Symptomatic atrial fibrillation and risk of cardiovascular events: data from the Euro Heart Survey
ConclusionPersistence or development of symptoms after medical treatment are associated with an increased risk of CV events during a 1-year follow-up. Type of AF, along with hypothyroidism, COPD and chronic heart failure are significantly associated with symptoms persistence despite medical treatment. (Source: Europace)
Source: Europace - June 30, 2017 Category: Cardiology Source Type: research

Intraoperative arrhythmias in children with congenital heart disease: transient, innocent events?
AbstractAimsThe significance and incidences of intraoperative arrhythmias occurring in the operating room (OR) in children with congenital heart disease (CHD) are unknown. Aims of this study were to determine incidences of intraoperative arrhythmias in children with CHD and to examine whether they are associated with persistent arrhythmias during follow-up.Methods and resultsContinuous ECG recordings obtained from 134 consecutive paediatric CHD patients were manually examined from the moment the aortic cross-clamp (ACC) was removed [use of ACC and cardiopulmonary bypass (CPB)], when CPB was stopped (use of only CPB) or whe...
Source: Europace - June 28, 2017 Category: Cardiology Source Type: research

Shifting to a non-vitamin K antagonist oral anticoagulation agent from vitamin K antagonist in atrial fibrillation
ConclusionIn a contemporary setting among VKA-experienced NVAF patients; VKA is still prevalent although about 30% by December 2015 had shifted to a NOAC. (Source: Europace)
Source: Europace - June 28, 2017 Category: Cardiology Source Type: research

Sex differences in outcomes of primary prevention implantable cardioverter-defibrillator therapy: combined registry data from eleven European countries
AbstractAimsTherapy with an implantable cardioverter defibrillator (ICD) is established for the prevention of sudden cardiac death (SCD) in high risk patients. We aimed to determine the effectiveness of primary prevention ICD therapy by analysing registry data from 14 centres in 11 European countries compiled between 2002 and 2014, with emphasis on outcomes in women who have been underrepresented in all trials.Methods and resultsRetrospective data of 14 local registries of primary prevention ICD implantations between 2002 and 2014 were compiled in a central database. Predefined primary outcome measures were overall mortali...
Source: Europace - June 28, 2017 Category: Cardiology Source Type: research

Cause-of-death analysis in patients with cardiac resynchronization therapy with or without a defibrillator: a systematic review and proportional meta-analysis
ConclusionOverall, compared with CRT-D patients, unadjusted mortality rate was almost two-fold higher in CRT-P recipients, with SCD representing one third of the excess mortality. Rate of SCD was significantly higher in certain subgroups (males, ischaemic cardiomyopathy, NYHA class 3), where a CRT-D may be of more pronounced benefit. This deserves further focused investigation. (Source: Europace)
Source: Europace - June 28, 2017 Category: Cardiology Source Type: research

Cardioversion of atrial fibrillation in a real-world setting: non-vitamin K antagonist oral anticoagulants ensure a fast and safe strategy compared to warfarin
The objectives were the waiting time to cardioversion, and thromboembolism and major bleeding events within 60 days. In total, 2150 electrical cardioversions were performed; 684 (31.8%) of patients were on NOACs and 1466 (68.2%) were on warfarin. The waiting time to non-TOE-guided cardioversion was significantly shorter in the NOAC group compared with the warfarin group for all cardioversions (P  
Source: Europace - June 26, 2017 Category: Cardiology Source Type: research

Rocking makes the difference
Maasset al.1 introduced the CAVIAR response score as a tool for improving patient selection for cardiac resynchronization therapy (CRT). It is interesting to read, that apical rocking, a simple mechanical dyssynchrony marker, was an independent predictor of volumetric response to CRT and was proposed as one of the four scoring parameters. We would like to congratulate the authors to this study which confirms to a great extend our 1000-patient, multi-centre experience reported in the PREDICT-CRT study which investigated the relationship of apical rocking and septal flash to clinical outcomes following CRT.2 Both apical rock...
Source: Europace - June 26, 2017 Category: Cardiology Source Type: research

