Percutaneous Left Atrial Appendage Closure in Patients With Prior Intracranial Bleeding and Thromboembolism
Percutaneous left atrial appendage closure (LAAC) is an alternative treatment in atrial fibrillation patients with contraindication to oral anticoagulation. Still, patient selection criteria for LAAC are debated. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Jussi-Pekka Pouru, Juha Lund, Samuli Jaakkola, Tuija Vasankari, Fausto Biancari, Antti Saraste, K.E. Juhani Airaksinen Source Type: research

Pacing in vasovagal syncope: physiology, pacemaker sensors and recent clinical trials. Precise patient selection and measurable benefit.
The role of pacing in vasovagal syncope (VVS) is considered from a physiological basis. Most VVS patients lose consciousness due to hypotension before severe bradycardia/asystole occurs. Patients that benefit from dual-chamber pacing are typically older with highly symptomatic, late-onset, frequent and severe syncope with short/no prodrome and documented severe cardioinhibition. Tilt-testing is of value in patients with recurrent unexplained syncope to identify important hypotensive susceptibility stemming from reduced venous return and stroke volume. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Richard Sutton, Jelle SY. de Jong, Julian M. Stewart, Artur Fedorowski, Frederik J. de Lange Source Type: research

Initially Unexplained Cardiac Arrest in Children and Adolescents: A National Experience from the Canadian Pediatric Heart Rhythm Network
Unexplained cardiac arrest (UCA) is rare in children. Despite investigations, the etiology in up to half remains unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Taylor Cunningham, Thomas M. Roston, Sonia Franciosi, Michelle Chang Liu, Joseph Atallah, Carolina A. Escudero, Sharmila Udupa, Jason D. Roberts, Santokh Dhillon, Frederic Dallaire, Anne Fournier, Meena Fatah, Robert Hamilton, Shubhayan Sanatani Source Type: research

A Novel Method of Demonstrating Dual Atrioventricular Nodal Physiology in the Clinical Electrophysiology Lab
This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The author has no conflict of interest in the generation of this report. (Source: Heart Rhythm)
Source: Heart Rhythm - February 5, 2020 Category: Cardiology Authors: Patrick Tchou Source Type: research

An electrocardiographic sign of idiopathic ventricular tachycardia ablatable from the distal great cardiac vein
Idiopathic ventricular arrhythmias (IVAs) can originate from the distal great cardiac vein (DGCV). However, inadequate distinction sometimes occurs when electrocardiographic (ECG) characteristics are used to distinguish ventricular arrhythmias (VAs) arising from the DGCV from those arising from the adjacent left ventricular endocardium (LV ENDO). (Source: Heart Rhythm)
Source: Heart Rhythm - February 2, 2020 Category: Cardiology Authors: Yuan-Nan Lin, Jing Xu, Yang-Qi Pan, Cheng Zheng, Jia-Xuan Lin, Jin Li, Jia Li, Jia-Feng Lin, Yue-Chun Li Source Type: research

The Presence of Ectopic Atrial Rhythm Predicts Adverse Cardiovascular Outcomes in a Large Hospital-based Population
Whether ectopic atrial rhythm (EAR) is a high-risk cardiovascular phenotype (e.g., the manifestation of a diseased sinoatrial node) or just a benign accelerated ectopic pacemaker remains unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - February 2, 2020 Category: Cardiology Authors: Sung-Hao Huang, Yu-Feng Hu, Pei-Fen Chen, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Fa-Po Chung, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Ting-Yung Chang, Chin-Yu Lin, Chih-Min Liu, Ting-Chun Huang, Jennifer Jeanne B. Vicera, Po-Tseng Lee, Isaiah Carlos Source Type: research

Short stature is associated with incident sudden cardiac death in a large Asian cohort
There is little data on the association between height and the risk of sudden cardiac death (SCD) in Asian populations. (Source: Heart Rhythm)
Source: Heart Rhythm - February 2, 2020 Category: Cardiology Authors: Young Min Park, Jeonggeun Moon, In Cheol Hwang, Hyunsun Lim, Bokeum Cho Source Type: research

