Safety and Outcomes of Catheter Ablation for Atrial Fibrillation in Adults with Congenital Heart Disease: A Multicenter Registry Study
An increasing number of adults with congenital heart disease (CHD) are undergoing catheter ablation for atrial fibrillation (AF). Data on ablation strategy and outcomes is limited in CHD. Rhythm control is often felt to be of greater importance among patients with complex CHD. (Source: Heart Rhythm)
Source: Heart Rhythm - December 26, 2018 Category: Cardiology Authors: Jackson J. Liang, David S. Frankel, Valay Parikh, Dhanujaya Lakkireddy, Sanghamitra Mohanty, J. David Burkhardt, Andrea Natale, Judit Szilagyi, Edward P. Gerstenfeld, Jeremy P. Moore, Kathryn K. Collins, Joseph D. Kay, Pasquale Santangeli, Francis E. Marc Source Type: research

EP News: Heart Rhythm Case Reports
Without evidence from a large randomized trial that evaluates His-bundle pacing compared with cardiac resynchronization therapy, the procedural benefits with His-bundle pacing associated with long-term risks and complications have been revealed primarily through registry, observational, case series, and case report data. One of the most common challenges with His-bundle pacing is elevated thresholds that can result in rapid battery depletion. Kim et  al (DOI: https://doi.org/10.1016/j.hrcr.2018.11.007) shared a case of a 68-year-old woman who presented with presyncope and 2:1 atrioventricular block. (Source: Heart Rhythm)
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

Cardiorenal status using amino-terminal pro –brain natriuretic peptide and cystatin C on cardiac resynchronization therapy outcomes: From the BIOCRT Study
Cardiorenal syndrome comprises a heterogeneous group of disorders characterized by acute or chronic cardiac and renal dysfunction. (Source: Heart Rhythm)
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: Quynh A. Truong, Jackie Szymonifka, James L. Januzzi, Jigar H. Contractor, Roderick C. Dea ño, Neal A. Chatterjee, Jagmeet P. Singh Source Type: research

Feasibility of complex transfemoral electrophysiology procedures in patients with inferior vena cava filters
The presence of inferior vena cava filters (IVCFs) has been considered a relative contraindication to electrophysiology (EP) procedures that require transfemoral venous placement of multiple catheters and/or long sheaths. There are inadequate data related to complex EP procedures in this population. (Source: Heart Rhythm)
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: Todd B. Mendelson, Pasquale M. Santangeli, David S. Frankel, Jeffrey S. Arkles, Gregory E. Supple, David Lin, Michael P. Riley, David J. Callans, Saman Nazarian, Matthew C. Hyman, Ramanan Kumareswaran, Andrew E. Epstein, Rajat Deo, Sanjay Dixit, Fermin C. Source Type: research

EP News: Allied Professionals
In the BRUISE CONTROL-2 study, Birnie et  al (Eur Heart J 2018;39:3973, PMID 30462279) sought to assess the effect of continuation vs interruption of direct oral anticoagulants (DOACs) at the time of cardiac implantable electronic device (CIED) surgery. This was a multicenter, randomized study performed at 15 centers in Canada and 1 in Is rael in patients with atrial fibrillation (AF) who had CHA2DS2-VASc score ≥2 and were on DOAC for the prevention of thromboembolism undergoing CIED implantation or replacement surgery. (Source: Heart Rhythm)
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

EP News: Clinical
Bernie et  al (Eur Heart J 2018;39:3973, PMID 30462279) evaluated 2 strategies to manage direct oral anticoagulants (DOACs) at the time of pacemaker and defibrillator surgery. They hypothesized that performing device surgery without DOAC interruption would result in a reduced hematoma rate. The investigators randomly assigned patients with atrial fibrillation and CHA2DS2-VASc score ≥2 to continued vs interrupted DOAC (dabigatran, rivaroxaban, or apixaban). The primary outcome—pocket hematoma resulting in reoperation, interruption of anticoagulation, or prolongation of hospital stay—was blindly ev aluate...
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Case Reports
Without evidence from a large randomized trial that evaluates His-bundle pacing compared with cardiac resynchronization therapy, the procedural benefits with His-bundle pacing with associationed long-term risks and complications have been revealed primarily through registry, observational, case series, and case report data. One of the most common challenges with His-bundle pacing is elevated thresholds that can result in rapid battery depletion. Kim et  al (DOI: https://doi.org/10.1016/j.hrcr.2018.11.007) shared a case of a 68-year-old woman who presented with presyncope and 2:1 atrioventricular block. (Source: Heart Rhythm)
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

