Outcomes for catheter ablation of anteroseptal and midseptal accessory pathways in pediatric patients
Outcomes for catheter ablation of accessory pathways in pediatric patients have steadily improved, with the exception of pathways located in the anteroseptal (AS) and midseptal (MS) regions, which is limited by the close proximity of normal atrioventricular (AV) conduction. (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2019 Category: Cardiology Authors: Joshua R. Kovach, Douglas Y. Mah, Dominic J. Abrams, Mark E. Alexander, Frank Cecchin, John K. Triedman, Edward P. Walsh Source Type: research

Sudden Cardiac Death Risk Prediction in Heart Failure with Preserved Ejection Fraction
Sudden cardiac death (SCD) comprises 25% of the deaths in heart failure with preserved ejection fraction (HFpEF). (Source: Heart Rhythm)
Source: Heart Rhythm - December 11, 2019 Category: Cardiology Authors: Selcuk Adabag, Lisa Langsetmo Source Type: research

Prognostic Impact of Atrial Rhythm and Dimension in Patients with Structural Heart Disease Undergoing Cardiac Sympathetic Denervation for Ventricular Arrhythmias
Cardiac sympathetic denervation (CSD) is a promising treatment for patients with structural heart disease (SHD) and refractory ventricular tachyarrhythmias (VT). The effect of CSD on atrial rhythm, as well as the prognostic impact of atrial arrhythmias (AAs) or left atrial volume index (LAVI) on CSD outcome is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - December 10, 2019 Category: Cardiology Authors: Veronica Dusi, Julie M. Sorg, Jeffrey Gornbein, Jean Gima, Jane Yanagawa, Jay M. Lee, Natalia Vecerek, Marmar Vaseghi, Jason S. Bradfield, Gaetano M. De Ferrari, Kalyanam Shivkumar, Olujimi A. Ajijola Source Type: research

Pulmonary vein isolation and beyond: Predictive value of vagal reactions in second-generation cryoballoon ablation for the outcome of persistent atrial fibrillation
Cryoballoon ablation (CBA) is gaining increasing acceptance in the treatment of persistent (per) atrial fibrillation (AF). The cardiac autonomic nervous system plays a pivotal role in the regulation of AF. (Source: Heart Rhythm)
Source: Heart Rhythm - December 9, 2019 Category: Cardiology Authors: Denise Guckel, Anke Schmidt, Klaus-J ürgen Gutleben, Britta Körber, Thomas Fischbach, Dieter Horstkotte, Philipp Sommer, Georg Nölker Source Type: research

Long-term transesophageal echocardiography follow-up after percutaneous left atrial appendage closure
Peri-device leaks and device thrombi are assumed to lead to ischemic events after percutaneous left atrial appendage occlusion (LAAO). While these device related complications are well assessed until 12 months after LAAO, no data are available beyond this period. (Source: Heart Rhythm)
Source: Heart Rhythm - December 9, 2019 Category: Cardiology Authors: Stephan Staubach, Leonhard Schlatterbeck, Moritz M örtl, Henning Strohm, Petra Hoppmann, Karl-Ludwig Laugwitz, Harald Mudra, Jakob Ledwoch Source Type: research

An Unusual Supraventricular Tachycardia with Discrepant Findings: What is the Mechanism?
The patient was a 55 year old female with a longstanding history of recurrent palpitations, despite ongoing use of propranolol for essential tremor. Holter monitoring documented a narrow complex tachycardia (Figure 1A) which prompted electrophysiology study. Quadripolar catheters were placed in the right atrium (RA) and right ventricle (RV), and steerable decapolar catheters were positioned across the His bundle region (His) and inside the coronary sinus (CS). The baseline rhythm was sinus with normal atrial-His (AH) and His-ventricular (HV) intervals. (Source: Heart Rhythm)
Source: Heart Rhythm - December 9, 2019 Category: Cardiology Authors: Matthew Ortman, Jared A. Collins, Talya Spivack, Reginald T. Ho Source Type: research

