Taking the heavy load off Arrhythmogenic Right Ventricular Cardiomyopathy
Rare disease require specific therapy, which may include repurposing of existing treatments. While this paradigm has been successfully implemented in oncology, cardiovascular therapies are currently still aimed at large, broadly defined patient groups, e.g. “heart failure with reduced ejection fraction”. In the cardiovascular field, genetically conferred cardiomyopathies have the potential to become exemplars for the development of specific therapies. Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is a rare, genetically conferred cardiomyop athy and one of the most common causes of sudden death and vent...
Source: Heart Rhythm - April 17, 2021 Category: Cardiology Authors: Larissa Fabritz, Monica Patten, Paulus Kirchhof Source Type: research

Omissions and Misconceptions on Vein of Marshall Ethanol
Krisai et al. ’s description of their approach to vein of Marshall (VOM) ethanol infusion1 contains omissions and misconceptions. (Source: Heart Rhythm)
Source: Heart Rhythm - April 13, 2021 Category: Cardiology Authors: Miguel Valderr ábano, Jose L. Baez-Escudero, Kaoru Okishige Source Type: research

Response to “Omissions and Misconceptions on Vein of Marshall Ethanol”
We thank Valderr ábano et al for their letter to the editor. (Source: Heart Rhythm)
Source: Heart Rhythm - April 13, 2021 Category: Cardiology Authors: Philipp Krisai, M élèze Hocini Source Type: research

A novel pathogenic role for galectin-3 in early disease stages of arrhythmogenic cardiomyopathy
Arrhythmogenic cardiomyopathy (AC) is a myocardial disease due to desmosomal mutations, whose pathogenesis remains incompletely understood. (Source: Heart Rhythm)
Source: Heart Rhythm - April 12, 2021 Category: Cardiology Authors: Marco Cason, Rudy Celeghin, Maria Bueno Marinas, Giorgia Beffagna, Mila DellaBarbera, Stefania Rizzo, Carol Ann Remme, Connie Bezzina, Natascia Tiso, Barbara Bauce, Gaetano Thiene, Cristina Basso, Kalliopi Pilichou Source Type: research

Cardiac Potassium Inward Rectifier Kir2: Review of Structure, Regulation, Pharmacology and Arrhythmogenesis
Potassium inward rectifier channel Kir2 is an important component of terminal cardiac repolarization and resting membrane stability. This functionality is part of balanced cardiac excitability and is a defining feature of excitable cardiac membranes. “Gain”- or “loss-of-function” mutations in KCNJ2, the gene encoding Kir2.1, cause genetic sudden cardiac death syndromes, and loss of Kir2 current, IK1, is a major contributing factor to arrhythmogenesis in failing human hearts. Here we provide a contemporary review of the Kir2 channels’ f unctional structure, physiology and pharmacology. (Source: Heart Rhythm)
Source: Heart Rhythm - April 12, 2021 Category: Cardiology Authors: Louise Reilly, Lee Eckhardt Source Type: research

Flecainide-Induced QRS Complex Widening Correlates with Negative Inotropy
The negative inotropic effect of Class IC antiarrhythmic drugs limits their use for acute cardioversion of atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - April 10, 2021 Category: Cardiology Authors: Ana B. Rabelo Evangelista, Felipe R. Monteiro, Bruce D. Nearing, Luiz Belardinelli, Richard L. Verrier Source Type: research

The “Guidant Affair”: Little Has Changed Since Joshua’s Death
In regard to The “Guidant Affair”: 15 years later,1 I disagree with the authors’ conclusion that now there is “greater transparency (and more effective communication) with independent advisory boards and effective product performance reports.” (Source: Heart Rhythm)
Source: Heart Rhythm - April 10, 2021 Category: Cardiology Authors: Robert G. Hauser Source Type: research

Cardiac Afferent Signaling Partially Underlies Premature Ventricular Contraction-Induced Cardiomyopathy
The mechanisms underlying premature ventricular contraction (PVC)-induced cardiomyopathy remain unknown. Transient receptor potential vanilloid 1 (TRPV1) afferent fibers are implicated in the reflex processing of cardiac stress. (Source: Heart Rhythm)
Source: Heart Rhythm - April 9, 2021 Category: Cardiology Authors: Yuichi Hori, Taro Temma, Christian Wooten, Christopher Sobowale, Christopher Chan, Mohammed Swid, Olujimi A. Ajijola Source Type: research

