Sinkhole syncope
(Source: Europace)
Source: Europace - May 2, 2017 Category: Cardiology Source Type: research

Prognostic value of elevated high-sensitivity cardiac troponin T in patients admitted to an emergency department with atrial fibrillation
AbstractAimsElevated levels of high-sensitivity cardiac troponin T (hsTnT) indicate underlying heart disease and are known to predict adverse outcomes in various patient populations. Their role in atrial fibrillation (AF) is still under debate.Methods and resultsThis retrospective study included 2898 consecutive patients presenting with AF to the emergency department of the Department of Cardiology, Heidelberg University Hospital. Multivariable Cox regression was used to assess associations between hsTnT and mortality. Elevated hsTnT levels were associated with increased risk of all-cause mortality in all patients with AF,...
Source: Europace - April 27, 2017 Category: Cardiology Source Type: research

Non-vitamin K-dependent oral anticoagulants have a positive impact on ischaemic stroke severity in patients with atrial fibrillation
AbstractAimsSeveral studies showed reduced stroke severity in patients with atrial fibrillation (AF) if the international normalized ratio (INR) was ≥ 2 at stroke onset. There are no respective data for non-vitamin K-dependent oral anticoagulants (NOACs). The aim of this study was to compare the impact of NOAC or phenprocoumon intake on stroke severity.Methods and resultsIn this single-centre observational study, 3669 patients with acute ischaemic stroke were retrospectively analysed regarding AF status and medication immediately before admission. Using multivariable regression, we analysed the association of pre...
Source: Europace - April 27, 2017 Category: Cardiology Source Type: research

Vernakalant does not alter early repolarization or contractility in normal and electrically remodelled atria
ConclusionIn goat atria, vernakalant does not have an atrial positive inotropic effect and does not affect early repolarization. At high rates vernakalant may even have a negative inotropic effect. (Source: Europace)
Source: Europace - April 25, 2017 Category: Cardiology Source Type: research

Surface electrocardiography characteristics and radiofrequency catheter ablation of idiopathic ventricular arrhythmias originating from the left infero-septal papillary muscles: differences from those originating from the left posterior fascicle
ConclusionPM ventricular arrhythmias could be identified from LPF ventricular arrhythmias by calculation of QRS duration combined withVi/Vt using ECG. (Source: Europace)
Source: Europace - April 24, 2017 Category: Cardiology Source Type: research

Reappraisal and new observations on atrial tachycardia ablated from the non-coronary aortic sinus of Valsalva: authors' reply
We thank Madaffari and his colleagues for the interest in our recent publication inEuropace regarding the ablation of atrial tachycardias from the non-coronary sinus of the aortic root.1 Perhaps the key statement in their letter reads ‘We agree with the analysis done by Markowitz’. The ‘analysis’ performed by Markowitz,2 however, was an editorial commentary on the investigation performed by Pap and colleagues, to which Madaffari and his associates also refer.3 In his ‘analysis’, Markowitz makes the key statement that ‘a detailed understanding of anatomic relationships can suggest n...
Source: Europace - April 24, 2017 Category: Cardiology Source Type: research

Improved outcome and cost effectiveness in ablation of persistent atrial fibrillation under general anaesthetic
ConclusionsIn patients with persistent AF, it is both clinical and economically more effective to perform ablation under GA rather than sedation. (Source: Europace)
Source: Europace - April 21, 2017 Category: Cardiology Source Type: research

Catheter ablation for ventricular tachycardia in patients with cardiac sarcoidosis: a systematic review
AbstractAimsCardiac sarcoidosis (CS) is associated with a poor prognosis. Important features of CS include heart failure, conduction abnormalities, and ventricular arrhythmias. Ventricular tachycardia (VT) is often refractory to antiarrhythmic drugs (AAD) and immunosuppression. Catheter ablation has emerged as a treatment option for recurrent VT. However, data on the efficacy and outcomes of VT ablation in this context are sparse.Methods and resultsA systematic search was performed on PubMed, EMBASE, and Cochrane database (from inception to September 2016) with included studies providing a minimum of information on CS pati...
Source: Europace - April 21, 2017 Category: Cardiology Source Type: research

Left atrial volume predicts atrial fibrillation recurrence after radiofrequency ablation: a meta-analysis
ConclusionsPatients with AF recurrence following RFA have a higher mean LAV/LAVi compared to patients with no recurrence. Large LAV/LAVi increases the odds of AF recurrence post RFA. (Source: Europace)
Source: Europace - April 21, 2017 Category: Cardiology Source Type: research