Pulmonary Vein Isolation and Beyond: Predictive Value of Vagal Reactions in Second Generation Cryoballoon Ablation for the Outcome of Persistent Atrial Fibrillation
Cryoballoon ablation (CBA) is gaining increasing acceptance in the treatment of persistent (per) atrial fibrillation (AF). The cardiac autonomic nervous system (ANS) plays a pivotal role in regulation of AF. (Source: Heart Rhythm)
Source: Heart Rhythm - December 9, 2019 Category: Cardiology Authors: Denise Guckel, Anke Schmidt, Klaus-J ürgen Gutleben, Britta Körber, Thomas Fischbach, Dieter Horstkotte, Philipp Sommer, Georg Nölker Source Type: research

Both selective and nonselective His bundle, but not myocardial, pacing preserve ventricular electrical synchrony assessed by ultra-high-frequency ECG
Right ventricular myocardial pacing leads to nonphysiological activation of heart ventricles. Contrary to this, His bundle pacing preserves their fast activation. Ultra-high-frequency electrocardiography (UHF-ECG) is a novel tool for ventricular depolarization assessment. (Source: Heart Rhythm)
Source: Heart Rhythm - December 1, 2019 Category: Cardiology Authors: Karol Curila, Radka Prochazkova, Pavel Jurak, Marek Jastrzebski, Josef Halamek, Pawel Moskal, Petr Stros, Jana Vesela, Petr Waldauf, Ivo Viscor, Filip Plesinger, Ondrej Sussenbek, Dalibor Herman, Pavel Osmancik, Radovan Smisek, Pavel Leinveber, Danuta Cza Source Type: research

Both Selective and Non-Selective His Bundle, but not Myocardial, Pacing Preserve Ventricular Electrical Synchrony Assessed by Ultra-High-Frequency ECG
Right ventricular myocardial pacing leads to non-physiological activation of heart ventricles. Contrary to this, His bundle pacing preserves their fast activation. Ultra-high-frequency ECG (UHF-ECG) is a novel tool for ventricular depolarization assessment. (Source: Heart Rhythm)
Source: Heart Rhythm - December 1, 2019 Category: Cardiology Authors: Karol Curila, Radka Prochazkova, Pavel Jurak, Marek Jastrzebski, Josef Halamek, Pawel Moskal, Petr Stros, Jana Vesela, Petr Waldauf, Ivo Viscor, Filip Plesinger, Ondrej Sussenbek, Dalibor Herman, Pavel Osmancik, Radovan Smisek, Pavel Leinveber, Danuta Cza Source Type: research

Amiodarone treatment in atrial fibrillation and the risk of incident cancers: a nationwide observational study
In observational studies, case reports, and animal studies, amiodarone has been associated with incident cancer. (Source: Heart Rhythm)
Source: Heart Rhythm - November 28, 2019 Category: Cardiology Authors: Peter Vibe Rasmussen, Frederik Dalgaard, Gunnar Hilmar Gislason, Christian Torp-Pedersen, Jonathan Piccini, Maria D ’Souza, Martin H. Ruwald, Jannik Langtved Pallisgaard, Morten Lock Hansen Source Type: research

Implantable Cardioverter-Defibrillators and Patient-Reported Outcomes in Adults with Congenital Heart Disease: an International Study
Implantable cardioverter-defibrillators (ICDs) are increasingly used to prevent sudden deaths in the growing population of adults with congenital heart disease (CHD). Yet, little is known about their impact on patient-reported outcomes (PROs). (Source: Heart Rhythm)
Source: Heart Rhythm - November 28, 2019 Category: Cardiology Authors: Val érie Lévesque, Laurence Laplante, Azadeh Shohoudi, Silke Apers, Adrienne H. Kovacs, Koen Luyckx, Corina Thomet, Werner Budts, Junko Enomoto, Maayke A. Sluman, Chun-Wei Lu, Jamie L. Jackson, Stephen C. Cook, Shanthi Chidambarathanu, Luis Alday, Katri Source Type: research