Supraventricular tachyarrhythmias in patients with a persistent left superior vena cava
ConclusionAmong adult SVA patients who underwent an EP study or RF catheter ablation during the 10-year study period, 0.27% had PLSVC. The most common type of SVA was AVNRT. The success rate of catheter ablation was 82% in SVA patients with PLSVC. There were no procedure-related complications. (Source: Europace)
Source: Europace - June 20, 2017 Category: Cardiology Source Type: research

CHA2DS2-VASc score and blood biomarkers to identify patients with atrial high rate episodes and paroxysmal atrial fibrillation: the role of TIMP-4 regulation
We read the article by Wakulaet al.1 with great interest, and congratulate the authors on their excellent work. As the authors correctly state, the discriminatory performance of CHADS2-VASc for paroxysmal atrial fibrillation (PAF) is increased by addition of selected biomarkers. The authors also state that serum levels of TIMP-1,-2, and -4 are significantly elevated in patients with PAF and that TIMP-4 is the strongest parameter associated with PAF among all tested circulating biomarkers. However we would like to call attention to several points that need further clarification. There is evidence that miR-146b-5p, matrix me...
Source: Europace - June 19, 2017 Category: Cardiology Source Type: research

Hypertension and cardiac arrhythmias: a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulaci ón Cardíaca y Electrofisiología (SOLEACE)
AbstractHypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnes...
Source: Europace - June 17, 2017 Category: Cardiology Source Type: research

Corrigendum
to: Burri H, et al. Left univentricular pacing for cardiac resynchronization therapy [Europace doi:10.1093/europace/euw179] (Source: Europace)
Source: Europace - June 17, 2017 Category: Cardiology Source Type: research

The prognostic impact of single extra-stimulus on programmed ventricular stimulation in Brugada patients without previous cardiac arrest: multi-centre study in Japan
AbstractAimsThe prognostic value of programmed electrical stimulation (PES) in Brugada syndrome (BrS) remains controversial. One of the reasons for discrepant results may be due to the selection of stimulation protocol. We evaluated the prognostic value of a positive PES result (PES+) according to the inducible pacing sites and the number of extra-stimuli in BrS patients without previous cardiac arrest (CA).Methods and resultsWe enrolled 224 consecutive BrS patients without previous CA (mean age 51  ± 14 years, 209 males), who underwent PES with the identical protocol. Clinical outcomes of development ...
Source: Europace - June 16, 2017 Category: Cardiology Source Type: research

Elevated homocysteine increases the risk of left atrial/left atrial appendage thrombus in non-valvular atrial fibrillation with low CHA2DS2-VASc score
AbstractAimsTo assess the association and the predictive value of plasma homocysteine (Hcy) levels with LA/LAA thrombus in non-valvular Atrial fibrillation (AF) patients with low CHA2DS2-VASc score.Methods and resultsEight hundred and eighty-eight consecutive patients in non-valvular AF with CHA2DS2-VASc score of 0 and 1 were enrolled. All patients routinely underwent transthoracic echocardiography and transoesophageal echocardiography. A total of thirty-two patients had LA/LAA thrombus. Compared with patients without LA/LAA thrombus, plasma Hcy levels were significantly higher in patients with LA/LAA thrombus (16.5 &thins...
Source: Europace - June 16, 2017 Category: Cardiology Source Type: research

A stepwise approach to conduit puncture for electrophysiological procedures in patients with Fontan circulation
AbstractAimsIn patients with Fontan circulation, the conduit may be punctured for electrophysiological procedures. We evaluated the feasibility and safety of a stepwise approach to conduit puncture in adults who have undergone Fontan operation.Methods and resultsWe included 13 consecutive patients with lateral tunnel or extracardiac conduit Fontan circulation [median age (interquartile range), 24.0 (16.0 –25.0) years; seven men] who had undergone electrophysiological procedures. We performed a stepwise approach to conduit puncture: 1st, Brockenbrough needle; 2nd, Brockenbrough needle with snare; 3rd, extra-ste...
Source: Europace - June 14, 2017 Category: Cardiology Source Type: research