EP News: Basic and Translational
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a hereditary arrhythmia syndrome. Mutations in ryanodine receptor type 2 (RYR2) are responsible for ≈60% of cases of CPVT. In the present study, Pan et al (Circ Res 2018;123:953, PMID 30355031) tested whether in vivo genome editing using the CRISPR/Cas9 system could correct CPVT in mice heterozygous for RyR2 mutation R176Q (R176Q/+). Guide RNAs were designed to disrupt the mutant allele in the neonatal R176Q/+ mice with the SaCas9 (Staphylococcus aureus Cas9) genome editing system using a single subcutaneous injection of adeno-associated virus ...
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP NEWS Source Type: research

Feasibility of Complex Trans-Femoral Electrophysiology Procedures in Patients with Inferior Vena Cava Filters
Presence of inferior vena cava filters (IVCFs) have been considered a relative contraindication to electrophysiology (EP) procedures that require trans-femoral venous placement of multiple catheters and/or long sheaths. There are inadequate data related to complex EP procedures in this population. (Source: Heart Rhythm)
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: Todd B. Mendelson, Pasquale M. Santangeli, David S. Frankel, Jeffrey S. Arkles, Gregory E. Supple, David Lin, Michael P. Riley, David J. Callans, Saman Nazarian, Matthew C. Hyman, Ramanan Kumareswaran, Andrew E. Epstein, Rajat Deo, Sanjay Dixit, Fermin C. Source Type: research

Cardiorenal Status using Amino Terminal Pro Brain Natriuretic Peptide and Cystatin C on Cardiac Resynchronization Therapy Outcomes: From the BIOCRT Study
Cardiorenal syndrome (CRS) comprises of a heterogeneous group of acute and chronic cardiac and renal dysfunction. (Source: Heart Rhythm)
Source: Heart Rhythm - December 24, 2018 Category: Cardiology Authors: Quynh A. Truong, Jackie Szymonifka, James L. Januzzi, Jigar H. Contractor, Roderick C. Dea ño, Neal A. Chatterjee, Jagmeet P. Singh Source Type: research

Pediatric and Congenital Electrophysiology Society Initiative on Device Needs in Pediatric Electrophysiology
There are few cardiovascular devices approved in children (Table1), with only 5 devices approved for use in the pediatric electrophysiology patient in the last 10 years. This lack of appropriate pediatric-tested technology has resulted in a high rate of off-label device utilization in children.1 Sutherell and colleagues found an off-label use of an approved device in 63% of patients treated in an interventional pediatric cardiology program.2 (Source: Heart Rhythm)
Source: Heart Rhythm - December 20, 2018 Category: Cardiology Authors: Anne M. Dubin, Bryan C. Cannon, Elizabeth V. Saarel, John K. Triedman, Charles I. Berul, Yaniv Bar-Cohen, Maully J. Shah, Jessica Paulsen, Hetal Patel, Jonathan Reich, Mark D. Carlson, Kenneth Stein, James O. Gilkerson, Robert C. Kowal, Vasum Peiris Source Type: research

Leadless pacemaker implantation: Is it possible to eliminate pericardial effusion as a complication?
The year 2018 celebrated the 60th anniversary of the first implanted pacemaker. During those 60 years, many considerable developments in the therapy for cardiac pacing were made. Current devices are complex and sophisticated. They have many algorithms intended to emulate normal cardiac physiology, with remote management and wireless communication representing the standard of care. However, conventional pacing with implanted generators and leads placed in the vasculature to the heart are associated with significant short- and long-term complications. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Paul R. Roberts Tags: Editorial Commentary Source Type: research

