EP News: Basic and Translational
Structural and electrical remodeling play critical roles in the maintenance of atrial arrhythmias. Rommel et  al (Circ Res 2018;123:550–563, PMID 29930145) sought to identify transcription factors and downstream target genes involved in atrial structural remodeling in atrial tissues from patients with permanent atrial fibrillation (AF). They identified the transcription factor ETV1 (E twenty-six variant 1) to be significantly upregulated in AF. Moreover, Etv1 expression was 5-fold higher in atria compared to ventricular tissues. (Source: Heart Rhythm)
Source: Heart Rhythm - October 26, 2018 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

Performance And Limitations Of Non-Invasive Cardiac Activation Mapping
Activation mapping using non-invasive electrocardiographic imaging (ECGi) has recently been used to describe the physiology of different pathologies. These descriptions differ from prior invasive studies, and both methods have not been thoroughly confronted in a clinical setting. (Source: Heart Rhythm)
Source: Heart Rhythm - October 26, 2018 Category: Cardiology Authors: Josselin Duchateau, Fr édéric Sacher, Thomas Pambrun, Nicolas Derval, Judit Chamorro-Servent, Arnaud Denis, Sylvain Ploux, Mélèze Hocini, Pierre Jaïs, Olivier Bernus, Michel Haissaguerre, Rémi Dubois Source Type: research

Impact of the Arrhythmogenic Potential of Long Lines of Conduction Slowing at the Pulmonary Vein Area
Areas of conduction delay (CD) or block (CB) are associated with higher recurrence rates after ablative therapy for atrial fibrillation (AF). (Source: Heart Rhythm)
Source: Heart Rhythm - October 25, 2018 Category: Cardiology Authors: Elisabeth M.J.P. Mouws, Lisette J.M.E. van der Does, Charles Kik, Eva A.H. Lanters, Christophe P. Teuwen, Paul Knops, Ad J.J.C. Bogers, Natasja M.S. de Groot Source Type: research

Evaluation and Management of Ventricular Tachycardia in Patients with Dilated Cardiomyopathy
Recurrent VT is an important cause of increased morbidity and mortality in patients with non-ischemic DCM. Current recommendations for the treatment of VT in patients with structural heart disease rely mainly on data derived from patients with ICM. Unlike post-infarction ICM, DCM comprises multiple different etiologies with variable disease progression and prognosis, which often requires an individualized approach to risk stratification and treatment. Prevention of VT recurrence in DCM is challenging, especially when antiarrhythmic drugs are ineffective or contraindicated. (Source: Heart Rhythm)
Source: Heart Rhythm - October 25, 2018 Category: Cardiology Authors: Micaela Ebert, Sergio Richter, Borislav Dinov, Katja Zeppenfeld, Gerhard Hindricks Source Type: research

Association of regional myocardial conduction velocity with the distribution of hypoattenuation on contrast-enhanced perfusion computed tomography in patients with post-infarct ventricular tachycardia
Cardiac magnetic resonance imaging has been shown to be beneficial for identification of the ventricular tachycardia (VT) substrate prior to catheter ablation. Contrast-enhanced perfusion multidetector CT (CEP-MDCT) is more generalizable to clinical practice; and wall thickness and regional hypoenhancement on CEP-MDCT can identify potential substrate sites, albeit with decreased specificity. (Source: Heart Rhythm)
Source: Heart Rhythm - October 25, 2018 Category: Cardiology Authors: Tuna Ustunkaya, Benoit Desjardins, Bolun Liu, Sohail Zahid, Jaeseok Park, Nissi Saju, Natalia Trayanova, Stefan L. Zimmerman, Francis E. Marchlinski, Saman Nazarian Source Type: research

Long-term performance of a pacing lead family: A single-center experience
The performance of Abbott/St. Jude Medical Tendril pacing leads has not been well characterized. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Mikhael F. El-Chami, Birju Rao, Anand D. Shah, Carolyn Wood, Michael Sayegh, Patrick Zakka, Krista Ginn, Lauren Pallotta, Bryanna Evans, Michael H. Hoskins, David Delurgio, Michael Lloyd, Jonathan Langberg, Angel R. Leon, Faisal M. Merchant Source Type: research

