Beyond the exercise stress test: Does the cardiac ryanodine receptor affect intellectual function?
Sixty years ago, when describing a familial syndrome of deaf-mutism, QT prolongation and sudden death,1 Jervell and Lange-Nielsen posed the question: “Was there any connection between the patients’ cardiac disease and the deaf-mutism?” They concluded that, “The coexistence of deaf-mutism and this peculiar heart disease…hardly can be considered purely incidental.”1 It would take four decades to unravel the molecular basis for this seve re form of long QT syndrome (LQTS), now known as Jervell and Lange-Nielsen syndrome (JLNS): shared potassium channel isoforms in the inner ear and cardiac...
Source: Heart Rhythm - September 11, 2018 Category: Cardiology Authors: Thomas M. Roston, Shubhayan Sanatani Source Type: research

Gender difference in Brugada syndrome-Mirror images of long QT syndrome?-
COI: Dr. Morita is affiliated with the endowed department by Japan Medtronic Inc. (Source: Heart Rhythm)
Source: Heart Rhythm - September 11, 2018 Category: Cardiology Authors: Hiroshi Morita Source Type: research

The anatomy of para-Hisian arrhythmias
In the “hands-on” vignette published in relation to para-Hisian arrhythmias, 1 the authors referenced one of the early publications of one of us.2 Our insights of ventricular septal anatomy have now changed significantly, aided by virtual dissection of computerised tomographic datasets.3 It is incorrec t to suggest that the muscular ventricular septum can be separated into inlet, apical, and outlet components. Due to the “wedged” position of the subaortic outflow tract, the so-called “inlet” septum separates the inlet of the right ventricle from the outlet of the left. (Source: Heart Rhythm)
Source: Heart Rhythm - September 11, 2018 Category: Cardiology Authors: Robert H. Anderson, Shumpei Mori Source Type: research

Time interval from left ventricular stimulation to QRS onset is a novel predictor of nonresponse to cardiac resynchronization therapy
Left ventricular (LV) lead placement at the late activation site (LAS) has been proposed as an optimal LV pacing site (ie, Q-LV interval). However, LAS may be relevant to local electrical conduction, measured as an interval from LV pacing stimulation to QRS onset (S-QRS interval). (Source: Heart Rhythm)
Source: Heart Rhythm - September 4, 2018 Category: Cardiology Authors: Daigo Yagishita, Morio Shoda, Yoshimi Yagishita, Koichiro Ejima, Nobuhisa Hagiwara Source Type: research

Clinical presentation and follow-up of women affected by Brugada syndrome
Studies in Brugada syndrome (BrS) have mainly consisted of men. (Source: Heart Rhythm)
Source: Heart Rhythm - September 4, 2018 Category: Cardiology Authors: Pauline Berthome, Romain Tixier, Jean Briand, Olivier Geoffroy, Dominique Babuty, Jacques Mansourati, Laurence Jesel, Jean-Marc Dupuis, Paul Bru, Florence Kyndt, B éatrice Guyomarch, Aurélie Thollet, Nathalie Behar, Philippe Mabo, Frédéric Sacher, Vin Source Type: research

Arrhythmogenic Cardiac Alternans in Heart Failure is Suppressed by Late Sodium Current Blockade by Ranolazine
Cardiac alternans is promoted by heart failure (HF) -induced calcium (Ca2+) cycling abnormalities. Late sodium current (INa,L) is enhanced in HF and promotes Ca2+ overload, however, mechanisms underlying an antiarrhythmic effect of INa,L blockade in HF remain unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - September 4, 2018 Category: Cardiology Authors: Hidehira Fukaya, Bradley N. Plummer, Joseph S. Piktel, Xiaoping Wan, David S. Rosenbaum, Kenneth R. Laurita, Lance D. Wilson Source Type: research

Unexpected Shift in Circadian and Septadian Variation of Sudden Cardiac Arrest: The Oregon Sudden Unexpected Death Study
Earlier studies have reported both early morning and Monday peaks in occurrence of sudden cardiac arrest (SCA) in the community, and appropriate defibrillator shocks in patients with implantable cardioverter defibrillators (ICD). However, a more recent analysis of ICD shocks reported absence of these peaks. (Source: Heart Rhythm)
Source: Heart Rhythm - September 4, 2018 Category: Cardiology Authors: Yu-Ming Ni, Carmen Rusinaru, Kyndaron Reinier, Audrey Uy-Evanado, Harpriya Chugh, Eric C. Stecker, Jonathan Jui, Sumeet S. Chugh Source Type: research