Triple-site pacing for cardiac resynchronization in permanent atrial fibrillation: follow-up results from a prospective observational study
AbstractAimsCardiac Resynchronization Therapy (CRT) is associated with a particularly high non-response rate in patients with atrial fibrillation (AF). We aimed to assess the effectiveness of triple-site (Tri-V) pacing CRT in this population.Methods and resultsProspective observational study of patients with permanent AF who underwent CRT implantation with an additional right ventricle lead in the outflow tract septal wall. After implantation, programming mode (Tri-V or biventricular pacing) was selected based on cardiac output determination. Patients were classified as responders if NYHA class was reduced by at least one ...
Source: Europace - April 19, 2017 Category: Cardiology Source Type: research

A devices ’ game of thrones: cardiac resynchronization therapy vs. pacemaker
ConclusionThis paper emphasizes the importance of knowing the distinct pacemaker brady mode behaviours after battery capacity depleted indicator has been reached, according to the pacemakers ’ manufacturer, including the possibility of automatic brady mode change from sensing to pacing mode. It also highlights the potential for severe bradycardia or asystole of this automatic brady mode change from a previously implanted pacemaker in pacemaker dependent patients submitted to CRT upgra de. (Source: Europace)
Source: Europace - April 18, 2017 Category: Cardiology Source Type: research

Vagal third-degree atrioventricular block in a highly trained endurance athlete
Electrocardiogram (ECG) characteristics of athletes have recently become a topic of intensive study. Athletes are well known to have low-heart rates, but it is difficult to determine how low is too low for pacemaker indication. (Source: Europace)
Source: Europace - April 18, 2017 Category: Cardiology Source Type: research

Visualizing induced silent steam pop with intracardiac echocardiography
A piglet underwent aggressively endocardial radiofrequency catheter ablation (RFCA) (FlexAbilityTM; St Jude Medical). RFCA was applied in the left ventricle. An intracardiac echocardiography catheter (ViewFlexTM, Xtra ICE Catheter; St Jude Medical) was inserted in the right ventricle (PanelA). Formation of focal microbubbles was observed before steam pop initiation. After 44 s from initiation of RFCA, a silent steam explosion occurred. Explosive microbubbles were clearly observed. The impedance tracing was not remarkable. The endocardial damage caused by this induced steam pop was a void 15  mm in diameter and 8 mm ...
Source: Europace - April 18, 2017 Category: Cardiology Source Type: research

Inappropriate sinus tachycardia in a heart transplant successfully treated with ivabradine
A 55-year-old male with history of two prior orthotopic heart transplants presented with his third heart failure hospitalization in 4 months with a steady decrement in left ventricular ejection fraction (LVEF) from 65% to 35%. During each hospitalization, he demonstrated a long-RP tachycardia in the 130 beats/min (Panel A). His tachycardia preceded the deterioration in LVEF. An extensive evaluation included a right heart catheterization showing elevated filling pressures, coronary angiography showing no epicardial coronary artery disease, and endomyocardial biopsies at two different times finding no evidence of allograft r...
Source: Europace - April 18, 2017 Category: Cardiology Source Type: research

Implantable cardioverter defibrillator use for primary prevention in ischaemic and non-ischaemic heart disease —indications in the post-DANISH trial era: results of the European Heart Rhythm Association survey
Implantable cardioverter-defibrillator (ICD) is the standard of care for prevention of sudden cardiac death (SCD) in high-risk patients. For primary prevention of SCD, in patients with ischaemic heart disease, there is more robust data on the effect of ICD therapy compared with patients with non-ischaemic heart disease, but current real-life practice may differ substantially. The aim of this European Heart Rhythm Association survey was to evaluate the clinical practice regarding implantation of ICD for primary prevention among European countries in patients with non-ischaemic and ischaemic heart disease. Furthermore, we wa...
Source: Europace - April 18, 2017 Category: Cardiology Source Type: research

Cryoballoon pulmonary vein isolation and lung lobectomy
(Source: Europace)
Source: Europace - April 18, 2017 Category: Cardiology Source Type: research