Use and outcomes of subcutaneous implantable cardioverter-defibrillator (ICD) after transvenous ICD extraction: An analysis of current clinical practice and a comparison with transvenous ICD reimplantation
The subcutaneous implantable cardioverter-defibrillator (S-ICD) does not require the insertion of any leads into the cardiovascular system. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Stefano Viani, Federico Migliore, Gianfranco Tola, Ennio C.L. Pisan ò, Antonio Dello Russo, Giovanni Luzzi, Paolo Sartori, Agostino Piro, Roberto Rordorf, Giovanni Battista Forleo, Anna Rago, Luca Segreti, Emanuele Bertaglia, Mauro Biffi, Mariolina Lovec Source Type: research

Bachmann bundle and interatrial conduction: comparing atrial morphology to electrical activity
Bachmann bundle (BB) is one of the major interatrial muscular connections. Macroscopic anatomy and electrophysiological properties of BB have so far not been linked, and differences in activation patterns are most likely due to anatomical variations. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Wiebe G. Knol, Christophe P. Teuwen, Gert-Jan Kleinrensink, Ad J.J.C. Bogers, Natasja M.S. de Groot, Yannick J.H.J. Taverne Source Type: research

Ablation compared with drug therapy for recurrent ventricular tachycardia in arrhythmogenic right ventricular cardiomyopathy: Results from a multicenter study
The comparative efficacy of antiarrhythmic drug (AAD) therapy vs ventricular tachycardia (VT) ablation in arrhythmogenic right ventricular cardiomyopathy (ARVC) is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Saagar Mahida, Jeroen Venlet, Ardan Muammer Saguner, Saurabh Kumar, Samuel H. Baldinger, Amir AbdelWahab, Usha B. Tedrow, Silvia Castelletti, Antonis Pantazis, Roy M. John, William J. McKenna, Pier D. Lambiase, Firat Duru, John L. Sapp, Katja Zeppenfeld, Source Type: research

Ablation Compared to Drug Therapy for Recurrent Ventricular Tachycardia in Arrhythmogenic Right Ventricular Cardiomyopathy; Results from a Multicenter Study
The comparative efficacy of antiarrhythmic drug therapy (AAD) versus ventricular tachycardia (VT) ablation in arrhythmogenic right ventricular cardiomyopathy (ARVC) is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Saagar Mahida, Jeroen Venlet, Ardan Muammer Saguner, Saurabh Kumar, Samuel H. Baldinger, Amir AbdelWahab, Usha B. Tedrow, Silvia Castelletti, Antonis Pantazis, Roy M. John, William J. McKenna, Pier D. Lambiase, Firat Duru, John L. Sapp, Katja Zeppenfeld, Source Type: research

Bachmann ’s Bundle and interatrial conduction; comparing atrial morphology to electrical activity.
Bachmann ’s bundle (BB) is one of the major interatrial muscular connections. Macroscopic anatomy and electrophysiological properties of BB have so far not been linked and differences in activation patterns are most likely due to anatomical variations. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Wiebe G. Knol, Christophe P. Teuwen, Gert-Jan Kleinrensink, Ad J.J.C. Bogers, Natasja M.S. de Groot, Yannick J.H.J. Taverne Source Type: research

Incidence and Predictors of Atrial Fibrillation Progression: A Systematic Review and Meta-Analysis
More sustained forms of atrial fibrillation (AF) are less amenable to treatment and associated with worse outcomes, but the incidence and predictors of AF-progression are not well defined. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Steffen Blum, Pascal Meyre, Stefanie Aeschbacher, Sebastian Berger, Chlo é Auberson, Matthias Briel, Stefan Osswald, David Conen Source Type: research

Protected channels can be formed by a functional line of block in human atrial tachycardia
A 63-year-old woman with hypertrophic cardiomyopathy underwent a second ablation procedure for persistent atrial tachycardia (AT). She had undergone a pulmonary vein isolation, left atrial (LA) roof line ablation, and ablation targeting complex fractionated electrograms for atrial fibrillation 2 years prior. The starting rhythm was stable AT with a cycle length of 333ms. Ultra-high resolution activation mapping (Rhythmia, Boston Scientific, Cambridge, MA) and entrainment mapping revealed that the mechanism was a single-loop reentrant AT with a narrow channel on the LA septum (Fig. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Shinsuke Miyazaki, Kanae Hasegawa, Kenichi Kaseno, Hiroshi Tada Source Type: research