EP News Clinical April 2021
Replacement Myocardial Fibrosis in Patients with Mitral Valve Prolapse (Source: Heart Rhythm)
Source: Heart Rhythm - April 9, 2021 Category: Cardiology Authors: N. A. Mark Estes Source Type: research

EP News: Case Reports,
Parahisian pacing to unmask Brugada pattern with concomitant left bundle branch block and to document epicardial ablation endpoint in Brugada syndrome (Source: Heart Rhythm)
Source: Heart Rhythm - April 9, 2021 Category: Cardiology Authors: T. Jared Bunch Source Type: research

Diagnosis and Ablation of Atrial flutter: The Prototypical Reentrant Atrial Arrhythmia
Following the first reports of using radiofrequency energy to ablate accessory pathways causing pre-excitation syndromes (including orthodromic atrio-ventricular tachycardia) by Jackman, et.al. and Calkins, et.al. in 19911,2, radiofrequency catheter ablation (RFCA) has rapidly and widely been adapted to ablate other arrhythmias in the atria and eventually the ventricles. This included the ablation of the cavo-tricuspid isthmus (CTI) for the treatment of atrial flutter (AFL), the first reports of which we published in 1992 in Circulation. (Source: Heart Rhythm)
Source: Heart Rhythm - April 9, 2021 Category: Cardiology Authors: Gregory K. Feld Source Type: research

EP News: Allied Professionals,
The authors (Constant Dit Beaufils et al. Circulation 2021. doi: 10.1161/CIRCULATIONAHA.120.050214. Online ahead of print. PMID: 33706538) sought to assess the relationship of myocardial fibrosis detected on cardiac MRI (CMR) to outcome in a large group of patients with mitral valve prolapse (MVP). All patients had MVP and trace to severe mitral regurgitation (MR) and underwent standard transthoracic echocardiography (TTE), CMR, and 24 hour Holter to assess baseline premature ventricular contraction (PVC) burden, with frequent PVCs defined as>1% burden. (Source: Heart Rhythm)
Source: Heart Rhythm - April 8, 2021 Category: Cardiology Authors: Erica S. Zado Source Type: research

Sporadic High Pacing and Shock Impedance at Remote Monitoring in Hybrid Implantable Cardioverter Defibrillators Systems: Clinical Impact and Management
Sporadic high impedance values without other anomalies have been recently described by remote monitoring for hybrid cardiac implantable electronic device (CIED) systems. The clinical significance and related hazard of this phenomenon are not fully understood. (Source: Heart Rhythm)
Source: Heart Rhythm - April 7, 2021 Category: Cardiology Authors: Carlo Pignalberi, Marco Valerio Mariani, Antonello Castro, Agostino Piro, Barbara Magris, Bruno Albano, Stefano Aquilani, Michele Magnocavallo, Furio Colivicchi, Francesco Fedele, Carlo Lavalle Source Type: research

Validation of an Algorithm for Continuous Monitoring of Atrial Fibrillation Using a Consumer Smartwatch
Consumer devices with broad reach may be useful for screening for atrial fibrillation (AF) in appropriate populations. However, currently there are no consumer devices capable of continuous monitoring for AF. (Source: Heart Rhythm)
Source: Heart Rhythm - April 7, 2021 Category: Cardiology Authors: Robert Avram, Mattheus Ramsis, Ashley D. Cristal, Viswam Nathan, Li Zhu, Jacob Kim, Jilong Kuang, Alex Gao, Eric Vittinghoff, Linnea Rohdin-Bibby, Sara Yogi, Emina Seremet, Valerie Carp, Fabio Badilini, Mark J. Pletcher, Gregory M. Marcus, David Mortara, Source Type: research