Five year trends (2008 –2012) in cardiac implantable electrical device utilization in five European nations: a case study in cross-country comparisons using administrative databases
ConclusionTo aid in policymaking and track outcomes, HD administrative data provides a reliable, relatively cheap, methodology for tracking implant rates for PMs and ICDs across countries, as comparisons to EHRA data and the literature indicated. (Source: Europace)
Source: Europace - June 14, 2017 Category: Cardiology Source Type: research

Anatomical predisposing factors of transmural thermal injury after pulmonary vein isolation
ConclusionThe anatomical proximities of the LA posterior wall, LIPV, and descending Ao surrounding the oesophagus are strongly associated with the prevalence of TTI. (Source: Europace)
Source: Europace - June 12, 2017 Category: Cardiology Source Type: research

How to prevent atrial-oesophageal fistula following ablation of atrial fibrillation: are there actually any effective methods?
We read with great interest the article by Medeiros De Vasconceloset al.1 recently published in the journal. The authors presented a series of atrial-oesophageal fistula (AEF) cases between 2003 and 2015 in eight centres in Brazil. Ten cases (0.113%) of AEF were reported in 8863 ablations, and 8 of the 10 recruiting centres were referral units for atrial fibrillation (AF) ablation and had performed more than 200 procedures at the time of AEF occurrence. The level of mortality was extremely high (70%) regardless of the treatment given (surgical in 60% of patients, stenting in one patient), and only one patient was cured wit...
Source: Europace - June 12, 2017 Category: Cardiology Source Type: research

Prevalence and predictors of low voltage zones in the left atrium in patients with atrial fibrillation
AbstractAimsTo describe the extent and distribution of low voltage zones (LVZ) in a large cohort of patients undergoing ablation for paroxysmal and persistent atrial fibrillation (AF), and to explore baseline predictors of LVZ in these patients.Methods and resultsConsecutive patients who underwent a bipolar voltage map guided AF ablation, were enrolled. Voltage maps were conducted for each patient using 3-dimensional electroanatomical mapping system and LVZ were defined as areas of bipolar voltage
Source: Europace - June 10, 2017 Category: Cardiology Source Type: research

Radiofrequency ablation of accessory pathways in patients with the Wolff –Parkinson–White syndrome: long-term risk of mortality and coronary events
AbstractAimsThe long-term outcomes of radiofrequency catheter ablation (RFCA) in patients with Wolff –Parkinson–White syndrome (WPW) remain unclear. We investigated the impact of RFCA on the long-term risk of coronary events and mortality in WPW patients.Methods and resultsWe conducted a prospective cohort study utilizing the Taiwan National Health Insurance Research Database. Between 2000 and 2003, WPW patients with no prior coronary artery disease (CAD) history, aged over 18 years, who underwent RFCA were identified. WPW patients without RFCA were matched with propensity-score 1:4 matching for confounding cor...
Source: Europace - June 10, 2017 Category: Cardiology Source Type: research

Urine albumin excretion and the risk of incident atrial fibrillation: predictive or aetiological relevance —Authors' reply
We appreciate the continuing interest of Abbasi1 in the PREVEND cohort. Our article showed that in a community-based cohort increased albumin excretion, and not estimated glomerular filtration rate, was associated with incident AF, even after adjustments for established cardiovascular risk factors.2 We agree that we cannot rule out unmeasured confounding or reverse causality. Theoretically, a randomized controlled trial or Mendelian randomization may be approaches to provide more causal evidence.3 However, the Mendelian randomization as brought forward based on GWAS variants are also not immune against unmeasured confoundi...
Source: Europace - June 10, 2017 Category: Cardiology Source Type: research

Supraventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy associate with long-term outcome after catheter ablation of ventricular tachycardias
ConclusionSVT and older age are associated with the recurrence of VT after catheter ablation in patients with ARVD/C. (Source: Europace)
Source: Europace - June 7, 2017 Category: Cardiology Source Type: research