Cardioinhibitory and vasodepressor responses to different stressors on head-up tilt
We describe the case of a 37-year-old man with a history of laughter-induced syncope, which caused him to crash his car. The patient was a non-smoker with a history of obstructive sleep apnoea and obesity with a body mass index of 33.5. He underwent head up tilt testing with glyceryl trinitrate provocation. On four occasions, the patient was asked to laugh which all ended in a spontaneous vigorous cough after which he started to feel lightheaded. There was concordant drop in systolic BP without any decrease in heart rate (PanelA). At 32  min, there was sinus arrest for 12 seconds and loss of consciousness for...
Source: Europace - April 17, 2017 Category: Cardiology Source Type: research

Avoiding oesophageal injury during cardiac ablation: insights gained from mediastinal anatomy
ConclusionMediastinal anatomy, specifically the presence of a loose connective tissue that attaches the oesophagus to the parietal pericardium overlying the posterior LA wall will allow for a lateral displacement of the oesophagus. This should decrease or eliminate the likelihood of thermal injury of the oesophagus. Using an endotracheal stylet, we investigated the lateral displacement of the oesophagus in 11 human cadavers. In six with the stylet extending to the GE junction, the oesophagus was displaced a mean of 3.8  cm. In five, with stylet 4 cm cranial to the junction, the displacement was 4.56 cm. (Source: Europace)
Source: Europace - April 16, 2017 Category: Cardiology Source Type: research

Radiotherapy in a leadless pacemaker
In conclusion, in this first experience of RT in a patient with a leadless pace maker implanted within the radiation field, continuous monitoring of device rule out remarkable damage to the pacemaker, endorsing its potential use in patients with RT requirements. (Source: Europace)
Source: Europace - April 16, 2017 Category: Cardiology Source Type: research

Epicardial ablation may not be necessary in all patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and frequent ventricular tachycardia: author ’s reply
We thank Dr Mussigbrodt and colleagues for their interest in on our study.1,2 (Source: Europace)
Source: Europace - April 16, 2017 Category: Cardiology Source Type: research

Shock efficacy of single and dual coil electrodes —new insights from the NORDIC ICD Trial
AbstractAimsDual coil (DC) electrodes are preferred to single coil (SC) electrodes because of an assumed higher shock efficacy. However, DC-electrodes may be associated with an increased difficulty and risk of lead extraction. We aimed to compare SC- and DC-electrodes with respect to the first shock efficacy (FSE) after implantable cardioverter defibrillator (ICD) implantation.Methods and resultsOne thousand and seventy-seven patients of the NORDIC ICD trial were randomly assigned to first time ICD implantation with or without defibrillation (DF) testing. The electrode configuration was determined before randomization. One...
Source: Europace - April 13, 2017 Category: Cardiology Source Type: research

Structuring (right) atrial fibrillation: location matters
This editorial refers to ‘Differences in the structural characteristics and distribution of epicardial adipose tissue between left and right atrial fibrillation’ by H. Hasebeet al., 20(3);435 –442. (Source: Europace)
Source: Europace - April 13, 2017 Category: Cardiology Source Type: research

Voltage gradient mapping and electrophysiologically guided cryoablation in children with AVNRT
ConclusionsVoltage gradient mapping of Koch ’s triangle, combined with the search for the slow potential signal in low-voltage bridges, is effective in guiding cryoablation of AVNRT in paediatric patients, with a complete acute success rate and no AVNRT recurrences at mid-term follow-up. (Source: Europace)
Source: Europace - April 12, 2017 Category: Cardiology Source Type: research

CHA2DS2-VASc score for ischaemic stroke risk stratification in patients with chronic obstructive pulmonary disease with and without atrial fibrillation: a nationwide cohort study
ConclusionsOur study is the first to show that the performance of CHA2DS2-VASc score in predicting ischaemic stroke is better for COPD patients without AF than for COPD patients with AF. (Source: Europace)
Source: Europace - April 12, 2017 Category: Cardiology Source Type: research

Urine albumin excretion and the risk of incident atrial fibrillation: predictive or aetiological relevance?
I read with great interest the article by Marcoset al. investigating observational associations of urine albumin measures either by a simple urine albumin test or a more complex 24-h urine collection test with incident atrial fibrillation (AF) in an apparently healthy general population cohort enriched with individuals having an urine albumin concentration  >10 mg/L at baseline.1 In line with previously published epidemiological studies, the authors report a positive association between elevated urine albumin and an increased risk of incident AF. While the associations were independent of common and novel risk fa...
Source: Europace - April 12, 2017 Category: Cardiology Source Type: research