An ECG Sign of Idiopathic Ventricular Tachycardia Ablatable From the Distal Great Cardiac Vein
Idiopathic ventricular arrhythmias (IVAs) can originate from the distal great cardiac vein (DGCV). However, inadequate distinction sometimes occurs with the use of electrocardiography (ECG) characteristics for distinguishing ventricular arrhythmias (VAs) arising from the DGCV and the adjacent left ventricle endocardium (LV ENDO). (Source: Heart Rhythm)
Source: Heart Rhythm - February 2, 2020 Category: Cardiology Authors: Lin Yuan-Nan, Xu Jing, Pan Yang-Qi, Zheng Cheng, Lin Jia-Xuan, Li Jin, Li Jia, Lin Jia-Feng, Li Yue-Chun Source Type: research

Adverse Event Rate during Inpatient Sotalol Initiation for the Management of Supraventricular and Ventricular Tachycardia in the Pediatric and Young Adult Population
Sotalol is an important antiarrhythmic in the pediatric population. Given the risk for proarrhythmia, sotalol is initiated in inpatient settings, with adult studies as recent as 2015 supporting this practice. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2020 Category: Cardiology Authors: Stephanie F. Chandler, Esther Chu, Robert D. Whitehill, Laura M. Bevilacqua, Vassilios J. Bezzerides, Elizabeth S. DeWitt, Mark E. Alexander, Dominic J. Abrams, John K. Triedman, Edward P. Walsh, Douglas Y. Mah Source Type: research

mAdverse Event Rate during Inpatient Sotalol Initiation for the Management of Supraventricular and Ventricular Tachycardia in the Pediatric and Young Adult Population
Sotalol is an important antiarrhythmic in the pediatric population. Given the risk for proarrhythmia, sotalol is initiated in inpatient settings, with adult studies as recent as 2015 supporting this practice. (Source: Heart Rhythm)
Source: Heart Rhythm - January 30, 2020 Category: Cardiology Authors: Stephanie F. Chandler, Esther Chu, Robert D. Whitehill, Laura M. Bevilacqua, Vassilios J. Bezzerides, Elizabeth S. DeWitt, Mark E. Alexander, Dominic J. Abrams, John K. Triedman, Edward P. Walsh, Douglas Y. Mah Source Type: research

EP News: Pediatric and Congenital Electrophysiology News
van de Werf et  al (Eur Heart J 2019;40:2953, PMID 31145795) reported the efficacy of implantable cardioverter-defibrillators (ICDs) in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) presenting with sudden cardiac arrest (SCA) while undiagnosed and therefore untreated. SCA survivors su bsequently diagnosed with CPVT (N = 136) and treated with β-blockers, flecainide, and/or left cardiac sympathetic denervation (LCSD) and/or ICD were analyzed. The primary outcome was sudden cardiac death (SCD). (Source: Heart Rhythm)
Source: Heart Rhythm - January 26, 2020 Category: Cardiology Authors: Maully J. Shah Tags: EP News Source Type: research

EP News: Basic and Translational
This is a prospective study by Lebek et  al (Circ Res, doi:10.1161/CIRCRESAHA.119.315755; PMID 31902278) to directly assess the effects of Ca2+/calmodulin-dependent protein kinase II (CaMKII) on the Na+ current (INa) and atrial proarrhythmic activity in patients with sleep-disordered breathing (SDB). The investigators enrolled 113 patien ts undergoing elective coronary artery bypass grafting. The presence of SDB was determined before surgery. Patients with SDB (n = 57) show a significantly increased level of activated CaMKII in the right atrial appendage biopsies compared with patients without SDB. (Source: Heart Rhythm)
Source: Heart Rhythm - January 26, 2020 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

Focal source and trigger mapping in atrial fibrillation: Randomized controlled trial evaluating a novel adjunctive ablation strategy
Intraoperative mapping has demonstrated focal activations during human atrial fibrillation (AF). These putative AF sources can manifest sustained periodic bipolar and unipolar QS electrograms (EGMs). We have automated the detection of these EGM features using our validated Focal Source and Trigger (FaST) computational algorithm. (Source: Heart Rhythm)
Source: Heart Rhythm - January 24, 2020 Category: Cardiology Authors: Vijay S. Chauhan, Atul Verma, Sachin Nayyar, Nicholas Timmerman, George Tomlinson, Andreu Porta-Sanchez, Sigfus Gizurarson, Shouvik Haldar, Adrian Suszko, Don Ragot, Andrew C.T. Ha Source Type: research