Age at Diagnosis of Brugada Syndrome: Influence on Clinical Characteristics and Risk of Arrhythmia
Despite a strong genetic background, Brugada syndrome (BrS) mainly affects middle-aged patients. Data are scarce in the youngest and oldest age groups. (Source: Heart Rhythm)
Source: Heart Rhythm - November 28, 2019 Category: Cardiology Authors: Mathilde Minier, Vincent Probst, Pauline Berthome, Romain Tixier, Jean Briand, Olivier Geoffroy, Nicolas Clementy, Jacques Mansourati, Laurence Jesel, Jean-Marc Dupuis, Paul Bru, Florence Kyndt, B éatrice Guyomarch, Aurélie Thollet, Nathalie Behar, Phil Source Type: research

A narrow QRS tachycardia easily provoked by exercise during sinus rhythm
A 15-year-old boy was referred to our outpatient clinic for the evaluation of palpitations. They started 2 years ago, happening daily after light exercise. When exercise was continued, he noted acceleration of palpitations and onset of dyspnea. Those complaints were reason to reduce exercise as much as possible. The use of a β-blocking agent (metoprolol), prescribed by his general physician, resulted in less palpitations but they still appeared during exercise. (Source: Heart Rhythm)
Source: Heart Rhythm - November 27, 2019 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

The Heart Rhythm journey: Education, engagement, and expanding reach
The vision of the Heart Rhythm Society (HRS) is to “end death and suffering from heart rhythm disorders,” which is certainly a bold and courageous goal. If anyone can achieve this, I am confident that our passionate members can. Innovation, hard work, and discovery have taken us on an incredible journey over the past 40 years and steered us to t he road of success. (Source: Heart Rhythm)
Source: Heart Rhythm - November 27, 2019 Category: Cardiology Authors: Andrea M. Russo Tags: President's Page Source Type: research

EP News: Quality Improvement and Outcomes
In this issue of HeartRhythm, we continue this quarterly feature highlighting important developments and advances in quality improvement or systems-based practice improvement in the delivery of heart rhythm care. This issue focuses on quality improvement surrounding atrial fibrillation (AF) and highlights some opportunities for measuring, reporting, and improving the quality of heart rhythm care for AF. (Source: Heart Rhythm)
Source: Heart Rhythm - November 22, 2019 Category: Cardiology Authors: Jonathan C. Hsu, Anne Marie Smith, Jonathan P. Piccini Tags: EP News Source Type: research

EP News: Clinical
Andrade et  al (Circulation October 21, 2019, https://doi.org/10.1161/CIRCULATIONAHA.119.042622, PMID 31630538) randomly assigned 346 patients with drug-refractory paroxysmal atrial fibrillation (AF) to contact force–guided radiofrequency ablation (CF-RF ablation, 115), 4-minute cryoballoon ablation (CRYO-4 , 115), or 2-minute cryoballoon ablation (CRYO-2, 116). The primary outcome was time to first documented recurrence of symptomatic or asymptomatic atrial tachyarrhythmia (AF, atrial flutter, or atrial tachycardia) between days 91 and 365 postablation or a repeat ablation procedure at any time. (Source: Heart Rhythm)
Source: Heart Rhythm - November 22, 2019 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Case Reports
Inappropriate sinus tachycardia (IST) is a syndrome of an inappropriately elevated heart rate (>100 beats/min at rest or with modest activity). Medical therapy is often poorly tolerated and/or ineffective in improving symptoms. Catheter ablation has been advocated as a means to modify the sinus node and improve the heart rate, but lack of efficacy and procedural end points limit its broad use. Reissmann et  al (DOI: https://doi.org/10.1016/j.hrcr.2019.10.016) shared a case series of 3 patients with IST. (Source: Heart Rhythm)
Source: Heart Rhythm - November 22, 2019 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

EP News: Basic and Translational
In the current study, Ardell et  al (JCI Insight 2019;pii:131648, PMID 31671074) investigate the mechanism underlying cardiac neural decentralization and spinal cord stimulation (SCS) in ischemia-induced ventricular fibrillation (VF) and sudden cardiac death (SCD) in a canine model using direct measurement of norepinephrine (NE) levels in the left ventricular interstitial fluid. Transient left anterior descending coronary artery occlusion (CAO) was performed. The authors demonstrate that during CAO, there was a 152% increase in NE level when the neuraxis was intact compared to 114% after intrathoracic neuraxial decent...
Source: Heart Rhythm - November 22, 2019 Category: Cardiology Authors: Nipavan Chiamvimonvat Source Type: research