Time interval from left ventricular stimulation to QRS onset is a novel predictor of non-response to cardiac resynchronization therapy
A left ventricular (LV) lead placement at the late activation site (LAS) has been proposed as an optimal LV pacing site (i.e. Q-LV interval). However, LAS may be relevant to local electrical conduction, measured as an interval from LV pacing stimulation to QRS onset (S-QRS interval). (Source: Heart Rhythm)
Source: Heart Rhythm - September 4, 2018 Category: Cardiology Authors: Daigo Yagishita, Morio Shoda, Yoshimi Yagishita, Koichiro Ejima, Nobuhisa Hagiwara Source Type: research

Circadian rhythm of cardiac electrophysiology, arrhythmogenesis, and the underlying mechanisms
Cardiac arrhythmias are a leading cause of cardiovascular death. It has long been accepted that life-threatening cardiac arrhythmias (ventricular tachycardia, ventricular fibrillation, and sudden cardiac  death) are more likely to occur in the morning after waking. It is perhaps less well recognized that there is a circadian rhythm in cardiac pacemaking and other electrophysiological properties of the heart. In addition, there is a circadian rhythm in other arrhythmias, for example, bradyarrhythmi as and supraventricular arrhythmias. (Source: Heart Rhythm)
Source: Heart Rhythm - August 29, 2018 Category: Cardiology Authors: Nicholas Black, Alicia D ’Souza, Yanwen Wang, Hugh Piggins, Halina Dobrzynski, Gwilym Morris, Mark R. Boyett Tags: Contemporary Review Source Type: research

Circadian rhythm of cardiac electrophysiology, arrhythmogenesis and the underlying mechanisms
Cardiac arrhythmias are a leading cause of cardiovascular death. It has long been accepted that life-threatening cardiac arrhythmias (ventricular tachycardia, ventricular fibrillation and sudden cardiac death) are more likely to occur in the morning after waking. It is perhaps less well recognised that there is a circadian rhythm in cardiac pacemaking and other electrophysiological properties of the heart. In addition, there is a circadian rhythm in other arrhythmias, for example bradyarrhythmias and supraventricular arrhythmias. (Source: Heart Rhythm)
Source: Heart Rhythm - August 29, 2018 Category: Cardiology Authors: Nicholas Black, Alicia D ’Souza, Yanwen Wang, Hugh Piggins, Halina Dobrzynski, Gwilym Morris, Mark R. Boyett Source Type: research

Predictive Value of Exercise Testing in Athletes with Ventricular Ectopy Evaluated by Cardiac Magnetic Resonance.
Exercise-induced ventricular arrhythmias (EIVA) in young athletes raise the suspect of an underlying heart disease at risk of sudden death. (Source: Heart Rhythm)
Source: Heart Rhythm - August 29, 2018 Category: Cardiology Authors: Alberto Cipriani, Alessandro Zorzi, Patrizio Sarto, Martino Donini, Ilaria Rigato, Riccardo Bariani, Manuel De Lazzari, Kalliopi Pilichou, Gaetano Thiene, Sabino Iliceto, Cristina Basso, Domenico Corrado, Martina Perazzolo Marra, Barbara Bauce Source Type: research

A Pore-Localizing CACNA1C-E1115K Missense Mutation, Identified in a Patient with Idiopathic QT Prolongation, Bradycardia, and Autism Spectrum Disorder, Converts the L-type Calcium Channel into a Hybrid Non-Selective Monovalent Cation Channel
Gain-of-function variants in the CACNA1C-encoded L-type calcium channel (LTCC, Cav1.2) cause type 8 long QT syndrome (LQT8). The pore region contains highly conserved glutamic acid (E) residues that collectively form the LTCC ’s selectivity filter. Here, we identified and characterized a pore-localizing missense variant, E1115K, that yielded a novel perturbation in the LTCC. (Source: Heart Rhythm)
Source: Heart Rhythm - August 29, 2018 Category: Cardiology Authors: Dan Ye, David J. Tester, Wei Zhou, John Papagiannis, Michael J. Ackerman Source Type: research