Giovanni Maria Lancisi ’s Description Of Commotio Cordis
Commotio cordis, is the syndrome of sudden death following blunt trauma to the lower part of the chest (1,2). It has received attention in recent times for its prevention (especially in contact sports) and has led to basic studies to define a mechanism.(3) One of the earliest sports-related cases was sudden death following a cricket ball injury in 1898.(4) (Source: Heart Rhythm)
Source: Heart Rhythm - January 21, 2020 Category: Cardiology Authors: Kalyanam Shivkumar, Noel G. Boyle Source Type: research

Effect of Acute Myocardial Ischemia on Inferolateral Early Repolarization
Inferolateral early repolarization (ER) is associated with an increase in arrhythmic risk, particularly in the presence of myocardial ischemia. (Source: Heart Rhythm)
Source: Heart Rhythm - January 21, 2020 Category: Cardiology Authors: Michael Stoller, Alexander Boehler, Nando Bloch, Christian Seiler, Dik Heg, Mattia Branca, Laurent Roten Source Type: research

Giovanni Maria Lancsi ’s Description Of Commotio Cordis
Commotio cordis, is the syndrome of sudden death following blunt trauma to the lower part of the chest (1,2). It has received attention in recent times for its prevention (especially in contact sports) and has led to basic studies to define a mechanism.(3) One of the earliest sports-related cases was sudden death following a cricket ball injury in 1898.(4) (Source: Heart Rhythm)
Source: Heart Rhythm - January 21, 2020 Category: Cardiology Authors: Kalyanam Shivkumar, Noel G. Boyle Source Type: research

A 78-year-old woman with heart failure
A 78-year-old woman was admitted because of heart failure. She was known to have nonischemic dilated cardiomyopathy. During the past 2 weeks, she developed severe shortness of breath. The people around her also noticed memory loss and confusion in time and place, suggesting that she was becoming demented. On admission, her daily medication consisted of a β-blocking agent, an angiotensin-converting enzyme inhibitor, a diuretic, and 1/8 mg of digoxin. (Source: Heart Rhythm)
Source: Heart Rhythm - January 21, 2020 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

The role of long noncoding RNAs in atrial fibrillation
Atrial fibrillation (AF) is a common arrhythmia with serious clinical sequelae, yet little is known about its genetic origins. Recently, the untranscribed 98% of the human genome has been increasingly implicated in important processes such as cardiac organogenesis, physiology, and pathophysiology. Specifically, long noncoding RNAs (lncRNAs) have been shown to interact with the transcriptome in various ways that alter gene expression. Previously, multiple lncRNAs have been identified in disease processes such as heart failure, coronary artery disease, and diabetes. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: Savalan Babapoor-Farrokhran, Deanna Gill, Roozbeh Tarighati Rasekhi Tags: Contemporary Review Source Type: research

Esophageal temperature dynamics during high-power short-duration posterior wall ablation
Increased peak luminal esophageal temperature (LET) is associated with increased risk of esophageal injury after left atrial posterior wall (LAPW) ablation. The magnitude, distribution, and risk factors of LET increase with high-power short-duration (HPSD) LAPW ablation are not well understood. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: Chirag R. Barbhaiya, Edward V. Kogan, Lior Jankelson, Robert J. Knotts, Michael Spinelli, Scott Bernstein, David Park, Anthony Aizer, Larry A. Chinitz, Douglas Holmes Source Type: research

Examination of pathologic features of the right atrioventricular groove in hearts with Ebstein anomaly and correlation with arrhythmias
Catheter ablation of accessory pathways (APs) in patients with Ebstein anomaly (EA) has a higher recurrence rate than in subjects with normal hearts. Anatomic features could account for suboptimal ablation outcomes. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: Luciana Marcondes, Stephen P. Sanders, Pedro J. del Nido, Edward P. Walsh Source Type: research

