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

21 Thromboembolic events in left ventricular endocardial pacing: long-term outcomes from a Multicentre UK registry
We examined if the long-term thromboembolic risk in this cohort is significant and related to any patient or procedural characteristics. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

2 A multi-centre study into the use of Ripple Mapping to differentiate atrial scar from conducting tissue during tachycardia ablation
Background: Atrial tachycardias (AT) that occur following previous ablation arise secondary to iatrogenic scar predisposing to reentry. There exists no bipolar voltage threshold that defines scar with 3D mapping. Ripple Mapping (RM), developed in our institution, displays each mapped electrogram (EGM) as a moving bar at its acquired 3D location relative to a stable fiducial reference, and is displayed over a bipolar voltage map. We developed an approach to differentiate atrial scar from conducting tissue using RM as a guide to ablation, and tested this approach in new users mapping post-AF-ablation ATs. (Source: Europace)
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

1 Non-invasive detection of exercise induced cardiac conduction abnormalities in sudden cardiac death survivors in the inherited arrhythmic syndromes
Introduction: Rate adaptation of the action potential ensures spatial heterogeneities in conduction across the myocardium are minimised at different heart rates which provides a physiologically protective mechanism against the development of ventricular fibrillation (VF) and sudden cardiac death (SCD). Whilst beat to beat whole heart activation patterns may be characterised with current electroanatomical mapping techniques, quantifying these changes remains a challenge. We developed a method to rapidly quantify changes in ventricular activation in response to rate cycle length changes as a surrogate for abnormalities in ra...
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

Arrhythmogenic right ventricular cardiomyopathy: implications of next-generation sequencing and of miRNAs regulation in appropriate understanding and treatment
We read the article by Medeiros-Domingoet al.1 with great interest and congratulate the authors on their excellent work. As the authors correctly state, currently, nearly 40% of the patients with an arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC) phenotype according to the task force 2010 criteria remain genetically elusive. By using whole-exome sequencing and analysing the protein coding exons and flanking splice sites of 96 genes associated with cardiomyopathies and channelopathies, they found rare genetic variants that may explain the phenotype in 64% of the cases.1 However, we would like to call attent...
Source: Europace - October 4, 2017 Category: Cardiology Source Type: research

Migration of an ‘injectable’ loop recorder in the dorsal pleural cavity
The BioMonitor 2, Biotronik is provided with a specifically designed insertion tool set which allows easy sub-dermal insertion. Due to an excessive angle of penetration, of about 40 °, the pocket tool was inadvertently inserted in the 4° intercostal space until the pleural cavity. The implantable loop recorder was placed in a support tool and both were inserted together straight into the pre-shaped pocket. A latero-lateral Rx ray image showed that the loop recorder migrated i nto the left pleural cavity and was finally located in its postero-inferior recess. The device could be interrogated and properly programmed....
Source: Europace - September 28, 2017 Category: Cardiology Source Type: research

Estimation of the effects of multipoint pacing on battery longevity in routine clinical practice
AbstractAimsMultipoint pacing (MPP) permits simultaneous multisite pacing of the left ventricle (LV); initial studies suggest haemodynamic and clinical benefits over conventional (single LV site) cardiac resynchronization therapy (CRT). The aim of this study was to estimate the impact of MPP activation on battery longevity in routine clinical practice.Methods and resultsPatient (n = 46) and device data were collected from two centres at least 3 months after MPP-CRT device implantation. Multipoint pacing programming was based on the maximal possible anatomical LV1/LV2 separation according to three prede...
Source: Europace - September 23, 2017 Category: Cardiology Source Type: research

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation
AblationArrhythmiaAtrial fibrillationAtrial flutterAtrial tachycardiaCatheter ablationSurgical ablationStrokeAnticoagulation (Source: Europace)
Source: Europace - September 15, 2017 Category: Cardiology Source Type: research

2017  HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary
AblationArrhythmiaAtrial fibrillationAtrial flutterAtrial tachycardiaCatheter ablationSurgical ablationStrokeAnticoagulation (Source: Europace)
Source: Europace - September 15, 2017 Category: Cardiology Source Type: research

The double adenosine test: a simple and non-invasive tip to unmask unapparent pre-excitations: an example of Mahaim fibres
We report the case of a 16-year-old youth who was admitted for a wide QRS tachycardia caused by an atypical atriofascicular bypass tract (the so-called ‘Mahaim fibers’). These bypass tracts give rise to antidromic atrioventricular re-entrant tachycardias, in which the bypass tract serves as the anterograde limb of the circuit and the atrioventricular node as the retrograde limb of the re-entrant circuit. Unfortunately, in these patients, it is easy to make a misdiagnosis of supraventricular tachycardia with functional left bundle branch block or even of ventricular tachycardia. Indeed, due to the slow and decre...
Source: Europace - September 12, 2017 Category: Cardiology Source Type: research

Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulaci ón Cardíaca y Electrofisiología (SOLEACE)
AbstractAtrial fibrillation (AF) is a major worldwide public health problem, and AF in association with valvular heart disease (VHD) is also common. However, management strategies for this group of patients have been less informed by randomized trials, which have largely focused on ‘non-valvular AF’ patients. Thrombo-embolic risk also varies according to valve lesion and may also be associated with CHA2DS2VASc score risk factor components, rather than only the valve disease being causal. Given marked heterogeneity in the definition of valvular and non-valvular AF and variable management strategies, including no...
Source: Europace - August 30, 2017 Category: Cardiology Source Type: research