Low-Temperature Electrocautery for Secondary Cardiac Implantable Electronic Device Implantation: Are We Ready for Their Routine Clinical Application?
Cardiac implantable electronic devices (CIEDs) represent an important therapeutic modality in management of patients with various rhythm disorders. As a result of aging population and increased prevalence of cardiovascular co-morbidities, the magnitude of CIED implants continues to follow an upward trajectory. For example, an analysis of United States National Inpatient Sample database from years 1993-2008 showed an exponential 96% increased rate of CIED implantations over the study years (1). This increase was experienced for both pacemakers and implantable cardioverter defibrillator (ICDs) devices. (Source: Heart Rhythm)
Source: Heart Rhythm - April 7, 2021 Category: Cardiology Authors: Muhammad Bilal Munir, Ulrika Birgersdotter-Green Source Type: research

Anti-diabetic drugs for preventing atrial fibrillation: a new revolution?
Type 2 diabetes mellitus (DM) and atrial fibrillation (AF) are two of the great epidemics of our time. DM affects and estimated 8.5% of adults in the US1, and is associated with an increased risk of cardiovascular events, including AF.2 AF in turn affects an estimated up to 12.5% of adults over age 65 years in the US, decreases quality of life and increases the risks of heart failure, stroke and death 3,4. In 2015, the EMPA-REG OUTCOME randomized controlled trial (RCT), assessing a sodium glucose co-transporter 2 inhibitor (SGLT-2i), sparked interest in the therapeutic potential for oral anti-diabetic agents to reduce card...
Source: Heart Rhythm - April 7, 2021 Category: Cardiology Authors: William F. McIntyre, Jeff S. Healey Source Type: research

Electrical Storm in Patients with Left Ventricular Assist Devices: Risk Factors, Incidence, and Impact on Survival
Ventricular arrhythmias (VAs) and electrical storm (ES) are recognized complications following left ventricular assist device (LVAD) implantation, although their association with long term outcomes remains poorly understood. (Source: Heart Rhythm)
Source: Heart Rhythm - April 7, 2021 Category: Cardiology Authors: Michael R. Rehorn, Eric Black-Maier, Rahul Loungani, Sounok Sen, Albert Y. Sun, Daniel J. Friedman, Jason I. Koontz, Jacob N. Schroder, Carmelo A. Milano, Michel G. Khouri, Jason N. Katz, Chetan B. Patel, Sean D. Pokorney, James P. Daubert, Jonathan P. Pi Source Type: research

Left-axis deviation in patients with nonischemic heart failure and left bundle branch block is a purely electrical phenomenon
Possible mechanisms of left-axis deviation (LAD) in the setting of left bundle branch block (LBBB) include differences in cardiac electrophysiology, structure, or anatomic axis. (Source: Heart Rhythm)
Source: Heart Rhythm - April 5, 2021 Category: Cardiology Authors: Saer Abu-Alrub, Marc Strik, Peter Huntjens, F. Daniel Ramirez, Mark Potse, Hubert Cochet, Hugo Marchand, Samuel Buliard, Romain Eschalier, Michel Ha ïssaguerre, Pierre Bordachar, Sylvain Ploux Source Type: research

"Strategy after Vein of Marshall Ethanol Infusion added to catheter ablation of persistent atrial fibrillation: please, follow the line"
Catheter ablation is an established treatment strategy for patients with drug-refractory atrial fibrillation (AF). However, the success rates in patients with persistent AF remain modest. Current ablation strategies for treatment of persistent AF can be broadly categorized into tailored approaches, aimed at eliminating sources of AF maintenance, and anatomic approaches in which the left atrium (LA) is electrically partitioned by predefined linear lesion sets. Although effective at terminating AF in the acute setting, tailored approaches have been associated with a high risk of subsequent organized atrial tachycardias (ATs)...
Source: Heart Rhythm - April 5, 2021 Category: Cardiology Authors: Nicolas Derval, Thomas Pambrun, Michel Ha ïssaguerre Source Type: research

Left axis deviation in patients with non-ischemic heart failure and left bundle branch block is a purely electrical phenomenon
Possible mechanisms of left axis deviation (LAD) in the setting of left bundle branch block (LBBB) include differences in cardiac electrophysiology, structure, or anatomical axis. (Source: Heart Rhythm)
Source: Heart Rhythm - April 5, 2021 Category: Cardiology Authors: Saer Abu-Alrub, Marc Strik, Peter Huntjens, F. Daniel Ramirez, Mark Potse, Hubert Cochet, Hugo Marchand, Samuel Buliard, Romain Eschalier, Michel Ha ïssaguerre, Pierre Bordachar, Sylvain Ploux Source Type: research