EP News: Clinical
Diederichsen et  al (J Am Coll Cardiol 2019;74:2771, PMID 31779791) evaluated the natural history of subclinical atrial fibrillation (AF) in at-risk patients from the general population. The authors studied 590 individuals ≥70 years of age with ≥1 of hypertension, diabetes, previous stroke, or heart failure; w ithout a history of AF; and with long-term implantable loop recorder monitoring. End points included AF burden, AF progression, symptoms, and heart rate during AF. In a total of 685,445 monitoring days, AF lasting ≥6 minutes was detected in 205 participants (35%). (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Allied Professionals
Alcohol ingestion can be a trigger for atrial fibrillation (AF) episodes. In this randomized trial performed at 6 Australian centers, Voskoboinik et  al (N Engl J Med 2020;382:20, PMID 31893513) sought to assess the effect of alcohol abstinence on AF occurrence. They enrolled patients aged 18–85 years with symptomatic AF who drank ≥10 standard drinks/wk. Those with paroxysmal AF needed to have ≥2 episodes in 6 months before enrollment and those with persistent AF were undergoing a rhythm control strategy, and these subjects needed to be in sinus rhythm at the beginning of the study. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

EP News: Case Reports
Insertion of an implantable cardioverter-defibrillator (ICD) typically requires both local and systemic anesthesia. In patients who are implanted with a subcutaneous ICD (S-ICD), anesthesia requirements may be greater because of the size and depth of the generator incision and the need for an addition sternal incision. Peri- and postprocedure anesthesia with narcotics can be associated with side effects and dependency. Scaglione et  al (DOI: https://doi.org/10.1016/j.hrcr.2019.12.008) shared a case of a 44-year-old man with Brugada syndrome with a spontaneous type 1 ECG and syncope. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

Examination of pathological features of the right atrioventricular groove in hearts with Ebstein ’s anomaly, and correlation with arrhythmias
Catheter ablation of accessory pathways (AP) in Ebstein ’s anomaly (EA) has a higher recurrence rate than in normal hearts. Anatomic features could account for suboptimal ablation outcomes. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: Luciana Marcondes, Stephen P. Sanders, Pedro J. del Nido, Edward P. Walsh Source Type: research

Esophageal Temperature Dynamics During High Power Short Duration Posterior Wall Ablation
Increased peak luminal esophageal temperature (LET) is associated with increased risk of esophageal injury following left atrial posterior wall (LAPW) ablation. The magnitude, distribution, and risk factors of LET increase with high power short duration (HPSD) LAPW ablation are not well understood. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: Chirag R. Barbhaiya, Edward V. Kogan, Lior Jankelson, Robert J. Knotts, Michael Spinelli, Scott Bernstein, David Park, Anthony Aizer, Larry A. Chinitz, Douglas Holmes Source Type: research

The Role of Long Non-Coding RNAs in Atrial Fibrillation
Atrial Fibrillation (AF) is a common arrhythmia with serious clinical sequelae, but despite its significance little is known about the genetic origins. Recently, the untranscribed 98% of the human genome has been increasingly implicated in important processes like cardiac organogenesis, physiology, and pathophysiology. Specifically, long non-coding RNAs (lncRNA) have been shown to interact with the transcriptome in various ways that alter gene expression. Previously, multiple lncRNAs have been identified in disease processes such as heart failure, coronary artery disease, diabetes, and more. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: Savalan Babapoor-Farrokhran, Deanna Gill, Roozbeh Tarighati Rasekhi Source Type: research

Prevalence and clinical impact of spontaneous and adenosine-induced pulmonary vein reconduction in the Contact-Force vs. Cryoballoon Atrial Fibrillation Ablation (CIRCA-DOSE) Study
The use of an intraprocedural observation and pharmacologic challenges have been proposed as a means to differentiate permanent pulmonary vein (PV)-left atrial conduction block from inadequate ablation lesions. (Source: Heart Rhythm)
Source: Heart Rhythm - January 20, 2020 Category: Cardiology Authors: Jason G. Andrade, Marc W. Deyell, Stanley Nattel, Paul Khairy, Marc Dubuc, Jean Champagne, Peter Leong-Sit, Umjeet Jolly, Mariano Badra, John Sapp, Atul Verma, Laurent Macle, CIRCA-DOSE Study Investigators Source Type: research