Economic impact of remote monitoring after implantable defibrillators implantation in heart failure patients: an analysis from the EFFECT study
AbstractAimsHeart failure (HF) patients with implantable cardioverter-defibrillators (ICD) require admissions for disease management and out-patient visits for disease management and assessment of device performance. These admissions place a significant burden on the National Health Service. Remote monitoring (RM) is an effective alternative to frequent hospital visits. The EFFECT study was a multicentre observational investigation aiming to evaluate the clinical effectiveness of RM compared with in-office visits standard management (SM). The present analysis is an economic evaluation of the results of the EFFECT trial.Met...
Source: Europace - April 12, 2017 Category: Cardiology Source Type: research

Atrial fibrillation: a mechanism or just a bystander?
This editorial refers to ‘Rate vs. rhythm control and adverse outcomes among European patients with atrial fibrillation’ by Y. Purmahet al., doi:10.1093/europace/euw421. (Source: Europace)
Source: Europace - April 12, 2017 Category: Cardiology Source Type: research

Therapeutic approaches for Long QT syndrome type 3: an update
This editorial refers to ‘Long-term flecainide therapy in type 3 long QT syndrome’ by Chorinet al., on pages 370 –376. (Source: Europace)
Source: Europace - April 11, 2017 Category: Cardiology Source Type: research

Left atrial appendage empirical electrical isolation for persistent atrial fibrillation: time for a change in practice
This editorial refers to ‘Left atrial appendage isolation in addition to pulmonary vein isolation in persistent atrial fibrillation: one-year clinical outcome after cryoballoon-based ablation’ by H. Yorgunet al., on pages 758--768. (Source: Europace)
Source: Europace - April 11, 2017 Category: Cardiology Source Type: research

Long-term outcome of surgical cryoablation for refractory ventricular tachycardia in patients with non-ischemic cardiomyopathy
ConclusionIn select pts with NICM and VT refractory to RFCA, SA guided by pre-operative electrophysiological mapping and ablation may be a therapeutic option. (Source: Europace)
Source: Europace - April 10, 2017 Category: Cardiology Source Type: research

ST segment depression on 24-hour electrocardiography predicts incident atrial fibrillation in two population-based cohorts
ConclusionST-depression at 24h-ECG is independently associated with incident AF, and incidence is substantially lower in individuals with neither ST-depression or high SVA. 24hECG can be used not only to diagnose AF but also to identify individuals at high and low AF risk. (Source: Europace)
Source: Europace - April 10, 2017 Category: Cardiology Source Type: research

Reappraisal and new observations on atrial tachycardia ablated from the non-coronary aortic sinus of Valsalva
We read with great interest the work published by Bohoraet al.1 and we agree that in the vast majority of cases it is possible to eliminate this subgroup of atrial tachycardias (ATs) with early activation close to the His-bundle from the aortic root and in particular from the non-coronary aortic cusp (NCC). This has an anatomical explanation: the NCC in fact delineates the superior aspect of the paraseptal region, lying on the epicardial tissue between the right and left septum, and thus provides access to this area. Bohoraet al. reported a 100% success in eliminating these ATs by radiofrequency (RF) energy application in ...
Source: Europace - April 10, 2017 Category: Cardiology Source Type: research

Efficacy and safety of the second generation cryoballoon ablation for the treatment of paroxysmal atrial fibrillation in patients over 75 years: a comparison with a younger cohort
ConclusionsThe results of our study showed that CB-A for the treatment of PAF is a feasible and safe procedure in elderly patients, with similar success and complications rates when compared with a younger population. (Source: Europace)
Source: Europace - April 10, 2017 Category: Cardiology Source Type: research

Significant reduction of radiation exposure in cryoballoon-based pulmonary vein isolation
The objective of this study is to evaluate a modified fluoroscopy protocol aiming at reduction of radiation exposure in CB ablation.Methods and resultsA total of 120 patients with symptomatic AF underwent pulmonary vein isolation (PVI) using the second generation CB and an ablation strategy considering the individual time-to-isolation. The first 60 patients (Group 1) underwent CB-based PVI with conventional fluoroscopy settings. An optimized approach was applied in the following 60 patients (Group 2) by (i) using fluoroscopy instead of filming for verification of pulmonary vein (PV) occlusion after contrast injection, (ii)...
Source: Europace - April 7, 2017 Category: Cardiology Source Type: research

