to whether   cardiac resynchronization therapy-defibrillation (CRT-D) is superior to CRT-pacing (CRT-P), particularly in patients with non-ischemic cardiomyopathy (NICM). (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

4 Insights into the mechanisms of triggered activity during long qt conditions in the intact heart using optical mapping
Introduction: Early afterdepolarisations (EADs) are cellular events defined as depolarisation during the early repolarisation phase of the action potential (AP).  EAD-triggered APs are thought to be responsible for the induction of Torsades de Pointes (TdP) polymorphic ventricular tachycardia in the long QT syndrome (LQTS). This cellular mechanism cannot be directly extrapolated to the intact heart, where electrotonic coupling will oppose any local depolari sation. Indeed, computational modelling has estimated that synchronisation of EADs across thousands of cells is required for an EAD-triggered AP to propagate in th...
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

3 The end of pre-implant subcutaneous ICD screening? Using mathematical vector rotation to generate a personalised sensing vector resulting in universal device eligibility
Introduction: Subcutaneous implantable cardioverter defibrillator (S-ICD) eligibility is determined by QRST morphology across three sensing vectors; primary (P), secondary (S) and alternate (A), with small R:T ratios conferring an unacceptable risk of T wave over sensing. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

42 Atrial fibrillation ablation as a day-case procedure: three-year single-centre experience
Introduction: The most widespread current model for atrial fibrillation (AF) ablation involves overnight hospital admission post-procedure. We hypothesized that ultrasound (US)-guided venous access and a streamlined peri-ablation anticoagulation strategy would allow  early mobilization, thereby facilitating same-day discharge. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

41 Evolution of PROMS data and what it tells us about patients undergoing catheter ablation for atrial fibrillation
In this study, we investigated the association of body mass index (BMI) and other predictors with the patient reported quality of life outcome data. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

40 Development of atrial fibrillation following ablation for typical atrial flutter cannot be predicted by conventional risk factors; time for a rethink in ablation strategy?
Introduction: Many patients develop Atrial Fibrillation (AF) following cavotricuspid isthmus (CTI) ablation for Atrial flutter (AFL), impacting on long-term arrhythmia cure rates and decreasing the cost-efficacy of AFL ablation. We sought to assess whether clinical factors can help to pre-identify these patients, to allow consideration of alternate treatment strategies. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

39 Application of the novel ‘shanghai’ diagnostic criteria for brugada syndrome reduces the number of diagnoses with low risk of arrhythmic events in index cases
Introduction: Current expert consensus states that the diagnosis of Brugada Syndrome (BrS) requires only the presence, either spontaneous or provoked, of a type 1 Brugada ECG pattern in a single ECG lead. Recently a novel diagnostic scoring system, the ‘Shanghai criteria’, was developed encompassing additional diagnostic requirements related to clinical and familial characteristics. This scoring system has not yet been validated however. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

38 Multimodality image reconstruction and fusion to guide VT ablation
Introduction: Ventricular tachycardia (VT) ablation remains a clinical challenge, with significant risks and variable success rates that need to be improved. Cross sectional imaging can  be used to plan and guide ablation, but further developments are needed to help clinicians to interpret and utilise the information available. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

37 Effect of activation wavefront on electrogram characteristics during ventricular tachycardia ablation
Introduction: Catheter ablation of ventricular tachycardia (VT) in structural heart disease may be  challenging due to non-inducibility or haemodynamic compromise. Ablation procedures often depend on substrate-based techniques e.g. elimination of local abnormal ventricular activities (LAVAs), representing regions of low conduction velocity (CV) in the scar border zone (SBZ). LAVAs hidden within farfield signal may be unmasked by pacing manoeuvres, but effects of activation wavefront on CV and LAVA characterization in relation to scar anatomy and VT isthmus characteristics have not been assessed. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

36 Derivation of a prediction model for the optimization of patient selection for catheter ablation of atrial fibrillation: the AF-FREEDOM score.
Background: Catheter ablation is the most effective treatment option for restoring sinus rhythm and potentially eradicate or reduce the overall burden of atrial fibrillation (AF). Success rates as high as 80% have been described for patients with paroxysmal AF, but for other forms of this arrhythmia, or for patients with specific comorbidities success rates are known to be well below 50%. This therapy is associated with costs and non-negligible procedural complications. Development of a risk predictive model to identify patients with higher chances of procedural success could be of interest to improve the risk-benefit, and...
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

35 Power, lesion size index and oesophageal temperature alerts during atrial fibrillation ablation (PILOT-AF): a randomized study
Background: Oesophageal heating is a collateral effect of RadioFrequency (RF) catheter ablation for atrial fibrillation (AF) on the left atrial (LA) posterior wall. It is attributed to conductive heat transfer from the ablation site, a time-dependant process. Lower powers are routinely used to prevent this damage, requiring a longer duration of RF applications to reach the target lesion size index (LSI, a recently introduced parameter to predict the RF lesion size and depth). We investigated whether the risk of oesophageal heating is reduced by use of higher powers for shorter times compared with lower powers for longer ti...
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

34 The impact of the presence of left atrial low voltage areas on outcomes from pulmonary vein isolation
Introduction: AF ablation (AFA) with pulmonary vein isolation (PVI) is a highly successful treatment for patients with paroxysmal atrial fibrillation (PAF). However, success rates for AFA with PVI alone in persistent AF (PsAF) are significantly lower and the optimal ablation strategy for PsAF remains unclear. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