Ventricular-triggered atrial pacing: a new maneuver for slow-fast atrioventricular nodal reentrant tachycardia
Atrioventricular (AV) node duality is suggested by several electrophysiological findings, none of which are strong predictors of AV nodal reentrant tachycardia (AVNRT). (Source: Heart Rhythm)
Source: Heart Rhythm - January 16, 2020 Category: Cardiology Authors: Josselin Duchateau, Romain Tixier, Konstantinos Vlachos, Yosuke Nakatani, F. Daniel Ramirez, Cl émentine André, William Escande, Rémi Chauvel, Thomas Pambrun, Nicolas Derval, Frédéric Sacher, Mélèze Hocini, Pierre Jaïs, Michel Haissaguerre Source Type: research

Value of Mapping and Ablation of Ventricular Tachycardia Targets within the Coronary Venous System in Patients with Non-ischemic Cardiomyopathy
Patients with nonischemic cardiomyopathy (NICM) often require an epicardial ventricular tachycardia (VT) ablation procedures via subxiphoid access. The coronary venous system (CVS) provides limited access to the epicardial space (Source: Heart Rhythm)
Source: Heart Rhythm - January 15, 2020 Category: Cardiology Authors: Michael Ghannam, Konstantinos C. Siontis, Hubert Cochet, Pierre Jais, Mehdi Juhoor, Rakesh Sharaf Dabbagh, Miki Yokokawa, Fred Morady, Frank Bogun Source Type: research

Predicting Atrial Fibrillation using a Combination of Genetic Risk Score and Clinical Risk Factors
Atrial fibrillation (AF) has a genetic basis, and environmental factors can modify its actual pathogenesis. (Source: Heart Rhythm)
Source: Heart Rhythm - January 10, 2020 Category: Cardiology Authors: Yousaku Okubo, Yukiko Nakano, Hidenori Ochi, Yuko Onohara, Takehito Tokuyama, Chikaaki Motoda, Michitaka Amioka, Naoya Hironobe, Sho Okamura, Yoshihiro Ikeuchi, Syunsuke Miyauchi, Kazuaki Chayama, Yasuki Kihara Source Type: research

Algorithm for the analysis of pre-extraction computed tomographic images to evaluate implanted lead –lead interactions and lead–vascular attachments
The number of lead extractions is growing because of the greater population and increasing age of individuals with a cardiac implantable electronic device. Lead extraction procedures can be complex undertakings with risk of significant mortality, and vascular tears in the superior vena cava are of greatest concern. (Source: Heart Rhythm)
Source: Heart Rhythm - January 9, 2020 Category: Cardiology Authors: Mikayle A. Holm, Pierce J. Vatterott, Erik N. Gaasedelen, Imran Syed, Akbar Khan, Tinen L. Iles, Paul A. Iaizzo Source Type: research

Outcomes following implantable cardioverter –defibrillator generator replacement in adults: A systematic review
Randomized trials inform the use of implantable cardioverter –defibrillators (ICDs) for prevention of sudden cardiac death, yet management of patients considering ICD generator replacement procedures remains largely dependent on clinical judgment. Thus, we performed a systematic review of all studies evaluating outcomes associated with ICD generator replace ment. We queried PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews for relevant studies with a prespecified search and adjudication strategy (PROSPERO registration number CRD42018100818) to evaluate outcomes including (1) survival; (2...
Source: Heart Rhythm - January 9, 2020 Category: Cardiology Authors: Killian J. McCarthy, Andrew H. Locke, Margo Coletti, Diane Young, Faisal M. Merchant, Daniel B. Kramer Tags: Contemporary Review Source Type: research