EP News: Allied Professionals
In this retrospective review of data from a national database, Cheng et  al (J Am Coll Cardiol 2019;74:2254–2264, PMID 31672181) sought to assess the incidence, trends, and predictors of early mortality (within first 30 days) after atrial fibrillation (AF) ablation. They used the National Readmissions Database (NRD), which is administered by the United States governm ent to provide a nationally representative sample and bins discharges by diagnosis and procedures performed and then tracks readmissions in the same state within the same calendar year. (Source: Heart Rhythm)
Source: Heart Rhythm - November 22, 2019 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

Reply to the Editor —S-ICD Oversensing: A Fork in the Road
We thank Mr Monkhouse and Dr Lambiase for their interest in our article and for sharing their own experience with the S-ICD. (Source: Heart Rhythm)
Source: Heart Rhythm - November 21, 2019 Category: Cardiology Authors: Antoine Noel, Sylvain Ploux, Pierre Bordachar Source Type: research

Letter to the Editor —S-ICD Oversensing: A Fork in the Road
We read with interest the article by Noel et  al1 published in the Heart Rhythm Journal. However, we have concerns regarding the high rates of oversensing with the subcutaneous implantable cardioverter-defibrillator (S-ICD) and the fact the device had to be extracted in 5.6% of cases, without the use of preoperative screening intensively to e nsure maximum sensing vector options (right/sternal) or consideration of lead/generator repositioning early or even pre-emptively. (Source: Heart Rhythm)
Source: Heart Rhythm - November 21, 2019 Category: Cardiology Authors: Christopher Monkhouse, Pier Lambiase Source Type: research

Validating Defibrillation Simulation in a Human-Shaped Phantom
We previously developed a computational model to aid clinicians in positioning implantable cardioverter defibrillators (ICDs), especially in the case of abnormal anatomies that commonly arise in pediatric cases. We have validated the model clinically on the body surface; however, validation within the volume of the heart is required to establish complete confidence in the model and improve its use in clinical settings. (Source: Heart Rhythm)
Source: Heart Rhythm - November 21, 2019 Category: Cardiology Authors: Jess D. Tate, Thomas A. Pilcher, Kedar K. Aras, Brett M. Burton, Rob, S. MacLeod Source Type: research

Letter to the editor: S-ICD oversensing, a fork in the road
We read with interest the article by Noel et.al1 but have concerns regarding the high rates of oversensing with the S-ICD and that 5.6% of cases had to be extracted, rather than pre-operatively screen intensively to ensure maximum sensing vector options (right/sternal) or consider lead/generator repositioning early and even pre-emptively. (Source: Heart Rhythm)
Source: Heart Rhythm - November 21, 2019 Category: Cardiology Authors: Christopher Monkhouse, Pier Lambiase Source Type: research

Letter to the editor: S-ICD oversensing, a fork in the road.
We thank Christopher Monkhouse and Pier Lambiase for their interest in our article, and for sharing their own experience with S-ICD. (Source: Heart Rhythm)
Source: Heart Rhythm - November 21, 2019 Category: Cardiology Authors: Antoine Noel, Sylvain Ploux, Pierre Bordachar Source Type: research

Comparison of Measures of Ventricular Delay on Cardiac Resynchronization Therapy Response
Left ventricular(LV) pacing at sites of prolonged LV delay(QLV) or at long interventricular delay(RV-LV) is strongly associated with cardiac resynchronization therapy(CRT) response. QLV and RV-LV have been independently evaluated, but little is known regarding the interrelationship between these measures or of delay to the RV. (Source: Heart Rhythm)
Source: Heart Rhythm - November 21, 2019 Category: Cardiology Authors: Michael E. Field, Nancy Yu, Nicholas Wold, Michael R. Gold Source Type: research