Persistent Atrial Fibrillation Ablation in Cardiac Laminopathy: Electrophysiological Findings and Clinical Outcomes
Little is known about persistent atrial fibrillation (AF) ablation in patients with cardiac laminopathy (CLMNA). (Source: Heart Rhythm)
Source: Heart Rhythm - March 31, 2021 Category: Cardiology Authors: R émi Chauvel, Nicolas Derval, Josselin Duchateau, Arnaud Denis, Romain Tixier, Nicolas Welte, Clémentine André, F. Daniel Ramirez, Takashi Nakashima, Yosuke Nakatani, Tsukasa Kamakura, Takamitsu Takagi, Philipp Krisai, Ghassen Cheniti, Konstantinos Vl Source Type: research

Diagnosis and cure of supraventricular tachycardia
The seminal work of Dr Mel Scheinman marked the onset of the era of catheter ablation, a major advance in the management of patients with various arrhythmias.1 In the early 1980s, direct current (DC) shocks were initially used to create third-degree atrioventricular (AV) block in patients with atrial fibrillation and an uncontrolled ventricular rate or drug-refractory AV nodal reentrant tachycardia associated with severe symptoms. Targets for DC ablation gradually expanded to include posteroseptal accessory pathways (APs) and ventricular tachycardia, both idiopathic and postinfarction. (Source: Heart Rhythm)
Source: Heart Rhythm - March 29, 2021 Category: Cardiology Authors: Fred Morady Tags: Viewpoint Source Type: research

COVID-19 does not only disturb our social rhythm
With 10 vaccines currently approved and another 81 potentially to be approved in the coming months, the focus on the coronavirus disease 2019 (COVID-19) pandemic has changed from confinement to elimination. However, it is a known viral law that when the going gets tough, the tough get going, with natural selection bringing forth the most favorable mutations. Among these, the most worrying were found in South Africa, Brazil, and the United Kingdom, of which the latter initially has been designated as a “variant of concern.” Early research shows that mutations in these variants might (partly) escape the immune re...
Source: Heart Rhythm - March 29, 2021 Category: Cardiology Authors: Arthur A.M. Wilde, Joost Allard Offerhaus Tags: Editorial Commentary Source Type: research

Differentiating atrial tachycardias with centrifugal activation: Lessons from high-resolution mapping
A centrifugal activation is not always the origin of a focal-AT (True-Focal), but a passive activation from the other structures (Pseudo-Focal). (Source: Heart Rhythm)
Source: Heart Rhythm - March 29, 2021 Category: Cardiology Authors: Masateru Takigawa, Takamitsu Takagi, Claire A. Martin, Nicolas Derval, Arnaud Denis, Konstantinos Vlachos, Ghassen Cheniti, Josselin Duchateau, Thomas Pambrun, Yasuhiro Shirai, Susumu Tao, Yoshihide Takahashi, Masahiko Goya, Frederic Sacher, Hubert Cochet Source Type: research

Depolarization of the atrial resting membrane potential as an approach to enhance the anti –atrial fibrillation efficacy of sodium channel blockers
Antiarrhythmic agents are often used for rhythm-control therapy in patients with atrial fibrillation (AF). The development of more effective and/or safe anti-AF agents is desirable. Among the prominent investigational anti-AF pharmacological approaches proposed during the past 30 years, only atrial-selective inhibition of the sodium channel current (INa) has been shown to be valid in terms of efficacy and safety in both experimental and clinical studies.1 –4 Of note, atrial-selective prolongation of the effective refractory period (ERP) and anti-AF efficacy of the ultra-rapid delayed rectified potassium current and t...
Source: Heart Rhythm - March 26, 2021 Category: Cardiology Authors: Alexander Burashnikov Source Type: research

Relationship of paced left bundle branch pacing morphology with anatomic location and physiological outcomes
Left bundle branch pacing (LBBP) is an emerging physiological pacing modality. However, little is known about pacing at different locations on the left bundle branch (LBB). (Source: Heart Rhythm)
Source: Heart Rhythm - March 26, 2021 Category: Cardiology Authors: Jinxuan Lin, Qingyun Hu, Keping Chen, Yan Dai, Ruohan Chen, Qi Sun, Yu ’an Zhou, Lirong Yan, Wenzhao Lu, Yao Li, Yuanhao Jin, Feng Chen, Michael R. Gold, Shu Zhang Source Type: research