Extraction of Transvenous Leads While Anticoagulated
Each year, over one million cardiovascular implantable electronic devices (CIEDs) are implanted worldwide1. Many patients with CIEDs also have other comorbidities placing them at elevated risk of thromboembolism and necessitating anticoagulation, such as mechanical heart valve prostheses, atrial arrhythmias, and left ventricular assist devices. Typically, when these patients need extraction of endovascular leads, anticoagulation is held due to the risk of catastrophic bleeding, despite the known risk of thromboembolism. (Source: Heart Rhythm)
Source: Heart Rhythm - August 29, 2018 Category: Cardiology Authors: Jay A. Montgomery, George H. Crossley Source Type: research

Role of obstructive sleep apnea on the response to cardiac resynchronization therapy and all-cause mortality
The role of obstructive sleep apnea (OSA) on the response to cardiac resynchronization therapy (CRT) and all-cause mortality in patients with advanced heart failure (HF) is unknown. (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Ghanshyam Shantha, Amgad Mentias, Naga Venkata K. Pothineni, Prashant D. Bhave, Tyler Rasmussen, Abhishek Deshmukh, Frank Pelosi, Michael Giudici Tags: Featured Article Source Type: research

Vectorcardiographic QRS area is associated with long-term outcome after cardiac resynchronization therapy
Recent studies have suggested that vectorcardiographic measures predict left ventricular (LV) reverse remodeling and clinical outcome in patients receiving cardiac resynchronization therapy (CRT). (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Kasper Emerek, Daniel J. Friedman, Peter Lyng ø Sørensen, Steen Møller Hansen, Jacob Moesgaard Larsen, Niels Risum, Anna Margrethe Thøgersen, Claus Graff, Joseph Kisslo, Peter Søgaard, Brett D. Atwater Source Type: research

Prognostic efficacy of platelet count in patients with nonvalvular atrial fibrillation
The prognostic efficacy of quantitative platelet activity in atrial fibrillation (AF) remains unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Jiesuck Park, Myung-Jin Cha, You-jung Choi, Euijae Lee, Inki Moon, Soongu Kwak, Soonil Kwon, Seokhun Yang, Seoyoung Lee, Eue-Keun Choi, Seil Oh Source Type: research

EP News: Clinical
Stambler et  al (J Am Coll Cardiol 2018;72:489, PMID 30049309) assessed the efficacy and safety of etripamil nasal spray, a short-acting calcium-channel blocker, for the termination of paroxysmal supraventricular tachycardia (SVT). At electrophysiology study, patients in SVT for 5 minutes received either place bo or 1 of 4 doses of the active compound. The primary end point was the SVT conversion rate within 15 minutes of study drug administration. Secondary end points included time to conversion and adverse events. (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: N.A. Mark Estes Tags: EP News Source Type: research

EP News: Allied Professionals
In this post hoc analysis of data from the RE-LY (Randomized Evaluation of Long Term Anticoagulant Therapy) trial, Kent et  al (J Am Coll Cardiol 2018;72:255–267, PMID 30012318) sought to assess the effect of the concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and oral anticoagulation (OAC) in patients with atrial fibrillation (AF). In the RE-LY trial, 18,113 subjects with AF were randomized to 1 of 2 doses of dabigatran (110 or 150 mg) or warfarin. NSAID use was captured on case report forms at study visits. (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

Prognostic efficacy of the platelet count in patients with non-valvular atrial fibrillation
Prognostic efficacy of quantitative platelet activity in atrial fibrillation (AF) remains unclear. (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Jiesuck Park, Myung-Jin Cha, You-jung Choi, Euijae Lee, Inki Moon, Soongu Kwak, Soonil Kwon, Seokhun Yang, Seoyoung Lee, Eue-Keun Choi, Seil Oh Source Type: research

Are Pediatric Catheter Ablation Outcomes Approaching a Pareto Frontier?
“Perfect is the enemy of good” – commonly attributed to Voltaire (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Jonathan R. Kaltman Source Type: research