Cardiac resynchronization therapy and electrical storm: results of the OBSERVational registry on long-term outcome of ICD patients (OBSERVO-ICD)
ConclusionPatients with CRT had a lower incidence of ES when compared with propensity-matched ICD patients. The long-term benefit of CRT seems to be due to the improved haemodynamics, as CRT-responders performed markedly better over a long-term follow-up. (Source: Europace)
Source: Europace - June 7, 2017 Category: Cardiology Source Type: research

Suggestions for clinical studies on percutaneous left atrial appendage occlusion: authors' reply
The Munich consensus document is a physician-initiated effort to establish better and more consistent methodology for studies related to percutaneous left atrial appendage occlusion (LAAO).1 The document is endorsed by EHRA, EAPCI, and other professional societies. The proposed definitions and endpoints for data collection are based on the available published data, and pertinent clinical experience. Our group aimed to provide meaningful definitions and to recommend data collection strategies that are both clinically relevant and feasible. We would like to thank the authors for their letter.2 Herein, we try to reply to all ...
Source: Europace - June 7, 2017 Category: Cardiology Source Type: research

Proteomics of the epicardial fat secretome and its role in post-operative atrial fibrillation
ConclusionFor the first time we describe EAT secretome as a possible substrate for POAF. It contains various proteins differentially expressed in patients who later develop POAF. Amongst those gelsolin, involved in inflammation and ion channel regulation, was associated with maintenance of sinus rhythm. Understanding the role of EAT may offer novel insights into prevention and treatment of AF. (Source: Europace)
Source: Europace - June 5, 2017 Category: Cardiology Source Type: research

Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the MARC study – authors reply
We thank Stankovic and Voigt1 for their interest in our study2 and agree that the identification of apical rocking as an independent predictor of response to cardiac resynchronization therapy (CRT) in the MARC study is not a new finding.3 (Source: Europace)
Source: Europace - June 5, 2017 Category: Cardiology Source Type: research

Comparison of epicardial vs. endocardial reimplantation in pacemaker-dependent patients with device infection
ConclusionWe observed similar in-hospital outcomes in our EPI and TP cohorts. Twenty-five percent of the patients initially paced by a TP strategy finally needed an epicardial device, mainly because of infection of their TP lead. Use of TP resulted in lower rates of late endocarditis and device reintervention. (Source: Europace)
Source: Europace - June 3, 2017 Category: Cardiology Source Type: research

A case of removal of a “dancing” Micra
Micra ™ (Medtronic Inc) transcatheter pacing system (TPS) late removal raises a concern since the absence of a specialized tool system and the possibility of early endothelialization. (Source: Europace)
Source: Europace - June 3, 2017 Category: Cardiology Source Type: research

Comparison of the effects of selective and non-selective His bundle pacing on cardiac electrical and mechanical synchrony
ConclusionSelective His bundle pacing and high-output NS-HBP could restore normal electrical and LV mechanical synchrony. (Source: Europace)
Source: Europace - May 31, 2017 Category: Cardiology Source Type: research

Ultrasound-guided versus conventional femoral venipuncture for catheter ablation of atrial fibrillation: a multicentre randomized efficacy and safety trial (ULTRA-FAST trial)
AbstractAimsComplications of catheter ablation for atrial fibrillation (AF) are frequently related to vascular access. We hypothesized that ultrasound-guided (USG) venipuncture may facilitate the procedure and reduce complication rates.Methods and resultsWe conducted a multicentre, randomized trial in patients undergoing catheter ablation for AF on uninterrupted anticoagulation therapy. The study enrolled consecutive 320 patients (age: 63  ± 8 years; male: 62%) and were randomized to USG or conventional venipuncture in 1:1 fashion. It was prematurely terminated due to substantially lower-than-ex...
Source: Europace - May 30, 2017 Category: Cardiology Source Type: research