Transvenous lead extraction in 1000 patients guided by intraprocedural risk stratification without surgical backup
Transvenous lead extraction (TLE) carries a significant risk of morbidity and mortality. Reliable preprocedural risk predictors to guide resource allocation and optimize procedural safety are lacking. (Source: Heart Rhythm)
Source: Heart Rhythm - March 26, 2021 Category: Cardiology Authors: Ziad F. Issa Source Type: research

Global approaches to cardiogenetic evaluation after sudden cardiac death in the young: A survey among healthcare professionals
Thorough investigation of sudden cardiac death (SCD) in those aged 1-40 years commonly reveals a heritable cause, yet access to postmortem genetic testing is variable. (Source: Heart Rhythm)
Source: Heart Rhythm - March 26, 2021 Category: Cardiology Authors: Lieke M. van den Heuvel, Judy Do, Laura Yeates, Heather MacLeod, Cynthia A. James, Johan Duflou, Jonathan R. Skinner, Christopher Semsarian, J.Peter van Tintelen, Jodie Ingles Source Type: research

Depolarization of the atrial resting membrane potential as an approach to enhance anti-atrial fibrillation efficacy of sodium channel blockers
Anti-arrhythmic agents are often used for rhythm control therapy in patients with atrial fibrillation (AF). The development of more effective and/or safe anti-AF agents is desirable. Among the prominent investigational anti-AF pharmacological approaches proposed during the past 30 years, only atrial-selective inhibition of the sodium channel current (INa) has been shown to be valid in terms of efficacy and safety in both experimental and clinical studies.1-4 Note, atrial-selective prolongation of ERP and anti-AF efficacy of the ultra-rapid delayed rectified potassium current (IKur) and the small-conductance calcium-activat...
Source: Heart Rhythm - March 26, 2021 Category: Cardiology Authors: Alexander Burashnikov Source Type: research

Transvenous lead extraction in 1,000 patients guided by intraprocedural risk stratification without surgical backup
Transvenous lead extraction (TLE) carries a significant risk of morbidity and mortality. Reliable preprocedural risk predictors to guide resource allocation and optimize procedural safety are lacking. (Source: Heart Rhythm)
Source: Heart Rhythm - March 26, 2021 Category: Cardiology Authors: Ziad F. Issa Source Type: research

Low-temperature electrocautery reduces adverse effects from secondary cardiac implantable electronic device procedures: Insights from the WRAP-IT Trial
Cardiac device procedures require tissue dissection to free existing device lead(s). Common techniques include blunt dissection, standard electrocautery, or low-temperature electrocautery (PlasmaBladeTM); however, data on the type of electrosurgical tool used and the development of procedure- or lead-related adverse events are limited. (Source: Heart Rhythm)
Source: Heart Rhythm - March 26, 2021 Category: Cardiology Authors: Suneet Mittal, Bruce L. Wilkoff, Jeanne E. Poole, Charles Kennergren, David J. Wright, Brett J. Berman, David Riggio, Darius P. Sholevar, Joaquin Martinez-Arraras, Jean B. Moubarak, Robert D. Schaller, John C. Love, Robert A. Pickett, Francois Philippon, Source Type: research

The Relationship of Paced Left Bundle Branch Pacing Morphology with Anatomic Location and Physiologic Outcomes
Left bundle branch pacing (LBBP) is an emerging physiologic pacing modality. However, little is known regarding pacing at different locations on the LBB. (Source: Heart Rhythm)
Source: Heart Rhythm - March 26, 2021 Category: Cardiology Authors: Jinxuan Lin, Qingyun Hu, Keping Chen, Yan Dai, Ruohan Chen, Qi Sun, Yu ’an Zhou, Lirong Yan, Wenzhao Lu, Yao Li, Yuanhao Jin, Feng Chen, Michael R. Gold, Shu Zhang Source Type: research