Linking the Heart and the Brain: Neurodevelopmental Disorders In Patients With Catecholaminergic Polymorphic Ventricular Tachycardia
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an uncommon inherited arrhythmia disorder characterized by adrenergically-evoked ventricular arrhythmias. Mutations in the cardiac calcium release channel/ryanodine receptor gene (RYR2) are identified in the majority of patients with CPVT. RyR2 is also the major RyR isoform expressed in the brain. (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Krystien V.V. Lieve, Judith Verhagen, Jinhong Wei, J. Martijn Bos, Christian van der Werf, Ferran Ros és i Noguer, Grazia M.S. Mancini, Wenting Guo, Ruiwu Wang, Freek van den Heuvel, Ingrid M.E. Frohn-Mulder, Wataru Shimizu, Akihiko Nogami, Hitoshi Horig Source Type: research

A balanced translocation disrupting SCN5A in a family with Brugada syndrome and sudden cardiac death
Brugada Syndrome (BrS) is a primary arrhythmia syndrome affecting 1 in 2000 of the general population. Genetic testing identifies pathogenic variants in the sodium voltage-gated channel α-subunit 5 gene (SCN5A) in up to 25% of familial BrS. Balanced translocations, which involve the exchange of the ends of two different chromosomes, are found in approximately 1 in 500 people and are usually benign, and only rarely reported to cause arrhythmogenic disorders. (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Laura Yeates, Jodie Ingles, Belinda Gray, Suresh Singarayar, Raymond W. Sy, Christopher Semsarian, Richard D. Bagnall Source Type: research

Vectorcardiographic QRS Area is Associated with Long-Term Outcome Following Cardiac Resynchronization Therapy
Recent studies have suggested that vectorcardiographic measures predict left ventricular (LV) reverse remodeling and clinical outcome in patients receiving cardiac resynchronization therapy (CRT). (Source: Heart Rhythm)
Source: Heart Rhythm - August 28, 2018 Category: Cardiology Authors: Kasper Emerek, Daniel J. Friedman, Peter Lyng ø Sørensen, Steen Møller Hansen, Jacob Moesgaard Larsen, Niels Risum, Anna Margrethe Thøgersen, Claus Graff, Joseph Kisslo, Peter Søgaard, Brett D. Atwater Source Type: research

EP News: Case Reports
Cardiac sarcoidosis is a significant cause of morbidity and mortality in patients with sarcoidosis. Cardiac manifestations of disease are largely dependent on the region of inflammation and subsequent fibrosis and scar. Although atrial arrhythmias occur in approximately one-third of patients with cardiac sarcoidosis, sinus node dysfunction is rare. Bhaskaran et  al (DOI: https://doi.org/10.1016/j.hrcr.2018.06.014) described a case of a 42-year-old previously healthy patient who presented with symptomatic sinus bradycardia with intermittent junctional bradycardia and sinus pauses up to 8 seconds with intermittent episo...
Source: Heart Rhythm - August 23, 2018 Category: Cardiology Authors: T. Jared Bunch Tags: EP News Source Type: research

EP News: Basic and Translational
Scroll waves are self-organized dynamics of vortex-like rotating waves and form the basis for complex spatiotemporal patterns in excitable systems. Filament-like phase singularities associated with 3-dimensional scroll waves serve as the organizing centers of cardiac arrhythmias. However, one of the main challenges in the field is to directly visualize the 3-dimensional spatiotemporal dynamics of scroll waves inside the heart. Christoph et  al (Nature 2018;555:7698, PMID 29466325) took the advantage of high-resolution 4-dimensional ultrasound-based strain imaging to noninvasively image and quantify the 3-dimensional m...
Source: Heart Rhythm - August 23, 2018 Category: Cardiology Authors: Nipavan Chiamvimonvat Tags: EP News Source Type: research

Does plastic chemical exposure contribute to sudden death of patients on dialysis?
Approximately 14% of the U.S. adult population has impaired kidney function1, 2. End-stage renal disease (ESRD) is characterized by extremely high mortality (20% per year), and a rate of cardiovascular (CV) death that is up to 100 times higher than that in the general population3, 4. The differences in longevity between the ESRD patients and the general population are striking5. Dialysis patients younger than 80 years old are expected to live less than one-third as long as their counterparts without ESRD. (Source: Heart Rhythm)
Source: Heart Rhythm - August 22, 2018 Category: Cardiology Authors: Larisa G. Tereshchenko, Nikki G. Posnack Source Type: research