Corrigendum
to: Outcomes of atrial arrhythmia radiofrequency catheter ablation in patients with Ebstein ’s anomaly [Europace 2018;20:525 –30] (Source: Europace)
Source: Europace - May 30, 2017 Category: Cardiology Source Type: research

Recognition of short RP atrial tachycardia due to intra-atrial conduction delay: utility of a septal AH/HA Ratio & lt;1
A 59-year-old man underwent ablation for cavotricuspid (CTI)-dependent right atrial flutter. Post ablation programmed stimulation reproducibly initiated supraventricular tachycardia with a cycle length 300 –310 ms. The rhythm strip showed short RP tachycardia with a prolonged P wave duration (175 ms), which was much longer compared with during sinus rhythm (110 ms) (top panel, left). (Source: Europace)
Source: Europace - May 30, 2017 Category: Cardiology Source Type: research

Long-term outcomes of different ablation strategies for ventricular tachycardia in patients with structural heart disease: systematic review and meta-analysis
ConclusionIn patients with SHD who had VT related mainly to ischaemic substrates, there was a significantly lower risk of the composite primary outcome of long-term VA recurrence and all-cause mortality among those undergoing substrate modification compared to standard ablation. Long-term success is improved when performing complete substrate modification. (Source: Europace)
Source: Europace - May 26, 2017 Category: Cardiology Source Type: research

Peritoneal migration of an epicardial pacemaker
A newborn with complete congenital atrioventricular block of immune origin, in severe heart failure, was implanted with a pacemaker at 1 day of life. The pacing lead was fixed to the epicardial right ventricle and the generator conventionally implanted in a pocket created beneath rectus muscles. (Source: Europace)
Source: Europace - May 25, 2017 Category: Cardiology Source Type: research

Family history of atrial fibrillation as a predictor of atrial substrate and arrhythmia recurrence in patients undergoing atrial fibrillation catheter ablation
ConclusionThe presence of a 1st-degree family member with AF does not impact the clinical outcomes of catheter ablation for paroxysmal AF. However, a positive family history is associated with worse arrhythmia free survival in patients with PeAF. This finding is not explained by differences in clinical characteristics, atrial substrate assessed by voltage maps or ablation characteristics. (Source: Europace)
Source: Europace - May 24, 2017 Category: Cardiology Source Type: research

Current management and clinical outcomes for catheter ablation of atrioventricular nodal re-entrant tachycardia
ConclusionIn a large, contemporary cohort, catheter ablation for AVNRT remains highly successful with low complications rates. The increased use of anaesthesia as well as modern mapping and ablation tools were not associated with changes in clinical outcomes. Further prospective evaluation of such contemporary practices is warranted given the lack of evidence to support their escalating use. (Source: Europace)
Source: Europace - May 24, 2017 Category: Cardiology Source Type: research

The effects of gender on electrical therapies for the heart: physiology, epidemiology, and access to therapies
AbstractThe difference between men and women is clear even just by looking at an electrocardiogram: females present higher resting heart rate, a shorter QRS complex length and greater corrected QT interval. The development of these differences from pubertal age onward suggests that sexual hormones play a key role, although their effect is far from being completely understood. Different incidences between sexes have been reported for many arrhythmias, both ventricular and supraventricular, and also for sudden cardiac death. Moreover, arrhythmias are an important issue during pregnancy, both for diagnosis and treatment. Inte...
Source: Europace - May 19, 2017 Category: Cardiology Source Type: research

A new electrogram-based diagnostic algorithm to improve the left ventricular effective pacing detection corrected a non-response to cardiac resynchronization therapy pacing
We present a case of a 79-year-old male, non-responder to cardiac resynchronization therapy (CRT) despite the classic pacing counters indicating 99.3% biventricular (BiV) pacing. A new EGM-based diagnostic algorithm was used to uncover poor delivery of CRT pacing. The left ventricle (LV) cathode –right ventricle (RV) Coil electrogram (EGM) corresponding to each paced beat was analysed by the algorithm which automatically determined if the EGM had a QS/QS-r morphology and accordingly classified the paced beat as effective or ineffective. If CRT pacing is effective, the electrogram recorded from the pacing site should ...
Source: Europace - May 19, 2017 Category: Cardiology Source Type: research