Gorenek B, et al. Device-detected subclinical atrial tachyarrhythmias: definition, implications and management –an European Heart Rhythm Association (EHRA) consensus document, endorsed by Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE)
[Europace doi:10.1093/europace/eux163] (Source: Europace)
Source: Europace - August 30, 2017 Category: Cardiology Source Type: research

Long-term impact of intrathoracic impedance findings on survival and heart failure hospitalizations after cardiac resynchronization therapy in ICD Registry patients
AbstractAimsTo determine adjusted associations among OptiVol® threshold crossings, long-term survival, and hospitalizations among heart failure (HF) patients with Medicare coverage in the United States.Methods and resultsA cohort with OptiVol®-enabled cardiac resynchronization therapy defibrillators (CRT-D) devices from the Implantable Cardioverter Defibrillator Registry was linked to both Medicare claims/summary data and Medtronic ’s CareLink® Network data. An extended multivariable Cox model was used to analyse associations among OptiVol® threshold crossings (treated as time-dependent covariates), m...
Source: Europace - August 25, 2017 Category: Cardiology Source Type: research

Guerra F, et al. Symptomatic atrial fibrillation and risk of cardiovascular events: data from the Euro Heart Survey
[Europace doi:10.1093/europace/eux205] (Source: Europace)
Source: Europace - August 24, 2017 Category: Cardiology Source Type: research

Pacemaker implantation and mortality: no role as a quality control indicator: Author ’s reply
We thank Dr Brough for her interest in our article. She provided additional data in her letter1 that further corroborate our findings i.e. mortality after device implantation (permanent pacemaker, ICD, CRT) is related to patients ’ underlying comorbid conditions including advanced age.2 Taken together, these data indicate that mortality is not a useful parameter for assessing and comparing quality or for public reporting of individual or institutional quality for device implantation. These findings highlight the need for future research to identify a more meaningful and robust marker to determine not only the quality...
Source: Europace - August 19, 2017 Category: Cardiology Source Type: research

How to prevent atrial oesophageal fistula following ablation of atrial fibrillation: are there actually any effective methods? —Authors’ reply
We would like to thank Dr Giulio Zucchelli and colleagues1 for their letter regarding our recent report, which highlighted atrial oesophageal fistula (AEF), a severe complication of atrial fibrillation (AF) catheter ablation, and presenting very high-mortality rate in that population.2 (Source: Europace)
Source: Europace - August 10, 2017 Category: Cardiology Source Type: research

To downgrade, or not to downgrade: that is the question
I have read with great interest the review paper entitled ‘Cardiac resynchronization therapy (CRT) device replacement considerations: upgrade or downgrade? A complex decision in the current clinical setting’ by Nakouet al. in the latest issue of the journal.1 They nicely summarized and commented on device selection at the time of replacement, considering patient ’s history, demographics, clinical characteristics, and currently available scientific knowledge. Some important issues, however, should be mentioned; (i) Super response to cardiac resynchronization therapy (CRT) seems as a remission process, not ...
Source: Europace - August 10, 2017 Category: Cardiology Source Type: research

The effect of ventricular pre-excitation on ventricular wall motion and left ventricular systolic function
Conclusion  Right-sided accessory pathways may impair ventricular wall motion and LV systolic function, resulting in decreased LV ejection fraction and increased LV end-diastolic diameter. These effects occurred in patients with LV dyssynchrony. These effects, including LV dyssynchrony, resolved after radiofrequency ablation. A right-sided free-wall accessory pathway may have more detrimental effects than a septal accessory pathway. Left ventricular dyssynchrony and abnormal interventricular septal motion appeared to be responsible for the pathogenesis of LV dysfunction and remodelling. (Source: Europace)
Source: Europace - August 9, 2017 Category: Cardiology Source Type: research

Association between socioeconomic factors and ICD implantation in a publicly financed health care system: a Danish nationwide study
AbstractAimsFor patients surviving out-of-hospital cardiac arrest (OHCA) with a shockable rhythm, implantable cardioverter defibrillator (ICD) is recommended for non-reversible causes of arrest. We aimed to determine factors associated with implantation of ICD and survival in patients surviving non-AMI OHCA in a nationwide register covering all OHCAs in Denmark.Methods and resultsWe identified 36  950 OHCAs between 2001 and 2012, 1700 of whom were ICD naïve, ≥18 years, of non-AMI cardiac aetiology and surviving until discharge. Six hundred fifty eight patients had ICD implanted during index admission....
Source: Europace - August 9, 2017 Category: Cardiology Source Type: research

Age and sex differences in atrial fibrosis among patients with atrial fibrillation
AbstractAimAge and female sex are associated with a higher risk of stroke in atrial fibrillation (AF). We sought to determine whether advancing age and female sex are associated with higher atrial fibrosis.Methods and results  We conducted an observational cohort study of patients with AF enrolled in the University of Utah AF Database and a non-AF control group who underwent late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) for atrial fibrosis quantification. Participants with contra-indications for contrast MRI scanning were excluded. Nine hundred and eight consecutive men and women with AF and 15 non-...
Source: Europace - August 9, 2017 Category: Cardiology Source Type: research