Long-Term Performance of A Pacing Lead Family: A Single Center Experience
The performance of Abbott/St Jude Tendril pacing leads has not been well characterized. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Mikhael F. El-Chami, Birju Rao, Anand D. Shah, Carolyn Wood, Michael Sayegh, Patrick Zakka, Krista Ginn, Lauren Pallotta, Bryanna Evans, Michael H. Hoskins, David Delurgio, Michael Lloyd, Jonathan Langberg, Angel R. Leon, Faisal M. Merchant Source Type: research

Significance of Clinical Ventricular Tachycardias Induced by Antitachycardia Pacing in Patients with Prior Myocardial Infarction
In patients with implantable cardioverter-defibrillators (ICD), ventricular tachycardia (VT) can occur spontaneously or as a result of antitachycardia pacing (ATP) that changes, rather than terminates, a spontaneous VT to a different VT. The relevance of ATP-induced VTs is uncertain. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Ghaith Sharaf-Dabbagh, Konstantinos C. Siontis, Rakesh Latchamsetty, Krit Jongnarangsin, Miki Yokokawa, Sangeeta Lathkar-Pradhan, Fred Morady, Frank Bogun Source Type: research

Use and Outcomes of Subcutaneous Implantable Cardioverter Defibrillator (ICD) After Trans-venous ICD Extraction: an Analysis of Current Clinical Practice and a Comparison with Trans-venous ICD Reimplantation
The subcutaneous implantable cardioverter-defibrillator (S-ICD) does not require the insertion of any leads into the cardiovascular system. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Stefano Viani, Federico Migliore, Gianfranco Tola, Ennio CL. Pisan ò, Antonio Dello Russo, Giovanni Luzzi, Paolo Sartori, Agostino Piro, Roberto Rordorf, Giovanni Battista Forleo, Anna Rago, Luca Segreti, Emanuele Bertaglia, Mauro Biffi, Mariolina Lovecc Source Type: research

The Bachmann bundle and interatrial conduction: comparing atrial morphology to electrical activity
The Bachmann bundle (BB) is one of the major interatrial muscular connections. Macroscopic anatomy and electrophysiological properties of BB have so far not been linked, and differences in activation patterns are most likely due to anatomical variations. (Source: Heart Rhythm)
Source: Heart Rhythm - October 23, 2018 Category: Cardiology Authors: Wiebe G. Knol, Christophe P. Teuwen, Gert-Jan Kleinrensink, Ad J.J.C. Bogers, Natasja M.S. de Groot, Yannick J.H.J. Taverne Tags: Experimental Source Type: research

The importance of being selective
The normal initiation and orderly propagation of electrical impulses through the heart requires a tightly orchestrated sequence of changes in ionic currents that sum to produce the dynamic and phasic change in membrane potential referred to as the cardiac action potential. This process is enabled by multiple ion channel proteins having exquisite selectivity for specific permeating ions. For example, voltage-gated sodium channels prefer Na+ ions over K+ and Ca2+ by a factor of ∼50, whereas voltage-gated potassium channels have an ∼100-fold preference for K+ over Na+ ions. (Source: Heart Rhythm)
Source: Heart Rhythm - October 17, 2018 Category: Cardiology Authors: Alfred L. George Tags: Editorial Commentary Source Type: research

Patient plus partner trial: A randomized controlled trial of 2 interventions to improve outcomes after an initial implantable cardioverter-defibrillator
Interventions to improve physical and psychological outcomes in recipients with an initial implantable cardioverter-defibrillator (ICD) and their intimate partners are largely unstudied, though likely to have a major impact on adjustment to the ICD and general well-being. (Source: Heart Rhythm)
Source: Heart Rhythm - October 16, 2018 Category: Cardiology Authors: Cynthia M. Dougherty, Elaine A. Thompson, Peter J. Kudenchuk Source Type: research