Demonstration of left bundle capture: Timing is everything
In this issue of Heart Rhythm Journal, Jastrz ębski et al1 present novel electrocardiographic (ECG) criteria for determining left bundle branch (LBB) capture. They compared native conduction to nonselective and selective LBB capture as well as to local septal capture. In an analysis of 124 patients, they validated their hypothesis that the ti me measured from QRS onset to peak R wave in lead V6 (R-wave peak time [RWPT]) during LBB capture equals that in normal sinus rhythm, with high degrees of sensitivity and specificity. (Source: Heart Rhythm)
Source: Heart Rhythm - March 25, 2021 Category: Cardiology Authors: Rahul N. Doshi Tags: EDITORIAL COMMENTARY Source Type: research

Vein of Marshall ethanol infusion in the treatment of atrial fibrillation: From concept to clinical practice
The vein of Marshall (VOM) contains innervation, myocardial connections, and arrhythmogenic foci that make it an attractive target in catheter ablation of atrial fibrillation (AF). Additionally, it co-localizes with the mitral isthmus, which is critical to sustain perimitral flutter, and is a true atrial vein that communicates with underlying myocardium. Retrograde balloon cannulation of the VOM from the coronary sinus is feasible and allows for ethanol delivery, which results in rapid ablation of neighboring myocardium and its innervation. (Source: Heart Rhythm)
Source: Heart Rhythm - March 25, 2021 Category: Cardiology Authors: Miguel Valderr ábano Tags: Contemporary Review Source Type: research

EDITORIAL COMMENTARY Demonstration of left bundle capture: Timing is everything
In this issue of Heart Rhythm Journal, Jastrz ębski et al1 present novel electrocardiographic (ECG) criteria for determining left bundle branch (LBB) capture. They compared native conduction to nonselective and selective LBB capture as well as to local septal capture. In an analysis of 124 patients, they validated their hypothesis that the ti me measured from QRS onset to peak R wave in lead V6 (R-wave peak time [RWPT]) during LBB capture equals that in normal sinus rhythm, with high degrees of sensitivity and specificity. (Source: Heart Rhythm)
Source: Heart Rhythm - March 25, 2021 Category: Cardiology Authors: Rahul N. Doshi Source Type: research

EDITORIAL COMMENTARY Leadless intracardiac pacemakers: MACE, including death, in context
The story of leadless pacing began some 50 years ago.1,2 Over the past decade, technological advancements, including circuit miniaturizations, improved battery technology and electrodes, and sophisticated fixation mechanisms, have facilitated development. (Source: Heart Rhythm)
Source: Heart Rhythm - March 25, 2021 Category: Cardiology Authors: Dwight W. Reynolds Source Type: research

Defining Idiopathic Ventricular Fibrillation: A Systematic Review of Diagnostic Testing Yield in Apparently Unexplained Cardiac Arrest
Idiopathic ventricular fibrillation (IVF) is diagnosed in patients with apparently unexplained cardiac arrest (UCA) after varying degrees of evaluation. This is largely due to the lack of a standardized approach to UCA. (Source: Heart Rhythm)
Source: Heart Rhythm - March 25, 2021 Category: Cardiology Authors: Wael Alqarawi, Omar Dewidar, Rafik Tadros, Jason D. Roberts, Christian Steinberg, Ciorsti J. MacIntyre, Zachary W.M. Laksman, Martin S. Green, Girish Nair, George Wells, Andrew D. Krahn Source Type: research

Vein of Marshall Ethanol Infusion in the Treatment of Atrial Fibrillation From Concept to Clinical Practice
The vein of Marshall (VOM) contains innervation, myocardial connections, and arrhythmogenic foci that make it an attractive target in catheter ablation of atrial fibrillation. Additionally, it co-localizes with the mitral isthmus, critical to sustain perimitral flutter, and is a true atrial vein that communicates with underlying myocardium. Retrograde balloon cannulation of the VOM from the coronary sinus is feasible and allows for ethanol delivery, which results in rapid ablation of neighboring myocardium and its innervation. (Source: Heart Rhythm)
Source: Heart Rhythm - March 25, 2021 Category: Cardiology Authors: Miguel Valderr ábano Source Type: research