33 Accuracy of left atrial bipolar voltages obtained by ConfiDENSE multielectrode mapping in patients with persistent atrial fibrillation
Background: Endocardial bipolar voltage mapping of the left atrium (LA) has been suggested as a way to assess substrate for atrial fibrillation (AF), with low voltage areas being considered surrogates for atrial fibrosis and targets for catheter ablation (CA). The ConfiDENSE module in Carto V4 allows rapid annotation of endocardial points acquired by multi-electrode (ME) mapping, but the accuracy of voltage data obtained by ConfiDENSE mapping has not been studied. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

32 Improving target identification of persistent atrial fibrillation ablation using simultaneous intracardiac mapping
Introduction: Identification of areas for successful ablation in patients with persistent atrial fibrillation (persAF) remains challenging. We aim to improve ablation target identification using frequency and phase mapping to better understand the underlying mechanisms of persAF. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

31 Ablation of longstanding persistent atrial fibrillation using the ACQMAP 3-D mapping system – an early single centre experience
We report our early experience of a novel, non-contact 3-D imaging and mapping system capable of generating ultrasound (U/S) anatomies and displaying dipole density (DD) data& real-time mapping of longstanding persistent atrial fibrillation. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

30 Optimising the predictive capability of a mathematical model of AF progression using cardiac device data
This study uses retrospective data from implanted cardiac defibrillators (ICDs) to calibrate the model. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

29 Refining the diagnostic criteria of the postural orthostatic tachycardia syndrome (POTS) using power spectral indices
Introduction: Postural orthostatic tachycardia syndrome (POTS) is characterised by frequent symptoms and rise in heart rate of  ≥ 30bpm within 10min of standing, in absence of significant orthostatic hypotension. Clinical evaluation of patients with suspected POTS includes detailed history and non-invasive investigations such as head-up tilt (HUT). The pathophysiology of POTS remains ill-understood, but increased symp athetic expression may cause the multitudinous symptoms. Heart rate (HR) and blood pressure (BP) variability characterise the sympathovagal balance. High frequency (HF) reflects vagal tone an...
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

28 Left atrial voltage predicts AF recurrence after ablation, irrespective of the rhythm during mapping, while circulating biomarkers of fibrosis do not.
This study tested the predictive capabilities of type III procollagen N terminal peptide (PIIINP), galectin-3 (gal-3), fibroblast growth factor 23 (FGF-23), and type I collagen C terminal telopeptide (ICTP), and whether low voltage areas in the LA predict  AF recurrence irrespective of the rhythm during mapping. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

27 Markers of depolarization abnormalities (fragmented QRS and early repolarization pattern) in patients with myocarditis.
Background: Myocarditis are the group of diseases in which fibrosis and inflammation myocardial changes are observed. These changes create conditions for electrical myocardial instability. Electrical myocardial instability can appear as different depolarization abnormalities including fragmented QRS (FQRS) or early repolarization pattern (ERP). These markers practically have not been studied in patients with myocarditis.   (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

26 Neuro-cardiac profiling of electrophysiologic and structural remodeling in an in-vitro rabbit heart failure model
Introduction: Sympathetic (SS) and vagus (VS) nerve stimulations exert positive and negative responses in heart rate (HR) respectively. They modulate ventricular fibrillation threshold (VFT) and action potential duration restitution (RT), both of which are markers of arrhythmia vulnerability. We aim to assess the effect of autonomic nerve stimulation on HR, atrio-ventricular delay (AVD), VFT and RT in a coronary ligation rabbit model of HF.  Transthoracic echocardiogram (TTE) and ex-vivo cardiac MRI (CMR) were performed to assess structural remodeling. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

25 First evidence that differences in the t-wave upslope of the body surface ECG reflect right to left dispersion of repolarization in the intact human heart
This study aimed to examine the association between intracardiac ventricular repolarization in the intact human heart and the T-wave on the body surface ECG ( SECGTW ). (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

24 Long-term outcomes of supraventricular tachycardia ablation in congenital heart disease: single centre UK experience
Introduction: Catheter ablation for supraventricular tachycardia (SVT) in patients with congenital heart disease (CHD) is an important therapeutic option, which is safe and effective. Ablation outcomes vary significantly with increasing complexity of cases and data are limited. We reviewed the safety and long-term efficacy of SVT ablation in CHD patients and examined the differences in outcomes of simple and complex cases in a leading UK center. We also examined the predictors of arrhythmia recurrence post ablation. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

23 Empiric versus entrained cavotricuspid isthmus line ablation in congenital heart disease: a single centre experience
Introduction: Catheter ablation for supraventricular tachycardia (SVT) in patients with congenital heart disease (CHD) is an important therapeutic option. Typical atrial flutter (AFl) is the most commonly observed atrial arrhythmia, however induction of sustained tachycardia at the time of ablation is not always possible. We hypothesized that performing an empiric cavo-tricuspid isthmus (CTI) line ablation in case of non-inducibility leads to good outcomes. Long-term outcomes of empiric versus entrained CTI ablation in CHD patients with right-sided supraventricular arrhythmias were examined. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

22 Cied lead extraction in the elderly has low risk
Introduction: CIED lead extraction is a growing problem. The procedure is known to carry significant morbidity and mortality. Data about safety in the elderly is limited (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research