Leadless cardiac pacemakers: Paradigm shift in cardiac pacing
Since the first permanent endocardial pacemaker was implanted, there have been significant technological advancements in device programming, lead function, and battery longevity. However, the device design for the conventional transvenous pacemaker had essentially remained unchanged —a pulse generator connected to 1 or more transvenous leads. The complications associated with these devices were either related to subcutaneous pocket, including hematomas or skin erosions increasing the risk of infection, acute complications at the time of implant such as cardiac tamponade and p neumothorax, or late complications such a...
Source: Heart Rhythm - October 16, 2018 Category: Cardiology Authors: Jalaj Garg, Vivek Y. Reddy Tags: Editorial Commentary Source Type: research

Catheter ablation of premature ventricular complexes arising from the left fascicular system
Idiopathic premature ventricular complexes (PVCs) that originate from the left fascicular system have rarely been reported. (Source: Heart Rhythm)
Source: Heart Rhythm - October 16, 2018 Category: Cardiology Authors: Jinlin Zhang, Cheng Tang, Yonghua Zhang, Xi Su Source Type: research

Patient Plus Partner Trial: A Randomized Control Trial of Two Interventions to Improve Outcomes following an Initial Implantable Cardioverter Defibrillator
Interventions to improve physical and psychological outcomes in recipients with an initial implantable cardioverter (ICD) and their intimate partners are largely unstudied, though likely to have a major impact on adjustment to the ICD and general well-being. (Source: Heart Rhythm)
Source: Heart Rhythm - October 16, 2018 Category: Cardiology Authors: Cynthia M. Dougherty, Elaine A. Thompson, Peter J. Kudenchuk Source Type: research

Leadless cardiac pacemakers – Paradigm shift in cardiac pacing
Since the first permanent endocardial pacemaker was implanted, there have been significant technological advancements in device programming, lead function and battery longevity. However, the device design for the conventional transvenous pacemaker had essentially remained unchanged – a pulse generator connected to 1 or more transvenous leads. The complications associated with these devices were either related to subcutaneous pocket, including hematomas or skin erosions increasing the risk of infection, acute complications at the time of implant such as cardiac tamponade and pneumothorax, or late complications such as...
Source: Heart Rhythm - October 16, 2018 Category: Cardiology Authors: Jalaj Garg, Vivek Y. Reddy Source Type: research

Permanent His Bundle Pacing Anatomy: I Can See Clearly Now
Much of what is currently understood about permanent His bundle pacing in humans comes from inferences combining classical anatomical definitions, autopsy studies1, 2, imaging of leads with fluoroscopy3, ultrasound2, 4 (Source: Heart Rhythm)
Source: Heart Rhythm - October 16, 2018 Category: Cardiology Authors: Daniel L. Lustgarten Source Type: research

Global Disparities in Cardiac Pacemaker Therapy: Problem Statement, Potential Solution, and Call to Action
While permanent pacing has improved millions of lives since its adoption almost sixty years ago, global usage has varied significantly, with particularly low application rates in many low-middle income countries (LMICs) with symptomatic, life-threatening bradyarrhythmias. This manuscript highlights the importance of pacemaker underutilization in many LMICs and reviews potential solutions, emphasizing the scientific advances supporting pacemaker reutilization. (Source: Heart Rhythm)
Source: Heart Rhythm - October 12, 2018 Category: Cardiology Authors: Joseph E. Marine, Thomas C. Crawford, Sunil K. Sinha, Behzad B. Pavri, Sri Sundaram, Kim A. Eagle, Stephen C. Vlay, Thomas F. Deering Source Type: research

Impact of dense “smoke” detected on transesophageal echocardiography on stroke risk in patients with atrial fibrillation undergoing catheter ablation
Spontaneous echocardiographic contrast ( ”smoke”) within the left atrial cavity on transesophageal echocardiography (TEE) suggests low blood flow velocities in the heart that may lead to thromboembolic (TE) events. (Source: Heart Rhythm)
Source: Heart Rhythm - October 9, 2018 Category: Cardiology Authors: Ömer Gedikli, Sanghamitra Mohanty, Chintan Trivedi, Carola Gianni, Qiong Chen, Domenico Giovanni Della Rocca, J. David Burkhardt, Javier E. Sanchez, Patrick Hranitzky, G. Joseph Gallinghouse, Amin Al-Ahmad, Rodney Horton, Luigi Di Biase, Andrea Natale Source Type: research