Demonstration of Left Bundle Capture —Timing is Everything
In this issue of the Journal, Jastrzebski and colleagues have presented a novel ECG criteria for determining left bundle branch (LBB) capture1. They compared native conduction to non-selective and selective LBB capture as well as to local septal capture. They validated their hypothesis in 124 patients that the time measured from QRS onset to the peak R wave in lead V6 (RWPT) during LBB capture equals that in normal sinus rhythm with a high degree of both sensitivity and specificity. Moreover, they established a cut-off value for RWPT of 74 ms that was 100% specific for LBB capture. (Source: Heart Rhythm)
Source: Heart Rhythm - March 25, 2021 Category: Cardiology Authors: Rahul N. Doshi Source Type: research

Leadless Intracardiac Pacemakers: MACE, including Death, in Context
The story of leadless pacing began some 50 years ago1,2. Over the past decade, technological advancements including circuit miniaturizations, improved battery technology, improved electrodes and, sophisticated fixation mechanisms have facilitated development. (Source: Heart Rhythm)
Source: Heart Rhythm - March 25, 2021 Category: Cardiology Authors: Dwight W. Reynolds Source Type: research

Erratum
In the article titled “Blood-based 8-hydroxy-2’-deoxyguanosine level: a potential diagnostic biomarker for atrial fibrillation” that was published in the February 2021 issue of Heart Rhythm (2021:18:271-277). Figure 1 was incorrect. The correct figure is given below. The publisher regrets this error. (Source: Heart Rhythm)
Source: Heart Rhythm - March 20, 2021 Category: Cardiology Tags: Erratum Source Type: research

Association of SGLT2 Inhibitors with Arrhythmias and Sudden Cardiac Death in Patients with Type 2 Diabetes or Heart Failure: A Meta-Analysis of 34 Randomized Controlled Trials
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce hospitalizations and death from heart failure (HF), but their effect on arrhythmia expression has been poorly investigated. (Source: Heart Rhythm)
Source: Heart Rhythm - March 20, 2021 Category: Cardiology Authors: Gilson C. Fernandes, Amanda Fernandes, Rhanderson Cardoso, Jorge Penalver, Leonardo Knijnik, Raul D. Mitrani, Robert J. Myerburg, Jeffrey J. Goldberger Source Type: research

Amiodarone During Ventricular Tachycardia Ablation: A Total Eclipse of the Heart?
Sustained ventricular tachycardia (VT) causes significant morbidity and mortality in patients with structural heart disease.1 While implantable cardioverter-defibrillators (ICDs) are effective in terminating VT and reducing arrhythmic death risk, ICD shocks negatively impact quality of life and are associated with increased morbidity and mortality.2 –4 Catheter ablation is an effective modality for controlling VT and is superior in decreasing VT burden and ICD therapies compared to medical therapy. (Source: Heart Rhythm)
Source: Heart Rhythm - March 19, 2021 Category: Cardiology Authors: Jos é M. Sanchez, Wendy S. Tzou Source Type: research

Significance of Manifest Localized Staining during Ethanol Infusion into the Vein of Marshall
Localized staining due to venule injury is one of the incidents attributable to ethanol infusion into the vein of Marshall (Et-VOM). (Source: Heart Rhythm)
Source: Heart Rhythm - March 16, 2021 Category: Cardiology Authors: Takamitsu Takagi, Thomas Pambrun, Takashi Nakashima, Konstantinos Vlachos, Cl émentine André, Philipp Krisai, F. Daniel Ramirez, Tsukasa Kamakura, Yosuke Nakatani, Ghassen Cheniti, Romain Tixier, Remi Chauvel, Josselin Duchateau, Frédéric Sacher, Hube Source Type: research

Atrial resting membrane potential confers sodium current sensitivity to propafenone, flecainide and dronedarone
Although atrial fibrillation ablation is increasingly used for rhythm control therapy, antiarrhythmic drugs (AADs) are commonly used, either alone or in combination with ablation. The effectiveness of AADs is highly variable. Previous work from our group suggests that alterations in atrial resting membrane potential (RMP) induced by low Pitx2 expression could explain the variable effect of flecainide. (Source: Heart Rhythm)
Source: Heart Rhythm - March 15, 2021 Category: Cardiology Authors: Andrew P. Holmes, Priyanka Saxena, S. Nashitha Kabir, Christopher O ’Shea, Stefan M. Kuhlmann, Suranjana Gupta, Dannie Fobian, Clara Apicella, Molly O’Reilly, Fahima Syeda, Jasmeet S. Reyat, Godfrey L. Smith, Antony J. Workman, Davor Pavlovic, Larissa Source Type: research