Technique Analysis: How can we improve outcomes?
No conflicts (Source: Heart Rhythm)
Source: Heart Rhythm - August 22, 2018 Category: Cardiology Authors: Bruce L. Wilkoff Source Type: research

Cosmetic Aspects Of Device Implantation
The cosmetic aspects of device implantation implies achieving an aesthetically pleasing surgical result. It involves concealing the cardiac implantable electronic device (CIED), avoiding unsightly scars, device bulges and protrusion. (Figure 1) Cosmetic device implantation is indicated for the extremely thin patient at risk for erosion and the young patient concerned with body image. These techniques are also important in the pediatric population, burn patients and post mastectomy. For years, various techniques have been developed to conceal and protect the device. (Source: Heart Rhythm)
Source: Heart Rhythm - August 22, 2018 Category: Cardiology Authors: Peter H. Belott Source Type: research

Assessing the accuracy of an automated atrial fibrillation detection algorithm using smartphone technology: The iREAD Study
The Kardia Mobile Cardiac Monitor (KMCM) detects atrial fibrillation (AF) via a handheld cardiac rhythm recorder and AF detection algorithm. The algorithm operates within predefined parameters to provide a “normal” or “possible atrial fibrillation detected” interpretation; outside of these parameters, an “unclassified” rhythm is reported. The system has been increasingly used, but its performance has not been independently tested. (Source: Heart Rhythm)
Source: Heart Rhythm - August 21, 2018 Category: Cardiology Authors: Amila D. William, Majd Kanbour, Thomas Callahan, Mandeep Bhargava, Niraj Varma, John Rickard, Walid Saliba, Kathy Wolski, Ayman Hussein, Bruce D. Lindsay, Oussama M. Wazni, Khaldoun G. Tarakji Source Type: research

Implantation techniques and outcomes after cardiac resynchronization therapy for congenitally corrected transposition of the great arteries
Patients with congenitally corrected transposition of the great arteries (CCTGA) are at risk of congestive heart failure (CHF). There are limited data on cardiac resynchronization therapy (CRT) techniques and long-term outcomes in this population. (Source: Heart Rhythm)
Source: Heart Rhythm - August 17, 2018 Category: Cardiology Authors: Jeremy P. Moore, David Cho, Jeannette P. Lin, Gentian Lluri, Leigh C. Reardon, Jamil A. Aboulhosn, Abbie Hageman, Kevin M. Shannon Source Type: research

The anatomic substrates for outflow tract arrhythmias
Much has been learned regarding the cellular and molecular mechanisms involved in producing idiopathic ventricular tachycardias originating from the ventricular outflow tract. Questions remain, however, regarding their genesis. In part, this reflects the uncertainty regarding the anatomic arrangement of their myocardial components. This is exacerbated by the lack of consensus regarding the appropriate terms to describe their components, as shown by the current use of “cusp,” used interchangeably to describe either the valvar sinuses or the leaflets of the arterial valves. (Source: Heart Rhythm)
Source: Heart Rhythm - August 17, 2018 Category: Cardiology Authors: Robert H. Anderson, Timothy J. Mohun, Dami án Sánchez-Quintana, Shumpei Mori, Diane E. Spicer, Jim W. Cheung, Bruce B. Lerman Tags: Contemporary Review Source Type: research

Net clinical benefit of anticoagulant treatments in elderly patients with nonvalvular atrial fibrillation: Experience from the real world
Oral anticoagulation (OAC) is effective in stroke prevention in elderly patients with nonvalvular atrial fibrillation (AF), but older patients are also at higher risk of bleeding. (Source: Heart Rhythm)
Source: Heart Rhythm - August 17, 2018 Category: Cardiology Authors: Hilmi Alnsasra, Moti Haim, Adi Berliner Senderey, Orna Reges, Maya Leventer-Roberts, Yoav Arnson, Morton Leibowitz, Moshe Hoshen, Meytal Avgil-Tsadok Source Type: research