Refining the prediction of stroke in atrial fibrillation: An elusive endeavor
Atrial fibrillation (AF), the most common sustained arrhythmia, is responsible for>20% of all strokes.1 AF-associated strokes are more severe, causing significantly greater long-term disability, accounting for greater resource utilization, and resulting in significantly higher mortality compared to non-AF strokes.2 –4 Oral anticoagulants (OACs) are the standard of care for the prevention of AF-associated stroke and systemic thromboembolism. To date, OACs are the only therapeutic intervention that has been consistently and definitively shown to improve survival in the AF population. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Jason G. Andrade, Laurent Macle Tags: Editorial Commentary Source Type: research

More frequent postextrasystolic potentiation in patients with premature ventricular contraction –related cardiomyopathy: The missing link between premature ventricular contractions and cardiomyopathy?
Premature ventricular contractions (PVCs) are extrasystoles that originate from the ventricles. PVCs are frequently observed in patients with heart disease who require medical treatment to resolve the underlying issues. PVCs have also been observed in people with structurally normal hearts for whom medical treatment was deemed unnecessary. However, studies in a canine model have shown that exposing healthy hearts to frequent PVCs can cause cardiomyopathy (PVC-induced CM), evidenced by a decline in left ventricular (LV) ejection fraction (LVEF; to ≤40%) and LV end-systolic dilation. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Gea-Ny Tseng Tags: Editorial Commentary Source Type: research

Obstructive sleep apnea is associated with nonsustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is associated with arrhythmias and cardiovascular death. Obstructive sleep apnea (OSA) is highly prevalent and independently associated with atrial fibrillation in patients with HCM. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Shengwei Wang, Hao Cui, Changpeng Song, Changsheng Zhu, Rong Wu, Liukun Meng, Qinjun Yu, Xiaohong Huang, Shuiyun Wang Source Type: research

Refining the Prediction of Stroke in Atrial Fibrillation. An elusive endeavor
Atrial fibrillation (AF), the most common sustained arrhythmia, is responsible for>20% of all strokes.1 AF-associated strokes are more severe, causing significantly greater long-term disability, accounting for greater resource utilization, and result in significantly higher mortality when compared to non-AF strokes.2-4 Oral anticoagulants (OACs) are the standard of care for the prevention of AF-associated stroke and systemic thromboembolism. To date OACs are the only therapeutic intervention that has been consistently and definitively shown to improve survival in the AF population. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Jason G. Andrade, Laurent Macle Source Type: research

Leadless Pacemaker Implantation – is it possible to eliminate pericardial effusion as a complication?
Paul Roberts has received honoraria from Medtronic for consultancy and speakers bureau. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Paul R. Roberts Source Type: research

Syncope, conduction disturbance, and negative electrophysiological test: predictive factors and risk score to predict pacemaker implantation during follow-up
Patients with syncope and bundle branch block (BBB) are at risk of atrioventricular block (AVB). Electrophysiological study (EPS) can help in identifying patients at higher risk of AVB but false-negative rate is remarkable. Few data are published about predictors of the need for pacemaker implantation during follow-up. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Ivo Roca-Luque, Jaume Francisco-Pascual, Gerard Oristrell, Juli án Rodríguez-García, Alba Santos-Ortega, Gabriel Martin-Sanchez, Nuria Rivas-Gandara, Jordi Perez-Rodon, Ignacio Ferreira-Gonzalez, David García-Dorado, Angel Moya-Mitjans Source Type: research

More frequent post-extrasystolic potentiation in patients with premature ventricular contraction (PVC)-related cardiomyopathy – The missing link between PVC and cardiomyopathy?
Premature ventricular contractions (PVCs) are extrasystoles originating from the ventricles. PVCs are frequently observed in patients with heart diseases, who require medical treatment to resolve the underlying issues. PVCs have also been observed in people with structurally normal hearts, for whom medical treatment was deemed unnecessary. However, studies in a canine model have shown that exposing healthy hearts to frequent PVCs can cause cardiomyopathy (PVC-induced CM), evidenced by a decline in left ventricular ejection fraction (LVEF, to (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Gea-Ny Tseng Source Type: research

Obstructive sleep apnea is associated with non-sustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is associated with arrhythmias and cardiovascular death. Obstructive sleep apnea (OSA) is highly prevalent and independently associated with atrial fibrillation among patients with HCM. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Shengwei Wang, Hao Cui, Changpeng Song, Changsheng Zhu, Rong Wu, Liukun Meng, Qinjun Yu, Xiaohong Huang, Shuiyun Wang Source Type: research