Mitral isthmus ablation: A hierarchical approach guided by electroanatomic correlation
Mitral isthmus ablation is an established technique used to treat perimitral atrial flutter. The classic approach involves creating an ablation line connecting the left inferior pulmonary vein (LIPV) to the lateral mitral annulus.1 Its feasibility was first prospectively studied by Jais et  al,1 who reported a high rate of bidirectional block. However, subsequent studies by the same group, as well as others, have been less promising.2 This is important because failure to achieve bidirectional block with ablation has been shown to be proarrhythmic. (Source: Heart Rhythm)
Source: Heart Rhythm - October 9, 2018 Category: Cardiology Authors: Bhupesh Pathik, Subbarao Choudry, William Whang, Andre D ’Avila, Jacob Koruth, Aamir Sofi, Marc A. Miller, Srinivas Dukkipati, Vivek Y. Reddy Tags: Hands On Source Type: research

Impact of dense ‘Smoke’ detected on Transesophageal Echocardiography on stroke-risk in patients with atrial fibrillation undergoing catheter ablation
Spontaneous echocardiographic contrast ( ‘Smoke’) within the left atrial cavity on transesophageal echocardiography (TEE) suggests low blood flow velocities in the heart that may consequently lead to thromboembolic (TE) events. (Source: Heart Rhythm)
Source: Heart Rhythm - October 9, 2018 Category: Cardiology Authors: Ömer Gedikli, Sanghamitra Mohanty, Chintan Trivedi, Carola Gianni, Qiong Chen, Domenico Giovanni Della Rocca, J. David Burkhardt, Javier E. Sanchez, Patrick Hranitzky, G. Joseph Gallinghouse, Amin Al-Ahmad, Rodney Horton, Luigi Di Biase, Andrea Natale Source Type: research

Mitral Isthmus Ablation: A Hierarchical Approach Guided By Electroanatomical Correlation
Mitral isthmus ablation is an established technique used to treat peri-mitral atrial flutter. The classical approach involves creating an ablation line connecting the left inferior pulmonary vein (LIPV) to the lateral mitral annulus.1 Its feasibility was first prospectively studied by Jais et al, who reported a high rate of bidirectional block.1 However, subsequent work by the same group, as well as others, have been less promising.2 This is important since failure to achieve bidirectional block with ablation has been shown to be proarrhythmic. (Source: Heart Rhythm)
Source: Heart Rhythm - October 9, 2018 Category: Cardiology Authors: Bhupesh Pathik, Subbarao Choudry, William Whang, Andre D ’Avila, Jacob Koruth, Aamir Sofi, Marc A. Miller, Srinivas Dukkipati, Vivek Y. Reddy Source Type: research

Safety and accuracy of the Rhythmia mapping system in pediatric patients
A new mapping system (Rhythmia) using a 64 mini-electrode small basket array (Orion) was developed that enables rapid high-density mapping in a short time. However, there are few reports about the usefulness of this system in pediatric cases. (Source: Heart Rhythm)
Source: Heart Rhythm - October 8, 2018 Category: Cardiology Authors: Hitoshi Mori, Syota Muraji, Naokata Sumitomo, Ritsushi Kato, Tomohiko Imamura, Akiko Komori, Noriyuki Iwashita, Toshiki Kobayashi, Kazuo Matsumoto Source Type: research

The Safety and Accuracy of the RHYTHMIA Mapping System in Pediatric Patients
A new mapping system (Rhythmia) using a 64 mini-electrode small basket array (Orion) was developed and enables rapid high-density mapping in a short time. However, there are few reports about the usefulness of this system in pediatric cases. (Source: Heart Rhythm)
Source: Heart Rhythm - October 8, 2018 Category: Cardiology Authors: Hitoshi Mori, Syota Muraji, Naokata Sumitomo, Ritsushi Kato, Tomohiko Imamura, Akiko Komori, Noriyuki Iwashita, Toshiki Kobayashi, Kazuo Matsumoto Source Type: research