Continuous monitoring after second-generation cryoballoon ablation for paroxysmal atrial fibrillation in patients with cardiac implantable electronic devices
The second-generation cryoballoon (CB) is effective in achieving pulmonary vein isolation. Continuous monitoring would eliminate any over- or underestimated freedom from atrial fibrillation (AF) postablation. (Source: Heart Rhythm)
Source: Heart Rhythm - August 17, 2018 Category: Cardiology Authors: Rajin Choudhury, Hugo-Enrique Coutino, Radu Darciuc, Erwin Str öker, Valentina De Regibus, Giacomo Mugnai, Gaetano Paparella, Muryio Terasawa, Varnavas Varnavas, Francesca Salghetti, Saverio Iacopino, Ken Takarada, Juan-Pablo Abugattas, Juan Sieira, Pedr Source Type: research

The Anatomical Substrates for Outflow Tract Arrhythmias
Much has been learned regarding the cellular and molecular mechanisms involved in producing idiopathic ventricular tachycardias originating from the ventricular outflow tract. Questions remain, however, regarding their genesis. In part, this reflects the uncertainty regarding the anatomical arrangement of their myocardial components. This is excacerbated by lack of consensus regarding the appropriate terms to describe their components, as shown by the current use of “cusp”, used interchangeably to describe either the valvar sinuses or the leaflets of the arterial valves. (Source: Heart Rhythm)
Source: Heart Rhythm - August 17, 2018 Category: Cardiology Authors: Robert H. Anderson, Timothy J. Mohun, Dami án Sánchez-Quintana, Shumpei Mori, Diane E. Spicer, Jim W. Cheung, Bruce B. Lerman Source Type: research

Continuous Monitoring Following Second Generation Cryoballoon Ablation for Paroxysmal Atrial fibrillation: In Patients with Cardiac Implantable Electronic Devices.
The second generation cryoballoon (CB) is effective in achieving pulmonary vein isolation. Continuous monitoring would eradicate any over or under estimated freedom of atrial fibrillation (AF) post ablation. (Source: Heart Rhythm)
Source: Heart Rhythm - August 17, 2018 Category: Cardiology Authors: Rajin Choudhury, Hugo-Enrique Coutino, Radu Darciuc, Erwin Str öker, Valentina De Regibus, Giacomo Mugnai, Gaetano Paparella, Muryio Terasawa, Varnavas Varnavas, Francesca Salghetti, Saverio Iacopino, Ken Takarada, Juan-Pablo Abugattas, Juan Sieira, Pedr Source Type: research

Net Clinical Benefit of Anticoagulant Treatments in Elderly Patients with Non-Valvular Atrial Fibrillation: Experience From the Real World
Oral anticoagulation (OAC) is effective in stroke prevention in elderly patients with non-valvular atrial fibrillation (AF), but older patients are also at greater risk of bleeding. (Source: Heart Rhythm)
Source: Heart Rhythm - August 17, 2018 Category: Cardiology Authors: Hilmi Alnsasra, Moti Haim, Adi Berliner Senderey, Orna Reges, Maya Leventer-Roberts, Yoav Arnson, Morton Leibowitz, Moshe Hoshen, Meytal Avgil-Tsadok Source Type: research

Implant Techniques And Outcomes After Cardiac Resynchronization Therapy For Congenitally Corrected Transposition of the Great Arteries
Patients with congenitally corrected transposition of the great arteries (CCTGA) are at risk for congestive heart failure (CHF). There are limited data on cardiac resynchronization therapy (CRT) techniques and long-term outcomes in this population. (Source: Heart Rhythm)
Source: Heart Rhythm - August 17, 2018 Category: Cardiology Authors: Jeremy P. Moore, David Cho, Jeannette Lin, Gentian Lluri, Leigh C. Reardon, Jamil A. Aboulhosn, Abbie Hageman, Kevin M. Shannon Source Type: research