Outcomes of Simultaneous Unipolar Radiofrequency Catheter Ablation for Intramural Septal Ventricular Tachycardia in Non-Ischemic Cardiomyopathy
Radiofrequency (RF) ablation of intramural septal ventricular tachycardia (VT) in patients with non-ischemic cardiomyopathy (NICM) is challenging. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Jiandu Yang, Jackson Liang, Yasuhiro Shirai, Daniele Muser, Fermin C. Garcia, David J. Callans, Francis E. Marchlinski, Pasquale Santangeli Source Type: research

Propensity-Matched Comparison Of Cryoballoon And Radiofrequency Ablation For Atrial Fibrillation In Elderly Patients
Pulmonary vein isolation (PVI) with a cryoballoon (CB) is an effective treatment for atrial fibrillation (AF). The efficacy of CB PVI for elderly patients with AF remains unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2018 Category: Cardiology Authors: Takashi Ikenouchi, Junichi Nitta, Giiti Nitta, Shunichi Kato, Tsukasa Iwasaki, Kazuya Murata, Matsuda Junji, Tatsuhiko Hirao, Miki Kanoh, Tomomasa Takamiya, Nobutaka Kato, Yukihiro Inamura, Ken Negi, Akira Sato, Tsunehiro Yamato, Yutaka Matsumura, Yoshihi Source Type: research

Hemodynamic consequences of premature ventricular contractions: Association of mechanical bradycardia and postextrasystolic potentiation with premature ventricular contraction-induced cardiomyopathy
The relationships between hemodynamic consequences of premature ventricular contractions (PVCs) and development of premature ventricular contraction-induced cardiomyopathy (PVC-CM) have not been investigated. (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2018 Category: Cardiology Authors: Sophie Billet, Anne Rollin, Pierre Mondoly, Benjamin Monteil, Pauline Fournier, Eve Cariou, Marie Sadron Blaye-Felice, Michel Galinier, Didier Carri é, Olivier Lairez, Clément Delmas, Philippe Maury Source Type: research

Differences in the upslope of the precordial body surface ECG T wave reflect right to left dispersion of repolarization in the intact human heart
The relationship between the surface electrocardiogram (ECG) T wave to intracardiac repolarization is poorly understood. (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2018 Category: Cardiology Authors: Neil T. Srinivasan, Michele Orini, Rui Providencia, Ron Simon, Martin Lowe, Oliver R. Segal, Anthony W. Chow, Richard J. Schilling, Ross J. Hunter, Peter Taggart, Pier D. Lambiase Source Type: research

Safety and feasibility of a midseptal implantation technique of a leadless pacemaker
The major risk of implanting a leadless pacemaker at the right ventricular (RV) apex is cardiac perforation. (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2018 Category: Cardiology Authors: Jo-Jo Hai, Jonathan Fang, Chor-Cheung Tam, Chun-Ka Wong, Ka-Chun Un, Chung-Wah Siu, Chu-Pak Lau, Hung-Fat Tse Source Type: research

A New Model to Predict Ischemic Stroke in Patients with Atrial Fibrillation Using Warfarin or Direct Oral Anticoagulants
Stroke risk stratification scores (e.g., CHA2DS2-VASc) are used to tailor therapeutic recommendations for patients with atrial fibrillation (AF) in different risk groups. (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2018 Category: Cardiology Authors: J ’Neka S. Claxton, Richard F. MacLehose, Pamela L. Lutsey, Faye L. Norby, Lin Y. Chen, Wesley T. O’Neal, Alanna M. Chamberlain, Lindsay G.S Bengtson, Alvaro Alonso Source Type: research

Differences in the Upslope of the Precordial Body Surface ECG T-Wave Reflect Right To Left Dispersion of Repolarization in the Intact Human Heart
The relationship between the surface ECG T-wave to intracardiac repolarization is poorly understood. (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2018 Category: Cardiology Authors: Neil T. Srinivasan, Michele Orini, Rui Providencia, Ron Simon, Martin Lowe, Oliver R. Segal, Anthony W. Chow, Richard J. Schilling, Ross J. Hunter, Peter Taggart, Pier D. Lambiase Source Type: research