Shortening of the atrial-His bundle interval during atrial pacing as a predictor of successful ablation for typical atrioventricular nodal re-entrant tachycardia
AbstractAimsShortening of the atrial-His bundle (AH) interval during the sinus rhythm is occasionally observed after slow pathway ablation for atrioventricular nodal re-entrant tachycardia (AVNRT). In addition, high-rate atrial pacing is useful for avoiding atrioventricular block. We hypothesized that shortening of the AH interval during slow pathway ablation under high-rate atrial pacing would lead to successful ablation of typical AVNRT.Methods and resultsThis retrospective study included 37 patients in whom successful ablation of typical AVNRT was performed under atrial pacing. The AH interval was measured immediately b...
Source: Europace - May 17, 2017 Category: Cardiology Source Type: research

Management of untreatable ventricular arrhythmias during pharmacologic challenges with sodium channel blockers for suspected Brugada syndrome
AbstractPharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Current consensus guidelines suggest to adopt cautious protocols interrupting the sodium channel blockers as soon as any ECG alteration appears. Nevertheless, the risk of life-threatening arrhythmias persists, even adopting a safe and cautious protoc...
Source: Europace - May 17, 2017 Category: Cardiology Source Type: research

Dabigatran vs. warfarin in relation to the presence of left ventricular hypertrophy in patients with atrial fibrillation — the Randomized Evaluation of Long-term anticoagulation therapY (RE-LY) study
ConclusionsLVH was associated with a lower antithrombotic efficacy of warfarin, but not of dabigatran, in patients with AF. Consequently, the relative benefit of the lower dose of dabigatran compared to warfarin was enhanced in patients with LVH. The higher dose of dabigatran was superior to warfarin regardless of LVH status.Clinical trial registrationhttp:www.clinicaltrials.gov. Unique identifier: NCT00262600. (Source: Europace)
Source: Europace - May 17, 2017 Category: Cardiology Source Type: research

The effects of gender on electrical therapies for the heart: procedural considerations, results and complications A report from the XII Congress of the Italian Association on Arrhythmology and Cardiostimulation (AIAC)
AbstractUse of cardiac implantable devices and catheter ablation is steadily increasing in Western countries following the positive results of clinical trials. Despite the advances in scientific knowledge, tools development, and techniques improvement we still have some grey area in the field of electrical therapies for the heart. In particular, several reports highlighted differences both in medical behaviour and procedural outcomes between female and male candidates. Women are referred later for catheter ablation of supraventricular arrhythmias, especially atrial fibrillation, leading to suboptimal results. On the opposi...
Source: Europace - May 17, 2017 Category: Cardiology Source Type: research

Non-laser percutaneous extraction of pacemaker and defibrillation leads: a decade of progress
AbstractAimsNon-laser-based methods are safe in lead extraction but in the past have been less effective than laser methods. In the past decade, new equipment has been introduced including the Evolution ® Mechanical Dilator Sheath and the Evolution® RL. We sought to determine the impact of new equipment on outcome in mechanical lead extraction.Methods and resultsWe considered 288 consecutive patients (age 66 ± 18 years) who underwent transvenous lead extraction (TLE) of 522 leads in the decade to the end of 2014. Three groups were identified: Group 1 (pre-Evolution® period, 76 patients, 133 leads), Group...
Source: Europace - May 17, 2017 Category: Cardiology Source Type: research

Severe conduction defects requiring permanent pacemaker implantation in patients with a new-onset left bundle branch block after transcatheter aortic valve implantation
ConclusionThe severity and persistence of a new-onset LBBB after TAVI is associated with mortality. Cardiac conduction defects requiring PPI are associated with prior AF, the use of digoxin, CoreValve implantation, and a left heart axis. In these patients, PPI portends a better prognosis than no PPI. (Source: Europace)
Source: Europace - May 17, 2017 Category: Cardiology Source Type: research