Electrocardiographic J wave: Early repolarization, Brugada wave, and conduction delay
The J wave is a deflection between the QRS and the ST segment whose polarity is commonly in the same major direction of the QRS complex. The J wave may stand as a distinct delta wave following the QRS or be partially buried inside the QRS as QRS notching or slurring.1 –3 Since the J wave occurs at the junction that marks the completion of ventricular depolarization and beginning of ventricular repolarization, it can be part of either conduction delay or early repolarization. In other words, the J wave is simply an electrocardiographic (ECG) definition that doe s not clearly tell us whether it belongs to ventricu...
Source: Heart Rhythm - August 14, 2018 Category: Cardiology Authors: Datun Qi, Yuan Gao, Gan-Xin Yan Tags: Editorial Commentary Source Type: research

Electrocardiographic J Wave: Early Repolarization, Brugada Wave and Conduction Delay
J wave is a deflection between the QRS and ST segment of which polarity is commonly in the same major direction of the QRS complex. J wave may stand as a distinct delta wave following the QRS, or be partially buried inside of the QRS as QRS notching or slurring.1-3 Since J wave occurs at the junction that marks completion of ventricular depolarization and beginning of ventricular repolarization, it can be part of either conduction delay or early repolarization. In other words, J wave is simply an ECG definition that does not clearly tell us whether it belongs to ventricular depolarization or repolarization. (Source: Heart Rhythm)
Source: Heart Rhythm - August 14, 2018 Category: Cardiology Authors: Datun Qi, Yuan Gao, Gan-Xin Yan Source Type: research

Identification of paroxysmal atrial fibrillation subtypes in over 13,000 individuals
Paroxysmal atrial fibrillation (PAF) is broadly defined despite high variability in the occurrence and duration of PAF episodes. (Source: Heart Rhythm)
Source: Heart Rhythm - August 14, 2018 Category: Cardiology Authors: Nathan E. Wineinger, Paddy M. Barrett, Yunyue Zhang, Ikram Irfanullah, Evan D. Muse, Steven R. Steinhubl, Eric J. Topol Source Type: research

What have we learned in the last 20 years? A Comparison of a Modern Era Pediatric and Congenital Catheter Ablation Registry to Prior Pediatric Ablation Registries
Since the onset of pediatric catheter ablation, the pediatric electrophysiology community has reported outcomes via various registries (PAPCA and the Pediatric Catheter Ablation registry (PCAR)). Most recently, a modern era pediatric and congenital ablation registry (MAP-IT) was developed for eventual incorporation into the NCDR IMPACT registry. (Source: Heart Rhythm)
Source: Heart Rhythm - August 14, 2018 Category: Cardiology Authors: Anne M. Dubin, Neal W. Jorgensen, Andrew E. Radbill, David J. Bradley, Jennifer N. Silva, Sabrina Tsao, Ronald J. Kanter, Ronn E. Tanel, Bhavya Trivedi, Ming-Lon Young, Andreas Pflaumer, Jorge McCormack, Stephen P. Seslar Source Type: research

Letter to the Editor —TB or not TB? That is the question
We read with interest the article on the use of fluorine-18 fluoro-2-deoxyglucose positron emission computed tomography (PET) in patients with unexplained atrioventricular (AV) block.1 Danwade et  al1 identified a case of tuberculosis (TB) with a positive PET scan and concluded that TB may be an important cause of unexplained AV block in developing countries. (Source: Heart Rhythm)
Source: Heart Rhythm - August 13, 2018 Category: Cardiology Authors: Ashley Chin, Chisala Chisala Source Type: research

Reply to the Editor —TB or not TB: That is the question
Myocarditis due to granulomatous inflammation is being increasingly recognized now compared to past when the diagnosis was usually made during autopsy. It comprises cardiac sarcoidosis (CS), cardiac tuberculosis (CTB), and other rare granulomatous disorders. It presents as ventricular tachycardia, atrioventricular conduction block with or without cardiomyopathy, and heart failure. The paucity of constitutional symptoms and the lack of awareness result in delayed diagnosis. (Source: Heart Rhythm)
Source: Heart Rhythm - August 13, 2018 Category: Cardiology Authors: Tamiruddin A. Danwade, Calambur Narasimhan Source Type: research

TB or not TB? That is the question.
We read with interest the article on the use of fluorine-18 fluoro-2-deoxyglucose positron emission computed tomography (PET) in patients with unexplained atrioventricular (AV) block.(1) The authors identified a case of tuberculosis (TB) with a positive PET scan and conclude that TB may be an important cause of unexplained AV block in developing countries. (Source: Heart Rhythm)
Source: Heart Rhythm - August 13, 2018 Category: Cardiology Authors: Ashley Chin, Chisala Chisala Source Type: research