Safety and Feasibility of a Mid-Septal Implantation Technique of A Leadless Pacemaker
The major risk of implanting leadless pacemaker at the right ventricular apex is cardiac perforation. (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2018 Category: Cardiology Authors: Jo-Jo Hai, Jonathan Fang, Chor-Cheung Tam, Chun-Ka Wong, Ka-Chun Un, Chung-Wah Siu, Chu-Pak Lau, Hung-Fat Tse Source Type: research

Hemodynamic consequences of premature ventricular contractions Association of mechanical bradycardia and post-extrasystolic potentiation with premature ventricular contraction-induced cardiomyopathy
relationships between hemodynamic consequences of premature ventricular contractions (PVCs) and development of PVC-induced cardiomyopathy (PVC-CM) have not been investigated so far. (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2018 Category: Cardiology Authors: Sophie Billet, Anne Rollin, Pierre Mondoly, Benjamin Monteil, Pauline Fournier, Eve Cariou, Marie Sadron Blaye-Felice, Michel Galinier, Didier Carri é, Olivier Lairez, Clément Delmas, Philippe Maury Source Type: research

Incidence and effect of early postoperative ventricular arrhythmias after congenital heart surgery
Postoperative arrhythmias after pediatric congenital heart disease (CHD) surgery are a known cause of morbidity and are associated with mortality. A comprehensive evaluation of early postoperative ventricular arrhythmias (VAs) after CHD surgery has not been reported. (Source: Heart Rhythm)
Source: Heart Rhythm - December 4, 2018 Category: Cardiology Authors: Sarah R. Fuchs, Andrew H. Smith, Sara L. Van Driest, Kim F. Crum, Todd L. Edwards, Prince J. Kannankeril Source Type: research

Atrial fibrillation occurring during head-up tilt testing: Once detected, atrial fibrillation should be monitored, regardless of how it is detected
Atrial fibrillation (AF) often progresses to more sustained forms and increases the risk of ischemic stroke or sinus node dysfunction. However, there have been no data on the clinical outcomes of patients who developed AF during head-up tilt testing (HUT). (Source: Heart Rhythm)
Source: Heart Rhythm - December 4, 2018 Category: Cardiology Authors: Jun Hyung Kim, Sung Ho Lee, Seung-Jung Park, Kyoung Min Park, Young Keun On, June Soo Kim Source Type: research

Left ventricular activation-recovery interval variability predicts spontaneous ventricular tachyarrhythmia in heart failure patients
Enhanced beat-to-beat variability of repolarization (BVR) is strongly linked to arrhythmogenesis and is largely due to variation in ventricular action potential duration (APD). Previous studies in humans have relied on QT interval measurements; however, a direct relationship between beat-to-beat variability of APD and arrhythmogenesis in humans has yet to be demonstrated. (Source: Heart Rhythm)
Source: Heart Rhythm - December 4, 2018 Category: Cardiology Authors: Bradley Porter, Martin J. Bishop, Simon Claridge, Nicholas Child, Stefan Van Duijvenboden, Julian Bostock, Benjamin J. Sieniewicz, Justin Gould, Baldeep Sidhu, Ben Hanson, Zhong Chen, Christopher A. Rinaldi, Peter Taggart, Jaswinder S. Gill Source Type: research

Atrial Fibrillation Occurring During Head-up Tilt Test: Once detected, AF should be monitored, regardless of how it is detected
Atrial fibrillation (AF) often progresses to more sustained forms and raises the risk of ischemic stroke or sinus node dysfunction (SND). However, there has been no data on the clinical outcomes of AF developed during head-up tilt testing (HUT). (Source: Heart Rhythm)
Source: Heart Rhythm - December 4, 2018 Category: Cardiology Authors: Jun Hyung Kim, Sung Ho Lee, Seung-Jung Park, Kyoung Min Park, Young Keun On, June Soo Kim Source Type: research