Algorithm for the Analysis of Pre-extraction Computed Tomography Images to Evaluate Implanted Lead-Lead Interactions and Lead-Vascular Attachments
The number of lead extractions is growing due to a higher population and the increasing age of individuals with cardiac implantable electronic devices. Lead extraction procedures can be complex undertakings with risk of significant mortality, and vascular tears in the superior vena cava are of greatest concern. (Source: Heart Rhythm)
Source: Heart Rhythm - January 9, 2020 Category: Cardiology Authors: Mikayle A. Holm, Pierce J. Vatterott, Erik N. Gaasedelen, Imran Syed, Akbar Khan, Tinen L. Iles, Paul A. Iaizzo Source Type: research

Outcomes Following Implantable Cardioverter-Defibrillator Generator Replacement in Adults: A Systematic Review
Randomized trials inform the use of implantable cardioverter-defibrillators (ICD) for prevention of sudden cardiac death, yet management of patients considering ICD generator replacement procedures remains largely dependent on clinical judgment. Thus, we performed a systematic review of all studies evaluating outcomes associated with ICD generator replacement. We queried PubMed, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews for relevant studies with a pre-specified search and adjudication strategy (PROSPERO registration number CRD42018100818) to evaluate outcomes including: 1. (Source: Heart Rhythm)
Source: Heart Rhythm - January 9, 2020 Category: Cardiology Authors: Killian J. McCarthy, Andrew H. Locke, Margo Coletti, Diane Young, Faisal M. Merchant, Daniel B. Kramer Source Type: research

Oral Anticoagulant and Reduced Risk of Dementia in Patients with Atrial Fibrillation: A Population-Based Cohort Study
It remains unclear whether oral anticoagulation (OAC) can prevent dementia or cognitive impairment (CI) in patients with atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - January 9, 2020 Category: Cardiology Authors: Pajaree Mongkhon, Laura Fanning, Wallis C.Y. Lau, Gary Tse, Kui Kai Lau, Li Wei, Chuenjid Kongkaew, Ian C.K. Wong Source Type: research

Stellate ganglion stimulation causes spatiotemporal changes in ventricular repolarization in pig
Dispersion in ventricular repolarization is relevant for arrhythmogenesis. (Source: Heart Rhythm)
Source: Heart Rhythm - January 5, 2020 Category: Cardiology Authors: Veronique M.F. Meijborg, Bastiaan J.D. Boukens, Michiel J. Janse, Siamak Salavatian, Michael J. Dacey, Koji Yoshie, Tobias Opthof, Mohammed Amer Swid, Jonathan D. Hoang, Peter Hanna, Jeffrey Ardell, Kalyanam Shivkumar, Ruben Coronel Source Type: research

Improving long QT syndrome diagnosis by a polynomial-based T-wave morphology characterization
Diagnosing long QT syndrome (LQTS) remains challenging because of a considerable overlap in QT interval between LQTS and healthy subjects. Characterizing T-wave morphology might improve LQTS diagnosis. (Source: Heart Rhythm)
Source: Heart Rhythm - January 5, 2020 Category: Cardiology Authors: Ben J.M. Hermans, Frank C. Bennis, Arja S. Vink, Tijmen Koopsen, Aurore Lyon, Arthur A.M. Wilde, Dieter Nuyens, Tomas Robyns, Laurent Pison, Pieter G. Postema, Tammo Delhaas Source Type: research

Improving Long-QT syndrome Diagnosis by a Polynomial-Based T-wave Morphology Characterization
Diagnosing long-QT syndrome (LQTS) remains challenging due to a considerable overlap in QT-interval between LQTS and healthy subjects. Characterizing T-wave morphology might improve LQTS diagnosis. (Source: Heart Rhythm)
Source: Heart Rhythm - January 5, 2020 Category: Cardiology Authors: Ben J.M. Hermans, Frank C. Bennis, Arja S. Vink, Tijmen Koopsen, Aurore Lyon, Arthur A.M. Wilde, Dieter Nuyens, Tomas Robyns, Laurent Pison, Pieter G. Postema, Tammo Delhaas Source Type: research