Presyncopal episodes after implantation of dual-chamber pacemaker programmed in SafeR pacing mode
[Europace 2017, doi:10.1093/europace/euw440] (Source: Europace)
Source: Europace - May 16, 2017 Category: Cardiology Source Type: research

Atrial fibrillation: a left atrial neuro-myopathy?
This editorial refers to ‘Longitudinal association of short-term, metronome-paced heart rate variability and echocardiographically assessed cardiac structure at a 4-year follow-up: results from the prospective, population-based CARLA cohort’ by D. Medenwaldet al., on pages2027 –2035. (Source: Europace)
Source: Europace - May 15, 2017 Category: Cardiology Source Type: research

Automatic remote monitoring utilizing daily transmissions: transmission reliability and implantable cardioverter defibrillator battery longevity in the TRUST trial
AbstractAimsBenefits of automatic remote home monitoring (HM) among implantable cardioverter defibrillator (ICD) patients may require high transmission frequency. However, transmission reliability and effects on battery longevity remain uncertain. We hypothesized that HM would have high transmission success permitting punctual guideline based follow-up, and improve battery longevity. This was tested in the prospective randomized TRUST trial.Methods and resultsImplantable cardioverter defibrillator patients were randomized post-implant 2:1 to HM (n = 908) (transmit daily) or to Conventional in-person monitorin...
Source: Europace - May 10, 2017 Category: Cardiology Source Type: research

An atypical roof-dependent atrial tachycardia with a long channel of conduction identified with high-density mapping: pitfall of the conventional assessment of the roof line block
A 60-year-old woman presented for radiofrequency (RF) ablation of an atrial tachycardia (AT) after initial atrial fibrillation (AF) ablation. At the time of the electrophysiological study, the patient was in AT (CL = 245 ms). An activation map with the OrionTM basket catheter and the RhythmiaTM system (Boston Scientific, USA) displayed a dual-loop macro-re-entrant AT with roof-dependent and peri-mitral circuits. RF application to the mitral isthmus terminated the AT with the end point of bidirectional block. Subsequently, we completed the roof line and confirmed block while pacing the left atrial appendage (LAA); the durat...
Source: Europace - May 7, 2017 Category: Cardiology Source Type: research

Long-term clinical impact of permanent cardiac pacing after transcatheter aortic valve implantation with the CoreValve prosthesis: a single center experience
ConclusionPatients requiring a PPM after TAVI did not have an increase in mortality, or an increase in the likelihood of developing a stroke at a long-term follow-up. However, this subgroup of patients showed an increase in rehospitalization due to HF at medium- and long-term follow-up. (Source: Europace)
Source: Europace - May 4, 2017 Category: Cardiology Source Type: research

Successful catheter ablation of ventricular ectopy in a young patient with implanted Melody valve
A 17-year-old male after transcatheter implantation of Melody pulmonary valve (TPV) (Medtronic) was admitted for catheter ablation (CA) of frequent and highly symptomatic premature ventricular complexes (PVCs —Figure) refractory to treatment with bisoprolol. The patient had a history of surgical correction of truncus arteriosus. Due to moderate stenosis and severe regurgitation of the valved conduit, a TPV Melody was implanted and was functioning properly at the time of the procedure. Morphology of PVC s implied origin from the right ventricular outflow tract. (Source: Europace)
Source: Europace - May 4, 2017 Category: Cardiology Source Type: research

Suggestions for clinical studies about percutaneous left atrial appendage occlusion
With great interest, we read the Munich consensus document on definitions, endpoints, and data collection for clinical studies about percutaneous left atrial appendage occlusion (LAAO).1 The authors have to be congratulated for their effort to standardize the definitions and to propose a consistent approach in the reporting of LAAO studies. However, regarding the sequelae of LAAO the following questions and concerns arise. (Source: Europace)
Source: Europace - May 2, 2017 Category: Cardiology Source Type: research