Incidence and Impact of Early Postoperative Ventricular Arrhythmias after Congenital Heart Surgery
Postoperative arrhythmias following pediatric congenital heart disease (CHD) surgery are a known cause of morbidity and are associated with mortality. A comprehensive evaluation of early postoperative ventricular arrhythmias (VAs) after CHD surgery has not been reported. (Source: Heart Rhythm)
Source: Heart Rhythm - December 4, 2018 Category: Cardiology Authors: Sarah R. Fuchs, Andrew H. Smith, Sara L. Van Driest, Kim F. Crum, Todd L. Edwards, Prince J. Kannankeril Source Type: research

Left Atrial Appendage Closure Device Implantation in Patients with Prior Intracranial Hemorrhage
The Watchman ™ device (Boston Scientific, MN), used for left atrial appendage closure (LAAC) was approved for stroke prevention in patients with atrial fibrillation (AF) and an appropriate rationale to avoid long-term oral anticoagulation. Patients with AF and prior intracranial hemorrhage (ICH) were excluded from clinical trials due to perceived risks of peri-operative anticoagulation. (Source: Heart Rhythm)
Source: Heart Rhythm - December 2, 2018 Category: Cardiology Authors: Erika Hutt, Oussama M. Wazni, Walid I. Saliba, Mohamed Kanj, Khaldoun G. Tarakji, Jose Aguilera, Amr F. Barakat, Peter Rasmussen, Ken Uchino, Andrew Russman, Shazam Hussain, Dolora Wisco, Samir Kapadia, Bruce D. Lindsay, Ayman A. Hussein Source Type: research

Effect of hypertrophic cardiomyopathy on the prediction of thromboembolism in patients with nonvalvular atrial fibrillation
Anticoagulation is recommended for hypertrophic cardiomyopathy (HCM) with nonvalvular atrial fibrillation (NVAF) according to European and American guidelines. However, it is unclear whether HCM is a risk factor for thromboembolism in NVAF in Japan, and the management for NVAF with HCM is not established. (Source: Heart Rhythm)
Source: Heart Rhythm - November 29, 2018 Category: Cardiology Authors: Toyonobu Tsuda, Kenshi Hayashi, Noboru Fujino, Tetsuo Konno, Hayato Tada, Akihiro Nomura, Yoshihiro Tanaka, Kenji Sakata, Hiroshi Furusho, Masayuki Takamura, Masa-aki Kawashiri, Masakazu Yamagishi, the Hokuriku-Plus AF Registry Investigators Source Type: research

Impact of hypertrophic cardiomyopathy on the prediction of thromboembolism in patients with nonvalvular atrial fibrillation
Anticoagulation is recommended for hypertrophic cardiomyopathy (HCM) with nonvalvular atrial fibrillation (NVAF) according to European and American guidelines. However, it is unclear whether HCM is a risk factor for thromboembolism in NVAF in Japan, and the management for NVAF with HCM is not established. (Source: Heart Rhythm)
Source: Heart Rhythm - November 29, 2018 Category: Cardiology Authors: Toyonobu Tsuda, Kenshi Hayashi, Noboru Fujino, Tetsuo Konno, Hayato Tada, Akihiro Nomura, Yoshihiro Tanaka, Kenji Sakata, Hiroshi Furusho, Masayuki Takamura, Masa-aki Kawashiri, Masakazu Yamagishi, the Hokuriku-Plus AF Registry Investigators Source Type: research

Variant of Ventricular Outflow Tract Ventricular Arrhythmias Requiring Ablation From Multiple Sites: Intramural Origin
The optimal site of ablation of idiopathic left ventricular outflow tract (LVOT) ventricular arrhythmias (VAs) is challenging as activation mapping can reveal similar activation times suggesting an intramural origin. (Source: Heart Rhythm)
Source: Heart Rhythm - November 29, 2018 Category: Cardiology Authors: Luigi Di Biase, Jorge Romero, Erica S. Zado, Juan Carlos Diaz, Carola Gianni, Patrick M. Hranitzki, Javier E. Sanchez, Sanghamitra Mohanty, Amin Al-Ahmad, Prasant Mohanty, Chintan Trivedi, Domenico Della Rocca, Pasquale Santangeli, J. David Burkhardt, Fer Source Type: research