Effect of ivabradine on cardiac arrhythmias: Antiarrhythmic or proarrhythmic?
Cardiac arrhythmias are a major source of mortality and morbidity. Unfortunately, their treatment remains suboptimal. Major classes of antiarrhythmic drugs pose a significant risk of proarrhythmia, and their side effects often outweigh their benefits. Therefore, implantable devices remain the only truly effective antiarrhythmic therapy, and new strategies of antiarrhythmic treatment are required. Ivabradine is a selective heart rate –reducing agent, an inhibitor of hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels, currently approved for treatment of coronary artery disease and chronic heart failure...
Source: Heart Rhythm - March 15, 2021 Category: Cardiology Authors: Mariusz Marciszek, Aleksandra Paterek, Marta Okni ńska, Zuzanna Zambrowska, Urszula Mackiewicz, Michał Mączewski Tags: Contemporary Review Source Type: research

Letter to the Editor —Electrophysiological Study in Women with Brugada Syndrome
The results of the study by Rodr íguez-Mañero et al1 are in line with those reported by the two other most active groups in the field of Brugada syndrome (BrS).2,3 All three have confirmed the rare occurrence of malignant arrhythmic events (AEs), the lower prevalence of spontaneous type 1 BrS electrocardiogram (ECG), and the low er ventricular fibrillation (VF) inducibility rate in female patients with BrS. Similar to the Belgian2 and French3 reports, the Spanish study did not find that VF inducibility can be used for predicting arrhythmic risk in female patients. (Source: Heart Rhythm)
Source: Heart Rhythm - March 15, 2021 Category: Cardiology Authors: Bernard Belhassen, Giulio Conte Tags: Letters to the Editor Source Type: research

Reply to the Editor —Electrophysiologic Study in Women with Brugada Syndrome
We thank Belhassen and Conte for their interest in our study.1 We agree with all points raised in their letter. As they remark, the results of our study are in line with previous data, once again emphasizing the rarity of malignant event occurrence. This finding is somewhat encouraging for patients with Brugada syndrome (BrS) and their treating physicians. Additionally, there are discernible gender differences related to the frequency of ventricular fibrillation (VF) inducibility and the incidence of spontaneous type 1 electrocardiogram pattern. (Source: Heart Rhythm)
Source: Heart Rhythm - March 15, 2021 Category: Cardiology Authors: Mois és Rodríguez-Mañero, Elena Arbelo, Josep Brugada Source Type: research

Rate-dependent left ventricular filling time: A critical factor for adequate cardiac output
In patients with heart failure and in the elderly, changes in ventricular rate are a major determinant of cardiac output. In these patients, the range of effective ventricular contractions is markedly reduced than in young and normal adults in whom faster heart rates are well tolerated and contribute to increased cardiac output, particularly in conditions characterized by high adrenergic tone. The picture becomes even more complex when atrial fibrillation develops. The loss of atrial contraction, which reduces ventricular filling and the occurrence of left ventricular desynchronization often induced by fast ventricular rat...
Source: Heart Rhythm - March 15, 2021 Category: Cardiology Authors: Federico Lombardi Source Type: research

Atrial resting membrane potential confers sodium current sensitivity to propafenone, flecainide, and dronedarone
Although atrial fibrillation ablation is increasingly used for rhythm control therapy, antiarrhythmic drugs (AADs) are commonly used, either alone or in combination with ablation. The effectiveness of AADs is highly variable. Previous work from our group suggests that alterations in atrial resting membrane potential (RMP) induced by low Pitx2 expression could explain the variable effect of flecainide. (Source: Heart Rhythm)
Source: Heart Rhythm - March 15, 2021 Category: Cardiology Authors: Andrew P. Holmes, Priyanka Saxena, S. Nashitha Kabir, Christopher O ’Shea, Stefan M. Kuhlmann, Suranjana Gupta, Dannie Fobian, Clara Apicella, Molly O’Reilly, Fahima Syeda, Jasmeet S. Reyat, Godfrey L. Smith, Antony J. Workman, Davor Pavlovic, Larissa Source Type: research