Cardiac sympathetic denervation via a transtracheal approach: It ’s a long way to Tipperary
The intriguing history of the clinical attempts to protect patients from life-threatening cardiac arrhythmias by surgically interfering with the sympathetic innervation of the heart goes back more than 100 years1 and has been thoroughly reviewed.2,3 Whenever novel approaches are proposed, the first step should be a fair assessment of the current situation. (Source: Heart Rhythm)
Source: Heart Rhythm - October 5, 2018 Category: Cardiology Authors: Peter J. Schwartz, Luigi Pugliese Tags: Editorial Commentary Source Type: research

A novel tool to evaluate the implant position and predict defibrillation success of the subcutaneous implantable defibrillator: the PRAETORIAN score
Suboptimal positioning of the subcutaneous implantable defibrillator (S-ICD) increases the defibrillation threshold and risk of conversion failure. (Source: Heart Rhythm)
Source: Heart Rhythm - October 4, 2018 Category: Cardiology Authors: Anne-Floor B.E. Quast, Sarah W.E. Baalman, Tom F. Brouwer, L. Smeding, Arthur A.M. Wilde, Martin C. Burke, Reinoud E. Knops Source Type: research

Native T1 Mapping as a Biomarker of Underlying Ventricular Myopathy and its Reversal in Patients with Atrial Fibrillation and Preserved Ejection Fraction Undergoing Catheter Ablation
Atrial fibrillation (AF) is a progressive disease that is not only a consequence of structural, hemodynamic and electrophysiological remodeling but also a perpetuator of the same processes. These factors often coexist in a complex arrhythmogenic substrate characterized by infiltration of diffuse fibrosis in the myocardium.1 There is now compelling evidence to suggest that the substrate is rarely restricted to the atria alone, but rather commonly present as extensive myocardial remodeling throughout the myocardium. (Source: Heart Rhythm)
Source: Heart Rhythm - October 3, 2018 Category: Cardiology Authors: Dragana Rujic, Saman Nazarian Source Type: research

The Changing Epidemiology of Ventricular Arrhythmias and Sudden Cardiac Death: Is it a Reality?
A few reports have suggested that the risk of sudden cardiac death (SCD) may be decreasing in patients with systolic heart failure.1-3 While this may be true and can be explained by improved pharmacologic and device-based therapies, it is important to keep in mind the context in which this decreasing risk of SCD was observed. The vast majority of data on the declining risk of SCD were generated in randomized clinical trials which notoriously enroll “healthier” patients receiving excellent medical therapy that is often hard to achieve in clinical practice. (Source: Heart Rhythm)
Source: Heart Rhythm - October 3, 2018 Category: Cardiology Authors: Sana M. Al-Khatib, Christopher B. Granger Source Type: research

A wobbling tachycardia: What is the mechanism?
A 34-year-old man presented to the emergency department with acute onset palpitations and dyspnea. His electrocardiogram revealed a wide QRS complex tachycardia with a typical left bundle branch block pattern that spontaneously converted to sinus rhythm. (Source: Heart Rhythm)
Source: Heart Rhythm - October 1, 2018 Category: Cardiology Authors: Benjamin M. Moore, Raymond W. Sy, Kim H. Chan Tags: Unknown of the Month Source Type: research

Type 2 diabetes and coronary artery disease: Preserved ejection fraction and sudden cardiac death
Previous studies have shown that type 2 diabetes (DM2) is associated with sudden cardiac death (SCD) risk in post –myocardial infarction patients. The treatment of coronary artery disease (CAD) as well as DM2 has changed over time. (Source: Heart Rhythm)
Source: Heart Rhythm - October 1, 2018 Category: Cardiology Authors: M. Juhani Junttila, Antti M. Kiviniemi, E. Samuli Lepoj ärvi, Mikko Tulppo, Olli-Pekka Piira, Tuomas Kenttä, Juha S. Perkiömäki, Olavi H. Ukkola, Robert J. Myerburg, Heikki V. Huikuri Tags: Clinical Source Type: research

A 73-year-old woman with high-degree AV block
A 73-year-old woman was admitted because of severe shortness of breath. Six years ago she had experienced an inferior myocardial infarction. Her ECG on admission is shown in Figure  1. (Source: Heart Rhythm)
Source: Heart Rhythm - October 1, 2018 Category: Cardiology Authors: Hein J. Wellens Tags: Josephson and Wellens ECG Lessons: A Monthly Visit to the 12 Lead ECG Source Type: research