A call for safety during electrophysiological procedures: US in, why not US out?
We read with great interest the paper by Sobolevet al.1 entitled ‘Ultrasound-guided cannulation of the femoral vein in electrophysiological procedures: a systematic review and meta-analysis’. Like all meta-analyses, it does not provide certainties but may set the stage for launching randomized trials on this important topic. Vascular damages during electrophy siological (EP) procedures are critical events which may have a substantial impact on patients prognosis, thus increasing their anxiety and fear towards the procedure. Furthermore, when compared with other complications (i.e. atrioventricular block, emboli...
Source: Europace - April 7, 2017 Category: Cardiology Source Type: research

Transvenous biventricular pacing in double-inlet left ventricle following ventricular septation and atrioventricular valve replacement
Here we report the first case of successful transvenous biventricular (BiV) pacemaker implantation in a 32-year-old man with double-inlet left ventricle following mechanical atrioventricular valve replacement and permanent atrial fibrillation. The patient underwent ventricular septation and epicardial pacemaker implantation for a surgical heart block at 4 years of age and mechanical right-side atrioventricular valve (functional tricuspid valve) replacement at 21 years of age. Because of epicardial pacing lead failure and worsening heart failure, we attempted to place BiV transvenous pacing leads. We cannulated the coronary...
Source: Europace - April 7, 2017 Category: Cardiology Source Type: research

( T peak − T end )/QRS and ( T peak − T end )/(QT × QRS) as risk markers in Brugada syndrome: authors' reply
(Source: Europace)
Source: Europace - April 7, 2017 Category: Cardiology Source Type: research

Does atrial fibrillation cause cognitive decline and dementia?
AbstractAtrial fibrillation (AF) and dementia are both frequent diseases with substantial socioeconomic impact. While AF has been associated with cognitive dysfunction and dementia, we currently lack an exact understanding of the complex association between AF and cognitive decline. Based on an extended literature search we summarize key publications focusing on AF-related cognitive decline and dementia. Moreover, ongoing trials and potential therapeutic implications are discussed. While further prospective studies using a standardized definition of AF and cognitive decline are urgently needed, growing evidence supports th...
Source: Europace - April 6, 2017 Category: Cardiology Source Type: research

Differences in the structural characteristics and distribution of epicardial adipose tissue between left and right atrial fibrillation
AbstractAimsRight atrial (RA) fibrillation (RAF) was previously characterized by initiation from RA ectopies, presence of a right-to-left dominant frequency gradient during atrial fibrillation (AF), and augmentation of the gradient by adenosine triphosphate infusion. We investigated structural characteristics of the bi-atria and epicardial adipose tissue (EAT) volume in patients with RAF.Methods and resultsBy using multidetector computed tomography, RA, left atrial (LA), right and LA appendage (RAA and LAA, respectively) volumes, pulmonary vein (PV) sizes, and EAT volumes were compared between the RAF group (n =&thi...
Source: Europace - April 6, 2017 Category: Cardiology Source Type: research

Is echocardiography valid and reproducible in patients with atrial fibrillation? A systematic review
AbstractAimsEchocardiography is vital in the routine assessment and management of atrial fibrillation (AF). We performed a systematic review of the validity and reproducibility of echocardiographic left ventricular systolic and diastolic function in AF, and optimal acquisition methods.Methods and resultsOnline databases were searched for studies in patients with AF at the time of echocardiography (1960 to August 2015), prospectively registered with PROSPERO (CRD42015025297). The systematic review included 32 studies from 3  066 search results (1 968 patients with AF). Average age was 67 years, 33% were women, mea...
Source: Europace - April 6, 2017 Category: Cardiology Source Type: research

Presyncopal episodes after implantation of dual-chamber pacemaker programmed in SafeR pacing mode
A 71-year-old man underwent implantation of a dual-chamber pacemaker (REPLY 200  DR, Sorin Group) programmed in SafeR mode (AAI ⇔ DDD) as treatment for a paroxysmal complete atrioventricular (AV) block and sinus node dysfunction. Three months later, he experienced several presyncopal episodes. (Source: Europace)
Source: Europace - April 6, 2017 Category: Cardiology Source Type: research

Roof-dependent atrial-flutter after a 28  mm second-generation cryoballoon ablation
A 73-year-old woman underwent a 28  mm 2nd generation cryoballoon ablation, and a roof-dependent atrial-flutter (AFL) was induced just after the pulmonary vein isolation and left atrial (LA) voltage mapping. Ablation of the PV antrum was performed with two applications per vein, one for 180 s followed by another for 150 s. The voltage map during sinus rhythm revealed an overlap of the cryoablation lesion on the LA posterior wall, and the overlapping lesion created slow conduction during the AFL. The AFL terminated after a roof linear ablation, and no further atrial arrhythmias were documented during 1-...
Source: Europace - April 6, 2017 Category: Cardiology Source Type: research