Predictors and Outcomes of Atrial Tachyarrhythmia among Patients with Implantable Defibrillators
atrial tachyarrhythmia (ATA) are common among heart failure (HF) patients. (Source: Heart Rhythm)
Source: Heart Rhythm - November 21, 2019 Category: Cardiology Authors: Arwa Younis, E. Kevin Heist, Scott McNitt, Mehmet K. Aktas, Spencer Rosero, Ilan Goldenberg, Valentina Kutyifa Source Type: research

New electromechanical substrate abnormalities in high-risk patients with Brugada syndrome
The relationship between the typical electrocardiographic pattern and electromechanical abnormalities has never been systematically explored in Brugada syndrome (BrS). (Source: Heart Rhythm)
Source: Heart Rhythm - November 18, 2019 Category: Cardiology Authors: Carlo Pappone, Valerio Mecarocci, Francesco Manguso, Giuseppe Ciconte, Gabriele Vicedomini, Francesco Sturla, Emiliano Votta, Beniamino Mazza, Paolo Pozzi, Valeria Borrelli, Luigi Anastasia, Emanuele Micaglio, Emanuela Locati, Michelle Monasky, Massimo Lo Source Type: research

Application of noninvasive signal-averaged electrocardiogram analysis in predicting the requirement of epicardial ablation in patients with arrhythmogenic right ventricular cardiomyopathy
Signal-averaged electrocardiogram (SAECG) provides not only diagnostic information but also the prognostic implication of ablation in arrhythmogenic right ventricular cardiomyopathy (ARVC). (Source: Heart Rhythm)
Source: Heart Rhythm - November 18, 2019 Category: Cardiology Authors: Fa-Po Chung, Chin-Yu Lin, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Ting-Yung Chang, Vern Hsen Tan, Ling Kuo, Cheng-I Wu, Chih-Min Liu, Jennifer Jeanne B. Vicera, Chun-Chao Chen, Chye-Gen Chin, Shin-H Source Type: research

Effect of acute and chronic ethanol on atrial fibrillation vulnerability in rats
Even though ethanol consumption has been associated with risk of atrial fibrillation (AF), little is known about how ethanol affects atrial electrophysiology.Objectives: to study electrophysiologic effect of ethanol on rat atrial fibrillation. (Source: Heart Rhythm)
Source: Heart Rhythm - November 18, 2019 Category: Cardiology Authors: Hao Zhang, Hongmei Ruan, Dolkun Rahmutula, Emily Wilson, Gregory M. Marcus, Vasanth Vedantham, Jeffrey Olgin Source Type: research

Influence of Vegetation Shape on Outcomes in Transvenous Lead Extractions: Does Shape Matter?
Small vegetations ( (Source: Heart Rhythm)
Source: Heart Rhythm - November 18, 2019 Category: Cardiology Authors: Yingyot Arora, Adryan A. Perez, Roger G. Carrillo Source Type: research

Skin sympathetic nerve activity and ventricular rate control during atrial fibrillation
The relationship between ventricular rate (VR) during atrial fibrillation (AF) and the skin sympathetic nerve activity (SKNA) remain unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - November 18, 2019 Category: Cardiology Authors: Takashi Kusayama, Anthony Douglas, Juyi Wan, Anisiia Doytchinova, Johnson Wong, Gloria Mitscher, Susan Straka, Changyu Shen, Thomas H. Everett, Peng-Sheng Chen Source Type: research

The Application of Noninvasive Signal-averaged Electrocardiogram Analysis in Predicting the Requirement of Epicardial Ablation in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy
Signal-averaged electrocardiogram (SAECG) provides not only diagnostic information but also the prognostic implication of ablation in arrhythmogenic right ventricular cardiomyopathy (ARVC). (Source: Heart Rhythm)
Source: Heart Rhythm - November 18, 2019 Category: Cardiology Authors: Fa-Po Chung, Chin-Yu Lin, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Tze-Fan Chao, Jo-Nan Liao, Ting-Yung Chang, Vern Hsen Tan, Ling Kuo, Cheng-I. Wu, Chih-Min Liu, Jennifer Jeanne B. Vicera, Chun-Chao Chen, Chye-Gen Chin, Shin- Source Type: research