Positive impact of pulmonary vein isolation on biventricular pacing in nonresponders to cardiac resynchronization therapy
Cardiac resynchronization therapy (CRT) is less effective in patients with atrial fibrillation (AF) because of impaired ventricular CRT capture. (Source: Heart Rhythm)
Source: Heart Rhythm - September 28, 2018 Category: Cardiology Authors: Thomas Fink, Enida Rexha, Michael Schl üter, Christine Lemes, Tilman Maurer, Christian-Hendrik Heeger, Bruno Reissmann, Laura Rottner, Tobias Tönnis, Amaar Ujeyl, Matthias Krüger, Nathaniel Portz, Peter Wohlmuth, Shibu Mathew, Feifan Ouyang, Andreas Ri Source Type: research

Temporal Relationships between Esophageal Injury Type and Progression in Patients Undergoing Atrial Fibrillation Catheter Ablation
Currently very little is known about the onset, natural progression and management of esophageal injuries after Atrial fibrillation (AF) ablation. (Source: Heart Rhythm)
Source: Heart Rhythm - September 28, 2018 Category: Cardiology Authors: Bharath Yarlagadda, Thomas Deneke, Mohit Turagam, Tawseef Dar, Swathi Paleti, Valay Parikh, Luigi DiBiase, Philipp Halfbass, Pasquale Santangeli, Srijoy Mahapatra, Jie Cheng, Andrea Russo, James Edgerton, Moussa Mansour, Jeremy Ruskin, Srinivas Dukkipati, Source Type: research

Positive impact of pulmonary vein isolation on biventricular pacing in non-responders to cardiac resynchronization therapy
Cardiac resynchronisation therapy (CRT) is less effective in patients with atrial fibrillation (AF) due to impaired ventricular CRT capture. (Source: Heart Rhythm)
Source: Heart Rhythm - September 28, 2018 Category: Cardiology Authors: Thomas Fink, Enida Rexha, Michael Schl üter, Christine Lemes, Tilman Maurer, Christian-Hendrik Heeger, Bruno Reissmann, Laura Rottner, Tobias Tönnis, Amaar Ujeyl, Matthias Krüger, Nathaniel Portz, Peter Wohlmuth, Shibu Mathew, Feifan Ouyang, Andreas Ri Source Type: research

Arrhythmogenic cardiomyopathy: What blood can reveal
Blood, serum, and plasma represent accessible sources of data about physiological and pathologic status. In arrhythmogenic cardiomyopathy (ACM), circulating nucleated cells are routinely used for detection of germinal genetic mutations. In addition, different biomarkers have been proposed for diagnostic purposes and for monitoring disease progression, including inflammatory cytokines, markers of myocardial dysfunction and damage, and microRNAs. This review summarizes the current information that can be retrieved from the blood of ACM patients and considers the future prospects. (Source: Heart Rhythm)
Source: Heart Rhythm - September 26, 2018 Category: Cardiology Authors: Ilaria Stadiotti, Giulio Pompilio, Angela Serena Maione, Chiara Assunta Pilato, Yuri D ’Alessandra, Elena Sommariva Source Type: research

EP News: Basic and Translational
Sudden cardiac death from ventricular arrhythmias accounts for a significant number of deaths in patients suffering from heart failure (HF). Dey et  al (Circ Res 2018;123:356, PMID 29898892) tested the mechanistic roles of mitochondrial reactive oxygen species (mROS) in an in vivo model of nonischemic HF. The investigators demonstrated that there is a significant increase in mROS in failing ventricular myocytes. More importantly, treatment wi th MitoTEMPO, a mitochondrially targeted antioxidant, results in normalization of cellular ROS, reverses HF, as well as electrical remodeling. (Source: Heart Rhythm)
Source: Heart Rhythm - September 26, 2018 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