Cold-inducible RNA-binding protein modulates atrial fibrillation onset by targeting multiple ion channels
Atrial fibrillation (AF), the most common sustained arrhythmia, significantly increases cardiovascular and cerebrovascular morbidity and mortality. The pathogenesis and treatment of AF remain a major challenge in the field of cardiology. We previously found that cold-inducible RNA-binding protein (CIRP) regulated ventricular repolarization by post-transcriptionally regulating Kv4.2/4.3 ion channels in rats, but the role of CIRP in AF is not clear. (Source: Heart Rhythm)
Source: Heart Rhythm - January 5, 2020 Category: Cardiology Authors: Duanyang Xie, Li Geng, Shuo Wang, Ke Xiong, Tingting Zhao, Guanghua Wang, Zhiqiang Feng, Fei Lv, Cheng Wang, Dandan Liang, Dan Shi, Xiue Ma, Yi Liu, Jian Yang, Chao Zhang, Yi-Han Chen Source Type: research

Stellate ganglion stimulation causes spatiotemporal changes of ventricular repolarization in pig
Dispersion in ventricular repolarization is relevant for arrhythmogenesis. (Source: Heart Rhythm)
Source: Heart Rhythm - January 5, 2020 Category: Cardiology Authors: Veronique M.F. Meijborg, Bastiaan J.D. Boukens, Michiel J. Janse, Siamak Salavatian, Michael Dacey, Koji Yoshie, Tobias Opthof, Mohammad Amer Swid, Jonathan D. Hoang, Peter Hanna, Jeffrey Ardell, Kalyanam Shivkumar, Ruben Coronel Source Type: research

Distinct Calcium/CAlmodulin-dependent Serine protein Kinase domains control cardiac sodium channel membrane expression and focal adhesion anchoring
Membrane-associated guanylate kinase (MAGUK) proteins function as adaptor proteins to mediate the recruitment and scaffolding of ion channels in the plasma membrane in various cell types. In the heart, the protein CASK (Calcium/CAlmodulin-dependent Serine protein Kinase) negatively regulates the main cardiac sodium channel, NaV1.5, which carries the sodium current (INa) by preventing its anterograde trafficking. CASK is also a new member of the dystrophin-glycoprotein complex, and like syntrophin, binds to the C-terminal domain of the channel. (Source: Heart Rhythm)
Source: Heart Rhythm - January 1, 2020 Category: Cardiology Authors: Adeline Beuriot, Catherine A. Eichel, Gilles Dilanian, Florent Louault, Dario Melgari, Nicolas Doisne, Alain Coulombe, St éphane N. Hatem, Elise Balse Source Type: research

State of the Journal 2020
Heart Rhythm Journal (HRJ) is entering its 17th year. In addition to the Heart Rhythm Society (HRS) and the Cardiac Electrophysiology Society, HRJ is now also the official journal of the Pediatric& Congenital Electrophysiology Society. HRJ continues to excel on multiple fronts and is the most cited arrhythmia-focused journal (Figure 1A). The impact factor increased from 4.743 to 5.225, and the Google Scholar ranking is 10th of all cardiology journals and 1st among arrhythmia-focused journals. The average time to first decision is 10 days. (Source: Heart Rhythm)
Source: Heart Rhythm - December 31, 2019 Category: Cardiology Authors: Peng-Sheng Chen Tags: Editorial Source Type: research

Hearing your voices
It is my great honor to greet you as the Chief Executive Officer of the Heart Rhythm Society (HRS). It is a privilege to lead this great organization and build on the many contributions that your long-time executive James Youngblood provided. I have now been with HRS for 10 months, and they have been educational, inspirational, and intriguing. (Source: Heart Rhythm)
Source: Heart Rhythm - December 31, 2019 Category: Cardiology Authors: Patricia Blake Tags: Message from the CEO Source Type: research

EP News: Basic and Translational
Zhao and Li (Sci Rep 2019;9:18504, PMID 31811197) determined the effects of the inhibition of multiple cardiac ion channels on electrophysiology using a family of cardiac cell models (Purkinje, endocardial, mid-myocardial, and epicardial). The authors reported that QT prolongation alone might not be sufficient to predict arrhythmogenicity since it does not necessary lead to early afterdepolarization (EAD) events. In addition, mid-myocardial cells are more vulnerable to drug-induced arrhythmias and can develop EAD at slower pacing rates. (Source: Heart Rhythm)
Source: Heart Rhythm - December 25, 2019 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