Impact of Hypertrophic Cardiomyopathy on Prediction of Thromboembolism in Patients with Non-valvular Atrial Fibrillation
Anticoagulation is recommended in hypertrophic cardiomyopathy (HCM) with non-valvular atrial fibrillation (NVAF) according to European and American guidelines. However, it is unclear whether HCM is a risk factor for thromboembolism in NVAF in Japan, and the management for NVAF with HCM is not established. (Source: Heart Rhythm)
Source: Heart Rhythm - November 29, 2018 Category: Cardiology Authors: Toyonobu Tsuda, Kenshi Hayashi, Noboru Fujino, Tetsuo Konno, Hayato Tada, Akihiro Nomura, Yoshihiro Tanaka, Kenji Sakata, Hiroshi Furusho, Masayuki Takamura, Masa-aki Kawashiri, Masakazu Yamagishi, Hokuriku-plus AF Registry Investigators Source Type: research

Two different P waves after a single ventricular premature beat in a 33-year-old man
A 33-year-old man came to the outpatient clinic because of palpitations. He noticed their occurrence during the last 3  months. He denied to have felt rapid heart rhythms. (Source: Heart Rhythm)
Source: Heart Rhythm - November 28, 2018 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

Termination of a narrow complex tachycardia by a single extrastimulus: What is the mechanism?
A 49-year-old woman with symptomatic Wolff-Parkinson-White syndrome underwent diagnostic electrophysiological study because of rapid palpitations and ECG-documented narrow complex tachycardia (NCT). Echocardiography was normal. Baseline atrio-His and His-ventricular intervals were 69 ms and 29 ms, respectively. Her clinical tachycardia was induced by rapid ventricular pacing and repeatedly terminated by a single extrastimulus delivered from the distal bipoles of a decapolar catheter (2-5-2 mm spacing) positioned in a posterolateral branch of the coronary sinus (CS) (Figures  1 and 2). (Source: Heart Rhythm)
Source: Heart Rhythm - November 28, 2018 Category: Cardiology Authors: Jonathan P. Logue, Arnold J. Greenspon, Reginald T. Ho Tags: Unknown of the Month Source Type: research

Electrical isolation of the left atrial appendage increases the risk of ischemic stroke and transient ischemic attack regardless of postisolation flow velocity
Electrical isolation of the left atrial appendage (LAA) is associated with a lower rate of atrial fibrillation (AF) recurrence in patients undergoing radiofrequency catheter ablation. However, LAA isolation can significantly impair LAA contractility. (Source: Heart Rhythm)
Source: Heart Rhythm - November 28, 2018 Category: Cardiology Authors: Yun Gi Kim, Jaemin Shim, Suk-Kyu Oh, Kwang-No Lee, Jong-Il Choi, Young-Hoon Kim Tags: Featured Article Source Type: research

Left atrial appendage isolation at the time of atrial fibrillation ablation
Since the description of pulmonary vein firing as a trigger for atrial fibrillation (AF),1 pulmonary vein isolation (PVI) has formed the cornerstone of AF ablation. The success rate of PVI has been as high as 65% –70% in patients with paroxysmal AF.2 However, the success rates for persistent AF and long-standing persistent AF ablation have been as low as 40% in some studies.3 This has prompted a search for extra-pulmonary vein targets in order to increase the effectiveness of ablation of persistent and lon g-standing persistent AF. (Source: Heart Rhythm)
Source: Heart Rhythm - November 28, 2018 Category: Cardiology Authors: Nishant Verma, Bradley P. Knight Tags: Editorial Commentary Source Type: research

Engagement and collaboration: Working to advance the HRS vision
The Heart Rhythm Society (HRS) vision “to end death and suffering due to heart rhythm disorders” is bold in stance and global in scope. Scientific advances and improvements in care delivery have provided us with better tools to treat potentially serious conditions such as atrial fibrillation and sudden cardiac arrest. However, world wide demographic, economic, and lifestyle trends have resulted in an increase in both the prevalence and the incidence of heart rhythm disorders. Accordingly, to reach our audacious goal, we will need to engage committed individuals and collaborate with other organizations, with a f...
Source: Heart Rhythm - November 28, 2018 Category: Cardiology Authors: Thomas F. Deering Tags: President's Page Source Type: research