New Electro-Mechanical Substrate Abnormalities in High-Risk Patients with Brugada Syndrome
The relationship between the typical ECG pattern and electro-mechanical abnormalities has never been systematically explored in Brugada syndrome. (Source: Heart Rhythm)
Source: Heart Rhythm - November 18, 2019 Category: Cardiology Authors: Carlo Pappone, Valerio Mecarocci, Francesco Manguso, Giuseppe Ciconte, Gabriele Vicedomini, Francesco Sturla, Emiliano Votta, Beniamino Mazza, Paolo Pozzi, Valeria Borrelli, Luigi Anastasia, Emanuele Micaglio, Emanuela Locati, Michelle Monasky, Massimo Lo Source Type: research

Evaluation of the reentry vulnerability index to predict ventricular tachycardia circuits using high-density contact mapping
Identifying arrhythmogenic sites to improve ventricular tachycardia (VT) ablation outcomes remains unresolved. The reentry vulnerability index (RVI) combines activation and repolarization timings to identify sites critical for reentrant arrhythmia initiation without inducing VT. (Source: Heart Rhythm)
Source: Heart Rhythm - November 17, 2019 Category: Cardiology Authors: Michele Orini, Adam J. Graham, Neil T. Srinivasan, Fernando O. Campos, Ben M. Hanson, Anthony Chow, Ross J. Hunter, Richard J. Schilling, Malcolm Finlay, Mark J. Earley, Simon Sporton, Mehul Dhinoja, Martin Lowe, Bradley Porter, Nicholas Child, Christophe Source Type: research

Evaluation of the Re-entry Vulnerability Index to Predict Ventricular Tachycardia Circuits Using High Density Contact Mapping
Identifying arrhythmogenic sites to improve ventricular tachycardia (VT) ablation outcomes remains unresolved. The re-entry vulnerability index (RVI) combines activation and repolarization timings to identify sites critical for re-entrant arrhythmia initiation without inducing VT. (Source: Heart Rhythm)
Source: Heart Rhythm - November 17, 2019 Category: Cardiology Authors: Michele Orini, Adam J. Graham, Neil T. Srinivasan, Fernando O. Campos, Ben M. Hanson, Anthony Chow, Ross J. Hunter, Richard J. Schilling, Malcolm Finlay, Mark J. Earley, Simon Sporton, Mehul Dhinoja, Martin Lowe, Bradley Porter, Nicholas Child, Christophe Source Type: research

Early repolarization pattern on ECG recorded before the acute coronary event does not predict ventricular fibrillation during ST-elevation myocardial infarction
Generally considered benign, electrocardiographic (ECG) early repolarization (ER) pattern was claimed to be an indicator of increased susceptibility to ventricular arrhythmias during acute ischemia. (Source: Heart Rhythm)
Source: Heart Rhythm - November 13, 2019 Category: Cardiology Authors: Marina M. Demidova, Jonas Carlson, David Erlinge, Pyotr Platonov Source Type: research

Early repolarization pattern on ECG recorded prior to the acute coronary event does not predict ventricular fibrillation during ST-elevation myocardial infarction
Generally considered as benign, electrocardiographic early repolarization (ER) pattern was claimed to be an indicator of increased susceptibility to ventricular arrhythmias during acute ischemia. (Source: Heart Rhythm)
Source: Heart Rhythm - November 13, 2019 Category: Cardiology Authors: Marina M. Demidova, Jonas Carlson, David Erlinge, Pyotr Platonov Source Type: research

To the Editor — Understanding the complex anatomy of the Marshall bundle might improve the ablation efficacy
We read with great interest the article by Vlachos et  al,1 in which they reported that recurrences of Marshall bundle (MB) conduction were mostly observed after radiofrequency ablation (49%) compared with ethanol infusion (11%).1 Undoubtedly, MB, an epicardial structure, is challenging for clinical practice because of its complex anatomy.2 In our pre vious study,2 with a stepwise approach to elaborately mapping large areas of the lateral left atrium (LA) and/or coronary sinus (CS), MB connections could be successfully eliminated by radiofrequency ablation from endocardial and/or within the CS in 59 of 61 patients (96...
Source: Heart Rhythm - November 6, 2019 Category: Cardiology Authors: Songwen Chen, Genqing Zhou, Xiaofeng Lu, Yong Wei, Shaowen Liu Tags: Letter to the editor Source Type: research