Erratum
to: Incidence of asymptomatic oesophageal lesions after atrial fibrillation ablation using an oesophageal temperature probe with insulated thermocouples: a comparative controlled study [Europace 2017;19:385 –91] (Source: Europace)
Source: Europace - April 5, 2017 Category: Cardiology Source Type: research

Characteristics and early clinical outcomes of patients undergoing totally subcutaneous vs. transvenous single chamber implantable cardioverter defibrillator placement
AbstractAimsIn 2012, the first totally Subcutaneous Implantable Cardioverter-Defibrillator (S-ICD) was approved by the Food and Drug Administration (FDA) in the United States. A possible benefit of this device is that it does not involve placing leads ‘in’ or ‘on’ the heart, potentially reducing complications.Methods amd resultsNinety-one S-ICD and 182 single chamber TV-ICD implants were performed between 10/22/2012 and 9/22/2015. During this period of time, 91 patients with S-ICD were matched to TV-ICD patients using single centre NCDR ICD Registry Data based on dialysis status, gender, and age. In...
Source: Europace - April 4, 2017 Category: Cardiology Source Type: research

Preparticipation cardiovascular evaluation for athletic participants to prevents sudden death: author ’s reply
We thank Dr Herbert L öllgen for his letter1 and interesting remarks regarding our recently published position paper.2 We agree with most of his comments and, indeed, firmly believe that proper measures need to be taken to foster a safe participation in exercise programmes and competitive sport. Yet we would like to address some of his comments on the performance of the exercise test and the role of exercise as a ‘disease promoter’. (Source: Europace)
Source: Europace - April 4, 2017 Category: Cardiology Source Type: research

Local activation time sampling density for atrial tachycardia contact mapping: how much is enough?
AbstractAimsLocal activation time (LAT) mapping forms the cornerstone of atrial tachycardia diagnosis. Although anatomic and positional accuracy of electroanatomic mapping (EAM) systems have been validated, the effect of electrode sampling density on LAT map reconstruction is not known. Here, we study the effect of chamber geometry and activation complexity on optimal LAT sampling density using a combinedin silico andin vivo approach.Methods and resultsIn vivo 21 atrial tachycardia maps were studied in three groups: (1) focal activation, (2) macro-re-entry, and (3) localized re-entry.In silico activation was simulated on a...
Source: Europace - April 3, 2017 Category: Cardiology Source Type: research

New surgical approach to implantation of the subcutaneous implantable cardioverter-defibrillator
This editorial refers to ‘Intermuscular technique for implantation of the subcutaneous implantable cardioverter defibrillator: long-term performance and complications’ by J. Winteret al., on pages 2036 –2041. (Source: Europace)
Source: Europace - April 3, 2017 Category: Cardiology Source Type: research

Median nerve stimulation prevents atrial electrical remodelling and inflammation in a canine model with rapid atrial pacing
ConclusionsThe effects of MNS on atrial electrical remodelling and AF inducibility might be associated with the cholinergic anti-inflammatory pathway. (Source: Europace)
Source: Europace - March 31, 2017 Category: Cardiology Source Type: research

Infective endocarditis after cardiac implantable electronic device implantation: incidence and associated mortality ‘The real path to enlightenment starts with recognition’. Buddha
This editorial refers to ‘Infective endocarditis and risk of death after cardiac implantable electronic device implantation: a nationwide cohort study’ by C. Özcanet al., on pages 1007 –1014. (Source: Europace)
Source: Europace - March 31, 2017 Category: Cardiology Source Type: research

Cryoballoon dysfunction indicated by abrupt temperature drop during atrial fibrillation ablation
A 46-year-old male patient with symptomatic, paroxysmal atrial fibrillation underwent cryoballoon ablation. During cryolesion delivery at the right inferior pulmonary vein, an abrupt and rapid temperature decline was noted from −42°C to −72°C within 7 s (Figure). Ablation was terminated, but retraction of the cryocatheter within the sheath was not feasible. The cryoballoon catheter and the sheath had to be retractedenbloc to the right atrium. Visual inspection demonstrated a kink in the shaft and inability to fully unwrap the balloon (Figure). The patient ’s in-hospital course remained unev...
Source: Europace - March 30, 2017 Category: Cardiology Source Type: research