Characterizing localized reentry with high-resolution mapping: Evidence for multiple slow conducting isthmuses within the circuit
Reentrant circuits are considered to be critically dependent on a single protected slow conducting isthmus. (Source: Heart Rhythm)
Source: Heart Rhythm - November 27, 2018 Category: Cardiology Authors: Antonio Frontera, Rajiv Mahajan, Corentin Dallet, Konstantinos Vlachos, Takeshi Kitamura, Ghassen Cheniti, Masateru Takigawa, Claire Martin, Josselin Duchateau, Anne Lam, Felix Bourier, Thomas Pambrun, Meleze Hocini, Frederic Sacher, Arnaud Denis, Nicolas Source Type: research

Characterizing localised reentry with high resolution mapping: evidence for multiple slow conducting isthmuses within the circuit.
Reentry circuits are considered to be critically dependent on a single protected slow conducting isthmus. (Source: Heart Rhythm)
Source: Heart Rhythm - November 27, 2018 Category: Cardiology Authors: Antonio Frontera, Rajiv Mahajan, Corentin Dallet, Konstantinos Vlachos, Takeshi Kitamura, Ghassen Cheniti, Masateru Takigawa, Claire Martin, Josselin Duchateau, Anne Lam, Felix Bourier, Thomas Pambrun, Meleze Hocini, Frederic Sacher, Arnaud Denis, Nicolas Source Type: research

The benefit of implantable cardioverter –defibrillators beyond the first generator
Implantable cardioverter –defibrillators (ICDs) are lifesaving and are placed based on guideline recommendations for primary or secondary prevention of fatal arrhythmic death due to underlying cardiomyopathic processes.1 Although the benefits of ICD therapy are clear, potential drawbacks such as inappropriate shocks can l ead to significant morbidity and may be associated with increased mortality.2 Indwelling leads and devices are prone to bloodstream infections.3 Psychosocial aspects, such as posttraumatic stress disorder from shocks,4 and disqualification or restrictions in certain vocations, driving, and competiti...
Source: Heart Rhythm - November 23, 2018 Category: Cardiology Authors: Christopher V. DeSimone, Yong-Mei Cha Tags: Editorial Commentary Source Type: research

EP News: Basic and Translational
Long noncoding RNAs (lncRNAs) are non –protein-coding transcripts longer than 200 nucleotides that have recently been shown as one of the critical players in biological regulation. Zhang et al (Nat Commun 2018;9:4176, PMID 30301979) identified a unique lncRNA (AK045950) to be downregulated in a mouse model of heart failure (HF) and i n patients with HF. The downregulation results in the slowing of cardiac conduction and enhances arrhythmogenicity in HF. The authors named this unique lncRNA as cardiac conduction regulatory RNA (CCRR) and demonstrated that CCRR silencing induces arrhythmias in healthy mice. (Source: Heart Rhythm)
Source: Heart Rhythm - November 23, 2018 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

EP News: Allied Professionals
From a single center located in an area with a high prevalence of human immunodeficiency virus (HIV) infection, Alvi et  al (J Am Heart Assoc 2018;7:e009857, PMID 30371221) sought to assess the incidence, predictors, and effects of implantable cardioverter-defibrillator (ICD) therapy in patients living with HIV (PHIV). They studied a group of patients admitted for decompensated heart failure (HF) who had an ICD and who were followed up at their center. Using retrospective chart review, they assessed a number of clinical variables and follow-up data over a median follow-up of 19 months. (Source: Heart Rhythm)
Source: Heart Rhythm - November 23, 2018 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

EP News: Case Reports
Primary cardiac tumors are rare and vary in their clinical manifestations. Some of the arrhythmia manifestations are sustained ventricular tachycardia (VT) and sudden death. If possible, symptomatic surgical resection is an upfront therapy. Haskova et  al (DOI: https://doi.org/10.1016/j.hrcr.2018.10.007) shared a case of a 34-year-old man who presented with multiple repetitive monomorphic VTs of different morphologies. Cardiac magnetic resonance imaging (MRI) revealed a large intramyocardial tumor with features consistent with a fibroma. (Source: Heart Rhythm)
Source: Heart Rhythm - November 23, 2018 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research