Reply to the Editor — Understanding the complex anatomy of the marshall bundle might improve the ablation efficacy
Chen et  al1 highlight perceived differences in acute and medium-term success rates between their mapping and ablation strategies for creating mitral isthmus (MI) lines1 and our recently reported outcomes of Marshall bundle (MB) reentrant atrial tachycardia (AT) ablation.2 (Source: Heart Rhythm)
Source: Heart Rhythm - November 6, 2019 Category: Cardiology Authors: F. Daniel Ramirez, Nicolas Derval Tags: Letter to the Editor Source Type: research

Understanding the complex anatomy of Marshall bundle might improve the ablation efficacy
We read with great interest the Vlachos and colleagues ’ article, in which they reported that recurrences of Marshall bundle (MB) conduction were mostly observed after radiofrequency ablation (49%) compared to ethanol infusion (11%).1 Undoubtedly, MB, an epicardial structure, is challenging for clinical practice due to its complex anatomy.2 In our pre vious study2, with a stepwise approach to elaborately mapping large areas of lateral left atrium (LA) and/or coronary sinus (CS), the MB connections could be successfully eliminated by radiofrequency ablation from endocardial and/or within CS in 96.7% (59/61) patients. ...
Source: Heart Rhythm - November 6, 2019 Category: Cardiology Authors: Songwen Chcen, Genqing zhou, Xiaofeng Lu, Yong Wei, Shaowen Liu Source Type: research

Author ’s reply to: Understanding the complex anatomy of the Marshall bundle might improve ablation efficacy
Chen et al highlight perceived differences in acute and medium-term success rates between their mapping and ablation strategy for creating mitral isthmus (MI) lines1 and our recently reported outcomes of Marshall bundle (MB) reentrant atrial tachycardia (AT) ablation.2 (Source: Heart Rhythm)
Source: Heart Rhythm - November 6, 2019 Category: Cardiology Authors: F. Daniel Ramirez, Nicolas Derval Source Type: research

Long-term impact of catheter ablation on arrhythmia burden in low-risk patients with paroxysmal atrial fibrillation: the CLOSE to CURE study
Few studies evaluated the impact of catheter ablation (CA) on atrial tachyarrhythmia (ATA) burden in paroxysmal atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - November 6, 2019 Category: Cardiology Authors: Mattias Duytschaever, Jan De Pooter, Anthony Demolder, Milad El Haddad, Thomas Phlips, Teresa Strisciuglio, Philippe Debonnaire, Michael Wolf, Yves Vandekerckhove, Sebastien Knecht, Rene Tavernier Source Type: research

Safety of uninterrupted direct oral anticoagulants for ambulatory common atrial flutter catheter ablation: a propensity score-matched cohort study.
Same-day home discharge after common atrial flutter catheter ablation (CAFCA) is a feasible, safe and cost-effective practice, but there is currently no data concerning patients treated with direct oral anticoagulants (DOAs). (Source: Heart Rhythm)
Source: Heart Rhythm - November 6, 2019 Category: Cardiology Authors: Pierre Ollitrault, Mathieu Chequel, Laure Champ-Rigot, Patrick Bittar, Arnaud Pellissier, Joachim Alexandre, Damien Legallois, Paul Milliez Source Type: research

Impact of age and sex on the long-term prognosis associated with early repolarization in the general population
Early repolarization (ER) has been linked to the risk of sudden cardiac death (SCD) in the general population, although controversy remains regarding risks across various subgroups. (Source: Heart Rhythm)
Source: Heart Rhythm - October 31, 2019 Category: Cardiology Authors: Arttu Holkeri, Antti Eranti, M. Anette E. Haukilahti, Tuomas Kerola, Tuomas V. Kentta ¨, Jani T. Tikkanen, Harri Rissanen, Markku Helio¨vaara, Paul Knekt, M. Juhani Junttila, Aapo L. Aro, Heikki V. Huikuri Source Type: research