"TB OR NOT TB: That is the Question."
Myocarditis due to granulomatous inflammation is being increasingly recognised compared to past when the diagnosis was usually made during autopsy. It comprises cardiac sarcoidosis (CS), cardiac tuberculosis (CTB) and other rare granulomatous disorders. It presents as ventricular tachycardias, atrio-ventricular conduction blocks with or without cardiomyopathy and heart failure. Paucity of constitutional symptoms and lack of awareness results in delayed diagnosis. (Source: Heart Rhythm)
Source: Heart Rhythm - August 13, 2018 Category: Cardiology Authors: Tamiruddin A. Danwade, Calambur Narasimhan Source Type: research

Coronary artery compression from epicardial leads: More common than we think
A child with an epicardial pacemaker presented with sudden death at our institution, secondary to coronary artery compression. This case prompted enhanced surveillance of all patients with epicardial pacing or defibrillation systems. (Source: Heart Rhythm)
Source: Heart Rhythm - August 12, 2018 Category: Cardiology Authors: Douglas Y. Mah, Ashwin Prakash, Diego Porras, Francis Fynn-Thompson, Elizabeth S. DeWitt, Puja Banka Source Type: research

More epicardial electrode issues to remember
Cardiac pacing using epicardial electrodes has been an important tool since the beginning of cardiac pacing. This is especially true not only in small patients but also when the risk of thrombus formation is high or when no direct venous access to the ventricle exists (eg, after the Fontan procedure). It is also becoming more widely used in the adult population because of the increase in the adult congenital heart disease population and the need for left ventricular pacing when optimal coronary sinus lead position cannot be achieved. (Source: Heart Rhythm)
Source: Heart Rhythm - August 12, 2018 Category: Cardiology Authors: Gerald A. Serwer Tags: Editorial Commentary Source Type: research

Clinical presentation of ventricular-Hisian and ventricular-nodal accessory pathways
Narrow QRS tachycardia or premature beat with bystander atrial activation or ventricular-atrial dissociation is an unusual arrhythmia that can present diagnostic and therapeutic challenges. When ventricular-atrial conduction is robust, these arrhythmias can be difficult to distinguish from atrioventricular nodal reentry. (Source: Heart Rhythm)
Source: Heart Rhythm - August 10, 2018 Category: Cardiology Authors: Roy Chung, Oussama Wazni, Thomas Dresing, Mina Chung, Walid Saliba, Bruce Lindsay, Patrick Tchou Source Type: research

Updated Performance of the Micra Transcatheter Pacemaker in the Real-World Setting: A Comparison to the Investigational Study and a Transvenous Historical Control
Early results from the Micra investigational trial (IDE) and Micra post-approval registry (PAR) demonstrated excellent safety and efficacy performance; however, intermediate-term results across a large patient population in the real-world setting have not been evaluated. (Source: Heart Rhythm)
Source: Heart Rhythm - August 10, 2018 Category: Cardiology Authors: Mikhael F. El-Chami, Faisal Al-Samadi, Nicolas Clementy, Christophe Garweg, Jose Luis Martinez-Sande, Jonathan P. Piccini, Saverio Iacopino, Michael Lloyd, Xavier Vi ñolas Prat, Michael Dilou Jacobsen, Philippe Ritter, Jens Brock Johansen, Claudio Tondo, Source Type: research

Clinical Presentation of Ventricular-Hisian and Ventricular-Nodal Accessory Pathway
Narrow QRS tachycardia or premature beats (PB) with bystander atrial activation or ventricular-atrial (VA) dissociation is an unusual arrhythmia that can present diagnostic and therapeutic challenges. When VA conduction is robust, these arrhythmias can be difficult to distinguish from atrioventricular nodal reentry. (Source: Heart Rhythm)
Source: Heart Rhythm - August 10, 2018 Category: Cardiology Authors: Roy Chung, Oussama Wazni, Thomas Dresing, Mina Chung, Walid Saliba, Bruce Lindsay, Patrick Tchou Source Type: research