Improving Outcomes After Left Atrial Appendage Closure
Dr. Estes has no conflicts of interest related to this editorial. (Source: Heart Rhythm)
Source: Heart Rhythm - December 25, 2019 Category: Cardiology Authors: N. A. Mark Estes Source Type: research

Higher Risk at the Lower End of the Age Spectrum in Brugada Syndrome
Brugada syndrome, a familial arrhythmia syndrome with a characteristic ECG appearance and increased risk for sudden death, is usually diagnosed in middle-aged men.1 Of historical interest, the paper attributed as the original description of Brugada syndrome included 8 patients, 3 of whom were children (2-8 years).2 An earlier paper described comparable ECG findings in 6 patients with “idiopathic” ventricular fibrillation, 3 of whom were children (14-18 years).3 Although children comprised many of the patients in the original reports, Brugada syndrome is indeed rare during childhood. (Source: Heart Rhythm)
Source: Heart Rhythm - December 23, 2019 Category: Cardiology Authors: M. Benjamin Shoemaker, Prince J. Kannankeril Source Type: research

EP News: Allied Professionals
In this multicenter, single-blind, randomized trial, Andrade et  al (Circulation 2019;140:1779, PMID 31630538) sought to assess the efficacy of pulmonary vein isolation (PVI) via contact force radiofrequency (CF RF) vs second generation cryoballoon using 2 different strategies—2-minute and 4-minute ablation durations—in patients with paroxysmal atrial fibri llation (AF). All patients failed class I or III antiarrhythmic drugs and were randomized in a 1:1:1 fashion to CF RF (n = 115), 2-minute cryoballoon (Cryo-2; n = 117), or 4-minute cryoballoon (Cryo-4; n = 115) ablation. (Source: Heart Rhythm)
Source: Heart Rhythm - December 20, 2019 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

EP News: Clinical
Perez et  al (N Engl J Med 2019;381:1909, PMID 31722151) assessed the ability of a smartwatch application (app) to identify atrial fibrillation (AF). Participants without AF used a smartphone app for consent. If the algorithm identified possible AF, a telemedicine visit was initiated and an electrocardiogra phy (ECG) patch was mailed to the participant. The main objectives were to estimate the proportion of notified participants with AF shown on an ECG patch and the positive predictive value of irregular pulse intervals. (Source: Heart Rhythm)
Source: Heart Rhythm - December 20, 2019 Category: Cardiology Authors: N.A. Mark Estes Tags: Ep News Source Type: research

EP News: Case Reports
In patients with significant heart failure or refractory arrhythmias, left ventricular assist devices can be used to provide procedural stability during ventricular tachycardia (VT) ablation. Percutaneous right ventricular assist devices (pRVADs) are also available, but their use to assist in VT ablation has not been reported in patients with significant right ventricular cardiomyopathies. Aguilar et  al (DOI: https://doi.org/10.1016/j.hrcr.2019.10.019) shared a case of a 71-year-old man with late surgical repair of a sinus venosus atrial septal defect and severe right ventricular dilatation with moderate systolic dys...
Source: Heart Rhythm - December 20, 2019 Category: Cardiology Authors: T. Jared Bunch Tags: Ep News Source Type: research

Arrhythmia recurrence is more common in females undergoing multiple catheter ablation procedures for persistent atrial fibrillation: Time to close the gender gap.
Female gender is associated with an increase in recurrence of atrial fibrillation (AF) following catheter ablation (CA). Although AF is more common in men, women make up a significant proportion with persistent AF (PsAF). (Source: Heart Rhythm)
Source: Heart Rhythm - December 18, 2019 Category: Cardiology Authors: Hariharan Sugumar, Shane Nanayakkara, David Chieng, Geoffrey R. Wong, Ramanathan Parameswaran, Robert D. Anderson, Ahmed Al-Kaisey, Chrishan J. Nalliah, Sonia Azzopardi, Sandeep Prabhu, Aleksandr Voskoboinik, Geoffrey Lee, Alex J. McLellan, Liang-Han Ling Source Type: research