2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy: Executive summary
Arrhythmogenic cardiomyopathy (ACM) is an arrhythmogenic disorder of the myocardium not secondary to ischemic, hypertensive, or valvular heart disease. ACM incorporates a broad spectrum of genetic, systemic, infectious, and inflammatory disorders. This designation includes, but is not limited to, arrhythmogenic right/left ventricular cardiomyopathy, cardiac amyloidosis, sarcoidosis, Chagas disease, and left ventricular noncompaction. The ACM phenotype overlaps with other cardiomyopathies, particularly dilated cardiomyopathy with arrhythmia presentation that may be associated with ventricular dilatation and/or impaired syst...
Source: Heart Rhythm - October 29, 2019 Category: Cardiology Authors: Jeffrey A. Towbin, William J. McKenna, Dominic J. Abrams, Michael J. Ackerman, Hugh Calkins, Francisco C.C. Darrieux, James P. Daubert, Christian de Chillou, Eugene C. DePasquale, Milind Y. Desai, N.A. Mark Estes, Wei Hua, Julia H. Indik, Jodie Ingles, Cy Source Type: research

EP News: Clinical
Yasada et  al (N Engl J Med 2019;381:1103, PMID 31475793) conducted a prospective randomized multicenter trial of 2236 patients with atrial fibrillation (AF) who had undergone percutaneous coronary intervention or coronary artery bypass grafting more than 1 year earlier or who had angiographically confirmed coronary artery disease not requiring revascularization. Patients were randomized to monotherapy with rivaroxaban or combination therapy with rivaroxaban plus a single antiplatelet agent. The primary efficacy end point was a composite of stroke, systemic embolism, myocardial infarction, unstable ang ina requiring r...
Source: Heart Rhythm - October 27, 2019 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Basic and Translational
Boyle et  al (Nat Biomed Eng August 19, 2019; doi:10.1038/s41551-019-0437-9, PMID 31427780) provided evidence for personalized computational modeling for the predetermination of ablation targets to guide the ablation procedure in patients with persistent atrial fibrillation (AF) and atrial fibrosis. The per sonalized computational models of the atria are reconstructed from each patient’s late gadolinium enhancement magnetic resonance imaging scans and are designed to eliminate the ability of the patient’s fibrotic substrate to sustain AF. (Source: Heart Rhythm)
Source: Heart Rhythm - October 27, 2019 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

EP News: Case Reports
Removal of chronic leads remains one of the most challenging aspects of long-term pacemaker and implantable cardioverter-defibrillator (ICD) management, and procedural morbidity and mortality remain relatively high compared to other electrophysiology procedures. Singleton et  al (DOI: https://doi.org/10.1016/j.hrcr.2019.08.007) shared a case of a 78-year-old man with an ICD due to a history of ventricular tachycardia and high-grade atrioventricular block. He was referred for an elective generator replacement and lead extraction because of a 16-year-old recalled right v entricular lead (St. (Source: Heart Rhythm)
Source: Heart Rhythm - October 27, 2019 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

EP News: Allied Professionals
Gigli et  al (J Am Coll Cardiol 2019;74:1480, PMID 31514951) sought to assess the correlation of the genotype with the outcome in a large group of patients with nonischemic cardiomyopathy (NICM). To accomplish their goal, they evaluated group of patients with NICM who had next generation sequencing genetic testing. All patients had NICM with left ventricular (LV) ejection fraction (LVEF) (Source: Heart Rhythm)
Source: Heart Rhythm - October 27, 2019 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

Defibrillation failure in patients undergoing replacement of subcutaneous defibrillator pulse generator
Defibrillation threshold (DFT) testing is commonly performed in patients undergoing subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation. Growing evidence indicates that successful DFT testing correlates with the technique used for implantation of the defibrillation lead and pulse generator. However, evidence on whether DFT testing should be performed in patients undergoing S-ICD pulse generator replacement is lacking. (Source: Heart Rhythm)
Source: Heart Rhythm - October 24, 2019 Category: Cardiology Authors: Boris Rudic, Erol T ülümen, Fabian Fastenrath, Ibrahim Akin, Martin Borggrefe, Jürgen Kuschyk Source Type: research