Arrhythmogenic Cardiomyopathy: what blood can reveal?
Blood, serum and plasma represent accessible sources of data about physiological and pathological status. In Arrhythmogenic Cardiomyopathy (ACM), circulating nucleated cells are routinely employed for detection of germinal genetic mutations. In addition, different biomarkers have been proposed for diagnostic purposes and for monitoring disease progression, and these include inflammatory cytokines, markers of myocardial dysfunction and damage, microRNAs. This review summarizes the current information that can be retrieved from the blood of ACM patients and consider the future prospects. (Source: Heart Rhythm)
Source: Heart Rhythm - September 26, 2018 Category: Cardiology Authors: Ilaria Stadiotti, Giulio Pompilio, Angela Serena Maione, Chiara Assunta Pilato, Yuri D ’Alessandra, Elena Sommariva Source Type: research

Correction
In the article by Kusumoto et  al, “Systematic review for the 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society,” which published ahead of print on October 30, 2017, and appeared in the October 2018 issue of the journal (Heart Rhythm 2018;15:e253–e274. DOI: https://doi.org/10.1016/j.hrthm.2017.10.037), several corrections were made during the proofing stage and are outlined below. ...
Source: Heart Rhythm - September 26, 2018 Category: Cardiology Tags: Correction Source Type: research

Correction
In the article by Al-Khatib et  al, “2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death : A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society,” which publish ed ahead of print on October 30, 2017, and appeared in the October 2018 issue of the journal (Heart Rhythm 2018;15:e73–e189. DOI: https://doi.org/10.1016/j.hrthm.2017.10.036), several corrections were made during the proofing stage and are outlined below. (Source: Heart Rhythm)
Source: Heart Rhythm - September 26, 2018 Category: Cardiology Tags: Correction Source Type: research

Correction
In the article by Al-Khatib et  al, “2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society ,” which published ahead of print on October 30, 2017, and appeared in the October 2018 issue of the journal (Heart Rhythm 2018;15:e190–e252. DOI: https://doi.org/10.1016/j.hrthm.2017.10.035), several corrections were made during the proofing stage and are outlined below. (Source: Heart Rhythm)
Source: Heart Rhythm - September 26, 2018 Category: Cardiology Tags: Correction Source Type: research

EP News: Heart Rhythm Case Reports
In patients with persistent subtypes of atrial fibrillation (AF), the left atrial appendage (LAA) can be a critical source of nonpulmonary vein triggering. The addition of empirical isolation of the appendage in patients with persistent AF has been shown to improve arrhythmia-free outcomes compared to standard-of-care ablation approaches. The LAA can be challenging to isolate and often requires higher power settings and extensive ablation to create durable isolation. Ibrahim et  al (DOI: https://doi.org/10.1016/j.hrcr.2018.06.007) shared 2 cases from LEIO-AF (LAA Electrical Isolation and Occlusion to Treat Persistent ...
Source: Heart Rhythm - September 25, 2018 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

Sudden Cardiac Death in Patients Undergoing Dialysis: More than a single toxin
Dialysis is a lifesaving procedure, or perhaps life prolonging is more appropriate. The native kidneys work 24 hours a day, 7 days a week and filter over 1000 Liters of blood per week. In addition, to concentrating the filtrate (urine), the kidney tubules reabsorb, metabolize, and secrete various metabolites. Thus, kidney failure results in the accumulation of fluid, and accumulation of multiple toxins leading to systemic symptom. Unfortunately, dialysis does not correct the majority of these abnormalities. (Source: Heart Rhythm)
Source: Heart Rhythm - September 24, 2018 Category: Cardiology Authors: Sharon M. Moe Source Type: research

A Review of Bioelectrodes for Clinical Electrophysiologists
The theory of bioelectrodes describes the rules governing the passage of electrical charge between electrodes and electrolytes. In this review, we explain the basis of bioelectrodes with focus on clinical electrophysiology. The central concept is the double-layer capacitance that forms in the interface between electrodes and tissue. This phenomenon controls charge transfer between electrodes and tissues and contributes to detrimental effects such as electrode polarization and motion artifacts. Many methods critical to the practice of electrophysiology, including fractally-coated pacemaker leads, biphasic stimuli, signal fi...
Source: Heart Rhythm - September 24, 2018 Category: Cardiology Authors: Shahriar Iravanian, Jonathan J. Langberg Source Type: research